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HomeMy WebLinkAbout1114 RIDGECREST CIR - Building Permits CITY OF COSTA MESA BUILDING DIVISION >• ' ,r a DEVELOPMENT SEF*ICES DEPARTMENT PERMIT NUMBER PERMIT 05-01736 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.rBIILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1114 RIDGECREST CI Status: ISSUED Suite: Applied: 09/30/2005 Vicinity: ROOF Issued: 09/30/2005 Primary Occ: R3 Type of Construction: V-N • Parcel Number: 42203128 Zoning: Applicant: CARSTENSEN, OWNE Address: 960 ENTERPRISE ,{ ---Phone: 714-637-1530 ISSUED BY: (C/�LC ORANGE,CAn'Zip 92867 ° Owner SCOTT!, KAREN F a> Address 1114 RIDGECREST CIR COSTA MESA,CA - - Zip: 92627-3977 - _ Contractor T AND &ROOF REMOVAL Address: 960 ENTERPRISE- Phone: 714-637-1530 ORANGE,CA Zip: 92867 " - License: 657689 Arch - Eng: Address: Address: Phone: - -Phone • License: SCOPE OF PERMIT ai ;T/O EXISTING PLYWOOD SHEATHING,INSTALL NEW SHEATHING AND REROOF W/TIMBERLINE 30 YEAR SHINGLES ON HOUSE AND •GARAGE,APPROX:ITSOUARES. - - - FEE SU L MAR"?'` Plan Check: ' $0.00 CalcsValuation. _• $5,096.74 Permit .r ;$125.25 - _ .- • Claim Valuation $5,096.74, SMIP W, ` $0.51 SMIP Com $0.00, • e,r Other $0 00 `= Inspection:- $0:00 • Total $125.76 PLANNING &ZONING SETBACKS • MAIN STRUCTURE.Front 0-0 Rear 0 0 - Lek. 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, 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 2446-46(6/00) DECLARATIONS 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 Fork 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 iccrled. My workers'comps tion surance yarrier an alloy number are: �Camer. \L� Policy,Numei:-bP7C)O/.'?(G— O(O O $ (This section need not b completed if the permit is fund et one hundred dollars($100)or less.) ❑ I codify 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 alifomia,and agr=' that if I�Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these ions. Appecant'Slpnature: P DO S / 1 - or, caitige J O ©-S_ WARNING:FAILURE TO SECURE WO-; 'S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100.000),IN rn ON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F 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.Lic.M �p Class it C -,7 Contractofs'Slgnaturei 3. o c (1/ld"• • .v Date: r-,.-7(0 -QJ' q _ L' uj- CONSTRUCTION LENDING AGEN ❑ 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,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.). • O 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 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: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: 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 death 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,false qµ'?., .5emolition 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). r-;�-w' O As owner-builder, I will not employ anyone to do work wh ould regiyre 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: l: t'f, 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 PI e ency response to release or threatened release of a hazardous material? 0 Yes 0 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? 0 Yes 0 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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes 0 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? 0 Yes 0 No (If'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 Duality 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 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-descririribeeddd prroperty for inspeecvTtiG�odn purposes..7t agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Date q�CJr}'o' - gn(_e/f/1f LeA livnej)sem 9 '9d— (AndOOr Authorized Applicant Oate` 1 CODE t INSPECBOH TYP CAT& INRML$ CODES JNSPECTION TYPE QAg 1MIRAL$ 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 Building/Occupancy 9 CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. 89/5 DATE 47/2 7/7 7 IAT NO. / / • ADDRESS /771/ Pj ccc€6rr exece; • The developer of the above entitled tract desires tosell the above set forth lot prior.