HomeMy WebLinkAbout2367 FORDHAM DR - Building Permits(714) 754-5273 • Fa�t (714) 754-4856
CITY OF COSTA MESA
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 2367 FORDHAM DR
Suite:
Vicinity:
Parcel Nunmber: 14148409
BUILDING PERMIT
Zoning:
� . .
N� R
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 10/15/1998
Issued: 10/15/1998
Applicant: DARNELL, PHILIP
Address: 1718 W IOWA �
- Pfibne:�..714-751-8783 -: �
COSTA MESA � -� /%r=: = -' � � - Zip:- 92626 � ��'�, ,,
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owner: DARNELL/,,ROBERT W� � �� '�% � I ��.�`�� ���\,
Address 2367 FORDHAM DR� �. � �' � �_� ��; ��.. ;�
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/ COSTA'MESA'CA ' Zi 92626 � � � � � �� ���� � �
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�� � f � i - - SCOPE OF PERMIT � � � " , r � ��
� � j � 'rTEAR OFF RESHEATH WITH 1/2" CDX.PLYWOOD�&'R-'ROOF�W/20=YR�COMP. � � � � � �� - � ��� ,
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-�' ' r FEE SUMMARY tJ '' �'�"
� Plan Check: . � $0.00
`�� Permit: ' $7475
SMIP Res:, �„$0.50
SMIP Com �, $0.00
�,'`�: Other ��, A�$0.00
Inspecfion = �$0':00
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��,Total: � $75.25 �;
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, _._ .�Claim Valuation: y„'� ;� g2,�oo,00
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� �� � � �PLANNING & ZONING ✓ ;�/' j i .'
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SETBACKS �, /._ `1 -� ��,���� .� i� � � �.�// d
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MAIN STRUCTURE�Front 0- 0� Rear 0 0' ' ` CeR 0 0�' Right - 0- 0/,�,
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ACCESSORY Front � 0-�0 . �'-' , Rear , 0- 0 , LeR -, 0- 0, �" Righf 0 0��
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PARKING Existin : 0�� _ �Requi2d: 0 � �, Pr000sed: � �0 %�= -'
NOTES: � . ,, .. � ,. � ,- _ .,
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeeliona and final epproval must be obtained. Failure to obtain inspections and final appioval will result in the expira�ion of this permit.
POR INSPECTIONS CALL: (714) 7545626
J
WORKERS' COMPENSATIGN OECLAYiAT10N: � �
I hereby effirtn untler penalry oi perjury one of the following tleclarstions:
❑ I have and will maintain e certificate ot consent to setl-Insure tor workars' wmpensation, as providetl for by section 3700 oi the Labor Code, for ihe petlormence of the
work for which lhi5 permit i5 i55ued.
❑ I �ave antl will maintain workers' compensation insurence, as required by seaion 3700 of the Labor Cotle, for Ihe perfortnance of the work for which ihis permit Is issuad.
My workers' compensation Insuranca carrier and policy numDer are: �
Cerriec Policy Numbec
(ThJs secflon need nat be wmp/efe0 i/ fhe permit is valued af one hundred dollars ($f 00) or less.)
❑ I cenity thet in the pertortnance of ihe work tor which Ihis permit is issued, I shell not employ any person in any manner so as to become subject to the workers'
wmpensallon laws of California, entl agree that If I should become su6ject to the workers' compensation provisions of Sactlan 3700 oi the Lebor Code, I sha0 forthwith
comply with these provisions.
Applicent Signeture: Date:
WARNIN(3: FAILURE TO SECURE WORKERS' COMPENSATION C/JVERAGE IS UNL4WFUL ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HIINDRED
TFIOUSAND OOILARE ($100,00p), IN A�DITION TO THE COST OF CAMPENSATION, OAMAGES A$ PfiOVIpE� FOR IN SEGTIIXJ 3706 OF THE IABOR CODE, IMEREST, AND ATTOqNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby effirtn ihat 1 am licensed under provisions of Chaptar 9(commencing with Section 7000) of Division 3 of ihe Business end Professions Code, end my license is in full
torce and eHect. Lic. x Class N
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I �erehy atfirtn that ihera is a conslmction lending agenty for Ihe peAormance of ihe work for which Ihis pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Neme: LentleYs Atldreu:
SignaNre: �ate:
OWNER-BUILDER DECLARA710N5:
I here6y eHirtn ihat untler penelry of perjury ihat I am E%EMVT FROM 7HE CON7RACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry which requires a permit to construq, alter, Improve, demolish, or repair any sirucNre, D�or to its issuence, elso requires t�e applicaN tor such permit
to file a sipnetl statement Ihet he or she is licensetl pureuant to tha provisions ol fhe Contractors License Lew (Chapter 9(commencing with Section 7000) ot Division 3 ot ihe
Busineu entl Protessions Code) or Ihat ha or she is exempt theretrom and ihe basis for iha alleged e:emption. My violation of Section 7031.5 by any applicant tor a pertnit
sub�acts Ihe applicant �o a civil penalry of not mora then five hundred dollars ($500).):
❑ I, as owner of Ihe properry, or my employees with wages as Iheir sole compensation, WILL DO T}IE WORK, and the structure is not intentled or oHered tor sale (Sec.
