HomeMy WebLinkAbout934 AZALEA DR - Building Permits---
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 934 AZALEA DR
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 41221209
Zoning: R1 R1
Applicant: BURKE, MIKE
Address: 1653 SUPERIOR AVE � � � � - � �� �. -
- .Phone: (949) 642-7222
COSTA MESA, CA' ' - Zip: 92627
Owner. LEWIS, KEVIN
Address 934 AZALEA DR - . ,
� . - -� ' Phone: .� .
COSTA MESA, CA " Zip: 92626-1702
Contractor. LEE ROOFtNG OF COSTA MESA
Address: 1653 SUPERIOR AVE
COSTA MESA, CA
Zip: 92627
Arch :
Address:
zip:
Phone: (949)642-7222
License: 349686
Eng:
Address:
Phone:
License:
ISSUED QY:
Status: ISSUED
Applied: 06/18/2002
Issued: 06/18/2002
Phone:
License:
= SCOPE OF FERMIT
REROOF: T/O EXISTING WOOD SHAKE, 1/2' OSB SHTG, 1,LAYER 36# F.ELT, APPLY "30-YEAR COMP SHINGLES."
3:12 PITCH 32 SQ
FEESUMMARY
Plan Check: . $0.00 - " Calc Valuation: .Ss,�oo.00
, Permit: $139.25 Claim Valuation: $s;�oo.00
SMIP Res: $0.61
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00 �
Total: $139.86
PLANN�ING-& ZONING � �
SETBACKS
MAIN STRUCTURE Front 0- 0 Rear 0- 0
ACCESSORY Front 0- 0 Rear �- 0
PARKING Existina: o Required: a
NOTES:
Left 0- 0
LeR 0- 0
Pr000sed: 0
Right 0- 0
Rlght 0- D
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis 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 780 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
requlred Inspections and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 _
2416-46(fi/00)
WORKERS' COMPENSATON DECLARASION: ., . ... --
I hereby aflirm under penalty of perjury one of the following declarations:
❑ I have antl will maintein e certificate ot consent to self-Insura tor workers' compensation, as provided for by section 3700 of ihe Labor Cotle, for ihe pertortnance of ihe
— /work far Which this pertnit is issuetl. .
r.� I have entl will maintain workers' compensation insuranca, as required by section 3700 ot ihe Labor Code, for the perfortnance of ihe work for which ihls pertnit is issuetl.
My workers' campensetion Insuren� cerrier d policy number are: �J 1//
Carrier. � !fJ%P �(��1–(J,1�� PolicyNumber. I.7OGC%LZ �3
(lhls 5ection npqd not be complet� i/ (he permit is velued ef one hundred dollars ($100) or less.) �
❑ I certify that in ihe peAormance o1 ihe k for which this permit is Issued, I shell not employ eny per9on in eny manner so es to become subled to ihe workers'
compensation laws ot CeliFo1�I, ei �� e ihef if I should become subJect to the workero' compensatlon provislons of Section 3700 of t e Lebor Code, I shall forthwith
complywiththes is'efis /�
Applicent SignaNra: Dete: CL /�f /J �L
WARNING FAILURE TO SECUFE ORKER ' COMPENSAiION COVERAGE IS UNLAWFUL AND SHALL Sl1BlECT AN EMPLOVER TO CRIMINAL B NALTI S AND CIVIL FlNES UP TOONE HUNDRED
THWSAND DOUARE ($700, , IN ADDITION TO TME COST OF COMPENSATION, DAMAGES AS PROVIOED f-0R IN SECTION 37060F THE IABOR CODE, IMEHEST, AND ATTORNEI"S FEES.
LICENSEO CONTRACTORS DECLARATION:
I hereby affirtn that I am licensed under p�r�oJv)'sic
force and effect. Lic. # _-t��:1���/�'�� �P _
Con[ractor's Siqnemre: � �✓ i -„ �
(commencing with Section 7000) ot Division 3 of the Business and Protessions Code, and my license is in full
Cless p L �J %
--�— oete: G,-�/J�G�
CONSTRUCTION LENDING A(GENCY: '
❑ I hereby aHirm that there is a construction lantling agency for the performance oi the work tor which this permit is issued. (Sec. 3097, Civil Cotle).
