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Home My WebLink About1703 SAMAR DR - Building Permits ----, -. CITY OF COSTA MESA i L 1509 BUILDING DIVISION PEF , T NUMBER F �; DEVELOPMENT SERVICES DEPARTMENT :05I NUMB \' PERMIT (714)754-5273 • Fax(714)754-4856 • ww.ci.costa-mesa PERMIT w 77 FAIR DRIVE,COSTA MESA,CA 92626 Status: ISSUED Suite: Job Address: 1703 SAMAR DR Applied: 09/06/2005 SIssued: 09/06/2005 Vicinity: Type of Construction: V-N Prima ry : R3 Zoning: R1 Parcel Number: 13927304 Applicant: LUKE,GARY Address: 448 S.MONTGOMERY Phone: (714)633-8798 ISSUED BY: ORANGE,CA Zip: 92667 Owner PAIGE, JO ANN TR %? , Address 1318 WATSON AVE _ t,, phone: . 714-546-5,5A7 ' - Zip: 92626 - : COSTA MESA,CA r Contractor. LUKE ROOFING INC �' Address' 448 S.MONTGOMERY phone: (714)633-8798° . - ORANGE,CA - - " License: 672569 Zip: 92667 ... Eng: -- Arch : r,e ..,, Address: - Phone: Address: Phone: - .. _ ��° '<( License -F License'. - " • SCOPEPERMIT 71 , IT/OFF ROCK ROOF INSTALL 2-15 LB FELT ON A 3:12 SLOPE AND INSTALL 30 YR COMP SHINGLES.2800SF` FEE SUMMARY _ s7,000:oo "CaIc Valuation Plan Check : ' $0.00 Claim Valuation ' $7,000.00 ' Permit =$139 25 .: , , SMIP Res: $0.70 l ' , {. , Inspection Otheri$0.00 � $0 00 Total: - $139.95 PLANNING& ZONING SETBACKS - Rear 0.0 ' 'Left0 0:,r', Right 0-0` MAIN ST_ RUCTURE Front 0 0n " . , c- g Le 0 0 Right 0 0 ACCESSORY '- ^ Front 0-0 Rear 0 0"° ' Ezrstm 0�" . Redurted "0, s '' Proaosed "0 PARKING �9� �.% r,' i S y t, ,,,,:o . % V . VS IIIS . 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 190 days. b INSPECTIONS: for authorizedpermit to be considered legal, comply with iall required Inspections and final approval must be obtained.Failure to obtain inspections final approval will result in the expirationof this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/Ont DECLARATIONS WORKERS'COMPENSATION DECLARATION: - I hereby..affirn 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 Labof Code,for the performance of the work for which this permit Is Issued. I I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for whi h this permit Is Issued. 114 _65,4 y workers'co�mppens jlon Insurance carrier and policy number are: , r: CS/"/( "C.---.-/ Icy N ber: le 7.9/i' (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ , ' at in the performance of the work for which this permit is issued,I shall not employ rson-in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the-wor"kers' ompensation arovislons of Section 3700 of the Labor Code,I shall forthwith comply w'th these provisions. .------- Q Applicant Si. ature: Date: Iy.— E91_. WARM •.FAILURERE TO SECURE WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED r.<• •ND DOLLARE($100,000),IN ADDITI TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,ANO ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 I h I,^'effi that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Divisio of the Business and Professions Code,and my license Is In full I. •an• :s act.lac.e X71 �� S Cl e: f ontr tors Signature: Da e: >�' %-sg -c-,j--- NSTRUCTION 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 chill 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 loan 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: 9 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,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: 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? ❑Yes ❑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? ❑Yes ❑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 Califomia 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 a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 9 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 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 (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade). '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 ❑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 Mateyals and Emissions. Signature: cit, Date: J CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY;Alee ntler 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 1 ilding 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. Signature Of Le.- ' Date .100.11' S` 7- oT And/Or •• orized Appt•. t -D`te 1 CODE r VISPECPONTYPE PATE INTmALS con r INSPECTIONTYP[ PAIS ?MALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final /� G' �jl�� 208 Final Plumbing 200 Final Re-Roof -I '/2`01 ""-"tr' 210 Final Electrical 201 Final Block/Retalning 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 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA' P MIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT I No --/p$/3 3385 1 /31/84 • 33.50 TL Prrject Address ./ / at/ TYPE OF CONSTRUCTION- LI NEW U ADD U ALTERATION LI REPAIR Wis. ❑ CONVERSION 111 DEMOLISH IL OTHER PPlicant's Mailing Address - .'a Al =/ - •L / A.P.