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Home My WebLink About830 PINE PL - Building Permits. � � � CITY OF COSTA MESA • � ~ �,O�pMFS,P BlIILDONG DIVISION it�� 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • wv+w.ci.wsta-mesa.ca.us F � � FOR INSPECTIONS CALL: (714) 754-5626 $oq�o {7 PERMIT NUMBER: M09-00035 PERMIT TYPE MECH APN: 42245405 JOB ADDRESS: 830 PINE PL CM vicinity: SQ. FT: 0 � STATUS: ISSUED DATE ISSUED: 04/1612009 � ISSUED BY: RMD Suite/Unit: SCOPE OF WORK: MECHANICAL PERMIT FOR WALL FURNACE CHANGE OUT FAU < 100 K BTU FOR A SFD. OWNER: GUEVARA, MARTHA � Address: PHONE: 949-722,1046 � - City/State/Zip: APPLICANT: PRADO, SOFIA � - � � Address: PHONE: 714-960•7052 City/State/zZip: CONTRACTOR: J K CONSTRUCTION Address: 915 LAKE STUnit: PHONE: 714-404-9846 CELL City/Slate: HUNTINGTON BEACH, CA - CELL: 714-960-7052 . � MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.30 PLAN CHECK FEE: $0.00 INVESTIGATION FE�: � $0.00 REINSPECTION FEE; $0.00 TOTAL FEES: $38.30 830 PINE PL Unit: COSTA MESA, CA 915 LAKE STREET Unit: HUNTINGTON BEACH, CA License No. 450297 . �ZipCode: 92648 NOTICE: The work authorized by ihis permit shall comply witb all applicable bandicap access requirements under California s[atutes and related 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 the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections ahd final approval must be obiained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. CODEt. INSPECTIONTYPE ORTE INTIT11L5 GO�E� INSPEC110NTYPE 5', �� IN� 1616 Fixed System Final Fire Prevention 206 Final Mechanical { 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Elecirical 201 Final Block/Retaining Wall 272 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 FinalSign 222 Final Site 204 Final Demolition ' 250 Final BuildinglOccupancy WORKERS' COMPENSATION DECLARATIO� I hereby affrm under penalry of perjury one of Ihe following declarations: ❑ I have and will maintain a certi0cate of consent to self-Insure /or workers' compensation, as provided (or by section 3700 of the Labor Cotle, for �he peAormance o( the work (or which this permit is issuetl. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the perfortnance o( Ihe work (or wfiich Ihis pertnit is issued. My workers' compensation Insuran e carrier and policy number are: ^� �� C. Carrier• ! 7 (Thrs sec(nn need ol �e cn � tej tl(h�iR is valuetl at one bvntl�ed ddlnrs (5100) orless ) /: / _ /p� Policy�Number: F 0 �u, ��S ❑ I certify that in the pertormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become suhjecl to [he workers' compensation laws of California, and agree Iha� if I should become sub' c[ to the v rke s' com ensalion provisions of Section 3700 of Ihe Labor C sh I f iw com ly wi[h [hese ptovisions. �' � � "O ca 's ignawre Da�e WARNING: F ILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 aKrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code, and my license isfin full force and ef(ect. Lia #' i7 �� Class # • � � � � � � ra or's i9 a � � Dale T CONSTRUCTION LENDING AGENCV: ❑ I hereby affrm ihat ihere is a consWclion lending agency for lhe peRortnance o( the v,ork for which this permit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature OWNER-BUILDER DECLARATIONS: I hereby aKrm that un0er penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to constmct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to fle a signed statement [hat 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 Pro(essions Cotle) or that he or she is exempt therefmm antl the basis for the alleged exemption. Any violation of Sec[ion 7031.5 by any applicant for a permit subjects the applicant �o a civil penalty of not more than five hundred dollars ($500).): ❑ I, as ovmer of the property, or my employees with wages as their sole compensalion, WILL DO THE WORK, antl the strucWre is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herselF or through his or her own employees, provided that such improvements are not intended or offered for sale. I(, however, lhe building or improvement is sold within one year of completion, Ihe ovmer-builder will have the burden ot provinq that he or she did not build or improve for purpose o( sale.). ❑ I, as owner o( lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS to consiruct the pmject (Sec. 7044, Business and Professions Code: The contractors License Law dces not appty to an ovmer of property who builds or impmves thereon, and who contracts for such project with a contractor(s) license pursuan[ to the Contractws License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 3051-a6(3/Ol) '�\ � Owner ID verifed by dri