HomeMy WebLinkAbout958 GOLDENROD DR - Building Permits� �,
(7ta) �54-5273 • Fax pta) 75a-aess • www.ci.costa-mesa.��LDING PERMIT �� rnin unrve, wa iM mta,v, �r, acom
JobAddress: 958 GOLDENRODDR
Suite:
Vicinity: HOUSE & AT7ACHED GARAGE
Parce� Number: 41217328
Applicant: GUZMAN, YVONNE
Address: 958 GOLDENROD DR
COSTA MESA,CA
owner: GUZMAN, GEORGE
Address 958 GOLDENROD DR
COSTA MESq, CA
Contrector: O W N E R-B U I L D E R
Address:
Arch :
Address:
Zip:
Phone:
Zoning: R1 Rl
Phone: (714)979-4948
Zip: 92626
Phone: (714) 979-4948
Zip: 92626
Phone:
License: 0
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 09/29I2000
Issued: 09/29/2000
Phone:
Zip: � License: License:
SCOPE OF PERMIT
REROOF EXISTING SINQLE FAMILY RESIDENCE & ATTACHED�GARAGE (28 SQ). TEAR OFF EXISTING ROOFING 8
RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 1 LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH 40 YEAR
COMPOSITION SHINGLES.
Plan Check: $0.00
Permit: $9725
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Existin : p
NOTES:
Rear 0-0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
sa,000.00
sa,000.00
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes antl related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become voitl if work is not commenced within 180 days, or it work is suspended or abandoned
tor 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 Inspeetions and final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
244&bfi (B/00)
WORKERS'COMPENSATON DECLARATON:
I hereby affirm untler penalty of peryury one of the following tleclarations:
❑ I have entl wlll malntain a Cenificate oi consent to self-Insure br workers' compensation, es provitletl for by section 3700 of the Lebor Code, for the pertormence of ihe
work lor which this permii is issued.
❑ I have antl wlll meintain wofkers' compensatlon Insurenca, as required �y section 3700 0� Ne Labor CoOe, for Ihe pertormance ot the work for which this Dertnit Is issued.
My workers' compensation Insurance carner antl poliq number are:
Cartier: Polity Number:
(This section need no( be crompla�ed i! Ne permif is va/ued et one hunOred dollars ($100) oi less.)
❑ I certity t�at In Ihe pertortn5nce of Ihe work for which this pertnit is issuetl, I shall not employ eny person in any menner so as to become sublect to the workers'
compensation laws of California, entl agrae that II I should Eecome subject to the workers' compensation provisions of Section 3700 0l Ihe Le6or Cotle, I shall torthwith
comply with ihese provisio�s.
Applirent SignaNre: Date:
WARNING: FAILURE TO SECURE WO�ERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIhllNAL PENALTIES AND dVl� FlNES lIP TOONE HUNDRED
T/qUSAND OOLLARE �E100.000), IN MDRION TO THE COST OF COMPENSATION, DAh41GE5 AS PROVIDED FOR IN SECTION 3]O60P TNE LABOR CODE, IMEREST, PND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLAFATION:
I hereby ettirm that I em licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Pmfessions Code, antl my license is in full
torce end eMect. Lic, a Class a
Contractors Signe�ure: Date:
CONSTPUC710N LENDING AGENCY:
❑ I hereby aHirtn t�at ihere is a constmction lendinq agency for ihe performance of the work tor which this permit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lendefs Atltlress:
Signa�ure: Date:
OWNER-BUILDER DECLARATI�NS:
I hereby aHirm thel under penalry of perjury tha� I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for tha following reason (Sec. 7031.5, Business entl Protessions
Code: Any city or counry which raquires a permit to constmCt, eltar, improve, demolish, or repair eny sirucwre, prior to its issuance, also requires the applicant tor such permit
10 flle e signed stetement that he o� she Is licensed pursuent to �he provisions of the Contrectors License Lew (Chapter 9(commencing wlih Sectlon 7000) ot Division 3 ot t�e
Business and Pmfessions Code) or that he or she is exempt therefrom and tha �asis for the ellegea exemption. Any violetion of Sectlon 7031.5 by eny epplicant tor a pertnit
subjects tha applicant to a civit p�nally of not more ihan five hundred tlollars (5500).):
�I, as owner o� the properry, or my employees with weges as their sole compensation, WILL DO TME WORK, entl the siructure is not intendetl or oNered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properry who 6uilds or improves t�ereon, antl who doas such work
himself or herself or thwugP �is or her own employees, provided Ihat such improvements are not iniended or oflered for sale. If, however, ihe builtling or improvemen� is
soltl within ona year of completion, Ihe owner-builder will have ihe burden ol proving ihe� ho or she did no� build or improve For purpose ol sale.).
