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150 THE MASTERS CIR - Building Permits
MF • CITY OF COSTA MESA BUILDING DIVISION F• r,rhliTrEr' . DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER / PERMIT - 1 ` _, 601-00217 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us. LDING PERMIT - 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 150 THE MASTERS CI SUIStatus: ISSUED Suite: Applied: 02/15/2001 Vicinity: Issued: 02/15/2001 Parcel Number: 11939113 Zoning: Applicant: COFFEY, BRIAN ISSUED BY: Address: Phone: 949-722-8846 Zip: Owner DEAN, BETTY M Address 528 PASEO COMPANEROS Phone: T\ CHICO,CA Zip: 95928 t L Contractorcto THE ROOFING SPECIALISTS S �C� a3 Address: 2428 NEWPORT BLVD#5 DA41'F. Phone: (949)722-8846 COSTA MESA,CA Zip: 92672 License: 734068 Arch : - - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT RE-ROOF.TEAR OFF EXISITNG SHAKE AND BUILT-UP ROOF. INSTALL OSB PLY OVER SPACED SHEATHING ONE PLY 30#FELT,APPLY 25 YEAR COMP. FEE SUMMARY Plan Check: $0.00 - Calc Valuation: $4,995.00 Permit: $111.25 Claim Valuation: $4,995.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $111.75 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 2446-46(6/00) 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 work for which this permit is issued. ❑ 1 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: 0 Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) O I certify that in the performance of the wo or 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 a that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these ions. / Arppplican6Sgnature: Date: // WARNING:FAILURE TO SECURE WORKS PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN AD O O 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 1 Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.#_= � Classat : a Contractor's 5ig`nature: -Y / 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: _ 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(5500).): ❑ 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. 0 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: ❑ 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 ❑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 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? DI Yes LI No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 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 ❑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 ins•ection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ignature Of Legal Owner(s) ate 4/1" `- 4ir ,e2-//S C6// r • •Or Authorized Applicant Date COBE 1 INSPECTIO PE PAIS JN'UTIALS CODE )NSPECTIONTYPE PAIS 11121Thg$ 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 OWNER OPIl1YU3 11811111 n. DATE 7-°-4-f± C(JOB ADDRESS 150 Masters Circle BUILDING PERMIT NO.33107 GENERAL CONTRACTOR Owner-B1dr. DESCRIPTION of WORK A1ter.Gar. _ APNo119-391-13 LOT TRACT FIRE ZONE VALUE $ 25.00 3INSPECTIONS Signature Date GROUP V TYPE .1 ZONE R1 \\A SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE 9 HOUSE CON. 9 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 9 POWER 9 ROUGH WIRING Heating and Vent. TRENCHES 9 FORMS ❑ STEEL REINF. 9 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLASTER, BROWN COAT 1 STRUCTURAL, FINAL Electric -� HEATING, VENT., REFRIG, AND A,C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL. ne a-. f .4 W fl.'.PIC"tC cTh.KyA rj 54e7?-7 i 231117 /' MAY 24-71CM5j00 910 0*****5.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED D`AATE RECEIVED D TE ISSUED BUILDING (/' 4- J -7 -1;21- 2/ADDRESS ,,��1//�ll� �7//1-...�-47,./4-:77 )......, /.