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Home My WebLink About133 LISA LN - Building Permits ,cotliti-,,t, CITY OF COSTA MESA .. Y- ). BUILDING DIVISION -ce 1 t i ^"• ^' ' DEVELOPMENT SERVICES DEPARTMENT W u • PERMIT PERMIT NUMBER B98-01416 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 133 LISA LN Status: ISSUED Suite: Applied: 08/10/1998 Vicinity: Issued: 08/10/1998 Parcel Nunmber: 43908113 Zoning: Applicant: MALONE, SEAN • Address: Phone: 714-754-1000 Zip: Owner GRISWOLD;P:SHANE, . , Address 6534ST,GERMAIN CIR-� //".// /'- . / " P.hone> - �� ORANGE,CA�- Zip: 92669 '-� - I1/// / Contractor A PLUSROOFING , ��V Address: 11237 SLATER-AV :/ , �/ ;/i % Phone: ii,' i FOUNTAIN VALLEY CA Zip 92708 • �' License: 675241 J Arch l Eng : - . . Address: . ' ' " � _Phone: . - • , l:' 7 — Zip: License: - SCOPE OF PERMIT / T/O EXIST INST 7/16 OSB 30#ASTM AND 40 YR COMP.- - FEE SUMMARY , Plan Check: $0.00 — :--. - - , Calc Valuation: $8,241.00 Permit: $149.75 - / /' Claim Valuation:, $8,241.00 SMTP Res: $0.82 / r • SMIP Corn: . $0.00 - -- _/_ ' ' Other:.. $0.00 - - -- Inspection: ',$0.00 Total: $150:57 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: • 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. s 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 and 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 DECLARATIORK, i.<:1 WORKERS'COMPENSATION DECLARATION: t I hereby affirm under penalty of perjury one of the following declarations: 0 I have nd 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 I w or which this permit is Issued. I have and will 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'comp t¢tion rance carrier and policy number are: n ` (/y-i r7• Carrier: • Policy Number: S— ''n06/nlCA (This section need not be completed the pewit is valued at one hundred dollars($100)or less) ❑ I certify that in the perfo .•e the work r which this permit is issu:d, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of Cali: la, :ntl agree th If I - ould b:.4 me su• to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith _ •'th these pro ns. O-�`yJ •at C....1111� - i Date: ( U ,•••-. •••=,•AILURE TO SECURE WORKERS'COMPENSATION'-• ERA -IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COS • COMP' SATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am!icons:/under provisions o Chapter 9(commencing with Section 7000)of Division 3 of the Business and Profes„slons Code,and my license is in full force:•• .•. Lic.a • / Class s C.� ontracto s a ure: A .� a./' Date: 2s'(0 —`J f� �' -6 .44'.---- 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,Civil 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 Division 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 to a 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 under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes ❑No Drivers License No. 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 Will 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? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time 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). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? lJ Yes ❑No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 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 California Health end 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 C. PLIANCE 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 • ply w' • : laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described•-•pe or Inspection urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Oa O �61grfSture • :•- • ner(s) / / Da :q iii - •i•r Au I•4111C Ap•. . Date r. i SQDLL INSPECTIONTYPE GAD: WEALS =El INSPECTION TYPE RATE HEM= 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing 200 Final Re-Roof •J 210 Final Electrical 201 Final Block/Retaining Wall O 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 unN[n w ^ y nada-.w ++tc.. OAitx i.+_IJ JOB ADDRESS 133 Lisa Lane BUILDING PERMIT,N037615 GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Triplex w�att.0ar. AP No. 119-040-22 LOT' 3 TRACT 0277 FIRE ZONE VALUE E 58,450.00 IF CTIONS Signature Date TYPE V GROUP Yi & U ZONE& SG /45 /-7-73 SUBCONTRACTOR PERMITS ISS ED GAS Date I Number I Signature WATERg4qf /(—)q Plumbing • ROUGH PLUMBING /Un ?dT 1' ei.9. 4f • /2c27-73 LV7flr PROP. SWR. LINE ❑ HOUSE CON.10 n'27 'n-7'7 Y / Via/-7 7� SPRINKLING SYSTEM „Q„' . / - iita7 MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ eROUGH WIRING 0417,2 t 7 i /` Heating and Vent.TRENCHES O FORMS ❑ STEEL REINF. `/_1.7'P /[/ic}7'o�n UC 7-‘-7K /On,- FLOOR SYSTEM A C/-Ju r `-I^"-I !