HomeMy WebLinkAbout585 BAY ST - Building Permits.; w
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CITY OF COSTA MESA
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05'- s9 BlIILDING DIVIS/ON
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i ,,,,w^ , 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
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�. FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: B09-00111
PERMIT TYPE B_ROOF2
APN: 42213304
JOB ADDRESS: 585 W BAY ST CM
Viciniry:
STATUS:
DATE ISSUED:
ISSUED BY:
, Suite/Unit:
ISSUED
06/23/2009
CAC
Squares: 0 � . - �� Valuation:- ' $5,000.00
SCOPE OF WORK: T/OFF BUR ON A 3:12 ROOF INSTALL 275L6 FELT REPAIR SHEATHING AS NEEDED AND APPLY 30 YR COMP.
SHINGLES � + � �
OWNER: COCKERSELL; STEPHEN EDWIN Address: 585 W BAY ST - " ' � Unit:
PHONE: , , � Ciry/State/Zip: COSTA MESA, CA � -
APPLICANT: CARLOS ENRIQUEZ •.�"� � .. Address: -22365 E6�TOR0 RD , � Unit: :
PHONE: 949-770-7663 � � - - City/State/Zip: LAKEFOREST,CA - � . , .., ?�7 ��G.�,� I
CONTRACTOR: BEST VALUE ROOFING - License No. 678356
Address: 22365 EL TORO RDUnit: � ' � ' PHONE: � � - 949-770d663 - � �
City/State/Zip: LAKE FOREST, CA -' . 92629 - - ' ` � - - - - CELL: - � ,
'ARCHITECT: � � Cicense No. PHONE:
ENGINEER: � - . License No. �PHONE:
�FEE SUMMARY '
Reroof Plan Check: $0.00 j�ti,�� „���`,�
Reroof Permit Fee: $111.25 . - � � � �
Reinspection Fee: ���� $0.00� ". , �� � . - - ' , , ' � '
Bldg Std Admin Fund �$1.00 - � � � ,
r.t;. . . .. Uiti;.
TOTAL FEES $112.25 � - � � � � - �
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Unil; .
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'NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under California staWtes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. �
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
^OOEM. INSPECTIONTYPE DATE INTITIRLS LOOEp INSPECTIONTYPE � .�RT-;�.���,�p IN7ITIALS
��1616 Fized System Final Fire Prevention 206 Final Mechanical
,1266 Pool Spa Final 208 Final Plumbing
�200 Final Re-Roof _�-(� � 210 Final Electrical �'���"
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval ������� -
203 FinalSign 222 FinalSite ^ ; sR;`'�'+'�
204 Final Demo�ition 250 Final Building/Occupancy
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WORKERS' COMPEN$qTION DECLARATION:
I hereby affirm under penalry of perjury one of the tollowing declarations:
❑ I have antl will maintain a certifcate of consen[ to sel(-Insure (or workers'
compensation, as pmvided for by section 3700 of Ihe L.a6or Code, for the
peAormance o( the work for which this permit is issued.
�I have and will malntain workers' compensation insurance, as required by
section 3700 of the Labpr Code, for the performance of the vrork (or which Ihis
permrt "' sued. My workers' compensalion Insurance carrier and policy
erar . ��� ��n�
(Tb Ironneed�rofDerpmp�lejled�(he�pyermdisvaluetlalonehuntlretltlollars(5100)oileSsJ
Pol' y Num . 1 O�l", ���
❑ I certify thal in the pedormance of the work (or which Ihis permit is
issued, I shall not employ any person in any manner so as to become subject
[o [he workers' compensation laws of Califomia, and agree thal if I should
become subject to the workers' compensalion provisions of Section 3700 of
the Labor Code, I shall f ,'P �wply with these provisions.
` 6.a3-o
p icanf na Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT 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 LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
�,�.`�ens '' full forc0 and eHect.
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G ,�- 3 ;�
onlracl ' Sign �
CONSTRUCTION LENpING AGENCV:
❑ I hereby affirtn Ihat there is a consiructbn lending agency for the
peAormance of the work fa which this pertnil is issuetl. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
OW NER-BUILDER DECLARATIONS:
I hereby affrm that untler penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or lhe following reason (Sec. 7031.5,
Business and Professions Code: Any ciry or counry which requires a permit lo
construct, alter, improve, tlemolish, or repair any slrucWre, prior to its
issuance, also requires the applicant for such permit to file a signetl statement
that he or she is licensed pursuant to ihe provisions of the Contractors
License Law (Chap[er 9(commencing vnth Section 7000) of Division 3 of the
Business and Professi0ns Code) or Ihat he or she is exempl therefrom antl
the basis for [he alleged exemption. Any violation of Seclion 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five huntlre0 dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensalion, WILL �O THE WORK, and lhe structure is not intended or
oRered for sale (Sec. 7p44, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builtls or improves
thereon, and who does such vrork himsel( or hersel( or [hrouqh his or her own
employees, provided ihal such improvements are not intended or offeretl for
sale. If, however, the building or impmvement is sold within one year of
completion, the owner-huilder will have the burden of proving thal he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the properly, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRAC70RS to conslruct the projecl (Sec. 7044, Business and
Pmfessions Code: The comrectors License Law dces not apply to an owner of
property who builds or improves Ihereon, and who contracts for such project vnth
a contracta(s) license pursuant to the Contractws License Laws.).
