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Home My WebLink About970 GOVERNOR ST - Building Permits� CITY OF COSTA MESA ��pM"q B!/ILDING DIVISION �� 77 FAIR DRNE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us ��'�o FOR INSPECTIONS CALL: (714) 754-5626 "� PERMIT NUMBER: B10-00233 PERMIT TYPE B_ROOF2 APN: 42242325 JOB ADDRESS: 970 GOVERNOR ST CM Vicinity: Squares: 0 STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: Valuation ISSUED 0810612010 BE $3,000.00 SCOPE OF WORK: TEAR OFF EXISTING COMP SHINGLE AND INSTALL NEW 30YR COMP SHINGLE ROOF WITH 30LB FELT APPROX 13 SQUARES. OWNER: LEFFLER, WAYNE E Address: 3025 SAMOA PL Unit: PHONE: City/State/Zip: COSTA MESA, CA APPLICANT: JOHN BATIOFF PHONE: 714381-7974 CONTRACTOR: THE ROOF GUY Address: 9787 EAS7WOOD ClUnit: City/State/Zip: VILLA PARK, CA g2867 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Sld Admin Fund $o.00 $83.25 so.00 $1.00 Address: City/State2ip: PHONE: Litense No. License No. Unit: : LicenseNo. �899593"'�15(�0�%3 714-921-1500 CELL: PHONE: PHONE: HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday Ihru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am Ihru 6:00 pm. Prohibitietl all hours - Sundays and the following Federal NOTICE: The vrork aulhorized by thiS permit shall comply with all applicable handicap access requirements under Cali�omia statutes and relatetl 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 lhe woAc authorizetl under this permit to be considered legal, such work must comply with all applicabla codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permil. COD�E I INSPEC710N TYVE �AT IN TIAL CODEI INSPEC➢ON iYPE 0� INPTIRLS 1616 Fi.eO System Final Fire Prevenlion 206 Final MeChaniCal 72fi6 Pool Spa Final � �(� 208 Final Plumbing 200 Final Re-Roof ��l1iKi 210 Final Electnwl 201 Fina181ocWRelaining Wall 212 Final Fire Preven�ion 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupanty WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following tleclarations: ❑ I ha antl will maintain a certifcate of consenl to selt-Insure !or workers' compe ation, as providetl for by seclion 3700 of Ihe Labor Code, for the ped manCe o( Ihe work lor which this permil is iS5ue0. I have and will mainUin Harkers' compensation insurance, as requiretl by section 3700 of the Labor Code, (w the performance of the v.ork la which this pertnit is issued. My workers' compensalion Insurance carrier and policy numberare: �� _ p _ r� Carrier. 'f7.t.J�{� I (Th¢seamnaeorroloeoompet epem'�irt1isvCalu�e''tltatonanurMredoalars(St00)aiessJ Policy Number. � �' �T i �/ ❑ I certify ihal in the peAormance o( the vrork 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 b lhe workers' compensation provisions of Section 3700 of the Labor Cotl I II f rt�with comply vdlh these provisions/ .�/ �'b l � A nf Sigwlure Dale WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF25 ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAM�GES AS PROVIDED FOR IN SECTION 3706 OF TNE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrm that I am licensed under provisions of Chapter 9(commencing vrith Section 7000) of Division 3 of lhe Business antl Professions Code, and my license i�n�lj f�e� eHecL �p�� 9/ li1 I 1 Lic. k ( �iJy7.� � Class tt _��.t. ICf71� � O �b / � Conuattor's ature Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby af(um that there is a construction lending agency for the peAortnance ol the xqrk for which this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenaer's Address: SignaWre Da�e OWNER-BUILDER DECLARATIONS: I hereby a((rm that under penalry of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business and Professions Code: Any city or counly which repuires a permit to construct. alter, improve, demolish, or repair any slructure, prior to its issuance, also requires the applicant for such permit to file a signed statement lhat he or she is licensed pursuant to [he provisions ot the Contracrors License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ne Business anC Professions Code) or that he or she is exempt therefrom antl the basis (or the