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Home My WebLink About2040 FULLERTON AVE - Building Permits r O�MFS CITY OF COSTA MESA `'� BUILDING DIVISION Jt ' DEVELOPMENT SERVICES DEPARTMENT PERMIT PERM NUMBER B99-00028 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2040 FULLERTON AV Status: ISSUED Suite: Applied: 01/05/1999 Vicinity: Issued: 01/05/1999 Parcel Nunmber: 42619122 Zoning: Applicant: BERNARDIN,LISA Address: 02476 NEWPORT BL Phone: 714-645238 COSTA MESA CA Zip: 92627 Owner: PICASCIA, STACY Address 549 AVENIDA BUENOS AIRES Phone: 949-498-6870 SAN CLEMENTE,CA Zip: 92672 Contractor: PERFORMANCE ROOFING CO. Address: • 02476 NEWPORT BL Phone: 714-645238 COSTA MESA CA Zip: 92627 License: 661267 Arch : - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OF WOOD SHAKE INSTALL 1/2"CDX AND REOOF WITH 25YEAR COMP.SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $9,840.00 Permit: $162.25 Claim Valuation: $9,840.00 SMIP Res: $0.98 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $163.23 • 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: EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 480 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 v WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 I have end 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: c\ Cartier: L 0 IN rA JCO A - O • Policy Number: � 0 C T a's'-}4 (This section need be completed If the permit Is valued at one hundred dollars($100)or less) ❑ I certify that in the performance of the work for which this permit is Issued, I shall not-employ any person in any manner so as to become subject to the workers' I Celifo�r119,and agree that II!should become subject to ih workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith th these pr. !/I� 1 I //g !J Applicant Signatur .Q(( /C/. .P/`.�/ �"t/'�t�/lam Date: / — 5 - �/f��/j) q —I WARN 3:FAILURE TO SECURE WORKERS'COMP SAT1ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM OVER T RIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(SI"';.. • •DDRION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSE N'•ACTORSi• CLARATION: I her y affirm the t I am lic: sed under provisions of Chapter 9(commencing with Section 7000)of Divisior • a Busin•- and Professions Code,and my license is In full I e and effect. :c.It Class k omractors Signa / , . .y .. Date: arintdif .- , I --____--••—, CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATION$: 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 properly, 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 driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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 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 Safely 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 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 apermit for such construction or modification from the South Coast Air Oualily Management District or from any other air pollution control district or agency? IJ 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 es 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 end 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sign: ' egal• •ner(s) f l i - 5 Date- 91_ . _ — An• s •uth•� c--13a Ap•I .-I - - ee CODEr IESPFCTIDNTYPF DAM g1II AL6 CODEC INSPECTIONTYPF ' PATE MAO 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final pp 208 Final Plumbing F�// 200 Final Re-Roof 'tel a 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 TC-pi ( '-I CITY OF COSTA MESA REQUEST FOR OCCUPANCY Project Name TR '7 -) 1`( Date (1/-.4/72, Address 2°'i u r U L-LI k1I 0 id City Identification Ref. Lor S Building Permit No. 31 3 1/44 The developer of the above entitled project desires to rent or lease prior to the time that the project has been completed and accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) advised