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Home My WebLink About201 AMHERST PL - Building Permits CITY OF COSTA MES? JJr>� Y P.O. BOX 1200 • 77 FAIR DRIVE t,��1.•� • CALIFORNIA 92628-1200 FROM THE DEPARTMENT OF PUBLIC SERVICES/ENGINEERING DIVISION May 20, 2004 Dianna M. Coleman 4D 201 Amherst PL Costa Mesa, CA 92626 SUBJECT: Parkway Maintenance along Fairview Avenue Dear Ms. Coleman: The City of Costa Mesa has now finished paving Fairview Road from Fair Drive to Newport Boulevard. The next phase of construction will consist of parkway repairs along the same segment of Fairview Road, and is tentatively scheduled to begin in late June 2004. There are several private wall segments within these limits that are in disrepair, some to the point of becoming a public hazard. If your wall is in need of replacement and/or repair, the City is recommending that you make your repairs at this time. if you choose to replace your wall, you may either hire the City's contractor for the work or you may choose to locate your own contractor for the wall reconstruction. Thank you in advance for your cooperation. If you have any questions, please feel free to contact Larry Dreiman, Engineering Technician, at (714) 754-5014. Sincerely, 3iLL Gided) Fariba Fazeli Senior Engineer LD/ch c: William J. Morris, Director of Public Services Ernesto Munoz, City Engineer Tom Banks, Senior Engineer Burt Morgan, Chief Plans Examiner Larry Dreiman, Engineering Technician Ill PHONE: (714)754-5343 FAX: (714)754-5028 TDD: (714)754-5244 www.0i.costa-mesa.ca.us • • ' CITY OF COSTA MESA 4 9 BUILDING DIVISION F , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT 4. "'/ B02-01992 ltberomnso (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.caJI LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 201 AMHERST PL Status: ISSUED Suite: _ Applied: 12/09/2002 Vicinity: ROOF Issued: 12/09/2002 Parcel Number: 14146507 Zoning: Applicant: RICHARD CHURCHILL ISSUED BY: ' Address: 4425 E FOREST GLEN RD Phone: 714-974-0456 ANAHEIM,CA Zip: 92807 Owner COLEMAN, DIANNA M Address 201 AMHERST PL Phone: COSTA MESA,CA Zip: 92626 Contractor CHURCHILL CONTRUCTION Address: 4425 FOREST GLEN RD Phone: (714)974-0456 ANAHEIM,CA Zip: 92807 License: 660990 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 2 LAYERS OF 15#FELT,30YEAR,COMPOSITION SHINGLES.2,610 S.F.INCLUDES ATTACHED GARAGE. • FEE SUMMARY Plan Check: $0.00 - - - Calc Valuation: $4,872.00 Permit: $111.25 Claim Valuation: $4,872.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 • PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 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 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) DECLARATIONS n �� WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I 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 of the y�- 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: ,,// Cerner:} 5'(7% I !ci>ND Policy NumberT /3 , 37 fg-5 (This section need not be completed if the permit Is valued at one 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 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 eApplicent Signetu�ey (Datel / _ -,1.7 -0 2 WARNING.'FAICURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND Del I ARE($100,000).IN ADDITION TO 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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,end my license is in full force and effect.Llc.