HomeMy WebLinkAbout261 SANTO TOMAS ST - Building Permits ' N CITY OF COSTA MESA
I. ,4y A, BUILDING DIVISION PERMIT NUMBER it
F t """' ' DEVELOPMENT SERVICES DEPARTMENT
PERMIT
*o+mso'F B99-01436
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
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Job Address: 261 SANTO TOMAS-BT` Status: ISSUED
Suite: Applied: 09/08/1999
Vicinity: REAR OF HOUSE Issued: 09/08/1999
Parcel Number: 43920141 Zoning: yyy���//►►
Applicant LANGFORD, DENNIS ISSUED BY: . -- / /
Address: 261 SANTO TOMAS ST. -- - -
CA , -Phone:'-(949)722-1700 -
COSTA MESA /, ,: - Zip: 92627 - -
Owner: HALE;NANCY J
Address 4032 VAL \.ETA ST #311 � / �"
'/ ��•�_
-CAj /. A / _
JjSAN,DIEGO \ - - Zip: 92110 �,-.\ . \-\,
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Contractor:! Hv �l '\V\ ,, ‹ - H, ' / \\\A\
Address: �� '.v ��'
i 1/ Phone: V� ,
1 //0/ -/ License:_`
',Arch : _ i�,!��,� -- J--\ • Eng: �.
' Address: lc/� '" /��� 'Address: , < ��
1. "f"" i ' .^Phone: --- Phone:
4
Zip: ,7 '�
` License: _'..,,e.,:/ �lLicenser
1 v . / ,` � SCOPE OF PERMIT N v-
1�
CONSTRUCT 180 SF(15'x12'). SLE
OPEN PATIO COVER ATTACHEDO REAR OF/SINGFAMILY DWELLING. r
1 '( i ,,
FEE SUMMARY
. Plan Check:, $54.11 , Calc Valuation: $2,901.60
v Permit: , , . $83.25 , v,„.` — - • , :., Claim Valuation: ' - $0.0o
SMIP Res: • , $0.50 — 7 , ,
.
SMIP Com: • $0.00 ,
Other $0.00 .
Inspection: 30.00 - ' _ •� -
Total:,, $137.86
PLANNING &ZONING -
SETBACKS �i ' :-/-' -
P
/.) v.,� s , . /
MAIN STRUCTURE Front.' 0-0' Rear " 0-'0 -Left' 0-'0 . -. Right '0-0'� / -
ACCESSORY"'-`-Front 0-'/0 y. Rear .0.0 • Left -0-0 - _ ''Right ' 7-0,0�' ', = '
i
PARKING 'Existing: 7-0 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. 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
DECLARATIONSD
_._. - . ,
WORKERS'COMPENSATION DECLARATION: '
4I hereby affirm under penalty of perjury one of the following declarations:
O 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:
Carder: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ 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 FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF 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.Llc.If Class a
Contractors 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: Lenders 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 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.).
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 Contr.l tors License :ws.).
❑ I am ex pt under sec. as Business end Professions Code for this reason: 7
Signature: 0.(/1(1.{1 4 ,_en w� Date: t—Si—
Owner ID veld by driver's lice IN/ e. 0 No Drivers License No. Expires:
Verification of Ownership by(type of docu :nt,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O 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? 0 Yes ❑No
(Section 25505 of the Califomia 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 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 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? 0 Yes 0 No
(Section 65850.2 of the California Govemment 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 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 Califomia 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 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.
Signature Of Legal Owner(s) Date
And/Or Authorized Applicant Date
CODE, INSPECTIONTYPE 291E INTIOAL5 CODE, INSPECTIONTYPE DATE INTRUL$
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 II /1/1411 P 1T
2446-46
NOTE: SHOW AND DIMENSION PROPOSED
PATIO COVER AND YARD AREAS
•
cj; SEE DETAILS ON REVERSE SIDE .