i s license. ❑ Yes ❑ No � Driver's License No. Expires: Venfication of Ownership by (type of documeN, i.e. - propeAy tax bill or deed): �IVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICA710N: ❑ I hereby certify that no excavation frve (5) or more teet in depth into which a person is requiretl to tlescentl, will be made in connection with v.ork authorized by [his pertnit, antl Ihat no building slrucNre, scaffdding, falsework, a demolition or dismanlling thereof, will be more Ihan thirty-six (36) teet high (Chap. 32, Grp 2, M 2, Sec. 341, Ttle 8, California Administrative Cotle). ❑ As ownervbuilder, I will not employ anyone to do work which would require a permit irom ihe Division o( Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applicanfs Signalure �ale Division of Industrial Sa(ety Permit Number HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or presenl or future building occupant need to file and ceRify a Business Plan for emergency response to release or Ihrea[ened release ot a hazardous material? ❑ Yes ❑ No (Sec[ion 25505 0( the Cali(omia Health and Safery Code requires, wi[h some exceptions, ihat a Business Plan be filed with the Costa Mesa Fire Department by every 6usiness which has at any one time during a reported year a quantity ot hazardous materials equal to or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of compressed gas a[ standard temperature and pressure). 2. Does or will the applicant or present or tuture building occupant need to file a registration (orm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Sa(e[y Code, wi[h some exceptions. requires regislration with the Costa Mesa Fire Department by each business which al any one time has on hand a quantiry o( acutely hazardous materials equal [o or greater [han 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 Ihe applicant or present or (uture buildinq occupant need to prepare an RMPP (Risk Management and Prevention Pmgram for acutely hazardous matenals)? ❑ Yes ❑ No (Section 25534 of [he Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require �he preparation, certi(cation ana 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 Seclion 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the appliwnt or presenl or fWure building occupaN require for the work which is the subject of this application a permit for such constmction or modifcation from the South Coast Air Quality Management Distnct or from any other air polWtion control tlistrict or agency? ❑ Yes ❑ No (Section 658502 of ihe Califomia GovemmeM Cotle requires thal the requested intortnation be fumished on applications fa non-residential building permits). 6. Will any part of the facility to be constructetl under [his permit be within 1000 feet fmm the outer boundanes of a school? ❑ Ves ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of [he Cali(omia Health and Safety Code). 7. If a permit (rom the South Coast Air Quality Management District or other air pollution contml district or agency is required for the vrork which is the subject of this application, have all of the disclosures prescribed by Califomia Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf "yes", aitach certificate of compliance from the appropriate air polWtion conirol oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. SignaWre Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read �his applica�ion and state [hat the information given is correcc I agree to comply with all state laws and city ordinances relating to building consWction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property (or inspection purposes. I agree not to occupy or allow occupancy of any buitding authorized by this permit until fnal inspec�ion. g tr olLe �� /� v� ! r u�hori d Appllcanl / " Dale , Ii1D5 DUE TO CI'I'l' 1?-JO-0S � /"• P��s71J-7i4-5330 Aun: Uan ISnker • crrti� or cosr,� nussn Ncighburhood Improvcmcnl Program �Vork \Yritc Up Name: Martha Guevara, 830 Pine Placc Home Phone: 9d9-722-1046 All �rork is to be Jone per City o(Costa Mesa Building, Pl,mnine a�id Public Works Codes. in ordcr Io cslablish standards of yuality, the detailcJ specifications may refer to a cerlain proJuct hy name and/or from a major manufncturer. This procedure is nol to 6e construcd as eliminating Irom competition other products o( equal or 6etter quality by other manufacwrers. The Contractor shall fumish �he list o( proposed desired subs�iWtions prior to signing Ihe commeL All items listed on the work Jescription, unless othcnvise specificd, shall include all pa[ching and finish work, including tcim, hurdware, putching and linish painting und/or smining. 7'he Contractor is responsiblc Cor .