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Home My WebLink About1122 PAULARINO AVE - Building Permits} (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1122 PAULARINO AV Suite: Vicinity: Primary Occ: Type of Construction: Parcel Number: 14160418 Zoning: R1 Applicant: NGUYEN, CHUONG Address: Owner: CHAU,PHAT BO Address 1122 PAULERINO COSTA MESA, CA ISSUED BY Phone: 714 545-6994 Zip: Phone: Zip: 92626-2851 Contractor: VILLA ROOFING PROFESSIONALS INC Address: 14351 EUCLID ST SUITE E Phone: (714) 545-6994 GARDEN GROVE, CA Zip: 92843 License: 758361 Arch : Address: Phone: Eng: Address: Status: ISSUED Applied: 04/05/2005 Issued: 04/05/2005 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF COMPOSITION ROOF, INSTALL 30# FELT AND 21 SOR'S OF 30 YR. COMP. SHINGLES. 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 perlod 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 'aa tawt FEE SUMMARY Plan Check: $0.00 Calc Valuation: 54,100.00 Permit: $111.25 Claim Valuation: 54,100.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 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 perlod 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 'aa tawt 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' compensetion, as provided for by section 3700 of the Labor Code, for the performance of the work for which this penmil is Issued. I have end will maintain wetkers' 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 Ins renca Cartier antl policy number ere: // ^7 Cartier. _ST� Polity Number: (This secAw need not be completed if the permit is valued at one hundred dollars IS 100) or less.) ❑ 1 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 ?hal If I sh uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply withthese provisions. - Applicant Signature: Date: Y O WARMNG: FAILURE TO SECUREZ TG -I RA E IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO CRIMIN M PENALTIES AND CL FINES UP TO ONE HUNDRED THOUSAND DOLLARE 8100,000). THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION NOS OF THE LABOR CODE. INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under TiLovisiops of Ch ter 9 (commencing with Section 7000) of Division 3 of the Business and P10 ssio05 Code, and my license is in full force and effect, Lic. P Class I C C- �i Contractor's 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: — _. Lender's 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 01 the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation o1 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 appy 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. 11, 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 contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professiors 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 live (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: 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 o1 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 hazartlous materials? []—Ye—s-- ❑ 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). ............._...........will...__—.._.._._.._.___._...........__antnee........._.._...._...._._._................_..................ar-l...................vo.................o.g.r....m--tor......_..___...._.___.........._._.__ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management antl Prevention Program tort acutelyhazertlous matenaLs)? ❑ 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 pusinesses which are required to register acutely hazardous materials with the Fire Department. ...................... ....... .................................. _................................... .......................................... ___................... _........................................................................................... .................................... .._......................._................... __._............... _. 4 It an RMPP is presently required, has Saction 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 plication aemit for such consWction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yea 8 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? ❑Ves ❑ 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 ...................................................................................................f'r"o.................................................... l u ti..................................................................................................................................................................................................................... - 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: Dale: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of porjury that I have road this application and state that the information given is correct. 