� 1, es ownor ol ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe prolect (Sec. 70dd, Business antl Protessions
Cotle: TTe conirettor5 LicenSe Lew does not epply to an owner ot pmperty who huiltls or impmves Ihereon, anA who conlracis br such projeci wit� a conlracior(s)
license pursuant to ihe Cont�actors License Lews.).
Business antl Professions Code for this reason:
.Signewre:— �/•W t�. i Rcr.....
Owner ID ve fietl by tlrivers license. ❑ Yes No rDtivefs Cicense'No: _
Venfication of Ownership by (type of tlocument, I.e. - property tex �III or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTiFICATION:
❑ I hereby certily t�a� no exc2�ation five (5) or more leet in Oepth into which a person is requlred to descend, will be made in connection with work euthonzed by Ihis
permil, and that no building s�maure, scaHolding, lalsework, or demolition or Aismantling thereol, will be more �han ihirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Titla 8, Celifomia Atlministrative Cotle).
❑ As owneo-huiltler, I will not employ anyone to do work which would require e permit from Ne Division of Industnal Satery, as noted ebove, unless suc� person has e
permit �o do such work fmm ihe division. .
SignaWre: _ Date:
Division of Intlustrial Sefery Permit Number:
CERTIFlCA7E OF COMPLIANCE NdD AUfHORIIATON OF EMAV: I certify under penalry of perjury that I �ave read this application and state that the intormation 9iven is
wrrect. I agree to comply with all stete laws entl ciry ortlinences ralating to building consiruction, antl authonze representaWes ot Ihe Ciry oi Costa Mesa to en[er upon ihe
aDove-described pr rry fa inspeaion purposes. l�\ag�re�e nol to occuDY o� allow occupancy of eny huiltling auttwdzad by this pertn�it yunG inal in �ection.
\ //(f�l'?1/t�/ � �-Y./.cjllGc�- / -�'%�3OT!7�
Signature OI Legal Own -- - Date ��-" -
' �-_-�,..,_" _ _ - - - -
AnN�r Authorizetl Applicent Date
COOE �. INSPECTION TYVE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Ra-Raoi
207 FInaI BIocWRetaining Well
202 Final Fatiory Fire Place
203 FinalSign
204 Final Demolilion
PA7E Iti�LALi
COOE 1 INSGECTION TYPE
206 Final MeChanical
208 Final Plumbing
210 Finel Elecirical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final BuiltlinyOccupancy
� �
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(7�a) �54-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT �� FAIH UHIVt, GUS I A MhSA, l:A tlL6Z6
JobAddress: 958 GOLDENROD DR
Suite:
Vicinity:
Parcel Number: 41217328
Applicant: GUZMAN, YVONNE
Address:
owner: GUZMAN, GEORGE
Address 958 GOLDENROD DR
COSTA MESA, CA
Contractor:
Address:
Zip:
Arch :
Address:
Zoning: R1 R1
Phone: 714-979�948
Zip:
Phone:
Zip: 92626
Phone:
License:
Eng:
Address:
ISSUED BY:
Status: ISSUED '
Applied: 10/09I2000
Issued: 10/09/2000
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
INSTALL SKYLIGHT ABOVE THE DINING ROOM/ENTRANCE AREA ICBO 3933.
