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Home My WebLink About1075 SANTA ROSA AVE - Building Permits sip If CITY OF COSTA MESA 44-S) BUILDING DIVISION :j ..sDEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER I d� �. PERMIT t.* 1.1% 05-02475 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.EtLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 1075 SANTA ROSA AV Status: ISSUED Suite: Applied: 12/30/2005 Vicinity: Issued: 12/30/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 41205207 Zoning: Applicant: ANDERSON, MILTON L TR Address: 1075 SANTA ROSA AVE �/ Phone: 714-751-5445 ISSUED BY: ///� — •j COSTA MESA,CA Zip: 92626-1619 • Owner ANDERSON, MILTON L TR Address 1075 SANTA ROSA AVE Phone: 714-751-5445 COSTA MESA,CA Zip: 92626-1619 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF THE WOOD SHAKE.INSTALL 1/2"CDX AND 2-15LB FELT AND 30 YEAR COMP SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,600.00 Permit: $125.25 CP luation: $5,600.00 SMTP Res: $0.56 SMTP Com: $0.00 R R I Other: $0.0000 Inspection: $0.00 Total: $125.81 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 2446-46(6/00) DECLARATIONS I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: t I. ❑ 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. + s ❑ 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 section need not be completed it 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 California,and 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 provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN 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.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: o 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 fora 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 Contr ctors License Laws.). I amxe J'•Ly��'ec Business and Professions Code for this reason: Ig a wr Ii 44�� s: 1-1--o G 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: , I 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 9 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 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 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 LI 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 pan 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.1 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 to laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above- d pr art r ec on purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signatur•Of Le.. •wner(s) Date And/Or Authorized Applicant Date CODE I INSPECTION TYPE PATE ISM ALS CODE I INSPECTION TYPE an Ri1ID$LS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing r- 200 Final Re-Roof / (7--p , -7;1:---V/ --V 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 r . 250 Final Building/Occupancy S 29575 car COSTA MESA BUILDING-SAFETY DEPARTMENT JAN -7-69CM5D00 207* ***1 as.C` P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 - • For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING e: For Office Use Only BUILDING Ile ADDRESS 10 5 a to t• a & ' RECEIPT NO.• LJ J ' COSTA MESA. CALIFORNIA RECEIVED EY DATE RECEIVED • I- IS ED OWNER Heltzer Enterprises-Costa Mesa A.. A0/41 �� :. BUILDING , if ' MAIL . ADDRESS f076! . ADDRESS 144 South La Brea Avenue - ' FIR t o CITY Los Angeles 90036 laT936-1104 :` ZONE 3 TYPE ✓ GROUPNay-y. ARCHITECT TEL 57141 - APPROVED DATE . OR ENGINEER Frank Gonzales NO.S 2-6878 `.' 1336 E. Chapman Avenue ZONING ADDRESS I . •• • • • . • • •: ZONE NO.OF USE OF NEW - • ,1 Rl PUNS 2 BUILDING h Ga axe 1 CONTRACTOR George J. Helrzer & Assoc. ' ', ADDRESS 144 South La Brea Avenue uE°s elPnoN .t 50 Tract No. 6637 • CITY Los Angeles . California 90036 i N P.NO. None NOTE: NO[AVE OVERHANG SHALL BE LESS THAN LIC..NO. 201098 NOS 936-1104 30'TO SIDE REAR P.L. '' SIZE I NO.OF SLAGS. ALLOWED (U.B.C.REQUIREMENT) '1. OF LOT Mow ON LR 0 YARDS APPROVED YARDS APPROVED IS USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREET) • SETBACK LINK FROM • I Pmits.T. FT. • CENTER OF STREET REAR YARD 27 '-6" • i SIDE TA'D LEFT 5 I RIGHT 81-4" FT. ' DESCRIPTION OF WORK PT. NEW X TERATI•N ADDITI•N FT. :4 BET.MAIN e REPAIR MOVING DEMOLISH • ACCESS.BLDGB. j. VAR.