�II permits, fees, Ci1y business licenses, plans, e[c. Cit}' of Cos1a \Iesa Standard Rehabililnlion Specifications apply [o all i�ems lis[ed on �cork descrip�ion. LCad �Vurl< � All original casement windows (4) have tesled positive for lead based paint. Provide and install new retrofit vim�l windows (Mil,ard or equall to fullv encausulate all metal portions of windows. All disturbed painted surfaces of windows will need [o be cared for using lead safe work prac[ices. � Both the front door and side kitchen door Games have tested positive for lead based paint. Using lead safe work practices properly remove and disoose of the front door frame and install new frame return orieinal door to onenin�. Remove nnd dispose of side door and frame usin_ lead snfe work practices. Installation to include all new uim and hardware. New door style to match previous existing door. �3 Fascia and eaves on nonh (Kitchen side) and east (Back) side of property have tested positive for lead based paint. Using lead safe work practices properly remove and discard all fascia on both sides of property. Reinstall ne�v Is6 fnscia and completelv box in eaves with applic161e exterior gr�de Iv�� vood. Bnsure ventila[ion holes are s[rltegically places in order for proper at[ic ven[ilation. f� Esterior water heater door �nd trim have [ested positive Cor lead. Using lead safe work prac[ices, properly remove and discard per IiUD guidelines. Provide and install new exterior door completc with new trim and hardware. ��'ater Hruer: Remove �esisting and replace with new 30 gallon warer heater. Installation ro meet all applicable plumbing eodes. $ Rain Guncrs: Provide and install rain guucrs around entire perimeter of properry. Gutters to be 5" $ seamless �rith all applicnble down spouts. Convactor ro ensure water is diverted away fiom low spot ai rear of propem-. spa�i�tallatiomcomplete��"vitli�iherni0stat�:cont"r_blsl =Gic �,lude �in price all applicabte dry.walLrepair._ 3 Slidin2 elass door: Provide nnd install new retrofit dual pane sliding olass door nt master bedroom. $ Door to bc Milgard or equivalent. Smoke de�ectors: Check smoke detectors, if missing or not working, install them to code. ** All $ bedrooms nnd one in hallw�y. G�terior P;iin[ine: Power-��-ash existing home and prepare entire strucmre for paintino escluding patio covers. Repair �nd match all stucco surfaces with existing texture and c�ulk all cracked areas � widi applicable elastomeric caulkin�. Prime all bare wood and repaired areas with applicable primer. Paint entire sVucmre includina wood �rim using Dunn Edw�ards painL I-lomeowner to select color of' both body and trim from samples provided by contractor. TOTAL I have revicwcd the above �eork Jcscription,md undcrstand that any ch�ngcs, additions or deletions shall have prior npproval by the Ci[y of Costa �icsa Ncighborhood improvcmcnt Pcrsonncl. uevara, 830 Pine Place �ale ;•� e � , : J. �m A: PERMIT TYPE � CITY OF COSTA MESA � B!/ILD/NG D/VISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(774) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ra.us FOR INSPECTIONS CALL: (714) 754•5626 ELEC JOB ADDRESS: 830 PINE PL CM Vicinity: SIDE OF HOUSE PERMIT NUMBER: E07-00815 STATUS: DATE ISSUED: - ISSUED BY: Suite/Unit: ISSUED 0912012007 RMD SCOPE OF WORK: UPGRADE SERVICE PANEL TO 200A FOR A SFD, SAME LOCATION (SIDE YARD). OWNER: GUEVARA, MARTHA PHONE: 949-722-1046 APPLICANT: GUEVARA; MARTHA � PHONE: 949-722-1046, �. „ , CONTRACTOR: OWNER-BUILDER Address: Unit: PHONE: Ciry/Stale: ZipCode: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $54.00 Reinspection Fee $0.00 TOTAL FEES $54.00 Address: 830 PINE PL Unit: City/State2ip: COSTA MESA, CA Address: 830 PINE PL Unit: City/State/zZip: COSTA MESA, CA� tl License No. 000000 CELL: •�• , ,, n., I :I;; ;:;,,,, �-s �- T. i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statules and related 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 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 expirelion o( this permit. C OE/ INSPEC710NTYPE DRi INTI� CODEt INSPECTIONTYPE 0�T INTITIRL 1616 Fixetl System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing � 200 Final Re-Roof 210 Final Electrical y� rr�� 201 Final Block/Retaining Wall ' 272 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 FinalSiB� 222 Fina15ite 204 Final Demolilion 250 Final Builtling/Occupancy WORKERS' COMPENSA710N DECLARATION� ' I hereby a�rm under penalty of perjury one of Ihe following declarations: � ❑ I have and will maintain a cehifcate Of consent to sel(-Insure tor workers' compensation, as provided for by section 3700 of the �Labor Code, for the peAormance of �he work for which Ihis permit is issued. ❑ I have anq v,ill maintain workers' compensation insurance, as requiretl by section 3700 of Ihe Labor Code, fw the per(ortnance of the v.ork (or which lhis pertnit is issuetl. My workers' compensation Insurance carrier and policy number are: Carcier: (This sedion npiy rp� pp rpmdetetldlhe pertM k valuM al me huMretl tloNars (5100) a less ) Policy Numher: C�—I�certity Ihat in the peAortnance of the work for which t�is permit is issued.