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Home My WebLink About829 JENNIFER LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626 BUILDING PERMIT JobAddress: 829 JENNIFERLN Suite: Vicinity: ROOF Parcel Number: 41812113 App�icant: KIM, JOHN Address: 1236 CRENSHAW BLVD LOS ANGELES, CA Owner: GLAZEWSKI, WILLIAM Address 4922 DOWNEY AVE Zoning: R3 R3 Phone: 213-487•1234 Zip: 90019 Phone: LAKEWOOD, CA Zip: 90712 Convactor: VICTORY PAINTING AND ROOFING Address: 1236 CRENSHAW BLVD Arch : Address: Phone: 213-487-1234 lOS ANGELES, CA Zip: 90019 License: 606479 Phone: Eng: Address: Status: ISSUED Applied: 02/18/2003 Issued: 02/18/2003 ISSUED BY: � Phone: Zip: , License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1/2" OSB PLYWOOD, 30 YEAii, COMPOSITION SHINGLES. 2,800 S.F. INCLUDES ATTACHED GARAGE. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fronl 0-0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0-0 Required: 0 FEE SUMMARY PLANNIN� 3 ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $4,0OO.OQ Sa,000.00 NOTICE: The work authorized by this parmit shall comply with all applicabla handicap access requirements under California statutes and ralated regulations. (Ord. No. g2-2B, § 1, 72-21-92) i EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned �I for a period of 180 days. � INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inapeetions and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 ?44646 (BNO) WORKERS' COMPENSATION DECLARAiION: + I hereby aHirm under penalty ol perjury one of t�e Iollowing declarations: ❑ I have entl will maintain e certllicate ot consent to sell�lnsure tor workers' compensation, es proNtled for by section 3700 of ihe Lebor Code, for the peAormance of Ihe work tor which this permit is issue0. _I have and will maintain workers' compensation Insurance, as required by sectlon 3700 oF the Labor Code, for the peAortnance of the work for which Ihis pertnit Is issuetl. Mv workers' comoensatlon Insurence carrier entl oalicv number are: (Poli`tyNumber: ��h; �� oNeuJ �- - - - / � ❑ I certify ��at in Ihe pertortnance oi ihe work tor w�ich this pertnit is issued, I shall not employ eny person in any manner so as to 6ecome subject to the workers' compensation lews ol Celifomle, antl egree Ihet IfyaMooM�pewme su6jea to the workers' compensation provisions of Sedion 3700 of the Wbor Code, I shell forthwit� comply with ihese Drovision f p p ApPI,_icant Signeture:" � �� /�Date: � �-!��/ OJ WAFiNING FAILURE TO SEC ORKERS' COMPENSAiION COVERAOE IS UNIAWFUL rWD SHALL SUBJECT AN EMPLOVER TO CRIMINAI PENALTIES AND GNL FlNES UP TO ONE HUNDRED THOUSAND DOLURE (5100,000�, IN ADDITION TO THE COST OF CAMPENSATIqJ, DAM4GE$ AS PROVIDED FOR IN $EGTIIXJ 3�06 OF THE UBOR CODE, INTEREST, AND ATTORNEY'S FEES. IICENSED CONTRACTORS DECLARATION: I heretiy aKrm ifieCfam licensed under provlslons of Chapter 9(commencing with Sectlon 7000) oF Divlsion 3 af the Business end Prolessions Cotle, and my license Is In tull �lorce�end enea.