HomeMy WebLinkAbout232 MONTE VISTA AVE - Building Permits(714) 754-5273 • Fex (714) 754-4856 • �wn✓.cf.costa-mesa.ca.us •
BUILDING PERMIT
Job nddress: 232 MONTE VISTA AV
Suite:
Viciniry:
Parcel Number: 43918154
Applicant: SKIDMORE, GLENN
Address: 232 MONTE VISTA AVE
COSTA MESA, CA
Owner: SKIDMORE, GLENN
Address 232 MONTE VISTA AVE
Contractor:
Address:
Zip;
Arch :
Address:
COSTA MESA, CA
Zoning:
Phone: 949-
Zip: 92627-1315
Phone:
Zip: 92627-1315
Phone:
License:
Eng:
Address:
Phone:
// YAIFi UHI V C, GV J I N MCSA, liH tlLOLti
ISSUED BY:
Status: ISSUED
Applied: 09/20/2002
Issued: 09/20/2002
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF WOOD SHAKE, INSTALL SHEATHING, COVER WITH 50 YEAR COMP. INCLUDES ATTACHED GARAGE.
Plan Check: $0.00
Permit: $12525
SMIP Res: $0.60
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.85
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existin : 0
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,000.00
ss,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ortl. No. 92-28, § 1, 12-21-92)
EXPIRATION: This pertnit sha�l automatically expire and become void if work is not commenced within 780 days, or if work Is suspended or ebandonetl
tor a period of 180 days.
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeetlona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiratlon of ihis pertnit.
FOR INSPECTIONS CALL: (714) 754-5626 �
zsas+e�aroo�
WORKERS' COMPENSATION DECLARATION: � �
I here0y aRirm undar penalry of per�ury one of the tollowing decleretians:
O I have entl wiil malntain e certilicate ot consent to self-Insure lor workers' compense0on, es provided for by seaion 3700 of Ihe Lebor Code, br the peAortnance of the
\ wOrk for which ihis permit i9 issuetl.
❑ I �ave enA will maintain workers' compensetlon i surance, es required by sectlon 3700 0l the Labor Cotle, tor I�e pertortnance oi Ne work for which Nis pertnit is issued.
My workers' compensati/p�n �In/yy ce carrie number ere:
Carder: �( V/7� � PpllCy Number. O �
!s s tion need not 6e O�et d i fhe pem is velued af one hundred dol/ars (S/00J or /ess.) ��
I certily thel in the peAortnence of the work for which Ihis permit is issued, I shaA not employ any person In any manner so as to hecome suDject to the workers'
compensation laws of Celifomia, ena egree that If I should become sub�ect to ihe workers��mpen5ation provisions 01 Section � t�e Lebor Cotle, I shell fonhwith
comply with these D�o '�o s. {�_ � � //�7,�- � 7� �]
ApplicentSigneture: 0/hm �.7T"f,�1,+Wf7`✓�1 Dele: !/(.JI l /
WARNINO: FAILURE TO SECIIRE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTI 5 D GVI�UP TOONE HUNDRED
TTIOUSAND DOLLARE (5100,000), IN ADDITION TO TME COST OF COMPENSATION, DAMAGES AS PROVIOEO FOR IN SECTION 3]OB OF THE LABOR CO�E, IMEREST, AND FTTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby altirm that I am licensed under pravisions ol Chapter 9(commencing with Seclion 7000) of Division 3 0l the Business antl Professions Cotle, end my license is in full
force end effect. Lic. N Cless q
Coniractors SignaNre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby ettirtn that Ihere is e construction lending agency for Ihe pedormance ot the work tor which this partnit is issuetl. (Sec. 3097, Civil Cotla).
Lentlefs Neme: Lenders Adtlress:
Signetura: Oeta:
OWNER•BUILDER DECLARATIONS:
I hereby eltirm thet under penelty ol perjury that I em E%EMPT FROM THE CON7RACTORS LICENSE LAW tor I�e following reason (Sec. 7031.5, Business and Protessions
Cotle: Any city or counry which requires e permit to consiruct, elter, improve, tlemolish, or repair any structure, pdor to ils issuance, elso requires the epplicant for such pertnit
to Ille e signed statement thet he or she Is Iicensetl pursuent m the provislons ol the Contrectors License Lew (Chapter 9(commencing wit� Sectlon 7000) of Division 3 of the
Business end Professions Code) or Ihat he or she is exempl theretrom and Ihe besls for the alleged a:emption. Any Woletlon of Sectlon 7031.5 Dy any eppliwnt for a permlt
su6�ects the epplicant to e civil penelry af not more t�en five hundred dollers ($500).):
❑ I, es owner of ihe properry, or my employees with weges es Iheir sole compensatlon, WILL DO 7HE WORK, and the slructure Is no� Intended or oHered for sele (Sec.
