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Home My WebLink About442 18TH ST - Building PermitsI� � � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 442 E 18TH ST Suite: Vicinity: WINDOW CHANGE-OUT Parcel Number: 11733232 App�icant: ANDERSON, GARY Address: 164 E WILSON COSTA MESA, CA Owner: ANDERSON, GARY Address 164 E WILSON ' COSTA MESA, CA Con tra cto r: O W N E R-B U I L D E R Address �� Zip: Arch : Address: Zaninq: Phone: 949-6893858 Zip: 92627 - Phone: 949-6893858 Zip: 92627 Phone: License: 000000 Eng: Address: Status: ISSUED Applied: 03/31/2004 Issued: 03/31/2004 ISSUED BY: . Phane: Phone: Zip: , License: License: _ SCOPE OF PERMIT CHANGE-OUT OF 11 WINDOWS IN AN EXISTING SINGLE-STORY SFD (LIKE FOR LIKE). , NO OTHER WORK AUTHORIZED WITH THIS PERMIT. ' Plan Check: $0.00 Permit: $12525 SMIP Res: $0.60 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.85 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front � 0- 0 PARKING Existinq: o FEE SUMMARY Calc Valuation: Claim Valuation: PLANNING & ZONING Rear 0- 0� Left 0- 0 -" Right 0- 0 Rear 0. 0 Left 0- 0 -�� Right 0- 0 Re uired: .0 � . Proposed: • 0� � ss,000.00 ss,000.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 72-21-92) 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 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply wiih all applicable codes, and all required Inspections and final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � !d46d8 (8/00) WORKERS'COMPENSAnON DECLqpAnON: I hareby attirtn untler penalry of perjuty one ot the following daclarations: ❑ I have end will maintain e certificate of consent to selFlnsure tor warkers' compensation, as pmdded tor by sedion 3700 0l the Labor Code, for the pertormance of the wark for which ihis pertni� is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 oi Ihe Labor Code, for ihe peAortnance of Ihe work For which Ihis pertnit is Issued. My workers' compensatlon Insurance carrier and policy number ere: Certier: Policy Number: (TTis sec need no( be complefed il fM1e Oermit is veluetl af one hundred dollers (3/00) or less.) I certity thet in the padormence ot the work tor which this pertnit is Issued, I shall not employ any person in eny manner so as to become sub�ect to t�e workers' compensation laws of California, end egree that if I should become sub�ecl lo Ne workers' compensatlon provisions oi Section 3700 of Ihe Lebor Code, I shell forthwith comply with these pravisions. - Applicant Signatwe: Date: WARNING: FAILURE TO SECUFE WORK�RS' COMPENSATION COVERAGE IS UNLAW FUl M1D SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES lIP TO ONE HUNDRED T1KK15AND OOILFRE ($100,000). IN ADOITION TO THE CQST OF COMPENSATION, DAMACaES AS PROVIDED FOR IN SECiION 37080F THE LABOR CODE, IMEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I �ereby aHirtn that I am licensed untler provisions of Chapter 9(commencing with SeIXion 7000) of Division 3 of the Business antl Professions Code, enA my license Is in full lorce and eHecL Lic. N Class a Contracmts Signeture: Dete: CONSTRUC710N LENDING AGENCY: ❑ I hereby aflirtn ihat there is a consiruction lentling egency for the pertormance of the work For which ihis permil is issued. (Sac. 3097, Civil Code). Lender's Name: Lender's Adtlress: Signature: �ete: I hereby eHirtn that unCer pene Cotle: Any ciry or caunry,which to file a signetl statament ihai I Business and Professions Cod sub�' s the epplicent to e civll �=1, as owner of Ihe properl / 7044, Business and Profi himself or herseN or ihro� sold wi�hin one year ot c< ry ot per�ury thet I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor the lollowing reason (Sec. 7031.5, Business antl Professions repu{res e permit to consWct, altar, Improve. demolish, or repair any strucWre, pnor to ils issuance, elso requires the applicant for such pertnit e or she is licensed pursuant m the pmWsians ol the Contredors License Lew (C�apter 9(wmmendng wilh Sectim 7000) of DlNsion 3 of Ihe 3) or that he or she is exempt thereirom and the basis tor the alleged exemp�ion. Any Nolation of Section 7031.5 by any applicent for a pertnit �enalry of not more ihan five huntlred dollers ($500).): r, or rriy employees