HomeMy WebLinkAbout885 17TH ST - Building Permits' ct�sT i7�t1 s�em 885
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�nu� isa-azi� • rax �na7 75a-ad56 • www.ci.costa-mesa.cBaUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 885 W 17TH ST
Suite:
Vicinity: FLAT PORTION OF ROOF
Parcel Number: 42410103
Applicant
Address:
Owner.
Address
Contrador.
Address:
Zip:
Arch :
Address:
Zip:
Zoning:
JONES, CHARUE _ _ _ issueo sv:
1222 MAGNOLIA AVE #705-219� �, ; �i' = ' � � _ - ,
/ j% , - • Phone: (909) 739 7663' � _ �
CORONA CA;, �� -;; � Zip: 92881 � ,�� �
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CREAGER �DODDS JANICE _ . . - � � / i ���\��
,1400 MIRP,MAR DR - _ - � i � � � ` �
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-FULCERTON. CA _ Zip: 92831 � " �.'�-- �� ' �' � A
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`THE ROOF STORE ,
7222 MAGNOLIA AVE #105-219 ��
� ; - � � Phone: ; (909) 73&7663 �-�3
CORONA;�CA . . �A'S��
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92887�"� ' License: - 760394 . - ' � .
Status: ISSUED
Applied: 12/17/2001
Issued: 12/17/2001
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' , Phone:
.� \ --Llcense:
- " - \Eng:
� . - Add?essi'„ �
,' ,.. ..-,.,_- �„ SCOPE OF PE
� � REROOF FLAT PORTION OF EXISTING SINGLE FAMILY RESIDENCE
TORCHDOWN ROOF. � � � � �
Plan Check: $0.00
Permit: $54.00
� SMIP Res: � $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: - $0.00
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\ TotaL• � = $5� �
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SETBACKS �
MAIN STRUCTURE Front
ACCESSORY Front
PARKING Existinq:
NOTES:
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2-0FF EXISTING ROOF& INSTALL '
� - , � � FEE.SUMMARY- ;%", -^.,. „ � ! � ,� ; � �
� - - ' — " � � = �� ' �= Calc Valuation: j ' �� si,soo.00��
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" ' � ' ' �� � „�" �" � Claim Valuation: �- � ' � $�,soo.00
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0-0 � , Rear �0-0 � - �Left 40 �_ Right ���0-0�� �� "%
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1247-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendetl or abandoned
for a period of 180 days.
INSPEC710NS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all
required Inspectlona end final epproval must be obteined. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2NW8(e'W)
WORKERS'COMPENSAnON DECLARATON:
I hereby aKrm under penalry ot perjury one ot t�e lallowing tleclarations:
❑ 1 have end wlll malntaln e cenificate ol consent lo aell-Insure tor workers' wmpensatlon, es D�ovided tor by section 3700 0l ihe Lebor Code, for I�e pertormence oi ihe
�°'ork for wMch this permit is Issued.
,0' 1 have arW will malntaln workers' compensation Insurence, es reQulretl by sectlon 3700 al the Lebor Code, tor Ne peRortnence of the work lor which Ihi9 p6rtnit Is luued.
My workers' compensatlon Insurenc(�e carAer entl policy number ere: �^ - O�ll ���
CeMer. - �N P% 1�) Poliq Number: % �N
(lhls sed/on neetl nol be own e�e !! the pe'm/f Js ve/ued nt one hundretl Collers ($100) w less.)
❑ I certity tha� In the pertortnence of t�e work for whic� this pertnit is IssueO, I shall nat employ any person in any manner so es to Eecome sub�ect to tha workers'
compensatlon laws ol Calilomla, antl agree Ihet It I s�ould become suDlect to Iha workers' compensatlon pmvi5ion5 ot Sectlon 3700 at the Lebor Cotle, I shall torthwith
compy witn these vrovis � 1 � / � " / / " O /
Ap�liceN�SigneNre:" � ^ . Date:
�____.�
WAqNING: FAILURE TO SEWRE WORKERS' CAMPENSATION COVERA�E IS UNLAW FUL AND SNALL SUBJECT AN EMPLOYFA TO CNAUNAL PENALTIES AND CML FlNES UP TO ONE HUNDRED
THOUSAND DOLURE (5100,000), IN A�DRION TOTHE COST OF COMPENSATION, �AMAOES AS PflOVIDED WR IN SECTION 37080F THE UBOR CODE, INfEREST, AND FTfORNE1"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eftirtn Net I em Iicensedy nder grovislo af Chepter B(commencing with Secilon 7000) of Division 3 0l Ihe Business anQ P tessio �pd e, end my license Is In full
rorce ena enec�. uo. x `7 (/�b Yi�l G� aess n L�°I ET1Ci
Contractofs SignaWre: � Date:-- � �,T_/ "n �
1 �_ p �
CONSTRUCTON LENDING AGENCY:
❑ 1 �ereby aflirtn Ihat there is a construction lentling egency tor Ihe peAormance of the work for whicl� this permit is iuued. (Sec. 3097, Civil Code).
