The URL can be used to link to this page

Home My WebLink About982 MODJESKA CIR - Building Permits(714) 754-5273 • Fax (714) 754y856 • v+v+w.ci.costa-mesa.caB.UILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 982 MODJESKA CI Suite: Vicinity: Parcel Number: 4220$221 Applicant: FUNKE, KENNETH Address: 18567 PLUMOSA ST. FOUN7AIN VALLEY, CA Owner: WILDERMAN, MICHAEL D Address 982 MODJESKA CIR COSTq MESA, CA� Contractor. K & R CONSTRUCTION Address: 18567 pLUMOSA ST. Arch : Adtlress: FOUN7AIN VALLEY, CA Zip: 92708 Phone: Zoning: Phone: (714) 964-7171 � Zip: 92708 Phone: Zip: 92627 Phane: (714) 964-7171 License: 348877 Eng: Address: ISSUED 8Y: Status: ISSUED Applied: 02/27I2003 Issued: 02/27/2003 Phone: 2ip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING, RE-SHEATH AND COVER WITH 50 YEAR COMP SHINGLES. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $12525 $0.52 $0.00 $0.00 $0.00 5125.77 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front p-p PARKING Existina: p NOTES: Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0. 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 ss,2oo.00 $5,200.00 � '� NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under California statutes and related � regulations. (Ord. No. 92-28, § 1, 12-27-92) 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 I for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspeetione and final approval must be obtained. Failure to obtain inspections antl final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (71q) 7545626 2446d6 (6W) WORKERS' COMPENSATION DECLAHA710N: I hereDy eNirm untler penelly of perjury one oi ihe tollowing declarations: ❑ I heve entl will malntain e certifice�e of consent to self-Insure for workers' compensation, as pmvided for 6y sectlon 3700 ot the Lebor Cotle, tor ihe pertormence ol the ork tor which �his pertni� is issued. heva end will maintain workers' campensation insurence, as required hy section 3700 of ihe Lebor Coda, for the pedortnance of the work for whiCh this permit IS issuetl. My workers' compensetlon Insurance cerner and policy number are: � . Cerrlar: PoliCy Number: (This section need not be campleted i! �he permit is velued af one hundred dWlars ($700) or less.) ❑ 1 certity Ihat in ihe peAormance of the work for which this permit is issued, I shall not employ eny person in any menner so es to Decome subject to the workers' compensatlon laws of Califomia, end egrea thet II I should becomeI subject to the workers' compensation provisions ot Sacl�lony37 ot ihe Le or Code, I s�all lonhwit� com0ly with ihese provisio .A�� 1=� ✓ .�J� �� Applicant Signeture: �� Dete: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UMAWFUL AND SNALL SUBIEC� rW EMPLOYER TO CRIMINAL PENALilES AND CML FlNES UP TOONE HUNDRED TiqUSAND DOLLARE (5100,000). IN AODfTION TO THE WST OF WAIPENSATIdJ, DAM4GE5 AS PROVIDED FOR IN SECTION 3]O60F THE IABOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSEU CONTRACTORS DECLARATION: I hereby eHirm that I am licensed under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 of the Business and Prol§ssions Catle, and my license Is in tull force and eXecL Lia a Cless a TT/1—� / Conirectofs Signatura: 7 Date: _� / 1�_� � CONSTRUCTION LENOING AGENCY: � I hereby eflirm that there is a wnsiruction lentling agency for Ihe peAormanca ol Ihe work lor which ihis pertnit is iuueC. (Sec. 3097, Civil CoOe). Lentler9 Neme: Lenders Addr855: ' Signeture: Date: OWNER•BUILDEFi DECLARATIONS: I hereby attirtn that under penalry of per�ury that I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for �he fallowing reason (Sec. 7031.5, Business and Professlons Code: Any ciry or counry which requires e pertnit to consiruct, alter, impmve, demolish, or repair any structure, prior to its issuance, also requires ihe epplicant tor such pertnit to file e signetl stetement thet he or sha Is licensed pursuent to ihe provisions of the Coniracrore License Lew (Chepter 9(commencing with Sactlon 7000) of Division 3 0l t�e Business ana Protessions Gode) or thet he or she is exempt Iheretrom and Ihe basis for Ihe alleged exemption. Any Nolatlon of Section 7031.5 �y eny epplicant for e pertnit suhjects the epplicant to e civil penelry of not more than Nve hundred dollars (5500).): ❑ I, as owner ol Ihe property, or my employees with wages as their sole compensatlon, WILL DO THE WORK, end the structure Is not intended or oNeretl tor sale (Sec. 7044, Business end Protesslons Cotle: 7Te Contraciore License Law dces not apply to an owner of property who builtls or