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Home My WebLink About3024 LANGS BAY - Building Permits • • Cra j O m" £&p 744 ilia 1/6; y fl cs/,S4,6d S7 45 , ,�i61,& >1 L$f..sqo say 3ozaJ 221244 a6/ iej 30 fCOSTAMEABUILDING-AYDEPIE6 ' APPLICATION FOOkRf( Ri.PERMli683.50 TL P.O. COSTA CALIFORNIA _ REC V P;AAIT 24%12 7LT - ,.A� For Applicant to Fill in CompletelyA.)//.../20 - Use Ink Only �� ii{{- B76 2-N2 +Fig ADDRESS Tract 10626 rJ/[. lj/ ,�ifl ' A.P. ' _ Qq I—( 1 (47 )I —1412_—12_1-2-7 OWNER OR / ADDRESS.. BUILDINGLi9wcd•l{ray�og 81oye TENANT M.D. Janes Co. . Inc. UNIT OMAILING S R x•__77 E ADDRESS 2950 Airway Ave. , D-9• TPA O NO. LOT BLK. Y Costa Mesa NOL CIT �� 979-3 i76 NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER Not selected • BRANCH N/A OWNER ADDRESS N/A VALUE ARCHITECT 1011:. 546-3693 � USE $ OR ENGINEER Danielian & Assoc. .E V 'N-... ADDRESS 3848 Campus Dr. , N.B. ZONE TYPE GROUP icl- IT— I APPROVED CONTRACTOR owner BY DATE ADDRESS e - TEL. CITY a NO. e (' STATE CITY APPROVED SETBACKS LIC. NO. e LIC. NO. e SIZE NO.OF BLOCS. (FROMC/L STREET) 0. OF LOT 550' x 334' NOW ON LOT a FRONT FT. re, . 4 USE OF ��/�7 cn /� EXISTING BLDG. N/A R 2DE OAT. J/�, ESeparate permits are required for L.SIDE C electric,plumbing and heating work. 1 REAR FT. tom,• USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION 44 Q .Z2 OM( £l. wt (2P454014; -7-E- 7 ci /�-O I A DATE APPROVEDg2--24-77 Sj n hi/Pi l,,,,,e ,..f C BY APARN�J/� �•O DAT -/y-7 / ce W CI hereby acknowledge that I have read this application and creta e ce that the above information is correct and agree to comply with48 A. all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of a .111 = the State of California. 2.33L35 H m /�• , 3 I hereby certify that I am properly licensed as a contractor under 44°7° 150.FT. N the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — am exempt from the •rovisions of the State of California Business VALUATION PERMIT FEE $ and Professions Cod- Diviyott 3,Chapter 9. 4 / I PLAN CHECK $6244, S� 2,-A,, Signature of G/; it risi Permittee / S 51 r ' TAX $ z Or A. it; &Y:r.9s • Authorized Age to • TOTAL PAID S&fp3• .. t d �4-0 CITY OF COSTA MESA +a•,,c .4, BUILDING DIVISION PERMIT NUMBER �' "^^w' ' DEVELOPMENT SERVICES DEPARTMENT Ii. �� PERMIT B99-00628 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 3024 LANGS BAY Status: ISSUED Suite: Applied: 05/06/1999 Vicinity: Issued: 05/06/1999 Parcel Nunmber: 93768069 Zoning: c Enp Applicant: BOB RICE/PENTRIGE COVE HOA ISSUED BY: Address: 2492 WALNUT AV #200 Phone: 714-665-2900XT260 TUSTIN,CA Zip: 92780 Owner: EZZEDDINE, ALI H Address 3024 LANGS BAY • Phone: COSTA MESA,CA Zip: 92626 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip License: Zip: License: SCOPE OF PERMIT REPAIR MOISTURE DAMAGE TO SHOWER ENCLOSURE. FEE SUMMARY Plan Check: $48.59 Calc Valuation: $2,300.00 Permit: $74.75 Claim Valuation: $2,300.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $123.84 PLANNING &ZONING SETBACKS • MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0.0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections end final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS - WORKERS'COMPENSATION DECLARATION: I hereby&lirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and wit maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,003).IN ADDrnoN TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,MD ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force end effect.Lic.N Class p Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of DMsion 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toe civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation.WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt Ander g. Business and Professions Code for this reaso ' —4 Signature: Date: D rylftil,T .(D( 060Owner ID verified by drivers cense. ❑Yes 0 No Driver's License No. -< 1y Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Wit the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the Califomla Health end Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one lime has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). Management Prevention Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification LJ from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes'.attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: • Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. //iv, Signature Of Legal Owner(s) / May JDate qQ J And/Or Authorized Applicant Date CODE L IN2ELIM NTYPE PEE MILS CODE( INSPECTION TYPE USE ISIS 1818 Fixed System Final Fire Prevention 208 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Flre Prevention _ 202 Final Factory Fire Place 220 Final Planning Approval . 203 Final Sign 222 Final Site r 204 Final Demolition 250 Final Building/Occupancy i i- `g 244e-4e aerU ay: emu; 17146656989; May-5-99 11 :52AM; Page 1 /1 May-O5-99 '11 ;34A Mark Wilmseno P,O1 Sent By: CMC; titad6SBBaa; Ap •to roe ftu T, DECLARATION OF AUTHORITY sag. POMO e FOR AGENTS OF PROPERTY OWNER This Permit s TO APPLY FOR PERMITS Prot Cnie /orvrpwnfr I4S {1wn rd v lel 4- it aeLf _ r� vast Adams* AP NeS I. I (we). - I rn+et COut _ 1404- declare that f am the Owner of Title or the above referenced rued properly. and that I (We) hereby etched= awl r2,te [7N) to45—env a .s4o Na,,. tonko a Mo. a q q t?. Pea bi t+r�,rir cc,* Dm saran AnOma 7-Aid-La (A/. EnrA 133.,7 S6 Coy • 91a1. n 1 /� DP l0 Obtain permits in my behalf. as owner/builder, for _ Yln f r.4.�e ( 'o n ?d f • et the aboys referenced property. 2. Should any pinion become an employee engaged in the Improvement of the prepef y.I(vee)rnali 3.m. • meaistey provide Worker's Compensation insurance coverer and Mala certificate 0 that oeaerege to be Med with the Building Division of the City of Costa Mesa. as whala by State of Caltfomia laws. 3. As Owner/builder in fact.I understand and accept that my neponeibilitii do not trees*to any sear per. son, cor mMy Or corporation. 4. I mine to Indemnity and hold the City Of Costa Mess and its emplejreee or oMOen harmless erpn any claim resulting in Carnage or personal injury to myself or any other penes as a null of was pyleortrteo by the permits Prem the City of Costs Mesa. 5. I declare under the penalty tof perjury that ,,tyh�e foregoing is trueandcored. Eaocutod this f y St'1 day of /rIM? 19 7 R ,it T r`N , Cslifaornia. ^. 4' ! Mat'Prinienti m(CAt c) (— ,S/S/�o.. • i•• tiro NOTE: this authorization does nOt grans autnOrl2atlon to perform the work as owner, It solely provides for limited power Of attorney to secure this permit in any behalf. an«von urs, t j (a 9/444 &alb y V irsiQiss z ` 4, OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 9 Yes y❑ No 2. 1 (have/have not) h t u VI61 signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name 30 h t(-e Address ;14 q i). LW)Iht AL/4- C1 POO City %rnS-7-i'vi Phone( 7i'1) 4)6 Cpe QO ecf! '&O Contractor's Lic. No. 4. I plan to provide portions of the work, but 1 have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work 1042-46 (REV.9/98)