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Home My WebLink About496 CABRILLO ST - Building PermitsCITY OF COSTA MESA F BIIILDING DIVISION � i � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.p. F �.��. FOR INSPECTIONS CALL: (714) 754-5626 ' PERMIT NUMBER 607-00866 PERMIT TYPE B_ROOF2 JOB ADDRESS: 496 CABRILLO ST CM Vicinity: RES AND ATiACH�D GARAGE ONLY SQ. FT: 3000 STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: Const.Type: Valuation: ISSUED' 07/23/2007 BJK ?? $0.00 SCOPE OF WORK: REROOF RES W/ATTACHED GARAGE ONLY: TIO WOOD SHAKE, 7/16" OSB, 30# FELT PER MFGR'S SPECS, APPLY "30-YEAR TIMBERLINE COMP SHINGLES." 30 SQ PITCH 5:12 ' � - OWNER: PINE,MARTHATR PHONE: � City/State2ip: APPLICANT: THOMPSON, MARTHq PHONE: 949-981-6678 CON7RAC70R: LEE ROOFlNG OF COSTA MESA Address: 1653 1/2 SUPERIOR AVEUnit: City/State: COSTA MESA, CA ZipCode: 92627 , ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES 'Address: 2004 VISTA CAUDAL Unit: NEWPORT BEACH, CA, , � Address: Unit: Ciry/State/zZip: . ' License No. 349686 � PHONE: 949-642-7222 CELL: � License No. , License No. - - � so.00 , , $167.25 . $0.00 - St 67.25 PHONE: PHONE: NO710E: The work authorized by this permit shall comply with all appliwble handiwp access.requiremenLs under Califomia statutes and relaled regulations. (Ord. No. 92-28. § 1, 12-21-g2) El(PIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � INSPECTIONS: In order (or the work authorized under this pertnit to be considered legal, such work musl comply with all applicable codes, and all required inspeetions and final approval must De obWined. Failure to obtain inspections and final approval will result in the expiration of this permil. CpDEI. INSPECPONTYVE Qp� INTRI�LS 400E� INSPECTIONME ORTF NI11nR15 1818 Fixed System Final Fire Prevention � ' 208 Final Mechanical , , 1268 Pool Spa Final � 208 Final Plumbing 200 Final Re-Roof �� 210 Final Electrical 201 final Blak/ReWining Wall 272 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 20a Final Dertalition 250 Final Building/Occupancy �, . WORKERS' COMPENSATION DECLARATION: � 1 hereby aKrtn under penalty o! perjury ona of lhe fou ng declarations: ❑ I have antl will maintain a certifcale ot wnsent to seli-Insure,for vrorkers' compensation, as provided for by section 3700 of the Labor Cotle. for the p rtormance of the work for which Ihis permit is issued. I have and will maintain �norkers' canpensatbn insurance, as required by s ion 3700 of the Labor Cotle, for [he pedortnance o( the v.ork for which this permit is issued.�� ers' compensation Insurance carrier and policy number are: � Cartier. (TlrasttAonneetlnaDaromp(l'e�te0/tneµrrtNUVahro/Ca'� �urMretl4lars(S�Gi�)wless.) Policy Number: � (T J ��7 fc� ��I certify Ihat in the peAormance of the work tor which this pertnit is issued. I shall not employ any person in any manner so as to become subject to the vrorkers' compensation laws ol Cali(omia, antl agree that il 1 should become subjatt lo Ihe workers' wmpensation provisions of Section 3700 of Ihe bor Cotle._ I�hall torthwit wmply vn these Drovisj ns. /^� TIl4.< 7L J C� �_ rappnom�a'slm�atum,. �ey WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DM1AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CA�E. INiEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrm that I am licen5ed under provisions of Chapter 9(commencing wilh Section 7000) o( Division 3 of Ihe Business and Professions Code, and my license is in tull /forc nd Nect. Li . # � C� Class # � Contractor'sSignamre �e� CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that there is a construction lending agency for the per(ormance of the vqrk fv which Ws permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Atltlress: Sign3Wre OWNER•BUILDER DECLARATIONS: I hereDy aKrm that under panalry of perjury Ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for tha following reason (Sec. 7031.5, Business antl Prolessions Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair any sWcture, prior to its issuance. also requires the applicant for such pertnit to (ile a signed s[atemeN thal he or she is licensetl pursuant to the provisions of the Contractors License Law (Chapter 9(commencing wi�h Seclion 7000) of Division 3 of the Business antl Prolessions Cotle) or that he or she is exempt lherefrom and Ihe basis tor the alleged exemption. Any violation o( Section 7031.5 by