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Home My WebLink About1009 PARKHILL DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1009 PARKHILL DR Suite: Vicinity: ROOF Parcel Number: 42431314 Zoning: 09/29/2003 Applicant: JAUREGUI, JESUS SMIP Com: $0.00 Address: 1009 PARKHILL DR Inspection: $0.00 Phone: 949-631-1591 COSTA MESA, CA Zip: 92627 Owner: JAUREGUI, JESUS Address 1009 PARKHILL DR Phone: 949-631-1591 COSTA MESA, CA - Zip: 92627 Contractor: OWNER -BUILDER Address: Phone: Arch : Address: Zip: License: 000000 Phone: Eng: Address: Status: ISSUED Applied: 09/29/2003 Issued: 09/29/2003 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL VILLA, DURALITE, 5.8 LBS., ICBG #ER2656. 13 SQUARES INCLUDES ATTACHED GARAGE. Plan Check: $72.31 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $184.06 SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 NOTES: FEE SUMMARY PLANNING & ZONING Left 0-0 Left 0-0 Proposed: 0 Calc Valuation: Claim Valuation Right 0-0 Right 0-0 $4,600.00 $4,600.00 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 it 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 2466-06(&00) WORKERS' COMPENSATION DECLARATION: r I hereby affirm under penalty 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 Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it 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 C end agree that If I shout become subject to Na workers' compensation provisions of Seco n 3700 of Labor Code, I shall forthwith comply with these ions. p /h//a Applicant Signature �y�--moi Date: ��L�T�� WARNING: FAILURE CURE WORKERS' COMPEW06ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), 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 of the Business and Professions Code, and my license is in full force and effect. Lic. M Class N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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 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 permlt 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 Ls sold within we 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 proje with acontractor(s) license pursuant to the Contractors License Laws.). 7nf I am axe� u d'e/r s—ec. Business and Professions Code for this reason: Signature: //LdSlf�'Date Owner fled by driver's licen [IYes ❑ No Driver's License No. , Expires: Verification of Ownership by (type of document, i.e. - property lax 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 B, 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: 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 builtling occupant need to file a registration forth for acutely hazardous materials? []Yes ❑ 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 o1 compressed gas at standard temperature and pressure). .._..............._.._......._............_ ........__._..............___................_.___.__....._......_........................ildi.........ccup__._.................__......................_._....................__._.......................................................___......._...._hazardous-m. 3 Does or will the appplicant or present or future building occupant need to prepare an RMPP (Risk Management end 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 tiling 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? ❑ Yes [I No ......._........................................... ....... ...................................... _............................................ _..__........................... ._....__.................. . 1 ............................. _................ _._............ _............ _.._... 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication apemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes IJ 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 at 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 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 ............................................................................................................................................................................................................................................................................................................................................................................................ B (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 er" property to aetion purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final insg