HomeMy WebLinkAbout722 16TH ST - Building Permits(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Adqress: 722 W 16TH $T
Suite:
ViCinity:
Parcel Number: 42412123
Applicant: ESCOBAR, DANIEL
Adclress: CDL D3770475
Owner: MILLER, RICHARD A
Address 722 16TH ST
Zoning:
Phone:
Zip:
Phone:
COSTA MESA, CA Zip: 92627-4303
Contracror. ROOFCORP OF CA INC DBA HOMES ROOFING
Adtlress: PO BOX 6569
ORANGE,CA
Zip: 92863
Arth :
Address:
Phone: 714-997-5684
License: 80371 B
Eng:
Address:
Phone:
ISSUED BY:
Stalus: ISSUED
Applied: 02/26/2003
Issued: 02/26/2003
Phone:
Zip: License: License:
SCOPE OF PERMIT
INSTALL FIBERGLASS, MECHANICAL BASE SHEET FASTENING, APP ROOF SYSTEM BY POLYGLASS, GRANULES SURFACING, 26 GAUGE
SHEET METAL. 30 S�UARES. "RICHARD'S PAINT AND BODY"
Plan Check: $0.00
Psrmit $139.25
SMIP Res: $0.00
SMIP Com: $1.26
Other: $0.00
Inspection: $0.00
Total: $140.51
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSQRY Front 0- 0
PARKING Existinq: o
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
PropOsed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0-0
$s,00s.00
$6,006.00 '
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements undar Califomia statutes and related
regulations. (Orq. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become vold it work is not commenced within 180 days, or it 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 vrith all applicable codes, and all
required Inspectlona and final approval must be obtained. Failure to obtain inspections antl final approval will result in the expiration of this permit.
FOR INSPECTIbNS CALL: (714) 7545626
zmws (siool
WORKERS'COMPENSAnON DECLARAnON: ' .
I �eredy aHirm untler penalty of perjury one of Ihe following declaretions:
❑ I have and will meintain a cenificate of consent to self�lnsure for workers' compensation, es provitled for Gy sec�ion 3700 of ihe Lebor Code, for Ihe pertortnence of Ihe
work tOr which this pertnit is issued.
S
❑ 1 have end will maintain woAcers' pensation insuranca, as requiretl by sectlon 3700 of Ihe Lehor Code, for ihe peAortnance of Ihe work for which ihis pertnit is issued.
My workers' compen tion Insur cerrier/� ntl policy number are: /' q ��
Cartier: ST4�Z, he� Policy Num�ec (0 3 / b 3
(This section need not be cromple(ed the permit is valued ef one hundred dollers ($100) or IeuJ .
❑ I certity that in Ihe performan e of Ihe work for which this parmit is issued, I shell not employ eny person in any manner so es to becoma subject to tha workers'
compensation laws oi Celif a, entl egre that If I should become subfect to the workers' compensetion provislons of Sectlon 3700 0l Ihe Labor Cade, I shell lorthwith
comply with ihese provisio s
ApplicentSignature: Date: � 2G � 3
WARNING: FAIWRE TO SECLIR WORKERS' W� ENSATION GOVEMGE IS UNLAWFUL M1D SHALL SU&IECT AN EMP�OVER TO CRIMINAL PENALTIES ANO CNIL FlNES UP TOONE HUNDRED
TF%%15PND OOLLARE (5100, . IN ADDITION TO E COST OF �MPENSATION, DAM4GES AS PROVIDED FOR IN SELTION �OB OF THE LABOR COOE, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am
torca and aflact. Lic. a_
Contractols Signaiure:
of C�apter 9(commencing with Sectlon 7000) ot Division 3 0l ihe Business and Professlons Coee, antl my license is In full
n ciass x C_ - �9
CONS7RUC710N LENDING AC:ENCY:
❑ I hereby attirtn that Ihere is a construction lentling egency for the peAormance oi the work for which t�is pertnit is issued. (Sec. 3097, Civil Cotlo).