�l shall �ot employ any person in any manner so as to become subject to the vrorkers' compensation laws of Calitomia, and agree that if I should become subject to the workers' compensation provisions of Section 9700 of t La oi Co I shall hwilh cOmply with these provisio �--� ' , _�— �i.l-v� lo�t Apoliwnfc Signawre Da�e� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFU� AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�, IN qDDIT10N 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 aKrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code, and my license is in (ull force antl eHect. Lic. # Class # Conv�nwi SiB��ure Date CONSTRUCTIpN LENDING AGENCY: ❑ I hereby affirm that there is a constructbn lending agency tor the per(ormance of Ihe �wrk fa which this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name; Lender's Address: SignaWre OW NER•BUILDER DECLARATIONS: I hereby aHirm Ihat under penalty o( Derjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a Dermit lo consWct, alter, improve, demolish, or repair any slrucWre, prior to its issuance, also require5 Ihe applicant for such permit to file a signed stalement Ihal he or sh0 is licensetl pursuant to Ihe provisions of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of t�e Business antl Professions Code) or that he or she is exempt therefrom antl the basis (or the alleged exemption. Any viotation of Section 7037.5 by any applicaN for a permit subjects the applicant to a civil penalry of not more than fve huntlred dollars ($500).): ❑ I, as owner of lhe property, or my employees with vrages as their sole compensation, WILL DO THE WORK, and the structure is not intended or oftered for sale (Sec. 7044, Business antl Professions Code: The Contraclors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself orherself or Ihrough his or her ovm employees, prOvided Ihat such improvements are not intended or offeretl tor sale. I(, however, the building or improvement is sold within one year of completion, thC ovmer-builtler will have the burden'of proviog lhat he or she did not build or improve (or purpose ot sale.). ��I, as ovmer of the property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED,CONTRACTORS to conswct the projecl (Sea.7044. Business and Professions Cotle: The contractas License Law tices not applyto an owner of property who builds or impmves thereon, and who contracts for such projecl vrith a cont2cta�s) license pursuant to the Contractas License Laws.). ❑ I am exempt under sea � Business and Professions Code /or this reason: Z� �b� ' Sip�mre! (-Oare_ � 305]<6 (3/0]) L-- � � Owner ID verifed by driv Expires: b 20 �� Veii`fc ion of Own hip by (typ f doCument, i.e. rproperty tax bill or deed): DIVISION OF INDU57RIAL SAFETY PERMIT CERTIFICA710N: � - ❑ I hereby certify Ihat no excavatbn five (5) or more (eet in depth into wfiich a person is required to descend. will be made in connection with work authorized by this pertnit, antl that no building siructure, scaf(dding, falsework, or tlemolition or dismantling thereof, will be more than �hirty-sia (36) feet high. (Chap. 3.2, Grp 2. M 2. $EC. 341, TI��E 8, C2�I(Ort11d Adff11f115�f31NQ COdE). ❑ As ovmer-builder, I vnll not employ anyone to do work which wnultl require a pertnit from the Division of Industrial Satety, as noted above, unless such person has a permit to do such vrork from the division. Applicam's Signalure Division of Intlustrial Sa(ety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or Wture building occupant neetl to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec�ion 25505 of the Califomia Health antl Safety Code requires, with some exceptions, ihat a Business Plan be filetl wilh lhe Costa Mesa Fire Department by every qusiness which has at any one time durinq a reported year a quan[ity of hazardous matenals equal to or greater than a weight o( 500 pounds, or a�volume of 55 gallons, or 200 cuhic feet of compressed gas at standard temperaWre and pressure). 