HomeMy WebLinkAbout3206 MINNESOTA AVE - Building Permits�.
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(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 320$ MINNESOTAAV
Suite:
Viciniry:
Parcel Nunmber: 1390$202
Applicant: SCHOTT, CARLOS
Address: C/O PETRONELLA ROOFING
BUILDING PERMIT
Zoning:
Phone: 949-548-7645
Zip:
Owner: HARpING, HELEN GEORGE TR
Address 3206 MINNESOTA
COSTq MESA,CA
Contractor: PETRONELLA ROOFING
Address: 2626 NEVJPORT BL
COSTp MESA, CA
Zip: 92627
Arch :
Address:
Zip:
Phone:
Zip: 92626
Phone: 949-548-1645
License: 460707
Eng:
Address:
Phone:
License:
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PERMIT NUMBER �
898-02210 `�
77 FAIR DRIVE, COSTA MESA, CA 92626
SCOPE OF PERMIT
T O EXIST. BUILT-UP ROOF; REPIACE W/ NEW 25-YR RATED COMP SHINGLE O/30# FELT.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation:
Permit: $74.75 Claim Valuation:
SMIP Res: $0.50 ,
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $75.25
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0.0
PARKING Existina: o
NOTES:
Rear 0-0
Rear 0. 0
Required: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0.
Proposed: 0
Right 0- 0
Right 0- 0
Status: ISSUED
Applied: 12/10/1998
Issued: 12/10/1998
Phone:
License:
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$2,225.00
5z,zzs.00
EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days. .
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetlons end final approval must be obtained. Failure to obtain inspeclions and final approval will result in ihe expiration o� �his permii.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penalry ot pery'ury one oi the following declarations:
❑ I have�and will maintain a certificate oi consent to sell-Insure tor workers' compensation, as provitletl for by saction 3700 ot the Lebor Code, for tha peAormance ot the
work lor which Ihis pertnit is i�uatl.
❑ I heve end will maintain workers' compensation insurance, es required by section 3700 of the Labor Code, Por the pedormance oi the work for which this pertnit is issued.
My workers' compensation Insurance cartier entl policy number are:
Carner. QLO�Ir Policy Number: W� Z— O`�7}7 yY
(Thls secfion need not be comp/efpd il the permit is velued e( one huntlretl tlollers ($100) or less.)
❑ I cartify thet in Ihe pedormence of the work for which Ihis pertnit is issuetl, I s�ell not employ eny person in any manner so es to become subject to the workers'
compensetion lews of Celitamia, and agrea ihat II I should become subject to the warkers' crompensetion provislons of Section 3700 ot the Lebor Code, I shall forthwith
comply with ihese pro islons. �
Applicant Signature: Date: ��- — (D �— �% g
WARNINO: FAILURE TO SEC ORKERS' COIAPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRE�
TMOUSANDDOILARE�E100, ),INAODITIONTOiMEWSTOFCOMPENSATION,DnMAGESASPROVIDEDFORINSECTION3]080FTHELABORCADE,IMEREST,ANDATTORNEYSFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirm ihet I em licensed under provisions of Chapter 9(commencing with Section �000) ot Division 3 ot Ihe Business and Professions Code, and my license is In tull
lorce and eflact. Lic. M b D 07 Class M G� 9
Contrector'sSigneture: 5���� Date: /7--/d—�
CONSTRUC710N LENDING AGENCY: �
❑ I hereby aflirm that there is e constmction lending agenty for the pedortnence ol the work for which ihis permlt is issuetl. (Sec. 3097. Civil Code).
Lender's Name: Lendefs Address:
SignaNre:
Date:
OWNER•BUILDER DECLARATIONS:
I hereby eflirtn Ihei undar penelry q� perjury lhat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for �he tollowing ree5on (Sec. 7031.5, Bu51ne5s end Profaulons
Code: Any ciry oi counry which requiras a permit to conswct, alter, improve, demolish, or repair eny strucWre, prior to its issuance, also requires the applicant for such pertnit
to tile a signetl statemem thet he or she is licensad pursuant to the pmvisions of the Contractors License law (Chepter 9(commencing with Section 7000) of Division 3 ot the
Business and Professions Cotle) or ihat he or she is ezempt ihere(rom and t�e basis for the elleged ezamption. Any violation ot Section 7031.5 by any applicant for a permit
subiects the epplicant lo e civl peqalry oi not more Ihan five hundred dollars (5500).):
❑ I, as owner of the pmperty, 6r my employees with wages as Iheir sola wmpensation, WIIL DO THE WORK, and Ihe stmcture is not intended or oftered for sala (Sec.
