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Home My WebLink About968 17TH ST - Building PermitsW. 1'(th St. g68 k363y- 3-�-78 '47� -io-19-78 3iec. iv.C. Outlets add :iec. I[C (Out>e's) ff f (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�.��LDING PERMIT �� FAIR ORIVE, COSTA MESA, CA 92626 Job Address: 968 W 17TH $T Suite: Viciniry: Parcel Numbec 42437109 npplicant: LIEBHERR, THOMAS Address'. Owner. SACCIDO, DAVID L Address .954 W 17SH COSTA MESA, CA Contractor: PRIMO ROOFING Address: 77066 PALMDALE ST HUNINGTON BEACH, CA Zip: 94627 � . Arch : Address: Zip: Phone: License: Zoning: Phone: 714•841-0456 Zip: Phone: Zip: 92627 Phone:" (714)841-4456 License: 331120 Eng: Address: SCOPE OF . PARTIAL RE-ROOF OF SFD. (NO WORK ON ATTACHED GAR,qGE) CLASS A SHINGLES OVER 15# FELT. Plan Check: $�.00 - Permit: $66.20 SMIP Res: $0.50 SMIP Com: . $0.00 Other: $0.00 Inspection: $0.00 Total: $66.70 _ i , . SETBACKS �. � - � � MAIN STRUCTURE Front . 0- 0 Rear 0- 0 ACCESSORY Front 0- 0 , Rear 0- 0 PARKING Existin : 0� Reauired: 0 N07ES: FEE SUMMARY Status: ISSUED Applied'. U3l14f2401 Issued: 03174/2007 ISSUED BY: Phone: License: 2 COMP ROOFS, INSTALL GAF SENTINEL PLANNING & ZONING Left 0- 0 Left : 0-0 � Pr000sed: 0 Calc Valuation: $i;as2.00 Claim Valuation: , gi,as2.00 Right .0-0� " ' � Right .0_ 0 , , NO710E: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related , regulations. (Ord. No. 92-26, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become voltl if work Is not commenced within 786days, or if work is suspended or abandoned � tor a period of 780 days. ' ' • I INSPECTIONS: In orcler tor ihe vrodc authorized under ihis permit to be considered legal, such work must comply with all applicaWe cales, erM afl � requlred Inepectiona end final epproval must be obtained. Failure lo obtaln inspectlons and final approval will result in the expiration of this permlt. I FOR INSPECTIONS CALL: (774) 754-5626 �seaae (arool WORKERS' COMPENSATION DECLAF�ATIOIC', / � I hereby aHirtn untler penalry oi perjury one oi ihe tollowing declarations: ❑ I heve end will mdintain e certiticete of canseni to setl-Insure lor workers' compensation, es provided for by sectlon 3700 ot the Labor Code, for the peAormence ot the or which thls pertnit is issuetl. I have entl will malnWin wwkers' compensatlM Insurance, as requiretl Dy section 3700 ot the La6or Code, for t�e peAormance of t�e work f r whtch this pertnit is issuetl. My workers' c mpensatlon I ra�n/iepwrrier arM pdiq numDer are: Certier, l �C_J`__ Policy NumDer. (This sectiar need not be con ef � d i! (he peim/t!s va/ued et one hundretl dd/ero ($100) or /e55.J ❑ I ceniiy that in 1�0 Pedo ance of t�e work br which this pertnit is issued, I shall not employ eny person in eny menner so as to e subject to Ihe workers' compensation laWs ol Calilomia, entl epre Ihat it shoW d como subject to t�e workers' compensation provlslons af Section 37 0 /,i Ihe Lebor Code, I shall forihwith wmplywiththesB ro /� � �� `�/� � Applicant SlgnaNre: �`��L�79GD�� Date: / WAANINO: FNLURE TO SEa1RE WORKERS' CdAPEN$ATION COVEMGE IS UNL1W FUL AND SHF11$UBJECT AN EMPLOYER TO CRIMINAL PENKPES rWD�GVI� FlNES UP TO ONE HUNDRE� THOUSPND WLURE (5100.�WI. N1 ADDR�OM TO THE WST OF OOMPENSATION, DAMAGES AS PFOVIDED FOR IN SECTION 3�O60F THE LABOR COOE, IMEREST, AND ATTORNEI"5 FEES. LICENSEO CONTRACTORS DECLARATION: I hereby eMirm ihat I em licensetl under provislons of Chapter 9(commencing wilh Section 7000) ol Division 3 of Ihe Business and Protessions Cotle, end my license Is In full lorce end eHect. Lic. a '� � � Class a (" • 3� i.