Plan Check: $15.28
Permit: $23.50
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $39.28
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Ezistinq: o
NOTES:
Rear 0- 0
Rear 0-0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Lek 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0-0
Right 0- 0
stso.00
S75o.o0
NO710E: The work authorizetl by this permit shall comply with all applicable hantlicap 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 il work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order for ihe work authorized under �his permit to be considered legal, such work must comply with all applicabla codes, antl all
required Inapeetiona and (inal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
�aawe (aroo�
WORKERS' COMFcNSATICA DECLARATION: i
I hereby attirm under penalry of perjury one ot Ihe lollowing dedara�ions:
❑ I have and will maintain a certificete of consent to self-Insure lor workere' wmpensetion, es provided for by section 3700 of t�e Labor Code, for the peAortnance oi the
work for which Ihis permit Is issuetl.
0 I hava ana wlll maintain workero' compenutlon insurance, as requiretl by secGon 3700 of Ne Lebor Code, for the peAormance of ihe work tor which this pertnit is issuetl.
My workers' compensation Insuranca wrrier and policy number ere:
Carrier. Policy Numbec
(This sectian need not be comp/efed i! the permiNs va/uetl af one hundred dollars (S 100J or less.)
❑ I certify that in ihe peAortnence of the work for which �his pertnit is issued, I shell not employ any person in eny manner so as to become subject to the workers'
compansetion lews ot Calllomla, end agree thet if I should becoma subject to ihe workers' compensation pmvisions of Section 370 of � Labor Code, I shall tort�with
c ply with ihese provisions.
�A an em7.� Data:
RNWG FAILURE TO SECURE WORNERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAL PE TIES ANO CIVIL FlNES UP TOIXJE HUNDRED
THOUSANO OOLL4RE (E100,000), IN F�DRION TO THE CQST OF COMPENSATION, DNMAGES AS PPOVIDED FOR IN SECTION 3]O60F THE LABOR CO�E, INrEREST, AN� ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Ihat I am li ensed under provisions of Chepter 9(commencing with Section 7000) of Division 3 of ihe Business and Professlons Code, and my license Is in full
f�prce eHect. Lic. N Class a
nt�c - � i re:1 . Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm that there is a construction lentling egency tor Ihe pedormance ot the work for which ihis permit Is issued. (Sec. 3097, Civil Code).
Lentler'S Neme: Lender's Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby attirm ihat under penalty ot parjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Protessions
Code: Any city or county which requires a permit to consiruct, alter, improve, damolish, or repair any stmcWro, prior to its issuance, also requires Ihe applicant for such permit
to tile a signed statement that he or she is licensad pursuant to the pmvisions ot the Contractors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of the
Business and Professions Cotle) or that he or she is exempt iherefrom antl Ihe basis for the alleged ezemption. Any violation of Seclion 7031.5 by any appliwnt for a permii
subjects the applicam to a civil penalty of not more than five �untlred dollars ($500).):
❑ I, as owner of the property, or my employees with wages es iheir sola compensetion, WILL DO THE WORK, and the structure is not intentletl or oHered for sale (Sec.
7044, Business and Professions Code: The Contractors License Lew does no� apply �o an owner of property who builds or improves ihereon, antl who does such work
himself or herself or through his or her own employees, provided that such improvements ere noI intentled or oNered tor sale. If, however, the buildinq or improvement is
sold within one year of completion, the owneo-builder will �ave iha Durden of proving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTOfiS to constmct the project (Sec. 7044, Business an0 Professions
Code: The coniracior License Law tloes not apply to an owner ot pmperty who builds or improves ihereon, antl who contracis for such project with a contractor(s)
license pursuant to tFj� Con�ractors License laws.).
I am exempt
Vediication of
Busineu antl Professions Code for this reason:
�/� - � _2�j7iJd T Date:
license. ❑ Y ❑ No Driver's License No. xpires:
by (rype oi document, i.e. - pmperty tax bill or deetl):
DIVISION OF INDUSTqIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity tha� no excavation fiva (5) or more feet In depth into which a person is required to tlescand, will be made in connection with work au�horized by Ihis
permit, antl thal no builtling siruciure, swfloltling, falsework, or demolition or dismantling Ihereoi, will be more �han thirty-six (36) teet high. (Chap. 32, Grp 2, Atl 2, Sec.
