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Home My WebLink About979 MODJESKA CIR - Building Permits(714) 754-5273 • Fax (714) 754-4056 • www.ci.costa-mesa.��{LDING PERMIT 77 FAIR DRIVE, GOSTA MESA, GA 92626 dobAddress: 979 MODJESKACI Suite: Vicinity: Primary Occ: R3 Parcel Number: 42205225 Applicant: BRANNON, THOMAS Address: 15161 LAFAYETTE ST WESTMINSTER, CA Owner: MURAOKA, GERALD M Address 979 MODJESKA CIR COSTA MESA, CA Contractor: BRANNONS ROOFING Address: 15161 LAFAYETTE ST WESTMINSTER, CA Zip: 92683 Arch : Address: Phone: Type of Constmclian: V-N Zoning: Phone: 714-897-8147 Zip: 92683 Phone: Zip: 92627 Phone: 714-897-8147 License: 609940 Eng: Address: Status: ISSUED Applied: Ot/26/2006 Issued: 01/262006 ISSUED BY: �"'� \ Phone: Zip: License: License: SCOPE OF PERMIT TEAR OF WOOD SHAKE INSTALL 12" CDX 1-30L6 FELT AND 30 YR COMP. SHINGLES Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $111.25 $0.50 $0.00 $0.00 $0.00 $111.75 SETBACKS MAINSTRUCTURE Fronl 0-0 ACCESSORY Front 0-0 PARKING Exislina: 0 Rear 0-0 Rear 0- 0 FEE SUMMARY PLANNING & ZONING teR 0- 0 Left 0- 0 Required: 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 8a,aoo.00 sa,eoo.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPEC710N5: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetlona and (inal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 eaati<6ltvoo) WORKERS' COMPENSATION DECLARATION: _ I hereDy eHirtn under penalty of perjury one ot the tollowing declarations: � ❑ I have end.will mP�ntein a certificate of consent to self-Insure tor workers' compensetion, es provided for by section 3700 of the Labor Cotle, for the padormance oi the w tor which this permit is issued. I have ntl will maintain woMers' compensation insurance, as required by section 3700 of the Labor Code, for the peAormance of the work for which this permil is issued. My wo ers'�corm�0� en on Ins nce carrier and policy numher are: — Carrier: J/ _�U�� Pol' Numbe /a�a 8'9,P d �o Thi ctlon need nof be completed il the permit is valued at one huntlretl dollars ($100J or less.) ❑ 1 cerii ' the pedormance oi ihe work ior w�ich ihis pertnit is issuetl, I shall not employ any person in any manner so as to become subject to the workers' pensation s oi Califomia, and agrae that if I should become subject to the workers' compensation provisions ot Section 3700 of ihe Labor Cotle, I shall forthwith co ith thes prov ns. '7� Appli niSigneture: �a; � �¢(p �� WA ' TO SECURE WORKERS' CAMPENSATIqJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOV TO CRIMI PENALTIES AN� CIVIL FINES OP TOONE HUNDRED THOUSANDOOLLARE�SiW.�O),INADDITIONTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]O6 ELPBORCADE,INTEREST,ANDATTORNEYSFEES. LICENSED CONTRACTORS DECLARATION: I hereby aH� a I am licensed un r r ipigrys�oSChapter 9(commencing with Section 7000) of Division siness nd P.yf ions Code, and my license is in full force an eHect. �. N 7 Y�J lass q J Contiac rs Si re: Date: '� CONSTRUC ON LENPING AGENCY: ❑ I hereby affirtn that Ihere is a consiruction lentling agency tor Ihe pedormance ot the work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lendefs Name: Lender's Adtlress: Signaiure: OWNER-BUILDER DEFLARATIONS: Date: I hereby affirm that untla� penalty of perjury ihat I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any city or county which requires e permit to consiruct, atter, improve, demolish, or repair any stmcture, prior to its issuanCe, also requires ihe applicant for such permit to file a signed siatement that he or she is licensed pursuant to the provisions oi ihe Contractors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of the Busi�ess antl Professio�s Cotle) or that he or she is exempt theretrom and the hasis tor tha allegetl axemption. Any viWation ot Section 7o31.5 by eny epplicant fw e pertnit subjects the epplicant ttl a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner ot the p�operry, or my employees with wages as thei� sole compensetion, WILL DO THE WORK, and ihe structure is not intended or oHered for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law dces not apply to an owner of pmperty who builds or improves thereon, antl who does such work himself or herself or through his or her own employaes, provided Ihat such improvemenis are not intended or oflered tor sale. If, however, ihe building or improvement is soltl within one yeer ot completion, the owner-builtler will have the burden of proving that he or she tlid not build or improve tor purpose of saie.). ' ❑ I, es owner of the p�opetly, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Professions Cotle: The contreC�ors License Lew tloes no� apply to an owner of property who builds or improvas [hereon, and who contracts for such pwject with a comractor(s) license pursuant t0 the Coniractors