% to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. • The undersigned,1by executing this agreement, acknowledges that / (he-she-they) �/ j (was or were) 11-A-14-i— 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. BY f' / 113P_u/rchaser dj • EYE%'% iy? Develop.,r and/or authorize rep ea *ive 1 ,y BY , :' Lender r , ; ., . . "'4726,. . \PR 16-76E;F:00 87;' 52.81 t i:hu;} COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only _ - I :Y DATE RECEI ED - DATE ISSUED BUILDING IIIT R����n r 0'- . ,� ."�r .'� p-it- - ADDRESS _ _, PERMITMA " OWNER ,t�a) 'EI«L.°- Aar? , A.P. NO - - I. ((��EE MAIL �" 111+7T� e. BUILDING ADDR ESSISS �_. , ADDRESS • , T . CITY( -Q �367 NEC 2.•4240 TR ACTRCh LOT I• BLOCK CONSTRUCTION //, ' NEW ADD ALTER REPAIR MOVING DFMOLISH LENDER `� • BRANCH • /x` OWNER ADDRESS /�./�/�� ARCHITECT /1 /4/ A T _�t2S USE A,.W ' te,raWfia 4OR ENGINEER J./f"L�{ N 7� '' -' ` x FIRE 64`/r `i ADDRESS _ /�/ .,r� ////_�++ /� // ZONE TYPE �/ ^'J !'YItY4 r /��G � APPROVED • CONTRALTO r• BY DATE ADDRESS/8a// / O E�1�//� NO.OF USE OF NEW // CIT AN/4 NEO 2-ejZ,c, 1„/(- PLANS BUILDINrE15 ^9� Pr E• STATE i CITY YARDS APPROVED YARDS APPROVED (/ LIC.NO. LIC.NO. BUILDING ACCESSORY BUILDING I (FROM C/LS r T) W SIZE NO.OF BLOCS. . O 0F LOT NOW ON LOT RONT JuD FT. USE OF ug EXISTING BLDG. a SIDE FT. FT. V) / HSeparate permits are required for L.SIDE FC- Uq fi ..1 , welectric,plumbing and heating work. REAR /J FQT. f FT. [.y USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET.EBET.MAIN& O MAIN BLDGS. /1 �J�/ACCESS. BLOCS.OC `/.���1 DATE ..#1:-1 /�X& LL/1,24 / TYCO 20'-a CA Q.,. COVARP#TlAl /S/D APROVED/SLS �///J APPROVED/•/� r�P� DATE eCCJ-7Z 0 �W W ® • . , . �� - O I hereby acknowledge that I have read this application and state N that the above Information is correct and agree to comply withn Cl.. F all laws regulating building construction, and I shall not employ HOLD L/R SPE-IAL Rtt2LllcEMENTS ' m Z any person in violation of the workman's compensation laws of m 14 the State of California. /��'Y T • 3 I hereby certify that I am properly licensed as a contractor under /����"'SO. FT. �J T/'7� N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o / Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VA ENATION �,`�v - < • and Professions Code, Division 3,Chapter 9 / PERMIT FEE $ (gyp v, �.6 agar n y, / 1 t/11 " PLAN CHECK. $ �A �� o ' Signature of 'n ' r�)�^/ / •� p.l�_ Permittee el.C/�t -, 'j.fere �O $ I y ((/ TAX S u. T • U Authorized Agent 1 TOTAL PAID $ zs a./ i PAIu 4b1 Z1, WI. zR-76�Msn003291 d***160.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 / • A TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only J►LJ /'� s� C Q RE E V DATE RECEIVEDe DATE ISSUED BUILDINGDREin * 'Rt D& ~�OC ST C g _ ADDRESS t\ 4. PERMIT NO. OWNER A.P. NO. MAIL BUILDING U 14 R�rx- lae�5r . ADDRESS ADDRESS TEL. TRACT LOT BLOCK CITY NO. CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DEMOLISH LENDER ` 4 BRANCH OWNER ADDRESS /� ARCHITECT TEL. USERES w��'lo•tt•—y VALUE T$ OR ENGINEER N . FIRE ADDRESS ZONE TYPEjr" GROUJ APPROVED CONTRACTOR BY DATE ADDRESS . TEL. ZONE INO.OF USE OF NEW PLANS BUILDING CITY NO. rte. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING CR SIZE NO.OF BLDGS. (FROM C/L STREET) C B. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF tn i—iEXISTING BLDG. R.SIDE FT. FT. to I—. • Separate permits are required for L.SIDE. FT: FT. electric,plumbing and heating work. • WREAR FT. FT. (..i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& -< MAIN BLDGS. ACCESS. BLOGS. lin VAR.# DATE C.U.P.# APPROVED a — APPROVED >. _BV OATF •a w B. I hereby acknowledge that I have read this application and state us N N 12 that the above information is correct and agree to'comply with m B. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of m r4 the State of California.I m I hereby certify that I am properly licensed as a contractor under SQ. FT. — iv the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapt • er 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY am exempt from the provisions of the State of California Business ��i o VALUATION PERMIT FEE $ and Professions Code,Division 3,Chapter 9. lop, n PLAN CHECK $ rn Signature of l LL Permittee• $ / t�7/r�/ TAX $ U. 6c...1 - G Authorized Agent _............r...... TOTAL PAID $