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Home My WebLink About830 TOWNE ST - Building Permits(774) 754-5273 • Fax (714) 7544856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 830 TOWNEST Suite: Vicinity: ROOF Parcel Number: 42418115 Applicant: BRIAN WOLSKY Address: 77662 MET2LER LN HUNTINGTON BEACH, CA Owner: MOODY, LOREN A Address 830 TOWNE ST COSTA MESA, CA Convactor: TOM BYER ROOFING Address: 17662 METZLER LN Arch : Address: HUNTINGTON BEACH, CA Zip: 92647 Phone: Zoning: Phone: (714) 847-9332 Zip: 92647 Phone: Zip: 92627 Phone: (774) 847-9332 License: 575002 Eng: Address: Status: ISSUED Applied: 10/14/2004 Issued: 10/14/2004 ISSUED BY: � Phone: Zip: � License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 2 LAYERS OF 15# FELT, G.A.F. 20 YEAR COMPOSITION SHINGLES, HOT ASPHALT BUILT UP ROOF WITH CAPSHEET ON FLAT. 19 SQUARES ON SLOPE AND 3 SQUARES ON FLAT. �;;, _S, Plan Check: Permit: SMIP Res: � SMIP Com: Other: Inspection: Total $0.00 $111.25 $0.50 $0.00 $0.00 $0.00 $111.75 SETBACKS • MAIN STRUCTURE � Fmnt 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: , 0 Rear 0-0 Rear 0-0 Reouired: 0 FEE SUMMARY PLANNING & ZONING Lek 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Cfaim Valuation: Rlght .0- 0 Rlght 0- 0 sa,a�s.00 $4,875.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquiremenis under Califomia statutes and related regula�ions. (Ord. No. 92•28, § 1, 12-21•92) EXPIRA710N: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorizetl under this permil to be considered Iegal, such work must comply with all applicable codes, and all requlred inepectlone end final approvel must be obtained. Fallure to obtain inspections and final apProval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ?aeaae (eroo) WORKERS' COMPENSAnON DECLARAnON: � � �_ � I hereby ettirm under penalry of perjury one ol Iha tollowing declarations: ❑ I heve antl will melntain a certificata ot consent to self-Insure loi workers' compensation, es pravidetl for by seciion 3700 oi the Lebor Code, for ihe peAortnance ol lhe wo or which this permit is issue0. 1 have antl will malntain workers' compensetion Insurance, as requiretl by section 3700 of Ne Lahor Cotle, tor Ne peAormance ot Ihe work tor which this pertnit Is issuetl. My workers' p tlan Insurence cardel end policy number ere: l / i- "� Cartier: �� Policy Number. _ _ ( h �� , � -iL (fhis section need no( be complefed i! Ihe permlf is valued a( one hundred dollers ($ f00) or less.) , ❑ I certity that in the peAormance of the work for which this pertnit is iuued, I shell not employ eny person in eny manner so es to become subject to Ihe workers' compensatlon laws ol California, end agrae that Ii I should bacome sub�ect to the workers' compensation provlslons oi Section 3700 of he Lebor Cade, I shall lorthwith comply with these provisions. 11 Applican�5igna�ure: Dflte: �G,� 7 Q� WARNING FAILURE TO SEGURE WORK ' CAMGEN ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FMES UP TOIXJE HUN�RED THOUSANDDq1ARE(5100,000),INADDI QSTOFCOMPENSATIIXJ,OAMAGESASPROVI�EDFORINSECilON31080FTHEL400RCODE,INTEPEST,ANDATTORNENSFEES. LICENSED CONTRACTORS DECLARATON: I hereby attirm ihat I am licansed under provi5ic force and eflact. Lic. N .� Conirector's Signawre:� 9(cammencing with Section 7000) of Division 3 0l Ihe Business end P,[Qfe sians Cotle, end my license Is In full class a ��' �S �, Date: �( O� CONSTRUCTION LENDING AGENCY: ❑ I hereby aRirm ihat Ihere is a construction lending agency for Ihe pedormence of the work for which ihis permit is issued. (Sec. 3097, Civll Code). Lenders Name: __ Lentler's Atldress: Signature: __ _ Date: OWNER•BUILDER DECLARATIONS: I hereby eNirm that untler penelty of perjury thet I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for �he following reason (Sec. 7031.5, Business end Professions Cotla: Any ciry or coumy which requires a permit �o construc4 alter, improve, demolish, or repair any structure, prior Io its issuence, elso requires the epplicant lor such permit to tile e signed statement thet he or she Is licensed pursuent to Ihe pmvlsions oi the Conirectors Llcense Lew (Chapter 9(commencing wlih Sectlan 7000) of Divislon 3 a� the Business and Pwlessions Cotle) or ihat he or sha is exempt therelrom end the basis tor the alleged exemption. Any violetlon ol Section �031.5 by eny epplicent