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Home My WebLink About830 JENNIFER LN - Building Permits; (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: H30 JENNIFERLN Suite: Vicinity: RESIDENCE AND ATfACHED GARAGE Parcel Number: 41812122 Applicant: OLIPHANT, JEFF Address: 16542 POTTER CI� HUNTINGTON BEACH, CA Owner: LIN, HUA LUNG TR Address 4254 COUNTRY CLUB DR BAKERSFIELD, CA Contractor: PARAGON ROOFING . Address: 16542 POTTER CI HUNTINGTON BEACH, CA Zip: 92647 Arch : Address: Zoning: R3 R3 Phone: 714-843-1950 Zip: 92647 Phone: Zip: 93306 Phone: 714-843-1950 License: 726753 Eng: Address: ISSUED BY: Status: ISSUED Applied: 07/07/2004 Issued: 07/07/2004 Phone: Phone: 2ip: License: License: SCOPE OF PERMIT REROOF RESIDENCE AND ATTACHED GARAGE: T/O 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: $0.00 Inspection: . $0.00 Total: $139.90 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: 0 Rear 0-0 Rear 0-0 Reauired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Righl 0- 0 $s,soo.00 $6,500.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 72-21-92) E%PIRATION: This permit shall automatically expire and become void ii work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for Ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, antl all requlred inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446�46 (6I00) WORKERS'COMPENSAnON DECLARAnON: I hereby aHirm under penalty ot perjury one of the following tleclerations: ❑ I have and wiil maintain e certiticate ol consent to seN-Insure tor workers' compenselion, as provitled for by section 3700 of the Le6or Cotle, for the'pertormanca of the work tor which this permit is issued. �I have and will maintain workers' compensation insurance, as requiretl by section 3700 ot ihe Labor Cotle, Por �he perfortnence of the work tor which Ihis pertnit is issued. M workere' co ens1a1ion Ins nce ca er and olic number ere: /� Carner.Y �'�1"/�� U /� � p Y Policy Number. �Z U �p �� I 3 (This section need nof be completed i( fhe permit is valued at one huntlred dollars ($100) or less.) ❑ I certity that in Ihe performence of Ihe work for which Ihis permit is issuetl, I shell not employ any person in eny manner so as to become sublect to iha workers' compensation laws ot Calitomia, antl egree that it I should become subject to the workers' compensetion provisions ot Section 3700 ot the Labor Code, I shall torthwith comply with these pmvisi //��.� - Applicant Signeture: �0�� // Vi� Date: � b� t� Q% �L i WARNMG FAILURE TO S RE rc�RS' CAMPENSATIqJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMMOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE Ml1NDRED T}10USANDOOLLARE($1 ,000),INADDITIONTOTHECOSTOFCOMPENSATION,DAM4GESASPROVIDE�FORINSECTIdJ3]O60FTHEL480RCODE,IMEREST,ANDATTORNEY'SFEES. IRa3�F1� �iZ�I.`��JS9[�i3-9�7��11_�:Lrli[�P.R I hereby aHirtn that I am force and eHect Lic. # _ Contractor's Signeture: Chapter 9(commencing with Section 7000) of Division 3 of the Business and PrQ�essions Cotle, arC my license is in full Class # L � l Y Date: ( �— I— o y CONSTRUCTION LENDING AGENCV: ❑ I here6y aHirm that there is a consWction lending agency tor ihe pedormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lentlets Address: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby aflirm that under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to consimct, elter, improve, demolish, or repair any structure, prior to its issuance, elso requires the applicant for such pertnit to tile e signed stetement ihat ha or she is licensed pursuant Io �he provisions of Ihe Contractors License Law (Chapter 9(commendng with Section 7000) ot Division 3 oi t�e Business and Professions Code) or iha� he or she is exempt iherefrom end the be5i5 for ihe elleged exemption. Any violetion of Section 7031.5 by any epplicent tor e permit sublecis ihe applicant to a civil penalry ot not more then five hundred tlollers ($500).): ❑ I, as owner of ihe properry, or my employees with wages es t�eir sole compensation, WILL DO THE WORK, end the structure is not intendetl or oHered for sela (Sec. 7044, Business entl Professions Code: The Contractors License Law dces not apply to en owner of property who builtls or improves thereon, and who does such work himself or herselt or ihrough his or her own employees, provided ihat such improvements are not intendetl or oNeretl for sale. If, however, the building or improvement is sold within ona year of completion, the owner-builder will have the burden ot proving ihat he or she did not build or improve for purpose ot sale.). ' � I, as owner of the properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to construd the D�Mea (Sec. 7044, Business and Professions Cotle: The contractors License Law does not apply to en owner of property who builds or Improves ihereon, antl who contracts tor such project with e contractor(s) license pursuant b the Contractors License Laws.). ❑ I am ezempi under sec. 8usiness and Professions Code for this reason: Signature: Date: Owner ID veritietl 6y tlriver's license. ❑ Ves ❑ No Driver's License No. Verification of Ownership by (type of tlwument, i.e. - property tea bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Expires: ❑ I hereby certiy ihat no excavation five (5) or more feet in tlepth into which a person is required to tlescend, will be made in connection with work authonzed by this permit, and ihat no building sWdure, scallolding, talsework, or tlemolition or dismantling thereof, will be more Ihan Ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 347, Title B, Calitomia Administretive Cotle). ❑ As owner-huilder, 1 will not employ enyone to tlo work which would require a pertnit irom the Division oi Industriel Safery, es noted abave, unless such person has e permit to do such work from tha division. Signature: Date: Division of Industrial Safery Permit Num6er: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTAY: I certify under penalry of perjury ihat I have read this application and state that the iniormation given is corred. I agree to comply with all state laws end city ordinances relating to building construction, and euthonze representatives of the Ciry of Costa Mesa to enter upon the ebove-descnbed propeey for inspection purposes. I egree not to occupy or ailow occupancy ot eny building euthorized by Ihis permit until final inspaction. COUE N, INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 200 201 Pool Spa Final Finel Re-Roof. Finel Block/Retaining Well 202 Final Faclory Fire Place 203 Final Sign 204 Finel Demolition � PAL€ IMITIALS �,-�-�y �� Date �� -a � Date COOE11 INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Finel Planning Approval 222 FinalSi�e 250 Finel Building/Occupency OpTE nmru�s . �4�3��9 ,- /'+�'� , _ . �,�:�I' COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COS7A MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILOING _ _ _ OWNER �(�]3�(] Se ADDRESS 136 Roches cirv Costd MeSa CONSTRUCTION Un�Q1OW1,1 1 FNlIFR BRANCN ADDRESS ADORESS CONTRACTOP ADDRESS CITY � STATE � LIC. NO. {a7 SI2E �. OF LOT a USE OF � EXI5iING B�OG. � TEL. No. 642- Costa Mesa TEL. NO. CITV l IC. NO. INO. OF LB�DC'�.5. NOW ON LOT FSep�rate permits are required for � electric, plumbing and hea[ing work. (.W. USE OF BUILD�NG AND WORK TO BE PERFORMED a A -a /'� G!i 4 � C!/Y! Q 7 r a x � a 'F!3-2-77�;��0� 139"� A�:*162.OL APPLICATION FOR STRUCTURAL PERMIT RECEIVEDBV DATERECEIVED �eTpiscuFr BUILDING ADDRESS R� - FIRE 20NE APPROVED fxE NO.OF .� � PLANS � VAROS APPROVEO MAIN BUILOING (FROM C)� S-CREr(6). DISTANCE BET MAIN BLDCS. VAR. # _ � USE OF f�EW BUILDIN � � 1 VARDS PPROVED ACCESSORV BUILDI BET. MAIN & � Q 1 hereby ackntl�+'�edge ihat I have reatl this aPPlication antl stata � � that tha above Informetion is correct end apree to comply with 0. ell laws reguleL��9 builtlinp conrtruction, entl I shall not employ rZ any pe�son In ��olatlon of Me workmen's compensallon laws of �, the Stete of Ca�ifomle. �� n� �Y 3 I hereby certify t�ot I am properly Ilcenaetl as a eoniracmr untler SQ. F �J �%�� the Steta of Ca��tornla 8uslnau and Profeuions Cotla, Division 3, THE AMOUNT SHOWN UNDER VALU Chnpter 9, antl [hat such licenses ere In tull forc0 antl Btfoct, or 1 THE PUR�OSE OF ESTAHLISHING A PERA nm exempt from the Orovislons of tha State oi Cellfornia Business VALUATION ontl Profacsions C a, Dlvislon 3, Cheptar 9. PERMIT FEE 5 �� ` PLAN CHECK § SiO�ature of /J'n� Permlttea � UOU TAX b Authori ABa�i TOTAI.PAID E � S � N FOR m ILY; " b v v� m / '^ 0 3 LL � � ` � ...� i v '� COSTA MESA BUILDING-SA ETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CAIIFORNIA 9262fi I For Applicant to Fill in Completely — Use Ink Only AD'DRESS 830—A,B,C Jenn_ifer Iane. C.M. OWNER gichard S�aell Inc. ADORESS 136 Rochestes Street TEL. ciTv �psta Mesa 92627 No. 42-49 CAN5TRUCiION LENDEF BRANCH ADDRESS ARCHITECT _ _ TEL. __ __ F � W 6i d � y S7 F A F Q O .a a > �' � �. W a �i P. � �S'� 3 ADDFESS R ADDftESS TEL. CITV NO. STATE CITY uc. No. 28161 R S� LIC. NO. SIZE i NO.OF BI�GS. OF lOT NOW ON LOT USE OF EXISiING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BVILOING AND WORK TO BE PERFORMED rkel J.. iAi�-G-77f„�'(li1 f.�03 <,-,t,: jl.�1.('{i APPLICATION FOR STRUCTURAL PERMIT RECEIVE� BY DATE RECEIVED �oTF �ccucr A TRACT FIRE ZONE 20NE NO.OF . PLANS VARDSAPPROVED MAIN BUILDING (FFOM GL STflEET) VAR. # C.U.P. # APPqOVED I hereby acknowledge that I have �eed this application end stata thet the above information is corract antl agree to comply with all laws regulating building consttuction, and I shall nox employ any person in violation of the wo�kman's compensation laws of the State of California. I hereby cerNfy that I am p�operly Iicensetl as a contractor under the State ot Californie Businass and Professions Cotle, Division 3, THE AMO Chapter 9, antl that such licenses a�e in full force antl effect, or I THE PURPi am ezempt from ihe provisions ot She State of Celifornia Business VALUATION antl Professians Cotle, Division 3, Chaptar 9. Slgnature of ///�r — � Pe�m(ttee • ` $ Authorizetl nt lOT B�OCK ci�� VALUE S � U GROUP DATE USE OF NEW BUILDING BET. MAIN & ACCESS.BLp DATE APPROVED v/l N v n m w' m N VN UNDER VA�UATION IS FOR �y 'ABL�SHING A PERMIT FEE ONLY: e PERMIT FEE $ a N n PLAN CHECK $ "� O LL TAX $ � TOTALPAID '"�/�;! Z� V U