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Home My WebLink About1578 SANTA ANA AVE - Building Permits • • CITY OF C 11111 OSTA MESA ` BUILDING DIVISION Fµ ti 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us piqk FOR INSPECTIONS CALL:(714)754-5626 At 00 • PERMIT NUMBER: B09-00180 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42532122 DATE ISSUED: 08/31/2009 ISSUED BY: RMD JOB ADDRESS: 1578 SANTA ANA AV CM Suite/Unit: Vicinity: ROOF Squares: 0 Valuation: $4,000.00 SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS AND REROOF WITH A BUILT UP ROOF SYSTEM ON AN ATTACHED HOUSE AND GARAGE,APPROX 17. OWNER: WILLIAMS, DAVID L Address: 407 PIRATE RD Unit: PHONE: City/State/Zip: NEWPORT BEACH,CA APPLICANT: WILLIAMS,DAVID L Address: 407 PIRATE RD Unit: : PHONE: 949-642-5316 City/State/Zip: NEWPORT BEACH,CA CONTRACTOR: OWNER-BUILDER License No. 000000 Address: Unit: PHONE: City/State/Zip: CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $97.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $98.25 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE t INSPECPON TYPE pn1fl INTMALC CODE! INSPECTION TYPE DRi INPML5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 9—/{f 04/ `L[ ° /k10 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 • '4' • WORKERS'COMPENSATION DECLARATION: Owner IDverifiedby driver's license. Yes ❑'No 1 I hereby affirm under penalty of perjury one of the following declarations: D rsvelicense No. E cLptres.1lZ//4- ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This seaAn net not be completed d the pends valued at one hundred dollars($100)a less.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless s ed, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Appiirant's Signature Date the Labor Code,I shall forthwjth corn ly with these provisions. 720 G1// �Q�' [)+ r� '/o 7 Division of Industrial Safety Permit Number: (��Adbho✓n/(e lSig�n�atu�reLe D/L, ` HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No Lender's Address: (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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fa non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. My violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes".the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ye'-I'as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other ompensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If. however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date properly who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I as Tree not to upy or allow occupancyupof any building • au}hori ed y eof i Owner p ection. / �- Si [tire of IOwners Dat 3057-46(3/07) LSt And/or Authorized Applicant Date JOB ADDRESS 1578 Santa Ana Ave. BUILDING PERMIT NO. 18489 GENERAL CONTRACTOR K. P. D' - inson VP- "E $ 847.0Ari0 ALL.Gar-tc AP No.117-221-01 LOT _.<ACT FIRE ZONE DESC1__'PION OF WORK INSPECTIONS Signature DATE GROUP J TYPE V ZONE R-2 RCG I Soil PERM ITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. 0 • Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line 0 House Con. 0 St.Swr. d _ Sprinkling System Construction Pole Underground 0 Power ❑ �p�� , Rough Wiring LQ!- �% 1-2 (.9c. _/ 'trenches 0 Forms 0 Steel Reinf. ❑ �� jam- . T_"a Floor System • Bond Beam 0 Steel Reinforce 0 Sheathing /3 �-� Frame and Flashing n .t / _ 3-Cj Lathing — In 0 Out 0 .-Q jr-fIT j Plaster, brown coat �'�� -(rk. 1,�,�i-Á `3 Refrig. ❑ Air Cond. 0 . Final I Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final _ .... rtt RECEIVED 18489 DEC 14 1982 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILIADDRDESS/b 2R $ #744NA 41/4- COSTA MESA. CALIFORNIA For Office Use Only OWNER .1 7,1 /5/4'.'Ry I RECEIPT NO. 16489 MAIL I d RECEIVED BY DATE RECEIVED I DATE ISSUED ADDRESS /;lir SANE 4 4NA -�' - -u-yd /s'////4�/E��sz-4 /cZ//L4/F TELCITY e(/,j J�'�Q /j/j gS NO. '"'^ BUILDING ADDRESS/V 7 C-Lf(� ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. FIREI ADDRESS ZONE —3.-r---e•--.-r---e•--TY.-r---e•--TYPE // GROUP �A i /' APPROVED I/ - LIPlt BYDATEADDRESS PM . 2-0 il OLL A - ZONING 'f• 6). / A�r.y�O yl� fine ZO(p�I�� I NO.OF �I BUI OF N6 ,�i i / CITY /(/T. Y, /T fine I h/�� PLANS BDILDINO /` STATE - TEL. / i t J,. LEGAL t AF / ///� I LIC.NO. NO. l� DESCRIPTION f 11 '2-6 SIZE CC NO. OF BLOCS. 2 I III} OF LOT 50.?;,i /30 '/2 I Now ON LOT A.P.NO. O�'�1 _" USE OF YARDS EVES EXISTING BLDG. JP 4 at APPROVED ALLOWED SETBACK LINE FROMQy e Y (CENTER LINE ST.) CENTER OF STREET FT< REAR YARD O-O FRONT '_ 0 FT. it IN. r / SIDE YARD I LEFT /7.7-2 I RIGHT • ^' 'l f ^-�R.SIDE 1 FT(4 7 IN. DESCRIPTION OF WORK ., 7 IN. L.SIDE NEW I k"ALTERATION I II ADDITION \ REAR /�FT. 84 IN. ^7 REPAIR I LOVING I DEMOLISH APPROVED VSA - O DATE/ �j T 6 Y BUILDING r it ( (c NO. S J SIZEr i .t'2.�-C ROOMS I STORIES / EXTERIOR WALL i. ROOF COVERING // G C(0 COVERING CU qn F. USE OR BUILDING AND WORK TO BE PERFORMED • 1rASPA- Gt 4t74 /tS to A2C5Iparc C&std-l-' Dan' /v PLACE e-F tU/.veabd 30e°' 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 OF ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. N VALUATION SIGNATURE OF PERMIT FEE $ ‘' R� PERMITTEE �d-O n S j>i�/j PLAN CHECK $ "-^ AUTHORIZED AGENT / 6.0 ¢ TOTAL FEE (!�' c