HomeMy WebLinkAbout413 FORD RD - Building PermitsOwxER W. G, LONG CO ' DATF 6_p_��
JOB ADDRESS Zl'i-A Ford Rd BUI; dG PERMIT N0. . ��,Kq�,
sEIdEIiAL CONTRACTOR OWt1eT VALUE $ 10,676.00
AP. No. LOT /iL T1tACT N371H FIRE ZONE DESCSi.IPTLON OF WORK Si nal c+ PPR_
SUBCONTRACTOR I _ __ PERMITSISSUED__
Fo�m 410—SM-17-5fl S-B P UNIT A(L�l.j� NOLD FOR SPECIAL REQUIREiVIENTS
OWNER W_ (;_ T.ON(: (:n_ - DATF . (�_�_[��
JOB ADDRESS l�13-B & C Ford , v- �,�ii `�., � �i BUIl IG PERMIT N0. 14595
GENERAL CONTRACTOR Oumar VALiIE S 9]_ .77 �_ On �
DATE � GROUP I,q� � TYPE V ZONE R_I
�I SUBCONTRACTOR I _ PERMITSISSUED__
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OCCUPANCY I I � �� I
Form 410-SM-N-59 S-B P�jJj�jIT}S� B& C HOLD FOR SPECIAL REQUIREMENTS �
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CCiSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX J77 C08TA MEHA. CALIFORNIA
For Appllcanf to Fill In Complefely
TYPE OR PRINT
BUILDING
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COSTA MESA. CALIFORNIA
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FIN�AN �o �APMESA
APPLICAi(ON FOR PERMIi
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For Office Use Only
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COSTA MESA. CALIFORNIA
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DESCRIPTIOId OF WORK
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PLY WITM ALL CIT' �OPD NANCE AND $$$���xT8 LAW9 qHOULATINO
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AMOUNT
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VALUATION IG POR�
A PBPMIT P8H ONLY.
' FEE $ / / �'
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CC�3TA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIRORNIA
Fo� Applicanf fo Fill In Complefely
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COSTA MESh CALIFORNIA
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DESCRIPTION OF WORK
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� �NANCE DEPT.
APPLICXTII�NFFDK PEKfvili'
BUILDING
For Off7ce Use
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COSTA MESA, CALIFORNIA
ZONING
NO. OF 86 OP N8W
PLANB BUILDINO
fCENTHR LINe BTJ ���
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1 H8R8�Y AGKNOWLHOGB THAT 1 HAV6 H6AD THIB APPLIGTION AMOUNT BXOWN UNDER VALUATION I! POR THH
ANO HTATB THAT TH8 AGOVB IB CORPCR AIm A6RCE M CON� pUqPo9E OF H9TA61JBHINO A PERMIT P¢6 ONLY.
PLY WITH ALL CIiY OqDINANCEB AND,BTATB LAW6 R80ULATINO
BUILDINO CONBTRU qN. �l VALUATION �
/
616NATURE OP j� PERMIi FEE $
PERMITTE
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' $ �� PLAN CHECK $ /
AUTHORIZED A6ENT /O �j 76 � rnr.. e�� .
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(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.c��ILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 4'I$ FORDRD
Suite:
Vicinity: DUPLEX ROOF
PrimaryOcc: R3
Parcel Number: 4� 92�204
Applicant: GUY SMITH, JUDY ANN
Address: 413 FORD RD
Type of Construction: V-N
Zoning:
COSTA MESA, Cq � �
Owner: GUY, JOSEPH DEWITT AND JUDY
Address 413 FORD RD . �
COSTA MESA, CA . . '
Comractor � OWNER-BUILbER'�'
Address: � � �- � ' /
Zip: .
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Arch :
Address:
�
Phorie: 949-013-9425
� Zip: 92627-2035 �
Status: ISSUED
Applied: 12/21/2005
Issued: 12/21/Z005
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Phone ' � 949-413-9425 � � : �
Zip 92627-2035
► ; .. . .. � . .
Phone:
License: 000000 • -
Eng:
' . .. Address:
� , , Phone: - � _. . ' ,�
. . Z�P�. .. . . ' . License; �. � .. . �.. - . .
