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HomeMy WebLinkAbout1043 LINDEN PL - Building Permits E CITY OF COSTA MESA • _ - 4 • BUILDING DIVISION 1.•0 . .As DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1 /* PERMIT / �`O4•o.mm - /604-02048 • (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1043 LINDEN PL Status: ISSUED Suite: Applied: 12/06/2004 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 12/06/2004 Parcel Number: 42247318 Zoning: -' Applicant: STERNBERG, RICK ISSUED BY: /a`� Address: 8662 DOLPHIN DR Phone: (714)968-3233 HUNTINGTON BEACH,CA Zip: 92646 Owner: RASMUSSEN, JOHANNES C Address 9192 PIONEER DR Phone: HUNTINGTON BEACH,CA Zip: 92646 Contractor: CENTURY ROOFING Address: 8662 DOLPHIN DR Phone: (714)968-3233 • HUNTINGTON BEACH, CA Zip: 92646 License: 674019 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE:T/O EXISTING COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 30#FELT, APPLY 30-YEAR ELK COMP SHINGLES. 15 SQAURES • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,300.00 Permit: $97.25 Claim Valuation: $3,300.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 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 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 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 244646(6/00) • . , WORKERS'COMPENSATION DECLARATION: • • I hereby affirm 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. 3iLlmhave 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. y works1c�ompgnation Insurance carrier and policy number are: 11\\ Cartier: BH& L ' y-. Policy Number: I LI V S (This section n not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation I. . California,and agree that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with then: 1-- Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND rn t ARE($too,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I amlicensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Busines3,and Professions Code,and my license Is in full force andteffect.Lic.Signature: e ��1`+"01 z'. Classata C.. 3 S Contractor's Signature: —�_\ Date: ( L ' la 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). Lender's Name: Lender's 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 es 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,em 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 driver's license. 0 Yes 0 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 B,Califomia 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? ❑Yes 0 No (Section 25505 of the Califomia Health end 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,ore 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? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aaermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? lU Yes LJ No (Section 65850.2 of the Califomia 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 feel from the outer boundaries of a school? 0 Yes ❑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 and Safety Code Section 42303 been made? ❑Yes ❑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 slate 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, SignitT5a Of Legal Owner(s) i ate And/Or Authorized Applicant Date CODE t INSPECTION TYPE UTE MALE CODE( INSPECTIONTYPE QAIE MALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof —/1-0 K _ 210 Final Electrical 201 Final Block/Retaining Wall 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 ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT 636 North FORy BUILDING SANTA ANA,, CALIFORNIALI FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO, BUILDING ADDRESS 1043 Linden Place 7 z J-9 -.3 /4 z SCHOOL DIST. /y {. RECEIVED BY DATE OF APPL. DATE ISSUED OR TOWN Costa Mesa }� CROSS sr. State Ave, pis, /r /d 1-7. -1 /0 /7 -3 L� BUILDING 'f OWNER PANNEE HONES, INC. ADDRESS O _ ' %t� f MAILDDRESS 9363 WILSHIRE BLVD. SCHOOL DIST. j AOR TOWN ,!•.f.6 BEVERLY MILLS TEL.CR. 54361 NEAREST _ � CITY NO. CROSS ST. _ i / i ARCHITECT OR TEL. ZO E NO. OF TY$�_.� I -GRRO,U fp ENGINEER CAIN E. MCKERRACHER NO. SY. 64891 7j/ I PLANS ]T / �! Jf 7 ADDRESS 2110 WALNUT ST., PASADENA SETBACK LINE FRt�M3 ENTER EO S/T. K "rrl _-CC 1 TEL. REAR YARD ///��� LJ IDE YARD lO(�lO 1 NTRACTOR NEWPORT VISTA CONO. CR• 54361 \ APPROVEDY / ( � BY ,A�/'_ f / DATE/o/?.... ADDRESS 9363 WILSHIRE BLVD., BEV.HILLS CORRECTIONS LEGAL DESCRIPTION I LOT NO. 103 I BLOCK 1712 (ATTACH METES & BOUNDS) TRACT M PLU NO. OF BLDGS. SIZE OF LOT 7200 SQ.FT. NOW ON LOT 0 USE OF NO. OF NO. OF ' EXISTING BLDG. FAMILIES I ROOMS • DESCRIPTION OF WORK NEW I X I ALTERATION I I ADDITION O 5 REPAIR I MOVING I I DEMOLISH / 2 BUILDING NO. OF • J r SIZE 10314 SO.FT ROOMS 5 STORIES 1 WALL ROOF CONPO COVERING STUCCO COVERING siwpakes USE OF NEW BUILDING RESIDENCE ,ktt._Carport 1 APPROVALS FOUNDATION: LOCATION INSPECTOR DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS, /J/i /4 ?/ ‘C•:-S F APPLICATION AND STATE THAT THE ABOVE IS CORRECT S .4-r'C AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. BRACING, BOLTS /-'1/23 -3 /� J< AND STATE LAWS REGULATING BUILDING CONSTRUCTION. • LATH. INT. _ jh A24,0 SIGNATURE OF NEWPORT VISTA Co_. LATH. EXT. X/�IiJ� PERM ITTEF y/�- AUTHORIZED AGT.� • ‘• AL PLASTER. INT. AUTHORIZED nn PLASTER, E(%T. ., l �J 7h $ 4830.00 P. C• S J L MASONRY REINFORCED FEE / 9 $ BOND BEAM O l VALUATION FEE /� FINAL ._L&�� ��t'.3i% 1 . ._ _W ._ . . . . �. Z — Z . 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