for e pertnit subjects ihe epplicent to e civil penalty of not morU Ihan tive huntlretl dollers ($500).): ❑ I, as owner of ihe properry, or my employeeS wi�h wages es iheir sole compensation, WILL DO THE WORK, entl the struc�ure is not Intended or ofleretl for sale (Sec. 7044, Business and Professions Cotle: The Coniractors License Law does not apply to an owner of property who builds or improves thareon, end who does such work himself or herself or ihrough his or her own employees, pwvided thet such impwvemams ere nol intendetl or oHeretl for sele. II, however, the building or Impmvement is sold within one year ol completion, ihe owntl�-builder will heve ihe burtlen oi proving ihat he or she did no� build or improve tor purpose of sele.). ' ❑ 1, as awner of the properry, em E%CLUSIVELY CONTRAC7INC WITH LICENSED CONTRAC70R5 to constmct the project (Sec. 704a, Business entl Pmfesslons Code: The comractars License Lew tloes no� epply to en owner of pmperty who bulltls or Impmves �hereon, and who comracts tor such pro�ect with e conirector(s) license pursuam to the Contractors license �ews.). ❑ I em exempt under sec. Business antl Professions Code for ihis reeson: Signatura: Date: Owner ID venfied by dnver's licensa. ❑ Yes ❑ No DriveYs Licenso No. Veritication ot Ownership by (type oi tlocumem, i.9. - property tex 6ill or tleetl): DIVISION OF INDUSTRIAL SAiETV PERMIT CHAnFiCATION: Expires: ❑ I hereby certify Ihet no excavetion five (5) or more leet in depth into which e person Is requlred to descend, wlll be matle in connectlon with work eu�hodzed by this pertnit, entl ihat no builtling s�ructure, scaflolding, lalsework, or tlemolition or dismentling ihereoi, will be more ihan thirly-siz (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Calitomia Administrative Code). ❑ As owner-builder, I wiil nol employ anyone �o do work which would require e permit from the Division of Indusidal Safety, es notetl above, unless such person �es e parmit to do such work from ihe division. SignaNre: Date: Division ot Indusinal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUiHOR17AT10N OF ENTRY: I certify under penelry ol perjury �ha� I �ave reatl �his epplication an0 siate thet the information given is correct. I agree to comply with all state laws end city ordlnances relating to builtling construction, end euthonze representatives of Ihe Ciry oi Costa Mesa to enter upon tha above-descnbed property tor inspection purposes. I agree not to occupy or allow occupancy of eny building authorized by Ihis permit until linal inspection. 40DE �. INSPECTONTYPE 1616 Fixetl System Final Fire Preveniion 1266 Pool Spa Final 200 Finel Re-Roat 201 Final Blxk/Aeteining Well 202 Final Factory Fira Placa 203 204 Finel Sign Final Damolition PAg II�9L5 �-' "� �ey-!/l� �"/�`+ Q� Dae COOE 1 INSPEGTION TYPE 206 Finel Machanicel 208 Finel Plumbing 210 Finel Elecirital 212 Finel Flre PrevenNon 220 Finel Planning Approval 222 Final Site 250 ' � Final 8uiltling�Occupancy PAg U�dLB Ni00DY, LOREN ALVIS JOB ADDRESS GENERAL COr LOT INSPECTIONS OCCUPANCY a'a pUG � SUBCONTRACTOR DATE 2-fi-61 BUILDING PERMIT TYPE V ZONE R1 � PERMITS ISSUED Form 210—SM-11-59 S-B P 13790 ��o COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBA. CAIIFORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT su��oiNc c% �; n '.f..... �n . —r�, ... �..� � MAIL COSTA MESA. CALIFORNIA TEL ti f4 � � fy/�i: � No. 4'� � : TEL. GITY �r-- STATE TEL. NO. OF BLDGB. NOW ON LOT �� 6HiBACK LIN6 FROM / IEFT .� RIGMT % DESCRIPTION OF WORK BUILDING '? � / � NO. OF SIZE GC (O ROOMS / EXTERIOR WALL/�� Q�/ ROOF C COVERING A COVERING USE OF BUILDING qND WORK TO BE PEP fz' Lc�i��F_'. C il_s P I N¢PEBY AGKNOWLEOGB THAT 1 HAVE R6AD iH18 APPLIGTION ANO eTATE TMAT THE ABOV6 IB CORReCT ANO 11ORE8 TO COM- PLY WITH AL� CITY ORDINANLEe AND BTATE LAW9 R6GULATING BUILOINO CtlNBTRU /` BIGNATURE OF � � � ,., /� �.� ��w.ti.��_ FIRE LEGAL �EE �� E B 7 1961 F�ANCE DEPT. APPLICGq'�I��iI' �R.iT�R1M�IA BUILDING For Office Use Only qECE1PT NO. 4)IL"rN� 'q�qATE�RECP��V� DATE 186UED � �rt !J � � -6 -G , COSTA MESA, CALIFORNIA ZONING NO. OF I UBE OF N PIAN$ BUllO1N6 � * �/ _. / i � '- / fCENTHF LIN! 8T.] APPROVED P� _" TXE AMOUNT BHOWN UNDHR VALt1AT�ON IB FOR THE PUPP09E OP H9TABL19HIN0 M1 PHRMIT FEE ONLY. VALUATION n � // C��' PERMIT FEE $ � $ �/J �" � PLAN CHECK $ C LL