2. Does or will the applicant or present or fuWre building occupanl need to file a registration form for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Califomia Health antl Safery Cotle, with some exceptions, requires registretion with the Costa Mesa Fire Department by each business which at any one time has on hand a quantiry of acutely hazardous ma[erials equal to or greater Ihan a weight of 500 pounds, nr a volume ot 55 gallons, or 200 cubic (eet of compressed gas at standard temperature and pressure). 3. Does or will the applicaN or present or (uture building occupant need to � prepare an RMPP (Risk Management and Prevention Program (or awtely hazardous materials)? ❑ Yes ❑ No (Seclion 25534 of the California Health antl Safety Code provitles that Ihe Costa Mesa Fire Department may require ihe preparation, certifcation and fling with the Fire Deparlment of an RMPP by businesses which are required to register acutely hazardous ma�erials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health antl Safety Code been fully complied wiN? ❑ Yes ❑ No 5. Does or will the applicant or present or fWure building occupant require for lhe work whic� is the subject of this applicalion a permit for such consWction or modificalion fmm the South Coast Air Qualiry Management District or from any other air pollution control tlislrict or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Code requires that the requested in(ortnation be fumished on applications (a rao-resitlential building pertnits�. 6. Will any part of the lacili�y to be constructed untler this permit be within 1000 feet trom tbe outer boundaries of a school7 D Yes ❑ No (I('yes", the faciliry must meel the reqUirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air �uality Management District or other air pollution contml tlistrict or agency is required for Ihe work which is Ihe subject o( this application, have all of [he disclosures prescribetl by California Health and Sa(ety Code Seclion 42303 been made? ❑ Yes ❑ No . 8. Qt "yes", attach certi(cate o( compliance from the appropriate air pollution control offcer). � CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to compty with all state laws and city ordinances regarding Hazardous Materials and Emissions. - Signalure Date CERTIFICATE Of COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury thal I have read Ihis application and stare that the information given is wrrect. I agree to comply with all state laws and city ordinances relating to Duilding consWction, antl authorize representatives o� the City of Costa Mesa lo enter upon the aDove-describetl pmperty for inspection purposes. I a ree not to occupy or allow oc�paqcy of any builtling au or .ed�q � i perm' u il lnal inspeclioa `! i i� i/�-, �� LSig`aWre oi LeBal Owner(s) , Date � And/orAut�onle0 , -� i C� °� L oQta y2eQa Su��us� ��a� OWIoIER-BUILDER VERIFIC�►TION Add� ��`-' � �� Permit #: v A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require Ihe completion and require the retum of, an owner- builder verification. . _ Attention PropeRy Owner: An bwner-builder' building permit has been applied for in your name and beanng your signature. Please complete and retum this in£ormation in the envelope provided at your earliest opportuniry to av,oid unuecessary delay in processing and issuing your building pemiit. No buildingpemiit will be issued until diis verification is received. L.� I personally plan to provide the major labor and materials for construction o£ the proposed property improvement. �es ❑ No 2� I(have/have not) signed an application for a building permit for /the proposed work. / �3. I have coTntracted with�i the foll ing person ( � ) ro provide the proposed constn�ction: Name 1) GU � CI� ��, l�� Address Phone ( City _ Contractor's Lic. No. 4. I plan to provide portions of [he work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address Phone ( City _ Contractor's Lic. No. I will provide some of [he work but [ have con[racted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work i t0a2�46 (Rev.11IW) r.� I hereby affirtn that 1 have received a copy of the information set forth in Section 19830 of the Statc of Califomia Health and Safety Code and have comple[ed the above infortnation to the bes[ of my personal knowledge, in compliance with this State law. Signed: '� �� --/�--� GD e_ 1 I2- �� :.� � , � � N�: . i1,9 C� (��v�'1% (Printed or Typed) C.�..#'��A�,# v \ For more information call City of Costa 11esa Building Di�•ision at (714) 754-5273. 