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Home My WebLink About425 FORD RD - Building Permitsy� a..�.� . r�. �� o��. e��. ' .� � �Y`��' �4`.�89 i'-'�� <,�� F E RECEIVE COSTA MESA BUILDING-SAFETY DEPARTMENT �,,' ��A�' 261�" `. °. B°x "' `°�" ""�". °"""°R""" � FINnANCE DEPT. � , Fo� Applicanf fo,Fill In Comple+ely APPLICATIOIG��R'FPER7�,1(t MESA �' TYPE OR PRINT 7 BUILDING � BUILDING�� (��, � ADORE68 ...,J � ' r '� �i � COSTA ME5A CALIFORNIA For Office Use Only �� n neceiPr xo. /P MI � OWNER � J. � � MA�L �" �p� ,j� RHCEI BY DATB N�BC�H/IVE.D/ AI /O H I68U6D � ADDRE69' ll '� L�U.6 i , .'o W� � d��c�(O/� O Z- � C TEL. /� CITY �� '� NO. � 1 1 ADDRE58 T �Ci � neCHiT¢Cr � r/ f� ^� EL./ ,� COSTA MESA. CAL FORNIA OR ENGINEE a . f w ��.�'Y Oj. � \ A � � � � U / FIRE � Z ADORESB' �- ZONE TYPE GROUP L'J� %'�� /� APPROV Q CONTRAGTOR4A/: ( •^ • , •- Bp DATE � Z ' (� 5 . ADDRE68 °� �-�- . �.a �T r ZONING � ,�,�_ � , Z N NO. OF 1168 OP N8W � CI'fY q„! r'� <� �� .� C I PUNB '/ I 6UILDINO � BTATH 'j� TEL. + j ! � LIC.NO. � " NO. �li� Leow� .� D68CRIP�ION Q BIZ6 4 NO. OP B1D68. V OF LOT� �. NOW ON LAT p, p, NO. LLI q USE OF � YARDS EVE6 a ! EXISTING BLDG APPROVED ALLOWED � � � 9HTB�CN LINB FROM % r �� I� �j (�NTeP IJNe 9T.) O �I ceNT6R OP ern[HT � JC REAR YARD.� FRONT FT. IN. {;,, ` I � � I �� .1 Q SIDE YARD LEP'f .. RIGHT R. SIDE V FT. IN�� ] Q DESCRIPTION OF WORK �' p ,- q �% II I II ' L. SIDE FT. IN. � ,Qv��•�, ROOMS TO BE � 1_ L bC�\eb' l_aY � V 1 I XBHBBY �CItNOWLED08 TMAT I XAVB R D TH18 APPLIGTION AND BTATC TH�T THe ABOV¢ �8 GOPREGT AND AGRB¢ TO CON- PLY WITN ALL CITY OPGIHANCE AND ¢ LAW! R¢DULATING BUILDINO CONBTRU/O,ilOt/� . SIGNATURE OF NI / _ .� ti AGENT - W! (' �'(�,��G� • �� — 3 �s �� TME AMOUNT BHOWN UNOHR VALUATION 1! POR �Ie PUfiP09¢ OP [9TA0LIBHINO A PHRMIT F88 ONLY. VALUATION , // f,� PERMIT FEE $ �� $�� / / J,b PLAN CHEGK $ ��•S� TOTAL FE8 G %.'S O 4k( � %nJo. � � 0 �� - � ��5�g . �EE_ RE.CEIVED � . COSTA MESA BUILDING-SAFETY DEPARTMENT V �AY 2 6 i$1 P. O. BO% 977 C08TA MfiBA, CALIPORNIA . : ' INANCE For�A lican+�io Fill In Com letel DEPT. PP _ . P Y..: nrru.cnri�d71��. W�41rMESA . . . TYPE OR PRMT -' ..• .. .. , . ` • euaoiNc' .` t,—� ` . , . • 'BUILDING ' :,. ADDR85S :J- � �O - i _ � • - � - ^ � � � COSTA MESA GALIFORNIA FO� Offlce Use Only � , " ' ' . ' nece�vr Ho. � rerwrt o. OWNER `W� �. G•. LOII CO ' MAIL � RH BY OAl6 RE�N[D' O TE'183tlHC ADDRE66 ' - li y. TEL. UILDING ' CITY 4 B NO. � DDRESS RCENGINEER HOI:TSIl •3WOTtt1 No��J 2O COSTA MESA: CALIFORNIA • 1 .. t ADDRE65 626 w� C�Q��iO%�%ie$ �r On RIRE )/ � ZONE TYPE 6 GROUP � CONTRACTOR - . APPROV .•.(1 , . ' . -. � ' 4: I BY DATE .•� ' � . ADDRE65 00 W.� Coast Hi hwa .� ZONING.�., ., � � a � Z ` NO. OF(' ' U8E OF N6W , - - W CITY .. I PLAN9 a-.�. .I BUILDINO ��p � a .] LIC.TNO. Z�I.�BZ •� NO. MI�6 1':, " �w� ' / - a DEHCRIP�ION' i�: SIZE [ � NO. OF BL008. � _ �. . ..