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Home My WebLink About1969 FEDERAL AVE - Building Permits 9 CITY OF COSTA MESA 4 BUILDING DIVISION r.; .. F i ,T�� ; DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER s Ira • PERMIT B05-00814 41/veD 6% BUILDING PERMIT (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.oa-uo 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1969 FEDERAL AV Status: ISSUED • Suite: Applied: 05/23/2005 Vicinity: ATTACHED CARPORT Issued: 08/05/2005 Primary Occ: R Type of Construction: V-N enc' ] Parcel Number 42251205 Zoning: ti..1006 1 Y Applicant: DOUGLAS E PARKER ogrE i Address: 1969 FEDERAL AV {�� Phone: 714-642-1003 ISSUED BY: 4' -r / COSTA MESA,CA Zip: 92627 Owner: HAWLEY, MARY K TR Address 1801 N INDIAN RIVER'RD • Phone: NEW SMYRNA BEACH, FL Zip: 32169 Contractor: OWNER-BUILDER • Address: . Phone: . Zip: License: 000000 , Arch : Eng: , Address: Address: , Phone: Phone: Zip: License: License: • SCOPE OF PERMIT INSTALL NEW BARN STYLE DOORS TO EXISTING,ATTACHED CARPORT.2 SIDES OF CARPORT WILL REMAIN OPEN. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. - ' FEE SUMMARY >., ' Plan Check: $15.28 k, Calc Valuation $500.00 Permit: $23.50 Claim Valuation: $500.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $39.28 . : : PLANNING:&,ZONING-- ' - SETBACKS - MAINSTRUCTURE Front 0-0 Rear--^^040 - . 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. • 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 ell 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(8'00) . DECLARATIONS WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: I • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,es provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I 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. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed ii the permit is valued at one hundred dollars($100)or less.) O 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 become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Llc.a Class N Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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). Lender's 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 of the Busine s 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 sub' s the applicant to a civil penalty of not more then five hundred dollars($500).): ,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.If,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.). • O 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 contractor(s) license pursuanttothe C tractors License Laws.). ❑ I am exer sec Business and Professions Code for this reason: Signature: Owner ID verified by driver's license. es 0 No Drivels Gcanse No>`/. Exp(res; 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 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 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 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? 0 Yes 0 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 of 55 gallons, or 200 cubic feet Of compressed gas at standard temperature and pressure). 2 Theis or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 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 ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes I No (Section 65850.2 01 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? 0 Yes 0 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 ell of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (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. '• a /Of Le Owner(s) Date 1 : 7 s -S I _ r'n•,• thr Auorized Applicant'-' Date- CODE# INSPECTION TYPE CAIS ItIIIDAL5 CODE( INSPECTION TYPE DATE ?ALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing - 200 Final Re-Root 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 r ert,, of 6t4weal /au� Veveast 111% OWNER-BUILDER VERIFICATION . 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 the completion and require the return of, an owner-builder verification. Attention Property Owner: . An 'owner-builder building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will he issued until this verification is received. I. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 1, Yes ❑ No 2. I (have/have not) ail xH signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Tho U G UA S ?MAKER Address I%1 Fat a-?i_ P&C City 6677i AW45 i JCA Phone (lilt) £ 4, a- I B'fl3 Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name SAM€ Address City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work SRnng _ J 104246 (REV 9/98) DECLARATION OF AUTHORITY BIdg. Permit# eRn6 FOR AGENTS OF PROPERTY OWNER This Permit# TO APPLY FOR PERMITS Street Address:� I.glioq FCI/AI 2-AL A>JE cvsTA AEsa,CA AP Number: 1. I (we), A'pIRQ.T R. HAuiLE7 , declare that I am the Owner of Title of the above referenced real property,and that I (we)hereby authorize: �J / Name: .DtU&i4.AS FAZWEFt Telephone Number: 7/4/4 kitty- ,8D 3 Street Address: I 1 1O i/14FE.96 kA Ave // City: CloSTA eS4 State: CA- Zip: `7x017 to obtain permits in my behalf,as owner/builder,for &Mu.) C-9't R_A,E .L sik. at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Workers Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa,as required by State of California laws. 3. As owner/builder in fact, 1 understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. • Executed this /aite day of _ ..2-1./A)E 20 Our ,at -fir 1 5 t)(LLE - er ia. • Print Name: MARY M A I,J Signature: 1\.\ ,1 LDate: - i -- oZ DDS C� Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. 0779-46(rev.11/00) "1 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION • COURTESY NOTICE OF PERMIT EXPIRATION May 18, 2007 Diana M Green & Roberta J McCarthy 2660 Saint Pauls Dr Titusville Fl 32780-6759 PERMIT NUMBERS: B05-00814 FOR: Install Doors on Carport PROJECT ADDRESS: 1969 Federal Av., Costa Mesa Our records indicate the above listed permits were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits will expire on June 4, 2007. Additional fees will be required to finalize expired permits. Requesting an inspection—If you need to request an inspection please call our Inspection Request Line at 714-754-5626. Requesting an extension—If you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, • al , / / // Mary Jane Weidenkeller Office Specialist II Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD(714)754-5244 • www ci.costa-mesaca.us VnINLN Hawley, Emerson VAIL }-.3-../0 'JOB ADDRESS 1969 Federal Ave. BUILDING PERMIT NO. 41386 GENERAL CONTRACTOR Owner DESCRIPTION o/WORK Alum Patio Cover A '..115-482-OS LOT 412 TRACT 1712 FIRE ZONE VALUES 600.00 --ECTIONS Signature Date TYPE V GROUP J ZONE R1 .i SOIL SUBCONTRACTOR PEjiMITS ISSUED GAS Date I Number I Signature WATER - Plum bldg ROUGH PLUMBING I I PROP. SWR. LINE Q HOUSE CON. n YSPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING • TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS ❑ STEEL REINF. p FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLATER. BROWN COAT Sl 'URAL, FINAL Electric HEAI ING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST in ELECTRIC, FINAL BUILDING, FINAL ./.44 al.4..74) nOWNtR Haw�eyr Fmersnn DAIt 1-4-76 `e J0B ADDRESS 1969 Federal Ave BUILDING PERMIT NO. 41386 pi GENERAL CONTRACTOR Owner DESCRIPTION of WORK Patio Cover A .115-482-05 LOT TRACT FIRE ZONE VALUES 600.00 IHSrECTIONS Signature Date TYPE V GROUP J ZONE R1 SOIL PERMITS ISSUED GAS SUBCONTRACTOR Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. E \SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVICE OR POLE • UNDERGROUND n POWER 0 ROUGH WIRING Heating and Vent. . TRENCHES ❑ FORMS 0 STEEL REINF. ❑ FLOOR SYSTEM ' BOND BEAM n STEEL REINFORCE in • SHEATHING FRAME AND FLASHING LATHING - IN n OUT in PI. "'Ai, BROWN COAT S_. URAL, FINAL Electric HEATING. VENT., REFRIG. AND A.C., FINAL PLUMBING. FINAL AND GAS TEST n ELECTRIC, FINAL �` BUILDING, FINAL Air -/. - V 71P • MAR 11-76Pp OO 4578 *** =*6.50 �" 41386 rK : P"'=•OO 457 COSTA MESA BUILDING-SAFETY DEPARTMENT MAR 11-76ps P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP .LIC T N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only ,`�.'