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Home My WebLink About974 MODJESKA CIR - Building Permits(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.BuUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92628 JobAddress: 974 MODJESKACI Suite: Vicinity: ROOF Parcel Number: 42205223 Applicant: JOE SHULMAN Address: 7721 ETNA CL HUNINGTON BEACH. CA Owner: TOLEDANO,JAMES Address 2080 NEWPORT BLVD #122 COSTA MESA, CA Convactor: SHULMAN ROOFING Address: 7721 ETNA CL HUNINGTON BEACH, CA Zip: 92648 Arch : Address: Zoning: Phone: (714) 536-5116 Zip: 92648 Phone: Zip: 92627-7166 Phone: (714)536-5116 �icense: 690617 Eng: Address: Status: ISSUED Applied: 07/21/2003 Issued: 07/21/2003 �� Phone: Phone: Zip: . License: License: - SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16 O.S.B., 30# FELT, CERTAINTEED TL, 50 YEAR COMPOSITION SHINGLES. 21 SQUARES INCLUDES ATTACHED GARAGE_ Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $125.25 $0.58 $0.00 $0.00 $0.00 $125.83 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: 0 Rear 0- 0 Rear 0-0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $s,�so.00 $5,750.00 NOTICE: The work authonzed by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIpATION: This permit shall automatically ezpire and become void if work is not commenced wi�hin 180 days, or if work is suspended or abandoned for a period of 1 BO 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 inspeetions end final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 <cc-<6�dao� WORM9RS' GOhiPENSATION DECLARATION: ' � I hereby aNirm untler penalty of perjury one of the followinq declarations: � -�+ ❑ I heve end will maintein e ceniticate of consent �o selt-Insure tor workers' compensatlon, es providetl for by sec�ion 3700 of the Lahor Code, for the pedormance ot the work for which this permit is issuetl. ❑,, I have and will meintain workers' compensation insurance, as requiretl by section 3700 oi Ihe Lebor Cotle, for the pertormance ot Ihe work for which Ihis pertnit is issued. .' My woM �/ coT pensat n 1 urance carrier antl policy number are: 'Carrier. �+G�TL/ �� Policy Number. � 2�� ^ � 3 (lhis secfion need not be completed H the permit is velued at one hundred dollars ($100) or IessJ ❑ I certity that in the peAormance ol Ihe work for which this pertnit is issued, I shall nof employ any person in any manner so as �o bewma subject to t�e workers' compensetion laws of Cell� la, end egree if I sho d�suD�ect to the workers' compensation pmvisions of Section 3700 of the Lebor Catle, I shall forthwith comply with these provisiq 'Applicant Signature: l a�,� Date: �''2-�' d3 WARNINO: FAILURE TO SEIXfB � WOFKERS' COMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMIWIL PENALTIES AND CIVIL flNES UP TOONE HUNORED THOUSAND DOILARE (5100,obo�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PFOVIDED F-0R IN SECTION 3]OB OF THE LABOR CODE, IMEREST, AND A7TORNEYS FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby attirm Ihat I em licensed u e rovisio force and eHect. Lic. k� Contractors SignaWre: CONSTRUCTION LENDING AGENCV: of Chapter 9(commencing with Section 7000) of Divlsion 3 of the Business and Profe sions Code, antl my license is in tull qass a ' G 3� �.... Date: 7 1l —O� ❑ I hereby attirm that there is a consiruciion lentling egency for the pertortnance of the work for which fhis permit is issuetl. (Sec. 3097, Civil Cotle). Lentlers Name: Lendafs Address: Signature: OWNER•BUILDER DECLARATIONS: Date: I �ereby eHirtn ihat under penalry of perjury �hat 1 am EXEMPT FROM T1E CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requires e permit to construct, alter, improve, demolish, or repair eny structure, prior to its issuance, also requires Ihe aDP�icant lor such permil to file e signed stelemanl Ihet he ar she Is licensed pursuent to ihe proNSions 01 Ihe Conlrectors License Lew (Chapter 9(commencing with Sectlan 7000) ot Divislon 3 of the Business entl Professlons Code) or thel ha or sha is exempt iherelrom end the Dasis tor the elleged ezemption. Any violation of Section 7031.5 by eny applicant for e Dermit sublecis Ihe aDD�icant to e tivil penalty of not more ihan five hundred tlollers ($500).): ❑ I, as owner ot the pmperty, or my employees with wages as Iheir sole compansatlon, WILL DO 7HE WORK, end tha structure is not inientled or oflered for sele (Sec. 7044, Business and Professions Code: The Comractors License Lew does not appy to an owner oi property who builtls or improves thereon, entl who does such work himsalt or herself ar through his or her own employees, provided ihat suc� improvemenis ere nat intended or oHered for sele. If, however, the building or improvement is sold within one year ot completion, the ownervbuiltler will have the burtlen of proving that he or she ditl not Duild or improve tor purpose of sale.). � ❑ I, es owner ot the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe project (Sec. 7044, Business and Professions Code: The contractors License Lew tloes not apply to an owner ol property who bullds or impwves thereon, end who coniracts tor such pmlect with a