341, Title e, Califomia Atlministrative Code).
❑ As owneo-builtler, I will noi employ anyone to tlo work which would require a permit irom ihe Division of Industrial Sefery, es noted ebove, unless suc� parson has e
permit b tlo such work from the division.
Signature: Dare:
Division of Indusinal Sefety Permit Number:
CERTFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTAV: I cehify under penalty ot perjury �ha� I have reatl this application and state that Ihe information given is
correct. I egrae to omply with ell state laws entl ciry or Inances relating to building wnstruc�ion, and authorize representatives of the City ot Casta Mesa to emer upon tha
ebove-described ropetly for inspectio purpases. I a�re not to occupy or ellow occupancy of eny building authorized by ihis permit umil final inspection.
� 1� ��. �
`Slgnatu�eY6 egal Owner s) � �� �a�
\
� Or AaN 'z d_Aodica t J � te
CO�E �. INSVECTIONTYPE
7616 Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
�g ��
!D__-�-o�
CQOE� INSVECTIONTYGE Q�jF ��
206 Final Mechanical
20B Finel Plumbing
210
212
220
203 Final Sign 222
204 FinalOemolition 250
Finel Electrical
Finel Flre Prevenlion
Finel Planning Approval
Finel Slte
Finel Builaing/Occupency
OWNER
ROIIGH PLUMBING
PROP. SWR. LINE
MISCELLANEOUS
ROUGX NEATING AND AIFi CONDITIONING
UN�ERGROUN� U POWER U
flOUGX WIRING
TRENCXES FORMS STEEL REINF.
FLOOH SVSTEM
BOND BEAM � STEEL REINFORCE ❑
SHEATHING
FRAME ANO FLASHING
PLASTER, B
STr 7RAI
HEr ., VI
BUIL�ING, FINAI
DATE
Drive BUILDING P
SUBCONTRACTOR
••
,
"�'' "' 36413
401 ACOSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
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OWNER Larwin Southern California
ADDRESS 16255 Ventura Blvd.
cirv Encino, California No� 986-8
CONSTRUCTION
IENDER Larwin Southern California
BFANCH 16255 Ventura BZvd.
ADDRESS Encino, California
ARCHITECT _ , _ _ .. _ TEL.�_, -
CONTRAGTOR ��in Southern California
ADDRESS 16255 Ventura Blvd,
TEL.
cirv Encino, California No. 986-8890
uc No. 1913ll uc�No. B-1
OF l0T 63 X 96 I NOW ON LO �
USE OF
EXISTING BLDG.
SIZE OF NO. OF
NEW BLDG. I.7S�F ROOMS STORIES 1
EXTERIOR WALL ROOF
COVERING StllCCO COVEPING w00C1 shingle
USE OF BUIIDING AND WORK TO BE PERFORME�
1 hereby acknowletlge that I hava reatl this application and sta[e
that the ebOva info�mation is correct and apree to comply with
all laws reBuleting builtlinp consSruction, antl I shall not employ
eny Derwn in violatlon of tha workman's compensaSion laws of
[he State af Celifornia.
1 hereby certHy [hat I am properly licensetl es e wntrector untler
the Stem ot Celifomia Business antl Professions Cotle, Division 3,
Chaptar 9, end thet such licenses are in tull force and effact, or I
am exempt from the provlsions of the Staie ot California Business
entl Protassio/ns C�/Q a, Division 3, Ghapter 9.
Sipnecura pl'` /� __ ,,,�� �/
Authorizetl
�-�s 11-7�P�'-�on �2n:: :: ^
�,: � ��� 14?..�s8
APPLICATION FOR BUILDING PERMIT
:EIVED BV DATE RECEIVED �.�rc �cen�
BUILDING
ADDRESS 9�� (
TRACT]SS%-B
a LA,Cu���✓
f%ES crJ/
FIRE
20NE
APPROVED
ZONE NO.OF
]Z- / a�a.r�s 2
YARDS APPROVED
MAIN BUILOING
(FROM GLSTREET)
VAR. #
C.U.P.�I
THEAMOUNT
THE PUFiPOSE C
VALUATION
q 26,900
[/ci-r«l/ �L..
