HomeMy WebLinkAbout2133 NATIONAL AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.gEy�DiNG PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2133 NATIONqL AV
Suile:
Viciniry: RESIDENCE AND qTTqCHED GARAGE
Primary Occ: �R-3 Dwellings/ Cong Res <10 Type of Constmclion: V-N
Parcel Number: 42244244 Zoning:
Applicant: DEATON, EDWARD
Address: 1002 N PARTON
SANTA ANA, CA
Owner: CLINE, ROSS
Address 2133 NATIONAL qVE
COSTA MESA, Cq
contractor: OW N ER-BU I LbE R
Address:
Zip:
Arch :
Address:
Phone:
Zip:
License:
Phone: 714336-5759 ISSUED BY:
Zip: 92701
Phone:
2ip: 926273382
Phone:
License: 000000
Eng:
Address:
Status: ISSUED
Applied: 02/22I2006
Issued: 02/22/2006
Phone:
License:
SCOPE OF PERMIT
REROOF RESIDENCE WITH ATTACHED GARAGE: T/O EXISTING COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED, 2 LAYER 15# (3
SQUARES FLAT ROOF) WITH 7 LAY�R 30# ON PITCHED ROOF, APPLY "30-YEAR FIBERGLASS SHINGLES." TOTAL ROOF 2300 SQ FT
Plan Check: $0.00
Permit: $8325
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
FEESUMMARY
Calc Valuation: $2,eoo.00
Claim Valuation: 82,eoo.00
Total: $83.75
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0 _
ACCESSORY Front 0-0
PARKING Existin : 0
Rear 0- 0 Left 0- 0 Right 0- 0
Rear 0- 0 Lefl 0- 0 Right 0- 0
Reauired: 0 Pr000sed: 0
NOTICE: The work authorized by this pprmit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In order for ihe work authorized under this parmit to be considered legal, such work must comply with ail epplicabie codes, and all
required Inepeetlons and finel approval must be obtained. Failure to obtain inspections and final approval will result in �he expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
ewo-an �uw7
WORKERS'COMPENSATON DECLARATION: �
1 hereDy sttirm urWer penalry of perjury ona of t�e following tleclereifons:
Q I heve end,will maintein a certificate of consent to self-Insure for workers' compenseUon, es proddeA tor by section 3700 oi the Labor Code, tor the peAortnance of Ihe
work lar w�ich Ihis pertnit is issued.
❑ 1 have and will maintain workers' compenution insurence, es requireC by section 3700 of the Lebor Cotle, for ihe pertormanca oi the work For whlch �hls permit is issued.
My workers' compensation Insurence cartier and policy num6er era:
Cerrier: Policy Number:
(7his secfion need not be comp/ete0 il the permit is va/ued e( one huntlied dollers ($100) or /ess.)
�I certify that in Ihe paAormance oi ihe work tor which this permit Is iSsueQ I shall not employ eny parson in any manner so as to become subject to the workers'
compensetion laws oi Celifomia, and agrea that if I should Oecome subiect to the workers' compensation provisions ot Section 3700 of the Lebor Catle, I shall torthwith
Comply�"w'ith th85e proYiSio /%� % n�
��g nt,SiCa g�+ a ur� �i� . //f� - Date:>, % / ?�2/vU
WM IN Np ILURE TO SECURE WORN�ENSATION COVERAGE IS UNIAWFUL ANO SHALL SUBIECi AN EMPLOVER TO CRIMINAL PENNLTIES AND GVI� FlNES UP TO ONE HUNDRED
TMOUSAND OOLLARE (Et00.000�, IN ADOITION TO THE COST OF COMPENSATION, �AM4GE5 AS PFOVIDED FOR IN SECTION 3]O60F iHE LABOR CODE, IMEPEST, AN� ATTOPNEY'S FEES.
