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Home My WebLink About895 19TH ST - Building Permits0 k*EST '-dfki SfREST ��5 15745 - Complete �1=c. ?iC (re.rigl 3209� - 9-19-62 P?b3. ^iC (re:'ri8) �3818 - 8-i8-61 5-uvt ccm'1 ti&3. 15691 - 11-14-61 � �1ec. �r�u.�d �'_g:: 19562 - 7-u-64 Add i5 _igc tc onla 36602 ' 6-23-73 ��e�.;. l•iaii SiEa (21 a � B-97888 PCR45 5-905 + . $��1/ (� °n 1 ; .. I 40,853• Soo. 3�• : 800.. ; n � t � � CITY OF COSTA MESA _, � eva��N6 oms�oN � � DEVELOPMENT SERVICES DEPARTMENT � PERMIT PERMI� �o�mm � 699-00329 ,/ (714) 754-5273 • Fax (714) 754d856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite: Viciniry: 895 W 19TH ST COMPLETE BUILDING parcelNunmber: 42419103 Applicant: ROBERTS, WALTER Address: BUILDING PERMIT Zoning: Phone: � Zip: /., owner: BISHOP; f1NITA LYDIA TR Address P O BOX�2341 � , - � - � Phone: �=WRIGHTWOOD, CA � _ _ - � Zip: 92387 Contractor. LEE ROOFING OF COSTA MESA Address: 01653 SUPERIOR AV . ' Phone: 949-642-7222 � .COSTA MESA CA , Zip; 92627 � � License:. 349686 Arch : ' � . - Eng: Address: � . - Address: Phone: - Zip License: Zip: Status: ISSUED Applied: 03/1011999 Issued: 03I10/1999 Phone: License: SCOPE OF PERMIT � , REROOF - T/O, NEW BUILT UP HOT MOPPED ROOF. � � 1 LAYER 25# FELT, 2 LAYERS 11# GLASS PLY 1 LAYER 72# � - CAP SHEET. . FEE SUMMARY Plan Check; $0.00 �" � Calc Valuation: $i2,2�5.00 Permit: $199.75 .� � Claim Valuation: $iz,2�s.00 SMIP Res: $1.23 SMIP Com: $0.00 " ' Other: $0.00 Inspection: $0.00 � � Total: $200.98 5ETBACKS MAINSTRUCTURE Front -0-0 ACCESSORY Front 0- 0 pARKING Existina: 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING �en a o Left 0. 0 Pronosed: 0 Right o- 0 Right 0- 0 EXPIRATION: This permlt shali eutomatically expire and become vold if work is not commenced within 180 days, or if work is suspended or abandoned far a pedod of 180 days. j INSPECTIONS: In order for the work aWhodzed under this pertnit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetiona end final approval must be obtained. Failure to obtain inspections and final epproval will result in tha expiration of this permit. � FOR INSPECTONS CALL: (7t4) 754-5826 ' � WORKERS' COMPENSATION DECLAHATION: - I hereDy atfirtn under penelry of perjury one of Ne iWlmving dedaretions: 0,. I heve and wlll meintain e certiticete of consen� to self-Insure for workers' compensatlon, es provitleA tor Cy section 3700 ai t�e Lebor Code, for ihe Dedormence W the work far whlch thl9 pertnll is issued. , ❑ I have and will maintain workere' compensation insurance, es requlietl Dy section 3700 of Ne Lelwr Code, for ihe peAortnance of Ne work tor which this peimlt fs issuetl. My workers' compensatlon Insurence caMer end policy num6er ara: Cartler. Policy Number. (Thls section neetl not be completed il the OermJt Is velued et one hundred dollers ($100) or less.) ❑ I certity thet in the peAortnance of Ihe work 1or which ihis permit is Issued, I shall not employ any person in any menner so es to become subject to the woAcers' compensetlon lews of Celltomia, thet If I s�oultl bacome sub�ect to the workers' compensatlon provisions of Section 3700 of Ihe Lebor Cotle, I shall tonhwith compty wiN Ihese pmvisio�n1s. / Applicent Signature: � / • li/J . � Date: ��d/7 �� WARNING FNLURE TO SEW RE WORKERS' COMPENSATION