any appliwnt for a permit subjec�s the applicant to a civil penalty of not more than fve hundretl tlollars ($500).): ❑ I, as ovmer of the property, or my employees with vrages as Iheir sole compensation, WILL DO THE WORK, antl the stnicture is not intendetl or oRered (or sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such work himselt or herself or throuqh his or her ovm employees, provided that such improvements are not iMendeO or offered for sale. If, however, the building or impmvement is sold within one year of completion, the ovmer-builder will have tha burden of proving ihal he or she did not builC or improve !or purpose ol sale.). ❑ I, as ovmer of Ihe property, am EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044. Business and Protessbns Cotle: The contractors License Law dces not apply lo an ovmer of property who builtls or impmves thereon, and vfio cmt2c[s for such projecl with a contractoqs) license pursuaN to the Contractors License Laws.). ❑ I am exempt unCer sec. Business antl Prolessions Code for this reason: ]OSPd6�107) � � Owner ID verifed by driv se. ❑ Yes ❑ No • • Driver's License No. Expires: Verification of Ownership by Qype o( tlocument, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certdy that no ezcavation frve (5) w more (eet in depth inro wfiich a pereon is required Io descend, will be made in connectbn with wurk authorized by this pertnit, and Ihat no building slructure, scaFfdding, false�+ork, or demolition or dismaNling thereol, v,ill be more than thirty-s& (36) leet high. (Chap. 3.2, Grp 2. M 2, Sec. 341, Tlle 8, Cali(omia Administ2live CoCe). ❑ As owner-builder, I will not employ anyone lo do work which vrould require a permil from the Division o( Industrial Salety, as noted above, unless such person has a permit to do such work from the division. Ap0licnnl's SipnaWre Date Division ol Induslrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7. Will the applicant or present or lulure building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous matenal7 ❑ Yes ❑ No (Section 25505 0( the Califomia Health and Safery Cotle requires, with some ezceptions, thal a Business Plan be fletl with the Costa Mesa Fire Department by every business which has at any one time tlunng a reported year a quantity o! hazardous materials equal to or greater than a weiqht of 500 pounds, or a volume of 55 gallons, or 200 cubic feet ot compressed gas al standard temperature and pressure). 2. Does or will the applicant or present or fuWre builGing occupaN need to file a reqistretion form for acutely hazartlous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Satey Code, vrith some eaceptions, requires registration with Ihe Cos[a Mesa Fire Department by each business vfiich at any one lime has on hantl a quantity of acutely hazardous materials equal to or greater than a weigM of 500 pounds, or a volume of 55 gallons, or 200 cubic feet ot compressed gas at standard tempereture and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazartlous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides Ihat t�e Costa Mesa Fire Department may require lhe preparation, certificatlon and filing with the Fire DeDartment o� an RMPP by businesses which are required to register acutely hazaraous materials with the Fire Department. 4. If an RMPP is presently required, has Seclion 25534 0( ihe Califomia Health and Salety Code been fully complied with7 ❑ Ves ❑ No 5. Does or will Ihe applicant or present or fulure building occupant require lor Ihe work whith i5 lhe subjecl of this appliwtion a pertnit lor such construc�ion or motlification Irom �he SouN Coast Air Quality Management Districl or from any other air pollution control district or agency7 ❑ Yes ❑ No �Sactbn 65850.2 0l the Califomia Govemment Cotle requires tliat the requesletl inlormation be fumished on applications ta ran-residential buildirg permils). 6. Will any part ol Ihe facility to be constructed under this permit be within t0001ee1 from the outer boun0aries of a school7 ❑ Yes ❑ No pt'yes", the tacility musl meet the requiremem o( Sections 25534 antl 42303 of the Califomia Health and Safety Cotle). 