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Home My WebLink About246 WILSON ST - Building Permits CITY OF COSTA MESA ! 4 " BUILDING DIVISION > :j r., 4, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 'A �� PERMIT itb4Porearso`#* BOS-0011 (714)754-5273 • Fax(714)754-4856 • vnvw.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 246 E WILSON ST Status: ISSUED Suite: Applied: 01/19/2005 Vicinity: Issued: 01/19/2005 Parcel Number: 11909208 Zoning: • Applicant: HANK HAMMERSTROM ISSUED BY: Address: 18903 SAN CARLOS ST Phone: 714-655-2231 FOUNTAIN VALLEY,CA Zip: 92708 Owner: GREEN, ADRIENNE Address P 0 BOX 11392 Phone: COSTA MESA,CA Zip: 92627 • Contractor ABSOLUT ROOFING CO Address: 18903 SAN CARLOS ST Phone: 714-655-2231 FOUNTAIN VALLEY,CA Zip: 92708 License: 761118 Arch : Eng: Address: - Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT T/OFF AND REROOF 2300SF RESIDENCE VV/COMP SHINGLES W/2-15#FELT. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,100.00 Permit: $111.25 - Claim Valuation: $4,100.00 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 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 244646(6/00) • L s 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 Cale,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. My workers'compensation Insurance,{ carrier and policy number are: C` Carrier: St R r 4 }-�/h�� Policy Number: �SKI550 (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) 4 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,and agree that II I should become subject to the work rs'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these ro sion 1 ...�1 Applicant Signature: liL,�.�il A tilt Date: I � 14").3 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37080E THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under r visions of Chapter 9(co mencing with Section 700 of Division 3 of the Business an Professions Code,and my license is in full force and effect.Lic.8 /� A �/J1 P8 Dates q — I Contractor's Signature: L�Lt. LL Date: I— •I )' dh o i UCyION L N�AGENCY: ❑ I hereby affirm t 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 properly 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 Safely,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 Califomia 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 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 Califomia 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 occupant require e which e subject ... 5 Does e will the tcAir u present or future building o from at other for the work ontch isi the sor this application epermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LLII yes Ll 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 pan of the facility to be constructed under this permit be within 1000 feet 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 COMPUANCE 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 agr a to comp with all state laws and ci' ordinances relating to building construction,and authorize representatives of the Ciry of Costa Mesa to enter upon the v est ed prop:. y nspesation purposes.I :gree not •.occupy or allow occupancy of any building authorized by this permit until final inspection. et? )d, nS Signature Of Legal Owner(s) Date And/Or Authorized Applicant / Date -� CODE t INSPECTIONTYPE gAff. 1NTmALS CODES UISPECT1ON TYPE DAIF !MALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof �'1-95 210 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' Mesa Building Department 4PPLICATION FOR PERMfi P. O. Box 317 3339 BUILDING 1 -,COOSTA MESA, CALIFORNIA FOR OFFICE USE ONLY ' FM APPLICANT TO FILL IN Receipt No. Permit No. Address 246 E. Wilson ,3 Sir Costa Mesa, California Received by Date Rec'd. �D7ate Issued Nearest —7, T ‘ —it /'/O cross st. Santa Ana Building ' Address Owner R. L. Keppen Costa Mesa, California Mail 419 E. 17th St Address Nearest Tel, Cross St. City Costa Mesa No. Li 8-1159 Zone 49•,A No.of I Type / Grou7 Architect toe L' Plans Engineer uarlson & Middlebroq , Approved Date Garden Grove by Address CORRECTIONS Contractor Dike and ColegroveNo?" 52997 Address 419 E. 17th St Legal I Lot 12 I I 3033 Description No. Block 1 Tract (Attach Metes and Bounds) No.of Bldgs. Size of Lot 75 X 82.5 Now on Lot none Use of I No.of I No.of � - A Existing Bldg. none Families-I- Roy,ir O Setback Line from t Rear Yard z Center of Street 49 11 Side Yard l0t r - - - D DESCRIPTION OF WORKr• New I X I Alteration I I Addition I Repair I I Moving I Demolish I , Building No.of .