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Home My WebLink About338 REIMS LN - Building Permits:� . .va CITY OF COSTA MESA � avao�Na o�v�s�oN ' � � � DEVELOPMENT SERVICES DEPARTMENT � - B9S-O'IO6Z •4 � � PERMIT PERMIT NUMBER `�+aienP (714) 754-5273 • Fax (714) 754•4856 gUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite: Vicinity: 338 REIMS LN Parcel Nunmber: 43914116 Applicant: DUKE HANSEN Address: Zoning: Phone: Status: ISSUED Applied: O6/17/1998 Issued: O6/17/1998 ION: This permit shall aulomatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned d of 180 days. ' ' � ONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all iepectlons and nnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. iCTIONS CALL: (714) 7545828 � � � � � � � WORKERS'COMPENSATON DECLARATION: ' � I here6y eHirm under penalry of pe�ury one of Ihe tdlowing declaretlons: :: � � ' � ❑ I heve entl will meintaln e certifcate of consent to self-Insura for workers' wmpensetbn, es provided for Cy sectlon 3700 ai t�e Lebor Cotle, for the pertortnence of t�e work for whlch this permit Is Issuetl. � I heve antl wN �maintein wwkers' compensetlon insurence, es requlred by section 3700 of Ne Lebor Catle, tor Me pertormance ol ttie work fp which ihis parmit fs issuetl. My workers' wmpe�etlo jsurance certler end polity number ere: Cerr�er. .si /� Ly� /- i l/✓0 � Pdiq Number. �`f b- P�- V�a 63oZ � (T}rls sectlon neeC not be �p/efed ll fhe peimlt !s valued af one hundred dollars ($100) or less.) ❑ I ceNry Uat in the pertortnence of the work for which ihis permit is issueq I shell not employ any person in eny menner ao es to Decome subject to t�e workers' wmpensation laws of elifomle, and egree that if I should becrome sub�ect to ihe workers' campensetlon proNsions of Secllon 3700 ot the LeDor Code, I shell forthwith compty with these pr 'ons. / ./ � �Applicent Signeture: � �GK----�'— Dete: F� — / %' /�D WARNINO: FNLURE TO SEWRE WOHKE0.S' COMPENSATION WVEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYEP TO CRIMINAL PENALTIES ANO CML FINES UP TO ONE HUNDRED TlqUSAND DOLLARE (5100.000). IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMFOES PS PROVIDED FOR IN SECf10N 3]OB OF THE LABOR CODE, INTEREST, M1D ATTORNE`f5 FEES. � LICENSED CONTRAGTORS DECLARATtON: I hereby aKrtn thet I em licensed under proNsians o1 Chapter 9(commancing wlth Section j,900) of Division 3 of the Busine end Profe�s5ions Code, end my Ilcensa is in full force anC effect LJc. M 2 d Z— (/ Cless q �" .3 i Contrectars Signeture: � � /4...�� Date: � — / 7— �O CONSTPUCTION LENDING AGENCY: ❑ I hereby effirtn that Ihere is e construction lending agenq for the pertortnance oi the work for which thls pertnit Is issued. (Sec. 3097, Civil Code). Lenders Neme: Lenders Address: � �� Signeture: Dete: OWNER-BUILDER DECLARA710N3: � I hereDy aifirm thet under penelry o1 pehury ihet I em EXEMPT FROM THE CONTiiACTORS LICENSE LAW far ihe following reason (Sec. 7031.5, Business and Professions Cade: My ciry or counryw�ich raqulres e pertnit to construct, elter, improve, demollsh, ar repalr eny atructure, prior to Its issuarke, elso requires the epplicant for such permit to Tile e signetl stetement that he or she is Iicensed pursuant to the pravisions of the Contrectors License Lew (Chepter 9(commencing with Seclion 7000) of DiWsion 3 oi the Business end Professions Code) or ihat he or she is eaempt iherefrom end Ihe besis for the elleged exemptlon. Any vidation of Secllon 7031.5 by eny epplicant tor a permit subJecLv Ihe epplicant to e civll penalry of not more Man flve hundred dollers ($500).): ❑ I, es owner af the properry, or my employeas with weges es their sole campensation, WILL DO THE WORK, and the siructure is not intentletl or otfered for sale (Sec. 7044, Business entl Professions Code: The Contrectors License Lew does not appty to an owner at praperry w�o bullds ar Imprrnes thareon, and w�o tloes such work hlmself or herselt ar ihrough hls or her own employees, pmvitled thet such improvemen(s ere rwt intentled or oflered tor sela. If, havever, the bullding or improvement Is sdE within one year of completlon, ihe owner-builder wlll have ihe burden of proving that he or she tlitl not bulld or Improve tor purpose of sele.