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Home My WebLink About664 SURF ST - Building Permits� CITY OF COSTA MESA � � ` ' BI/ILDING DIVISION F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�856 • www.ci.costa-mesa.ca.us ��. FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER 08-00236 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 42223311 DATE ISSUED: 08I14I2008 ISSUED BY: RMD JOB ADDRESS: 664 SURF ST CM Suite/Unit: Vicinity: HOUSE AND CARPORT ROOF Squares: 1000 • Valuation: $7,500.00 SCOPE OF WORK: TEAR OFF�(E)�ROOF MATERIALS, INSTALL A MINIMUM OF 2 LAYERS OF 15# FELT ON A 2:12 OR LESS THAN 4:12 PITCHED ROOF OR A MINIMUM OF 1 LAYER OF 15# FELT ON A 4:12 PITCHED ROOF OR GREATER AND ' REROOF WITH 40 YEAR COMP. SHINGLES;ON AN ATTACHED HOUSE AND CARPORT, APPROX.10 SQUARES. REPAIR AND REPLAC� SHEATHING AS NEEDED. ' � � OWNER: MEDINA, ALFRED AND KATHERINE G, , � Address: � 326 E 18TH STREET �� Unit: PHONE: 949-642-0782 . �. City/State/Zip: COSTA MESA, CA � , APPLICANT: MEDINA,�KATHERINE G, ✓� �. Address: 326 E 18TH STREET " � - � ' Unit: : PHONE: 949-642-0782 � . .. „ , ., . Ciry/State/Zip: COSTA MESA, CA ' CONTRACTOR: OWNER-BUILDER � Address: Unit: � PHONE: City/Stete/Zip: - � ' � � ' ' ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES $0.00 $54.00 $0.00 $54.00 License No. License No. License No. 000000 CELL: PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONB: In order tor the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit. CO�Ei INSPEC110ry}ypE DRT IN1111qL GOpEt INSPEC710NTYVE D� IN71 AL 1816 Finetl Sys�¢m Final Fire Prevention 206 Final Mechanical 1266 Pool Spg Final . 208 Final Plumbing 200 Flnal Re-Root 9_ab _ o$ � 210 Final Electrical 201 Final 8iock/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 20a Final Damolition 250 Final Builtling/Occupancy WORKERS' COMPENSATION DECLARATION: � I here6y a�rtn under penalty of perjury one of t�e following declaretions: ❑ I have and will maintain a certificate of consent to self-Insure for wo�kers' compensation, as provided for by section 3700 of the Labor Code, for the peAormance of Ihe work (or which this permit is issued. ❑ I have and will maintain wnrkers' compensation insurance, as required by sectbn 3700 0! the Labor Code, tor the peAortnance of the wark fa which this permit is issued. My workers' compensalion Insurance carrier and policy number are: Cartier: (ih¢ sedm neeond ee mrw'eretlllne pcv.N s vaNce at me humhed dWaslStoO) a �ess.) Policy Numbec ❑� I certify that in the pertormance of the vrork (or 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 Ihe Labor C tle, I all forthwith comply with these provisions. ��'e��`1,�I�� =/S� QK Applicanl'sSigN e � oale WARNING: FAILURE TO S RE WORKERS' COMPENSATION COVER4GE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force antl eRect. Lic. # Class # ConVatlor's SiB��ure Da1e CONSTRUCTION IENDING AGENCY: ❑ I hereby aKrtn that there is a consWction lentling agency fw the peAortnance of the v.ork fa wliich Ihis pertnil is issued (Sec. 3097. Civil Code). Lentler'S Name: Lender's Address: Da�e OWNER-BUILDER DECUIRATIONS: I �ereby affrm thal under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW (or Ihe follovnng reason 1Sec. 7031.5. Business and Professions Gotle: Any city or county which requires a permit t0 consWct, aller, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such pertnit b file a signetl statement that he or s�e is licensed pursuant to the provisions of the Coniractors license Law (Chapter 9(cOmmencing with Section 7000) of Division 3 of Ihe Business and Professions Coae) or that he or she is exempt therefrom and the basis (or the alleged exemption. Any violalion o( Section 7031.5 by