HomeMy WebLinkAbout580 WILSON ST - Building Permitspia� �sa-s2�s • Fax (�ia� �sa-aess
Job Address:
Suite:
Vicinity:
CITY OF COSTA MESA
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
580 W WILSON ST
HOUSE 8 GARAGE
Parcel Number: 42216107
npplicant: LARRY WILLIAMS
Address:
BUILDING PERMIT
Zoning:
.
PERMIT NUMBER
�' B99-01463
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 0 911 3/1 9 9 9
Issued: 09/13/1999
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Ownec HILARIO, TIRSO� , � � � ' - -
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Address 580 W WILSON ST, APT. A' . � -- ,
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�-COSTAMESA�CA� � -�-` Zip: 92627 ���V ,��'� �—��
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Contracror: � ALL-COAST ROOFING � � '
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Address: �\2107 WALCACE'AV '��.; �, - - ��
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� ,�/��i Phone: (714)444-1116 � „� � \
COSTA MESA, CA . , �
' �' Zip:� 92627"�j License� 598440 � � � _
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Address: ' � � -�i� � � Address:
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Zip: � � � License:
Phone:
, �';�License:
� � �-� SCOPE OF PERMIT � �
�� REROOF,- T/O, USINGE EXISTING SHTG, 2 LAYERS OF 15# FELT AND 25 YEAR COMPOSITION SHINGLES.
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� , FEE SUMMARY
Plan Check: . $0.00 �
Permit: $11125
� SMIP Res: � $0.50
SMIP Com: $0.00
Other. $0.00 -
Jnspection: $0.00 �
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Calc Valuation: sa,5oo.00
Claim Valuation: 5a,soo.00
TotaL•: $1�1175 � � � - �
� �� PLANNING & ZONING- � �-
SETBACKS �
MAIN STRUCTURE Front 0. 0�
ACCESSORY � - Front 0-0-
PARKING � �Existina: ' o
NOTES:
Rear 0- 0
Rear . 0- 0
Re uired: 0
Left 0- 0
LeR 0- 0
Pro osed: 0
Right 0. 0
Right 0-0� . �
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
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 a period of 180 days.
I INSPECTIONS: In ordar for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlons end flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
.WORKERS' COMPENSATION DECLARA710N:
I hereby attirm untler penalry of Derjury one oi ihe tollowing tleclarations:
❑ I have entl wlll melntain e cenllicete of consent to self-Insure tor workers' compensation, es provldetl for by section 3700 ot ihe Lebor Cotle, for the pertormance oi the
work for which Ihis permil Is Issuetl.
❑ I have and wil�n{8i�orker compe tion Insurence, as required hy section 3700 oi the labor Code, for the peRormance of the work tor which this permit is iuued.
My workers' pe�e n a ce ner entl policy number ara:
Cerder. X Policy Number:
(This section naed n f be cromplete 11 the permit is ve/ued et one huntlred dollers ($100) or less.)
❑ I certily that In Iha pe rmance of Iha work (.ar 'c� this permit is issued, I shall not employ eny person in eny menner so as t becoma subject to �he workers'
compensation lews of lifornie, end egr e �(at �I I hould become subject to the workers' compensetion provislons of Sectlo 3700 f ihe Lebor Cotle, I shall forthwith
wmply with Ihese pr ' ns. ,. .,
Appliwnt Signeture: Date:
WARNING: FAILURE TO SECUP ORKE ' DMPENSATION COVERAGE IS UNLAWFUL AND SHnLL SUBIECT AN EMPLOYER TO CRIMINAL P NALTI AND CNIL FINES UP TO ONE HUN�RED
THWSAND OOLLARE (510D,000). IN FDDIiI TO THE CO6T OF COIAPENSNTION, DAM4GE5 PS PROVIDED FOR IN SEGTION �OB OF TME LABOR CODE, IN�EREST, AND AiTOFNEY'S FEES.
LICENSEU CONTRACTORS DECLARATON:
I hereby aHirtn ihat I em licensed
force antl aHecL Lic. »
Contractots Signature: _�
CONSTRUCTION LENDING AGENCY:
wlth Section 7000) ol Dlvision 3 of tha Business an r essions Code, and my license is In full
_ Class a �� !
_ Date: _ _
❑ I hereby aHirtn thei there Is a construction lending agency tor the pedormence oi the work lor which this permit is issuetl. (Sec. 3097, Civil Code).
Lenders Name: Lendels Address:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aftirm ihet under penalry of perjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW For Ihe following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or county which requires e permit ro construc�, alter, improva, demolish, or repair eny structure, prior lo its issuance, also requires the applicant for such permit
to file a signed statemem that ha or she is licensetl pursuant Io the provisions of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) ot Divislon 3 of ihe
Business antl Professions Code) or thet he or she is exempt therefrom and Ihe basis lor the ellegetl ezemption. Any vloletion of Section 7031.5 by any epplicant for a permit
subjects the applicant to a civll penalty ol not more than Ilve hundretl tlollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sola compensation, WILL DO 7HE WORK, end ihe structura is not inrended or offered for sale (Sec.
7044, Business antl Protesslons Code: The Contractors License Law doas not epply to an owner of property w�o builtls or improves thereon, and who tloes such work
himself or harseN or through hls or her own employees, provided that such improvements ere not Intended or oflered for sale. If, however, the huilding or improvement is
sold within one year of completlon, ihe owner-builder will have ihe burtlen of proving that he or she tlitl not builtl or improve tor purpose ot sale.).
