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Home My WebLink About402 16TH PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.caB.u;ILDING PERMIT �� FAIR DRIVE, COS7A MESA, GA 92626 U Job Address: 402 16TH PL Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 42514201 App�icant: BLUE SHOE ROOFING CO Address: 16 CAPSTONE � IRVINE, CA- " Owner: PHILLIPS, DEBORAH F Address 402 16TH PL COSTA MESA, CA . ' Contrector: BLUE SHOE ROOFING CO Address: 16 CAPSTONE IRVINE, CA Zip: 92606 Arch : Address: Zoning: Phone: 949-387-9428 Zip: 92606 Phone: Zip: 92627 Phone: 949-387-9428 License: 810900 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: O6/11/2003 Issued: 06/11/2003 Phone: Zip: � License: License: " SCOPE OF PERMIT TEAR OFF EXISTING SHAKE ROOF. INSTALL SOLID SHEATHING, FELT AND COVER WITH 30 YEAR COMP SHINGLES. INCLUDES AN ATTACHED GARAGE. '� - ' - - - Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.54 SMIP Com: $0.00 Other: $0.00 Inspection: $0:00 Total: $125.79 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: 0 Rear 0- 0 Rear 0. 0 Re uired: 0 FEESUMMARY PLANNING & ZONING Lek 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Righl 0- 0 Right 0- 0 55,350.00 $5,350.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutas and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 1 BO days. � INSPECTIONS: In order for the work authorized undei this permit to be considered legal, s�ch work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspec�ions and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 zats-as �s�oo� WORKERS'COMPENSAnON DECLARAnON: � I hereby ettirm untler penelty of perjury one of tha tollowing tleclarations: ❑ I heve and will maintain e Certifcate ol conseni to selbinsure for workers' compensation, e5 provided lor by section 3700 of tha LeDor Code, for the pertortnance of the work for w�lch lhl5 permit is issuetl. I have and will meinlain warkers' compensation Insuranca, as requiretl 6y SecNo f 00 of�he Lflbor Code, for Ne petlortnance ot t�e work for which this pertnit is Issued. y worke�`rs' compensatlon(y�� wnce cer er end Dolicy number ere: � �^ Carrier. SYQ'� `i—.�.� PolicyNumber. �� I Z� \ "� �� (This section need nof be canp/eted i! the permit is ve/ued at ane hundred dollers ($100) or IessJ ❑ I cani�y thet in Ihe pertormance ol the work for which Ihis permit is issued, I shall not employ any person in eny menner so as lo become subiect to ihe workers' compensetlon lews of Celitomle, end e ae thet If I should become sub�ect to the workers' compensetion provisions of Sectio 3700 pl the Wbor Cotle, I s�all forthwith comply wlih �he5e p ' n5. ��i� �AGD11CenI:SlgnaWre� r�. C�C�� Dele: � � I V� WMNWG: FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINPL PE TIES D GVIL FlNES UP TOONE MUNDRED THOUSANO DOLLARE (E100,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]060F THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTHACTORS DECLARATION: I hereby ettirm thet I em force end eHecl. Lic. q ConiractW s�SignelOre: ol Chapter 9(commencing with Section 7000) of Division 3 of the Bi Class x . Dete: Code, and my license is in full CONSTRUCTION LENDING AGENLY: ❑ I hereby attirm thei Ihere is a construction lentling egency lor the peAortnance ot the work br which �his permit is issued. (Sec. 3097, Civil Coda). Lentler'S Name: LentleYs Atltlress: Signeiure: Dale: OWNER-BUILDER DECLARATIONS: I hereby eNirtn that under penelly of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Busineu and Professions Code: Any ciry or counry whic� requires a permit to construct, elter, improve, demolish, or repair eny 5trucWre, pnor to its issuance, elso requires ihe epplicant tor such pertnit to file e signed stetement Ihat ha or she is Ilcensed pursuant to the praNsions ol the Contrectors LJcense Lew (Chapter 9(cammencing wii� Section 7000) of Division 3 of the Business and Pmfesslons Code) or ihat he or she is exempt tharelrom entl the Eesis tor the alleped exemptlon. Any dolation oi Sectlon 7037.5 by eny epplicant for a permit subjecis ihe applicant to a civll penelry at not more then five hundred dollers ($500).): ❑ I, es owner oi the property, or my employees with weges as Iheir sole