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Home My WebLink About370 19TH ST - Building Permits' 4 BUILDING PERMIT Job Address: 370 E 19TH ST Suite: Viciniry: RESIDENCE AND DETACHED GARAGE Parcel Number: 42630118 Applicant: ALAJON, RICHARD , Address: 25672 TALADRO CIR , � . SUIITE E MISSION VIEJO, CA - � Owner: HART, GARY WALDEEN TR. Address . 370 E 19TH ST - COSTA MESA, CA " Conuactor. JA ROOFING Address: 25672 TALADRO CIR SUIITE E � MISSION VIEJO, CA Zip: 92691 Arch : Address: � Zoning: Phone: 949-481-8917 Zip: 92691 Phone: Zip: 92627 Phone: 949-481-8917 License: ' 735404 , Eng: � � Address: Phone: Status: ISSUED Applied: 02/17/2004 Issued: 02/17/2004 ISSUED BY: � Phone: Zip: , License: License: - . SCOPEOF PERMIT . TEAR OFF EXISTING SHAKE ROOF, INSTALL SHEATFiING AND COVER WITH 40 YEAR COIviP SHINGLES. Plan Check: Permit: SMIP Res: SMIP Com: , Other. Inspection: � , Total: $0.00 $11125 $0.50 $0.00 $0.00 $0.00 SETBACKS MAIN STRUCTURE Front 0- 0" ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY Calc Valuation: Claim Valuation: PLANNING & ZONING Left� 0-0 Right 0-0 Left 0- 0 Righl 0- 0 PrOpOSEd: 0 3a,5oo.00 54,soo.o0 NOTICE: The work authorizad 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 conslderetl lagal, such work must comply with all applicable codes, and all requlred inapectlona end (inal approval must be obtained. Fallure to obtain inspections and (inal approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 !yye.ye Igpp� - . . WORKERS' COMPENSATION DECLARATON: � � , I hereby effirtn under penalty oi perjury one of the tollowing tleclarations: ❑ I have and will maintain e cenificate of consent b self-Insure for workers' compensetlon, es providetl tor by section 3700 of the Lehor Cotle, for the pedormanca ot Ihe work tor which this permlt is issued. - I have erM will main�ain workers' compensation insurance, as requireU by section 3700 ot Ne Labor Cotle, tor tha peRortnance of the work tor which Nis pertnit i5 issued. My workerys' —cnompensdtlon I!nsu,r�nca cerner end% ollcy number ere: 9 /7�{ Cerrier. �l ll � l"(�{Nli �/1/��i��%�i� PoliCyNumber �O.SiS iYQ� (This section need nof be comple(ed /! fhe permit /s valuetl af one hundretl dollars ($100) or less.) , � M ❑ I certity that in the performance ot the work or which ihis pertnit is issuetl, I shell not employ any pereon In eny menner soq� to become subject to the workers' compensation lews of Cali ,�}mia, e d agr thet I sry uld Cec na sub�ect to t�e warkers' campensetion provisions of Secqon 3700 t the � Code, I shall forthwit� �complY�with�these.p�vis' � k. , /� I I � � �� e Applicent SigneNre_ Date: li WARNING:FAILURETOSEC EWORNERS'COMPENS/ ONW' RA�EISUNLFWFULANDSMAlLSUBJECTANEMPLOYERTOCRIMINALPENALTIESANDdVIIFlNESUPTOONEHUNDRED TqUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF MPENSATION, ONAAGES AS PPOVIOED FOR IN SECTIIXJ 31O60F THE UBOR WDE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby alfirm that I am licansetl under provisiSins of ChaBter 9 to¢e antl eHect. Lic. q n i /l n// � 7000) of Divislon 3 ot the B Class a oace: antl my license is in tull CONSTHUCTION LENDIN4 QGEMCY: ❑ I hereby aHirm that there is a constructlon lentling agency tor t�e pertortnance ot the work lor which this pertnil Is issuetl. (Sec. 3097, Civil Cotle). Lentlers Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLAqqTIONS: I hereby aflirtn that untler penalry oi perjury Ihet 1 em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business end Professions Code: Any ciry or counry whi�h reQuires a pertnit to consiruct, elter, improve, demolish, or repair any swcture, pnor to its Issuance, elso requires the epplicam