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Home My WebLink About986 MODJESKA CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAdtlress: 986 MODJESKACI Suite: Vicinity: RESIOENCE AND ATTACHED GARAGE Parcel Number: 42205220 Applicant: CLINE, ROBERT Adqress: 244 N OLIVE ST UNIT 8 OR4NGE, CA Owner: ULRICH, ROBERT E Address � 986 MODJESKA CIR Zoning: Phone: 714-771-5514 Zip: 92866 Phane: COSTA MESA, CA Zip: 92627 Contracror. CLINE ROOFING AND CONSULTING Adtlress: 244 N OLIVE ST UNIT B Phone: 714-771-5514 ORANGE,CA Zip: 92866 License: 807421 Arch : Address: Eng: Address: Stalus: ISSUED Applied: 07/22/2004 Issued: 07/22/2004 ISSUED BY: � Phone: Phone: Zip: License: License: ' SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE: T/0 EXISTING WOOD SHAKE ROOF, 1/2" CDX SHTG, 1 LAYER 30# FELT, APPLY "50-YEAR ELK PRESTIQUE WITH RIDGEGLASS RIDGE. 1900 SF Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $125.25 $0.51 $0.00 $0.00 $0.00 $125.76 SETBACKS�� MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: o 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 �� , 35,�00.00 as,ioo.00 NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under California 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 180 days, or if work is suspended or abandoned for a period of 780 days. INSPEC710N3: 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 final approvel must be obtained. Failure to obtain Inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALI: (714) 7545626 26a618 (B/00) WORKERS' COMPENSATION DECLARATION: I hereby eHirm under penelty of perjury one ol ihe following declarations: ❑ I have and will meintain a certiticate ol consent to seli-Insure for workers' compensetlon, es provided tor 6y sectlon 3700 of the Lebor Catle, br Ihe peAormence of the work lor which Ihis pertnit is issuetl. ❑ I have flntl will maintain workers' compensetlon Insurence, as requlred 6y sectirn 3700 ot the Labor Cotle, for the peAortnance ot the work for w�lch this pertnit is issued. My workers' compensatlon Insuranca carrier end polity number ere: Cartier: Policy Number: (This sectfon need wt be cromplefetl i! (he permif is valued al one hundred dollars ($100) oNessJ �j I cenity t�et in the peAormance of t� work to �ich this permit Is issued, I shall not employ any person in eny manner so as to become sub�ed to ihe workers' campensallon laws of C Ia n gree II I should become sub�ect to the workers' compensetion provlslons of Saccc{{{��on 3700 nt t�e Labor Code, I shall forthwith comply wlth t�esa prov' io . �/Z �/� � ApP��cant SlgneNre: Dete: � WARNINO: FAILUPE TO SECURE wORKERS' COMPENSATION CAVEqAOE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CPIMI PENAL IES AND CIVIL FINES UP TOIXJE HUNDRED TFIOUSAND OOLURE (E100.000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAOES AS PROVIDED f-0R IN SECiiON 3108 OF THE LABOR CODE, INTEREST, ANO ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eHirm that I em licensetl untler�ppr visl ns of af�ter 9(cf}�mencing with Section 7000) ot Division 3 of Ihe Busines lorce entl eHecL Lic. N. 8O7`'l Z � l/ /l // Class R � Comrecrofs Signawre: /4 _ Date: � en0 my license Is in full CONSTRUCTON LENDING AGENCY: ❑ I hereby eNirm Ihat t�ere is a construction lending agency lor ihe perlormance of Iha work for which this permit is Issued. (Sec. 3097, Civil Cotle). Lender's Neme: Lentler's Address: Slgneture: Date: OWNER-BUILDER OECLARATIONS: I hereby eftirtn that under penalty ot perfury lhal I am E7(EMPT FROM 7HE CONTRACTORS LICENSE LAW tor the tollowinq reason (Sec. 