with wages as their sole comDenseHon, WILL DO THE WORK, antl Ihe structura is not intended or oHeratl for sale (Sec. ssions Corle: The Coniractors License Lew does not apply to an owner ot property who builds or improves ihereon, end who tloes such work ph liis or.her own employees, provided that such improvements are not Intendetl or oNeretl for sale. If, however, the building o� improvament is npletion. the owner-builder will have the burden of proving that he or she did no� build or improve for purpose of sale.). ❑��ner ot lhe properry. §m� E%CLUSI LV CONTRACTING WITH LICENSED GONTRACTORS lo con5�ruct the pro�aci (Sec. 7044, Business and Prolessions The contrecmrs lic➢fi " Law do not appry to en owner oi properry who bullds or improves thereon, and who conirects for such pmject with e contwctoqs) i se pursuant to Ihef76 Ctors ense Laws.). ifs IicenSB. by (type W Business end Professions Code for this reeson: Ves ❑ No Drivers License Na. i.e. - propeM tex bill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETy pERM1T CERTIFICATION: ❑ I hereby certify ihat no exwvation live (5) or more teet in depth into whlch e person is required to descend, will be made in connection with work euthorizad by ihls pertnit, and that no building siructure, sceHolding, talsework, or demolition or tlismantling thereot, will be more then thirty-six (38) teet high. (Chap. 32, Grp 2, Atl 2, Sec. 341, Title B, Californle Administrative Code). ❑ As owner-builder, I wlll not ereiDloy enyone to do work which would require e permit from the Divislon oi Industnal Safety, es noted above, unless such person has e pertnit to do such work irom the division. Signature: Date: Division ot Intlustrial Salery Permit Numbar: CODE t. INSPECTIONttPE 1616 Fi:ed System Final Fira Prevention 1266 Paol Spa Final 200 Final Re-Roof 201 Finel BIxWReleining Wall 202 Final Factory Fire Place 203 Finel Sign 20a Final Demolition QBjE II�9L¢ 4QD�F[ INSPECPONTYPE 206 Final Mechanical 208 Finel Plumbing 210 Flnal Electntal 272 Final Fire PrevenHon 220 Final Planning Approval 222 Final Site 250 Final Buiiding/Occupency �411�Ii111111S�j (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.c��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 442 E 18TH ST Suite: Viciniry: Parcel Number: 11733232 App�icant: ANDERSON, GARY Address: 164 E WILSON COSTA MESA, CA owner: ANDERSON, GARY Address 164 E WILSON COSTA MESA, CA ConVactor. Address: Zip: Arth : Address: Phone: Zoning: � Phone: 949-689-3858 Zip: 92627 Phone: 949-68&3858 � Zip: 92627 Phone: License: Eng: Address: SWtus: ISSUED Appfied: 07/10/2003 Issued: 07/10/2003 ISSUED BY: Phane: Zip: License: � License: SCOPE OF PERMIT CONSTRUCT TWO ATTACHED PATIO COVERS. FRONT PATIO COVER IS APPROX 83 S�. FT. REAR COVER IS APPROX 187 SQ. FT. BOTH COVERS PER CITY STANDARD. - � Plan Check: $72.31 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $184.06 SETBqCKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Ezistin : 0 Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Leh 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation Right 0• 0 Right 0- 0 $4,352.40 so.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related I regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION; This permit shall autometically expire and become void if work is not commenced within 1 BO days, or it work is suspended or abandoned for a period of 180 days. INSPECT�ONS: In order for the work authorized under this permit to be considerad legal, such work must comply with all applicable codes, end all required Inspectlona end finel approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CAIL: (714) 754-5626 � WORKERS'COMPENSATION DECLARATION: I hereby eHirm under penelry af perjury one ot the lollowing declarations: � ❑ I have end will maintaln e cBNlitetB ot wnsent lo sell-Insure for workers' compBnSBtlon, as provitlBO for 6y Section 3700 ot the Lebor Cotlo, tor �e pertortnance ol the work tor which Nis permit Is issuetl. � ' } ❑ I heve antl will meintain workers' campensetlon insurence, es requiretl by sectlon 3700 0l Ihe Lelwr Code, for the pertortnflnce ol the wurk lar whicn IhLs partnil Is issuetl. My workere' compensetion Insurence cerder