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Home My WebLink About1867 SANTA ANA AVE - Building Permits 5111 CITY OF COSTA MESA .r . . a) BUILDING BUILDING DIVISION ).• i ..E 4i P7.171•71,4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1. 1 ....±.. I P4 • PERMIT /605-00583 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.glILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1867 SANTA ANA AV Status: ISSUED Suite: Applied: 04/12/2005 Vicinity: REROOF DUPLEX: 1867 8 1869 Issued: 04/12/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 11721313 Zoning: Applicant: GRAY, PATRICK Address: 1015 E CHESTNUT ISSUED BY: ."/ /f Phone: (714)953-5444 . SANTA ANA,CA Zip: 92701 Owner: MITCHELL FAMILY TR Address 1867 SANTA ANA AV Phone: .•• COSTA MESA,CA Zip: 92627 • Contractor: YOUNGS ROOFING CO, INC Address: 1015 E CHESTNUT Phone: (714)953-5444 SANTA ANA,CA Zip: 92701 License: 568560 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF DUPLEX AND ATTACHED GARAGE(ADDRESSED 1867 AND 1869):T/O EXISTING COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 30#FELT,APPLY"40-YEAR COMP SHINGLES."2500 SQ FT FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,500.00 Permit: $125.25 Claim Valuation: $5,500.00 SMIP Res: $0.00 SMIP Corn: $1.15 Other: $0.00 Inspection: $0.00 Total: $126.40 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 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'compensation,as provided 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. y wo ks pensetlon 1 ran��f�_�mer and po,cy number are: 1-72_i_00-)0 Carden -T c --{-r.(.hl� \ anti: (T t�"lw'Tsectlon need not be completed if th permit is valued a 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 Ca ia, rid a that If I should become subject to the workers'compensation provisions of Section 3700 of t Labor Code,I shall fdnhwith comply with these proviso / I4 Ap I ature: a4.2)v L Z (} 171 WARNIN URE TO SECURE WORKERS'COMP SATI OVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL ER TO GRIM AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLtARE($100,000),IN ADDITION TO E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provision . fha.ter • coLI mencing with Section 7000)of Division 3 of the Business and rof ssions Code,and my license is in full force and effect.LIc.z / a (o • q- Qfa k G- , Conhactos s ghat t+.. (Oa : / 7,rD 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.). 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: ❑ 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 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,ora 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 al 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? 0 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollutlOn control district or agency? Yes 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Dale: 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. ti'Si;natureSegal Owner(s) Date / I . - An• Or•;"..:ized-Ap.r ant Date CODE A INSPECRON TYPE DAIL INTITIAL5 PHI INSPECTION TYPE RAIL 'PUMAS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final /' f� /�� 208 Final Plumbing 14 200 Final He-Roof 'ZZ w 65`-. 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 OWNER KLORS, MR0 MRS. WM. DATE 5-1-57 . JOB ADDRESS 1867.69 Santa Ana Ave. BUILDING PERMIT NO. #1i926 GENERAL CONTRACTOR Owner Bldr. VALUE $ 16,1i98.00 _ AP117-213-13 AS PER U. B. C. LOT 211 BLOCK G TRACT 5911 Dup. w/dbl. gar. GROUP I & J TYPE V ZONE RIy FIRE DISTRICT 4940 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench ! 1z r Foundation Forms and Grade to Ga,�r7a�g- 5 ' Rough Framing v`l 7 `,, / Plumbing,Rough to Slab /�h E 5 .7570-7 ::&;_e�inta,1 iG 67- 7 -S7 9a9-7 ✓Plumbing, Rough Complete A445 i - t1� Temporary Pole QI{1Y Ai• -/ 1/45-- a—$-7 6-99 ' e-- l Wiring, Rough r r-/7-)7 f-invi. eatS--el.-S7 Cry6-3-0S/S S-/ Heating, Rough MN'S ;24'-57 . jc.22„te-.0 arra . 7-s 7 y3 7 Heating, Final in az-S 9--//-S-7 cc Sewer, Houseewer,St.' 417-1 ,V3 cJ�s7 7=2o.=,S7 /G.S,/�6 Septic Tank or Cesspool / Lathing, In c% --Out COSSt Plastering , Plumbing,Final,Fixtures Complete,/ylt S 9.4/• S7 t / 7� ' Plumbing, Final Gas Test/S/f ) c5 7 %jam. cJ//-S-7 - ; / 7 Wiring, Final yyn 7? /7 I et // , / /9.. Occupancy r r /rnti2--• 9/l-S77 I FORM 210 3M 10-35 4926 4940 FEE RECEIVED COSTA MESA BUILDING DEPARTMENT ?