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Home My WebLink About122 THE MASTERS CIR - Building Permits 4` 9 CITY OF COSTA MESA 41,11, BUILDING DIVISION F •_ ,I I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4110411PERMIT B05-02359 � (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.B1+MLDING PERMIT 7 iwl: u-IVE,COSTA MESA,CA 92626 P Job Address: 122 THE MASTERS CI : - :. Status: ISSUED Suite: f �' Applied: 12/22/2005 Vicinity: "N�qqL,,,,,\ Issued: 12/22/2005 Primary Occ: R Type of co t elle? V-N Parcel Number 11939106 Zoning: Applicant: STEVE JANOSIK Address: 1621 E ST ANDREW PL 44 Phone: 714-259-5120 ISSUED BY: 1 SANTA ANA,CA Zip: 92705 `-'IMPIr Owner RIVERA, RUDY G Address 122 MASTERS CIR - - Phone: COSTA MESA,CA , -- Zip: 92627 Contractor: ALUMINUM.ROOFING-SPECIALISTS-DIAL ONE WINDOW REP : . Address: -1621'E ST ANDREW PL - . - • Phone: 714-259-5120 ' • , SANTA ANA,CA , Zip:'' 92705 License: 523043 - Eng: ' Address: . Address: ' Phone: Phone: -Zip: ' License:,, _ License: - • . SCOPE OF PERMIT REPLACE 3 PATIODOORS WITH VINYL,DUAL GLAZE TO MEET 1997 U.B.C.REQUIREMENTS.HEADERS WILL REMAIN THE SAME. FEE SUMMARY Plan Check: , $0.00 -- Calc Valuation: $7,500.00 • • Permit I ll-1$153.25 _ Claim Valuation: � $7,50000 SMIP Res: • $0.75 SMIP Corn: $0.00 ' Other: ,$0.00 -' _ Inspection: $0.00 . - Total: . . $154.00 A' PLANNING &ZONING ° SETBACKS . • MAIN STRUCTURE Front 0-0 • Rear -' 0-0 Left' 0-0 . _ Right 0-0 ACCESSORY Front 0-0 , •:•:-.,,—Rear 0-0 - Left0-0 . Right 0-0 • PARKING . Existing:. 0 'Required:. - 0 - Proposed: 0- ' • .�h 1 r 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(6/%) I, DECLARATIONS 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 ��,,,...,,,rrr work for which this permit is issued. -� -Iliav'e andd 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. C �My workers'compensation Insurance carrier and policy number are: 8(011- ,Carrier- �Jl'� 17 ~,Policy Number: ZOO (Tris sectionnedd not be completed if the permit is valued at one hundred dollars($100)or less.) 9 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,end 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 options. Applicant Signature:- —t i 1.Q Date:"•`-11a I .Za_ le C THOU-WARNING:FAILURE-TO( SECURE WORKERS COM EN COST O MPENS IS UNLAWFULMGSAND SHALL IDEDSUEUECT I AN E EMPLOYER TO-CRIMINAL PENALTIES AND EMIL RDFS UP N ONE'SHUNDRED. THOUSAND DOLLARE($100,000l,IN ADDITIO i AHE COST OF COMPENSATION,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,licensed.uOnnder provi ' ns of Chapter 9(commencing with Section 7000)of Division3 of Me-Business d Professions Code,and my license is in full forceand'effect.Lic.N--- 'o�a�4 -Class'# CContractor's Signature: ' r-'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,Civil Code). Lender's 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.). • ❑ 1,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. ❑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 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 ❑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? ❑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 apermit for such construction or modification 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 Calitomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 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. erature Of egal Owner(s) Date r, / 4 . �cV. Jo r -An.rir or•ed Applicant _ . CODE P INSPECTION TYPE DACE INTITIAL@ CODE, INSPECTION TYPE PALE INITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 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 T I • � CITY OF COSTA MESA 44/ANI 96 BUILDING DIVISION }•4onraawctbs..4r DEVELOPMENT SERVICES DEPARTMENT PER NUMBER Ft �• 11.1141PERMIT itt r * B03-00911 iftrosalno (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 122 THE MASTERS CI Status: ISSUED Suite: Applied: 06/02/2003 Vicinity: ROOF Issued: 06/02/2003 Parcel Number: 11939106 Zoning: Applicant: ERIC PETERSON ISSUED BY: Address: LEE ROOFING COSTA MESA, CA Phone: 949-642-7222 1653 SUPERIOR AV Zip: Owner: RIVERA, RUDY G Address ' 122 MASTERS CIR Phone: COSTA MESA,CA Zip: 92627 Contractor: LEE ROOFING OF COSTA MESA Address: 1653 SUPERIOR AVE Phone: (949)642-7222 COSTA MESA,CA Zip: 92627 License: 349686 Arch : Eng: Address: Address: Phone: Phone: Zip: • License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1/2"O.S.B.PLYWOOD,30#FELT,40 YEAR CLASS A PRESIDENTIAL SHINGLES.25 SQUARES INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,000.00 Permit: $153.25 Claim Valuation: $8,000.00 SMIP Res: $0.80 