HomeMy WebLinkAbout1010 ARBOR ST - Building Permits"o . i
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1010 ARBOR ST
Suite:
Vicinity: HOUSE & ATTACHED GARAGE
Parcel Number: 42253216
Applicant: PORST, TERRY
Address: 18096 YOSEMITE CT
FOUNTAIN VALLEY, CA
Zoning:
Owner: MC CLELLAN, ROLLO W JR TR
Address 2424 WINDWARD LN
NEWPORT BEACH, CA
Contractor: CLONTS ROOFING
Address: 18096 YOSEMITE CT
Arch :
Address:
FOUNTAIN VALLEY, CA
Zip: 92708
Phone:
Phone: (714)936-8867
Zip: 92708
Phone:
Zip: 92660
Phone: (714)936-8867
License: 728774
Eng
Address
ISSUED BY:
Status:
ISSUED
Applied:
12/14/2000
Issued:
12/14/2000
Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE & ATTACHED GARAGE (17 SQ). TEAR OFF EXISTING LAYERS OF
ROOFING & REPLACE SHEATHING AS NEEDED. INSTALL 1 -LAYER OF 15# FELT UNDERLAYMENT & REROOF WITH 20
YEAR FIBERGLASS SHINGLES.
Plan Check:
$0.00
Permit:
$83.25
SMIP Res:
$0.50
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $83.75
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0
ACCESSORY Front 0-0 Rear 0-0
PARKING Existing: 0 Required: 0
NOTES:
FEE SUMMARY
Calc Valuation: $2,700.00
Claim Valuation: $2,700.00
PLANNING & ZONING
Left 0-0 Right 0-0
Left 0-0 Right 0-0
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 I
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
244&46(6=)
IIIIIIIJ
DEXLARATIOMS
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.
11—have aqd 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 mer and policy number are:
�Cartldr: �? �^'r1°Y'�L...pi✓l� Policy Number— C.
VUl/NIY' �J
(This section need nofibli completed if the permit is valued atone hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for whi 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 t hould come subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Comply with these 'ons.
Applicant Signature Datei ti.Q.
WARNING: FAILURE -TO CURE WORKE SMP SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100.000), IN ADD O O THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR MOE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that am icensed uncle provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and �ProfQessions Code, and my license is in full
force and effect.Ll`c# ClasJ �" 67�/
Contractor's Signaturee
> `Dale:—
t _ �•— I G
CONSTRUCTION LENDING AGENCY:
❑ 1 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:
1 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 Lew (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).):
❑ 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.).
❑ 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 pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Data:
Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
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, 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? ❑ 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 building 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).
............................... ....... ............................................................................................................................................ .............. .................................................................... ....................... ................................................................ ............. I...................
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 apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? _J Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
................................................................................... ....................................................................................... ..................................................................................... ......................................................... ............. ................ ........................ I ............
..
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 El No
............................................................................................................................................................................................................................................................................................................................................................................................
B (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.
Signature O CG Dete,� V
`n OrPptl App (cant--^ ,, (Rate
CODE I. INSPECTIONTYPE DATE 7LITITIAL$ CODES INSPECTION TYPE geTF INTITA
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 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
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE
r�ORPRINT
BUILD
ADO IES /'>•
S 210 APOOK
COSTA MESA. CALIFORNIA
FEE RECEIVED
DEC 14W60
�' ��F�iNANCEE$U�MESa
APPLICATI�N'yFA PERMIT
BUILDING
For Office Use Only
RECEIPT NO.
OWNER 0J.111.
MAIL
,dN
CEI VE pY
I
ADDRESS OIO 'AI ` o7��
/
�q�/ �fl
1�
CITY SSI
BUILDING
ADDRESS /D��
ARCHITECT
COSTA MESA. CALIFORNIA
OR ENGINEER /
FIRE
'l
ADDRESS
ZONE
TYPE 1 -GROUP �.
CONTRACTOR C W k
APPROVED
BY
/�^(
I / 1 DATE
ZONING
ADDRESS
CITY
ZONE
� f
NO. OF
PLANS _[
USE OF NEW
BUILDING
STATE TEL.LEGAL
LIC. NO. NO.DEB<RIFTION
SIZE / /
LOT
NO
NOq
p NO
�OF
USEOFYARDS
EVES
EXISTING BLDG. IC GS 1 1_APPROVED
ALLOWED
��ffC l I _/
T
SETBACK LINE FROM 7/ L
(CENTER LINE
ST.)
CENTER OF STREET / REAR YARD_' C!
FRONT
FT. IN.
I 1-7 � 6
SIDE YARD LEFT
RIGHT
R. SIDE
.S FT. IN.
