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HomeMy WebLinkAbout2722 SANDPIPER DR - Building Permits CITY OF COSTA MESA 4 ►? BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER v. 1 �....' ERMIT B04-00170 .1torbointso (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2722 SANDPIPER DR Status: ISSUED Suite: Applied: 01/14/2004 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 01/14/2004 Parcel Number: 13953121 Zoning: R1 R1 Applicant:ddressSHAULMAN,ETNA N, JOE ISSUED BY: Address: 7721 ETNA CL Phone: (714)536-5116 HUNINGTON BEACH,CA Zip: 92648 Owner: STUCKMEYER, JOHN V Address 2722 SANDPIPER DR Phone: COSTA MESA,CA Zip: 92626-4738 Contractor: SHULMAN ROOFING Address: 7721 ETNA CL Phone: (714)536-5116 HUNINGTON BEACH,CA Zip: 92648 License: 690617 Arch : Eng: Address: Address: Phone: Phone: Zip: License: • License: SCOPE OF PERMIT TEAR OFF EXISTING SHAKE ROOF.INSTALL SHEATHING,FELT,NEW FLASHING,COVER WITH 30 YEAR COMP SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 59,500.00 Permit: $181.25 Claim Valuation: $9,500.00 SMIP Res: $0.95 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $182.20 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.Nb.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 2440.48(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: , ❑ I have and will maltain 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 maint n workers'compensation insurance,as required t pe eq by section 3700 of the CatSor redo,for the performance of the work for which this permit Is Issued. My workerrs.,'c9inp anon Insuvranc carder and policy number are: Carrier: 7.Via. C A.» y IPolicy Number: � (l ITl GOP (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) O 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 C:Hort,and agree hat If I hould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro '1• s. I (� f,JJ(1, Applicant Signature: / //-_J. . — Date: 61/44 WARNING:FAILURE TO SE,: RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI 1L FINES UP TO ONE HUNDRED THOUSAND DOLIARE($1.r,00)),IN ADDITION TOTHE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Llc.N Class a 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 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 Cafe: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.). O 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 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 struclure,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? 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 Firo 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). _ _ ..___l....— _._ _. _..___...__ 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 Califomia Health end Safety Cale,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). or..p.r_.se___ ._.._ _ _. ..._._ _ __s)?_... 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 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 a ermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes U 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? ❑Yes 0 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 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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. �natur Of Legal Legal Owner(s) ( In 1` Date And/Or Authorized Applicant Date ;ODE t INSPECTION TYPE gall IttRMLS CODE( INSPECTION TYPE ;all IIMIALSS 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 7 / 208 Final Plumbing _ 200 Final Re-Roof / _2-7_,( 4, 6t✓l` 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 41 OWNER SOGN, O. DATE 6-17-70 JOB ADDRESS 2722 Sandpiper Drive BUILDING PERMIT NO. 31968 GENERAL CONTRACTOR ; •r • ; ., n: DESCRIPTION of WORK Patio Cover AP No. 139-531-21 LOT 66 TRACT 6237 FIRE ZONE VALUE $480.00 INSPECTIONS Signature Dote GROUP J TYPE IV ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISSUED .l GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS 0 STEEL REINF. FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT in PLASTER, BROWN COAT _ STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL if/14,( 6/6/70 i k 91988 . li'I! 17-7Ccnn001871 4***Yet-5 00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely /f�� RECEIVEDVEsBY DATE RECEIVED DATEAISSUED ADDRESS 7.2 Sandfiprrr A-. �'✓ p t0//-7g/70 (D--/7- OWNER O . So�_ A.P.NO./39 '6 3 -2/ PERMIT NO- MAIL SOL BUILDING 4 / Z ADDRESS uayh.e ADDRESS ri722 .moi / ;/1.0 Lii TEL. n.U CITY Cosi et m w S O NO. Sear TRACT 4'3 7j LOT G‘ BLOCK Z Z Q CONSTRUCTION NEW ADD ALTER REPAIR 'MOVING OEMOI ISH 0- LENDER0 a co 41. ` J 3 BRANCH J Ca OWNER C w ADDRESS 03 J I. K fir 2 X ii VALUE �s _J .4 OR ENGINEER-03 ARCHITECT FFQgl- �nf?c.r1l'�leo. L.