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Home My WebLink About3119 MADEIRA AVE - Building Permits (2) OWNER SYCAMORF TAW) CO DATE 6-29-59 JOB ADDRESS 3339 Madeira A„e. BUILDING PERMIT NO. 9757 GENERAL CONTRACTOR Malgren Const. VALUE $ 16,936 AP. No. LOT 79 TRACT FIRE ZONE DESCRIPTION OF WORK res att gar_ I' ',ECTIONS Lw DATE I GROUP I & J TYPE V ZONE R1 L aground Soil? .G. Water /(^ _ _ PERMITS ISSUED SUBCONTRACTOR Underground Gas !(G DATE NUMBER Overhead Water and Gas I-_ — Rough Heating �G>!L - Gfe2 t , ,-.As-±5:7 - .2 053__ e /o s?- / ,Dl_ Rough Plumbing L _ > � �.c�e-�y✓/Eyca 7 iS 7 /77 �,�,�0 Miscellaneous _ Prop. Swr. Lina/ House Con.',-St. Sw 9-/b-,59 /fro./Q2,i/4 4e..G�J el/E-59 /s'99,3 ' Sprinkling System % // /f Heating, Final 4.,W _\ Plumbing Fixtures 4' - "Q' Final Gas Test / L!,f�G.I_el Construction Pole . Underground Power /_ / Rough Wiring CI 2 4-i5 `'�, o./cC .� e l—r- - /66 7 S , Trenches !/ Forms // Steel S 7-/H-S-9 / Floor System /L1_7) fr -.3-51 Steel Reinforce Chimney Re-Rod Bond Beam Sh.?athing fin- 4 -U- - L't?r";e and Flashing d9 9 '-gat - Loa;"iing, In,ll Out 6'7.- lo-Iy-7-y Plaster, brown coat //-19,-r4' Plumbing Fixtures, Final A . /^2.4'.60 Electric Fixtures, Final �I Building, Final Me r r '�`/'� OCCUPANCY Form 210-3M-45? _ iDATEOWNER AIMACK, ROBERT 5-29-69 JOB ADDRESS 3119 Madiera Avenue BUILDING PERMIT NO. 30354 GENERAL CONTRACTOR Royal Pools, Inc. DESCRIPTION of WORK Pvt. Swim Pool p a• 139-162-07 LOT 79 TRACT 3363 FIRE ZONE VALUE $ 2,1{00,00 $IA1S CTIONS Signature Date GROUP J SUBCONTRATYPECTOR III ZONE R-1 SOIL GAS PERMITS ISSUED Date I Number I Signature WATER / Plumbing ROUGH PLUMBING t i -f-tif(1,./W q 2y. 7 3r/ PROP. SWR. LINE Q HOUSE CON. Qt-✓ - "//W tt(j/� SPRINKLING SYSTEM � M I SCEL LAN EOUSe) temipC C y...zaew, ft..44sC.-//-6 ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND F- POWER Q a4.2.y_(01 iA ROUGH WIRING �j.' t(. cg Heating and Vent. TRENCHES Q FORMS Q STEEL REINF. Q FLOOR SYSTEM BOND BEAM STEEL REINFORCE [4.._- /-{,e, SHEATHING FRAME AND FLASHING LATHING - IN n OUT Q PL^'TER, BROWN COAT H (URAL, FINAL A C:43C 3Ctr' Ap'A 5� yr �e HE,, ING, VENT., REFRIG. AND A.C., FINAL 1/(/iJ,'/C' �j/(jL/ L/l /SlF` PLUMBING, FINAL A If rT !(.6QTi ELECTRIC, FINAL BUILDING, FINAL %/_, S . PAID 34.50 1Y 29 64CN5f001723 ** = f 30354 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely BUILDING//(� Q _//_. " RECEI VJyBIBY DA3"1'ECE1V%- DATE ..-2 ISSUED f i ADDRES/S/,�/ / �,��J CI'_(I��ClL+�aQ-+ �`�•!Yl /! /'`J/y PERMIT OWNER/ X'O v2clJ'YILZG .4.__ I ';7 - /42 - 17 PES (T.NO. (/� A.P.NO. MAIL BUILDING .-2, i 14 -� AA 0 Li Q ADDRESS ADDRESS 0-U CITY � ' NO. TRACT 33431 LOT 79 BLOCK Z2 Q CONSTRUCTION cn ( NEWI ADD ALTER I REPAIR MOVING OFM(II LSH LENDER O y J BRANCH V`'tel ' a 1C� 2WL J'n OWNER a ADDRESSt (�� LUE �//�,(C4 ARCHITECT ///�//� CJS TEL. USE d�nr✓s,t�t- ,K�tr'a-� S }z'/l`' J Q � OR ENGINEER / / / /�•� NO IIM ,f n FIRE 3 // Z Q ZONE TYPE ��/ GROUP W ADDR •S d W APPROVED ` p W2CONT- -C Ae . ' 612-CO BY DATES! 7-/7 J Q m Z Af W W ADDRESS a • Y/ � 414� ZO NO.OF USE OF NEWywL Z FCITY GC., ' PLANS LBUILDING 6...„ WO STATE / CIT YARDS APPROVED YARDS APPROVED N 2 LIC.NO. /y.3i 2.