Loading...
HomeMy WebLinkAbout316 21ST ST - Building Permits tet•• CITY OF COSTA MESA C. I t1 BUILDING DIVISION PER T NUMBER DEVELOPMENT SERVICES DEPARTMENT, �.•�, PERMIT %bongo t 00-00778 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 316 21ST ST Status: ISSUED Suite: A Applied: 05/31/2000 Vicinity: UNIT B Issued: 05/31/2000 Parcel Number: 42616104 Zoning: ISSUED BY: 7 Applicant: STEVE GLAZER Address: 1915 W BALBOA Phone: (714)612-8260 NEWPORT BEACH,CA Zip: 92663 Owner MATTSON, JOHN E Address 24186 OKEECHOBEE LN Phone: LAKE FOREST,CA Zip: 92630 Contractor GLAZER ROOFING Address: 1915 W BALBOA Phone: (714)612-8260 NEWPORT BEACH,CA Zip: 92663 License: 739156 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF-PRE-ROOF INSPECTION REQUIRED.INSTALL 25 YEAR COMPOSITION SHINGLES OVER 1 LAYER OF EXISTING COMPOSITION SHINGLES. • FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,250.00 Permit: $47.90 Claim Valuation: $1,250.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $48.40 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not,commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: 4 f I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this pemlit is issued, My workers'compensation Insurance carrier and policy number are: . Carrier: - Policy Number: is section need not be completed if the permit Is valued at one hundred dollars($f 00)or less.) I certity that in the performan : of the work fo w 'ch this permit is issued, I shall not employ any person in any manna so as o become subject to the workers' compensation laws of Califo Ia,end agree th h uld become subject to the workers'compensation provisions of Sect n 370 of the Labor Code,I shall forthwith comply with these provisio t 5 I 2 bo p Applicant Signature: Or .� Date: WARNING:FAILURE TO SECURE W" RS'COMPENS I N COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(Momit DDRION TO THE ST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed •:r.royi of Chapter 9(commencing with Section 7000)of Division 3 of the Businesstd P ff, ions Code,and my license is in full force and effect.Lic.# I. / - Class# � -> Contractors Signature: arena Date: ' KM 2-0LJ6.7 1 CONSTRUCTION LENDING AGENCY: O 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). 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 end 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.). ❑ 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 properly 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. 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: O 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 B,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? 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 0 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 end 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 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? c3 Yes LJ 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? 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 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 purpo e I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • Or t I er(s) / t paW JJ A Or ut ri Applicant it CODE 4 INSPECTION'fYPE DAN jNrTtAL& CODE I/ INSPECTION TYPE 263 INTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final � 208 Final Plumbing 200 Final Re-Roof d—!'f/-00 £ J 210 Final Electrical 201 Final BIocldRetaining 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 Design Type Codes • Requested By 001 - Single Family Residence Address 999 - Misc. Improvements Phone Signature • PUBLIC SERVICE INFORMATION FORM SFR/TH/CONDO 1 j 2 I 3 I = I 5 I 6 I 7 I 8 I 9 I 10 I 11 I 12 I 13 I 14 BLDG BLDG BLDG kINISF;E7 TOTAL GARAGE/ CONST USE DESIGN SIZE SIZE SIZE ADD SSMT EEDRMS CRPRT POOL LAND APN BLDG.'- YEAR BODE TYPE 1ST FL 2ND FL 3RD FL SIZE SIZE & BATH I SIZE Y/N SIZE Cki – G – 4 I (YL_,-I 5 ; I I _ I - i i, -67— ,2, 7g 9(i. )- F 743 I• I ! I I l • • l I I l 1 1 1 I I I 1 1 I i I I I II I i I i I I I I t i Authorized By Check Amount S Zc :7 Hd OC -{ 00 Cash Amount.S li`.'OITnn d: . ca u HOSS SS r :: ,,:...: .....:.:ao Mailed Date By 1/98 qp M.S. • ORANGE COUNTY ASSESSOR DEPARTMENT NOTICE Property Characteristics Information • The people of the State of California do enact as follows: SECTION 1. Section 408.3 added to the Revenue and Taxation Code, to read: 408.3 (d) The Legislature finds and declares that information concerning property characteristics is maintained solely for assessment purposes and is not continuously updated by the assessor. Therefore, neither the county nor the assessor shall incur any liability for errors, omissions, or approximations with respect to property characteristics information provided by the assessor to any parry pursuant to this section. Further, this subdivision shall not be consii-ued to imply liability on the part of the county or the assessor for errors, omissions, or other defects in any