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Home My WebLink About3421 WIMBLEDON WAY - Building Permits�»a� �sa-s2�a • Fax (�ia� �sa-aess CITY OF COSTA MESA r BUILD/NG DIV/S/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT ,lobnddress: 3421 WIMBLEDON WY Suite: Vicinity: HOUSE & GARAGE ParcelNunmber: 41207337 Applicam: SELL, RON Address: Owner: EDMUNDSON, GARRY F Address 3421 WIMBLEDON WAV COSTA MESA, CA Contractor: SELL ROOFING COMPANY Address: 17072 ROSEBUD YORBA LINDA CA Zip: 92686 Arch : Address: Phone: BUILDING PERMIT Zoning: R1 R1 Phone: Zip: Phone: Zip: 92626 Phone: 714-993-3328 License: 323842 Eng: Address: , � PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: O6/21/1999 Issued: 06/21/1999 Phone: Zip License: Zip: License: SCOPE OF PERMIT REROOR - T/O, INSTALL NEW 7/2" OSB BOARD, 1 LAYER 2 LAYERS OF 15# FELT 8 NEW EAGLELITE ICBO #4660 LIGHT WEIGHT TILE ROOF. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $149.75 $0.89 $0.00 $0.00 $0.00 $150.64 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEESUMMARY PLANNING 8 ZONING Left 0- 0 Lek 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0-0 Sa,soo.00 sa,soo.00 NOTICE: The work authonzed by this pertnit shall comply with all applirable handicap access requirements under Calitomia statutes and related regula�ions. (Ord. No. 92-28, § 1, 1241-92) - � 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 e period of 180 deys. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vrith all applicable codes, and all requlred Inepeetiona end flnel epproval must be obtained. Feilure to obtain inspections and tinal approval will result in the axpiration of ihis pertnit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLAfiATION: I �ere0y aHirtn untlar penalry ai pehury ane af t�e following declarations: � ❑ I heve end will maintain a cenificate of cnnsent ta self-Insure for workers' crompensetion, as provitled for by sectlon 3700 of the Labor Cotle, for Ihe pertortnance oF ihe work for which this permit is IsSued. ❑ I have and will maintain workers' compensation insurance, es requiretl by seqion 3700 of the Labor Code, for Ihe peAormance of Ihe work for which Ihls pertnit Is issued. My workers' compen n I suren rner an olicy number are: / (� Carrier: � �O � Policy Number: �L/� � �� / (ihls section n�tie co p el d i the permlt is velued et one huntlred tlollars ($100) or /ess.) ❑ I certify ihat in the peAormance of the work tor whlch thls permit is issue4 I shall not employ any person in eny manner so es to becoma su6�ect to the workers' compensation laws of Califomi end egrq� thai It I shoultl become subject to the workers' wmpensation provisions of Section 3700 of the Lebor Code, I shall forthwith comply with these provisio� �///� V�% / U^� l_� � Applicant Signature: �(/I� .ux�� Date: � WARNING: FAIW FE TO SECURE WORKERS' WMPENSATIqJ COVERAGE IS UNLAW FUl AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENPLTIES AND CNIL FlNES UP TO ONE HUNDRED TlKKISAND OOLLARE (51 W,OW), IN NODITION TO THE COST OF ODMPENSATION, DAM4GE5 AS PFOVIDED FO{i IN SECiION 7/O60F THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aflirm Ihat I am licensed untler ro� io o C te69 (commencing wi�h Section 7000) of Division 3 of the Business antl P�rpfessions Code, entl my license is in full force end effecL Lic. # �� ciass a C" —'�9 Contreciols Signature: (�_ Date: /<J � — CONSTRUCTION LENDING AGENCY: ❑ I hereby atlirtn that there is e construction lentling agency tor the peAormance ot the work tor which Ihis permit is Issued. (Sec. 3091, Civil Code). Lentler's Name: Lendefs Atldress: Signeture: Deta: OWNER-BUILDER DECLARA710NS: I hereby aHirtn that untler penalty of perjury ihat I am EXEMPT FROM THE CON7RACTORS IICENSE LAW for ihe following reason (Sec. 7031.5, Business end Protessions Code: Any ciy or counry which requires a pertnit to consimct, elter, Improve, demolis�, or repair any sWCNre, pnor to its issuance, also requires the epplicent for suc� permit lo fila e signetl statement that ha or she is licensed pursuent to the provlslons ot Ihe CoMractors llcense Law (Chapier 9(commenUng with Sedlon 7000) of Division 3 oi t�e Buslness entl Professions Code) or that ha or she is exempl t�erefrom entl ihe basis for ihe ellegetl exemption. Any violation oi Section 7031.5 by eny epplicent tor a pertnit subjects the eppliwni to e civil penalry of not more then fiva huntlretl tlollers ($500).): ❑ I, es owner of the property, or my employees with wages as their sole rnmDensetion, WILL DO THE WORK, end the structure is not intentletl or otteretl