end policy number are: Certier: Pollcy Numher. (This secNon need nof be completetlll Ne pertriltls luetl ( one hundred dWlers ($100) oi lessJ � 1 cenity Ihet in Ihe perfo nce oi Ne w� o whi this pertnit is issued, I shall not employ eny person In eny manner so es to become suCject to the workers' compensatlon laws ot C lomlp, enC e� at if shou d beco e sub�ect to t�e workers' campensetlon proNsions of Section 3700 ot the Labor Cade, I shall tonhwlth cornDN wiU these Provisi � / ^ ' � � � O � Appl(cenl Slgnature: -� i � � // � Date: � WARMNG: FNLURE TO SEIX1R{ W (E 5' EO PENSATIIXJ COV PAGE IS UNIAW Fl1L M!D SWLLL SUBIECf Ml EMPLOVER TO CRIMINAL PElYLLT1E5 AND CML FlNES UP TO ONE HUNDRED TKK1SlWD OOl1ARE �5100,00%, IN ADDfTpN TO THE COST OF WMPENSATION, DAMAGES /S PROVIDED WR IN SECfION 3N8OF THE LABOR CODE, INTEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DEC��ARATION: I hereby eNirtn that I em licensed untler provisions ol C�epter 9(commencing with Sectlan 7000) ot DiWsion 3 0l the Business and Protessians Code, and my license is In tull IOfcO en0 BflecL 11C. k Cless p Cont S Date: � CONSTRUCTION LENDING AGENCY: ' ❑ I hereby aKfm t�at Nere is e conswctlon lentling egency for the peAortnance of the work tor which Ihis pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: LendeYs AAdress: Slgnature: Date: OWNER-BUILDER DECLARATIONS: �. I hereby eNirtn thet untler penally 01 perjury Ihei I am EXEMPT FROM TME CONTRACTORS LICENSE LAW fOr Ihe lollowing reason (Sec. 7031.5, Bu5lness end Protes5ions Cotla: My dry w cwnry wNch �reqWrea e pertnit �o construct, alter, imprwe, Aemdish, or reDalr eny sWCNre, ptlor ta Ib issuance, elsa requires Ihe ap0licant for such pertnll m fila e slgnetl stetement thet he ar s�e is Ikensetl pursuent to lhe provisions ol ihe CoNrectors License Law (Chapter 9(cammendng wit� Sectlon 7000) of Division 3 ot Ihe Business end Pmfessions Code) or ihet he or she b eaempt theretrwn enA t�e besis tor Ne allepetl e:emptlon. My vidaGm of Sectim 7031.5 by eny applicant far e pertnit u6j Ne epplkant to e dvil penalry ol not more Ihen flve hundred ddlers (5500).): I, as owner oi ihe pmperty, or my employees wilh wages es their sole wmpensation, WILL DO 7HE WORK, antl Ne sirucNra Is not Intended or oMeratl for sele (Sec. 7044, Business and Pmtessians Code: The Contreciore License Lew does no� apPty to en owner at property who Duiids or improve9 Ihereon, end who does such work himselt or hersetl or ihrough �Is or her own employees, provitletl that such imprrnements ere not Intendetl or oflered for sele. II, however. Ue builtling or Impmvement Is soltl within one year of completion, ihe owner-builder wlll have the Curden ol proving ihat he or she did not �uild or improve lor purpose of salo.). � ❑ I. es owner of Iho prop y, am E%CLUSIVELY CONT CTING WITH LICENSEO CONTRACTORS to construct the project (Sec. 7044, Business end Professions Catle: Tha comrector �Llcensa Lew tloes n e ly t en awner ot property w�o bulltls or Imprwes thereon, end who coniracts lor such pro�act wlth e contrector(s) license pursuem to t e Co tractors Lico s. ❑ t em eaempt under ec. � usi ess entl Pmlessians Cotle lor t�is reason: SlgnaNre: � � � /. Date: � � �Owner ID verllied by tl e lice � s o - Drivers License No. Ezpires: Verilicatbn ot Ownership Dy (typ��p(Eocume , i.e. - properry taz bill or tleetl): DIVISION OF INDUSTRIAL SKFETY PERMR CERTIFICATION: ❑ I hereby cenify that no excavatlon five (5) or more feet In depth Into which e person is requlred to descend, will be made in connectlon with work authorized by this pertnit, and that no buildinp sirucNre, scaHolding, talsework, o� demollllon or dismantling Ihereol, will be more ihan ihirty-siz (38) teet high. (Chep. 32, Grp 2, Art 2, Sec. 3a1, Tltle 8, Celltomia Atlministrative Code). ❑ As owner-builder, I will not employ enyone to do work which woultl require e permit from (he Divlsion ol Indus�riel Sefery, as noted above, unless such person �es e pertnit to Co wch work fmm the diNsion. Signelure: Division ot Industnal Safery Permil Number: Date: Will ihe epplicent or present or tuWre 6uilding occupant need to tile entl certity e Business Plan for emergency response to releese or threatened releese of a hazerdous matedel7 ❑ Yes ❑ No (Section 25505 of Ihe Celitomia Health antl Sefery Cotle requlres, wilh some exceptions, that e Business Plen be tiletl with t�e Coste Mesa Fire Deparimen� by every business which has at any one time during e reported year e Quentity ot hazartlous matenals equal to or greater than e weighi of 500 pountls, or a volume o155 gallons, or 200 cubic teet of compressetl gas at stendard tempereNre antl pressure). _"—_...