� d ilk' .e, Size 1205. sq ft Rooms 6i Stories 1 Exterior Wall Stucco I Roof Comp — Covering Covering APPROVALS Use of New Single family res and gar Foundation Location Inspector Date Building Forms,Materials, Under-Pinning Plan 64B Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws regulating building construction. Lath.Ext. Signature tteeof Dike and ColegrovePermitplaster, Int Authorized Agt. `� �. , ,'"' Plaster,Ext. Valuation Permit Fee $ o? 6 Masonry Reinforced �/p Plan Check$ 1/3 Bond Beam $ /Q/ T lO. Total Fee $ ✓ / FINAL FORM 209 10.55 O.P.&5. . v J c 0 o L . RA�CST� ;tr ... r" • _, . • : . • r. -C • Street i PLOT PLAN Show location and distances from -. property line and between buildings. _ IPW . 40963 - DEC -9-75e—S?OO 436* ****54.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely - Use Ink Only BUILDING n t� REED BY DATE ECEIVED DATE ISSUED ADDRESS L�q c. ` . 'N „co., cm. - " - Q //��i -7-76- /0? -9-75/vt -��/JJJ �/�r� OWNER RLI%CI.> �1zfL1A alb._ A.P.NO. II L- t/ 1t'-OV P,M in9 MAIL �t�� BUILDING / ADDRESS 24(3 P . V 41L_50rJ S-i'. ADDRESS 'ZL4[,s �. �1L_40s.1 ST, �OS ` w � TEL TRACT3033 LOT la BLOCK T� CITY 'W NO.4.31728(P. CONSTRUCTION `t In NEW ADD ALTER REPAIR MOVING DFMOI ISH LENDER \I�ICLL.S' rq�.Rl'O 1�A.Kak BRANCH W. Coals is., KC � P�L-IF jA\ �y�/ ADDRESS ` � ) Ruls..4&Pat' •' OW w. �it.0 oo otc— VALVE ��/I OR ENGINEER1049, ITECTO..I an-f JLltUDWcL NO. USE E�4Y//s.�Y's<O.(�M�wLWY��S �t/1 FIRE ADDRESS ZONE V E : GROUP r R L_ L APPROVED r CONTRACTOR CBy /j� DATE. ADDRESS ZO NO.OF USE OF NEV✓JETrL TEL. Ot JPLANS I BUILDING K.-rrsas 1 CITY TE 21 �T.v'tr ,-, STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE INO.OF BLDGS. ,`_ (FROM C/L STREET) o. OF LOT l NOW ON LOT Ot 14FRONT FT. fT. Q USE OF e� 1\T�_ La EXISTING BLDG. St.o RLS VW�-ls��., R.SIDE F ` FT. - hdii F Sra eparate permits are required for L.SIDE .P'� FT. electric,plumbing and heating work. [08 REAR FT. FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0 MAIN BLOC'S. ACCESS.SLOGS. {''�� VAR.# DATE "'t SI NIALCh--'p�l`Q_\t_� typy,ac C.U.P.# APPROVED a / �t �j ..-75.-- >x K\VC .et„ 2 ec larTh e� —flPPROVEQ� , ,� J DATE I C.�- t ..l B. B. 0 I hereby acknowledge that I have read this application and state fY that the above Information is correct and agree to comply with - Os all laws regulating building construction, and I shall not employ Zany person in violation of the workman's compensation laws of the State of California. I herebycertifythat I amSQ. FT. w properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ta Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: to am exempt from theprovisions of the State of C fornie Business pVALUATION PERMIT FEE $ Sir t M and Professions Cod ',Ion 3,Chapter 9. of PLAN CHECK E ^t Signature of I O s 4"'� o Permittee $5,10 u. TAX E t 54 U Authorized Agent TOTAL PAID $ 54 6o X471 47 ft0364 12/11/73 - . 8:50 TL -COSTA-MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PLICA ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only air-7.5. - /' / R C I ED DATE RECEIVED f9L�T IS/SV EDBUILDING /y ADDRESS �^7�r 67 (�S/.S®tet/ n p "pOE��)RMiT NO. 7c�f/ OWNER / O ?. ' 1Tr'Y, A.P.NO. It7 -07.2 -0fr MAIL //'V BUILDING �/// �• �iy/ ADDRESS e� 4 � ,.ckC OaJ ADDRESS TC7 G !/' ��.Ts�N `` TEL TRACT 3O 3 3 LOT /Z BLOCK CITY lxi ��.].4 NO.f / CONSTRUCTION NEW ADDI ALTER ,REPAIR IMOVING f)FMOIISH LENDER y BRANCH /l � OWNER j(/ ADDRESS /� VALUE ARCHITECT TEL. a` t $ r412 OR ENGINEER NO FIRE ADDRESS � ZONE TYPE FROUP //�JJ / .•-------- APPROVE /_ CONTRACTOR��/��t/ ! BY VL DATE/d-111 ADDRESS '/O C.r-Cn: . � ZONE /r NO.OF USE OF NEW //(NQ Cf� CITY S,_ar(r A '4 NO`.t/9/�5/ 2 I PLANS 2_ BUILDING Loa LL (b STATECITY YARDS APPROVED YARDS APPROVED LIC. NO.aC697,...r LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. BLOCS. (FROM C/L STREET) • O. OF LOT NOW ON LOT RONT FT. �/ nl /\ L h USE OF ,...gi 7 •t"O„ EXISTING BLrn $.SUM FT. FT, Ca FSeparate permits are required for L,SIDE aT. FT. electric,plumbing and heating work. REARFT. FT. (•., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& �Q MAIN BLDGS. ACCESS.BLOCS. (,._ HVAR.# C.U.P.$• DATE . 1 e/Or®/a147. Cl ‘2 :Ser-LC‘./ APPROVED R APPROVEDCO ( " ' DATE nil/7 81.il/78> >" ..1 C4 w A. I hereby acknowledge that I nave read this application and state n CC that the above information Is correct and agree to comply with m L all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of o the State of California. .: I hereby certify that I am properly licensed as a contractor under SO. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMiT FOILY: 0— am exempt from the provis sof the State of C Iifornie Business PERMIT FEE E ny 4C-C) and Professions Code, n 3,Chapter 9. - m PLAN CHECK $ o Signature of �//' o Perm' a �_ $ S(e)i) , TAX $ Authorized Agent TOTAL PAID S �A/ • SU