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Home My WebLink About642 WILSON ST - Building Permitse � y CITY OF COSTA MESA � � BI/ILD/N6 D/VISION F _ � DEVELOPMENT SERVICES DEPARTMENT � � PERMIT PERMI� �� 698-01443 (714) 754•5273 • Fax (714) 7543856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 642 W WILSON $T Suite: Vicinity: Parcel Nunmber: 42215316 Applicant: DARYL EVE Address: Owner: Atltlre55 Contracfor. Address: BUILDING PERMIT Zoning: Phone: ' Zip: PROVENZANO, BENJAMIN V TR 642 W WILSON ST �';' " .� , - �Phone: . . COSTA MESA,CA ' Zip: 92627 SUNDANCE ROOFING CO 1752 MIRAMAR DR Status: ISSUED Applied: 0811311998 Issued: OB/13/1998 Phone: 673-6063 . BALBOA, CA Zip: � 92661 Licensec � 718369 � Arch/Eng: � ,�� Address: � � �� Phone: � 2ip: , License: , SCOPE OF PERMIT Voff 8 reroof 2100sf w/comp shingles 8 400sf Flat roof w/built-up. � Plan Check: $0.00 Permit: $87.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $87.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinu: o NOTES: Rear 0- 0 Rear 0• 0 Required: 0 FEE SUMMARY — ,/ PLANNWG & ZONING Left 0- 0 Lefl . 0- 0 Proposed: 0 Calc Valuation: ss,soo.00 Claim Valuation: Ss,soo.00 Right Right EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � , INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inepeetlona and finel approvel must be obtained. Failure to obtain inspedions and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5828 � � WORKERS' COMPENSATION DECLARATION: ' I hereby atfirtn under penalry of perjury one oi lh0 following tleclaratlons: ❑ I have entl will meintain e ceNficeta o1 consent to self-Insure far workers' wmpensetlon, es provlded lor by section 3700 of lhe Lebor Cala, for lhe pertormance o� Ihe work far which this pertnit is issuetl. ❑ I �ave entl will melntein workers' compensa�on Insurence, es requiretl by 5eqion 3700 t ihe Lebor Cotle, lor U�e peAortnence ot Ne work tor which Nis pertnit is isSueC. My workers' compensetion Insurence caMer an0 policy numher ere: � Cartier. Policy Number: _ / (Th/5 secNon need nof be comp/etetl i/ Ne peimit /s ve/ued et CreC dollars ($ f00) or /ess.J ❑ 1 certiTy that in t�e wo o s pe ' is issuetl, I shall not employ eny person in eny manner so es to become subl�i to the workers' compensation la ot Celifomie entl e et I s Id beca sub�ed to the workers' compensallon provlslons of Section 3700 of Ihe Lebor Cotle, I shell forthwith comP�' � isio . �,�7 / ApplicaniSig Wre: Date: _�—I � —I � WARNINO: FAILURE TO SEWRE WOPKERS' CAMPEN^�1T1IXJ RAGE IS UNUW R1L AND SHFLL SU&IECf PN EMPLOVER TO CRIMINAL PENFLTIES AND CML FlNES UP TO IXJE HUN�RED hKK154ND OOIJARE (E100,000�, IN ADIXiION TO THE C0.5T OF COFIFENSATION, DAMhGES AS PROVIOED FOR IN SECTIp! 3)OB OF THE LABON COOE, INTEREST, PND ATTORNENS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm Ihet I em Ilcens d und � provisions oi forca and effed. Lic. q �� Contrectofs Signetur : with Sectlon 7.(100) ol DlWsion 3 of Ihe Business entl P�Qtessions Cotle, and my Ilcense is in full � Class q �� J % _ � oe�a: �t3—/ 3-4f� CONSTRUCTION LENDING AGENCV: ❑ I hereby effirm Net thare is e construction I��tling egenty for the paAormance oi the work for which Nis Oermit Is issued. (Sec. 3097, Civil Code). Lendefs Nema: Lendels Atldress: Signature: Date: � OWNER-BUIIDER DECLARATIONS: I hereby eXirtn thet under penelry of per�ury that I am E%EMPT FROM TXE CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professians Code: Any clry or county which requlres e permit to canstmct, elter, Improve, damolish, or repelr eny atructure, pdar to