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Home My WebLink About1741 Tustin Ave - Building Permits (8)(714)754-5273 • Fax(714)754-4856 Job Address: 1741 TUSTINAV Suite: 9 Vicinity: ROOF AREA Parcel Number: 93328034 Applicant: JOHN SMITH Address: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Owner: ORLEAN COMPLEX Address Contractor: JOHN SMITH ROOFING Address: 3410 IA SIERRA $111.25 F149 SMIP Res: RIVERSIDE, CA Zip: 92503 Arch : Address: Zip: Phone: License: BUILDING PERMIT Zoning: Phone: 909-657-5600 Zip: Phone: Zip: 92661 Phone: (909)657-5600 License: 443878 Eng Address SCOPE OF PERMIT T/OFF AND REROOF 2700 SF DUPLEX W/COMP SHINGLES, FEE SUMMARY Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $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 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES PERMIT BER 99-01650 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Calc Valuation: Claim Valuation: Right 0-0 Right 0-0 Status: ISSUED Applied: 10/12/1999 Issued: 10/12/1999 Phone: License: $4,700.00 $4,700.00 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: I hereby affirm under penalty of perjury one 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 Cotle, 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. M workers�°° I er and policynumber are: Carrier: y 01 /m/r/y Policy Number: (This section need not be completed i/ the permit is valued at one hundred dollars ($100) or less.) ❑ I certify that in the pert nuance of/$e work fo hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o itOrnia, a re Ilh 'f I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these pr visi ins. Applicant Signature: Date: m WARNING: FAILURE TO SE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE ($100. I, 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 the! I am license r rov' ions Chapter 9 (commencing with Section 7000) of Division 3 of the Busine35-and P,cgff ions Code, and my license is in full force and effect. Lic. # Class # LL.... i% Contractors Signature: Date: -�2— CONSTRUCTION LENDIN3 AGENCY: ❑ 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). Lenders 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).): ❑ 1, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: bate: 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, talsework, 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? ❑ 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 ❑ 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 feel 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 compiled with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisapplication aggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Byes L-1 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building pernits). 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 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: 1 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 inspec ion purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si ure e n s) ! D D✓t/ y AffcVOr Authori2ed Applicant Date CODE 4 INSPECT6N TYPE DATE INTITIAL CODE INSPECTION TYPE DAFT Ig$jTIAlS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-RootO' G�l� 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 2446-46 7 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING / ADDRESS / 7a COSTA MESA. CALIFORNIA OWNER B e a C012j6t. C MAIL BOX 1 ADDRESS p,0 TEL. CITY NO. 11 p� ARHITECT ORCENGINEER BE L♦ BOIDbeS T NO. 0 1642 ADDRESS 1355 Via Lido RewPoTC BBHCh CONTRACTOR Goo, D BpCC01R ADDRESS 9700 Newport Blvd CITY Ifewpo rt Beach STATES.L.ceLa TEL. LIC. NO. ++JJ��••JJ�� - NO. L OF LOT 01 2 660v I NOF BLOGB. ON LOT -NOW USE OF EXISTING BLDG. BETSACK LINE FROM h CENTER OF STREET -/ REAR YARD %- SIDE YARD I LEFT IZ- ( RIGHT DESCRIPTION OF WORK NEW X II ALTERATION I LDDITION I 1I I REPAIR I II MOVING I II DEMOLISH BUILDING ANO. OF SIZE ROOM6 STORIES EXTERIOR WA�,L, ROOF y� COVERING AL1),CCO (COVERING "UCk USE OF BUILDING AND WORK TO BE PERFORMED F> �T . I HEREBY ACKNO LEDGE AT 1 AYE READ TH 'APPLICATION AND STATE THAT T E AS VEb ORRECT O ORES TO COM- PLY WITH ALL C ORD CES D STA REGULATING BUILDING CO VCTIO SIGNATU PERMITTE AUTHORIZED AGENT L9 FEE RECHUD M2 F Pj;'';�,E DEPT. ,ITy OF COSTA IJIESA APPLICATION FOP PERMIT BUILDING /2d' -/i 9 For Office Use Only REll2D BY I DA iECEI_VEDi I 0 T IBpII Ep,G BUILDING ✓/" !!/'/�Ij ADDRESS COSTA MESA. CALIFORNIA FIRE ///�cJ ZONE TYPE / GROUFC / APPROVED \ M -.3 .- -. y/ 7 ZONING ZONEO. OF UBE OF NEW t- _L PLANS Z BUIWINO Z el;, 7" LEGAL/ ; �O ; f DESCRIPTION LC/e /y /" yf A. P. NO. // / — LO/— L, Z? 2i// (CENTER LINE ".1 6 FT. S APPROVED BY Zi 'LL dy-,2lsyf' 9- 3,2 Q" THE AMOUNT BROWN UNDE114VALUATION IB FOR THE PURPOBE OF, ESTABLISHING A PERMIT FEE ONLY. VALUATION � PERMIT FEE E �1 so?e, 7i.�1 � PLAN CHECK $ TDTAL FEE A C OWNER BUCCOLA, George D. DATE 10-18-62 JOB ADDRESS 17141 Tustin Ave. BUILDING PERMIT N0.180 4 GENERAL CONTRACTOR Braebyn_�srltction VALUE $ 2500.00 AP No.117-281-02,_ LRT TRACT FIRE ZONE DESCRIPTION OF WORK Pvt. BLk.Wall INSPECTIONS Signature DATE I GROUP J TYPE III ZONE R-2 Soil SUBCONTRACTOR PERMITS ISSUED Gas DATE NUMBER Water Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line ❑ House Con. ❑ St. Swr. ❑ Sprinkling System Construction Pole Underground ❑ Power 0 5ugh Wiring renc Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing Frame and Flashing Lathing — In ❑ Out ❑ Plaster, brown coat Refrig. ❑ Au Cond. ❑ Final I Heating, Final Plumbing Fixtures, Final ;4L d