-1, .NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L TREET) SIZENO.OF BLDGS. OF LOT I NOW ON LOT FRONT . 4. FT. SW— ' FT. USE OF �1rr�� EXISTING BLDG. R.SIDF 7V FT. FT. I— SIZE OF NO.OF Z NEW BLDG. �� ROOMS STORIES L.SIDE it FT. FT. ✓ EXTERIOR WALL ROOF it COVERING COVERING REAR G FT. FT. ' USE OF B G AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS. BLDGS. O s CURP.�It APPROVED F APPROVE '-' It GATE 7 �/l Z - �Y tiN-Vt' �p�, /"?--6. 7 O y C.) I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of (n the State of California. co Z I hereby certify tha properly licensed as a contractor under SQ. FT. o the State of Co •rnla B iness end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, a.• that such censes are In fu •rce and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 am swamp rom t a pr• islons of the f California Business and Prof:.sionf C. •'vision 3,Ch: CC VALUATION .7 ebco �/1 PERMIT FEE $ .4,2 --7 N Fermin.-Signare •f �� $ /�D PLAN CHECK $ 7/6— E O� ( ( o Authorized gent —� TOTAL FEE $ S 9 Zi u. di IL —CCI VED JUN30 1959 COSTA MESA BUILDING-SAFETY DEPARTMENT E`itnNCE DEPT. P.O.BOX 317 COSTA MESA,CALIFORNIA L I l•t Lir rnQl A ry_Cq FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING :3 /� [/� ADDRESS v/�% /�i4he /e A. {/C COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. J€RMIT NO. OWNER Sycamore Land. Co. I 7C7 MAIL 10835 Santa Monica Blvd.. RECEIVED Y' (�DOATE REItD I "-TE ISSUED ADDRESS 1,--45 T,y�I Y Los Angeles 25 TELBr23l87 BUILDING CITY NO. ADDRESS OR ARC 'SNEER L. C. Mai Or CT NO. COSTA MESA, CALIFORNIA ADDRESS11015 S . Paramount Blve. ' FIRE 1/ 9.-- 9 Malgren Const.STATrL53335 APPROVED p�- CONTRACTOR LIC.NO. BY DATE ADDRESS 10835 Santa Mnni ra. 131 vd_ ZONING LEGAL LOT 7 ZONE I NO.OF I USE OF NEW /A DESCRIPTION NO. I BLOCK I TRACT336 PLANS BUILDING I(/��//4 APPROVED /A A.P.NO. BY //� DATE 4/7),_,,L.�1 SIZE /�/� ]( »> OF LOT 1 (1() 1111 7 No.OF SLOGS. YARDS EVES O nn NOW ON LOT 0 REQUIRED ALLOWED USE OF (CENTER LINE ST.) G� EXISTING BLDG. r� FRONT d V FT. IN. SETBACK LINE FROM 50 28 CENTER OF STREET REAR YARD R.SIDE .$ FT. IN. ``r SIDE YARD LEFT 5 I RIGHT 5 L.SIDE U FT. IN. DESCRIPTION OF WORK REAR FT. IN. NE) I X II ALTERATION I II ADDITION I REPAIR I II MOVING I II DEMOLISH I BUILDING 1707 NO.OF 6 1 SIZE ROOMS STORIES EXTERIOR WALL I ROOF COVERING �'y.stucco COVERINGp (-rush rock Dllvie111ngG newW cOnstnuction 2BR Att. Gar. 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- PURPOSE OF ESTABLISHING A PERMIT R88 ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCT' i VALUATION SIGNATURE OF (i PERMIT FEE S � PERMITTEE.,O �.c.-> f> G /��//�-/ /�T /�, � $// f3 PLAN CHECK $ �` AUTHORIZED AGENT //� O Sr e,,'-• i �� TOTAL FEE $ CITY OF COSTA MESA . • 4 Na. BUILDING DIVISION >i •,,,• ..4, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER :t7. PERMIT V. nu' - 1P03-00159 00 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 3119 MADEIRA AV Status: ISSUED Suite No Applied: 03/12/2003 Issued: 03/12/2003 Vicinity: A9 .