1p42<6 (Rev. 1 VOa) JobAddress: 830 PINEPL Suite: Vicinity: RESIDENCE ONLY Primary Occ: R3 Dwellings/ Cong Res <10 Parcel Number: 42245405 Applicant: GUEVARA, MARTHA Address: 830 PINE PL COSTA MESA, CA - Owner. GUEVARA, MARFHA Address 830 PINE PL , . COSTA MESA, CA � , Contractor: .'OWNER-BUILDER' - Add�essi'� �- � - , F : i Zip: Amh : Address: . Zip: Type of Construclion: V-N Zoning: . - Phone: � 949-722-�046 ISSUED 8Y: _ _ - Zip: 926273326 : , � Phone: . � - Zip: �.92627-3326 - , Phone: �.. � � License: 000000 , Eng: �. � . Address: Phone: - License: Status: ISSUED Applied: 11/08/2005 Issued: 11/08/2005 Phone: License: SCOPE OF PERMIT LEGALI2E REROOF RESIDENCE.ONLY: T/O EXISTING COMP SHINGLES, REPAIR/REPLACE SHTG AS NEEDED, FELT PER MFGR'S SPECS, RER "30-YEAR COMP SHINGLES" APPROX 2000 SF REF: C05-2592 . : - - _ � . . ' . - - ^ FEE SUMMARY Plan Check: $0.00 Calc Valuation: Sa,000.00 Permit: $97.25 Claim Valuation: $a,000.00 SMIP Res: $0.50 -- - -_- - SMIP Com:` $0.00 • Other: $0.00 Inspection: $0.00 Total: $97.75 � - PLANNING & ZONING SETBACKS ' � � � � � - - MAWSTRUCTURE 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 Existina: �-0 ��Reauired: - 0 " Pr000sed: 0 � , ._ P R R► NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia 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 ot 180 days. INSPECTIONS: In order tor tha work au[horized under this permit to be considered legal, such work must compty wi�h all applicable codes, and all requlred Inepeetions and final epproval must ba obtained. Failure to oblain inspections and final approval will result in the expiration ot this permit. IFOR INSPECTIONS CALL: (7/4) 754-5626 �� WORKERS'COMPENSAnON DECLARAnON: � � . � I hereby eHirm undar penalty of parjury one of the followinq declaretions: '� ^ . � . ' ❑ 1 have and will maintain a certilicale of consenl to self-Insure tor workers' compensation, es provide� tor by section 3700 of the Lebor Code, for the peAortnanca oi ihe work tor which �his permi� is issuetl. � � ' � ' ❑ I heve and will meinWin workers' compensation insurance, as required by section 3700 of the Labor Code, for the peAortnance of t�e work tor which this pertnit is issuetl. My workars' compensation Insurance carrier end policy number are: � -• Carner: Policy Number: (Thi� sec(ion need nof be comp/eled il (he permit is velued at one huntlretl tlollars ($100) or Iess.J .fY1T certify Ihat in paRormence of the work for which this permit is issued, I shall not employ any person in any manner so es to become suDject to tha workers' T� compensatlon of elitomla, d'agree thet if I sh become sublect to Ihe workers' compensatlon provislons of Sacti n 3700 of he Lebor Code, I shall totlhwith complY with the ro sions. (� A�� a;�. � ��.___ oe�- �--� ��f o � WARNING FAILLIRE TO SECURE WORNERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNOPED THWSAND OOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CADE, IMEFEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aMirm ihat I am licensed under provisions ot Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professlons Cotle, and my license is in full force end ettect Lic. M Class # Contractofs Signeture: Date: CONS7RUCTION LENDING AGENCY: ❑ I hereby aMirtn Ihat there is a constmction lentling agency tor Ihe pedormance of tha work for which ihis permi� is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lendefs Address: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I herehy aHirm thet untler penalry ot perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for tha tollowing reason (Sec. 7031.5, Business end Professions Code: Any city or county which requires e pertnit to construct, alter, improve, demolish, or repair any structure, pnor lo its issuance, elso requires Ihe applicant for such permit to file a signed statement that he or she Is licensetl pursuent to Ihe pmvisions of Ihe CoNractors License Law (Chapter 9(commenGng wlih Sectlon 7000) 01 Division 3 oi [he Business and Professions Code) or that he or she is exempt lherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit .sub�ecls ihe applicant to e civil Denalry oi not more than five hundretl tlollars (5500).): .Q�, as owner ol ihe properry, or my employees wiih wages es t�eir sole compensation, WILL DO 7ME WORK, antl the struciure Is not Intentle0 or otlered tor sale (Sec. 7044, Business antl Professions Cotle: The Comractors License Law dces not apply to an owner of pmpeny who 6uilds or improves thereon, and who does such work himseli or hereeN or through his or her own employees, provided Ihat such improvemenis are not intended or offered for sele. If, however, Ihe builtling or improvement is soltl within one year of completion, the owner-builder will have ihe burtlen of proving that �e or she tli0 not 6uild or improve tor puryose of sele.). ' ❑ I, as owner of the pmperty, am E%CLUSIVELY CONTRACTING WITi LICENSED CONTRACTORS ro constmct the pwjact (Sec. 7044, Business antl Protessions Code: The comractors License Law does not epply to en owner of property who builds or improves Ihereon, and who conirqC�s tor such project with e comractor(s) license ursuant to the Conirectors icense LewsJ. � l !1 1 O� ❑ I am e mp unetlars Busines5�a ([o•(\e�s LDOte--=i- . . Owner ID verifietl by tlriver's license. ❑ Ves ❑ No DrNer_s 4icanse:No?