HomeMy WebLinkAbout381 16TH PL - Building Permits(714) 754-5273 • Fa�t (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
�ob nddress: 381 16TH PL
Suite:
Vicinity:
Parcel Number: 42519108
Applicant: ROBERT ZERGMAN
Adtlress: 17092 VAN DYKE LN
HUNTINGTON BEACH, CA
Owner: CARR, TIM
Address 4 CIVIC PLA7A #260
NEWPORT BEACH, CA
Contrector: ROB'S ROOFING
Address: 77092 VAN DYKE LN
Arch :
Address:
HUNTINGTON BEACH, CA
Zip: 92647
Phone:
Zoning:
Phone: (714) 842-5397
Zip: 92647
Phone:
Zip: 92660
Phone: (714)542-5397
License: 532516
Eng:
Address:
Status: ISSUED
Applied: O6I21I2000
Issued: O6/21/2000
ISSUED BY:
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Phone:
Zip: License: License: '
SCOPE OF PERMIT
TEAR OFF WOOD SHAKE INSTALL 1l2" CDX , 15LB FELT AND 25 YEAR COMP. SHINGLES.
Plan Check: $0.00
Permit: $111.25
SMIP Res: 50.50
SMIP Com: 50.00
Other: �0.00
Inspection: $0.00
7otal: 57�1.75
SETBACKS
MAIN STRUCTURE Frant 0- 0
ACCESSORY Front 0-0
PARKING Extstinq: 0
NOTES:
Rear 0-0
Rear 0- 0
Required: 0
FEESUMMARY
PLANNING 8 ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
54,900.00
Sa,soo.00
NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulalions. (Ord. No. 92-28, § 1, 12-21-92) '
EXPIRATION: This permit shall aulomatically 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 authorizad under this permit to be consitlered legal, such work must comply with ell applicable codes, and all
raqulred inepectlona and final epprovel must be obtained. Failure to obtain inspections and final epproval will result in the expiration ol ihis permit.
I FOR INSPEC710NS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby ettirm under penelry o� perjury one ol the tollowing tleclarations:
❑ I hevB end wlll meinteln e Certificate oi Con58ni to sell-Insure lor workers' compensetion, es provitletl for by secllon 3700 at ihe Labot Cotle, for Ihe peAortnance oi Ihe
��-///''' work for which this permit Is issuetl.
J�' I have end wlll maintaln workere' compensatlon insurance, as required by section 3700 of the Lebor Code, for the peAortnence of ihe work for which this pertnit is issued.
�\ My workers' wmpensetlon Insurance carner end pdicy numCer are:
Carrier. Pollcy Numbec
(Thls secf/on need nof Ce comp/etetl i! Ne perm/f is veluetl ef one huntlred tlollers ($100) or /essJ
❑ I certify thai in �he pe te f lhe work lor whlth thi5 p8rmii i5 I55ued, 1 5hell noi employ any persOn In eny manner so as to become 5ubject to ihe workere'
wmpensetlon lews ol alllor le, tl agre It I shoultl Decoma sub�ect to the workers' compensation provisions of Saction 3700 of Ihe Lebor Cotle, I shall forthwlth
co\I w prov io. � �`Da . / p
ica SlaneWre: i 1`� ���— U��
TO SECURE WORKERS' ODMPENSA IIXJ COVERAGE IS UNLAW FUL AND SHALL SUBJECT O CRIMINAL PENPLTIES AND CNIL FlNES UP TO ONE HUNOPED
T/10USAND DOLLARE (5100.000), IN ADDfiION TO TNE WS� OF OOMPENSATIbN. DAANGES AS PROVIDED FOR IN SECfIIXJ 3lOfi OF TME L11BOR CODE, IMEREST, AND ATTOflNEV'S FEES.
LICENSED CONTRAC70RS DECLARATION:
provisions ot C�apter 9 �commencing with Section 7000) ol
Lic. a
Dafo:
entl Protessions Coda, antl my license is in tull
CONS7RUCTION LENDING AGENCV:
❑ I hereby eNirm t�et there Is e conslruction lending egency for the pertortnanca ol ihe work lor which t�is permit is issued. (Sec. 3097, Civil Cotle).
