HomeMy WebLinkAbout1078 WESTWARD LN - Building Permits ti
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill inCompletely — se Ink Only RECEIVED BY DATE RECEIVED
BUILDING ' 07 �/ 4 /r-I taut"
DATE ISSUED
ADDRESS (/ V( (Hti //j QI�QZ, PERMIT NO.
OWNER �� L� A.P. NO. //5/��//eye//�-��/>j$i'�,D�.-r���Ip� � / �
MAIL S E• �.0°11 /J - •:L ///// BADDRESS IV 76 1/•L�(JI I/V!y'--r./ L
�s^J� / 12 •02. /
CITY J,��DY/ • / NEO�j ��� TRACT(JJ"J-J LOT, - f �1 C/JCK -
CONSTRUCTIO �--A_A NEW ADD ALTER REPAIR MOVIINN/G DEMOI ISH
LENDER /�,�(� \/
BRANCH �JJ i---41 ,
y /j/� -,
//� !�/ OWNER A'' -/a/ `/IL I s•—. _
ADDRESS T--- 71
ARCHITECT /�j TE • 97J/! US- J as W £2AIC VALU$
OR ENGINEER la- .Sr s.� G /J
ADDRESS ees V ZONE TYPE GROUP
/� APPROVED
/ ,
CONTRACTOR a2�C BY DATE
ADDRESS tr
TEL. ZO✓J(J� PLANS BUILDING NEW
aWM�r�,� ,//�Q
CITY NO. /�L- OK&�.J(iY�
F^ STATE CITY YARDS APPROVED YARDS APPROVE/D
g LIC.NO.?6 'f�' LIC.NO. /••� MAIN
I(�)BUILDING(FROM / ACCESSORY BUILDING
OW.. SOF LOT t 'l �� I NNF BL
OW ON LO T C/ FRONT/moi�FT_. 0I fl GL
Q USE OFVI /// i},9
EXISTING BLDG. R SIDE /�/�(� F FT.
CC
F Separate permits are required for L.SIDE Z 7roe(
r FT.
C electric,plumbing and heating work. REAR )agry FT.
LIZ
USE OF BUILDING AND WORK TO BE PERFORMED Man)
BET. ��-�'�
F' DISTANCE BET.MAIN O
-.2
MAIN BLDGS. /,, ACCESS.BLDDGGS. 7 �r�
•, J //J /�yfy� i �I C URP.aW/j� /LD-lJV DATE
APPROVED�/^/ / ��W
11:7j APPROVED�e _ I
''4 N I's+ DATE /-21--9-9—
>" /i -RY-- t//l✓/_/
w TOLD FOR SPECIAL REQUIREMENTS
O I hereby acknowledge that I have read this application and state on
N
t4 that the above information is correct and agree to comply with
m
0+ all laws regulating building construction, and I shall not employ
i
Z any person In violation of the workmen's compensation laws of a
Lid the State of California.Z. /7 I (.s s/I (//}/f -
I hereby certify that I am properly license• as a contractor under /r �C SO. FT.� r✓�C/ ^ r ss^� a
the State of California Business and Profe Ions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and t.. ' c.1
liven a ar: , II force and eff t,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
go
am exempt f •- •`vista•s of e S ate of C. ifornia .usiness VALUATION PERMIT FEE $ a
and Profe ions ••. r I lsl• 3, 'ha• •. v+
In
Signature of / PLAN CHECK S n
/ o
Permittee - $ TAX $ LL
2
u
Authorized Agent TOTAL PAID $
ADDRESSccm043: 1070 WESTWARD LN LM: CITY OF (COSTA MESA - BUILDING PERMIT
uVNE"s"'wEIFIaOWN' WESTBLUFF HOMEOWNERS ASSO • .. PERM NO: B 076827
' 111 PACIFIC tt250
( IRVINE CA 92714 PERMIT NO: .B 076827 PLAN CHECK NO: . N GOVT: N SUPP : N
727-26x0
Ant.SWUNG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE; STR PURPOSE: OTH
• mann Oil ENGINEER: uCN .: JOB DESCRIPTION : T/OFF & REROOF W/BUILT-UP SQ FT: 6, 800 •
SACK OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: 6, 800 .00 CALC-/VALUE: 6, 800. 00 GROUP OCC: R-1 /
CONmsCTON'sNwE: R.P. HIRSCHMAN ( 714 ) 960-8329
CONTRACTORS YMU%G 8855 ATLANTA COMMENTS: REROOF 5UNIT CONDO, ADDRESS 'INCLUDES 2:072-10744-06e8/ WESTWARD/
Amass, HUNTINGTON BEACH CA uc.ND_ 475948 **********+E+F*it�FrtFFFF**FF�F*****FFFEFE�E*Feu-*FE+t*****+t+FrEu-Ft-�F+EFL**** ***I ** ****FF*********
92646 Wn: 285 Z ONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby slim under penal,of perry then am licensed under promos of Chapter 9 SETBACKS
(commencing with Seaton 7000)of Divscn 3 d the Busmen and Professions Code.and my license sit Iulllute end effect.
