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Home My WebLink About567 TRAVERSE DR - Building Permits. � 0'rfA 14F 4 � 0 , _ : J. qt �s �"�oertw (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIV/S/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 567 TRAVERSEDR Suite: Vicinity: Parcel Nunmber: 4� a022�9 Applicant: NGUYEN, CHUONG X. Address: 567 TRAVERSE DR COSTA MESA Owner: NGUYEN, CUONG XUAN Address 567 TRAVERSE DR Contrador: Address: Zip: Arch : Address: COSTA MESA,CA BUILDING PERMIT Zoning: R1 R1 Phone: 714-608-2865 Zip: Phone: 714-608-2865 Zip: 92626 Phone: License: Eng: Address: �� PERMIT NUMBER 899-00053 �/ 77 FAIR DRIVE, COSTA MESA. CA 92626 Status: ISSUED Applied: 01/71/1999 Issued: 01/71/1999 � � �� Phone: - Phone: Zip: License: License: SCOPE OF PERMIT T/O EXIST WD SHAKE; RE-SHEATH W/ 7/i6 OSB; NEW 40N FELT; NEW CLAY MAX TILE @ 5.8 LB/SQ Ff; ICBO# 3523. CERTIFICATE ATTACHED TO PERMIT. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $99.75 $0.50 $0.00 $0.00 $0.00 $700.25 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0- 0 PARKING Existina: 0 NOTES: Rear 0- 0 Rear 0- 0 Reouired: 0 FEE SUMMARY , PLANNING & ZONING LeR 0- 0 Lek 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $4,500.00 Sa,soo.00 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons and (Inal approval must be obtained. Failure to obtain inspections and final approval will result in �he expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPEN$p7�ON DECLARATION: I hereby affirm under penalty ot Oer�ury one ot the following declarations: ❑ I heva entl wlll mqintain e certificate of consent to salf-Insure lor workers' compensatlon, es providetl tor by section 3700 of the Lebor Cotle, for ihe pertormence of the work for w�ich �hig pertni� is issued. ❑ I have entl will maintein workers' compensation insurence, es required by section 3700 of Ihe Lebor Code, tor Ihe pedortnence ai the work tor which this pertnit is issued. My workers' compensation Insurence wrtler enE policy number era: Carrier: Policy Number: (77Ns seclion need not be completed illhe permlt is valued et one hundred dollers ($700) a/ess.) ❑ I certity that In the pertortnance of the work for which this pertnit is issued, I shell noi employ eny person in any manner so es to become sub�eCt to ihe workero' compensation laws of Celifomia, end egree lhet If I shoNd become subject to Ihe warkers' compensetion proWsians ot Sectlon 3700 0l tha Lebor Gode, I shall torthwiih comply with these provisions. Applicant Signature: Dete: WARNING FAILURE TO S�CURE WORI(ERS' WMPENSATIqJ ryJVERAGE IS UNLAWFUL AND SHALL SUBIECT PN EM%.OVER TO CFIMINAL PENPLTIES AND CIVIL FINES UP TO ONE HUNORED THOUSAND OOLURE (510p,ppp), IN ADDITIIXJ TO THE COST OF CqMPENSATION, DAM4GE5 AS PfiOVIDED f-0R IN SECTION 31080F THE 1A00R ODDE, INiEflEST, ANO AiTORNEV'S FEES. IICENSED CONTRAC70RS DECLARATION: I hereby aHirtn that I em licensed under provislons at Chapter 9(commencing with Sectlon 7000) ol Division 3 of the Busineu and Pmfessiors Cotle, entl my license is in full brce and eNect. Lic. a Class N Cantractofs Signeture: . � Dete: ICONSTRUCTION LENbING AGENCV: ❑ I hereby ettirtn thq� there is a consiructlon lentling egenry lor the pedortnance of the work for w�ich �his pertnit is issued. (Sec. 3097, Civil Cotle). � Lenders Nema: Lenders Address: , Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby eMirtn Ihat