compensation, WILL 00 TNE WORK, antl Ihe siructure is not intentled or otleretl tor sale (Sec. 7044, Business and Prolessions Code: The Con(ractors License Lew does not apply to an owner ot property who builds or improves thereon, and who tloes such work himself or hersell or �hrough his or her own employees, provitled ihat such improvemenis are not Intended or oflered for sale. If, however, the building or impravement is sold within one year of complation, the owner�builtler will have-Ihe burtlan of proving Ihat �e or s�e tliA not builtl or improve lor purpose ot sale.). � ❑ I, as owner oi the properry, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe prolect (Sec. 7044, 6usiness and Professions Code: The contrectore License Lew tloes not apply to en owner ot propeny who builtls or Imprwes lhereon, end who contrecis lor such project wiih a coNractor(s) license pursuent to the Contractors License Laws.). ❑ I em ezempt under sac. Business entl Protessions Code lor ihis reason: Signature: Date: Owner ID verifled 6y tlriver's Iicense. ❑ Yes ❑ No Drivefs License No. Venficatlon of Ownarship by (type oi tlwumeni, i.e. - pmpeny tax bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: Expires: ❑ I hareby certify thet no excavatlon five (5) or more feei In depth into which e person is requiretl to descenq will be made in connection wit� work euthonzed by this permit, entl that no builtling swcfure, scaHolding, lalsework, or demolition or dismantling thereot, will be more then thirty-six (36) laet high. (Ghep. 32, Grp 2, Art 2, Sec. 347, Title 8, Califomla ACminlstrelive Cotle). ❑ As owner-builtler, I will not employ anyone to do work w�ich would require e permit trom the Dlvision of Industrial Safery, as notetl ebove, unless such person hes a permit to tlo such work irom iha division. Signature: Date: Division ot Intlustrial Salery Pertnit Numbec CERTIFlCA7E OF COMPLIANCE AND AIIT}IORIZA710N OF ENfTiV: I certify untler penalry ol perjury that I �eve read thvs applica�ion entl state that Ihe information given is correcL I agree to comply with all stete lews end clty ordinences releting to bullding consWction, end euthodze represen4.��ives ot Ihe Clly ol Coste Mese to enter upon the ebove-descnbed property tor inspection purposes. I egree not to occupy or ellow acupancy ot any building euthonzetl by this permit un�il final inspection. �� Si aWre egal _ner(s) �p�ypf: Aul �zBd:ApPlicani— COOE I. INSVECTION TYPE 1616 Fixetl System Final Fire Preventlon 1266 200 201 202 203 Pool Spe Finel Finel Re-Rool Final BIocWRetaining Well Final Fectory Fire Place Final Sign 204 Finel Demolition PeIE INTRIALS �'/ � � [� i � I o �;'a ate CODE♦ INSVECTIONTYPE 206 Finel Mec�anical 208 Final Plumbing 210 Final Elecirical 212 Final Flre Preventlon 220 222 250 Final Plenning Approval Flnal Site Final Builtling/Occupency PA7E It�LB 29242 COSTA MESA BUILDING-SAFEIY DEPARTMENT P.O. BO% 7200 COSTA ME6A� CALIFORNIA 926i0 for Applleant to F!U In Completely . TYPE OR PRINT 8��,No 4o.z � Tu ��R�� ADDRE88 COSTA MESA. CALIFORNIA OWNER Newport Balboa Savings & Loan MAIL 3366 Via Lido ADDR880 ��TM New ort Beach No' 6733131 !e^N,GENE6RllT'Y011 F,QT}"], erger No 540883: AJ.H AOCRE884SO1 B17C�7 New ort Beach CONTRAGT R Fabre Gonstruction Gorp. ADDRHBi 4501 Birch St. cirr New ort Beach uc no. 146423 rTi°L' 540 8833 BiZe__ o�l __ GN I xo.or�Loot. A YCTGACR L�X[ I�ROY DESCRIPTION OF WORK ' x T[RATI N AODITI H REPAIR IN M Ll! euaoiNa 1563 NO.OF 6 1- 81ZE ROOMB �11 EXTERIOR WALL ROOP COVERINa StUCC COV8RIN0 shake UYH OF DU ILDINY AND WORK TO G6 P[RPORM[D Family dwelling w/attached garage Plan 5B f0 De� 0� 1 HERlBY ACRNOWL6pOR TNAT i NAV6 R6AG TXI/ AP�LIG il AN� BTATB TNAT TN6 AGOV6 I{ GORRBCT�AND AOR6[ TO CO PLY WIiH ALL CITY OpDINANC�L�tlD /TAi[ LAWB PtO1RaTu � AUTHORIZQD AO�NT OCT �6'6HPA10OO �%�%�' TM**103.SG c�;sn APPLICATION FOR PERMR BUILDING for Off1ee Use Only ZONINCi NO.OI YD[ •uns _ euu 8lIALL BE L688 THAN YARDEMPROVHD I YARD9MPROVED MAIN BUILDINO ACCE0.40RYBUILDIN6 tOM C/L YTRQIT) ,� 417L� �l- lf� *N (:� �_ vwn.�t V-40-68 � owre TH[ AMOUtR rYRP006 OP s��% � �AT! !�—�'[�no iL � � �� ai 7 k_ o VALUIITION IB FOp TH6 j A PHRM�T FHH ONLY. y � � IT FEE p � � W �.,�..v Q