� �.... Veritication of Ownership by (rype ot document, I.e. � property taa bill or deedj: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I here6y certify that no excavation five (5) or more teet in depth into which a person is required to descend, will be made in connection with work authorizetl by this permit, and thet no building siructure, scaHoltling, talsework, or demolition or dismantling ihereof, will be more ihan thirty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle B, Calitornia Atlministretive Code). ❑ As ownervhuilder, I will not employ Bnyone to tlo work which woultl require e permit from the Division of Induslriel Setety, 05 noted ebove, unless such person has a permit to do such work irom the division. Signature: Date: Division ot IntlusMal Safety Permit Number CERTIFlCATE OF COMPLIANCE AND AUiHORVATON OF ENfTiY: I certify under penalty of pery'ury that I have read this applica�ion and state that ihe information given is correct. I agree comply wi�h all state laws and city ortlinances relating �o builtling consWction, antl authorize represenia�ives of Ihe Ciry ot Costa Mesa to enter upon Ihe above-descnbed p pe y for ins io urpo I agree not to acupy or allow occupancy ot any building authorizad by Ihis permit n�il fi al inspection. �l �e � �� t � � �� o ��-- Signat�re�OhL'egal'Owner(s) [Date�,. AnNOr Authorized ApDlicant Date LOUE I, INSPECTONTYVE �"' PAIE'� ' ' A� " 7616 Fixetl System Final Fire Praven�ion 1266 200 201 202 203 204 Pool Spe Final Pinal Re-Root ' • Final Block/Retaining Wall FinalFactory�Fire�Place � Final Sign Final Demolition CODEt INSFECTIONTYPE• . 206 � Final MeChaniCal 208 Final Plumbing 210 Final Electrical 212 Final Flre Prevention 220 222 250 Final Planninq Approvel Final Site Final Building/Occupancy Q�, INi1MLS C� °� C'oa,ta y�%Qa �'uiE?du y Dicu�iac� OWIoIER-BUILDER VER(FiCATION Address: p ✓ `-� (/�'�-'�� ✓ � Permit #: �� .� —� �! � A city or coimty, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent ro issuing a building permit, require the completion.and require the retum of, an owner- builder verification. Attention Property Owner: An `owneo-builder' building permit has been applied for in your name and bearing your signature. Please complete and retum this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. A'o buildin�permit will be issued un[il this verification is received. i. 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. ❑ Yes � No 2. 1(have/have not) ,,�Gd 2.. signed an application for a building permit for the proposed work. � 3. [ have con[racted with [he following person (firm) ro provide [he proposed construction: Name Address Phone ( ) City _ Contractor's Lic. No. 4. I plan to provide portions of the work, but 1 have hired the following person to coordinate, supervise and provide the major work: Name Address � Phone ( ) City – Contractor's Lic. No. 5. 1 will pro�ide some of the work but 1 have contracted (hir d) Ihe following perso to provide the work indicated: � ��j �.v �-eq0 v i c �� tu $ 4?A ui ci� J Name Address Phone Type of Work t0a2<6 (Rev. 11/Od) I hereby affirtn [hat I have received a copy of [he information set forth in Section 19830 of the State of Califomia Health and Safety Code and have completed the above information to the best of my personal knowledge, in compliance with this State law. Signed: �� Name: (Pnnted orTyped) C.D.L. # OR S.S. # �� Date: �'l�g�o�" For more information call City of Cos[a Mesa Building Division at (714) 754-5273. tOC2•d6 IRev.11l0a) � GENERAL CONTRACTOR INSPECTIONS I DATE VALUE SUBCONTRACTOR ' I PERMITSISSUED OCCUPANCY Form Z10—SM-11�59 5-B P , �i6nn . .;. �" ~ .1L.A.��i� COST,A MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 3f7 COBTA MEBA. WLIFORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT BUILDING �j ADDRE6S a 6 � COSTA MESA CALIFORNIA i— OWNER rtw�2�NGL: W. �ou /i/� MAIL � .. � �l( AOORE5p6 d cirr (� 0.3 �%R �"/ <314 No. v,l rr's INO. OP BLDGB. �N/OW ON LOT � y ■ 9HTBACK LINB FI10M n 9 � LEFf �C `� RIGHT �� DESCRIPTION OF WORK BUILDING � �'(��bROOMS I STORIES SIZE EXTBRIOR WAL7,,� ROOF COVERING d(JG� COVERING �`�� USE OF BUILOING ANO WORK TO BE PERFORMED � : / � o0 1 NHRBBY ACKNOWLfiDGC THAT 1 H/�V8 RGO THI9 A]PLIGTION AND BTATH THAT THE �BOVB IB COHRBR AND AaPEe TO COM- PLY W�TH I1LL CITY OPDINANCHe ANO BTATH LAW9 R86UlATINO BU�LDINO CONBTRU � � �� 81GNATURH oF PERMITfHF AUTHORIZED AGENT 6=EE REC�(��D -�� -��J FINA�ICE DEPT. APPLICA� IOM(FOR�:P,�RW117aA BUILDING For Offlce Use Only COSTA MESA. CALIFORNIA 20 NO. OP i I — Pur�e teow� DeBCRIR�ON '� A. P. NO. �J ' YARD6 APPROVED ICBNT[R LINE BTJ .