its Issuance, elso reQuires the applicaN tor such permlt to file e slgned statement Ihet he ar she Is licensetl pursuaN to the provislons ol the Coniractors License Law (Chepter 9(commencing with Sectlon 7000) of Divislon 3 0� ihe Business end Profeuions Code) or thet he or she is exempt Iherefrom and the 6esis for lhe allegetl exemption. Any vloletion of Sectian 7031.5 Dy any epplicant for e pertnit subJecu the appllcant to e clvll penalry of not mora than frve huntlreG tlollers ($500).): ❑ I, as owner oi lhe Droperry, or my employeUs wlth wages as thelr sole compensetlon, WILL DO THE WORK, entl the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors Llcense Lew daes not epply to an owner oi property who builds ar improves ihereon, end who tloes such work �Imseli or herealf or through,his or her own employees, provltletl thet such improvements ere not Intended or otteretl for sele. II, however, ihe bullding or ImOrovement is sold within one year of completian, Ihe owna�-bulltler wlll have ihe burden oi proving that he or she dld not bulltl or Improve for purpose of sale.). ❑ I, es owner of Ihe property, am EXCLUSIVELY CON7RAC71NG WITN LICENSEO CONTRACTORS to canstruct ihe prolect (Sec. 7044, Business and Professions Code: The contrectors License Lew does not epply Io an owner of pmperry who bullds or Improves ihereon, end who coNracts for such project with e contractor(s) license pursuant to the Conirectors License L.aws.). ❑ I am enempt untler sec. Signature: Owner ID verifled by tlriver's license. ❑ Ves ❑ No Business and Professions Code br this reason: Venficetlon of Ownershlp by (type ot document, i.a. - properry tax blll or deed): DIVISION OF INDUSTRIAL SAFE7V PERMR CEATIFICATION: Driver's License No. Dete: Expires: ❑ 1 hereby certity tha� no excevatlon flve (5) or more feet in tlepth Into whlch e person Is requlretl to tlescentl, wlll be metle In connecllon with work euthodzed by this pertnit, and thet no building strucNre, scaHo�tling, lalsework, or tlemolitlon or dismentling Ihereoi, wlll be more ihen ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tiile 8, Califomla Atlministretive Code). ❑ As owner-builder, I wlll nat employ enyone to do wark which woultl requlre e permlt irom ihe Dlvlsion oi Intlustriel SeFery, as noted ebave, unless such person has a pertnit to do such work irom the tlivision. Signature: Date: Division of Industnal Satety Pertnit Numbar: CEHTIFlCATE OF COMPLJANCE AND AUTHORW 0! F EMAY: I certify under penalry ot perjury thet I have resd Ihis application and steta Ihat Ihe infortnetion given is correct. I�gre I stete �ws pM� s@s relating to building construction, end euihorize representatives ot Iha Ciry of Coste Mesa to enter upon the ve- b ribe opeM1y e �ion oses. a iee ot Ib occupy or allow occupency of any Duilding eut�orized by Nis permit until final inspection. �-13-`� � Signeture OI Leg ner(s) / Dete AnNOr Authodzetl App�icant � Date r Fj}QEy INSVELTIONTYPE 1616 Fixetl System Finel Fire Preven�lon 1266 Pool Spa Final 200 Flnel Re-Raat 201 Finel Block/Reteining Wall 202 Finel Factory Flre Plece 203 Flnel Sign 204 Final Demolitlon 2466de � �/ i I�� COOE� INSPECTIONTYVE 20fi Finel Mechanicel 20B Finel Plumbing 210 Final Elecirlcel 212 Final Fire Preventlon 220 Finel Plenning Appraval 222 Final Site 250 Finel Builtling/Occupancy �g I�� .' . . � '7`�� '�OSTA MESA BUILDING DEPARTMENT P. O. BOX 3 I] COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN COSTA MESA. CALIFORNIA E5s 419 B. 17th St. Costa Mesa cosrn ¢ ,��A��O AUG-7-59�aEs::" U4u APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO� -7zY3_ �eceivco ev n 1c eceiY:��j o`<r s5 I raiL.AJ� �i ��'.