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Home My WebLink About826 JENNIFER LN - Building Permits(714) 754-5273 • Fax (774) 754-4856 • www.ci.coste-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 826 JENNIFER LN Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcel Number: 41812121 Applicant: OLIPHANT, JEFF Address: 16542 POTTER CI HUNTINGTON BEACH, CA Owner: HAGGARD, SUSAN P TR Address 3122 YELLONlfAIL DR LOS AtAMITOS, CA Contracror: PARAGON ROOFING Address: 16542 POTTER CI Arch : Address: HUNTINGTON BEACH, CA Zip: 92647 Phone: Zoning: R3 R3 Phone: 714-843-1950 Zip: 92647 Phone: Zip: 90720 Phone: 714-843-1950 License: 726753 Eng: Address: Sfatus: ISSUED Applied: 07I07I2004 Issued: 07I07I2004 ISSUED BY: Phone: 2ip: License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE: T/0 EXISTING WOOD SHAKE ROOF, 1/2" CDX PLYWOOD SHTG, 1 LAYER 15# FELT, APPLY "30-YEAR COMP SHINGLES' 26 SQUARES Plan Check: $0.00 Permit: $139.25 SMIP Res: $0.65 SMIP Com: $0.00 Other: $Q.00 Inspection: $0.00 Total: $139.90 SETBACKS MAINSTRUCTURE Frant 0-0 ACCESSORY Front 0. 0 PARKING Exisfino: p Rear 0- 0 Rear 0. 0 Reauired: 0 FEE SUMMARY PIANNING & ZONING Left 0- 0 LeR 0- 0 Propased: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 Ss,soo.00 56,500.00 NOTICE: The work autnorizetl by ihis permi! slrall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Orcl. No. 92-28, § 1, 1247-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commencad within 700 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply wi�h all epplicable codes, antl all raqulrad Inspectiona end final approval must be obtained. Failure to obtein inspections and tinal approval will result in the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 tansae �smo) WORKERS'COMPENSAnON DECLARAnON: �� I hereDy eflirm under penalry of perjury one ot t�e following deGaretions: ❑ I have antl will maintein e ceNficate of consent to self-Insure for workers' compensation, es proWtlad lor by section 3700 oi the Lebor Code, far the pertortnence ot the work lor whith thi5 p8rtnii is Issuetl. � I heve entl will maintain workers' compensatlon insurance, as raquireG Dy sectlm 3700 of tlie Lebor Cotle, tor tha pertortnance ol che wwk for whicli �his pertnit is iswed. My workers' mpensation/I�nwrence certler entl policy number ere: Cerrior: C, �4 � e !'� ✓� Ot Policy Number. 2 y(1 g{ "��/ � (Tbls secf/on eed nat be completed 1! the permff Is velued a( one �untlretl dWlere ($ f00) or less.) ❑ I cenity thet in iha pertortnance ol the work lor which Ihis permit Is luued, I shall not employ eny pereon In eny manner so as to become subl�� o the workers' wmpensetlon laws oi Calllomla, end agree Ihat if 1 should become sub�act to the workers' campensa�lon provislons oi Sectlon 3700 0l the Labor Cotle, I s�all lorthwlth comply with Ihese �p si �/J / AppliwntSigneWre: _„`..��ZL� Date: /�—J"'d � WARNINO: FAILURE T�ECU ORKERS COMPENSqT10N COVEMGE IS UNLAWFUL AND SHP11 SUBJECT Ml EMPLOYER TO CRIMINAL PENaLT1E$ AND CML FlNES UP TOONE HUNDRED TVIOUSAND DOLURE (5100,000), IN ADDRION TO TNE W5T OF COMPENSATION, OAAUGES AS PROVIDEO FOfi IN SECTION 3108OF THE UBOq CODE, IMEREST, AND ATTORNE'I'S FEES. LICENSED CONTRACTORS DECLARATION: � I hereby aHirm that I am Ilcensetl untler QroNsloys al C�h9Pter 9(wmmencing with Section 7000) of Dlvlsion 3 of �he Business antl P�ofe�sslons Code, enA my Ilcense is In full lorce entl otlect. Lic. q C�i'I I Z- b�5 3 Cless s L I ContrectoYs SlgnaWre: Date: ! a—� �' y CONSTRUCTION LENDING AGENCY: ❑ I hereby eflirtn ihat there Is e construction lending agenq for Ihe pedortnance ot the work br which