Lenders Name:
Signature: _
OWNER-BUILOER DECLARATONS:
Lendefs Atltlress:
Date:
1 hereby affirtn Ihet under penalry oi perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor t�e following reason (Sec. 7031.5, Business end Profes5ion5
Cotle: Any ciry or counry whic� requires e permit to consiruct, eltar, impmve, demolish, ar repeir eny siructure, prior to its issuance, also requires iha eppliwnt lor such permit
to file a signeC statemem thet he ar she is Iicensed pursuent to the prodsions o( the Contrectors License Lew (Chapter 9(commancing wlth Seclion 7000) ai Divislon 3 0l the
Business antl Profeuions Code) or t�et he or she is exempt therefmm and t�e besis tor the ellegetl anemptlon. Any dWetion ol Section 7031.5 by eny epplicent tor e permit
subjects ihe epP�icant to e civil penelry ot no1 more then tive hundred dollers ($500).):
❑ 1, es owner oi ihe property, or my employees with weges es Iheir sole compensation, WILL DO THE WORK, and ihe structure is not IntentleC or otferetl tor sale (Sac.
7044, Business and Protessions Code: The Contracbrs License Law tloes noI apply to an owner oi property who builds or improves thereon, end who does such work
himself or hersetl or through his or her own employees, provided that such im0�ovements ere not Intanded or oHered for sele. II, however, Ihe building or improvement is
sold within one year ot completioq the owner�Duilder will have the burden ol proving thet he or she did nol build or improve for purpose oi sele.�. '
❑ I, es owner of tha property, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to tOnStruct the projecl (Sec. 7044, Buslne55 and Protessions
Cotle: The contractors License Lew tloes not epply to en owner ot propeny who bullds or improves Ihereon, entl who contracts tor such project wlih e comractor(s)
license pursuant to �ha Con�rectors License LewS.).
❑ lam e:emptundarsec.
Signature:
Owner ID venfietl by tlrivers licensa. ❑ Yes ❑ No
Business antl Protessions Cotle for this reason:
Verificetion of Ownership by (rype of dacument, i.e. - propeRy lar hill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
Dnver's License No.
Date:
Expires:
❑ I hereby cenify ihat no exwvation tive (5) or more lee� in depth into which e person Is required to dascend, will be mede in connection with work authonzed by this
pertnit and that no building structure, scaflolding, talsework, or tlemolition or tlisman�ling Ihereot, will be more than thirty-six (38) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Tltle 8, Califomia Atlministretive Code). ,
❑ As owner-builder, I will not employ anyane to do work which would require e permit trom the Division ot Indusirial Sefery, es notetl above, unless such pereon has e
permii Io do such work Irom �he tlivision.
Signature: Date:
Division of Industnal Safery Pertnit Numbec
CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF EMRV: I cenify under penelry of perjury thet I have reatl �his epplication and state that ihe informetion given is
correcc I agree m wmpty with ell state laws end ciry ordinanws relating to Duiltling construction, end aNhodze representatives ol the qry ot Costa Mesa ta emer upon the
ebove-described propeny tor ins ction purposes. gree not to occupy or ellow occupancy of eny building aulhorized by this permit umil linal inspection.
ignature Ot Leg Owner(s) � Date
02 Z6 ��
AnNOr Authorized Applicam Date
COOE 1, INSPECTONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spe Finel
200 Final Re-Roof
201 Finel BIocWRetaining Wall
202
203
204
Finel Factory Fire Place
Finel Sign
Final Damoli�ion
� lt��
CODE� INSPECTIONTYPE �
206 Final Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Flnel Planning Approval
222 Final5lte
250 Fineleuilding/Occupancy
QdIF It�EL$
City of Costa Mesa
Building Safety Deparfinent C E R T I F I C A T E O F O C C U P A N C Y N° 2345 C.
P. O. Box 317
Cmto Meso, Califomio �� '
S
The B�ilding located at 'T22 t�PAt �LL tt*+�*
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordi�ances applicable thereto
for a Grovp F—'2 Occupancy.