* DATE BUILDING NO.OF i mu ROOMS STORIES 2 ' C.U.P.* APPROVED /// ;,1 EXTERIOR WALL ROOF APPROVED '' nn / I // '• COVERING S tUCCo I COVERING wood shin• le er U20,4 N/ DATE (/'116 6/4n USE OF BUILDING AND WORK TO BE PERFORMED I 1 C Dwelling and Attached Garage N Plan 404B - Lot 50 1 • 1 61 5 Q.FT./ >1:2 ° ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION _ THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j • AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO cos. PURPOSE OP ESTABLISHING A PERMIT PEE/-O.NLY. JNP, PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION O ^ BUILDING CONSTRUCTION. LJ .J0 SIGNATURE OF a PERMIT FEE PERMITT[8 �+ / /, 5 077/5-417 .. •._ . lignai 6 AUTHORIZED AGENTS/ /er �,"" r x n.. =I....... - :a•. ,.. .:2:'....f+. ..:... .. - TOTAL FEE 02202 "OWNER RTVKING, LESLIE & DTANE DATE 4-24-75 7,_JOB ADDRESS 1075 Santa Rosa Ave, BUILDING PERMIT NO. 3 98 99 `-.GENERAL CONTRACTOR Owner Bldr. DESCRIPTION of WORK Patio Cover 'F AP No.412-02-07 LOT TRACT FIRE ZONE VALUE $ 200.00 <S INSPECTIONS Signature Date TYPE V GROUP J ZONE Hi • SOIL PERMITS ISSUED GAS SUBCONTRACTOR Data Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. Li SPRINKLING SYSTEM MISCELLANEOUS � ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND fl POWER f ROUGH WIRING Heating and Vent. TRENCHES lig" FORMS STEEL REINF. Li .WLCJ 3�-Ts FLOOR SYSTEM BOND BEAM Li STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN fl OUT I PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG, AND A.C., FINAL PLUMBING, FINAL AND GAS TEST pi EI-ECTRIC, FINAL .� t 39899 PA,B APR 24-75-5:00 904* *****5.50 i COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECE ED Y DATE REOf IVED DAT (SSU D BUILDING /I -s 2-i---co JE+ �[E ADDRESS lo'75 SANTA 'ROr' AVE �"` � 7 vZJ�7 11 ES1�a-052 PERMIT NO. OWNER L [.SE T J�SANi: .Z 1/K/AlNO A.P.NO. Gam. MAIL 017 S ( BUILDING 1O2S .A� A Z ADDRESS / JAN 7A T. ASE ADDRESS //l//�� c^ `.3s C Q CITY C0ST9 MEf- , NO.TE5c7-522L TRACT(,p( 37 LOT SO BLOCK CONSTRUCTION NEW ADD ALTER IRFPAIR (MOVING DFMOIL¢H Oal- LENDER Lel Ss _ID BRANCH ' J N OWNER < W ADDRESS 03-J I ' 4�2,d/LU$J03 ARCHITECT TEL. USE a&t) a OR ENGINEER NO. Z Cr) FIRE 2 ADDRESS ZONE TYPE �7 GROUP 8- 0-01 APPROVED/14 V 4% W Z CONTRACTOR 0 L✓ /N Ca BY APPROVED/ l4/ �r//n ATE J O co Z JCC ADDRESS W W TEL. ZO NO.OF USE OF NEW1r"IO O= CITY NO. \ PLANS BUILDING Coder_ Z1- W O STATE CITY YARDS APPROVED YARDS APPROVED ct¢ LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L. STRFET) SIZE I NO.OF BLDGS. _ OF LOT NOW ON LOT FRONT {Arllft� FT. FT. USE OF �y� EXISTING BLDG. R._EIDE `'r FT' FT, I— SIZE OF NO.OFQ r Z NEW BLDG. ROOMS STORIES L,SIDE 49 FT-- FT. -- KC Q EXTERIOR WALL I ROOF n V COVERING COVERING REAR I ( FT.t FT. - - J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 0- MAIN BLDGS. ACCESS. BLOCS. Q // VAR.# DATE 0 D�L �� 'TIO IL 00 C.U.P.# / APPROVED �/s ,4t H APPROVED (, �LP 11 ,1 DATE 4— `--- !^-7� 6q RY W�'YV 2 Uo fl I hereby acknowledge Nat I have read this application and statethat the above information Is correct and agree to comply withall laws regulating building construction, and I shall not employany person in violation of the workmen's compensation laws ofI Zthe State of California. CO I hereby certify that I am properly licensed as a contractor under g the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 am exempt from the provisions of the Stateef California Business c and Professions Code, Division 3,Chapter 9. VALUATION .�^ B PERMIT FEE $ ,r) -- N _^/ n D Signature of (TO tJ ..moi co Permittee $ PLAN CHECK $ E �. o `o Authorized Agent TOTAL FEE $