HomeMy WebLinkAbout3209 MINNESOTA AVE - Building Permits(7�4) 75a-5273 • Fax (77a) 754-ae56 • www.ci.costa-mesa.��LDING PERMIT �� FAIFi �HNt, GV51A MtAA, GA BLbLb
,lobAddress: 3209 MINNESOTAAV
Suite:
Viciniry: HOUSE 8 ATTACHED GARAGE
Parcel Number: 13908109
npp�icant: WOLSKY, BRIAN
Address: 17662 METZLER LN
HUNTINC�TON BEACH, CA
Owner: BRISSO, THEODORE
Address 3209MINNESOTAAVE
COSTA MESA, CA
contractor: TOM BYER ROOFING
Address: 17662 METZLER LN
HUNTINGTON BEACH, CA
Zip: 92647
Arch :
Address:
Zoning:
Phone: (714) 847-9332
Zip: 92647
Phane: (714) 5403300
2ip: 92626
Phone: (774)847-9332
License: 575002
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 11 /09/2000
Issued: 11/09/2000
Phone: Phone:
2ip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (27 SQ). TEAR OFF EXISTING ROOFING 8
RESHEATH WITH 1l2" CDX PLYWOOD. INSTALL 30# FELT UNDERLAYMENT & REROOF WITH "ELK" 30 YEAR
COMPOSITION SHINGLES.
Plan Check: �0.00
Permit: $125.25
SMIP Res: $0.58
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $'125.83
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY front 0. 0
PARKING Existina: o
NOTES:
Rear 0-0
Rear 0. 0
Required: 0
FEESUMMARY
PLANNING & ZONING
LeR 0- 0
LeR 0. 0
Pr000sed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Righi 0- 0
85,810.00
55,810.00
NOTICE: The work authorized by this permii shall comply with all applicable handicap access requiremenis under California statutes antl related
regulations. (Ord. No. 92-28. § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
lor a period of 1 BO days.
INSPEC710N5: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectiona and flnal approval mus� be obtained. Failure to obtain inspections antl final approval will result in the expiration of Ihis Dermi�.
FOR INSPECTIONS CALL: (714) 7545626
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WORKERS'COMPENSATON DECLARATION:
I hereby affirtn untler Denelty ol perjury one ot the following tleclaratlons:
❑ 1 heva antl wlll malntain a certificate of consent to self-Insure br workers' compensetloq as pmvided for by section 3700 ot the Lebor Code, for the peAortnance of the
work for which Ihis permit is issued.
� bhavo antl will maintain workers' compensation insuranca, as requiretl by section 3700 of ihe Lebor Cotle, for Ihe DeAormence of the work lor wMch this pertnit Is Issued.
My warke mpjrjsation Insurance wrtier and policy num�er are: L
'Certier:_ . �1 �Gy�O�A � �JO�83�a.�
Policy Number:_
-(fils sec7on need nof be comp/eted i! the pemvf is ve/ued et one hundred dWlars (S I00) or /essJ �' —
❑ I certity thet in the peRormanca ol the work tor w1�n Ihis pertnit is luued, I shall not employ any person in any manner so as to become subjecl lo Ihe workers'
compensatlon laws oi Calitomia, arW egree Iti it"f I shoulA become sub�ect to t�e workers' campensation provisions oi Section 700 oi the Lebor Code, I shall Porthwith
complywit�t�e ovi i
ApPllcnnlSlgneNre: �� rDater._ l/ Li�jL
WARMNG FAILURE TO SECURE ORKERS' COMP GOVEMGE IS UNIAWFUL M1D SHnL� SUBIECT AN EMPLOVER TO CRINJNAI PENnLTIE$ AND pVIL FlNES UP TOONE HUNORED
T110USlwD DOLURE (SI00,000). IN ADORION TO THE COST OF COMPENSATNXy DAI.NGES AS PROVIDED fOR IN SEGTON 3%OB OF THE LABOR CODE. IMEREST, ANO ATfORNE1"5 FEES.
LICENSEU CONTRACTORS DECLARA710N:
I hereby aHirm thaLl.am.licens�d.u�e�rqyisio
r
force end eflect. Lic_M .–� ��i � r�
of Chapter 9(commencinp with Section 7000) of Division 3 of the
Cotle, antl my licanse Is in full
1 l-G - �
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm Ihat ihere is a consWction londing agency for ihe peAormance of Ihe work br which this permit is issuetl. (Sec. 3097, Civil Codo).