Use of e�ilding 2 UIISt CO�erclol Bu11d1IIg
Legal Description 116-291—�U
(See nvenu side for Metes and Bo�nds)
Building Permif No. a1�851 Eleciriml Permit No2 '�HT Pa 25'2� Plumbing Permit No. ��
Floor Load S�gns have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. . required under Sec. 3301 (1) U. B. C. —
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occ�pied
until the owner or operator has been issued a valid certificate of occupancy by ihe enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or poriion thereof
2) The n�mber of apartments or guest rooms
3) Ownership
If Gro�p H Occupancy, number of apartmenfs and/or guesf rooms as required under Sec. 17050.1 (d), California
Adminisirative Code, Title 8, Chapter 9, Article 8.
Number of apartments_ and/or g�est rooms
ISSUED TO: Building Official
T&R� �IC by o—
Date kklrCh 2� 1�
This Cerfificafe of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. eorm au�iM—ii-a�ss a
OWNER CDIEo JOHi'I J. {JR.�. DATE �r���
�oB nDDRESS 722 td. 15th Street ' BUILDING PERMIT
A �. 424-12:-
INSPECTIONS
SOIL
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W ATER
ROUGH PLUMBING^
PROP. SWR. LINE ` ' HO
SPRINKLING SYSTEM
MISCELLRNEOUS
UNDERGROUND U POWER
y ROUGH wllilNG
� TRENCHES [ FORMS
� FLOOR SVSTEM
� BONO BEr1M [] STEEL RE
C SMEATHING
� PRAME ANO FLASMING
NI.qTMING - iN n OUT
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rJ PI 'ER, 9AOwN COAT
Q 5 fURRI.FINRL
HEA�iNG, VENT., REFRIG. A�
PLUMBING, FINAL RND G�5 T
ELECTRIC. FIN4l
BUILOING. FINRL
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING ��/� / �' .J/ `��
ADDRE$$ / 4 /b
OWNER OR\ /_ / b / �%�/`�
TENANT Kl`2! � L�
MAILING ��^ ���� �1
ADDRE55 J �
CITV ��"��f .//i'lDrA N�`J���
CONSTFUCfION
LENDER
BRANCH
ADDRESS
ARCHITECT TEL.
CONTRACTOR ��i(�J'L[.Xi�'
ADDRESS
TEL.
CITV NO.
STATE CITV
LIC. NO. LIC. NO.
SIZE NO.OF BLDGS.
OF LOT NOW ON LOT
USE OF
EXISTING BLW.
Separate permits are required for
electric, plumbing and heating work.
A.P.
UNIT OR
SPACE NO.
NEW � ADD UiLTER
USE
f � 4
`.4F�k�rLPERMII'�40•10 TLe
N°� _..
MOVI
DATE
DATE
�
I heraby acknowletlge thet I havo reatl this application antl stete �
ihat the abova Intormetion Is correct antl egrae to comply with
all laws reBulo[Inp builtlinp construcNon, and I shall noc employ
any parwn in violatlon of tho workmen'a compensatton laws of m
Me Stata of Californle.
m
1 �areby certify 2hot 1 em proparly Iicansetl es e conttactor untler Sn' FT' �
the Smte of Celifornlo Business antl Protessions Code, �ivision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chap[ar 9, end [hei tuch licenses era in tull torce antl effect, or I THE PURPO6E OF ESTABL6NING A PERMR FEE NLV: �
em ezampt from tha provlsions oi She Stete of Celitornia Business VALUATION PERMIT FEE E q
entl Protessions Divl ion 3, Chepter 9. .�O u+
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PLAN CHECK § "�
0
SIB�atvre � LL
Perm�`ttee 5 OQ� TA% 5 O �� u
Authorizatl A nt Date TOTAL PAI D S O. / O
24851;
COSTA, MESA BUILDING-SAFETY DEPARTMENT
P. O. BOl[ 91] C06TA M68A, CALIPOFNIA
For Applican! !o Fill In Compiefely
TYPE OR PRINT
AODftE'S5 7a 2 U-+. i 6'� sT.
