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Home My WebLink About2085 GOLDENEYE PL - Building Permits CITY OF COSTA MESA 4 , BUILDING DIVISION • :l ;, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMB R 1. tarl.Iis argik PERMIT 4h,muton . B04-0 31 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2085 GOLDENEYE PL Status: ISSUED Suite: Applied: 08/31/2004 Vicinity: Issued: 08/31/2004 Parcel Number: 13954401 Zoning: R1 R1 Applicant SHULMAN,JOSEPH ISSUED BY: _ Address: 7721 ETNA CL Phone: (714)536-5116 HUNINGTON BEACH,CA Zip: 92648 Owner FLOREY, JERRY J TR Address 2085 GOLDENEYE PL Phone: COSTA MESA,CA Zip: 92626 Contractor: SHULMAN ROOFING Address: 7721 ETNA CL Phone: (714)536-5116 HUNINGTON BEACH,CA Zip: 92648 License: 690617 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT T/OFF WOOD SHAKE INSTALL 7/16'OSB,30LB FELT AND INSTALL LIGHT WEIGHT EAGLE TILE 7.2PSF ICBG 4660. FEE SUMMARY Plan Check: $117.81 Calc Valuation: $9,487.00 Permit: $181.25 I Claim Valuation: $9,487.00 SMIP Res: $0.95 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $300.01 . • 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)7545626 2446-48(8/00) DECLARATIONS ( s ( l WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: A ❑ I have and will this ea Is uete of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and wit 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 work � �mpq�sation Insuryce carter and policy number are: cam: ?�-4•r AL,APct 'Nam e: figi- rn2-/Kc,-Qy (This section need not be completed If the permit Is valued at one hundred dollars($100)or less.) ❑ I 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 fomia,and agree t If I shId become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr ons. A/g'o_ — Q^ APPI`a0t A/w✓ter alei rs' / d el WARNING:FAILURE TO S RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S1 ,OCO),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 affirm that I am licensed unde r Igns gf Chapter 9(commencing with Section 7000)of Division Rte Business an Prrooffeiions Code,and my license Is in full forseand�ifl�ce R'k.q h ! IC. co t re: ii.c g / OY CONSTRUCTION LENDING AGENCY: ❑ I 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 1 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 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 end 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.). • O 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 Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 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: O 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,end 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,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 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 certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 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,ore 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? 0 Yes 0 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 WIII 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 Califomia 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 an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 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_ ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished 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 Califomia 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? 0 Yes 0 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. Signature)/-.al Owner Date And/Or Authorized Applicant Date a ;ODE F INSPECTION TYPE 29IE ittTITIAL6 CODE! INSPFCTION TYPt v DATE RMALs 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �f208 Final Plumbing 200 Final Re-Roof 4-1 11'41 S�.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 28023 , COSTA MESA BUILDING-SAFETY DEPARTMENT • - JAN.12 6110 435* ***135.75 P.O.BOX 317 COSTA MESA,CALIFORNIA a For Applicant to Fill In Completely APPLICATION FOR PERMIT Trq� 5492 TYPE OR PRINT Pl . 64-CR BUILDING For Office Use Only ILDING • ADDRESS 2085 Goldeneye Place RECEIPT NO. 2 IT23 COSTA MESA, CALIFORNIA G�1lJ IG�J RECEIV D B DATE RECEIV D DATE ISSUED OWNER Mesa Verde Builders f-/ -b? ON 1 6 1968 MAIL BU I LD I ADDRE G t 5 A3 ADDRESS 2850 Mesa Verde Drive Costa TEL. FIRE CITY Costa Mesa NO,549,3395 ZONE TYPE GROUP APPROVED ACHITECT' OR cy NEER Kaltenbach rTio'5478046 BY DATE AdrNs 1823 E. 17th St . S.A. ZONING ZONE I PLANSNO. I USE DI NEvbingl Fan. E•l 2 BUILDING att gar/ CONTRACTOR Mesa Verde Builders ILL LEGAL ADDRESS 2850 Mesa Verde Drive DESCRIPTION Lot 11, Tract 5492 CITY Costa Mesa, California A.P.NO. none NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE 181269 TEL 549-0395 90'TO SIDE&REAR P.L. SIZE EAVES SLOT 59x92x108 I NOW ON LDTS 0 ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/LST$€ET) SETBACK LINE FROM 65 , 22 ' FRONT C () FT. PT. CENTER OF STREET V REAR YARD - SIDE YARD I LEFT 5 ' I RIGHT 10 1 R.SIDE I 0 Fr.S�~� FT. DESCRIPTION OF WORK L.SIDE T. FT. X REAR NEW ALTERATION _ ADDITION (f SBFT. FT. DISTANCE BET. •BET.MAIN @ REPAIR I MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. BUILDING 2163 S NO OF 8 2 VAR. DATE SIZE q ROOMS STORIES C.U.P.$R APPROVED EXTERIOR WALL Wood IOROOF APPROVED COVERING StucCW COVERING wood ' BY W. L. D.4 �TE 1-3-68 ' USE OF BUILDING AND WORK TO BE PERFORMED 1_ : .,moi i /. l / / I Fr ,40#14, . I HEREBY AOKNOV/LEDOE THAT I HAVE -- D THIS APPLICATION THE AMOUNT SR. N UNDER VALUATION IS FOR THE • AND ITH THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY TN ALL cR RDINANCBS AND STATE LAWS REGULATING VALUATION 5 90 tO BUIL NO CONS1/R I//. RDI. AS PJ. /J `/ H ' SIGNATURE-{l)F7//,..y�1� J/�e�lya PERMIT FEE PERMITTEE Y�"'�� F/ �Y� //�� / • AUTHORIZED AGENT sc2 / n, I" PLAN CHECK $ .. oz ,. Q 77 «((G�Jr/ /J 4 TOTAL FEE 5/196 •