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Home My WebLink About251 SIERKS ST - Building Permits .1 ' 4`0 U 69 CITY OF COSTA MESA BUILDING DIVISION . • ' r, DEVELOPMENT SERVICES DEPARTMENT ERMIT NUMBER Ft .......R rl PERMIT tr p+[�� a B02-01645 `�P0RRR0 04 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDIJob Address: 251 SIERKS ST Status: ISSUED Suite: Applied: 10/08/2002 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 10/08/2002 Parcel Number: 42621102 Zoning: Applicant: VAZQUEZ, ADRIAN ISSUED BY: GG/? .� ----" Address: 2402 W BROOK ST Phone: (714)571-0120 SANTA ANA,CA Zip: 92704 • Owner: BELNA, SAMUEL TR Address PO BOX 2538 - ' Phone: NEWPORT BEACH,CA Zip: 92659• . Contractor: FIRST QUALITY ROOFING Address: 2402 W BROOK ST . Phone: (714)571-0120 SANTA ANA,CA Zip: 92704 License: - 776969 Arch : Eng: • Address: . Address: Phone: - Phone: Zip: License: License: SCOPE OF PERMIT REROOF:T/O EXISTING WOOD SHAKE,7/16"OSB SHTG, 1 LAYER 30#FELT,APPLY"40-YEAR COMP SHINGLES."38 SQUARES -FEE SUMMARY' _ Plan Check: $0.00 _ - Calc Valuation: $a,000.00 Permit: $153.25Claim Valuation: $8,000.00 SMIP Res: $0.80 SMIP Corn: $0.00 - - Other: $0.00 • Inspection: ' $0.00 Total: $154.05 ' . 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: 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 244646(6/00) DECLARATIONS fl WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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 ork for which this permit is issued. have and will maintain nworkers'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'cpmpens lionnsurenc de poli number are: / /62 5_ c �67 Carrier: web/ (_7Wc// i , Policy Number: f/D (This section n d no a corn eted if th&permi rs value 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 California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these prov' ions h Applicant Signature: ' CYj-7 e b Z ,r1? Date: //?7 f en ,7-z , WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAG UN/'LAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND ML RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDrON 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 pro 'sions o�ha ter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# 7 2 Class# C ((f7,i Contractor's Signature: A - '4 /h/// '/�/L c "7 Date: 70 / 2 e-- CONSTRUCTION CONSTRUCTION LENDING AGENCY: �< O 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: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 properly 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 Drivels 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,Califomia 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,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 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 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 Califomia 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 aaermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes U 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? 