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Home My WebLink About3141 BOSTON WAY - Building Permits�4 , CITY OF COSTA MESA BUILD/NG D/VISION 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: BX07-00080 PERMIT TYPE B MISC STATUS: ISSUED DATE ISSUED: 08/14/2007 _r. ISSUED BY: RMD JOB ADDRESS: 3141 BOSTON VIIY.CM ; �' :Suite/Unit: Vicinity: GARAGE Primary Occ: i Const Type :?? SQ. FT: 0 " `_Valuation F -�$3;000.00 `-�-�� ,,. SCOPE OF WORK: INSULATION,;DRYWALL WORK AND, 2 LIGHT'FIXTW/FAN, 2 LIGHT FIXT, 2 ELECTRIAL OUTLETS,,2'SWITCHES AT INTERIOR OF GARAGE: .;`: R ;` . OWNER: CHAVEZ, MARIA�G. Address:, 3141 80$TON WAY Unit City/State: COSTA MESA,,CA , Zip Code:, 92626-2705 Phone: 949-307-8620 - APPLICANT: IDIAQUEZ, EDDY Address: Unit Ciry/State: . ,- _.. . _ . , , =. Zip.Code: Phone: 714-546-4805 CONTRACTOR: OWNER-BUILDER - License No., 000000 Address: i . "- :. �: Unit: City/State: Zip Code: Plione ; �Cell: ARCHITECT: License No. ' , Phone � ENGINEER: � - ,: Cicense No. Phone "•FE E. SU MMARY " Building Plan Check � � �._�$0.00 ,��. '`' '� �� Building Permit: �� $83.25 , Electrical Permit: $32.30 , SMIP Residential $0.00 SMIP Commercial $0.00 $O.00TOTAL FEES $115.55 i ). NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Cali(omia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 fnal approval will result in the expiration of this permit. CODEt. INSPECPONTYPE pATE IN77TIAL5 COUE/ INSPEGTIONTPE OATE INTITIRLS 1616 Fized System Final Fire Prevention 206 Final Mechanical 1266 Poo15pa Final 208 Pinal Piumbing �� 200 Final Re-Roof 210 Final Electrical �S/ 7 207 202 203 zoa Final BIocWRetaining Wall Final Factory Fire Place Final Sign Final Demolition 212 220 222 250 Final Fire Prevention Finat Planning Appro�al Final Site Final Builtling/Occupancy � ��NORKERS' COMPENSATION DECLARATION: 1 bereby aKrm under penalty o( perjury one o/ the follovnng declarations; ❑ I have and will maintain a certifcate o( consent to self-Insure for workers' �ompensalion, as provided for by seclion 3700 of the Labor Code, for the pedormance ot the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by secl'an 3700 of the Labor Code, for the pertortnance of ihe work (or which this pertnit is issuetl. My workers' compensation Insurance carrier and policy number are: Carrier. (This secYd+need irof be �HedAlhe pevm.P is valuedalone nundietl �llars (EtGb) orless) Policy Number: G❑�I-certify that in the performance of the vrork for which this permit is isgued, I shall not employ any person in any manner so as to become subject to the vrorker�comge tiea_laws o( Calitomia, and agree thaf if I should becom 6�ect [o ihe �rkers' com E tion provisions of Section 3700 of th� L� d, shal f rt' 'th comply with ese provisions. - - O� /�l-o% - �s rgna�we a Dat�_��.7 �---- WARNING: FAI�URE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P�NALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($7DD,000), IN ADDI710N 70 THE COST OF COMPENSA710N, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, II�fTEREST, AND ArTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under provisions o/ Chapler 9�commencing w4h Section 7000) of Division 3 of [he Business and Professions Cotle, and my license is in full force antl eftect. Lit. # Class # Comractor's SignaWre Dale CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrm that there is a wnstmction lending agency for the perlortnance of lhe work !a wfiich this permit is issued. (Sec. 3097, Civil Code�. LEntler's Name� Lender's Address: Dale OWNER-BUILDER DECLARATIONS: I hereby aKrm Ihat under penalry of perjury that 1 am EXEMPT FROM THE CON7RAC70R5 LICENSE LAW (or the (ollowing 2ason (Sec. 7031.5, BUsiness and Profe55ions Code: Any city or counry which requires a permit to cOnstruct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to file a signetl statement that he or she is IicenseQ pursuanl to [he provisions of lhe Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pmfessions Code) or that he or she is exempt therefrom and the basis for the alleged ezemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than f,..v/e hundred dollars ($500).): L� I, as ovmer of the property, or my employees with wages as Iheir sole CcOmpensation, WILL DO THE WORK, and lhe sirucNre is not inlended or oHeretl for sale (Sec. 7044, Business and Protessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herself or through his or her owo ' employees, provided thal such improvemenis are not intended or oNered for sale. If, however, the builtling or improvement is sold within one �year of completion, the ovmer-builder will have the burden 0f proving thaChe or she did not builtl or improve for purpose of sale.). ❑ 1, as ovmer ot the property, am EXCLUSIVELY CON7RAC7tNG WITH LICENSED CONTRACTORS to constmct the pmject (Sec. 7044, Business and Professions Code: The contractas License Law dces not apply to an owner of Signawre oaie property who builds or improves thereon, and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF EN7RY: I a contractor(s) license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have reatl Ihis application and stale that []- I am exempt under sec. - the intormation given is correcL I agree to comply with all state laws and city � ordinances relating lo building construction, antl authonze �epresentatives of 8usiness and Professiorrs"Co3E-forthi eason: - lhe City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any builtling � aulhorized by ihis permit until final inspeclion. � �d L��/ —0 / � H Daie ' !