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Home My WebLink About2109 FEDERAL AVE - Building Permits(714) 754-5273 • Fax (774) 754-4856 • www.Ci.Costa-me5a.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 BUILDING PERMIT Job.4ddress: 2109 FEDERAL AV SUite: Vicinity: Parcel Number: 42245312 Appliaant: HAN, AUSTIN Address: 1022 W ORANGETHORPE FULLERTON,CA Owner. SMILEY FAMILY TRUST Address 2408 MARGARET DR NEWPORTBEACH,CA Convactoc ACE ROOFING SYSTEMS CO Address: 1022 W ORANGETHORPE FULIERTON,CA Zip: 92838 Arch : Address: Zoning: Phone: (714) 871-9923 Zip: 92838 Phone: Zip: 92663 Phone: (714) 871-9923 License: 679543 Eng: Address: ISSUED BY: Status: ISSUED Applied: 03/18/2004 Issued: 03/18/2004 Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF; TEAR OFF EXISTING ROOF, REPAIR SHTG. AS NEEDED, INSTALL 30 YR. COMP. SHINGLES. Plan Check: $0.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 SETBACKS MAIN STRUCTURE Fronl 0- 0 ACCESSORY Fronl 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 52,850.00 $2,850.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap accass requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permlt shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPEC710NS: !n order for ihe woAc aufhorized unde� this permit to be considered legal, such wak must comply with atl applicable codes, and ell requlred Inapeetlona end finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. fOR INSPECTIONS CALL: (714) 754-5626 244&48 (6'00) WORKERS' COMPENSATION DECLARATION: � � I hereby afllrm under penelty of perJury one of Ihe following tleclerations: � ❑ I have entl wlll fielntaln e certlficate oi consent to self-Insure tor workers' compensation, es provided for by section 3700 of ihe Lebor Code, for the pertormence of thb /w�ork for which ihis permit Is Issued. �/ i lieve flnd witl maintain wy rke ' compensation insurence, es required by section 3700 of ihe Lebor Cade, for,ihe'peAormance of the work for which this pertnit Is Issued. / My workero' wmpeue�e'6n I wrancgpemer e poliry num�er are: / J` �, � %� Camer. %✓�4 �.�� ` 'Poli"ty Number. �� D 6 6 �(' [�-/-� (lhis section need nof be comp/etetl l7 he permit is v� I etl al one hundred dWlars ($100) or less.) V ❑ I certify that in t�e peAormence of the wark compensatlon laws ot Celltomia, entl egree comply wiih t�ese provisions. Appli�'cant Signature: W� NG: FAILURE TO SECURE WORKER P ,TTIOUSAND DdlARE (5100,000), IN ADDRION TO Tf1 LICENSED CONTRACTORS DECLARATION:� •h Ihis permit is iuued, I shall not employ any person in eny manner so es to become subj q to the workers' s�o Itl become sub�ect ro the workers' compensation pmvislons of Section 370 of the or Cotle, I shell forthwith / � �7 i o 7" �v� COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CHIMINFL PENAL ES NND ^ML FlNES UP TO ONE HUN�RED ° COMPENSATIQV, DAMAGES PS PROVIDED FOR IN SECiION 31080F THE LABOq CODE, IMEREST, ANO ATTORNEI"S FEES. I hereby aHirtn Ihat I em licensetl under provis' ns of Chapter 9 �ce aqtl ettea. uc. a Cantrac{afs SigneWre: CONSTRUCTION LENDING AGENCV: Section 7000) af Dlvisi�.3�oi �Ae Business antl Pmfeuions Code, antl my Ilcense is in full ❑ I hereby eHirm that there is a wnstruction lending egency for ihe peAormence of the work for which Ihis permit is Issued. (Sea 3097, Civil Cade). Lender's Name: Lentler's Atldress: Signature: OWNER-BUILDER DECLARA710NS: Data: I hereby effirm ihet under penelty of per�ury thel I am EXEMP7 FROM 7ME CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, eusiness end Professions Cotle: Any ciry or counry which requires e permit to constma, elter, improva, tlemolish, or repeir eny stmcture, prior to its issuance, elso requires the applican� for such permit to file a signetl statement Ihet he or sha Is Ilcensetl pursuent ro the provisions oi the Contrectors Ucense Law (Chepter 9(rqmmencing with Seclion 7000) of Divislon 3 ot ihe eusiness and Professions Cotle) or that he or she is exempt therefrom end ihe basis for the elleped e:emption. Any Wolation of Section 7031.5 by any epplicant for e permit sublects the aDD�icant to a civil penalry of not more ihan (iva hundred dollars (5500).): ❑ I, as owner o11he properiy, or my employees with wages as �heir sole compensatlon, WILL DO THE WORK, antl t�e s�ructure Is not intended or oHeretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner ol properry w�o builtls or improves ihereon, and who tloes such work himself or harself ar t�rough �is or her own employaes, pmvided ihat such improvements era not Intendetl or oNered for sale. tl, honaver, the building or improvement is sold wi�hin one year oi completion, lhe ownerbuilder will heve the burden of proving that he or she did not builtl or improve for puryose of sale.). ' ❑ I, as owner at the proparty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Protessions Code: The coniractors License Law Ooes not apply to en owner of pmpeny who builds or Improves thereon, entl who contracis tor such project with a contrector(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under SaC. Busineu end Protessions Cade lor this rea5on: SigneNre: Da�e: Owner ID veniied by dnver5liCenSe. ❑ Ves ❑ No Dnvefs License No. Expires: Verifice�lon of Ownershlp by (�ype of documenL i.e. - property tar bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON: ❑ I hereby cartity that no excevetian tive (5) ar mare leet in depth into which e person is requlred to tlescen4 wlll be mede in connection with wark authonzed by Ihis permit, and Ihet no building siructure, scaHolding, lalsework, or demolition or dismamling Ihereof, will he more then thirry-si: (36) feet �igh. (Chap. 32, Grp 2, Ar12, Sec. 341, Titla e, Californle Atlminisiretive Code). ❑ As owner-6ulltler, I will nol employ enyone to tlo work w�ich wauld require e permit from Ne Division of Intlustrlel Sefety, es noted ebove, unless such person hes e permit to do such work from tha division. Signature: Date: Division of Indus(riel Safety Permit NumOer. CERTIFICATE OF COMP ANCE AND AIJiHORVATION OF ENTHY: I certify under penalry of perjury thal I have read this epplicetion end state that ihe information given is correct. I agree m compl with all stete laws end city ordinances relating �o bullCing constructlon, enO euthodze representaiives ot Ihe Ciry of Costa Mesa to enter upon ihe ebove-descnhed prope for inspection purposes. I agree not to occupy or allow occupancy ot any building euthorized by Ihis Dertnit until finel inspection. COOE 1. 1676 1266 200 �. t uuL141 Fised System Flnal Fire PrevenUon Pool Spe Finel Finel Re-Rool '� Z' 3� �'� 207 Final BIocWReteining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Finel Demoll�ion � �i�la��-G COOE� INSPEC710NTYPE 206 Final Mechaniwl 20B Final PlumDing 210 Finel EleciriCel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Building�Occupancy o�h u�s ORANGE COUNTY BUILDING DEPARTMENT 636 North Broadway ' ' � , " SANTA ANA, CALIFORNIA '� FOR APPLICAPiT TO FILL IN APPLICATION FOR PERMIT � --._��JILDI�G FOR OFFICE USE ONLY RECEIPT NO: P MIT NO. BUILDING i � �/ 1 �� A � ADORE55 �(�C� �i�(jra•I , � SCHOOL DIST. RECEIVEO BY. OAT OF APPL. OR TOWN / 1 �J �J NEAREST �. / / /� 5�� cftoss sT. Vi rttnn:ai R+� S� �� Bl11LDING �� /O �- � OWNER O�AGE HOME�� ING. ADDaE55 MAIL 9363 w��sH�Re BLVD. SCHOOLOIST. n AODRESS OR TOWN �, /�YLtr� CITY BEVERLY HI��_S NO�R. 5436� NEAREST GRO55 ST. C�'�� ARCHITECT OR TEL, /11 ZOJJJ}}}�� NO.OF TVP ENGINEERCAIN & MLKERRACHER NOJY• O4S9� {�/^ / I�PLAN$ I� � �� ADDRESSZ��O E. WALNUT ST.p PASADENA SETBACKLIN OM CENTER OF ST. �� REAR'YARO ��'� � ,Y SIDE YARD �05 u'ranc'roeNEMPORT VISTA CO.No R. 6� i � . APPROVEO ADDRE55 9363 w��sH�RE BLVD.� BE . IL�S eV � � LEGAL / CORRECTIONS DESCRIPTION I LOT NO. p2 BLOCK � u� (ATTACH METES & BOIlNDS) _ � __ TRACT NO. OF BLDGS. � � SIZE OF LOT 7O X � � O NOW ON LOT O � USE OF I NO.OF I NO.OF EXISTING BLDG. FqMi�ies ROOMS DESCRIPTION OF WORK eui i7 USE OF NEW BUILDING APPROVALS FOUNDATION: LOCATION INSPEC I HEREBV ACKNOWLE'JGE THAT I HAVE READ THIS FORMS, MATERIALS, APPLICATION AND STATE THAT THE AHOVE IS CORRECT UNDER-PINNING ANO AGREE TO COMPLY WITH ALL COUNTV ORDINANCES FRAME: FIRE STOPS, AND STATE LAWS REGtILATING BUILDING CONSTRUCTION. BRACING, BOLTS ��Q � LATH. I NT. ..d5i/�� SIGNATUREOF NENPORT VIST CO. LATH.E%T. ��'�� PERMITTEE /J� //�• PLASTER. INT. _!�'/• � AUTHOHRED AG �.,__.�,.{ i - , _. � 4830.0o P = s FEE S VALUATION FEE � 1f� � � e s � u� I• w - 2 P w J � Z d � � PLOT- PLAN •-' , � �rc o a � a `' ,,, �., �� ; . . � ';� _ i. .... ._, ... - .�, , �',� • __ , �, , , �h u < w STREET • ..,.:� _�._.. - ,.. ..';J� -^i',:C_'I�'��V .. f.. '� . . _ .�I' �_.,_,_. f' . _ _,�� . . =,.c, " .: �;.� -_,... �., .-..,_ , ._ crr.: f . c: :, r:: i' r�: :ta_:1 ,.._ .,.:%` �..•,,i, ='I�:.:_I'ri . ... � � 0 o r r: c�- � . . . . . � � C :I:JJ � ...!7.:IL . ..C_.:"i� �. �; . `1 �•��' � _._.,_,^.I ^-'.. .JJ :,i: I�' �..J94i_'..i y� ` � . ' '.l- .J,T' . ' 9 .