allege0 exemption. Any violalion of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o( not more than five huntlred dollars (5500).): ❑ I, as owner o! the pmperty. or my employees with wages as their sole compensation, WILL DO THE WORK, and lhe slruclure is not intended or offered for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law dces not apply to an ovmer of property who builds or improves thereon, and who tloes such vrork himself or herself or through his or her ovm employees, providetl that such improvemeMs are not intended or offered for sale. If, hovrever, the building or improvement is sold within one year of completion, Ihe ovmer-builder will have the burden of proving Ihat he or she did not builtl or improve lor purpose of sale.�. ❑ I, as ovmer ol Ihe property, am EXCLUSIVELY CON7RACTING WITH UCENSED CONTRACTORS to construct the pmject (Sec. 76a4, Business and Professbns Code: The contractors License Law dces not apply to an ovmer of property wfio builds a improves thereon, and who contracts tor such projecl wich a cmt2ctor�s) license pursuant ro the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Cotle for this reason: Sign2Wre Dale 3051A6(10'!) � Owner ID venfied by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verifiwtion of Ovmership by (rype ol document, i.e. - property taz bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certify thal no excavation frve (5) w mwe feet n depth into wfiich a person is required to descend, will be made in connection vrith wnrk authonzetl by this pertnit, and that no builtling structure, scaffdding, (alsev.ork, a demolition or dismanlling thereol, will be more Ihan Ihirty-su (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, T�le 8, Califomia AdministraMe Code). ❑ As ovmer-builder, I will not employ anyone to do work which vrould require a permit from the Division ol IntlusMal Safery, as noted above, unless such person has a permit to tlo such vrork (rom the division. Aod��'s s�e��e Dale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant neetl to file antl certify a Business Plan tor emergency response to release or Ihreatenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health antl Safery Code requires, with some exceptions, that a Business Plan be fled with Ihe Costa Mesa Fire Department by every business which has at any one time durinq a reportetl year a quantity o� hazartlous matenals equal to or greater than a weight ol 500 pounds, or a volume ot 55 gallons, or 200 cubic feet of compressed gas at stan0artl tempereture and pressure). 2. Does or will iha applicant or present or future building occupanl need to fle a registretion torm for awtely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health antl Safety Code, wilh some exceptions, requires registration with the Costa Mesa Fire DepaAment by each Dusiness which at any one time has on hand a quanlity o! acutely hazardous materials equal lo or greater Nan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of wmpressed gas al slandard temperawre antl pressure). 3. Does or will ihe appliwN or present or future building occupanl need to prepare an RMPP (Risk Management antl Prevention Prog2m lor acutely hazardous materials)7 ❑ Yes ❑ No (Section 25534 0l the Califomia Health and Safery Code provitles that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials with the Fire Oepartment. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Salety Code been fully complietl vrith? ❑ Ves ❑ No 5. Does or will the applicant or present or WWre building occuDaN roquire for the work which is ihe subject o! this application a permit for such consWclion or motlifcation Irom the South Coast Air Quality Management Districl or lrom any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 0! the Califomia Govemment Code requires that the requestetl informa�ion be fumished on appliwtions ta rao-resNential building pertnits). 6. Will any part of lhe faciliry to be wnswcted under this pertnit be within 7000 leet from the outer boun0aries of a school? ❑ Ves ❑ No p( yes", the facility must meet the requirement of SecUons 25534 and 42303 of the Calitomia Health and Safery Code). 