HomeMy WebLinkAbout1087 EL CAMINO DR - Building PermitsI
9
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1687 EL CAMINO DR
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 14162314
Zoning:
Applicant:
COFFEY, BRIAN
Address:
2428 NEWPORT BLVD
UNIT 5
Phone:
(949) 722-8846
COSTA MESA, CA - -
Zip:
92672
Owner:
PURCELL, AARON GEORGE
TR
Address
1087 EL CAMINO DR. - -
-
- --. -
/.
,
Phone:
Zip:
92626
Contractor:
�THE'ROOFING SPECIALISTS
Address:
2428 NEWPORT BLVD
UNIT 5, ;."
Phone:
(949) 722-8846
-
COSTA,MESA,CA
Zip:
92672
License:
734068
Arch
. ,
_
- Eng:
Address:
-`
-
_ Address:
Phone:
)
Zip: - License:
Status: ISSUED
Applied: 07/02/2003
Issued: 07/02/2003
ISSUED BY:
Phone:
License:
- - -SCOPE 01--PEKMI I -
' REROOF RESIDENCE AND ATTACHED -GARAGE: T/O, EXISTING WOOD SHAKE; 1/2" OSB SHTG;'l LAYER 30# FELT, APPLY "30-YEAR•ELK
COMP SHINGLES." 26 SQUARES -
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $5,259.00
Permit: $125.25 / Claim Valuation: $5,259.00
�, SMIP Res: $0.53 -
SMIP Com:,°, .$0.00
Other: \`-•.,$0.00
Inspection: - �� $0.00
',Total: $125.78`
PLANNING'& ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear - 0-0
ACCESSORY Front 0-0 Rear 0-0
PARKING Existing: 0, - Required: .0
Left 0-0 Right 0-0 '
i
Left 0-0 Right 0- 0
Proposed: 0 -
-
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2446-46(6/00)
I
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance o1 the
work for which this permit Is issued.
1 have and will maintain workers' compensation insurance, as required by section 3700 of the labor Code, for the performance of the work for which this permit is� �Issued.
A My work'rr��mpensSion IInnsulranca carver and policy number are: / /,q _ z-(.d.z
Carrier: i ! ✓Af ) Policy Number:$ 1,65 f �ii/ J
(This section need not be completed if thelpermit is valued atone 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 became subject to the workers'
compensation laws of California, a d Ell that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these pr I ns..-J,/
s._ J /
Applicant Signature: ( l Date: d I D
WARNING: FAILURE TO SECURWORKER PENSATION COVERAGE IS UNLAWFUL AND SHAH SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND L FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000). IN ADDRID 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 license of the Business and Professio,gqs Code. and my license is in full
force and effect. Lic. it oder Provisio of Chapter 9 (co encing with Section 7000) of Division 3 Class gd 1'
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 pernit 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 permit
subjects the applicant to a civil penalty of not more than five hundred dollars (5500).):
❑ 1, 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. II, 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.).
❑ 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 project with a contractors)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, Le. - 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 Cade).
❑ 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 WIII 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 tiled 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).
........._.......... _......... _.......... .............................. ............................................................................................................. ................................................................................. _.__............................. I...........I......................................... _............
__.
2 Dces 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 California Health and Safety Cade, 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 applicant or present or future building occupant need to prepare an RMPP (Risk Management and 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 filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.............................................................. __.......... _.._................ .......... _......... .......... ..............................................................._......................................... .................... ..................................................................................._..... ..... _...... ....
4 If en RMPP 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 application a emit or Suchconstruction or m ication
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U 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).
..._........._......................_.........._....................................................._..........___.._..........__.._..._............................................................................................................._.................................... ..............................
e WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade).
............................... _..................... __....... __...................._............................................................................. _...... _.... __... ......... _... _._..-.................................. ................................................... ............................. _........ __...............................
7 If appermit from me 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
applicatlon, have all of the disclosures prescribed by California Health and Safety Cade 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-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
ig Of Legal Owner(s) Date
?-Z v7
r Authorized Applicant Date'
CODE I. INSPEC NTYPE gAiF RNTITIA45 CODE11 INSPECTION TYPE gd¢. 7y)]pALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 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
20262 :
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX SIT COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
COSTA MESA, CALIFORNIA
Dw,ER Mesa Del Mar Development Co.
FEE RECEIVED
V1L 2 5 1969
A P CAIT�,ppN FLq� . PERMIT
�i�APBLtiL N�cl`
CIiMolOPffia §MANY
RECEIPT NO. ^iEEEMIT� .
. R DATDAT R DATEISSUED
ARCHITECT Macco Realty Co. TEI-OR3-4220 BYPROVED
OR ENGINEER O.
JOVV R. l.V#3L
Macco Real
same as above
same as above
ucTNo. 207343 -A -SB -1 no'OR 3-4220
SIZE 1 1 NO. OF BLDGy
OF LOT 69 x 96 NDW,N,AT4ione
USE OF none
EXISTING BLDG.
B ETBACK LINE FROM
CENTER OF STREET 4 '1 REAR YAR
SIDE YAR61 LEFT 101 RIGHT 81
DESCRIPTION OF WORK
1X501611 ROOMS 8 STORIES 2
mLawood I ROOF Wood shake
so StnCCOI COVERING
Plan 600-C
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.
SIGNATURE OF Macco Realty Company
PERMITTEE_
AUTHORIZED AGE
ZONING
ZONE.NO.
R-1
OF
PLANE 2
USE OF NEW SinO
BUILDING W att gar.
O
LEGAL Lot 63 Tract 5023
DESCRIRION 1
A. P. NO. nolle .
NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
30" TO SIDE @REAR P. L.
EAVES
ALLOWED (U. B. C. REQUIREMENT)
YARDS APPROVED
MAIN BUILDING
YARDS APPROVED
ACCESSORY BUILDING
( FROMC/L STREET )
FRONT PT.
FT.
R. SIDE FT.
FT.
L. SIDE PT.
REAR
FT.
DISTANCE BET.
MAIN BLDGS.
BET. MAIN Q
ACCESS. BLDGS.
VAR.*
C.U.P.#
DATE
APPROVED
APPROVED, L.D.
BY 4l
DATE -22-6
dwelling 9974 A
garage 453 s.E.
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
$ 23,985.00
111
_
�
PERMIT FEE $ 2:E-
PLAN CHECK
TOTAL FEE $ /J