this permit is issued. (Sec. 309), Civil Code). Lendels Neme: Lentlefs Address: Signatura: Date: OWNER-BUILDER OECLARATIONS: I hereCy eNirm Ihet under penelry ot perjury thai I flm EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business entl Pratesslons Code: Any ciry or counry which requires e permit m cronstruq, alter, impmve, demolish, or repair any structure, pdor to its issuance, elso requires Ihe epplicant for such pertnit to tlle e signed statement that he or she is licensed pursuant to the provlsions of the Contrectors LJcense Lew (Chapter 9(cammencing with Sectlon 7000) of Dlvision 3 0l Na Business entl Professions Cotle) or ihat he or she is exempt lheretrom entl the besis tor the allegetl exemption. Any vialation of Sactian 7031.5 by eny applicant tor e pertnit subiects the epplicam to a civll penalry ot not more ihan frve hundred ddlers (5500).): ❑ I, es owner ol the properry, or my employees with wages as �helr sole wmpensation, WILL DO THE WORK, antl the siructure is nat Intended or oNered lor sala (Sec. 7044, Business and Professions Cotla: The Contractore License Lew dces not apply to en awner of property who builtls or impmves thereon, and who tloes such work himself or hersetl or Ihrough his or her own employees, providetl that such imprwaments are not fntended or oHered for sale. If, however, tha building or improvemeni Is sold within one year oi completion, ihe ownar-builder will have the burden of proving ihat he or she tlitl not build or improve for purpose of sale.). � ❑ I, as owner ot the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to construct the pro)ect (Sec. 7044, Business and Prolessions Cotle: The cnntrectors Licensa Lew does not applY to en owner ol properry w�o builtls or Improves thereon, end who contracts tor such pro�ect with a coniractor(s) license pursuant to the Contrectas License Laws.). ❑ I am exempt under sec. Business and Pmfessions Cotle for this reason: Signe�ure: Da�e: Owner ID verified by dnver5llCensa. ❑ Yes ❑ No Orivers License No. Vedflcatlon ot Ownership by (rype at dacumeN, i.e. - proDerry tex bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATION: ❑ I hereby certify thai no exwvetion Me (5) or more leet In depth Into whic� e person is required to descend, will be metle In connection with work euthorized by this pertnii, end that no huilding sWCWre, scaHolding, falsework, or tlemolition or dismantling Ihereol, will he more Ihen Ihirry-six (38) teet high. (Chap. 32, Grp 2, A� 2, Sec. 341, 7tle e, Califomia Atlministrative Cotle). ❑ As owner�Duiltler, I will not employ enyone to tlo work which would require a permit Irom the Olvislon of Industriel Sefety, as notetl e6ove, unless such pergon hes e pertnit to do such work Irom the divislon. Slgneture: Date: DlWsion of Industrial Sefery Permit Number: CERTFlCATE OF COMPLIANCE AND AUTXORIZAiION OF ENTRV: I conify under penelty ot perjury Ihet I have reed this epplication end state Ihat the infortnaiion given is correct. I agree to compty with ell stete laws entl ciry ortlinences relating to building constructlon, antl euthorize representatives oi the Giry oi Gosta Mesa to enter upon the ebove-descnbed Droperty br inspection purposes. I agrae not lo occupy or ellow occupancy ol eny bulltling authorized by this permit until tinel inspection. CO�E 1. INSPECTIONTYPE 1616 Flxed System Final Flre Preventlon 12fi6 200 201 202 203 Pool Spe Final Final Re-Root Final Black/Releining Well Final Feciory Fire Place Finel Sign 204 Finel Demolition �.I JIII: ,i i ..:.ai .�_ � _oy ��.