1 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 i pecllon pugres not to occupy a allow Occupancy of any building authorized by this Permit until final inspection. te e NCrli 45,111A Sa AndfOr Authorized Applicant I Data CODE E. INSPECTION TYPE QAIi INITIALS CODE I INSPECTION TYPE g/Jj[ jyEDMIL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final (� 208 Final Plumbing 200 Final Re -Root JIJ(�([ 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 Se v_xew Hotness Inc DATE 6-19-62 JOB ADDRESS 1192 Pnn'lnrinn Avenue 13UILDING PERMIT NO. 17299 GENERAL CONTRACTOR $, V, Hunsaker &Sons VALUE $ 14Z471.00 AP No. LOT 8 TRACT 4565 FIRE ZONE DESCRIPTION OF WORKres x att r INSPECTIONS Signature DATE GROUP J&j TYPE V ZONE R1 Soil$yA't2;%.0 _ SUBCONTRACTOR _ PERMITS ISSUED Gas Water ...- �_ �.�Z— Rough om. Refrig. [DAir Cond. ❑ Rough HeatingFf[ Rough Plumbing Miscellaneous Prop. Swr. Line douse Con, la -SE. Swr. ❑ Sprinkling System Construction Pole Underground ❑ Power �� _ p� _E 7-9 L 'L DATE _7_ NUMBER _ . fj (L) G [ 1$—✓ \I%' ugh Wiring renc les ❑ Forms ❑ Steel Reinf. ❑ G Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing 7-/ - Frame and Flashing Lathing — In d— Out Fl-- Plaster, brown coat Refrig. ❑ Air Cond. ❑ Final Heating, Final �Q .� Plumbing Fixtures, Final �/ o Z Final Gas Test 6'. ^�- Iff. e a 2— Electric Fixtures, Final L Building, Final OCCUPANCY 17299 raRM Rao . 6M — 7.61 'I `, W. COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 817 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING -z- ADDRESS ADDRESS / COSTA MESA. CALIFORNIA FEE RECEIVED JUN z � 6" FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. P[ MI n OWNER / J MAIL R.= HY T8 EIV D DAT. 188UHD R! D ADDRESS a I .IUN TEL. BUILDING CITY NO. ADDRESS ARCHITECT TEL. COSTA MESA. CALIFORNIA OR E N G I NEER NO. LOTI// FIRE EiF ZONE TYPE GROUP SD S APPROVED CONTRACTOR BY DATE ZONING ADDRESS L _ ZONE NO. OF IPLANS USE OFNEW Sinn �F IOUILDING GITY R�1 STATETEL. LIC. NO. NO. - LEGAL De RIFTION -f - 8 LO 7 SIZE n NO. OP CLODS. OF LOT L NOw ON LOT A. P. NO. USE OF YARDS EVES EXISTING BLDG APPROVED ALLOWED ICENT.R L'" ST.1 q SETBACK LIN; PROM I / // �J CENTER OF STREET V REAR YAR2 ✓ FRONT '/ FT.-� IN. I SIDE YARD LEFT RIGHT _S R. SIDE '} FT. IN. DESCRIPTION OF WORK S– L. SIDE FT. IN. NEW 11I ALTERATION I ADDITION I REAR `— 2-7 FT. " IN. REPAIR I II MOVING I II DEMOLISH I APPROVED n / Z / DATE BUILDING ) /?SO. OF /V' [- SIZE f 2 d ROOMS 'V STORIES �C..-- EXTERIOR WALL,J/L� ROOF ( G6 COVERING !- COVERING L USE OF BUILDING A D WORK,TO BE PERFORMED GL ..r Oti /.1J o ,V1,42Z 61 aro I e, L 1HEREBY ACKNOWLEOGS THAT 1 HAVE READ THIS APPLICATION THH AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE CT THAT THE ABOVE IS CORREAND AGRE! TO COM. PUpp09; OF eSTAeLIBHINO A PERMIT PHE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTION. SIGNATUREO PERMIT FEE S ,/— PLAN CHECK $ 7 — PERMIT s --- / AUTHOR D A T TOTAL FEE Y08 ADDRESS 'GENERAL COI AP No.141-6 INSPECTIONS SOIL GAS WATER ROUGH PLUMBINI PROP. SWR. LINE SPRINKLING SYS MISCELLANEOUS ROUGH HEATING TEMPORARY SER UNDERGROUND E ROUGH WIRING LOT TRACT F AND AIR CONOITI BOND BEAM ( STE SHEATHING FRAME AND FLASHING LATHING - IN ❑ PLASTER, BROWN COAT AND PLUMBING, FINAL AND G ELECTRIC. FINAL BUILDING, FINAL INF. SUBCONTRACTOR RMIT NO. 39226 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Pnfn 1V15-T4cf�s; 00 533`*8.50 1 �� AP LI ATION FOR BUILDING PERMIT For Applicant to Fill in Completely qE I V I DATE RECEIVED FD BUILDING ADDRESS D PE OWNER �L�-..+ 1 T Sj}E A.P. NO. MAIL BUILDINGADDRESS 1 7(Yi E ADDRESSQTEL g A NO.-p(CONSTRUCTION bS LOT. t�CITY _34''11TRACT W JADOIALTERIREPAIR JISSUED MOVINGLENDERBRANCH nOWNER r RADDRESSVALUEARCHITECT S J TIO $ 710ORENGINEER C� TEL. V N 0.FIRE ADDRESS ZONE YPE GRO APPROVED CONTRACTOR BV DATE [� ADDRESS' J LAS ig ZO NO. OF USE OF NE U IrUU TE PLANS BUILDING CITY LNO. STATE CITY ( YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. b MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLOCS. (FROM C/L ST T) OF LOT NOW ON LOT RONT FT. USE OF r E S OCE EXISTING BLDG. I O FT SIZE OFNO OF ,/ NEW BLDG. I�—A'L0 ROOMS STORIES L. SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING U REAR �T. FT. USEOF BUILDINN_ WOR ;=FORMED DISTANCE BET. BET. MAIN & { MAIN BLDGS. ACCESS. SLOGS. VAR.# DATE C.U.P,# APPROVED APPROVED By IATIIJ— I hereby acknowledge that I have read this application and state V' that the above information is correct and agree to comply with e all laws regulating building construction, and 1 shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under D SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Divisicn 3, Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exampt from tl-e provisions of the State of California Business VALUATION and Professionss C.nue_, Division 3, Chapter 9.. PERMIT FEE $ Signature of ��-�.CA �M1Yr�'�7 Permittee $ � � 0 �'� PLAN CHECK $ Authorized Agent TOTAL FEE $ 1 ��