� U OF LOT � 1S �l O� u � ` I r+oW oN Lor •O q, p. NO a USH OP YARD6 EVES N EXISTING BLD APPROVEO ALLOWED [�; B6TBACK LINB PROM (C6MHR LINe 8T.1 O GHNTeR OP eTN¢HT � REAR YARD � FRONT S FT. IN. � I ��{ "y �� Q BIDE VARD LEFT � RIGHT� � R, SIDE �J FT. . �" iN. `� \ DESCRIPTION OF WORK' �' i s 1 HQRHBY ACKNOWlPCO! iXAf I HAVE ReAD TXIB APP4WTION JTH6 AMOUNT BXOWN UNDep VALUATION 16 FOp THH ANU BTAT¢ THAT TN8 ABOVE 18 CAPRELT AND I�pRHH TO GON- pURP09E OF 89TABLIBMINp A PERMIT FEE ONLY. PLY WITH ALL CIiY O INANCE AND HT LAWB R80ULJ�TNO BUILDINO CONBiR f.T10 . VALIlAT10N &IGNATURE OF � PERMIi FEE $ � PERMITTE J " S / � PLAN CHECK $ ^ AUTHORIZE� AGENT /%) ! Y v `/ TOTAL FEE � �_ � _ ' ; . :� � •�:;.�,.. .. . , .. _ . , �,�'Candi'tions�'of'Variance No. 802 ��' ' (1)�._All�.the.�requirements oY the City IIigineer (Tract 3718 zrill �take -'� ' • . care of this condition� (2)�-� Dedication to the City of Costa Mesa Yor street purposes of all land required for the extension of Parsons St,. and_Foxd Road as shown on Precise Plan A. (Tract 3718 wi11 take care of-this condition) (3) The applicant shall improve the extensions of Parsons Street and ' Ford'Road at his expense and said improvements s�hall include carbs, gutter,s, paving, base, sidewalks and street lights,as�,required by an3 under.trie�direction of the City Eagineer. ' ' � . . _ . � . ' , ' : . . (4) The applicant shall provide two Yor one usable_off-street parking under the direction of the Director of.Planning� � �� - . . . ...�'- - ... . . . (5) A maxira� of one-unit�,ior each 1500 sq.,ft. .. . (6} Subject to the adoption of the amended�Precise�Plan £ror the extension of Pa.rsons St. and Ford Road.and Patricia Place.(This.has been - . . :' adopted) (7) �e� firlal location of all structures'shall be agreed.upbn by. the applicant and the Plannin.g Department regarding setbacks and. off-street parking:' ' ' a i. � t �'- .� BUILDING PERMIT AP. No. LOT /jl T1tACT 37 8 FIftE ZONE DESCRIPTION OF WORK DuDl. INSPECTIONS � p!/ I DATE � GROUP I Sc J TYPE V. ZONE SUBCONTRACTOR OCCUPANCY I I I Form 210—SM-11-59 S-B P UNITS B& C(42S) HOLD FOR SPECIAL REQUiREMENTS (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT 0 Job Address: 425 FORD RD Suite: Viciniry: ROOF FOR TRIPLEX Primary Occ: R Parcel Number: 41920201 Applicant: LEE, CHEE TAT TR Address: P O BOX 3781 . Type of ConsWction: V-N Zoning: COSTA MESA; CA Owner. LEE„CHEE TAT�TR' � Address, � P O BOX 3781 , -" - _ , ,,, % �. , � // , -. � `COSTA MESA; CA �; - �" Convactor: O W N ER-BUILD ER , Address: "� � i; Zip: � - Phone:. 714-641-3788 �- . Zip:. 92628 � � . � .' I Phone ' , Zip: 92628 � . . Phone: Status: ISSUED Applied: O6l08/2005 Issued: 06/OB/2005 , ".License: � 000000 ' � r Arch : � , . . _ �_. " . , . Eng: - � � , , Address: , - � � � � - � " � � : Address: - , _ , i � � -�Phone: � � _ , " � Phone: - � � �V ' , � ,. , . � Zip: � . - �� Lioense: �� _ License: � � ' • • " SCOPE OF<PERMIT . � � TEAR OFF EXISTING ROOF. INSTALL 2�LAYERS OF 15# FELT, 30 YEAR COMPOSITION SFIINGLES, AND REPAI WREPLACE SHEATHING AS NEEDED TO TRI-PLEX. 42 SQUARES. � - � � � � -: - FEE SUMMARY � Plan Check: $0.00 , . _ Calc Valuation: , , , S5,5oo.00 Permit: $12525 Claim Valuation: ; , . ss,soo.00 � $0.55 � ' $0.00 $0.00 $0.00 `� `�� .. 5125 80 �'_ � �: SMIP Res: SMIP Com: Other. ' Inspection: Total: � �� /� � . � � ii � / >�� i /; `��.