� 1� tl l-. (� T�o LI 8—ll59 nooRD1ss ecT UCc-tsuu oc L�c. iNeea NO. COSTA MESA. CALIFORNIA � FIRE � Garden Grove ZONE ww�� & Colegrove, Inc. c�r� �� L SQl ��"E � ;° °° L TVPE LwNS CTOR NO. / J :� 419 E. 17th St. �N; IS 8-1159 BVPR�/,✓/r"` ��-f �l :o ,e i LEGAL OESCRIPTION A.P. NO. USE OF E%ISTING BLDG, SETBf�CK L NE FFOM �n' CENTEP OFISTREET G rvo.or a�ocs. �IOW ON LOT ............. �itt SIOE YAR� RIGHT Ot �EFT Jt DESCRIPTION OF WORK . NEW X ALTERATION qODITION REPA MOVING DEMOLISH SITEDING13H0 $Cl�fti• ROOMS 6 STORIES 1 E%TERIOR WALL ROOF �nvvarNr. .itillCCO COVERiNG COIDD• garage Plan ll0 A C�tjl \ii 1��:�i.i I:"r1i1 EY_� _F-!% DA STI�TE THPT THE ABOVE IS CORPECT TN� AGREE TO COMPIV W!TH ALL CITY OROINFNCE$ FND STATE 4W5 REGVLATING BVIL�ING NSTRUC� rioN. VALUATION SIGNATURE OF PERMITTEE ' 81/+f �3 •�� PERMIT FEE $ PI,AN CHECN � TOTAL FEE VOMI � uwneK PRovENZArIo, B. v, unit �JOB ADDRESS 642 West Wi I5on Street BUILDING PERMIT N0.41035 GENERAL CONTRACTOR Cyri I B Norri s DESCRIP710N of WORK Add Fami ly Room A°"o.l.l5-6t6-17 LOT TRACT fIRE ZONE VALUEf6 000.00 II .CTIONS Si noture Date TYPE GROUP ZONE R— sai� �„e,.,,�,�.e, PERMITS ISSUED cns I ' � � `� � � � � ` � � � Date Number Sionature WRTER �� plumbi�a � ING MISCEL LINE � � HOUSE CON. FOUGH NEATING RND aIR COH�ITIONING TEMPOAARY SERVICE OR POLE UN�ERGROUN� [] POwER � ROUGH WIRING TRENCHES FORMS STEEL REI FLOOR SYSTEM BONO BEAM � ST SHEFTHING FRAME ANO fLRSHING AT ST� TURAL, FINAL Ht .G, VENT., REFRIG. ANO PLIIM9ING. FINRL ANO GRS TE ' 41035 � COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 12tl0 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVILDING / CI � 1 1. 1 /III �O ADORESS U t �•�J (�✓ � OWNEH -�- S 1 O E Z/7+�/�'. MAIL ADDRESS S /✓1C TEL. CITY Q y� L,S NO. CONSTRUCTION LENDER BFANCH �� ADDRESS ARCHITECT TEL. CONTRACTOR � O � S ADDRESS �� N. '[� TEL. CITY .(J. NO.sl� ��J(I F STATE CITV � LIC. NO. p�Z �j IIC. NO. {1� SIZE NO.OF BLDGS. L7. OF LOT NOW ON LOT Q USE OF /' .�„ EXISTING BLDG. �W E�. L/� 7 y � Separate permits are required for � electric, plumbing and heating work. w USE OF BUILDING AND WOFK TO BE PERFORMED =� /� .b —� O /�/ Q 7 � r .� z � � I hereby acknowleOYo thet I heva reetl this epplicallon antl stete y� that the ebove InfOtmaiion la corract antl agree io comply with d all lews raBuletinp bulltlin9 conrtruction, antl I zhell not employ Z any Derson In violetlon of Me workmen's eompenaation laws of � Me Stata of Celifor��e. 3 I hereby cartity ihat I am proparly Iicensetl es a contreetor under tha Stete of Celtfor��e Busineae end Profecaionz Coda, Division 3, Chapte� 9, antl theS S�halcenws are In full forca antl affact, or em exempS from tha provlsionc of t mta of Callfornie Busi ss entl ProfaszlonsGotle!Dlvlsia 3, ter 9. 1 l SIB�aturo O � Permlttae �nr� -2-�FP"�L00 o2ix �**>�54.50 �H�. APPLICATION FOR STRUCTURAL PERMIT RECE DATE RECEIVED qTE I �� ' /'/ _ 1. PEIiMIT NO. A.P. NO. CO�•�O � BUILDING i A� �.. 1 1 _ Q� TRACTGL1 LOT BLOCK W AD AL R PA OWNER �Li/O�V � �/�y S �` '✓ •C� / VALU$ /CA r ,/ t/v� FIRE ZONE TYPE GROUP APPROVED / 7 � BV DATE f'�L� Z NO.OF USE OF NEW h�t ' PLANS Z BUILDING�M �^ VARDSAPPROVED VARDSA�PROVED MAIN BUILOING ACCESSORV BUILDII REAR �� FT. DISTANCE BET. BET. MAIN MAIN BLOGS. ACCF55. 81 VAR. # DATE - 2� n m i �y m ✓�V SQ.FT. a THE AMOUNT SHOWN UNDER VALUATION IS FOR m THE PURPO6E OF ESTABLSMING A PERMIT FEE NIY: � VALUATION PERMIT FEE E �OO a N �400�0 PLAN CHECK y � OO o $ TAX E LL I � � U TOTALPAID S S