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Home My WebLink About381 22ND ST - Building Permits(714) 754-5273 • Fex (714) 754-4856 • w�vw.cl.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 381 22ND ST Suite: Vicinity: ROOF Primary Occ: R3 Dwellings/ Cong Res <10 Type ot Conslruction: V-N Parcel Number. 42617113 Zoning: Applicant: ODELL GLEN Address: 430 W 768TH ST GARDENA,CA Owner: PEILETIER TRUST Address C/O EILEEN WHALLEY 16 CORPORATE PLAZA DR NORTHERN TRUST BANK NEWPORTBEACH,CA Contractor: MUTUAL ROOFING COMPANY Address: 430 W 168TH ST GARDENA,CA Zip: 90248 Arch : Address: Phone: Phane: 310-327-2263 Zip: 90248 Phone: Zip: 92660 Phone: 310327-2263 License: 442500 Eng: Address: ISSUED BY: Status: ISSUED Applied: 04/18/2005 Issued: 04/18/2005 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING COMPOSITION SHINGLES AND INSTALL NEW HOT MOP/GRAVEL ROOF (34 S�). Plan Check: $0.00 Permit: $237.25 SMIP Res: $1.40 SMIP Com: $0.00 Other: 50.00 Inspection: $0.00 Total: $238.65 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Re uiretl: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 31a,000.00 sia,000.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) ' EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned 'I for a penod of 180 days. �I INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all ��., requlred inapaetlons and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOH INSPECTIONS CALL: (714) 7545626 '448d8 (6/00) WORKERS'COMPENSAnON �ECLARAnON: I hereby eHirm under penelry of per�ury one ol tha following daclaretlons: ❑ I heve and will meintain e cenificate ol cronsent to self�lnsure lor workars' compensetlon, es provided lor by section 3700 of the Lnbor Code, for [�e pertormance of the %'�ork for which this Dertnil i5 issued. � 1 heve and will maintain workers' compen5etlon insurence, es reqWretl by sectlon 3700 0l Ihe Lebor Code, lor t�a podortnance of t�e work for whiCh this pertnit is issued. My workers'�penselipop Insu�r/en�ce carrl7e�r e�/r��d policy number ere: A^n �p CBMPJ:�A�_�i�U, �11[7. �IOV/f �Poliry�Number:,C.W��p�� .�� (Thls sectbn need not cromplBfed i! the peimit is wlued e! one hundred dollars ($100) or lass.) � I certify ihat in the peAortne��e of the work tor whlch Ihis permil b Issued, I shall not employ any person in any menner so es to Decome subject to the workers' crompensation laws ol CeIlfOmia, end egrae Ihel lf I shoula 6BComa sub�ect to the workers' crompen9ellon provisions o1 Section 3700 ot the Lebor Cotle, I 5hall torthwith Comply with �hese provisiohs. Applicenl SigneNre: Deta: WARNING�. FAIWRE TO SECURE WORKERS' COMPENSATION CpVERr1QE IS UNIAWFUL AND $HALL SUBJECT qN EMPLOVER TO CRIMINAL PENALTIES r1ND GVIL FlNES UP TOONE HUNDRED h10USAN0 DOLURE (5100.000), IN ADDITICX� TO TNE WST OF CdAPENSrITION, DAMRGES AS PROVIpED FOq IN SECiION 3106 OF THE LABOR CODE, INrERESi, M1D ATTOqNEI^5 FEES. LICENSED CONTAACTORS D�CLARA710N: I hera6y eftirm Ihai 1 em lice%s�d untler pro slons ol Chepler 9(commencing wllh SBclion 7000) ol Dlvlslon 3 0l ihp� Sine s tl(p�� olessions Code, antl my Iicsnse i5 in tull force entl ettect,l:l` M,y97 yaS�� C�9,k��' �/ Contractor'sSignature: rOnle: ��3%' /YiS� CONS7AUCT10N LENDING AGENCY: ❑ I hereby aRirtn ��e� t�ere i5 e ConSiruclion Iendlnp egonry lor iha poAormance ol Ihe work br which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lentlef9 Neme: Lender's Atltlress: Signature: OWNER-BUILDER DECLARA710NS: Date: I hereby eHirtn thet under penely ol per�ury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor ihe lollowing reason (Sec. 7031.5, Business antl Protessions Coda: Any dN or counry whic� r04uire5 e partnit to Construct, aller, improvo, tlomolis�. or ropair eny slrucWre, prior to its issuance, also requires the applicaN for such permit to file a signetl statement Ihel he or s�e is IlcenseA pursuant to lhe provlsians ol t�e Contrettors lkense Lew (Chepter 9(commencing with Seciion 7000) of DMsion 3 of t�e Bu5ine55 entl Pmfeuion5 Code) ar lhet he or she is exempt Iheretmm entl Iho besis tor tha ellegod axempNon. Any Wolalion o1 Section 70.31.5 hy any aDD��wnt for a pertnit suDjects the ep0�icant to e civil pPnalry W not more than (Ive huntlred tlollere (55001.): � I, es owner oi the property, or my employees with weges as �helr sole compense�lon, WILL DO 7HE WORK, entl the stmcture is not intendea or oflereC for sale (Sec. 7044, Business and Profess�ons Cotle: The Contractors License Lew does not epply to an ownor ol propeny who Duilds or improves Ihereon, and w�o tloes such work �imself or herself or t�rougp his or her own empl0yees, providetl thet such Improvements ere not Intended or oHered �or sale. If, however, the builtling or improvement is sWtl within one year of comple�ion, the owner-buildar will heve Ihe burtlan ol pmving that he or she did not Ouiltl or im0�e�e lor purposc ot sale.). ❑ I, as owner ot i�e property, am EXCWSIVELV CONTRALTING WITH LICENSED CONTRACTORS �o constmct the Oroject (Sec. 7044, Business and Pmfessions Code: The cnntrectors LiceOse Lew doe5 not appty to an owner ol property who bullds or Improves Ihereon, antl who contracis for suth prolect wiN a contrector(5) license pursuent to �he Contreciors License LEws.). ❑ I em esempt under sec. Business end Protessions Codo for this reason: Signeture: Dale: Owner ID venfietl by dnvels license. ❑ Ye5 ❑ No Dnvefs Litense No. Venficetion oi Ownars�ip by (cype ol document, i.e. - property Ia: bill or deetl): Expires: DIVISION OF INDUSTRIAL SAFEtt PERMIT CER7IFICATION: ❑ I hereby certity �ha� no exce�elion five (5) or more feet in dept� In�o which e person is required to descend will be mede in conneaion wit� work authonzed by this permit, antl t�a� no Duilding strucWre, scaHolding, lelsework, or tlemoli�ion or dismentling Ihereol, will be more then �Oirty-sia (36) leet high. (ChaO� 32. Grp 2, Art 2. Sec. 341, Title B, Calitomia AtlmlNs�retive Code). ❑ As ownarbuiltler, I will not employ enyone lo tlo work which would require e permil Irom ihe Division ot Indusinal Salery, es notetl above, unleu such person has a permit to do suc� work Irom Ihe division. Signe�ure: Oate: Division ol Indusinal Safery Perm�i Number. CERTIFlCATE OF COMPl1ANCE �D AUTHOH¢ATON OF ENTAY: I cenify undor penally ol perjury ihat I �ave read this epplication antl stata l�at the informalim given is correa. I egree to comply with ell stete lews en0 Ury orElnences relatinp lo bullding conslmction, entl authodze representatives of the Ciry ol Casta Mesa lo enter upw� l�e ebove�descnbed pwperty lor InspecUon purposes. I egree not to occupY or allow occupancy ol eny �uiltling aut�orizetl by th�s permit until final inspection. COOE 1. INSVECTIONTYPE 1616 Flxea System Final Firo PmvonUon 1288 Paol Spe Final 200 Finel Ro�Roal 201 Finel BIocWRetelning W PII 202 Flnel FettOry Firo PIeCo 203 Finel Sign 204 Finel Domolition QdIE INTRIALg _fc1LL f� GQQE� INSPECTIONTYPE 208 Finel MochaNcal 200 Finel Plum�ing 210 Final Eloclrical 212 Finel Flre Prevention 220 Finel Plenning Approval 222 Final Sila 250 Finel Building/Occupency _ /�' �� '�-•-Data� Q�SF IIIIIIIDSS