❑ I am exempl under sec.
Business and Professiqns Code for this reason:
SigneWre Dale
305]-46(3/0))
� �.
Owner 10 veri(ied by drivei s iicense. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcalion of Ownership by pype ot document, i.e. - pmperly tax bil�r deed�:
1 �
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certi(y Ihat no excavation fve (5) or more leet in tlepth into which a
person is required to descend, will be made in connection with work authonzetl
by Ihis pertnif, antl that no building strucWre, scaRoltling, falsework, or tlemolition
or dismantling thereof, will be more than thirty-six (36) fee[ high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Cali(omia Administra�ive Cotle).
❑ As owner-builder, I will not employ anyone [o do work which woultl
require a permii from the Division of Industrial Sa(ety, as noted above, unless
such person has a permit to do such work from the division.
AppllcaN's SignaWre Dale
Division o( Indus[rial Safety Permit Number;
HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or tuture building occupant need to Tile antl
certify a Business Plan for emergency response to release or ihreatenetl
release of a hazardous material? ❑ Ves ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, Iha� a Business Plan be fled with the Costa Mesa Fire
Department by every business which has al any one time during a reportetl
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 (ee[ of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or tuNre building occupant need ro file
a regislration form for aculely hazardous materials? ❑ Yes ❑ No
(Section 25533 of lhe California Health and Safety Code, with some
exceptions, requires registralion with the Costa Mesa Fire Departmen[ by
each business which a[ any one time has on hand a quantity of awtely
hazardous matenals equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet ot compressed gas at standartl
temperature and pressure).
3. Does or will ihe applicanl or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program tor acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of ihe California Health antl Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
fling vnth the Fire Department of an RMPP by businesses which are requiretl
ro regisler acutely hazartlous materials vrith the Fire Departmen[.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health antl Safety Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre building occupant require for
Ihe work which is the subject of this applicalion a permil for such consWc[ion
or modifcalion from the Swth Coast Air �uality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the Califomia Govemmenl Code requires [hat the requesteU
infortnation be fumishetl on applications fv non-residential building pertnits).
6. Will any part of the (acility to be constructed under �his permi� be vnthin
1000 feet from Ihe outer boundanes of a school? ❑ Yes ❑ No
(I/'yes", the (aciliry must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Cotle).
7. If a permit from the SoWh Coast Air Qualiry Management District or other
air pollution control district or agency is required for the vrork which is the
subject of lhis application, have all of the tlisclosures prescribetl by California
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. (If "yes", attach certifcate of compliance from the appropriate air pollution
control offceQ.
CERTIFICATE OF COMPLIANCE: I certify thal under penalry ot perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty o( perjury that I have read this applica[ion and state tha[
the infortnation given is correcL I agree to comply with all state lavrs and city
ortlinances'relating to building construction, and authonze representatives of
the Ciry of Costa Mesa to enter upon the above-descnbed property for
inspection purposes. I agree nol to occupy or allow occupancy of any builtling
aWhorized by this permit until fnal inspection.
SignaWreofL Owe Dale
-, 6 ��-� v9
Anm �umonz a oate
OWNEH BBK & H INC V DATE 10-8-74
JOBADDRES$ rjsrj $a� Street BUILDINGPERMITNO. 799
GENERALCONTRACTOR Dike � C018F_POVB VALUE$ B4OOO.00
�or 17 a�ocK TRACT 2315 Single Family Residence
FI
PERMITSISSUED
INSPECTIONS DATE 3UBCONTRACTOR
' _ _ DATE I NUMBER
Foundation Forms and G
/!'Rough Freming y �
(�Plumbing, Rough to SIa6
Plumbing. Rough Comple
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
Sewer �
Septic Tank or Cesspool
Lathing �
Plas[ering
Plumbing, Final, Fixture�
Plumbing, Final GasTesl
Wiring, Final
Occupancy
Form 210 GH lbf 1E�68
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�OWNER BLACK, Jesse A. DATE 7_11-57
JOB ADDRESS 585 w. Bav BU[LDING PERMIT NO. 5�
LOT l 7 TRACT ��'I K PIRE ZONE DESCRIPTION OF WORK
PLAN NO.
