HomeMy WebLinkAbout319 16TH PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DFIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job nddress: 319 16TH PL
Suile:
Vicinity: ROOF
Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N
Parcel Number: 42521106 Zoning:
Applicant: VASQUEZ, FREDDIE
Address: 906 S FIGUEROA ST
SANTA ANA, CA
Owner: PURO, MARK
Address 319 -A E 16TH PL �
COSTA MESA, CA .
Contractor: FIRST QUALITY ROOFING
Address: 906 S FIGUEROA ST
SANTAANA, CA
Zip: 92704
Arch :
Address:
Phone:
Phone: p14) 7753375
Zip: 92704
Phone:
Zip: 92627
Phone: (714) 7753375
License: 776969
Eng:
Address:
Status: ISSUED
Applied: 03/29/2005
Issued: 03/29/2005
ISSUED BY: /1, v
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING & REROOF WITH 30 YR. COMP SHINGLES (31 SQ) & HOT MOP ON FLAT AREA (4 SQ).
FEE SUMMARY
Pian Check: $0.00
Permit: $167.25
SMIP Res: $0.85
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $168.10
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Existin : 0
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Left 0- 0
Le(t 0- 0
Proposed: . 0
Calc Valuation: Sa,soo.00
Claim Valuation: $s,soo.00
Ri9ht 0- 0
Right 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 9248, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become voitl if work is not commenced within 1B0 days, or if work is suspended or abandoned
tor 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 inspectiona and final epproval must be obtained. Failure �o obtain inspections and final approval will result in ihe expiration of this permit.
, FOR INSPECTIONS CALL: (714) 7545626
446>fi (fY00)
WORKERS'COMPENSAnON DECLARATON:
I herehy effirm under penalty of perjury one of the tollowing declarations:
D,.rl heve and will meintein e certificete oi consent b self-Insure for workers' compensetion, as pmvided br by section 3700 of the Labor Code, for the pertormance of tha
�.{!w v.brk tor which ih�s pertnit is issued.
❑ 1 heve entl will mPin[ain workers' compensellon insurence, as required by sectlon 3700 ot the Labor Code, for the perfortnance of the work for which ihis pertnit is issuetl.
��My"Workers' compensation Insurence certler end cy number ere:
�Ma�': ��kT� ��t. V� p��,,. mba,: oo z6S"�l9 —�,cr��
(This secNon need not be cromple e0 il f f permit is velued e( one hundred dollers ($100J or less.)
❑ I certity Ihat in th0 Pertormance ol ihe work br which thi� p rmit is issued, I shall not employ eny person in any manner so as to become sublect to Ihe workers'
compensation laws ot alifomie, en egn e thet if I sho d 63come su6�ecl lo the workers' compensatlon provisions o1 Section 3700 of the Lebor Code, I shall forthwith
comply with these pr sion5. � '"� dy �+�
F,ppli' e�nt 9igneture: �mDete�� i—�/ �� J
WARN� ING: FAILURE TO S E WORKERS' WPAPENSATION COVERAOE IS UN FUL AND ALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
T}KKISANDDOlL4RE(51�. ),INA�DITIONTOTHECOSTOFCOMPENSAiION,DAMAGESNSPROVIDEDFORINSECTIIXJ3I060FTHEL4BORWDE,INrEREST,ANDATTORNEY$FEES.
UCENSED CONTRACTORS DECLAFATION:
I hereb aflirtn t�hat I a-�, licen e underP rovisioy s o� Cha �er 9(commencin wilh Section 7000 of Division
force antl ettec� -l'c a A �6 Q 6 q i Pi _ / 9 ,
and my license is in full
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn tha� there is a consiruction lending agency for the padormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lentler'S Name: Lander's Address:
Signature:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby alfirm thet under penalty of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or county which requires e pertnit to construct, alter, improve, demolish, or repair any stmcWra, prior to its issuance, also requires the applicant for such pertnit
to file e 5igned statement ihat he or sha is Ilcansed pursuant Io the pravislons of Ihe Contractors License Lew (Chapler 9(commencing with Section 7000) of Division 3 at the
Business entl Protessi0�5 Code) or that he or s�e is exempt theretrom a�W the �ssis tor the sllegatl exemption. Any violetion of Sedion 7031.5 by any applicent tor a permit
subjects the epplicant to a civil panelty of not more then five �untlretl tlollers ($500).):
❑ I, es owner ot Ihe Property, or my employaes with weges es their sole compenselioq WILL DO THE WORK, and Ihe stmcture is not intendetl or otteretl for sale (Sec.
7044. Business a�d Protessions Cotle: The Comractors License Law does not epply lo an owner of property w�o builds or improves ihereon, and who dces such work
himself or herself or Ihrough his or her own employees, provided thel such Impmvemenis ere not Intended or oHerad Por sale. If, however, the builtling or improvement is
sold within one y6ar ot completion, ihe ownerbuiltler will heve ihe burden of pioving thet he or she tlid not builtl or improve for Durpose of sale.).
