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Home My WebLink About2426 MISENO WAY - Building Permits� � CITY OF COSTA MESA � , � �' � BlIILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 ��'' ��7�,��l �. � APN. TPN00143 DATEj'�� JOB ADDRESS; 2426 MISENO WY CM Vicinity: GARAGE ROOF Squares: 400 PERMIT NUMBER: B08-00018 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 S�UARES. OWNER: BACK BAY GARDENS PHONE: APPLICANT: SIMMONS, DEBOR4H 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 $0.00 $83.25 $0.00, $83.25 Address: City/State/Zip: Address: R0840718 - City/State/Zip: - SUITE 281 License No. License No. License No. 781923 ANONE: 714-960-8329 92646 CELL: PHONE: PHONE: Unit Unit NO710E: The work authorized by this permit shall wmply with all applicable handicap access requirements under Calitornia 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 legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. CODE�. INSPEG110NTVPE OATE IN1f11A�5 CODEt INSPECTIONTYGE OATE INTITIRLS 1616 Fixed System Pinal Fire Prevention 206 Final Mechanical 1266 Pool Spa Final , 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Bbck/Retaining Wall 2t2 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign ppp Final Site 204 Final Demolition 250 Pinal Building/OcCupanCy Q WORKERS' COMPENSATION CLARATION: � I here�y aKrtn under penalty of �jury Lna of lhe following declarations: ❑ I have and will maintain a certifica[e of consent to self-Insure for vrorkers' compensation, as providetl for by section 3700 of the Labor Code, for the peRormance of the work for which this permil is issued. ❑ I have and will maintain workers' compensation insurance, as required by sectqn 3700 of the Lahor Code, for the pedormance of the work (or which this pertnit is issued. My workers' compensa�ion Insurance carrier and policy number are: ) carrier:� �/ i�'�� /J��/� �lThis sedron neetl not oe mmple(etl iltne peimrt u valved a/t �on,e,� nundred tlollars (E100) w less.) PolicyNumber 0��%�� (J7J � i 0 I certify ihat in the pedormance of the work for which this permit is issuetl, I shall not employ any person in any manner so as to become subject to the vrorkers' compensation laws of Califomia, and agree that if I should become subject to the workers' compensation pmvisions of Section 3700 0( the Lab Code, I shall torthwith comply with these provis.io,ns.�� ,�vrn�hn.��-,�— / / / ! Applicanfs5'g'nalu �� --- �.�= WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under pmvisions o! Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in full force antl effec[. Q Li #�. �._�/� �� q.�� cl sa s�#�` Ci � / /, J�a!'XJty'UJ+��L �.%r✓+'vwYW %/i�/vX ° `Contractor'sSignaWre � �— ✓ CONSTRUCTION LENDING AGENCY: � I hereby affirm ihat Nere is a consWction lending agency (or the peAortnance of the work far wfiich this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Dale OW NER-BUILDER DECLARATIONS: I hereby affirm tha[ under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor 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 lo its issuance, also requires the applicant for such permit to file a siqnetl statement that he or she is licensed pursuant to the provisions of Ihe Con[ractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of lhe Business and Professions Code) or ihat he or she is exempt therelrom and the basis (or the alleged exemption. Any violation of Seclion 7031.5 by any applicant for a permit su6jecls Ihe applicant to a civil penalty o( not more than five hundred tlollars ($500).): ❑ I, as owner of the property, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, and lhe structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such vrork himself or herself or through his or her ovm employees, provided that such improvements are not intended or oflered for sale. If, however, the building or improvement is sold within one year of complelion, [he owner-builtler will have the burden of proving thal he or she did not build or improve for purpose of sale.