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Home My WebLink About1014 NANCY LN - Building PermitsCITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT Job Address: 1014 NANCY LN Suite: Vicinity: Parcel Nunmber: 93530008 Zoning: Applicant: MIRANDO, FRANK Address: Phone: Zip: ,/ 0 � - V B98-01132 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED 1t " Applied: 0612511998 Issued: 0612511998 Owner: MUNOZ, FRANCES _ Address 507 AVOCADO ST` 1014 ,, _ Phone: CORONA DEL MAR,CA Zip: 92625 Contractor.;' .ISLAND PACIFIC ROOFING Address: ;j17762 CAMERON ST Phone: H.B. CA%' / _ j' Zip: 92647 License: '631472 Arch/ Eng: "- " ; _ Address: - ' - Phone: .. .Zip: - - _License: ' SCOPE OF PERMIT ' ' REROOF THE ATTACHED TRIPLEX WITH 1 LAYER OF COMP. SHINGLE. 2ND LAYER. CERT. ATTACHED TO PERMIT ' / Plan Check: Permit: SMIP Res: SM I P. Com: Other: Inspection: Total: SETBACKS $0.00 $45.75 $0.50 $0.00 $0.00 $0.00 $46.25 MAIN STRUCTURE Front 0-0/ Rear 0-0 ACCESSORY Front 0-0 . 'Rear 0-0 PARKING Existing: 0 Required: 0 NOTES FEE SUMMARY PLANNING & ZONING Left 0.0 Left 0-0 Proposed: -0 Calc Valuation: $1,400.00 Claimed Valuation: $1,400.00 Right 070 ' i Right 0-0 EXPIRATION: This penult 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) 7645626 I . r WORKERS' COMPENSATION DECLARATION: er by affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to seg -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' oompensation insurance, Be required BY section 3700 of the Labor Code, for the perfomumost of the work for which this permit Is issued. M work s' m tl n nsu a ca at r n m or are; /�� Carier:y J i Policy Number: //��'/%/! (This section need not a completed If the permit /s v/bed of one hundred dollars ($100) or less.) ❑ 1 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 agrive Itlat If I should become subject to the workers' compensatlon provisions of Section 37 of the Labor Code, I shall forthwith compiy,wlth these �ns�� ' /`p�p,�( Applicant - IAA _ _ (/ Date:- WARNING>FAILURE TO SE RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER.TO CRIMINAL PE TIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37090E THE LABOR CODE. INTEREST. AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Lic. N Class N ContredOI' Signature: T �D) CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there Is a construction lending agency for the performance 01 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 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 Me hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages Be 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 Lew 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 Coda for this reason: Signature: Date: Owner ID verified by driver's 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 excavatlon Me (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, 32, 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 Divislon of Industrial Safety, as noted above, unless such person has a pennli to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII 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 Docs or will the applkant or present or future bulltling ocarpent need to 91e a regiSUelion form for acutely hazardous meterfals7 ❑Ves ❑ 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 600 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 Mass 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. II en RMPP Is presently .............................................................................................................................. ................. ........................ 4 required, has Section 25534 of the California Health and Safely Code been fully complied with.. ❑Yes ❑ No ...................................appl..............................futu.....uildin.....................quir.......................whi-...................ject.....this.....-.-.-.tion.........-..-...................nstructi............odificat..n 5 Does Or will the applicant u present or future building occupant require for the work which di the subject of this a plication afertnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Ye5 1Li NO (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... 6 WIII any pan o1 the fedliry to be cinsimctad under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes-, the facility must meet the requirement o1 Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................... 7 If a ppermit from the South Coast Air Quality Management District or other air pollution control district or agenis 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 madecy ❑Ves ❑ No .................................................................................................................................................................................................................................................................................... 8 (11 yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: 1 certify that under penalty of perjury the infornation 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 comity 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 dry 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. ��d�re(OI Lgge! I Owner(s) �� /�� Date And(Or.Au Azed Applicant // _Data -- CODE S ate__CODES. INSPECTION TYPE gAjE INTMALS CODE INSPECTION TYPE OAff INMALS 1616 Fixed 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2""e OWNER W ALIS & PIGIMI M114 V LI.Ln1'1L'w"I RAL I UR V."',-A1LU1 . ULd MIF I BUR ar nVnn ' LI -4 ICA M UEU1 C AP No. 115-023-11 LOT TRACT 9691 FIRE ZONE VALUES 120.200.00 INSPECTIONS et el Si nature Date 11TYPE v GROUP T ZONE SOIL 0 Z5 7A SUBCONTRACTOR PEP"Number ED ces Data Si nature WATER G e.. Plumbin ROUGH PLUMBING PROP. SWR. LINE 0 HOUSE CON. O D ( Q SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING' �r TEMPORARY SERVICE OR POLE UNDERGROUND POWER E] ROUGH WIRING •i Nea in on Vent. TRENCHES Le FORMS STEEL REINF. J FLOOR SYSTEM -.!. J BOND BEAM 'STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN El OUT PLASTER, BROWN COAT _ STRUCTURAL, FINAL HEATING, VENT„ REFRIG. AND A.C., FINAL T.. 1 -%1 `' PLUMBING. FINAL AND GAS TEST ELECTRIC. FINAL W. BUILDING, FINAL•i JQ- SPECIAL REQUIREMENTS wv _ (ily •7 0 I I 43574 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use ink Only ADDRESS 2 -!o/f /e/i ,vr ,vcr Lfl✓fi OWNER (,/f / ADDRESS Zoos /}L L✓O• TEL. CITY A/ /w7' 1-1 NO.6 Tj_Zp CONSTRUCTION LENDER BRANCH ADDRESS ARCHITECTTEL, OR ENGINEER CI l 4 OG •NO. 16;_Zf L PLANS ADDRESS'nlG L Y VA, N 6>- CONTRACTOR ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE NO. OF BLDGS OF LOT NOW ON LOT USE OF EXISTING BLDG Separate permits are required for electric, plumbing and heating work. E OF BUILDINGT AND WORK TO B ER RME G /tea 1 hereby acknowledge the, I bave read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any Person in violation of the workman's compensation laws of the State of California. I hereby certify that I em properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from th provisions of the State of California Business and Professions C , Division 3, Ch ter 9. Signature 0 PermitiM Authorized Agent APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY DATE RECEIVED D TE I)LED /9 � TRACT "I/n sf I I LOT OWNER II/ircVALUE E APPROVED n BY DATE V ' SO. FT. A&L e U5E OF N W APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY DATE RECEIVED D TE I)LED /9 � TRACT "I/n sf I I LOT OWNER II/ircVALUE E APPROVED n BY DATE V ' SO. FT. A&L OF U5E OF N W to PLANS BUILDIN YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDIN (FROM C/L 5TrREET)/ n BET. I BET. MAIN & n iOLDm 1\ .li LLI iL Rt. 4• k"rt.; > SO. FT. A&L am THE AMOUNT SHOWN UNDER VALUATION IS FOR to THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ Q) n n PLAN CHECK 5 ^ $�J// TAX S r LL i "Y v Gf i�st TOTALPAID 11 411 U,