� coniractors siqnamra: �,L, �7;t(�J ,, �_/ /,/ oate: -�7 CONSTRUCTION LENDING AGENCV: ❑ I �e�eby eHirtn Iha� ihere is a construction lending agency for ihe peAormence ot ihe woB for which this permit is issued. (Sec. 3097, Civil CodeJ. Lentler's Neme: Lender's Atltlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirtn Ihet untle� penalry of perjury I�eI I em EXEMP7 FROM TFIE CONTRACTORS LICENSE LAW lar Ihe following reeson (Sec. 7031.5, Business and Professions Code: My dry or counry which requires a permit to construd, alter, impmve, tlemolish, or repeir any strucWre; pnor to its issuance, also requiras the epplicant br such pertnit to tila a signed s�atement thet he ar she is Gcensed pucsuant ro Ne proWsions of the Contracto�s License law (Ghapter 9{commendng wtth Section 7000) ot DiWs{on 3 ot the Business and Professio�s Cotlej or ihat he or she is exempt therefmm end the basis br Ihe allegetl exemption. Any vialation of Section 7031.5 by eny epplicant for e permit subjecls the epplicant t� e civil penalry ot not more than frve huntlretl tlWlars ($500).): ❑ I, es owner ol t�e P�operty, or my employees wlih wages as �heir sole compensation, WILL DO TME WORK, and the structUre is not intenCeO or oHeretl for sale (Sec. 7044, Business ar�d Professions Cotle: The Contractors License Lew does no� aDPly lo en owner oi property who 6uiltls or improves Ihereon, end who does such work �imself or herself or Ihrough his or her own employees, provided tha� such improvements ere not intended or oMered for sale. If, however, the builtling or improvement is sold within one year ol wmpletion, the awner-builder will have the 6urden of proving t�at �e or sha did not builtl or Improve lor Durposa ot sale.). ❑ I, as owner ot the G�Wetly am EXCLUSIVELY CONTRALTING WITH LICENSED CONTRACTORS to construct the project (SecJ044, Business and Professions Code: The mmraG�o�s Llcense Law does nm appy m an owner ol property who builds or Improves ihareon, antl who conirects tor such project with e comractor(s) license pursuent ro the Contradors License Laws.). ❑ 1 am e:empt untle� sec. Business an0 Professions Cotle lor this reeson: SignaWre: Date: Owner ID venfied hy dri�er's license. ❑ Ves ❑ No Dnvefs License No. Vedfication of Ownarship by (type of tlocument, I.e. - praperty taz blll or deed): DIVISION OF INOUSTRIAL SAFETY PERMR CERTFICATION: Expires: ❑ I hereDy certify Ihe� no excavetion tive (5) or more laet in dep�h Into which e person is requiretl to descend, will be mede in connection with work euthorized by Ihis permit, antl that n0 building strucNre, scaXoltling, fe4sework, or tlemolilion or dismantling thereof, will be more than Ihirry-six (36) feet high. (C�ap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, CelifOmia Atlminis�retive Code). ❑ As ownerbuilder, I wiil not employ enyone to do work which would requlre e permil Irom �he Division ol Intlustriel Selery, es notetl ebove, unless such person hes e pertnit Io tlo such work fmm Ihe division. Signeture: Dale: Division ot Industrial Safary Pertnil Number: CERTIFlCATE OF COMPUANCE AND AIffHORIZA710N OF ENTAV: I certiy under penalry ol porjury that I have reetl IMs appliw6on and state Ihat the infortnation given is wrrecl I egrea lo compN with ell state laws en0 dry orOlnances relating to builAing constructlon, antl aut�orize representatives of lhe Ciry of Costa Mesa to emer upon the above-describetl property �or inspecibn purposes. I agree not to occupy or ellow occupancy of eny building authorized by lhis pertnil until final inspection. COOE �. INSPECTIONTYPE 7818 Fizetl System Finfll Fire Prevention 1266 Pool Spe Finel � 200 Final Re-Rooi 201 Final BIocWRetaining Well 202 Final Fec�ory Fi�o Place � 203 Finel Sign 204 Final Demditio� PdIE It�i � � ' =-�-,-� � �'�I �Date CODE1. INSPECTIONTYPE � p�¢, �$ 206 Finel Mechanical 20B 270 212 Final Plumbing Final Electdcal Final Fire Preventlon 220 Final Plenning Approval 222 Final Siie 250 Final BuildinryOccupenc