Lentle/s Nemo: � Lentler's Atldross:
Signeture:
OWNER-BUILDER DECLARATIONS:
Dete:
I hereby aHlrtn Ihac under penelry at perjury �het I am EXEMPT FROM TME CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Protessions
Catle: Any ciry or counry whic� requires a pertnii to consWcL alter, impmve, tlemolis�, or ropair eny strucWre, pnor to its issuence, elso requires the applicam tor such pertnit
to lile a signetl siatement �hat he or she is licensetl pursuant m the provisions ot the Contraciors License Law (Chapter 9(commendng with Seccion 7000) ot Division 3 of tha
Business entl Professlons Cotle) or that he or she is exempt theretran antl t�e basLs lor the ellegetl exemption. Any violation oi Section 7037.5 by any epplicent for a pertnit
subjects Ihe epplicem ta a civil penalry af not more than Me hundred tlollare (5500).):
❑ I, es owner ol Ihe properry, or my employees with wages es Iheir sole compensation, WILL DO TME WORK, antl t�e swcmre is not imentla0 or ottered for ule (Sec.
70a4, Business end Professions Code: The Contractors License Law does no1 epD�' �o an owner oi property who builds or improves thereon, antl w�o tloes such work
himselt or hersetl or througA his or her own employees, provitletl that such impmvemen6 ere not intended or ottered tor sale. N, havever, tha building or improvement is
sold within one year ol completion, the owner-builder will have the burden ol proving that he or she tlitl not builtl or improve lor purpose ot sale.).
❑ I, as owner of the proparry, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTAACTORS to construct the project (Sec. 7044, Business antl Professions
Catle: The contractars License Law does noi appy ro an owner ol proparty who bulitls or improves Nereon, and who contracts tor such pwject with a contractor(s)
license pursuant to Ne Conirectors License Laws.).
❑ I am exempt untler sea Business antl Professions Code for ihis reason:
Signeture: Date:
Owner ID verilied by driveYs licensa. ❑ Yes ❑ No Drivers License No.
Vedficetion of Ownership by (type ot tlwument, i.e. - property tax blll or daetl):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cently that no excevation tive (5) or more leet in tlep�� Into which a person is requiretl to tlescentl, will be ma0e In connec�lon with work euthonzetl by ihls
pormil, and that no huilding structure, scattoltling, lalsework, or demolition or tlisman�ling �hereof, will ba more Ihan thirry-six (36) teel high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Titla 8, Celitomia Atlministrative Cotle).
❑ As owner-builder, I will not employ anyona to do wark whic� woulA require a permit Irom the �ivision ol Intlusinel Selety, es notetl eDove, unless such pereon has e
pertnit to tla such woB tmm the tlivisian.
Signawre: Date:
Division ol Intlustrial Salery Pertnit Num�er:
CERTFICA7E OF COMPLIANCE AND Al7TFiORVATION OF ENiAY: I certify under penalry of perjury that I have read this application end state Ihat Ihe information given is
wrrect. I agroe to comply with ell state laws and ciry ordinances relating �o buil0ing conswction, end authorize representativos ot ihe Ciry ot Casta Mesa to enter upon the
ebova-described propeny for inspection purposes. I agree not to occupy or ellow accupency of any building authonzed by t�is pertnit until linel inspection.
LOpE I, INSVECTIONTYPE �
1618 Fizetl System Final Fire Preventlon
1268 Pool Spe Finel
200 Finel Re-Roof
201 FIneI BIaWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolilion
��I�11111.\l�j
I.J A�/
CODE 1 INSPECTION TYGE
206 Finel Mechanical
20B Finel Plumbing
210 Final Elactrical
212 Finel Flre Prevenilon
220 Final Planning ApDrovel
222 FinalSita
250 Final Building/Occupancy
PAg Iti�Li
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ROUGH PLIIMBING
PROP. SWR. IINE
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ROUGH HEr1TING ANO AIR CONOITIONING
TEMPORNRV SENVICE OR POLE
UNOERGROUNO [] POWER �
ROUGH WIRING
STEEL REINF.