# Class# 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 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($500).): O I,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.). yliii4EA as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions iCode: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 pursuant to the Contractors License Laws.). ❑ I am exempt ender sec. '� Business �1)Professions Code for this reason: 1SlgnatUhdi R a """""te / 1 Date: ) I 1 - ---a 2- 27e OwnerlDvenfied by driver's license. ❑Ves 0 No (Driver's License No. .Expire-9 �l Verification of Ownership Py(type of document,1.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 Will 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 Does 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 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 an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes jJ No (Section 65850.2 of 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 all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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. 12, Si lure Of Legal Owner(s) Date Com- _ (And/or Authorized Applicant ) r Date 1 CODE I INSPECTION TYPE DEE II{IIIIBU ;ODE It INSPECTION TYPE PEE INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final j 208 Final Plumbing 200 Final Re-Roof /2-3)0-f0.2 `'A-4' 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 DECLARATION OF AUTHORITY Bldg. Permit# FOR AGENTS OF PROPERTY OWNER This Permit# TO APPLY FOR PERMITS Stree At ddre'ss: ZO I Am F4EIZSV PL. 1 AP Number: 1. /1-(w-b), 7)/dlf/i7z_r o Z. alah , declare that I am the Owner of Title of the above referenced real property,and that I (we)hereby authorize: Name: C itatf cc-- /Z-66Fig 6- Telephone Number: (76.9 f 7 —d 44''S6 Street Address: (1(42-S" Lf fa err GCod go City: A'Nf)YIE7Na State: Zip: q'2dn to obtain permits in my behalf,as owner/builder,for � - \\C) 4- at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Worker's 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, I 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. ''5.1 I declare under the penalty of perjury that the foregoing is true and correct. / ` Executed this - 7 day of -e_ 20 �t (_ DS/o ..- 7c--S cc,. ,California. • Print Name: Y / cr-h n c>_ �7AAr--if C ,4 . e f Signature . i `� � Da .i�e�, 7____ D Z_ • Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attomey to secure this permit in any behalf. • 0779-46(rev.11/00) . 780-tit ECEI�lE® ii COSTA MESA BUILDING DEPARTMENT FlIVAh10E DEpj is ' P.O. BOX L 6lTY OF COSTA COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING ��(/ BUILDING ADDRESS 2(11 Amharat-Rn(d el. COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY Inc. RECEIPT NO. OWNER Princeton, Inir i MAIL RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS 419 E. 17th St. AO e-y-A? OCT 1 7 195 TEL. BUILDING CITY Cnsta Mesa,_ Calif. NO. Tei . R_1159 ADDRESS ARCHITECT Casson' LIC. COSTA MESA. CALIFORNIA OR ENGINEER l�.,,.. r<iiii]l ehrnelr NO. R/1 ADDRESS Garden Grave �j'[ 4 FIRE ZONE CONTRACTOR n&le oyes 14Ti. ND. 841 ZONE NO.LOF TYPE / GROUP Mke ' Y LIC R.1 PLANB ✓�kI/,/'(\/(1`/' ADDRESS 419 E. 17th St. TNE15 Li. 8-1159 BY APPROVED t DATE LEGAL LOTCORRECTIONS DESCRIPTION NO. 26 BLOCK TRACT 2955 A.P.NO. SIZE NO.OF SLOGS. OF LOT 85 x 102 NOW ON LOT none USE OF � US STING BLDG. �IILJI'I SETBACK LINE FROM CENTER OF STREET /5jt REAR YARD 201 SIDE YARD RIGHT 5t LEFT 30.7Lt DESCRIPTION OF WORK NEW X ALTERATION ADDITION REPAIR MOVING DEMOLISH BUILDING NO.OF SIZE 1647 SO tJc ROOMS 7 STORIES 1 EXTERIOR WALL ROOF COVERING St11000 COVERING Comp. USE OF NEW BUILDING Single family residence with attached garage. Plan.760A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS ,O RRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND BT E LAWS REGULATING BUILDING CON TRUC- tf TION. - VALUATION PERMIT