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Home My WebLink About2822 FRANCIS LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c��s ILDING PERMIT �� FAIR DFiNE, G05lA MESA, GA 92626 JobAddress: 2822 FRANCISLN Su'de: Vicinity: ROOF Parcel Number: 14133202 Applicant: BRIAN WOLSKY Address: 17662 METZLER LN HUNTINGTON BEACH, CA Owner: HASSEL, ROBERT H TR Address 2822 FRANCIS LN 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 Phone: Zip: 9262G5836 Phone: (714)847-9332 License: 575002 Eng: Address: ISSUED BV: Status: ISSUED Applied: 08/12/2003 Issued: 08/12/2003 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL NEW SHEATHING, 30# FELT, AND CLASS A COMPOSITION SHINGLES. 2,500 S.F. INCLUDES ATTACHED GARAGE. Plan Check: $0.00 Permit: $16725 SMIP Res: $0.87 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.12 SETBACKS MAINS7RUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existing: o Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 $8,715.00 58,715.00 NOTICE: The work authorized 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) EXPIRATION; This permit shall automatically expire and become void if work is not commenced within 1B0 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 Inspectiona end final approval must be obtained. Failure to obtain inspections and final approval will resufl in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545826 i44648 (8�00) WORKERS' COMPE?15ATIbN'DELLARATION: � � I hereby aNirm under penalty of perjury one of ihe follawing tlecleretions: ' . . � ❑ I have and will maintain a cehificate ot consent to seN-Insure for workers' compensatlon, es provided for by section 3700 of the Lebor Code, for �he pertormance ot the work lor w�ich this permii is issuetl. � �I have and will maintain workers' compensetion insurance, as requiretl by section 3700 ot t�e Labor Cotle, for ihe pertortnance ol the work for which this pertnit is issuetl. My wor�ke6'/yp�rt}�p' -ensat/lon Insur ce carder entl policy number ere: / Cerriec _ 7%]✓`E-� fZ—v� � Polity Number. �lo I C�_� 3�' (This sectlon need not be comp/etetl i! the permif /s velued e( one huntlred dol/ars ($100) or IessJ ❑ I cehity Ihat in iha performence of Ihe work for which this Dermi� Is i55ueQ I s�all not employ any person in any manner so as to become subject lo fha workers' compensetion lews of Celifomia 0 a ree Ihat II I should become sub�ect to Ihe workere' compenselion provisions af Section 3700 ot ihe La6or Cotle, I shell forihwith comply with ihese prov' ns. n � / �y Applicant Signeture: ��-%�� Date: O/� L�'1 WARNING: FPILURE TO SECUPE WORKERS' COMPENSATION COV E IS UNLAWFUL AND $MALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUN�RED THOUSAND DOLLARE ($t00,OW), IN ADDITION TO THE COST OF CAMPENSATION, OAMAGES AS PRWIDED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND AiTORNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hareby aNirm that I em Ilcensed under provislons of Chapter B(commencing with Section 7000) ot Division 3 of the Business antl Professions Code, and my license is in full torce and ettect. Llc. a ��%�+l— Class p C''-3 1 Contractor's Signature: �P � Date: K I L CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirm that ihere is e consiruction lending egency lor the Oedormence of the work tor which this permit is issued. (Sec. 3097, Civil Code). LendeYs Name: Lentlers Address: SigneNre: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm that unaer penelty ol perjury ihat I am EXEMPT FROM TF1E CONTiiAC70RS LICENSE LAW for ihe following reason (Sec. 7037.5, Business and Professions Code: Any ciry or counry which requires e Derml� to consiruct, alter, improve, demolish, or repair any slmcNre. Orior to its issuance, also requires Ihe epplicant tor such pertnit to tile a signed stetement that he or she Is Ilcensetl pursuant to the provisions of Ihe Contrectors License Law (Chapter 9(commencing with Section 7000) of Division 3 0l the Business and Professions Cotle) or thet he ar she is exempl therefrom an0 the Desis for the alleqed e:emption. Any violation of Section 7031.5 by eny epplicent