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Home My WebLink About277 ROSE LN - Building Permits 4 CITY OF COSTA MESA <� 9 BUILDING DIVISION >y ,.,,, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1. tMP° iia PERMIT /1303-00299�� (714)754-5273 • Fax(714)754-4856 w.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 277 ROSE LN Status: ISSUED Suite: Applied: 02/20/2003 Vicinity: RESIDENCE AND PATIO AND ATTACHED GARAGE Issued: 02/20/2003 Parcel Number: 42615148 Zoning: Applicant: MARTIN ARROSAGARAYS ALL SEASONS ROOFING ISSUED BY: 401 Address: 2508 BOWDOIN PL Phone: 714-556-8867 COSTA MESA,CA - Zip: 92626 Owner: BREWER, KELLY Address 277 ROSE LN Phone: COSTA MESA,CA Zip: 92627 Contractor MARTIN ARROSAGRAYS ALL SEASONS ROOFING Address: 2508 BOWDOIN PL Phone: 714-556-8867 COSTA MESA,CA Zip: 92626 License: 622480 Arch : Eng: Address: - Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REMOVE EXISTING ROOF.COVER WITH 30 YR COMP SHINGLES.ADD ONE LAYER OF TORCH DOWN ON PATIO FEE SUMMARY Plan Check: $0.00 Calc Valuation: $3,500.00 Permit: $97.25 Claim Valuation: $3,500.00 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(6'00) DECLARATIONS n WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: I hye 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 w for which this permit is issued. have Qa ittfmaiintai ntlo ricn ersn comce pensation and Insurance,nasnure are: by section 3700 of the Labor Corti,for the pnrtonnance of the work forrwhichicthis permit Is Issued. trz Cartier: 5I-c,f C lci Polity Number: �4 7 5-7 J 3 -D (This section need not be completed it the permit is valued at one hundred dollars(S 100)or less.) - 0 I certify 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 California,and ogre that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr ilino � G ^ _l _ \3 Applicant SignatureO SECURE WOU'' t`FAILURE TO SECURE WORKERS'COMPENSATION COVERAGES CrNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOUARE(SI COCCO).IN AMMON TO THE COST OF COMPEN ION,DAMAGES AS PROVIDED FOR IN SECrON 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed und`p=gvisip is of Chapter 9(commencing with Section 7000)of DMsion 3 of the Business and Professions Code,and my license is in full force and effect.Lt.# aY C/ Class a --/S7Contractors Signature:--/S7 _ 1 V' O b r ' Date: arten 1 CONSTRUCTION LENDING AGENCY: ❑ 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). Lenders 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 DMsion 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 properly 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 Drivers 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 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)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safely,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: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response t0 release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia 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 Califomia 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? 0 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D yes u No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Win any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality 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? ❑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-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 71../tot Sinature Of Legal Owner(s) to And/Or Author Applicant Date VOCE I, INSPECTION TYPE , 118,7E INTOlALS COPE/ INSPECTION TYPE DALE ItRIDSLS • 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 3-4.1-0.3 210 Final Electrical 201 Final Block/Retaining Well 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 DTF2 & COLEGROVE ! DATE 12-28-55 JOB ADDRESS 277 Rose Lane BUILDING PERMIT NO. 2211 GENERAL CONTRACTOR Dike & Colegrove VALUE $ 8,000.00 \ L 46 BLOCK TRACT 2562 Residence & Garage GROUP I TYPE V ZONE RG FIRE DISTRICT 2220 PERMITS ISSUED INSPECTIONS `/,� f DATE SUBCONTRACTOR DATE NUMBER Footing Trench /`Ivy�" — /3_i Foundation Forms and Grade to Garage _ ' - Rough Framing �ri".. —� 4S- ' • - -4D4' Plumbing,Rough To Slab 7�G�',5 — / 3, a '. Plumbing,Rough Complete n` )O.S .14I (4),,,4_4_4'-ci `icc/ 34 z/J 4/c//a, Temporary Pole y / / Wiring, Rough ?1€141 Z -t7 — 2�L�yy//art -a -S(o a D6 • Heating,Rough Heating,!VII v sewer„r,} d` 4. Sewer,St. // etJrn-P_CP a—a g —3-6 Li 1 3 O Septic/Tank o C spool Yy I 1g, In Out•t &`tr'' t 23'27 "17g4--1t/ Plastering � 3-/C—Sb Plumbing,Final,Fixtures Complete,f(� I /t. _ Plumbing,Final Gas Test SSW (O•�1 i J JY 0 a- e.,Cera_ / -J1L7f ;)A,/ 5Wiring, Final P 'Lr_� Occupancy /"i / "/ �� t/� Pnrm 91(1(1-14 15001-55 Costa Mesa Building Department i PLACATION FOR PERMIT • 111 EAST 20th STREET /® BUILDING e,. COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. I Permit No. Building a a // Address 277 Rose Lane ,/ Date Issued Costa Mesa, California '11e '7 G Nearest !/'�clued by I �P �DatP Recd��s �.f -�4 �� Cross St. 21st St. & Orange Ave. Building Address Owner Dike and Colegrove Costa Mesa, California Address 419 E. 17th Street Nearest Tel. Cross St. City Costa Mesa NoLi 8-1159 Zone II 4 I No.of I Type j Group.t. Architect or tic. K.� Plans Engineer Carlson & MiddlebroNd. Approved b Date Address Garden Grove CORRECTIONS • City Lic. C -actor Dike & Colegrove No. 2707 Address 419 E. 17th St.,, Costa Mesa Legal I Lot I Description No. 46 I Block I Tract 2562.' Ii 1 /tv\\ I tt p .\ (Attach Metes and Bounds) CJ L-_, c--1 x•F p i I No.of Bldgs 1,-4 Size of Lot 801 x 80' I Now on Lot none - 0 Use of I No.of No.of 1 • DEC 14 1 Ib) m Existing Bldg. none Faml illesI Rooms 54 y1 Setback Line froRear Yard m Center of Street 50- Side Yard j51 141 q j nr nAOTA M[e+A DESCRIPTION OF WORK rni vs i s vi vVv I ti Ivis.Nn New I X I Alteration I I Addition I Repair I I Moving I I Demolish I 2 - - :-, BuildingNo.of i Size 984 Sq. i t.Rooms 52 Stories 1 r prior WallI Roof - ring Fr. Stucpo Covering Comm. APPROVALS • Use of New 'Foundation Location Inspector Date Building Single Family Residence & Garage Forms,Materials, I. Under-Pinning Plan 12A 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 Dike and Colegrove Permittee - " ' Plaster, Int. Authorized Agt. ' Plaster,Ext. Valuation Permit Fee $ 0.70 — Masonry Reinforced Plan Check$ /0 — Bond Beam $ 8000.00 Total Fee $ u0 — FINAL FORM 204 S-BP 2M 6-55 -. . .1 C C, - a - L . . o. _ - C. corn i INET, ?7-5`Ptni a ii21� :t , =NJ' o • • i Street - - • • PLOT PLAN Show location and distances from . property line and between buildings - • • 1 '