FEE $38.00 SIGNATURE OF PERMITTEE //� ,n__-�' 38.00 $ 16,598.00 PLAN CHECK }}�� • "BMF AUTHORIZED AGENT Dike & Colegrove, inn. TOTAL FEE $ OWNER PRINCETON, INC. DATE 10-17-58 _ JOB ADDRESS 201 Amherst Road BUILDING PERMIT NO. ' 7823 GENERAL CONTRACTOR Dike & ColeP_rOVe VALUE $ 16,596.00 AP. No. LOT 26 TRACT 295*IRE ZONE DESCRIPTION OF WORK Res. & Gar. G? SUP I & J TYPE V ZONE • PLAN NO. Y -/td". PERMITS ISSUED Ih(c: CTI NS 4 DATE SUBCONTRACTOR DATE NUMBER Trenches Trens Porms r Steel d et aliger Floor System v Steel Reinforce Chimney Re-Rod _ Bond Beam �` Frame and Flashing .1�N�a l Lathing, In 4/Out arA1 �� Plaster, brown coat J �a� f , — Underground soil i 5 W/G Pipe TestiliS/o-j Top Out ]' Furnace = 6 _ inV a C Gas Vents _ Rough Plumbing SAME 4MI-K li-y 19 • Cesspool Septic Tan Prop. Swr. ,L House ., St. Swr. 11i�IJ!//��/il.��l t k+i � : = ,� (e Sprinkling System Heating Final 4h INEM2 Illa P .in. Fixtures, Final 4/ Mini MENEMMMIMEM Jr • 111.1111111a lti Construction 'ole 1' V Underground Power ril Rough Wiring �T !L i /AInia I Fixtures, Final tatV,Zt" a in OCCUPANCY /ra'S 3 3/- - Form 210-5M-1-57 7821 9349 o-EE ,RECEmVEO COSTA MESA BUILDING-SAFETY DEPARTMENT �—aO— Sq V v.._ P.O.BOX 31"] COSTA MESA. CALIFORNIA FINANCE DEPT. \ IC �SRE TOR APPLICANT TO flit /N COMPLETELY APPLATIONFOPERMIT TYPE OR PRINTgBUILDING BUILDING ,o/ Let�• 4/Zf It ADDDRESSRESSaS COSTA ESA. CALIFORNIA/` FOR OFFICE USE ONLY / oI RECEIPT NO. OWNER ../t �' 2 ___, .n/yJ c)`vifgJ .,,,,,7 / iT/T// MAIL //ll //// R C IVED BY [RATE RECEIVED( (DATEIISSUED ADDRESS ,. /9 7 L•C-Jr gt. .S-�A ' .7 /L/--;S TEL. ..../_ ' ADD DING CITYr/R fy(,�/Thyq.�{ .1 ...-2.2yA,•-,--- ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA '. ADDRESS FIRE ZONE Type Group //�� STATE APPROVED 1 CONTRACTOR t_As �E Si?.NO.�3,��P{'/ BY DATE ADDRESS y 7 C 7;21-0 •-,;(7,A. ZONING ZONING : LEGAL I LOT c] �' 'I /y�Y Com` ZONE .F; NO.OF 7TH ```USE OF NEW '/J DESCRIPTION NO. P BLOCK qR /VFX, I IPLANB/R ycUILDING ,(A/1,�'/--_ APPRO `/ // /,/ DATE St-4)01 A.P.NO �/ /, BY z ,}�/�y/ P SOF LOT S J� v NOW ON LOTB YARDS nen REQUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT UFT. 74 IN. SETBACK LINE FROM S C ' O// , CENTER OF STREET REAR YARD R.SIDE FT. / IN. // // SIDE YARD ILEFT / RIGHT / L.SIDE FT. / IN. DESCRIPTION OF WORK REAR FT. 0IN. NEW I II ALTERATION I II ADDITION • REPAIR I II MOVING 1 I DEMOLISH BUILDING NO.OF SIZE ROOMS STORIES ' EXTERIOR WALL I ROOF ' COVERING COVERING USE OF BUILDING AND W��O�R�/{[(y�T�p BE PERFORp EDI_ il / • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AN • TATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. VALUATION • j SIGNATURE O _ PERMIT FEE $ /T/_� PERM ITTEE•yc�( ., 075 -Y// 9 $ J 1 S PLAN CHECK $ • ;' AUTHORIZED AGENT TOTAL FEE $ OWNER WILLIAMS, THOMAS DATE 5-20-59 JOB ADDRESS 201 Anherst BUILDING PERMIT NO. 93)49 GENERAL CONTRACTOR Byron E. Dangler VALUE $439.00 AP. No. LOT 26 TRACT 295,5 FIRE ZONE DESCRIPTION OF WORK Block wall Ir'--'ECTIONS DATE I GROUP TYPE ZONE R 1 ground Soil U.G. Water — SUBCONTRACTOR PERMITS ISSUED L ..ground Gas DATE NUMBER Overhead Water and Gas Rough Heating _ '�,' Rough Plumbing „ Miscellaneous .9 Prop. Swr. Line House Con. St. Swr. Sprinkling System \� Heating, Final _ Ae,t{- Al 6 Plumbing Fixtures 'I Final Gas Test 1. Construction Pole - Underground Power b X ,( 0 Rough Wiring W/ r 4 Trenches Forms Steel Y 1 1N Floor System r.N„U Steel Reinforce Chimney Re-Rod I4 y 0' Bond Beamt t Sheathing Li i" F e and Flashing „I 1 ,g, In Out Plaster, brown coat Plumbing Fixtures, Final Electric Fixtures, Final Building, Final _ OCCUPANCY I Form 210-3M-4-59 - . ___._ . ._.. _ 931.1.9