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Home My WebLink About3249 WASHINGTON AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DiiIVE, GOSTA MESA, GA 92626 BUILDING PERMIT JobAddress: 3249 WASHINGTONAV Suite: Viciniry: Parcel Number: 13905614 Applicant: BRESLIN, BILL Address: 1835 WHITTIER AV UNIT F12 COSTA MESA, CA Owner: KIRK, JOHN A Address 3249 WASHINGTON AVE Zoning: Phone: 800-7&4-8787 Zip: 92627 Phone: COSTA MESA, CA Zip: 92626 Convactor: 21 ST CENTURY ROOFING INC Address: 1835 WHITTIER AV UNIT F12 Phone: 800-784-8787 COSTA MESA, CA Zip: 92627 License: 807430 Arch : Address: Phone: Eng: Address: ISSUED BY Status: ISSUED Applied: 03/26/2004 Issued: 03/26/2004 Phone: Zip: License: License: SCOPE OF PERMIT REROOF; TEAR OFF EXIST. BUR, REPAIR EXIST. SHTG. AS NEEDED 8 INSTALL 30 YR. ELK COMP. SHINGLES; INCLUDES ATTACHED GARAGE Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.52 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.77 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: 0 Rear 0- 0 Rear 0• 0 Re uired: 0 FEE SUMMARY PLANNING 8 ZONING Left 0- 0 Left 0- 0 Proposetl: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $s,170.00 ss,no.00 NOTICE: The work authorized by Ihis permit shall comply with all applicabla handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor 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 cotles, end all requlred Inspectlons and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiratlon of this permit. POfl INSPECTIONS CALL: (714) 7545626 2446-68(6�00) WORKERS'COMPENSAnON DECLARAnON: I hereby attirm under penalry of perjury one oi the following tleclarations: . ❑ I have and will maintain a �ertificate of consent to self�lnsure for workers' compensatlon, as providetl for by section 3700 ot the Lebor Cotle, for the pertormance of ihe � work tor which this permit is I55ued. � I have flnd will maintain wp�er5' tompensatiOn inSUfenCB, as requite0 by SeCfiOn 3700 0l [hB LebOf Code, lor thB peAormance of Ihe work Por whiCh �his pertnit IS issUetl. My work s' compensa.,lii �Insura/n^ce' wrner end policy num68r are: (J/ // 9 Carrier: �'�C/ /— (� I�% � PoliCy Number: ,� � I / U/ 7 O"�pS O[7S� (This section need nof be comp/efed i the pertriit is aluetl ef one �undred tlollars (5700J or IessJ " _ ❑ I certity Ihat in t�e pedorrqanca ot the work br whic� this pertnit is issued, I shall not employ any person In eny manner so as to 6ecome subject to the workers' compensation laws of Ca Ia, antl/�agree �thy/b if I shoul ecome sub�ect to the workers' compansation provisions ot Sactlon 37p/p 0l Ihe Le/por Code, I shall tonhwith cromPly vhth Ihese Provi w.� � X // ,YI r J/� 6 /� 1 Applicant SignaWre: _ _ Date: WARNING: FAILURE TO SECU WORKERS' COMPE SATION CAVERAGE IS UNL4WFUL ANO SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENNLTIES AN� IVIL FlNES UP TOONE HUNDRED TFK)USPND DOl1ARE (5100.000). IN ADDITIIXJ TO TNE COST OF COMPENSATION, DANAGES AS PROVIDED FOF IN $ECiION 3]Oq OF TME 1A80R COOE, INTEREST, AND ATTORNEI"S FEES. IICENSED CONTRACTORS OECLARATION: I hereby aHirtn that I am licensed under provisi� torce entl etteci. Lic. q� Contractor's Signature: (commencing with Section 7000) ot Division 3 of ihe Busines antl Protessions Cotle, end my license is In full T_ ciess a� C 3�( �! I C� Dete: —� � V CONSTRUC710N LENDING AGENCY: ❑ I hereby aflirm ihat Ihere is a wnstruction lending agency for the OeAormance of �he work for which this permit is issued. (Sec. 3097, Civil Cotle). Lendars Name: Lendars Address: Signature: Date: OWNER•BUILOER DECLARAYIONS: I hereby aflirtn that under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or counry w�ic� requires e pertnit to consiruct, alter, impmve, tlemolish, or repair eny structure, pnor to its Issuance, also requires tha epplicaN for such pertnit to tile a signetl stetement that he or she is licensed pursuant to the provisions ot Ihe Coniractors Ucense Lew (Chapter 9(commencing with Section 7000) ot Division 3 oi the Business and Professions Codg) or that he or she is exempl [herefrom an0 the Uasis Por the ellegetl e:emption. Any violetion ot Sectlon 7031.5 by any epplicant far a pemit subjects the applicant to a civil penalry of not more than tive �untlred dollars ($500).): ❑ I, as owner oi the property, or my