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Home My WebLink About3027 MADEIRA AVE - Building Permits V E _ 1 CITY OF COSTA MESA • BUILDING DIVISION >• DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER F I IPA ..1 PERMIT 801-01453 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 3027 MADEIRA AV Status: ISSUED Suite: Applied: 09/18/2001 Vicinity: Issued: 09/18/2001 Parcel Number: 13917216 Zoning: R1 R1 Applicant: HOYT,BRIAN ISSUED BY: Address: 3860 E EAGLE DR B - Phone: (714)632-6636 ANA Zip: 92807 Owner: MCKAY, HARDY H TR Address 16601 GREENVIEW LN Phone: HUNTINGTON BEACH,CA Zip: 92649 Contractor: HOYT ROOFS Address: 3860 E EAGLE DR B Phone: (714)632-6636 ANA Zip: 92807 License: 606111 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF SHAKE ROOF, RESHEATH WITH 7/16"OSB AND INSTALL 25 YR ELK DIMENSIONAL COMP. SHINGLES WITH 30 LB FELT UNDER. FEE SUMMARY Plan Check: $0.00 - Calc Valuation: $6,985.00 Permit: $139.25 Claim Valuation: $6,985.00 SMIP Res: $0.70 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.95 • PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Lek 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 2448-46(8/00) 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. 4"I have and will main 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'comper*atlon Insurance carrier and policy number are: Carder: Policy Number. (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify the - - .-•ornance 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' com.: ation laws of,allfomia,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith •••icant Signature: / . . - Ai —( b —m CARNINO:FAILURE TO SECURE WORKERS'OOMPENSATION COVERAGE IS UNLAWFLL AND SHALL SUBJECT AN MPLOYER TO CAM PENALTIES AND CIVIL FINES UP TO ONE HUNDRED _THOUSANDDOLLARE(Stooxe*W ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN CRON 3709OF R CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTR•• •- . DECLARATION: I hereby affi n - I am lice, ed under provisions of Chapter 9(commencing with Section 7000)of DMsion 3 of the :u '• - . . -rofessions Code,and my license is in full force :••effe• .Lic.a . / Co . . .A C.' Co. actor's -igneture: t4GN-.--a. --- Date: — L CONSTR -•N LENDING AGENCY: • 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 perry' 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 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 A,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 0N (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 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 aagermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? 0 Yes Ul 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 ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code). 7 If a permit from the South Coast Air Oualily Management District or other air pollution control district or agency is required for the work which is the subjectof this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑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. 4 SIg4 eebt Leg Ow er(s) Date 4�r- 9—/�Yc9/ An A dzed App t �9etfl CODE I INSPECTIONTYPE MTh MALI LODE/ INSPECTIONTYPE C MI R{tiIMS$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final q 0 208 Final Plumbing 200 Final Re-Roof 6 e IPf 210 Final Electrical 201 Final Block/Retaining Well 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 OWNER ; •f 3 I All • DATE 6-29-59 JOB ADDRESS 3027 Madeira Ave. BUILDING PERMIT NO. 97 — GENERAL CONTRACTOR Mal gren Const. VALUE $ 163956 AP. No. LOT62 TRACT ✓3 5 FIRE ZONE DESCRIPTION OF WORK res att gar INr CTIONS DATE GROUP 1 x` TYPE V ZONE R1 U. ground Soil U.G. Water/CW 7.-24457 PERMITS ISSUED Underground Gas SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating .t/� -oa ' ci. - i 6534 'v Rough Plumbing +(_,/-(/ .l 07�G6cr .:.,��✓LS - ,_ /9 9.2_)/'� Miscellaneous Prop. Swr. Ude House Con/ St. SwK.ec G/76/-,57 /y4� Q:�' G (Alt �--/6--.51 A Sprinkling System /` ✓ n , y 6d Heating, Final i Plumbing Fixtures ,/s "`�i'— i Final Gas Test )5 .ir • g-151-t, /> 1 '- Construction Pole Underground Power Rough Wiring Cir/// r9 _ ! tA� / 9-4- T7 /464,2 �" Trenches t\ I\-Forms QivleSteel ir 1- i{ -5y Floor System Steel Reinforce Chimney Re-Rod _ Bond Beam Sheathing ' ' r 9-I -sp_ F e and Flashing ✓f 9 I. R-iu1 L. .ng, In f' Out q 1-951 -' Q Plaster, brown coat . [ -i9 -.49 Plumbing Fixtures, Final /,�/ -V-QS Electric Fixtures, Final 1. /It Building, Final A. I.!/ X-p'-�eY OCCUPANCY Form 210-3M-4-59 9740 : .. ',,.;I;3 0 1959 I COSTA MESA BUILDING-SAFETY DEPARTMENT M 1r'^ . E OEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA I I`j1 .I• 'r..; =C POR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT ^ BUILDING BUILDING 3^Z� �j/ACW� //rG- BUILD N 39a7 4 r COSTA MESA, CALIFORNIA fOR OFFICE USE ONLY RECEIPT NO. 1 MIT NO. OWNER Sycamore Land Co 440 MAIL 10835 Santa Monica Blvd. RECEIVED Q�! I/GATE RECEIVED4 �DA�--11- ADDRESS TB,� /QL/nl- 9 S1�J Los Angeles 25 TEL.Br2328I BUILDING CITY NO. ADDRESS ARCHITECT LIC. COSTA MESA, CALIFORNIA OR ' 'NEER ¶,c-(' _ Msa Y nr NO. 11015 S . Paramount Blvd. FIRE ZONE TYPE GROUP 0--. ADDHt.SS Malgeen ConstaTATE153335 APPROVED CONTRACTOR LIC.NO. BY DATE ADDRESS 1 O �5 GanFn Monica lvd R ZONING .. LEGAL LOT 9 ZONE NO.OF BUI OF:GE NEW /�/1� DESCRIPTION I NO. 6 2 I BLOCK ITRAC3363 _�K f PLANB I BUILDING /yy _ A.P.NO. APPROVED // BY / DATE{� tj / SIZE NO.OFYARDS EVES OF LOT 108.99 X 70.00 I NOW ON LOT n REQUIRED ALLOWED ' (CENTER LINE ST.) E($$ ppN99LDG. • FRONT Su FT. IN. • SETBACK LINE FROM 50 - 36 CENTER OF STREET REAR YARD R.SIDE r- FP. IN. SIDE YARD (LEFT 5 (RIGHT 5 L.SIDE S FT. IN. DESCRIPTION OF WORK REAR nit a FT. IN. NEW I X 'ALTERATION I II ADDITION 1 •. REPAIR I ('MOVING ' I DEMOLISH I SIZIE DING 1707 NO.OF IROOMS _ 6 STORIES 1 EXTERIOR WALL StUCCQTEOOF wood. shingl COVERING rr COVERING USE OF BUILDING AND WORK TO BE PERFORMED Dwelling new construction 2CR Att. Gar. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTCITYRU O 10DINANCEB AND STATE LAWS ULATING VALUATION SIGNATURE OF �,{ . PERMIT FEE $ /_ PERMITTEE f n?fir - �/ 93 7 �//'/� /A 47 $ / PLAN CHECK $ /� AUTHORIZED AGENTS //�/� 5-4 y TOTAL FEE $