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HomeMy WebLinkAbout929 EVERGREEN PL - Building Permitspia� �sa-sz�a • Fax (714) 754-4856 • www.ci.costa-mesa.�IJ9LDING PERMIT JobAddress: 929 EVERGREEN PL Suite: Vicinity: ROOF Primary Occ: R3 �wellings/ Cong Res <10 Type of Consiruction: V-N Parcel Number: 42252113 Zoning: Applicant: GAL�A RINI, MILES Address: 239 S WILLOW SPRINGS RD ORANGE,CA = ..�:, Owner: SWINGLE, VIRGINIR;A Address 914 EVERGREEN.PL � � ' / 6 � � COSTq"MESA,CA�, � / .'"� ; , . , " Contractor:'��, GAL�LA RINI, MICES :� _-�-' Address:`i 239"9 WILLOW SPRINGS RD � ., � ,� j�;%, vi �f � � �/�%. i/ ' �ORANGE;,CA , -� " � ' Zip: 92869'/,i' - . �j .,,rcH . i' � �. �� Address: : � 77 FAIR DRIVE, COSTA MESA, CA 92626 Phone: 714-757-1533 � ,Zip: 92869 '. �� Fhone: - . Zip: 92627 Phone: 714-757-1533 License: 663983 Eng: Address: � Phone: ISSUED BY: s: ISSUED ed: 11/13/2006 d: 11/13/2006 Phone: � . . �i� . -� � . � , •Zip� ' .� . , . License: �� �" , � , License: - � SCOPE OF PERMIT �,TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30# FELT, 4:12 PITCH, 30 YEAR GAF TIMBERLINE COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS NEEDED. 17 S�UARES INCLUDES ATTACHED GARAGE. � . . . j_ � �� Plan Check: ' � $0.00 ' Permit: $11125 � ` SMIP Res: . , $0.50 :,, SMIP Com:,, - $0.00 �` � � ', Othec " $0.00 , Inspectio�n: �„ $0.00 ` � TotaL• �`�. �� $111.75 � � r A.�'. , , �l� . .,.-�, „- .—FEESUMMARY � �, .. - -- `'--" - � � � - � � 1 " �^. FLANNING & ZONING SETBACKS � „ ,x- MAIN STRUCTURE Front ��0= 0 Rear ` �0- 0� Left 0- 0 �� ` � ��:���'�'yr'_'.," _. . . . ,' ACCESSORY , Front��� 0- 0� A� ��- Rear r 0- 0% = Left 0- 0 , �,.� � 'r ���'= '" � - �. _ . � PARKIPI('i� � Ezistino -0� � Required 0 - � Proposed 0 �� �� �.,. ,_.� � • . _ �A��. �i/ � =�., . ' .. , .. �� . �\ _, - � - � : - - � �,! „t, , . , �,; �. � � , _ A: _ - u _ Calc Valuation: $a,aoo.00' Claim Valuation: �a,aoo.00 Righl 0- 0 Righl . 0- 0 . , _ . ,`� , NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 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 780 days. ,- ��� . � INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codas, and all � required Inspeetions and final approval must be obtained. Failure to obtain inspections and tinal approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zans�as (wao) WORKERS'COMPENSAnON DECLARAnON: . � � � � I hereby ettlrm unEer penalry ol perjury one of tha following tleclarations: ❑ I heva end wlll melnteln e certilicate at consent to seH-Insure far warkere' compensatlon, es provided for by sedlan 3700 ot the LeDor Goda, for the pertortnence of ihe work for which Ihis pertni� Is IssueA. �1 have and will maintaln workero' compensadon insu2nce, as required by section 3700 of Ihe Lebor Code, for the pertortnance of ihe work for w�ich Ihis pertnit is issued. �y waC�y�q/-rs'�� m/pensatlon Insurance cerder end policy num6er are: /'� / /-7 �Cerrier. � I r wN� : P' .Numbbr. (/d if(J 7f .(Th/s'seCfion neBd not 6e Comp/efetl/l the permif /s velued et one hundred dollars ($100) or less.) ` ❑ I cerlify that in the pertortnance oi the work for which t�is permit is issued, I shell not employ any person in any manner so as to become subject to the workers' compensetion lews oi Califo and egrae thet if I should become subject to Ihe workers' compensation provisions oi Section 3700 oi lhe Labor Cotle, I shall fonhwith �oYply wit�h these provisions � i ,LAppll� nt Signature:. � = -'-"—� �Dete:w«� � � — � i �O � WARNINO: FAILURE TO SECURE WORKERS' COMPENSA WVERAGE IS UNUWFUL M!D SHALL SUBIECi AN E OVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TFKKISAND DOLLARE (5100,000), IN AODRIdJ TO TME COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOF CODE, IMEREST, P.ND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm Ihal I em licensed under proNslons ol Chapter 9(crommencing with Section 7000) of Divislon 3 of the Business and Professions Code, and my license is in full �orce�entl etleci"Cic'ne-^-�.-. �j ��j rr 3 i � ass �*. li? S- h �_ ��!�. Gontracto`rs Signatuie_F „j Date:^^+ i I�l y-�L _�..�...