� Date COpE1 INSPECTIONTYPE Qd¢, �$ 206 Final Mec�enicel 208 Finel Plumbing 210 Flnel Elecirlcal 212 Final Flre Prevenilon 220 Finel Planning Approval 222 Final Sita 250 Finel Building/Occupenry H�+ C W 4 Q y y x F G W F Q O � Q � r a a v� a � a P. z W S 3 " � 4;34��R COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING ADDRESS 826—A.S.0 Jennifer Iane. C.; OWNEF MAIL TEL. c�rv �osta Mesa 92627 No. CON5TRUCTION __ . BRANCH ADDRESS TEL. ADDRESS 1,j6 jl[�[le$tp�' S't.. (-OSTd P: CONTRACTOR OWY32Y ADORESS TEL. CITV NO. STATE CITV LIC. NO. Z8161H Bl LIC. NO. 51 Z E I NO. OF BLOGS. OF lOT NOW ON LOT VSE OF EXISiING eLDG. Separate permits are required for electric, plumbing and heating work. I hereby acknowlatlge Shat I heve reatl ihis appllcatlon antl state ihac the above Info�mation is correct antl agree to comply wiih all laws regulatine building consttuction, entl I shell not employ ony permn In vlolation ot the workman's compensation laws of, the State of Calitornla. I hereby certify that I em properly licansetl as a contractor �ntlar the State of California Business entl Professions Cotle, Divistan 3, Chapter 9, antl Net such licansas are in tull torce antl effact, or I am exempt from the Drovlslons of the State ot California eusiness and Professions Code, Dlvislon 3 a ter 9. Sipnature of L� �nh� Pe�mittee !/t- L\ c wa�u ;: �,�,t i� " B-2-77�—s. �0 138 1 fiZ.(�-, APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV DATERECEIVED nn-rciccimn � p i� p� � p BUIL�ING ADDRE55 OWNER F,,,4C.17f{I�,1 J � J USE TILI _ �t� v� FIRE ZONE TVPE APPROVED BV DP 7�qjyE � NO.OF � USE OF YARDS APPROVED DISTANCE BET MAIN BLDGS. VAfi. 5�`:�! C. V.P. �/J ` F;OLD FOR YAROSlIPPROVEC ACCESSORV BUILDI BET. MAIN & ACCE�. 8LD DATE / ,4L THE AMOVNT SHOWN UNDER VALVATION IS FOR THE PVRP�E OF E5TABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ $ � ^� � PLAN CHECK $ � �� r � TAX $ / TOTALPAID $ Q n m > m m N 7 m � a m M 0 LL F U F � W S Q h y � F L� � F a q ..1 a > r � x w a 0 CL' O� Z .T. 3 �3 3 , , COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely - Use Ink Only BUILDING nooaess g2(-ag.(' T nni fPr Tan (`_M_ OWNER gichard Sewell Inc. ADDRESS 136 Rochester SiS22t. TEL. ciTv ('nsta MPsa 92f,27 No. 642-49 BRANCH ADDRESS ARCHITECT *L T.� �y� TEL. !1F FN(:INFFR SC�III L]ll�K1WC11 NO. CONTRACTOR Q�rjj]�' ADDRESS TEL. CITV NO. STATE CITY LIC. NO. z8].(1S B]_ LIC. NO. SIZE I NO.OF BLDCS. OF LOT NOW ON LOT USE OF Separate permits are required for elec[ric, plumbing and heating work. OF BUILDING ANO WORK TO BE PERFORMED eriplex with attached aaraQe PAiu .'.'aR -9-77�,;,;,�() 604 o'-*u241.CG APPLICATION FOR STRUCI'URAL PERMIT BUILDING ADDRESS OWNER FIRE ZONE APPROVED ZONE �NO.OF PLANS VARDS APPROVED DISfANCE BET APPROVED PERMIT NO. VALUE DATE USE OF NEW BUILDING VARDS APPROVEO ACCESSORV BUILDING BET. MAW & ACCESS. BLp DATE I heruby ecknowletlge ihat I have leatl this eppllcatiOn antl state thet the ebove Informetion is correct antl ogrea io comply with nll lews repuleting bulltling construcNon, antl I sholl not employ � O � ony person In violetlon of the workman'� compenSallon laws of i�e Smta of Colifornle. I hereby cartify thot I am properly Iicenzed as a eonttactor untler S Iho Smm of ColHornla Businev and Prof¢uions Coda, Dlvision 3, THE AMOUNT SHOWN UNDER VALUA' Chaptar 9, nntl thet euch Iicenws ere In tuli torco enA affeet, or I THE PURPpSE OF ESTABLISHING A PERMI' em exompt from tha provlsiona of the Stete of Celifornia Busineu VALUATION PERMIT FEE end Profossiona Cotle, Divislon 3, Cheptar 9. Signet�ra of �(// /�/-�/ /�'� /� PLAN CHECK E Pormlttee �� ! /,G.I� $ '� TAX S // �� AUMorizetl Ap6}�t TOTAL PAID � � n m m' m N FOR m JLV: � N n m 0 i u