7. If a permit from the South Coast Air �ualiry Manaqement District or other air pollution control district or agency is required for lhe work which is the subject of Ihis applicalioq have all of the disdosures prescribetl by Califomia Health and Salety Code Section 42303 6een made? ❑ Yes ❑ No 8. Qt "yes", attach certificate of wmpliance from the appropriate air polWtion coNrol officer). CER7IPICATE OF COMPLIANCE: I certify that under penalry ol perjury the inlormation given above is correct I agree to comply with all slate laws and ciry ordinances regarding Hazartlous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury thal I have read Ihis application antl state that the infortnation given is conecL I agree to compty vrith all state lav+s and city ordinances relating to builtling conswciion, and authorize representalives of the City of Costa Mesa to enter upon me above-descnbetl property for inspection purpose . I e ro oc pg.er allow occupancy of any builGing authonzetl by Ihis i�7 mspection. �/�� O SignaWreo ner(s) D k 7� � �/ Anabr Ao�M1onzee AOOliwm Da�e � JOB ADDIiE55 I' ECTIONS House 7 1T V� BUILDING PERMIT Date GROUY J TYPE SUBCONTRACTOR _, . � _ . 27559 . . COSTA Ml�SA BUILDINCrSAFETf DEPARTMEP(r P, O. BOX 120� COSTA MFBA, CALIFORNIA 02E2E Foi Appllmet fe Ftll In Compleldy TYPE OR PRINT COSTA ME6A, CALIFORNIA ,, or e�nw. 88TBACK L�N[ InOM 6FT l � RIOlfT DESCRIPiION OF WORK 1 N6M6GY ACRNOWL�DO[ TNAT.1 MAV[ pYD TNI� A�ILIGTON AND eTAT6 TMwT iNt AGOV[.10 COM[CY AND A011[[ M COY. PLY w1TH ALL CITY OIIDINIWCO AND RA*{ lAW/ II[OYLAi1N0 OUILDINO CONBTRUL?ION. BIONAYURQ OP '�� i� � PHRA71T78� w AUTXORIZ[DAO�NT��R Y.a.p c yHa+�... �. SEP 1 �r67cnsn.00 379 � c:':";�':S..;C MPLICATION FOR PERMR BUILDING for OHIn U» Only 11[CtIR NO. if ZONINO �� -�y3-�s OVHRHANO BHALL EH LQ88 TMAN YARDB MPROVED MAIN BUILDING :OM GL RPHLT) ear. vwrt. # VARDBAPPROV6D ACCfi880RY BUILDINO DAT@ �� TI[ AMOUIR tNOWN YN06q VALUATON �e /Op THt ►URM![ 0► [RAGLIOMINO A �6NYIT I[t ONLY. VAWATION � PBNMIT PE6 � • o�,SO X � TOTAL PHH � C W ��y I � 0 A 7 W E w ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT � �� ; � 636 Norfh Broadwar , � � � � �' � � � SANTA ANA, CALIFORNIA ` .,_ � FOR APPLICANT TO FILL IN FOR OfFICE USE ONLY � - REGEIPT NO. PF.AMIT NO. BUILDING � �� aooRess 970 Governor St. ' ri�i.'2(��Q SCHOOL DIST. RECEIVED,BV DATE REC'O. DATE 158trlD OR TOWN Ci�Bt$ Mesa rn/^�^—/ (� �y � CROSSSST. StHUC OY• �h v// �7 �f�/ /� OWNER ADORESS . / //J /�`�lll t..[�I �I�iiN/ t Chicksam Homea Inc. 2A� � MAIL 9363 Wilshire Blvd. ADDRE55 ��r Beverly Hille �o Cx 54361 ARCHITEC��,�n—McKerracherNo � ENGINEER ADDRE55 2110 E.Walnut—Pasadena .JTRACTOR A&ZbOB VSBY�& dQl 1`F�'L�1 ADDRE55 g'i63 Wilshire—Beverlv Hil ��.�-r:, USE OF I NO. OF I NO. OF E%ISTING BLOG. F�Mi�iea R 5 SETBACK LINE FROM:'1 s� FEAR YARD CENTER OF STREET W� 1 L. SIDE YARD O�- DESCRIPTION OF WORK SIZIED'1�JW eq.ft.ROOMS � STORIES EXTERIOR WALL�. I ROOF O�DO �VERING DtUCCO COVERING 2'11II _ ,ILDINGEW REBSC BIICB�Rtt . Carport A f CORRECTIONS FOUNDATION: I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORM5,1 APPLICATION AND STATE THAT THE I�BOVE IS CORRECT UNDER-P. AND AGREE TO COMPLV WITH ALL COUNTV ORDINANCES FRAME: FIRE BRACING AND STATE LAWS REGULATING BUII.DING CONSTRUCTION. AUTMORIZED VALUATION S 1��o.00 PHHMIT FE8 i/[� �+ � PL�N CMECR � TOTAL �� FEE IVALS INSPEC' DATE . j,il � �J O � � z n r STREET PLOT PLAN Show location ond distances from property line and between buildings. . �. , 1��' 1 r • Y .J'. � .'y'•n:. f'\�^ ' �y,�., .,__,n� ' . � ...? ^'.'�� . `J: 1 'S : .,": . .r .: 9 ' ... . . . �" ..- ' - - -- - ' � ,. A` ''� , . .,,'Fi . .�:'• y:;. � . . _ ;-r•:`:^'�-a':_ .-.._ •;'i -- -�� >n.•-� r,ri-_ " �. . _. '7 t'- . . (L"r'af' r„� .�+�p; ;-.,�.::'�� ' _ . - - . . i. f,,. f. . _ .�..` - . : �- ..-9•'_. � _ . . �� r } ^ . . . ' ,1 .. �rl ( F f'n .. . 7��. _ ' I r�_ i�� . r.. ,+4 2��' . .. � , .n � � . .�.,. � +'"J . 4� : _.. � O:iG.. .. . 3'Y�i . � �i�.:. J " .— . ' o . . . � ' "' "" ` "_ __ _ "_ " � .. t _. t'` _ _ � 1 ' " � d�� u . . �: � �:. . � . ��...':F�� ' . �