any applicant for a pertnit subjecls the applicant lo a civil penally of not more than five huntlred dollars ($500).): ❑ I, as owner o( the prtlPerty, or my employees wi[h wages as �heir sole compensation, WILL DO 7HE WORK, antl ihe structure is not intended or oftered (or sala (Sec. 7044, Business and Professions Code: The Contractors License Law dces not appry to an ovmer of property who builds or improves thereon, and who dces such work himself or herself or Ihrough his or her own employees, provitled that such Improvemenis are not intended or offered for sale. If, however, ihe builtling or improvement is sold within one year of wmpletion, the owner-builder will have the burden of proving ihat he or she did nol builtl or improve for purpose of sale.). ❑� I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS lo construct the pmject (Sec. 7044. Business and Professions Code: The conC��as License Law dces not appty lo an owner of property who builds or improves thereon, and wfio cantracts for such project with a coniracta�s) license pursuant to the Coniractas License Laws.). ❑ I am exempt under seC. Business and Professions Gode for this reason: —• aL_,.,�� U�,�' _ /.,. . I/ _ Owner ID venfietl by drive. .:en. J Yes ❑ No Driver's License No. � �% � � E:pirea: �_ Venfication o( Ownership by (lype of documenl, i.e. - Droperty [ax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excava[ion Me (5) w more feet in deplh into v.fiich a person is requiretl lo descend, vrill be made in connectbn vrith work autlarized by ihis pertnit, and that no building sWcture, scaffdding, (alse.wrk, or demolilbn or tlismantfinq thereof, will be mo2lhan thirty-soc (36) feet high. (Chap. 32, Grp 2. M 2. Sec. 341, Title 8, Cal'rfwnia Administrative Code). ❑ As owner-builder, I will not employ anyone to Oo work which vroultl require a permit from the Division of Intluslrial Safety, as notetl above, unless such person has a permit lo do such work from the division. Applicanfs SignaWre Da�e Division of Industnal Safery Pertnit Number HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the appliwnt or present or tuture builCing occupant need to file antl certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 0( the Califomia Health antl Safety Cotle requires, with some exceplions, ihal a Business Plan be fled wilh the Cos[a Mesa Fire Department by every business vmich has al any one time dunng a reported year a quantity of hazardous materials equal to or greater than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubiC �eet of compres5ed gas at standard temperaWre and pressure). 2. Dces or will �he applicant or present or future building occupant need to file a registration form (or acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with lhe Costa Mesa Fire Department by each business which at any one [ime has on hand a quantity of acutely hazartlous materials equal to or greater than a weight of 500 pounds, or a volume ot 55 galbns, or 200 cubic feel ot compressed gas at sfandartl lemperature and pressure). 3. Does or will the applicanl or present or future building occupanl need lo prepare an RMPP (Risk Managemenl and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of lhe Califomia Health antl Safery Cotle provides that the Costa Mesa Fire �epartment may require the preparalion, certification and (ling with �he Fire Department of an RMPP by businesses which are required to regis[er acutely hazardous materials with the Pire Department. 