�" L BOND BEAM n STEEL REINFORCE n 4' SHEATHING %,3�2-c-lit FRAME AND FLASHING ' - ')Y. t LATHING BROWN ., OUT p e 9,eJ' / m—F--3_ LATH �4-i*7 , STRUCTURAL, FINAL Kit ��/ E eC liC HF G. VENT., REFRIG. AND A.C.,,y�FINAL /y f �/�'J �(.n, �7 �r. ,a-.2?-�'L 7O�G PL. SING. FINAL ANO GAS TEST 'T0z4 ffig ,/Y,7 �Jr.�I 7V ELECTRIC, FINAL I %/ �,�{7//. BUILDING, FINAL ti-�'C�QCJ'-) 7 Ca -. .i_-.i ':OV ?8-73�a�:'OC109o9 ***+=86.59 37618 Xe i-.3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • P ELI ATIONV O FOR BUILDING PERMIT For Applicant to Fill in Completely N,,�Y/ RE � E RECEIVED DATE ASS 133 LISA L. a c ' Q a 7,,2-7r ADDREDDRESS ,,,// T A.P. NO. tR-0 4O —L"L.BUPERMIT N?B OWNER eir�ere S/enef_,e ACC: G ` `x ,61 G,3 ADDRESS /45' l4 ffr 4 CS ( « S7" ADDRESS NG `33 L I5?t L-PtNL., Lu Lu . !7/!Ja27? 0- U CLS S ,�O TEL NOLP rj(SaCkr RACT 3 LOT ti4 BLOCK ZZ C CONSTRUCTION / NEW ADD ALT EPAIR MOVING DFMOI ISH O-N LENDER �/G/a"I A7 \l\ -J D BRANCH � ,r �c�y/�-�' ��JJ // F J CO OWNER iGMA/L!D (/(/t�.t,-- (`(/L C In J ADDRESS .- ' (7, ,t ^1 ,, , VALUE (yJ.�JJ m ARCHITECT TEL. USE (KI1'�- �Y"YKF.7KT $ �/`�' J Q OR ENGINEER 0 Lc/r1!Y NO. V Q FIRE .{f LJt w cc ADDRESS ZONE TYPE Si GROUP Fifa S W ZAPPROVED ////// Z CONTRACTOR 0 (/y,!/� BY DATE/17/7.-75 75 co- Z J cc ADDRESS �T'r/� W TEL TEL. ZO E n NO.OF USE OF NEW t t.IYLGSL. ZN CITY / (, NO. t _ PLANS Z BUILDING/4 k on.G`Arct. VED YARDS APPROVED LU O LIC. O. j3/ 0�6 �6 /O LIC.NO. YARDSY MABUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C/LSTREET/ OF LOT I NOW ON LOT FRONT 4(f-.6FT. FT. USE OF EXISTING BLDG. H.SIDE S FL FT, I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE S FT. FT. CaEXTERIOR WALL ROOF .1 _ COVERING COVERING REAR t JC FT. FT. JUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a' a MAIN BLDGS. ACCESS.BLDGS. QVAR.# �} DATE O I P+_"Q Li-ti-1 C.U.P.# 7J—(9 APPROVED 5—�— /l 3 CO _$APPPROVED Gaut Y U DATE 1 2 _ Z MOLD FOR SCIAL REQUI 8 O L� UI hereby acknowledge that I have read this application and state Q/ r that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ jp�( I— any person in violation of the workman's compensation laws of y m the State of California. m ZI hereby certify that I am properly licensed as a contractor under SO. FT, 6 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: o am exempt from the provisions of the State of California Business f 0 and Professions Cnae,Division 3,Chapter 9. VALUATION to PERMIT FEE $ D Signature of /� �yy/'/v//!(, /) V��/2211, m Permittee /2 <i e.Z $ ��f PLAN CHECK $FIgC — E o Authorized gent u. TOTAL FEE $ ?c7 f' DEC 18-73F_PAID. 6j13*** ' 165.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APP I ON FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI DATE RECEIVED' �� "�� BUILDING ) 1/V/] ADDRESS / (S G i0 LI t / � OWNER A.P. NO. I P1,I[O/O j MAIL BUILDING / Z ADDRESS ADDRESS / 33 tSq Qti C' LULL TEL. 0- U CITY NO. TRACT LOT BLOCK Z< CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH O co LENDER o- co JD BRANCH Jtn OWNER //\-L//� /^'� ( C &O LA al Czl. / t i_t__ mJ ADDRESS r / /' VALUE -CO ARCHITECT TEL. - USE 40 1 e?C e//T(74V $ OR ENGINEER NO. U Q FIRE Z ZONE GROUP ADDRESS 6YPE /� /�7fr APPROVE J Z CONTRACTOR BY DATE co Z J 2 ADDRESS W W TEL. ZONE NO.OF USE OF NEW O= CITY NO. _ PLANS BUILDING Z W0 STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 0 O (FROM C/L STREET) SIZE I NO.OF SLOGS. OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R SIDE FT. FT, I' SIZE OF NO. OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. VEXTERIOR WALL ROOF _ COVERING COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& C_ CL MAIN BLDGS. ACCESS.BLDGS. Q VAR.# DATE 0 C.U.P.# APPROVED I— APPROVED CO —ELY DATE\ b`)[ Z U I 0 VI hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with_ CC all laws regulating building construction, and I shall not employ' I— any person in violation of the workman's compensation laws of co the State of California. - e'9 2 I hereby certify that I am properly licensed as a contractor under SO. FT. o the State of California Business and Professions Code, Division 3,_ THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from tl a provisions of the State of California Business VALUATION A� pri N and Professions Cone,Division 3,Chapter 9. - PERMIT FEE $ / ' w Signature ofm Permittee $ PLAN CHECK $ E r b o Authorized Agent TOTAL FEE $ /4-1/4.3LL