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Home My WebLink About970 17TH ST - Building Permits(714) 754-5273 • Fex (714) 754-4856 Job Address: 970 W 17TH ST Suite: Vicinity: DUPLEX ONLY Parcel Number: 42437109 _ CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT, PERMIT Applicant: TOM LIEBHERR Address: 17066 PALMDALE ST HUNINGTON BEACH, CA � Owner. SACCIDO,'DAVID L , � Address ,g54 W.17TH �. . , . � �, ' , � , . . � � � � COSTA MESA, CA - Contraaor: �PRIMO"ROOFING Address: 17066 PALMDALE S7 � .� � HUNINGTON BEACH, CA Zip: 94627 Arch : BUILDING PERMIT Zoning: Phone: p14)841-0456 Zip: 94627 . �� . i �Phone: � � ' • . Zip: 92627 Phone:' (714)8414456 License: 331120 � � ` Eng: C PERMIT UMBER 00-00670 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05/10/2000 Issued: OS/10/2000 ISSUED BY: Address: --- - � � -�,� _ - � . Address:- �� . " � i " � . Phone: Phone: - • � ' Zip: , ' " - License: License: • . SCOPE OF PERMIT .� REROOF�- T/O, USE EXISTING SHTG, INS7ALL 2 LAVERS OF'15# FELT AND NEW 20 YEAR FBERGLASS SHINGLES. � FEE SUMMARY , Plan Check: • $0.00 ' . . � "�c, .. - ---.: ' ' �� Calc Valuation: gz,o3z.00 • Permit: ' $83.25 - - , ,` , Claim Valuation: g2,o32.00 SMIP Res: $0.50 � � SMIP Com: $0.00 Other: $0.00 '- - _ Inspection: $0.00 � Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Fwnt 0-0 PARKING Existin :" o NOTES: �- � � �� . PLANNING & ZONING Rear� �,0,0- ' Lefl �0-0 Right Rear 0- 0 . Left 0- 0 Right Re uiretl: - 0 � Proposed: 0 0- 0 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia.statutes and related regulations. (Orcl. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not:commenced within 780 days, or if work is suspended or abandoned for a period of 180 days, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetione and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSA710N DECLARA710N: – I hereby aHirm under penalry of Oeryury ona of the following tleclarations: ❑ I have and will meintain a certificate ot consent to self-Insure br workers' compansation, as providetl tor by section 3700 of ihe Labor Cotle, for ihe pertormance of the work for which this permit is issued. . ❑ I have antl will maintaln workers' compensation insurance, as requiretl 6y section 3700 of tha Labor Code, for ihe pe�ortnance of ihe work for which ihis Dermit is issue0. My warkers' compensation Insurance wrrier and policy number are: . . carder. �/PL�h�JG�C�i4 PolicyNumber:�r.�3U%c�3G�G (This secfion need not be completeU i/ the permit is velued at one hundred Oollars ($100) or less.) ❑ I certify that in Ihe pertormance of the work for which this permit is issued, I shall not employ any person in eny manner so as to becoma subject to the workers' compensation laws of Califomia, and agre that if I should become subject to the workers' compensation provlsions ot Section 3700 of tha Labor Code, I shall forthwith comply with ihesa provisio . /' Applicant Signature: ��rlaclvi �� Date: S�v/ 07 WARNING FAILURE TO SECURE WORKERS' PENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PEN TIES AND CIVIL FINES UP TOONE HUNDPED TMOUSAND OOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATIIXJ, DAAMGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR WDE, IMEREST, AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby aNirm Ihat I am licensed untlerj�rovisions of Chapter 9(commencing with Section 7000) of Division 3 ot ihe Business and Professions Cotle, and my license is in tull torce and ettect. Lic. # "-3//�^C !� Class # i�� -3 7 Coniractofs Signawre: �— ry F� i �� y�, Date: C�i –/�^ DL CONSTRUCTION LENDING AGENCY: ❑ I hareby aNirm that thare is a constmction lentling agency tor the performance oi the work for w�ich �his permit is issued. (Sec. 3097, Civil Coda). Lenders Name: Lenders Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby affirm that under penalry ot parjury �ha� I am EXEMPT FHOM TME CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requires a permit to consWct, alter, improve, demolish, or repair any sirucNre, pnor to ils issuance, elso requires ihe applicaN tor such permit to file e signed statement ihat he or she Is licensed pursuant to the provisions of the Con�rectors License Law (Chapter 9(commencing with Section 7000) o� Division 3 oi Ihe Business end Professions Code) or ihet he or she is exempt iheretrom end ihe basis for Ihe alleged exemption. Any violatlon of Section 7031.5 by any epplicent for a permit subjects the applicant ro e civll penalry of not more than five hundred dollers ($500).): ❑ I, as owner of the properry, or my employees with wages as Iheir sole compensation, WILL DO THE WORK, antl the structure is not intantletl or ofrered for sale (Sec. 7044, Business and Professions Code: The Contrectore License Lew dces not apply to an owner of property who builds or improves Ihereon, and w�o dces such work himself or herseN or t�rough his or her own employees, providetl Ihat such improvements are not intended or oflerad for sale. If, however, the building or improvement is soltl within one yeer of completion, ihe owner-builder will have �he burden of proving ihat ha or she tlitl not build or improve tor purpose of sale.). ❑ I, as owner of ihe propeny, am E%CLUSIVELY CONTRACTING WI7H LICENSED CONTRAC70RS to construct the project (Sec. 7044, Businass entl Professlons Code: The coniractors License Law does not apply to an owner of property who builds or improves thereon, and who coniracts for such project with e con[ractor(s) license pursuant to the Conirecmre License Laws.). ❑ I am exempt under sec. Signature: Owner ID veritied by drivers license. ❑ Ves ❑ No Business and Professions Code for this reason: Venfication of Ownership by (rype ot documenL i.e. � property tax bill or deed): Driver's License No. Date: Ezpires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify Ihet no excavetian five (5) or more feet in depih Into which e person is requlretl to tlescend, will be made in connection with work eutharizetl by this pertniL antl ihat no builtling stmcNre, scaHolding, felsework, or tlemolition or dismantling thereof, will be more ihan ihirry�six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Calitornia Adminisirative Cotle). ❑ As owner-builder, I will not employ enyone to do work which would raquire a permit from �he Oivision ot Indusirial Sa�ery, as notetl ahove, unless such person has a permit to do such work irom ihe division. SignaNre: Date: Division of Indusinal Safery Pertnit Number. CEHTIFICATE OF COMPLJANCE AND AUTFIORIZATION OF ENTRV: I certify under penalty ot perjury ihat I have reatl this application and state that the intortnation given is correcL I aqree to comply with all sta�e laws and city ordinances releting to building consiruction, antl authonza �epresentatives of the Ciry of Costa Mesa to enter upon ihe abova-dascribed properry for inspaclion purposes. i agree not to ocapy or allow occupancy ot any buifding aNhorized by ih�s pertnit until finel inspection. OE t INSGECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final RB-Roof 201 Finel BIocWReteining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demolilion 2446-06 /wner(s) � /O /D� Date Applicant � ' Date - P97E IHI1L��4 s�s- � �- COOE 1 INSPECTION TYPE 206 Final Methenical 20B Final Plumbing 210 Final Eleciricel 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy o� �MRIRLS