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Home My WebLink About1081 CORONA LN - Building PermitsCITY OF COSTA MESA BUILDING DIVISION PERMIT NUMBER DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1081 CORONA LN FEE SUMMARY Status: ISSUED Suite: Calc Valuation: $3,500.00 Permit: Applied: 06/30/1999 Vicinity: WHOLE HOUSE SMTP Res: $0.50 Issued: 06/30/1999 Parcel Nunmber: 14162424 Zoning: Other: $0.00 ISSUED BY: Applicant: EDWARDS, MARIA M. Total: $87.75 Address: 13741 CLINTON ST. PLANNING & ZONING CA - Phone: (714)554-5369 MAIN STRUCTURE Front 0-0 GARDEN GROVE Zip: 92843 Front 0-0 Owner: MANTON, ROGER PARKING Existing: 0 Required: 0 Proposed: 0 Address 1081 CORONA LN Phone: (714)556-6544 COSTA MESA, CA Zip: 92626 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone:' Zip License: Zip: License: SCOPE OF PERMIT RE -ROOF SINGLE FAMILY RESIDENCE & ATTACHED GARAGE. TEAR OFF EXISTING WOOD SHAKE ROOF & REPLACE SHEATHING WITH 1/2" COX PLYWOOD. INSTALL 1 -LAYER OF 15# FELT & CLASS W COMPOSITION SHINGLES (25 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 FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,500.00 Permit: $87.25 Claim Valuation: $3,500.00 SMTP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $87.75 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: 0 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 DECURATIONS CIO WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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. ❑ I have and 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 carrier and policy number are: Carrier: Policy Number: (This section need not be completed if 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 of California, and agree that if l should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: 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 3706OF 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. Lia N Class N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I 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: 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, pnor 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.). ❑ 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature='1ia(1,lLi��SY� Expires: Q004 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, 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). 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 It 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 appSmut for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 It 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 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 Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE N, INSPECTION TYPE QA-Ti INET 196$ C.RPEL INSPECTION TYPE 2M INTMALS 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 BuildingfOccupancy 244646 DECLARATION OF . _JTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS /081 (boeyna Ln Street Address ---Bldg. Permit # /qww FA C7 Permit # r71 I - 0/0w AP Number 1. I (we), _-��(_/r pa,146 )1 declare that I am the Owner of Title W of the above referenced real property, and that I (we) hereby authorize: n 1-4. Cdwar)dS (-7/y) 559-53(.cj Name Telephone No. 13�y/ ��in-km 51 5P ro �. Street Address y3 to obtain permits in my behalf, as owner/builder, for e6- A N&11 at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we) shall im- mediately 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 per- son, company or corporation. 4. 1 agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. 1 declare under the penalty of perjury Executed this day of foregoing is true and correct. NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. 077946 (Rev. W1) 4. J 2G2g3 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOY 317 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS 1081 Corona Lane COSTA MESA, CALIFORNIA nWNER Mata n-1 Mar Develolment CO. E. Coast TEL- CITY EL CITY Same as above STATE LIC. NO.2073(13_A-SB-1 NDL.Oriole 3-4220 SIZE - _-,_ Sr91 NO.OFBLDGB... __ SETBACK LINE FROM 1111 evwe veep %iI SIDEYARD1 LQPT 59 1 RIGHT 71 DESCRIPTION OF WORK I SO. Fr. S ZE`DI X5011511 ROOMS 8 ST RIES 2 WALL W00d EXTERIORDOVER ROVERINGWood NG Shake U 860E BUILDING KTO BH PfiRFORMEO garage. 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PLY WITH ALL CITY ORDINANCES AND STATE LAWS RBGULATIND BUILDING CONSTRUCTION. SIGNATUROF Macc alt o. PERMITT`EE'J�E AUTHORIZED G NT� rEE RECEIVED AUL 2 5AWRATION FOR PERMIT CI I n nuBUILDING NO. BUILDING ADDRESS FIRE ZONING ZONE NO. OP YS[OP N[W R-1 PUN. 2 1 .ILDINGW/ att Par `EDCRIPTION A` OeeLot 94 Tract 5023 A. P. NO. none NOTE: NO SAVE OVERHANG SHALL BE LESS THAN 90' TO SIDE A REAR P. L. EAVES ALLOWED (U. B. C. REQUIREMENT'. YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING VAR.# DATE N SO. Fr. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE I PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION S 23,985.00 e PERMIT FEE J Sa PLAN CHECK S7.RM 4 TOTAL FEE $ //�� COSTA MESA BUILDING—SAFETY DEPARTMENT P.O. BOX 1200 Costa Mesa, California =;d I l"llil�l�af:all�lil• CONTRACTOR,. Address City Zip Code�'r._.". State License No. 21"- "_3570 Class. d� City License No. Tel. NUMBER TYPE OF FIXTURE OR ITEM FEE Bathtub Laundry Tub or Tray Automatic Washing Machine Shower Sink, Bar Sink, Kitchen - Wash Basin (Lavatory) Water Closet (Toilet) Drinking Fountains Floor Drains interceptors • b Receptors Sinks, Commercial or Industrial,' Sinks, [laor Sinks, Service Swimming Pool" Urinals Dishwasher Garage Disposal Water Softener A- Water Heater and Vent Gas System ... Outlets .. . Roof Drains CMF 0450-46 TOTAL FEE I -';I,'.. / t TRACT NO. RECD. BY LOT NO. DATE ISSUED BUILDING USE }l�' Adddress ing 9"A'3 rely' Vr'^ Owner L^-``' Mail I'--- Cz Address r. s. f• City Tel. No. S45 :j a` I hereby acknowledge'that4l have read this application and state that the above is correct and agree to comply with all City Ordinances and StateLawsregulating plumbing. 1 certify, that Lpossess the above valid State of California classi- fteation ort am the legal owner of the residential property de- scribed above. I' certify that I have obtained a permit from the State Division of Industrial Safety for excavations, other than swimming pools, five feet deep or deeper and into which a person is required to descend. Signature Permittee_:i: t.- •Tp •r-.e'.'n«- ';.n INSPECTION RECORD APPROVALS BLDG. PERNT