-t-; /7r2. CJ P.O. BOX 317 � COSTA MESA, CALIFORNIA RIMEDEPT. ' • �R �A�/PPLICANT TO FILL IN APPP IQATAFM M PERMIT nfr- ADILDIN_GJ.(/. _ _ y.4, 9- 4//- ��(,a.WG fT�l ,�rH.�L BU I LD I N G ADDRESS L'1 ' � XX ///s/si�pp,,.. �/� —fJ7c007.-EJog .R.�C.ALIFORNIKIA'a' fix [ FOR OFFICE USE ONLY ' ^t�// 4 Aim 1 ' /, /Q" RECEIPT NO. /PERMIT OWNER /IE///I, r I• /I/!, WW1.. 'ick"/- Ij/`Q_ MAIL / /�,� LQ - ^µ RECEIVED BY DATE DATE RECEIVED DATE_ISSUED, ` ADDRESS /Y./, /^]��////ee / IMG mai / v/ fta• /�-S/ ,..5-/-.1 1 CITY ��1.6I1y.. /wwry/G✓�. TN O. s BUILDISS Ape V� 9i � ORCM"F CT II/I 1 II LIC. COSTA MESA. CALIFORNIA/ OR NEER 000+��I ]��y/"'//l(bbb�/(_'OJ(�/�I//� I/nl NO. FIRE ADDRESS 19 �R LG4� /W� ten_ahAL ZONE / ` ZONE / NO.OF TYPE V OROU%V ///� CITY LIC. I. PLANS \Y// CONTRACTOR LIWN� NO. '� I V q / A _ )�.I .µn}�_, /)))�//) EL. APPROVED r4 ADDRESS f/91r •LYu. /LM1 T4 ANO. IIISt +1W BY 44AiDATE / — / If LEGAL [LOT ,(y(I/ //'� CORRECTIONS DESCRIPTION NO. vT BLOCK (7• TRACT' 94- A.P.NO. 4-0.4-5-I17TT / :. . / APP :OVED OF LOT X 101-1' NO.OF BLOCS. NOW ON LOT CITY OF CO TTA MESA USE OF PLANN a DEPT. EXISTING SLOG. LA- TD • ?G. DEPT. RED. SETBACK LINE FROM / •i\ / /I L) / a Ce • CENTER OF STREET (5-1) REAR YARD Y� !(,` La. (• �- SIDE YARD RIGHT . ..• , LEFT / (>/ BY ,.� •'1Y DATE /1.----.2.1/� 7 DESCRIPTIONyOF WORK PLAN 1LCH.�//frE NE` /ALTERATION ADDITION I REPAIR • MOVING DEMOLISH BUILDING Pili % �1 NO.OF / SIZE '1 H ROOMS94 X STORIES -(�JQ• ((/� EXTERIOR WALL �� COVERING ��A�i' a...Age OOF 1 COVERING / / n USE DI NEW nQ u� / �( BUILDING :I(./14. P.elV \' livv 1/YKK. /9c,r. /'-C/ �`� • I PER / gift U, /d. & - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC• TION. n - /7 /////�� `1 VALUATION �f SIGNATURE OF /1 ' X _r -/ PERMIT FEE S �J PERMITTEE �YYC//NVV GG�LL.YYY"YYY11Y��\ "'��---000��•✓✓✓••.LfL// PLAN CHECK S / AUTHORIZED AGENT TOTAL FEE S / OWNER KLOHS, MARY & WILLIAM DATE 7-7-58 JOB ADDRESS 1869 Santa Ana BUILDING PERMIT NO. 7117 tNgZR1 L C NTRACTOR Owner VALUE $ 111.00 �{Y. No1 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Wood Fence GROUP TYPE ZONE PLAN NO. , _ INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel \,fi_56 i� Floor System IV 5 Steel Reinforce Chimney Re-Rod / Bond Beam v /V Frame and Flashing ,(�‘f Lathing, In Out ,� //f/ _ • 1 Plaster, brown coat . / (✓1 Underground soil W/G Pipe Test I V Top Out `C I - _- Furnace 0 .h,✓ Gas Vents 1/ a L Rough Plumbing ��', % J 1 I Cesspool Septic Tank j A / Prop. Swr. Line House Con. St. Swr. ( '/ ; 11,16 COSTA MESA BUILDING DEPARTMENT P. O. BOX 317 I 7117 COSTA MESA CALIFORNIA I FOR APP CANT TO_L-2 /•_ C.L. OF STREET---- I BUILDING ADD}?ESS �� y �' tom+^" / la fill �iPROP LINE I \ Owner ' AN/.• 1- L '--- -� - 12 FT. 61TTF3R \ �1 II `nw ft t . . I I 10 FT. FOR 60 FT. STREET-1 r5O FT. STREET i, Ij m Mail Ad s - A� // a. �llre p y City `Sass- Ph. No. HI la II 7(t_ I I .I j Z W Contractor &..W-N- Ph. No. / ""-'4- • ° 42 0 IE Address `i 50 Fll IF PRON[ 1v City Lic. No. State Lic. No. I J OF PROP. 1- U — III 150 FT' w L. Size of Lot D - I25AP No. 1 2/3— i- w ` y Setbacks: C/L Street to Rear O p z J a Side Yard - Right �- / Left O 4.1 y r---- ---a'� v Type of Fence /C2-4,4,..-o-0 4..I ' ALLEY OR PR 3P, LINE a Cs o. 1 �_r—� ;3 h --1 '/ I hereby acknowledge that I have read this application and state j z a= t C I �, . c IVI that the above is correct and agree to comply with'all City Ord- (NI cg, i r - 2 1\ inances and State La s regulating b 'Id' construction. J /11 1 O I— F G a F Signature ' �� l7 10 - I of Permittee C b _ Oji - -I �'_,� V z a FT I Agent arll talo I O c 0 37 1N• f3. y, -1 w I FOR OFFICE USE ONLY , FT. 1• A . z 40 z U N < FT 1 J .--I Permit No. 1 a m IC 60 FT St 4 Received by Date Received Date IS 25 50 ,.L r .,---,,72 7— 7—fl' 7— 7- CP FT. ST. U. PRO_p LINE U. _ VALUATION anc-e-h • y l a--a �- - -- -- - - - - - - - Permit Fee $ Oti __- 7^' "`' y-O I $ Plan Check $ • C.L. OF STREETS { 60-7-0TOTAL FEE $ MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE.SIDE FOR DETAILS