�,\ : , PLANNING&ZONING "-"ii% /^ ; ./ ,/ � �.�_ �,� � SETBACKS. .A, �-� ��c ,, . � i' / �\•/,,� MAIN STRUCTURE.Fronl � �0 �0 - �-� i � ^Rear ��-0- 0" � ��Left � 0 0 �� Right "0-�0 � �. � �,`-� `� � - . . ' _ ACCESSORY Front��0.�0�,, - Rear 0-0- � --' �Ceft 0-0 - - Right --0-0 � _� ��_ ._., - , , �, � -,, PARKING ExisEna: 0�'�< Re uired: 0' �`_ Pr000sed: 0� .-: �':%+, � .. .•?:. � <: :,"' , _, �.. ,: � � -;:� � ,/. � � ; � �. NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it 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 requlred InspeCtlona and flnal epproval must 6e obtained. Failure to obtain inspections and final approval will result in the expiretion oi this permit. FOR INSPECTIONS CALL: (714) 7545626 2d4&48 (B�OO) WOPKERS' COMPENSATION DECLARATION: I hereby ettirm unaer penelry of perjury one of �he following declara0on5: • � I heve entl will mainleln e certificete of wnsent to self-Insure for workers' compensetlan, es pravidetl for by sectlon 3700 of the Lebor Coda, for the peAormence o1 the work lor whiCh this pertnit Is IssueC. ❑ I have antl wlll maintaln workers' compen5ation insurance, as requiretl by seIXlon 3700 0l the Lebor Code, for Ne pertortnance of Ne work for whlch thls pertnit ls issued. My warkers' compensatlon Insurance carrler entl pallcy number ere: Cartier. Policy Number: (7h15 sectlon need nat be completetl i/ the permit is valued et one hundred dollers (5100) or Iess.J i1y Ihet in the pertormence oi lhe work tor which this pertnit is issued, I shell not employ eny person in any menner so as to become sublecl to ihe workers' iensetlan lews at Celif�o�mi�'°� tl agree that if I should b me sub�ect to Ihe workers' compensatlon proNslons of ection 3700 of the Lebar Catle, I shell lorihwllh ily wlt� Ihese provlslo''°��, J � �� —,, 7I �J Q� i.gna`(��tu,�re^ / (N�/VG� �/\ "` `D��afe: v l��-�O � �AILURE TO SECUFE WORKE PENSATON COVERAGE IS UNLAW FUL ANO S W1LL SUBIECT AN EMPLOYER TO CFll I PENALTIES AND GVIL FlNES UP TO ONE HUNDRED DOLLARE (§100,000), IN RDOrt10N TO THE COST OF COMPENSATION, DPMAGES AS PROVIDEO FOF IN SECiIIXJ 37080F THE UBOR CODE, INiEREST, AND ATTORNEYS FEES. LICENSED COMAACTORS DECLARATION: I hereby aKrtn that I em licensed under proNsions ot Chapter 9(commencing with Sectlon 7000) oi Division 3 of t�e Business and Professlons Code, and my license is in full torce entl eifect. lJc. a Cless a Contredofs Signature: � Data: CONS7RUCTION LENDIND AGENCY: ❑ I nereby ettirtn that there is e consWction lentling agen�y tor tne paAormance ot Ue work for wnkh ihis pertnit Is issued. (Sec. 3097, Civil Code). Lentlefs Neme: Lendefs Address: Signature: Da�e: OWNER-BUILDER DECLAflAT10N5: / I hereby eHirm Ihet untler penelry af perjury t�at I arAEXEMPT FROM TME CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Buslness entl Professlons Code: Any city or counry which requirea e pertnit to construct, elter, improve, demolis�, ar repelr eny structure, prior to Its Issuance, elso requires the epplicent lor such pertnit to file a slgnetl statemeN ihel he or she is IlcenseC pursuant ta the provisians at the Contrectors License Lew (Chapter 9(cammencing with