HomeMy WebLinkAbout1970 MONROVIA AVE - Building Permits.r
t CITY OF COSTA MESA
F BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714) 754-5273 • Fax (714) 754-4856
BUILDING PERMIT
.lob Address: 1970 MONROVIA AV
Suite:
Vicinity: HOUSE & ATTACHED GARAGE
PERMIT
0-00454
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/10/2000
Issued: 04/10/2000
Parcel Number; 42251325 Zoning:
Applicant; DAVIS, SAM
ISSUED BY:
Address; 984 N ELM ST
Phone: (714)628-9525
ORANGE, CA Zip: 92867
Owner: MILLAR, WILLIAM DECKER TR
Address 1970 MONROVIA AVE
Phone:
COSTA MESA,CA Zip: 92627 -
Contractor: DAVIS ROOFING CO
Address: 984 N ELM ST
- Phone: (714) 628-9525
ORANGE,CA
Zip; 92867 License: 509824
Arch Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (17 SQ). TEAR OFF EXISTING COMPOSITION
SHINGLES, INSTALL 1 LAYER OF 15# FELT UNDERLAYMENT, & REROOF WITH 20 YEAR COMPOSITION SHINGLES.
Plan Check;
$0.00
Permit:
$83.25
SMIP Res:
$0.50
SMTP Com:
$0.00
Other:
$0.00
Inspection: ,
$0.00
Total; $83.75
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0
ACCESSORY Front 0-0 Rear 0-0
PARKING Existing: 0 Required: 0
NOTES:
FEE SUMMARY
Calc Valuation: $2,450.00
Claim Valuation: $2,450.00
PLANNING & ZONING
Left 0-0 Right 0-0
Left 0-0 Right 0-0
Proposed: 0
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: 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 Inspectlona 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
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the 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 performance of the
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work for which this permit Is issued.
I - v and Will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
Myworker ' ompe sation Insurance mer and policy number are:7r: �r/or i� Policy Number. -.0
-(This section need not be completed i/ the permit is valued at 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 agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provlslo s. /
(A In _less-c_.-t� Date: '7� (��-�-��C
WARMNO:.FAILURE TO SECURE WO KERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM OVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($1110,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affir9-that+am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 1of the Business and Professions Code, and my license is In full
force and effeel. Lic_# -f S� �YA� �f Class
Cbntmctors Signature: 'C�Th,-x �r 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).
Lender's Name: Lenders 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 pernit
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 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, 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 Cade for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I 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 8, 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
permit 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 certlty 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 form 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 It 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 application aRPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits).
6 Will any part 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 Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8 (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: I 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.
L�IL/cam tura Of Legal Owners) G/ _ / -
1 Alld/Or Authorized Applicant ia—te-11
CODE N, INSPECTIONTYPE 2AN INTITIAL CODE I INSPECTION TYPE OATS INmIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof�� %Y'Oy y4F'„il/�/ 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"646
ALLEN3, MRS. MAJORIE
JOB ADDRESS 1
GENERAL CO
o. 115 -
II._ ,ECTIONS
DATE 0/I.0/o,
BUILDING PERMIT NO.
VALUE $ 100.00
Signature I DATE I GROUP J TYPE ill ZONE
Soil
Gas SUBCONTRACTOR
PERMITS
ISSUED
DATE
NUMBER
Water
Rough Com. Refrig. t] Air Cord. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line ❑ House Con. ❑ St. Swr. ❑
Sprinkling System
Construction Pole
Underground ❑ Power p
Rough Wiring
Trenches ❑ Forms p Steel Reinf. ❑ - J
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing
Frame and Flashing
I --'vg — In p Out'p
1 r brown coat
Ren1g. ❑ Air Con, ❑ Final
Pleating, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final
OCCUPANCY
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,COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
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1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
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ANO STATE THAT THE ABOVe IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABL15HINO A PERMIT FEE ONLY.
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OWNER ALLEN, IRWIN F.
DATE 6-16-60
JOB ADDRESS ly (U l°l0Ilr0Vla Ave _ BUILDING PERMIT NO. 12360 -
P^ No.
LOT TRACT FIRE ZONE DESCRIPTION OF WORK
-CTIONS
DATE I GROUP TYPE V ZONE
L- _,rground Soil U.G. Water
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SUBCONTRACTOR
PERMITS ISSUED
Underground Gas
DATE
NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches Forms Steel
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Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final
OCCUPANCY
Form 210-5M-11.59 S -B P 12360
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123
OOSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA .
For Applicant to Fill In Completely
TYPE OR PRINT
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COSTA MESA. CALIFORNIA
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1 HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION 1E FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
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DATE 7-16-70
BUILDING PERMIT
DESCRIPTION of WORK Add to and i
TRACT FIRE ZONE VALUE $1.000.(
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BUILDING, FINAL
.� 32059
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING
ADDRESS 1970 Monrovia Avenue
OWNER Lowell Dodge
Costa Mesa
TEL.
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I hereby acknowledge that I have 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
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any person in violation of the workman's compensation laws of
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the State of California.
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I hereby certify that I am properly licensed as a contractor under
. SO. FT.
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THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, antl that such license re In full force antl effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
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am exempt from the vision o the State of Cel tornla Busine
VALUATION
antl Professions Code OI isio Chapter 9.
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,<-1ANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT
636 North Broadway__
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