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1741 Tustin Ave - Building Permits (65)
4(,�'� 14 CITY OF COSTA MESA ° BUILDING DIVISION ;PER91111 NUMBER }�DEVELOPMENT SERVICES DEPARTMENT�•,yy - �;PERMIT "�o,mm B9-01544 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1741 TUSTIN AV Status: ISSUED Suite: 16 Applied: 09/27/1999 Vicinity: Issued: 09/27/1999 Parcel Number: 93328004 Zoning: Applicant: JOHN SMITH ISSUED BY: Address: Phone: Zip: Owner: ORLEANS COMPLEX Address 1741 TUSTIN AVE. Phone: (949)631-2168 COSTA MESA, CA Zip: 92627 Contractor: JOHN SMITH ROOFING Address: 3410 LA SIERRA F149 Phone: 909-657-5600 RIVERSIDE, CA Zip: 92503 License: 443878 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF - T/O, USING EXISTING SHTG, 2 LAYER OF 15# FELT & NEW 30 YEAR COMPOSITION SHINGLE ROOF. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,960.00 Permit: $125.25 Claim Valuation: $5,960.00 SMIP Res: $0.60 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.85 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear D-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 DECLARATIONS ORKERS' COMPENSATION DECLARATION: hereby affirm under penalty of perjuryone of the following declarations: ❑ 1 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 forwhichthis permit is issued. My workers'!!? ura}d policy number are: Carder: baN Policy Number: (This section need not be completed if the permit is valued at one hundred dollars (S 100) or less.) ❑ 1 certify that In the performance f 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 IlfomI nd a res th I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with theso pr vi ions. A Applicant Signature: �' Date: 59 -a7 -Fl WARNING: FAILURE TOS WORKERS' OOMPEJNSAT10N COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OOLLARE(S OOOI, IN ADOMON 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 lican all under provis Its of Chapter 9 (commencing with Section 7000) of Division 3 of the BuslnQsA rofessions Code, and my license is In full force and effect, Lic. N Class N Contractor's Signature: Date: r CONSTRUCTION LENDING AGE CY: ❑ 1 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 Lew 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 ❑ 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, An 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? ❑ 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 then 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 fano for acutely hazardous materials? ❑ Yes ❑ 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 materiels)? ❑ Yes ❑ NO (Section 25534 of the California Health and Safely 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, hes 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 a plication epennit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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? ❑ 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 Califomia 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 Materiels 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 propen for Inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. e el/Tvner(s) 4@t� oC � And/or Authorized Applicant Date CODE r, INSPECTION TYPE pR�T gNT111A CODE 0 INSPECTION TYPINTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof .B��U 9y 210 Final Electrical 201 Final Block/Retaining Well 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 2x46-46 BUILDING SAFETY D' RTMENT NG 16 41 P. 0. Bos No. 317 Costa Mesa, California ff Date �`�p C�11— CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No/ ^' fit Elec/tri�cal Permit No 4 Z*- Pl mbing PeTinit NO;, '?o Use of Building ^' ?sem /uZ✓}/�t: E°/'�r t The building located at/ •/ cz'-i- c Legal Descriptio (See reverse side for Metes and ounds) - 3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordin- ances applicable thereto for a Group frj' Occupancy. ISSUED!'TO• /,' i� ! City B ding Offi ial (Owner of Building) By�"'��l ..-�_./r1.U�✓ CC: ❑ original—Owner ❑ 1st copy—Gas Co. ❑ 2nd co B P PY—Ed(sonjCo. ❑ 3f SPY—File Form 206 S -B P 1M 1-60 • 16584 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 517 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS U/✓ /A COSTA MESA. CALIFORNIA F RECEDED MAR 6 1962 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILPING /S3 -/Sy -x.5.5 For Office Use Only /� CO weCHIPT NO. PERMIT NO. OWNER BraeNm t CO MAIL Boz 193,1 P.O♦ �C8�1c D I U�5r02 RECEIVED 4 DAT!5-7-4- ADDRESS / — ✓ � AA M1O 9 !) {J L� j�� 'Beach ELLDR31240 BUILDING CITY CITY He rt ADDRESS ARCHITECT B.L• �r Bomber TEL. or31642 W COSTA MESA. CALIFORNIA OR ENGINEER NO. 3355 Via Lido. Newport Beach FIRE ADDRESS ZONE TYPE GROUP APPROVEDBY DATE CONTRACTOR la' Newport ONING ADDRESS 3700 Blvd ZONe NO. OF U88 OF NEW W `L I PLANE �- B"UGE OFG LEGAL I OG �j-• Nim 74 De..RIFTIO. ifi // -L-,/ 2- L% 'A t` CITY Newport Beach 'IT1,^ LIC.TNO. / NO. 0R31240 LL 660' I nO. O LOTO, O OF LOT NOW ON LOT A. P. NO. 7 - USE OF YARDS EVES EXISTING BLDG, APPROVED ALLOWED APPROVED 4 SENTAR OF BE FROG '�/ ' 2 REAR YARDT -ETBACK / IceNTeR LIN. eT.IL FRONT FT. IN. SIDE YARD I LEFT -LO - 0 I RIGHT . �S^ G R. SIDE FT. 'S/� IN. DESCRIPTION OF L. SIDE O FT. C C IN. IgWORK NEW I II ALTERATION I ADDITION I O[G. REAR 1 ( / FT. / C/� IN. SII REPAIR I II MOVING I DEMOLISH I II APPROVED �p d VA DATE BUILDI G NO. OF SIZE -, ��-Yn3O-O ROOMS 2 STORIES Z EXTERIOR WAbL ROOF p� R0 COVERING LU.I�+CO COVERING USE OF BUILDING AND WORK TO BE PERFORMED / / 7 1 .....Y ACKNO' G TH 1 H READ TRIS LIGTION THE AMOUNT BROWN UNDER VALUATION 1E FOR THE AND BTATe THAT T BOV IB C R AN O TO COM- PURPOSE OF ESTABLISHING A PERMIT FSH ONLY. PLY WITH ALL CITY IN C BTATH W 6O.LATINO VALUATION .UILDIxO COMB ION. SIGNATURE ERMIT PEE $ D -.So N PLAN CHECK $ PERM ITTE n $ �� AUTHORIZED AGENT TOTAL PEE sDaS 16 A, Ile b, )&(,, )top OWNER BRAEBURN CONSTRUCTION CORPORATION DATE 3-20-62 JOB ADDRESS 1741 Tustin Ave..B1dg.16,Uni.ts 152,x,14,155 BUILDING PERMIT NO. 16584 C" WRAL CONTRACTOR Geo, D. BuccQla VALUE g 52,LQ2.00 A_ _�o.117-281r2.27.ieff 28 TRACT FIRE ZONE DESCRIPTION OF WORK )i unit Ant_ INSPECTIONS Signature DATE GROUP g & J TYPE p ZONE SoilPERMITS SUBCONTRACTOR ISSUED as G�� 7.' �, DATE NUMBER Water Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing�.- Miscellaneous ! %7` -- Prop. Swr. Line D -House Con. e -St. Swr. ❑ '1✓ Sprinkling System Construction Pole ,�-!f je7 — ' —I _ _ ._ �' Illi Underground ❑ Power ❑ Rough Wirin _ IR renches orms tFloor System Bond Beam ❑ Steel ReinfoSheathingand Flashing L- .ng — InOV Out ©�Plaster, 3FI,'inal brown coate ng. ❑ Air on . ❑ Heating, FinalPlumbing Fixtures, FinalElectric Fixtures, FinalBuilding, FinalOCCUPANCY