employees with wages as �heir sole compensation, WILL DO THE WORK, and Ihe structure is not Intanded or oflered for sale (Sec. 7044, Business and Pmfessions Code: The Con�rectors Licensa Law does not epply lo an owner ot propeM who builds or improves Ihereon, end who does such work himself or herseN or through his or her own employees, provided that such improvemenis are not intentletl or oHered tor sale. If, however, the bullding or improvement is sold within one year ot completion, the owner-builder will �eva the burden of proving Ihet he or she did not build or improve for purpose of seleJ. ' ❑ I, as owner of ihe property, am E%CLUSIVELY CONTRACTING WIT}1 LICENSED CONTRACTORS to construct l�e project (Sec. 7044, Business and Professions Coda: The coNractors LiCense Law does no� epply �o an owner of propetly who Duiltls or Impmves thereon, entl who w�tracls for such projact wilh a conirector(5) license pursuant to the Comractors License Lews.). ❑ 1 am ezempt under sec. Signature: Owner ID venfietl by tlriver's license. ❑ Ves ❑ No Busine55 and Professions CaAe lor this reeson: Verifiwtion of Ownership by (rype of document, i.e. - propeny tax bill or deed): Oriver's License No. Date: Expires: DIVISION OF INDUSTRIAL SqFETY PERMIT CERTIFICATION: ❑ I hereby certify iha� no exrava�ion fiva (5) or more feet in tlept� into which a pe�son Is required �o tlescend, will be made in connectlon with work euthonzed by Ihis permit, and Ihat no building siructure, scaflolding, falsework, or demolition or disman0ing thareof, will be more then thl�y-six (36) feet high. (Chep. 32, Gry 2, Ar12, Sec. 341, Ttle B, Calitornia Administrative Code). ❑ As owner-builtler, I will not employ anyone ro do work which woultl require a permit from the Division ot Intlustnel Selety, es notetl e6ove, unless such person has e permit to tlo such work irom �he tlivision. Signature: Date: Division of Industrial Safe�y Permit Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENiRV: I cenity untler penalty of perjury ihat I have read this application entl stale that the infortnation given is correct. I agree m comply with all state laws end ciry ordinences rela�ing to building construction, antl authodze representatives ot tha City of Costa Mesa to enter upon Ihe above-described properry tor inspection purposes. I agree not to occupY or allow occupenry ol eny building authonzed by this permit until tinel insDeciion. / � Signat t Legal O r(s) ,� � 6 DatO '/ 7 �— A�r Autho�nz d AppliCant ' ate CODE �. INSPECTONTYPE 1616 Fi:etl System Final Fire Prevention 1266 Pool SDa Final 200 Final Re-Root 201 Final8locWRetaining Wall 202 Final fectory Fire Place 203 Final Sign 204 Final Demolition � UATE �$ �Lil�1 ��%" CODE I INSPECTION TYPE 206 Final Mech9nical 208 Final Plumbing 270 Final Electrical 212 220 222 250 Finel Fire Prevention Final Planninp Approval Final Sita Final Building/Occupency � IliIID��fl . .. .SFaON� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 977 COSTA MEBA. CALIFORNIA For Applieanf fo Fiil In Complefely TYPE OR PRINT 6UILDING 32�19 Washington Ave. ADDRESS C05TA MESA, CALIFORNIA OWNER Amherst Development Co. ADORE55 1533 �er Street cirr Cost2 riesa NEo`: K19ll57 ARCHITECT C3T�.SOS3 RL TEL. OR ENGINEER NO. dl]ORFCC Garden Grove. Calif • I � �T„o. 167293 No: KI . 9-1 SIZE i� � �� I NO. OP U6E OF None 8X16TING BLDG serewcrc uHe vaoa CO� REAR YARD 31� CEMER OR BTRE6T � SIOE YARD I LEFT 7� I RIGHT S� DESCRIPTION OF WORK s�Z`"'"` 156o s.rt^�• �' i ROOMS 7 STORIES EXTERIOR WAL ROOF COVERING �utUCCO COVERING Rock USE OF BUILDING AN� WORK TO BE PERFORMED Single family residence with P 1 HEPEBY ACIINOW��GE TXAT 1 HAVE RE�D TM18 MPLIGTION AND BTATE THAT THE ABOV¢ IS CORRECT AND AOR TO COM- PLY WITH ALL CIT! ORDINAXCEe ANO TE LAW OUTATINO 9UILDINO CONBTRU � 61GNATURE OF � �� PERMITTE AUTHORIZED A6ENT Dike t4C Ci0 grove� I21C • FIRE ZONE APPROVED ZONE R• LEGAL FE RECEiVED �sEP i b�ssa FINAtVCE DEPT. C4tY OF GOSTA MESA APPLICATION FOR PERMIT BUILDING For Offiee Use Only aeceirr no. reaart No. A �3Q�3r� BY I DASE RECPJVED . �AT 199UGC COSTA MESA. CALIFORNIA ZONING NO.OR I U8E OF N PLANB il BUIIDING une ar.� APPROVED THE AMOUNT BXOWN UNDER VALUAiION 18 FOR TNE PURP08E OP EBTABLI6HING A PERMIT FEE ONLY. VALUATION PERMIT FEE $ 36o • $ Z6�ZO1• PLAN CHECK $ ,'u� Z 0 LL