far a pertnit subjecis ihe applicant to e dvil penalry ol not more than tive hundred dollers ($500).): ❑ I, as owner of Ihe property, or my employees with weges as �heir sole compensetion, WILL DO THE WORK, and �he siructure is not intendad or otterea for sale (Sec. 7044, Business antl Professions CoGe: The Gontractors License Lew does not apply to an owner of propeM who builds or improves Ihereon, and who Ooes such work himself or herselt or through his or her own employees, provided ihat such impmvemeNs are not intentlad or offered for ule. I(, however, the building or improvement is sold within one year oi compleUon, ihe ownerbuilder will have ihe burden ot proving ihat he or she ditl not builtl or improve for purpose of sale.). � ❑ I, as owner ot the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business and Professions Code: The comrectors License Ww doas not apply to en owner ol property who builtls or Improves thereon, antl w�o contracts br such pro�ect with a comractor(s) license pursuant to the Conirectors License LewsJ. ❑ I am e:empt under sec. Business end Prolessions Cotla tor t�is reason: Signature: Date: Owner ID venfied by drivers licensa. ❑ Ves ❑ No Drivers License No. Veriticetion of Ownership by (type oi dxumem, i.e. - properry tex bill or deetl): Ecpires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certify that no excavatlon five (5) or more teet In Gepth Into which e person is required to descend, will be made in connection with work euihorized by this permit, antl ihat no builtling siructure, scattoltling, lelsework, or demoli�ion or dismantling ihereoi, will be more than thirty-six (36) leet high. (Chap. 3.2, Grp 2, Ar12, Sec. 341, Title 8, Celifomia Atlministrative Code). ❑ As owner-builtler, I will not employ anyone to do work which would require a pertnit from the Division ot Industnal Sefery, as notetl aDove, unless suc� person has e pertnit lo tlo such work irom the division. Signa�ure: Date: Division of Intlusirial Satety Permit Number: CER7IFlCATE OF COMPLIANCE AND AUTHORIZATION OF EHTAV: I certity under penalry ot perjury that I have read this flpplication and state that the inlormation given is correc�. I agree to comply with ell sta�e lews end clty orCinances relating �o builtling consiruction, end au�honze representatives ol Ihe City of Casta Mesa to enter upon Ihe above-describetl properry tor inspection purposes. I egree nat to occupy or allow occupancy ot any building authorized by this permil until final inspection. COUE t' INSVECTONTYPE � � 1616 Fixetl System Final Fire Prevention 1266 Pool Spe Final 200 Finel Re-Root 201 Flnal Blxk/Retaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition �.1 JIII__ J� •\ �� ii 40DE � INSPECiION TYPE 206 . Final Mechanical 20B Finel Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAIE Iti�Li � �'�J 0�� Applicant to fill in all spaces except those within heavy�bortler lines antl si9n all appropria[e tleclarations. - . PERMIT NO. , TflACT NO. .LOT�NO. - UNIT N0. 1 arY oF COSTA MpESn C/ONSTRUCTIO PERMIT Project Address � O � r�' � � � � � ApplicanYsMa�ilin ddess - Owner's Name � S Phone � OO . Address � Arch/Eng. � ' License No. ' Address n-�, _�r/ Controctor's Nam `� -� / J V� Phone"L/�r1L�� Address(m�-I'nnlN �• /.!/��.(J ��f'/1P-/7i�)� City License No. ��-j L�CENSED CONTRACTOR DECLHRATION � I hereby affi�m'that I am licensetl untler provisions o( Charter 9(commencing witb secUon �000) of Division 3 of the Business antl Professions Cotle, antl my license is in full fo�ce a tl eftect. -� � Licen�5e1 Cl�ss,,,��ri/L��Li �nsehtlo.��`�� Date`% �•� C� a/ !l WOFKERS'COMPENSATION DECLAftAT10 � � 1 nereby aftirm that I have a certificate oi conient to self-insure or a certiticate � Workers' Compensation Insurance, or a certifietl mpy thereof (Section 100, Lab. CJ O �/ ( � �/,+� r��o.11icy No. Y�Q � Company �/�'ve%�' �/'n�� LTCe�rtlf�ieaQ c5qpY �5{ �M1eetlbwithrthencit��f+ m9 i isi �ate%-�� -" n � APplicanJ�� . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl if the permit is for one huntlred ($300) or Iess). I certify that in the pe�fo�mance of the work for which this Oe�m�t is issuetl, I shall not employ any person in any manne� so a5 to become subject to the Wockers' Compensation Laws of California. - ' Date Signature NOTICE: If, after making,this tleclaration, you�shoultl become subject to the � Workers' Compensation provi5ions of the Labor Cotle, you must to�thwith compry with such provisions o� this pe�mit shall be tleemetl revoketl. GONSTRVCTION LENDING.AGENCV ' 1 nereby atfirm that there is a construction lentling agency for the pertormance ot the work for wM1icn this permit is issuetl (Section 3097,,:Civ. C.) Lentler's Name Lentler's Atltlress - - - OWNER BUILDER OECLARATION - I he�eby atfirm that I am exempt from the Contractor's License Law tor the tollowing reason (Section 7031.5 Business and Professional Cotle: Any:city or county wnich requires a permit to construct, alter, improve, tlemolish or repair any structure, prio� to its issuance, also requires the applicant for such permit to file a signetl.statement that he/she is'licensetl pursuant to tne provisions of tne Contractor'S License Law (Chapter 9(commencin9 with Section 7000) ot Division 3, of tfie Business and Professions Cotle) or-that hejshe'is ezempt ; erefrom antl'the basis far the allegetl exemption. Any violation of Section `�'�'31 5: by any applicant for a permit subjects the applicant to a civil <"s'nalty of not more than five huntlretl tlollars ($500). �-L� I, as owner, of the'property or my, employees with wa9es as their sole ' comoensation, will tlo the work, antl the structure is not intentled or otferetl for,sale ($ectiom]044,'Business antl Protessional Cotle: The Contracto�'S License Law does'not apply to an owner of a property who builtlSor improves Thereon,'antl who tloes'such work himselt/herself or through his or her own employees, provitletl tM1at such improvements are not intentletl or otfered for sdle. If, howeveq the tiuiltling o� improvement is soltl within one year ot com- pletion, tne owner will have the burtlen of proving he/she ditl not builtl or im- prove for the purpose of sale). � � ❑ 1, as owner of the property, am exclusively mntracting with licensetl con- tractorsto mnstruct the project (Section 7044, Business antl Protessions Cotle: . The'ConVactor's �License Law tloes not appty to an owner of property who bulltls or improves thereon, antl-who contracts for such projects with a con- tractor(s) ❑cense pursuant to the Contractor's License law). I am aware that . proot of their Worker's Compensation insurance shoultl be provitledto �me. �� I am exempt untler Section _ B. & P. C. tor this reason oate Owner I heretiy certify that I have reatl this application antl state that the above information is correct. 1 aqree to comply with all city antl county ortlinances antl state laws relating to builtling consVuction, antl�hereby authorize repre- sentatives o s city to'eqter�lpon the above-mentionetl roperty for inspection r �es. ( Signature �� n`-A�-� l - Date aI � Drivers'��i Ssx �']- .= � 2co0 � 3 . TYPE OFCONSTRUCTION NEW ADD� ALTERATION REPAIR, ' �❑ CONVERSION ❑ DEMOLISH ❑ 0.THER _ q.p, # '_ �DESCRIPTIONOFWORK/USEOFBLDG. S MainBuildi TVPE O,F PERMIT ❑ GRADING��FOUNDATION ❑ STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear ❑ OTHER � . . _ . .' _ Q PROJECT DESCRIPTION 5t�. FT. oCCVaarvCv C Right K Left CONSTRUCTIONTVPE VAIUATION$ � � $ ,ZONE GRADING CU. VDS. ACRES _ P�ng. R¢f. � Remarks: � •. • � Pl2nnlnq NOt¢5: Sink <flow Preventer <flow Irrigation Drinking Fountains Floor Drains Floo� Sinks Gas Service Outlets Interceptors ' � Kitchen Sink � - Lavatorie's P-Trep Roof Dreins ' � Reinspection.Fee , , $15 3oiler Duct- UnderGround � Duct-Strucmrel , Duct - Ventilating ExhaustSystem ❑ Multiple�❑ Firepl/Fact Blt. ICBO # Heating System & Ducting. : ❑ 0-100,000 BTU O 100,000 BTI.