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Home My WebLink About1575 SANTA ANA AVE - Building Permits i CITY OF COSTA MESA BUILDING DIVISION Y %1 �� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER � PERMIT • B05-01862 - (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cteILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1575 SANTA ANA AV Status: ISSUED Suite: Applied: 10/182005 Vicinity: ROOF 0 Issued: 10/182005 Primary Occ: R-3 Dwellings/Cong Res<10 Typing ction: V-N Parcel Number: 42516311 Zoning: Applicant: DARYL EVE Address: 5151 WALNUT AVE UNIT 2 Phone: (949)653-5722 ISSUED BY: IRVINE, CA Zip: 92604 Owner VALLEJO, FLORENCE M Address 2201 HOLLY LN Phone: NEWPORT BEACH,CA Zip: 92663 Contractor: SUNDANCE ROOFING CO Address: 5151 WALNUT AVE UNIT 2 Phone: (949)653-5722 IRVINE,CA Zip: 92604 License: 718369 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TER OFF EXISTING ROOF.INSTALL 1 LAYER OF 30#FELT,30 YEAR COMPOSITION SHINGLES,TIMBERLINE,AND REPAIR/REPLACE SHEATHING AS NEEDED.2,100 S.F.INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,000.00 Permit: $139.25 Claim Valuation: $7,000.00 SMIP Res: $0.70 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 Total: $139.95 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 2446-4e(e/C0) 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 sell-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'compensation Insurance carrier and policy number are: Cartier. �- Policy Number: (This section need not be completed if the perm' is Oe/ubd-af one hundred dollars($100)or less.) _ -Ott!tompensa at in the pe 0i•:- U-wo or wh ? Is issued,I shall not employ any person In any manner so as to become subject to the workers' •n ee -of - end :gr'' that II a subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply wi these p ' p cant Slgnot _ x.y `Date:-- WAii ra FAILURE TO SECURE WORKERS'COMPENSA 'V• RAGE IS LuT AWFUL AND SHALL SUBJECT Ar(EMPCOYEAl0 CRIMINAL PENALTIES MID CML RNES UP TO ONE HUNDRED THOUSAND DOUJRE(S10 .CCO),IN ADDRIO14 TO THE COST OF COmeENSATIO4,04MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. -arLICENSED CONTRACTORS DECLARATION: I hereby affirm that Pam lice •:d un•eLyr• ion' • e Section 7000)of Division 3 of the Busine3s end( ssions Code,and my license is In full afo career e� n ct_L.ic_e .'3 �• • �.. •ass a- Gam— J IIaan� ��►°��i%� 9Gant e�toSlgnnturo: Date•.-- - - /0/s-os 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 Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business end 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 dvil 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.). 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: 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,lalsewoik,or demolition or dismantling mereoi,will be more than thirty-six(36)feet high.(Chap.3.2,Gm 2,Art 2,Sec. 341,Title B,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? ❑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 lime 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 en 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? 