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $154.05 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 2446-46(6/00) DECLARATIONS 14 WORKERS'COMPENSATIOMDECLARATION: ' I hereby affirm under penalty of perjury one of the tolloNing 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. Ilk 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'compensation Insurance carrier and policy number are: % Carrier: Policy Number: z mat - 2 cc 3 (This section need not be completed if the permit is valued et one hundred dollars($100)or less.) ❑ I certify that in the performan he 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 Calico ,g that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr.Yy.Ys II Ili Applicant Signature: •-a' _, Date: C-;- -0 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 DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business an P�oofessions Code,and my license is in full force and effect.Lic.# .�" Class# G I t C. Contractor's Signature: _---ds- Date: G -- 9 -0-3 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).): O 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.). o 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.). o I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑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: • O 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,Gm 2,Art 2,Sec. 341,Title 8,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? 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 Califomia 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 11 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 a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes UBNo (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? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 It 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 inbormation 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. :I • La.al Owner(s) C - 2--D- 0 —_A d/• 7''pplicant Date CODE I INSPECTION TYPE MI RIIIDAL$ CODE# INSPECTION PRP DAIS INTITIALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing / 200 Final Re-Roof 6 -ra-Q3 at, 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 I 204 Final Demolition _ 250 Final Building/Occupancy 31 4-22 FE13 20-70PAgiuu 614* ***141.00 COSTA MESA BUILDING-SAFETY DEPARTMENT cnsa P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely REC VED BL DATE RECEIVED DALE ISSUED BUILDINGa ADDRESS 122 The Masters Circle ( ^ '� �t'O R,VeT7f7 P M OWNER United Sav i n s & Loan Assoc. A.P. MAIL BUILDING/u1 �m.(��i��=(�y'!(/[!(/ ADDRESS 9800 S. Sepulveda Blvd. ADDRESSal ul "D CIU CITY Los Angeles, Calif. nN O. 670-7550 TRACT 6`"��) 67J I LOTC./y BLOCK ZZ CONSTRUCTION NEW I ADD AI TFR REPAIR (MOVING DFMOLISH N LENDER Owner I All n J BRANCH J, t' f• / / m 03 ADDRESS / A� VALUE ,{‘ (�D M J m ARCHITECT TEL. USE 7 �..0 Q OR ENGINEER R.J. Mary 1 ck NO 839-3840 U N FIRE '`'�I Z CC ADDRESS 1538 N. Century, Santa Ana ZONE TYPE GROUFOC d tL APPROVED J 0 CONTRACTOR Ryness-Smith Co. BY �� DATES —�y'—IV m IAA PP1 W fZ ADDRESS 140 E. Industry Ave. -T' 1�, W W TEL ZONF, NO.OF USE OF N Lii Z F CITY La Habra, Calif. NO. 879-31 1 1 G a- d'/-\i PLANS y BUILDING W 0 STATE CITY YARDS APPROVED YARDS APPROVED fn 1L LIC.NO. 167538 LIC.NO. 1964 MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SOIZE NO.OF F LOT 40 x III NOW ON LOS — ROM D FT. FT. USE OF EXISTING BLDG. SIDE Ft FT. I— SIZE OF NO.OF Z NEW BLDG. 1781 ROOMS 6 STORIES 1 L.SIDE 3 FT. FT. Q EXTERIOR WALL ROOF CLAY r/LB V COVERING StUCCO COVERING W.. REAR j 3 FT. FT. ' —I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d MAIN BLDGS. p E r ACCESS. BLOCS{{ "ii,Q VAR.# f [_� DATE L U " A� O Single family dwelling 8 two ear C-U.P.w E /S ' G APPROVED 3 --/f—6/ y attached garage APPROVED t(N//' J --//f//� RY �t./pATE z Lot 44 Plan 3-AR // O UI hereby acknowledge that I have read this application and state M that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ 1— any person in violation of the workman's compensation laws of V) the State Of California. '//� // Sito ? I hereby certify that I am properly licensed as a contractor under / SQ.FT.�J �/) o the State Of California Business and Professions Code, Division 3, THE AMOUNT SHOWN IJER VALUATION IS FOR c Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m am exempt from the provisions of the State of California Business end Professions Code, ivision 3,Chapter 9. VALUATION �� r-"� co rf PERMIT FEE $ D Signature Of 4 . l" m Permittee ��/ /I / / sS5�J // �� PLAN CHECK S /'V 7/ E Authorized Agent sty /. / /0 Ato/ 600 _/V) 1° u TOTAL FEE Y s