�Lic. a �'/ro�lG�J 9 � Gess a � � � , �� 9 �ContreqoYs Slgnature: �/l�C /r. �� Date: y/ � �� v L CONSTRUCTION LENDING AGENCY: ❑ I hereby efllrm ihet Ihere is e constmction lending egancy for the peAormance oi ihe work tor which this permit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lentlefs Atldress: SignaWre: OWNEP-BUILDER DECLARATIONS: Date: I hereby eXlrm thet under penalry oi per�ury thet I em E%EMPT FROM THE CONTRACTOFiS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professlons Code: Any ciry or counry which repuires a permit to cons�ruct, elter, improve, demolish, or repair eny structure, pnor to its issuance, elso requires the epplicant for such permit lo file a signed statement that he or she is Ilcensetl pursuant to Ihe provislons oi the Contrectors License Law (Chapter 9(commencing with Sectlon 7000) of Divlslon 3 of ihe Business and Profeulons Code) or t�et he or she is exempt therelrom end the besis for ihe alleged exemption. Any violation of Saction 7031.5 by eny applicani for e pertnit subjecis ihe applicant to a civil penalry ot nat more than live huntlred tlollars (b500)J: ❑ I, es owner of ihe property, or my employees wlth wages es t�elr sole wmpensa�ion, WILL DO THE WORK, ana the siructure Is not iniended or otfared for sale (Sec. 7044, Business end Prolessions CoOe: The Contrectors License Lew tloes not apply to an owner ol property who builds or improves thereon, end who Coes such work himseN or hereeli or Ihrough his or her own employees, provided ihet such imprwemeNs ere not inientletl or oHered for sale. It, however, ihe building or Impmvement is sold within one year ol completion, ihe owner-builtler will heve the burtlen oi proving ihat he or she did not builtl or improve for purpase of sele.). ' � I, es owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cansiruct the prqect (Sec. 7044, Business and Prolessions Code: The contractors License Lew tloes not epply to an owner ol property who bullds or Improves thereon, and who contrads tor such project with e cnntractoqs) license Dursuant to the Contractors License Lews.). ❑ I em exampt under sec. Business and Pmfessions CoCe tor Ihis reason: Signature: Date: Owner ID ventletl by tlnvefs licanse. ❑ Ves ❑ No Drivels License No. Venficatlon ot Ownership 6y pype ol tlocument, i.e. - propeny tax blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N: Expires: ❑ I hereby certity ihat no excavetion five (5) or more feet in depih into which e person Is required to descend, will be made In connection wiih work authorized by Ihis permit, entl that no builtling structure, scaflolding, falsework, or demolilion or dismamling thereof, will ba more than thirry-six (36) feet high. (C�ep. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Calilornia Adminisirative Cotle). . ❑ As owner-builder, I will not employ enyone to do work which would require a permit from ihe Division ol Industrial Safery, as noted ebove, unless such person hes a permit to do such work irom Ihe Civision. Signature: Date: Division ot Intlus�rial Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAV: I certify under penalry ol perjury that I �ave read this application and state that the infortnation given is correct. I agree to comply wit� all state laws entl city ordinances relating to building consiruction, antl authorize representatives ot Ihe Giry ol Costa Mese to enter upon Ihe ebove�descnbed property tor inspection puryoses. I egree not to ocapy or allow wcupency of any huilding authorized by ihis permit until tinal inspection. Signeture Ot Legel Owner(s) Date —�N _Fcl w�r . J--�/S7o 4 AndIM <inhnn ad Annlicant � 2I0' ' &OOE �. INSGECTIONTYPE 1616 Fiaed System Finel Fire Prevantion 1266 Pool Spe Finel 200 Finel Re-Rool 201 Finel BIocWRetaining Well � 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition Q� � � � CODE� INSPECTIONTYPE � 206 Final Mechanical 208 Final Plum6ing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Q�f. �$ - � A�d'�f� _.i . _ . � COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant [o Fill in Completely — Use Ink Only OWNER MAIL ADORE CITY BRANCH ADDRESS ARCHITEi OR ENGINE ADDRE55 $dSR TEL. NO. NA,� � / �FR'Z'�%��:.