for sale (Sec. 7044, Business antl Protessions Code: The Conirectors License Lew does not epply to en owner of property who builtls or improves therean, antl who does such work himself or herself ar ihrough his or her own employees, provided that such improvements are not intended or offered tor sele. If, however, the building or Improvement is sold within one year of completion, Ihe owner-�uiltler will heva the burden ot proving that he or she did not build or improve tor purpa5e oi saleJ. ❑ I, es owner of ihe properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consirucl the pm�ect (Sec. 7044, Business ena Protessions Coaa: The contractors License Lew does not appty to an owner of property who builtls or improves thereon, antl who conirects for such prolect wilh a contractor(s) license pursuaN to ihe Coniractore License Laws.). ❑ I am exempt untler sec. Buslneu end Professions Cotle for this reason: Signature: Date: Owner ID veritied by drivefs license. ❑ Yes ❑ No Drivels License No. Expires: Verification of Ownership by (type ot document, i.e. - propeey taz blll or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cehity ihat no excavation five (5) or more feet In depih Into which e person Is requiretl to descenq will 6e made in connection wlth work euthodzed by this permit, end that no builtling structure, scaHoltling, felsework, or demolitlon or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Atlminisiretive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permit Irom ihe Division of Industnal Sefety, es noted e6ove, unless such person has a permit to da such work imm Ihe division. Signeture: Date: Divislon of Intlustnal Safety Permit Number: CERTFICATE OF COMPLIANCE AND AUTHORVATION OF ENTAV: I certity untler penel�y of perjury that I have read this application and state that the informetion given is correct. I agree to wmply with all state laws antl city ordinances relating to building consiructlon, entl authorize represen�atives of the City of Costa Mesa to enter upon the ebove-tlescribed properry for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this pertnit until final inspectlon. Sig u��e9al n�r(af � �et5, / _p �+ fif� G! / ( d/Or Authorizetl Applicent Date COOEI, MSiECTIONTYPE 16t6 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Flnel Re-Roof 201 Flnel BIocWRetaining Well 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition zaaete PAg � CODE/ INSPECTONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final ElecMcal 212 Final Fire Preventlon 220 Final Planning Approval 222 FinalSite 250 Finel BuildincyOccupancy � � • � CITY OF COSTA MESA � BI/ILD/N6 DIVIS/ON 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.� �� FOR INSPECTIONS CALL: (714) 754-5626 . � PERMIT NUMBER. BC08-00232 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 07I24I2008 � � � � .. ISSUED BY: YH �oaaooRess: 3421WIMBLEDONWYCM ,' Suite/Unit:,: APN: 41207337 . '--ZOning.R1,', Vicinity: - � Primary Occ: R3 � ConstType: V-B SQ.�.FT:_�- 58 ��- Valuation: $5,359.20 . SCOPE OF WORK: ENCLOSE EXISTING-21VD FLOOR DECK TO ADD 58 SQ.FT. TO DWELLING TO CREATE SEWING ROOM ADJACENT TO MASTER BATH-:':�.'- - � ELEC. - 4 FIXTURES, 2 RECEPT/OUTLETS & 2 SWITCHES. �- . �. � . NO NEW PLUMB. OR MECHS AUTHORIZED BY THIS FERMIT.' �. . � � . OWNER: EDMUNDSON GARRY F.TR ��' � Address: 3421 WIMBLEDON WAY � <Unit: ,� .�,.., � Phone: -: �City/State/Zip: COSTA MESA, CA � � � � � • � - APPLICANT: HEINSOHN„BRIAN �� .� Address' ' .. � . � ;�'�Unit: : Phone: 949462-0WO , �.�'�City/State/zZip: � � � - �.. - coNraaCiOR: BRYMELHOMEIMPROVEM ENT.SPECIALISTS " � LicenseNo.- 725371 .� � � � Phone: 949-462-0090' , Address: 23025 EL CABALLOUnit: - . . � Cell: - City/State: LAKEFORESTCA - : ,ZipCode 92630 � ARCHITECT: License�No: -� � - � PHONE: ENGINEER: - � . License No..� ., � PHONE: COMBINTATION PERMIT FEE.SUMMARY'.' Building Plan Check: _ , ` $81:41", . " , _ � � Building Fees: $125.25 ' ' . Electrical Fees: `�- $32:30- - << •� � Mechanical Fees: ; -. ,;$0.00� ' -, - ' Plumbing Fees: ' >.$0:00 ' ' � � � � .