WVEMGE IS UNLAW R1L AND SHALL SUBJECT AN EMPLOYER TO CRIMI P TIES AND qVIL FlNES UP TO ONE MUNDRED THOUSAND DOLLARE ($100,000�, IN FDDITION TO TME COST OF COMPENSATIqJ, DAMAOES AS PFiOVIDED FOR IN SECfION 3lOfi OF TME LABOR CODE, IN�EREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm Ihat I em licensed under pjro �ions ol Chepter 9(commencing with Section 7000) of DiWsion 3 oF Ihe Business end Professions Code, end my license is In full torce entl eHed. Lic. M /�C \/ Clau # G�-� �%• Comreqors Signeture: ! , F/„ Date: �//O �J � � CONS7RUC710N LENDING AGENCY: ❑ I hereby aHirm thet ihere Is a construction lending egency tor the pertortnance ot the work tor which Ihis pertnit Is issued. (Sec. 3097, Civil Coda). Lendefs Name: Lenders Address: Signeture: Dete: OWNER-BUILDER DECIARATIONS: I hereby aXirtn thet under penalty oi per�ury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe followinp reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry whic� requires a pertnit to consiruct, alter, impmve, tlemolish, or repeir eny sWcture, prior to iLs issuflnce, elso requires the applicant for such pertnit to file e slgned statemant that he or she is Ilcensetl pureuent to the proNsians oi tha Contrectore License Lew (Chapter 9(commencing with Sectlon 7000) ot Divislon 3 of the Buslneu end Professions Coda) or thet ha or she Is exempt therefrom and the basis for the alleged exemptlon. Any violatlon of Sedion 7031,5 by eny applicant for a permit sub�ects Me epplicant to e civll penalry of not more then five huntlred dollars ($500).): ❑ I, es owner of the properry, or my emplayees wlth wages as thelr sole compensatian, WILL DO THE WORK, enG ihe structure is not intended or o%eretl for sale (Sec. 7044, Business entl Profeuions Code: Tha Contrectors License Lew does not eppty to en owner of property who bullEs or Impraves thereon, end who does such work himself or herself or throug� his or her own employees, proNded thet such Improvements are not Intended or oflerad for sele. II, howeveq t�e bullding or improvement is sold within one year of completlon, the owner-bullder will have ihe burden ot proving t�at he or she ditl not builtl or Imprwe lar purpose of sele.�. ❑ I, es owner o1 t�e properry, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to conswq ihe proleci (Sec. 7044, Businass end Profeuions Code: The conirectors License Lew does not epply to an owner ot property who bullds or Improves thereon, end who contrects for such pro�ect with e contractor(s) Ilcense pursuant to the GONrectors License Lews.). ❑ I am exemp� under sec. Signature: Owner ID venfiad by driver'S license. ❑ Ves ❑ No Business end Professions Code for Ihls reason: VeAflcation of Ownerehlp by (type af document, i.e. - property ta�c bill or tleeA): Driver's License No. Date: Explres: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I here6y cently ihet no excavatlon Nve (5) or more feet in depth Into which a person Is requlred ta tlescenq wlll be metle in connectlon with work euthodzed by ihis pertnlL antl ihet no building structure, scaflolding, falsework, or demolitlon or dismantling ihereoi, wlll be more ihen Ihlrry-slx (38) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Cellfomie Atlministretive Cotle). ❑ As owner-builder, I will not employ anyone to Ao work