LICENSED CONTRAC70R5 DECLARATION:
I pereby aNirm ihat I am licensetl under provisions of Chapter 9(commancing with Section 7000) of Division 3 0l the Business and Pmfessions Code, end my license is in full
force and aHect. Lla M Class u
Co�«acbr's Signature: Date:
CONSTRUCTON LENDING AGENCV:
d I hereby aNirtn that ihere is e construction lending egency for lhe pedortnance ot the work tor wnic� ihis pertnit is issued. (Sec. 3097, Ci•nl Code).
LBntler's Neme: Lenders Address:
Sig�ature: Date:
ON�NER-BUILDER DECLARATIONS:
I I+ereby ettlrm Iha� under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
COde: Any city or counry which requires e permil to construcl, aller, improve, tlemolish, or repeir eny stmcWre, prio� to its issuance, also requires the ap0liceM for such pettnit
to ��le a signea s�atement t�et he or she is litensetl pursuent lo t�e provisions of lhe Contrecrors Lice�se Lew (Chapter 9(commencing with Section 7000) af Division 3 of the
B�sinoss entl Professions Code) or that he or she is exempt fherefrom end the basis tor the alleged exemption. Any violetion of Section 7031.5 by eny epplicant for e permit
5pl7ects the epplicant ro a civil penalry of not more than five huntlred tlollars (5500)J:
��I, as owner of the properly, or my employees with wages as Ihelr sole compensailon, WILL DO TNE WORK, antl t�e siructure is not intendetl or oHeretl for sale (Sec.
7044, 8usiness antl Protessions Code: The Contractors License Law dces not apply to an owoer of p�operty who builAs ar improvas ihereon, anU who does such work
himsell or hereelf or through his or her own employees, providetl that such improvements ere not Intentletl or oMeretl for sale. If, however, ihe 6uilding or improvement is
soltl within one year of completion, ihe ownervhuilder will heve Ihe burden of proving t�et he or she did not build or improve tor purpose of sale.). �
❑ I, as owner ol Ihe properry, em E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to constn�ct tha prolact (Sec. 704d, Business and Professions
Coda: Tha coniractors License Law tloes not epply ta en owner of pmperty who builtls or Impmves thereon, and who contracls for such projecl wlih a contrecior(s)
license pursuant to the Coniractors Licensa Laws.).
under
ID v�ri�edbv tlrivers licensa.
Ved�ication ol Ownership by (type oi
Businass and Professions Code for t�is reason:
Ves ❑ No
i.e. - pmpeny tez blll or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hareby certify that no excavation five (5) or mora faet in dapih into which a person is requiretl to dascend, will be meda in connection with work euthodzed by this
permit, and that no building siructure, scallolding, felsework, or tlemolition or dismantling t�ereol, will be more ihan thiny�six (36) teet high. (Chep. 3.2, Grp 2. An 2, Sec.
341, Title 8, Calitornia Atlministmtiva Code).
❑ As owner-builder, I will not employ anyrone ro tlo wo�k which woultl require a permit tmm the Division of Intlustrial Safery, as noted above, unleu suc� person has a
permit to tlo such work from the division.
Signawre: Date:
Div�sion of IntlusMal Safety Permit Number:
ICERTFlCA7E OF COMPUANCE AND AUTHORIZATION OF ENTAY: I cehify under Oenalry ot perjury that I have read this application and state Ihat Ihe information given is I
correct. I agree to comply wit� all state laws end ciry ordinences releling to 6uiltling construction, end authonze representatives ol t�e Ciry of Coste Mesa to enter upon the
ebo�e-descnbetl proparty for inspection puryoses. I egree not to occupy or allow occupancy of any 6uilding authorized 6y this permit umil final inspection.