Lenders Name: . Lendars Addreu:
Signature: � Date:
OWNEfl-BUILDER DECLARATONS:
I hereby attirtn ihat unCer penalry of perjury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe Idlowing reason (Sec. 70.31.5, Business entl Professions
Code: My ciry or counry which requires e pertnit to construct, el�er, improve, Aemolish, or repair eny structure, prior to its iuuance, also requires t�e epplicant tor such partnit
to file e signed statemen� tha� he or she is IlcenseA pursuant to ihe provisions o1 the Contrectars License Lew (Chapter 9(commendng wi�h Sectbn 7000) 01 Dlvision 3 ot the
Business and Professions Code) or thai he or she Is exempt therefrom end the Desis for the elleged eaemption. Any Woletion of Section 7037.5 by eny eppliwnt for a Dertnit
sub�ects �he appllcant to e clvil penalry af not more lhen five hundred dollers ($500)J:
❑ I, es owner of Ihe properry, or my employees with weges es thelr sole compensatlon, WILL DO THE WORK, and the sWdure Is not IntenGeG or oflered for sele (Sec.
7044, Bu5in85s and Prolessions Cotle: The Contrac�ors License Lew does not apply to en awner of property who builds or Improves Ihereon, entl who does such work
himseM or hersetl ar Ihrough his or her own employaes, provided ihet such Improvemen�s are not in�ended or oHered for ule. If, however, the bullding or improvement Is
� soltl within one year ol wmpletion, the awner�builder will have Ihe burden ot proving that he or she did not build or improve tor purposa of sale.).
❑ I, as owner ol the prapany, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 704a, Business and Prateuions
Cotle: The comreciors License Lew does not apply to an owner ol propetly w�o builtls or Improves t�ereon, entl who contrects br such pro�ea with e contrector(s)
license pureuant to t�o Contrectors License Lews.).
❑ I am exempt under sec. Business antl Prolesslons Cotle tor Ws reason:
SignaNre: Date:
Owner ID venfied by drivefs Iicense. ❑ Ves ❑ No Drivers LJcense No.
Vedflcetion oi Ownership by (rype of dwumem, I.e. - pmperty tex �ill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N:
❑ I hereby certlly thet no excaveUon 1Ne (5) or more leet in dept� into wNch e person is required to descend, wlll be mede In connectlon with work euthorized Gy Ihis
pertnit, antl that no builtling structure, scaMolding, falsawork, or demolitlon or Aismantling t�ereot, will be more than thirty-six (38) feet high. (Chap. 3.2, Grp 2, Ar12, Sec.
347, 71Le 8, Califomle Atlministretive CoOe).
❑ A5 owner-Duiltler, I will not employ enyone to tlo work whlch would requlre e partnit tram Ne Divisian ol InAustnal SafeN. as noteA eDove, unless such person hes e
pertnit to do such wark Irom Ihe division.
Signature: Date:
Division ol Industnel Safary Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUfHORIZA710N OF ENTAV: I cehify under penalry ot perjury that I hava read this applicetion enE atate thet the infortnetlon plven is
correct I agree to compty wlth ell stete lews entl city ordinences relating to bulltling construc0on, and authodze representelives ot Ihe City ot Costa Mese to enter upon Ihe
ebove-descnbetl D�operry tor inspection purpases. I agree not �o occupy or allow occupenty of eny 6uilding authodzed by this pertnii until finel inspaction.
COUE I. INSPECTIONTYPE
1676 Fixetl System Finel Fire Prevention
1266
200
201
202
203
204
Paol Spa Finel
Final RaRoo1
Flnal BIocWRetaining Well
Final Feaory Fira Place
Final Sign
Final DemoliGon .
�. 1 .1111.
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COOE� INSVECTIONTYPE
206 Final Mechanlcal
208 Finel Plumbing
210 Finel Electdcal
212 Final Fire Preventlon
220 Final Planninp Approval
222 Final Si�e
250 FinelBuilding�Occupancy
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'V COUNTY OF ORMGE
BUILDING DEPT.
