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Home My WebLink About2924 JACARANDA AVE - Building Permits• '. � ` , CITY OF COSTA MESA ' B{/ILD/NG DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(774) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa. FOR INSPECTIONS CALL: (774) 754-5626 PERMIT NUMBE 607-00980 PERMIT TYPE B ROOF2 STATUS: ISSUED DATE ISSUED: 1 011 712 0 0 7 . , ISSUED BY: JOB ADDRESS: 2924 JACARANDA AV CM Suite/Unit: Vicinity: . Squares: 0 . ' -� Valuation: $5,200.00 SCOPE OF WORK: TIOFF AND�REROOF 1400SF RESIDENCE W/COMP SHINGLES. � � OWNER: PHONE: APPLICANT: PHONE: REECE, EUGENE C JR TR BRIAN ATKINS 949-597-0192 CONTR%1CTOR: SOUTH COUNTY ROOFING Address: 23517 WHITE DOVE DRUnit: Ciry/State2ip: LAKE FOREST, CA 92630 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES $0.00 $125.25 $0.00 $125.25 Address: 2924JACARANDA AVE City/State/Zip: COSTA MESA, CA � . Address: Ciry/State/Zip: PHONE: License No. Litense No. .. . . . -- License No. 737515 949-597-0192 CELL: PHONE: PHONE: :�f +�i�;;. � :,�,. , _ r. .�;�„� . > 5�;�,.. t Unit: Unit: : NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectlons and final approval must be obWined. Failure to obtain inspections and final approval will result in the expiration of this permit. COpE/, INSPEC7IONTYGE DFTE I� UE/ INSPECTIONTYPE D� IN7fII�LS 7816 Fixetl System Final Fire Prevention 208 Final Mechanical 1286 Pool Spa Final 208 Final Plumbing 200 Final Re-Rool ��i ' � � 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Plara 220 Finat Planning Appmval 203 Final Sign 222 Final Site 204 Final Demolition � 250 Final Building/Occupancy � t , , WORKERS' COMPENSATION DECLARATIO� Owner ID verifietl Dy driver's .. .,e. ❑ Yes ❑ No I hereby aHirm untler penalty o( perjury one o( the following declaralions: Driver's License No. Expires: ❑ I have an0 will maintain a certificate of consent to self-Insure for workers' Verifcation of Ovmership by (rype of documenl, i.e. - property tax bill or tleed): compensation, as proviCed for by seclion 3700 0( the Labor Code, for the •- perfo ce of Ihe'wnrk (or whic� Ihis permit is issued. � I have antl will maintain workers' compensation insurance, as required by � sectbn 3700 0( the LaDor Code, !a the perfortnance of the work for wfiich Ihis DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: . pertnit is issuetl. My v.vrkers' wmpensation Insurance cartier anE policy ❑ I hereby certKy that no excavatbn frve (5) or maa (eet in depth into wfiich a number are: ` person is requiretl lo tlescend. will be matle in connectbn with �wrk authorized Dy �his pertnit, antl Ihat no building strucNre, staFfdding, (alsework, or GemWition Carner: �a.fP Fun or dismantlinq thereof, will be more than lhirty-s& (36) feet hig�. (Chap. 32, Grp (TNsseUmmMnoteeom!m1pet�edAllnepa,m�/vs.a4maafarenwimedtl�Wrs(5�00)alessJ 2 ArtZ Sec.341,TitIeB,CalifomiaAdministrativeCotle�. Policy Number: �Y / 7 !V % �L!!1 � ❑ I certify that in Ihe peRormance of the v.vrk for which this pertnil is issued, I shall not employ any person in any manner so as to hecome suDject to Ihe vrorkers' compensation laws af Califomia, and agree that if I shoultl Decome subject to the wvrke �S compensation provisions ol Section 3700 of Ihe La or CodE, I shal y_with thesa provisions. _7� �/O /7'0 %�� Apd� ��'� $ipnalurG Dale WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION 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 LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECIARATION: I hereby aKrm that I am licensetl untler provisions o( Chapier 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code, and my license is in full force antl eflecL / i ��. � ' 7s;cs "55 # C' -39' ._p �. � . l" /s-i� a> � �� Convactw's Signawre Da�e CONSTRUCTION LENDING AGENCV: ❑ I hereby aRum Ihat there is a constructbn lending agency fw the pertormance ot the vurk (a wf�ich tlds permit is issued. (Sec. 3097, Civil Code). Lender s Name: Lender's Address: SignaWre Dale OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty o( perjury �hat I am E7(EMPT FROM THE CONTRACTORS IICENSE U1W for Ihe follovring reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county which require5 a permit to GOnSWtt, al[er. improve, demolish, ar repair any swcmre, prior to it5 issuance, also requires the applicant for such pertnit to file a signed statement thal he or she is licensed pursuant to the provisions of Ihe Contractors LitenSe Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business antl Professions Code) or that he or she is exempt there(rom and Ihe basis for the alleged exemplion. Any violation of Section 7031.5 by any applicant for a permit subjects Ihe applicant to a civil penalty of nol more than fve huntlred dollars ($500).): ❑ I, as ovmer ol the property, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the structure is not iNended or ofleretl lor sale (Sec. 7044, Business and Professions Cotle: 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 ovm employees, provided that such improvements are not intended or oRered for sale. If, hovrever, the building or improvement is sold within one year of completion, lhe ovmer-builder will have lhe burden of proving that ha or she did not build or improve for purpose of sale.). ❑ I, as owner af tha property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractas License Law dces rwt appy to an ovmer ot property who builds or improves thereon, and who cont2cts for such project with a cmtracta(s) license pursuant ro the Contractors License Laws.). ❑ I am exempt under sec. Business antl Professions Code for Ihis reason: 305]�46 (10]) � As ovmer-builder, I will nol employ anyone to do work which would require a permit from the Division of Intlustrial Safety, as noted above, unless such person has a permit to tlo such vrork Irom the division. AVO��'s SipnaWre Da�e Division of Industrial Sa(ety Permit NumOec _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will 1he applicaM or preseN or (uture building occupant neetl ro file antl certify a Business Plan (or emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of Ihe California Health and Safely Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fire Departmen� by every business which has al any one time during a reportetl year a quantiry of hazardous matenals equal ro or greater than a vreight of 500 pounds. or a volume of 55 gallons, or 200 cubic feel of wmpressed gas at standard temperature and pressure). 2. Does or will the applicanl or present or future building occupant need to fle a registration form for awtely hazartlous matenals? ❑ Yes ❑ No (Section 25533 0! the California Health antl Safety Code, vAth some exceptions, requires registration wilh the Costa Mesa Fire Department by each business which at any one time has on hand a quan[iry of acutety hazardous materials equal to or greater lhan a weight ot 500 pounds, or a volume ot 55 gallons, or 200 cubic feet of compressetl gas a[ standard temperature antl pressure). 