FLOOR SVSTEM
BONO BENM � STEEL R
SMEATHING
ANO FLASMING
Pl �R.BROWN O
51 fURAL, FINAI
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX.1200 COSTA MESA, CALIFORNIA 92626
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For App/icant to Fill in Completely
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;FR 13-74cri�.00 561 � �*'�*::8.50
APPLICATION FOR BUILDING PERMIT
REGEIy�D BV DATE RECENED nnTo icciu
BUIIDING
ADDRES:
FIRE
20NE
APPROVE
N NO.OF
PLP'NS c
YARDS APPROVEO
MAIN BUIIDING
DISTANCE BET
MAIN BLDCS.
VAR. #
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I hereby acknOwl¢tlge that I heve reatl this application antl stata
that the above information is correct and agree to comply with
all laws regulating builtling consvuction, antl I zhall not amploy
any person in violation of the workman's compensation laws of
the Sta[e Of Celifornia.
I hereby certify that I am praperly licensetl as e contrector untler SQ. PT
Me Smte of Celifornia Business antl Professions Cotle, Divisicn 3, THE AMOUNT S
Chapter 9, antl that such licansas ara In full torce antl effact, or I THE PURPpSE OF
em exempt from tlie provisions of the State of California Busines5 VALVATION
end Protessians Cnae ivisi9 n 3, �hapter 9. n
Sipnatura of / // � / /1 �y��
Parmittee lN( lV� $ /
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USE OF
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IN UNDER VA�UATION IS FOR �
AB�ISHING A PERMIT FEE ONLV: m
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PERMIT FEE S c'
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TOTAL FEE $
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W ATER
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PROP. SWR. LINE Q HOUSE CON. �
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MISCELLANEOUS
ROUGH HEATING AND AIR CON�ITIONING
iEMPORARY SERVICE OR POLE
UNOERGROUNO � POWER �
ROUGH WIRING
TRENCHES FORMS � STEEL REINF
FLOOR SYSTEM
BON� BEAM ❑ STEEL REINFORCE n
SHEATHING
FRAME AN� FLASHING
V- 'NG - IN ❑ OUT [J
F ER, BROWN COAT
STRUCTURAL, FINAL
HEATING. VENT., REFRIG. AN� A.C., FINAL
PLUM8ING, FINAL ANO GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL
DATE 3-25-70
BUILDING PERMIT N0.
RIPTION of WORK pvt. Block W
ZONE VALUE$ 225.00
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11AR 7_5-70�nsn�0 707 c�'i*****5.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPIICATION FOR BUILDING PERMIT
For Applicant to Fill in Campletely
,f RECEI ED BV DATE RECEIVED DATE ICSSU
ADIDRESS dGC L/.f�Cr�/A � �' _�� ��J'�
�/J /�c P R IT N
OWNER
�/Y�� /C IS�J A.P. NO. � (% � C%
�J r BUILDIN
ADDFlESS � �(/ � � J7T�p ADORESS �
TEL. TRACT,3 LOT � BLOCK
CITV �/Q NO. �-
CpN$TRUCfION W A
LENPER
BRANCH
OWNER
ADDRESS �j� n
ARCHITECT TEL. S Lv�US Of��
OR E GINEEii N
FIRE �
ADDRESS 20NE TVPE GROUP
��r� •- APPRO E� ? �/C��IQ
CONTRACT6R iL BY DATE �� 7XJ /
ADDRESS
TEI. Z �� NO.OF USE OP NEW
PIANS�Y BUILDING
CITY NO.
STAYE CITV VAFOSAPPROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE NO.OF BLDGS. (FROM C/lSTREET)
OF LOT v NOW ON LOT RONT FT. �
USE OF
ExISYING BLpG. �
SIZE OF NO. OF
NEW LDG. ROOMS STORIES L.SIDE FT. �T. _
EXTERIOR WALL ROOF / ��
COVE:��NG COVERING REAR FT. FT.
