HomeMy WebLinkAbout1588 SANTA ANA AVE - Building Permits CITY OF COSTA MESA
tBI/ILDIN�1i DIVISION
>:J, ,;,,t '; DEVELOPMLINT SEFgVICES DEPARTMENT PERMIT NUMBER
t• PERMIT h /805-02212
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trait
(714)754-5273` �• Fax(714)754-4856 • www.ci.costa-mesa.iS.LMLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1588 SANTA ANA AV Status: ISSUED
Suite: Applied: 12/05/2005
Vicinity: ROOF Issued: 12/05/2005
Primary Occ: R3 Type of Construction: V-N
Parcel Number: 42532124 Zoning:
Applicant: DALES MILLER
Address: 13781 NEWHOPE ST
,/'�
Phone: 714-534-6398 ISSUED BY: ► //
GARDEN GROVE,CA Zip: 92703
Owner: ZUPKAS, PAUL F
Address 5197 ALTA VISTA ST
Phone:
SAN DIEGO,CA.. Zip: 92109-1302
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Contractor: DALES ROOFING
Address: 13781 NEWHOPE ST
Phone: 714-534-6398
GARDEN GROVE,CA
Zip: 92703 License: 503508 ,
Arch : , ' - Eng:
Address: Address:
' Phone: - - Phone:
Zip: e > License:. License:
SCOPE OF PERMIT
T/O EXISTING CAP SHEET ROOF,INSTALL NEW CAP SHEET ROOF ON HOUSE ONLY,APPROX 14SQUARES ON FRONT UNIT(1588 SANTA
ANA). REPAIR AND REPLACE SHEATHING AS NEEDED. .
' FEE SUMMARY r <:' '
i �
Plan Check [
' ; $0.00Calc Valuation: i' $3,900:00
Permit: iii, , $97.25 Claim Valuation: $3,900.00
SMIP Res: , ,; $0.50
SMIP Com: $0.00
Other ,"i
Inspection: $0.00
Total: ` $97.75
.PLANNING=B ZONI
SETBACKS
MAINSTRUCTURE Front 0-0 " Rear- ' 0-0, . Left 0-0 fight 0-0
ACCESSORY ' Front 0-0 Rear.. '0-0 .-Left` 0-0 . ' Right 0-0
PARKING ' Existing: , 0 m Required ;.,;0-'. 7 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
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 self-Insure for workers'comper!;ation,as)rovided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
"❑'""[_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 sarrier and policy number are: _
Caniahf 5r'-/e " ,FU n� PolicyNumber --/g&^/! / (o
(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 Ca' • nia,a Agree at if s".become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply withthese provi
,
/
Applicant -A / /—.- Date: /a r- 5
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND Doi I ARE($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 prov,'(sion5 of Ch ter 9(commencing with Section 7000)of Division 3 of,the Business and Professions Code,and my license is in full
force and.effect.Lie.s S 11' Class II
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Contractor's S g tura: —
F. n
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 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 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 ❑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 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:
HAZARDOU&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 orfuture building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the California Health ana'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 aciitely 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).,,1
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? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications tor 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 ❑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 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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
/-Thd//j Ignat eget Owner(s) Date
And/Or Authorized Applicant I'Darn
CODE 0 INSPECTION TYPE BATE INTmAL$ CODE♦ tNSPECRON TYPE PATE INTRIAL9
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical
1006 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof +4.(_ 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
; ,
'` DEPARTMENT OF BUILDING SAFETY
City of Costa Mesa, California •
ATTEN >NOWNER-BUILDERS
I, / , owner of the property located at
9 , also known as APP- //7"-ZZ / 'C 3_
Lot "2 , Block , Tract / Z-F .7 , am to be the owner-builder of the
new construction planned for this site.
As owner-builder, and as provided by Section 7044 of the Business and Professions Code, State of California, I
agree that such new structure or structures, with or without appurtenances, is not intended or offered for sale
and contains no more than three dwelling units of which one shall be my actual domicile if designed for residential
occupancy.
Id this structure be sold or offered for sale within one year of the date of completion, it would be presumptive
evidence that the structure was undertaken for purposes of sale.
We wish to call to your attention Federal and State laws (here-in noted for your convenience) which require you to
adhere to the following when you build a house (or other structure) yourself, and in the course of such construction
employ persons outside of your immediate family.
1. You must register with the Federal and State Governments as an employer.
2. You must withhold income taxes on every employee working on the project.
3. You must withhold and report to the proper authorities social security and unemployment benefits on every
employee.
4. You must carry Workmen's Compensation Insurance on every employee.
S. A separate and additional city permit must be obtained for Electrical, Plumbing, Heating, Refrigeration, Venti-
lating, lath and plaster, chimney and masonry, roofing or other work as required by City Ordinance.
6. You must furnish a list of all sub-contractors to Building Safety Department before final inspection will be made.
7 You cannot legally sub-contract any portion of the work to any person who is not licensed by the State of
:alifornia.
S. You cannot legally build homes or other structures which are intended for sale, unless you have a contractor's
license.