# Zone Owner's Name i4/5:11 '� Phone —a��7 DESCRIPTION OF WORK /TOS,, #4// ✓f 1Main Building: Accessory Building: Z Addrssi 763 r,Wm a✓ D [� ' O J TYPE OF PERMIT ❑ GRADINGUFOUNDATION ❑ STRUCTURAL Front _ - N Arch/Eng . License NO. ❑ TENANT ❑ ELECT•IC•` ❑ MECHANICAL Rear•Address /� q ❑ OTHER I _ N Contractors Namel IQiq� �eccPhones$ a' / 'PROJECT DESCRIPTION SQ. F . a • OCCUPA V /IL9tt - R a-rCONSTRUCTION TYPE L 'VALUATION$ - /(!V E Address(mailing)/� 3 1 I ZONE GRADI NG CU.YDS. ACRES Ping. Ref.# Park.Fees $ U City License No. L—! `� LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided • t I hereby affirm that I am licensed under provisions of Charter 9 (commencingR , with section 7000) of Division 3 of le Business and Professions Code,and Use of Building: E my license.is in full to e a • of -et. License lass` - icer// `/ �� '/ PLUMBING I FEES Planning Notes: . E Date Signet ��L�L.. „fir 4/2,2 Bar Sink Showers N e�Wx.,OR KERS' COMPENSATION D-•"' ORATION T -t • ereby affirm that I have a cer-f' ate of consent to self-insure or a certificate Beckfl0 eventer Seluste Sink S # Workers' Compensation 'In ante, or'a certified copy h reof (Section - • • --• -' - 38oQ Lab. Cc ..rr•�'--�� Y '2-e • Backf low Irrigation Sewer Cap „ ELECTRICAL • FEES Policy No. pt 7d-7 Company n/ 1� Certified copy Is hereby furnIshed, • , ' Bathtubs Sewer Connection ■ 15:50 KW Certified copy is filed with the city iplinfi�/y�i��gy .pp 7^� /� / ■ ! ate ( Applicant� "ry[�S. ` re••>r, ( (�; Clarifiers ySolar Collectors i Cons:ruction Pole Sub. . - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION . •'z , -'/ - (This section need not be completed if the permit Is for one hundred ($100) or Dishwasher Solar Piping, " ■ 100. less). ' Drinks tains/f • Solar Tank I ••Dishwasher ■• t t • I certify that in the performance of the work for which this permit is t to l I re / y shall not employ any person In any manner so as to become subject to the O OC Workers' Compensation Laws of California. FIoorrtfaiM- ,y Swimming Pool w/S•a .•,\ s �• • ■ ■ Date Signature ' /s - Q - 1 ;r' 1 NOTICE: If,after making this declaration,you should become subject to the ' FlodnSirSes N 0 Urinal �`- ■s ■ Workers' Compensation provisions of the Labor Code, you must forthwith' . Q- y/ V comply with such provisions or•this.,permlt shall be deemed revoked. Go.s dike / _Outlets Water Closet* p 'f ■• • ■ CONSTRUCTION LENDING. AGENCY P I hereby affirm that there is a-construction lending agency for the performance Ifiker q�¢ptors• / , Water Heat ' pie• y _ of the .work 'for which this permit •is issued.t(Secdon 3097 Civ: C.). - C /J _ v b/'+� '_ Lenger's Name ' ' Kitq en Sink Water ServiQ* 17t - Device Lender's Address LaDetories //. - - A OWNER BUILDER DECLARATION - Outlets ' .RangeI hereby affirm that I amexempt from the Contractor's License Law for the p—Tra / • I\47• following reason (Section.7031.5 Business and Professional Code: Any city.e P county which requires a permit•to construct,alter,Improve,demolish or ret4r- , _ _ _ any structure, prior to its Issuance, also requires the applicant for such permit-^ Roof 'retains V I IL._iia_r,:ri e • to file a signed statement that he/she is licensed pursuant to the provisions of 'a .to Contractor's License Law (Chapter 9 (commencing with Section 7000)of enerator 00-5 05-15 KW Trash Compaclor 9sion,3 of the Business and Professions Code) or that he/she is exempt • - - • _ refrom and the basis for,the alleged exemption. Any violation of Section .31.5 by any applicant fo0-a permit subjects the applicant to 'a civil ' • :wally of not more than five hundred dollars ($500). _Reinio F�F apectee.'. :I $25 lsStt$.Fee • . $' 3 .0 I,'as owner of the.property for my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3 ' compensation, will do the work, and the structure is not intended or offered - ' . MECHANICAL - .I FEES - for sale (Section 7044, Business and' Professional Code: The Contractor's s - -- - - - - 1 - - PUBLIC SERVICES REQUIREMENTS: • - License Law does not apply to an owner Of a property who builds or improves Boiler . - Hood or Type I 0 thereon, and•whoitlOes such Work himself/herself or through his or her own - Zoning Approved By Date • employees, provided that such improvements are not intended or offered for Canopy ' Type II ❑ p • 'Sr /_y/ p� sale. If, however,the building or Improvement is sold within one year of com- Duct_Under Ground I ApplicationApprovedy r7 O pletion, the owner,will have the burden of proving he/she did not build or im- • B Als' / Date rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By _ qt ��•-- I Date /1.F�—ECX oI, as owner of the property, sin exclusively contracting with licensed con- ' I I tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU • SUMMARY OF FEES -The Contractor's License Law does not apply to an owner-of property-who _ - - - . - • builds or Improves thereon, and who contracts for such projects with a con- • Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ • DO SMIP $ (9•LCO tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section b.