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Home My WebLink About3006 SAMOA PL - Building Permits • CITY OF COSTA MESA BUILDIN4 DI ,N►SION h "4) DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER +y, • PERMIT B05-01710 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.$IJNLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3006 SAMOA PL Status: ISSUED Suite: Applied: 09/27/2005 Vicinity: LIVING ROOM AND DINING ROOM Issued: 09/27/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 13918128 Zoning: R1 Applicant: ROBERTS, JOHN D Address: 3006 SAMOA PL Phone: 714-549-9200 ISSUED BY: a J COSTA MESA,CA Zip: 92626 Owner: ROBERTS, JOHN D Address 3006 SAMOA PL Phone: COSTA MESA,CA Zip:- 92626 Contractor: . OWNER-BUILDER bigroJ1_, Address:. Phone: Zip: License: 000000 • Arch :. _ Eng: Address: Address: Phone: Phone: . Zip: License: License: SCOPE OF PERMIT -REPLACE EXISTING 8'HIGH SLIDING DOORS,LIKE FOR LIKE IN LIVING ROOM AND DINING ROOM FOR SFD. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $2,000.00 Permit: $69.25 Claim Valuati : $2,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: • $0.00 1.* Inspection: $0.00 Total: $69.75 • 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 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 244046WM) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: f ❑ 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. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This ction need not be completed it the permit is valued at one hundred dollars($100)or less.) -jos 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' I compensah h es rofo California Tee ih�if l;houl become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions.%% Applicant Signature: ['Date: rr 7 - at WARNING:FAILURE TO SECURE W KERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100.000),I ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.# Class# Contractor's Signature: Date: 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 subje the applicant to a civil penalty of not more than five hundred dollars(5500).): .1fire 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 properly,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.). O I am exempt undd--7p�7 s c. // °r Business and Professions Code for this reason: (Signature:. ' _ ' ' Expires_//'/Z-6C 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,California Administrative Code). o 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. 1 . •. Signature: .i r Date: c',Ly• J Division of Industrial Safety Permit Nt ber: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:...: N. . 1 Will the applicant or present or future building occupant need to file end certify:a Business Plan for emergency response to release or threatened release of a hazardous - material? ❑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 ❑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? ❑Yes ❑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_aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? u 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 ❑No (If'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 ❑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 prop: for insp: io purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. y _, ✓1"V- 2 7 or (_Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE# INSPECTION TYPE • PrAIE INTITIALS CODE# INSPECTION TYPE paE f�LS 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 De, fCLAzffrvwc 3oO6–S/moq P1- cos404 Mash" iv gym-6,79 �� cc vii o sfi�'- --s;d r r+l-K - - —I 1 if el -*P - 1`) —) -4,--z-_ - -- —} 1 N �J;d4 yrs 1 "S.' -31-61- - 2> --5:1797-64 FT-C-<:-4--- I - staff – ire-Ma-44 tS — ire-M -44 —iri—I ,— S-e-e te/i�N4 - . X- - ` - - - iFs- - 'r 3=f e w APPROVED City of Costa Mesa Building Dept. APPROVAL OF THESE er._._.._ DATE. / i .6 STRUCTURAL PLANS DOES THESE PLANS MUST BE ON JOB AT ALL TIME NOT CONSTITUTE APPROVAL MAKE NO CHANGES WITHOUT PRIOR APPROVAL } OF DEPT. OF PLUMBING, ELECTRICAL OR THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL CONTINGENT INSTALLATIONS. OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO BE A PERMIT FOR, OR AN APPGOV;L OF, ANY VIOLATION L '� OF ANY OF THE PROVISIONS OF NIS CODE. NO PERMIT PRE. •+ SUMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE Perm d 479S PROVISIONS OF THIS CODE SHALL BE VALID. EXCEPT IN S0 THIS l MF MUST ACCOMPANY THIS NU v1B_2 ACCOMPANY FAR AS THE WORK OR USE V/FIICH IT AUTHORIZES IS LALYFUL. - ALL INSPECLON RF_QUESTS THE ISSUANCE OFA PEWIT BASED UPON PLANS AND SPECIFICATIONS SHALL NOT FRLVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION OF €R S _ IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING FOR BU.!D W-5 TO BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN GE EA1:'LO,r:�. V.: SU ,"'-" T.i..N TILL IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE SATE Q. 0`i OF OF THE CITY. mDUS M\'. CSidSUCfED f0+ 3006 Samoa Place Costa Mesa, Calif. March 1, 1967 . Planning Commission, City of Costa Mesa, Costa Mesa, Calif . Gentlemen: This is to advise you that we have removed the storage shed, as per your instructions, and wish you to make final inspection. Thanking you, Yours very truly, MW C-19.„tc • OWNER ' Mesa Ver' Est.atpa DATE 1-.2A-59 JOB ADDRESS 3006 San. _ Pl APP k�`�"I';DING PERMIT NO. 81153 GENERAL CONTRACTOR L. G. Rnhinann VALUE $ 114,319.00 AP. No. LOT 143 TRACT 3115 FIRE ZONE DESCRIPTION OF WORK Residence & Att. Gar. GROUP I&J TYPE V ZONE Al PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches //Forms t/ Steel /4+C /-L9-Sz! Floor System ' Steel Reinforce Chimney Re-Rod Bond Beam ft.-/E4 :f-/A— ri`ti Frame and Flashing C "t3- /6"3 T Lathing, In Out 3.---,c---e S^,�- � ' $ Plaster, brown coat �t , .-rt/6- Y Underground soil /Wt-fW.G Pipe Test,/4.,g'J-;Z'-SS- l f 1 \ Top Out /-2- -Wi4e-crt/Gt-4jL i�k// 9 ' �(U'',Ju,. 4„,/ 6/(, OZG 3 f jt II Furnace /VMS 3//-5`�/ �. -{- �I�f-'C C2 -0---„../__57-3-2 //`i' / Gas Vents !!!/// <I/ Rough Plumbing /0.-a5 3-//sr Kr,"4.etn i -,., r f 33—Sr'/ / 7 0 /f, T Cesspool Septic Tank Prop. Swrrbint— HotVCon. St. Swr. 14'/Y? 1:3,64.6..-1--- 2-174I ' / S / _ Sprinkling System I Heating Final /Lfic_i-G-S% Plumbing Fixtures, Final M.ts S--(-s-9 i i Final Gas Test /5 /1y}S r-6-,5-9 � Construction Pole \ I l` Underground Power _ �f Rough Wiring ./1-J - Q�-�+ ( . , ,.1 .' - '-S 14 3 L I /nx `\ Fixtures, Final 1 � } OCCUPANCY 7-...2.21.- 1f i Form 210-5M-1-57 • F84:53 : .4:L. UU�..Ii� I "V L COSTA MESA BUILDING DEPARTMENT JAN 221959 P.O. BOX 317p FIfUTAP!CE DEPT.. . COSTA MESA. CALIFORNIA Cii OF C" rf-Y% FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING BUILDING ADDRESS 3006 Samoa Place _ COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. �,s�I4,�' OWNER MPRR Verde Estates MAIL RECEIVED BY DATE RECEIVEDI � DATE ISSUED ADDRESS 1701 Gisler. 9t. /-a? S 2 ' 19 BUILDING CITY Costa Mesa TE No-K15-1751 ADDRESS ' ARCHITECT LIC. COSTA MESA, CALIFORNIA OR ENGINEERJ.R, Shelley NO. 0-2170 FIRE ADDRESS Long Beach 0e 9-0908 ZONE ZONE NO.OF TYPE GR 014 P SS CITY LIC. PLANS v/`/j/(1`'/. CONTRACTOFL.0• RobinsoniNO. 