4. If an RMPP is presently requireC, �as Section 25534 0( the Califomia Heal[h an0 Safely Code been fully complied vrith? ❑ Yes ❑ No 5. Does or will ihe applicant or present or future building occuDant repuire tor Ihe vrork which is the subject o( this application a permit for such construclion or modifcation from the South Coast Air Quality Managemen[ District or from any other air pollution conlrol tlis[rict or agency? ❑ Yes ❑ No (Section 658502 0! the Califomia Govemment Code requires ihat the requested information he fumishcb on applications tor non-resbental builAing pertnils). 6. Will any paN of the facility [o be wnslructed untler this pertnit be within 7000 teet from I�e outer boundaries o� a sc�ool? � Ves ❑ No pf yes", the facility must meel Ne requirement o( Seclions 25534 and 42303 of the Califomia Health antl Safety Code). 7. If a pertnit from the South Coast Air Quality Mana9ement Disinct or other air pollution conlrol disMct or agency is required for the vrork which is the subject of Ihis application, have all of lhe tlisclosures prescribetl Dy California Health and Salety Code Section 42303 been made� ❑ Yes ❑ No 8. Qf'yes", attach certificate of wmpliaace tmm the appropriate air polWtion control oKcer). . CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury Ihe information given above is correcl I agree to comply with all state laws�and city ortlinances regarding Hajardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certi/y under penalry ot perjury thal I have read Ihis application and slate that the information given is cortect. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the Ciry of Cosla Mesa to enter upon the above�describetl property for inspection purposes. I aqree not to occupy or allow occupancy of any builCing aulhori tl y is pemrit un i mal ins e lion. � � /5< D.S� �B��wadLegal eqs) Date '1 And/o� A�I�oniee AOOliwnl Dale HARBOR E5TATES DATE � I JOBADDRESS 66li SUPf St, '� BUILDINGPERMITNO. v-lBO GENERALCONTRACTOR Dike & Cole�rove � VALUE $ S�OOO.00 LOT 67 BLOCK TRACT 1986 S]riglB famil,y residence �3I1 1� G�.�JP j TYPE V ZONE R({ FIRE DISTRICT �J.tI% PERMITSISSUED INSPECTIONS _ DATE SUBCONTRACTOR DATE I NUMBER Foundation Forms and Grade to G Rough Framing��—_� Plumbing, RougKfA"$Iali W J� Plumbing, Raugh CompletA�-¢ Temporary Pole Wiring, Rough Heating, Rough Heating. Final "� Sewer, House � Sewer, St. E^pticTank or Cesspool Lathing,ln Out/ P `ering F �bing, Final, Fixtures Co le� Plumbing, Fin�al Gas Test Wiring,Final ,, OccupanCy % L F.,,-.,, m n �_u � Fnn i_ss ,�, 1liesa Building Department APPLICATION FOR PERMIT � 111 EAST 20th STREET , 1�9% B U.I_L.D.,L N G.. ____ , , ; � COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN ' �OR OFFICE_USE ONLY i qeceipt No. Permit � Building . -' �`��%_ Address 664 Surf Street �=� I � G Costa 1liesa, CiB��OP111& Recmve y Date Ree'd. Date I�u crossst 19th Street auudto�� /' �IS�� 7— � Address ow�� Harbor Estates Costa Mesa, California Mail 419 East 17th Street - Address Nea�est ' city Costa Mesa N;�.i.8-1159 Zone St�, I No.or I Type V i Group nrcn�taco�3r son & Midd e r Pians Englneer No. Approved ; CantraCtor Grove Fast 1 t 67 s�:e or �ot 60 x ll0 Use of Existing Bldg. ROI18 SetbackLinefrom 50� Center of Street acy uo.�01 ^ove rvo. i Street Block I Tract 1 INo. o+ eid9s. none Now on Lot INo.of No.ofC Famillesl Roomsi2 Rear Vard � , ' " Si New : Y I Alteration I I Addition ' I CORR�CTIONS .....y Size 9`jl r�•�• RoomsS� Stories �- Exterior Wall I Roof Cevering $'tUCCO Covering Comp. AppROV. Usc of New Sl le £ami residence Foundation Location in Building � �' Forms, Materials, P�an ��l Under-Pinning Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application Lath. Int. _ and State that the above is rnrrect and agree to rnmply Lath. Ext. with a❑ City Onlinances and S[ate Iaws regulating bullding construction. s�9nacu�e or g�ke & Colegrove Plaster, int _ Permittee n /� �j Plaster, Ext _ Authorized Agt. < l. ��,.