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Home My WebLink About2424 MISENO WAY - Building Permits� CITY OF COSTA MESA � ; `• BYILDING DIVISION t ' 77 FAIR DRIVE, COS7A MESA, CA 92626 • Q14) 754-5273 • Fax p14) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 '( � PERMIT TYPE B_ROOF2 �� y�� .a']/� APN: TPN00143 � Dg2E JOB ADDRESS: 2424 MISENO WY CM Vicinity: GARAGE ROOF Squares: 400 ' :7� �1�I��1111�11:��:�C�IF:�1jlIlyfl STATUS: DATE ISSUED: ISSUED BY: Suite/Unit:, Valuation: ISSUED 01117/2008 RMD $2,085.25 SCOPE OF WORK: TEAR OFF (E) ROOF MATERIALS AND INSTALL 4 PLY BUILT UP ROOf SYSTEM WITH ROCK ON 4 ATTACHED GARAGE ROOF UNITS, APPROX 4 SQUARES. ' OWNER: BACK BAY GARDENS PHONE: APPLICANT: SIMMONS, DEBORAH PHONE: CONTRACTOR: HIRSCHMAN, Rp AND SONS INC Address: 9582 HAMILTON AVEUnit: City/State/Zip: HUNTINGTON BEACH, CA ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES $o.00 $8325 $0.00 $83.25 Address: City/State/Zip: � Address: R0840718 City/State2ip: SUITE 281 License No. � � License No. License No. 781923 PHONE: 714-960-8329 92646 CELL: PHONE: PHONE: Unit: Unih . 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: 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 tegal, 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 resWt in the expiration of this permit. GOUEp. INSPECTIONTVPE DATE INIITALS CODEM INSPECTIONTYPE DATE INTITIALS 1616 Fized System Finai Fire Prevention 206 Final Mechanical 1266 Pool Spa Final . 208 Final Plumbing 200 Final Re-Roof 210 Final Eiectrical 201 Final BIocWRetaining Wail 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 WORKERS' COMPENSATION DECLARATION: � I hereby aKrm under�penalty olperjury one of Ihe 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 peRortnance of the work for which this permit is issuetl. ❑ I have and will mainlain workers' compensa[ion insu2nce, as required by section 3700 of the Labor Code, for the pedortnance of Ihe work for which this pertnit is issued. My vrorkers' compensation Insurance carrier and policy number are:,�7� J— fCarrier. �J � � �Ti �)�� (Tha seaion neeE � Oe cnmdeted F�imrt a vaWeO af we �nun.O1m�d'cU7llars (5100) wlessJ PolicyNumber. �� U U / � ❑ I certify Ihat in the peAormance of the vrork for which this permit is issuetl, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree that if I shoultl 6ecome subjecl to the vrorkers' compensation provisions o( Seclion 3700 0( the Lab Co shall fort�with comply with Ihese provisions. �/}�J'Yli�'� _ �- l v ApplicanfsSignaNre ��2te 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 IABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS UECIARATION: I hereby aKrm that I am licensed under provisions of Chapter 9(commencing wilh Sec[ion 7000) of Division 3 of the Business antl Professions Cotle, and my license is in full rce and flect. n � f f _ _ , (. �Lic. �f � �� Class#--� � 1 GtinvaaofsSiB�aWre � r� _Dale� ✓ CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn lhat there is a conslrucl'qn lending agency for the peAormance ot the v.oM for which this pertnit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Address: SignaWre OWNER-BUILDER DECLARATIONS: I hereby aff�rm that untler penalry ot peryury that I am EXEMPT FROM THE CON7RACTORS IICENSE LAW for the following reason (Sec. 7031.5, Business and Pmfessions Cotle: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any shucture, pnor to ils issuance, also requires the applicant for such permit to fle a signed statement tha� he or she is licensed pursuant to [he provisions of the Contractors License Law (Chapter 9(commencinq vnth Section 7000) of Division 3 of lhe Business and Professions Code) or that he or she is exempt ihere/rom antl the basis for the alle9ed exemplion. Any violation of Section 7031.5 by any applicant for a permit subjects Ihe applicant to a civil penalty of nol more than five hundred tlollars ($500).): ❑ I, as owner of the property, or my employees with vrages as their sole compensation, WILL DO THE WORK, and ihe swcture is not intended or oRered for sale (Sec. 7044, Business and Pro(essions Code: The Contractors License Law does not apply to an owner of property who builds or improves �hereon, and vfio does such work himself or herself or Ihrough his or her own employees, provided that such impmvements are not imende0 or offered tor sale. If. hovrever, the building or improvement is soltl within one year of completion, the ovmer-builder will have the burtlen of proving that he or she did not build or impmve for puryose of sale.). ❑ I, as ovmer of the propeny. am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS lo conslruct Ihe project (Sec. 7044, Business and Professbns Code: 7he contractors License Law dces not apply to an ovmer of property who builds or improves thereoq antl who cont2cts for such project with a contracta(5) license pursuant to the Contractas License Laws.). ❑ I am exempt under sec. Business and Professions Code !or this reason: SiqnaWre 309-a6 (3/O]) Ovmer ID veri(ietl by driver's i� ❑ Yes ❑ No Dnver'S License No. � Expires: Verification of Ownership by (type of documenl, i.e.