----- Parcel Nunmber: 13916207 ISSUED BY: Applicant: VROOMAN, REL Address: 18782 MAIN ST Phone: 714-841-1653 HUNTINGTON BEACH,CA , Zip: 92648 Owner: SMITH, CHRISTOPHER Address 4206 DAWN LN . Phone: 714-434-9266 RIVERSIDE,CA Zip: 92504 Contractor: SHADETREE ENTERPRISES INC Address: 187782 MAIN ST - - Phone: 714-841-1653 HUNTINGTON BEACH,CA Zip: 92648 , License: 584518 Arch / Eng: - , , -. • -- - . . Address: - . . .- - - - . - Phone: Zip: -- - - License:' SCOPE OF PERMIT RE-ROUTE GAS LINE FROM METER TO POOL EQUIPMENT, RELOCATE HOT WATER FROM INTERIOR TO GARAGE. ,.;.FEE SUMMARY: . AMT QTY • AMT 'QTY AMT QTY ISSUE FEE $23.50, , - - Laundry Tub/Washer $0.00 0 • Sump Pump $0.00 0 Backflow irrigation $0.00 ' 0 ' Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventers $0.00 0\ , P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 ' \ Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 • Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) , $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units . $0.00 - 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 , Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 . ' Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 - 0 Water Re-pipe $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 244846(arae) 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 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 insuran required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'co e�}tion nsurance cam number are: Carrier: Policy Number: / \ is section need not be to comple if the pe tis valued at one hundred dollars($100)or less.) l S7! laeHify 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,and agree that if I should become subject to the workers'compensation provisions of Section 37)0 of the abor Code,I shall forthwith comply with these . . Applicant Signature: � Date: \a WARNING:FAILURE TO SEC.- - E COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND L FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST 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 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.IS t �{ fClass M r Contractor's Signature: �(� /i Date: - Y2–)t -C1J 1 \ 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: 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 wit have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,dm 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 ❑No Driver's 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(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: I 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 al 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 requited,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does he willo the oast ou present or future buildingso from at require for the work ontch the sor age c this a pliestion 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? �Yes LU 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 B (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. / �1 ` ' Signature Of Legal Owner(s) k.21� e �V\/�7�`11l U And/Or Authorized Applicant ✓ ate CODE 0 INSPECTION TYPF PAIL ?NUM CODE( INSPECTION TYPE • PAIL UITmAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing _as at 200 Final Re-Roof 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