7044, Business end Professions Cotle: The Contracbrs License Law does not apply to en owner oi property who builds or improves thereon, and who tloes such work
himself or herself or through his or her own employees, provided that such improvements are not Intentled or otteretl for sale. H, however, Ihe builtling or improvemem is
sold within one year ol com0�etion, the owner-builder wiil have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of t�e properry, am E%CLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business and Professions
Code: The contraqors License Ww tloes not appty to an owner of property who builds or improves thereon, antl who contrects for such project with a contractor(s)
license pursuant to the CoNractors License Lews.).
❑ I am ezempt under sec.
Signature:
Business and Pmfessions Code for this reason:
Owner ID veri(ied by tlrivers license. ❑ Yes ❑ No Drivers License No.
Vediication ot Ownere�ip by (rype ot document, i.e. - property tex bill or tleetl):
DIVISION OF INDUSTRIAL SAFE7Y pERMR CERTIFICATON:
Date:
Expires:
❑ I hereby cenity that no excavetion /ive (5) or more feet in depth into whlch e person Is required to descand, wlll be metle In connection wlth work euthorized by this
pertnit, end lhat no huilding structure, ScaHoltling, falsework, or demolition or dismentling thereot, will 6e more than ihirry-six (36) teet high. (Chep. 32, Grp 2. Art 2, Sec.
341, Title 0. Celifornla Atlministretive Code).
❑ As owner-builder, I will not employ enyone to do work which would require e pertnit Irom the Division of Industrial Safety, as nated above, unless such person hes e
permil to tla such work irom the division.
Signature: Date:
Division of Indusirial Safely Permit Num6er:
CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF ENfAV: I certity under penelty of perjury that I heva read this application and state ihat ihe informetion given is
correct I agree lo comply with all state lews and ciry ortlinences relating to building consiruction, and authorize representatives of the Ciry ol Costa Mesa to enter upon ihe
ehove-describetl properry tor inspection purposes. I agree not to occupy or ellow occupancy of any building authorizetl by this Dertnit until tinal inspection.
Signeture Of Date
/�- —
And/Or Aui ' d Applitani Date
CODE �. INSVECTIONTYPE
1616 Fixed System Final Fire Preventian
1266
200
201
202
203
Pool Spe Finel
Final Ra-Rool
Finel Block/Retaining W411
Final Fectory Fire Place
Final Sign
204 Final Demoliiion
2aa6 <6
UAIE II�lLS
yQp$� INSPECTONTYPE
206 Finel Mechanical
208 Finel Plumbing
210 Final Elecidcel
212 Final Fire Prevention
220 Final Plenning ApD�oval
222 Final Site
250 Final Building/Occupancy
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�OT ZO - TRACT 3625
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBiA MEBA. CqLIRORNIA
For Applicanf fo Fill In Compleiely
TYPE OR PRINT
BUILDING zOG MINNESOTA AVENUE
ADDRESS 3
COSTA MESA, CALIFORNIA
owNER KENKOL CONSTRUCTION C0.
ADDRESS � PLACENYIA AVENUE
C�Tv NEWPORT BEACH No:Mt 6-3G
ARCHITECT TEL.
R K.W. Ko��
�555 PLACENYIA AVENUE
NEWPORT BEAGH
6�t95 No:Mi 6-32z7
O 1�� X� OO' I NO. OP BLDGB. O
BBTBACK LINE FROM '�� �
caMER OP 8'IHEET O� REAR YARD
Q�i 7f
SIDE YARO ILEFT " RIGHT 1
DESCRIPTION OF WORK
NEW � I X II aLTFwAYION I II ADDITI�N I
5 =1ELDING � ��� • F NO. OF
J ROOMS STORIE6 '
E%TERIOR We1 �. CCO I R�OF RO LK
COVERING J��� G�VERING
USE OF BUILDIN6 AND WORK TO BE PERFORMED
A ACHI
GARAGE PLAN 2-E
FIRE
ZONE
APPROVED
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APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. PEI
COSTA MESA, CALIFORNIA
ZONING
NO.OF /� I IISE OP NEW
PLPN9 ` � BVILDING n
LINE BTJ
APPROVED
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1 H6REBY ACKNO OE TXAT 1 HAVE REAO TH18 qPPLIWTION THE AMOUNT BHOWN UNO¢R VALUATION Ie FOR THE
AND 6TATE TH�THE A60VE IB LORH¢Ci NO AGREC TO COM- pUPP08E OF EeTABL18HING A PERMIT FEE ONLY.
PLY WITH ALL T" INANC A D 6TA ..UWB7lEpULATINO
euilDiNa Cq1J � u ION. VALUATION
SIGNATURE 4 F � l � �— ' ,�� PERMIT FEE � � �
PERMITTE (///, '—�
$ �`/ /�� ~ Pl,AN CHECK $ �� .
�AUTHORIZED AGENT