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1692 PALAU PL - Building Permits
'J CITY OF COSTA MESA 4 BUILDING DIVISION ry. 4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER • t !ti • PERMIT ,y' J B04-00581 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1692 PALAU PL Status: ISSUED Suite: Applied: 03/22/2004 Vicinity: Issued: 03/22/2004 Parcel Number: 13927109 Zoning: R1 R1 Applicant: BERBER, ISRAEL 0 ISSUED BY: Address: 2702 W POMONA ST Phone: (714)754-4107 SANTA ANA,CA Zip: 92704 Owner: HUFFMAN, ESKER AUBREY TR Address 1692 PALAU PL Phone: COSTA MESA,CA Zip: 92626 Contractor: R B ROOFING Address: 2702 W POMONA ST Phone: (714)754-4107 SANTA ANA,CA Zip: 92704 License: 772680 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF;TEAR OFF EXISTING ROOF, INSTALL NEW OSB.30 LB.FELT 8 30 YR.COMP.SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,500.00 Permit: $153.25 Claim Valuation: $7,500.00 SMIP Res: $0.75 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $154.00 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, 12-2192) 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 2446-48(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 ^work for which this'permit is Issued. • '0 •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 worLke m pensation Insure carrier and policy number are: (/9 p 9 )� ,Cern r. c7 '1 rC rXL/YId Polity. umber: poo 7/7 `dOO 7 ( ✓his section need not be plated if the permit Is valued of 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 California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these prions. /� ,,Applicant Signature: �^ "JP.r/irw rOate: C —22-09 'WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),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 affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3.pfthe Business and Prof as ions Code,and my license Is in full force and effect.Lic.N 772 6 class'4 0 3 9 MC. �Crac opttors Signature: of 0,4na/., costa: .1—�22 — fJ f/ 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). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penally of perjury that I 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 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 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.). • ❑ 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 drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 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,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more then thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California 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: I 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 tho Costa Mesa Fire Department by every business which has at any one time during a mooned 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). �i..._ .��. _ _ ._ _... 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 greeter then a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature end 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 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 application-1i ermit for such Construction or modification from the South Coast Air Quality Management District or from any other air pollutlen control district or agency? Yes No (Section 65850.2 of the California Government 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? 0 Yes 0 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? 