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Home My WebLink About270 DEL MAR AVE - Building Permits' i6836 � COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. 90X S17 COBTA MEBA. CALIRORNIA For Applieanf fo Fill In Complefely TYPE R PRINT BUILDING ADDRE55 COSTA MESA. CALIFORNIA OWNER � `'/ MAIL �/ /- ADDRESS !/ E TEL. ' CITY NO. ARCHITECT _ TEL. FEE RECEIVED � MAR 2 9196;� FINANC� DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT �; BUILDING For Office Use Only RECEIPT NO. PEqMIT NO. '� I �J/ %plfE'(� Z�I ^�RT� 193U U� -T_�r� � , , i; ADDRESS � �"I /� � LVI�II�V /� � �1../ - ZONE I NO. OF I U8E OF NEW cin v'/��i�u_� f� PLANS BUIIDlNG , GI'ATE Q O NE�' pgscrtiPTiON O/ LIC. NO. SIZE I I rvo, oF etoae. O , OF L07 rvoW ON �oT p, p, NO. USE OF EXIBTING BL�G. APPROVED ALEOWED S6TBACK LIN¢ PPOM (n / (CENTER LINE 8TJ C¢NTER OF STqEET J/�/ ��+ REAR YARD FRONT FT. SIDE YARD I LEF'Ry I RIGHT !/ R. SIDE ( FT. IN. DESCRIPTION OF WORK L. SIDE � FT. � W. NEW I II ALTERATION I II AODITION I REAR FT.t IN. REPAIR I IIMOVING I IIDEMOLISH I ByPR �� 3-�Z'G pATE BUIL�INGq NO. OF SIZE � oC ROOMS � STORIES k�L�_ �� U l�(J �.CI�ZC'-(��a�f, EXTERIOR WA I ROOF � . t� COVERING COVERWG c>_0tti,j�{� USE OF BUILDING AND �"10RK TO HE PERFORM �. � � D' — d�0� � � ,�O _ 3/ _ p' �, . � 1 9Y ACNN LEDGE THAT 1 HAVE READ iHi9 APPLIWTIO }HE AMOU '6HOWN UNDER VqLUAT10N 19 FOR THE AN TATE TH T THE pBOVE IB CORRECT AND AGREE TO GOM- pUppOBE OF EBTqBL18NING � PERMIT FEE ONLY. PL W�TH ALL TY OPDINANCEe �N� 9ThTE LAWB fiE6ULATING au1LDINa CONBTxucrloN. � VALUATION �J// 6IGNATURE OF /// /O '�� O PERMIT FEE $ J`}'. b PERMITfE T � PLAN CHECK $ � � AUTHORIZED AGE ' C � � �� c TOTAL FEE � � LL Stan JOB ADDRE5S c BUILDING PERMIT NO. GENERAL CONTRACTOR Frank Bissell VALUE $1h.1�00 AP No.119-16 -1 LOT TRACT RIR� ZONE DESCRIPTION OF WORK Res.w�att.Gar. P- "'ECTIONS - Signature DATE GROUPI � j TYPE �7 ZONE R-1 � -!�. F�RMi•rs issuLn G� - _ -F, ' � ^ � SUBCONTRACTOR DATE NUMBER � OCCUPANCY ' CITY OF COSTA MESA BYILDING DIVIS/ON 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 � PERMIT NUMBER: B08-00300 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 43920120 DATE ISSUED: 10/20l2008 - _. ISSUED BY: BJK JOB ADDRESS: 270 pEL MAR AV CM ,,; Suite/Unrt ,- Vicinity: RESIDENCE AND bETACHED'GARAGE �:,;; r .. . . . ; . ,,..�, ' � ' �.;. � ..: Squares: 2400 ' " ..Valuation: ', , $5,000.00 ��=: . f ''. _".'-' ` , ;. . SCOPE OF WORK: REROOF RESIDENCE AIJD�DETACHED GARAGE: T/O EXISTING COMP ROOF 7l16"�OSB, FELT PER MFGR'S SPECS, APPLY "30-YEAR CLASS A�COMP SHINGLES." PITCH 3:12 24 SQUARES � �te " �l OWNER: ROY M PIZAREK 7R �� Address: �� 270 DEL MAR AV ` �- Unit PHONE: . � . - -�:City/StAte/Zip: COSTA MESA, CA � „ , . . .....�. .. -: : � . , . n , APPLICANT: ROY M PIZAREK Address: 270 DE6�MAR �AV '- Unit: : PHONE: 949-548-7983 City/Stafe2ip: COSTA MESA,;CA� , ; , CONTRACTOR: OWNER,BUILDER. _ �;�:� � ' `-;.�:" , � � � . � . _ �_ �� License No'. .�� 000000 Address: Unit: -,--. , �- ___- : - j �', - " PHONE: . , ' � ; � � � i:' City/State/Zip: -- � ' _ . ' � - CELL . � . .,: .. . _. .., ,. - . .. ,. ._ . ... - . ARCHITECT: � License No. -- , � � ^� � PHONE"�'a , '� ' y - ENGINEER: � � License No. - �"� .. � � PHONEi -' i FEE SUMMARY „: ' ..,: . . : ' ' ° .,, . ' i" � . 1 � �' . '... . „, i... . . Reroof Plan Check: �.�- $0 00 '�. Reroof Permit Fee: � $153 25 � '.