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lei } `,.•..• ROOF SHEATHING
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DIVISION OF BUILDING SAFETY • ITY OF COSTA MESA DROP PATIO W LL z x . Z p
CITY OF COSTA MESA PLANNING DIV. FLOOR 2' g go \ a z Q
APPROVED SUBJ CT. TO BLDG. DEE T. REG. 'o ��
SLOPE TO DRAIN 1 PLATE 1" L�
nn �1 ABOVE SLAB 1I.
Y . Dae ' lam' / BY I Mg-E., DATE ZE' ..:.P.'>. . , _ .: . . .ally
rm sef et plass PS spe*at', ,MUST bekept on this lee atill tines an/itis untewhd to (M . . . . . . ±., . . .. :...._ •u�
make way changes or alteration Sway Costa Mesa. WS eaten Pemi650n Iran be Djakarta)dll ddiy I OV Fi ixitt �� s-ic __ ,_26 CA. G.I. FLASHING 1 . . ^,
and fYJ IiLCAiLO I.I.I) I I
ry WOOD _,J_L__ J
The stamping ofthis plan and-,...', SHALL NOT beheld toprmddtobeanap'Nwl �� Q STRUCTION PIERS 12" SOJs o
o the violation of any pr' ' ', of any City d Costa Mesa Ordinance andlor Statq te. a
These plans and penny shall- ., .• - - ., ' " or NOTE .-
- u
work is not commenced and . .: - alive per UBC 4303(d)withal MO days issuance. i
,__5G1.4 Lit, ADDITIONS, DELETIONS, OR CORI ECTIONS SHALL - LL
J STREE • BE APPROVED BY THE PLANN NG DIVISIoSIDE ELEVATION
/0/)la D
PLOT PLAN •
CONSTRUCTION DETAILS
a
DECLARATION OF .UTHORITY Bldg. Permit /1
FOR AGENTS OF PROPERTY OWNER This Permit # 1
TO APPLY FOR PERMITS
c2C � Scew-L 1 1- . 439aolyloo
Street Address AP Number
00 sl aWSow
1. I (W ), nQXI ti 1 3 . Hsi .I e - fvre 1 v‘4`-' declare that I am the Owner of Title
of the above referenced real property, and that I Ore) hereby authorize:
Ts& �1and qqq -1 Z.2 -1"1oO
Name Telephone No.
a co k Std CIr.1Q5 S� .
Street Address
@bsL YVles� �I z(oa�
City State Zip
to obtain permits in my behalf, as owner/builder, for
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we) shall im-
mediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties as a result of work authorized
by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that tict
the foregoing is true and correct.
Executed this , 0 day of /CI-13505 19gl9 , at )( A--Dieso , California.
InUin } ei e 8 - 18 -�q
Printed Name Date
Signature
NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides
for limited power of attorney to secure this permit in any behalf.
0779.46(Rev.1/91)
• U
OWNER KREIBICH. George P. •DATE 3-18-58
.JOB ADDRESS 261 Sant omas $4.AV, BUILDING PERMIT NO. 6511
GE l CONTRACTOR Owner-Builder VALUE $ 13,984.00
11 •--I,
• P. o. LOT 69 TRACT376 FIRE ZONE DESCRIPTION OP WORK Duplex w/att gar.
GROUP I et J TYPE V ZONE R4 PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
r r/yf�,� DATE NUMBER
Trenchesb.�' Steel 1,77/7
Floor System 4 (
Steel Reinforce Chimney
rie
Frame and Flashing iiihp-
Lathing, In Out $q/y r $'�r/y
Plaster, brown('�coat v T CA.W ss
Underground soil/!Q/-i5 WIG Pipe est*J/jS y ad:t-r
Top Out N-2-3-.5C/
Furnace/{7U i(j
Gas Vents
Rough Plumbing / W (j/i•6PI . i4.rvne+t-y .i- fo Si-22-£r /ant / /
Cesspool Septic Tank
Prop. Swr. Lin& House Con. St. Oi�"j[( ¶aM lc� eateva a '( I f'rf'-'- I l gig 4
Sprinkling System � '
k
Heating Final 'W •qrf "Jtf S 6/4 a-rya h/ 9- a.S-c f /-i/ 9s—a—. ()
Plumbing Fixtures, Final i I I-fn' • ,APP-- ' k/]
Final Gas Test / I 4,trls -
Construction Pole , /i.