VSE OF BVII�ING AND WORK TO BE PEflFORMED DISTANCE BET. BEf. MAIN &
MAIN BLDGS. ACCESS. BLOGS,
/ � � VAR. aW DATE
W
C.U.P.# qPPROVED
APPROVED � �
I horeby acknowled8e thnt I �eve raatl this opplicaxion antl state
thut tho above informe[lon ia correct entl aprea to comply wlt�
ell Inws reBulating builtli�p conctruction, entl I shall not employ
nny person In violatlon oi tha warkmon's compensation laws of
the S[ero of Califomla.
I heroby certify thet I am pro0arly Iicenxtl es a contractor untlar SQ. FT.
[he S[ate Of Celifornia Buslnazs antl Profassions Cotla, Dlvificn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, entl thac such Iicansez are In full torce antl effect, or I THE PURP06E OF ESTABLISMING A PERMR FEE ONLV:
em exempt from Ne provisions o( the State of Californla Buflnocs V ALUFTlON � /�
entl Piofassions Cotle �sion 3, Chapto PERMIT FEE S •�^'��
� /�
SlpnnCura oi / ' n �V
ParmRma �� 5�/� -� PLAN CHECK 5 ��
C�/
AuNorized ABont , �
TOTAL FEE
i or j� - TRALT 3625 .
J�` �� i�a�� C�� ������9��
COSSA MESA BUILDING-SAFETY DEPARTMENT �`�.5-��'��
P. O. BOX 9f7 COHTA MHBA. GALIFORNIA r• �� 7
, i►1f,t�Cr QEP..
Fo� Appliean+ fo Fill In Complefely APPLICA710N FORrPERMI AF�
TYPE OR PRINT
BUILDING BUILDING
aoDRess 3zp9 �"�1NNESOTA AVENUE
COSTA MESA. CALIFORNIA FOf Office US@ DO��/
RECHIPT NO. PERMIT NO.
oWNeR KENKtlL CONSTRUCTION CO. ��
MAIL �555 PLAGENTIA FiVENUE AEc v pv oercnicerveu -i��el �,V�
ADDRE6S %~ ^ � V G
L,� / BUILOING { ,
ITY B ACH NOI"�I O- 2z qD�RESS
ARCHITECf 7e�. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRESS FIRE
ZONE TYPE GROUP
CONTRACTOR K•W• Ko�� APPROVED
BY DATE
pooRess � PLACENT 1 A AVEN UE ZONING
NEWPORT BEACH LON6 t I NO.OP U8E OF NEW � L
CITY PLANB BUILD�N�
STATE 6t t(]C� TEL. M I 6-32z7 LECAL / a S
LIC.NO. JJ NO. OE9CHIPTION •- (O
61ZE /O X� QO I NO. OP BLDG9. Q
OF LOT � NOW orv �oi A. P. NO.
USE OF NONE YAROS EVES
E%ISTING BLDG. APPROVED ALLOWED
SHTBACK LINB PROM � � qOi (ceNTCP Lrtie e�.l
eeerten ov nrnesT O REAR YARD � FRONT /�
' � (.PT. IN.
SIDE YARO I LEF " I RIGHi � R. SIDE FT. IN.
DESCRIPTIOM OF WORK
L. SIDE FT. IN.
NEW I X IIALTERATION I IIADDITION I REAR FT. IN.
REPAIR I IIMOVING I IIOEMOLISH I BY�'ROVEdII
(.(/ OATE rJ!
BUILDING t6p'ZSF NO. OF 7 � '
SIZE l ROOMS STORIES
EXTERIOIi W L ROOFWOOD
COVERING � UCCOp., OqICOTVEREINGE SHINGLE %
SENGLEU�FAMI�LY KES1ISER�tPA��RMED p�
� /�'�� 7 ,+
ATTAGHED ARAGE „� j� .
PLAN -B
1 HEPeBY ACItNOW��08 THAT I HAV6 READ TH19 MP4WTION THH AMOUNT eNOWN UNDER VALUAT�ON IB POR THE
ANC BTATB TXAT ABOV¢ 18 GORPECT AND AGREH TO COM- pURP088 OP EBTABLI6HING A PERMIT FEE ONLY.
PLY WITN ALL ITY INANGe ND - 6-REOULATNO
BWtDINa eo eTRV oN. _ � VALUATION �
SIGNATUR6 F PERMiT FEE $
PERMITTE �� � �
$ � �� PLAN CHECK S
AUTHORI2ED AGENT � �� �
TOTAL FEE �