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTINO WfTH LICENSED CON7fiACTORS to consirud the project (Sec. 7044, Buslness enA Protessions Code: The contractors Llcense Lew does nat appty to en owner af properry who bullds or Improves ihereon, end who contrects for such pro�ect with e contrector(s) Ilcense pursuanl to Ihe Contrectars License Lews.). ❑ I em exempt under sec. Business end Profeulons Code tor this reason: Slgnature: - Date: Owner ID vertlied by tlAvefs licensa. ❑ Yes ❑ No Drivers License No. Explres: VeAflcatlon M Ownershlp by (type of tlocument, i.e. - property te�c �ill or deed): ' DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certHy thet no e:cavatlon Me (5) w mare feet in tlepth Into w�ich e person Is requlred to tlascend, wlll be maAe in connecllon wlth work euthorizetl by this pertniL entl that no buildinp strudure, scsMoltling, falsawork, or demolition or tlismentling ihereof, wiA be more t�en iMrty-six (36J feet high. (Chap. 32, Carp 2, Art 2, Sec. 3dt, Title 8, Cfllitomie AtlmlNStreWe Cotle). ❑ As owner-builGer, I will not employ enyone to do work which would require e permit irom Ne Dlvislon of Intlustrial Setety, es noted above, unless such person has a pertni� to do such work from the tliNsion. Signeture: Data: DMsion ot IiWustrial Safery Pertnit Number. MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATON: 1 WIII ihe epplicant or present or tuture bulltling occupent neetl to file end certity a Business Plan for emerpency response to release or threetened release of a �ezardous matedel4 ❑ Ves ❑ No . (Sedion 25505 of Ne Celitornia Health and Safety Code requires, with some exce0��ons, that e Buslness Plan be filetl with ihe Coste Mese Fire Deperiment by every business which has et eny one time during a reported year e quantity of hezerdous metarials equal to or 9reeter ihan e weigM of 500 pounds, or e volume oi 55 gallons, or 200 cubic feet of wmpressed ges et stendard IemperaNre entl pressure). ...................................................................................................................................................................................................................... ................. .................................... 2 Doe9 or vnll [he epplicent or pre5enl or future DUI1Cing occupent nead to file a registre�on form for awtely hezertlou9 me�edals9 ❑ Ves ❑ No (SecUon 25533 ot the Celifomle Healih flnO Sefery Code, with some exceptions, requires registretlon with ihe Coste Mesa Fire Depenment by each huslness which et en� ona Gme has on hend e quantlry oi ecutety hazardous matedels equal to ar greeter thfln e weigM of 500 pounds, ar e volume of 55 gellons, or 200 cublc faet c compressed gas et slantlard tempereture entl pressure). � Does or wi11 Ne appllcant or ❑ Yes ❑ No prepare en Progrem l 01 Ihe Califomla HeaIM entl Sefery CaAe provides thet ihe Costa Mese Fire Department may require t�e preparetion, certlflcetlon end filing wlth t�e Fl an RMPP 6y businesses which ere required to register acutety hezardous matadals with the Fire Daperiment. .............................................................................................................................................................................................................................................. �resentiv reouired, has Section 25534 ot the Celifomia Health end SefeN Code been tully comDlletl withl ❑ Yes ❑ No uoes or win me appucem or presem or �mure ounding accupant reqmre ror me wonc wnicn is tne sub�ect oi hom the South Coast Air �ualiry Management Disttld or from any other eir pollutlon Conirol tlistdcl or egenc (Seclion 850502 of the Calitomia Gwemmen� Code