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Home My WebLink About3003 JEFFREY DR - Building Permitsm � . GTY OF COSTA MESA BUILD/NG DIV/SION � L� 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 � t �`�J APN: 41812214 ��"'(j �j,�ti � �21 y l � JOB ADDRESS: 3003 JEFFRE M Vicinity: DUPLEX ROOF Squares: 3400 PERMIT NUMBER: B08-00068 STATUS: DATEISSUED: ISSUED BY: Suite/Unit: Valuation: ISSUED 03/OS/2008 RMD $9,600.00 SCOPE OF WORK: TEAR OFF (E) ROOF MATERIALS, INSTALL A MINIMUM OF 1 LAYER OF 15# FELT ON A 5:12 PITCHED ROOF AND REROOF WITH 30 YEAR COMP SHINGLES ON A DUPLEX, APPROX 34 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: LUNDE, ERIK WILSON AND NATALIE PHONE: APPLICANT: RAMOS, JOSE PHONE: 714-565•0433 CONTRACTOR: STAR COURSE ROOFING COMPANY Address: 8902 SAILPORT DRUnit: City/State/Zip: HUNTINGTON BEACH, CA CELL: ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTAL FEES $0.00 $181.25 $0.00 $181.25 Address: 3003 JEFFREY DR Ciry/State/Zip: COSTA MESA, CA Address: 8902 SAILPORT DR City/State2ip: HUNTINGTON BEACH, CA License No. License No. PHONE: License No. 532778 774-962-2203 92646-2664 PHONE: PHONE: Unit: Unit: . 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. INSPEC710NS: In order for the work au[honzed under this pertnit 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 lhis permit. , GO�E� INSPEC710NTYPE OATE IN7f11A�5 GOUE� INSGEC110NTYGE DATE INi111AL5 1616 Fixed System Final Fire Prevention 7266 Pool Spa Final . 200 Final Re-Roof 201 Fina181ocWRetaining Wall 202 Final Factory Fire Place 203 Final Si9n 204 Final Demolition 208 Final Mechanical 208 Final Plumbing 210 Final Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupancy � •. WORKERS' COMPENSATION DECLARA710N: I hereby aKrtn untler penalty of perjury one of the following tleclarations: ❑ I have an0 will mainlain a tertificate o( wn5ent ro Self-InSure (of workers' compensation, as provided for by seclion 3700 of the Labor Code, for the per(ormance of Ihe vrork tor which Ihis pertnit is issued. ❑ I have and will maintain workers' compensation insurance, as required by sectqn 3700 of Ihe Labor Code, fa the peAormance of the work fw which this pertnit is issued. My wo ers' ompensation Insurance c� rrier antl policy number are: // �Cartier:' u--�< �v J S� CL (TniSsecfionneeE�pt�em-7mpefeOAlnece�R' �uetlalonen�ndretlOdlars(St00)aless) Policy Number: / / � �7 � O C — �DO % ❑ I certify thal in the peAormance of the vrork for which this pertnit is issued, I shall not employ any person in any manner so as to become subject b Ihe vrorkers' compensatio laws of Califomia, and agree that if I should become subject to the vrork rs' compensation provisions of Section 3700 of Ihe Labor Code, I 5hall (o �Ih c �nply wi�h �hese provision5. / O g �AOW' aWre Da� WARNING: FAnyU O SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL `P.ND SHALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000�, 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 DECLARATION: I hereby affirtn that I am licensed under provisions 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. ��ic. u S3 2 Gass u C� 3"j GY Cw� Ignawre Da� CONSTRU ION LENDING AGENCY: ❑ I here� aKrtn thal there is a construction lending agency for ihe peAormance of lhe work fa which ihis pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: SignaWre Da�e OWNER-BUILDER DECIARATIONS: I hereby affirm thal under penalry of peijury thal I am EXEMPT PROM THE CONTRACTORS LICENSE LAW for lhe follovnng reason (Sec. 7031.5, Business and Pmfessions Code: Any city or county which requires a permit to constmct, alter, impmve, demolish, or repair any slrucWre, prior to its issuance, also requires the applicant for such permit to file a signed statement Ihat he or she is licensed pursuant to lhe provisions o( the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pro(essions Code) or that he or she is exempt therefrom and the basis for the allegetl exemption. Any violation of Seclion 7031.5 by any applicant for a permit subjects Ihe applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with �rages as their sole compensation, WILL DO THE WORK, antl the strucWre is not intended or oRered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply lo an ovmer ot property who builds or improves ihereon, 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, ihe ovmer-builder vnll have Ihe 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 IJCENSED CONTRACTORS to consWct lhe project (Sec. 7044, Business and Professbns Code: The contraclors License Law dces not appty to an ovmer of propeny who builds or improves thereon, antl who contracts for such project with a contracta(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Prolessions Code for this reason: SigwWre Dale JOS�-A6 pl0'!