The URL can be used to link to this page

Home My WebLink About1949 POMONA AVE - Building PermitsOWNER FRY0 T.Rl1N A_ DATE 10-6-58 )OB ADDRESS 1949 A & B Pomona BUILDING PERMIT NO. 7730 �LYlZ{o4-4f LOT 31 TRACT 612 FIRE ZONE DESCRIPTION OF WORK TTtnl or & A+.+rte.. r > I & J TYPE V INSPECTIONS I DATE I SUBCONTRACTOR Gas Test C PERMITSISSUED FLIJUa 30 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us T7 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1949 POMONA AV Suite: A Vicinity: ROOF Parcel Number: 42226128 Zoning: R3 R3 Applicant: KYLE LEWIS Address: 4071 E LA PALMA SUITE K ;� , - Phone: 714-632-3800 ANAHEIM, CA- �� - Zip: 92807 Owner: HAEFELE, ROBERT C TR Address 1186 N GROVE ST //, Phone: ANAHEIM; CA, , Zip: 92806 Contractor: 'LEWIS &'SONS CONSTRUCTION Address: 4071 E LA'PALMA SUITE K ;% Phone: 714-632-3800 ANAHEIM, CA Zip: 92807 ,License: 416525 _ Status: ISSUED Applied: 11/20/2003 Issued: 11/20/2003 ISSUED BY: Arch _ Eng: Address: - - - Address:- ' - - Phone: Phone: Zip: - license: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 30# FELT, 30 YEAR COMPOSITION _SHINGLES AND REPLACE SHEATHING AS NEEDED. 27 SQUARES . FOR BLDG. A FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,000.00 Permit: $97.25 Claim Valuation: 54,000.00 SMIP Res: $0.50 SMIP Com:, $0.00 Other:',, $0.00 %Inspection:_ $0.00 Total: $97.75 ' PLANNING & ZONING SETBACKS_-� MAIN STRUCTURE- Front 0-0 ` Rear - 0-0 Left 0-0 Right' 0-0 - �' ACCESSORY Front 0- 0, Rear 0-0 Left 0-0 Right 0-0 , PARKING Existing: �0, Required: 0 Proposed: 0' - 1 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work Is suspended or abandoned for a perlod of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2448.48 (sm) I e WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to sell -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I My workers' mpensation Insurance caller and policy number are: Carder: Policy Number: (This section need nojSEWORKERT let / he permit Is valued at one hundred dollars f$ 100) or less.) ❑ I certify that in ta 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 la, and agree that II I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with theT Applicant Signature: Date: ��'ZG ✓ WARNING: FAILURE TO COMPENSATION OOVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSANDDOU.ARE(SADDITION TO THE ODST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAR TION: I hereby affirm that I am Ilcen d ro of Chapter 9 (commencing with Section 7000) of Division 3 of the Businee a pypfessions Code, and my license is In full force and effect. LIC. N) Z Class ff _ 1. 1 / Contractor's Signature: Date: - /—Z 6r 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). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby effiml 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, eller, Improve, demolish, or repair any structure, Odor 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 01 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 UNI 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 appy 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. It, 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 (Seo. 7044, Business and Professions Code: The contractors Llcense 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ You; ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): 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 Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII 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 re rted 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 Califomla Health and Safety Cade, with same excepdons, requires registration with the Costa Mesa Fire Department by each business which at any one time hes 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 appplicant or present or future building mcupent need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia 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. ....................................................._.........re—_.__.._.................—..._.._...�._..........._............................_..................................L ..........._........ .........._. ....__— 4 Ii an RMPP Is presently required. has Section 25534 of the California Health and Safety Cade been fully compiled with? LJ Yes ❑ No ......_....._.._._._._—..___ t _.. .........or the_...............___....................................................plic.........................._............................. .... .... ....Uon or ......._... 5 Does or will h applicant or present or future building occupant require for the work which is the subject c this a plication appe,rmlt for such conswcdon or rtlotliilCa9on from the South Guest Air Quality Management District or from any other air polutlon control district or agent)? � Yes u No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). ........_...............__—__.._........."._..__.____.__"...._..._.....................__._.................__...................................._.............................................._—.... ........_— _ 8 Will any ped of the facility to be constmded untler This permit be within 1000 feet from the outer boundaries of a stood? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade). . ................................. ...... _...................................... ........................................................ _.._..._.................. ___....................... __................................... _............................................ ___.._...__—__._ 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 prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes [I 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: Dote: CER7IFICA COMPLIANCE AND AUTHORIZATION OF ENTRY: I cerity under penalty of perjury that I have read this application and state that the information given is cored. I e to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City 01 Costa Mesa to enter upon the above -des d 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) / // Z il' �1-3ate And/Of Authorized Applicant IV V Data 1 CODE 1. INSPECTION TYPE QM INTRIA CODE INSPECTION TYPE gATE ISL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Sita 204 Final Demolition - 250 Final Bulli ing/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 1949 POMONA AV Suite: B Vicinity: ROOF Parcel Number: 42226128 Zoning: R3 R3 Applicant: KYLE LEWIS Issued: 11/20/2003 Address: 4071 E LA PALMA $0.00 Other: ` SUITE K i ; > "- Phone: 714-632-3800 ANAHEIM, CA-/ �- Zip: 92807 $97.75, - Owner: HAEFELE,"ROBERT C TR _ Address 1186 N GROVE ST, - -- - Phone: �/ANAHEIM, CA,', '; Zip: 92806 Contractor: LEWIS 'SONS CONSTRUCTION Address: 4071 E LA PALMA - SUITE K Phone: 714-632-3800 ANAHEIM, CA Zip: - 92807, License: 416525 Arch : Address: Phone: Status: ISSUED Applied: 11/20/2003 Issued: 11/20/2003 ISSUED BY: Eng: Address: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 30# FELT, 30 YEAR COMPOSITION SHINGLES AND REPLACE SHEATHING AS NEEDED. 