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Home My WebLink About3045 JEFFREY DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAlfi DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT r ,. Job nddress: 3045 JEFFREY DR Suite: Vicinity: TRIPLEX ParcelNumber: 41812202 Zoning: R3 R3 npplicant: GALITSKI, GUY � � , ;J��-� � ^ . , ISSUED BY Address: 19792POTOMAC i,-��.��,.r''�- � "-"� '-'�---�,�—'��,� �_� /"-1 r'-r %� �� j ��Phone' (714) 965-2387 ^"'�.�� G��' C�,,,_ Owner: DIPIETR TOIVIO; STE / / V / / / \ Address /3045 JEFFREY DR � �� 5"�� \� � � j �CO\STAMESA/,-C%A/% j� Con�c� �. �/ i i // ;�/ tor. GG ROOFWG�CO INC � / i/ c'/ ��AJddress7 19792 POTOMAC o ('" ��? ��% �N HUNTINGTON BEACH, CA � Zip:l 9264fi� /�``� � l/i//L/"_`�� UArch j: �� U l� � �Address:� �) � � �� 1�� -��„� °°=-Pnone j� l� � � �� Zip: � o �/ ucense I01�, % � I ��n� �_ _ V III��' % �'7I" REROOF EXISTING TRIPLEX (30�SQ).JT FELT UNDERLAYMENT�&�REROOF WITH 25 YEA�R ELK ( SETBACKS MAIN STRUCT ACCESSORY PARKING NOTES: �, $0.00 $139.25 Status: ISSUED Applied: 03/21/2001 Issued: 03/21/2001 , � ` Z p 1 92646 � � / ��, `. ' ' - " __��— �_ // / (�.v�'�� .- _._-� _ _.� ..J � A \AA -..-c<rn�-= •- c v� z`\ �� Phone ~, �� \\��1�� Zip: 92626 �' �`�\ \�� /�� . �� /�� . �� `\Q�� \'i / Phone:'�(714) 965-2387 ��, � / ��'p�� o,,Zu�.•. yr o�t��' �,�`� ° �� a i� � O o0o p . �:—'4�'�,.a m`\i f. o�C !�Qp 9 -r, lJ `6 �c � �_ 0 �%>� � � D�� „ . OSB. Calc Valuation: Claim Valuation: v�%J U%/� � a8 ,o°��`"PLANUINGU&�ZONING �°_�' ��-</ � U(� �/'�.� ��-�-~�:. o o�- .. O �Frov� 0=�0) J/ )%r�R�elr 0-0; ,�---- —Ceft- =0=0 Right �0� 0 �G � `U � C/ \__i � �� Front 0?0 C/�Rear `0- 0 Left 0- 0 Right 0- 0 i � ��,�,��-��, �--�� Existina: 0 a,Reouired: �0�--1..f��Praposed: 0 � � � � 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within.l BO days, or it work is suspended or abandoned for a period of 180 days. � - • INSPECTIONS: In order for ihe 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 tinal approval will result in the ezpiration.of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 24d6-46 (N00) WORKERS'COMPENSATON DECLARATON: .. �� I horeby eRirm under penalry tlf perjury ona of the following declarations: � � ' ❑ I have and will maintain e cenifcate oi consem b self�lnsure for workers' compensation, as provitled for by section 3700 of ihe Labor Code, for the peAormance of Ihe „T�w�ork for which this permit is issuetl. �,D;,�bhave and will maintain Workers' compensation insurence, as required 6y section 3700 of �he Labor Code, for the pedormance of ihe work for which ihis permit is issued. My workers' compensation Insuran a c� r�� ntl policy number are: 2 ^ _ O.� �Ca�ner. �� "t�l 1� � � �PolicyNumber:, � � �y � � '(This secfion need nof be camp�ered il the pelmit is veluetl at one hundred dollars ($100) or less.) ❑ I cetlify ihat in the pertormance oF the work for which t�is permit is issued, I shall not employ any person in any menner so as to become subiect to the workers' compensatlon laws oi C�lifomia, and agree that if I should becoma subject to Ihe workere' compansation provisions ot Section 3700 of ihe Labor Code, I shall forthwith compiy wilh thesa prwis� Applicant SlgnaN�e;"� �� Da�e: _ 3 �� '— �i 1 WARNING: FAILURE TO SECURE ERS' COI CAVERAGE IS UNLAWPUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLL4RE ($10p,000 A�DITION TO OSTOFCAMPENSATION, DAMFGES AS PROVIOEO FOq IN SECTION 37060F THE LABOP CADE, INTEREST, AND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: . I hereby aflirm thetJ ;am�licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 ol�lhe Business and Professions Code, and my license is in tull force end ettect�uc';a�° 3�0 `f I'T L_ �:ciass xr..4 �� 3�7 CONSTRUC710N LENUING AGENCV: ❑ I here6y aXirtn that there is a conslmction lentling agency tor the peAortnance of ihe work for which this pertnit is issued. (Sea 3097, Civil