DESCRIPTION OF WORK
L. SIDE 6T IN.
NEW Y I A4TERATION I II
ADDITION I
REAR
/
�OFL r IN./
REPAIR MOVING I
DEMOLISH
APPROVEDDATE
(p
BUILDING / �1'NO. OF
SIZE XIISX ROOMS STORIES
EXTERIOR WALL
ROOF
I
COVERING
COVERING
USE OF BUILDING AND WORK TO:BE PERFORMED
-
0 J, ML
C'Ay,pcio, HAfWILi.F}Ecvur--r_w
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE -
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM-
PURPOSE
OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
VALUATION
BUILDING CONETRU O
SIGNATURE OF
PERMIT FEE S `(
PERMITTE
PLAN CHECK S
AUTHORIZED AGENT
/ f
TOTAL FEE 9
ANDERSON
AUG 18 rsl
JOB ADDRESS 1010 Arbor'-- " ---- - y BUILDING PERMIT NO. 13502
GENERAL CONTRACTOR Owner-Bldr. VALUE $ 810.00
AP. N0.115-502-16 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Ena.Cpt.&Add Cp
INSPECTIONS
DATE I GROUP V TYPE J ZONE R1
U-',rground Soil U.G. Water
——
SUBCONTRACTOR
PERMITS ISSUED
I 'ground Gas
DAT
NUMBER
Ov,.head Water and Gas
Rough Heating
L
Rough Plumbing
Miscellaneous
Prop. Swr. Line I -louse Con. St. Swr.Ir
Sprinkling System
Heating, Final
dA I
k
Plumbing Fixtures
-
o
Final Gas Test
Construction Pole
Underground Power
1
Rough Wiring
Trenches/{//jy,F,orrns RGV4&eel
-�
Floor System'
Steel Reinforce Chimney ReRod
Bond Beam
Sheathing
-
6
Frasne and Flashing
-
n M IIV o e -
a
I ;, In Out
1, brown coat
Plm..oing Fixtures, Final
Electric Fixtures, Final
O AiGt�
_
Building, Final
OCCUPANCY
Form 210-5M-11.59 S•B p 4 A"-4� ��„'"-f�.el�j.C� X. -a , _ 13502
ORANGE COUNTY BUILDING DEPARTMENT
r 636 North Broadway -
SANTA ANA, CALIFORNIA
APPLeICeATION FOR
PERMIT
ltal
•
I
FOR OFFICE USE ONLY ;
FOR APPLICANT TO FILL IN
I
RECEIPT NO.. PERMIT NO.
I 3J �� `.
BUILDING ADDRESS 1010 Arbor St.
SCHOOL DIST. Costa Mesa
OR TOWN
R EIVED BY
DATE OF APPL.
/ /
DATE ISSUED
11
NOV 51 9531
♦�ry�NEAREST
CROSS ST. it LltttSer Ave.
I
WG
I
OWNERBUILD
I ROOUOIS I'IONESy
MAIL
WILSHIRE BLVD.
SCHOOL DIST
AD RE559363
OR TOWN
I
CITY BEVERLY DILLS TEL
CR. 54361
CROSS ST.
�i(/t� ✓��
ARCHITECT oR TEL.
& MCKERRACHER SY. 64891
ZO J
NO. OF TYPE GR UPI -
ENGINEERCAIN NO.
(IPLANS
ADDRESS 2110 E. WALNUT ST., PASADENA
SETBACK LINE
REAR YARD
FROM CENTER OF ST.
i •`-`:--SIDE YARD
CTEL1.
CONTRACTORNEWPORT VISTA CO. NO.CR• J4361
APPROVED
BY
I DATE /
9363 WILSHIRE BLVD., BEV.HILLS
CORRECTIONS
ADDRESS
LEGAL �a
DESCRIPTION I LOT NO. 363 BLOCK 1712
—
---
(ATTACH METES B BOUNDS)
TRACT
I
---
nn NO. OF BLOGS.
SIZE OF LOT 7200 eQ.FT• I NOW ON LOT 0
USE OF I NO. OFI NO. OF
EXISTING BLDG, FAMILIES ROOMS
DESCRIPTION OF WORK
j
I
— D
NEW I X ALTERATION I ADDITION
D
a
REPAIR I MOVING (
I DEMOLISH
-� y
BUILDING 'I NO. G OF 1
. r -
SIZE 1034 SQ.FT ROOMS 1 STORIES 1
---CGNt�O
COVERING STUCCO COOF
OVERING SHI NOLES
USE OF NEW
BUILDING RESIDENCErAtt_n.DDrt
APPROVALS
FOUNDATION:
LOCATION
INSPECTOR
--.DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
FORMS. MATERIALS,
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
UNDERPINNING
FRAME: FIRE
BRACING,
STOPS,
BOLTS
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
LATH. INT.
SIGNATURE OF
p�
C/
'
PERMITTEEA
LATH. EXT.
PLASTER.INT.
AUTHORIZED AGT.
PLASTER, EXT.
$4830-00 P. C. 3 y
MASONRY REINFORCED
FEE
$
BOND BEAM
� � � •�/
VALUATION
�
FEE
FINAL
li
...
z
,
i
- PLOT
PLAN
evA
'J'It. YJ :-k, -.
--,
A! A':_Tu:lJn':1 Off
`. —
.00 AT.-IV
:IJII,.V:': �.CVJ[. 3;IN':JI`1
m
y; iq
.T i..00
_ , l ._.. .,
STREET
'1 `. __•'.__.'J .. .' .. ..
- - I
-
05170 )
I
i
I
� 1.