�- properry3tax bill or Ceed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation frve (5) or more feet in tlep[h into which a person is required to descend, vrill be made in connectbn with work autMrized by this pertnit, and that no building strucWre, scattdding, talsev.ork, ar demolition or dismantling thereof, will be more Ihan thirty-56c (36) (eet high. (Chap. 32, Grp 2. M 2, Sec. 341, Title 8, Califomia Administrative Code�. ❑ As owner-builder, I will not employ anyone to do vrork which would require a permit from the Division of Industrial Safety, as notetl above, unless such person has a permit to do such vrork from t�e division. Apdiwnl's Sigrewre Date Division of Induslrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will lhe applicant or present or fuWre building occupanl need to file and certify a Business Plan for emergency response to release or threalened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, wit� 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 pounOs, or a volume o/ 55 gallons, or 200 cubic feet of compressetl gas al standartl lemperaNre and pressure). 2. Does or will the applicant or present or fuWre building occupant need to file a regi5tralion fortn (or aCutely hazardou5 matenal5? ❑ Ve5 ❑ No (Section 25533 of the Califomia Heallh and Satery Code, with some exceptions, requires regislration with the Cosla Mesa Fire DepartmeN Dy each business which a� any one time has on hand a quantity of acutely hazartlous materials equal to or grealer than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at stantlartl temperature and pressure�. 3. Does or will the applicanl or present or future building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materials)? � Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides lhat the Costa Mesa Fire Depariment may require the preparation, certification antl filing wi�h Ihe Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with lhe Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Calitornia Health and Safety Code been (ully complied with? ❑ Yes ❑ No 5. Ooes or will Ihe applicant or present or future builtling occupant require far ihe vrork which is ihe subject of this application a permit (or such conslruction or modi(cation fmm Ihe South Coast Air Quality Management District Or (rOm any other air pollution con[rol tlislrict or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Cotle requires that the requestetl intortnation be fumished on applications fa rwn-residential building permits). 6. Will any part of the faciliry ro be constructe0 untler this permit be within 1000 feet from the outer bountlaries of a school? ❑ Ves ❑ No Qf'yes", the faciliry must meet the requirement of Sections 25534 and 42303 of the Calilomia Health and Safety Code). 7. If a permit from Ihe South Coast Air Quality Management DisMct or other air polWtion control district or agency is required for the vrork which is the subject of this applicalion, have all of the disclosures prescribed by Califomia Health ana Safety Code Section 42303 been matle? ❑ Yes ❑ No 8. (If'yes", attach certificate of compliance from the appropnate air polWtion control oKcer�. CER7IFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury lhe in(ormation given above is correct. I agree to comply with all state laws and city ordinances regartling Hazardous Materials and Emissions. SignaWre oate CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state that Ihe information given is correcL I agree to comply vrith all state laws antl city orCinances relating to building construction, and authorize representatives of the Ci[y of Costa Mesa to enter upon Ihe above-descnbed property for inspection purposes. I agree nol to occupy or allow occupancy of any building authorized by Ihis permit until final inspection. ignature of Legal Owner(s) Date / ' � "�nzea�oM(w"' �' _., = OWNER mXLE & SHIELDS DEVELOPMIIVT Co.,Inc. DATE 6-3-63 JOB ADDRESS 2424 Miseno BUILDING PLRMIT N0. GENERAL CONTRACTOR ik�vle R� Rhielde Dev.Co..Inc. VALUE S 19.417.00 Ir' S Gas F H._ DATE SUBCONTRACTOI: o� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. Bbi 31] COBTA MHHA. CALIFOPNIA For qppiicon} fo Fill In Complately TYPE OR PRINT eu��owa v aooResa � COSTA MESA. CALIFORNIA OWNERDo le & Shields Dev.Co.,I ADDRfi88 831 So. Manchester Ave. CITV Anaheim Np,' �11 AftGHITECT . _ TEL. � / 1� �11 LIC.�NO.ZSI�ZSO�B�1 No' PR 2-8020 sizE no. or e�cae. OF LOT I NOW oN tAT USE OF EXISTINO BLqp, �� serancrc un[ P�oM 2O. SO � R6AR YARD CENTER Ol YTnqR �� 8IDE YARD Lgp7' ^ I RIOHT '� DESCRIPTION OF WORK s ze '"�3x53.50 nooms 6 sr niea 2 EXTERIOR WA�,{, ROOP �ry�< <' COVERING StLlCCO COVERINO 0• USEOFBUILq�N6ANDy+ORKTOBEP RFORMHD Residence w/attache� garage Model 32C 1 NHPeBY �Cllryp�yLHOOI TNAT I NAVB qHAD TNIY APpI,IGTION AND BT�TO TH.�T TH6 ABOV6 IH COqRfiCT AND AOq6C TO COM. PLY WITM �LL CITY ORDINANCB/ AND BTAT[ I.�W� R[OULATIHG BIIILOINO CONqTR��U]]]111CTION. r 1 SIGNATUR80�� f:1,,, ly, � � �� PERMI7Tfi� X�w.V^� AUTHORfZHOAGiNT � �'{ ,�,yA FEE RECEIVED ��!1 R s 1963 FINANCE OEPT. CiiY � COSTA MESA APPLICATION FOR PE R BUILDING For Ofiice Use On1y � P6C61PTN0. P . �' YARDSAPPROVED MAIN BUILDIli6 DI6TANCfi BET MAIN BLDGB. VAR. iC TH8 AMOOHT 8M� PUNPOBH O� e VALUATION $/9 ��. � 3 I DAT8188UED �un s �s 1 � , GROUP DATB � � OF N _ . SHALL BE LESS THAN (U.B.C.REOUIREMENTI YARDSAPPROVED ACCESSORV BUILDING BET. MAIN C ACCE58. BL[ DATE / �rP's p � " 0 JCH VALUAT�ON 19 IOH THfi 9' INO A PEpMIT PHC ONLY. � iRMITFEE $ l�,�_� � --. _..__.. _ �.,,sa �