Cotle). LendersNeme: — —. LendersAdtlress: Signature: OWNER•BUILDER DECLARATIONS: oate: I hereby aNlrm ihat under penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for �he following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or county whicn requires a permit to consimct, altar, improve, demolish, or repair any stmcWre, prior to its issuance, also requires ihe applicant for such permit to tile a signetl stetemeN lhat he or she Is licensetl pursuent to ihe provisions of �he Contractors License Law (Chapter 9(commencing with Section 7000) oi Dlvlsion 3 of the Business entl Professions Code) or that ha or sha is exempt iherefrom end the basis lor the elleged exemption. Any violation oi Section 7031.5 by any epplicent tor a permit subjecis ihe epplicant to a civil penalry of not more ihan five huntlrea tlollars ($500).): ❑ I, as owner of t�e properry. or my employees with wages as Iheir sole compensation, WILL DO 7HE WORK, and ihe siructura is not intended or oHered for sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply lo an owner of property who 6uilds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, provided ihat such improvemenis are not intended or oHered for snle. If, however, the builtling or improvement is soltl within one year of completion, the owner-builtler will have ihe burden of proving that he or she tlitl not build or improve for purpose of sale.). ❑ I. a5 owner of ihe propedy, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to con5tmct the projecl (Sec. 7044, Business and ProfasSions Cotle�. TTe contracbrs Lice�se law does not apply to an owner ot property wtw builtls or improves ihereon, e�W wtro wMracls for such project witfi a coMractor(s) license pursuant to the Contracbrs License Wws.). ❑ I am exempt under sec. Business and Prolessions Cotle for this reason: Signature: Date: Owner ID verified by driver's IiGense. ❑ Yes ❑ No Driver's LiCen58 No. Verilicetian of Ownership by (type of tlowment, I.e. - property taz bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Expires: ❑ I hereby certity �hat no excavation tive (5) or more feet in tlepth into which a person is required �o descend, will be made in connection with work authonzed by Ihis permit, antl Ihat no building siructure, swflolding, lalsework, or demoli�ion or dismantling ihereot, will be more than ihirty-six (3fi) teet high. (Chap. 3.2, Grp 2, Art 2, Sec. 345, Ttle B, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit from the Division of Industriel Sefety, as noted above, unless 5uch person hes a permit to do such work from ihe division. ' Signature: Date: Division of Industrial Safety Pe�mit Number: CER7IFICATE OF COMPLIANCE AND AUh10RIZA710N.OF EN7RY: I certify untler penalry of perjury iha� I have read ihis epplication and state that the information given is correct. I agree to comply wi�h all state lews and city ordinances relating to building consiruction, and authonze represen�atives ot �he Ciry of Costa Mesa to enter upon t�e ebove-descnbed property for inspection purposes. 1 agree not to aapy or allow occupency of eny building aulhorized by this permit until final inspection. LODE �, INSPECTIONTYPE 7616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Final BIocWRetaining Well 202 Final Factory Fire PIaCe 203 Final Sign 20a Final Demolition ' DPTE� . INTRIALS � ..� Ii�H'v" Date 2 - ZI _ �I COOEN INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final euilding/Occupency OATE INiRIRLS i; , ��.�'" _ 4:�11d;6 �FH-2-7:��„s°QD �u2°� a,�ai62.04 COSTA MESA BUILDING-SAFETY DEPARTMENT . � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 . � " APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BV DATE RECEIVED DATE ISSUED ADDRESS 3�} A B C J fr Dri C.M. . . /S�/-/n%-o:� 02� o3.n51. ..PEe-„�.