� � , � Owner ID verifietl by dnver's c .❑ Ves ❑ No r Dnver's License No. Expires: _ Venfication of Ownership by (type of tlocumenl, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certAy that no excavation frve (5) or more fee[ in deplh into which a person is required to tlescend, will be made in connection wilh xork au[honzed by this pertnit, and Ihat no building struclure, scaf(dding, false�wrk, a demolition or dismantling thereof, will be more than thirty-shc (36) feet high. (Chap. 32, Grp 2, Art 2, Sea 347, Title 8, Califomia Administrative Code). ❑ As owner-builtler, I vrill not employ anyone to do work which would require a permit from the Division of Intlustrial Safery, as noted above, unless such person has a permit to tlo such work from lhe tlivision. AVWiwnfs Signalure Date Division of Induslrial Safery Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or presenl or luture building occupant need lo fle and certify a Business Plan for emergenq response to release or mreatenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 0( the Califomia Health and Safety Cotle requires, with some exceptions, thal a Business Plan be (led with the Costa Mesa Fire Department by every business which has al any one lime tluring a reported year a quanlity of hazar0ous materials equal to or greater than a weight of 500 pounds, or a volume o! 55 gallons, or 200 cubic feel of compressed gas at standard temperaWre and pressure�. 2. Does or will the applicant or present or tuNre building occupant need to fle a registration form lor acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Cali(omia Healih and Sa(ety Code, wi[h some exceptions, requires regislration with the Costa Mesa Fire Department by each business which at any one time has on hantl a quantity of acutely hazardous materials equal lo or greater than a weight of 500 pounOs, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standartl temperature and pressure). 3. Does or will the applicant or present or fulure building occupanl need to prepare an RMPP (Risk Management and Prevenlion Program for acutely hazardous materials�? ❑ Yes ❑ No (Section 25534 of ihe Califomia Health an0 Safety Code provi0es that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department ot an RMPP by businesses which are required lo register acutely hazardous materials vrith the Fire Department. 4. If an RMPP is presently reQuired, has Section 25534 of the Califomia Health and Safery Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for Ihe vrork whic� is the subject of this application a pertnit for such construction or modifwtion from the South Coast Air Ouality Management DisMct or fmm any other air polWtion control district or agency? ❑ ves ❑ No (Section 658502 0( lhe Califomia Govemment Code requires Ihat ihe requestetl information be fumished on applications fa non-residential building pertnits). 6. will any paA of Ihe faciliry to be consiructed under this permit be vnthin 1000 feel from the outer boundanes of a school? ❑ Yes ❑ No Qt'yes", the facility must meel lhe requirement of Sec[ions 25534 and 42303 o! the California Health and Safety Code). 