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Home My WebLink About3036 FILLMORE WAY - Building Permits� � = CITY OF COSTA MESA " � ' � Bl/ItDlN6 D/V/SION > � 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: BX08-00196 PERMIT TYPE B MISC STATUS: ISSUED APN: 14113421 DATE ISSUED: O6/27/2008 Zoning: , ISSUED BY: JOB ADDRESS: 3036 FILLMORE WY CM SuitelUnit: Vicinity: . PrimaryOcC: � , . ConstType :?? SQ. FT: 0 Valuation: $600.00 � SCOPE OF WORK: CONSTRUCT 5-6' CONCRETE TRASH ENCLOSURE PER CITY BLOCK WALL DETAILS. OWNER: ALEXANDER,GEORGETRUST Ciry/State: COSTA MESA, GA Phone: 7146693195� ' . - APPLICANT: ALEXANDER,GEORGE TRUST CitylState: COSTA MESA, CA Phone: 7146693195 ' , ,� CONTRACTOR: Address: City/State: Zip Code: AR HITECT: Phone ENGINEER: Phone Building Plan Check: Building Permit: Electrical Permit: " � SMIP Residential � SMIP Commercial TOTALFEES Address:: 3036 FILLMORE WAY Zip Code: 92626 Address: 3036 FlLLMORE WAY Zip Code: 92626 . License No. Phone License No. License No. FEE SUMMARY $0.00 $26.55 $0.00 $0.00 $0.00 $26.55 , Unit Unit: Unit: Cell: NOTICE: The work authorized by this permit shall comply with all aDP��ble handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28. § 1, 12-21-92) � ' - - EXpIRA710N: PERMtT EXPIRES t80 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPEC710N. INSpEC710NS: In order for the work authonzed under this permil to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure lo obtain inspections and final approval wlll resull in the expiration of this permit. coo��. ixsvecnoxTrve o� xni n��s cQo� ixsvecnoxTrve ' pgr� ixnnus 1818 Fized System Final Fire Prevention 208 Final Mechanical 1288 Pool Spa Final 208 final Plumbin9 200 Final Re-Roof ��L// � 210 Final Electriwl 201 Final Blopk/Relaining Wall � f`" /" 212 Final Fire Prevention 202 Final Factory Fire Place 22U Final Planning Approval 203 Final Sign ?22 ,, Final.Site . ?� �.. 204 ^• Final Demolition Z50 Final BuildinglOccuOancy ' ' � _ • � WORKERS' COMPEN�ATION OECLARATION: � 1 hereby aKrm unCer penatty oi pe�ury one of ihe following deGaretions:.. ❑ I have and vrili maintain a ceAificate of consent to self-Insure for v.nrkers' compensalion, as prOvidetl for by section 3700 of lhe Labor Code, for the peAortnance o( Ihe wvrk (or which this permit is issued. ❑ I have antl will maintain wnrkers' compensation insurance, as required by section 3700 of the Labor Code, tw the peRwmance of the v.ork for wfiich this permit is issuetl. My workers' compensation Insurance carrier antl policy number ate'. Carrier (Tnis sedion neetl rrol oe compleletl �I the peimn is valued at one �un0ietl b�llars (Et00) o� IessJ Policy Number: ❑ I certity that in the pertormance of the work for which Ihis permit is issuetl, I shall not emp�oy any person in any manner so as to become subject lo the workers' compensation lavrs of Califomia, and agree that if I shoultl become subject to [hB workers' compensation provisions of Section 3700 of the LaDor Code. I sha0 forthwith wmply wilh these O�o�isions. AOOlicanfs SignaWre Date WARNING: FAIIURE 70 SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($700,000), IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRAGTORS DECLARATION: I hereby aKrtn lhat 1 am licensed under provisions of Chapter 9(commencing with Seclion 7000) of Division 3 of ihe Business and Professions Code, antl my license is in full (orGe and effect. Lic. # __ . Class # Conlratlor's Siqnalure CONSTRUCTION LENDING AGENCY: ❑ I hereby affrcm that there is a consWction lending agency for the peAwmance o( the NOA� for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: OWNER-BUILDER DECLARATIONS: I hereby affirm that untler penalry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or