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Home My WebLink About3116 ROOSEVELT WAY - Building Permits CITY OF COSTA MESA t t. BUILDING DIVISION >:�pi PM ..�r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT 1.115. + ro J601-01767 Rmso (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 3116 ROOSEVELT WY Status: ISSUED Suite: Applied: 11/05/2001 Vicinity: HOUSE&ATTACHED GARAGE Issued: 11/05/2001 Parcel Number: 14169331 Zoning: R1 R1 Applicant: COON, ROGER ISSUED BY: Address: 11782 REVA DR Phone: (714)534-6205 GARDEN GROVE,CA Zip: 92640 Owner SCHLEIGER, GRANT W Address 7820 CYPRESS CREEK COURT Phone: PLEASANTON,CA Zip: 94588 Contractor: R C ROOFING COMPANY Address: 11782 REVA DR Phone: (714)534-6205 GARDEN GROVE,CA Zip: 92640 License: 456490 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING FAMILY RESIDENCE&ATTACHED GARAGE(30 SQ).TEAR OFF EXISTING SHAKES&RESHEATH WITH 1/2"CDX PLYWOOD. INSTALL 15#FELT UNDERLAYMENT&REROOF WITH ELK 40 YEAR COMPOSITION SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,800.00 Permit: $125.25 Claim Valuation: $5,800.00 SMIP Res: $0.58 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.83 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 Existinq: 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 2448-46(6/00) • EC1ARATIONS 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 work for which this permit is Issued. f have and wilt maintain workers'compensation insure ce,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My work54-0.mpenjfat1lon Insuran Mer and po number ere: /� r,y� Carrier:_ -- Pe ! e �� bl Policy Number: .2g�—V) (/T J frit 6" 7 (This section need not be completed if the permit Is veto et et one hundred dollars($100)or less.) ` .__ ___ ❑ 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 Ifomia,antl agree 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 ons. (/-�� 1 z.+[� _Applicant Signature: Car-- oats: 1) O WARNING:FAILURE TO SECURE WO RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,CCO),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm thatI am Ilcens d uncle pr ' n of Chapter 9(commencing with Section 7000)of Division 3 of.the.Businessd P4eeions Code,and my license Is In full force and effect.tic.# ) Class e ) `-(S \J Contractor's Signature: ! — L `� Date: / )-.r 0) 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). 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.). ❑ 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. 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: ❑ I hereby certify that no excavation live(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,Gip 2,Art 2,Sec. 341,Title 8,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 e 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 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? 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? Li 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? 0 Yes 0 No Of'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 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 California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (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. n nature Of Legal Owner(s) Date V"�—vf�'"_— /I —`�—a )Cry,_ And/Or Authorized Applicant ( Date CODE/ 21SPECTION TYPE DATE RAS CODE( INSPECTION TYPE. DATE I IIMLL5 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 21341 FEE RECEIVED COSTA. • MESA BUILDING-SAFETY DEPARTMENT JAN 1 7 1964 cn / P.O.BOX 917 COSTA MESA.CALIFORNIA 7iFINRRA��NCrrEnn��DEP1, For Applicant to Fill In Completely ArP��PLICATIdW 4R'P RA1R TYPE OR PRINT BUILDING BUILDING For Office Use Only ADDRESS 3116 Roosevtselt Way RECEIPT NO. 2 174 r. COSTA MESA, CALIFORNIA G J RZCZI RD BY pATf Rf 1 6D DATE ISSUED OWNER Northgate Homes �� t� �y JAN i 6 Ia64 15939 ADDRESS