for such pertnit m file e signed statement th�t he or s�e Is Ilcensed pureuem to Ihe proNslons of I�e Contreaore License Lew (Chepter 9(commendng with Section 7000) 01 Divislon 3 of the Business and Protessions Cotle) or �het ha or she Is exampt therefrom and the basis lor the alleged exemption. Any violation of Sectlon 7031.5 by any epplicant tor a pertnit subjecis the epplicen� �o a clyil penelty oi nat mare ihen five hundretl Oollars (5500)J: ❑ I, es owner of the properry, or my employees with wages as their sole wmpensaiion, WILL DO THE WORK, antl Ihe siructure Is not intended or otterad tor sale (Sec. 7044, Business end Prolessions Cotla: The Coniractors License Lew tloes not apply to an owner of properry who builds or improves thereon, and who dces such work himself or herself or through his or her own employees, provi0etl Ihal such improvemenls ere not Intended or oHered for sele. I(, however, ihe buifding or improvement is solA within ane year at completion, the owner-huilder will have Ihe burtlen of proving thai he or she ditl not build or improve for purpose ol sale.). ' ❑ I, as owner of the pmperry, am E%CLUSIVELY CONTRACTNG WIT}I UCENSED COMRACTORS ro construct the project (SecJ044, eusiness and Professians Code: Tlie contrecrors Llcense Lew tloes not epply to an owner of property w�o bullAs or Impmves thereon, end who wntrects for such project with a contractor(s) license pursuent to the Contrectors License LewsJ. ❑ I em exempt under sec. Business end Prolessions Code tor this reason: Signature: Date: Owner ID verifietl by drivefs license. ❑ Ves ❑ No Drivefs LJcensa No. Expires: Verificetion of Owners�ip by (type oi document, i.e. � pmperty teu bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATION: ❑ I hereby certify thet no ezcavation five (5) or more feat in depth into which e person is required to descend, wlll be metle in connection with work euthorized 6y this permit, end that no builtling structure, scaftolding, telsewotk, or demolition or dismentling theteol, will be rtrore than thlrty-six (36) �eet high. (Chep. 3.2, Grp 2, Ar! 2, Sec. 341, Ttlla B, Califomla Adminisiretiva Code). ❑ As owner-builder, I will nat employ enyone �o do work whlch woultl requlre e permlt from the Division of Industrial Safety, es noted above, unless such person hes a permit to do such work Imm ihe division. Signature: Dete: Division ot Indusirial Safery Permit Number. ARDOUS MATERIALS qND EMISSIONS CERTIFICATION: WIII Ihe epplicant or present or tuture buliding occupent neetl to tile end certlty e Buslness Plen for emerBency response to release or ihreatened release of e hazardous meterial? ❑ Yes ❑ No (Section 25505 of the Celitomia Health end Sefery Cotle requlres, wilh some e:ceptions, that a Business Plan be filetl with the Costa Mesa Fire Department by every business which hes at any one time during a reportetl year a quantity of hezardous materlals equel to or greeter then e weight ot 500 pountls, or e volume oi 55 gallons, or 200 cubic feet ot compressetl gas at standard tempereWre and pressure). ................................................................................................................................................................................................................................................................................._._..... ....................... ......................