9. You can build a home for your own occupancy.
10. Be sure to check with your local Building Department and State Contractors License Board to avoid difficulty
during construction.
I have read and agree to fulfill and abide by all the above requirements, if permit is granted.
Permit N,o 2d Z'S--- C Date / / c
signature of owner-builder address
FORM BU-3s-IM SETS 2-64
WAN cal £GWGLL, 1. J• LATE' aune 9, 1907
JOB ADDRESS 15db Santa Ana Avenue BUILDING PERMIT NO. 21+257
GENERAL CONTRACTOR owner-builder DESCRIPTION OF WORK Add 2 bdrms & Gar.
CC--AP No.117-221-03 LOT TRACT FIRE ZONE 3 VALUE $ 5,1118
INcpECTIONS I Signature Date GROUP I & J TYPE V ZONE R 2
Icy PERMITS ISSUED
Gam SUBCONTRACTOR I Date I Number I Signature
Water Plumbing
Rough Plumbing ilaSSESelogigi,_ do a.Sc
Prop. Swr. Line p House Con.,0
Sprinkling System
Miscellaneous
Rough Heating and Mr Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring or 2 .0,/r Heating and Vent.
Trenches Forms a" Steel Reinl. ❑ I jy c 2 car
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing /7 6
Frame and Flashing 4 • Z.
Lathing—In 0 Out 0
Plaster, Brown Coat
Structural, Final Electric .
)' 'ng, Vent, Refrig. and A.C., Final &ur11.4 .. d,tDplr2. /b-ll-( , (95/25
k. ..bing, Final and Gas Test 0
Electric, Final
C
Building, Final e Sa,Gar'67
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24257 CITY OF C c i H MESA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA,CALIFORNIA
For Applicant to Fill In Completely APPLICATIONNOR n155
TYPE OR PRINT BUILDING
� For (r
@r S
ADDRESS
DGSpg 1 /�/,/ / zGRHCHIFT
NO. FaRM 1{O.
COST,MES CALIFORNIA ar 9,/,1257
r e . • // b:tc/ J/ REDHI DAT R[•=v[D D EISSUED�
7
OWNER
AADLREJSS41et. Ica- at�� ADRS /J6 ¢ S N.m 4"419 Ater
FIRE
CITY{� NO. '. A.i.s ZONE _ TYPE ROU
TEL al r APPROVED //_ /
AP^HITECT TEL BY Y/ / `A4
F IGINEER NO. f� V
1 ZO ING ��,l {j`r t n
ADDRESS '-' NZONE 1 FLANS .I I BUILD NO .P�"� A ... Q/
� � ♦ a (1/�`/ FLANS USE OF E �- i' `/
CONTRACTOR 6> Esc/ l�^� d- p:c)/ ( ,: ��11 3
LDESCRIPTION L o f t R I lb 9
ADDRESS _ ^�
. A.P.NO. /l [7 ^ of Q - V p�
a
CITY
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. SO'TO SIDE ft REAR P.L.
LIC.NO. NO.
(+q !�(^ J EAVES
OF LOT 5 1• /J i I 3u- / L . I NOW OH LOTS ALLOWED W.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. S (FROM C/L STREET�1 ,
SETBACK LINE,FROM ,. tI L 5? FRONT ^.34)
CENTER OF STREET 5��� REAR YARD yam
SIDE YARD I LEFT /3 1 RIGHT C ._S ,_ R.SIDE/3FT. 6 FT.
DESCRIPTION OF WORK L.SIDE /Fr. FT.
I ALTERATION _ ADDITION Y REAR /,} F7. FT.
DISTANCE BET. BET. MAIN B
MAIN SLOGS. ACCESS.SLOGS.
REPAIR MOVING DEMOLISH /�
BUILDING r9 �/ ^sj{O.OF / STORIES / CSU.P. ,^ ,).J APPROVED
SIZE K "Y�/�L QROOMB �J� �`^ /(
: COVERING EXTERIOR WAL-/ U�,(�COVERING /l� [Cin BYPROVfi6 �� E / /il // ('�
USE'9�BUILDING ANOD WOBKT 7 PERFOkx n 1� c/, l/ l/ (�J
atin
n ca
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or N
3�4 SQ.FT. 27e9G
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE x
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
' PLY WITH ALL CITY ORDI ES A STATE LAWS R GULATINO
' BUILDING corveTRucTI�� VALUATION OB N •
PSIGNATURE RMITTEF V PERMIT FEE $ SO m
$ L /�7 PLAN CHECK $ I 0 E /!
AUTHORIZED AGENT CJ a ✓�� H
a TOTAL FEE $ 3/
>• Vlt l`1CR Fg4TFT,T ThPmaa T VAI[ 4-2-76
JOB ADDRESS 15BR Santa Ann AxAntio BUILDING PERMIT NO. 41509
GENERAL CONTRACTOR M,rr,,GW. Stoneman DESCRIPTION of WORK Add Dining Rm. ,Bedrm. & Bath
N.