—._......___.�.........___ ........................................._..........__._...__�..._...""" ' ..._._................._................ Does or will Ihe applicant or present or fuNre building occupant need ta tile a registretion fortn tw acutely hazartlous materials7 ❑ Yes ❑ No (Section 25533 oi ihe Calitomia Heelth entl Safery Code, with soma exce ilons, requires repistretlan wlth Ne Costa Mesa Fire Depertment by each business w�ich el eny one tlme hes on hentl a quantiy of eately hazardous mereriels equePto or greater Ihan e weight ot 500 pounds, or e vdume oi 55 gellons, or 200 cubic teet ai compressetl gas at standard tempereWra entl D�essura). or present or prepare an �ection 25534 of ihe Calitomia Heelth end Sefety Code provides Ihat Ihe Costa Mesa Fira Depenment may require ihe preperation, certilication end filing with the Flre epertment ot an RMPP Gy buslnesses which are requlretl to register ecutely herartlous materfels wilh tha Fire Deparlman�. ......._ ................. ........ .......................................................................................................................................................................................................................... ........................ ................................................................... an RMPP is presently requireq has Section 25534 of Ihe Calitomla Heelth and Safery Cada been tully comD�ied with7 ❑�Yes ❑�No 5 �oes or will the epplicant or present or tuture bullding occupent requlre lor the work which I5 the aubject oi this a plicatlon a Pertnll tor suc from the South Coast Air �ualiry Manegemem Disidct or from eny other eir pollutlan control tlistdq or epencyt � Yes LJ No (Section 658502 of Ihe Calilomia Govemmen� Code requires that t�e requestetl infartnation be fumis�etl on epplicetions br non-residentiel �..-._.._.__...._._— ........................__.................................................._...................___"'_.....__.._....._-....� ..._...... ...._._............_ 6 Will any pan of Ihe tadliry to be constructed under Ihis pertnit be within 1000 teet frwn ihe outer boundades ot e schod? ❑ Ves ❑ P (It yes', ihe IaGliry must meet Ihe requlrement ol Sections 25534 end a2303 of the Califomie Health end Satery Cotle). e r omer ev pqmuon convw a�smct or egency entl SefeN Cotle Sedlon 42303 been matle7 or itlach cetliticete ol wmpllance fmm the appmpriate elr polWtion contrd aHicer�. �� :ATE OF COMPLIANCE: I certlty that under penalry of per�ury the inlortnation given ebove is correct. I agree to comply with ell stete laws end ciry ordinances Hezartlous Materials end Emissions. Slgneiure: CERTIFlCATE OF cortect. I egree to ebove-0eunbetl p Dete: ��E AND AUTHO tfA�ION OF RV: I ceAty under penalry oi perjury ihat I have read this epplicatlon enO state thet the intormetion glven is all sleta lews nd ry ortlina s relatinp to builtlinp consiruction, entl eut�wize reD�esentatives of t�e Ciry ot Coste Mesa lo enter upon Ihe �pection ur e I egree Plo axupy or allow occupancy of any builtlinq euthorized by �his t until nal inspection. ;�/ -1-%�'- (`� 7 �� Date CODE �. INSPEC710NTYVE V 1616 Fixetl Syslem Final Fire Preventlon 1266 Pool Spa Final 200 Final Re-Roof 201 Finel BIocWReteining Well 202 Finel Fenory Fire Place 203 Finel Sign 204 FinelOemdition PA7F IIQ�ALS ' �j INSPECTIONTYPE 206 Final Mechanicel 208 Finel Plumbing 210 Finel Eleciriwl 212 Final Fire Preventlon 220 Final Planning Approval 222 Finel Sita 250 FinfllBuilding/Occupancy Qa�f. �$ p14) 7543273 • Fex (714) 754-4856 • www.cl.costa-mesa.C2.