License Laws.). ❑ I am exempt unde� sec. Business and Professions Code for ihis reason: Siqnature: Date: Owner ID veritied hy dnver's license. ❑ Ves ❑ No Driver's License No. Veriticatlon ot Ownership by (type of document, i.e. � pmperty tau hill or daed): _ Expires: DIVISION OF INDUSTR�AL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify tha� no excavation five (5) or more feet in aepth into which a person is requiretl to descend, will be made in connec�ion with work authorized by this permit, and Ihat no builtling sWCWre, scaHoltling, talsework, or tlemolition or disman�ling ihereof, will be mora than thirty-six (36) fee� high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Atlministrative Code). ❑ As owner-builder, I wili not employ anyone to do work which would require e permit irom the Division of Indusinal Safety, as noted above, unless such person has e permit to do such Work irom Iha division. SignaWre: Date: Division o( Industnal Safery Permit Number: CERTiFlCATE OF COMPL�ANCE AND AIJTHORVATION OF EMAV: I cenify under penalty of perjury �ha� I have read this appiication anC state Iha� �he infortnation given is wrrect I agree to comply with all slete laws and city ordinances relating to building consiructioq end authonze representatives of Ihe Ciry of Costa Mesa to enter upon the ebove-described property for inspection puryoses. I agree not to occupy or allow xcupancy of any buiiding aulhorized by Ihis permit until final inspection. CO�E t' INSPELTIONTYPE �- 7676 Fixetl System Final Fire Pravention 1266 200 201 202 203 2Q4 Pool Spa Final Finel Re-Rooi Finel BIocWReta�ning Wall Final Fectory Fife Place , Final Sign Finel Demalition RL 2_-z-OG � CODE I INSPECTION flPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 FinalBuilding/Occupancy / % �f -/ • ,�.� � � City uf Cosl� M Ibnnin� I.)cpnrbncnt � � " �- .�. , Posi O(liec l3ux i_.lU N�� /� �.{�y�� '� � 7% f:�ir Drivc V l � Id (q(�,1fl' t��11u`- Costa �A�sa, Culitornia 92G26 L U r��U�Uf:��il�Rlt�� (7t4),5G5zn5 RECEI_VED CITY QF CCS+A �,7ESA REQUEST FOR OCCUPANCY PI.."-^i@�,�;. „��t.�, . (Sinyle Family Residential or NOV 2� 1977 PM �ondominium Units) ��g�9�10�ll�12i1i2i3i4i5�6 � Tract No. 9592 Date October 1, 197� Lot No. Address 979 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 undersiyned, by executing this ayreement, acknowledges that (he, she, they) (was or were) advised that this tract has not been yiven final inspection nor has it been accepted by the City of Costa Mesa as haviny complied with the conditions of approval which were imposed by the Ciry at the timc the (inal tract mup was approved. � The City 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 2he City harmless from any daim resulting in damaye or personal injury to the undersiyned by reason of the aforementioned uncornpl GdF 0'iG9-26 By �� %%�(.(/"" D¢veloper n d or AuNorized R upr�;enmtive BY �' �ender p _ 438b5 COSTA MESA QUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 F � a ¢ � y S F G � F a G .i a > r � � w o� 0 � L z W 3 For Appl' ��ill in��pl�ly= Us�nk On B BUILDINGL � 'dC V`J�%L � �� ADDRESS OWNER J.H. Gregory nna�� 31 7"G" Airway Ave. ADDRESS 0$ a esa TEL. — CITV NO. LENOER��eat Western Svgs & Loan BRANCH 8484 Wilshire Blvd ADDRE55 B2V@Y'117 H111S Ci$• ARCHITECT JaCk HesteT' TELqC[�_02 OR ENGINEER N � � � ADDflESS NBW�JOpt Beach.rCa. u� CONTRACTOR J.H. Gre�orv Coi�structi ADDRESS 31V7 ��G�� Airway Ave• TEL. CITY �i�5't.a, r�7esa No� 751-38 LIC.No. 285-981 LICVNO. OOV1r OFLOT 35005Q.ft.avera �owoN�o� � USE OF Separate permits are required for electric, plumbing and heating work. USE OF BUIIOING AND WORK TO 8E PERFORMED Single Family Res. I hereby acknowledqe that I hava reotl this epplicaiion antl stete thet the ebove intormetlon is correct entl a0rae to comply with all lews raguleting building consvuciion, entl I shall not employ eny Derson in violetlon of the workmen'a compensation laws of the State oi Califo�nia. I hereby eertify that 1 em properly Iicen as a contractor untler che Sute of Califorqie Business and Pro ions Code, Division 3, Chapter 9, entl that such licen s er ull torce and eftect, or 1 am axemp ro the provisio s ot tete of Celifornia Buzinecs antl Prote slons otlo 'slo 3, ar 9. Signature of pa�o ,PR ?_5-77�.;� �01413�% *�: * ZSL.00 APPLICATION FOR STRUCTURAL PERMIT RECENED BY DATE RECEIVE� nn'rF issuFn ADDRESS � TRAi NEW ADI XX OWNER UE Res S— FIRE �i)1f�Z'L•1 J.H. Gregory C �:ar VALUE 1J. \'I �E _/i INO.OF�IUSEOFNEW �� -i/)�/ FV1NS ,� BUILDIN�I� VARDSAPPROVEO VAR�SAPPROVED MAIN BVI�DING ACCESSORY BUILDING DISTANCE BET. MAIN BLDGS. VAR. # C.U.P. � APPROVED I � 1?1�F SQ. FT. J—W57 sq. ft THE AMOUNTSHpWN UNDER VALUATION THE PVRPOSE OF ESTABLISHING A PERMfT FEF VALUATION PERMIT FEE $ L o PLAN CHECK $ $ �2�Voo TAX E TOTALPAID § � N n m i m N J m e a N m LL � U