7031.5, Busineu and Professions Code: Any ciry or counry which requires e permit to construct, alter, improve, demolish, or repair any swcture, prior to its issuance, also requires �he epplicam for such pertnit �o file e signed statement Ihat he or she is Iicensed pursuant Io the provisions oi the Contraaors License Lew (Chapter 9(commendng with Sealon 7000) of Divislon 3 of tha Business end Professions Code) or the� he or she is exempt �herefrom end iha basis for the elleged exemptlon. Any Nolation of Sectlon 7031.5 by eny applicant for e pertnit sub�ecis iha applicent ta e civil penelry af not more than tive huntlretl tlollers ($500).): ❑ I, as awner of t�e property, or my employeas with wages es t�eir sole compensa�ion, WILL DO THE WORK, and iha structure is not Intendad or oHered for sale (Sec. 7044, Business and Pmfessions Code: The Contractors Llcense Lew does not apply �o an owner of property who builds or improves thereon, ana who does such work �Imself or herself or ihrough his ar har own employees, provided ihat such improvements ere not Imended or oNered for sale. If, howeve�, ihe builtling or Improvement Is sold within one yeer of completioq the ownerbuilder will have �he burden ot proving ihat ha or she did not build or improve tor purpose of sale.). � ❑ I, as awner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe projact (Sec. 7044, Bubiness antl Profes5ions Code: The contractors License Law does not epply to an owner ol property who builds or Impmves Ihereon, ena who comrects lor such pm�ect wlt� a wntractor(s) . license pursuent to the ConirattorSliCen50 LewS.). ❑ I em exempt undar sec. Business and Prolessions Cade lor this reason: SignaWra: Date: Owner ID venfied by dnver'Slitanse. ❑ Ves ❑ No DriverS License No. Venlication of Ownership by (type oi tlocument, i.e. � pmperry tax bill or deed): Espires: DIVISION OF INDUSTRIAL SAFETY PERMI7 CER7IFICATION: ❑ I hereby certify that no excavetion five (5) or more feet in depth into which e person Is required to descentl, wlll be meda in conneclion with work euthonzed by this permi�, and that no building strucWre, scattolding, falsework, or demolilion or dismantling Ihereof, wlll be mora than Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Celifornla AtlminlstraNve Cotle). ❑ As ownar-builder, I will not employ enyone to tlo work which woultl require a Dermit from ihe Division oi Industriel Sefery, es note0 e6ove, unless such person hes a pertnit to tlo such work irom the division. Signature: Date: Division of Industrial Safery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUT}10RIZAl10N OF ENTFiY: I cetlify untler penalty of perjury that I have read this application end state �hat ihe information given is wrrect I egree b wmply wlih ell sta�e laws and ciry ordinences rela�ing to building consiruction, and euthorize representatives ot ihe Clty ot Costa Masa to entar upon the ebove-describetl property tor ins ection purpo s I agree not �o occupy or ellow occupancy of eny building euthonzed by �his Dermit un�il tinel inspection. n s� f L I ONner(s) ^� ?