Underground Power r Clic
Rough Wiring 'y ✓ ,
Fixtures, Final J �'�` Ta•J+47t! Ft�cr, - 7-Z�/-,SSS (07�f-tJ' �7
err -�,- ��
OCCUPANCY ; y�7t—J,
Form 210-5M-1-57
611
. . " 6511
COSTA619a �A**48.00
COSTA MESA BUILDING DEPARTMENT 'AR 17-SBPDmEsn
P.O. BOX 317
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL4r
APPLICATION FOR PERMIT
BUILDING ; SG�oin_u. ((L,. BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
� dd ����yy.�•• y 1��( V' RECEIPT NO. /PERMIT NO.
OWNER /iv\-"1J•L� ...)-7. v.cc`VI V\CH /0 /yy(7(/per
y "T ((.,/�� fD By pG%�EC`y'CD/ /J f// I
MAIL BSB 271y •neI/L�1(� \CI1l�W. P I •
[ `' -E / / LYv�' 3
CITY Q-trikb.) Wa/rya-, e.g.L v.TN O. , 13'JIti-O ADDREISS 2-" / 5I@Aim CY"TA f f /
ARCHITECTLIC. COSTA MESA. CALIFORNIA
OR ENGINEER NO. /
FIRE
ADDRESS ZONE IN
CONTRACTOR CITY LIC.NCZONE /! F.r% Tr PE caoO 7J
(^ } .fr� TEL. APPROV ' 1L ��,[//_ ///j
ADDRESS v 1V LU\t/ NO. BY an. 7L g DATE -3 /s/ ,
LEGAL ' LOT
(09TRACT
CORRECTIONS
DESCRIPTION NO. BLOCK TRACT3 �
A.P. NO. I\ / -- I OKr-' 0:- _ bn/ ',ERr4
IAPPn ®VL®
SIZE
OF LOT jO 7:, 11-4-0
NNo.WofONaLLOT .sat./
USE OF n CITY OF QSTA MESA
EXISTING BLDG. . / \\{.1 DL 1 ^ DEPT.
APIA V
SETBACK LINE FROM / LDC. DEPT. REG.
CS EE
of STREET �� REAR YARD .�`. SUBJECT TO
SIDE YARD RIGHT •
I LEFT i j 3-17-55
'
DESCRIPTION OF WORK .11--Y-1--19‘ D11TE. /
�[ BYPLAN TCCH.Q/h(� _
NEW x ALTERATION ADDITION
I
REPAIR MOVING DEMOLISHBU /�/
SIZIE DING 1 Gip, S9 rt NROOMS STORIES /y. 7
EXTERIOR WALL ROOF :
_COVERING �`y'�'..(� - COVERING� 4I PE 3
BUILDINGUSE OF
EW t•CK�MX-4:c. "� f�C�Ji..L/tC-iV7 /� Q p f/Lo O 'L
i.
HEREBY NOWLEgcsETHAT I HAVE RE THIS A LICAT ION AND_ / LJ-(� ��
CITY ORDINANCES ANDSTATE THAT THE S STATE IS LAWS REGULATING RRECT AND AGREE TBUILDO IINGYCONSTRUC.WITH ALL /�I �- T
SIGNATURETION
- E VALUATION PERMIT FEE $ 31.1...-----
r-
PERMITTEE
1.1��"�
PERMITTEE OF ♦ r �K--. L.:0.9.--
j'� /?/ (? y` r _
`�'rl'Ci {.fid J $7/C J)3 3 / PLAN CHECK $ /C
AUTHORIZED AGENT /Y'_ TOTAL FEE $ zg 9'"F