COSTA MESA. CALIFORNIA
OWNER T (�r /C-
MAIL Q_�OS • �RQ��S 5T'
AO�RE53
�ITY �� �: ,S � � ��SA
f�OV 1 1965
APPLICATION FOR PERMR
B
F�O _ i
rtecsirt no. re
ARGHITEGT E� N�� � ' APPROVED
OF o1NEER � NO.��� �¢! BY DATE
�/J o ZONING
ADDRESS ��'/ % RI/1FL�I /7//�. CIG'J�
ZON[ NO.OR U880FNHW
/y n�. PL/�N8 � �UILDINO �
CONTRACTOR CiC V L-lJUNO ti �/ /
o_ ��e S/ �eo�� Q . `7 �� ✓
AOORES3 �Oi �iY�%C OEBCPIPTION
CITY /i� ���ClT A.P.NO. KJ— � / � `�
NOTE: NOEAVEOVERHAN68HALLBELESSTHAN
STATE Q� ����9 NEOL./¢Z_.���� 90'TOSID88REARP.L
LIC. N0.1✓" Cp .
/ EAVES
OF LOT l07/X � 3 S/ I rvOw orv Lora:Yb.v ALLOWED (U. B. G. REQUIREMENT)
USEOF Q/�� �'ARDSAPPROVED YARDSAPPROVED
EXISTIN6 BLD6. /C `�!-!F�/� MAIN BUILDING ACCESSORY BUILDINa
f FROM GL HTREET)
BETBACKLINEFftOM / /• FRONT J�FT. FT.
OM}!R OP 9TREkT � G� REAR YARD $�d I r
SIOEYARDI LEFT �, 1' RIGHT�6,�/ L' R.HIp ��RT. ��� FT.
DESCRIPTION OF WORK �. sme �� xr. Fr.
NE' _ ALTERATION � ADOITION REAR �SFf. Ff.
pISTANCE BET. BET. MAIN @
REPAIR M VIN6 DEMOLISH MAIN BLDG9. ACCESS.BL�69.
BUILpIN NO.OF
VAR. # DATE
SIZE ROOM8 BTORIE9 � C. U. P.1F APPROYED
EXTERIOR c� ROOF �f(/L AP V8 (
COVERING Y`�"� GOVERIN6 BY t Q� �ATE �'a" �'(O
USE OF BUILDING AND 16�0 K TO BE PERFORMHD
,c�.y.,_., .i Sn.�.� w�..,, , ,�,� HOLD FO P C AL REO(IIF.�tA�?:Tc
� CCiv�,SX u � !I J
OOQ ac. Fr. "
1 HEpEBv ACKNOWLEOOH THAT 1 HAVE pfiAD THIB APPLICATION THE AMOUNT 9HOWN UNOER VALUAT�ON �8 FOR THH �
AND BTRTE THAT TX8 ABOVE 19 CORPHCT AND AOREE TO COM. PIIRPOS¢ OP 68TABL18HINO A PERMIT FEE ONLY. 0
PLY WITN ALL CITY ORDINANCeH �NO BTATH LAWB R80ULATINO ypLUAT1ON � 0
Bf11LO1N0 CONBTqUCTION. h
SIGNATUREOF PERMITFEE $ '—' m
PERMITTE //!) — �� 5 � F
s� ��%�� PLANCHECK $ �
AUTHORIZ D AGENT // �O
TOTAL FEE $ d
� � COSTA MESA BUILDING-SAFETY DEPARTMENT
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APPLICATION FOR STRUCTURAL PERMIT
IOo5G TL
•V uy^ LVV VVu,^•`V^V^` V• ^J`V`V RECENED PERMIT N° �5Q311
For Applican[ to Fill in Completely — Use Ink Only
BUILDING � �• / �h �/� - A.P. NO. 'S'l ... / �
ADORESS (y V
BUILDING � ,-/ / �
ENAN �R D�G�/ CO � r P.DORE55 r,� �
VNIT OR
MAILING SPACE NO.
ADDRESS � � T (�.`/ LOT BLK.
CITV .�� /7 d NOL�7��� iJ � �
CANSTRUCTION EW ADD ALTER EPAIR MOVING DEMOLISH
LENDER NO�E
BRANCH �(J�M ` 1.07�� V ��
OWNER
ADDRESS � VA UE
ARCHITECT TEL. USE DOO O $ OD
OR ENGINEER N . /'
A�DRESS ZONE CJ TVPE � OVP �
APPROVED
CONTRACTOF �� BV DATE � � Q
AODRESS �
TEL.
CITV NO.
