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Home My WebLink About1008 NANCY LN - Building PermitsA 4 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT t q� PERMIT PERMIT NUMBER • "+�ow�dP B98-01395 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1006 NANCY LN Status: ISSUED Suite: Applied: 08/06/1998 Vicinity: Issued: 08/06/1998 Parcel Nunmber: 93530005 Applicant: MIRANDA, FRANK Address: owner ABRAHAMS MARVIN Zoning: '- Phone:-. 714-557-6516. - Zip:- - ''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 NOTES: 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 Address 3520 HUGHES AV - - - �1008' Phone - �'LOS'ANGELES,CA, � _ � Zip. 90034 i Contractor: -PACIFIC ROOFING `- Address: .ISLAND 17762 CAMERON ST- ' Phone: .,- l ! H.B. CA'- ' i- Zip. r 92647 License, 6314721 'Arch/.Eng WI.'�. Address - - '�'" + •� r, � 'Phone - 1%,f _ Zip: License: SCOPE OF PERMIT \. APPLY #30 FELT OVER EXIST LAYER OF COMP AND•INST 25 YR COMP. SHINGLE. ' FEE SUMMARY Plan Check: f $0.00 Calc Valuation: $1,400.00 'Permit: $45.75 - - ,- : — _ -- Claim Valuation: $1,400.00 �SMIP Res: $0.50 r ,,SMIP.Com: $0.00 . Other:. :$0.00 = InSpection: ` ' ','$0.00 Total: $46.25; is ''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 NOTES: 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 DECLARATIOMS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: jE ❑ 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 f which this permit is issued. eve and will maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' co sation lnsuran carder and policy number are: y /��✓ /�� / Carder: L4 / {- Policy Number: (This section need not ba completed it Via permit is valued at one hundred dollars ($100) or less.) ❑ I certify that In the performancetpU wan r which this permit is issued, shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cal' rfrnia, and agr e t if should become s ject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith ith these prey s. plicent eture: Data: NINO: FAILURE TO SECAE WORKERS' COMPENSATION COVERAGE IS U LAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATIO I hereby affirm that em licensed u er r 1 io f hapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force an Lic. # Class # tractor's tura: Date: _ CONSTRUCTION LENDING AGENCY: ❑ 1 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 Na Lenders Address: 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) o1 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, 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, provitled that such improvements are not intended or offered for sale. It, 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 Cade: 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, Le. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 B, 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 Dent 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? ❑ Yes ❑ 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 forth for acutely hazardous materials? ❑ Yes ❑ 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 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? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L.l 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ 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 Ali Quality Management District or other air pollution control district or agency is repulred 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'! ❑ 9as ❑ No ..................................... ............................................................................................................................................................................................................................. e (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: 1 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. re eg ner(s) /' Date l 7 C!� u h d Ap nt Date 920—L INSPECTION TYPE RATE INTMALS CODE 1 INSPECTIONTYPE Ds1E INTMA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 208 FinalPlumbing 200 Final Re-Roof 210 Final Electrical 201 Final BlocklRetaining 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 !2 ilding/Occupancy 2"6.46 /I/O 7o -*ff0 Az- OWNER BALALIS & PIGNERI DATE 4_26_77 JOB ADDRESS lrvu_irnR_imn rBa. ra a BUILDING PERMIT NO. 4257-4 AP No. l l S -0P'4 -i i I OT TRA[T a4w FIRE ZONF VAI_UF S i Dn �>m nn INSPECTIONS tt gj Si nature Dat• RTYPE v GROUP V X T ZONE SOIL T12 JS 0 V10 14' SUBCONTRACTOR 1. PERM GAS Dote Number Si nulure WATER G. •D',-7� 7 Plum ina ROUGH PLUMBING^ & -' PROP: SWR. LINE `J HOUSE CON. rZGi S-/9-77 SPRINKLING SYSTEM 1.11SCELLANE OUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE pq G UNDERGROUND 0 POWER E] ROUGH WIRING Neaf in and Vypni. TRENCHES FORMS STEEL REINF. K %- If fW K47 FLOOR SYSTEM -77 BONE BEAM 'STEEL REINFORCE SHEATHING p! FRAME ANE iL AS NTNG LATHING — IN OUT O./ PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REPRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST r 1,• r _ Z,1 - W ELECTRIC, FINAL BUILDING, FINAL SPECIAL REQUIREMENTS 4 43573 COSTA MESA BUILDING -SAFETY DEPARTMENT, P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use ink Only BUILDING/AA/ _Inw4_ 11IA a.n_.. a. . A_,r OWNER jpq[ f MAIL ADDRESS ZOI CITY Atr,,l�/ CONSTRUCTION LENDER BRANCH ADDRESS ARCHITECT OR gNGINEER� ADDRESS qs CONTRACTOR NO. I, / I-& TEL. ('l NOA&_7-� APPLICATION FOR STRUCTURAL PERMIT CEIVED BY DATE RECEIVED D TE 21UF�.t: jC (i r s118y �9 NO.NG PE. I!�Q e'TRACT [ADDRESVO06, LOTBLOCK G. EW IADDIALTER P MAIN BUILDING W NER LIS P NO. OF BLDGS. BO /IA1'r3ALUE ( S FIRE ZONE APPROVED I USE OF N BUILDING. YARDS APPROVED MAIN & TEL. ZONE I NO.OF CITY NO. _ PLANS G. STATE CITY WARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING W SIZE NO. OF BLDGS. (FROM C/L T EE ) 06• OF LOT NOW ON LOT ONT FT Q USE OF PLAN CHECK f .�. EXISTING BLDG. /9Q rn TAX f � Separate permits are required for L SIDE 8t3FT.At TOTALPAID 11-97Z' _ electric, plumbing and heating work. REAR FT LD[, SE OF BUILDING AND WOR T BEP RFORM D DISTANCE BET. QO O MAIN BLOCS. VAR. q@ APPROV RY Ix�- C W C1 hereby acknowledge that I have mad this application and state Cd that the above Information Is correct and agree to comply win OLD all laws regulating building construction, end I shall not employ z any person In violation of the workman's compensation Iowa of _ the State of California. I hereby certify that I em properly licensed as a contractor under 770 SO. FT. THE AMOUNT SHO% the State of California Business and Profealons Code, Division 3, Chapter 9, and that such license, are In full force and effect, or 1 THE PURPOSE OF ES1 em exempt from th rovislon, of fns Stets of California Business end Profasnon, Cod Nidon 3, Cha r 9. VALUATION Signs ture of i Permittee f11?1Q, 200 Authorix Agent I USE OF N BUILDING. YARDS APPROVED MAIN & C m "IAL 4 I USE OF N BUILDING. YARDS APPROVED MAIN & C m "IAL r 13 N VN UNDER VALUATION IS FOR m 'ABLLSHING A PERMIT FEE ONLY: m PERMIT FEE f h PLAN CHECK f O O TAX f � TOTALPAID 11-97Z' _