LenCer's Name: Lender's Addrass:
Signeture: Date:
OWNER-BUILpER DECLARATIONS:
I hereby atfirm thet under penelty of perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counTy which requires a permit to consiruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permil
to file a signed stetement thet he or she is Ilcensetl pureuent to tha provisians af the Cantrecrors License Law (Chepter 9(commencing with Sectlon 7000) of Division 3 M the
Business and Professions CoUe) or that he or she is exempt Iherefrom end ihe besis for the alleged ezemption. Any violetion of Sadion 7031.5 by eny applicant for a pertnit
subjads ihe epplicant to e civil penalry ol not more then five hundred dollers ($500).):
❑ I, as owner of the property, or my employees with wages es their sole compensetion, WILL DO TFiE WORK, and the siructure is not Intended or oHered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properry who builds or Improves thereon, and who does such work
himself or harself or through his or her own employees, provided that such Improvements ere not Intended or oHered for sale. If, however, the building or improvement Is
sold within one year of completion, the owner-builder will have ihe burden of proving ihat he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCWSIVELV CONTRACiING WITH LICENSED CONTRACTORS to consiruct fha project (Sec. 7044, 8usiness end Professions
Code: The contractors License Lew does not apply to en owner of propetly who bullds or Improves the�eon, antl who contracis tor such proJect with a contrector(s)
liCense pUrsuant to ihe Contractors License Laws.).
❑ I am exerript under sec. Business antl Professions Cade far this reason:
Signature: Date:
Owner ID verifipd by drivers license. ❑ Ves ❑ No Driver's License No. Expires:
Venfication of pwnership by (type of dwument, i.e. - property tex bill ar deedj:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby canity that no excavefion five (5) or more feet in depth inro which e person is required to descend, will be mede in connection with work euthonzed by this
permit, and ihat no buildinq siructufe, scaHolding, falsework, or tlemolition or dismantling ihereot, will be more ihen ihirty-six (36) faet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, California Adminisirative Cotle).
❑ As owner-builder, I will not employ anyona to do work which would require e permit fmm the Division oi Intlustriel Sefety, as noted above, unless such person hes e
permit ro do such work from the division.
Signature: Date:
Division o� ��tlUstrial Safery Permit Numbar.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will ihe applicant or present or future building occupant neetl to tile and certify a Business Plan for emergency response to release or threatened releese ot e hazartlous
meterlal? ❑ Yes ❑ No
(Section 25505 of the Celifomia Health and Safety Code requires, with some ezceptions, thet e Business Plan be filed with the Costa Mesa Fire Depertment hy every
business Which has at any one time during a reported year a quentity of hazardous matanals equal to or greater then a weight of 500 pounds, or a volume of 55 gallons,
or 200 cu6ic feet oF compressed gas at standard temperature and pressure).
......hazard ........� ......^...I ..'...........Yes...... ......NO .............................................
..................................................................................................................................................................................................................................... . ....
2 Does or wlll the applicant or present or future builtling occupent need to file e registration torm for acutely ous ete a s ❑ ❑
(Section 26533 of the Celifomla Health and Sefery Cotle, with some exceptions, requires registretlon with the Costa Mesa Fire Department by each business which et eny
one time has on hend a quantity of acutely hazardous materlals equal to or greater then e welght of 500 pounds, or a volume ot 55 gellons, or 200 cubic feet of
compressgd gas at standard tempereture and pressure). �
............................................................................................._....._............._._........................................................................................................................................................................................,.....................................................................
3 Does or will the applicant or present or �uture building occupant nead to prepare an RMPP (Risk Manegement and Prevention Program for acutely hazardous materiels)7
❑ Yas ❑ No
(SeCtion 25534 of ihe California Health and Safery Code provides thet lhe Costa Mesa Fire Department may require the preparation, cehitication and filing with iha Fire
Deparimeht of an RMPP by businesses whlch are required lo register acutely hazartlous matenals with ihe Flre Department.
..................................................................................................................................................................................................................................................................................... ....................... ...................................................................
P is presently required, has Section 25534 of the Califomia Health and Safety Code been tully complied withl ❑ Yes ❑ No
4 ....If, an_RMP� ..................—..............._.._......................................................................................................................................................................,.........................................................,....................................................;..,.............
5 Does or will the applicant o� present or future building occupant require for lhe work which is Ihe subjecl of Ihis a plication a Permit for such constmction or motlificetion
from ihe South Coesi Alr Qualiry Manegement Disirict or from eny other eir pollution conirol disirict or egency7 � Yes LJ No
(Section 658502 of Ihe Califomie Go�emment Code raquires ihat ihe requested informetion be turnished on applications for non-residential bulltling permits).