27 SQUARES FOR BLDG.B -� Plan Check: $0.00 Permit: $97.25 SMTP Res: $0.50 SMIP Com: $0.00 Other: ` $0.00 Inspection: ,$0.00 Total: $97.75, - Calc Valuation: 54,000.00 Claim Valuation: - $4,000.00 PLANNING & ZONING SETBACKS` MAIN STRUCTURE Front 0-0 i; 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, 1241.92) 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 permlt. FOR INSPECTIONS CALL: (714) 754-5626 2"6.46(6100) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of penury one of the following declarations: ❑ I have and will maintain a conificale 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 Code, for the performance of the work for which this permit Is Issued. My workers'corpprisadoin Insurance carder and policy number are: �.��2 ^ / Carder: Policy Number: .J� (This secfl eed not be coarpieta&I the permit is valued of one hundred dollars (S 100) or less.) ❑ 1 certify that indRWORKERS* 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' compensationa, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with th Applicant SignatureDate:7 WARNING: FAILURE T COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND OML FINES UP TOONE HUNDRED THOUSAND DOLLARE (SIO0,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DEC ATION: I hereby affirm that 1 am lice ry�visi of Chapter 9 (commencing with Section 7000) of Division 3 of the Busmie anlrgt9ssions Code, and my license is in full force and effect. Lic P G Class i, alt Contractor's 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). Londer'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 pammil 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 theretrom 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 (5500).): ❑ I, as owner o1 the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not Intended or offered for sets (Sec. 7044, Business and Professions Code: The Contractors License Law does not appy 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 Droving 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 appy 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers 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 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: Data: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to rates" or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Coda 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 standartl temperature and pressure). ..... ....._.._..__...........................................ildi............__.............._....._.____......._._._...............................................................................-s-7............a................................... .... .... ........ .................. . 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazartlous materia157 ❑Ves ❑ 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 iuturo building occupant need to prepare an RMPP (Risk Management end Preventbn Program for eatery 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 an RMPP is presently required, hes Section 25534 of the California Heal. and Safety Code been fully complied with? Ll Yes ❑.No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisa plication eggermit for such construction or motllllcmlon from the South Coast Air Quality Management District or from any other air pollution control district or agency? 8 Yes LJ No (Section 65850.2 of .e California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........---......._Y...._--.....ry......._........._..._..._.........................-----..................---......_..........._.................. ....---.........__....................................................... 8 WIII an pan of the radii to be constreded under this rmlt be within 1000 feet trom.e outer boundaries of a school? ❑Ves ❑ No (11 'yes", .e facility must meet the requirement of Sections 25534 and 42303 of .e California Health and Safety Code). 7 It a permit from .l South Coast Air Qualify Management a Heal or other etr pollution S control district n agency H required for the work which is the subject o1 this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑ No 6 (II 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 CO � If CS.E AND AUTHORVARON OF ENTRY: certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to c IlT�/yy//with ell state laws end city ordinances relating to building conslmclion, and aulhodze representatives of the City of Costa Mesa to enter upon the above-described pr for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owners) //_ ?Z ^ _O Date AncVOr Authorized Applicant ! GDate Y CODE Jr. INSPECRONTYPE PAIE INTITIALS CODE If INSPECTIONTYPE 2&U IN®AL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pad Spa Final 208 Final Plumbing 200 Final Re -Rad 210 Final Electrical 201 Final Blocu'Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 2134 Final Demolition 250 Final Building/Occupancy 17730 COSTA MESA BUILDING DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA 'L FOR APPLICANT TOO FILL, IN BUILDING '47 FEE RECEIVED Vu FIRM DEPT. CITY Of CMTA 90 APPLICATION FOR PERMIT BUILDING COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY J RECEIPT NO. PERMIT NO. OWNER D MAIL RECEIVED BY DATE R//ECEIV( DATE ISSUE. ADDRESS 1Q - 6 -J �O 6'Sd TEL. /.(f BUILDING CITY NO. ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA FIRE ADDRESS ZONE CITY LIC. ZON vii NS TYPE GROUP // CONTRACT NO: TE APPROVED ADDRES Q NO.Y DATE 'LEGAL Lor CORRECTIONS DESCRIPTION NO. Q3 BLOCK TRACT A.P. NO. S — 3 �' SIZE�/ +� NO. OF BLOCS. �� OF, LOT .T y� _ 110. ONLOT USE OF Z%l AiHVED, EXISTING BLDG. SETBACK LINE FROM/ A CITY 0. ' ceNrER OF STREET /O REAR YARD PLAN NG DEPT. SUBJECT TO BLDG. D SIDE YARD RIGHT LEFT pr.� DESCRIPTION OF WORK - PLAN T:Cyy� NEW ALTERATIONADDITION REPAIR MOVING DEMOLISH BUILDING NO.OF �� SIZE ROOMS STORIES EXTERIOR WALL ROOF COVERING COVERING USE OF NEW v BUILDING C.G 0 - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY O STATE LAWS REGULATING BUILDING CONSTRUC. TION. VALUATION q ✓ ,, SIGNATURE��--i��K�• PERMITTEE /Q PERMIT FEE i PLAN CHEC! AUTHORIZED AGENT TOTAL FEE SMT