HomeMy WebLinkAbout378 19TH ST - Building Permits��
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(714) 754-5273 • Farz (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 378 E 19TH ST
Suite:
Vicinity: ROOF
Parcel Number: 42630116
Applicant: PURCELL, ELIZABETH S
Address: 378 E NINETEENTH ST
COSTA MESA, CA "
Owner: PURCELL, ELIZABETH S
Address 378 E NINETEENTH ST
Contractor:
Address:
Zip:
Arch :
Address:
COSTA MESA, CA
Zoning:
Phone:
Zip: 92627
Phone:
. . Zip: 92627
Phone:
LicenSe:��
' Eng:
Address:
Status: ISSUED
Applied: 04/30/2003
Issued: 04/30/2003
ISSUED BY: f��
Phone: Phone:
Zip: License: � License:
SCOPE OF PERMIT
LEGALIZATION OF A REROOF. TEAR OFF AND�REPLACE SHEATHING. REPLACE STAf2TER BOARDS WHERE NECESSARY. 40 YEAR COMP
SHINGLES - '- -- -� '
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00 _
$139.25
$0.65
$0.00
$0.00
$0.00
$139.90
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: 0
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Lett 0- 0
Left 0- 0
Pronosed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
Ss,soo.00
36,soo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis undei 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 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and e0
required Inspeetlona and (inal approval must be obtainetl. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
tma-as �eroo�
WORKERS' COMPENSATION DECLARATION:
I hereby ettirtn under penalry of perjury one oF iha following declarations:
❑ I hava and will meintein e certificate oi consent to sell-Insure for workers' wmpensaiion, es providetl for by section 3700 of the Lebor Code, lor Ihe pedormence ot the
work ior which ihis permit is Issued.
❑ I have anG will maintain workers' compensation insurence, es requiretl by section 3700 of Ihe Lebor Code, for the peAortnance of Ihe work tor which thls pertnit Is IssueO.
My workers' wmpensatlon Insurance carner antl pollcy number ere:
Cerrier: Policy Number:
(This section need not be comp/eted i! Ihe permit is valued e( one hundred Oollars ($100) or /eu.J
❑ I certiy that in the peAormance of the work for which this permit is issue4 I shall not employ eny person in any manner so as to 6ecome subject to tha workers'
wmpensetion laws oi Celltomia, entl egree that ii I should become subject to the workers' compensation provislons of Section 3700 of the Lebor CoOe, I shall torthwith
comply with these proNslons.
Applicam Signeture: Date:
WARNINp: FAILURE TO $ECUFE WORKERS' COMPENSATION COVERAOE IS UNLAWFUL PND $MALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND dVIL FINES UP TO IXJE HUNDRED
TYIOUSAND DOLLARE ($1 W,000�, IN AODITION TO TME COST OF CAMPENSATION, DAMAGES AS PROVIDED WR IN SEGTIIXJ 31060F THE L4BOR COOE, IMEREST, NND ATfORNE1^S FEES.
LICENSED CONTRACTORS DECLAHATION:
I hereby aHirtn that I em licensetl untler prohsions ot Chapter 9(cammencing with Section 7000) ot DiNsion 3 01 ihe Business and Professions Code, end my license is in full
torce ana ettect Lic. a ' Class q
Comrectofs SignaNre: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm that there is a conslmG�ion lending egency for ihe performance oi lhe work for which ihis permit is issuetl. (Sec. 3097, Civil Cade).
Lendefs Name: Lenders Address:
Signeture: Dete:
OWNER•BUILDER DECLARATIONS:
I hereDy eNirtn that under penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, 8usineu anC Professlons
Code: Any city or county which requves a permit to consiruct, elter, improve, demolish, or repair eny sWcture, pnor to its issuance, elso requires Ihe epplicant for such pertnit
to file e signea statement thet he or sha is I��ensed pursuent �o �he provlsions of the Contractors License Law (Chepter 9(commenGng wiih Section 7000) of DiNsion 3 of ihe
Business and Professions Code) or thet he or she is exempt therelrom end the basis lor Ihe elleged ezemption. Any violation of Section 7037.5 by eny apD���ent for a Dartnit
,s�u�bi'e� s the epplicant to a dvll penelry of ntlt more ihan five hunAretl dollars ($500).): ,
�I, as owner ot Ihe proparty, or my employaes with weges as iheir sole compensation, WILL DO THE WORK, and Ihe structura Is not iniended or oHereO for sele (Sec.
7044, 8usiness end Professions Cod6: Tha Con�ractors License Law doas no� apply to en owner of properry who huilds or improves �hereon, and who tloes such work
hlmself or herself or ihrough his or he! own employees, provided that suc� improvemants ere not Intended or aHaretl tor sele. If, however, ihe building ar improvement is
sold within one year ol completion, ihB m+'ner-builtler wlll have the burden ol proving thatihe or she did not build or improve tor purpase ot ule.).
I, es owner oi Ihe pmperry, em E%CWSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (SecJ044, Business and Pmfessions
e: The contractars License Lew tl0es not epply to an owner ol pmperly who bullds or Improves ihereon, antl w�o contracis lor such project wit� a contractoqs)
cense pursuant m the Contradors liGens�lews.).
iam
Business end Professions Code for this reason:
i
Owner ID v' b rivar's licensa, ��es ❑ No
Varllicstion af Ownership by (type af dxumen�, i.e. - propeM1y tex blll or deed):
Dnvefs Licensa No.
Date:
Expires:
DIVISION OF INDUSTRIAI SAFETV PERMR CERTIFICA710N: �
❑ 1 hereby certity that no excavatlon five (5) or more feei in depih into which e person is requlred ta descend, will be mede in connection with work authorized by ihis
pertnit, end thaf no building structure, scaHolding, talsework, or demolition or dismanlling t�ereof, will 6e more then ihirty-six (36) feet high. (Chap. 32. Grp 2, Art 2, Sec.
341, Title 8, Celitomia Administrative Code).
❑ As owner-builder, I will not employ enyone lo do work which would raquire e permit trom tha Division of Industriel Sefery, as noted ebove, unless suc� person has e
pertnit to do such wodc imm ihe division.
Signeture: � Dete:
Division of Industnal Safety Permit Numbar:
cooe r. �Hsveenoxtrve
1616 Fixed System Final Fire Prevention
126fi Pool Spa Finel
200 Final Re-Roof
201 Finel Block/Retaining Well
202 Final Fadory Fire Place
203 Final5i9n
204 Final Demolition
PAg It�L�
CO�E I INSPECf10N TYVE
� 206 Final Mechanical
. 208 Finel Plumbing
� 210 Finel Elecincal
212 Flnel Fire Pravention
220 Final Planning Approval
� 222 Final Site
� 250 Final Building/Oaupency
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