0-vUG.N0.: 038468 uC.Cuss, C3 946 EXP: 04 /96 MAIN BUILDING ACCESSORY BUILDING
y Dau: -3- .1 S(P ContractLEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby eNum under pronely of perjury that I ant exempt from the Contractors License law for the
• 'o5owtttg reason(Section 703t5Bushes.end Professions Code:Say dy a coolly whim requires a permit to maws,abet,impota. PARKING REQ: PROV: PARCEL: 93523015 ZNE: REF NO:
awrolishVIC
icer'.put ,w repair to the p a date Cwraur.l+Samna,also intw Law�aph*e u(moan.dnp Wad*hh Sed�7 w)d a. iott that 3 01 live PLANNING NOTES>.
Business and Professions Code]or or that heshe u exempt therefrom and the baseed
for the dead ar mpticn.My violation of Sachs, ;>'
3 �
Professions •
7 I.5byany applicant for a permit subjects the applicant a penally d civil penally not s mothan grit hundred doges IS500D. *********************************************************************t**********
❑ °ii�tw°m°erty or my eepP101441604.es as Cdrole Crwthe
emo'nd the"aure is�nD E V E.7L OPMENT SERVICES R E Q U I R E M E N S«o. d (Sectionn wisand oe:The onlmmi...Law does n0applyto.maw
veto bush or imprgwe thereon,and wino does such work timed or hens/or trough t r her own empkyese,provided that such ',-7'
improvements are to intended or offered for sale.I.howevertha building or inprevrced is cold withinwr year d completion.the ZONING APPROVED r BY DATE:
ownerbuilder wit have the burden d proving he or she did to bold or improve for the pupae of sale). -
a I.as of the Code: tread ntredry with'ensed cormedosbcomer the pooled(Section 7044,Business and BUILDING APPROV 'D BY : DATE: '
apply to n owner d prmady who butt or improves thereon and who /
contracts for such pooled.with a contrador(s)licensed pursuant lo the Cando.License Law). 21• • '�rs I q t
0 tame=emgunder Set B.AP.C..bM'nseson APPLICATION ISSUED BY: DATE: 1l Y
******************************************** * ****************************** ,
°"'' "' LEGALIZATIONf1'] F E E SUMMARY STRUCTURALISEGMENT:Y
I do hereby certify der I am aware dud understand the requirements of California Health and Safety Code Sections 25505,25533.end
25.34,end iter 1 or any future buildup margin!will/wD rot(acs one)need to comply with said sats codes and the requirements to
apemitlpmslWionpmodifrationfromtheAi why ateemealatidRrdrselmMud
rionapplaa
tiouee.erngmm
from BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
per. PERMIT 90. 00 . 68
Dale: Applicad: ; /w SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby/drum under penally d perjury arae d the Idbwing dedarsiene: PLAN
Kra lheand wil maintain a certificate el to W consentMinns tor workers'ma
nprsha Sem
n, provided for by on the 3700d Lace BUILDING
FEE y
Code.for theperformance ofthework for which thspermleerued. BUILDING DIC > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE
p Ihave and witcompensation a
insurance, e
by San37D3dthe Labor Code for the pramof the TOTALS > •90 . 68 0 . 00 0 . 00 90 . 68 90 . 68 . 00
ii':
work for m Mie which pent is issued.My wcrkeri compensation insurance earner an!policy number ere:
Gather. .STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 90 . 68 OVER/SHORT: .00
Poky Number: 1977190-94 10/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
unit esdim need not a competed l the pemtt at roc one handed dollars lemon or en.) 90 .00 / . 68
dI trey that performanceperpermit le in the of the work for which this permit Word staff nemploy any person In any reamer ens to I I.
become subject to the worker.'compensation law d Ce$farie.and agree Chat if I should bacon subject to the waders' *******************************************************************************
comPeneatm provision,of Sedon 3700 of the labor 'h cot*ern dues paysars. I N D I V I D U A' Ti' F E E BREAKDOWN
Dent: '73._I S-Sear L
^� WAming:Failure to secure wortaa'compensation towrope unlawM,and shall subject an employer to criMnelpenatdes and TYPE QTY D E S C R I P T I O'-, N UNIT COST TOTAL COST _
civil pas W one e hundred thousand dollen($104000).St adfldon to the cost of compensation,damps as provided for In r
Sedan 3706 3Tolme Labor CodeInterest,and simmers fees. SFR 6800 REROOF BY VALUE RESIDENTIAL NOZONE 1 .00 6, 800 .00
CONSTRUCTION LENDING AGENCY:I hereby One under penalty of perjuy that Ids ie a conslrudien lading teensy for M. END OF FEES
perfonnnce of the work for which the perm'is issued(Section 3057,Ci..C).
LENDER'S NAME: `r')
LENDER'S ADDRESS: 4
J.
I amity that I have read this epplcaun and slate that the above hlomslbn is coned.I agree to comply with at thy and thorny ordinances
and stele laws resiting to buildeg conatrtdion and hereby auhpbe epreeentaives of this dry b enter upon the above-mentired property • �I 1-. / ,(
forunped'an purposes. _
BOB HIRSCHMAN i . •`
Pots Name
oat.:3 iS -QIP r
•
Signature of owner/ApenVan-LCp
AppSonitep / /
.w Wort WA....n..:unn A}.,osis Awan-flar hone anni,as•pn&3Wenir•nd,l.nn.Lla.anew