�. � Reinspection Fee: - $0 00 ' `- '' ' TOTAL FEES $153.25 �. NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes 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 fi�al approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permil. CODEt, INSPELTIONTPE ORT I 1I71A 4 DI�E�� INSPECTIOXTYPE � D� � � NTI� TIRlS 1816 Fixed System Final Fire Prevention 206 Final Mechanical � 1266 Pool Spa Final _ 200 Final Re-Root _ 201 Final Block/Retaining Wall _ 202 Final Factory Fire Place , _ 203 Final Sign . —' _ 204 Final Demolition _ 208 210 212 220 222 250 Final Plumbing Final Electnwl Final Fire Prevention Final Planninq Approval Final Site ` Final Building/Occupancy �� - �� WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalry tl� Cerjury one of Ne following tlecWralions: ❑ I have antl will mainlain a certifwte of wnsent to selt-Insure for vrorkers' wmpensation, as provided f0�, by section 3700 of the Labor Cotle, for the peAormance of the v+ork for wYiich this permit is issued. ' � 1 have and will maintain workers' compensation insu2nce;'as required by section 3700 of the Labor Code, fa Ihe peAortnance of Ihe v.ork for which this pertnit is issued. My wnrker5' compensation Insurance carner and policy number are: Carner. (This setlEn naetlnot be mndet�/Ne pemM k vaNetl at rne hurrtlietl W9ars (51 W) a IessJ Policy Number: ❑ I ceAify that in the peAormance of the vrork for which this permil is issued, I shall not employ any person in any manner so as [o become subject to the workers' compensation laws of Califomia, and agree that if I should become subject to the worke�s' wmpensation provisions of Sec[ion 3700 of the Labor Code, I shall (orthwith comply with these provisions. AOplit�anl's SignaWR WARNING: FAILURE 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 7HE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm Ihat I am licensed under provisions of Chapter 9(commencing wilh Section 7000) of Division 3 of [he Business and Professions Code, an0 my license is in full force and effect. Lic. # Class # Gontractor's Si8^aWre Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a consWction lentling agency tor the peAortnance of the v,ork fa wfiich this pertnit is issued. (Sea 3097, Civil Code). Lender's Name: Lender's Address: Signalure Oale - OWNER-BUILDER DECLARATIONS: ' � I hereby atfrm Ihat under penalty of peryury 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 pertnit to conslruct, alter, improve, tlemolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit to fle a signed statement that he or she is licensed pursuanl to Ihe pmvisions of the Con[ractors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and �he basis for Ihe alleged exemp��on. Any violation of Sec�ion 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o/ not more than five hundred dollars ($500�.�: ❑ I, as owner of the propeRy. or my employees with wages as their sole wmpensation, WILL DO THE WORK, and the structure is not intended or oKered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves there� n, and who does such work himself or herself or lhrough his or her own emp oyees, provided that sucb improvements are not intended or offeretl for sal . I(, however, Ihe building or improvement is sold within one year of w pletioq the ovmer-builder will have the burden oLpmving that he or she . di not build or improve for purpose o( sale.)._ . GI; as ownerbf the propeAy, am EXCLUSIVELY CONTRACTING WI7H CENSED CONTRACTORS to consWcl the project (Sec. 7044, Business and Protessions Code: The contractas License Law dces not �appty to an owner of property who builds or improves thereon, and who cont2cts fw such project with a contracta(s) license pursuant ro the Cont2ctors License Lavrs.). � I am exempt under sec. Business anC Professions Cotle for this reason: � ]OS]<6 �3I0]) �� Owner ID verified by dri e� ., �c ns . Yes o Verifcation 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 frve (5) or more teet in tlepth inlo wfiich a person is required to tlescentl, will be matle in conneclion wiih v.ork authonzetl by lhis permi[, and lhai no building structure, scaffdding, falseHvrk, or demolition or tlismantling Ihereof, will be more