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Home My WebLink About3248 MICHIGAN AVE - Building Permitsp�a) 7sa-s273 • Pax (77a� 7sa-ae9s • www.cf.cos�a-mesa.c�ILDING PERMIT dob Address: 3248 MICHIGAN AV Suite: Vicinity: RESIDENCE Parcel Number: 13907208 Appiicant: HENNINGER, COREY Address: 12262 HESTER PL GARDEN GROVE, CA Owner: SWEENEY, JACQUELINE C Address 3248 MICHIGAN AVE COSTA MESA, CA Zoning: Phone: (714) 534-7000 Zip: 92841 Phone: Zip: 92626 Contractor: ASSURED PROFESSIONALS INC Address: 12262 HESTER PL Arch : Address: Phone: (714) 534-7000 GARDEN GROVE, CA Zip: 92841 License: 760384 Phone: Eng: Address: 77 FAIR DRIVE, GOSTA MESA, GA 92626 ISSUED BY: Status: ISSUED Applied: 10/09/2003 Issued: 10/09/2003 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF COMP SHINGLE ROOFF. INSTALL FELT.AND 20 YEAR COMP SHINGLES OVER EXISTING SHEATHING. Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other. $0.00 Inspection: $0.00 Total: $111.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fronl 0-0 PARKING Existinq: o NOTES: Rear 0-0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Lek 0- 0 Left 0- 0 Praposed: 0 Calc Valuation: Claim Valuation: Righl 0- 0 Right 0- 0 $4,300.00 $4,300.00 NOTICE: 7he work authorizetl by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRA71pN: This permit shall automatically expire and become void if work is not commenbed within 1 BO 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 requlred Inapecllons and final approvel must be obtained. Failure �o obtain inspections and final approval will result in ihe expiretion oF ihis permit. FOR INSP�CTIONS CALL: (714) 7545626 2aa�as Is�oo) WORKERS' COMPENSA710N DECLAfiATON: I hereby attirm untler panalry of perjury one of the following tleclarations: ❑ 1 heve entl wlll mainlain a certificete of consent to selGlnsure for workers' compensation, as provitletl tor by soclion 3700 of ihe Labor CodB, lor ihe peAormance of lhe work tor which Ihis permit is issued. ❑ I have antl will maintain workers' compensatlon Insurence, es requlretl by section 3700 ol the Labor Coda, tor the petlortnance ot ihe work tor which Ihis pertnit Is issued. My worka com1pensation Insur�{ca carrier and policy number are: '/ Carrier. � +C �.rn-N PolicyNumber. I� Z�Z'-(�' V3 (This sec(ion need nof be complefed i/ (he permit is velue0 et one hundred dMlers (.SY00) or /b.s.) ❑ I certity ihet in Ihe pertortnance of ihe work tor which this pertnit is issuetl, I shall not employ eny person in any manner so as to become subject to lhe warkers' compensetlon laws of Califomia, and egree that If I shoulA become sub�ect b Ihe workers' compensetlon provisions of Section 3700 0l the Labor Code, I shall forthw0h comply wilh ihese provsisy' �n/5 . ��i/ � Applitan� SlgnaWre: _ // C Dete: � 7 � WARNING FAILURE TO SECURE WOiiKERS' COMPENSATION GE IS UNLAWFUL rWD SHALL SUBIECi M' EMPLOVER TO CPIMINAL PENALTIES AND ClVIL FlNES UP TOONE HUNDRE� T/KKISAND DOLLARE (5100,000), IN ADDITION TO THE CQST OF COMPENSATION, DAMAGES AS PROVIDED FOP IN SECiION 3]Ofi OF THE IABOR CODE, INTEPEST, MI� ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm Ihet I am lorce and effect. Lic. a_ Coniractols Signa�ure: CONSTRUCTION LENDING AGENCV: of Chepter 9(commencing with Section 7000) of Division 3 ot the Busin§ss'�a�Pmfesslons Cotle, end my licansa is in full Class a L T— Date: /N4/07 ❑ I hereby aHirm Ihat ihere is a conswction lending egency for the pedormance ol lhe work lor w�ich Nis Oermit is issued. (Sec. 3097, Civil Code). Lendefs Neme: Lender's Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm thet under penelty of perjury ihat I em EXEMPT FROM THE CON7RACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Protessions Cotle: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair eny simcWre, prior to its issuance, elso requlres ihe epplicaN for such permit to tile a signed statement ihat he or sha Is Iicensetl pursuent to the provisions of the Contrectors License Lew (Chapter 9(commencing wlth Sectlon 7000) of Division 3 ot ihe Business and Professlons Code) or thel he or she is exempt therefrom and the basis for the elleged ezemption. Any vlolation ot Sectlon 7031.5 by any epplicant for e parmit sublecis the epplicent to e civil penalry of not more than tive hundred dollers (5500).): ❑ I, as