ction. ;yP763 Signature Of Legal Owners) Date And/Or Authorized Applicant Date CODE 1. INSPECTION TYPE DATE INTMAL4 CODE 1 INSPECTIONTYPE RAIL IIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof �q -le-oZ 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 OWNER STANNARDCraig DATE 1/9/7-j OJOB ADDRESS 1009 Parkhill 'Dr. BUILDING PERMIT NO. -i5882 `SAP No. 116-013-14 LOT TRACT FIRE ZONE VALUE $ 450.00 INSPECTIONS Si nota,. Date GROUP J TYPE V ZONE R=1 SOIL SUBCONTRACTOR PERMITS ISS ED GAS Date Number Si nature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES E] FORMS [—] STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN M OUT PLASTER, BROWN COAT STRUCTURAL, FINAL _ HEATING, VENT., REFRIG. AND A.C., FINAL _ PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL �' / G ji " `'t3" PF 10 ;,;c �n-13-- 00 515'515-".-�r•'+�r��t�5.50 crl�r 35882 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY DATE RECEIVED DAT ISS ED BUILDING ADDRESS ST C S A.P. NO. PERM OWNER j T MAIL A 1 L BUILDING ADDRESS O0 Z ADDRESS •� f a U WW CITY TR 0 rQ No. y6-SS66 TRACT 7O�I•� LOT BLOCK Z_fg Z Q CONSTRUCTION W A A P O N LENDER Pi CL m J D J tn BRANCH OWNER �/CY <W M_1 ADDRESS VALUE _Sm Q ARCHITECT TEL. S&44e $ U < OR ENGINEER N FIRE W ADDRESS ZONE T PE GRO P dw APPROV J Z CONTRACTOR AV — .Q BY DATE T Z S E' J m ADDRESS w W ZONE (J / NO.OF USE OF NEW 0 lt = CITY NO / �/ PLANS ;D, BUILDING ZF STATE CITY YARDS APPROVED YARDS APPROVED U.1 (C LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING =U IF ROM C/ ET SIZE NO. OF BLDGS. OF LOT NOW ON LOT FRONT FT. USE OF fl Ofr EXISTING BLDG. (Y- o FT. H SIZE OF NO. OF S Z NEW BLDG. ROOMS STORIES L SIDE os� FT. FT. UEXTERIOR WALL ROOF Z/ _ COVERING COVERING REAR FT., FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& 1 a MAIN BLD S. ACCESS. BLDGS. QVAR.+ DATE Q G/ C.U.P. * APPROVED F- APPROVED . 1 1 9--7 N W1 Z 0 UI hereby acknowledge the, I have read this application and state STATE that the above information is correct and agree to comply with cc all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of fn the State of California. e z I hereby certify he, I am properly licensed as a contractor under SD. FT. TAX o THE AMOUNT SHOWN VNDER VNIMATION IS FOR the State of California Business and Professions Code, Divisicn 3, Chapter 9, and that such licenses are In full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a ' am exempt from the provisions of the State of California Business and Professions Code, Division Chapter 9. VALUATION �� m � PERMIT FEE $ J �� Signature of r m Permittee $ 0o) PLAN CHECK $ E Authorized Agent V LL TOTAL FEE $ .�� f.* 32,513 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1290 COSTA MESA, CALIFORNIA 92626 p,7_�13tFor Applicant to Fill in Completely PEC-2-7(°CXSAA1—°00 164* *** 133.50 APPLICATION FOR BUILDING PERMIT RECEIVED Bf I DATE RE I ED DATE ISSUED /-� _ _ �� PERMrTM9. q OWNER � _ A.P. NO. _•- BUILDING _ // ADDRESS / 0 O n (� J1 MAIL Z W W D. U Z Q ADDRESS 0 r TEL. CITY / �^ NO� 1 TRACT �Q 3 LOT BLOCK W A D CONStRUCTION O F- LENDER l� a m J 7 BRANCH J to Q W M J J Q V) W < OWN6 ADDRESS �/'/ VALUE�� ., " ARCHITECT TEL.USESS'y'`` OR ENGINEER S N e vi FIRE ZONE TV PE GROUP=;I i`/ ADDRESS 3r Z�% APPROVED 2 W W O CONTRACTOR �z(• BY DATE to J M WW ZF ADDRESS ZONE NO. OF PLANS USE OF NEW BUILDING TEL CITY k� NO Q� �� STATE CITY LIC. NO. LIC. NO. YARDS APPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING WO N (r O SIZE A ND. OF BLDGS. /y OF LOT ya/O NOW ON LOT [/ (FflOM C/L STREET) FROM SFT. FT. USE OF EXISTING BLDG. � SrST FT H Z SIZE OFJJ JJ�� p / NO. OF NEW BLDG, f7�L/ ROOMS STORIES L. SIDE FT. FT. Q EXTERIOR WALL COVERING LGO ROOF r�'0/6iY COVERING �--+ REAR rJFT. FT. J CL C USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. MAIN BLDGS. BET. MAIN & ACCESS. BLDGS. O V vUR CPWr--7 3-70 AP ROVED — % 12d F (n F1 CJ Z 0 UI x F- N ? 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 1 shall not employ any person In violation of the workmen's compensation laws of the State of California. I hereby certify that I am properly licensed ase contractor under SQ. FT. THE AMOUNT SHOWN UNDEWVALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt provisions of the Stat f California Business antl Profq ons Code, (vision 3, Chap Signature ofm Permlttea THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY' a m N ] EE a VALUATION ' $ r],�r v V z PERMIT FEE $ r PLAN CHECK $ % Authorized Agent TOTAL FEE $ J3:3 S'a