7044, Business end Profeuions Cotle: The Contractore Licensa Law tloes noi apply to an owner of properry who builds ar improves ihereon, and who does such wark
himself or hersetl or through hIs or her own employees, provided that such Improvements era not intantletl or oHeretl tor sale. If, however, Ihe bulitling or improvement Is
soltl within one year of completion, the owner-builtler will have �he burtlen oi provin9 ihet he or she did not build or improve tor purpose of sale.).
❑ I, as owner ot ihe property, em EXCLUSIVELY CONTRACTING WITF1 LICENSED CONTRACTORS to construct t�e pro�ect (Sec. 7044, Business end Protessions
Gotle: The conireciors License Law does not appty to en owner ot properry who builds or improves theraon, antl who contracts for such project with a croniractor(s)
licensa pursuant to the Con actore License Laws.).
� �^?� der sec. 1 O� eusiness and Protessions Cotle tor this reason:
Signatu : '-Tl ��t_c.� � oete: O � 5
ner ID venhed by dnver's license. e�Yes ❑ No nve s nse Na Exp' er�sr � � �
Vedficatlon oi Ownerehip by (rype ot document, I.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N:
❑ I hereby certify that no e:wvation Hve (5) or more teat in tlepth into whic� a person is required to descend, will be made in connection with work authodzed �y this
pertnit, and that no building sWCNre, sceffolding, talsework, or Demolition or tlismantling thereof, will be more than thirty-sia (36) taet high. (Chap. 32, Grp 2, Atl 2, Sac.
341, Tltle 8, Galifomia AdminlSlralNe Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which woultl require e pertnit from the Division of Intlustnal Safery, as noted ebove, unless such person has e
pertnit to do such work from ihe division.
SignaNre:
Division of Intlusirial Setery Permit Number:
Date:
CERTIFlCATE OF COMPLUWCE /WD AUTHORVJITON OF EMAY: I ceriify under penalty ot perjury Ihat I have read this application and state that the information given is
correct. I agree to comply with all state laws and ciry ordinances releting to building construction, and authorize representatives ot Ihe Ciry of Costa Mesa to enter uDon ihe
ebove-tlescnbad properry tor inspection purposes. I agree not Io occupy or allow occupancy of any building euthorized by this pertnit until final inspection.
jQp(y INSVECTIONTYVE
1678 Fixetl System Final Fire Preventian
1268 Pool Spe Finel
200 Final Re-Roof
201 Finel BIocWReteining Wall
202 Finel Fectory Fire Place
203 Final Sign
204 Finel Demolition
26a6d8
I��
�Z�" ! fLH'�
COOE� INSVECTIONTYPE
206 Finel Mechanicel
20B Final Plumbing
210 Final Eleqncal
272 Final Fire Prevention
220 Final Planning Approval
222 Final5lte
250 Final Building/Occupancy
Costa Mesa Estates
DATE
JOBADDRES$ 2367 Fordham DI'1V2 BUILDINGPERMITNO. ZG6].
GENERALCONTRACTOR Roven-Spiegel Co VALUE $ �-�-)200.00
LOT 6�. BLOCK TRACT 275� Sin�le Res W�att �ar
(: Jp I& J TVPE V ZONE RIi FIRE DISTRIGT p6g3
I PERMITS ISSUED
INSPECTIONS I DATE SUBCONTRACTOR DATE I NUMBER
1
Trench
rion Forms and Grade to
Plum6inp. Rouqh to Slab
Wirir
Heati
Fi
St.
sepuc � anK or cesspaoi
Lathing,ln OutX i �� r }
PI-..e�_�9 c!_ 3 "S— /
r�6
F ing, Fin�al, Fixtures Compiete/yi/f $ 4-�9�5�7
PlUmbing, Fin.al GasTest/,>' /ij f{ S �j.-�Ir%-.S 7 - "
Wiring,Final MNY 1 �y57 ��B
Occupancy MAY 1 1951 VCB
FORM 210 3M �O�•v5
i1
�
��r� ; osta Mesa Buildin`g Department
� s�� ' 171 EAST 20th STREET
, .,COSTA MESA� CALIFORNIA
I � FOR APPLICANT TO FII.L IN
Costa Mesa, California
Q ., �
� APPLICATION�FOYi PERMIT
���,; BUILD�tNG �
� FOR OFFICE USE ONLY
��i
c"� 5g si. //v�� �1'�Ji� ��Lt y�/
Owner �cx�Ti� �iCT��� ���'fi7E�j
Mail � I�.1 � !/� :� 'I�Gi, -_
Address •
Clty �s �iri�iz>r<=S 3-C No.,/��3�a��
Arohitector�� Lic.