_......................._. Does or will Ihe applicant or presem or tuture builtling occupem need to file e registretion torm for ecutely hazerdous materials? ❑ Yes ❑ No (Sectlon 25533 of Ihe Gelifomle Healih and Sefery Cotle. wich some exceptlons, requires registretlon wlth the Costa Mesa Fire Depertment by each Duslness which et eny one time has on hentl a quentiry of ecutery herardous metedals equel to or greeter then e weight of 500 pounds, or e volume o1 55 9allons, or 200 cubic feet of compressatl gas at stendard tempereture end pressure). ................................................._.._......................................................................................................................................................................................................................................................................................_.............................. Does or will the applicant or present or IuNre building occupant neeU Io prepare an RMPP (Risk Manegemenl and Prevention Program tor acutely hazartlous matenals)7 iection 25534 ot epanment ot en .................................... en RMPP is ore: ol the A the Caste Mesa Fire Department may requlre the preparetion, certification and filing with the Fire ecutely hezertlous matedels wlth ihe Fire Department. 5 Does or will fhe epplica�� or present or tutura Eulltling accupenl requlre for Ihe work which Is ihe suh�ect oi tNs e plicatlon a�a rtnit for such construction or trom Ihe Soulh Goesl Alr �ualiry ManeBement Districl ar from eny other elr pollutian control Alstrict ar egenc�? � Ves �J No (Section 658502 of the Califomia Government Code requires Ihat the raquested infortnatian be furnishetl on eppllcations br nomresidential builtling pertnits). .................._................_.._...................,_..................................................................._............................_._............................_........................__'_'..................................._.._ .._..........._......................................._ 6 WiA any part of the faciliry to be consiructed under this pemuf be withln 1900 feet fmm ihe outer boundades of a schaol4 O Yes ❑ No (If'yes", lhe faCility mUst mee� �he requlfement of Section5 25534 antl 42303 ot the Calitornie Heelth end Setery Code). ............._....._..........._........................�...................................._....................................._.............................___.....................__..............................................................................._..._...................._................_.............. 7 If a pertnit fmm the Squth Coest Air Quality Menegement DisMct ar other elr polWtlon control district or egency is repuired for Ihe wark which is the su application, have ell ol the disclasures prescrlheA by Celllornla Health end Selety Cade Sectlon 42303 been maAe7 ❑ Yes ❑ No pf yes', atlach certiticale ol compliance irom the eppropriate eir ponutlon controi orciceq. � CERTIFICATE OF COMPLIANCE: 1 cetlify t�at untler penalry ot Derjury the InlormeUon given above is wrrecL I egree to comply with ell slate laws and dry orCinancas regarding Hassrdous Metenals and Emissions. Signature: Date: CERTIFlCATE OF COMPLIANCE AND AURiORRATION OF EMRY: I cenify under penalry oi perjury that 1 have reaG this application entl state that the intormation given is conect. I agree to comply with ell staie laws end city ordlnences relating to bull0ing consiruction, end aut�orize representatives of the Ciry oi Costa Mesa Io enter upon the ebove-described property for inspection purposes. I egree not to occupy or allow occupency of eny building euthonzed by this pertnit until tinal inspection. 400E �. 