7. If a permit from the South Coasl Air Quality Management District or other air polWtion control disirict or agency is required for [he work which is the subject of this application, have all o( Ihe disclosures prescnbed by Cali(ornia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", attach ceAificate of compliance from the appropriate air pollution control oKcer�. CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury Ihe information given above is covect. I a9ree to comply with all state laws antl ciry ordinances regarding Hazardous Malenals and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: i certify under penalry of perjury that I have read this application and state that the infortnation given is wrrecl I agree to wmply vdth all state laws and ciry ordinances relating to building construction, and authonze representatives o( the City of Costa Mesa to enter upon Ihe above-descdbetl pmperty for inspeclion purposes. I agree not to occupy or allow occupancy of any building authorized by this permit unti final inspection. Signalureo' 1'n rR) O e � - MW PVlitdnl - O� . � nA � rI � .. Q.ILa�� COS7A MESA BUILDING-SAFETY DEPARTMENT P.p. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only � BUILDING ADDRE5S — � 7e, C.M OWNER S 11 Ij]C. ADDRESS 136 Rochester Street TEL. CITV costa t�sa 92627 No. 642-49 BRANCH TEL. PA:O 'FR -2-77��;5,00 153�` +�*� 162.Q4 APPLICATION FOR STRUCI'URAL PERMIT RECEIVEOBY OATEREGEIVED neTc�cc��o vr�c OWNER U LOT FIRE ADDRESS 136 Rochestex St. C.M. zoNe TVPE GROUP APPROVED CONTRACTOR �1� BV DATE ADDRESS TEL. E� n NO.OF USE OF N - CITV NO. � PLAN$ BUILD F STATE CITV VARDSAPPROVED YAqDS PROVED � LIC. NO. 2H�.E�.H BZ LIC. NO. MAIN BUILDING ACCESSORV BUILDIN W 512E NO.OF BLIX'.S. (FROM C/ �. OF LOT NOW ON LOT RONT � FT. a VSE OF � EXISTING BLDG. E FT h FSeparate permi[s are �equired for �, SIDE FT. FT. eleclric, plumbing and heating work. � FEAF FT. FT. [.. VSE OF 6UILOING AND WORK TO BE PERFORMED OISTANCE BET. BEf. MAIN & QMAIN BLDGS. ACCESS. BLDGS. � a VAR. DATE _ 1 C.U.P. � —� APPROVED Q � . APPROVED LT i' � O D FU` S��CI�,L REQUfREMENTS w Q I hereby acknowletlpe t�at I hava reatl this epPlleation and rtate � N y� that the pbove Info�metlon IS totfett end aptee to comply wiM m 4 ell laws repulating bulltlin0 conctruction, antl I sheli not employ z any Oerso� �� loletlon of Ma workman's compensetlon laws of a � Me Stete of Celifornie. - .—. 3 1 haroby tertify Mat I em proDo�ly Ilcenwtl aa a connactor untler SQ. FT. �� N tha Smte ei Collfornlo Bu�inasa antl Prolessions Cotle, Divblon 3, THE AMOUNT SHOWN UNDER VALUATION �S FOR m Chapnr 9, entl thac e�eh Ileenfee era In full forca antl affect, or 1 THE PURPOSE OF ESTABLISHING A vERMIT FEE ONLY: am exomOT from tho D�ovlalonsot theSteta of Callfornla Businau iO VALUATION PERMIT FEE 5 � and ProfeSsions Code, Division 3, Chapter 9. � �n n / GLAN CHECK E '^ 0 SIB�ature o� LL Permittoa �� a0� TAX E S� 3 f U Authorizetl ant TOTALPAID E O � -� '�� .� s� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFOHNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING _ _ _ _ _ _ __ _ , _ __ OWNER MAIL TEL. cirv ('psta Mesa 92627 "o CANSTRUCTION __ _ BRANCH ADDRESS TEI. ADDRESS l.tt, xocnester at. �:osra r CONTFACTOR �i[]px' AODRESS TEL. CITV NO. F STATE CITV LIC. NO. '�$ 1 B LIC. NO. � SRE NO.OF BLDGS. LL OF LOT NOW ON LOT a USE OF ^ EXISTING BLOG. � FSeparate permits are required (or � electric, plumbing and heating work. �.W., USE OF BUIIDING AND WORK TO BE PERFORMED Q � -� Tri lex with attached ara e a > r � x v� a '��n-9-7��M`;OQ 6zb �'.�'=7.41.00 APPLICATION FOR STRUC7'URAL PERMIT RECEIVED BY DATE RECEIVED nnrc issucn A.P. NO. BUILDING AODRESS � TRACT FIRE ZONE APPROVED ZONE LOT BIOCK a P 'P EuIEGL �� VALU$ H�y �e � �i TVPE GROUP DATE NO.OF USE OF NEW PLANS BUILDING 'ROVED YARDSAPPROVED ROM C/L STRE VAR. � C.U.P. qy+ 0 I hereCy acknawlatlpe that I have reetl this apP��cetion antl state p: thet the above informetlon Is corract entl epree to comply with a all lews repulating buildlnp eonrtrucNon, entl I shall not amploy z any person in vloletion o1 the workmen's compensatlon laws of � Ma State ot Califomle. 3 I hareby certify thet I em properly Iicensatl es a contractor untler the State of Cellfornle Business and Professions Cotle, Division 3, THE AMO Chapter 9, antl thet sueh Ilcanaea ere In tull forca entl ettect, or � THE PURP� am ezempt from tho provlsions of thaSiato of Californle Business VALUATION entl Profassions Cotla, Dlvielon 3, Cheptar 9. Signeture of Permlttee $ Authorizatl nt & DATE APPROVED OD � n � � � i m N VN UNDER VALUATION IS FOfi m 'ABLISHING A PERMR�FEE ONLV: � PERMIT FEE d n m PLAN CHECK $ ^� 0 TAX E LL f U TOTALPAI