Engineer YJ���r ��G�i No.
�dress S�O�PG�2J /��l��y �;r�7L i/i- ' �ri'
I � � c c�ty �ic. ,
Contrector 'G/�i /�%Fl����1yo. /Z>j�6%
Address �1�`s� `U� �Z��Y.^-�•:�C/Z;C�
Legal I Lot �/ I �I
Description No. Block I Tractz��'J
§ize of Lot �5� � �
Use of
5 -�j i,� Kea�
Side
Alteration I I Addition
nwwmgL/ � NO. of
%d� � �7/ Rooms �
rior Wa115.�.,�� � � R
vering I Coverir
UseoTNew//_�,.o � �
Buildinn .l!% cfX<_ dlL�1�
v . �
I hereby aclmowledge that I have read this Application
and state that the above is correM and agree to rnmply
with all City Ordinances and State Iaws regulating
building cronstruction. ,p-
SignatureoT �/A-�(�G/,� �5„ft7��
Permittee �
Valuation Permit Fee $ �� �
Plan Check $
$ 7� u�� Total
Fee $ o� �
RM 204 S-HP 2bi 6-55 �
ate Rec'd. Date IssuW
_ ���_�% <,l-��_.c
�9 .
ss
Costa 1VYesa, California
Nearest
Cross St.
GORREG�IONS
APPROVALS
ation Location InspeCto
ns, Materials,
;r-Pinning
: Fire Stops.
P
�
�
JOB ADDRESS
GENERAL COD
AP No.
INSPECTIONS
�
DATE 8-1.6-62
lt A Yt ti I:OTiStI'llCt10i1 VALUE $ 4,370,00
LOT TRACT RIR� ZONF. D�SCRIPTION OP R�ORK1
ISignature� DATE GROUP S TYPE p 7.ONF
� � „� ¢l SUBCONTRACTOR �Y�E�Ril9_�
_ _ T A TP. 1
" � ��677
COSTA MESA BUILDING-SAFETY DEPARTMENT
' P. O. BOX 917 COBTA MEBA. GALIFORNIA
For Applleanf fo Fill In Complefely
TYpE OR PRINT "
COSTA MESA. CALIFORNIA
■ ARCHITECi
SIZE /OO '� � �
OF LOT
USE OF
EXISTING BLDG.
68TBACK LINH PPOM O
�NTEN OF BTtELT :�
/
SIDE YARD ILEFT �^ �
DESCRIPTION OF
�
ROOF
COVERII
K TO BE
'I HEREBV �CKNOWLEOGE YNAT 1 HAYE RE
AND 9TATE THAT THE ABOVQ IB CORR6CT
PLY WITH ALL CIIY OROINu'1GE8 ANO 8TA
BUILOINO CON91BlIGT10N.
■ AUTHORIZED AGENT
FEE RECEIVED
auc i e fsa2
fINANCE D�PT.
CiTY OF C05TA MESA
APPLICATION FOR PERMIT
BUILDING bii✓
For Office Use Only
RECEIPT NO. I PERM�I
RECEIVFy �Y
r l��
TEL. BUILDING
N�� ADDRE55 �p
TEL. CC
-r+e--
FIRE
ZONE
'U(��IOII �`PPROVE �
%V-�/�
NO. OF BLD66.
v
MESA. CALIFORt31A
ZONING
ZON _� NO. OF USE OF NEW 6�5�
(� I PLAN6 z BIIILOING � /.
M
LE6AL Ti, Z /
pi" G/ ��
OEeCRIPT�ON
A. P. NO. � �y' - y,� v- 0 9
YARDS EVES
APPROVED ALLOWE�
(CENTER LINE BT.)
FRONT -5—� FT. � �~� d�
R.SIDE �" �`L`� �T. �XrS�''iaf
�
L. SIDE �J FT.
,
REAR 3 9 f FT.
APPROVED�� `i��
HY � � . �ATF
�a�� ,
UGfON THe pMOUNT BHOWN UNOER VqLUAT10N I6 FOR THE
TO M- pURP086 OF, EBTABLIBHING • PERMIT F6E ONLY.
:ULATING
� VALUATION
PERMIT FEE $ /�
^I N
$ / � �� PLAN CHECK $ � �
�/ � p
TOTAL FEE y
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