....................................................................................................................................................................................................................................................................................... ............................................................................................
6 Will any part of the faciliry to be consimcted under this permit be within 1000 feet from the outer boundaries ot a school9 ❑ Yes No
(tl "yes", the faciliry musi meet ihe requirement of Sections 25534 and 42303 of the Calitornie Healih and Safety Code).
........._ .................... .................................................._............................................................................... ..........................................,................................................._...................,.....................................................................
7 If e permit from the South Coast Air �uelity Management Distdct or other eir poUuUon coaUW distrkt or agency is required for the wak which is ihe sub}ect of ihis
eDP�ication, have all of the disclosure5 D�escdbed by Celifornla Health and Safety Gode Section 42303 been mede7 ❑ Yes ❑ No
CER71FICqTE OF COMPLIANCE: 1 certily Mat under penelty ot perjury t8e information given above is correcC I agrse to compty with all state laws and city ortlinances
regarding Hezardous Materials antl Emissions. �
Signature: Date:
CERiIFICATE OF COMPLIANCE AND AUTHORIZJITION OF ENTTiY: I cenity under penalty of perjury thet I have read this application and state thet the information given is
correct I agree to comply with all state lews and city ordinances relating to buildinq consimaion, and authotlze representetives of the City of Costa Mese to enter upon the
above-describ�d property for inspection puryoses. I agree not to occupy or allow occupancy ot eny building aUthonzetl by this permit until final inspection.
CODE t, TYP
1616 F� ed System Final Fire Preventio�
1268 Pool Spe Flnal
200 Final Re-Root
201 Finel BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Finel Demolition
D�TE �7pJ�^�
Z 2 �C��--
COOEt INSYECTIONTYPE
206 Final Mechanical
20B Finel Plumbing
270 Final Eleddcel
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Si[e
250 Final Building/Occupancy
Qeg ut�a�i
'%' 346b +
� . COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
F r Applicant to Fi!l in Completely
',!" —3-?2�Q��`,�00 ty3as ,���*g4.12
cr.—
' A PLICAT`IIDN OR BUILDING RMI�����
RECGIVEDBV DATERECEIVED nnre�cciirn
8��� A�z A�. ��- G�', ��- �
ADD ESS
_ OWNER I�y W /�l �. A.P. NO.
/ �j AODRESS �'
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APPROVED
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W O STATE CITV q YARDS'APPROVED
y� LI0. NO. CIC. NO. z� �/ . MAIN BUILDING
� O (FROM C/LSTREET)
SIZE NO.OF BLDGS. �
OF LOT �� h ' � 3 NOW ON LOT Q FHONT `J FT.
USE OF S
EXISTING BLDG. $
,z NEW BLDG. /�✓ / ROOMS �
STORIES L.SIDE FT. �
�% COVE ROING L DOtl S� �� COVOEFING � P REAR FT.�
J USE�OF BUIL ING AN� W flK TO BE PERFORM D DISTANCE BET.
a MAIN BLDGS.
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F - � APPR k / �
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UI hereby acknowletlBe that I have read this appllcation entl state
= that ffie above information is carrect end aB�� to comply with
� all laws regulating building constructio�, and I shall not employ HOLD FOR SPf
� any pe�son in violation of the workmen's compensaiion laws of
y the State of California. '
? I he�eby certify that I am p�ope�ly licensed as a conttactor untle� SQ. FT.
� Me State ot Calitornia BUsiness antl PrOtessions Cotle, Divisicn 3, THE AMOUNT SHOWN
' , Chapter 9, a�d that cuch licenses are in full force end effeci, ar I THE PURPOSE OF ESTAE
� am exempt from the provisions of the Steie of California Businezs VALUATION
antl Professions de, Division 3, Chapt r 9; ��� PF
518^ature o1� . � /� �, V
Permittee $ 7 D PL
Autho�izetl Agent / T�
VALUE
GfiOUP �
DATE '���/ �
BET. MAIN &
��
A PERMIT
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OWNER
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A� No. LOT
GAS
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SPRINKLINC SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CON�ITIONING
TEMPORARV SERVICE OR POLE
UNDERGROUND � POWER �
ROUGH WIRING
FLOOF SYSTEM
BONO BEAM � STEEL REINFORCE
SHEATHING
FFAME ANO FLASHING
�
.STER, BROWN COAT
HEATING, VENT., REFRIG.