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Atldress: 442 E 18TH ST Suite: Vicinity: ROOF Parcel Number: 11733232 Applicant: ANDERSON, GARY Atldress: 164 E WILSON �. ; � "- COSTA MESA; CA � t�., / \ Owner: ANDERSON,�GAP.'Y Address. �,164 E WILSON � . " - , � ;, COSTA MESA; CA - - Contracror: OWNER-BUILDER Address: Zip: Zoning: "Fhone: 949-689-3858 Status: ISSUED Appl ied: O6/24/2003 Issued: O6/24/2003 2ip: 92627 , . - � � �� Phone: 94&6893858 - � � ��, `. Zip: 92627 � i�� -� �� ._ � � � �. � �. A Phone: �..,License: 000000 Arcb : ' . �, Eng: ' - � . Address: � " � � � Address: � � ' Phone: - � � , , � Phone: - Zip: " � License: �� ,�License: ,� ,- SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 30 YEAR COMPOSITION SHINGLES, 30#�FELT, AND REPLACE SHEATHING AS NEEDED. 1,300 S.F. FOR S.F.D. AND 700 S.F. FOR DETACHEO GARAGE. WORK WfLL BE DONE CONCURRENTLY. � Plan Check: $0.00 Permit: $9725 `. SMIP Res: . $0.50 SMIP Com: ' $0.00 Other.. $0.00 � Inspection:' �'. $0.00 � Total: $97:75�� . ; � � .. FEE SUMMARY,= ' � Calc Valuation: � � � � -- Claim Valuation � . �" ',. SETBACKS�. � MAIN STRUCTURE Fiont � 0. 0 '� Rear - 0. 0 � ACCESSORY Front ,0.0 Rear 0-0 PARKING Existln : 0� Reouired: � 0 PLANNING & ZONING Left 0- 0� Right �� 0- 0 , Lefl 0- 0 Righl 0. 0, � Proposed: 0 . ". �, sa,000 00 sa,000.00'•., NOTICE: The work authorized by this permit shall comply with all applicable handirap access requirements under Calitomia statutes and related �e9ulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: Thls permit shall automatically expire and become void Ii work is not commenced withln 180 days, or ii work is suspended or abandoned lor a period of 1B0 days. � , INSPECTIONS; In order for the work euthorized unde� this permit to be considered legal, such work must comply with all epplicable codes, end all required inapaetione end final epproval must be obteined. Failure to obtain Inspectlons and tlnal approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 '-a5aae Iaroo) WORKERS'COMPENSAnON DECLARATON: I hereby effvm under penalry ol perjury one ot t�e following Ceclaretions: ❑ I heve antl will maintein e certilicate ot wnsent to self-Insure lor workers' compensation, es provideG tor by sectlon 3700 of Ihe Labor Code, tor the peAortnance of Ihe work for whlch this pertnit is issuetl. ❑ 1 heve entl wlll meintain wwkers' compen5aiion insutance, es reQuired by secUm 3700 of Ne labor Code, for Ihe peAortnarxe ot the wark tw which this pertnit I5 Issuetl. My workers' compensetlon Insurance carrier entl poliq numbor ere: Cerder. Policy Number. (Thls sec(ion need nof be comp/ered il the pemUtls velued af one hundred dallars (E 100) or IessJ �1 certity �hat in tha perfor e ot the wark lor which this pertnit Is issued, I shell not employ eny person in eny manner so es to become subject to ihe workera' compensetlon laws of ie, and agree t�et Ii I should become sub�ect to Ihe workers' compenseUon provlsions yyyi Sectlon 3700 ot the lebor Code, I shall tort�with comply with these pro i+ � � � � / � � Appllcenl Signeture: Date: -��6 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEMGE IS UNLAW FUL AND SHALL SU&IECT rW EMPIOYER TO CRIMINPL PENALTIES AN� CML FlNES UP TO ONE NUNDRED TFKKISAND OOLLFHE (5100.0OO�.IN ADDfTION TO THE COST OF COAIPENSATION, OAALIGES AS PROVIDED WR IN SECTION 31080F iHE IABOR Q�OE, INTEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eNirm Ihat I em Ilcensed untler provisions ot Chapter 9(commendnp with Sectbn 7000) of Dhnsion 3 0l the Buslness end Pmlessions CoOe, entl my Iltsnse Ls In tull torce an0 ettect. tic. a Class M Contractofs SlgneWre: Deto: CONSTRUCTION LENDING AGENCY: ❑ I hereby eMirm thet Ihere Is e construction lendinp egenq for Ihe pedormance of the work tor whic� this permit Is issued. (Sec. 3097. Civil Cotle). Lender's Name: Lentlefs Atldress: Signeture: Date: OWNER-BUILDER DECLARATONS: I hereDy eHirtn thet untler penalcy of perjury ihat I em E%EMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, 8uslness enC Protesslons Cotle: My riry or counry whic� requires e permil to cronstrucl, elter, Improve, demdis�, or repair any slruCWre, pdor lo Its issuance, elso requires the eppliceN for sucl� pertnil to tile e signetl statement Ihet he or she Is Ilcensed W rsuent m the provisions ol Ne Contrectore IJcense Lew (Chepcer 8(cammenGnp