Lentlers Name: lentlefs Atltlress:
Signeture:
Date:
OWNER-BUILDER DECI:ARATIONS:�t�
I hereby aflirm ihat under penelry M.per�ury Ihat I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Pmfessions
Code: Any ciry or wunry which raquires e�pertnit, to'construct, elter, improve, tlemollsh, or repair any strucWre, pdor �o its Issuance, elso requires Ihe applicant for such permit
to file a signetl stetement thei he or she is licensed pursueN to ihe pmvisions ot the Contrectors License Lew (Chaptei 9(commencing with Section 7000) of Division 3 of ihe
Business antl Professions Code) or Ihat �e or she is exempt Iheratrom end the basis lor Ihe elleged eaemptlon. Any vlolatlon of Section 7031.5 by eny apPlicant far a permit
suh�ects the applicant to e civil penelry ot not more than Tive huntlretl tlollers ($500).):
❑ I, as owner ol the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, end the structure is not intended or oMeretl for sale (Sec.
7044, Business end Pralessions Coda: The Contractors License Lew tices noi epDly to an owner of propeny who builtls or improves thereon, antl who tloes such work
himsell or harself or through his or her own employees, provitletl that such improvements ere not intendetl or offered for sale. If, however, Ihe building or improvement is
sold within one year of completion, Ne ownerbuiltler will have Ihe burden ot pmving Ihat he or she did not Duild or improve for purpose of sale.).
❑ I, es owner of t�e property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the projed (Sec. 7644, Business antl Professions
CoOe: The comrectors License Lew does not appty to an owner ot property who �uiltls or impmves thereon, end who contracts for such project with a contractor(s)
license pursuant to the Contractors License LawsJ.
❑ I em e:empt under sec. Business and Professions Code tor this reason:
Signature: Date:
Owner ID veritied Dy drivefs license. ❑ Yes ❑ No Drivefs License No.
Venfication ol Ownership by (rype of documen4 i.e. - property tax bill or tleed):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATON:
Expires:
❑ I �ereby cenily ihat no axcavation five (5) or more leet In tlepth inm which a person Is reQNretl to tlescend, wlll be made in connection wiN work authorizetl by this
permil, end ihat no bulltling atructure, sceHolding, falsework, or tlemolitlon or tlismentling ihereof, wlll be more ihan thirty-siz (36) feet high. (C�ap. 32, Grp 2, An 2, Sec.
34t, Tille B, Celilomia Administrative Cotle).
❑ As owner�builder, I wlll not employ anyone to tlo work which would require e pertnil twm Ihe Division of Intlusinal Safey, as noted e6ova. unless such person has e
permlt to tlo such work Irom Ihe division.
Slgneture: Dete:
DiNSion of Industriel Selety Pertnit Number:
CER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I cetlity under penalty of perjury ihat I heve read this application and state that ihe information given is
wrrect. I egree to comply with all state laws and ciry ordinances relating to 6uilaing wnstruction, entl euthodze representatives of tha Ciry ot Costa Mesa to en�er upon the
ebo - 'b �n paEion purposes. I agree not to acupy or ellow occupancy oi eny bullding amhorizetl by this permi� umil final inspection.
_ _ _ . _ . . 'a•�—�-1 �
COOE �. INSPECTONTYPE
1616 Fizotl System Finel Fire Prevention
1266 Pool Spa Final
200 Final Re-Rool
201 Final BIocWReteining Well
202 Final Factory Fire Plece
203 Finnl Sign
204 Finel Demolition
2M&ab
�jE �j$ �� INSPECTIONTYPE
206 Finel Machanicel
20B Finul Plumbing
210 Finel Elecirical
212 Finel Flre Prevention
220 Final Plenning Appmval
222 Flnal Site
250 Final Builtling/Owupancy
z.�c
2A� LH�1!!4i
edgewater development company
38125ANDUNE LANE • CORONA DEL MAR, CALIFORNIA 92625 •(lt4) 644�1385
June 28, 1q73
Mr. Robert D. Brittain
Asaistant Planner
City of Costa Mesa, Calif.
Dear Mr. Brittain=
In reguard to our conversation this day , idems numbers six(6) and
seven (7) are being worked on at this present time and xill be
compleated iri.th in thirtq (30) days.
That is to say that trash enclosures xill be inste.11ed, and the
back yaxds xill be planted, and c�abs will be installed, all
xithin thirty days.
RPYtbb
Respe��yo� ' �
8o�b1e�t P. Warmington
CITY OF COSTA MESA PLANNING DEPARTMENT
A.P. No. 177-?71-31
Bldg. Permit No. 35505 & 35506
FAIO '� �utrZZQ.C�
1CT25-7?cnsr��1215 a��'
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address 381 and 383 East 16th Place, Costa Mesa. Calif.