Ihe following reason (Sec. 7031.5, Business antl Profe55i0ns Coae: Any city or county which requires a permit lo conslruct. alter, impro�e, demolish, or repair any sWCNre, pnor to its issuance, also requires lhe applicant for such permit to file a signetl statement that he or she is lic¢nsetl pursuant lo the provisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) of DiviSion 3 0( the Business and Pro(essions Code) or that he or she is exempt iherefrom and ihe basis for the alleged exemption. Any violation of Section 7037.5 by any applicant for a pelmit subjects Ne applicant to a civil penalry of not more Ihan fve hundred d011ars ($500�.�: �- I, as owner o( thz properry, or my employees vri[h wages as their sole compensation, WILL DO THE WORK, and the stmcture is nol intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply to an owner of property who builds or improves 'thereon, antl who dces such work himself or herself or lhrough his or her ovm employees, pmvided ipat such improvemenis are nol intended or oflered for sale. I(, however, lhe builtling or improvement is sold wilhin one year of completion, Ihe owner�builder will have the burden of proving that he or she tlid not build or improv6 for purpose o( sale.). , ❑ 1, as owner ot th¢ property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conSWct lhe project (Sec. 7044, Business and Professions Code: The �n[ractors License Law dces not apply to an owner of p�opeRy wfio builds or irnpmves [hereon, and wfio con[racts for such project with a contractor(s) license pursuant to the Coniractors LicenSe Lavs.�. ❑ I am exempt unde� sec. Business and Professions Cotle for this reason: �� o� Z % gig�9Wre " � Dat J059�46(3/0)) Owner ID verifietl by Arive. _ ncense. ❑ Ves ❑ No � � Driver's�License No. Fxpires: . -� Verifcalion of Ownership by (type of tlocument, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � �- ❑ I hereby certAy that no excavation frve (5) a more feet in tlepth into which a person is required to descen�, wiU be matle in cwi�ection with worlc authodzed by �his pertnil, and that no building s[ructure, scaffdding, falsework, or demolition or dismantling �hereof, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2. Ari 2. Sec. 341, Title B, Califomia Adminislrative Code). ❑ As owner-builder, I will not employ anyone to do vrork which vrould require a permit (rom the Division o� IntlusMal Safety, as noted above, unless such person has a permil lo tlo such work from the division. AO�lifant's Signalure Dale Division of Intlustrial Safety Permi� Num6er: HAZARDOUS MATERIALS AND EM15510N5 CERTIFICATION: 1. Will the applicaN or present or tuture building occupant neetl b file antl certify a Business Plan for emergency response to release or Ihreatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Calilomia Health and Safery Code requires, with some exceptions, that a Business Plan be filetl with Ihe Costa Mesa Fire Department by every business vfiich has at any one time during a reportetl year a quantity of hazardous ma[erials equal ro or greater Ihan a weight of 500 pountls, or a volume ot 55 gallons, or 200 cubic feet of compressed gas a� standard temperaNre and pressure). 2. Dces or vrill the applicanl or present or future builtling occupant need [o file a registration lorm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of lhe California Health and Safety Code, wilh some exceptions, requires registralion with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity o! acutely hazardous matenals equal to or greater than a weighl of 500 poUntls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaWre and pressure). 