(e� % J L � (/ �7 AnNOr Authonzed Applicant Date COUE 1. INSPECTIONTYGE 1616 126fi 200 201 202 Flzetl Sys�em Final Flre Prevention Pool Spa Final Final Re-Roof Flnal BIocWRetaining Well Final Factory Fire Place 203 Final Sign 200 Final Demolition P6g UIIID9L5 8-31roti � COOE I INSiECTION TYPE 206 Finel Mechanicel 208 Finel Plumbing 210 Final Electricel 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final Bullding�Occupancy Q�g �$ AGolieant ta fill in all spaces exeeo< tnose within heavy Oortler Iines antl sign all apP�oDriate aeclarations. CITY.OF COSTA MEsn CONSTRUCTION PERMIT . Project Address � • � ApplicanYs Mailing Address . �� •Owner's Name �'� Y"� t- S - Phone�� -% <<+'� Address G�j � i �.7 C� �.l < S i� A � i2 � Arch/Eng. Licenu No. Address Contractor'sNam «+�S � ��^M � - phone�� Addresslmailingl � '�� '�'� ��(' -'7 . CitY License No _ �+`,_� r . Q . � . � 7j 1 �- ' _ _ LICENSED CONT DECL ATION � 1 hereby aftl�m that I am litense untlar provision5 of Charter 9(commenUn9 M,witn section ]000) of Divislon 3 ot tha Business antl Protezslons Cotle, antl I\v my Iicense is in tuli (orce a tl eHect. �p License Class C-` �� Licens Ne,� o. �'7 �� Oate ( �-•S -f+l 519nahre mW�H--�u 1C._�h./� . � WORKERS' COMPENSATION DECIARATION � � I hereby atiirm that I have a certifiwte of mnsent to self-insure or a certificate \ of Workers' Compensation Inzurance, or a certliietl cooY Ihereoi (Settion � 3800, Lab. CJ n �IicY No. ��."��'f%,� ComPanYG�%��P \ Certi(ietl mpy is here�y fumishetl. � Certi etl py is,�j�etl wlth the city Builtling Division pate �� '�'�'S / APPlicanl' L fC� V� $ �� I M�- EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be Completetl if the permit is fOr one huntlretl ($300) or I255). 1 certify that in the ptrfOrmance Of thC work fo� which this permk is i55ueQ I snall not employ any person in any manner so as to become subject to the Workers' Compensatlon Laws of Calitomla. Date Signa[ure � 'NOTICE: I(, atter making this tleclaratlon, you shoula become subject to the Wo�ken' Compensa[iOn provisions of [he t2bor Cotle, you must to�tbwith mmply witit sucn O�ovi5ion5 or this Oe�mil Shall be tleemetl r¢vok¢tl. CONSTRVCTION LENDING AGENCY - 1 hereby affirm that there is a construction lentling agenq for [he performance ot the work for which [his permit is i55uetl (Section 3097 Civ. C.) Lender's Name �entler's Atltlress OWNER BUILDER DECLARATION I M1ereby a/firm thal I am exempt lrom tbe ConVdctor's License Law to� the followinq reason (Settion ]031.5 Businezs antl Professional Cotle: Any ci[y or county wnich requires a permlt lo construct, alter, improve, tlemolish or repalr any st�ucture, prlor to Its i55uance, also requires the applicant fo� such permi[ to tile a siqnetl statement thdt he/she I5 IiwnSetl pursuant to lhe proviSlons o1 Ihe Con[ra<ror's Litense Law (Chapter 9.(rommencing with SeCtionJ000) of Divislon 3 ot fhe Bu5ine55 and Profe55ion5 Cotle) or that he/she i5 exempt there(�om antl the basis for the allegetl exemption. Any viOla[ion of Sectlon ']031.5 by any applican[ to� a petmit subjects the applicant to, a Civll nenalty of not more than tive huntlretl tlollars (5500). � I, as owner ot the property Or my employees with wa9es as thaii sola �mpensation, will tlo lhe work, antl the structure is not intentletl or ofteretl �or sale (Section 7o4a, Business antl Professional Gotle: The Contractor's Litense Law tloes not apply to an owner of a property wM10 Oulltls or improves thereon, antl who tloes such work hlmself/herseli or through his or her own em0loyee5, provitletl Iha[ such improvaments are"noi intentletl or offeretl for sale. It, however, the bu71tlin9 or improvement 155oltl within one year of com- pletion, tne owner wlll have the burtlen of proving he/she tlltl not builtl or Im- prove for the purpose o( sale). � � , ❑ I, as owne� of tne property, am oxclusively contracting with licensetl con- iractors to consVuct the project (Secllon 7044, Business ana Protessions Cotle: The Contractor's License Law tloes not apply co an owner of prooerty who builtls