�..., CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that Ihere is a consiruciion lending agency tor Ihe perfortnance of Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentlels Name: Lendefs Atltlress: Signemre: Date: OWNER-BUILDER DECLARATIONS: I here6y ettirtn thet under penelry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, eusiness antl Professions Cotle: Any city or county which requires a permit to consiruct, alter, improve, demolish, or repair any stmcNre, pnor to its issuance, also requires fhe epplicant for such permit to file a signed slatement Ihat he or she is Ilcensed pursuent to the pmvisions of the Contrectors License Lew (Chapter 9(commencing with Section 7000) ot DlNslon 3 oi the Business end Professlons Cotle) or that he or she is eMempt therefrom and t�e basis tor the elleged e:emption. Any violation oi Section 7031.5 by any applicent for e permit sub�ects ihe applicant to e civil penalry cl not more than five hundred dollars ($500).): - ❑ I, es owner ot the proparry, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and the siruciure is not intended or oNeretl tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law dces not apply to an owner of property who builtls or improves ihereon, and who does such work himself or herseN or through his or her own employees, provided that such improvements ere not intended or ofteretl for sale. It, hor.ever, t�e building or improvement is sold within one year of completion, the owner-builder will hava ihe 6urden ot proving that he or she did not build or improve for purpose of sale.). ❑ I, es owner Of the Droperty, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to canstruct the pro�eq (Sec. 7044, Busine5s end Professions Code: The contractors Llcense law tloes not epply to an owner ol pmperry who builtls or improves thereon, and who contracis tor such project wtlh a coniractor(s) license pursuam ro the Coniredor5 License LawS.). ❑ I am exempt under sec. Business and Professions Cotle for this reason: Signeture: Date: Owner ID venfied by driver's license. ❑ Ves ❑ No Dnvefs License No. Expires: Vedilcetlon of Ownership by (type oi document, I.e. - property te: 6ill or deetl): DIVISION OF INDUS7RIAL SAFE7Y PERMR CERTIFICATION: ❑ I hereby certify Ihat no exwvation five (5) or more teet in depth into w�ich a person is required to descend, will be made in connection with work authonzed Dy this permit, end that no builtling siruclure, scaHolding, falsework, or demolition or tlismantling ihereof, will be more than thirty-sia (38) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ti(le B, CalifOmia AOministrative Cotle). ❑ As owner-builder, I will not employ anyone to do work which woultl require e permit irom the Division of IndusMal Safery, as noted ebove, unless such person has a permii to tlo such work irom the division. Signature: Division of Industnal Sefery Permit Number: Date: W III ihe applicant or present or future bullding acupant need to fila entl certiFy a Business Plan for emergency response to release or ihreatenetl release of a harardous metedal7 ❑ Ves ❑ No ' (Section 25505 of ihe Celifornia Healih and Safery Code requires, with some exceptions, thet a Business Plan be filetl with Ihe Costa Mesa Fire Department by every business which has at any one time dunng e reported year a quantiry of hazardous materials equal to or greater than a weight of 500 pountls, or a volume oi 55 gallons, or 200 cubic feet ol compreued gas et standard temperature antl pressure). .............................................................................."'...................___._.._...._................................................................................................................................._._......................... ....................... ................................................... Does or will Ihe applicant or present or future building occupant need to file e registretion fortn tor ecutety ha�rdous matenals7 ❑ Yes ❑ No (Sectlon 25533 oi lhe Califomla Heelth en0 Satery Code, with some exceptions, requires registretion with the Costa Mesa Fire Department by eech Dusiness which at eny one time has on hend e quentity of ecutely he=ertlous materials equel to or graeter Ihan e waight of 500 pounds, or e volume of 55 qellons, or 200 cubic feet of compressetl ges et slentlerd tempereWre end pressure). 