which would require e pertnit fram ihe Division of Indusinel Setery, as noted ebove, unleu such person hes e pertnit to tlo such work from the divislon. SigneWre: Date: Division of Indusinel Sefery Permit Number: CERf1FlCATE OF COMPLIAMCE AND AllfXORPJ1710N OF ENTHY: I certity under penalry oi perjury thet I heve reed this epplication anO slete thet the Information given Is conect. I agree to compty wflh all state laws end ciry oNinances relating to building conswaion, end emhorize represemetives of 1he Ciry of Coste Mesa to enter upon the flbovadescnbed properry tor inspection purposes. I egree not to occupy or allow ocapanty ot any building aufhorized by lhis partnit until Onal InspecUon. �' • • i►�!!�� cooE �. R15vetnoxme 1676 Fixed SySlem Flnel Fire Preven6on 1266 Pool Spe Final � 200 Flnal Re-Rooi 201 Finel BIocWRetelning Well 202 Finel Fectory Flre Plece 203 Final Slgn 204 Finel Demolitlon 2MBd8 P6� It1iIDll5 FpyF� wsvetTroxme 208 Finel Mechanicel 208 Finfll Plumbing - 210 Finel Eleclncal 212 Finel Fire Prevention 220 Finel Planninp Approvel 222 Finel Sita 250 Flnal Bulltling�Occupency � � , f �, , * , _.. . � � �-� ��-g �� 6 , FEE R�, CEI ED �`�.,� , COSTA MESA BUILDINGSAFETY DEPARTMENT. ''.(��,��• 9— �j �' �. P. O. BOX 917 C09TA MfiBA..CA6IPORNIA ' � �� , � �FINANCE �EPT. For A lieanf fo Fill In Com letel " � `�.c�' '"'—n cnS�p p4F�q '-�t PP P Y A L1c:A�lUN FOR PERMIT; �• � . ,\ TYPE OR PRINT i{" '�a g5�. �...—�.BUILDING � '� BUILDING �-- (,��a'� �� `' '�-'S� ADDRESS C057 MESA. CALIFORNIA � R�"�� For �Office� UseiOnly �r � •� � � ;' REC8IPT�NO. /P� IT O. � OWNER �G`UC D,: � U�S!/C� ' • ` •l.' � / � � RECEIVEO Y I �DAi��rtECEIVEOr I D 198UHD M^IL�.....i7y�c) iC .�� i��m�� ' .��. �1.+1 _K _ /_ I 1 L.� LI�I ) BUILDINGJ I� /./ / ) "�� ADDRESS J �� / ' p�y �� i . �j ' ' � COSTAMESAt�CALIFORNIA FIRE ZONE � ' ' ' ' T.`lPE GROUP' '� '� 'APPROVED � //�� r "-' RV . . . � . ��1�� I]GTF �I NO. OF BLDOe. � � 6ETB�GK LINB PROM DESCRIPTION OF WORK 'BUILDING /! (�// s��e .�, F 1 f. i r: .�n ✓ A' NO. OF / ROOMS /O � I ROOF COVERING WORK TO BE,PERF f+ ,�G E<r �' � /pPH C � � ZONING NO. OF I uee on p ruxs �% f au��nixa LEGAL A.P.NO��rO J%` U� � YARDS EVES � APPROVED AL W D fCENTER LINH 9TJ JJ FRONT FT. C R. SIDE 'FT. � IN. '� L. SIDE . FT. • �lN. — �j��` // REAR . a � FT. N. APPRO — BY DATE HOLD FOR SPECfAL - .EpA�W ' _ . n n • k I I HCREBY ACKNOWL8�48 TiAT 1 XAVB R6AD TX19 APPLIGTON ANO BT�TH TXAT THB �OVH 18 GORRER ANO AGRlE TO COM- PLY WITH ALL CITY ORDINANCH9 ANO 9TATH UWB REOUI.ATIN6 BUILOINO CONBT1UGnON. � � �. /] / �� TXG AMOUNT BHOWN 11NOHp VAWAT�ON IB FOR TNfi PURPO88 OR ESiABLI6HIN0 ♦ PERMIT IH6 ONLY. s yo �s.� C C � ,_ . . . . ; ;,�- - - _. _ __ • . , � � ' �,. � r� -� I ,t� t ; �L ;. ' - �EQU�I�� .' � ,� „ � � � � �w� -.,�.�� -�-f� � DATE / � � . '_R. No. AFPROVED .'� -� � / • , . Special Conditions: HOLD FOR SPECIAL REQUIREI�1=;.^,'� 1. Dedication of 10' to the City of Costa Mes�/£or the proposed widening of W. 19t1i St. and the corner spandrel. 2. Off-street parking under the direction of the Director'of Planning . . -. . . . - - - 3. Installation of courmercial sidewalks on_W. 19th St. and Monrovia Ave. by the applicant, at his expense when approved by and under the direction of the City Engr. ' �� ,, .� � �� .. '_ ", � .. � _ . _. .