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Home My WebLink About3131 SAMOA PL - Building Permits CITY OF COSTA MESA 4 BUILDING DIVISION >'tract� DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER 1. 1 DEVELOPMENT -0PERMIT / 05-01662 .4* (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3131 SAMOA PL • Status: ISSUED Suite: Applied: 09/21/2005 Vicinity: ROOF Issued: 09/21/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 13915325 Zoning: R1 Applicant: WHEELER, RICK Address: 10582 WLKER STREET I, ,,^ Phone: 714-220-2660 ISSUED BY: {`�'J/�� CYPRESS,CA Zip: 90630 Owner: DANIELSON, NORMAN.H Address 3131 SAMOA PL Phone: : R 1 P COSTA MESA,CA Zip: 92626 Contractor: . NEW MILLENNIUM ROOFING • Address: 10582 WLKER STREET Phone: 714-220-2660 CYPRESS,CA Zip: 90630 License: 770859 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TIO EXISTING ROOF,REROOF WITH 30 YEAR COMP SHINGLES ON ATTACHED HOUSE AND GARAGE,APPROX 30 SQUARES.REPAIR AND REPLACE SHEATHING AS NEEDED. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $6,000.00 Permit: $125.25 Claim Valuation: $6,000.00 SMIP Res: $0.60 SMIP Corn: $0.00 Other • $0.00 Inspection: $0.00 Total: $125.85 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 2446.4816' 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,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ 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' omp�s'Ion Insurance carrier and policy number are: /7 t7 " Cartier: ` Policy Number: (This section no be completed if the permit Is valued at one hundred dollars($100)or less.) `--`--- L❑ I certify that in the performance 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 Caliii .,end agree th= I should be ome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro ';• n /� Applicant Signature: �� Date:, 794 C WARNINO:FAILURE TO SE•r•E WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OP THE LABOR CODE,INTEREST,MID ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under• • Ions of Chapter 9(commencing with Section 7000)of Division 3 of the Businespgd Pw�s .Code,and my license is In full force and effect.Lic.It '?i�f I Class* \ Contractors Signature: i c' r Date CONSTRUCTION LENDI 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: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm hat 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 requites 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 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,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 presgnt 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 fJ 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 Dy 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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 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 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 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 prope • nspection urposes. gree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ' Signet eI��Ownead)'� (CP f "An orizeaApplicant Vit Date - OPE/ ' • a' QAIE INTRIALS CODE/ INSPECTION TYPE QrIIE 1NIML5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final /� 208 Final Plumbing ` 200 Final Re-Roof 7 c4Q, � 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 SUMNFRLAND LAND CO. DATE 2_28_57 - Si31 JOB ADDRESS Samoa Place BUILDING PERMIT NO. #(1(167 GENERAL CONTRACTOR Owner Bldr• VALUE $ 10,686.00 L 95 BLOCK TRACT 2353 Single res. w/att. gar. GROUP I & J TYPE V ZONE FIRE DISTRICT 4520 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench 4S' '4 .4- i .2 7 Foundation Forms and Grade to Garage Rough Framing zir• 6 -✓ - - • Plumbing,Rough to Slab W_ 7/1.4_, S c51:77 7 in �'!� a+j�f1 tr-S0n0 .j �' y ZS 7 !1 G '1/7 Plumbing, Rough Complete )14,d-9 YI 9 ;S= 4`7 (� Temporary Pole • Wiring, Rough JUN 1957 v.. LI tr =i y- 0-9-s7 y95 ` ✓ a Heating,Rough Pin d.S 5';4'67 6n., . _ - _ - — 94' 7,5 t•------ Heating, ✓Heating, Final k14C.5 0 •5.6'7 ,- _ SewerctIo e50/1-'' Sewer,St..1 5 ,9 /-rl:c -J`r::,,-,,.. �- I•-.- 7 4 9.r- 7 Sentic Tank or Cesspool a Ing, In\ Out, > i ,, .' -' 7 Plasteringr�77 G-t--- f'X.7- 7 Plumbing,Final,Fixtures Complete}rj.45 ,9-g-J07 Plumbing, Final Gas Test AS'in- keit 5 0-$'f `j I, - / ,_^ / l/-3 Wiring,Final Tfi 0old J1_ 4Ce-y'(?Fc( /- ' / / .' d / 6 /(�/ Occupancy /0*S /2 -H'5-7 FORM 210 3M 10-55 • OWNER nAMTFT.SON_,_tOPMAN H, DATE 11-1-61 JOB ADDRESS 3131 Samoa PlarP • • BUILDING PERMIT NO. 157614 GENERAL CONTRACTOR Rahcork-Gorne_,Custom Blds_._,Inc. VALUE $ 2,250.00 frpl. AP No. 113-3831i LOT TRACT FIRE ZONE DESCRIPTION OF WORK Add fart.rm:& 7" `ECTIONS Signature DATE GROUP I TYPE V ZONE R-1 So.. PERMITS ISSUED Gas /7 ✓' SUBCONTRACTOR DATE NUMBER Water Rough Corn. Ref rig. 0 Air Cond. ❑ Rough Heating Rough Plumbing Miscellaneous zjeatri_(`Dr Prop.Swr.Line ❑ House on. 0 St.Swr. 0 6 Sprinkling System Construction Pole Underground ❑ Power S. Rough Wiring e 7 /,1 CCIlc �! clia it j1-11 1 Te,.32nit Trenches 0 V Forms ❑ Steel Runt J7' // Floor System _ Bond Beam 0 Steel Reinforce 0 _ Sheathing gq _ /(_I$-(-/ Frame and Flashing /�f Q�_� )1 �/ Lathing — In 0 Out 4/] ✓J -0 11-Lo-G PI 'er, brown coat erg p_.N-cT g. 0 Air Cond. ❑ Final Heating, Final Plumbing Fixtures, Final Final Gas TestWhic-Thrkiy• Electric Fixtures, Final (F , d _ Z / Building, Final L /'�/d `C I OCCUPANCY rflDRA PITA.AM _ 7 I 157614 1Y; i 973'x- ttt nC .,LIvLiV -.� .` 15�y6NOV1 1961 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. CITY OF COSTA MESA P. O. BOX 917 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT �/� BUILDING ADDRESS ) �/_ •9,1- /y o /J FCJ/_�- BUILDING' )/, ,'I fi �Y-F-�A I I(� CCOST�A1`MESA/. CALIFORNIA F For Office Use Only J�1/�f OWNER Nog/4)I I/V~ it • V4L /`•� t , C"G/ 1 RECEIPT NO. I/ PERMIT -' / D ADDRESS '�/ j��`}}- '�d�. Ay 0a ./�MAIL ‘Rn BY I l/—iTE E- 4,,eD(/ ii 1/4+i%---6 V//rte. CITV !'O 57 /1 Al f .-1"4 NO /....,22.72,,,. �J l ADOORE/S(SA / �J 3�1Y//_ L/ C WirtAR 1 S TELT / Ca.• . ESA. CALIFORNIA 'OR .INFER N�I C�r/ NO Jz-fl/1 j� �� /j ADDRESS ,e,..- L. A' /7 C' FIRE rte'// (J/� /.t // ss�� ZONE ` TYPE GROUP J/ // CONTRACTOd3, /JC LT".'k K oPLJ 4 V=i"-C'kt" A // /V/ .-t BP D DATE ADDRESS /13 Jct ` ✓JL-AC.if I' Al ING _ b4A r r — Q 1 ZO - NO.OP UNEW /////JJfff CITY r� �"" �/ `� / r( PLANS// I BUILDING735-3-at&(Y LIC.STANO,E l`/Ia /I` / ,y NO. �.1�_ LEGAL �/ )• j oEBCRIPnoNLO rf1T� t/ 1 /f 3" ✓ l SIZE ej/ ✓ / o o I HO. OF BLDGS. 