or improves thereon, antl who <ontracts for sucn projects with a wn- tractor�51 IlcenSe pursuant to the Cont�aciot's Llcense Law). I am awar< that proof of lheir Wotker'S Compen5ation in5urance shoultl be provltletl to me. ❑ I am exempt untler Se<tion � B. & P. C: for fhis reason Date Owner 1 hereby certify that I have reatl thiz applicatfon antl state that the-above information Is corract. I agree to <omply wrth all dty antl munty ortlinances antl state lawz relating to builtling construction, an0 nereby authorize repre- sentatives oi tnis city to enter upon the above-mentionetl property for inspectlon purpases. � Signa[ur¢'�+arc� lj �. i\ .� Dale I.� -.� �rt� Drivers' Litense or SS � � �—�' �- TVPE OF CONSTRUCTION LJ NEW LJ ADO Ll ALTERATION LJ REPAIR � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p,p,# DESCRIPTION OF WORK/USE OF BLDG. S Main Building: E TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PRQIECT DESCRIPTION 5t;. FT. OCCUaANCv C Right K Left CONSTRUCTIONTYPE VALUATION$ $ � ZONE GRADINGGU.VDS. ACRES p�ng.Ref.#� rmmarks: - Planning Notes: Bar Sink ' Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher � Drinking Fountains Floor Drains � Floor Sinks Gas Service Outlets Kitchen Sink Lavatories . °—Trap Roof Drains . Reinspectian Fee, $15 Ducl-UnderGround Duct -'Structural Duct - Ventilating_ Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑6100,000 BTU 0100,000 Reinspection Fee � $15 CMF 0865-46, rev. 30/84 White - BUIltling; Canary - Applicant: Pink - Accountin9: Goltlenrotl - AssesSor Showers Servite Sink Sewer Cap Sewer Connection ' Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash - Issue Fee IANICAL Hoad or Typel ❑ � Canopy Type I I ❑ � Re(rigeration System ❑aioo,000sru ❑ioo,000 System Fiepair/Alteration Fire Dampers ' Registers laue Fee FEES E Auwmatic Washer Canstruction PoleSub. Cooking Unit "f . Dishwasher Dryers ❑Gas �Eleceric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �0�5 KW 05-15.KW 3592 I/21/8B Zone Accessory Building: Parking Req./ r id � � ��I��FD c 7 ICAL Transformer ❑ 75-50 KW ❑ 50+KW Meter ❑up to 100amps Meter ❑over 100 amps Sub Panel Motors �0-1 HP �1 %- 8 Inc.Solar 09-15 HP �16-75+ Microwave � Pole Light Range ' Si9n ; Standing Sections Trash Compactor $ 3 I � Reinspection'Fee $15 luue Fee FEES DEVELOPMENT SEF VICES REQUIREMENTS: Zoning Appravad By Building Appraved By —�� Applicstion laUed By �� 1� $ 3 SUMMARV OF FEES BUILDING PEfiMIT $ SMIP PLAN CHECK $' � PERMIT PLUMBING g ISSUANCE PLAN CHECK 25% $ ENERGV P.C. ELECTRICAL $ ' GRADING PLAN CHECK 50°h $ � MICROFILM MECHANICAL $, TOTALFEE, PIAN CHECK 25% $ $ 5oUv TL FEES $ 3 Z O N I N G R E Q M T S \ _ 1 . `i ' CONSTRUCTION AND PLANNING POOL &' APPROVALS Permit# uate Inspector qppROVALS Permit# Date Inspector -1. l'"emporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcemen[ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement , 56. Rough Plumbing & Pressure Test �6.` Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System. 61. APPROVAL TO DECK . � 11. �Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-CondOit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 1Z..-Rough Wiring Sign 68. APPROVED FOR PLASTERING 18+. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19'Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.-Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test . 