7616 1266 200 201 202 203 204 INSPECTION TYPE Fixed Sysiem Final Fire Prevention Paol Spa Finel Final RaRooi Final BIocWRetflining Wall Final Fadory Fire Piace Final Siqn Final Demolition ' PAIE 1NiIDeLi I . i. ir • � � FOOE� INSPFCTIONTYPE 208 Finel Mechenical 20B 270 212 220 222 Finel Plumbing Final Electrical Flnal Fire PrevenHon Final Planning Approval Final Site Final 8uIl01ng/Occupency Date Date QAiE II�L4 Costa Mesa Suilding Department APPLICATION FOR PERMI� ' � 111 EA8T 20th STREET ��j g U I L D �� N G � COSTA MESA� CALIFORNIA ' "�^�� •• FOR O&'FICE USE ONLY II�'OR APPLICANT TO FII.I. IN Receipt No. Permit No. Building ry C ,/ Addresa ( � � � � T/ Costa Mesa, California Recetved by te Rec' . � Data Issued Nearest � " 7 _� � Cross St. �� _ Addrass 3 7� � � 9 ` '�`" � . Owner G-. F Costa 1VIesa, California � Mail Address � Nearest I11tCCL OI' y �Ineer ./ie�. Iress � tractor Iress %'L o-N. / Lega�l L'ot :cription � No. ,S tach metes and Bou Size of Lot J 2 X� J) Use oi Existing Bldg.� -y Setback Llne from Center ot Street S O� DESCRIPTI( New li� I Alteral Repair I I Moving Building _, � _ , � Tel. No. —Lic. ` No. L � � No. of Bldgs .y„ty Now on Lot No.ot , I No.ot Side APPROVALS m Lxation I InsP�o� Materials, I hereby ackRowledge that I have read this Application LatA. Int. and state that the above is correct and agree to comply Lath. Ext. with all Clty Ordinances and State Laws regulating building construction. Signatureof �� Plaster,lnt. Permittee � � - p�aster. Ext. Valuatfon� � � � ermitFee $ y Plan Check $ $ �� Total �- = Fee $ eneu ona n.0 eM 5-56 - Date �, _ ; � ;; � J o. 0 � a �^ 'ti � C""" r.� �^� It � �� '� i`� _� .. � �S.+F .'�.=.�' : '� E .r, ..... _ . . .. . � �': ��.'.'17 4• . r� Street i, �• Show locatlan and distancea from property Iine and between buildinga `.�- � ...',._j_ ,-�_ -- - _ _ _-_ _'_ . . . _ -'- ..... . _ __ ' ' � . . .. � - �..,' ti �� . � . � .., • _ _ '• COSTAMESABUILDINGSAFETVDEPARTMENT APPLICATIONFQ� R CT ALPERMIT �� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 � r�� TL RECEIVEDBV PERMIT N° � 51353 � � �� For AppGcant to Fill in Completely — Use Ink Only � BUI�DING / .L/1 _ A.P.NO. 4`�� A O D R ESS CJ�CJ BUILDING � D / t OWNER OR �C � AODRE55 TENANT MAILING UNIT OR ADDRE55 SPACE NO. - TR.NO w LOT�_r lO�� BLK. TEL. 4� �, CITV NO. CANSTRUCTION NEW ADD LTER 0.EPAIR MOVING DEMOLISH LENDER � BRANCH /� - OWNER �`f��/eJ'F' \ ADDFESS VALUE ARCHITECT TEL. USE ��(,(��)(�(,� $ (� 1 . OR ENGINEEfl � O ADDRESS ZONE TVPE GROUP APPROVEO � CONTRACTOR BV DATE � ADDRESS TEL. CITV NO. � F STATE qTV P.P7ROVEDSETBACKS � LIC. NO. LIC. NO. {s,� SIZE NO.OF BL�CS. (FROM �Cj/L STREET) CL OF LOT NOW ON LOT ONT l FT. a USE OF '� EXISTING BLDG. � F , � � - - F Separate permits are required for L. SIDE s�r. electric, plumbing and heating work. !\ � REAR � FT. \ 1 F USE OF BUI�DING AND WORK TO BE PERFORMED PLANNING ACTION �� Q r DATE APPROVED � .3 � C_.ommu u � T � sr n'� o" C�.S Z o r a a w pI hereby acknowletlge ihet I hava reatl this application antl state � a! chat the abova information is correct and a8�ee to comply with �+ all laws regulating builtling cons<ruciion, and I shall not amplay Z any person in violation of the workmen's compensation laws of . � ffie Stata of Califomta. � ,� I hereby certify ihat I am properly licensatl as e contractor untler Sn' FT• � the Stata of California 6usiness antl Professions Cotla, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chaptar 9, antl that such licenses are In full force antl effect, or I THE PURPOSE OF ESTABLISHING A PEfiM1T FEE ONLV: � am exampt from the provisions of tha Stata of California Business VALUATION � and Professions Cotla, Division 3, Chepter 9. PERMIT FEE S .� N n Signature of � i PLAN CHECK S o Permittee l $ / � or / _�. J TAX S � Authorized Agent Date l� �� V TOTALPAID §