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Home My WebLink About399 19TH ST - Building Permits(7ta) 754•5273 • Fax (77a) 75a-ae56 • www.cl.costa-mesa. BUILDING PERMIT �� FAIH UHIVt, (:US IA MtSA, (:A 9"LtiLti Job Address: 399 E 19TH ST Suile: Viciniry: RESIDENCE AND DETACHED GARAGE Parcel Number: 11729410 npplicant: HIGBEE, THOMAS Address: 8212 WORTHY DR MIDWAY CITY, CA owner: BUNGE, LISA JOYANN Address 71-11110LUOLU , � KAILUA KONq, HI Contractor: HIGBEE ROOFING COMPANY Address: 8212 WORTHY DR MIDWAY CITY, CA Zip: 92655 Arch : Address: Phone: Zoning: Phone: (714)891-2549 Zip: 92655 Phone: Zip: 96740 Phone:" (714)350-2549 License: 631967 Eng: Address: ISSUED BY: \ SWtus: ISSUED Applied: 01/07/2004 Issued: 01/07/2004 Phone: Zip: Llcense: License: SCOPE OF PERMIT REROOF RESIDENCE AND DETACHED GARAGE: REMOVE CAP ROOF AND INSTALL "30-YEAR COMP SHINGLES " PITCH 5:72 2000 S� FT TOTAL Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $9725 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: p FEE SUMMARY Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING Left 0. 0 Left 0- 0 . , , Proposed: 0 Calc Valuation: 33,700.00 Claim Valuation: $3,700.00 Right � 0- 0 Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilomia statutes and related regulations. (Ord. No. 92-28, § 1, 72•21-g2) EXPIRATION: This permlt shall eutomatically expire antl become void if work is not commenced withln 180 days, or If work Is suspended or abandoned tor a pariod af 180 days. INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicabla codes, and all requlred Inspeetlona and final epproval must be obtalned. Failure to obtain inspectlons and flnal approval will result in ihe ezpiration ot this pertnit. FOR INSPECTIONS CALL: (714) 750.5628 '.aasea laroo) WORKERS' C041PENSA�ON DECIARATION: I �ereDy eMirm urWer penalry of perjury one of tha tWlowing CeUaretlons: � �, ❑ I heve entl will maintain e ceniticete ot wnsent ta selt-Insure for warkers' wmpensetlon, es provided for by sectlon 3700 oi Ihe Lebor Code, br Ihe peAarmence of the wo tor w�ich this pertnit Is issued. � I have antl will maintaln workers' campensaUon insurence, es requiretl by sectlon 3700 ot Ne Lffiwr Code, for Ne peAortnence ol Ne work lor whidi Ws pertnll is Lswed, My workers' compensation Insur nce carrler and poliry number are: Cerrier.s7�.� �� POIIcyNumber:+/J/JrJ Z.11� g -o� (Thls sectlon need nol be camp/etetl/l fbe permlf Is velued et one hundred dWlers (5100) or less.) ❑ I ceNiy ihat In ihe peAortnence ot t�e work lor which this pertnit is Issued, I shall not employ eny person In eny menner so es to become sub�ect to the workera' compensatlon lews ot Calitomia, enC epree Ihat il I shoultl become sub�ect to the workers' compansatlon provislons ol Sectlon 3700 ot the Lebor Code, 1 s�all fanhwith comply wi�h Ihese ProvLslons. Applicant Sipnature: -�� Dete: �� 7—� �% WARNINO: FAILURE TO SEW RE WORKER5 COMPENSATION COVERAGE IS VMAWRIL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CMl FlNES UP TO ONE HUNDRED TFKKASMID OOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PRWIDED FOR IN SECTION 3]OB OF THE IABOR CODE, IMEREST, AND ATTOMIEVS FEE$, LICENSED CONTRACTORS DECLARATION: I here6y eHirm ihal I em Ilcensed untler provlsions oi Chapter 9(commencinp wl�h Section 7000) of