contrectoQs) license pursuant to lhe Contrectors License Laws.). ❑ I am eaempt unaer sec. Business end Prolessions Code for ihis reason: Siqnaturo: Date: Owner ID verified by drivefs license. ❑ Yes ❑ No Driver's License No. Vanfication af Ownership by (lype af tlocumeni, i.e. - property tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby certify thei no excavation five (5) or more feet in depth in�o which a person Is required to descend, will be made in connection with work euihonzed by Ihis pertn0, and that no building structure, scattol0ing, falsework, or tlemolition or tlismantling thereoi, will be more Ihan thirty-siz (36) teet high. (Chap. 32, Gry 2, An 2, Sec. 341, Tille B, Calitomia Adminisirative Cotle). ❑ As owner-builder, I will not employ anyone to tlo work which would require a permit from Ihe Division of Industnal Satery, as noted ebove, unless such person hes a permit lo da such work from lhe division. SignaNre: Date: Division ol Indusirial Sefery Permit Number: CERTIFICATE OF COMPLIANCE ANU AUTHORVATION OF EMRV: I certify un0er penalry of perjury that I heve reatl Ihis applica�ion antl s�ate that �he information given is correct I agree Io comply wl�h all s�ate laws and ciry ordinances rela�ing m building consiruction, and eu�horize representa�ives of the Ciry of Coste Mesa to enter upon ihe ebove-described property tor inspection puryoses. I agree not to occupy or allow occupency of any building authorized by this permit uMil finel inspection. CODE I. INSGEttIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pad Spa Finel 200 Final Re-Rool 201 Finel BIaWReteining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition PA7E lt�lel5 7 1-1 ro-3 Date � cooe" ixsvecnoxrrve 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning ADProval 222 FinalSite 250 Final Building/Occupancy PdIE 1tl�LS Cily uf Cwl� Mi A�ininq Ucpurbnent •. .^k. Post Olficu Hox 1..�U , ,GQI�'�� , Fuir Ur�_� � (%0.0'�(�\'C�� Cosw Mes.i, Califoniia 9?.62G Li�Jr�2 �(Q�'�I fil .1 ��ei��!��he�i�� 4� �5s-szn� Tract No. 9592 Lot No. 2� REQUESTFOR OCCUPANCY RECEIVED CITY OF COSTA MESA �, .,...,��,. .._�T acr l�.�s» (Sinyle Family Residential or Condominium Units) 7�g�gi�J�llil2ili2i3i4i5 6 � � Date October 1, 1977 Address 974 Modjeska Circle, Costa Mesa, Ca. The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he, she, they) (was or were) advised that this tract has not been given tinal inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the Cicy at the time the final tract map was approved. The Ciry assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned ayrees to indemnify and hold the City harmless from any claim resul[iny in damaye or personal injury m the undersiyned by reason of the aforementioned uncompleted condition. `' B� g� BY � Lendur CfAF OSG9-2G CITY C 'OSTA MESA PAKK FEES Fee Payment Receipt Project N° 2'7'7 A. P. No. I/ S — C Jr� —Oi, � y/ O.�Q�/ I�/ � Building Permit No. Owner's Name Mailing Address ."5 I K � / (r FEE Single Family • Multiple Family ** Planning ApplicanPs Signature ' Clty ortlinance 72-4 •' City OrClnance 7�-4 •" QtY Resolutlo:;?4: Whlte • Planning; Canary �� F No. of Units �L� @ 5455.20 = �� d No. of Units @ $321.32 = � Total Fee ��3 %�! • O O - 2% By��Gt>�PG / oE • APplicant CMF 0174-26 � � ,A _ 43863 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applic�pj gt„Fj� in f,Qmplet�ly — Use jnk Only� F � W 6. a � h z F G w F a 0 .-1 a > r .a a m a � a. L Z W x 3 ADDRESSLv� �� ii"'"u—Jl/`� OWNEIi J.H. Gregory nooaEss3187 "G" Airway AVe. CITY Costa Mesa NOL751-3 �° oER�TG°P'eat Western Svgs & Loan BRANCH a�+8� Wilshire Blvd ADORESSB2V@Y�ly H111S� �a. ARCHITECT TE OR ENGINEE Jack Hester �„��59-0? � - iv �i�in .�Z CONTRACTOR f �]-I. Ure�orV uonstructii ADDRESS 318� "G" Airway Ave. __ _ CITY �i�$t'd Mesa NO�51—lVW � � No. 285-981 LICVNO.00H�. r 7 OF LOT 3500Sq. ft. (aver��ON LO � USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED Single Family Res. 1 hereby acknowletlge that I have reed this eppllcation end siate that tha ebova Information is correct and aprae to comply wIN all laws reOulaNng buildin8 construcNon, entl I shall not employ any perwn in vlolaSion of the workman's compensotion lews of the State Of Californ(a. I he�eby cartify thet I am p�ope�ly Iicensetl a cont�ecto� untlet the State of California eusinesz an Profe ns Cotle, Dlvlslon 3, Chapter 9, antl thet such I(cansas to�� i forca entl affact, or I am exerp�?qm the provisions,' f tyeh e of Callfornia euslnass and Prq�ezsions\Cotle, Dlvlsion , Chbbt 9. Permittee PdiJ 'PR 25-77��_-001410�• '��''`�:7Z�.tG APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY �ATE RECEIVED �eTp �scucn BUILDING ADDRESS BLOCK $� � � � � � OWNER J.H. Gregory USE Single Fam ile$ VALU$ 'jsr'lOQ FIRE _.,..� V ,,..,.,,..IBLJ ED YARDS API MAIN BUI VAR. DATE �f "p� �J � USE OF NEW � L BUILDING VA D$ APPR V ACCESSORV BUIL IN & ` ��• N n m i _ m 1406 SQ. FT. J=449 sq. ft. � THE AMOUNTSHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ES'fABLSHING A PERMIT F ONLV: � VALUATION PERMIT FEE E �Q a m PLAN CHECK S Z� o LL $ 35,700.0o TAX $ . � TOTALPAID $ 20��