❑ I, as owner of ihe property, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business entl Professions
Cotle: The comractors License Law does not apply to an owner of properry w�o builtls or impwves t�ereon, end who coniracts for such pmject wiih a contractor(s)
license pursuant to Ihe Contractore License Laws.).
❑ I am exempt untler sec. Business and Protessions Code tor this reason:
Signa�ure: Date:
Owner ID verified by drlvers liCenSa. ❑ Yes ❑ No DnvefS Licen50 No.
Verification of Ownership by (type of tlxument, i.e. - pmperty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV 7ERMIT CER7IFICATION:
Expires:
❑ I hereDy certity tha� no excava�ion five (5) or more teet In depth into which e person is requlretl to tlescena, will be made in connection with work authorizetl by ihis
permit, entl ihe� no builtling structure, scaHolding, falsework, or demolition or tlismantling thereot, will 6e more ihan �hirry-six (36) teet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Title B, Calilarnia Administrative Cade).
❑ As owner-builtler, I will not employ enyone to do work which would requlre a permit trom ihe Division of Intlustrial Safety, as noted above, unless such person hes a
permit to tlo such work irom ihe division.
Signeture: Date:
Division of Intlustrial Sefery Permit Number:
CERTIflCATE OF COMPLIANCE AND IZATON OF EMAV: I cetlity under penelty of perjury ihat I have reetl this application and state ihat the information given is
correcl. I agree to qqmply with a stet la s an�1 ciry ordinances relating to 6uiltling construction, end emhorize representatives of Ihe Ciry oi Costa Mesa to enrer upon the
e6ove-described prA6arty for inspec pu os��gree not to occupy or ellow occupancy oi any builtling authodzea by this pertnit until tinal inspection.
GOOE �. INSGECiIONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final Blotk/Retaining Well
202 Final Factory Fire Place
203 Finel Slgn
204 Final Demolition
2M6 46
pAjE INTIfIAIS
CODEr INSPECTIONTYVE
206 Final Machanical
208 Final Plumbinq
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
DpTE �NTITIRLS
._ • •
OWNER DAWSON. HarOld B. -" DA'rE 7-1-57
JOB ADDRESS 5$0-W. W11S01] � UI11t A • BllILDING PERMIT NO. "S36%
ZONE
&
PLAN NO.
'ECTIONS I DATE I SUBCONTRACTOR I PERMITSISSUED
DATE NUMBEF
OWNER DAWSON, H3TOld B. '� DATE 'j-1-57
)OB ADDRESS �,$0 41. Wilson [init B BUILDING PERMIT NO. sj(7
G�N,NERALCONTRACTQR OVmer-Builder VALUE; 18,3%2•00 .
DESCRIPTION OF WORK AAt. 3 UI71bS —
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�ECTIONS � DATE I SUBCONTRACTOR
cou[
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PLAN
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1wDRnsS 580 W. W31
ERAL CONTRACT R OWl']
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UP H & J TYPE
�ECTIONS
:hcs Porms Stcel
coat
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DATE
vatuE
�E ZONE DESCRIPTION OF WORK
ZONE RL� PLAN
DATE gUBCONTRACTOR —
PERMITS ISSUED
NUMBEF
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. COSTA MESA BUILDING DEPARTMENT
- P. O. BOX 31�
COSTA MESA. CALIFORNIA .
FOR
APPLICANT TO FILL IN
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COSTA MESA, CALIFORNIA
OWNER Q���� Q,
ADDRESS�OO/ C.Cii
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F�EE .REC�EIVED
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�fIIQANCE EPT.
���y`'p�"COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
fEL 4 BLIILDING -
NO.l�� ��7� AOORE55
uG COSTA MESA. CALIFORNIA
NO.
FIRE
ZONE
ZONE NO.OF TYPE � /
LIC. PLTNS ` �
CONTRACTOR NO.
TEL. APPi�0 D ///� � % / ��
ADORE55 NO. ' BV /'. � V t� OPlrE
LEGAL LOT , Faa
oESCaiPiION NO. �f IyCOT,3/ BLOCK) TRAC
A.P. NO. / IS �U � C./ � /
SIZE� ��O �/^ n NO. OF BLDGS.
OF LOT (00` c� INOW ON LOT
�5E oF A�,�
E%ISTING BLDG.
SETBPCH LINE FROM I
cerviEw oF siw[Er SO REAR VARD
SIDE YARD RIGHT S� LeFT �
M�
NEW ALTERATION ADDITION
REPAi�. MOVING /^ DEMOLISH
SZIEDING O, /a ROOMS / STORIES /
E%TERIOR WALL ROOF
COVERING lSTL�CO COVERING CRA✓���-
BUELDFNGEW /��� J UNIT "7 �'nRAG �.
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CORRECTIO
SUBJECT
T: CH.
DEPT.
STATE TH4T TME ABOVE IS CORFECT AND LGflEE TO COMPLY WITH ALL
CITV OFOINANCES AND STATE LR�NS REGVLATING Bl11LUING CONSTRVC-
iiOrv. VALUATION
SIGNATURE OF PERMiT FEE 5
PERMITTEE
' J� n�7 +� PLAN CHECK S
S / ✓ / l�%
AUTHORIZED AGENT TOTAL FEE $