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HomeMy WebLinkAbout2002 SANTA ANA AVE - Building Permits • CITY OF COSTA MESA BUILDING DIVISION F•% .,4. DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER .f PERMIT '�, awn" B02-00639 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2002 SANTA ANA AV Status: ISSUED Suite: Applied: 05/09/2002 Vicinity: DUPLEX-2002 AND 2004 SANTA ANA AV Issued: 05/09/2002 Parcel Number: 42622101 Zoning: Applicant: WALKER, JOHN ISSUED BY: (/ Address: P O BOX 3467 ' ' " ,;(--(it / •Phone: 714-290-9959 COSTA MESA;CA %". ' Zip: 92628 / - / Owner: PORTICO PROPERTIES NEWPORT HEIGHTS.LLC�� � � AddressP O BOX 3467V - - ti N -N, /,/ /'N\ , \ -- - I - Phone: 714-290-9959- ' ! 'COSTA MESA,CA - Zip: 92628 _ / V - Contractor: ////// / Address:; / V\\// / Phone:, A;°;A • . Zip !7;�/ ' License.- - - � / '/' .... - _ i . Arch : , 7/ r. N ' — • Address: i / - •_ Address:, ; - ' Phone:- - N ,'/ ` Phone: -- - 'Zip: , 7 License: License: / ;. /i- •;-- , . /_,„ SCOPE_OF PERMIT .,_ ,_: \ ' REMOVE ROCK ROOF. REPLACE ANY DAMAGED WOOD AS NECESSARY,COVER WITH 30 YEAR COMP SHINGLES. FEE SUMMARY ' , Plan Check: $0.00 / - _ Calc Valuation: $3300.00 Permit: $97.25 - - ' -- _ _ Claim Valuation: - $3,300.00 SMIP Res: $0.50 G ' , ;SMIP Com: $0.00 ,/� Other: $0.00 - Inspection: $0.00 -Total: $97.75 7/ 1;:;.;',.--•- JI 2 * PLANNING &ZONING ' / (, , / SETBACKS.. / /` /- /i /, / 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: N 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 1 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(6/00) 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 pro�'ded for by section 3700 of the Labor Code,for the performance of the work for which this‘permitis issued. v '� . ❑ I have and will maintalp workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the worrrNNN for which this permit Is Issued. My workers'comption Insurance car ' nd policy number are: Carrier: Policy Number: (This section need not be completed i/the rmit is valued at one hundred dollars($100)or less.) • certify that in the performance of the work for which this pe ••' is .ued,I shall not employ any person in any manner so as to become subject to the workers' compensatl•n laws of -.• i.,and agr•e that if I should•:1 isubject to the workers'compensation provisions of Section 3700 pf the /oz_ or Code,I shall forthwith comply with�:l- r• Bions. •��� e, 'li/ 1 Applicant Signature: `--11�, Date: yt//WARNING:FAILURE TOS= URE ORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE(S1••000),I ADDMON 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 under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.B Class• Contractors Signature: Date: 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 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 ned 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 Busi s 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 cts the applicant to a civil penalty of not more than five hundred dollars($500).): I,as owner of the properly,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 properly 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 n owner of properly who builds or improves thereon,and who contracts for such project with a contractor(s) license pursua •the Con actors License La ❑ I ^t,_mpt nder s:. S Th Business and Professions Code for this reason: Signature: . l� -4111,110110111, 7 Date: /��/////�f Owner ID veri ed b drivers license. Yes 0 No Drivers License No. Expires: O Verification of•wne .hip by(type of doc ant,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(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia 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 end 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 Califomia 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 ap ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 10 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 pert 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 Califomia 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 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 :I certify under penalty of perjury that I have read this application and state that the information given is corre :.ree to c•.•• all sta: laws and city ordi eating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the abo :-descn•.•,• ••: ctio pup.:. I a• ` • cAI opy or allow occupancy of any building authorized by this n I f aljOspection. Signature Of ega •wner(s) Date And/Or Authorized Applicant Date CODE 0 INSPECTION TYPE MI 1NTIALS CODE! INSPECTION TYPE PATE RALE • 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final4 208 Final Plumbing - 200 Final Re-Roof !-1vf r 02- C 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