�. ❑ I, as owner of the property, am E%CLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct lhe project (Sec. 7044, Business and Pm(essbns Code: The contrac[ors License Law dces not apply to an ovmer of property who builds or improves [hereon, antl who contracls fw such project with a contracta(s) license pursuant tothe Contractors License Laws.), ❑ I am exempt untler sec. Business and Professions Code for this reason: SignaWre Date 3051-n6 (3/0]) Owner ID venfetl by tlriver'� ❑ Yes ❑ o Dnver's License No. � Expires: Verifca[ion o( Ownership by (type of document, i.e. - pmperty tax Dill or deed): DIVISION Of INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I he2by certify Ihat no excavation frve (5) or more feet in depth into wfiich a person is required to descend, v+ill be made in connectbn with work authonzed by this pertnit, and that no builtling swctu�e, scaffdtling, falsework, a demolition or tlismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Califomia 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 notea above, unless such person has a permit to do such work from the division. Applirants Signalure Division of IndusMal Safety Permit Numbec _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant need to file antl certify a Business Plan for emergency response �o release or Ihreatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Salety Code requires, with some exceptions, that a Business Plan be fled with [he Costa Mesa Fire Depariment by every business which has at any one time during a reportetl year a quanti[y of hazardous materials equal [o or grea[er than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will �he applicanl or present or fu�ure building occupant need to fle a registration form for acutely hazardous materials? ❑ Yes ❑ No - (Section 25533 of ihe Califomia Health and Safety Code, with some exceptions, requires regisiration with the Costa Mesa Fire Depanment by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic fee[ 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)? ❑ Ves ❑ No (Seclion 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparalion, certifcation and fling with the Fire Depariment of an RMPP by businesses which are required to register acutery hazardous materials with Ihe Fire Departmenl. 4. If an RMPP is presently required, has Sec[ion 25534 of the California Health and Safety Code been fully complied wilh? ❑ Ves ❑ No 5. Does or will Ihe applicanl or presen� or future building occupant require for the work which is the subject o! lhis applicalion a permit for such construction or modifcation from the South Coas[ Aii Quality Management District or from any other air polWtion control district or agency? ❑ Yes ❑ No (Sectbn 658502 of [he Califomia Govemmen( Code requires that the requestetl information be fumished on applications for noo-residential building pertnits). 6. Will any part of �he facility to be consiructed under Ihis pertnil be within 1000 feet from �he outer boundanes of a school? ❑ Yes ❑ No (If'yes", the facility must meet the requirement of Sections 25534 and 42303 of Ihe California Health antl Safety Code). 7. If a permit from the South Coast Air Qualiry Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all o( the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate o( compliance from the appropriate air pollution tontrol 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 antl Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cehify under penalty of perjury ihat I have read Ihis application and state that Ihe information given is wrrecL I agree to comply with all s[ate laws antl city ordinances relating to building construction, and authorize represematives oi Ihe City o( Costa Mesa to enter upon Ihe above-described propeRy for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signawre of Legal Ovmer �a�e� / �i-r� �;�m�ti� � I '`I//> AntllorAul�orizetlAppl¢anl r'D2te _— _ L— OWNER DOYLE & SHIELDS Development Co.,Inc. DATE 6�3=6� JOB ADDAESS 2426 Ml6eri0 BUILDING PliRMIT NO. 107nh GEN�RAL VALUE $ �9�1{ iSCRIPTION OF DATE I GROUP TR��.T TYPE V ZONE SUBCONTRACTOR -` � � s�a�. COSTA MESA BUILDING•SAFETY DEPARTMENT P.O. BOX 917 C08TA M88A. CALIPORNIA - For Applicant to Fill In Completely TYPE OR PRINT BUILDING ,C( �i P ADDRE55 ��0�'�O COSTA MESA, CALIFORNIA 6 ARCHITECT o Nn n•� a ni w LIC.TNO. S�� N NO. SIZE �� (��/�. I NO__OPOLOOl�� OF LOT VJ -- USE OF �. EXISTING BL�Q. 9CTGACK LINC RI�OM . , CENTER OF 9TqER O � RE/1R HIOEYARDI LEFT �D�{� I RIQHT DESCRIPTION OP WORK � U86 �- G I NEREBY ACKNOWLEOGE TXAT 1 NI1VE HEAO TX�9 APpL�CATION ♦NO BT/TE THM1T TN6 ABOVB 18 CORRECT AND AOqE6 TO COM- PLY WITH ALl CITY OR��NANC88 ANp �fAT{�}�WH R6OULAT�XO BUILOINO CONBTRUCTION. � // , n � AUTHORIZED AGENT FE ftECEIUED JU N 3-1963 FINANCE DEPT. CITY Of COSTA MESA APPLICATION FOR PERMfT BUILDING For Ofiice Use Only R[C61P1' NO. PE��1¢Y�� ! lJ � OATt R6C¢IVBD DATE188UEO C- 1A_ /"t IIIN 'i 1oc� ZONING NO. OF U8E O! PLANB BOILOI � VE OV ERHANO BHALL BE LESS THAN YARDS APPROV ED MAIN BUILDIf�6 oisrwncfi eeT MAIN BLDpB. VAR. $� TX6 AMOUNT 6H' PIIRPOSE OP VALUATION $ /4; - `/�7. °' YARDSAPPROVE� ACCE590RV BUILOING BET. MAIN 8 ACCE93. BL[ DATE �3fieQ' IINDEp VALUATION IS FOR TN8 I6HIN0 A PERMIT FEE ONLY. PERMITFEE S �U � e...�.-.,�.-� a �3�r