MAILILDING Las Flores ADDRESS ADDRESS FIRE ///n/wt(/�/)''� TEL. ZONEGROUP CITY Fountain Valley TYPE No. 531679L j �/{ TTT ARCHITECT C. Hiller TE1E52007 APPROVED DATE OR-- 'WEER NO. ZONING n ADL•RESS Anaheim ZON NO.OP///�� use OF E 1 V - PLANS' I/I BUILDI I CONTRACTOR Bonser onst. Inc. �` ` ADDRESS 939 Las Flores LEGALDESCRIPTION .l 1. Q 1– /S /0 46—a.2 CITY Fountain Valley A.P.No. et-- NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LICTNO.714QL1.9 E NO5316792 EAVES SIZE 90'70 SIDE ti REAR P.L. [' 77 NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT) OF LOT 60x102 I NOW ON LOT 0 USE OF 00 YARDS APPROVED YARDS APPROVED EXISTING BLDG, MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SCENTEETBACKRof LINESTRFREEOM it 5 RYARD 35 FRONT FT. FT. T EAR SIDE YARD I LEFT 5 I RIGHT 5 R.SIDE FT. FT. DESCRIPTION OF WORK L.sloe((ffS rr.. FT. REAR 3[.7((FT. FT. NEV _x ALTERATION ADDITION DISTANCE BET. BET.MAIN e MAIN BLDGS. ACCESS.SLOGS. REPAIR MOVING DEMOLISH VAR.# DATE BUILDING NO.OF 1434 ROOMS STORIES 1 C.U.P.# APPROVED EXTERSIZE p y COVERINGBYORa DUCCO I COVOERING F shingle APPROVE DATE /"i USE OF BUILDING AND WORK TO BE PERFORMED . • 10:1- fam. res. w. att. _ar. J- A/7/9 so.PT. �ao a"... N a I HEREBY ACK•• DOE T I H •- READ THIS APPLICATION THE AMOUNT SHOWN DER VALUATION IS FOR THE F AND STATE •AT THS :O IS CORR: AND AGREE TO COM. PURPOSE OF EBTASLISHI NO A PERMIT FEE ONLY. O PLY WITH L CITY OR•``" ES ND ATE LAWS REGULATING VALUATION ry BUILDING •NSTRUCTI• �.1'" • PERMIT FEE $ e//r^'e) 1 PIGNATOR=OP ///�� PERMITTEP �: , Ail 5./ N/�✓7 / / AUTHORIZED AGENT Iy/ v A TOTAL FEE S //(� k 2758 9/11 /79 64.00 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPL ATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RE BY PERMIT For Applicant to Fill in Completely — Use Ink Only q NI2 4 8 7 7 8 BUILDING Qp ..y., G(>4/ A.P.NO. �`— 6 1 3I ADDRESS �/16 /C OOSCVP�/ /4 BUILDING //�/. OWNER OR SC / /Q�9Z r ADDRESSOrrinee.xneeit 64r. TENANT {� J UNIT OR MAILING SPACE NO. ADDRESS _Sat hic TR.N,/_2 /� LOT )O BLK. TECITY ` rj•j( Moves• NOI.SS73 �(/ NEW ADD ALTER REPAIR MOVING DEMOLISH NSTRUCTIO LE / ` LENDER ><C tc /][` BRANCH OWNER,/ p ,QCH i4tea. ADDRESS HArJD/ 8/4 . IinA.-//,y i USE ALOEs/„Jur, S „.. ARCHITECT L. re OR ENGINEER O, ADDRESS ZONE g TYPE GROUP APPROVED CONTRACTOR°rill 1 c'„Gini c ,1:ON BY DATE ADDRESS /p1.' /Z F VI/ yve_ 4-007 �•�/ _� CITY SA /?$L. CoL .//7. NO.,542,E & b STATE J CITY APPROVED SETBACKS LIC. NO. 4///3/ LIC.NO. uu SIZE /iA/ / NO.OF BLOCS. (FROM C/LSZfiEEA) O. OF LOT 60X._ l03.. NOW ON LOT / FRONT 6c(b[iF••rOtuo,•Clll Q USE OF •/ 3O / /1 cn EXISTING BLDG. po_s/ .„1, G R SIDF FT. 0 'SF Separate permits are required for L.SIDE S ,FTO H electric,plumbing and heating work. REAR is/ FT. O// i _Ill F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q ALL Zn, 7y- fotzl ,(Jc WYDoni R4, DATE /t I ,J APPROVED >▪' �! _A ROVEp�I./y,� /A/ DATE ^I �� LU �i L.PV1� `1 W Cl. I hereby acknowledge that I have read this application and state n 0 Ce that the above information Is correct and agree to comply with S all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of IV the State of California. I hereby certify that I am properly licensed as a contractor under Dei SO. FT. — ea 2 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR yrm� Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: • am exempt fro • the provisions of the State o California Business VALUATION PERMIT FEE S n and Profess'• •ode,Divisio• pter •/ Signet ,//}' _ oaw� OO PLAN CHECK S `///�J. Qo a Pormi //l (((/// $ Z� Zs%f/� • TAX S C.• �,� or 7./0? Authorized Agent Date TOTAL PAID S 6.t1s 60 �--- . _ •- _ '"— COSTA MESA BUILDING-Sh. DEPARTMENT APPLICATION,_,.CSCRUCTURAL PERMIT . P,p.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED/BY PERMIT 4.