HomeMy WebLinkAbout1777 TANAGER DR - Building Permits ,501 F CITY OF COSTA MESA
4 BUILDING DIVISION
}1 "IDEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
F ""l i PERMIT
'.� o• BOO-01479
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesatos. G PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1777 TANAGER DR CSl1 Status: ISSUED
Suite: Applied: 09/20/2000
Vicinity: Issued: 09/20/2000
Parcel Number: 13962402 Zoning: R1 R1
Applicant: MANGISI,RICK
Address: 15201 PIPELINE LN#A ISSUED BY:
`/
Phone: (714)936-5908
HUNTINGTON BEACH,CA Zip: 92649
Owner: PICKETT, HARRY E
Address 1777 TANAGER DR
Phone:
COSTA MESA, CA Zip: 92626
Contractor: CONSUMER SERVICES
Address: 15201 PIPELINE LN#A
Phone: (714)936-5908
HUNTINGTON BEACH,CA
Zip: 92649 License: 676090
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF INSTALL 7/16"OSB,30LB FELT AND 30 YEAR COMP.SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $7,000.00
Permit: $139.25 Claim Valuation: $7,000.00
SMIP Res: $0.70
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.95
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 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
2446.48(64x1)
DECLARATIONS 1 n
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
O 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 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.worksTq�ompensatloryll,I�n�s��urance carder and policy number are:• O�
Car r. V CtNe..4 r✓ Policy Number: biz
Or
(This section ne d not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performa a 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'
compen . •• - •f Calif ia,a agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith 1
:.....„.• 'with these p •visio rtMPRo•-
:. ant Signattu - i ' b --- -----Date: q • v LO
WARNING' •KURE TO SECURE WO ERS'COMPENSATI• RAGE IS UNLAWFUL AND SHALL SUBIE • EMPLOYER TO CRIMINAL PENAL'ES D ct L FINES UP TO ONE HUNDRED
r--. , D DOLLARE($100,000),IN A DITION TO THE COST• PENSATION,DAMAGES AS PROVIDED FOR I '.- No. r•..• r. ,- .••E,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I here rm that I am .:timid under provisions of Chapter 9(commencing with Section 7000)of Di ' .• of the Busine s and ofessions Code,and my license Is in full
e and effect.Lic.# CO -D 'U Class N • C Y
Contractor's Signature:�/�t ` Date: •
•
ANSTRUC••N LENDING AGENCY: ar /
0 •• eby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
:nder'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 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 driver's license. 0 Yes 0 No Driver's 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:
I 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 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 Cale been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this�epplication appermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? ID.4 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 1000feet 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 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.ita /up
r- egal cwn: ate 07r
And/Or Au •�>'-�•�hT•I� / Dat
CODE t INSPECTIONTYPE PATE IMalEALS CODE t fISPECnON TYPE PATE 11100361I
1616 Fixed System Final ire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof //On jr'•
r- 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
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO. €5.:7,6-759 DATE Z9:4170- ' /972
LOT NO.
ADDRESS /7-7 7 ,cJACE2 A!L
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he-she- 4'" (was or , , advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uncompleted condition.
BY
///�/
al? �1
(purchaser/�
BY 6? Ce'.G C9•,p %G/ �v�
//��Developer and/or a authorized
representative
BY (.4
Lender
10-4 7 S 33714 . . .
84
PILIAAC-OSTA MESA BUILDING-SAFETY DEPARTMENT I 0 Q I 191 I
CALIFORNIAP.O.BOX 1200 COSTA MESA,C 92626
APPLICATION FOR.BUILDING PERMIT •
For Applicant to Fill in Completely -
�(//� RECE ED V DATER CcEIVED „DATE ISSUED
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SIZE / / NO.OF BLOCS. (FROM C/L STREET),u J
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USE OF /
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VAR.# DATE
O C.U.P.4s APPROVED ,/
NAPPROVED/// �(r/RY DATE /O—7 — 7/
Z HOLD FOR S EP COAL REQUIREMF.NTs
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t~.1 I hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of
t/g the State of California. �/ / O St?/I� es
Z I hereby certify that I am properly licensed as a contractor under tf SO. FT. ,/i{' O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ;
Chapter 9. and that such licenses ares���'{{{{{{ full force effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 9
am exempt fro the provi ns of tate of Cal nia Business
and Profession de, Div' n 3, r • er 9. VALUATION / .57) CO
56 PERMIT FEE $ /0(p
Signature of /r n zc
Permittee /jjf/t I $9J J 0PLAN CHECK $ 3 E
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Authorize ant /L9 7S
TOTAL FEE $