with Sectlon 7000) ol Dlvislon 3 0l Ne Businoss entl Prolessions CoOe) or Nat he or she is exempt therefrom end t�e 6asis lor Ihe elleged exemptlon. Any vidation of Section 7031.5 by eny applicent for e permit sub�ects Ihe ep0�lcant to e dvll penelry af not more then iNe hundred dWlers (5500) J: � I, es owner of tha property, or my employees with wages as iheir sole wmpensatlon, WILL DO THE WORK, end Ihe structure is not intanded or ottere0 for sale (Sec. 7044, Business and Professions Code: The Contreqore LJcense Lew does not appty to an owner of property who bullds or Improves ihereon, antl who does such work hlmselt or hersetl ar thwugh his or her own employees, pmvided that such imprwemenu ere nol Intended or oHered tor sele. tl, however, the building ar Impmvemant is sdtl within one yeer of completian, Ihe ownerbuiltlor wlll have�ihe Ourden ol provinp Uat he or sho did not builtl or impmve far purpose of saleJ. ' ❑ I, as owner at h property, em E%CLUSIVELY CONTRACTING WITH LILENSED CONTRACTORS to construct the projecl (Sec. 7044, Business end Pratessians Code: The t ctors LJcense Law tloes nat appty lo en ownar of properry who builds or Improves Ihereon, en0 w�o wNrecls br such pro�ect wlth e cnntractor(s) license purs o the Gontr 7s Ucense Laws.). [ail flm ex , c. Business enA Professions Code for �his reason: Signature: Date: '� – - Owner ID verllletl Oy tlrlvef911tense. Yes ❑ No DrivBYs License No. Evpir09: — Vedflcatlon ol Ownershlp by (type ol Ox e, i.e. - property tex blll or daotl): OIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATION: ❑ I �ereDy certity t�et no ezcavetlon INe (5) or more leet in depth into which e person is requlred to descend, will be mede In connectlon with work eut�arizetl Dy this permit, enC t�et no builtling structure, scattoltlinp, talsework, or tlemWitlon or dismantling thereol, wlll be more than thirty-six (36) teet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Celifomla Atlministrative Cotle). ❑ As owner-builAer, I will not emplay enyone m tlo work whic� woultl require a pertnit iram the Division oi Intlustrial Salery, as notetl abova, unless suU person �as e pertnit to tlo such work trom the tlivision. Signature: Daie: Division of Industrial Safery Partnit Number: COOE 1. INSPECTIONTYPE t6t6 FIxeC System Final Fire Prevention 1288 200 201 202 203 Pool Spe Flnel Flnel Re-Rooi Flnei BIocWRetaining Well Finel Fadory Fire Plate Final Sign 2(M Finel Demdltion �g � ./I .�m �� CODE 1 INSPECTION TYVE 206 Final Mechanical 20B Final Plumbinp 210 Finel Electdcal 212 Final Fire Prevontlon 220 222 250 Finel Planning Apprwal Flnal Site Final Building�Occupanty PAg It�ELi (714) 754•5273 • Fax (714) 754-4856 • www.cl.costa-mese.S�fl,4�LDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 tSU ,lob Address: 442 E 18TH ST Suite: Vicinity: RESIDENCE ONLY Parce� Number: 11733232 nppiicant: ANDERSON, GARY Address: 164 E WILSON ST COSTA MESA, CA Owner: MORCK, DIANE Address 442 E 18TH ST COSTA MESA, CA Contractor: OWN ER-BU I LDE R Address: Zip: Arch : Address: Phone: Zoning: ISSUED BY: Phone: 949-642-7369 - Zip: 92627 Status: ISSUED Applied: 07/12/2001 Issued: 07/12/2001 Phone: � � �/�hJ(bfi� Zip: 92627 �� /��• \� OA� � Phone: License: 0 Eng: Address: � , Phone: Zip: License: , � License: � � SCOPE OF PERMIT :. , ,� REROOF RESIDENCE ONLY: 3RD LAYER OF COMP SHINGLES (CLASS C OR BEITER) OVER 2 EXISTING. � , 1000 SQ FT - � " Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection:" Total: $0.00 $83.25 $0.50 $0.00 $0.00 $0.00 �; � " _ __ FEE SUMMARY, �,� . � � � � � � � � � , _' - Calc Valuation: � � � 53,000.00 „� � Claim Valuation: � ,53,000.00 ' '_ - ,, , .. �i.; � � . :: . � v�- j i ,', �,:, ,,-- �..s, , , 75` !- �-. �. . . . . ' . � .. ,_�c�:i.;'� �-i//ii . ` \�\�C. � , .�. � ' ,�, . 'v _�!.%�/ �i . ` ' � �'�/ �i� ` � �_� \ \ � - PLAk SETBACKS � � � /� / " , � � ��`� �� MAIN STRUCTURE -Front 0- 0� �� i�'Rear 0- 0 �� ACCESSORY Front� �0.0��, �- ' Rear 0-0 PARKWG Existin : 0`- Reauired: 0 ING'& ZONING�% � �� '�/ � r ;� . �an ao�� Rgn� ,^-o-o ."� ' -�, �'� VA; i� � . �LeB � 0.0--;' � �� Right ,.,0.�0 Pr000sed:� 0 _ ' �'�� i�<� � , NOTES: _ � ,. . � � - � i, �i NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access requlrements under Califomia statutes and related '� regulations. (OM. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2aaede la'oo) WORKEPS'COMPENSATONDECLARATION: I hereby aKrm under penelty of per�ury one of the fdlowing dedaretions: ❑ I heve and will meinleln e certlllcate ot wnsent to selt-Insure for workers' compensaqon, as provided for by section 3700 0l the Lebor Coae, lor Ihe pertortnence oi Ihe work for whic� NIs pertn�� L5 �ssuetl. ❑ I heve eM wlll melnta�n workers' compensatlon Insurflnce, as requlreA Dy secUon 3700 of ITe LeOor CoOe. Iw the peAormance ot the work Iw whkh this pertnll Ls IssueC. My workers' compe�setion Insurence cerrler entl policy number are: Certier. PWiCy Number _ (Thls secflon neetl no( be �p�etetl/l Me permit !s veluetl e! one hundred dollers (5100) or Iess.J ❑ I certiTy ihet in tha peAormence ol the work ior which this permll is issuaQ I ehell not omploy eny peraon in eny mannor ao es to become subjeci lo Ihe workers' compensatlon laws of Celllomle, entl egree thet If I should become aub�ect to Iha workers' compensetlan proNsions of Sectlon 3700 of the Lebor Catle, I ahall forthwith compy with ihese plovisions. Applicant Sipnamre: Date: WMMNO: FARURE TO SEW� W�E0.5' OOAIPENSAiION ODVERAOE I$ UNLAWFUL AND SHALL SUBJEGT Ml EMPLOVER TO CRIMINAL PEWLLTIES AND CML FlNES UP TO ONE HUNDRED TFIOU..RND OOLLARE (5100,0�). IN ADDITION TO THE ODST OF COMPENSATION, DMMGES AS PROVIDED FOR W SECTION 37080F THE IABOR OODE, IMEREST, AND ATTORNEY'S FEES. IICENSED COHTRACTtlRS DECLARATION: I hereby eKrm that I am liCensed under provisions of Chapter 9(commendng wit� Section 7000) ot Dlvision 3 of the Bu5lness anC Protesslons Code, antl my license is In tull force end eHect. LJc. a qas5 p Contractors Signeture: Date: CONS7RUCTION LENDING AGENCY: ❑ I hareby aHirtn t�et there is e construction lentling agency tor the peAormance ol the work for w�ich this permit is issuad. (Sec. 3097, Civil Code). Lentlers Name: Lender's Address: Signature: Da�e: OWNER-BUILDER DECLNiATIONS: 1 hereby affirtn that under Peflalry Of�pel�ury thaf I em EXEMM FROM THE COMRAC7oRs LICENSE LAw Ior ihe tdlowing rbeson (Sec. 7031.5, Business antl Professlons Code: nny dry or eounry whicn requires,e�pertnit to construc6 elter, Improva, tlemolish, or repair any sirucWre, pdar to Its Issuance, elso requires the applicant for such pertnit to file e signed sietement �hat he a she.i4�.IlteriseE pu,rsuant to Ihe proNslons af Ihe Contrectors License Lew (Ghflpter 9(commendng wiN Seclion 7000) ot DMsion 3 W the Businass and Pmfessions Code) a that he-oushe Is aiceiop� )hereirom and the besLs lor �he alleged exempGon. Any Wolellon o1 Section 7037.5 by any epplicant tor e pertnit sub' Ihe epplkant to a�� penalry ot not more ihen five hundred dollars (E500).): ti:�eV I, as owner of Ne property. or my employees with wages es their sde compensetion, WILL DO THE WORK, entl the structure Is no� intentled or oHeretl for sale (Sec. 7044, Busine55 end Professions Code: The Coniractars Llcense Lew does not appy to en ownor of properry who builds or Improve5 t�eraon, end who tloes such work himself or herseli or through his or her own employeee,�provided that such imprwements ere not imended or oHered tor sele. H, hov.•ever, the builAing or improvement Is sold wilhin ane yeer ol completion, the awnar-builder will heve the burden ol proNng ihat �e or she did not build or Improve lar purpose ot sale.). ❑ 1, as owner ol th¢�propeM• am EXCLU IVEW CONTRACTNG WITH LICENSED CONTRACTORS ro canstruct the prqect (Sec. 704a, Business antl Pmfeulons Cotle: The conifecto�s Llcense lew e� npS epply to en ownei of propeny who bulltls or Improves ihereon, antl who wnirects tor such project wlth a contractor(s) license oursuafV to Ne Comrector p6n$4 Laws.). ❑ I am exemp� G Signature: Owner IO ved 0 by Edvi Verttiwtion of Ownarship DIVISION OF �Business end Professions Coda for this reeson: _ �, oeie: � � G ❑ No DriveYs License No. Ezpires: al dacument, i.e. - property tax bill or Ceetl): SAFETY PERMR CERTIFICATION: ❑ I hereby ceNfy Ihat ho excavatlon five (5) or more feet in depth into which e person is required lo tlescenQ will be made In connection with