STATE CITV APPROVEDSETBACK$ �
LIC. NO. UC. NO.
SI2E NO.OF BLDGS. (FROM C/LSTREET)
OF LOT NOW ON LOT J RONT FT.
USE OF
EXISTING BLIX'i. ALCTO '�E�o2AT1 O h1 s yL
Separate permits are required for �. s Fr.
electric, plumbing and heating work.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED L,qryNING ACTION
1 BFr, boon �Ay � �! DATE
APPROV
FRONT iZOOM /O,►� " ED p
1 hereby acknowledge thai I have reatl this apPlication antl state �
Mat tha ebova information is carrect antl agree to comply with
all laws regulaNng builtlinB �o^struction, antl I shall not amploy
any person in violation of tha workman's compensation laws of :
the State of California.
SQ.FT C% O �
I hereby certify that I am properly licansetl as a contractor untler �
the Staie of California Business and Professions Code, Division 3, THE AMOUNT SH WN UNDER VA�UATION IS FOF ro
Chapter 9, antl that such licenses are in full force and effect, or I THE PURPpSE OF ESfABLISHING A PERMIT FEE ONLY: �
am exempt from the provisions of the State of Calitornia Businass a
VALUATION PERMIT FEE $
and Professionns C-ode`, D_ivi`sio 3, C apter 9���-�C`/ �� m
UO'�/1✓� PLAN GHECK S �— "�
Signature of iT �y �{/' �
Permittee d /'"LLl�/�. $ �Q(%.-� TAX $ �
or ��'y � u
Authorized Agent Dace � � TOTALPAID $ `Q. ��
pbk
COSTA MESA BUILDING-SAFETY DEPARTMENT
. P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
AD�RESS ��a% �, �� �� � •
�A�R �/ov.0 J_ G�ar'� �%'.e.
MAILING C��E
ADDRE55 v
CITvCiQS%/� /'/�as%if 7�Ge1 % NE��S7� ai
L�ENDER�ION I'ONE
/V
BRANCH
ADDRESS
AflCHITECT TEL.
APPLICATION FC
c
RECEIVE V PE
A.P. NO. ����
BVILDING "�� L
A�DRESS �
UNIT OR
SPACE NO.
TR. 1% LOT
NEW ADD AI_TE
USE %�a,}�-I�TIO/W
n APPROVED
CONTRACTOR S/�n(� BV
ADDqESS
TEL.
CITV NO.
� STATE CITV .QPPROVEDSETBACKS
LIC. NO. ' LIC. NO.
� SIZE NO.OF BLDGS. (FFOM C/L
6. OF LOT NOW ON LOT RONT
a USE OF
� EXISTINGBLDG..A.LCiU �4
y
FSepara[e permits are required for L. SIDE
Q electric, plumbing and heating work. �
H USE OF BUILDING ANO WORK TO BE PEIiFOFMED ING
a T Ftoa t
> WA'-�— vE
} ( ( CU U E N F120 Ic.»'
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� I hereby acknowletlge thet I have reetl this application entl state
[� that the above information is correcS and agree to comply with
�+ all laws regulatlng builtling construction, and 1 shell not employ
,'� any person in violation of tha workman's eompensation lews of
ythe State of Califarnia.
3 I hereby certify that I am proparly licansetl as a contractor under
the State of California Business end Protessions Cotla, Division 3, THE AM(
Chapter 9, antl t�at such licenses are in tull forca antl aftact, ar I THE PURI
am exempt from Me provisions ot the State of California usiness VALUATIOI
antl Professions Cotle, Divisionn 3, CAhapter 9i n_�
Signature of � (/�`/j,./ —4���i���(/� � �' �./� �
Permlttee �/Ll% //. �1.�9L.R�-�-�/ $ �
a, � f�� �o
Authorizetl Apent Date
ACTION
C?URALPERMIT 6e50 TL
Icb/Ou
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BLK.
i MOVING OEMOLISH
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Li /e '
VALUE
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1 GROUP �"^
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OATE
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HOWN UNDER VALUATION IS FOR t0
ESTABLISHING A PERMIT FEE ONLV: �
PERMIT FEE $ . � a
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PLAN CHECK $ �- o
'rax s d • O i
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TOTALPAID $ q� �(