��y�'_9 SE s 7fLs5 �A'� 5 Cs) J �3• FIRE y� Z Q t u•NE TYPE GROUP d ELIZ CL ADDRESS / • l��.� 3.4 �i- i APPROVED 44 -/7- / J Z CONTRACTOR AI rPi.n BY • ATE (p -/7-70 CO Z \\ Jr ADDRESS 13OLZ Cre_►7Q�QL1 ftIUn ' W W ZOD�E NO.OF USE OF NEW �/ 0_ / TEL A -r /J--/ PLANS BUILDING a "� ZF CITY lin ra QKOL NoairQIQ3 L A-0.--.. - u:O STATE CITY YARDS APPROVED YARDS APPROVED N It LIC. NO. a 3aoo n LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE X f NO.OF BLOCS. /�gpL�Aq[{��{,,T,)� OF LOT �. /6 I NOW ON LOT FRONT—..e• ••^r'[--lacy FT. USE OF IC &AIT IY Q'C' ///'/1/` �^ `/ EXISTING BLDG. Si nes( R.SIDE /tel FT. FT. I— SIZE OF / NO.OBI ! Z NEW BLDG. ROOMS STORIES ' L.SIDE S. FT. FT. 'C EXTERIOR WALL ROOF /p p/� , _ COVERING COVERING REAR fin. / FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 a • MAIN BLDGS. ACCESS. BLDGS. O TX IT a4 s ? \:o1_ N_oytr C.U.P.# APPROVED I— �y F APPROVED —7 Ca d I 2 -- 2 .94 45 — RY DATE gr-77— 70 2 0 UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of La the State m of California. —}� � Z 24/0 I hereby certify that I am properly licensed as a contractor under SO. FT. V o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR s Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 cr am exempt from the provisions of the State of California Business VALUATION and Professions ode, iv' Ion 3,Chapter 9. ry OP PERMIT FEE S /co O • Signature of _-s �- (0 Permittee �f/�ll[ Q $ �D PLAN CHECK $ E /V/// c` Authorized Ager a TOTAL FEE 9 / UWNEit v.14v41 1,4-ati'" ...... ....) a..•-•. JOB ADDRESS 2122 Sandpiper Dr. - BUILDING PE,RMIT NO.26943 GENERAL CONTRACTOR Mesa Verde Slurs. ,- inc. DESCRIPTION OF WORK Res.W att.Gar. AP No. LOT b6 TRACT b231 FIRE ZONE VALUE $ d9,1f60.00 INSPECTIONS Signature Date GROUP 1 8" TYPE V ZONE Rl Soilu -t --r C-1C-- I SUBCONTRACTOR PERMITS ISSUED Gas Date I Number I Signature Water � ✓A P umbing Rough Plumbing C f� .d _,1a%nz� a • , sof' Prop. Swr. Line®-House Con. Y2- -tee)/ 74' i' I, ' , /V - —Ce' 7-7.- . ; Sprinkling System Miscellaneous "'" Rough Heating and Air Conditioning (Z/,, J//e Temporary Service or Pole Underground 0 Power 0 Rough Wiring /Q R 7„ze..6 p eating ap Vept. Trenches EZ Forms A Steel Iteinf. ® P ---q_E7/ / ,/J ./I/flc�i,r -‘7 47,4 Floor System #Ps4 �, -, -6- / Bond Beam 0 Steel Reinforce 0 Sheathing //31.9 ?-S'..6? Frame and Flashing MO 7,24_67 Lathing— In Q Out J &Oa 8_-,.-67 _ Plaster, Brown Coat r, b-,y-6/ Structural, Final c ectri9 Heating, Vent., Refrig. and A.C., al ir2 ��� Q .� . 1-1s-ill l a7330 Plumbing, Final and Gas Test Electric, Final Ih „pyy_ �' ”'Building, Final /J--..,-4. • itPAID 4* 2Gs13 APR 25 67cnsa001273< *-d 135.75 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 917 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT Lot' 66 TYPE OR PRINTTraCt 6237 BUILDING / For Office Use Only BUILDING �/j^) J I ADDRESS 22 £4 RECEIPT NO. P �4,, COSTA MESA. CALIFORNIA syL� 9p /7777 R[ j17 D7 77-G l ��/!SUED 47 Mesa Verde Builders Inc. F OWNER PgMbaNfiabiliitniefi3j3rIliataL MAIL BUILDING ADDRESS 2850 Mesa Verde Drive ADDRESS 549- FIRE VA ye CITY Costa Mesa TEL ZONE TYPE GROUP ��'S- i ARCHITECT TEL. � �-S BYPROVED DATE OR ENGINEER Kaltenbach NQ. 8046 ZONING ADDRESS 1823 E. 17th St. Santa Ana EO R NO.OF UBE OF N[W�Qp (,� - Mesa verde Builders , inc. TT I PLANE. I BUILDING �, CONTRACTOR �X TaT }.' N-XIIEW. n ] LESCR /� •T. ��727 ADDRESS 2850 Mesa Verde Drive DESCRIPTION GI iJ CITY Costa Mesa A.P.NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC..NO. 187318 TEL 549-0395 3O TO SIDE$REAR P.L 6 0 x 16 n EAVES SIZE V I No.of BLOOB. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/{.,STREET) SETBACK LINE PROM FRONT G// PT. FT. CENTER of STREET REAR YARD 4 _ SIDE YARDI LEFT I RIGHT R.SIDE 7T. F7'- DESCRIPTION OF WORK L.SIDE ST FT. FT. NEW X ALTERATION _ ADDITION REAR 32-FT. FT. DISTANCE BET. BET.MAIN e MAIN BLDGS. ACCESS.BLDGS. REPAIR MOVING • DEMOLISH BUILDING NO,OF VAR.# DATE SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WA ROOF Shake APPROVE4/l ./ COVERING OtUCCOI COVERING Sh i ngl P BY (_JAG,.`' DATE }'// FP7 USE OF BUILDING AND WORK TO BE PERFORMED J New Residence n n N se 409' 80.FT. . m r. I HEREBY ACKNO LEDGE THAT'HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL CITY ORDINANCES AND STATS LAWS REGULATING �^/� BUILDING CONSTRUCTION. VALUATION PERMIT FEE ✓ U SIGNATURE(DF)17 W m PERMITTEE $ PLAN CHECK S 9. �� 9 �/Go. D , AUTHORIZED AGENT N. TOTAL FEE $/ 35,"7.x"