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Home My WebLink About1152 BUCKINGHAM DR - Building Permits • • ":".%) ` 9, " • CITY OF COSTA MESA 6g BUILDING DIVISION > 4 •.,.,' DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER i "'^�` In • 4. • 602-01662 +ro (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1152 BUCKINGHAM DR Status: ISSUED Suite: 1126 Applied: 10/09/2002 Vicinity: ROOF,BUILDING#1126 Issued: 10/09/2002 Parcel Number: 41208412 Zoning: Applicant: PAINGBURN, DEBBIE ISSUED BY: ±4 :gft___ �� Address: 1007 W GROVE AV Phone: (714)997-9449 ORANGE,CA Zip: 92865 Owner WIMBLEDON GLEN ASSOC L P Address %ARNEL MANAGEMENT CO COSTA MESA,CA Phone: 950 S COAST DR STE 200 Zip: 92626 Contractor: FAIRWEATHER ROOFING INC Address: 1007 W GROVE AV Phone: (714)997-9449 ORANGE,CA Zip: 92865 License: 770565 Arch : Eng: Address: _ Address: Phone: Phone: • Zip: License: • - License: SCOPE OF PERMIT REMOVE EXISTING ROCK ROOF. INSTALL BUILT-UP ROOF SYSTEM.'WIMBLEDON GLEN HOW 2,600 S.F.INCLUDES APARTMENT BUILDING ONLY. • FEE SUMMARY Plan Check: $0.00 • Calc Valuation: $4,862.00 Permit: $111.25 Claim Valuation: $4,862.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 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(w00) DECLARATIONS i ' . ' 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 insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My work 'co�P ensatl Insurance card rand policy number are: > i Carder: '' `(L�� %fl C\ 'S CC). Policy Number:y.) C}c 1 (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify 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 III should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with th rovi ion I Applicant Signature: Date: /C, C/f� WARNING:FAILURE TO SECURE WORKERS' ENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO GRIM TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION T E 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 un er revisions of Cha ter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full forneactlr'sfSigatue S Classat : N� Contractor's 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). Lender's 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 sho 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 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 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 properly,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 Drivel'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,fatsework,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 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 aro 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 ❑No ._ ___.._ .._ l.._...._.._._.....___._..____ _ .._.._..._. 5 Does or will the applicant or present or future building occupant require for the work whichTs the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ___rt of th _ .1000 feel from Will any pan 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). permit fromenD__. l._..___. oed f __.._.....__...t__be_._ 7 If a athe South Coast Air Quality Management Californiaal or other air pollution ooncontrol district03 or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califoia Health and Safety Code Section 42303 been made? ❑Yes ❑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 ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is corect.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. �\ e ?azure OI Legal Owner(s) 1 U!I q pate And/Or A odzed Applicant Date gnu 0 INSPECTION TYPE DAIS INMall CODE! INSPECTION TYPE QAIL KUALA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof Jr' -1-.3--a— 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 - . . 4 51 6 • - CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT ERMIT NUMBER PERMIT B02-01661 4kbePoRmso • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.caus DING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1152 BUCKINGHAM DR tSUI Status: ISSUED Suite: 1124 Applied: 10/09/2002 Vicinity: ROOF,BUILDING 1124 Issued: 10/09/2002 Parcel Number: 41208412 Zoning: Applicant: PANGBURN, DEBIE ISSUED BY: • Address: 1007 W GROVE AV Phone: (714)997-9449 ORANGE,CA Zip: 92865 • Owner: WIMBLEDON GLEN ASSOC L P Address %ARNEL MANAGEMENT CO COSTA MESA,CA - Phone: 950 S COAST DR STE 200 - Zip: 92626 ' Contractor: FAIRWEATHER ROOFING INC Address: 1007 W GROVE AV Phone: (714)997-9449 ORANGE,CA Zip: 92865 License:. 770565 Arch : Eng: Address: Address: Phone: Phone: • Zip: License: - License: SCOPE OF PERMIT REMOVE EXISTING ROCK ROOF.INSTALL BUILT-UP ROOF SYSTEM."WIMBLEDON GLEN HOA"2,600 S.F.FOR APARTMENT BUILDING ONLY. • FEE SUMMARY Plan Check: $0.00 Calc Valuation: 54,862.00 Permit: $111.25 Claim Valuation: $4,862.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 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 it 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 2446-48 WOO) 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 1 work for which this permit is issued. \p—I have and wilI 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 Insure carrier and I number are: c7y-�� • -Carder:' S- C ct`( tAVNLI- % % '�8 CPon un1r Tier.—W CR-7S (_poll ) -fThis'sect/on need-not be completed/t the permit is valued at one hundred dollars(5100)or less.) ❑ I certify 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 la. • of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the-- 'slons., ` -Applicant-Signature:- P , PI rDate"k / 9 nZ- 1YARMNGrFAILDRETO'SECURE WORKERS'COM/ SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLcER TO CRIMINA PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND COLLARS(5100,000),IN ADDMON TO r'E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 he affirm that I am licensed u de,Lprovisips Chapter 9(commencing with Section 7000)of Division 3 of the Busine a P fessions Code,and my license is In full (orrgaADdefact..Lic.N 1 ( b ss'R " o rrac 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). Lender's 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 DMsion 3 of the Business and Professions Code)or that he or she is exempt therefrom end 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 es 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 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 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(38)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 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). ........................_..-.._._..__..._... _..�_..____ ._t. — __.._--..- 2 Dces or will the applicant or present or future building occupant need to file a registration forth for acutely hazardous materials? 0 Yes ❑No (Section 25533of the California Healthcud Safety Codhazardous with some exceptions,to or greater a ewith the u Msso a lumeofDepartment by each,business which al any oneotime has hand ta d rd quantity of acutely ressmaterials 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). __.t...._...._ _ . _...._ _ and.._.e_._._ _ .__.. 3 Does or will the applicant or present or future building occupant need to prepare en RMPP(Risk Management and Prevention Program for acutely hazardous metedals)? ❑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 ❑No . 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a ermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? ILI Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1005-Get 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 ....._._..(I.....yes",..__ach c .____ 8 (II 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. Signature Of Legal Owner(s) /0/ 4/0 L Date nN /gM Orottzed'Applfeant- I ( Date coos L INSPECTION TYPE PAIL 1101A19 900E E BISPEDTION TYPE QAIE EfIIIIALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �J � 208 Final Plumbing 200 Final Re-Roof 1 -f.� 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