� �� SMIP Residential: $0.54 � - _ , ,: SMIP Commercial: $0.00 TOTAL FEES: $239.50 "Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia sfatutes 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. . INSPECTIONS: In order for the work authorized under this permit to be wnsidered 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. CODE /. INSPEG110N TYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 202 203 204 Final BIocWRetaining Wall Final Factory Fire Place Final Sign Final Demolition � iNmu�s eoueR ixsrecnoxTrre 206 Final Mechanical 208 Final Plumbing ' 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 final Site 250 FinalBuilding/Occupancy .P/n �t_ onh iannn�s n�. : . r�:�, � WORKERS'COMPENSATION DECLARATION:� . I hereby affrtn untler penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for vrorkers' compensation, as provided for by section 3700 of the Labor Code, for the pedormance of the work for which this permit is issued. - ❑, . I'have and will maintain vrorkers' compensation insurance, as required by sectbn 3700 of the Labor Code, (or the pedortn e of the work for which this permit is issued. My work rs' comp sation urance carrier and policy number are: `/I Carrier: J �g �� % � (ihu seqion need rwt be mmpeted ilthe peimjrt is v/a�lued at on�e7hunQl� dollars (5100) oi less ) Policy Number: � ln 7� � ! �l _ ❑ I certify [ha[ in [he performance of the vrork for which [his permit is issuetl, I shall not employ any perso in any manner so as [o become subject to the worker ompensati of California, and agree that if 1 should become sub' ct to the ompensation provisions of ection 700 0( the Labor , I shall rt omply with Ihese provision . � 7a�f08' Applicanfs SignaWre Da�e� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SU&IECT 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, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm [hat I am licensed under provisions of Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code, and my license is in full force and effect. � Lic. # � Class # //.a�_ _ , . ? J� Y 1� � � Contractor'sSgnaWre ale CONSTRUCiION LENDING AGENCY: ❑ I hereby affrm that there is a construction lending agency for the pertormance of the Kork fa which [his permit is issued (Sec. 3097, Civil Code). Lender's Name: Lenders Address: oa�e OWNER•BUILDER DECLARATIONS: I hereby aKrtn that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any city or county which requires a permit to construct, alter, impmve, demolish, or repair any struc[ure, prior to its issuance, also requires the applicant for such permit to Tle a signed statement that he or she is licensed pursuant to the pmvisions of the Contractors License Law (Chapter 9(commencing wi[h Seclion 7000) of Division 3 of Ihe Business and Pro�essions Code) or Ihat he or she is exempt therefrom and lhe basis for the allegetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjecls [he applicant to a civil penalty of not more Ihan fve hundred dollars ($500).): ❑ I, as ovmer of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the s[ructure is no[ intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrac[ors License Law does not apply to an owner of property who builds or improves ihereon, and who does such vrork himself or herself or through his or her own employees, provided tha[ such improvemen[s are no[ intended or oRered (or sale. If, however, the building or improvement is sold within one year of completioq the ownervbuilder 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 Protessions Code: The contractors License Law dces not apply to an owner of property who builds or impmves thereon, and who coniracts for such projec[ wi[h a contractor(s) license pursuant to the Contrdc[ors License Laws.). ❑ I am exemp[ under sec. Business and Professions Cotle for this reason: 305]-46�3/0]) .� Ovmer ID verified by drivi cense. ❑ Ves ❑ No Driver s License No. Expires: Venfication of Ownership by (type of dowmen[, i.e. - propeRy tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � ❑ I hereby certify tha[ no excavation frve (5) or more feet in dep[h into which a person is requiretl to descend, will be made in connection vrith work au�honzed by this pertnit, and [hat no building sWc[ure, scaffdding, falsework, a demoli[ion or dismantling thereo(, will 6e more than thirty-six (36) feet high. (Chap. 32, 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 [he Division of IndusMal Safety, as noted above, unless such person has a permi� b do such vrork from [he tlivision. Applicanl's SignaWre Da�e Division of Indus[rial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will Ihe applicant or present or future building occupan[ neetl to file and certi(y a Business Plan for emergency response to release or [hreatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health antl Safery Code requires, wi�h some exceptions, that a Business Plan be filed with [he Costa Mesa Fire Department by every business which has at any one time during a reporled year a quantity of hazardous ma[erials equal to or grea[er than a weigh[ of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard tempera[ure and pressure). 