AP No.117-221-03 LOT TRACT FIRE ZONE VALUE x,047.00
IN. �ECTIONS S.iygnature Date TYPE VTT GROUP T ZONE R-9
B' "` S tj_, a7 , SUBCONTRACTOR P RMITS ISSIED
c Ai; J
WATER Dote Number Signature aru re
Aq Plumbin ��,/�
ROUGH PLUMBING �j,� S. 17 -Z6 j�,r.,4,L,� /�I Al-e2-74 t,�g� r
PROP. SWR. LINE E HOUSE CON. ❑ Y ,(\N '� ` ,(/.}} S'-,( 7` 6 0 fir/
SPRINKLING SYSTEM I y,{5'' lY W T Y
MISCELLANEOUS gJH �/yjnQ.../-.27 .7-4 .
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND O POWER
ROUGH WIRING �ry AC_ ,'9ZA47L. Heating and Vent.
TRENCHES IJ FORMS ❑ STEEL REINF. /St N.
FLOOR SYSTEM^ f���///
BONO BEAM 1 1 STEEL REINFORCE n �]
SHEATHING a...- T 2a'/-e
FRAME AND FLASHING • C/Ate s-,7-J4,
LATHING — T dCrytoa
// Jadips Ater )F.)*Pena /QIGo S-eb 24
PLASTER. BROWN COAT
STRUCTORAL; FINAL Ele ire,
HF 'NG, VENT., REFRIG. AND A,C ,,
., FINAL 1� Ohnno -- OJAI&, C-11-16 4038Q1
^
'. P IING, FINAL AND GAS TEST I t \L C-14-74
„ ELECTRIC, FINAL \CZ ,L,
t'. BUILDING, FINAL LI -24,-21.
C A
AIN
(.. _ 41509 ] TR —2-75-700 143* ***,t,66.50
cnc
COSTA MESA BUILDING-SAFETY DEPARTMENT .
P.O.,BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to HI!in Completely— Use Ink Only '''
Ave- RECEI/yVyy�DATE RECEIVED D E issuE
BUILDING j5QR SANTAAA/4 H —2 /4,
'ADDRESS UILDINCJ C., v-7—
INP/YIAS _. FEWE.LL llr7-9<V1- 03 PERMIT NO.
1 OWNER A.P.NO
BUILDINGRS / QQ n /I rJt"-
AAIL o /) ADDRESS SS SA,f/ �{�//� �(
ADDRESS � / Q .S,LIu 7Ja A/tiA A✓I` �t
�/ TEL. TRACT'o1L07 LOT S BLOCK
CITY Q�TA �/FSA No..'��,e9323 CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH
LENDER
BRANCH OWNER MAAiA .c -i J^ g'u/ _L
ADDRESSVALUE `/ OE
ARCHITECT TEL. USE�if..S/d6{/17!4G $/D 7 �_
OR ENGINEER NO,
FIRE , /
ADDRESS ZONE TVP I GROUP •
APPROVED --2—A
e CONTRACTOR Ms p GL1S wi m,Q&/yhtPU BY DATE
ADDRESS .5145- USE OF N
C ITY a/j S rAJ)_Me-SA N06,949...47s4 ,�L/ PLANS BUILDING
F STATE ^ CITY YARDS APPROVED YARDS APPROVED
gLIC.NO. - L 'Q 6 3 4 LIC.NO. 8d9 _ MAIN BUILDING ACCESSORY BUILDING
LTA SIZE 1 NO.OF BLOCS.
(FROM C/L SSTPEE� y
L OF LOT NOW ON LOT FRONT V/�//r2 . FT.
Q USE OF ''tom Gr ,�-
V) EXISTING BLDG. I�"e.S /D&. r,AL R.SIDE .J FT. FT,
LA
H 02Separate permits are required for L.SIDE /FT.//,�,, FT.
J. electric,plumbing and heating work. REAR OZs9 T.�A`.f FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
MAIN BLDGS. ACCESS. BLDGS.
C e VAR.rW DATE
QC.U.P.# APPROVED
>. APPROVECkeir- .4—
a HOLD FOR SPECIAL REQUIREMENTS
`oT/ ;-' ^
I hereby acknowledge Information
tion I have read and gree to c o and withts ���r n- —J-1 � Ce .,AJ co
L that the above Information Is correct agree to comply I- L! � �
all laws regulating building construction, and I shall not employ _/ i
Z any person In violation of the workman's compensation laws of �0 ti a 49 _enc.' 2
W the State of California. 2
3 I hereby certify that I am properly licensed as a contractor under ♦rf/ SQ. FT. t i. 5° N
the State of California Business and Professions Code, Division 3,• HE AMOUNT SHOWN UNDLUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or 1 THE PURPOSE OF ESTABLISHING PERMIT F LY: n
am exempt from the provisions of the State of California Business VALUATION • PERMIT FE E 0U c
and Professions Code,Division 3,Chapter 9. / n
Signature of �:_ I / PLAN CHE K $ R4 •/1 Si?rut
/ H �{/� P'(/ o
�Pe nature ��� $/ O//{/� TAX $ s� LL
/ /Ss •
u
Authorized Agent TOTAL PAID $
1