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Home My WebLink About1922 SUVA CIR - Building Permits 4�c CITY OF COSTA MESA 9BUILDING DIVISION Os f r .a DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER �: jI PERMIT IIPP1 .AS B00-01497 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1922 SUVA CI Status: ISSUED Suite: Applied: 09/25/2000 Vicinity: Issued: 09/25/2000 Parcel Number: 13943122 Zoning: R1 R1 Applicant: PRICE, BOB ISSUED BY: Address: Phone: 714-573-0155 Zip: Owner: MAPSON, MARY M Address %FIRST AMERICAN TRUST CO 2161 SAN JOAQUIN HILLS RD Phone: SUCC TTEE RE103497 Zip: 92660 Contractor PREMIER ROOFING Address: 17501 NORWOOD PARK PL Phone: (714)573-0155 TUSTIN, CA Zip: 92780 License: 634404 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF/RE-SHEATH AND COVER WITH MARDI SHAKE,CLASS A SHAKE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $9,300.00 Permit: $181.25 Claim Valuation: $9,300.00 SMIP Res: $0.93 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $182.18 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 2446-46(WOO) DECLARATIONS I 4 c. 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. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for whi this permit is issued. My workers'compensation Insurance carrier and policy number are:Carrier: VI Policy Number: 104 a.(This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the p ance oft work for which this permit is issued,I shall not employ any person in any manner so as to bec•-subject to the workers' compensation lawsd C 1 ran agree that If I sh d become subject to the workers'compensation provisions of Sectio 3700• the Labor Code,I shall forthwith comply with these -o Applicant Signature' �, ) Date: / ��JJ7 o WARNING:FAILURE 7D SEC RE WORKERS'COMPENSATION ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED !/ THOUSAND DOLLARE(1100.000).IN ADDMTMON TO THE COST PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licen un ovisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full Xforce and effect.Sig atu e //C:Z � Class x Contractors Signature: /f // Date: / 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: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury Mat 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).): O 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. ❑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,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 California Health end 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? ❑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 a plication apermit for such construction or modification from the South Coast Air Duality 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 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 at 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 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 urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. fiaLfzl2nal Ot Legal Owner(s) q/^Se G Q( An Of Authorized Applicant Date r CODE A INSPECTION TYPE / DALE INTITIAL5 CODE! INSPECTION TYPE PAIS INITIALS 1616 Fixed System Final a Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 10`4!7'07 210 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 MAPSON, Jack DATE 4-24-72 JOB ADDRESS 1922 Suva Circle BUILDING PERMIT NO. 34552 GENERAL CONTRACTOR John Wielenga DESCRIPTION of WORK Res.w/att.garage & Patio AP No. 139-431-22 LOT TRACT FIRE ZONE VALUE $40,81&.00 \1 INSPECTIONS Signature Date GROUP I&J TYPE pl ZONE R-1 SOIL ' Al S- 6---V.--,2--- SUBCONTRACTOR I PERMITS ISSUED GAS Date Number Signature WATER t4,041fJ----3'77.- P m Ing ROUGH PLUMBING �//Ci £r2Ol ... "//;n/n} �/�p Q / PROP. SWR. LINE OUSE CON.- �/(C� -#JZ� ,fx � •I /�e 7 ''—74. t SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING S'G/)---7'] --' TEMPORARY SERVICE;g1,... OR POLE 5 jo.)Y (� UNDERGROUND � POWER 0 6=y-7L ROUGH WIRING 4.4 7f H-sting and ent. TRENCHES IX1 FORMSA] STEEL REINF. IPI r .-/ ""/[ C y 7 /1 z 7 9 y. P....- FLOOR FLOOR SYSTEM /" /! .._ -rAl 2r' ��/oltl/ y��16 VI / .�' BOND BEAM 0 STEEL REINFORCE n SHEATHINGME �e%}&;/v FRAME AND FLASHING '�H. �Z.(t}''/L LATHING — IN OUT Fll/fCj f,4))J „'L PLASTER, BROWN OAT N'' .147j STRUCTURAL, FINAL p . Electri y� // HEATING, VENT., REFRIG. AND A.C., FINAL 46"�/�� glen, / 76,L/P 4441-7 pro/ �//� PLUMBING, FINAL AND GAS TEST n n--40 7ri U ,/ T 5=3-- u,. „(!!e-c ELECTRIC, FINAL / /vO ?i7-724 o-h e., -I�'.