�� . OWNER R1C�1dT(1 SEi•rEl], Ij1C. A.P. NO ' - A' � . MAIL BUILDING ADDRESS 136 Rochester .StiE2t �+DDFESS ' CITV Costa Mesa 92627 NQ�. E)�IZ—�I9OS TRAC LO BLOCK CONSTRUCT�ON VJ A A P LENDER 1 BRANCH � OWNER �cNa�eo� �zu�z.c, � ADORESS ARCHITECT TEI.. USE � � VALUg � OR ENGIN ER S� �u-�d eh 642-4905 FIRE �� AODRESS 136 Rochester St. Costa Mesa ZONE TVP GROUP/ � � APPROVED CONTRACTOR Q.]fl�' BV DATE ADDRESS ' ' TEL. ' NE NO.OF USE OF W CITV � NO. 3 � PLANS BUILDIN � STATE CITV �'ARDSAPPROVED VARDS PPROVED LIC. NO. Zg],61H Bl LIC. NO. � MAIN BUILDING � ACCESSORV BUILDING {s� SI2E NO.OF BL�GS.' (FROM GL �. OF LOT ' NOWONLOT RONT •F . FT. a USE OF � '• � - � EXISTING BLDG. E F. FT h , � �� Separate permi[s are required for � ' �. sioE • JFT. �' Fr. W' Clectric, plumbing and heating work. REAR FT. FT. (.. USE OF 9U�LDING AND WORK TO BE PERFORMED DISTANCE BET. . BET, MAIN & � Qn � MAIN BlDGS. ACCESS. BLDGS. VAR. ay-` DATE ^-� C.V.P. � � APPROVE � a � � � ' APPROVED r w � OLD FOR SPtCI: �L REQUlREMENTS a 0 I h¢�eby aCknowlatlpa the[ I heva �aatl this epplltetion antl stete � y' thet tho obove Informetion le correct antl apree to comply with � m d oll laws raO�leNnp builtlinp construction, antl I shell not amploy _ Z ony parmn in vlolatlon of Ma workman's compensation Iaws oi - o � tha Stete of Celifornie. ' ^ � ,/ - 3 I hereby cartity Net I om properly Iicensatl ea e eontractor untler ��f S�• FT�� T� N tha State of Californla Bu�inasa antl Profeasione Cotle, Dlviston 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chepter 9, antl that such Iiconcas ore In f�ll force antl afiact, or I' THE PURPpSE OF ESTA6LISHING A PERMI7 FEE ONLV: nm exempt from Ma provisions of Ne Smta of California Buslness y VALUATION PERMIT FEE E antl Profass�ona Cotle, DW61on 3, Chapter 9. � �n m � � PLAN CHECK 5 ^ Slpnatura o� �%'�J\ • � Permittoe $ (/(/r� TAX y LL , . ) � 9 � Authoriz Apont � TOTAL PAIO § D I ' 2 / �.!4R-9-77�M�;�00�636 �**�C�!lA(J J � COSTA MESA BUILDING-SAFETY�DEPARTMENT P.O. BOX 1200. COSTA MESA, CALIFORNIA 92626 . �� APPLICATION FOR STRUCTURA[: PERMIT For Applicant [o Fill in Comple[ely'— Use Ink Only RECEIVEO BV . DATE RECEIVED . . DATEISSVED ao�oRess .3045-A,B,C Jeffre Drive� C.M. ' - ' � PERMIT NO. OWNER � `(,h�'(� Sev7e�.1 Ii1C. �+.P. NO. MAIL BUILDING � ' ADOFESS �.3(7 ROCY12St.Pi St.T22t. � �+DORE55 CITV (,'OS�d �Sd 92627�� No'642-4905 TRACT _ LOT ' BLOCK CONSTFUCTION � EW AD AL LENDER . BFANCH � . . OWNEF �� ADDRESS , ' VALUE OR EN �NE R .SC71R �!LY�i eh �n,o.`'�642-4905 S � P $ fIFE ADDRE55 ], S' � ZONE � TVPE GROUP ' .. APPROVED � CONTRACTOR • BY DATE ADORESS TEL. IONE NO.OF USE OF NEW' . GTV � NO. PLANS � BUILDING STATE CITY . �'/aRDSAPPROVED VARDSAPPROVED. IIC. NO. Bl LIC. NO. MAIN BUILDING ACCESSORY.BUILDING S12E � � NO.OF BLOCS. (FROM GLSTREET) - . OF LOT . NOW ON LOT RONT FT. FT. USE OF EXISiING BLDG. � � FT. Separate permits are required for �. sioe FT. FT. electric, plumbing and heating work. REAR FT. Fr. USE OF BUILDING AND WORK TO BE PERFORMED DISiANCE BET. BEf. MAIN &, ' - MAIN BLDGS. - ACCESS. BLDGS. - VAR, qW � DATE � � `].i1 ZPiC Wl�'1 dtt3CilECi d 2 C.V.P.qW �� ApPROVED , • , ' ', ' APPROVED . - I hareby acknowledge thet I hnve reaC this aOP�ication antl stete QO '^ n that the ebova Information is correci and agree to comply wIM m all laws reBulatin8 bulltling consvuction, antl I shall not employ ' � eny per50n in violaiion of Me workman's compensation laws of ' � the State of Calitomta. � - � I hareby certify that � em properly �Iicensed as a conirector untler SQ. FT. - • N the State Of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR m Chapter 9, antl [hat such Iicencas ere in full force�antl' atfect, or I THE PURPOSE OF ESTABLISHING A PERMR FEE ONLY: — am exampt from Ma provlsions of the State ot Celifornia Businass a VALUATION PERMIT FEE 5 � entl Professlons Code, Dlvislon 3. Chapter 9. ' . in m . SlBnature ot PLAN CHECK $ � ^� 0 Permlttea § TAX �� S ' LL f U Authorized ABa TOTAL PAID . S /