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Home My WebLink About1109 DANIELLE DR - Building PermitsI (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1109 DANIELLE DR Suite: Vicinity: ROOF Parcel Number: 41207435 Zoning: R1 R1 Applicant: SELL, RON Permit: $167.25 Address: 18032 LEMON SMIP Com: $0.00 Other: $0.00 Phone: (714)528-1758 YORBA LINDA, CA Zip: 92686 Owner: CARBONI, GERALD FRANCIS Address 1109 DANIELLE DR Phone: COSTA MESA, CA Zip: 92626 Contractor: SELL ROOFING COMPANY Address: 18032 LEMON Phone: (714)528-1758 YORBA LINDA, CA Zip: 92686 License: 323842 Arch : Address: Eng: Address: Status: ISSUED Applied: 07/22/2003 Issued: 07/22/2003 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL EAGLELITE TILE ROOF, ICBO #4660, NEW OSB PLYWOOD. 25 SQUARES INCLUDES ATTACHED GARAGE. Plan Check: $0.00 Permit: $167.25 SMIP Res: $0.89 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $168-14 SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 ACCESSORY Front 0- 0 Rear 0-0 PARKING Existing: 0 Required: 0 FEE SUMMARY Calc Valuation: $8,900.00 Claim Valuation: $8,900.00 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 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 2466-46 (6100) 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 sell -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, a required by section 3700 of to Labor Code, for to performance of the work for which this permit is issued. My workers' w so Insurance caDierand policy n bar are: / 6 Carrier: �. / �//l! Policy Number: oUJ (This section need not be completed if the permit is valued al a 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 a bloc t to the workers' compensation laws ro California, and agr It I should bac a subject to the workers' compensation provisions of Section 3700 0l 1h6� b0(Code, 1 Shall forthwith comply with these provisions.J64Ida00 of ab G Code, I Applicant Signature: t�L Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL P TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisio of p at -(r�mmencing with Section 7000) of Division 3 of the Business and Prgtesslon , and my license is in full force and effect. Lic. k Class M L✓ 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). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby allirm that under penalty of perjury that 1 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 ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to canstruct the project (Sec. 7044, Business and Professions Code: The contractors License taw does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor($) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Cade for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers 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 then 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 Induslnal 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 forth 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. ..........................................................................................................................................................................................................................................................................................................................................................................I................. 4 II en RMPP is presently . require ..... C1 No ................................................................................................................................................................................................................................................................................. 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this 2pplication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 WIII any pert 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 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 proscribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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 wit gY-e1Tte 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 pe on pu oses. I ree of occupy or allow occupancy of any building authorized by this permit until final inspection. Signatur at Owners ZDBIa, Q And/ r Authorized Applicant I t Date CODE I. INSPECTION TYPE nAIF. INTMALS CODE I INSPECTION TYPEptiEi INTMA$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final / 208 Final Plumbing 200 Final Re -Root op —I—,V3 U- 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 pQ CI__ OF COSTA MESA REQUEST FOR OCC NCY TRACT NO. ! v DATE LOT NO. �/3 RECEIVED C11Y Or COSIA MESA ADDRESS O ��. OEVEIOP;�r :i SL&VICESDEPARTMENT. SEP G 1919 PM The developer of the above entitled tract desires to slf� the aN6441kJek1 -14�16 lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he -she -they) (was or were) l� advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions/ necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. representative BY `ender J39 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely - Use Ink Only BUILDING liri4 MA kIIr-t 1 OWNER Properties West Uevelo ment Uo ADDRESS 508 29th Street TEL CITY Newport Beach. CA No. 67:�21 :� 7�+9L-14nsC•Pu BRANCH ADDRESS Pa10 122.64 ':0'J 10-77cnsa00 575# *** APPLICATION FOR STRUCTURAL PERMIT ECEIVED BY I DATE RECEIVED nnrPlssuac BUILDING ADDRESS ROVE Res. Atd. Gar. VALUE 73,400. ADDRESS NO. OF USE OF N TEL. NO. CITYapermits LAM BUILDING dlM STATECITY YARDS APPROVED YARDS APPROVED LIC. NO.LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM CIL REET) VALUATION OF LOT NOW ON LOT NT FT. FT. USE OF TAX s 5.14 Authorized Age.I li { EXISTING BLD FT F �J Sequired for L S `� FT FT. eleheating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. !?- 1 I B ..MAIN & I hereby acknowledge that 1 ha%Vread this d6pllcation and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ "'••' r r 1 r/�I Itnr•nf r• •.. 0 m I1. ��.t/ i• Ir ..r °•..r -.� .�.. .as..°•`" any person in violation of the workman's compensation lows of o. SO. FT. 2790 the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Coda, Division 3, Chapter 9, and that such licenses ars in full force and effect, or 1 N m THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: exempt from the prov slons of the State of California Business :no ontl Profossiom Cad ision 3, Chapter 9, ,o Y n VALUATION PERMIT FBE 3 PLAN CHECK $ en Signature O Permittee ' $ 73, 400. G LL i U TAX s 5.14 Authorized Age.I li { TOTAL PAID 3 �� 1. G V7 `!T COSTA MESA BUILDING -SAF Y DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use In Only BUILDING ADDRESS OWNER MAIL ADDRESS TEL. CITY NO. BRANCH ADDRESS ARCHITECT ADDRESS PERMIT NO. CONTRACTOR REAR FT. ADDRESS ADDRESS `( 2 TRACT TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE S NO. OF BLDGS. OF LOT APPROVED NOW ON LOT ".EC-9-77�n5C00 519 J -**235.00 APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY I DATE RECEIVED nArF uasuFn Separate permits are required for electric, plumbing and heating work. PERMIT NO. A.P. NO. REAR FT. BUILDING //D ADDRESS `( 2 TRACT LOT BLOCK W IADDIAL R REPAIR APPROVED OWNER UE S FIRE ZONE TYPE GROUP APPROVED BY DATE ZONE NO. OF USE OF NEW PLANS BUILDING YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDI Separate permits are required for electric, plumbing and heating work. L. SIDE FT. FT. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. MAIN BLDGS. BET. MAIN & ACCESS, BLDGS. Aid VAR. %% C.U.P.46 DATE APPROVED APPROVED I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. Signature of Permittee Authorized Agent Lc;p G<✓ N n m i m SO. FT. r THE AMOUNT SHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE E < N / PLAN CHECK E 'n o E TAX E u. U TOTALPAID E