0 Yes 0 No 5 Does or willo the applicant or present a future building occupant at y other for the work ontch Is the subject ragc this application a1p�ermit for such construction or modl0catlon from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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 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 whiac 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 taws and dry ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF C• - ANCE •.D AUTHOR it TI• 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 empty ith a to laws a • dry ;dl :noes relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-d- c •ed • ope y f•r in .: •n purpos:s.leg y.: net to occupy or allow occupancy of any building authorized by this permit until final inspection. �i '.f e•: Ow,:r(s)• /"3-713�O /— Wclf,Or Authori ')Applicant • -- (Dais 3i • ODE II INSPECTION TYPE atE INBBA1.5 COOFt INSPECTIONTYPE gaff. MILS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final / 208 Final Plumbing 200 Final Re-Roof Y 210 Final Electrical _ _ • 201 Final Block/Retaining Wall 212 Final Flre Prevention• _ 202 Final Factory Fire Place 220 ' Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition • 250 Final Building/Occupancy OWNER BADOUR, W. J. DATE 9-24-62 JOB ADDRESS 1575 Snnta Ana Ave. BUILDING PERMIT NO. 17859 GENERAL CONTRACTOR Owner-Bldr. VALUE $ 150.00 AP No. 117-182-15 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Md.i�nc.Pat. INCPECTIONS Signature DATE GROUP J TYPE V ZONE C . to Rec. R-2 ISSUED Gan SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line 0 House Con. 0 St.Swr. ❑ Sprinkling System Construction Pole Underground 0 Power ❑ Rough Wiring Trenches 0 Forms 0 Steel Reinf. 0 Floor System Bond Beam 0 Steel Reinforce ❑ Sheathing Frame and Flashing yy]m Lo — g— A.2- Lathing ZLathing— In ❑ Out ❑ Plaster, brown coat Rpsnrt-g. ❑ Air Cond. ❑ Final g ing, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final �ri'J o /p — OCCUPANCY FORM BU4-5M — 7.61 1 7RcO I /bb9 FE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT SEP ? 112 P. O. BOX 817 COSTA MESA. CALIFORNIA FINANCE DEPT. Applicant to Fill In Completely CITY OF COMA. MESA For P Y APPLICATION FOR P I �J TYPE OR^� -P,RINT J A/42 ,! }-_ BUILDING ADDRESS /V ` iS S// /I T ,7 A/I'? v COSTA MESA. CALIFORNIA For Office Use Only OWNER I/ 1. 2)-71:7O z. ` c libI RECEIPT NO. lib4I. J MAIL 1a 7r �e.7V �9 n k* Ave RECEIVED 59. O RE-/.e(`�V�D/ oALT/g IBp//- ADDRESS �y✓!Y/4 1j /-(/f /'/"p� �C /^V it—bet-t.. cm/LOST/9 /77 S' S R TEL NEL./ d �•r3Z BUILDING / ADDRESS ARCHITECTTEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS - FIRE ',JJ //, ZONE .�� TYPE P GROUPL CONTRACTOR ////�✓Y -M'1/ 6.1.4.. .P.,-,-1-,--• B?PROVED %Z DATE // oa- ADDRESS '�'7 ZONING _ ZONE /� NO.OF USE OF NEW-L-.../7. CITY /� 7...''' - PLANS y-BUILDING - /-A STATEIC.N / TEL.- LEGAL 1 /1/�' 3 �N iip-S' LIC.NO. NO. DESCRIPTION(lf �/i 2-14/7 /$/ SIZE �/ S-54 I Q s I NO. OF NOW ON LOTS / A.P.NO. / 1-7— / 8 O� / , -.- USE USE OF YARDS EVES EXISTING BLDG, APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.1 CENTER OF STREET �C REAR YARD ? X FRONT L�Ci(�r/_`. �: IN. SIDE YARD I LEFT E x I RIGHT /, R.SIDE rV FT. IN. DESCRIPTION OF WORK L.SIDE ZyZf, 1ST -- 9--'70.-- 9--'70. IN. NEW I II ALTERATION L y A II ADDITION I REAR//,j FT� S I-a—o4 •IN REPAIR I II MOVING I II DEMOLISH I BYPROVE _ y_6 .-DATA%./ i9' BUILDING '/ // NO. OF / ex..----ye i SIZE / D X/ IO ROOMS / .BTO Fj IES COVEXTERIOR % LL(1 4 / I ROOF EXTERIN -� Mr-✓ COVERING USE OF 13ZZNG I ND RK Tp SE PERFORMED fl2 AP/4J;l`..---"c_L 1 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 COW PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONS CTIN. VALUATION SIGNATURE O ( PERMIT FEE $ �� N PERMITTEF/ 'jLLL!!!� //�j C n $ �l PLAN CHECK S 'B " AUTHORIZED AGENT 3 IU TOTAL FEE $