�o .61. -` �� P 7,1Ir 1 34552 � � r:�,am , c,o 4,9 * * 64.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE VE BV DA RECEIVED DATE ISSU D BUILDING / W//2/�2 -.2+I 7f— ADDRESS 11 e /. S(/if C/IQ[� /�.; '7(y Lj •1 g��/p �+�' OWNER ___727e A him ps o#V A.P.NO. I: q -'131'- Y'- PE✓ O'ti� MAIL N BUILDING /}' 0 ADDRESS / O /2 On K Peck- ADDRESS �`/y g OG 0_U CITY Sr �4'an K. ('A NO TRACT 4s ! LOT( LOCK nd Z2 < CONSTRUCTIONin NEW ADD ALTER REPAIR MOVING OFMOI LSH �\ a m LENDER its U' C Ke: C inzeAi.s \/ JO BRANCH NEW f6itT eE/4CN J � _Gh. 1 COto OWNE E/ e_-,r2 m J ADDRESS �gsNr�•,. .Zsl..�/vAi i G/)GJ(�y��J, V VE �/_ rJ��-_ ARCHITECT TEL. VSE i9'! � $ 'j'Q//O J Q OR ENGINEERS/O�A/ 1.01C-/e4/44 NO. VN FIRE Q W Q ADDRESS ZONE TV E GROUP (I•ce 17 S 111 • • APPROVE J O CONTRACTO�o`( /t �c7/CM.—,/(G 4B �� DATE co Z J cc ADDRESS &ISF /c ,yy 41,6:- Lu w / ZONE NO.OF USE OF NEW• sy a t CITY TEL R I PLANS I BUILDING Res tocNCt z 41/4#E,4/ C4 s36 anYo- lL O STATE CITY YARDS APPROVED YARDS APPROVED In IL LIC. NO. /C92da LIC.NO. MAIN BUILDING ACCESSORY BUILDING DO (FROM C/ TREET) SIZE BLOCS. OF LOT 8'e qq I NOW ON LOT / FRONT FT. FT. USE OF C EXISTING BLDG. re-s/ pG.✓6E R SIM J FT. FT. I— SIZE OF ! NO.OF C/ t C Z NEW BLDG. 7 ROOMS / STORIES L L.SIDE 5'35 FT. FT. Q EXTERIOR WALL ROOF �-/� 7, 22 O COVERING .STudet COVERING�4fr't RE2S f FT.r FT. • J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CLa. MAIN BLDGS. ACCESS.BLDGS. 0..L/S/T>E/ice to/Tf/ r1 / clap C UR O p.# .s�s APPROVED I— //'' APPROVED{ r I4)(`' 'J('//7�. y Cil Co G6 W /� ��/ / l o ..--ELY 1/�/ DATE 111 l Z Co o cc# - I-IOLD FOR SPECIAL REQUIREMENTS I— I atracknowledge information tion I hcoe read this grpli to end with �T i O a�i' that the above information is correct and agree to comply with `�`••`� J1 CC all laws regulating building construction, and I shall not employ F any person in violation of the workman's compensation laws of / CO the State of California. 47 7 Go �-/ C '9 I hereby certify that I am properly licensed as a contractor under TO SO. FT. 7 "/ o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9 .nd at such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: ID et am exem•t from e provisions of the State of California Business VALUATION and Profs cions C.de, DIV.ion 3,C pter 9, m PERMIT FEE $ cx D Signature o 442 / /�✓, / r! o Permittee _ •/ $ /lam/vT/ PIAN CHECK $ (�I—�[J E \\/\ Authorls•.. Agent IL TOTAL FEE $ -7lirr 3 ,13v Pfo COSTA MESA BUILDING-SAFETY DEPARTMENT - `(' �' crate ��10G2 + *ty 131.86 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely U/7� �q RECEI D T RECEIVED D TE ISSU�yD BUILDING .Z �` f( �_ I i , IL_ ADDRESSe' 1 .YL.V`/A_I/'V PERMIT NO. OWNER (// 1'� A.P.NO. MAIL BUILDING Z ADDRESS ADDRESS W W TEL. d TRACT I LOT BLOCK Z CITY NO. Z m CONSTRUCTION NEW I ADO ALTER (R EPAIR (MOVING DEMOLISH 1- LENDER J D BRANCH J rn OWNER W J ADDRESS VALUE -CO ARCHITECT TEL. USE $ Q OR ENGINEER NO. - U Q FIRE W CC ADDRESS ZONE TYPE GROUP 0_Ly 'r�I, / / APPROVED W Z CONTRALTO��' �l��y[�(� �y�`�� BY DATE JQ r m Z J cc ADDRESS tL W TEL, ZONE NO.OF USE OF NEW 0 t CITY NO. PLANS BUILDING Z N WO STATE CITY YARDS APPROVED YARDS APPROVED co Cr LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 7 i (FROM C/L STREET) SIZENO.OF BLDGS. OF LOT (NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDE FT FT. I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. dal EXTERIOR WALL ROOF _ COVERING COVERING REAR FT. FT. \ J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL o GS. MAIN BLOCS. ACCESS.BLD� Cy QO I (ti(// � J VAR. DATE II C.U.P.# APPROVED F ' APPROVED 14 V) --ELY DATE CTF VI— I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ CC I— any person in violation of the workman's compensation laws of CrA, y m IA the State of California. � 2 I hereby certify that I am properly licensed as a contractor under SO. FT. O the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0 cc am exempt from the provisions of the State of California Business VALUATION cc at and Professions Code,Division 3,Chapter 9. /PERMIT FEE $ / 02/de j goo Signature of m Permittee $ PLAN CHECK $ E 0 Authorized Agentu. TOTAL FEE $ /c2 d 6