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. S nature Legal Owner(s) _ 0 4 Date ( / And/Or Authorized Applicant Date CODE S INSPECTIONTYPE PATE gRR1JL$ CODES INSPECTION TYPE DATE IMAE5 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final A 208 Final Plumbing ? - 200 Final Re-Roof Ts' a.t�L,. �L 210 Final Electrical 201 Final Block/Retaining Well 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 License 772680 l 4/1/02 To: All Cities Building& Safety Business License By this letter, R B Roofing is authorizing Israel Berber to pull permits& business licenses. lie also has a Worker's Compensation Certificate and a pocket size Contractor's State License. If you have any questions please feel free to call me at 714-412-9778 on my cell phone. Thank You. X1411;9/ teAtet, Refugio Berber 2702 Vi' Pomona Street, Santa Ana, CA 92704 Phone 714-754-4107 Fax 714-754-6499 je - y.,. srlr r op i 1 ' 0`i-- I • Q f�if ` 34,6 5r I::sTws- et . _ ,;+' :: Co PCrt sccrorl I r ++{ 'I I Jia ekTcuS I 41 • �j/_C1 '� To Y cF YtE/L i Q roFL v.'0.7'D �' N PFItt C-LS T,AK �t•/ft .`rid rel.4, I 1 :WM P.:>Tc aC 1-- -, . WOOD To . r` LvSTnccen I 4 :: 6 >< l6 L}— • !3Y OWN.-N FauJJDerr:or! r'&? �� L__. 11 i I �i(VclVril t, CITY Cop: t 1 I - L=t�6C. . I —\fl0¼ ME - Gwrn(G : nRffl i 0• EPT. GATE (a-- I r - to PEr•• peps. aE6-- Ta latjC.T -\ j` !Okb /• - d STJO`) SUBJECT 10 BLDG• / \ _ r STC-P U9 i pATE...,—, } t I— /Z I 'II FActs•at QZ z F-mu.., 4�E I;I! 1 C/ DIRECTOR O q TYF 130TH GATE! . -r-Ree { � 1 �y — 41. " • ' I j ` • 1 �) A � lyU�l � � J �j J STRUCTU4KL APPR$VAL ONLY . I IpP\ U ui{di 9pPci. l yO Cr AO SSG 17/ SEPARATE PERMITS A tEREQUIREDlJi % � 7 ��g / FOR ELECTRICAL, "LUft�BING, HEATING, l'Ei{TILE i I'y:3Ciil0,�4nus `vi Rv HHs uusl He c :u soh oa A ovA REFRIGERATIM WORK I `Y Y aao �Ariess �rml sul I; I VAL i OF ORPT PPRO H;.tIT OR A .-�' �` f ( CE OR GR-::n OF ' p :JT RE CO !/�O NSTRUEO TME ISSU." \F rile `�a ,: El VIOLATION OF PEAdS A•:U 1y-.q. �L OE ANY IS • NU #_ . _ I cANCEE THIS NU;. '.'R i. IS ACCOMPANY (+t TDLpL CEs.ES'.ITfOd OLt )L. CIO PERM17 PTHE ,,�,,))) VLDL tE Ofl IN SO ALL INSPECTION REQUESTS OF ANY 9`.4 n„uCNU;.,I E 3E JALID. EXCEPT WFOL 11 �I SWAIN F *HIS C„C. „ MOBILES E h. quFFM�I,tI 1 PROVISION'(? iitaCl=��t lyHi S11 IT A SED UPDN PIANS AND uH FAR PS THE WORM Un 1692 PAZP UDPCS.;!'”{E PE3SONS ARE TO THE 1 # DENT HE ERftO(Cft I BE EIMN.OYku, •.E S_'S-ST THAT THE i uAl;cE - d17 BUILDING OFFICIAL Cora 2211fO A GEQUI EN A DIVISION OF E UIIt4:1[ THE G HHEF M pREVENTINQ SUSTO FOR L; i SPECIFICPTIO(:�T�R ARt�/V I NDUSTRIAL Si:FO Y tl CU D, FOR � FROM THEREA II N THEREUNDER WNfh IN S„t0 P�i/-50 iN SOEING CARft1ECi OR DACE 1 5d�5 �A3�4.OYAL REQUIREN ENTS. J, G _G�7z I , �IIAAA o7NFR ON I 1 i HUIEUIC'C(vTF4?oGeS,) CDDEIOR OF NY 1 IN VIOUvIpNIUF '� c / J' _ +_T__. _7'.I--_ _i—�— - NF THE CI�{.__. .� i �-./” 14 - - 3 t 10 -°-- ____ VII =1'•'l i L.f�Q FCAfCe I • r__,,15 0 �_ I I Block 5au i•! ., - _ I r.v1 PL�tnl t � ) E. cL&%ATIOki r - iat 2 GF TS -I-3o-79 rirte ' i • � . I NouSe c - j —A • E • ``J • 0 tr- S• ELEVI\TIOU --�- -3— 3-o FeNcE q i scocN Tu2v---A v i- l4 siDEWRLK N No iskLAtE E, Etc-Vett-ton/ • SITE STANDARDS _SPECIFICATION RESIDENTIAL FENCE AND LANDSCAPINQ ::•.:..,,y---- 2'6p MAXIMUM • I FENCE HEIGHT =:1 -E-6I FENCE LINE t>al ll, -# id -F O , : COENEP LOT & FENCE LINE O � p : cUr2a 90'_ _ STLZE T _ `}� .. op,•N••,S vaaeo• �'�.�'�• •• OQp00oop0� 4. aN&Y)114 e d Q9_Fâ\ + _ __ /• O �I GLEAIZ FOR • �� VIStILIT e 1 • w n• l�1 I ••' I i • LANDSCAPING MAINTE-NANCE SECTION A-A A 1-ANIE7A2P rOC. VISit2ILITy AT INTEESEGTIONS AND Dr2lvEWAys 1110111)WHI Wl _.^ IMflfJll�` �i ' CrRADE —ems--� a—car —5—se CETAININO WALL C,Rse.DE Al ` • - ". ''- ELEVATION eEGTIoN Nvl >_ : FENCE puyo ONE HALF WALL a 6 FEET 02 LESS gli , 'Sill 1.13c..•711- rEE RECE�VIED I COSTA MESA BUILDING-SAFETY DEPARTMENT IA�11 NC 211960 J U P.0.BOX 317 COSTA MESA. CALIFORNIA FINAIy QF (�'/[�c7DEfPT. fOR APPLICANT TO fill IN COMPLETELY APPLICATION FO'R""P�ER�16S%�• TYPE OR PRINT BUILDING BUILDING 1692 Palau Place ADDRESS . COSTA MESA. CALIFORNIA Tom. fOR Off/CE USE ONLY OWNER Kenkol Development Co. , nc. I RECEIPT NO. nPER�MIIT NO. MAIL4( 1555 Placentia RECEIVE{Q�BY DA/7E RECEIVED. DATEYBSUED ADDRESS �1t G ,1 ! �y-I- / JAN 1 1 .,� Newport Beach TEL. ,..J. BUILDING �v CITY P N0.6-3777 ADDRESS OR( tT LIC. OR INEER C. COSTA MESA. CALIFORNIA CT FIRE ADDRESS ZONE TYPE I./ GROUP J -1--t CONTRACTOR K.W. Koll L STATE 61195 APPROVED BY DATE 1555. Placentia ADDRESS ZONING Newport Beach LEGAL I LOT •] I 13529 ZONE NO.OF .