The URL can be used to link to this page

Home My WebLink About1794 HAWAII CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1794 HAWAIICI Suite: Vicinity: ROOF Parcel Number: 13957208 Zoning: Applicant: BRIAN WOLSKY Applied: 12/03/2003 Address: 17662 METZLER LN - Calc Valuation: $3,490.00 Permit: $97.25 Phone: (714)847-9332 SMIP Res: HUNTINGTON BEACH, CA Zip: 92647 Owner: GLENN, TIMOTHY NOLEN Address 1794 HAWAII CIR Inspection: $0.00 Phone: Total: COSTA MESA, CA Zip: 92626 Contractor: TOM BYER ROOFING PLANNING & ZONING Address: 17662 METZLER LN MAIN STRUCTURE Front 0-0 Phone: (714)847-9332 ACCESSORY HUNTINGTON BEACH, CA Rear 0-0 Left 0-0 Right 0-0 Zip: 92647 License: 575002 Arch : Address: Eng: Address: Status: ISSUED Applied: 12/03/2003 Issued: 12/03/2003 ISSUED BY: / �/�---- Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL HOT ASPHALT BUILT UP ROOF WITH GRAVEL. 1,400 S.F. INCLUDES ATTACHED GARAGE. NOTES: 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 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 266846 (SM) FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,490.00 Permit: $97.25 Claim Valuation: $3,490.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 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: 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 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 266846 (SM) WORKERS' COMPENSATION DECLARATION: " I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 w rk for which this permit Is issued. I have 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. My workers' c^pe anon Insurance carrier and policy number are: 6 Carrier: '`-J Policy Number: 103 (This section need not be completed 11 the permit is valued atone 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 became subject to the workers' compensation laws of Celifomia, agree t,fhoould become subject to the workers' compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with these provision I Z /O Applicant Signature: Date: (/ WARNING: FAILURE TO SECURE WORKS ' COMP SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000), IN ADD ECOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed undo revisions 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. # Class # C-3 9 Contractor's Signature: —� Date: /L b G i 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 fallowing 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, poor 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 two hundred dollars ($500).): ❑ 1, 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. IL 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.). ❑ 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, i.e. - 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 8, California Administrative Cade). ❑ 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 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). ...........................................aor fut �.r..... uildin upant need to file a registration form for acutely materials?..... . ....Yes .....No ..................................................9 2 Does or will the applicant o present or u e b Occupant g y ❑ ❑ (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 enRMPP 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 emit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes a 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 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 California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ...... ......................................................_............................................._._................................................................................ ......................... ................................................................................................... -.............................................................. 8 (It yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certity 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. eture Of Legal Own 0Date JL Z � plicant Date CODE E. INSPE00NTYPE 2&U INTRIALS CODE? INSPECTION TYPE PATE INTITIeLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ,� 208 Final Plumbing 200 Final R _ 7 2e -Roof J—�' 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 CITY OF COSTA MESA REQUEST FOR OCCUPANCY / / TRACT NO. / y DATE (� — / {� - 70 LOT NO. ADDRESS The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (ase-she-issoF) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. Lender A.xagFIN E ZONE DATE 1-22-70 111114111',42M,m, INSPECTIONS Si nature DateGROUP TYPE ZONE R-1 SOIL v \ PERMITS ISSUED SUBCONTRACTOR ROUGH PLUMBING PROP. SWR. LINE I 1 44OUSE CON. AND AIR CONDITIONING UNDERGROUND lin POWER REINF. fcl"FY�� FRAME AND FLASHING Z . W W F- U HZ _ZF Oto am J � J N M J J m _ Q U Q Z � W 1 W WZ J 0 M J K W W 0 Z 1=- w0 �O 31291 PAiO * 444 P/# 11 Jnl�'2r-7��00 732 141.00 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI LJ V DftT�F�gCLIV7e T EDD BUILDING / / /4 �(J 7 ADDRESS PEFJMI f{ OWNER Apollo Development Corp. A.P. NO. MAILBUILDING E. 17th Street ADDRESS 17 ADDRESS 1104 CITY Santa Ana No� 547-9673 TRACT 6694 LOT 25 BLOCK CONSTRUCTION LENDER UJ S National Bank W X AREPAIR MOVING nP BRANCH Main Office OWNER Apollo Development C]15,7J00 ADDRESS 190 S. Broadwa San Diego VALUE S Dwellin $0 F.ermlt DOr7.11S TEL 675-1164 OR ENGINEER FIRE AODRESS 3111 2nd Ave., Corona Del Mar ZONE _TYPE�r GROUP j� CONTRACTOR Apollo Development Corp. ABY PPROVED PATE ADDRESS 1104 E. 17th Street /2_9� TEL ZO No- OF-'j� PLANS/ USE OF NE& r BUILDING CITY Santa Ana NO. 547-9673 NSTAo. 252549 1690 YARD APPR6�ED LIC. LIC. NTY O. MA NS BUILDINGAPPROVEDYARDS ACCESSORY BUILDING SIZE NO.OF BLDGS. — 55 114 IF ROMC/LST EETI OF LOT X NOW ON LOT -FRONT FT. FT. USE OF --U __ EXISTING BLDG. SIDE FT.FT. SIZE OF 1782 S.F. ROOMS B l OFT. NEW BLDG. STORIES L. SIDE FT. EXTERIOR WALL plans ROOF Shingle COVERING COVERING K REAR FT. i FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. SLOGS. Construct new dwelling With CURP.4W DATE APPROVED attached garage. APPROVED (/DATE� I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with I OLD FOR all laws regulating building construction, and I shall not employ N4VUIX!:MEN any person in violation of the workman's compensation laws of / the State of California. I hereby certify that I am properly licensed as a contractor under �� SO. FT. TJ THE AMOUNTS OWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION and Professions Co . Division 3, Chapter 9. PERMIT FEE $ LC PLAN CHECK S Signature of Permittee %% (% $ 7�// J ,/13 Authorized Agent TOTAL FEE S / ()