2 Does or will Ihe applicant or presen[ or future building occupant need to file a registre[ion form for acu[ely hazardous materials? ❑ Ves ❑ No (Section 25533 of the California Health and Safety Cotle, with some exceptions, requires registration with the Cos[a Mesa Fire Department by each business which at any one time has on hand a quan[i[y of acutely hazardous ma[erials equal to or greater �han a weigh[ of 500 pounds, or a volume of 55 gallons, or 200 cubic fee[ of compressed gas a[ standard temperature and pressure). 3. Does or will ihe applicant or present or tuture building occupant need lo prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Ves ❑ No (Section 25534 of [he Cali(ornia Health and Safery Code provides [hat the Costa Mesa Fire Department may require the prepara[ion, certifcation and fling with [he Fire Department of an RMPP by businesses which are required lo reqister acutety hazardous ma�erials wilh the Fire Depariment. 4. If an RMPP is presently required, has Section 25534 of the Cali(ornia Healih and Safe[y Code been tully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuNre building occupanl require for [he work which is Ihe subjecl of [his applica[ion a permit for such canstruction or modifica[ion from the South Coast Air �uality Management District or fmm any other air pollulion control disirict or agency? ❑ Yes ❑ No (Section 65850.2 of the Califomia Govemment Cotle requires that the reques[ed infortnation be fumished on applications for non-resitlen[ial building pertnits). 6. Will any part o( Ihe faciliry lo be constructed under this permi[ be within 1000 feet from the ou[er boundaries of a school? ❑ Yes ❑ No pf "yes", the faciliry must meet Ihe requirement of Sections 25534 antl 42303 of [he Califomia Heatlh and Safety Code). 7. If a pertnit from the South Coas[ Air Quality Management Distric[ or other air pollution control district or agency is required /or [he work which is the subject ot this application, have all of the disclosures prescribed by California Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certificate of compliance fmm the appropriate air pollution contml offcer). �' � CERTIFICATE OF COMPLIANCE: I�certify tha[ under penalty of perjury ihe information given above is correct. I. agree [o comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. �_ SiqnaWre Date . CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury Ihat I have read this application and slate that the information given is wrrecL 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 ccupy or allow occupancy of any building au[horized by this permit un[ fina nspection. . . gnaWreo(L r(s) te �' � zy a� Andbr Aulhofize0 AOOlicanl L ^Dete : �'� '� •' •7 J COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely - Use [nk Only BUILDING _ _ _ ___ __ OWNER McLain MAIL ADDRESS �.470 J ciTv Newoor BRANCH ARCHITECT evelopment Co. boree Road TEL. Beach No• 640-6800 TEI. _ ADDFESS 3661 Spruce St., Newport Beach CONTFACTOR McLain Development Co. ADDRESS 1470 Jamboree Road TEL. cirv Newport Beach No. 640-6600 �Ic no. 273875 LICVNO. S12E NO.OF HLDGS. OFLOT AS X 12Z �NOWONLOT Separare perrttits are requued for electric, plumbing and heating wock. UILDING AND WORK TO BE PERFORMED 6ingle family residence New House APPLICATION � E IVF T / A.P.NO. ��Z�O% BUILDING ��/ ADDRESS TRACT ZO2%% FIRE ZONE APPROVED NE NO.OF �a-mD P�^� VAPDS APPROVED DISTANCE BET. MAIN BLOGS. C URP. aW ZE -% A� nOLll FOR 2/21%79 _ 357.62CNP� �@�i��a��T i a - - � DATE ISSUED J PEFMIT NO. • . w i . USE OF NEW BUILDING R�'v VARDS APPROVED ACCESSORV BUIIDI DATE APPROVED KEOUINtnnr..n i i h¢reby acknoW�atlpa thet I have reatl this apPliceNon antl rtate thnt tha abova I�formetlon is correct antl aB�ae to eomply with all laws reBuleting building construction, enC I shall not amploy �Ol7Se Z35z eny person in vlolatlon o( tha workmen's componmNon laws of Mo Steta of Celilornle. I heraCy certify Lhat I am properly Ilcensetl as a contracior under sn. Fr. Gaz'age 678 tha Stom of Calitornla Businass antl Professions Code, Dlvlsion 3, THE AMOUNT SHOWN UNOER VALUATION IS FO Chopter 9, antl thet such Iieanses aro In full force antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV am azompt frOm lhe provis{ons ot (he Siate ot CalNornla Busfnau antl ProfBssions Cotla, Dlvislon 3, Chapter . VALVATION PERM�T FEE E �- PLAN CHECK E D Slpnamra o} � � �/I _ / ..�J Permlttee � <<-� 5 72�j� Tqx y � /�% �� ' Authorizetl � TOTALPAID 5 n m m J m d a N m LL 1