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Home My WebLink About3018 FILLMORE WAY - Building Permits� � CITY OF COSTA MESA ' BUILDING DIVISION 77 FAIR DRNE, 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: B09-00052 PERMIT TYPE B_ROOF2 APN: 14113416 JOB ADDRESS: 3018 FILLMORE WY CM Vicinity: Squares: 2800 STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: Valuation: ISSUED 04/1312009 BJK $6,500.00 SCOPE OF WORK: REROOF DETACHED DUPLEX: T/O EXISTING COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED (3/8" ORIG), FELT PER MRGR'S SPECS, REROOF WITH 30 YEAR COMP SNINGLES. PITCH 4:12 2800 SQ FT OWNER: ALBERT, LEONARD J MARTIAL TR PHONE: APPLICANT: CEDANO, RICK PHONE: 909-623-7753 CONTRACTOR: CUSTOM ROOF COMPANY Address: 293 E MC KINLEY AVUnih City/Sta[e/Zip: POMONA, CA 91767 ARCHITECT: ENGINEER: ��1�1�1�1�1�L�:,�� Reroot Plan Check: Reroof Permit Fee: Reinspection Fee: Bidg Std Admin Fund TOTALFEES $0.00 $139.25 $0.00 $1.00 $140.25 Address: 1018 FILLMORE WY City/State/Zip: COSTA MESA, CA Address: 293 E MC KINLEY AV City/State/Zip: POMONA, CA License No. License No. PHONE: License No. 859220 909-623-7753 CELI: PHONE: PHONE: Unit: Unit : NOTICE: The work authorized by this permit Shall wmply 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 authorizetl under this permit to be considered legal, such work must wmply with all applicable codes, and all required inspections and final approval must be obtained. Failure lo obtain inspections and final approval will result in the expiration of this permit. COOEt. INSPEG110NTYPE RTE mn� COpE1 INSVECTONTYVE on� iqnnn�s 1616 FixeO System Final Fire Prevention 206 Final Mechanical 126fi Pool Spa Final 208 Final PlumOing 200 Final Re-Root �a�, �.� 210 Final Electrical 201 Final 91ocWRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place .. 220 Final Planning Approval 203 Final Sign 222 Final Slte 204 Final Demolition 250 Final Building/OCcupancy WORKERS' COMPENSATION DECLARATIO� I hereby aKrm under penalry of perjury one of the following declarations: ❑ I have and will mainlain a certifcate o( consent to self-Insure for workers' compensation, as provitletl !or by sec�ion 3700 of the Labor Cotle, for Ihe peAormance of the vrork for which this permit is issued. ❑ I have and vrill maintain v.nrkers' compensation insurance, as required 6y section 3700 0( the Labor Code, for the peAortnance of the wark fw which this pertnii is issuetl. My woL�ompen� I�nce carrier and Policy number are: �Carrier: " (Tlvs serxm neetl not be mmpe�e•0�d ,th�ep,e�nri4 s val�etl at -o1ne �uJr pretl da0ars (5f 001 a�eu.) Policy Number: , -l"" �� I � ❑ I certify thal in the peAortnance of the wvrk for which lhis permit is issuetl, I shall not employ any person in any manner so as to become subject ro the workers' compensation laws ot Califomia, and agree that if I should becom bject b the vrorkers' compensalion provisions of Section 3700 of the L or a e, I forthwith comply with Ihese provisi ns. � . AOVlicanfs SignaNre �T oat WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMP�OYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS ($100,000), IN ADDITION TO THE 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 that I am licensed under provisions of Chapter 9(commencing vnih Section 7000) of Division 3 of �he Business and Professions Code, antl my license is'� fy�.forpC aryc�e ec �' �Lic. # '� (� d Class #:. Gommcmr's Signawre Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn that ihere is a construction lending agency (or the peAortnance of �he wurk for which Ihis permd is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: SignaWre Da�e OWNER-BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the follovnng reason (Sec. 7031.5, eusiness and Professions Code: Any cily or counry which requires a permit to consWct, alter, improve, demolish, or repair any swcture, pnor to its issuance, also requires the applicant (or such permit to file a signed statement that he or she is licensetl pursuant to the provisions of lhe Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefmm and the basis for Ihe alleged exemption. Any violation of Section 7031.5 by any applicant for a permil subjects the applican[ to a civil penalty o( not more [han fve hundred tlollare ($500�.�: ❑ I, as owner of the pmperty, or my employees wi[h wages as their sole compensation, WILL DO THE WORK, and the slmcWre is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply lo an owner ot properry who builds or improves thereon, antl who does such work himself or herself or through his or her own employees, provitled that such improvements are not intended or oBered for sale. If, however, the builtling or improvement is sold within one year of completion, the owner-huilder will have Ihe burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business and Professions Code: The contractors License law dces not apply to an ovmer of property who builtls or improves Nereon, and who coniracts (w such projecl vrith a cmtractor(s) license pursuant ro the Contractors License Lav+s.). ❑ I am exempt under sec. Business and Professions Code for this reason: r� Owner ID verifietl by drive�ense. ❑ Yes ❑ No Oriver's License No. Expires: Verifcation of Ovmership by (rype o! documenl, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFEN PERMIT CER7IFICATION: ❑ I hereby certify �hat no eacavation (rve (5) or more