3 Does or wlll t�e epplicant or present or future building octupant need to O�epare an RMPP (Risk Managemant end Preven�ion Program for ecutely hazertlous matenals)9 ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health and Salery Code prwides that the Costa Mesa Fire Department may require the preperation, cenificaiion and tiling with ihe Fire Depertment ot an RMPP by businesses which are required to register acutely hazardous materials with ihe Fire Depa�ment. .........................................................................._..................................._..__............................................................................................................................................................................................................................................................_.. 4 If an RMPP is presently required, has Section 25534 of the Califomia Health end Setery Gode been fully complied with7 ❑ Yes ❑ No Does or wlll the epplicant or present or tuWre building occupani require br Ihe work which is the subiect or tnis e plicetion e pertnit for such construction or motlificetion irom the South CoeSI Air Oueliry Management Disirict or from eny oiher eir pollutlon control tlistnct or agency? � Yes I.J No (Section 65850.2 of tha Calilomia Govemment Code requires ihat Ihe reQuested informatlon be fumished on epplications for non-resitlentiel bullding permits). ......................................................._.........._............_....................._............................................................................................................................................. .................. .............................................................._. Will eny pan of the faclliry to be wnstructed under this permit be within 1000 feet irom the outer boundaries of e school7 ❑ Yas ❑ No (tl'j�es", Ihe faciliry must meet the requirement of Sedions 25534 antl 42303 oi lhe Califomia Heali� and SeFery Code). heve all ot the tlisclosures Or Bgency is required an matle7 ❑ Ves Q� yes", atlach certificate ot wmpllance from ihe appmpnate eir polWtion control oHicer). CERTIFICATE OF COMPLIANCE: I certity t�at under penelry ot per�ury �he Informa�ion given above is correcl I a9ree to comply with all state laws and ciry ortlinences regar0ing Hazardous Matenals and Emission9. Slgnaiure: Da�a: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRY: I certify untler Denaly of perjury that I have read ihis application and state that �he informetion given is correct. 1 egree to comply with all stete lews end ciry ortlinances releting to building construction, and authorize representaiives of Ihe Ciry ot Cos�e Mesa to enter upon the ebove�descnbedDmperry tor inspectl�purposes. I agree not lo occupy or allow occupancy ot any building euthorized by this Dermi� until finel inspection. CODE �. INSPECTIONTYGE . 1876 Fixetl System Flnal Fire Prevention 1268 Pool Spe Final � 200 Final Ra-Rooi 201 Finel Block/Retaining Well 202 Final Fectory Fire Placa 203 204 Finel Sign Finel Demolition 7 a j1y1j[ INIITIRLS 'L� // iC/ � � //� CODEI INSPECTONTYPE 206 Final Mechanicel 20B Final Plumbing 210 Final Electrical 212 Finel Fire Prevention 220 Flnal Planning Approval 222 FinalSite 250 Final Building/Occupency p�g I�RLS OWNER �INGLE, L. J08 ADDRESS 929 Et'erg `.RAL CONTRACTOR 0.115-�+91-12 LO" � INSPECTIONS SOIL \1 GAS /� WATER ROUGH PWMBING PROP. $WR. LINE n MOl15E CON. MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARV SEFVICE OR POLE IIN�ERGR0UN0 � POWER � ROUGH WIRING TRENCHES I I FOPMS I� STEEL REINF. FLOOR SYS BONO BEAM SHEATHING F0.AME AN� ' ^THING - iTER, E STEEL REINFORCE NG TRACT DATE 5-18-72 BUILDING PERMIT N0. FIRE ZONE VALUE GROUP J TYPE SUBCONTRACTOR Nntu �,,•1,s-��.;;,:00 aQo+: f�*���,9.06 + 34735 � Z . �- U E- Z Z a O v~i n. m J � J V1 � UN Z a W � aW wz J Q m Z J � W W O= Z �- W � � O H z Q U Q H y Z � F U 7 � F N z COSTA�MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 7200 COSTA MESA,CALIFORNIA 92626 _ APPLICATION FOR BUILDING PERMIT ForApplicant to Fi!l in Completely RECEI D DATE REC IVED f^/ 7 rDATEISSUED ADIDFESS (� 11 ^r.' L'� i"/ �� '" � `� /� 7 OWNER � 1 L_ A p NQ /� y � PERMIT N� A�7 i `t / MAIL C � BUILDING�� ADDRESS J AODRESS q � �t�(+ r j TEL TRACT d LO BLOCK CITV C a� . '(k NO. CONSTRUCTION NEW ADD A P LENDER � BRANCH ��T' � - OWNEF �i ADDRESS i VALUE � ARCHITECT TEL. SE � OR ENGINEER I— � NO. G-� FIRE ADDRESS � �1 I � 20NE TVPE FiOUP APPflOV E CONTRACTOft �� Sr BY ATE � ADDRESS�3��' CY C ��UC� TEL. ZON NO.OF USE OF NEW ��Q CITY NO. P�.Nspf� BUILDING v �.