3. Does or will the applicant or presen[ or (uWre builtling occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous malenals)? ❑ Yes ❑ No (Section 25534 of Ihe Califomia Health and Safery Code provides thaf the Cos[a Mesa Fire Department may require the preparation, certification and fling wilh �he Fire Depanment of an RMPP by businesses which are required to register aculely hazartlous materials wi[h the Fire Department. 4. I( an RMPP is presently required, has Section 25534 0( [he Califomia Health and Safety Code been fully complied with? ❑ Ves ❑ No 5. Does or vnll the applicanl or present or future building occupant require for �he work which is lhe 5ubjecl o( lhis application a pBrmi� (O� SUCt1 COnStNGtion or modifiwtion from the Soulh Coast Air Qualiry Management District or fmm any other air pollution control district or a9ency? ❑ Yes ❑ No (Section 65850.2 of the Califomia Govemment Code requires that the requested intortnation be tumished on applications ta rarnresitlential builtling pertnits). 6. Will any part of Ihe faciliry to be wnstruc[etl un0er Ihis pertnit be wiihin 1000 (ee[ from the outer boundanes of a school? ❑ Yes ❑ No (It'yes". [he facili�y must meel Ihe requirement of Seclions 25534 and 42303 of the Califomia Heallh and Safery Code). 7. If a permit from ihe Swth Coast Air Quality Managemenl District or other air polW[ion control dislrict or agency is requiretl for Ihe vrork which is the subject of this application, have all of the disclosures prescribed by Califomia Health and Satety Code Section 42303 been made? ❑ Yes ❑ No 8. (It yes", atlach cenificate of compliance from the appropriate air pollution con�rol oKcer�. � ' � � ' CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the information given above is correct I agree to, comply with all state lav✓s and city ordinances regarding Hazardous Matenals and Emissions. :' � CER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read lhis application and slate that ihe information given is correcL I agree ro comply with all state laws and city ordinances relating to building construction, and authorize representatives of the' City of Costa Mesa to enter upon lhe above-tlescnbed property for inspection purposes. I agree not to occupy oi allow occupancy of any builtling authorized by this permit until final inspection. Si �uWreoiL I e(s) Dale � �� rAUNmzeOPPVIi�'ant Dd(¢ ;� �� C�� SUB�ECT R�VIEW INS APPROVAL ON SITE � J�tJD . ��3� ��L�o�� Wy APP OVF.,D CITY OF 'USTn l�tI�.SA PLANNI G DIVISIf1N SUBJECT TO LDG. DI:PT. REG. NOTE: nDDIT1�Ns. f�tl.1:"t�1��tis, OR Cl)ItRECTIONS till:\1.1. kl APPROVL'D BY THE PI.:�NNINt� U1�' BY: /YJ%�' pATH: LOT �� TRACT �ZH� 16�3� COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 917 C06TA MEBA. CAL�FORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT COSTA MESA. GALIFORNIA 1 MAIL AD�RESS CITY NEWPORT STATE LIC. NO. SIZE OF LOT � � USE OF EXIBTING BLOG N� 68TBAGK lINB FROM "' _"' FIRE ZONE .�.,... r,. APPROVED NO. OP B1D69. 0 NOW ON LOT 3TPesT �rj � REAR YARD � I LEFi H� ( RIGHi 5� DESCRIPTION OF WORK SF NO. OF 0 FE�E/ RECEIVED '// JAN 1 1 ��bt ��,fINANCE DEPF. CITY OF COSTA M£SA APPLICATION FOR PERMIT BUILDING For Office Use Only aeC¢�PT NO. PERMIT NO. BY COSTA MESA. CALIFORNIA ZONING ZONH I NO. OF 'J I U6E OP NEW 7 R��' PLANB L BUILDIN�/n� �e°�e.�.,,.� � // � Ti� t/ z lIHB 8T4 YS �� 8 is � ED i.J//I Q ^ � `�� N � r 9/6L 1 HCREBY ACKNOWLCDGE TXAT 1 XAVE RCAD TIilB APPLIGTION 7HE �MOUNT BHOWN UNDHR VpLUAiION IB FOR iHE AND 9TATE TXAT TH6 ABOVB IB COPHER AND AGREe TO COM- pUFP086 OP E9TABLIBH�NO A PERNIT F� ONLY. PLY WITN ALL CITY OPDINANCHB AND BTATH LAWe ReOULATNO BUIlLINO CONBTRUCiION. VALUATION L, �— SIGNATURE OF � � PERMIT FEE $ �/ PERMITTE q/y L, �'/� ! S �/ /� � FLAN CHECK S �'S � AUTHORIZED AGENT �-ir