feet in tlepth into wfiich a person is requiretl to descend, will be made in connection with vrork authonzetl by this pertnit, and that no building sWcture, scaffdding, (alsework, a demolition or tlismantling thereof, will be more than Ihirty-six (36) fee[ high. (Chap. 32, Grp 2. M 2. Sec. 341, TiUe B, Califomia Adminis�2live Code). ❑ As ovmer-builtler, I vnll not employ anyone to do work which would require a permii from Ihe Division o( Industrial Safety, as noted above, unless such person has a permit to do such vrork from the division. AOW��'s Signamre Division of Industrial Safety Permit Num6er: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or fuWre building occupant need lo file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Heal[h and Safety Code requires, with some exceptions, that a Business Plan be (led vrith the Costa Mesa Fire Department by every business which has at any one time during a reportetl year a quantity of hazartlous materials equal to or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic (eet of compressed gas at standard tempereture and pressure). 2. Does or will the applicanl or present or future building occupaN need to 6le a registration (orm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 ot Ihe California Heallh and Safery Code, with some exceptions, requires regisiration with Ihe Costa Mesa Fire Depariment Dy each business which at any one time has on hand a quantily of acutely hazardous matenals equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl temperalure and pressure). 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazar0ous materials)? ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health antl Safety CoOe provides that the Costa Mesa Fire Department may require the prepa2tion, certification antl filing with the Fire Department of an RMPP by businesses which are required to register acutely hazartlous malerials with the Fire Departmenl. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safely Code been fully complied with? ❑ Yes ❑ No 5. Does ot will Ihe ap0licant or present or future building occupanl require for the work which is lhe subject of Ihis applicalion a permit for such construction or modifcation from Ihe SoWh CoaSt Air Quality Managemeni Dislrict or Irom any other air pollution control district or agency? ❑ Ves ❑ No (Section 658502 of the Califomia Govemment Code requires that the requested infortnation be fumishetl on applications fa nomresidential building permits). 6. Will any part of the facility ro be constructed untler this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No Qf "yes", the (acilily must meel the requirement of Seclions 25534 antl 42303 o( the California Health and Satety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution contml tlistric[ or agency is required for Ihe vrork which is lhe subjecl of this application, have all ot ihe disclosures prescribed by Califomia Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'Yes", attach certificate of wmpliance from the appmpnate air pollWion control offcer). CERTIFICA7E OF COMPLIANCE: I certify that under penalry of perjury the information given above is cortect. 1 agree to comply with all state laws antl city ordinances regarding Hazardous Materials and Emissions. SignaWre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury Ihat I have read this application and state that the intormation given is correcL I agree to comply with all state lavrs antl ciry ordinances relatinq to building constr�ction, and aWhorize representa�ives ol the City of Costa Mesa to enter upon the above-0escribed property for inspection purposes. I agree not to ocwpy or allow cecupancy of any building aulhorized by this permit until final inspection. iB�a re alOvmeqs) � Date � Signd�ure Dale 305]�46�3/O]) ., q�p�ulhonzetlAppl¢am Oale ��--�..�.__ .�� t��-�. 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['-� �.�_�, �,� �� .a�� = ��ril; _.� �:.�� ,� �<< ��- - �'�� r ' � :� , �µ r ;� � � i', -.�r__ca_� _ ' i � 4n'�„1..�..�-+... y � �e � �'�T �--� �'_iT3C . �:�� ! . ��,I' IJJ.� II' - ' �1 11 "i��'�,��r� r—uric... t S�� LOT 6 TRACT �ZH� d ��"� � 1�031 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA M66A. CALIFORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT COSTA MESA. CALIFORNIA� K ENNETH . KOLL oWNER -{(- E E EP}'f-S6 -�N6 MAIL ADDRE66 CE A A ENUE CITY NEWPORT BEACH CALIf,pioMl 6 Z ARCHITBCE NONE NO. � OR ENGINEER '-" � v t�n� , BeTBACK LINB FROM CC I ,-� �.. �y. ,p ,-...� �� ,.�/ .,:..�,..�� .,.J ' j�^' JAN 111961 . ' 6-ti1;,P;�E DEPT. r,r, ; aF cosT,� � t:sA APPLICATION FOR PERM�T BUILDING For Office Use Only nece�rr r+o. renx4�NPn nece�ygp ar ✓�i COSTA MESA. CALIFORNIA FIRE ZONE APPROVED V ENUE ZONING ZONe NO. OF II68 OP N6W y� �-� 3 PI.AN9 z BUILDINO W��- 6- 22 oescnivrioH 4` � �o %/4 �/ Z 8� .",�;.,°�.,e�.oae. p - - -'- � I LEFf �� I RIGHT S� DESCRIPTION OF WORK 'UCCO ICOVERING ROCK AND WORK TO BE PHRFORMED .E FAMILY DWELLINGS WITH 1 une er.i SS �� 8 � s � cL _° LC�� „. J //9�6"'- PLAN I HEHHBY ACKNOW�ED08 TMAT 1 NAVE RBAD THI9 APPLIGTION THE AMOUM BXOWN UND¢P VALUATION 19 POR TH6 ANO BTATC THI1T TXE ABOV! I8 CO(iRER ANO AGRE! M COM- pUppOBE OP EBTABLI8HIN6 A PERMIT PEE ONLY. PLY WITH ALL CITY OflDINANCE6 ANO BTATH LAWB p80ULATINO BUIlDINO CONBTRVGTION. VALUATION PERmAiT77Ee OF � � PERMI7 FEE $ �C-�" S �-' `% �� ` PLAN CHECK $ �.S ` AUTHORIZED AGENT _ 7�-�_ f