Owner's Name Robert Warmington
Bachelor or 1- Bedroom Units
2 - Bedroom Units
$25.00 =
$40.00 =
3 - Bedroom Units Q @ $55.00 = $220.00
4 - Bedroom Units
5 - or more Units
Total Number of Dwelling Units n
$70.00 =
$75.00 =
Total Fee �220,0�
Planning Department Approval Date 10-25-7? Park Area No.�_
W.L.D. 9ob iy� �, ��
By Applicant's Signature_�6
35506 _ _
COSTA MESA BUILDING-SAFETY OEPARTMENT
D.D. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Campletefy .
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UI 1+ereby atknowletlge thet i heve reatl this appiicaci9n antl scate
� thet [he above information is cOrrecc and nprea m camply wiffi
� a11 laws ragulating builtlin8 consttuction, and I shall not employ
� any P¢rso� in vioiation of the workman's compensetion laws of
y the Ste[e of Catifornle.
z1 hereby certify that 1 am p�opetly Itcensetl aa a conbacto� under
fie State uf Califamia Business antl Frofessinns Cotle, Divis(on 3,
Chap[er 9, antl thec such liceases ere in full farce and effeci, ar 1
am esampi irom the provis'wns ot the Stete of Ca1lfornia Busine¢s
antl Professions Cotle Divis(on 3, C fapt
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7erm{ttee �I � / `� / �i
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THE AM�UNTSHOWN UNDER VALUATION IS FOR �j
THE PURPOSE OF ESTABLISNING A PERMIT FEE ONLY; Q
VALUATION �
PERMfi FEE $ � "'
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OCT 7.6-77P�`�001209 0
�ys; *•-�131.50
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
P I ATION FOR BUILDING PERMIT
For Applicant to Fil/ in C pletely
,.7 R EI E$V AT EC VqED DATE ISSUED
BUI�DING / � h/.r.// �� b— � !/ d �� �
ADORESS � ���
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OWNER ^
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ADDRESS ADDRESS d / 1(O LI
TEL. TRACT LOT BLOCK
CITV NO.
CONSTFVCTION A D
IENDER
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OWNER I(J (
ADORESS VALUE
AFCHITECT TEL. V PLE $ �i
OR ENGINEER N
FIRE
ADORE55 ZONE T PE ROUP
APPROVED [� _ �
CONTFACTOR BV DATE U�
ADDRESS •
TEL. ZONE NO.OF USE OF NEW
PLAfS BUILDING
CITV NO.
STATE CITV 1'.SFDSAPPFiOVEO VAflOSAPPROVED
LIC.NO. - UC.NO. MAINBUILOING ACCESSORVBVILDING
SIZE NO.OF BIDGS. (FROM C/L STREET)
OF LOT NOW ON lOT RONT FT. FT.
VSE OF
EXISTING BLDG. FT.
SIZE OF NO. OF
NEWBLDG. ROOMS STOflIES L.SIDE FT. FT.
EXTERIOR WALL ROOF
COVERING COVERING REAR FT. FT. --
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
VAR. #t DATE
L.L C.U.P.� APPFOVED
APPROVED
1 hereby acknowlatlge that I have reatl this application antl stnte
the[ ihe above intormetion is correct antl n0�ee to comply with ,
all laws regulatin8 builtling connruccion, antl I shell not employ
any perwn in violation ot Me workman's compensation laws of
t�e State ot Califomia. •,'�f'1 L� °�
/ / lCl �D
I heroby certify Mat 1 em Oroperly licansatl ez e contrector untler SQ. FT. O
the State of Calitornia Business antl Protesstons Code, Divis(cn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, entl that such licenses are In f�ll torca entl ettect, or I THE PURP06E OF ESTABLISHING A PERMIT FEE ONLV: m
am enempt irom the provisions oi Me $tete ot California Business ¢
ond P.otessions Cotle, Division 3, Chap�er VALUATION C�1 m
PERMIT FEE $ ' J �
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Signeture of E
Permlttee $ � PLP.N CHECK $
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A�thoriz¢tl Agant ��� � LL
TOTAL FEE $
• 7 'I � 3550� ACT -2-72PatcOO 006�` ****
cr,ss 11.70
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
A PLICATION FOR BUILDING PERMIT
For Applicant to Fill in Com let ly
CEVE BV �Q.TER�C'F�yED DATEISSUED
ADDRESS � 4 ` � r � lB a�-� �'
OWNER �/i'�•(�i�4 �a4 Dat/� A.P.NO.I �'��I�3 PER "�iQ.'dt��
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ADORESS � 6 d T�/� T I//�f fr ADDRESS , � � ��
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j O LIC. NO. Z� rC O � �IC. NO. MAIN BUILDING ACCESSORV BUILDING
512E NO.OF BLOGS. (FROM C/L STPEET) '�/�
OF LOT I Z.� X I L 0 NOW ON LOT O RONT FT. �" FT.