`Sig ur� lDa�e�� - O � -_. / 1J — p % �a5]-a6(3I0]� . � � `narocA orize _� nt-, (r_Date�r l , Owner ID verified by drivi �se, es ❑ No +� � z � Drivefs�License No. _/ Expires: � v� �� Verifcation of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INUUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby ceA'rfy ihat no excavation frve (5) or more (eet in depth into wfiich a person is required to descend, will be made in connection with work authorizetl by mis permit, and that no building structure, scaFfdding, falsework, a demolition or dismanping thereof, will be more ihan Ihirty-siz (36) feet high. (Chap. 32, Grp 2. Arl 2. Sec. 341, Ttle 8, Calitomia AdministraMe Code). ❑ A5 owner-builtler, I will not employ anyone to do work which would require a permit from Ihe Division of Industrial Safety, as noted above, unless such person has a permit to do such vrork from the division. Applican(s SignaWre Division of Industrial Safety Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building ocwpant need to fle and certify a Business Plan for emergency response to release or threatened release o( a hazardous matenal? ❑ Ves ❑ No (Seclion 25505 0/ [he Califomia Heallh and Safety Coae reqoires, with some exceptions, that a Business Plan be fled with the Costa Mesa Fire DepaAment by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet o( compressed gas at standard temperalure and pressure). 2. Does or will the applicant or present or future building occupant neetl to file a registralion fortn for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of ihe California Health antl Safery Code, with some exceptions, requires registration with the Costa Mesa Fire Department hy each business which at any one time has on hantl a quantily of acutely hazardous materials equal to or greater than a weight ot 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl temperaWre antl pressure). 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program tor acutely hazardous matenals)? ❑ Yes ❑ No (Section 25534 of the California Health and Safery Code provitles that the Costa Mesa Fire Department may require ihe preparation, certification and fling with the Fire Departmem of an RMPP by businesses which are required to register acutely hazardous matenals with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health antl Safe[y Code been fully complietl vrith? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for me work which is the subject of this application a permit for suc� consVuction or modifiCalion (rom Ihe Sou[h Coast Air Qualiy Managemen� DiSlfiCt of from any other air polNtion control district or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemmenl Code requires that the requested intortna�ion be fumishetl on applications for non-resitlential building permits). 6. Will any pad of the facility to be constructed under this permit be within 1000 feet from [he outer boundaries of a school? ❑ Yes ❑ No Qt "yes", lhe facility must meet the requiremen[ of Sections 25534 and 42303 of the Cafifornia Health and Safery Code). 7. If a permit fmm Ihe South Coast Air �uality Management Dishict 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 6y Calitornia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Q! "yes". attach certificate ot compliance from [he appropriate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct I agree to comply with all stale laws and city ordinances�regarding Hazardous Materials and Emissions. . DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS Street Address: t. �(we), X /� /r' 21,4 C�/ �4 ✓[ Z referenced real property, and that I(we) hereby authorize W� Bldg. Permit # This Permit # AP Number: declare that I am the Owner of Title of the above Name: �� J/ —� � ��' Q� L Z' Telephone Number: �� L�� S L�� a �� Street Address: Ciry: State: Zip: to obtain permits in my behalf, as owner/builder, for //� S J( /� T � onJ /,�j R.� w�( (, � //�.l (��(y�£, 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 indemnity and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myseif or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of pery'ury that the foregoing is true and correct. Executed this (� day of v, ��'� � 20 �, at � �i� , California. Print Name: � M� 2�� C�fi �� L Signature: �M��/r��1/G7 Date: � � O' D 7� O� Note: This aulhor¢ation does not grant authorization to perfortn the work as owner, d solely provides for limited power of attomey to secure this permit in any behaH. 0]]9<6 (rev.11/00) �i�oi COSTA MESA BUILDING-SAFEfY DEPARTMENT P. O. BOX 917 COBTA ME9A� CALIFORNIA For Applicanf to Fill In Completely TYPE OR PRINT . 512E OF LOT USE OF EXISTIN6 BL 6ETB.�CK LIN6 e U56 OF COSTA MESA. Bonser Const Inc. I NO. OP NOW OI Q� . DESCRIPTION .OF WORK FEE RECEIVED JAW 1 7 1964 FINANCE DEPT.� CITY OF COSTA MESA APPLICATION FOR PERMR BUILDING For Office Use Only P6CEIPlNO. l'� IPbp�.yTINO L ,1 U RHC61 8O BY OATB R8C8IV6p JH'Y 6189UE /—1 �1— L �/ 1 6 1 FIRE ZONE APPROVHD ZONING NO.OP 7 US[ PLANB !�� .BYII LEOAL NOTE: NO EAVE OVERHANQ SHALL BE LESS THAN � � YARD9 APPROVED MAIN BUILDIN6 IOM C/L STREET) VAR. $R ► YARDSAPPROYED � ACCESSORY BUILDIN6 OATE '�Y `6 � T� _ 4 � sa Fr. Z� 1 XEREBY ACKN EUO6 T HAVE READ THI9 �PPLIGTION TH2 AMOUNT BMOWN 11NOEP VALUATION 19 POq TH6 ♦N� BTATE T TH E I8, RRECT ANO AOFE6 TO COM- PURP08E OF EBTABLI8HIN0 • PERMIi FE6 ONLY. PLY WITH L CITY O N CH9 A D 9TAT6 LAWe ReOULATING ypLUATION � Ap auaDlrva oHSTRu o. - ' , pERMITFEE' $?O oo� SIGNATU PERMITTE � • /� � �� Ov AUTHORIZEDAGENT . � - , . �/��" �� 'C �� o0