.OT ]9 BLOCK
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DATE '��0���
E OF NEW,rF E.j �*
L�ING�� �A�
VAFDS APPqOVED
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VNOER VALUATION IS FOR �
LISHING A PERMIT FEE ONLV: ¢
RMIT FEE s 94.00 �
4N CHECK $ 4�.00 E
`o
141.00 "
TAL FEE $
�_ �Il �.'7 r ; � 1�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ [o Fill in Completely — Use Ink Only
BUILOING [ 1rj �n�✓�
ADDRESS UJ GOI.C�WAJPL R
OWNER . � �rNDl:l �
MAIL r. _.w _ ,_
CITY (_�yp�
CANSTfiUCTION
BRANCH
AODRESS
ARCHITECT /�!� r
!1R FNGINFFF L r.•Y`C
ADDRESS �LGL�C. �v'
CITV �,II�C�A.i �J�4�•:
STATE
uc. No. 1�� LZ3
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USE OF
TEL.
NO.
TEL. `�
NO.• �
CITV
UC. NO.
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INO.OF BLDGS.
NOW ON LOT
Separate permits are required Cor
electric, plumbing and heating work.
�—�UV ..�
I hareby acknowladpe that I heve reetl this eppllcaiion end rtete
thet the abova informatlan la corract antl agree to comply with
all lews reg�leNnp builtling construction, ontl I shali not employ
any person In violetion of the workmon's campensation laws of
the State ot Californie.
i hereby certify that I am properly Iicanse as a contracmr ntler
tha Staie of Celifornie Busl�ess entl Prof lons Cotle, Dlvi on 3,
Chapter 9, antl that �ych Itenses ere in ull force antl�eif t, or 1
am exempt from the {�ro Iiions of the ate of California sinesz
entl Profesztons Co Di iaton 3, ap er 9.
5�9118t11fBOf //� ///A.V_ . "{".'/��
Parmittae ��` �
Authorizetl Agent
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APPUCATION
RECEIVED 8V
A.P.NO. /�2' l�3 �
BUILDING �`/� /�/���
ADORESS .,7 tY �
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APPROVED
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VAWE i _.K _
ZON{� NO.OF USE OF NEW /�ip � E
/��I PlANS � BUILDING f�� �
VARDSAPPROVED VARDSAPPROVED
MAIN BUILDING ACCESSORY BUILDING
(FROMGLSTREET) �� 1jif�
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� �.
F . FT.
L SIDE FT. � FT.
REAR FT. S FT. �
DISTANCE BEf. BEf. MAIN &
MAIN BlDGS. ACC6S. BLDGS.
VAR, q1�' DATE
C.U.P. �
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TME AMOUD
THE PURPOSF
VALVATION
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e
PERMIT FEE $ � a
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PLAN CHECK E ^
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TOTALPAID $ .
• �� � �.GtvUCtt� KGLV
JOB ApDRESS 958 Golde
GENERAL CONTRACTOR B1
q�^b. 412-173-28 LOT
=CTIONS
ol LOcation
� orms
ain Drain
Steel Reinforce
�'Elec. Bond
Approval to Cover
Underground Elecvic _
Gas Piping Test
Filtering SYstem Lines _
Backwash Lines and Recep.
Electrical Final
Heater and Vent Final _
F System Final
Backwash and Recep. Final
Fencing Final
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SUYCQNTRACTOR
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CITY OF COSTA MESA
PLANNING DEPT.
QEUBIECT TO BLDG. DEP7. REG.
�d/C ��, �'/y �����
BY..l�3�.� DATE��_. � 9
OIRECfOR OA PLANNINO
�'r�2�Nc.
STRUCTURAL APPROVAL OP
SEPARATE PERMITS ARE REQU
FOR cLFC7RfC�aT�LAIINGg f'�
N,.�.Ti,.a�
REFRIGEitAT;Q•"J WORK
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