�1) �3�` ''r.�."4�t12•\ APPLICATION FOR STRUCTURAL PERMIT 1%��io i�, � � BUILDING T— ADDRESS TRACT� � OWNER S1S� FIRE 20NE APPROVED ADDRESS TEL. NO.OF CIT V NO. P�� r F STATE CITV VAFDSAPPROVED � LIC. NO. zQ161H � LIC. NO. MAIN BUILDING �,y SIZE �'10.OF BLDGS. (FROM G T �. OF LOT NOW ON LOT RONT a USE OF � EXISTING BLOG. h �� Separate permits are required for L. SIDE � electric, plumbing and heating work. REAa e W USE OF BUILDING AND WORK TO BE PERFORMED F DI5fANCE BEf. Q'L MAIN BLOGS. a� W (/!/ O� C VRP.� � APPROVE i' ' z HOLD FG:, w � I haraby eeknowletl0a that I hava reatl t�is application antl steta y� the[ the nboJe Informatlon Is correci nnd eprea t0 cOmply wlm a nll laws reguleting builtlinp conatruction, antl I chall not employ z nny person in �iolatlon of Mo workman'e compansetion lawc of � the Stnie of Gelifomle. 3 I hereby certify that I am proparly Iicansatl es e eonSractor under Sn. tha Stete af Ce�Ifornie Businasa entl Profes.+iona Code, Divizlon 3, THE AMOUN Choptar 9, entl that such Ileanam oro In full force antl et}aet, or 1 TME PUFP06E om exompt Ivom tha provisions of t�e Stete o( Celifornia Businass VALUAT�ON entl Professlons Co e, Dlvision Chapmr SIB�ature ot �%/'�( /�'J}� Permlttee � $ � / (%(/ V /� LOT - BLOCK :p �� . VALUS � �� V �1 'PE1,L— GROUBI� / 4 DATE USE OF N W BUILDI VAPOSA PROVED BET. MAIN & f SHOWN UNDER VALUATION OF ESTABLISHING A PERMR FEE PERMIT FEE E � PLAN CHECK E TAX E ` TOTALPAID E n m ry• m � m e a N m n 0 F U F � k7 C. d h � S F G W F a ❑ .d Q 7 .%' ..l a W M O a 0. zW SJ 3 3 _. . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX1200 COSTAMESA,CALIFORNIA92626 For Applicant to Fill in Completely — Use Ink Only BUILDING AODRESS 829-A,B,C Jennifer Lane, C.M. OWNER R1CYlaYCI SEW211 ITSC. ADDRESS 136 Rochester Street TEL. CITV ('nCta MPSa Qi�ii% NO. FiQi—Q� BRANCH ADDRESS ARCHITECT (1R FN(:INFFR SaIII ADDRESS CONTRACTOR AODRESS CITY STATE LIC. NO. SIZE OF LOT USE OF EXISTING BLDG. TE TEL. NO. CITY LIC. NO. INO.O lBF�DG.. NOW ON lOT Separate permits are required for electric, plumbing and heating work. OF BUILDING AND WORK TO BE PERFORMED I hereby acknowled9e thet I heve reatl this applicaiion and rtete ffiat ffie above information is correct entl aBree to comply wkh all laws regulating builtling construciion, end I shall not employ any person in violation of the workman's compensation laws of the State ot Californla. 1 hereby certify that I am properly Iicansetl as a contracto� untler the Scace of California Business and Professfons Cotle, �ivision 3, Chaptar 9, and thet such 1lcenses ara In full force and effact, or I am exempt trom xhe provlsions of the Stata of California Business antl Profassions Cotla, Divislon 3, Chapier 9. SIO�ature of // //�/ �� ¢ Pe�mittee iL//l %rJ Author(zed 9➢ nt ra;�. �;ne-o-�;��S,OD c�2 �:��241.00 APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV DATERECEIVED pqTEISSUEf BUIIDING ADDRESS TRACT OWNER �[ � \.J USE � FIRE ZONE T APPROVED BY ZONE NO.OF PLANS VARDS APPROV ED MAIN BVILDING (FPOM GL STREET) DISTANCE BET. MAIN BLDGS. VAR. # 0. V.P. # APPROVED THEAMOUNTS THE PUFPOSE OF VALVATIO $ PERMIT NO. VALUE USE OF NEW BUILDING YARDS API ACCESSORV DATE APPROVED � / 7ERMIT FEE 9 PLAN CHECK $ TAX $ TOTALPAID $ m N ON IS FOR m FEE ONIV: _ � U