owner ol the properry, or my employees with weges es their sole wmpensation, WILL DO T11E WORK, antl the structure is not Intended or oHeretl lor ule (Sec. 7044, Business end Professions Code: The Contraciors License Law does not appty to en owner ot property who builtls or impmves thereon, and who tloes such work himself or hersell or ihrough his or her own employees, provitled that such improvements are not intentletl or oNered for ule. If, howaver, tha builtling or improvement is sold wil�in one yaar of completion, ihe owner-builder will heve Ihe hurtlen of proving that he or she did not �uild or improve tor purpose ot sale.). � ❑ I, as owner ol lhe pmperty, am E%CLUSIVELV CONTRACTNG WITH LICENSED GONTRACTORS to consimct Ihe project (SecJOd4, Business and Professions Coda: The contractors License Law tloes not epply to en owner of pmpeny who builds or Improves t�ereon, end who contracts lor such pmject with a contrector(s) license pursuant to ihe Comractors License LewsJ. ❑ I am exempl untler Sec. eu5iness end Profeuions Code for Ihis reason: Signature: Date: Owner ID ventietl by tlnver's license. ❑ Yes ❑ No Orivefs License No. Verificetlan oi Ownership by (type of tlocument, i.e. - property tex bill or deed): Ezpiras: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON: ❑ I hereby certity ihat no excavation five (5) or more leet In depth into which a person is requiretl �o Eescentl, will be made in conneciion with work authonzed by this permit, and that no building structure, scaHolding, lelsework, or demolition or dismantling thereoi, will be more than thirty-sia (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, 7Ue 8, Celifomia AOministrative Cotle�. ❑ As ownervbuilder, I will no� employ enyone to tlo work which would require e permi� tmm Ihe Division of Indusirial Safety, as notetl above, unless such person has e pertnit to do such work from the division. Signature: Date: Division oi lntlustrial Safety Parmit Number. CERTIFlCA7E OF COMPLIANCE AND AUTHORVATION OF ENTRY: I certify untler penalry oi perjury Ihat I have read this application antl state Ihat the inlormation given is wrrecL I egiee Io wmply with all state laws end ciry ordinences rela�ing m building construction, and euthonze representatives ol the Clty of Costa Mesa to enter upon the ebove-descn6ed pmperty for inspection purposes. I agree noi Io occupy or ellow occupancy of eny building au�horized by this pertnit until finel inspection. �ignaWre Of Legal Owner(s) Date /6/�r/a > And/ r A orizetl Aoolicent Dale CODE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Final 200 Finel Re-Root 201 Final Black/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demdition p�TE INTRIpLS 0 -I 7- � COOE1 INSPELTONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Preventlon 220 Final Planning Approval 222 Flnal Sile 250 Finel BuiltlinyOccupancy PejE INTITULS Lor 31 - TR 2 ' ��<i COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX Sf7 COBTA MEBA. CALIFORNIA For Applicanf +o Fill In Complefely TYp� OR PRINT euao�nc p ' se" AODREss 32�U � '4VENUE COSTA MESA. CALIFORNIA OWNER KWK INVESTMENT CO.� INC. C�Tv NEWPORT BEABHi _CAL I F. N� I I ARCHITHGT TEL. Crcv NEWPORT BEA_CH� CALIF. LIC.TNO. O� � NO. M I 6- 6LZE �+� ��X�QQ I NO, OP OF L�!' xow o� USE OF EXIBTING BLDG. HEi9�CK LINH PPOM 5Q � p.e . 6� 5t IEFT RIGHT DESCRIPTION OF WORK IX II r.� rwwur�nv I II ennrrinv BUILDING Q NO. OF g�Zg � U SF ROOMS SiOR1E5 � EXTERIOR WAL{, ROOF ROCK COVBRING JTUCCO COVERING U8E OP BUILDING AND WORK TO BE PERFORMED A I Y RES$DENCE AND ATTACHED GARAGE PanN No. - 1 HEHEBY ACKNOWL80GE THAT 1 XAVE READ TH19 MPLIGTION ANO BTATE THAT THH ABOVE 18 GORNECT AND A6REE TO GOM- PLY WITN ALL CIN ORDINANC¢9 AN/¢` 9TATE W9 ReDU1.�T�NO BY�LDINO CONeTR�p� ' ' .��_ _ � / SIGNATURE OF �AUTHORIZEO AGENT F�E RECEIVED �o� �9AR 24?�9 1"F��tANce �EPT, CITY OF COSSA MESA APPLICATION FOR PERMI7 eua�iN� For Office Use Only RECEIPT NO. I. PGRMIT NO. BY DATE COSTA MESA, CALIFORNIA FIRE ZONING ZONE NO. OF IIBE OF N R-1 I PUNe /Z 6UILDING LEGAL oesca�rr�ox T.nt � Tl-a[`i: A. P. NO. nOne YAROS EVES APPROVED ALLOWEC (G6NTER LIN6 BTJ �� APPROVED � F THE AMOUNT'BXOWN UNOeR VALUATION 16 POR THe PUppOBE OF, EBTF9LIBXIN6 A PENMIT FEE ONLY. VALl1ATION / PERMIT FEE $ ��n � $ ��"f ��/ PLAN CHECK $ /" ' D K TOTAL FEE � � � LL t