Divislon 3 0l iha Business entl Protessions CoAe, and my Iicense is In full rorce end enect. uc. a• ��3/5� 7 Ciass"x y/ 3 9 Contrectofs SlgnaNre: _ �-� � Dete: / � 7-0 �% CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirtn that Ihere is e constructlon lendinp agenq br the performence of the work tor w�ich t�ls permit is issuetl. (Sec. 3097, Civil Cotle). Lentlels Name: LentleYs AOdress: Signeture: Date: ' OWNER-BUILDER DECLARATIONS: I hereby etlirtn thet under penelry of per�ury thet 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7037.5, Business entl Protesslons Code: Any clry or county which requlres e permit to construct, elter, improve, demolish, or repalr any sirucNre, pdor to Its issuance, elso requires the epDllcant tor such permit to flle e signetl stetement Ihat he or she is IlcenseA pursuant to Iha pravlsions of the Contractors License Law (Chapter 8(commencing with Sectlon 7000) of Dlvision 3 oi the Business and Prolessions Code) or that he or she is e:empt therefrom and tha 6esis far the elleged exemptlon. Any violatlon ai Sectlon 7037.5 by eny epplicent for e pertnH subjects t�e aDP��ent to a civil penelry ot not more then five huntlretl Gollars ($500).): ❑ I, es ownar ot the properry, or my employees with weges es Iheir sole campensailon, WILL DO THE WORK, end the structure Is not intentleG or ottered tor sale (Sec. 7041, Business end Professions Cotle: The Contractors IJcense Law does not epply to an owner of property who bu1105 or Improves thereon, end who tloes such work himself or herself or Ihrough his ar her own employees, providetl t�at such improvements ere not intentled or oHared lor sele. If, however, the builtling or Impmvement is sold within one year of completion, the owner-builtler will have the burtlen ot proving Ihat he or she tlitl not bulld or improve tor purpose ot ule.). ' ❑ I, es owner of the property, am EXCLUSIVELY CONTRACTING WfTF1 LICENSED CONTRACTORS to consiruct the project (Sec. 704a, Business entl Professions Cade: The comractors lJcense Lew tloes not eppty to an owner of properry who �uiltls or ImD�a�es �hereon, end who contrects tor suU pro�ect wlih e contractoqs) license pursuant lo Ihe Coniractors License Laws.). ❑ 1 em e:empt under sec. Busineu antl Prolesslons Code tor Ihis reason: SignaNre: Date: Owner ID verlfied by driver's license. ❑ Ves ❑ No DriveYs License No. Explres: Verlllcatlon ot Ownership by (rype oi dwument, i.e. - property tax blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby ceNty thet no excevetlon tNa (5) or more feet in dept� into whlch e person is raqulred ta descend, wlll he matle in wnnectlon wlth work euthorizetl by I�Is permit, entl that no building strucwre, scaHolding, falsework, or demolition or tlismantling thereoi, wlll 6e more then thlrty-siz (36) feet hig�. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, Califomia Administrethre Coda). ❑ As owner-builtler, I will not employ enyone lo do work which would require e permlt trom the Dlvision oi Intluslrfal Selery, as noted ebove, unless suc� person hes e permit to do such work from Ihe diWsion. Signeture: Date: DiWsion of Industrial Selery Permit Numbor: CEHTIFlCATE OF COMPLI4J�lCE AND AllTTiOR¢A710N OF EMAV: I cenity under penelty oi perjury that I heve read this epplicatlon antl state that Ne intortnatlon gNen is correct. I egree to wmply with all stete laws enO ciry orOinances releting to Dulltling canstruction, end euthorize represenlatives ot Ihe Clry oi Caata Mese lo enter upon the above-descdbed properry tor inspectlon purposes. I epree not to occupy or allow occupancy oi any building authodzed by Uis pertnit until final inspection. Signeture OI Legal Owner(s) Date ,a �' � j- �-�� AnNOrAuihorizedApplkant ' Date COUE �. INSFECTIONTYYE 1618 FIxeG System Finel Fire Preventlon 1268 200 201 Pool Spe Finel Final Re-Rool Flnal Block/Retaining Well 202 Final Feclory Fire Place 203 Finel Sign 200 Finel Demdltlon eeiE ll�s �_/� rba �_�_� 4QQf,d INSPECTIONTYPE 206 Finel Mechenicel 208 Flnal Plumbinp 210 Flnel Electrlcal 212 Flnal Fire Prevention 220 Flnal Planning Approval 222 Final Site 250 Finel Bulltling/Occupenq QAg Q�ELS Costa Mesa Building Department 111 EAST 20th STREET '! COSTA MESA� CALIFORNIA � FOR APPLICANT TO FILL IN Addre� 3 9y L" �Y-- ��i COSYw'L �0S&� C'd,�1fOPIIlB, APPLICATION FOR PERMIT 62� BUILDiNG � FOR O�'FICE USE ONLY Receipt No. Permlt No. /o Receiv by Date Rec'd. Data Issued Nearest y- ' 'S J ' '2 �� Croas Bt. l//S/ � Building Owner � %�/Vr i � �J / �� Address Arohitect or Engineer dress t�,�tractor ��-Lt/��t.fi Address Legal I Lot Description No. l� (Attach Metes and Bounds) Size of Lot (0�� O i� �.ZU use or � Existing Bldg. Setback Line from Centerof Street /- ,r CostaMesa,CaLfornia � Nearest y- Cross St. !! ��7L Zone No. oT Type I, � I Plana I !/ I:L•} �� //7-.�yy {� No. of Bldgs � Nowon Lot No.oT � No.of Familles I Rooma Rear Vard Side Vard p y OF WORH II Addition I II Demolish I � / g b Storina / APPROVALS Foundation Location ,Inspector Forms, Materlais, Under-Pinning ., Frame: Flre Stops, � Bracina. Bolts , � 'I hernby aclrnowledge that I have {�ad this Application and state that the above is rnrrect and agree to rnmply Lath. Inl. with all City Ordin ces and State ws regulating building constructio Lath. Ext Signatureof �% Permittee �� / ( � plaster,InL Authorized Agt plaster, Ext Vaivation � Permit Fee $ � r� Masonry Re Plan Check $ Bond Beam $ � O• 7otal ` Fee �' � � FINAL FORM 204 3-HP 2M 8-63 a � PR Date � � n PLOT PLAN 8how location and distancea from property Itne and between buildinga �,^.:. -. : . � ' '�' 5"�06 �OSTA MESA BUILDING DEPARTMENT P. O. BO% 3 I] COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN COSTA MESA. CALIFORNIA MAIL ADDRESS CITY ARCHITECT OR E' VEER LEGAL LOT OESCf11PT10N Np. � A.P. NO. � SIZE OF LOT D USE OF EXISTING BLDG. SETB�CM LINE FROM �REPAIR E%TERIOR WA COVERING USE OF NEW LIC. � NO. CITY LIC. NO. � U a�o�s. IOW ON �OT �.� DESCRIPTION OF WORK ALTERATION ADDITION MOVING DEMOLISH �p ROOM$ � STORIES � LL �•/ ROOF /�i� _ f fj J�JG[�(� COVERING � � nN �a.,,,i�ixa _ .;r��f� r �' /��.�.. L ' II FEE RECEIVED i �/�%%� FINANCE DEPT. ' CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY % � / /_J I� / — / � E — f� y�,< MESA. CALIFORNIA DATE ��- � �� CORRECTIONS SUBJECf TO E{�J:G. DEOT. REG ST�tE TMAT TNE IBOVE IS COFRECT ANO /�GREE TO COMP�Y WITN .�LL CITY OROIN�NCES �NO ST�TE L�WS REGULATING BUILDING CONSTRUC� iiorv. VALUATION SIGNATURE OF PERMITTEE ��. �� G D�✓NR _� / � / .;. � s .� 2 D � � �n Oh PERM�T FEE S �N � PLAN CMECK S ��0,(J.P TOTAL FEE 8 p2- �� `-°Nf