0 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: Date: CERTIFICATE OF COMPLIANCE MID 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. Ad Signature Of Legal Owner(s) Date kr, And/Or Authorized ppticant Date CODE I INNSPECTIONTYPE MI EMU COPES jNSPECTION TYPE PATE MAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof W 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 UWNtK WEST, EUGENE E. 4-24-68 %QJOB ADDRESS 251 Sierks Street BUILDING PERMIT NO. 28468 ' GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Residence W/Attached 3 Car Gar. /AP No. 118-14 -14 LOT 214 TRACT N•t.H! sFIRE ZONE VALUES .44 250.00 — INSPECTIONS Si.nature Date GROUP I & J TYPE - V ZONE R-1 sol ais_i L- /��CPERMITS ISS ED _ GAS i / Date Number Si• n atura WATER a Plumbin.., ROUGH PLUMBING - L,SKISPAr�r '� � i-IErai earl PROP. SWR. LINE.;I HOUSE CON. ti Ara. - , earn: f��ern��rinarayWP•a SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING ralligr TEMPORARY SERVICE OR POLE UNDERGROUND ❑ ,POWER M. IIp�� ROUGH WIRING /)f/f T mf1a► r'Pra'l7�a��rTJ�/l Sr' //�,H�_t��in. 'n• Vent. �y�/�.p TRENCHES / EOWiLIurilfi'• taa�f/�/��!/�"�i/'nrA, iffrin i.rannInnr� FLOOR SYSTEM U/dh«I•i1 - BOND BEAM U STEEL REINFORCE E 4�/fi�rt a{•I r� SHEATHING „ �____ 7k1It FRAME AND FLASHING ;/A MY 411111111111111 LATHING - IN O• OUT l ' PLASTER, BROWN COAT (A 63Mr STRUCTURAL, FINAL FINALElectgic, `/// HEATING, VENT., REFRIG. AND A.C., FINAL C - :t [ .azev._/ �. r-bd 772/0 — - PLUMBING. FINAL AND GAS TEST NIram ELECTRIC, FINAL raf . BUILDING, FINAL a/ I-/'" . 28468 COSTA MESA BUSAFETY DEPARTMENT APR 18-68---09:1128* ***19Z.O0 COSTA P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill In Completely. APPLICATION FOR PERMIT TYPE OR PRINT. BUILDING T •� / For Office Use Only ADDREISS Q•/ / S / _�j/R /IJ S SS I RECEIPT NO. y¢RMI NO /1 �•'COSTA MESA. CALIFORNIA (j/ S /9,y,J Oj_fJ[/A—X�7 F/7_1/j/�',(r� Fher,7)C iS jiW CCM Tl �! C'// Te9 I ISS ¢YV OWNER !7 •. �1.� �• q .�/J ,(// ' BUILDING �i/ ADORH/89�.J p�- /-- oYi^L� '�✓!' 'f(/,rX FIRE� CITY( / S A •.� 1. . NO ((/ =ON! ;ftTYP! ¢ROyU/- / / ARCHITECT TEL APPROVED 1 DATE ( /� OR ENGINEER NO. a '.✓/"./S./,- ZONING / ADDRESS ZO� I NO.OP ^ 'I USE OF NEW, ' �0 i l�� •-, k / ! /eN � / PUNS BUILDING , lett CONTRACTOR i/l/�/ /ClJ I //jj�� / ADDRESS ESC ImON j/'U� kat a U y- /' CITY A.P.NO. ! / 7 - l/S� 1� / NOTE: NO HAV!OVERHANG SHALL BE THAN STATE TEL 30"TO SIDE&REAR P.L. LIC.NO. NQ, EAVES OSIF LZE OTy }�a OC) I NO.OF NOW ON L.OT ALLOWED .(U.S.C.REQUIREMENT) / IO YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. s¢TeACX un¢PROM }� / .(FROM C/Ly��{ :I.ET) ClNTNI OP ETR6lT 3L-if, O/ REAR YARD‘7 Q/�J 0 ONT / PT. SIDE YARD LEFT JI / I RIGHT l( " R.SIDE �G Ff. FT. L. DESCRIPTION OF WORK L.SIDE `7 FT. J • PT. • :' NEW ALTERATION ADDITI•N REAR "�" Fr. A FT. • DISTANCE BET. BET.MAIN& 'i REPAIR . i1OYING DEMOL{SH MAIN SLOGS. ACCESS.BLDG/. 994/111:1307SJVAR.# DATE S ZT4 / /e STORIES C.U.P.# APPROVED 3 EXTERIOR NN��LI.�ILL ROOF c ' /S APPROVED A///1 rt COVERT Nortc GCI I COVERING. ]/./A/g2c • ST ((Ping AT! // (17 /6-3 OF BUILL�DINS AND WQRK TO BE LIIRF RMED 0 ( �� 0, Si 4/7)e t -n.1, ) y Par Gzui t4' .. 9 a 7 c,4 3 C 4 t • Y4; c 329AFT f1 9y, xl I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHO UNDER VALUATION IS FOR THE y. AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. e PURPOSE OP ¢BTABLIEHING A PERMIT FEE ONLY. i. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING , VALUATION BUILDING CONSTRUCTION. c________707 CJ •. SIGNATURE OF //�, PERMIT FEE �( a PERMITTE. 0 - I G. / 1 j $ / PLAN CHECK $ AUTHORIZED AGENT TOTAL FEE 5 / 9a +,...,_ ,., _. _ a....... ,•r