3. Does or will Ihe applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials�? ❑ Yes ❑ No (Seclion 25534 0/ the Califomia Health and Safery CoCe provides that the Costa Mesa Fire Departmenl may require the preparation, cenifcation and filing with the Fire Department of an RMPP by businesses which are required ro register acutely hazartlous matedals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 ot Ihe Califomia Health and Safety Code been fully complieC with7 ❑ Yes ❑ No 5. Does or will tha applicant or pBsenl orluWre builtling occuDant reduire tor tne work whicn is Ihe suDject of this application a pertnit for such cOnslNction or modifcalion from tha South Coast Air Ouality Management District or Imm any other air pollution conlrol districl or agency? ❑ Yes ❑ No (Sec�bn 65850.2 of the Califomia Govemment Code 2quire5 that the requested infortnation be fumishetl on applicatbns fa nornresitlential builtlinq pertnils). 6. Will any part of the faciliry to be consWcted under this permit be vrithin 1000 feel Irom Ihe outer boundaries of a school? ❑ Yes ❑ No Q/ yes", the faciliry must meat the requirement of Sections 25534 and 42303 of the California Heallh antl Salety Cotle). 7. If a permit from the South Coast Air Quality Management DisMct or other air polNtion conlrol disirict or agency is required for the work which is the subject of Ihis applicalion, have all of the tlisclosures prescnbetl by Califomia Health antl Salety Code Section 42303 been made? ❑ Ves ❑ No 8. Qf'yes", attach certificale of compliance from the appropriate air pollution control o(fcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct I agree to comply with all sWte lav+s and city ordinances regarding Hazardous Materials and Emissions. Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read lhis application and state that the intormation given is correcL I agree ro comply with all state laws and city ordinances relating to building wnslruction, and authorae representatives of lhe City of Cosla Mesa lo enter upon Ihe above-described propeny for inspection purposes. I agree not to occupy or allow occupancy ot any building authonzed by thispertnit until final inspection. Signature ol Le e� ) Date �.�.,.�J ��/ /0 /7-O� : �l7 AnalarAutnmzeaNpOliCdnl Ddte ' 14i'.4..." �� :�i3 , �= AUG 7 t95J.. COSTA MESA BUILpING-SAFETY DEPARTMENT , [('� P.O. BOX 31'1 COSTA MESA. CALIFORNIA �lf�i,�R'��1F ��iC i. ,��,- ^r; nn� . C��. FOR APPUCANT TO f/LC /N COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING , BUILDING 2921 J AODRESS t acaranda Avenue COSTA MESA, CALIFORNIA FOR OFFICE USL ONL7 I PECEIPI' NO. ( �%_ (d� L y OWNER Ad32n� Acres� II1C. ti � ADDRE55 41/ L• 1�U11 SO• RECELyED BY I DAT/RECEJVED I n�[J(.TE ISSl1El � �� U1v19 CITY � P TNo�81159 pDD E'S5 ARCHITECT Carlson Lc �� COSTA MESA, CALIFORNIA OR ENGINEER NO. io,a e ro /1 A�ORE55 Garden Grove FIRE �/ �{ ZONE TVPE GROUP�—t • � D7.�Ce & Colegrove, 111C�STATE 107293 �+P�'ROVEO f CONTRACTOR LIC.NO. gV DATE ADDRESS �J E. ��til1 Uti♦ VGSt.a. P1esa ZONING LEGAL LOT 20N� I NO. OF / I USE OF NEW )� OESCR�PTION NO. 1S3 � BLOCK TRAGT P4AN6 9UILOING �`� �9 / ✓� APPROVED A.P. NO. BY DATE SIZE / rvO.OF BLDGS. ypRDS EVES OF LOT VS X 101 rvow on �oi none REOUIRED ALLOWED USE OF ICENTER LINE ST.) ��) EXISTING BL�G. FRONT �� (/ FT. IN. SETBACK LINE FROM �� ceNrea or s'rw[Ei SO � REAR YARD � R. SIOE S �� IN. SIDE YARD ILEFT ZO� � IRIGHT �� L.SIDE D FT� IN. DESCRIP710N OF WORK � REAR n� �r. iN. NEW I d II ALTERATION I II ADDITION I REPAIR I II MOVING I �II DEMOLISH I SU=IEDING 156p ROOMS r STORIES 1 - �EXTERIOR WALLyuCCO I ROOF COVERING uV COVERING rock USE OF BUILDING AND WORK TO BE PERFORMED Single far.iil residence i+ri.th attached garage, . 4 14 I HEREBY RCKNOWLEDGE THAT 1 HAVE NEAO THIS APPLILATION THE AMOUNT SHOWN fINDER VALUATION IS FOR THE AND STATE THpT THE /BOyE IS CORNECT ANO RGREE TO COM� pLY WITH ALL CITY ORDINqryCES AND STRTE LAW REGULATI G PURP09E OF EST/BLISHING A PERMIT FEE ONLY. eui�oiruc coHSTRuci rv. VALUATION I SIGNATURE OF � PERMIT FEE S 35�� PERMITTEE Y '�" � $ 15,571 PLAN CHECK $ 17�5� AUTHORIZED AGENT Dytte & Cole Y'O�%2 TY1C. TOTAL FEE $ S��J" V,j