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Home My WebLink About281 16TH ST - Building Permits • 4111 CITY OF COSTA MESA ' A 4 BUILDING DIVISION u F tot ar• 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER FIMIT `94. J 602-00335 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 281 E 16TH ST Status: ISSUED Suite: Applied: 03/11/2002 Vicinity: Issued: 03/11/2002 Parcel Number: 42516416 Zoning: Applicant YOUNG, MIKE ISSUED BY: Address: 1015E CHESTNUT AV Phone: 714-953-5444 SANTA ANA,CA- " ' Zip: 92701 - Owner: HARVEY, RICHARD P Address ,261E 16TH ST , Phone: - COSTA MESA,CA Zip: 92627 , Contractor YOUNGS ROOFING CO, INC Address: 1015 E CHESTNUT Phone: (714)953-5444 SANTA ANA,CA . Zip: 92701 License: 568560 Arch : Eng: " - Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT- . TEAR OFF EXISITING ROCK ROF,INSTALL"2 LAYERS OF 15#PELT;CLASS A COMP SHINGLE ROOF. ' FEE SUMMARY Plan Check: $0.00 Calc Valuation: $2,500.00 • Permit: $83.25 .. . Claim Valuation: , $2,500.00 SMIP Res: $0.50 ./, 'SMTP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 - 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 2446.46(NW) 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 wk for which this permit is issued. have and will mainta' , orlers'co pensetign insurance,:Q_quired by section 3 A of the4ebor Code,for the performance of the work for which this permit Is Issued. My workers'compe nsur rrier� ts�n/d�po�l�icy n y.er are: i 1 c( 4 c Carrier: �'W✓x Policy Number: (This section need not be comple ed if the permit is valued et one hundred dollars WOO)or less.) O 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 nd agree that If I should become subject to the workers'compensation provisions of Section 37 0 of thLabor Code,I shall forthwith comply with th�a.a(/py/' lions. 1 Applicant Signature: / T' Date: `�/�-� I 1 6 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),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 that I am licensed and Is' ter Commencin with Section 7000)of Division 3 of the Business and Professions C ar nse is in full force and effect.Lic.#4/1T,--�rJS`7( 0 9 Class it Contractors Signature: /�` �.-- , Date: 1 k 10-1_ CONSTRUCTION LENDING AGENCY: 0 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). 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).): ❑ 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,end 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. 0 Yes 0 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(38)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 tile and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 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? 0 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 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 Califomia Health end 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 thisa�ppplication a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). T 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 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 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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) 31 it oDate Aorized Applicant ate ;ODE 1 INSPECTION TYPE 26Th INImAla CODE! INSPECROLEffe PATE 1_I__ELE - 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof _fri-16 t- 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 Costa Mesa Budding Department APPLICATION FOR PERMIT '111 EAST 20th STREET 2416 BUILDING 1 W+ COSTA MESA, CALIFORNIA • FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. Building g9-C Address 281 Sixteenth Street P Costa Mesa, California a�Reeceivyd by Date i Rec' DateIssued Nearest v �' " � 4fie/SZ Cross St. Santa Ana Avenue Building Address Owner Cyrus H. & E. Merle Gates • : Costa Mesa, California Mall Address 306 Ramona Place : Nearest Tel St. City Costa Mesa Naiad 8-7976 zone ✓' I No of I Type v I- Architect or Lie. �� Plans moi''py / EnglneerCarlson & Middlebrooko. Approved Address Garden Grove by Date City Lie. CORRECTIONS tractor Dike & Colegrove No. 2707 ' Address 4.19 E. 17th St., Costa Mesa Legal Lot Description I No. 15 I Block I Tract2934 ,'. (Attach Metes and Bounds) ' No.of Bldgs. Size of Lot 531 x 137.5- I Now on Lot none ; Use of . I No.of No.of �C[[11�� p Existing Bldg. none Families 11 Rooms6I I) Setback Line fromRear Yard 63.5 , 2 - Center of Street 50 Side Yard 5t -- - - - n. DESCRIPTION OF WORK . . r New I X I Alteration 1 I Addition I - rl e , .._. - ' Repair I 1 Moving I I Demolish I • Building No.of _Size 1205 Soft. Rooms 02 Stories 1 •terior Wall I Roof vening Fr. Stucco Covering COMP. APPROVALS • Use of New Building Single Family Residence & Garag:: Foundation Location Inspector I Date ' Under-Pinning Plan # Z5413 . Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application • Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating „ building construction. - Signature of Plaster, Int. Permittee Plaster, Ext. cAer Authorized Agt. c, r —„ Masonry Reinforced Valuation Permit Fee $ as — Plan Check$ // — Bond Beam $ 9,000.00 Total Fee $33 ' FINAL cn:o -Pn4 5-H 2M 5-54 • • c m S 6 a . C. (_. i Street - - - PLOT PLAN Show location and distances from • ' - ° property line and between buildings. . .- .� - .. -r a+.. .. - —__"— _ _ _ CDS • . - • +% .G ia• .. r 1 . . , CIL. _— iI _ -- __ • • • • < '- 17796 SEP 1 i 1962 €OSTA MESA BUILDING-SAFETY DEPARTMENT PI4 OPT P. O. BOX 517 COSTA MESA. CALIFORNIA (��Ayygy r oQ.-P71 vim For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING 77 1 C • rr-4 sr ADDRESS l COSTA MESA. CALIFORNIA For Office Use Only //) L RECEIPT NO. PERMIT NO. OWNER t)/ L.(-t04Akt �VMv Y p ADDRE//SSSS-'III 7 S 1 �c.- --j /(oC 4. ` ( / /.�¢�MAIL REC IyED By I JDwlE/�'E{uED„ I r �B�Eu -,--- CITY CITY C_J 1/� `-14 - J NO. ^!9'7'(7f BUILRDINGU,c7c/LI c /�� 5 . ARC"ITECT TEL. -- _ COSTA MESA. CALIFORNIA OR HNEER NO. ADDRESS FIRE ZONE TYPE ---g---GROUP AP /l CONTRACTOR _O 1/4-1-j /-1 G RBYPROV� DATE / 3 . ADDRESS ZONING HOOF UBE OF NEW CITY ` ^t/PLANS BUILDING STATEIC. TEL. DESCDESCR kCI NNN/& 11e �3 LIC.NO. NO. LEGAR-IPTION SIZE C ..\/' t ITI INO. OF BLOCS. ,I /)� ^ - �.% OF LOT Ij� NOW ON LOT A.P.NO. 1 II 1l 3 CJ USE OF ` EXISTING BLDG. -, (P'L YARDS EVES `J APPROVED c�vf ALLOWED--//E CSENTERKLINE OF STREETM O I REAR YARD 2 FRONT R LINE ST.)5.---0 PT. IN. I SIDE YARD LEFT 3 I RIGHT/"` - R.SIDE (y_//I Frr IN. DESCRIPTION OF WORK L.SIDE 3 FT. IN. I ' ALTERATION I II ADDITION I REAR 4I� (/� FT. 1- IN. REPAIR I I MOVING I II DEMOLISH I APPROVED /'- ( ��n 1-1.7-6 y BUILDING NO. OF IVl_�,✓ / SIZE ROOMS STORIES EXTERIOR WALL -c. I ROOF COVERING COVERING i. USE OF BUQSING AND WORK TO BE PERFORMED N. I Kep ^w-L-C 0Lit,r(,- _ • 96 eati I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CI RDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CON UCT N. VALUATION / 11 PERMIT FEE SIGNATURE i n /%7 p� $� R PERMITTEE �� LF-1 !� $3� PLAN CHECK $ — lb AUTHORIZED AGENT exoK TOTAL FEE y 1