SCOPE OF PERMIT
' TEAR OFF EXISTING ROOF, INSTALL t LAYER OF 3Q# FELT AND REROOF WITH 30'
��;� CARPORTS, APPROX 3,OOOSF. REPqIR AND REPLACE SHEATHING AS NEEDED.
,�. , . - .� " . — "-- - . _ .. _ . . . _,.
FEE SUMMARY '
Plan Check: $0.00
Permit: $11125
SMIP Res: ` $0.50
SMIP Com: $0.00
" ' ' Other. `� �� '' $0.00
fnspection: , $0.00
9
� Phone: �
_ License:-
'EAR ASPHAL7 SHINGELS ON�DETACHED DUPLEX AND
� Calc Valuation:
" Claim Valuation:
� Total: $11135 ` ' : `
PLANNING & ZONING
SETBACKS ;
MAIN STRUCTURE Front 0. 0 , ., Rear 0• 0 - Left �- 0- 0�� ��.;�. Right 0- 0
ACCESSORY Front 0-0 Rear �0=0 - ��� �' Lefl� 0-0 �•� . � � Right = 0-0� � �
.. . . . ..�3 � . . , .
PARKING . ,�Existin :- o � - Reouired� . o, . �Br000sed� -� 0�
-. .
ss,000.00
$5,000.00
NOTICE: The work aulhorized by lhis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulationa. (Ord. No. 92-28, § 1, 12-21•92)
EXPIRATION: This permlt shall allomaticalty expira and become void if wark Is not commenced wlthin 180 days, o� if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wlth all applicable codes, and all
requlred Inepectlone end flnal approval rriust be obtained. Failure to obtain Inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545628
24e8�a8�&00)
WORKERS'GOMPENSAnON DECLARAnON: ' - . �
I �ere0y aNirm untler penalry of perjury one of Ihe lollowing daclaretions: � ' � - ' � �
❑ I heve entl will meintain e cenificete at consem to setl-Insure for workers' compensetion, es provided tor by sectlon 3700 ot the Lebor Cotle, for Ne peAortnance of the .�
work for which this pertnit is issueA. . � ,. -•
❑ I heve an0 will maintain workers' compensaUon insurance, as requirad by seMion 3700 0l the labor Code, for the peAortnance oi the work for whiU Nis permit lv issuetl.
My workers' compensetion Insurance caMer entl polcy number ere:
Certier: PWicy NumDer.
(This section need not be cromp/etetl il Ne permi( fs ve/ued et one huntlred dWlers (S100J or less.) .
�J' -I-cenly that in the Dedormence ol tha work tor w�ich Nls pertnit is Issuetl, 1 shell not employ eny person in eny menner so es to become su6�ecf to the workera'
----compensatlon lews ol Califomia, end agree that N I should became sub�ect to Ihe workers' compensatlon provlsions ot Sedlon 3700 of Ihe Lebor Code, I shell torthwith
comply with Ihese Dro�s��,5./�� 1� %(�,, a-�, r� o r
Applk8nl Sf"�pn ra u et :... ��lXM '�1� —�7.`�' 1/ r'�a�e:
WNRNINO: FNLURE TO SEWRE WORI(E COMPENSATpI� COVERAGE UNLAW Rl� AND SN�LL SU&IECT AN EMPIOVER TO CRIMINAL PElULT1E$ AND GM� FlNES UP TOONE HUNDRED
THOUSAND OOLURE (f100,000). IN ADDITION TO THE ODST OF COIdPENSATION, DAMAOES AS PROVIDED FOR IN SECTION 3]OB OF iHE UBOR CODE, INTEREST, AND �TTORNEYS FEES.
LICENSED COMAACTORS DECLARATION:
I hereby eNirtn t�at I em Iicensed under provisions of Chapter 9(commencing wilh Sectlon 7000) 01 Divlsion 3 at the Business entl Protessions Code, end my Iicense La In full
torce ena ettect. uc. a clau a
Contractors Slgnature: Dete:
CONSTRUCTION LENDINO AGENCY:
❑ I hereby eflirtn thel lhare Is e wnstruction lending agenc,y tor the peAortnance ot the work for which Ihis permil Is issuetl. (Sec. 3097, CIWI Cotle).