untlgr penalty ol pe�jury ihet I em E%EMPT FROM TME CONTRACTORS LICENSE LAW tor the followinq reeson (Sec. 7031.5, Business and Proteuions Code: Any ciry or county which requires e permit to consiruct, elter, improve, tlemolish, or repair eny strucWre, pnor fo its issuance, afso repuires ihe appficant for such permit m tile e signed stetement thet he or she is Ilcensed pursuent to the provisians ol the Contraqors IJcense Lew (Chapier 9(Cpmmencing with Section 7000) of Division 3 of Ihe Business and Protessions Cotle) or t�et he or she Is exempt theretrom and ihe hesis lor the ellaged e:emption. Any violatlon ot Section 7031.5 by any epplicant for a permit �sub' cLs tha applicant to a civ,l penelty ot not more Nan fve hundred dollars ($500).): I, as owner ot t�e property, or my employees with wages es their sole compensation, WILL DO THE WORK, antl the structure is not Intendad or oflered tor sale (Sec. 7044, Business end Professions Code: The Conirgctors License Lew does not epply to an owner ot properry who bullds or improves thareon, antl who tloes such work himseN or herselt or through his or her own employees, providetl t�et such impmvements are not intentletl or oflereE lor sele. If, hawever, the building or impmvement is sola within one y0ar of completion, the owner-Duilder will heve the burtlan of proving Ihet he or s�e tlitl not build or improve for purpose ot sale.). ❑ I, as owner of thg property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct t�e prqect (Sec. 7044, Business and Prolessions Code: The contractore License Lew tloes not eppty to en owner of property who bullAs or Improves thereon, entl who contrects tor such pwject with a contractor(s) license pursuant to the Conirectors License Lews.). ❑ I em e:empt undpr Business antl Professlons CoOe tor this reason: Signemre: Dare: Owner ID veniie y ns . ❑ No Odver's License No. Expires: Vediication ot Owne ot document, i.e. - properry tex bill or tlead): DIVISION OF INDUSTpIpL SAFETY PERMR CERTIFICA710N: ❑ I hereby certiy Ihat no e:cavation five (5) or more teet In depth into which a person Is requlratl ta descend, will Ce maAa in connection wlth work authodzetl by this permit, enOlhat no bullding structure, 5cettolding, telsework, or tlemolition or dismantling thereot, will be more then ihirry-siz (36) leet high. (Chflp. 32. Grp 2, Art 2, Sec. 341, 7tle B, CeIlfOmia Atlminislretive Cotle). ❑ As owner-builder, I will not employ enyone to tlo work which would require a pertnl� trom the Divislon af Indus�rlel Safery, as noted ebave, unless such person �es a pertnit to tlo such work from t�e tliNsion. SignaWra: Date: Division oi Indusinal Safery Permit Number: CER7IFlCATE OF COMPLIANCE AND AIJTHORVA710N OF ENTSiY: I certify under penalry of perjury ihat I have read Ihis applica�ion and state Ihet ihe infortnation given is correcL I egree to comply with all stete lews end clry ortllnances releting to building constmction, end euthodze representetives of the City ot Costa Mesa to enter upon the aDove-dascnbetl erty for insp i� Duryoses. I egree not to occupy or allow occupancy of any Duiltling authonzed by ��i ertniyt ntil final inspaction. /////9 9 ign egalOwnar(s) �T Date Antl/Or Authonzed Applicant � Date cooe �. 