The URL can be used to link to this page

Home My WebLink About3248 INDIANA AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job nddress: 3248 INDIANA AV Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 13904123 Applicant: CLAYTON, MATT Address: 976 N LEMON ST ORANGE,CA Owner. KUMAI, SUSUMU TR Atldress 32481NDIANA AVE COSTA MESA, CA Contrector: WATERPROOF ROOFING Address: 976 N LEMON ST ORANGE,CA Zip: 92667 Arch : Address: Zoning: ISSUED BY: Phone: 714-532-0810 Zip: 92867 Phone: Zip: 92626 Phone: 714-532-0810 - License: 738880 Eng: Address: Phone: Status: ISSUED Applied: 01/21/2003 Issued: 01/21/2003 Phone: Zip: license: License: - SCOPE OF PERMIT- REROOF RESIDENCE AND ATTACHED�GARAGE: T/0 EXISTING 2 COMP SHIIJGLES AND B.U.R. ROOF, REPAIR & REPLACE SHTG AS NEEDED, 2 LAYERS 15# FELT, APPLY "20-YEAR GAF COMP SHINGLES:' 28SQUARES Plan Check: $0.00 Permit: $97.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: 0 Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING LeR 0- 0 Left 0- 0 Praposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Righl 0- 0 3a,000.00 $a,000.00 NO710E: 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) 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 180 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 Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 269646 (6/00) WORKERS'COMPENSAnON DECLARATION: � ' I hereby eHirm under penalry ol perjury one oi Ihe following tleclaretions: - ❑ I have entl wlll malntain e certiNcate of consent to self-Insure for workers' compensaHon, as providetl tor by sectlon 3700 of the Labor Cotle, for the peAormance of the / work for whlch ihis permit is issued. r I heve end wlll maintain workers' compensa�ion insurance, as requiretl by section 3700 0l the Lebor Cotle, for the padormance ot Ihe work for which Ihis permit is issued. My workers' compensa�ion Insurenc ce-rrrle�r entl pollcy number ere: �� ' Carrier. 5'�IQ-Tf? ��%� A/ PolicyNumber. ��U'6 6—� Z� (Trils sectlon neetl not be comple etl i/ the permit Is velued ef one huntlred tlollers ($100) or less.) ❑ I certity that in tha pertortnence oi Iha work for which this pertnit is issue0, 1 shall not emplay eny person in eny manner sa es to become subiect to the workers' compensatlon laws of Califomle, enC egre �RI-shouttl become subJect b t�e workers compensatlon provislons oi SecOon 3700 oi the Labor Cotle, I shall tort�with comply with these pr i Applicant Signeture: � Dete: �� /2 � �/n � • WAHNING: FNLURE TO SEWRE wOPoCERS' ODMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES rW D CML FlNES UP TO ONE MUNORED THOUSAND DOLURE (5100,000). IN AODRION TO THE COST OF COMPENSATION, DAM4GES AS PROVIDED FOR IN SELTION 31O80F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eAlrm ihat I am licensetl under pmvis� force entl eHect. Lic. q_-JI1jL� Conirectors Signawre: J � of Chapter 9(commencing with Section 7000) ot Division 3 0l the B i cless a � Dete: _ Cotle, and my license 15 in full CONSTRUCTON LENDING AGENCY: ❑ I hereby aHirtn that there is a consWctlon lending agency tor the pertormance ot the work for which this permit is issued. (Sec. 3097, Civil Gode). Lendefs Neme: Lendefs Address: Signeiure: Da�e: OWNER•BUILOER OECLARATIONS: I hereby afllrtn that under penalry of perlury ihet 1 em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sea 7031.5, Business and Protesslons Code: Any cly or counry which requires a permii to construct, alter, improve, tlemolis�, or repair any sWcture, pnor to its issuance, elso requires ihe epplicaN tor such permit to file a signed statement Ihat he or she Is licensed pursuant to the provisions of the Contreciors License Law (Chepter 8(commencing with Sectlon 7000) of Dlvision 3 of the Business end Prolessions Code) or thet he or she Is exempt Iherefrom end the basis lor Ihe elleged exemption. Any violatlon of Section 7D31.5 by any epplicent for a parmit subjecis the epP�� o a civil penalry of no� more t�en five hundred dollars ($500).): ❑ I, es awner af Ihe properry, or my employees with weges es