7044, Business and Professlons Cotle: 7he Con[raMors Licensa Law does not aDPly to en owner of properry who builds or improves �hereon, and who tices such work
himsetl ar hersetl or Ihroug� his or her own employees, providetl that such ImprovemenLs are nat intentletl or ottered lar sale. It, however, the building or improvement is
sold within one year ol completion, the owner-builder wlll have Ihe burden of proving that he or she did not Dulltl or improve for purpose of sele.).
� I, es owner of the property, em EXCLUSIVELY CONTRACTNG WITFI LICENSED CONTFiACTORS to construct t�e p�olect (Sec. 7044, Business end Professions
Catle: Ttie contractors License Lew does not epply to an owner ot pmperry who builtls or improves t�ereon, end w�a contrects tor such project wit� e contwctor(s)
licensa pursuant to the Contractors License Laws.).
❑ lam
SignaWre:
Owner ID
sec.
by tlrivers license. ❑ Ves ❑ No
Business end Professions Code br this reason:
Data:
Dnvels License No. Ezpires:
Vedticetion ol Ownership by (type at tlocument, i.e. - pmperry tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CERTIFICATION:
❑ I �ereby certify t�el no excavetlon tive (5) or more feel In depth inro which e person Is required to descend, wlll De matle in connectlon wlth work euthorized by thls
pertnit, end that no building strucNre, scallolding, talsework, or demolition or tlismentling thereot, will be more than thirry-sia (36) teet high. (Chap. 32, Gry 2, An 2, Sec.
341, Tltle B, Calitornle Administrelive Cotla).
❑ As owner-builder, I will not employ enyane to tlo work which would require e pertnit from the Division of Industnal Sefety, as notetl ebove, unless such person has e
permit to tlo suc� work tmm ihe division.
Signature: Date:
Division of Industrial Sefary Permit Number:
CER7IFICA7E OF COMPLIANCE AND AIJTHORIZATON OF ENTRY: I cenity untler penelty of perjury that I have read this epplicelion and stete ihat che intortnation given is
correct. I egree to wmply with all state lawspand ciry ordinances relating to Duilding constructlon, anC euthodze representetiv ot the Ciry ot Costa Mesa to enter upon the
ebovq�tle;cnbed prop��b� ecti nq purp ses. I agree not to occupy or ellow occupancy of eny building authorized by� jl,urpi�(ina��ns tp�1 ion. '
4r 1/. m. 11 � Yv� v U—
/A'LU/�� IdL�N/YYfU1P O
° Signature Oi Le9al Owner(s) ate
AnNOr Authorized Applicant
COOE I. INSFECfIONTYVE
1618 Fizetl System Flnel Fire Prevention
1268
200
201
202
203
Pool Spa Finel
Finel Re-Root
Finel BIocWRetelning Well
Final Factory Fire Place
Finel Sign
204 Final Demolition
P� Uffi944
Ib•-17-OZ cv'�
COOEt INSGECTIONTYFE
206 Finel Mec�anical
20B Finel Plumbing
210 Finel Electricel
212 Finel Fire Preventlon
220 Final Planning Approval
222 Finel Site
250 Finel Building�Occupanc.y
� It�
C''.�t.�y � C'� ��2ea.a s��� D��
OWNER-BUILDER
VERIFfCATION
,• _ � ti �: i
A city or county, which is reyuired to givc notice pursuant to Section 19830, shall a[[ach ro such notice, and,
as a condition precedent to issuing a building permit, requireihe completion'and �eyuire fhe reWm of, an
owner-buiider verification.
Attention Property Owner:
`- , ���.' .
An `owner-builder' building permit has becn applicd for in your name and bearing your signawre.
Please complete and retum this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building pertnit. No buildine permit will be issued until this
verification is received.
I. 1 personally plan [o provide the major labor and matcrials for conswction of the proposed
property improveme . ❑ Yes ❑ No
2. I(havelhave not) signed an applica[ion for a building permit for
the proposed work.
3. I have contrac[cd with the follawing person (tirm) to provide the proposed construction:
Name
Address
Phone ( )
City _
Contrac�ur's Lic. No.