72. Underground Flush - 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling 4Structurall & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 7S. FIRE PREV. FINAL � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric . Notes:�'_,,,�f" 34. Final Heatin9 & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. FinalPlumbing ' (�'�� (,� 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final r�:l ��:.� - . .... 42. Backflow Preventer ��'� :�. ' . � `� t+. 43. Backflowlrrigation, ,^!� �.=� Ci .� 44. Landscape Irrigation System�. �-�� .>' 45. Sound Attenuatio� ,��, �=�;�-�� 46. Handicap Regulations +- .?`"'? < 47. FINAL STRUCTURE & BUILDLNG 48. Special Requirements Corhpleted,, ' 49. Electric Release to Edison �.`�j, _ �. ) 50. Gas Release to Southern California Gas Co - �� .,' 51. CERTIFICATE OF OCCUPANCY - � ' No, Date ' � ' � Cily ql Cusw M `Idnninq IJr.parimtnl ,.!�' "' I'n5l U�fiCu I3Ux ._JO � ' � i.- � 77 Fair Urivc �� fq Costa nn�s.�, cali(ornia 92G26 ib��o��JCII!� (714155G5245 � / / ' � � � �� / / � � i I R E C�� pV E D REQUEST FOR OCCUPANCY CiTY OF �CDST�C'PAESA (Sinyle Family Residuntial or , , ,.,.,�.�^ �`�T. Condominium Units) NOV J'.0 IJ�� P� , r-. �►g►9�l0illi��.'�;++�l�e'��'��. � � Tra�ct'•No. 9592 Date October 1, 1977 CMF 0569-2G Lot No. 18 Address 986 Modjeaka Circle, Coeta 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 executiny this ayreement, acknowledges that (he, she, tfiey) � (was or were) ,(/Yi0_advised that this tract has not been given final inspeciion nor has it been accepted by the City of Costa Mesa �s having complied with the conditions of approval which were imposed by the City at the time the final tract map 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 the City harmless from any claim resulting in damaye or personal injury to the undersiyned by reason of the aforementioned uncom�leted condition. � � FioUru;untulivy av ��i �H-,� Lentler �j-1 � 438b0 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CAIIFORNIA 92626 �� For Appli n t Fill ' omp etely — U� e[nk O BUILDING n � ADDRESS L Trac � OWNER J.H. Gregory ADORESS3187 "G" Airway Ave. CITV CO$�.$ Mesa NpL� 751—. F � a a y h xi F G [r] F� Q Li `a > r .a � w a. 0 �. On Z � S 3 BftANCH ADDRES: �v i� ii i uu�c.,Jv ADORESS ewpo each, 3. CONTRACTOR J.H. Gre�orv Constructio ADOFiESS �ZO ( "G" Airway A � e. ��T� Costa Mesa Noy51-3840 LIC. No. 285-981 LICyNO. OOU1 ( 7 size 3500Sq.ft.averaAe"o.oFa�o�s. � OF �OT o NOW ON LOT USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WOFK TO BE PERFOFMED Single Family Res. •n!� 25-71�:t�oa,�o�� ::�z5�.eo APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY DATE RECEIVED DATE ISSUEC -- -- �..�-l'i..% ��s' S%a�'S "C � 11 A.P. NO. BUILDING ADORESS TRACT .�irJ XX OWNER FIRE ZONE APPROVED VARDS APPROVED V F �ISTANCE BET. MAIN BLDGS. VAR, gF` C.U.P. ^ APPROVED � VALUE v I&J USE OF W � BUILDIN VARDS APPR� ACCESSORV BUI BET. MAIN & � I hereby ecknowletlge that I have reatl this epplication antl state that tha above Intormation is correct antl agree to comply with all laws re8ulatinB building construction, and I shall not employ any person in violation of the workman's compensation laws ot the State of California. 171G, J=(NC7 Sq. ft. SQ. FT. � I hereby certity that I am properly licansatl a conttactor untler the Stata of Celifornia Business antl Profe ons Cotle, Division 3, THE AMOUNT SHOWN UN�ER VA�UATION IS Chapter 9, and that such Iicenses ar in I force and effect, or I THE PURPOSE OF ESTABLISHING A PEFMIT FEE am exempt the provisio s o e ate of Califomia Buslness VALUATION PERMIT FEE S antl Prof slons otle, Divisio 3, er 9. / PLAN CHECK 5 Signature � Pe�mittee $ �2 � ��. 00 TAX S Authoriza Age t TOTALPAID $ � � n m i m m N i m � � N m 0 LL � U