�/� 7 F �S �? � 4 STATE CITV �'ARDSAPPROVED VARDSAPPROVED LIC. NO. ' LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE . NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. � FT. USE OF � EXISTING BLDG. '�,-' F" fi ' FT. FT. SIZE OF NO.OF � NEWBLOG. ROOMS STORIES L.SIDE FT. /O FT. EXTEFIOR WALL ROOF COVERING COVEFING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISiANCE BET. BET. MAIN & � MAIN BIOGS. ACCESS. BLDGS. � � i i � VAR.#` DATE 3 � [,Jp�i C.U.P.# APPROVEO ,w P , . narao0e _ _ S qTF . 1 hereby acknowletlge ffiat I have reatl [his application and state D that the above info�mation is correct antl agree [o comply with all laws regulating builtling construction, antl I shall not employ any person in violation of ffie workmads compensation laws of T'4%( the State ot California. I hereby certify that I am properly licensetl as a conbactor untler ' SQ. FT. the State of California Business antl Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR Chapter 9, antl tha2 such licenses are in full force antl etfect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt trom the pfovisions of Me Staxe of California Business VALUATION antl ProfessiOns�n%, [7�� n 3, Chapte� 9. �� ��� �� PERMIT FEE $ Signature of L� �IO Permittee - $ �� � PLAN CHECK $ ' Authorized A nt TOTAL FEE S + OWNER STOROVICH, ROBER.T D, JOBADDRESS 929 Evergreen GENERALCONTRACTOR Ocaner-Buil3er L Zi]O BLOCK GROUP J TVPE V INSPECTIONS DATE Footing Trench � ��' / —� / . Foundation Forms and Grade to Gara e Rough Framing � � Plumbing, Rough to Slab ��� �—�/� Plumbing, Rough Complete Temporary Pole � Wiring, Rough Heating, Rough Heating, Final Sewer Septic Tank or Cesspool � s w,�-�-� � = -_ ��= R___ering Plumbing, Final, FixtureS.Complete Plumbing, Final GasTest Wiring, Final �r—y-� OccupanCy %e�U.� � Porm 210 G-H lbl 12-63 TRACT 1.��-Z ZONE R�- SUBCONTRACTOR DATE 1—uy-7S � � / BUILDING PERMIT NO. 83�- _ V A W E$ �-5O. OO � Convert carport to garage FIRE DISTRICT 81=�- , PERMITS ISSUED DATE I NUMBER n • Costa Mesa Building Department APPLICATYON FOR PERMIT . COSTAEMESA20CAL$ FORNIA �� � U I L D i� N G � FONM 2O4 G-H 2M 5-5a � ' 'f ( '. . . . � .. —. . ..r � �. i . �.� " . ', � . .1�t _ y. .. .. _. '� / . _.. . a... . . �.a♦ � U�:�_i�...; . �:t. i .a ..f a � 1 .1. ._ i c. fi]_.. .... i�ll ��b ` �.. . � ' ;..Jr.if` . .. ... . . . .s.l A�:.:.U'.J.�..�.�.�_....:.:'J '� , _ _' _ _ _ _ _ _ _ _ .. -, . . ' '. i ' .r,:. ,. -,.�� . .. . . ..�. , . - . 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J� . �� - � � - :--- _ � �,,�.: _ -___;�i� . �: �_ - -- - � . ." _ . _ __ _ '_ _ . `__` __ _ .. _'_ �____ �__ __ . _ . _ . � _..L:: .J'! � Costa Mesa Building Department ,/ APPLICATION FOR PERMIT ' 171 EAST 20th STREET -� �24R Q 11 1 1 n 1�►1 2 AA ppRM 204 G•N 2M 5-54 , _ _ . _...__ ,_ �. _.. . _ .i . . - ' _ � ' 'YS�i:; ..._ . �. r ,. ... .: �. ��.. . .�. . _ . . ..._ . . , .,, � - ' . . , _ 1�/� .. u ' . _ . �T:"/'r �-TL � 1 � .a.. . � '.1_. . . ' _. . .� . � . . . � . . C O 4 J. � ' ' . _ . . .. ' '� � f 'r J' . - , " ' o : . 'S�' a ':i:. _ . ' . � _ . .. . � o _" ' � a -- - - - - � ` - . . . a. � - .io, :i- ' �E � --'.- ._ . '- .' - '- _ . - - - . . _ - . F.^ Sbs` � _ . , , � , � i;- -- -- � .. � _ - -- - - -• - - - — - -- --- - - , � "' .,! ..— - -' - -�„ . _ .. . . . . __ _ �_Y- . . . . _ . . .v:� . �_ .—_._c' —_ � . " ' - ., - . ' ' _' ��y --'-.__.--'.'----'- '��--- --'---' � - --''. . � � L/' — .. . - _ . � �: � ._ - . � .a:' i nr :,.+�. . i . 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