�Qy�.a, INSPECTIONTYPE
1616 Fixed SyStem Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Final
Final Re-Roof
Final Block/Retaining Wall
Final Factory Fira Place
Final Sign
Final Demolition
Owner(s)
Appiican�
Q�jE �N1171AL5
— "r _ (O'�
2 Z�
COOEI INSPECTONTVPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Finel Planninq Approval
222 Final Site
250 Finel Builtling/Occupancy
Q�, IMR1Al5
DECLARATION OF AUTHORITY
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
Street Address: Z �
1. I(we). r� (% SS (i llrlifj
referenced real property, and that I(we) hereby authorize:
Bldg. Permit #
This Permit #
AP Number:
declare that I am the Owner of Title of the above
Name: GGLINti:U` �.lQ/il/uN TelephoneNumber. ��L/ `��� `r�� �
n i c
Street Address: � �/U �
r�' i
Ciry: ����� C�'T✓�« State: �
to obtain pertnits in my behalf, as owner/builder, for %L ��V '
at the above referenced property.
z�P: 4 z �'�
2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa, as required by State of California laws.
3. As ownerlbuilder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I agree to indemniTy and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
Executed this "Z( day of l�JI�H r"l 20 )� , at Ci`�5�� /""'S`� , California.
OP9d6 (rev.11N0)
Print N
Signab
Date:
Note: This authorization does not grent autFrorization to perform the work as owner,
it soiely provides for limited power of attomey to secure this pertnd in any behalf.
C� °� C''o¢ta ��leQa �ui�'dicr y Z�ic�iQiotii
OWNER-BUILDER
, VERIFICATION
Address: v� 3 J ` � Permit#: ��E� � l�-� 7
A city or counry, which is required to give notice pursuant to Section 1983Q shall a[tach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the retum of, an owner-
builder verification.
Attention Property Owner.
An bwner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the emelope provided at your eadiest opportunity ro avoid
unnecessary delay in processing and issuing your building permit. No building permit will be issued until this
verification is received.
L I personally plan ro provide the major labor and materials for construction of the proposed
property improvement. �, Yes ❑ No
2. have ve not) signed an application for a building permit for
oposed work.
3. :1 have contracted wi[h the following person (firm) to provide the proposed construction:
Name
Address City
Phone.( . ) Contractor's Lic. No.
_, 4. `I plan to provide portions of the work, but 1 have hired the following person to coordinate,
supervise and provide the major work:
Name
� —
Address
Phone ( )
City
Contractor's Lic. No.
5. , 1 will provide some of the work but 1 have contracted (hired) the following persons to
� provide the work indicated:
Name Address Phone Type of Work
�
e
tOd2d6 (Rev.11/04)
OWNER
�i•r• _ • .,
CHARLE'S
2133 National Ave
J
DATE ZZ-1%—S!l
BUILDING PERMIT NO.
GENERALCONTRACTOR Gentosi Bros, VA W E$ 300,00 �1 _
�or 3 BLOCK TRACT 1713 Enclose Carport £or Garage'
GROUP J ' TVPE V ZONE Rl FIRE DISTRICT %7L(
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE I NUMBER
� FootinaTreneh ��� /1-2�—$
Foundation Forms and Grade to
'Rough Framing i
� Plumbing, Rough to SIa6
Plumbing, Rough Complete
Temporary Pole
Wiring, Rough
Meatfng, Rough
• Heating, Final
Sewer
Septic Tank or Cesspool
Lathing
Plastering
PlUmbing, Final, Fixtures Compl
Plumbing, Firw�l Gas Tat
Wiring, Final
Occupancy
6'orm Z10 G-H 1Df 12-63
Costa Mesa Buiiding Department ��APPLIpCATION FOR PERMIT
iN EA5T 20th STREET p U I L D �� N G '
COSTA MESA, CALIFORNIA �
FOit APPLICANT TO FII.L IN FOR OFFICE USE ONLY �
I �.��No. �� i� .
Building � , . A Gz �
Address "c�,.v.f-I'
Costa Mesa, California Received by Date Rec'd. Oate IssuedrL
Nearest O , /'Z -/� _S 7
CrossSt. ��, 8uilding
Address
Owner Costa Mesa, California
Mail I�
Address �� 7 Nearest
Tel. Cross St.