& P.C.for this reason Firepl/Fact.Bit. ICBG# ' PLUMBING $ - ISSUANCE $ Date Owner Heating System& Ducting - • PLAN CHECK $ ENERGY P.C. $ 1 I hereby certify that I have read this applicatibn and state that the above . ❑0-100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ _ Information'Is correct. I agree to comply with al city and-county ordinances - • and.state laws ring to building constructio and hereby authorize repre- PLAN CHECK $ MICROFILM $ sentatives of th city to enter ...,.• the •Ove-mentioned property for - 7 inspection purp /' J MECHANICAL $ TOTAL FEE $ 3•So Signature a /'..� Date —�/ • Drivers' Licator SS# - Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ •CMF 0865 . 7/83 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - . -- - ..\ COPYSTRUCTION AND PLANNING "0- POC SPA Date *.APPROVALS Permit# l Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole` 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. k... 53. Steel Reinforcement 3.'ElectiicaI Conduit Utility,•Undrgrnd. .1 54. Forms . 4.-Electrical,Conduit;Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - , - .. 56. Rough Plumbing & Pressure Test 6. 'Electrical'UFER Grnd_ -1 57. APPROVAL TO COVER-GUNITE a 7.'Fo6tings- - 58. Electrical Conduit-Undrgrnd. 8. Foundation ::k- - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. e ,.1 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line.& House Connection '-�i• .c 62. Backwash & Receptor-Final 12. Sewer;Cap t '' 63. Heater & Vent-Final • 13. Roof Drains `' 64. Plumbing System - Final 14. Rough Plumbing;' '[. 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final -116. Rough Electric Wiring - . - 67. Fencing & Access Approval - . 17. Rough Wiring Sign. • 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling :•. 69. POOL/SPA SYSTEMS FINAL t 19. Rough Heating & Air Conditioning ',, FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test ,:ti 72. Underground Flush 24. Roof Framing . "'+ " 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing• 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. DryChemical-• . 27. Frame and Flashing 76. Dry_Standpipe & • 28. Lathing & Siding -77. EI)CED SYSTEM FINAL ' 29. Insulation 78-FIRE PREV. FINAL s HEALTH DEPT. REQUIREMENT 30. Drywall Nailing v -�_.;sr" 31. Plaster Brown Coat . -'r 79. FINAL INSPECTION 32. Electrical Power:Meter-Final y.-••• 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning r: 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service:Final • _ 41. Solar Domestic-Final ` - 42. Backflow Preventer ' 43. Backflow Irrigation . 44. Landscape Irrigation System 45. Sound Attenuation . ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed . 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co - , ' ' 51. CERTIFICATE OF OCCUPANCY . . . No. - Date sem. - E • • 11293 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 211960 d w R 0.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. FOR APPLICANT TO FILL IN COMPLETELY Aprreekl 1 CtialitdiESPERMIT TYPE OR PRINT BUILDING BUILDING 1703 Samar Drive ADDRESS • • COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY OWNER Kenkol Development Co. , Inc RECEIPT NO. ORZMI�T1�. MAIL 1555 Placentia RECEIV•EDY DATE RECEIVED DATE ISSUED ADDRESS (�l.( 1,-„,11-6 JAIL 2 1 Mk0 CITY Newport Beach TELL3227 BUILDING ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA, CALIFORNIA ADDRESS FIRE r/ __II (� ZONE TYPE V GROUP y- K.W. K011 STATE 61195 APPROVED CONTRACTOR LIC.NO. BY DATE 1555 Placentia ZONING ADDRESS NemmnrF Reach LEGAL I LOT I 13529 ZONE #91 I NO.OF USE OF NEWAri �- - DESCRIPTION NO. 8 BLOCK TRACT j 2) t I PLANS -tl//.. I BUILDING -//'i A.P.NO. BPPR YOVECy�y </� e DATE `((r: /-(.'O BY GG / OF LOT 76.8 x 100 I NO.OF SLOGS. 0 YARDS .EVES�e NOW ON LOT REQUIRED ALLOWED USE OFnone (CENTER LINE ST.) EXISTING BLDG. FRONT SIFT. IN. 5E1-BACK LINE FROM 50' 24.5' CENTER OF STREET REAR YARD R.SIDE /FT. IN. 5' 81 SIDE YARD I LEFT I RIGHT L.SIDE 1SFT. IN. DESCRIPTION OF WORK [; SFT IN M REAR 1. NEW I XII ALTERATION I II ADDITION REPAIR I II MOVING I II DEMOLISH I BUSIZE LDING 18005.f• ROOMS 7NO.OF STORIES 1 . EXTERIOR COVERING WALL S`tuL.•OVVERING OOF Rock USE OF BUILDING AND WORKO BE P �2ERFOD Single-Family Residence and Attached Garage . 1 HEREBY ACK L • E THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE 'AT THE BOVE IS ORRECT A D AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH 4L CIT 0 PINANG . AND C.1Z A REGULATING BUILDING C•NSTRU• •ON, SIGNATURE • VALUATION PERMIT FEE $ p(� — PERMITTEE A 1.1t. /J l q $ /V v.9 •j PLAN CHECK $ / AUTHORIZED AGENT 1 TOTAL FEE $ 7