1616 1266 200 201 202 203 204 2646dfi Fixed System Finel Fire Prevention Pool Spe Finel Final Ra-Roof Finel BIocWRataining Wall Final Factory Fire Placa Final Sign Final Demolition � '� 4ppF1 wsveenoNrrve 206 Finel Mechanical 20B 210 2I2 220 Final Plumhing Final Elacincal Finel Fire Prevention Finel Planning Approval 222 Final Site 250 Finel Building/Occupancy CAff UIfIDlLS 0 1`L iJH DL JOB ADDRESS � GENERAL CONTRACTOR or Forms BUILDING DESCAIPTION OF ` SUBCONTRACTOR .� :� �� 24581 COSTA MESA BUILDING-SAFEf`/ DEPARTMErIT • P.O. BOX 91] COSTA MESA, CALIFORNIA For Applicanf to Fill In Completely TYPE OR PRINT ' BUILDING 5 '� n AD�RESS COSTA MESA. CALIFORNIA ■ ARCHITECT USE OF EXISTING BLOO. BETBACK LINB FHOM TEL. CITY OF COSiA MESA AUG 19 1965 R[C[I'T NO. � _ PERMIT NO. � S ,. IONIN(i - ZON[ NO.OI UB80PN8 LS� PUN9� LDI O � 1 v L20AL IOO � �� /� �; � D88CHIPlION E A. P. NO. /Y� ' � / 4• NOTE: NO EAVE OVERHANO SHALL BE LESS THAN TEL. I�� 90' TO SIDE @ REAR P. L. NO. J I EAVES O No.opeLD08.� ALLOWED �U.B.C.REQUIREMENTI rvOw On LOT YAH�3APPROVED YAR�SAPPROVED 1/ _♦ MAIN BUILDIN6 ACCE590RY BUILOIN6 5 DESCRIPTION OF WORK N6 � / IT ROOMH OR Wq�,L. , . _ I ROOP .5 � I MEq6BY ACKNOWLHD�B TNAT 1 HAV6 RBAD TMIB APPLICATION ANO 9TAT2 THRT NH ABOVB 18 C RFlECT ANC OqEB TO COM. PLv w�TH wLL CI OqDINANCBO D eTAT6 8 P80lILATINO BUILOINO CONBTH ION. SIGNATUREOP L�. '� PERMITTE AUTHORIZED AGE T 5� VAR. # DATE e l6 77 sa. �. �4 6 2"'�' " n TXe �MOUNT BHOWN UN�Eq VALUATION IB FOp TXE F p11RP09H OP 88TABLIBXINO A PBRMIT F88 ONLY. 0 VALUATION �f OQ m N PERMIT FEB j bp m $��, � 9�� goo � TOTALFEE $ VWNtK """�.� '."...""' ". UAIt ' ' JOB ADDRESS averse r. BUILDING PERMIT N0. � AP No. LO7 100 (� INSPECTIONS SOIL GAS W qTER ROUGH PLI/MBING PROP. SWR. LINE � HOUSE CON. � SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNOERGROUND � POWER � ROUGH WIRING TRENCHES � F00.MS � STEEL REII FLOOR SYSTEM BONO BEAM � STEEL REINFORCE � SMEATNING .�S('-'t'� FRAME ANO FLASHIN LATHING — IN UT n PlASTER, BROWN COAT STRUCTURAL, FINAL NEATING, VENT., 0.EFRIG. AND A.C., FIN� PLUMBING, FINAI. AND GAS TEST �J ELECTRIC, FINAL a�ni niur. ciuei SUBCONTRACTOR `a '� " 31258 COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 7200 COSTA MESA. CALIFORNIA 92626 Z . W W a U FZ 2Q H am J � J N Q W 0] J m J Q U N Z a W � aw W Z J � m Z J � W W � ZH w� N � � � JHN 15-70�n5�00 431 0***¢*(.QQ APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BV DAT REC VED DA E ISS ED BVILDING I� ADDRESS S U•�L.� Y /S / S a /-1p �J PERMIT NO. OWNER p'WR •C• (I•E A.P.NO. /Q ��c`�JD �� 7 MAI L c J BUIIDING / ,(�� '� ADDFESSS�6 % ��/� V'�'�d S ��( AODRESS 310 .�J'/(/ : GTVCQS � � NOL.S-VO'�p �TRACT (�'�/ LOT UU BIOCK CONSTflUCTION W P LENDER D � BRANCH / OWN R Vb✓ Y ADDFESS � VA�UE / 1'� ARCHITECT TEL. $ (pO`G� OR ENGINEER N FI E ADDRESS ZONE TVPE GROUP APPROVED '� CONTRACTOF BY ATE S D ADDRE55 TEL. ZONE NO.OF USE OF NEW+�'�+��- CITV NO. �J/ P�� BUILDINC� STATE CITV �'ARDSAPPFOVED VAROSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE /� NO.OF BLDGS. (FROM C/L STREE I OF LOT (.) O�C f�� NOW ON LOT RONT T. FT. USE OF EXIS7ING BLDG. FT SIZE OF NO. OF NEWBLDG. ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFO(iMED DIST NCE BET. BET. MAIN& MAI BLDGS. ACCESS. BLOGS. �`., L �{ Z( y � C_. C URP. aW APPROVED A1 OA�w O'O!