7. I! a permit Irom Ihe South Coast Air Quality Management Dislnct or other air polWtion control tlistricl or agency is required for the work which is lhe subject ol lhis application, have all of the disclosures prescnbed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No, 8. Qf yes", attach cenificate of compliance trom tha appropriate air pollulion control o�cer). CERTIFICATE OF COMPLIANCE: I certify that under penalty ot perjury Ne information given above is correct. I agree to wmply with all state laws and city ordinances regartling Hazardous Materials and Emissions. � SlgwWre Date . CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I ceM1ify under penalty of perjury that I have read this appliwiion and sfate that the informa�ion given is wrrecL I agree to comply wiih all state laws and city ordinances relating to building construction, and authorize represenWtives o( the Ciry of Costa Mesa to enter upon the above-described pmperty for inspection purposes. I agree not to occupy or allow occupancy o( any building authorized by this permit until final inspec[ion. gnawre ol L Owner(s) - Date r� �� .a l,��n � . �n�arornumo eanod�� oa�e—�• 07/23/2,007 12:17 949-642-4384 LEE ROOFING CO ,PAGE x„ :. .. �9p1)00� �� ' ' D� DECLARATION �F ALITH4RIZA.TION F4R AG�NTS OF CONTRACTOR TO APPLY FOR PERMITS �, �� U K`e , dedere that nI hemby thorim the follcawiat pa�son(s) to ohtnin pemli�x an my behetP: CYy� (�B.e/`� /CP��N�'�, SIONATVRS /JI�-,er��T'� so.0 ' ' ' PRIHf AM8 ' � �t(1NAN0.I. � IRIM NAMG SIGNA'1YJR8 ' PII�MNAM6 Cc�S�c�� ow�ac•s ucea+asoR socuu. aecxmm e OIfN6LL'a u�@NAH OP AOCIµ SBCUPT' 11 oRlvp{'BUC6NS6aRJ�CW.SEl.l7ftT'� � 2, [ will alw file a Wortar'�.Co�npen80aon lnsurance Cerlificute, issped by my ineurance agent, covering ett perooas employed by myselP, my compsey or eorpon�ion prior to rhe isauence of eny pnmiits in aceordaoce with Section 3800 of �ha Stnte of Califomia Labor Code. 3: I undentand that rtry eignature below acte ae a continuous authorization until a wri[ten documen[ cnrtoetllns such aufio�a�tion oF eny or all of [he pareona liaud above 1e moeived by the Building , AivisSon. Any additiorts or uwdifiracionc will [equire a naW form, 4, i e�ra m inderonify and hold tho Ciry of Cosw Mcsa and iW amployees or offlceis haraJess from any eleim tesulting in dxmage or personal iryury co myaelf or pny other paRies ae a rosult of work • autharizad by ehe pemdtg Eiom tAe Ciry of Coata Me9a. m — �-----o-----a-----�-----a-----�-----a-- 5. 1 haye reedand under-ed th� above atettments as they pertain to tlu iasuance oP permi[s by the Ciry'oP ' Co9ln Mesa snd �ha nmla Sta[o Condactor's Licanae Bavd. 6. 1 dalare u�der [he'pandty of pary'ury that the fWe�oin; ie true and wrrect. E:ecutod �ie day of �%�� 19 QZ, at 0 % ; / � �C-�ce iu o �u'L Na r NA 0. !i ��,x�y � � C�XM �NY A BXA � 9Hy ��-7�x Z COMP�NYpMONBNUMBEII� ,aee�e crta•,wov1 8'/A'f00F FORNIACOM1l/.C�IM'9NUNBtR C—�9 C�s�� ,UV ACKNOWLEDCr6M@NT BY A NOTAgY PUBLiC OS CUN1'RACTOR'S 6IC3NA'fUR& i5 REQUIBID. A'A"TACN COpY OF STATE CONTAACTpk'S LICENSE. ,rCqgta Mesa Building Department � I 711 EAST 20th &TREET ' . � COSTA MESA, CALIFORNIA � �'OR APPLICANT TO FiLL IN nca�s� �f yf, CA�Hi[GD �'�, Costa Mesa, California NeareSt ,f Cross St. � %{ {�//(��' />{�f Addre5s �iz n iy"sr Tel. city �ot7'A /YIEfA rvo. S/, Architect or Lic. Engineer yj/PSTEJjA1DfJAFTiy(I No. Address City Lia Contrector/%ESA %�U/LAf�fS No. / Address $fZ W /9T�' �d5% f Leua�l I Lot __ I I. (Attach Metesand Bounds) SizeofLot �/O�,Y �8� Use oi Existing Bldg. Setback Lfne from � Cenfe�of Streef �} 3 Alteratlan No. of 81dgs. Q Now on Lot No.of No.oi Families Rooma Rear Yard Z 5r' CiAe Ve�A R� / Addition Demolish APP CATION FOR PERMIT �BUILD,�NG 'Q FOR OFFICE USE ONLY Receipt No. Permit No. �a �� :eived by � Date Rec'd. Dah Issued �.3-�.�.�� Address . Costa Mesa, California F�� Plans BUIIdIng Na.OT � Size _f�8 Z Rooms � Stories � Exterior Wali I Roof GtO9 Covering ,fJ"'(/CCO Coverings/fAKEf APPROVALS Use of New .Building ,��yE [ L/y G �Foundation Location Inspeeto� Forms, Materials, Under-Pinning \ Frame: Fire Stops, ` Bracing, Bolts I hereby acknowledge ihat I have read this ApplicaUon Lath. Int. , and state that the above is correct snd agree to comply Lath. Ext. with all City Ordinances and State Iaws regulating building construction. � Signature o1 / // Plaster, Int. Permittee 'is�N��iIr9 �%%Gi" . '-1 . Plaster. E�[t. Valuatinn rermic ree � ,f Plan Check $ � 3 � � ��d Feea� $ J� FOFM 204 G-H ZM 5-54 ■ � O F � 2 D r " � "�ti� � a-ssPDCOSTh � ;,.,;r��5.co uE�p 179a . � +� V 1 1 Llal� Show locatlon and distanees from property line gnd between bufldings. Y