, 636 No. Bmadway
Sanw Ana, CaG(omia
Phone: KI 2.6211
1. OWNER'S N
MAILING
-3a
Ciry /_/�L�.��'7n--M.J
State
Lic. No.----....---- .............---'------
PROPOSED
z. JOB
Application for Building Permit
. AND FOR A
Certificate of Use and Occupancy
�
c-�
Permit No.�-Y..-3b...�...
�
Dat - .'.,...,/...--��I...L.....�./.._----
V
- ---- �--�-�--- PHON �-Q:�f!?t�.9�.�..d-.�I W
......... CITY..C�e�-�-._.
Name ...._....��.�C!vI�`.'f.'...�.'.'._�...------..
(Contracror)
Address.._..---`---.....-------'--------'---------
City---`----------------'..
State
��
Lic. No..._.....-------....
Phone---"--'-----.......--'...-------'
House No.) / (Name ot S/vee[ / Town or School Districc
3. LEGAL DESCRIPTION: Lot-�,�_.SJ.Q..�.�-1...��8 ock lL.L4---�_9Q..�.......---- Tract -�'_-'_--_'_ -e�
(Metes and Bounds Description—Use reverse side of form) � S Gv ¢
4. CORNER LOT ( j INTERIOR LOT (� ) THROUGH LOT ( ) SLOPE OF LOT ( )
i. SIZE OF BLDG.��,GI../.f._.�.__._AREA:�.%.I....__.1...SIZEOFLOT:�O%.S .�....a......AREA:_..�...T..D...O-.-..--.-
� � i� -
C,. HEIGHT OF BLDG. � ..................... CEILING HEIGHT: �. ... NO. OF STORIES......_1..._.___.......__.
�- - - �� �--��-
9. NO. FAMILIES .................J.................._Sizc of Smallat Eedroom:�iS.,�.l...;l............._. Si:e of Ki[chen.a. ....L..y`...l.........
A. EXTERIOR WALL CONSTRUCtION:_�P<'Z�!�-`-w3.------------INTERIOR WALL COVERINGf�i.--�y.�...��..�...�...�_
(Frame, Stuccq Etc.) �� (�laster,Drywall, Etc.)
9. SETBACKS: Front Yazd From Center Line of Street_..�------ -------------��..._--.......-_------.-----_-_.........a.. '
--:-... . .
/ p� � �j � f s�� -�
Nearest Side Yardc�..___�?......__Rcar Yazd. ` . ... .............Distance in Fect Between Bldgs. on Same Lot......_........_ ....... �..._.
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. ��q�
. '` /f' � // /J�
11. Aaesso �a) Foocing: Width...----�f�----------------------Depth iny round-.- ------......-----.......Width of Wall.----_..._sl'-.'.-_--.
ry /� �'�/
Bldgs. and �b) Si:e of Studs,�/�...... ,! �
Similar '' - �----..Spacing ... .... ...............:'CC Material of Floo ......-----......--_---...._�"�.`�
Structures: �
(c) Size of Floor Joists: � �----- i� = -.... .... --.....Spacing. - -..... ---------- ----...."CC
(d) Size of Rafrers:��.�l.v--r�--.f.7t.�1---!�..-.---Spacing �_,�...o..._�/.._�. :....:'CC
12. VALUATION OF P O OSEnD WaORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $-----�--�'�-.�-fi-''�'--..........
13. I HERESY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF C�1LIF�NIA APPLICABLE '£HERETO.
Plans Filed:.. -�.�-� -_�.� ..........- ......._....
By:.
$Idg. Permit
Plan Check
Total • •
Receipt No.
Paid to -
bate .._......_
DA'
5M-2.l1
(Authorized Agcnt)
FOR DEPARTMENTAL USE ONLY
FEES: �C.{HECKING BY
�.�� ;.p � GROUP....,Z .. APPLICATIOIQ.f...�l�L_U HEALTH..._--_--.----_....._---
... ..... -
-
---
$ � '-Q--O--.....---- TYPE ...... - - � - - ....: ZONING -_- ....�- FIRE
$.�..�Ltc_Q.S�--....... llIST. p // PLANS AND -- MARSHAL ............ ........ -
--.%...D.�F../._......... SPEC'S- - ---------�--- STATE... -�----�-------� ��---
MAP_....._..il. .... ..... 7 .-.-.- ✓
__�i�LC�_..__.... SHEET NO..S ................... CORIZECTIONS ENGINEER
VFRTFTFn '�� C:P
PERMIT 1�5Uyap �NOHUE COUNTY BU�IR'�+'G
� INSP::CTOR
s.'.z -�.' ��-��- ..-. ... - .............�...��... �� �- -� - ....
" u`cF'UTY
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