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Home My WebLink About260 19TH ST - Building Permits . ' MCITY OF COSTA MESA - . .. I 9 , BUILDING DIVISION Y:<•,,,• ' t•"k DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER rt . PERMIT t B03-01718 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 260 E 19TH ST Status: ISSUED Suite: Applied: 10/06/2003 Vicinity: ROOF Issued: 10/06/2003 Parcel Number: 42628117 Zoning: • Applicant: WHITNEY, ROBERT ISSUED BY: Address: PO BOX 15396 - - Phone: (949)548-0769 NEWPORT BEACHI;=CA- Zip: 92659 Owner: HANSON,HAROLD 0 Address 262 KNOX PL Phone: COSTA MESA;CA" ., • - - Zip: 92627 Contractor: WHITNEY ROOFING Address: PO 15396 ' "7/ Phone: (949)548-0769 NEWPORT BEACH,CA Zip: 92659 : Licenser 406022 Arch : - _ Eng: Address: , ., Address: < Phone: Phone: Zip: ,- License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF.INSTALL 15#FELT,30 YEAR COMPOSITION SHINGLES AND REPLACE SHEATHING AS NEEDED.24 SQUARES INCLUDES DUPLEX WITH ATTACHED GARAGES. • FEE SUMMARY Plan Check: $0.00 =" - _ • Calc Valuation: $5,910.00 Permit: $125.25 , ... . - Claim Valuation: $5,910.00 SMIP Res: $0.59 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 • Total: $125.84 - 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 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 2446-46(6/00) • DECLARATIONS �1 WORKERS'COMPEN •TION 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 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 Insur c arrler and policy number are: "teat) ) Cartier. i (. Policy Number:. "T'W I'r//, (This section need not It—canted if the'permit is valued at one hundred ars($100)or less.) r r -- ❑ I certify that In the performance of the work for ch this permi ' ssued,I shall not employ any person in any manner so as to become su ' ct to the workers' compensation laws of California,anthill atif I ould e subject to the workers'compensation provisions of Section 3700 of th bor Code,I shall forthwith comply with these provisions?'/ IAppllcant Signatures ' WARNING:FAILURE TO SECURE WORKERS' PENSA COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES D CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($l00,o)0),IN ADDITION TO THE COST OF COMPENSATI• ,. GES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE.I EREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Ch:.ter 9(comm: i with Section 7000)of Division 3 of the Business and Profesy�iions fe,and m cense Is in full force-arid effect.Lt. .-�� r,e• 1..j� Class#-' CY'l K,A 1 Contractdr'ISlgnature: C"wr _ Date:--- lb es 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,end 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 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 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: • 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 hes 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 this 5 Does or will the tcAir or city a or future building occupant at y other for the work which is the nor of thia estion a aNnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes �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 AUTHORIZATIO 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 wand ci rdinances rel ling to building construction,and authorize representativ of the City of Costa Mesa to enter upon the above-described property for ins purpos agree not to py or allow occupancy of any building authorized by this r mit u til final inspection. Signet a ner(s) fM `_Date Odduthdrized cant ODE I1 7NSPECTIOHTYPE PATE INRTIALS CODE! INSPECTIONTYPE - PSI€ IRI& 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1008 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof (1;/ O 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 1 _ 7926 (FEE kicavE® / 1/13/si COSTA MESA BUILDING DEPARTMENT FIN NICE DEPT P.O. 317 CITY Ca cm COSTA MESA.A. CALIFORNIA , FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ADD BUILDING 2 .(p 0 t /7 f'E',�`, BUILDING (}� 777 ///C��OSTA MESA. CAL ORNIA FOR OFFICE USE ONLY 1 /2/• /p• 4 QRECEI NO. PERMIT NO. I\ OWNER ////��./`v /7 //. ` \(�� MAIL / YO // 44-e. ),:r#0,..K-- /� EI� / 'E V. �\ADDRESS 77 J V G'�l�./�- TEL. BUILDING �. e_ CITY (Je �1Lexa-- NO. ADDRESS ARCHITECT LIC. li OR TER NO. COSTA MESA. CALIFORNIA FIRE ADDRESS ZONE 1 ZONE NO. OF 4.....TYPE 7P/6/ CITY LIC. PLANS CONTRACTOR NO. '�//p TEL. APPROI%� / '`� ADDRESS NO. BY DATE LEGAL I LOT +/� CORRECTIONS DESCRIPTION NOO. // q5 BLOCK �J TRA /7 A.P.NO. // V / a, — 2-b SIZE / ° NO.OF BLOGS. OF LATA t 1„. a V// NOW ON LOT7--'-- USE �(''¢�'j��j 'OF 1.