improves thereon, entl who does such work himsetl or herself or ihrough his or her own employees, provitled that such improvements are not intended or oflered for sale. If, howaver, tha building o� Improvement is soltl wit�in one yeer ot completion, ihe owner-huilder will have ihe burden of proving that he or she did not build or improve for purpose ot sele.). � ❑ I, 85 owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTOflS to construct the prqett (Sec. 7044, Business end Prolessions Cotle: The contractors Llcense Lew tloes not epply ta en awner ot property who builtls or improves �hereon, and who contracts br such project wlih e contractor(s) license pursuant to ihe Conirectore License Lews.). ❑ I em ezempt under sec. Business and Professions Cotle for this reason: Signatura: Date: Owner ID verifietl by tlrivar's license. ❑ Ves ❑ No Driver'S License No. Venfcation af Ownershlp by (rype of document, i.e. � praperry tax bill ar deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Expires: ❑ I hereby cenify t�et no eacavetion Ilve (5) or more feat in tlepN imo which e person is required to descend, wiil be made in connectlon with work euthonzed hy this permil, end ihat no building siructure, scaflolding, lalsework, or demolition or dismantling fhereof, wiil be more �han thirry-six (36) leet high. (Chap. 32, Grp 2, Ah 2, Sec. 341, Title 8, Celitomia Adminisirative Code). . ❑ As owner-builder, I will no� employ enyone to do work which would require a Dermit from ihe Division o( Industrial Safety, as noted e6ove, unless such person hea e permlt to tlo such work irom the division. Signature: Date: Division ol Intlustnal Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVATON OF ENfRY: I ceniry under penalry of perjury that I have read this appliwtion and state thet the informatlon given is correcL I egree b comply with all stete laws end clry ortllnances relating to builtling consWction, and auihorize represenia�ives oi ihe Ciry ol Coste Mese to enter upon the ebove-describetl property for inspection purposes. I egrea not to occupy or allow occupancy of any buildinq authorized by this permit until tinal inspection. ig ur e�ner(sY � � �-�A'ye Lv%–P l�l ��7 AnNOr Authonzed Applicent Date COUE I, INSVECTIONTYPE 1616 Flxetl System Final Fire PreveNion 1266 Pool Spe Final 200 Final Re-Roof 201 FIneI BIocWRetelning Well 202 Finel Factory Firo Place 203 Finel Sign 204 Finel Demoli�lon Qdjg INTRIALS fl�F-�Z � CODE♦ INSiECTIONTYPE 206 Final Mechanicel 208 Final Plumbing 210 Final Electrical 212 Final Fire Preven�ion 220 Final Planning Approval 222 250 Final Site Final BuildingiOccupancy PAIE ItIIQ1dLi �,� , � 4386 I COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 F � w o. a y H CL' F G ¢ G .� d � ..l C v] a � � L Z W x 3 For Applicant to Fill i� .�pletely — U e In� BVILDING LOt 19 ract 9592 , ADDRESS OWNER J.H. Gregory MAIL 3187 "G" Airway AVe. ADDRESS !7C CITY Ci0$f.�d D1esa N0�( JZ— BRANCH t34Z54- wilsnire tslva ADDRESS BeVOY'I.�J I1111S � Ca • ARCHITECT JaCk HeSter TE"j59-02 OR ENGINEER N ir. r �u.230 ADDRESS ewAo� each. �a. CONTRACTOR J.H. Gre�ory Constructio�. ADDFESS3187 "G" Air�vay Ave. c�T� Costa Iviesa, No`.751-3a4 LIC. No. 285-981 LICyNO. OOSl79 OIF LOT 35oosq. ft. average N°owoN �oa� � USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILOING AND WORK TO eE PEfiFORMED I hareby eeknowletlge that I have reatl this applicaHon end stete ihat the ebove Intormation is correct antl agree to comply with ell laws reBulatinB building conrtruction, and I sholl not employ any person (n vlolation of Me workman's compensation lews of Me State ot Californla. I hereby cartify thet I am properly Iicensatl as a contrector under Ne State of California Business and Pro sions Cotle, Divlsion 3, Chapter 9,� et such li� ��re i II forca end affact, Or I em exempt the provist ns th eta of Calltornia Business entl Prof lons otla. Divis n ar 9. Pormittee �Fe 2F-��"`:°JOit:os�1 A-�22u.57 �,,<, APPLICATION FOR STRUCTURAL PERM[T RECEIVED BV DATE RECEIVED nnTF �ssiicr A.P. NO. OS� OJ � BUIIDING � ADDRE55 � � TRACT ( W AOD ALTER XX ER J.H. Gregory fies Vd/^var """'$ 36,660 OF VARDS APPROVED u r. USE OF NEW fJ�`�/p� BUILDING /� VARDSAPPROVED ACCESSORV BUILDING DI5TANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR.� '% , — % DATE � C.U.P.# APPROVED' ��`r� �APPROVE ' �/` / •� nnTc `T � �� 1442SQ. FT. J=467 sq. ft. THE AMOUNTSHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT F ONLY: VAIUATION PERMIT FEE S /DO PLAN CHECK y $ 36,660.0o TAX $ 2 TOTALPAID $ 22 S/ N n m m' m � m � m 0 � U