lhan thirty-six (36) feet high. (Chap. 32, Gry 2, M 2, Sec. 341, Title 8, Califomia Adminis�rative Cotle). ❑ As owner-builder, I vrill not employ anyone to do vrork which would require a permit from the Division of Industnal Safety, as noled above, unless such person has a permi[ to do such work from Ihe division. AOOlifanl's SignaWre Division of IndusMal Safery Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the appliwnt or present or fuWre building occupant neetl ro fle and certify a Business Plan (or emergency response lo release or Ihreatenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 of Ihe Cali(ornia Health and Safety Code requires, with some exceptions, �hat a Business Plan be fled with the Costa Mesa Fire Department by every business which has at any one time tluring a reportetl year a quantity o( hazardous materials equal lo or greater than a weight ot 500 pounds, or a volume o( 55 gallons, or 200 cubic feet o( compressed gas at standartl temperalure antl pressure). 2. Does or will [he applicant or present or tuture building occupant need to fle a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of ihe Cali(omia Health and Satety Code, with some exceptions, requires registration wi[h the Cosla Mesa Fire Depadment by each business which at any one lime has on hand a quantiry o� acutely hazardous materials equal lo 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 wi0 the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program fo� acutely hazardous materials�? ❑ Ves ❑ No (Section 25534 of the Calitornia Health and Safery Code provides that Ihe Costa Mesa Fire Department may require ihe prepara[ion, cerlification and filing with [he Fire Deparimen[ of an RMPP by businesses which are requiretl to register acutey hazardous materials with the Fire Department. 4. I( an RMPP is presently require0, has Section 25534 of Ihe Cali(ornia Heal[h and Safety Code been (ully complied with? � Yes ❑ No 5. Does or will the applicant or present or (uNre building occupant require (or the work which is Ihe subjec[ of Ihis application a permit for such consiruction or modifcation (rom the South Coast Air Qualiry Managemenl DisMct or from any other air pollution control disMct or agency? ❑ Yes ❑ No (Seclion 658502 of the Califomia Govemment Code requires that the requested infortnation be tumishetl on applications fa rron-resitlential builtling pertnitsj. 6. Will any part of Ihe (acili[y to be constructed under this permit be within 1000 feet from the outer boundanes of a school? ❑ Yes ❑ No Q('yes", [he facility must meet the requirement o( Sections 25534 and 42303 of Ihe Califomia Health and Safety Cotle). � 7. If a pertnit from Ne South Coast Air Quality Management DisMct or other air pollution control disMct or agency is required for the work which is the subject of this appliwtion, have all of the disclosures prescribed by Galifornia Health and Safety Cotle Section 42303 been made? ❑ Yes � No 8. (If "yes", attach certificate of compliznce from the appropriate air pollution coMrol oKcer). ' � � - � � � ' CERTIFICATE OF COMPIIANCE: Pcertify�that under penalry of perjury the information given above is cortecl. I agree to comply with all state lavrs and city ordinances regarding.Hazartlous Materials and Emissions. �' � ' S19^aWre oaie GERTIFICATE OF COMPIIANCE AND� AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ihe information given is correcL I agree to comply with all slate laws and cily ordinances relating to building constroction, antl authorize representatives of the City of Cosla Mesa ro enter upon the above-0escribed propeAy,for inspection purposes. I agree nol to occupy or allow occupancy of any building authorizetl by this permit until final i pection. � �-/�d/�' � —o�a AnObr A W �onzetl Ap01i W nl