USE OF e ^ `
EXISTING BLOG. . R. L .J FT
I— SI2EOF � �0 NO.OF
Z NEW BLDG. ROOMS � Y STORIES 1 l.SiD FT. FT.
EXTERIOR WALL «� ROOF f /�� /e,( ^
V COVERING �� COVEPING '1 � C� REAR FT. 04 FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN &
a MAIN BLDGS. ACCE�, BLOCv.
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VI hereby acknowletlge thet I have raotl thii application antl state
� thet tho ebove Intormation Is correet antl eBrae to comply with
� all lows reBuletlnB builtlinB �o^ztructlon, antl I iheil not emplay T�
� eny person in vlolation ot Ma workman'a componsation laws ot
y the Stete ot Califom(e. �
? I haroby certify ihai 1 em properly Iicansatl ea e eontractor untlar Q. FT. o
the Smta o( Celi(ornie Business antl 7rofenione Cotla, Division 3, HE AMOUNT SHOWN UNDER VA�UATION IS FOR �
Chapmr 9, antl Nat such licensea are In full toree antl effect, or 1 HE PURPO6E OF FSTABL6HING A PERMIT FEE ONLV: m
am ozampt from the provislons oi Me Stete ot California B�sineu ¢
antl Proteasions Cotle, i izlon 3, na er 9 VALUATION �� m
PERMIT FEE $ �
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Sipnot�re of / �/ � m
Pe�mlttea � $�// �' l,/ PLAN CHECK $ � E
/ O
Authorized Ageni LL
TOTAL FEE $ �—
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Comp/etely
BUILDING � / � / � � •��L uNrrR l
AODFESS (
OWNER /
MAIL
Z ADDRESS
W W TEI.
d U dTV NO.
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W � STATE CITV
� � �I0. NO. LIC. NO.
7 � SIZE NO.OF BLDGS.
OF LOT NOW ON LOT
USE OF
EXISTING BLDG.
I� SIZE OF NO. OF
Z NEW BLDG. FOOMS STOFIES
U EXTERIOR WALL ROOF
COVERING COVERING
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V1 hereby acknowledge that I have reatl this application antl state
� � that the above information is correct antl agrea to comply with
� all laws regulating builtling conztruction, and I shall not employ
F any person in violation of the workman's compensation laws of
y the State of Califo�nia.
zI hereby certify that I am properly licensed as a contractor unde�
the State ot California eusiness and Protessions Cotle, Oivisicn 3,
Chapter 9, and that such licenses are in full force antl ¢ffect, or I
am exempt from the provisions ot the Stat of California eusiness
antl ProfessionsCotle, Division 3, Chapter
Signature ot � % � —
Permlttee
`��=3��N'V vV
Authorized Ageni
�r,r z�-72�Ms°00�210 �==+:�k
23.00
l FOR BUILDING PERMIT
�ATERECEIVED nervwciicn
A.P. NO. ' S
ADDR'E S� / � � T/�'
TRACT LOT BLOCK
W A D A
OWNEF
, �� E vn�u$ �
SE
FIFE
ZONE VPE GROUP
�AvPROVED�I� , nn�r�� � L/ �
ZONE NO.OF
PLAfS
VAFDS APPROVE
MAIN BUILDINC
(FflOM GL STREET)
DISTANCE BET
MAIN BLDGS.
VAR. #
C.U.P. $
APPf±OVED
USE OF NEW
BUILDING
BET. MAIN &
ACCESS. BLDi
DATE
m
�
Q. FT. o
TH AMOUNTSHOWN UNDEq VALVATION IS FOR �
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
¢
VALUATION .
PERMIT FEE $ � �
�
m
$ -' PLANCHECK $� E
0
� LL
TOTAL FEE $