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Home My WebLink About233 ROSE LN - Building Permits t1I CITY OF COSTA MESA 4 ► BUILDING DIVISION >N- .,�i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F1 wr... I 1, PERMIT B02-00901 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 233 ROSE LN Status: ISSUED Suite: Applied: 06/20/2002 Vicinity: Issued: 06/20/2002 Parcel Number: 42614123 Zoning: Applicant: CRANK,JIM ISSUED BY: V Address: 126 COMMERCIAL WAY Phone: 949-548-5569 COSTA MESA,CA Zip: 92627 • Owner: BREJTFUS, EDWARD Address 233 ROSE LN Phone: COSTA MESA,CA Zip: 92627 • Contractor: CRANK BROS ROOFING CO INC Address: 126 COMMERCIAL WAY Phone: (949)548-5569 COSTA MESA,CA Zip: 92627 License: 794724 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT RE-ROOF.TEAR OFF. INSTALL NEW 40 YEAR ELK SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,468.00 Permit: $97.25 Claim Valuation: $3,488.00 SMIP Res: $0.50 SMIP Corn: $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 NOTES: • 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(6ro0) 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,.s provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. r have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Dodo,for the performance of the work for which this permit is issued. My workers'compepsation Insurance carrier and policy number are: Cartier: AI Policy Number: (This section need not b: .. fed if the permit is valued et on nd:viers($100)or less.) Eliiti I certify that in the pe nce of the work for which milt is sued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of.: oinks,and agree that If I d bec•.• e ubject to the workers'compensation provisions of Section 3700(20702— WANlNO: the La Code,I shall forthwith comply with these provisi•,: r / _C ApplicantSnate: l Date:FAILURE •SECUR' WORKERS'COMPEN COVERA - NLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TIX11 NAND r• - (5100,...),IN ADDITION TO THE COST OF COMPENSATION,0•"r GES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTO' I.ECLARATION: I hereby affirm that I am lice d under provisions of Ch r 9( ncing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and a .si nature `� '/ Classat : a 1 _ / ?O1 O '} —nd V1( O C �CoRVar:tor'eSlgnatum:� Date: CONSTRUCTIO LEN' NG AGENCY: • O I hereby a • at 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(5500).): ❑ 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.). ❑ 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 drivers license. 0 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: O I hereby certify that no excavation five(5)or mare 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)feel high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B,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: I Will 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? 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 lime 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? 0 Yes ❑No _ .._ _... ____.._ .tion . .... . 5 Does or willo the tcAir or present or future building occupant requirer for Loa work which the subject age of this a pliestion a0Permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes LJ 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If Nest,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 California Health and Safety Code Section 42303 been made? ❑Yes ❑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. gree 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- ribed property for inspection purposes.I agre: I to occupy or allow occupancy of any building authorized by this permit until final inspection. m!al •. er Co %/St- ..A — to • •r Authorized Applica • Date .INSPECTION TYPE QATh ItiID1ALfi l;OOET INSPECTION RALE gfiN]A49 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 7--/-O2 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 OWNER DIKE & COLEGROVE / DATE 12-28-55 JOB ADDRESS 233 Rose Lane BUILDING PERMIT NO. 2205 GENERAL CONTRACTOR Dike & Colerrove VALUE $8,000.00 • t ho BLOCK TRACT 2562 Residence & Gar. • GROUP I TYPE V ZONE R!I FIRE DISTRICT 2226 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR Footing Trench 14 / /-a DATE NUMBER Foundation Forms and Grade to Garage / Rough Framing I sy, _____st _a Plumbing,Rough to SlabsO� 77/4t / - 4.- 4 ,/ A / , Plumbing, Rough Complete 11.4.d - 2--17 S(, ,l/ er_e &c Ac i led soh ai,4i 6 c/d2,0 &. Temporary Pole -7 `T)/� ��//, Wiring, Rough « Z -• / ._ D & (' ✓-ni 02_02_S6 020 /02, Heating,Rough Heating, i I 0 i� '✓Sewer, a a Sewer,St. 7r ,Whiz .2 _.4 b9 40-e2 (F _—...0 Septic Tank or Cesspool Lat'-`"q, In OutSi �&``// 1'o20<i7& r4'rr Pl. ing 3 -/,--Ib Plumbing,Final,Fixtures Complete xa Ai_//, 1 ' . Plumbing,Final Gas Test II" {�- / 7 ( � ♦ - '� as,- 4j S Wiring,Final /�,e _// N -190 9Ci7/!