PLUMBING, FINAL AN� GA
TRACT
DATE
DESCRIPTION of WORK Sa
FIRE ZONE VALUE
GROUP TYPE
SUBCONTRACTOR
r 4�932
, COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIRORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDINGR/ � A AZ�LCn p�,
ADORESS(/\ �F /��
OWNER M�,� MRS. Joc J, c"Qu Z
nooAess 1489 SAN PABLO G/RCtt�
cirv cosTA M�s/+ rTvo`S�/6-3856
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CONTRACTORx o wNE'R -�/a�I:
ADDRESS
TEL.
CITV NO.
STATE CITY
LIC. NO. LIC. NO.
OF 40T �j�,b7�)( �Q Zl NOWONLO
USE OF , , , . _
Separate permits are required for
electric, plumbing and heating work.
USE
I he/aby acknowletlge tMei I heva raad this application antl stete
that tho abova information is correct and agree to comply wlth
all la�+s regulatlnp bu{Idl�O construction, and I shafl not employ
any percon in vlolation of the workman's compensation lews of
the 5tete of Calitornia.
I hereby certify that I am properly Ilcensed es a contractor under
tha 5<ete of California Business antl Protessions Cotla, Dlvislon 3,
Chaptar 9, antl that auch Iicenses are In full fOrce antl BffBct, or I
am exempt from the provisions of the Scata of Californie eusinass
and 7�ofesslans Code, Olvlsion 3, Ch ter 9.
SlBnature of �
Perm�ttae
Autherizetl ABent
^CT ?� -7�rnci'f141 � 53i1:� �,r.�:; t�t:�^,.5�
APPLICATION FOR STRUCTURAL PERMIT
EC��D BV ��: A�EIV�� �� E�IfSSnUE�
�� 7 ��
BUILDING
ADDRESS
TRF
B
' //i i�%� VAIUE
�./'CPQ��� $
FIRE
ZONE TV E GROUP
APPROVED �
BV OATE
ZON NO.OF USE OF NEW I
PLANS BUILDING
�ARDSAPPROVED VARDSAPPqOVEO
MAIN BUILDING ACCESSORV BUILDI
(FROM GL STREET/)/�
FRONT "'��T. // FT.
SI � FT. F ,
f
l. SIDE FT. FT.
t �
REAR FT. FT.
DI5TANCE BEL ��- BET. MAIN & ��
MAIN BLDGS. ACCESS. 6LOGS.
VAH. # DATE
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i SQ. FT. w
THE AMOUNT SHOWN UNDER VALUATION IS FOR m
THE PURPOSE OF ESTABLISHING A PERMIT FE V' �
VALUATION PERMIT FEE $ �
n
ro
�` 6G PI.AN CHECK $ ' o
$ o/IU �_ TAX S � �
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� TOTALPAID $ �
OWNER CRU2, Joe J,
JOB ADDRESS 934 Az�lea Drive
G" SRAL CONTRACTOR Owner Sldr.
A� .,o. 412-212-09 LOT TR
INSPECTIONS Si�
SOIL
Gr15
W NTER
ROUGM PLUMBING
ROP. SWP. LINE � NOI15E CON. �
� � SPRINKLING SVSTEM
MISCELLANEOUS
ROUGN HEAiING AND AIR CONOlTIONIN6
TEMPONARV SERVICE OR POLE
UNDERGROUN� � POWER �
ROU6H WIRING
TPENCNES FORMS STEEL REINF.
FLOOR SYSTEM
BONO BEAM STEEL REINFOq�E
SHEATNING
FRAME RND FLRSHING
� 'TNING - IN OUT
iTER, BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. AN� A.C., FINAL
PIUMBING. FINAL AND G�5 TEST
' ELECTRIC,FIN�L /
BUILOING,fINAL
DATE 10-28-76
BUILDING PERMIT N0.
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
UI�DING �3 � A�AL� a �� .
tORESS
OWNER
MAIL
ADDRE
CITY
BRANC
ADDRESS
ARCHITECT
ADDRESS //l
CONTRACTOR
ADOflESS /H
CITY � /
STATE ; �
U0. NO.
siz� 6'4
OF LOT
USE OF
E%ISTING BLDG.
SIZ� OF fC
NEW BLOG.
EMEF710P W LI
COVERING
UB80F BUILD
A.P. NO.