�(� �ROVED �/ �� 1 hareby acknowletlge that I have reatl t�is application antl stata that the above intormaiion is correct antl aBree to comp�y with all laws repulating builtling consttuction, and I shell not employ any person in violation of the workman's compensetion lews of tha State ot Celifornia. I hereby certity tnat I am proparly Iicensatl as e conirector �nder SQ. FT. ihe State o( Calitornia Business entl Protesslons Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOF Chapter 9, end that such licenses are In tull farte end effect, or I TME PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: om oxempt irom the provlsions of Na 5[ete of Callfornio Busine55 VALUATION entl PrOfeaslons Cotle, Dlvision 3, Chapter 9. GERMIT FEE 5 SiO�at�re of /�•�� t"� Permltiee •�n � �e ��"'l $� D�' PLAN CHECK 3 Aathorizatl Agent / AL FEE 5 YJ • -� tk uUlirav, HUWAitll OA 1 t 4�y- � r ADDRE55 SFi7 Traver�e• i]rive BUILDING PERMIT N0. �GENERAL CONTRACTOR pg� AP No. $18-022-09 LOT li NSPECTIONS l �{soi� G�S W�TEN (1 ROIIGH GLUMBING �bvROP: 5M'A. LINQ � MOl15E CON. �SPRINKLING SYS7EM MISCELLANEOUS ROl1GN MERTIHG �ND AIR CONDITIONING TEMPORRRV SEFVICE OR POLE UNOEl1GROUNO � POWEA � ROUGH WIRING TRENCHES CORMS STEEL RE FLOOR SVSTEM BONO BEPM [] �STEEL REINFORCE [ SHE�TNING FRAME ANO FLA$HING LRTHING - IN OUT PL�STER. BRO'MN COAT STRUCTURPL,FIN�L HE�TING, VENT., qEFRIG. AND A.C., FI PLUMBING, FINAL AN� GAS TEST ❑ ELECTRIC, FINA� BUIL�ING, FINA4 SUBCONTRACTOR i . �� 43893 �x� �� 2Q-7i�::.-0�1673-, ..,r�...;.;,;.54 COSTA MESA BUI�DING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFORNIA 92626 F�+ 7. W a a .�. � S F APPLICATION FOR STRUCTURAL PERMIT For Applicant to FiII in Completely — Use Ink Only RE%E_. iygo av� qq,TE R CEIV,E DATE IS ueo BUILDING �-6 %�AVf�SE �,P, ��' �f— — — ADOFiESS ��7 P J OWNER /OwA'.eD �GDEN <..P.NO. �O/yG" MAIL / �R. BUILDING / /'7 /��v�S D� ADDRESS S(�j T�f} VE/�SE AD�RESS J u i /1 TEL. TRACT 567� LOT OV BLOCK CITY Losr,v �E59 No. CANSTFUCTION W ADD Al P LENDEfl �/ /� BRANCH OWNER �W/�J(l{/ Q Or/V A�DFESS �%/Q ^�� VALUE ARCHITECT T L. S � 5 OF ENGINEEF OBE�T � /�U FIRE ADDFESS vAN NU�S 20NE TVPE GROUP Q n APPROVED CONTRACTOR %}C.ESE%%�E� .O/O6, C�O• gY DATE ADDRESS I/� S. �REn �IVO � TEL. ZONE NO.OF USE OF NEW O�%�(J GTY BQE/9 NO. So7 ^/ � I Pw� BUIIDING /� p.�VlZ, STATE CITV �'ARDSAPPROVED VARDSAPPROVED IIC. NO. � G O S LIC. NO. MAIN BUILDING ACGESSORV BUILDING SIZE NO.OF BLDGS. (FROM C/ISTREET) /� OF LOT NOW ON LOT ROM FT. !7 7�/-��C�� VSE OF �j � EXI5TINGBIOG. /`E-S/DENL�E' S1 FT � T FT Separa[e permits are required for L SIDE FT. S r FT. elec[ric, plumbing and heating work. REAR Fr. 2 y i.b Pc�. USE OF BUILDING ANq WpqK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACC65. BLDGS. vAR.qW DATE �UN1 iNUM f}Ti �o �o �/E.C_ c.�.P.vW APPROVEO APPROVED I hereby acknowlatl0e thet I have raetl thls epplication entl state thet ihe ebova informatipn Is eorrecc an� agrae fo comply wlih al� lews regulatln8 bulltling coneirueilon, antl I shall not employ any person in violation Of the workmon's compensation laws of Me State of California. 1 heraby certify thet I em prope�ly Iicensetl as a contracto� under SQ. FT. tha Stete of Californ(a BUsiness ond Protattions Code, Dlvision 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOii Chapter 9, and t�at sueh Iicenses ere in full force antl effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt from the provislons ot the Steta of Calltornia B�ziness VALUATION PERMIT FEE S /�[) antl Professions Code, Division 3, Chapter 9. • p,7p� /� �� ,�/� PLANCHECK S Sipnetura of �/I _ /' _ . " 1 I [r�' Permittee �i K��"� 4��D �— TAX b f D Authortzatl ABant TOTAL PAID E D