other information or records provided by the assessor pursuant to the provisions of this part. _ CITY OF COSTA MESA y BUILDING DIVISION PERMIT MBER 1-' ....4 'I DEVELOPMENT SERVICES DEPARTMENT, o 666 PERMIT %. o 00-00760 • (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 316 21ST ST Status: ISSUED Suite: B Applied: 05/30/2000 Vicinity: UNIT B Issued: 05/31/2000 Parcel Number 42616104 Zoning: Applicant: STEVE GLAZER ISSUED BY: _ Address: 1915 W BALBOA • Phone: (714)612-8260 NEWPORT BEACH,CA Zip: 92663 Owner MATTSON, JOHN E Address 24186 OKEECHOBEE LN Phone: LAKE FOREST,CA Zip: 92630 ~ Contractor: GLAZER ROOFING Address: 1915 W BALBOA Phone: (714)612-8260 NEWPORT BEACH,CA Zip: 92663 License: 739156 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF-PRE-ROOF INSPECTION REQUIRED. INSTALL 25 YEAR COMPOSITION SHINGLES OVER EXISTING 1 LAYER OF COMPOSITION SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,250.00 Permit: $47.90 Claim Valuation: $1,250.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $48.40 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: 1 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. ❑ 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: , Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the parlor .nce of the work this permit is issued, I shall not employ any person in any manner so as to b come subject to the workers' compensation laws of Ca' " '`-nd agree t ould become subject to the workers'compensation provisions of Section00 of a Labor Code,I shall forthwith comply with these provi o• �//�7 Applicant Signature: dr//�" Date: /31 2' t 0 WARNING:FAILURE TO SECURE •RKERS'COMPEN N COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES A D CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000,IN ADDITION TO THE T 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 un er rot"s�iyo s ofj Chapter 9(commencing with Section 7000)of Division 3 of the Busines and Prole ions Code,and my license is in full force and effect.Lic.# I 53 V Class# Contractors Signature: Date: ZC>c, CONSTRUCTION LENDING AGENCY: ❑ 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). 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($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.). ❑ 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 drivers license. 0 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 feel 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 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? 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 0 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 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisapplication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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 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 Duality 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 es 0 No e (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 proper for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sign i eg s) /2 5/ d •r t zed Applicant Date CODE# . P 9.1• ■P. QATE INTITIAL5 conn INSPECTI0N TYPE PATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ! 208 Final Plumbing 200 Final Re-Roof 6• _/L`C 2 .' ga�/' 210 Final Electrical 201 Final Block/Retaining Wall l 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 Consign Type Codes - •Requested By 001 - Single Family Residence Address 999 - Misc. Improvements Phone ( 1 Signature • PUBLIC SERVICE INFORMATION FORM SFR/TH/CONDO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BLDG BLDG BLDG FINISHED TOTAL GARAGE/ CONST USE DESIGN SIZE SIZE SIZE ADD BSMT BEDRMS CRPRT POOL LAND APN BLDG# YEAR CODE TYPE 1ST FL 2ND FL 3RD FL SIZE SIZE & BATH SIZE Y/N SIZE yak -I 6 I -0zf ( I9,s sF S F Tao -- . -- — -- ani -6L ti )7g ? /965- S F SF- lad — - , R�� �' ,� / I 1 I I I 1 1 i I I I I I i i I I 1 I 1 I I 1 1 1 1 I • _ . I _ . Authorized By Check Amount $ Ct cq kld 0£ AVW 00 • Cash Amount$ A O11in i.1 d31S83M bOSS3SSv AINP03 •.HvaO Mailed Date By 1/98 qp M.S. ORANGE COUNTY ASSESSOR DEPARTMENT NOTICE Property Characteristics Information • The people of the State of California do enact as follows: SECTION 1. Section 408.3 added to the Revenue and Taxation Code, to read: 408.3 (d) The Legislature finds and declares that information concerning property characteristics is maintained solely for assessment purposes and is not continuously updated by the assessor. Therefore, neither the county nor the assessor shall incur any liability for errors, omissions, or approximations with respect to property characteristics information provided by the assessor to any party pursuant to this section. Further, this subdivision shall not be construed to imply liability on the part of the county or the assessor for errors, omissions, or other defects in any other information or records provided by the assessor pursuant to the provisions of this part.