that this project has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. /� _�,� BY Jitet S (-fit12C Developer and/or authorized rreepresenttativvee BY //r[/i Cr,2 A-Pd ✓r, / c.y11 L Lender �14v4-5/e/c. OWNER SEWELL, Richard DATE 3-15-72 JOB ADDRESS 2040 Fullerton Avenue, A8c..B BUILDING PERMIT NO. 34342 GE"ERAL CONTRACTOR Same DESCRIPTION of WORK Duplex w/att.garages LOT 5 TRACT 7714 FIRE ZONE VALUES 32,000.00 INSPECTIONS Signature Dote GROUP Iea TYPE V ZONE 12-CP SOIL /i/7 5".3-15"-",la SUBCONTRACTOR PERMITS ISSUED GAS Dote I Number Signature WATER Ig .ipq ROUGH PLUMBING P7 / , •••42e:X. -1.40- -04 e/ - PROP. SWR, LINE BK1015, , ,-1 —A" -7,46oy_gs------ SPRINKLING SYSTEM yeee.enti e .71•-• lite fer17-41-146/1.045C5 .— SPRINKLING SYSTEM ROUGH HEATING AND AIR CONDITIONING Aelco-71/-7 TEMPORARY — TEMPORARy SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH wIRI1j . s' Air " _e't 4 - eatin• and • in. TRENCHES FORMS STEEL REINF. OW, 0--_c ,T tezej€4,. .,7770,177Minigteacterier o FLOOR SYSTEM ./.."... eter 'Ct.i . .e//18://)-70-4, '•:y e BOND ,..- BEAM 11] STEEL REINFORCE n SHEATHING at- 9/ 7---- FRAME AND FLASHING LA e ir •..1 LATHING - IN OUT At C ...I, r •• ..„.............."-- PL/ 1, BROWN COAT STE, JRAL. FINAL HEATING, VENT., REFRIG. ANO A.C., FINAL , 1 _,‘ Efee,yriptLej _ _ . AM-F_A-2-...?2, mifrzet r.. aiete-:-.,- --7g PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL )17k2V.-1/14- S 34342 PAICOSTA MESA BUILDING-SAFETY DEPARTMENT •'n 1S-7'�r OO 536* ***161.99 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT3-/"'7S- For Applicant to Fill in Completely RECEI ED BY DATE RECEIVED DATE ISSUED BUILDING 2O I t413 fv//p'a ohf /� JZ - ADDRESS s/� f �1/Iv � C / PERMIT O. OWNER ///C AQ/'C/ . 7 rade / A.P.NO. /13A MAIL //�� [[�� QQ �+ 71 r- BUILDING e� 40 Ag rat(ADDRESS /i 7149 / // �HI-17E�/L)[tea/. ADDRESS L-r/ T!'cr< d U CITY ra c/4 fide-<-- fy6./G 7Js/Vj TRACT 72/17 LOTS BLOCK 2 CONSTRUCTION /\ADD 9LTER REPAIR MOVING DFMOI ISH OI- LENDER up am J D BRANCH I^'G', OWNER 2 /,V_ m J ADDRESS ,`�,1 ALOE /qs 1� CO ARCHITECT ,� / TE L��/S!�.4 9 US EM S.7 X J Q OR ENGINEER//r // r/?it/1fr_ NO(E•(/ t1/'J/ / U Q f [ �^� FIRE 7wK AODRESS/Jp 7/� (_Q4/zIGL//;J�,/� /T CJ ZONE TV / GROUPa lL APPROVED JZ CONTRACTOR / S«/t// BY DATE m- Z ( ,p J CCADDRESS 4C 34' 4 F /.,„ , WW ,,/ ZONE NO.OF USE OF NEW 0 r CITY (/as 7a Ars 4 N r�y2 yC•1,J /22s�,/� PLANS z BUILDING pato)/ 2F W-o STATE CITY YARDS APPROVED • RDS APPROVED cro jO _LIC. NO. Qi a yf-diy LIC. NO. MAIN BUILDING AC SSORY BUILDING SIZE I NO.OF BLOGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONTFT. 0 FT. USE OF EXISTING BLDG. E sl` FL / F . I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE IC FT. 6 FT. UEXTERIOR WALL ROOF 5_, COVERING COVERING REAR /c0 FT.0 FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 0MAIN BLOCS. ACCESS. BLOCS. Q Wit t el VAR.# DATE 1 a {�!/ C.U.P.# APPROVED) /z (j N —�Y ROVEC��/� DATE /2)apt /2_ Z �T L^!/ o STATE I hereby acknowledge that I have read this application and state �s�' 7 P that the above information is correct and agree to comply with '1 cc all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of IAA C/) the State of California. es //T /7 7d_ /S/Is� z�_ ,a'_ I hereb certif that I am �(l/`/ i SO. FT (/// [S',�2W/,(r_y y properly Iicensatl as a contractor underthe State of California Business and Professions Code. Division 3, THE AMOUNT SHOWN UR VALUATION IS FOR 5Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLG A PERMIT FEE ONLY: Jr am exempt from the provisions of the State of California Business VALUATION and Professions Coda, Division 3,Chapter 9. PERMIT FEE S/0 1,iD w Signature of /� �, B Permittee' ..e/J1s2L:L /r LC-{M .L'�.. $ M PLAN CHECK $ ��/ �r E • �y,�� /s S•� u. uthorae Agay(BWLll F.OR SPECIAL REQUIREME -i v W/ TOTAL FEE $/�W/ /