--. �a�l`C-/' .�t �.ey'y EXISTING BLDG. ✓Ly (;�(s� !`l SETBACK LINE FROM / .J' C CENTER OF STREET sec SIDE YARD RIG ( Al GO O4'4Qt. �. A DESCRIPTION OF WORK U•S,( 'NON G. i) ' `.�1 NEWALTERATION ADDITION `M/ �v..\ op1 ' REPAIR MOVING DEMOLISH K - QV'' BUILDING NO.OFdcej • N'(�LV``,, ' SIZE ROOMS STORIES pK EXTERIOR WALL ROOF yy,pp v ! •^/,� COVERING .. COVERI NCff ( \ T/ �(- ////// USE OF NEW i`'�/�/ ' // /e'/ � BUILDING �/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STA E LAWS REGULATING BUILDING CONSTRUE TION. VALUATION Vj QQ SIGNATURE OF _ may. �`— .. PERMIT FEE S 0t- i PERMITTEE [•�✓� 3/O' PLAN CHECK S deo 4,/a S AUTHORIZED AGENT TOTAL FEE $ a ge� a "IMF 10558 k COSTA MESA BUILDING-SAFETY DEPARTMENT /� ) 7 U IL P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. rrry Oc me?A MESA , FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING 'y&c y _ / (� '(\.o ADDRESS �G: COSTA MESA, CALIFORNIA — 'FOR OFF/CE USE ONLY ea fi _k r. I RECEIPT NO. •.. 1, .7�PERMIT-,7–� OWNER (BCW/ MAIL RECEIVED �BY� DATE RECEIVED ' A. 7/2 DATE ISSUED ADDRESS •.3.-.0---71..4–C-1 ///7:2'2Ca /O /P�, 1 0 – Chl CITY NO. ADDRESS • ARCHITECT LIO. COSTA MESA, CALIFORNIA), ` , ORI NEER NO. 11 ADDRESS FIRE ZONE TYPE 4/ GROUP / CONTRALTO STATE APPROVED )• E/1)/ � ,� LIC.NO. BY Ad DATE } )4O 2•NING i ADDRESS `�' LEGAL LOT r�•''dyGRCAa ZONE ("��INO.OF (USE OF NEW •J) DESCRIPTION I NO. I I BL�JOCK •� TRACT /� PLANS BUILDING V(Cr/C'iO A,P.NO. P .�}7 /- O"�j BYAPPROVED, / DATE /��1 SIZE 3 ,I , 3 s / I NO.OF NOW FN LOTS YARDS !/ EVES I . OF LOT F REQUIRED ALLOWED USE OF (CENTER LINE ST.)L EXISTING BLDG. - FRONT c.Jel) FT. IN, o ' SETBACK LINE FROM CENTER OF STREET REAR Y•• ,AR // R.SIDE /.8 FT. IN. SIDE YARD I LEFT I RIGHT t��c y- .]L.SIDE FT. IN. • DESCRIPTION OF WORK �j ✓// REAR Or FT. IN. NEW I ALTERATION I II ADDITION I .r; REPAIR I II MOVING I II DEMOLISH I L BUILDING DING '1 �'v 3 7 ROOMS STORIES NO.OF \I EXTERIORWALL /�1 !! 7G ICOVE II - __ ' COVERING l/ COVERING 0.--f-rill, i USE OF BUILDING AND WORK TO BE PERFORMED y/ 44/'4 " ., I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN Eft VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT REE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING . BUILDING COOJlTQUUCTION. i .yam VALUATION c '‘ PIGNAUO TRE . 1 PERMIT FEE $ 37, PERMI TRh ) fir RJ1 J' �/� :j 44 $ // YZ']/•'� PLAN CHECK $ �/ ' 4".11 AUTHORIZED AG1EN�' ) -,...„_C ' TOTAL FEE $ C U •v L] E. 1 15194 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT �}'' MG 261961 P. O. BOX 917 COSTA MESA. CALIFORNIA f FINANCE DEPT. \ For Applicant fo Fill In Completely AP idAJI-OgnFOR11? R1vIIT TYPE OR PRINT �. BUILDING // BUILDING )) ADDRESS pGIOO F. I�( ST \ r COSTA MESA. CALIFORNIAAFor Office Use Only OWNER JAMES E. gMcEi na � I R7EiHCeIgPTc�NOg.D I 1 C.1T NOy. • ADDRESS /�(.0 a Mi ( s r I REce , (tf �I /2�5C�jiG f I �f'I11 Ni, (�'17G , LL CITY cas'rn /'1 g R NO. -I S-CilrI ADDRESS .207 0 L/ . / 9 ARCP'•'ECr TEL. 1� COSTA MESA. CALIFORNIA OR NEER NO. ADDRESS FIRE • ZONE TYPE GROUP • CONTRACTOR SELF APPROVED //\ DATE el ) ADDRESS , ZdI ING CITY ZONE /1 ,_NPO.OF I BUILDING ✓✓P'll ,y-/ y,�' STATE I _ STEL. DESCRIPTION .4-4- T/ SIZE / 2 ` NO. OP BLDG/3. OF LOT (,d, ' K i�, Now ON LOT ' A.P.NO. / / — /3/ a l0 USE OF YARDS EVES EXISTING BLDG. Ras. Do Pa y APPROVED ALLOWED SETBACK LINE PROM (CENTER LINE ST.) CENTER OF STREET REAR YARD FRONT Se FT. IN. SIDE YARD I LEFT I RIGHT R.SIDE / CFT. IN. DESCRIPTION OF WORK L.SIDE •a//FT. // �`��N^.�']j/1✓l� NEV I .4 H ALTERATION I II ADDITION REAR FT. L p IN. REPAIR / I II MOVING I II DEMOLISH I APPROVED&( 1�I DATE�Q -�.5-'!0/ BUILDING ING 1., IL' NO. OF �,(f IY at /� {7 Q/ ROOMS STORIES COVERINGEXTERIOR WALL{ /} TEF I COVERING USE OF BUILDING AND WORK TO BE PERFORMED LATtf N-ovsE— 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 OP ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONS n VALU TIONell SIGNATURE OF //�//�Jj,yA' - PERMIT FEE 9021PERMITTEE V B $502a2 PLAN CHECK $ AUTHORIZED AGENT �1 p TOTAL FEE $7� 0