` �' �� Masonry Reinforced Valuation Permit Fee S .'20. Plan Check $ ,3. O O Bond Beam s 8,000.00 Feeal a� 3, o o FINAL �orm '1Uf 1:- IDt 1�-63 Date u c .j d - 2 - a i � ' �S� " ' _ . . .. . � . ..� . . � � �u�—�-ssPD�as,�z �-�:�,��; sEsa 3Ga 23.�0 Street � ' PLOT PLAN Show location and distances trom property line and between buildings. i , t • 0 OWNER V. M, iOB ADDRESS :k J I�'"�ECTIONS brown wat Final Gas Tcst C mction �c DATE � �,'Zj1 7-31-5� PLAN NO. SUBCONTRACSbOR DATE + .h � — �� m RMITS ISSUED NUMBER 7� � �239 �OSTA ,MESA BUILDING DEPARTMENT P.O. BOX 31� � COSTA MESA. CALIFORNIA �,_ OR APPLICAIYT TO FILL IIV BUILDI COSTA MESA. CALIFORNIA OWNER CITY � ��lU (-� ARCHITECT OR ENGINEER � AODRE55 � CONTRACTOR C/ ADORE55 � IEGAL LOT� DESCRIPTION NO. � B A.P. NO. / / S � � S 1— SIZE � � OF LOT �� ' USE OF EXISTING BLDG. SETBPCK LINE FFOM TEL. NO. LIC. NO. rvo.or a�ocs. NOW ON LOT , cENrEa or srR[[r �� REAR VARD, �' SIDE YARO RIGHT ��'J.EFT /` �� ,/ DESCRIPTION OF WORK NEW ALTERATION ADOITION � REPAIR MOVING DEMOLISH BUIL�ING /�(//% � ROOMS �t�J✓STORIES l SIZE �� (0 EXTERIOR WALL A /--��COVERINCJ1S.i/N/�//�U/�/ rnvrair.ir. 1 ]!(� FEE RECEIVED� fiNANCE DEPT. CITY OF GOSiA MESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PERM+I�T NC K J RE VE� BV O� CEIV OA SVE i 5 � 3/ A�ORE55 'J Y� ) fi2� COSTA MESA. CALIFORNIA FIRE � ZONE ZONE y.� I NOqNs TVpE GROUP= v� J APPROV � 7 /� BV � (.�'7� - `DATE CORRECTIONS BY CITY OF Us �.a r:aco� � , r. �. SUBJ[�1 TO LbG. UEPT. REG. I XEREBV hCKNOWLE�GE TMFT 1 HLVE flE4O THI$ FPPLICATION AND STwTE THAT TME ABOVE IS COwRECT nNO AGREE TO COMPLY WITH ALL CITY OROINANCE$ RND $T/�TE LF�NS REGULNTING BVILDING CONSTRUC� TION. VALU/aTION SIGNATURE OF � /! PERMIT FEE $ 1` PERMITTEE / � �PL/N CHECK S s S (Y O� AUTHORIZED AGENT TOTAL FEE $ �� °�e uwncK Medina, Alfred JOB ADDRESS 664 Snrf Str TRACT FIRE j 1 ROUGN PLUMBING C � PROP. SWP. LINE � HOUSE CON. JSCELLANEOUS OIIGH NE�TING �NO AIR CONDITIONING' EMPOR�RY SERVi[E OR POLE NOERGROUN� n POWEP ri FLOOR SVSTEM BOND BEAM [� SXEATHING AND LATHING - IN L� OUT PLASTER, BROWN �O�T TURRI, FINAL M� �NG, VENT., REFRIG. PLUMBING, FIN44 �ND GAS ELECTRIC. FINAL BUILDING, FI UAIC SUBCONTRACTOR P � �� 8 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING / /� `�+' �r J� ennaFss / � .ty • F � W C. Q � y 7'. F O W F G1 �..7 a > �- .� z m a O P�. 6. Z W m 3 OwNEF CITY BRANCH CONTRACTOR ADOAESS G CITV , � STATE LIC. NO. � 512� OF LOT VSE OF TEL. v�� • TEI. NO. CITV LIC. NO. ISTING BLDG. Separate permits are required for electric, plumbing and hea[ing work. E OF BUILDING AND WORK TO BE PERFOFh / I horeby acknowlatlpa t�a[ I hava reatl this epP��cetlan antl state [hat �he ebova Informetion Is correct entl aprae to eomply with all lews repuletinp builtlinp conrtruc�lon, end I �hell not amploy any person In violation ot the workman's compeneation laws of the Stata of Cellfornie. I horoby cortify that I em proporly II<ensetl as a contractor untlar the S�ata of Californie Businass entl Profasslom Cotla, Div(slon 3, Chapmr 9, and thot [uch Iicensas ere in tull forco antl affaet, or I am BxemOt frOm i�o provisiOns Of thB $mto ot CaII/O�nia Buciness entl Frofossions Cotle, Divislon 3, Chepcor 9. Sipnetura oi / _J�� Parm�t<ea 1�� Authorizatl A9ent PA.. �� _ rr-�: .OD+ss� .... .:>:-r.SG 7'ION fOR STRllCTURAL PERMIT A.P. NO BUILDI A�DRESS TWi r: VALUE ROVED NE NO.OF USE OF NEW PLANS BUILDING YAROS APPPOVED VAqD$ Af MAIN BUILDING ACCESSOiY DISTANCE BET. LYSET. MAIN & MAIN BLDGS. I ACCESS. BLd VAi1.qW DATE BLOCK � n m i SQ. FT. a THE AMOUNT SHOWN UNOER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: � VALUATION PERMIT FEE E q m p�y PLAN CHECK S "� 0 5 �!i'�� TAX E '� f V TOTAL GAtD E � ��