City � No. _ p Zone I I No. of I Type ,/ I Group J
Arohittttor Lic. Plans V
��iG(�.hv'�i19. c��y
Contractor No.
�-i�, '
. , �'
Lot,/) I
No. '7 Bixk'
/1 No. of Bldgs
SizeofLot //11.i��.[(J NowonLot
ot
New
Repair
Building
Size
Exterior W�
Covering
Use of New
I hereby acknowled
and state that the a
with all Clty Ordi�.
building constructipo
Signature of �is
Permittee _����
Authorized Agt. ( ,
Valu,ation
$ �(/
of
ear
�cio� I / I naa�c;oo
9 I I Demolish
No. of
Rooms Stories
�v I covering A,PPji,QVAi G
�, �,��� Foundation Location Inspector
Forms, Materlals, /
Under-Pinning
��✓ Frame: Fire Stops,
Braeing, Bolts
that I have mad this Application Lath. Int.
ve is crotrect and agree to rnmply Lath. Ext.
�es and S[ate Laws regulating
/��� "tP Plaster, Int.
!� o �
Plaster, Ext �
Masonry Reinioroed .
Plan Check $ ,sp
Total
Fee $ � • 3 �
Date
O
A
�
2
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- PLOT PLAN
( Show locatlon and distancea from
� property line and between buildings.
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ORANGE COUNTY BUILDING DEPARTMENT
. ' 636�North Broodway
SANTA� ANA, CALIFORNIA - •
FOR APPLICANT TO FILL IN
APPLICATION FOR PERMIT �
��� ��'� V
FOR OFFICE USE ONLY I
RECEIPT NO. PERMIT NO.
�'33�— �o��,�
SCHOOL DIST. � COBtQ 1'1CS$ RECEIVED BY DATE REC'D. DA7E ISSIiED
OR TOWN
NEAREST /f�/J(� � /�� � i7 � �
CRO55 ST. �jj ntnni A Qtic � :� ��r/ �
. . i
BUILDING ��„ � ,_/�
OWNER PUEBLO HOMES INC. ADDRE55 -S -s ii
��
MAIL 93 3 W,�sH�Re BLVD. scttoo��isr. �
ADDRE55 �^���
, OR TOWN
ci7v �BEVERL'Y ii�l.l5 „o�� cR. 5436i NEAREST �y1 � •y� �
CRO55 ST. (/MitiP'LGi0..J
ARCHITECT pR LIC. ZONE NO. OF TYPE
ENGINEER CAIN B� MCKERRACHER NO. ^, I PLANS I
Z��O E. WALNUT ST.� PASADENA �`
ADDRE55 qPpROVE
pp BY
coNrrtncTort'NEHPORT VISTA CO.rLio � ��SWZ CORRECTIONS
LEGAL LOT
iCRIPTION NO.
USE OF
EXISTIN
IBLOCK I TRACT �� 1
ND51
x�, 1 I NOW ON LOTS O
I NO. OF I NO. OF
FAN.ILIES ROO 5
REAR�YARD }
C.(�'(�� CI�]F YAiif].rl ��Q 1
DESCRIPTION OF WORK
I X I A1 TFRGTIhN I I Af
REPAIR I I MOVING 1 I I
BUILOING NO. OF
SIZE � O�� S/J. FT. ROOMS S
EXTERIOR WALL ROOF
COVERING STUG[O I COVERING
use oF New RESIDENCE
BUILOING �AY.Y. _ C
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION ANO STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTV ORDINANCES
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
AUTHORIZEO
VALUATION
432�0•0o PfiRMIT FEE $
s �
PLRN CHECK S
TOTAL
FEE S
APPROVALS
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: PLOT PCAN „
Show location and-distances from
_property line and between buildings. � — __ ' , , f ., ' '
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