Lentlers Neme: Lenders Address:
SlpnaNre: Dete:
OWNER-BUILDER DECLAflA710NS: �
I hereby eHirtn Ihet under penalry oi perjury that I am EXEMP7 FROM TME CONTRAC70RS LICENSE LAW for Ifie Rllowing reeson (Sec. 7031.5, Business entl Pmtesslons
Code: Any Gry or counry which requlres a pertnit to construq, alter, improve, demdlsh, or repair any strucWre, pdor to Its issuance, also requlres ihe epDlicant for such pertnll
to fle e sipned sletement t�et he or she is Ilcensetl pursuant to Itie provisians of Ihe Cdntradors lJcense Lew (Chepter e(cammenGnp with Sectlon 7000) of DMsion 3 of the
Business entl Professions Cotle) or that he or she is exempt Uerefrom and the basis br ihe ellegad exemption. Any viWallon of Sectbn 7037.5 by any epplicent for e pertnit
subjects the applicant to e dvil penalry oi not more Ihan frve hundred Collars (E500).):
❑ I, as owne� of the property, or my employees wiN wages as their sole compensetlon, WILL DO THE WORK. anC Ihe 5lruciure is not intentletl o� oflered io� sale (Sec.
7044, Business antl Professions Code: The Contraclors License Lew does nol apply to en owner ofpl6perry who builds or improves thereon, enA who does such work
himsetl or �erself or through his or her own employees, provided thet such impmvements era not Intendad or aHered for sele. It, however. the builtlinp or Imprwement Is
sold within ona year of complelion, the owner-buildar will have the burden ol proving that he ar she did nat build or improve tor purposa at sale.). •
�I(es owner of the pmperty, am EICCLUSIVELV CONTRACTNG WITH UCENSED CONTRACTORS to construct the pmlect (Sec. 7044, Business and Professions
"` Code: The coniracrors License Law does not eppy to an owner ot propeM �'ho builas or Improves thereon, en0 who contrecis tor such pro�ect with a contrector(s)
license pursuant to the Contrectors License LawsJ. �
❑ I em,esempt ur�er sec. Business end Prafessions Code tor tF�s reason:
Slgneture:-� ����pA / . � Date:
Own D edfletl by driv rs license. ❑ Yes ❑ No Drlver'�sa. ���`--�'— e.Pi�ag: S—c��
Veriflcetion oi Ownership by (rype oi doeumen�, i.e. - pmperty tae blll or deed): �^-' `�� •
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereDy certily Ihat no excavetion five (5) or more taet in depth into which e person Is requlred ta descentl, wlll be metlo in connectlon wlth work euthorized Gy thls
pertnit, entl thet no building structure, scaMolding, telsework, or demolition or dismantling thereol, will be more then thirty-sl: (38) feet hiph. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Tl�le 8, Celifornia Adminlsiretiva Cotle).
❑ As owner�0uiltler, I wlll not employ anyone to do work which would redulre e permit Irom Ihe Divislan ol Industrial Sefety, es noted ebove, unless such person hes e
permit to do suc� work irom tha Uivision.
Signeture: Date:
Division ot Indusinal Sefery Permit Number:
CERTIFlCATE OF COMPUANCE AND AUfHORPJ1710N OF ENiAV: I cenity under penalry ot perjury that I heve read this epplication antl stete Ihet the inlormation given Is
corract. I agree to comply with ell state laws end dry ordinances relating to huilCing construction, end euthorize representatives ol t�e Ciry of Coste Mese to enter upon Ue
ebove-described property for ins 6onf "'`�°��s. �l egree /no�t to accupy or allow accupenty ot any building euthodzed by this pertnit un1^t�il flinel InspecUon.
. �� `.U/ A� l'1 Lt.(.l V1 R9-� /� -�' � v��.0 � I_
�— S n mreOf�LegalOwner(s)_` 7/ �Dare� (
�- � ----`_ i -'�I
Antl/Or Authodze0 Applicant Date
CQOE �. INSPEClIONTYVE
1616 Fixed System Final Fire Preventian
1268
200
201
202
203
204
Pool Spe Finel
Finel Re-Root
Final BIocWRelelning Well .
Finel Factory Flre Place
Final Sipn
Finel Domolition ' '
Q�f. �`
� �
COOEI INSPECTIONTYPE .
208 Finel Mochanical
20B
210
212
220
222
250
Final Plumbing ,
Final Electrical
Flnel Fire Preventlon.
Final Plenning Approval
Finel Site
Finel Bullding/Occupancy