{ Reinspection Fee � $15 CMF 0865-46, rev. 10/84 White - Builtlin9: Canary - Applicant; Pink - Accounting; Galtlenrotl - As5es5or n Showers - _ Service Sink Sewer Cap Sewer Connection Solar Collecrors ' Solar Piping � Solar Tank . Swimming Pool w/Spa Urinal .Water Closet � Water Heater - ' Water Service - AUtO-W25I1 luue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑aioo,aooeru Oioo,boo System Repair/Alteration Fire Dampers . Registers n Issue Fee 1 ng: . FEES .i � Automatic Washer- ' ConstructionPoleSub. Cooking�Unit ' � Dishwasher' Dryers ❑Gas� ❑Electri Fan. F.A.U. Fiztures Device Boxes � FEE 3TU � $B Switches Garbage Dispoul Generator �0-5 KW Fee DEVELOPMENTSER 2oning Approved By- Building Approved By 6146 IO/28/86 . , �5.p0 TL . . i - ._ �. .`.�Zone ._ Parking ELECTRICAL , . ' � Transformer ❑ 15�50 KW � - � ❑ 50+;KW . Meter ❑up to 100amps �. Meter ❑over_100amps: ' Sub Panei , ' . - � Motors D O-1 HP 01 %- 8 � Inc.Solar �9-15 FIP.016;15- Microwave' ' � Pole Li9ht ' ` � Range � LJ5-15 KW Standing Sections Trash Compactor , • $15 I I luue Fee — REQUIREMENTS: 2 O N I N G R E Q M T S FEES • � SUMMARV OF FEES , . � , ' BUILDING PERMIT. $ " -SMIP ' $ PLAN CHECK � $ —�—t- PERMIT ' ' . PLUMBING " , $ i � �—�'� ISSUANCE $ PLAN CHECK 25% $ � � ENERGV P.C. $-. ELECTRICAL . $ � GRADING � $ ' PLAN CHECK 50% $ � � � MICROPILM � $ .� MECHANICAL $ � TOTAL FEE $ � � PLAN CHECK 25% $ -� ' � ' CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # � Date Inspector t. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgmd. � 54. Forms 4. ElectricalConduit-Undrgrnd. 55. Electrical�Bonding �;? � • � <_� 5. Steel Reinforcement � 56. Rough Plumbing & Press,yre Test • " 6. Electrical UFER Gmd. � � 57. APPROVAL TO�COVER'�GUNITE � 7. Footings . 58. Electrical Conduit-Undr§r;nd. 8. Foundation - 59. Gas Pipe, O Undrgrnd.,;Test '� � 9. Water Pipe-Undrgrnd. _ , 60. Backwash Lines, P-Trap�,[� Undrgrnd. � 10. Structural Floor System 61. APPROVAL TO DECK ;'_? 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Firiel 72. Sewer Cap 63. Heater & Vent-Final . � 13. Roof Drains 64. Plumbing SYstem - Final , 14. Rough Plumbing 65. Electrical-Final � 15. Rough Electrical-Conduit � 66. Solar System-Final . � 76. Rough Electric Wiring 67. Fencing & Access Approval �17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling �� 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . 20. RougFi Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating - 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test �_ , 72. Underground Flush �. 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil � 25. Roof Sheathing ' 74. Overhead Hydro � � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � � 27. Frame and Flashing 76. Dry Standpipe � 28'. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation , 78. FIRE PREV. FINAL ' 30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat� 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning . ' 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Plum6ing Z� �j] (J� ' 39. Water Service-Final � . 40. Gas Service-Final - � � 41. Solar pomestic-Final • 42. Backflow Preventer . . 43. Backflow Irrigation - � 44. Landscape Irrigation System � 45. Sound Attenuation � 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed . 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOF.00CUPANCY No. Date ��.*[;:�3 F COS7A MESA BUILDING•SAFETY DEPARTMENT ' P. O. BOX S17 COBTA MEBA. CALIPORNIA For Applicanf io Fill In Compleiely TYPE OR PRINT � � COSTA MESA. CALIFORNIA ov e�nca. . ��. a^ L�i . AEC 9 1�0 �ot 8� P��N 3��.8'� D`'':' � nF ��:�i: I�ILC�'. APPLICATION FOR PERMIT BUILDING For Office Use Only N!ClIPT NO. P[RMIT NO. er I O� �g% V lf � I QLCi 28 AODRE55 2822 Francis LBIY � CASTA MESA. CALIFORNIA FIRE ZONING ZONE NO. OP I UeE OF NEW R�1 PLANB 2 BUIlDINO W LeoAl �..� 1 in ' N ' ' ' USE OF ' YARDS EXISTING BLDG APPROVED 96TBACK LINB FPOM � / �C=NTEp LINC 0T.) ceNTHR oP erneeT REAR YARO O FRONT ' 6IDE YARD ILEFT '` IRIGHT / R.SIDE DESCRIPTION OF WORK � d ___ ___ _ _ .. I SIOF ' � U6E OF BUILDING AND WORK.TO B8 HEREBY KNOWL2DG8 THAT I XAVE RHAD TH� �APPI�WTION NO BTAT THAT THP.�ABOVB 19 COPHHCT AN� R66 M COM- PLV WITH qLL CITY 6FDIN NC88 AND BTAT¢ 6 p60tILATINO BU�LO�NO CON9iAU�lON. 81GNATURE OF PERMITTE . I AUTHORIZED AGENT ' u TXG AMOUNT lHOWN UNDQq VALUATION IB IOR TNC PUPP08E OP E9TABLI6NIN0 A P6RMIT I!8 ONLY. $ 1�' ' 30, �f I PLAN CHECK