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Home My WebLink About916 MACKENZIE PL - Building Permits(774) 754-5273 • Fax (�ia) �sa-aess • www.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 916 MACKENZIE PL Suite: Vicinity: HOUSE & ATTACHED GAR4GE Parcel Number: 41805230 Applicant: ELLIS, RANDLE G Address: 916 MACKENZIE PL COSTA MESA, CA Owner: ELLIS, RANDLE G Address 916 MACKENZIE PL COSTA MESA, CA Contractor: OWNER-BUI LDER Address: Zip: Arch : Address: Phone: 2oning: R1 R1 Phone: (714)956-4495 Zip: 92626 Phone: (714) 956-4495 Zip: 92626 Phone: License: 0 Eng: Address: ISSUED BY: Status: ISSUED Applied: 08/71/2000 Issued: 08/11/2000 Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (25 SQ). TEAR OFF EXISTING WOOD SHINGLES & RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 1 LAYER OF 3QJf FELT UNDERLAYMENT & REROOF WITH GAF 25 YEAR COMPOSITION SHINGLES. Plan Check: $0.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0- 0 Rear 0- 0 Reouired: 0 FEE SUMMARY PLANNING 8 ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $2,600.00 s2,soo.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. � ' INSPECTIONS: In order For Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeotiona and final approval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiration of this permi�. FOR INSPECTIONS CALL: (714) 7545626 2446-4616�00) WORKERS' COMPENSATION DECLARATION: I hereby ettirm under penalty of perjury one ot the tollowing declarations: ❑ I heve and wlll maintain a certificate of consent to setl-Insure br workers' compensation, as provided for hy section 3700 of ihe Lebor Code, for tha pertortnence of ihe work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as requiretl by section 3700 ot ihe La6or GoOe, for ihe DeAortnance ot lhe wak for which lhis pertnit Is issued. My workers' compensatlon Insurance carnar entl policy number are: Carner. Policy Number. (This secfion need not be completed il the permit is valued af one hundretl dollars ($100) or less.) ❑ I certiy that In the pedormence of the work for which ihis permit is issued, I shell not employ any person in any manner so es to become subject to ihe workers' compensation laws oi Celifomia, and egree that If I should become subject to the workers' compensation provisions of Section 3700 ot Ihe Wbor Code, I shall forthwith tomply with Ihese provisions. Applicant Signature: Data: WARNIN6: FAILURE TO SEWRE WORKERS' CAMPENSATION fAVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYEF TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLARE �8100,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIOED FqR IN SECTION 3]W OF THE L4BOR CADE, IIJrEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 ot the eusiness and Professions Code, and my license is in tull torce an0 effecL Lic. a Class A Contractors Signature: Date: CONSTRUCTiON.LENDING AGENCV: _ ❑ I hereby attirm ihat there is a consimction lending agency for ihe pertormance of Ihe work tor which this permit is issued. (Sec. 3097, Civil Code). LentlefsName: � Lender'sAddress: Signeture: Date: OWNER-BUILDER DECLARA710NS: 1 hereby aHirm that under penalry of perjury Ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (SecJ037.5, Business and Professions Cotle: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant For such pertnit ro file a signed statement that he or she is licensetl pursuent to the provisions ot ihe Contractors License Law (Chapter 9(commencing with Section 7000) ot Divislon 3 of the Business end Professions Code) or thet he or she is enempt therelrom and the basis for the alleged ezempiion. Any violation oi Seclion 7031.5 by eny epplicant for a pertnit subjecisJhe epplicent to a civil penalty oi not more ihan five hundretl dollars ($500).): ��I,,es,owner of ihe property, or my employees with wages as Ihair sole compensation, WILL DO TME WORK, antl the sWcture is not intendetl or oHered for sele (Sec. 7044, Business and Professions CoOe: The Contractors License Law does not apply to an owner of