1 ^{ ` ,�^) OF LOT J� NOW ON LOT A.p,NO. [/-3 < 1 2 N USE OF YARDS EVES EXISTING BLDG4n.�..0- APPROVED ALLOWED SETBACK LING FROM (CENTER LINE ST.) / n� CENTER OF STREET REAR YARD FRONT p F ,A✓J7 IN. SIDE YARD I LEFT L I RIGHT .:] R.SIDE it OFT. / IN. DESCRIPTION OF WORK L.SIDE 5 FT. IN. NEN, I II ALTERATION I II ADDITION REAR / 0�FT. IN. REPAIR II MOVING II DEMOLISH BYPROVED Lt/ _ ! ' DATE /Y _/ 4 / SIZESILDING ) J !rr ROOMS / STORIES ( � � EXTERIOR/WA /•1C�-1 ROOF yl COVERING ! 4-Efts, I COVERINGer_n:+"�z/0) USE OF BUILLS 1116 AND WORK TO BEE{,PERF•- SL �-MED \ ' S�. • I I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND = ATE LAWS REGU• TING BUILDING CONSTRUCTION. • /� VALUATION SIGNATURE �)`.��•' 2i....4... PERMIT FEE $ it./ CYO PERMI ./,e "---/-r'' _ � < n $g7 GV� PLAN CHECK $ v AUTHORIZED AGENT t, / TOTAL FEE S /`-+ y -OWNER DANIELSON, NORMAN DATE 2-5-59 JOB ADDRESS 3131 Somoa P1. BUILDING PERMIT NO. "8604 GENERAL CONTRACTOR Better Bi1t Fence Co. VALUE $ 299.00 11Aip03—"Ll LOT 95 TRACT 2353 FIRE ZONE DESCRIPTION OF WORK Block Wall QIP TYPE ZONE PLAN NO. 8604 • INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing Lathing, In Out Plaster, brown coat Underground soil W/G Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System tia ng Final F- 'ain! Fixtures, Final Flat Gas Test Construction 'ole n / *it-- Underground Power '7 Rough Wiring Fixtures, Final �.. -OCCUPANCY Form 210-5M-1-57 RANI • COSTA MESA BUILDING DEPARTMENT ;IL I I SEB-4SePpCQ!14.n y2 **a2,00 P. O. BOX 317 E.E tU`. V - 8604 COSTA MESA CALIFORNIA 4' ' '_B 1959 FOR APPLICANT TO FILL IN C.L. OF STREET- FIN IP:CE ' D cm Ir, c s P'I_$q BUILDING ADDRESS �� erci / _J�PROP. LINE I Owner ��/�'+t�-- I o-- - - - T 10 FT. FOR 60 FT. STREET- -int: I Mail Address 3 3 �po«++st 6IlFF�R -T % %50 FT STREET I City P0,04- 'h-Do4-• Ph. No./i/ - 3-9134- I • I Contractor /1,7G " P Ph. NNoo. l -1//771 I Address 4-c ✓3 /L i ACC- A!!�� .d . • 50 TIIF FRON City Lic. No. State Lic. No. IOF PROP. F - 150 FT m Size of Lot 6i SC I D O AP No I- n7- 9\57, r� v9.353 //3— '38"g"- . / ` I- wI $.- Setbacks: C/L Street S- 1- Rear 4 _ w 2 CO ? / z ,�I X a` Side Yard - Right D Left 0 ai r---- a. v O Type of Fence i.,-,-it y5'1r14�C .4- I • O ALLEY I RAYL pr.. LINE\3\ I ¢i Lj 9i uJ�,L17 J/L 6" I y X a V F:::,-- -1 m -1 I hereby acknowledge that I have read this application and state J m a Z 0 it) a that the above is correct and agree to comply with all City Ord- ti • \ J t.to 14 2 ra finances and State Laws regulating building construction. 1 zt ~` E� lo � 5 G ..lila) Signature of Permitt6?ee �a.� . 0u..).4...., _ as` Tm T Agent _ M. o '2 � W 7 s IN. Alim Z FOR OFFICE USE ONLY ao FT. w J U s FT Ptc r6lv4 d m Gt 60 FT ST. Received by Date Received Date Issued o I 1 I 2- "S F ST. i F 1 '?- / -s s/ PROP LINE 4 t I VALUATION I- _ �� __ _ - Z - _ - - - -� / Permit Fee $ �- c9-0 \ to // I I $ q9, Plan Check $ C.L. OF STREETS v. ot.--0 TOTAL FEE $ MAXIMUM 4 FT FENCE MAY BE PLACED ON DOTTED LINES -- - --- MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS