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Home My WebLink About1856 PARKGLEN CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us NOTES: BUILDING PERMIT Job Address: 1856 PARKGLEN Cl Suite: Vicinity: ROOF Parcel Number: 42431118 - Zoning: 06/09/2003 Applicant: CHAMBERS, DARRELL SMIP Res: $0.63 Address: 414 N SHATTUCK PL - Other: $0.00 Inspection: $0.00 Phone: 714-771-3658 ORANGE, CA,,- Zip: 92666 Owner: TURNER, CHARLES J TR Address 1856 PARKGLEN CIR ' - Phone: ',.COSTA MESA, CA ' Zip: 92627-4507 Contractor: CORNERSTONE ROOFING Address: 414 N SHATTUCK PL • Phone: 714-771-3658 ORANGE, CA Zip: 92666 License: 616586 Arch : - Eng: Address: .. Address: 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 06/09/2003 Issued: 06/09/2003 ISSUED �—✓ Phone: Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING ROOF. INSTALL 7/16" OSB SOLID SHEATHING, CLASS A CERTAINTEED, 50 YEAR, COMPOSITION SHINGLES, 30# FELT INSTALL TORCH DOWN ROOF ON FLAT SECTION. 20 SQUARES INCLUDES ATTACHED GARAGE. 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 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) 754-5626 2446-46 (fi=) I FEESUMMARY Plan Check: $0.00 Calc Valuation: $6,254.00 Permit: $139.25 Claim Valuation: $6,254.00 SMIP Res: $0.63 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.88 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 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) 754-5626 2446-46 (fi=) I WORKERS' COMPENSATIGiN DECLARATION: I hereby affirm under penally of perjury one of the following declarations: ❑ 1 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. 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 workers' compensation Insutance carrier and policy number are: Carder: S l 1,,,o24 Policy Number: _2e A 420 05 (This son nee not be completed it the permit is valued at one hundred dollars ($100) or less.) (Thisecti ❑ 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 thesa�roXisions. Applicant Signature:�–��/� Date: _ ^6 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOME HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under flovisions 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. Lic. N S9Co . Class N G- 39 /i`/G Contractors Signature: ZS aQ, Date: — _ ^ lot? —&1 3 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 Coda). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty 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.). ❑ 1, 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 contractors) 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. ❑ Yes ❑ 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 than 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: Data: 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? ❑ Yes ❑ 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, or a 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? ❑ Yes ❑ No (Section 25533 of the Celifomia 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 will the appplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ 40 (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 Nen RMP' is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this Uplication a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... .......................................................................................... ..... YP Y ... .... 6 Wlil an art of the facilit to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Vas ❑ 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? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 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 e-described property for inspection purposas. I agree not to occupy or allow occupancy of any building authorized by this permit t9 final inspection. Ig ature Of Le al O der s / _ Q �Oat3 L And/Of Authorized Applicant Date CODE Y. INSPECTION TYPE PATE INTMALs CODE ♦ INSPECTION TYPE g9TE INITTLALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof SLS 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 SOP, COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Lot -52 For Applicant to Fill in Completely ) —AR BUILDING _ OWNER lIQperial 5avinae & Loan. P"'0 „,.9�F-71CNSA00 Boa fr13s.50 APPLICATION FOR BUILDING PERMIT MAIL RESS 66 Via—Lido, H Ju W W PERMIT NO. BUILDING TEL. FZ EESS 43 r—F;Aacb NG(,'J�—� 7'20 7 Pial Z QSTRUCTION _ J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. 1 a B ------- & Loan ONDER am VAR.# O resldence( �,, J NCH APPROVED AD: am J N RY Z Q WRESS m J O J MHITECT R. LaYana$ TE "71-7010 UI NGINEER U kAODRE all laws regulating building construction, and I shall not employ Q F any person in violation of the workman's compensation laws of W RES the State of California. t-BW— I hereby certify that I am properly licensed as a contractor untler SO. FT. THE AMOUNTS JOTRACTORmZ Chapter 9, and that such licenses are in full force d effect, or I THE PURPOSE OF am exempt from the rovisions of the state alifornia Business VALUATION J 2RESSW Signature Permittee + W $ TEL Z F Ne rt -Be Ch ND0- OTE CITY M NO. LIC.7 LOT 50 X 100 NO. OF BLDGS. I NOW ON LOT 0 P"'0 „,.9�F-71CNSA00 Boa fr13s.50 APPLICATION FOR BUILDING PERMIT FIRE ZONE APPROVED ZONE NO. OF USE OF NEW �J I -"""- R1 PLANS 2 BUILDINGRes./Att.Gar YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING DATE RECEIVED —DATE ISSUED H SIZE OF NO OF I PERMIT NO. BUILDING 6 Parkglen Circle EESS 43 LOT BLOCK 7 Pial COVOERING8hake—CO a REAR FT. _ J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. 1 a Savings & Loan VAR.# O resldence( �,, CVALUSAl D APPROVED AD: am N FIRE ZONE APPROVED ZONE NO. OF USE OF NEW �J I -"""- R1 PLANS 2 BUILDINGRes./Att.Gar YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING BET. MAIN & ACCESS. BLOGS. DATE APPROVED 3-24-71 EXISTING BLDG. --------- T H SIZE OF NO OF I z NEWSLDG.1620 sq. ROOMS 7 STORIEs2 L. SIDE FT. U, WALLS tUCC0 ROF 7 COVERING COVOERING8hake—CO a REAR FT. _ J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. 1 a MAIN BLOW. Q VAR.# O resldence( �,, C.U.P. qy+ F APPROVED AD: am N RY Z O UI hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of N the State of California. Z I hereby certify that I am properly licensed as a contractor untler SO. FT. THE AMOUNTS the State of California Business and Professions Code, Division 3. Chapter 9, and that such licenses are in full force d effect, or I THE PURPOSE OF am exempt from the rovisions of the state alifornia Business VALUATION and Professions e, Di isio hapt Signature Permittee + $ Author tl pent BET. MAIN & ACCESS. BLOGS. DATE APPROVED 3-24-71 0 O VALUATION IS FOR A PERMIT FEE ONLY: ry E $ m 7 :K$ E 0