� - L/� Occupancy �.hVl �y1' wnrrn 71n f:_N 15001-55 Bui ding Department APXLICATION FOR PERMIT /- i EAST 20th STREET BUILDING 1 - • COSTA MESA, CALIFORNIA - ' FOR APPLICANT TO FILL IN / FOR OFFICE USE ONLY Receipt No. 1 Permit No. Building 4°2 O S/ Address 233 Rose Lane Costa Mesa, California Re daby Date Reed. DateeIIssssued Nearest i ' a to 7 C5 hia-al Cross St. 21st St. & Orange Ave. Bu ding Address Owner Dike and Colegrove Costa Mesa, California Mail Address 419 E. 17th Street Nearest Costa Mesa TeLLj 8_11 9 Cross St. City No. 5. Zone ,I, I No.of I Type 1 Group `(' (/ Plans E g1 eer Carlson & Middlebroce: Approved by Date Address Garden Grove CORRECTIONS City Lic.2707 tractor Dike & Colegrove No, Address 419 E. 17th St., Costa Mesa Legal I Lot I Description I No. 40 I Block I Tract 2562 (Attach Metes and Bounds) o.ofdgs. - - Size of Lot 801 X 801 I NN owon BlLot none 1 Y—-\\ I ,i * D Use of I No.of No.of 1 `' I. 1i: ;'73 Existing Bldg. none Familia-al Rooms 5z �- Setback Line from Rear Yard .17.4: — €49/4,6/142,1./ ��7�- r� 2 Center of Street 501 Side Yard 7' I "Lg. "'' ( Ie./55 �' JL DESCRIPTION OF WORE t''In, _ /� New I X I Alteration I I Addition I w. 1 Uft frf v r,1 n . .,ri it!1.NA Repair I I Moving I I Demolish I Building No.of Size 971 sq. ftitooms 511 Stories 1 V"'rior Wall I Roof — ring Fr. Stucco I Covering Comp: APPROVALS L....of New. Buildingsingle Family Residence & Garage Foundation Location Inspector Date Forms,Materials, Under-Pinning Plan 11DR Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int with all City Ordinances and State Laws regulating building construction. Lath.Ext Signature of Qi/< E < 6&� C at 6. , Permittee /1 Plaster, Int Authorized Agt. C, C, ' ,ir Plaster,Ext. 5 Valuation Permit Fee $ a (9 -- Masonry Reinforced �.� Plan Check$ /D — Bond Beam $ Total Fee $ 30 FINAL FORM 204 S-BP 2M 6-55 --111111111111—, m u _ c 0 Jc - _ _ ' - o • d a` Q a . . . . • "ECz� 5PDcosrn ,� c *''*f-•30.P0 des 7� • • ' ; 7 Street — ' PLOT PLAN - Show location and distances from - - _ property line and between buildings. • • • �1 UcNtK H!(Pnl•'XFU5 .ED , WARD VAIt %JOB ADDRESS e33 Rose Lane BUILDING PERMIT NO. 39946 G ERAL CONTRACTOR Owner Bldr. DESCRIPTION of WORK Install Window 3 A 0,n8-112-19 LOT TRACT FIRE ZONE VALUE $200.00 INSPECTIONS Signature Date TYPE V GROUP I ZONE El SOIL • SUBCONTRACTOR PERMITS ISSUED GAS Dote Number I Signature WATER _ Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS 0 STEEL REINF. FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PI CR, BROWN COAT Sl (URAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC. FINAL iPAI: 39946 t"AY -fi-75Et,,.00 283* -****5.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely !� RECEIVEp'g DATE RECEIVED' 6D T SUED - ADBUILDING DRESS �3 ✓ IQ'�_ /�/ 5_ Z II a - - T^ P T1z OWNER .044 . 1/, ♦.fit /L4 j. . . aL1/ttt1..../ A.P. NO. / i ADDRESS aa � R� �MAIL ' / / BUILDING ADDRESS �Lr/�n� 0.JG �n/, n.U ' CITY 60/0,Z,„. I/ NOLt)�r TR ACT�a(p�L. LOT'�O t BLOCK Z < CONSTRUCTION I FYI/, , - }- // NEW ADD ALTER REPAIR MOVING OFMOI ISH Otcn LENDER � , �r I , (l • X _I to BRANCH SE OWNER 3" et_.1 T US C ADDRESS /,/// , bOLV VALUE ,20c2 J ARCHITECT TEL. =yip [/✓ LL/ G N.Q OR ENGINEER NO �//' Z Q ZONE TYPE I[j GROUP a.41WL9 ADDRESS ,// � /C ///� // {/-► J O CONTRACTOR (9(/�/ 4 L. / L APPROVED /` DATEJ �Zc CO Z J Er ADDRESS lL w TEL. ZON NO.OF USE OF NEW O= / PLANS UILOING Z H CITY NO. // — O STATE CITY YARDS APPROVED YARDS APPROVED 0.1 coLU O LIC. NO. LIC.NO. MAIN BUILDING ACC ES$O Y BURG SIZE go (fj '�I NO.OF SLOGS. I (FROM C/L STREET) OF LOT D V NOW ON LOT FRONT FT. _I FT. USE OF ,�/1 EXISTING BLDG. t0...A4-1, Z SIZE OF NO. MOF � - Z NEW BLDG. ROOMS STORIES L.SI RRRTTT�VV��I U EXTERIOR WALL ROOF _ COVERING COVERING REAR FT. 6,Pfr FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 9n/c1/±411 MAIN BLDGS. - ACCESS.SLOGS. 0 ✓ ' _ ± ' 0 tAily! _ _ VAR.* AATE PPR O �.j jJ, '1 Y��(, C.U.P. '+ APPROVED — f� �j to —AY ROVED/ �)T� DATE 5_U /� Z «s///IVVI/.�/ O I hereby acknowledge that I have read this application and state b(ATEi� D that the above Information Is correct and agree to comply with cr all laws regulating building construction, and I shall not employ U 1 F„ any person In violation of the workman's compensation laws of CO the State of California. m TAX W ZI hereby certify that I am properly licensed as a contractor under SQ. FT. _ o.- the the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California BusinessCC U V and Professions Code, Division 3,Chapter 9. VALUATION m •.- N PERMIT FEE $ Signature of , 0 0 �_ 0 Permittee/(/v"'" $ 200 r PLAN CHECK $ E to O o Authorized Agent 5 o LL ... TOTAL FEE $