�/� r p/ �J /� 0 /, ,� RE EI D.B DATE RREE`CEIIVV2/ DQ•J'E ISSN^ BUILDINA / I N -/ Fn./C�4ti, i e.,,mI c.5- 5— (S/j,3 ADORES c^ )I ) _let "Di PERMIT NO. OWNER CNK2L[./14.� 11 A.P. NO. let.MAIL //^� BUILDING //� ADDRESS y/' &(.yl.G#.Qenn cu ' ADDRESS /��Q .(/ • T CITY '�l.¢.r s.u4)tTek$t.M.tt NO.TE /04,2.451 TRACT I �(((!!!I///� LOT��. BLOCK CONSTRUCTION _ I NEW ADD _ALTER REPAIR MOVING DFMOIISH LENDER •\/Y`/ BRANCH �,.s� OWNS: EA4eneS it AZAteetEr ' ADDRESS ARCHITECT TEL. US- s i (XUCA i $ /444 OR ENGINEER NO. FIRE ADDRESS 1)/ ZONE /lie TYPE��C ROUP ��sss CONTR ACTO /LL�\J/ BY DATE 3- _/ /N` ADDRESS TEL. ZONE NO.OF USE OF N ,1, CITY NO. 1 PLANS L...„.. BUILDING OOJ�• ,F�y'++ STATE CITY YARDS APPROVED YARDS APPROVED C LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING {ra SIZE NO.OF BLDGS. (FROM C,��/,�r�L�'�SfjLT�'�R�EETtt)�'� C. OF LOT )NOW ON LOT FRONT.-P$ t'Y�G1t> FT. Q USE OF # EXISTING BLDG. R,SIDE JFT. FT. to FSeparate permits are required for L,SIDE It. %T. FT. f0- electric,plumbing and heating work. REAR Co FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& ,I} "/) MAIN BLOCS. ACCE . BLDGS. vAR.# DATE HJ /OXO5e/h4 e C.U.P.# APPROVED a> 7 C60 L 6 7 g FROVECC 9/ _ -6_76/_ELYATE W • M. I hereby acknowledge that I have read this application and state in g that the above information Is correct and agree to comply with m 0x all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of u „ the State of California. w �� 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. - N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FE rrLV: isi am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ �� d and Professions Code,Division 3,Chapter 9. u'+ m PLAN CHECK $ '^ o Signature •f ,--e id, o Permltte- 1' I �� - $ TAX $ Sir Authorized Agentep U TOTAL PAID $ ORANGE COUNTY BUILDING DEPARTMENT - APPLICATION FOR PERMIT a ...0 North636� FOM - BUILDING_.i�" SANTA ANNAA,, CALIFORNIAI FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY RECEIPT NO. PERMIT NOO..� BUILDING / 91,a 9{ ? ( 3 ADDRESS 1969 Federal Are. .41 9 l/.{� (X) J`\1 SCHOOL DIST. RECEIVED BY DATE OF APPL. DATE ISSUED OR TOWN 1 Y-4-3 l NEAREST Yy, / /I L�0 CROSS ST. l 9 141.SI.• Y/ .fes OWNER BUILDING �/ �y BANNDCK 1QMrc INC_MAIL . ADDRESS // 7/reel/et.'[Sr�//-(�� ADDRESS 93A3 WILSMI RF BLVD OR T TOWN DIST.OOL Co`_' .Y /Df � fvE CITY BEVERLY HILLS Np. CR. 54361 NEAREST /7."--1"'- CROSS ST. AENGINEERLAIN & MCKERRACHER TNEO. SY. 64891 ZONE NO. ANS TYPE GROUP ENGINEER 11.. PU t I I f+ -X ADDRESS2110 E. WALNUT ST. . PASADENA SETBACK LINEnFROM CENTER OF ST. t� TEL. REAR YARD 25t't. t SIDE YARD Il �IQ1611 4TRACTOR NEWPORT VI STA LO.NO. CR. 54361 APPROVED BY DATE ADDRESS9163 WILSH I PE BLVD. , BEV.HILLS CORRECTIONS LEGAL DESCRIPTION I LOT NO. 412 BLOCK 171? (ATTACH METES @ BOUNDS) _ TRACT SIZE OF LOT 66 x 110 I NOW ON LOTS 0 ' USE OF I NO. OF I NO. OF EXISTING BLDG. FAMILIES ROOMS DESCRIPTION OF WORK I 0 NEW I X I ALTERATION I I ADDITION O ^ REPAIR I MOVING I DEMOLISH I /i l/� y BUILDING NO. OF 1 /p• r SIZE 10311 SOFT ROOMS 5 STORIES [" // WALL I ROOF COMPO / ��A66"' COVERING COVERING SHINGLES ...Ai, USE OF NEW BUILDING RFSIDFNPF de - APPROVALS FOUNDATION: LOCATION INSPECTOR DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS. /1 1.70'5,_jAPPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING •/%� 1 ✓�.l AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. %f- yf (�' / (�`' AND STATE LAWS REGULATING BUILDING CONSTRUCTION. BRACING, BOLTS �/��j�j / 4 J l LATH. INT. //& 1-1.7-13 SIGNATURE OF NEWPORT VI STA CO. LATH. EXT. ,' //-r.0 PERM ITTE PLASTER. INT. J /� AUTHORIZED AG PLASTER, EXT. � MI,p "-4 7 $ 4830.00 P. C. $ -/ MASONRY REINFORCED .)I _ FEE / (/ $ BOND BEAM VALUATION ,L FEE �I FINAL gt /4 :7 r -"k- ---",_ w ..._ _ .. z w ..71z o _ - PLOT PLAN ' - .. ❑a 0 a a a ' r `.I • a • T , f a=.. A 11 .,3 ; :H A:: _fjfis —I u - "21f w STREET- - - 1 f e f ,:,,r .3 - 3::: I ._ . • i