� I' FRONT R. SIDE �� I L. SIDE �� REAR n.� � APPROVEO I .� i ING " � '. :� , ue¢ on xew /�r � " BUILDINO �-V�� .�� /'"1 /� � T 1 � iVE6 \LLOWED V' � L— IN. IN. / IN. ( IN. DATE � - � Q J U ,R�,ti.-�, THE AMOUNT BHOWN UNDEP V�LU/�TION �8 FOR TH6 PUHPOBH OP BHTABL�9HING A PlRMIT F8E ONLY. VALUATION W PERMIT FEE $ e � �� /, W w w S��^ n �/ tS � PLAN CHECK S �� o�v- � � �� o TOTAL FEE y JOB ADDRESS g3p Pine Place BUILDING PERMIT N0. 42302 GENERAL CONTRACTOR �iaue Patios DESCRIPTION oi WORK 2 Patio Covers AP No.115-424-16 LOT TRACT FIREZONE VALUE IN�oECTIONS Si nat�re Dote TYPE IV GROUf 5 SUBCONTRACTOR wnTER ROl1GH PLUM0ING PROP. SWR. LINE � H( SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AI QEMPORARV SERVICE 0 UNDERGROUNO � P ROUGN WIRING TRENCNES � FORMS FLOOR SYSTEM BONO BEAM n STE SNEATHING FqqME ANO FLASHtNG LRTMING - IN n ( P�ASTER,BROWN COAT STRUCTURnL, FINAL HE<T�NG, VENT., REFRI P' ING, FINAL AND � EL�..lRIC, FINAL BUILOING, FINRL CON. TIONING ANO R.C., F I TEST rI ' 42302 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use lnk Only BUILOING �� ADDRESS • OWNER . �\ U l l� Y �C'_� � MAIL C�i � — � � _ �_lT� 1 0 CITY CANSiRUCTION IENDER BRANCH ADDRE55 ADOflESS CONTRACTOR ADDRESS � G�TV � �' STATE � LIC. NO. {z1 SIZE a OF LOT a USE OF � EXISf1NG BLOG. � 0 T E 1.. T ��11 NO. CITV LIC. NO. NO. OF BLOGS NOW ON LOT F Separate permi[s are required for elec[ric, plumbing and heating work. USE OF DI ND WORK TO BE PE�FORMED Q � G � � � � ( %' ..1 C W a )U119-7bPa�o001786 7.50 cns� # *�°'�� APPLICATION FOR STRUCTURAL PERMIT RECEWEDBV DATE9ECEIVED nnroiccimn A.P. NO. I � BUILOING � " ADDRESS TFACT �� B�OCK ev - -- �� ZONE NO.OF USE OF NEW ' PL4N$ BUILDINGi�MA i t' �'_ VAR�SAPPFOVED VAROSAGPR MAIN BUILDING ACCESSORV B (FROM UL STR�ET) � RONT T. FT. � ir S� T. O F � / l SIDE FT. D FT. REAq/<��N��,) FT. VAR.3i'+ OATE C.U.P.qW �1 APPRpVED APPROVED I� L �G �!_ U �I � � I hareby ecknowledBe thot I �uva raetl this oppllcatlon and stnte � (� that tha above Info�mation Is co��oct antl ap�eo io cOmply with m 0+ all laws .ee��ei��c builtling conrt�uctlon, ontl I sholl not ¢mploy Z any Oerwn in violaiion of tho workman's compansation laws of � = tha State of Californla. m 3 I hereby certity that I am propurly Iicansed as a contrector untlar SQ. FT, w ihe State of Celitornia Buslness antl Profeuions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl that such licanses ere In full forca antl effect, or I THE PVflPOSE OF ESTABLISHING A PEFMIT FEE ONLV: �� am exampi trom ihe provisions ot the State o( Celiforn Business VALVATION a PERMIT FEE E antl Professions Cotle, Division 3, Chapter 9. I �+ 1 ^� PLAN CHECK f ^ � o Signatura ot /� � LL Permittea 5 (.�/'��— TAX S � �V � U AuthorizadAgent TOTALPAID S ORAjNGE COUNTY BUILDING DEPARTAAENT � � 636 North Broadway . '� �T SAN7:. ANA, CALIFORNIA FOR APPIICANT TO FILL IN BUILDING noosess 830 Pi na Pl ar.P� SCHOOL DIST. OR TOWN NEAREST � CRO55 5T. OWNER OSAGE HONES� INC. ADDRESS9yV0 W��SNIRE BLVD• �� iTY BEVERIY HIlLS Na:CR. 7'fj01 ARCHITEC OR TEL. ENGINEER,p�N S. MCKERRACHER No.sY. 6489t �RE55 ��0 E. WALNUT ST.� PASADENA TEL. L CONTRACTORNEMPORT VISTA C0. r+o.CR. rj�l�u,j ADDRE55 p WIlSHIRE BLVD. BEV.HI��S LECAL / � DESCRIPTION LOT NO. pQ 6LOCK � � fATTACH METES 8 BOUND51 TRACT SI2E OF LOT 7200 SO.FT. I NOW ON LOT O USE OF NO. OF NO. OF FXISTING BLDG. I F�M�iie.5 ROOMS DESCRIPTION OF WORK NEw I X I p�rFRnTInIJ I I enn�TnN I 1 COVERING STUCCO I OF NEW _ DING RESIDENCE I HEREBY ACKNOWLE'JGE THAT I HAVE REAO THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTV ORDINANCES AND STATE LAWS REGULAT�NG BUILDING CONSTRUCTION. SIGNATUREOF NEVP1}RT VISTNl.O{ .. .�I � AUTMOHIZED $ 4830.00 �P ° s � APPLICATION FOR PERMIT �� BUILDINC� FOR OFFICE USE ONLY �E�PT NQ. PERMIT NO. � ' �� RECEIVED BY DATE OF APPL. DiTE ISSIiED 6 �- 3 �'3 � �- �:5� BUILDING � ... .� � _ Q // SETBACK LI REAR VARO APPROVED A CENTER OF ST. �}. ,�.SIDE YARD CORRECTIONS A?PROVALS s tlVIVV tltPM vn�unnoH I FINAL �� FEE � n D r � .. . , . . � `�. � r • �.. � � , � ' .. . � � .I `�1.�� . r • � � J � �. . � { . �. . � . . . . I. ...� . .�.. . .. � , _ . _ � . . . . � '.. _ _ . . � . � � . i ... . .. . � � �J . . . ... �T?.��, , ,. J:� r� ( -.._I. . _ ... � ' IV,� i.� �. � . ' ' x ' t , .._ � r _._ . f i:.t" . . . .. _ _ _ � - - - w ` � _ - � _ . . . . :, i " � . . " " ' . , � ... • ..:i. ' . . „T.. . ..,.`q7�., � . _ _', ' - .. . .' __._ � _,