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Home My WebLink About1578 CORSICA PL - Building PermitsF 9 CITY OF COSTA MESA~ 4 BUILDING DIVISION > DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER f PERMIT J B04-01705 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1578 CORSICA PL Suite: Vicinity: Parcel Number: 13919116 Applicant: GRADY, DENNIS Address: 1578 CORSICA PL COSTA MESA, CA Owner: GRADY, DENNIS Address 1578 CORSICA PL Contractor: Address: Zip: Arch : Address: COSTA MESA, CA Zoning: R1 Rl ISSUED BY: Phone: 714-549-0733 Zip: 92626 Phone: 714-549-0733 Zip: 92626 Phone: $167.25 License: Claim Valuation: $8,089.00' SMIP Res: Eng: Address: Phone: $0.00 Status: ISSUED Applied: 10/01/2004 Issued: 10/01/2004 EXTENSION � PER EXPIRES a aD °16., Phone: Zip: License: License: SCOPE OF PERMIT CHANGE OUT WINDOWS AND 1 SLIDING GLASS DOOR THROUGHOUT S.F.D. REPLACE WITH DUAL PANE, VINYL WINDOWS TO COMPLY WITH 1997 U.B.C. EGRESS REQUIREMENTS. 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) 7545626 44&461NW) FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,089.00 Permit: $167.25 Claim Valuation: $8,089.00' SMIP Res: $0.81 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.06 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) 7545626 44&461NW) rl 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 maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed i/ 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 f Calfforma, and agree that I I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply with these r viision-s.- {'j� �'-�,�/ / _Applicant Signature, l' (' "^� A Date: V! �' 2 O O y (jr- �� WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 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, and my license is in full force and effect. Lic. rr Class rt Contractors Signature: Date: 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: 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).): ❑ 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 contractors) license pursuant to the Contractors License Laws.). ❑ I am axe t under sec. Business and Professions Code for this reason: Slgnelure: /R • (1'La..dU✓I/ Date: aQvner'fD verified by drivers license. ❑ YeSO❑ No 1`Drive[s.Licenae.No.,�- Verification of Ownership by (type of document, i.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, faisework, 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 e 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 reposed 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 en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes [I No ........................ ......................... ................. .......................................................____..... _._...__................................................_._....... ............................................____............................................. ._.......... _....... ....__.......... _........... _... S Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes ❑ 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 requiretl for the work which is me 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: CERTWIC F 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 gre to comply with tate la and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above -d rib d property for insp Ion rposes. I ee not to occupy or allow occupancy of any building authorized by this permit until final inspection. q-� 1 rJ 20 a y ,Slgnafore-Of Legal Ow a) [Date, t And/Or Authorized Applicant Date CODE,. INSPECTION TYPE PATE ItIIIDALS CODE, INSPECTION TYPE PATE IBTMAUS 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 BuildincyOcoupancy- S Ir M JOB ADDRESS 1578 Corsica Place BUILDING PERMIT NO. 92 GENERAL CONTRACTOR Dike & CGlegrove VALUE $ 14,387.00 AP. No. LOT aJ TRACT e0ee FIRE ZONE DESCRIPTION OF WORK lies./w.att.Gara INSPECTIONS S-aB -�,� DATE I GROUP TYPE ZONE A 1 Underground SoIA*,-S U.G. Water Al -I$' %- SUBCONTRACTOR PERMITS ISSUED Underground Gas _ DATE NUMBER ji Overhead Water and Gas Rough Heating /y) -/s ' �I--rb'-�/ t' /�- 9--5 j / 5 --3 3 ' Rough Plumbing Miscellaneous G . Prop. Swr. I4ne�House!Con. St. Swr. '%/ G� • �� (, :.1 •7 1 ./ -� ?L 1 Sprinkling System ' Heating, Final 7-29-,6-v Plumbing Fixtures - Final Gas Test — r Construction Pole Underground Power / Rough Wiring Trenches Forms Steel}'/lh: , -,:n Floor System I Steel Reinforce Chimney Re -Rod 1 Bond Beam 1 Sheathing AWA O,( 6"..$ Frame and Flashing KS Lathing, In Out C 'G/Lt/g-) Plaster, brown coat Plumbing Fixtures, Final /Y)•/S ?y/ Electric Fixtures, Final Building, Final / OCCUPANCY Form 210-3M-4-59 r 9283 9283 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL /N COMPLETELY TYPE OR PRINT ADDRESS 1578 Corsica Pl ce COSTA MESA, CALIFORNIA t" t R CEJ 9p MAY FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR Off/CE USE ONLY OWNER Comesa, Inc. I RECEIPT NO. PERMIT MAIL RE IVED Y I GATE RECEIVED DATE ISSUED AOOREss 9 E. 17th St. _ 3 Costa Celf.lT & LI8ll NG CITY Mesa AU ESS CHITECT MaRlebrook COSTA MESA, CALIFORNIA ORENGINEER� NO. Garden Grove FIRE ADDRESS ZONE Dike & Colegrove, Inc. STATE APPROVED, it CONTRACTOR LIC. NO. 16729 BY DATE // ADDRESS L119 E. 17th St. Costa Mesa ZONING LEGAL I LOT I 'J8,�J I'�jAy ZONE NO.OF (PLANS �i/I USE OF NEW DESCRIPTION NO. 43 BLOCK BUILDING A. P. NO. APPROVED )-� BY DATE S .3 "tel L L^ SIZE X l0O 60 NO. OF BLDGS YARDS OF LOT Now DN LDT hone REQUIRED ALLOWED USE OF none (CENTER LINE ST.) EXISTING BLDG. FRONT JDFT. IN. SETBACK LINE FROM CO( T CENTER OF STREET J FjEAR YARD 211 R. SIDE D FT. IN. SIDE YARD ILEFT 5t (RIGHT 51 L. SIDE S FT. IN. DESCRIPTION OF WORK REAR /�--FT. IN. NEW x ALTERATION I ADDITION REPAIR I I MOVING I DEMOLISH BUILDINGl' NO. OF 1430 6 SIZE ROOMS STORIES 1 EXTERIOR WALL stucco ROOF COVERING COVERING Shingle USE OF BUILDING AND WORK TO BE PGRFORMED Sin le famil e ' attached double garage Plan 1 OAR IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATETHAT THE ABOVE 15 CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. VALUATION. SIGNATURE OFPERMIT FEE $ 34.00 PERMITTEE �T 14,38/.00 PLAN CHECK $ 17.00 $ I 51.00 AUTHORIZED AGENT Dike e & Cole rove Inc. TOTAL FEE $