�)` II USE OF NEW,C.2.c7 a - DESCRIPDON NO. 36' BLOCK TRACT f (PLANS N"BUILDING iJ ) / o _ / APPROVED J// ('(//r// ,� I//1•/V A.P.NO. BY �7.J I P 1 //�DATE !-� A-/'-We SIZE 96x80 irreg .I NO.OF SLOGS. O YARDS LIVES/ -, OF LOT NOW ON LOT REQUIRED ALLOWED USE OF None (CENTER LINE ST.) EXISTING BLDG. � [_�[�,��; FRONT 1/4-52)FT. IN. SETBACK LINE FROM - -- '�"o 40: /' CENTER OF STREET 60- REAR YARD R.SIDE /. FT. IN. SIDE YARD I LEFT 15 II I RIGHT 15' l L.SIDE I SFT. IN. DESCRIPTION OF WORK - �//T. IN REAR • NEW 1 XII ALTERATION I II ADDITION I REPAIR I HI MOVING I II DEMOLISH I SIZIE DING.LUOO Si. NO.OF ROOMS 6 STORIES 1 EXTERIOR ER NG WALL Stocci IROOOF Wood Shingles ING USE OF BUILDING AND WORK TO BE PERFORMED Single-Family Aesidence and Attached Garage I HEREBY ACKNO. DGS THAT I HAVE READ THIS APPLICATION AND STATE T TH ABOVE IS •ORRECT AND GREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH A CIT O'DINANCE- N• S 'TE LAS 9 REGULATING PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. BUILDING C•NSTR C ON. , fes•_ VALUATION SIGNATURE •F . _ , Pitillir • _ PERMIT FEE $ 3r_ PERMITTEE J p _ - _ $ //' 5/35_ PLAN CHECK $ / ?-- AUTHORIZED AGENT TOTAL FEE S OWNER L. H. NUM-MAN DATE 7-0-/7 JOB ADDRESS 1692 Palau Place BUILDING PERMIT NO. 48740 GENERAL CONTRACTOR Owner/builder DESCRIPTION of WORK Vence ,3c,"4 744 C d39-271-09 LOT 36 TRACT 3529 FIRE ZONE VALUES J.000.UU IN... ECTIONS Signature Dote TYPE GROUP ZONE SOIL SUBCONTRACTOR PERMITS ISSI4ED GASData I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE[] HOUSE CON. E SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER q • ROUGH WIRING - Heating and Vent. TRENCHES ["FORMS 0 STEEL REINF. 1!'- ✓- FONDR SYSTEM BOND BEAM n STEEL REINFORCE [i 51/6?--% , SHEATHING FRAME AND FLASHING LATHING - IN 11 OUT [l PLA"ER, BROWN COAT - • A�! S' 'URAL, FINAL /_may ey-�1�0 Elertric HEA.INC, VENT., REFRIG. AND A,C., FINAL 7!/ PLUMBING, FINAL AND GAS TEST [] ELECTRIC. FINALo BUILD UI DING,FI me care ` '`J'/,y v -3j/ iB,e//G 76'itleto CAS )7 0,0 /OS Y - s 7re / ne€,tcM .3-7?Po 2493 9/05/79 �� i, -, TL ., `\ COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATIOI FOR STRUCTURALPERMIT r P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 0—I REC O V $! TJoRMISimalaLlmr For Applicant to Fill in Completely —Use Ink Only MIS BUILDING .{-� A.P. NO.ADDRESS 1609Z PA� rLL10E / 7z� a .. m. OWNER OR ADDRESS ////(C//�7 TENANT pt,�AlC—Q OR MAILING SPACCE NNO. ADDRESS SAA-ICSPA T R.Njy�� LOT 1BLK. Cos-r4 /�� TEL. (rll�Jcza CITY I�OST4 MC-5A NO. CONSTRUCTION NEW I ADD ALTER (REPAIR IMOVINGIDEMOLISH LENDER rVDA.(C BRANCH s.. 0. OWNER / Qii� ADDRESS ALUE /00r����yyyy,,,, ARCHITECT TEL. USE �t ca.__ b (� OR ENGINEER NO. ADDRESS ZONE TYPE GROUP APPROVED /t CONTRACTOR BY DATE fi.lr ADDRESS TEL. CITY NO. F STATE CITY APPROVED SETBACKS LIC. NO. LIC.NO. Lta SIZE ` NO.OF BLOC (FROM Cl• STREET) Cs OF LOT O �d NOW ON LOT ' FRONT I a T. a USE OF (r I / J 4 EXISTING BLDG. RESuJE—AtICC -ASI._ ;' / r //stYVA,//�/e_f•/ VD 1 H Separate permits are required for '•Sr FT' f C electric,plumbing and heating work. EAR E- (—, USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE /zENCe / y� /� 1DAtE7_APPROVED 7111, AROV / �I CC I hereby acknowledge Information tithon I have read this applicationa and stwith (� Vy) '/y��y'^4%�`'l� (Y that the above Information is rand agree comply with C. all laws regulating building construction, and I shall not employ � Z any person in violation of the workman's compensation laws of o 'WT. the State of California. .: m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 0 Chapter 9, end that such licenses are In full force and affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE S rr, �� and Professions Code,Division 3,Cha ter 9. H n Signature of z 1 / PLAN CHECK E S cc 2 Permittoe �/ ' / ©Q S 000 TAX S imii— or , So U Authorized Agent Date 9— c 79 "V TOTAL PAID S /7. 00