4. 1 plan to provide portions of the work, but 1 have hired the following person to coordinate,
supervise and provide lhe major work:
Name
Address
Phone ( )
City —
Contractor's Lic. No.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name
ID02�a6 (REv. s99)
Address
Phone Type of Work
I hereby afficm that I have received a copy of the infonnation set focth in Section 19830 of the State
of California Health and Safety Code'and have completed Ihe above information to [he best of my personal
knowledge, in compliance with Ihis State law.
Signed
Name:
(Printed or Typed)
C.D.L. # OR S.S. # �� �
For more information call City of Costa Mesa Building Division at (714) 754-5273.
1012J8 (REV. 898)
S OWNER
� JOB AC
GENER
0� `lo.
� 1. E(
SOIL
GAS
PROP. SWft. �INE U !
SPRINKLING SYSTEM
MISCE
ROUGM HEATING AN� A
UN�ERGROUN� U
ROUGH WIRING
TflENCHES � FORMS
FLOOR SVSTEM
THING
FRAME ANO FLASHING
- taE -
PLASTER, BROWN COAT
1TURqL, FINAL J
NF�
DATE
DESCRIPTION of
FIRE ZONE
SUBCONTRACTOR
CITY OF COSTA MESA PLANNING DEPARTMENT
A. P. No. 11Q_719..50
Bldg. Permit No. _� 3 j �
PARK AND RECREATIONAL FEES -
lUN 23-71�n��001253 0*+�*�+75.00
Apartment Developments
Fee Payment Receipt
Project Address 232 MONTE VISTA AVENUE
owner's Name SOREN J. SUNDBERG
Bachelor or 1- Bedroom Units @$25.00 =
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units
Total ninnber of Dwelling Units
@ S�s.00 = 75.00
Total Fee
Planning Department Approval Date __ Park Area No.
By Anne Applicant's Signature C�ly� �L
CITY OF COSTA MESA PLANNING DEPARTMENT 1�N23-��cnsuOO1253R�*�•tr*�S.CO
A. Y. No. 1�..1 i"_rn
Bldg. Permit No.
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address �32 '�'`7f "1iTP ��VE�:"�
Owner's Name S�RLt: J. S�ff:`i.F'�"
Bachelor or 1- Bedroom Units @$25.00 =
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units
5 - or more Units
Total ninnber of Dwelling Units
1
1
Planning Department Approval Date �-^-71
By ri:��' Applicant's Signature
@ $70.00 =
@ $75.00 = '7r �n
Total Fee
Park Area No. 7
OWNER SUNDBERG, Sore:
�JOB ADDRESS 232 Monte V
'GENERAL CONTRACTOR Own�
AP No. 119-�-50 LOT
IM ��CTIONS
5�
GAS
W ATER
ROUGM PLUMBING
PROP. $WR. LINE � HOUSE CON.
SPRINNLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONOITIONING
UN�ERGROUND U POWER U
ROUGH WIRING
TRENCHES FORMS � STEEL REINF.
FLOOR SYSTEM
BONU BEFM � STEEL REINFORCE �
SMEATHING
FRAME ANO FLASHING
LATMING - IN ❑ OUT ❑
PLASTER, 9ROWN COAT
STP��CTURAL, FINAI
H IG, VENT., REFRIG. AND A.C., FINAL
PL�..�BING, FINAL FND GAS TEST n
ELECTRIC, FINAL
BUII�ING, FINAL
DATE
BUILDING PERMIT
K 2 car Gara
VALUE 8 3.00O.i
SUBCONTRACTOR
�,� 3b I 33
�V` COSTAMESABUILDING•SAFETVDEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFOHN�A 92626
For Applicant to Fill in Completely
BUIIDING �7 �l 'J [i3O�� / J��TA`
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ADDRE55
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CITV NO.
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LIC. NO. � LIC. NO.
SI2E %�� f /O `j NO.OF BLOGS.
OF LOT fi /� � NOW ON LOT
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SI2E OF �/ X �86y qOOMS STORIES
NEW BLOG.
EXTERIOR WALL,•%��D ROOF �Gi^ 1/nl'�
COVERING K� COVERING �-�� �7`���
USE OF BUILDING AND WORK TO BE PERFORMED
I horeby acknowletlBe tAat I have reetl this application antl stata
thet the abova information is corract antl apree to comply wIM
ail lews repuletln0 builtlinp eonsvuctlon, antl 1 sholl not employ
ony peraon in violation of Ma workman'i eompansetion laws of
Mo Srote ol California.