Sedlon 7000) of Dlvislon 3 01 the Busin end Professlons Catle) or lha� he or s�e I5 exempt t�erefrom antl t�e besis for the elleped eaemption. Any violatlon ol Section 7031.5 by any epplicant br e pertnit su6 the epplicant to e clNl penalty of not more ihan five hundred dollere ($500).): •; 1 es owner ol tha property, or my employeas with weges as thelr sole compenselion, WILL DO THE WORK, enC Ihe sWclure Is not Intended or oifered lor sele (Sec. , Business end Professlons Cotle: The Contrectors LJcense Lew tloes not apply to en owner of property who Guiltls or improves Ihereon, entl who tloes suCh work ry himself or hersetl or through hls or her awn employaes, provided that such Improvements ere not Intentled or aHereA for sale. It, however, the builtling or Improvement is sold within one year of completion, Ihe owner-builder will have ihe burtlen of provinp thet he or she tlitl not build or improva for purpose of sala.). • ❑ I, as owner oi the property, em EXCLUSIVELY CONTFiACTNG WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business end Professiona Code: The contrectars License Law does uot eppy to en owner of pro0erty who bullds or improves Ihereon, and who contracis for such praject with e contrector(s) c„Flicepse pursuant to the Contractore License Lews.). . �� Business and Proteuions Catle lar t�is reason: by Ariv�rs license. ❑ Ves ❑ No Vedflcatlon of Ownewhip`Dy (type ot tlocument, i.e. - properry tex bill or DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFlCATION: • ❑ I hereby ceNfy that no excavetion Me (5) or more feet in tlepth inro which e person is required ro descentl, vrill be made in connection with woAc euthorized by Ihis permit, antl Ihat no huilding siructure, scaffoltling, falsework, or demolition or dismantling Ihereof, will be mora than ihirry-sia (36)leet high. (C�ap. 32, 6rp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Cotla). ❑ As ov.ner-bullder, I wlll not employ enyone to tlo work which would require e pertnil from Iha Divislon at Industrial Setety, as noted ebove, unless such peraon hes e permlt to tlo such work tram Ihe division. Signature: Date: Division of Industdal Sefery Permit Number. CEflT1FlCATE OF COMPLIANCE AND AURIORVATION OF Y: I certlly under penelry ol per�ury thet I have read thl9 applicetion end state that ihe Intortnetlon given Is correcL I eqree to wmply w tl II slet laws end city or In ces relatlng to bullding constructlon, antl authodze representetives of the Ciry oi Coste Mesa to enter upon the ebove-tlescribed properry I' specti purposes. I egr ot lo opqupy or ellow ocapancy of eny building authonzed by thls pertnit til final inspecyon., �� m � M9lu`re'OGLe-�alO4m6r(a� � Da'. �' And/OrAuthodzed Applicant Date 1818 1288 i, ' ni•. �r Fixed System Final Fire Prevention Paol Spe Finel 200 Finel Re-Roof 201 Finel BIocWReteining Well 202 Flnal Fectory Fire Place 203 Finel Sign 204 Finel Demolitlon pAg It�lS y'� �'" " COOE I INSPECf10N TYPE 206 Finfll Mechanicel 20B Finel Plumbing 210 Finel Electrical 212 Finel Flre PrevenUon 220 Finel Planning Approval 222 Final Site 250 Flnel BulldinglOccupency PAIE IIIIIII�Lfl