work euthorized by this pertnit, erW that no builtling sirudura, scafloltling, felsewo�k, or demditlon or tlismantling thereof, wlll ba more than tNrry-six (38) feet high. (Chap. 32, Grp 2, Ari 2, Sec. 341, Tltle B, Callfomia AtlminlSiretNe Code). ❑ As owner-builder, I w��l not employ enyone to tlo work w�lch would require e permit Irom the Divislon ol InduslAel Safety, es notetl above, unless such person hes e pertnit to do 5uch wo� �rom ihe division. Signetura: Date: Division ol Intlustrlal Satery Pertnit Numbar: CERT1flCA7E OF COMPL1NdCE AND AU7HORIZATION OF ENTRY: I cenity untler penalty of perjury thal I heve rea0 lhis epplicatlon and state thet the informatlon givon Is conect. I agree to compry wlth all stete laws enC ciry ordinances releting lo huilding construction, end authorize representetives of l�e Ciry of Coste Mesa to enter upon the ebove-describ� properry for Inspec�n purposes. I egree not to occupy or allow occuDency ol eny 6uiltling euthorized 6y ihis pertnit un�il linel inspection. woe �. 1616 Fixetl ystem Final Fire Prevention t266 Pool Spe Final 200 Final Re-Root 201 FInaI8locWRetaining Well 202 203 Flnal Factory Fire Plece Final Sign 204 Final Demolition Pd� Itf�AlB —/z��G� �,a COUE I INSPECIION iYPE 206 Final Mechaniwl 20B Fine{ Plumb{� 270 Final ElecMcal 272 Final Fire Preventlon 220 Flnel Planning Approvel 222 Final Site 250 Final Building/Occupenry Q� �� Costa Mesa Building Department �y APPI.ICATION FOR PERMIT ,yJ 111 EAST 20th STREET (�S B U I L D i N G ' � COSTA MESA, CALIFORNIA FOR OFF`ICE USE ONLY FOR APPLICANT TO F1LL IN Reeelpt No. Permlt No. Jlding I Q� r/� .� /� Idress - o� d !i Costa Mesa, California Rece�ved by oate Rec'd. Date Issued I. //-9 :arest (Y �/I /�y�� oss St , li /' l � l' �°- Building Addross ' Hner , Costa Mesa, L'e�l'If017118� ail ` Idrc Nearest fi � Tel. Cross St. ty /��A/„ � �,�/1� - No. Zone � I No. of I Tvo . Gmup.-� Addresv I:L•]I i.r•a Address 'i�S��C�! �I N•Q� DescrBiption I No. �� y I Block I Traet (Attach Metes and Bounds) No. of Bldga Size of Lo � Now on Lot Useof /1 � � No.ot / I No. Existing Bldg./.,��/� l,�n Famille� Roo SetbackLineirom i... / � RearYard Addition Rooms Date CORRECTIONS ring.. • � CoveNn APPj�vAj.�` � of 9°��-4�f��K S.t' llL� P Buildin Foundation Loeatlon Ins ecto Forms, Materials, . Under-Pinning I hereby acknowledge that I have read this Application "`��' ��`' and state that the above is correct and agree to rnmply Lath. Ext. with all Ci[y Ordinances and State Laws regulating building rnnstrucdon. Signature of Plaster, 1 nt. Permittee � Plaster, Ext. AuthoNzed A Masonry ReinToroed Valuation �/ Permit Fee $ Q�„�- $ �y - Plan Check $ * Bond Beam (> `� Total Fee $ � � -FINAL F�AM 204 �-H 2M 9-36 e• -� PLOT PLAN � 3how locat�on and distancea irom � r„ . �•� .. . 1 property Ilne enB'b'ehveen'bulldings.' �” _ _ _ ' ' ' ..n � - !' 1 � o i ,� . „� 1 ( 1 • -1 ` . . . 1 ,S\ , 1,\ . .�,\ . . ; ' . w • ` . �1 • a . ; . (. �: = _ . ` .. . • �. . - ' ' _-_ .. . . ';�: — : . , _ . . ' r'^�' ' .� . .. . i.. 't '1-' • i . . . � . . � . �. � i� . . '' _—t«:" _' ' _ ' .' "' ' , "_ ' '_ "_ _ __'_ ' ' "" ' "\ ��' _ . os a esa g Department � 111 EAST 20lh 8TREET . C08TA MESA� CALIFORNIA ' FOR APPLICANT TO FILL IN e��d��g �/!/� �' /STT/f - S7�' Address Cross Costa Mesa., � or [H:23i•Y71 PPLICATION FOR PERMIT BUILDiNG � FOR OFFICE USE ONLY 11by Date Rec'd. Date Issued g-�-ss � /e-= ' y�-�- �8 Costa Mesa, California Lis /� �(J �, Plans Date (Atfach Metes and SizeofLoi /'�% . i'. from New of Rear No. of 6WIO1 , rf0.0{ Siza �i�C Rooms Stories F--•erior Wall Root r�ng I Cover�ng I'f d/�r'/ APPROVALS �_� of� ' Buflding �. ��' �� / Foundation Location Inspecto Forms, Materials, Under-Pinning � Frame: Fire Stops, Bracing, Bolis I hereby acknowledge that I have read this Application n and state that the abme is rnrrect and agree to comply Lath. I nt � with all City '� nces and ate Laws re ating •., building const c' /./A Lath. Ext o'Iu�i Signatureof ✓ / �' i� Permittee l/ Plaster, Int r . 'i rn Authorized Agt. - Plaster, Ext FR ri Valuation o Permit Fee $ 1� Masonry Relnforoed ,. K� /� ��- Plan Check $ � Bond Beam ��` $ Total rp N Fee �'�r' FINAL '.n � FOAM 204 S-BP 2M 8-55 Date D r