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Home My WebLink About1115 CHARLESTON ST - Building PermitsFT (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1115 CHARLESTON ST Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Status: ISSUED Applied: 06/18/2002 Issued: 06/18/2002 Parcel Number: 14169211 Zoning: R1 R1 Applicant: GLAZER, STEVE ISSUED BY: Address: 1915 W BALBOA Claim Valuation: $4,000.00 SMIP Res: $0.50 Phone: (714)612-8260 SMIP Com: NEWPORT BEACH, CA Zip: 92663 Owner: MC KIERNAN, JAMES Address 1115 CHARLESTON ST Total: $97.75 Phone: COSTA MESA, CA Zip: 92626-2706 Contractor: GLAZER ROOFING Address: 1915 W BALBOA Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Phone: (714) 612-8260 Existing: o NEWPORT BEACH, CA Zip: 92663 License: 739156 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF: TIO EXISTING WOOD SHAKE, 1/2" OSB, 1 LAYER 15# FELT, APPLY "30 -YEAR COMP SHINGLES." 2200 SO NOTES: 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(600) FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,000.00 Permit: $97.25 Claim Valuation: $4,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 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: o Required: 0 Proposed: 0 NOTES: 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(600) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 work for which this permit is issued. ❑ 1 have and will maim n 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' compr(�Sation Insurance carder and policy number are: Cartier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) I cenity that in the performa oe of the work this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cel' andogre if should become subject to the workers' compensation provisions of Section 3 0 of 1 e Labor Code, I shall forthwith comply with these provi ns Applicant Signature: Date: y ��— WARNING: FAILURE TO SECU RKERS' COMPEN ATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100, 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 un rviso hapter 9 (commencing with Section 7000) of Division 3 of the Business ro sions Code, and my license is in full force and effect. Lk. 0 ' Class A Contractor's Signature: Date: s CONSTRUCTION LENDING AGENCY: ❑ I hereby off iml that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders 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).): ❑ 1, 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.). ❑ 1, 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 pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID vented by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document. i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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, 1 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? ❑ Yes ❑ 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 builtling Occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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 ❑ No ..........................................................__..................................................-......................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ffrmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes u 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? ❑ Yes ❑ 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 ❑ 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 OFCOMPLIANfvE AND AIlT}IORIZATK/N OF ENTRY: I cartify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply w 6 all state I s end city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property f pection t as. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. ignatur al nets) 4� ate A d/O Aul died Applicant Date CODE 1. INSPECTION TYPE PAF INiITALS CODE# INSPECTION TYPE am INTMAL1L 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root �S'�Z !2 `�`� 210 Final Electdcal 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 Li1= .COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOL[ SI) COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT [ADDRESSILDING �S C'/ 's T COSTA MESA, CALIFORNIA OWNER r c k�__ m Qt -S MAIL ADDRESS S I_ 2S TEL CITY NO.S ARCHITECT �l 1 I 1 TEL./ I n_.. FEE RECEIVED 'JAN 1 7 1984 FINANCE yI NnA�NCEnSTDpEP�1.0),t1 APIk&TIONCF'OR' pE'R7&A1T BUILDING For Office Use Only fl[C[IIT NO. E [Y DAT[ R[ 7Kq IIDATE ISSUED /(/J 6 TYPE 'GROUP Y- 17 n AYW CITY O U 11 ".0 A. P. NO. C NOTE: NO EAVE OVERHANG SHALL BE LESS THAN ATE_ TEL90" ' LIC. O L1 TO SIDE 8 REAR P. L. NO. J NO. ,� - EAVES SIZE OF I ALLOWED (U. B. C. REQUIREMENT) OF LOT O /� O NNO. OW ON LOTS YARDSAPPROVED YARDS APPROVED USEOF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. �+ ( FROM CQ ST�EET SETBACK LINE FROM L-1 ` CENTER OF STREET l J REAR YARD FRONT FT. FT. ( R. SIDE .7 F r. FT. SIDE YARD LEFT � RIGHT .1. (� DESCRIPTION OF WORK L. SIDE FT.. FT. NEW ALTERATION ADDITION REAR FT. DISTANCE BET. BET. MAIN 3 REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS. BLDGS. BUILDING Q NO.OF VAR. 4P GATE SIZE U ROOMS STORIES C. U. P.# APPROVED EXTERIOR WALII, ROOFCCtr11 PR COVERING L COVERING J^` BY4,1, DATE USE OF B ILD AND WORK TO BE PERFORMED A 4-- ) n „ 1 HEREBY ACKNOW E 08 THA AVE READ THIS APPLICATION THE AMOUNT SHO UNDER VALUATION IS FOR THE AND STATE T TH O IS C RECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH A CITY ORD 85 A STATE LAWS REGULATING m VALUATION BUILDING C STRUCTI PERMIT FEE $ Cll(p j SIGNATOR OF PERMITTE / PLAN CHECK p AUTHORIZED AGENT TOTAL FEE �I/