requires thet the requasteC infortnatlon be fumished on .......................................................................................................................................................................... Will any pan of the fadliry to be consiructetl under this pertnit be within 7000 feet hom the outer bountlades � (M yes , ihe facility must meet ihe requirement ot Seciions 25534 and 42303 ot lhe Calilomie Heelt� end Sa ihe stnct or Health i 1peRnit for such conStNctlon of ❑ Na non-residentlal hulltlin9 oertnits). or egency is repulred tar the � en matle7 ❑ Ves ❑ No CERTIFICATE OF COMPLIANCE: I certily thel untlar penalry oi perjury Ihe intormation given ebove is cortect. I egree to campy wlth all stete lews end clry ordin repartling Hazerdous Matenels antl Emissions. Slgnature: Dete: CEHTIFlCATE OF COMPLUWCE AND AUfHORVATION OF ENTHY: I Certify under penalry of perjury tha� I have reed �his appllcation entl s�ete Ihet the Infortnetion � cortect. I egree to compty with all state laws and ciry ordinances relating to huilding wnstruction, end authorize representetives of Ne Clry of Coste Mese lo enter u ebove-0escribed properry for Inspection purposes. I agree not to occupy or allow occupancy of eny building eu��oAzed by ihis pertnit until finel inspeCtion. Signature Of Legal Owner(s) ^-7 Dete � —f �ii�/ !'Z - � � '— � / — � � AnNOr Authorized Applicant Date COOE I. INSVECTON TYPE 1616 Fized System Final Fire Prevention 7268 Pool Spa Fnal 200 � Final Re-Roof 201 Finel8lock/Reteining Well 202 FinefFectory Fire Place 203 Final Sign 204 Final Demoli6on 2d4&<6 7.Y� I`unr.�a !/ SQQE� INSFECTONME 206 Finel Mechanical 20B Final Plumbing 210 Final Electdcal - 212 Final Fre Preventlon 220 Finel Plenning Approvel 222 Final Site 250 Final BuildinglOccupanc �g � OWNEA DOYLE & SHIELDS � 39 Reims House Forms P Co.,Inc. DATE 6-3-63 BUILDING PERMIT NO. SUBCONTRAC'POR tt. asEoS FEE RECEIVED COSTA MESA BUILDING-SAFEfY DEPARTMENT � ��;; 3 i9�3 P. a. B°X 9„ �o�," ^'e6^. °"'-'"'""," .l FINANCE DEPT. For Applicanf ro Fill In Complafely APPLICATKlM ��Y� iY�E$� � TYPE OR PRINT BUILDING . . /� For Offiee Use Only BUILDINO ��J ,� � / � ADDRE53 � ��\ 11QCEII�NO. ��^ COSTA MESA. CALIFORNIA J , /� pE VED DAT6 RFCPIY6/p pATE1S9YE➢ OWNER � /�{/YJ `-O. f�.I�t- � 1 r fi� Q - MAIL ' �j.�J %J� / BU ING {n( / ' ADDRE58n O�7- O. //�/QHG/�e,� fp v AD RE58 '�!l / M. �[J r �- /e TE4?J � ZONE TYPE GROU � CITY r7�%4. PjIY1 l.M/ NO.I ARCHITECT n� TEL.0 -�[. BYPROVBD - DATE ' OR ENGINEER��y C, �ah NO.O 7� f0 �D /� }G /1�/y ZONING ADDRE53 '�r a o Li/L.1 / LV/h Mol� N�/ ZO NO. OF U8E OF N6 ^` ,� �� Purva I auiLOlN CONTRAGTOR J'^ � �'. OE9CP1'TION �0 � � 6 �0. .� y� 3` ADDRESS �^�� 'e-� . CITY v�/�.-I� C ' . . A. P. NO. '� . STATE `S� ��O fJ NO �� GF �V �a 90T TO SIDE 8 REAR pH LN6 SHALL BE LESS TXAN �LI0. NO. �T 9 q EAVES OFLOT �J , Sp •�� ' � I NOW oN WTa.� ALLOWE� (II. B. C. REQUIREMENT) 'YAROSAPPROVED ' YARDSAPPROVED �USEOF MAINBUILDING ACCESSORYBUILOING E%ISTING BLOG. . � (FROMGLSTREET) , BETBACK LIrvEFqOM FROf`IT Ci FT. FT. CENTER OF 6TREg'( �• J� . REAR YARLI SIDEYARDI L6FT �"�� I RIQH�� R.BID6 � F�. F7'. DESCRIPTION OF WORK L. SIDH Ff. FT. REAR NEW ALTERATION ADDITION � �� DISTANCE BET. BET. MAIN @ REPAIR MOVIN6 DEMOLISH MAIN BLDGS. ACCESS.BLDG9. �7 VAR.�j DATE SIZ�E DING 9� �� O RO MS / STORIE9 �'Z" C. U. P. # - APPROVED� / �T EXTERIOR WAl�./ ROOF "�N�L � APPRO S.� �l �-� COVERING �J /(�G� COVERIN6 BY DATE d� U 8U1LDN6ANDWORKT B P RFO MED ' 'j � /� %I � Ci' ' QC � C7a i. h oc�� 3�Y— � /�a y 6a. � .T�a `� " m 1 HEPEBY A<KNOWLfiO6E TXAT I NAVH READ TXI9 APPLICATION ' TXE AMOONT 8 UNDEP VALUAT�ON 19 FOq THE { AND STATE THA7 iH8 ABOYE ID COqq£CT AND AOAEE TD COM• ) P�1RP04B Op 6 6L�6HIN0 A PERMIT FE6 ONLY. � PLY WITH'ALL CITT ORDINANC88 ANU IITAT[ LAWB R80UTATING ypLUATION BUILDIN6CON9TFUCTION. / � h PERMIT FEE $ (p� P RMITTE E�• C �,[[ �2 m S /9 ��7 � PLAN CHEGK $ `+// � 0 AUTHORIZED AGENT �� 1A. � ' . 4 TOTAL FEE / �