BUIIOING
ADDRESS
//IJD C..AL/ . /I32IV OWNER
�/li �JU. NiL. NpL�7�lyGi
FIRE
Wr�sN�a��✓�. �: l�.:.5 ZONE
ew,N� So. La���� ByPROV
k ���
No`9f'6-��i
CITV �w/
LIC. NO.
INO.OF BLDGS. /
NOW ON LOT
OS NO.OF
ROOMS STOF
%�� r COVOERIN�Ga,�SN/A
AND W RK TO BE PERFORMED
/
I heleby acknowledge that I have reatl this application and state
that tha above information is correct antl a8ree to comply with
all laws regulating building construction, antl I shell not employ
any Person in violation of the workman's compensation laws of
the Siate of Califomie.
I hereby ce�tity that I am properly licensetl as a convactor under
ihe 5tate of California Businass antl Professions Cotle, Divisicn 3,
Chapter 9, antl thai su �icanses are in full forca antl etfec[, or I
am exampt tron [h visions of t eState ot Calif nia Business
antl Professions Cn< , viston 3, pter 9
SignOiure f
Pe�mittee
Authorizetl ABent
TION FOR BUILDING PERMIT
. DATE RECEIVED nnre �ccir
1 NO.OF
PLANS
VARDSAPPROVE
MAIN BUILDING
ROM GL STREET)
DI5TANCE
MAIN BLIX
VAR. #
C.U.P. #
APPROVE�
THEAMOUNTSHOWN
THE PURP�E OF ESTAF
VALUATION
wl/I PE
���D�"�
PL
VALUE
VAflDS APPPOVED
CCESSORV BUILDI
FT
&
PPROVED _ — 1
'v
iP'� C�
� m��
b
O�
DER VA�UATION IS FOR � /
i1NG A PERMIT FEE ONLV: ¢%' J
T FEE $ � �
� ]
m
CHECK $ E
/'P ov_ °
TOTAL FEE
:�
.'
TRACT N0. � V �/' •
LOT N0. r{ �
ADDRESS��
CIT_ �P COSTA MESA REQUEST FOR OCCU; ,CY
DATE � /� /' � b
The developer of the above entitled tract deaires to sell the above set
forth Lot prior to the time that the tract has been completed and its streets
accepted by the C1ty of Costa Mesa.
The undersigned, by executing this agreemen:, acknowledgea that
(he-ehe-they)_� V (was or were) �GG�P�t..2� advised that this tract has
not been given final inepection nor has it been accepted by the City of Costa Mesa
ae having complied with the conditions of approval which were impoaed by the City
at the time the final tract map was approved.
The City asstunea 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 hasmless from
any claim resulting in damage or pereonal injury to the undersigned by reason
of the aforementioned uncompleted condition.
RECEIVED
CITY OF C05TA MESA
pr ryrur.�� ncpr.
JAN 29 1975
� �
7�8�9iJ0illi12�1 i2i3i4i5i6
!
BY `•��' � /R��X — i
Purch er
--,C _� /
/,,� ---�/--'- �
BY �l .�_����-i:�� .`jl�%c ,2��i' l'
Developer and/or authorized
representacive
BY �
�',r.�-��<<� ;r �l.t�,.,
Lender
u
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i
CITY OF COSTA MESA
CALIFORNIA 92626 P.O. BOX 1200
FROM THE OFFICE OF THE PLANNING DEPARTMENT
July 14, 1972
To: Building Department
The City of Costa Mesa wishes to advise you that in revising street
addresses, the £ollowing addresses have been changed:
Tract Lot
7557 ": 25'-
" P6
" 27
" 66
" 65
" 29
Old Address
909 Azalea Drive
911
915
908
912
923 *Sales office*
New Address
926�Azalea Drive.
928�
930�
925�
931�
934
For your convenience we are listing the agencies below that we have
notified of the change. In addition to those listed, you are advised to
notify your correspondents of the change in order to avoid any possible
interruptdon of mail service.
Your cooperation in this matter is appreciated,
Very truly yours,
W. L. Dunn
Director of Planning
cc: Board of Equalization
Orange County Tax Assessor
Pacific Telephone
Southern California Edison Company
Southern Counties Gas Company
United States Post Office
Bond Department
Building Safety Department
Communications
Costa Mesa County Water District
Engineering Department
Fire Department
License Department
Police Department
ar
Street Department
File