///-/ -1;21. OWNER '�f;f Jc/� l /1 ( F�,/A.l-9- A.P. NO.. - '- a - PER 1 11,I� MAIL //,, '' / BUILDING /So /__ r^ n �. �1`' ADDRESS "////K/ �C /,!i Z ADDRESS ` (J J * �Gy^ a 0 CITY �26,dc J� NO. ..J�S� TRACT t j, I LOTS? BLOCK ZZ CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH Z 0 LENDER am J 0 BRANCH J N OWNER CO J ADDRESS VALUE m ARCHITECT TEL. USE / $ J N OR ENGINEER NO UQ FIRE tier / QQQ WO. M ADDRESS ZONE /j Pi t'�Lr1PE V GROUP / w Z /� � / APPROVI/_]/1` LL J J Z CONTRACTOR tMdr.-/7-.—•./ BV"✓) �•• DATE m Z / , :ICC ADDRESS W w TEL. 20N NO.OF USE OF NEW ejlenisidaisij O r / PLANS © BUILDINr - •� Z r CITY NO. APP O /Lc- - - W(0 STATE CITY YARDS APPROVED YARDS APPRO D / In CC LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 7 SIZE iNO.OF SLOGS. (FROM C/L STR ) 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 F . FT. UEXTERIOR WALL ROOF k _ COVERING COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE B T. BET.MAIN& 1 BUMS.BLS. ACCESS. BLOCS. Q �/ •/ -/ ,, -/ /// VAR.* DATE o d(./ie -,e4A-e:s'/./�.<,Z/J U �C/X!J C 1.7,7I 'C.U.P.# APPROVED K / U) APPROVED DATE L�'071-7 Z ""�-//VV11 �- 0 UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ F- any person in violation of the workman's compensation laws of Nm the State of California. m Z I hereby certify that I am properly licensed as a contractor under SO. FT. 0 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: e Cr am exempt from the pfOvisions of 'Statoot California Business and Professions Code, ivt ion 3, apt& VALUATION m PERMIT FEE $ N G:�; D Signature of __ m Permittee ` 1 ��'P r /�i1-C $ ,/ f� PLAN CHECK $ E ( d Authorized Agent �• u. TOTAL FEE $ ✓- A PAID 607* ***159.75 y� 31 15 I FED 20 70tg COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECEIVE BY DATE RECEIVED DAT ISSUED BUILDING ADDRESS 150 The Masters Circle " -i/- 7d . -ao-7d - PERM( Nq c OWNER United Savings & Loan Assoc. A.P. NO. J : i1 ) MAIL BUILDING S D J/! at/J1> ADDRESS 9800 S. Sepulveda Blvd.u, LLI ADDRESS CL ;tied 0 0 CITY Los Angeles, Calif. TEL 670-7550 TRACT 6 ,, O LoT 3 7 BLOCK 24 CONSTRUCTION NEW/ ADD ALTER(REPAIR (MOVING DEMOLISH Q I- LENDER Owner •Y/ JI1 0. CO �{J�,. �/Jy J� BRANCH � yv OWNER Q W ADDRESS CO CO f /��{ �,t',' VALUE / JQ ARCHITECT TEL. USE/ ivs' 1%� $`�//v ' N OR ENGINEER R.J. Mary ick NO. Rag-3840 FIRE LL/ c� � s, alU < P'( Cie CC ADDRESS 1538 N. Century. Santa Ana ' ZONE TYPE GROU APPROVED ,,,1 JO CONTRACTOR Ryness-Smith Co. BY ya„t{-DATE`-��j• Or / 03 (l r�d y J ir ADDRESS 140 E. Industry Age. , 111 W TEL. ZONE NO.OF USE OF NE Z I- CITY La Habra, Calif. NO. 879-3111 ± - /� PLANS� BUILDING td6� STATE CITY YARDS APPROVED YARDS APPROVED co CC LIC. NO. 167538 LIC. NO. 1964 MAIN BUILDING ACCESSORY BUIU"'''bbbbbbING D O (FROM C/L STREET) SIZE NO.OF BLn L OF LOT 43.8 X 93 NOW ON LOTOT ••• FRONT - _5 FT. FT. USE OF L EXISTING BLDG. , R.SIDE *� FT.? FT. 1— SIZE OF NO.OF ^7 Z NEW BLDG. 2100 ROOMS S STORIES 2 L.SIDE ' FT. FT. Q EXTERIOR WALLROOF / C.) COVERING STUCCO COVERING Wood Shakes REAR / 6 FT. FT. i .I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& • C. MAIN BLOCS. ACCESS. BLOCS Q VAR.# [-I- ,f, DATE �/0 17 q Single family dwelling 8 two c.u.P.#� /�/,y� �(� �/ APPROVED Jj 7/ -61 I— car attached garage c ROVEDO [IRATE j / /y/? p Lot 37 Plan 5-A 4L Il! / 1 r UI 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 H any person in violation of the workman's compensation laws of y the State of California, CO r y • n ? I hereby certify that I am properly licensed as a contractor under / SD.FT. V <//`J' o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNOg VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from the provisions of the State of California Business VALUATION //11/ m and Professions Code, D' ision 3,Chapter 9. PERMIT FEE $ /r(JN/ �'� N Signature Of Permittee ''/'�/�j/////�/, �/ / ` $_ i 3.t !ti PLAN CHECK $ l/��f/..C2S E Authorized Agent i�1/-yr !f/f/! Cf ii J' TOTAL FEE $ /v /J • - li