INSPECTIONS � DATE I SUBCONTRACTOR
brown coat
Gas Test
PERMITS
NUMBER
,�' `} ostrt Mesa Building Department APPY.ICATIOIV FOit PERMIT
� 1N EAST 20th STREET �O� _B U I�.D_�',_N G_._ _`� �
� COSTA MESA, CALIFORNIA -- - --- -
FOR APPLICANT TO Y+ILL IN � FOR OFFICE US�+ ONLY �
1 Receipt No. Perrriit No. � �
Building I ' S •
address 585 Ba Street � � 5 i. �
R; cefved,by I Date Rec'd. I/ Date'�uld ;
Costa Mesa, California � �_c, ��
Nearest � �� 0 �
Cross St. $8[p11t.0II � Building : ��
Address � �
Owner ��& H Tn�., � Costa Mesa, Ca ornia ;
Mail �
nddress 419 L�'. 17th Sti'eet Nearest ,
Tel. eT j7 Cross St. � �
Cit COStfl Mesa No• R-1159 Zone r No.oi T e I Group ',/
Aroh�tector Lic. ' I P�ans I yP ` � :
Engi�eer l c _Td' No. Appro�ed � �
— by , Date ! �
nddress g593 G,G Blvd,_,GardenGrove ` COYtRECTIONS � '
� City Lic. ,
ConuaetornikeAcCol_e�SOV6 No. � ;
nddresa 419 E. 17th St. , C09ta Mesa � �
Le9al ' Lot I _ I �
oescription � No. 17 � B�ockI3one, Treor2315 ." D- a
i
(Attach Metes and Bounds) – – – � �
No. of Bldgs • - �
SizeofLot 63898.44 I Nowoo�otNone ___ __ .- --- o
Use of I Fam liee I Rooms ������ A
Existing Bldg. – – �
Setback Line from cJQ � � Rear Yard � r'� � - - �- ---� - ' --� – � '- '–"� '- � Z
Center oi Street Side vard 5.,� >
DESCILIPTION OF WORK ---CIT�!=8F-'69$�A-ME�A-�
New I X I Alteration I I Addition I �� �
I..h . .i . �u . � .i �, � <:.... ..�
Repalr I I Moving { I Demolish I
�� Build�ng No.af
� Size _gpuseArg� Rooms rj Storles 1 ,
Exterlor W II Rooi
Cevering �Ll1CC0 I Covering CODlPO. APPR��7��5
Use of New Foundation Location Inspeetor Date
. Build�ng .S1Rg18 family ti2S. Forms,Materials,
Under-Pinning
— Frame: Fire Stops, .
— BraC�ng, Bolts
Lath.lnt.
I hereby acknowledge that I have read this Application
nnd state that the above is corrr.et and egree to compty Lath. Ext.
with all City Ordinxnccs and 5tate Laws regulating
building construction.
Plaster, Int.
Signature of
Perm�ttee
Plaster, Ext.
AutMorized Agt.
asonry Refnforced
Valuation Permit Fee $
Plan Check $ Bond Beam c ,
$ ��� Feeal $L3•Oe� F1NAL G�C�G J.Z-.Za�
..�rm 204 (:- [ lAf 11-43
'1��1�; PI:OTPLAN':i:.i
Show lowtlon and distances Trom
property line and between buildinge.
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COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31�
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
BU I LDI NG
ADORE55
OWN
CITV �dQ
ARCHITECT
OR ENGINEER
ADDRE55
COSTA MESA. CALIFORNIA
NO�
LIC.
NO.
CITV LIC.
NO.
LEGwL LOT
DESCaivnOr+ NO. BLOCK T C
A.P. NO. /S � ^ [/ �
SIZE _� V G FJ I�� NO. OF BLDGS.
USE OF ��J ��_ �[('
EXISTING BLDG L!T�
SET9/�CK LINE FROM /� � /
CENTER OF STREET �i � REAR YARD
NEW
REPAIR
BUIL�ING
SIZE
F
RIGHI�/ S LEFT �—/
DESCRIPTION OF WORK
ALTERATION A�DITION
MOVING �EMOLISH
^ � ) NO.OF
J o� ROOMS STORIES
`�TUCG�� COVERING (//�"/•V •
ST�TE TMnT TNE .�BOVE IS C(
CITY OHOIrvaNCES ANO STFTE
TION.
E ECEIVED
� �'-j /�_$�� 9'�
FINAN DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
PECEIPT NO. yGN1.
�
C�I . BY O�TE RECENE aTE ISSUEO
` // � /\
BUILDING rS �� / / �
ADDRE55 e� �
COSTA MESA. CALIFORNIA
FIRE
ZONE / /
BV
BY
(.IjR7'G. DATE � �//�
CORRECTIONS
CITY OF � TA �4E�A
\ V r Y
SUBJECT TO B G. DEPT. REG.
wNO f�GREE TO COMVLY WITH �LL �
REGULATING BUILDING CONSTRIIC-
VALl1AT10N 1�
OQ PERMIT FEE S P ��
� �� % � PLAN CHECH $ �O �
g O�
TOTAL FEE S � �
9""
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