HomeMy WebLinkAbout234 SANTA ISABEL AVE - Building Permits CITY OF COSTA MESA
�� `,� BUILDING DIVISION
I. �"" - '_ DEVELOPMENT SERVICES DEPARTMENT
Pomo 4° PERMIT PE T BER
E 0411
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
•
Job Address: 234 SANTA ISABEL AV Status: SUED
Suite: Applied: 03/25/1999
Vicinity: HOUSE&GARAGE REROOF Issued: 03/25/1999
Parcel Nunmber: 11910103 Zoning:
•
Applicant: CRANK, JIM
Address:
Phone:
Zip:
Owner: SHAW, RUTH E TR
Address 234 SANTA ISABEL
Phone:
COSTA MESA,CA - Zip: 92627
Contractor: CRANK BROTHERS ROOFING CO
Address: 00126 COMMERCIAL WY
Phone: 949-548-5569
COSTA MESA CA
Zip: 92627 License: 408677
Arch : Eng:
Address: Address:
Phone: Phone:
Zip License: Zip: License:
SCOPE OF PERMIT
. REROOF-i/o, NEW 20 YR COMP.SHINGLES, 1 LAYER 30#FELT, USING EXISTING SHEATING.
2100 SF.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: • $3,800.00
Permit: $87.25 Claim Valuation: $3,800.00
SMIP Res: '$0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $87.75
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
NOTES:
•
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)754-5628
DECLARATIONS n "l
WORKERS'COMPENSATION DECLARATION: F If
I hereby affirm under penalty of perjury one of the following declarations:
1 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.
❑ 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 permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the erformance 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 California,and agr that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these pro ions.
Applicant Signature: .X_ _ Date: ' — Z Sr— 9
WARNING:FAILURE T SE RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CAVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLAR (S1 .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 un.=r provis9ns 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.Lic.it \ U. (0 7_ ! Class it C. 3 9
Contractor's Signature: n Date: — C'— 9 4
CONSTRUCTION LEN. G 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 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:
❑ 1 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,Califomla 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? 0 Yes 0 No
(Section 25533 of the Califomla 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 compiled 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 pollution 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? 0 Yes 0 No 1
(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 for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
. aOf .e. a er(s) Date
And/Or Aut ' licant Date
CODE I. IN6PECmONTYPE PATE IIQmALS CODE! EIAPFCTIr1N TYPE Deg MOILS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final (� 208 Final Plumbing •
200 Final Re-Roof -/'l r 9R (P"L/ 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
2446-46
Nc
COUNTY OF ORANGE a �j 6//(J `--
` BUILDING DEPT. - :� Permit No t� G
636 No.Broadway
Santa Anna, Californiaornia Application for Building Permit
'
Phone:KI 2-6211 AND FOR A •
Certificate of Use and Occupancy
. Date--/ 7- 6"/ / q
1. OWNER'S NAME yi...rl/ _....7 . LA ',�✓/" /` PHONE:-- �. ..e. ^�-.6 7”/
MAILING ADDRESS_..�.Si 1._.443-alt-44-. 59 1t- 2 C. CITY a-
..------,
Name Name
. • ,(Architect or Engineer) (Contractor)
Address `" Address `-----
City City •
State State
Lic. No Phone Lic. No9Phone
---PrQ Li d GL�i�F t-r-•�.r�Gf
1 PROPOSED USE t M- / , 4 - !/�Y-i�t� f ra's/
2. JOB LOCATION Z. 3 t 0 .4-4-2-44.- V/ ' '^.-14_ , v
(House No.) / (Name of Street) (Town or School District)
3. LEGAL DESCRIPTION: Lo 1 Block Tract.._.3 O0
(Metes and Bounds Descripti n Use reverse side of or 144)
4. CORNER LOT ( ) �I3d $R L 0(2-)O 3'[ f! OT ( ) SLOPE OF LOT ( )
5. -SIZE OF BLDG -3 A 3 ' AREA- / b IC �7 SIZE OF LO/..
T:.�!ZilW..
i ..AREA:...7 f 6 V
T.
6. HEIGHOF BLDG • /c[_/// lf� 7�
CEILING HEIGHT- 9 • NO. OF STORIES 0 '7` 1'
- --
7. NO. FAMILIES 0 i+-- .— Size of Smallest Bedroom- I 0 it
I V • Size of Kitchen.../0
X 1 0
8. EXTERIOR WALL CONSTRUCTION INTERIOR WALL COVERING........C_
(Frame, Stucco, Etc.) rr''11 (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard From Center Line of Street �J-..L--
Nearest Side Yard v..._kt Rear Yard .4 U it Distance in Feet Between Bldgs. on Same Lot !e"—t-
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. /�
11. For (a) Footing: Width' I ! vt'‘' Depth in Ground / 2 "- -4-42—
AccessoryWidth of Wall � .l"""�—
Accessoryp� tBldgs. a
/`? /f
Similar nd (b) Size of Studs:...rt X+ Spacing I G "Y` "CC Material of Floor �-""•' /A L
Structures: � AA � �
(c) Size of Floor Joists:..-Gly Spacing e "CC
(d) Size of Rafters:...... X Li Spacing 52 (�/1'.4ti- "CC •
12. VALUATION OF PROPOSED WORK: In Ging all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ :71't79€7.- pr.
- 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE
APPLICABLETHER
THERETO.