iheir sole compensetion, WILL DO TME WORK, anOl�e siructure is not intentletl or otterad for sele (Sec. 7044, Business and Professions Code: The Contractors License Lew does not epD�Y �o an owner of property who builds or improves Ihereon, antl who does such work himsell or hersett or Ihrough his or her own employees, provitled that such improvements ere not intended or oMered tor sale. If, however, tha builtling or Imprwement is sold within one year of completion, the owner�builtler will have the burden of pmving that he or she tlitl not build or improve for puryose ot sale.). ' ❑ I, as owner ot the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to con5trucl the prolect (Sec. 7044, Business end Professions Catla: The comraciors License Lew does not epply to en owner of pmpeny who 6ullds or impmves Ihereon, entl who contracts br such project wlth e contractor(s) license pursuant to the Contrecmrs License lews.). ❑ I am eaempt under sec. Business and Professions Code for ihis reason: SignaWre: Date: Owner ID verified by driver's license. ❑ Ves ❑ No Driver's License No. Eapires: Vedfication oi Ownership by (type of tlocument, i.e. � property tax bill ar tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity Ihat no excavalion five (5) or more teet in tlepth into which e person is required to descend, will be made in connection with work authodzed by Ihis permit, entl that no builtling siruciure, scaHolding, telsework, or demolition or disman�ling thereot, will be more ihan thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, 7tle B, Califomia Adminislra0ve Code). . ❑ As owner-builder, I will not employ enyone to do work which woultl require e permil irom the DivLsion ol Industrial Selery, as noted abova, unless such person hes a permit to tlo such work fram ihe division. Signeture: Date: Divislon ot Intlustnal Safery Pertnit Number: CERTFlCA7E OF COMPLIANCE AND AUTHORVJITON OF ENfAV: I certity under penalry of perjury that I heve read Ihis epplication end state Ihat Ihe information given is correcl I egree to comply with all stete laws end city ordinances relating to builtling consiruction, and authorize represeniatives of the Ciry of Coste Mesa to enter upon the above-describad property for inspection purposes. I egrea not to occuDY or allow accupancy of any building authonzed by this permit uNil final inspection. CODE �, INSPECTIONTYPE 1616 Fixed System Final Fire Preveniion 1266 Pool Spe Final 200 Finel Re-Roof 201 Flnel BIocWRetaining W ell 202 Final Factory Fire Place 203 204 Final Sign Final Demolition ]j�j€ INTITIALS CODEX INSPECTIONTYVE 206 Final Mechanicel 20B Final Plumbing 210 Final Elecirical 212 Final Flre Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupency C�J Pdg U�9L5 . �� COSTA ME5A BUILDING-SAFETY DEPARTMENT P. O. BOX 8f7 COBiA MEBA. GLIFORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT COSTA MESA. CALIFORNIA �EE RECEIiIED .�i�' d1AY 1 b 1�G FIPaAI�CE DEPT. CffY OF CQSiA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only BUILDING ADDRE66 COSTA MESA. CALIFORNIA APPROVED ADDRESS E. }iYl S't. ZONING ZONE NO. OF U6E OF N aTv COStB �SZ. jj_]_ I PUN9 '2 I BUILDINO W &t� �cTwo. 16729 No' Li 6-1159 LeOAL Lot 55 Tr. 3648 osscrtirrioH SIZE rfO� X 102� NO.OFBLD09. OF LOT O Now oN LOT r1071 p, p, NO. IlOIle U6E OF YARDS EVES EXISTING BLDG T APPROVED ALIOWED B6TBACK LINC FPOM IClNTHR LINC BT.1 Gee�Tea OP BTREHY L � REAR YARD O� FRONT FT. � L SIOE YARD I LEF7 � I RIGHT � R. SIDE �J FT. DESCRIPTION OF WORK /U FT. � _ L SIDE lV � DATE �� SIZE�'N 6O 5 ♦f't'i�ROOME EXTERIOR WALL ROOP COVERING ' �(�n COVEI USE OF BUILDING AND WORK TO I 1 HEREBY ALKNOWLE�OH THAT 1 HAVE HEAO TH18 APPUGTION }Hg AMOUNT BHOWN UNOER VALUATION 18 FOR TH6 AND BTATE THAi TXE ABOVE I8 CORRECT AND AGRE6 TO COM- PURP09E OP EHT/�BLI9HIN0 A P6RMIT PEE ONLY. PLY WITH ALL CI'� ORDINANCEB AND BTATE LAWB liHOUTATINO BUILD�Na caxeTRUR10N-� VALUATION SIGNATUR6 OP �T�, PERMIT FEE $ 36• PERMITTH � ],6�ZO1.• PLAN CMECK $ IB• AUTHORIZED AGENT Dike �olegrove� II1C• TOTAL FEE 54• z n