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Home My WebLink About972 17TH ST - Building Permits� '� � CITY OF COSTA MESA -- BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 APN: 42437109 JOB ADDRESS: 972 W 17TH ST CM Vicinity: UNITS A AND B ROOF Squares: 1292 PERMIT NUMBER: 609-00043 STATUS: DATE ISSUED: ISSUED BY Suite/Unit: Valuation: ISSUED 03125/2009 RMD $3,894.00 SCOPE OF WORK: REROOF DUPLEX ONLY, UNITS A AND B. TEAR OFF (E) ROOF MATERIALS, INSTALL 2 LAYERS OF 15 # FELT ON A 3:12 PITCH�D ROOF AND REROOF WITH 20 YEAR OWNES CORNING CLASSIC COMP SHINGLES ON DUPLEX ONLV, APPROX 1Zg2 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: SqLCIDO, DAVID L . , PHONE: 949-548-0358 APPLICANT: LI�BHERR, THOMAS . , � PHONE: 714•841-0456 � CONTRACTOR: PRIMO ROOFING CO Address: 17066 PALMDALE STUnit: CitylStale/Zip: HUNINGTON BEACH, CA 94627 ARCHITECT: ENGINEER: � FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund TOTALFEES $0.00 $97.25 so.ao $1.00 $98.25 Address: 954 W 17TH � � � City/StatelZip: COSTA MESA, CA Address: 17066 PALMDALE ST , City/State/Zip: HUNINGTON BEACH, CA � . � . �. -� " �� License No. - .331120 PHONE: 714-841-4456 CELL: License No. PHONE: License No. PHONE: Unit: Unit: : NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 oblained. Failure to obtain inspections and final approval will resull in the expiretion of this permit. COOE1. INSPECIIONTYPE D� N �l COOE/ INSPELiIONTYPE D� IN TIRL 7676 Fued System Final Fire Prevention ///�� 20fi Final MeUianical 7288 Pool Spa Fingl � 208 Final Plumbing 200 Final Re-Root 2.3 210 Final Electrical 201 Fina7 BIocWRetaining Wall 212 Final Fire Preveniion 202 Final Faclory Fire Place 220 Final Planning AOProval 203 Final Sign 222 Final Site 204 Final Demolilion 250 Final Building�Otcup2ncy j . . WORKERS' COMPENSATION DECLARATIO . I hereby aKrm under penalty o( perjury one of Ihe following deGarations: ❑ I have and vnll maintain a certificate o( consenl to seli-Insure for workers' compensation, as providetl for by section 3700 of the Labor Cotle, (or the peAormance o( the work for which this permil is issued. ❑ I have and will maintain workers' compensation insu2nce, as required 6y section 3700 of the LaDor Cotle, fw the peAortnance of Ihe w�rk for which this pertnit is issued. My workers' compensation Insurance wrtier and policy number ar�e:c�-r Carrier:. v / ��T� /c%i/i✓A �-- (Tnh seaian need nor ba mnpetetl✓tl�e perma a.mlueo al ma n�nwM mtlars (f f001 a ku.) �c'y'Number: �(G'S7S7lv —aOO� ❑ I ceAify ihat in [he pertormance ol the work (or which Ihis permit is issued, I shall not employ any person in any manner so as to bewme subject to the workers' compensation laws of Califomia, and agree that if I should become subject to the vrorkers' compensation provisions of Section 3700 0l th �ab� all fprthwit co with these provisi s. � 3 �?S O MWi. .�� 'pnowre (-Dale, l_ - . WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LP,BOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrtn lhat I am IicenseC under provisions ol Chapter 9(commencing with Section 7000) ol Division 3 ot the Business antl Prolessions Code, antl my license is in (ull force and eNect. �ic.:tt-�' 33—J/� a (— `'C�ass tt C`3 /t,�___/rrlyst�J �/� �3 .� O �5 iB��ure ' Dale_ � , _ � �. CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that Ihere is a construction lentling agency for the peAortnance o( [he v.ork for which this pertnit is issued. (Sec. 3097. Civil Code�. Lender's Name: Lender's Atldress: SignaWre Date OWNER-BUILDER DECLARATIONS: I hereby affirm [hat under penalty o( perjury thal I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or the following rea5on (Sec. 7031.5. Business and Professions Cotle: Any city or counry which requires a permit m constmct, alter, improve, demolish, or repair any slrucNre, prior to its issuance, also requires the appliwnl for such permit to f le a signed statement Ihat he or she is licensetl pursuaN to the provisions of the Contractors license Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code) or that he or she is exempt lherefrom and Ihe basis for the alleged exemption. Any viola�ion of Section 7031.5 by any appliwnt for a pertnit suDjects the applicant lo a civil penalty ol not more than (ve hundred dollare ($500�.�: ❑ I, as ovmer of ihe property, or my employees with vrages as iheir sole compensation, WILL DO THE WORK, and the structure is not intentled or ofleretl for sale (Sec. 7044, Business and Professions Cotle: The Contractore License Law does not apply to an owner o! property who builds or improves thereon, antl who tloes such vrork himself or herself or through his or her own employees, provided Ihat such improvements are not intended or oftered lor sale. If, however, the builtling or improvement is sold within one year o! completion, Ihe ovmer-builder vrill have the burden of proving that he or she tlid not builtl or improve for purpose of saie.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS to conswct the project (Sec. 7044, Business and Pro(essbns Code: The cont2ctors license Law dces not appty to an ovmer of property who builtls or improves thereon, and who contrads for such project vrith a contracta(s) license pursuant to the Comractors License Laws.). ❑ I am exempt under sec. Business and Professi0ns Cotle for Ihis reason: SignaWre Da�e 305]<6�Y0]� ` O�mer ID.verified by drive� .. ncense. ❑ Yes ❑ No Driver's License No. Expires: � � Verification of Ovmership by (type of documenl, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cerlAy that no excavation frve (5) or more (eet in tlepih inro wfiich a person is requiretl to descend, will be matle in connection vrith v.ork authorized by this pertnit, and that no building sWCWre. scaffdding, false.wrk, a demWitbn or tlismantling thereof, will be more than thirty-six (36) feel high. (Chap. 32. Grp 2, !vt 2, Sec. 341, Title 8, Califomia AOministrative Code). ❑ As owner-builtler, I will not employ anyone to tlo v.nrk which would require a permit from the Division of Industrial Safery, as notetl above, unless such person has a permit to do such work from the division. Appiwnfs SignaWre Dale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. WIII lhe appliwnt or present or fuWre building occupant need lo file and certify a Business Plan !or emerqency response to release or threatenetl release ol a hazartlous material? ❑ Yes ❑ No (Seclion 25505 of the Califomia Health and Sa(ey Cotle requires, v+ith some exceptions, that a Business Plan be fled vnth the Costa Mesa Fire Deparlment by every business which has at any one lime tluring a reported year a quantity of hazartlous matenals equal lo or qreater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl lemperature and pressure). 2. Dces or will the applicant or present or fuWre building occupant need to 61e a registration form for acutely hazartlous matenals7 ❑ Yes ❑ No (Section 25533 of the Califomia Health antl Salery Code, with some ezceptions. requires registralion with the Costa Mesa Fire Departmem by eaCh bUsine55 whiCh at any one time has on han0 a quantity O( aculely hazarCous 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 temperaWre and pressure). 3. Does or will Ihe applicant or present or fuwre Duilding occupaN neetl to prepare an RMPP (Risk Management antl Prevention Prog2m for acutely hazardous materials)? ❑ Ves ❑ No (Section 25534 of Ihe California Health and Safety Code provitles ihat the Costa Mesa Fire Department may require the preparation, certifiwtion and filing with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Cali(omia Heallh antl Safety Code been lully complied with? ❑ Yes ❑ No 5. Does or win the applicant or preseN or fWure builtling occupant require lor the work which is the subject ot this appliwtion a pertnit lor such wnstruction or modification from the South Coasl Air Qualiry Management District or (rom any other air pollution control district or agency? ❑ Yes ❑ No (Section 658502 0! the Califomia GovemmeN Code requires ihat the requested information be fumishetl on applications fa non-residential huilding permits). 6. Will any paA of Ihe lacility to be constructetl under this pertnit be vnthin 7000 feet from the ouler boundaries of a school? ❑ Yes ❑ No (It yes', �he facility must meet the requirement of Sections 25534 antl 42303 of ihe Califomia Health and Salety Code). 7. I( a pertnit from the South Coast Air �uality Management District or other air pollution control dislricl or agency is required lor the work v+hich is the subject of lhis applicalion, have all of the disclosures prescnbetl by Califomia Health and Safety Code Seclion 42303 been matle? ❑ Yes ❑ No 8. Qf'yes", attach certificale of compliance from lhe appropriale air pollution contml o(fcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury ihe information given above is correcL I agree to compty with all state laws and city ortlinances regartling Hazardous Materials antl Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify untler penalty of perjury that I have read this appliwtion and state Ihat the information given is correcl I agree to comply wit� all state laws and city ordinances relating lo building construction, antl authorize representalives of the Ciry o! Costa Mesa to enler upon the above-0escribeC property for inspection purposes. I agree nol to occupy or allow occupancy of any building authorizetl by this permit until final inspection. / ignaWre ol Lenal�s�� Da�e r� 3/a.�/d 9 1—AnOlor Aul nze AOO��nl �"—Date