Signed- 7. A d erav-LE -
(Owner)
Plans Filed:.
70c/5-H/
���/ By.
(Authorized Agent)
' FOR DEPARTMENTAL USE ONLY
FEES: �_� C 5. G BY
Bldg. Permit $ .71 rGROUP APPLICAT �•' ... EALTH
Plan Check • $ o� TYPE --. ZONIN".... FIRE
Total - ...1-4. _'49"C0i DIST. MARSHAL
n '� MAP SPANS AND
Receipt No. •. �f y ' -.�,i��fl�... SPEC'S /., STATE
Paid to - • ._a , _ SHEET NO CORRECTIONS ENGINEER
Date VERIFIED CAL
PERMIT .i
UED B
. er A:TE ?.... Ste/ ` / / :,..... .....L.)
1 °U
5M-•.51
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"a "^ KASHUBA. Adelaide L. ✓HIL 8-10-/6
JOB ADDRESS 234 Santa Isabel Street BUILDING PERMIT NO. 42431
4.GENERAL CONTRACTOR s -r tldr DESCRIPTION of WORK Blockwall
JAPNo.119-101-03 LOT TRACT FIRE ZONE VALUE $ 1.400.00
INSPECTIONS Signature Dote TYPE V
SUBCONTRACGROUPTOR j
ZONE R-1.SDIL PEfI iMITS ISSI4ED
GAS
Date Number I Signature
WATER Plumbing
'� ROUGH PLUMBING
PROP. SWR. LINE r] HOUSE CON. El
SPRINKLING SYSTEM
4MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
`UNDERGROUND El POWER ji
ROUGH WIRING / y Heating and Vent.
TRENCHES FORMS rp STEEL REINF. a f2' "-g!7 j/rl G
FLOOR SYSTEM
BONO BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER. BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST [-I
ELECTRIC, FINAL _ ^
BUILDING, FINAL 1-Z-0 b-24 1
SPECIAL REQUIREMENTS . .
• -P42431 ;AG 10-70 ,00 942* 1.50
AID Yritt*2
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP 1 ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely-Use Ink Only (tryy(]7r'•�
1 REC I ry` �TE,IEC D DATE ISSUED
BUILDING %3L{ Sa-ant& -cSL?r18�—�. I AAA��(((���i//��/IJIJIJIIILL I /
li I
ADDRESS J // + _ {�\ PERMIT NO.
D OWNER �1t b••-'.c4. . It�.� L _. 11" A.P.NO.) � I4�� � `/�� 1 cp(
MAIL {'-r"^-`�'V� BUILDING I r/y--4�111J.• ' �-�(
ADDRESS S Ar��1 C ADDRESS �` T) .,J)
,,J
TEL. TRACT ) I LOT/II BLOCK
CITY GOS7'h 1On'A 1250.- NO.
CONSTRUCTION NEW AD I ALTER REPAIR MOVING DEMOLISH ,
LENDER
BRANCH �—
OWNER �l�/i4• s N 06 4
ADDRESS �lii I, ( I/7 /I VALUE
OARCHITECTR ENGINEER STA wcl RlP,o� TEL. ' S_ �(�l�� $
FIRE �r.J�
ADDRESS . ZONE YPE y GROUP
s� t� APPROVED / i
1 CONTRACTOR [L0 u-,Ni Q,e. it•-.).1"`Leg, F. BY jam' DATEV T - ,
ADDRESS y A n- Q C,' ( 1�boo->Z- ppp���NE NO.OF.--2USE OF l
TEL. '/ N PLANS BUILDING 1 C rsoi
CITY NO.
E-- STATE , CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCES RY BUILDING
ILI SIZE NO.OF BLOCS. (FROM C/L STREET)
O. OF LOT NOW ON LOT FRONT FT.kt
� ,
USE OF Q
EXISTING BLDG. SI FT. F
V)
F Separate permits are required for L.S DE •
FT. FT. V
melectric,plumbing and heating work. REAR FT. FT. �/1
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
Q MAIN BLDGS. - ACCESS.BLDGS.
54
VAR.# DATE n
l0 7(LzL
04
0 I hereby acknowledge that I have read this application and state •
N
00 that the above Information Is correct and agree to comply with
O. buildingconstruction, and I shall not employ m
all laws regulating P Y B
Z any person in violation of the workman's compensation laws of m
ISLI the State of California. 1^//q[' l .
vg . FT. `°
3 I hereby certify that I am properly licensed as a contractor under tv
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business /' p-rj y
and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ /y- N
es
Signature of .12L d-n- /— � � � F-0 PLAN CHECK § 70-vHp
Permittee X/""` 9--` $ TAX $ J• A
U
Authorized Agent s U
TOTAL PAID $ a'�r