❑ I, es owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct ihe projeCt (Sec. 7044, Business and PmfeSsions
Cotle: The contraciors License Lew does not epply ro an owner of pmpetly who bWlds or Impmves thereon, and who contracts for such project wlth a coniractor(s)
licensa pursuent to ihe Contrac�ors License Lews.).
❑ I am e:empt under sea Business end Prolessions Code for Ihis reason:
Signature: Date:
Owner ID vanfietl bytlri�efs license. ❑ Ves ❑ No Driveis License No.
Yeriticstion ot Ownersh�p by (rype oi tlocument, i.e. � property taz bill or daed)�.
DIVISION OF INDUSTflIAL SAFETY PERMIT CERTIFICATION:
Ezpires:
❑ I hereby cetlity tha� no eacavetion five (5) or more feet in depih into which e person is requiretl to descend, will be made in connection with work amhonzed by ihis
permit, entl that no builtling sirucWre, scaHolding, ta�sework, or tlemolition or dismantling thereot, will be more ihan thirty-six (3fi) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Ttle 8, Califomia Administretive Code).
❑ As owner-builtler, I will not employ anyone to do work which would require e permit trom the Division of Industnel Safery, as noted ebove, unless such person has a
permit Io tlo such work from tha division.
Signature: Date:
Division of Industnal Sa�ery Partnit Number:
CERTIFICATE OF COMPLIANCE AND AUiHORVA710N OF EN7RY: I cenify untler penalry oi perjury ihat I heve read this applicalion antl sta�a Ihat ihe information given is
correct. I agree to wmply with ell stete laws end city ordinences rela�ing lo bullding consimction, and authodze represematives of the Ciry of Costa Mesa to ente� upon the
ebove-descnbed propedy �or inspection purposes. I egree not to occupy or ellow occupancy of any 6uilding aulhorizetl by this permit until linal inspaction.
COOE 1•
1616
1266
Fixed System Final Fire Prevention
Pool Spa Final
200 Final Re-Rool
201 Final BIocW(ie�aining Wall
202 Final Factory Fire Place
203 FinalSign
204 Final Demolition
� INTITIALS
� �
�� oa e �� �
ar—� _
�: a�. �u..»: �:.
CODE� INSPECTIONTYYE
206 Finel Mechanical
20B Finel Plumbing
210 Final Eleqrical
212 Final Fire Prevenlion
220 Final Plenning Approval
222
250
Finel Site
Finel Builtling/Occupancy
I'7-�i�PWL17�y
.,�A 20330
�• 'COSTA' MESA BUILDING-SAFETY DEPARTMENT
� J'�P.O. BOIOf] COSTA MEBA, CALIFONNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
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COSTA MESA, CALIFORNIA
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II HEREBY ACKNOWL8O08 THAT I HAVE READ TH�9 APPLIC�TION
AND BTATB THAT TH8 ABOVB IB COqqECT /�NO AOR6H TO COM.
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COSTA MESA BUILbING-SAFETY DEPARTMENT
' P. O. BOX a17 C09TA ME6A. CALIFORNIA
For Applicant fo Fill In Gomplefely
TYP� OR PRINT.
wooaEss C � L C�
COSTA M�SA. CALIFORNIA
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PLY WITH �LL CITY ORDINArypgB AND BTAT[ LAWB RHOULAT�NO
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COSTA MESA BUILDING-SAFEfY DEPARTMENT MAY 3 19b5
• P.O. BOI9O COSTA ME9A, CALIPORNIA
For Applicanf fo Fill In Complefely �A P�4�I�OR PE
TYPE OR PRINT
/ For Office Use Only
AD REI55 � C � G �� (ra C�G.'
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COSTA MESA. CALIFORNIA ��
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■ serawcrc une
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DESCRIPTION OF WORK
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SIZE � iiGEI;.A
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1 HEREBY I�CKNOWL200E TXAT 1 XAVB qBAO TXIB �PPLIGTION
ANO 6TATH THAT TH8 ABOVH IB CONPHCT ANO AOpEH TO COM-
PLY WITH ALL LITY ORDINANCHB AND BT�TH LAW9 p8011LATINO
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VALUATION � C� m
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'�OSTA MESA BUILDING-SAFETY DEPARTMENT
�' � P. O. BOX 9f] COSTA MHSA� CALIFORNIA
For Applieant to Fill In CompleTely
TYPE OR PRINT
BUILDIN6 • _ y. �� �� /
ADORE55 G
COSTA MESA. CALIFORNIA
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I HEREBY �CKNOWLH�6fi TH�T 1 NAVB qEAO TNI6 APPLICATION
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PLY WITH ALL CITY ORDINANCfiB AND 8TAT8 LAWB PCOULATINO
BOILOINOCONSTFOCTIO� �
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SIGNATUREOF �
PERMITTEF � �'�m �
AUTHORI2ED AGENT
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ACCESSORY 9UILDIfJ6
DATE
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THQ AMOUNT eHOWN UNOEA VALUAT�ON IB FOR TXe �
PURPO3H OP HBTABLI6HIN0 A PERMIT FEE ONLY. 0
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