properry who builds or improves thereon, an0 who does such work himself or herseN or ihrough his or her own employees, provided �hat such improvements are not intended or oHered tor sale. If, however, the builtling or impmvement is sold within one year of completion, the owner-builder will heve the burden of proving that ha or she did not build or improve for purpose of sale.). ❑ I, as owner of the propeny, am EXCLUSIVELV CON7RAC71NG WITH LICENSED CONTRACTORS to constmct the project (Sec. 704a, Business antl Professions Cotle: The contractors Licanse Law does not apply to an owner oi property who bullds or improves ihereon, and who conirecls for such pmject with a contractor(s) license pursuant to the Contrectors License Laws.). ❑ I am exempt y(}�ler sec. q/� Business and Protessions Cotle for this reeson: Owner ID verifiedD'y dnver's license. ❑ Ves ❑ No Dnvers License No. ,� � Ezpirez �'1 /�6 /OS Venfication of Ownership by (type of document, i.e. - property taa blll or tleetlJ: �-� DIVISION OF INDUSTRIAL SAFETY GERMIT CERTFICATION: ❑ I hareby certify ihat no e:cavation Five (5) or more feat in depth into which e Derson is required to descend, will be made in connection with work euthonzed by this permit, and that no building swcture, scaHoltling, Falsework, or tlemolition or dismarnling thereoi, will be more than ihirty-six (3fi) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calitornia Administrative Cotle). ❑ As owner-builder, I will no� employ anyone to do work which would require a permit from the Division of Indusinal Safery, as notetl above, untess such person hes a permit to do SUCh work frOm the division. Signature: Date: Division of Industdal Safery Permit Numbec CERTIFICATE OF COMPLIANCE AND Al1THORIZA710N OF EN7AY: I certify under penalry of pe�ury that I have read fhis application and state Ihat ihe information given is correct I egree �o comply with ell state laws antl city ortlinances relating to building constmction, and au�honze representatives of tha Gty of Coste Mesa to enter upon the above-tlescribed perty 1 r inspectiyn pyryoses. I agree not to occupy or allow occupancy ot any building authorized b�hjs per it until tinal inspection. .� /! I/ il f�x ,� r r Rn ' igneWre OhLegel Owner(s)- .- �� Date"' Antl/Or Authonzed ApplicaN Date CODE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Re-Root Final BIocWRetaining Well Final Factory Fire Place Final Sign 204 Final Demolition Q�j[ I R �s oL �._'" CODE� INSPECTIONTYPE 206 Finel Mechanical 208 Final Plum6ing 210 Final Electncal 212 Final Fire Prevention 220 Final Planninq Approval 222 Final Site 250 Final euiltling/Occupancy PAIE I[�dLS - ��3 COSTA MESA BUILDINCrSAFEf`f DEPARTMEM P.O. BOX 1200 � COSTA MESA, CALIFORNIA 82626 For Appitcanf ro Ft11 In Completaly TYPE OR PRINT ADDRES4 916 Mackenzie Place COSTA ME3A. CALIFORNIA - OWNER U. S. Financial ADDR89G 1355 Front Street eirr San Die o Calif. No 234-7 ARCHIn,v�cwe A C_ N nrsrrlr wnL ri�tii-ri. ■ STATH i� Avenue xo. or s�.00s. BUILDINO L[OAL FEB 17-67cwsa�0 725{r �',�� ^9�3.�� APPLICATION POR PERMtT BUIIDIN(; ior Office Use Only ZONIN(i no. o� � u.a or •uni euaon YARDB MPROVHD USE OF MAIN BUILDINO EXISTIN6 BLDO. r f FROM C/L 9TR[[T I YETOACKLIXtI�OY r'0� RGRY D 2%•7 RRONT Pr. CENTHII OF YTR[[T 7 Q � BID6YARDI LiFT � RIQHT J� R.DIDL .J!'T. DESCRlPTION OR WORK �. aioe J� rr. eu��oiNa no.o� vwn.# �y SIZE �18 Sf ROOMB 6 BTORI[y 1 C. U. P. f$ EXTERIORWALL ��- I ROOP Shake-Shin�le APp110' ttached � 1 HEREBY ACKNOWL6O06 TNAT 1 MAVt RHAD iMIB APPLICATIOH wrvo eiwi6 iXAT TH6 I1BOV6 It CORRBCI'�I1ND AOpEB TO COM. PLV WITH ALL CITY ORDI�UNCU AND YTATL IAWY R60YlATIHO eu��oino conerpucr�on. SIGFlATURE OP PERMITT6 �+'��✓ D �2 AYTHORIZ[D A66NT BMALL sE LE88 THAN (U..B.C.REqUIRHMENT7 YARDSAPPROV6D AGCE6SORY BUILDING DAT6 ar r/'c-AJ ewre Or-/'7'-/O/ a ro � �i� � � sa. Rr. d ? � TH[ /�MOUNT GXOWN UNDBR VAWATION 18 FOR TXC j ■YPPO88 OP iBiABLI8NIN0 A PlRMIi pE8 ONLY. 6 VALUATION D � �� O1 � PERMIT FEE E $ � �3y- �3/5 0 � TOTALFEE $ ��'J,S T