1123 (7 / // o- ADDRESS17-11 0is.�PT S`• c--(t.-- TEL 5-1751 APPROVED BY DATE LEGALLOr CORRECTIONS DESCRIPTION NO. 143 BLOCK TRACT 3' 5 A.P.NO. SIZE V NO.OF BLOCS. Q OF LOT_ 70 —100 _ NOW ON LOT none USE OF L1 EXISTING BLDG. SETBACK LINE FROM C CENTER OF STREET 501 plus REAR YARD 201pl��us SIDE YARD RIGHT 5lplus LEFT 5lplus DESCRIPTION OF WORK NEW x ALTERATION ADDITION • REPAIR MOVING DEMOLISH BUILDING IAA NO.OF SIZE 1`}3EXTERIOR1.34 Sq.Ft. ROOMS 6 STORIES 1 _COVERING WA OtUNKR!RINCAZphalt & Rock SUELOEN NEWResidence & Attached Garage . I HEREBY ACKNOWLEDGE THAT I HAVE READ T 5 APP ICATION AND STATE THAT THE ABOVE IS CORRE ND ACRE 0 C• PLY WITH ALL CITY ORDINANCES AND STATE L REGULATI B DING CONSTRUC- TION. 1k. VALUATION (y9 PERMIT FEE S I ey SIGNATURE OF PERMITTEE 5/i 7/2 cry PLAN CHECK S / AUTHORIZED AGENT TOTAL FEE 5 C-t t. p a226745PAID MAR -1-67cnfA00 045 F.4* ***5.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. SOX 1200 COSTA MESA, CALIFORNIA 92920 - For Applicant to Fill In Completely APPLICATION FOR PERMfi TYPE OR PRINT BUILDING HUILnINa n For Office Use Only ADDRESS 3 O0(, c M n It PA . - �rJj(y,L�JP RECEIPT NO. •`"' J l 45 COSTA MESA. CALIFORNIA /1RECE • • 1 RE El D DATE ISSUED OWNER PHk_i 1: c tti I V 1---2 e 4 — s. - - - Or BUILDING MAILc- ADORES- ADDRESS 2 0 0 /. .1 R M 0 CI P.L. t/� FIRE CITY (Tyr MesR NO. ZONE TYP aRouF� ARCHITECT TEL APPROVED Pf' 3 G F BY / DATE OR ENGINEER ALL/Al r 2 Ni?. I ZONING ,,if / ADDRESS - ZONS-I/ I NO.OF I Utt or .. 11 ra y nig. r{1�/ PLANS 2> SUILDIN0 cONTRACTQR O CO OL/ L:^ �. DECAL „et--74/4/3e - ?//S ADDRESS DESCRIPTION ? Q p �1 yam'/ CITY A.P.NO. /cl / -/p / d(/ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL SO'TO SIDE&REAR P.L. SIZeNO. V� (n�J�•Kr., •3 s jC EAVES NO.OF SLDOS. I ALLOWED (U.B.C.REQUIREMENT) OF LOT y Pa X hv, 97 I NOW ON LOT / YARDS APPROVED YARDS APPROVED USE OF ,��.'RES nEwcc MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. _i (FROM C/Le/T�STREET)/ SETBACK LINE FROM FRONT A /-/T FT6Y/ C PT. CENTER OP STREET REAR YARD ` /I SID;YARpI LEFT I RIGHT R.SIDE f,/ PT. / j FT. DESCRIPTION OF WORK / L.SIDE t 44Cl c(/ FT. NEW _ ALTERATION _ ADDITION V REARS PT. I FT. DISTANCE BET. BET.MAIN 9t REPAIR MOVING DEMOLISH MAIN E11.0061. ACCESS.BLDG!). BUILDING NO.OF VAR.# DATE SIZE ROOMS 6 STORIES 1 C.U.P.# APPROVED EXTERIOR WALL IROOF APPROVED�J�I9' COVERING COVERING PT �� DATE USE OF BUILDING AND WORK TO BR PERFORMED S. l Lu JNuM r(ILEF1nco INRA/ f1 ) 9 ANA STo&.9c& 2nAAl 1 As h//�/ /t SQ.FT. 7 1 HERESY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 0 AND STATE THAT THE ADONIS.IS CORRECT AND AGREE TO COM. PURPOSE OP EETADUSHINO A PERMIT PEI ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTIO f PERMIT FEE( 5 .CoO m SIGNATURE OF p :),,_1.,, .V 7/�,any,\/ '/ PERMITTEE /TL ��/•••..J// L(Wl 8 t 80PLAN CHECK $ �- w AUTHORIZED AGENT ff �QCd _7 / n TOTAL FEE 5 .,-5-/0✓ U WA tat .,.._...�.� .. .. _ DATE JOB ADDRESS 3006 Samoa P1. BUILDING PERMIT NO. 2671+5 GENERAL COIy:rIIA TOR Owner- Tr. DESCRIPTION OF V ; AlnmScreened Patio & Stor. AP No. 139-1151-213 LOT TRACT FIRE ZONE VALUE $480.00 INSPECTIONS Signature Date GROUP I TYPE J ZONE R1 Soil PERMITS ISSUED Gas SUBCONTRACTOR I Date Number Signature Water Plumbing Rough Plumbing Prop. Swr. Line 0 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 0 Forms 0 Steel Reinf. 0 Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing—In 0 Out 0 Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final Building, Final 7/C1 C 3-/-47