The URL can be used to link to this page

Home My WebLink About276 16TH PL - Building Permits • CITY OF COSTA MESA - BUILDING DIVISION a F I � ) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4. pita PERMIT B05-01370 • • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BtMLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 276 16TH PL Status: ISSUED Suite: Applied: 08/162005 Vicinity: TRIPLEX AND ATTACHED GARAGE Issued: 08/16/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 42522217 Zoning: Applicant: BURKE, MIKE Address: 1653 SUPERIOR AVE Phone: (949)642-7222 ISSUED BY: COSTA MESA,CA Zip: 92627 Owner: GOODRUM, CATHERINE M ET Address AL NEWPORT BEACH,CA Phone: P O BOX 1734 Zip: 92659 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 REROOF APT BLDG WITH ATTACHED GARAGE:TIO ROCK ROOF,REPAIR/REPLACE SHTG AS NEEDED,INSTALL 2 LAYERS 15#FELT,AND INS YEAR COMP SHINGLES ON PITCHED ROOF(28 SQUARES). FLAT ROOF(6 SQUARES):1 BASE 2 PLY AND ROCK ON FLAT GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 58,694.00 Permit: $167.25 Claim Valuation: 58,694.00 SMIP Res: $0.87 SMIP Corn: $0.00 • Other: $0.00 Inspection: $0.00 Total: $168.12 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(0/00) • 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. m.1 1 have and wit 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. fMy workers' mpensatiioo]Insurances niter an policy number are: Carier:J) c,to (hit7/0 77�>(J Policy Nunes r. Q��///) OO S (This section need not be comelet It th permit Is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the wo ,•sir hich t. permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of ' om :. d ag -IU"' if I rid uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these; . :.,-. / // / �i kAppllcanfSigpature: / Date:- b �lO�t� 9 WARNING:FAILURE TO SECURE W' ERS'COMP NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL NALTIE AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000), • ADDrtiON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37090F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Cha ter 9(commencing with Section 7000)of Division 3 of the Business and Profe sions Code,and my license is In full force and effect.' )) ,� �.. e (Class Y Cominctor'a Signature:_ - / CDele i, .a' CONSTRUCTION LENDING AGENCY: 1 ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which Ihis 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).): O I,es 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.). ❑ 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,faisework,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 Administrat ve Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as notod 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 Safely Code requires,with some exceptions,that a Business Plan be flied 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 ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 materlals)? ❑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 a ermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? j�Yes j�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 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If ycertificate 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. ction purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 7 /,/�// Pegal Owner(s) �/ Date ' in"Or.A0thordzed`Appllcent b ! D.2___^; woe , A •, s- DAIS INRTIAL8 cOOE t INSPECTION TYPE BAIL 18TlDAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final .(// 208 Final Plumbing 200 Final Re-Roof "l aG/Q 5 r f V 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 _•;Ia � > ��1959,93 1 -IMH?. COSTA MESA BUILDING DEPARTMENT nrF,,;CE DEPT. P.O. BOX 317 C'1' ` . �cll. +ccr� COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING BUILDING ADDRESS 276 — 16th Place COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. ERMIT NO. OWNER Santa ADA pAf:lp Homes, Inc. IS MAIL 1555 Placentia ECEIVED BY ((DATE RECEIVED DATE` hISSUED ADDRESS .J a0',� / �J `/cS9 TEL. R ILDING CITY Newport Baach, Cal. NO. 241 6-3227 ADDRESS ARCHITECT Same LIC. COSTA MESA. CALIFORNIA OR EP-"NEER NO. FIRE ADDR6,,S }r] /� Coame ZONE CATRAI:I VX011 Const. C . 1217 ZONE NO.OF TYPE GROUP ?, CITY NO.OL.1 � PLANS TEL. APPI/`(RY6L(V/'Eff zi ADDRESS same NO. Same BY "We/�// C AT�EE�� i LEGAL CV EcIILl1VJ DESCRIPTION NO. 15 BLOCK TRACT 2996 41[l'yj4 R ii \/1 jJ./.�}? 1(Ip a (`'1�'y ,...Y A.P. NO. Y A ,. L S 11 8� `7,/ :ki SIZE �] NO.OF BLOCS. }\^,� /,f/��\ �T YY ?J I ?Yy T'� OF LOT 50 x 125 I NOW ON LOT O f 9 11 11 F 1I1''I in�t1 IT ,ji USE OF in\ J.-4 �,- L .E:U L.i L. EXISTING BLDG. — I SETBACK LINE FROM i CENTER OF STREET 461_2R REAR YARD15 to C/L L�/1 / DA it SIDE YARD RIGHT 16 LEFT 8 ? VAR. No o APPROVEOS=U-'`l`GL DESCRIPTION OF WORK .�• NEW X ALTERATION ADDITION REPAInROm 9- -NO.OF DEMOLISH SIZE BUILDING 3123 ROOMS i6 STORIES 2 EXTERIOR WALL ROOF COVERING stucco COVERING hot-mop USE OF NEW BUILDING Triplex residence and att. garage Plan 4-CR I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES • STATE LAWS REGULATING BUILDING CONSTRUC. TION. VALUATION • SIGNATURE OFA >! y PERMIT FEE S 6 00 PERMITTEE s 26,378.00 PLAN CHECK s 223,00 AUTHORIZED AGENT TOTAL FEE S 69.00 jth I