�. C For Applicant to Fill in Completely — Use Ink Only \ )4.-A,- 4F: 7 7 6 BUILDING / �J A.P.NO. r'f',` 693 -31 ADDRESS 3�I(� /. CDOSC.Ve /t ��4r _ BUILDING , 3 //` / OWNER OR S-•C h le iI r ADDRESS /�(� Cc 6'II7{ (�Ct- as:4 - TENANT UNIT OR MAILING ADDRESS Su sr L SPACE NO. // e- TEL, TR,N4�2 LOT IC ' BLK. '• CITY Cos ft. /"'.54 No.SS73443, C NEW ADD ALTER REPAIR 'MOVING DEMOLISH . I ODI'STRUCrlON--- ;] � // — LENDER _ e-C . MC Al G BRANCH _ -�/� / �,Q�• ,/ p OWNER ll1J Ax f, Cil r 1 �,7r t, P/Tf+ ADDRESS MO/40/ B/,-I • in:-/'�,%r — VALUE �f' � ��y 4 ARCHITECT L. , USE f K7 l..t-'L) OR ENGINEER O. _ ADDRESS ZONE t TYPE GROUP �L APPROVED CONTRACTORIIOrns /r�0 Slr,I C�/'o. BY DATE ADDRESS /02J(3 a f /y'f I/Vt}c WGX CITY Sof c7710 A. Cr/! NOTELS42 iCS7/ I• STATE CITY APPROVED SETBACKS LIC.NO. ,..( y//3/ LIC.NO. ma SIZE '^� (NO.OF BLDGS (FROM C/LJJREE�T,) 6 OF LOT 4'J XC 1 O.3_ 1NOW ON LOT f FRONT f:</.C4Ea!/Q- _ h - EXISTING 1N n 30 On ESE OF BLDG. Po St:1w-di C G A.HIDE7✓ FT. / H Separate permits are required for L.SIDE s FTC, C electric,plumbing and heating work. REAR J5/ FT . Oo b USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q1 DATE / / < ,/--4d 7;en.1) 'Pttt-,-r 2dIDA o APPROVED �p /[' ROVEpf{,7Q /l OATS '9— / It LY lC �w ll�� Ka O I hereby acknowledge that I have read this application and state °' C that the above Information Is correct and agree to comply with C L all laws regulating building construction, and I shall not employ Zany person In violation of the workman's compensation laws of s the State of California. m • I hereby certify that I am properly licensed as a contractor under SQ.FT. N the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m� vC Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a ti- am exempt from)the provisions of the State o California Business VALUATION PERMIT FEE S Y v and Professionn..CCode,D visiof/9,�hepter u, 1 • Sipnetuie of • il I: B OO PLAN CHECK $ 'Co o \\ ' Per or ! t / S Zf r ZW�- TAX 3 00 a- or C'r////•7 2 b7ti- Autharlxetl Agent Date /!!! / TOTAL PAID $ �, ') 17 " 6689 9/254A, 7 we.00 TL i• - COSTA MESA BUILDING-SAFETY DEPARTMENT APPCATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 t -• ' REC PERMIT For Applicant to Fill in Completely — Use Ink Only N2 444+ BUILDING UILDING //4 23004e„ten A.P.NO. ADDRESS BUILDING')// G7// 6WATOSte• ADDREESSJ( UNIT O MAILINGSPACE NO. ADDRESS �f.4l t.... TR.NO. LOT IBLK. TEL. CITV NO. NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER '\/X`�r Qp�f BRANCH OWNER y�•�J •M^'i ADDRESS VSE ./`, Be a V .(/BLUES 2y ARCHITECT TEL. , •/ �/ OR ENGINEER NO. ADDRESS �/ /C/�'� ZONE TYPE GROUP CONTRACTORAP / 40.7 k.- �a 'rti-AA��+�(ra a% BY DATE DATE 4111 ADDRESS Q( 2 2 /F/t '_Via TE CITY sW'W(Q WELQ NOL, Z Z FeSTATECITY APPROVED SETBACKS LIC.NO. LIC.NO. SIZE NO.OF BLDGS (FROM C/L STREET) L OF LOT )NOW ON LOT _ __ FRONT FT. Q USE OF EXISTING BLDG. R SIDE FT. to ^sE-•- Separate permits are required for L.SIDE FT. G electric,plumbing and heating work. REAR FT. 1_, USE )�OFABUILDING ANDAN/ WORK TO BE PERFORMED v PLANNING ACTION - gala- i ea .._ • 4 /5 DATE •�/•� //«-- /��'� ,{/ ��LLL V APPROVED r S Qtlet AAA CIS _ / APPROVED DATE ., Sete..-s��wv�. `rvR/oC�I /TT!"IIr lT�/ Pg W On I hereby acknowledge that I have read this application and state r. gg that the above information is correct and agree to comply with D. all laws regulating building construction, and I shell not employ Z any person in violation of the workman's compensation laws of ° z, the State of California. .: m I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: n am exempt from ;e provisions of the State of California Business /VALUATION PERMIT FEE E /J and Profossio e,Divisio. Chapter 9. rn C•i •++� / �. /'� _ PLAN CHECK E �� o Signature • /iJ`/' /y Pormitta /�/��i� 5 TAX E T� P or Authorized Agent Date ! TOTAL PAID $ if sr