I hereby certify tha[ 1 em properly Ilcanaetl as a conttector untler
c�e Stata of Celifornia Buainesa anE Professione Cotle, Dlvision 3,
Cheptar 9, ontl [hat such Iicanms ara In full torca antl affxt, or I
am exempx fr � e ovislon ha Stata of Celifarnla Bu�inau
entl Pro�sssio � Cotle, Ivislo , C apmr 9.
I�' Sipnatura of J
Parmlttae �
� •••hprixed Apant
_PAIP
�a ��-�:,��,; GO �o�o � �:-: �35.CC
AP L GATION FOR BUILDING PERMIT
R C I E BY DATE RECEIVED DATE ISSU�
� �_ � �
PERM N .
A.P. NO. � � —S D `J � �'
ADDRiE 5 �`�� �O��Gv��C
TRACTItri7'/ 'L'OT / BLOCK
R
VALUE
FIRE
20NE
APPRO V E
'x N Z �5�. a cs
NE NO.OF USE OF NEW "
� � PLAN$ 'd BUILDING (��'�j
VARDSAPPROVED VARDSAPPROVED
MAIN BUILDI G ACCESSORY BUILDII
iOM /�STREE 1 ., � �.
REAR v FT. :O FT.
OISTANCE BET. BEf. MAIN &
MAIN BLDGS. ACCE�. BLDGS.
VAq. slE " DATE
C.U.P. q� APPqOVED
APPROVED 1 � �' (�Y� a,-z��-�3
RV 1J��� I lIATG I1
� `� �
SSQ. FT. o
TME AMOUNTSNOWN VNOER VALUATION IS FOR ^
TNE PURPO6E OF ESTABLISHING A PERMR FEE ONIV: �
¢
VALUATION
� VERMR FEE S � �
� ]
m
$�� PIAN CNECK § E
�j ' LL
TOTAL FEE S �
� ?3I47.
,.�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 � COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Complete/y
BUIIOING �' �2 �d�(/� , /�5�
ADDRESS ✓
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�ll;l-9-71�,.-� OO 3�'7:' A'.tl.t rn
APPLICATION FOR BUILDING PERMIT
RECEIVEQs DATE'ECEIVED ppT���l,l
/ � 7 � � 3 4
V �7 PER �
A.P. NO.I�7 �N3 �S� .�
OWN
TRACT
FIRE
ADDPESS ZONE T
CONTFACTOR S��'�E /N /7VOUF ByPA�VED
AODRESS �
TEL. Z�NE NO.OF
CITV NO. Pw�
STATE CITV �'ARDS APPROVED
LIC. NO. LIC. NO. MAIN BUILOING
SIZE /'�J NO.OF BLDGS. (FROM C/L STREET)
OF LOT ("j / j � D� NOW ON LOT O RpM FT.
USE OF
EXISTING BLDG. 5 E �FT.
NEWBLDG. ����� ROOMS � STORIES � L.SIDE FT.
EXTERIOF WA ROOF ((�O OFi�N _
COVERING �G� COVERING I�b • REAR FT.
USE OF 6UIL4�N AND W RK TO BE P RFORMEO DISTANCE BET.
�a�risT.� a� ,t�E i��o�; MAINBLDG,a.
Q.C/Li' �'9'H �C L}. %�E.f/.d6evT. c u P�
I hereby acknowletlge that I have reetl this application antl slate
thot che above intormation is correet and apree to comply with
nll laws regulating builtling construccion, and I sholl not employ
ony person in violation of [he wOrkman's compensatian laws ot
tha Stnto af Cnlitornia.
I hereby certify [hat I am properly licensetl os o conhoctor untler
[ho State of Celitomia Buzinezs antl Profazsions Cotla, DNisicn 3,
Chapter 9, antl that such licensas are (n full force ontl affec[, or I
am azampt irom the provisions of the �ot Californla Businesz
antl Professions Cotl iOTG3bn 3, pter 9.
Sipnotura ot �7�
Parminea ��'�k�
Authorizetl Agent '
0
VAWsd(J ����` �
/
ROUP I•I �
ATE '^ �� /
` � �
USE OF NEV�I..Q�¢i/ (�{/ �
BUILDINC���
)
VARDS APPROVED
ACCESSORV BUILDING
FT.
� / '1
FT.
FT.
BET. MAIN &
ACCESS. BLDGS.
DATE ��
APPROVED 3
, � L� r :a —� —% i
,D FOR � c( IAL REQUIREMEh'T:
�_P.1 1 1f �/ +� {Pitti_✓-P�
THE AMOUNT SHOWN UND�R V
THE PURPOSE OF ES'fABLISHING A
VALUATION
S
3' V � TOTAL FEE
IS FOR j
i ONLV: Q
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