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Home My WebLink About2915 PALAU PL - Building Permits(714) 754-5273 • Fau (774) 754-4856 • www.ci.costa-mesa.cBUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2915 PALAU PL Suite: Vicinity: ROOF Parcel Number: 13927204 Applicant: GRAY, PATRICK Address: 1015 E CHESTNUT SANTA ANA, CA Owner: SPEIRS, JERI L Address 2915 PALAU Pl COSTA MESA, CA Contractor. YOUNGS ROOFING CO, INC Address: 1015 E CHESTNUT SANTA ANA, CA Zip: 92701 Arch : Address: Phone: Zoning: R1 R1 Phone: (714) 953-5444 Zip: 92701 Phone: Zip: 926253728 Phone: (714)953-5444 License: 568560 Eng: Address: Status: ISSUED Applied: 10/06/2003 Issued: 10/06/2003 � �/� — .�Z.�3a:��i� Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL OSB SHEP.THING, 30# FELT, AND 40 YEAR COMPOSITION SHINGLES. 3,200 S.F. INCLUDES ATTACHED GARAGE. Plan Check: $0.00 Permit: $181.25 SMIP Res: $0.97 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $182.22 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existina: 0 Rear 0- 0 Rear 0- 0 Reauired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Righl 0- 0 Right 0- 0 Ss,s�s.00 $9,675.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California 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 wi[hin 180 days, or it work is suspended or abandoned tor a period of 1 BO days. INSPECTIONS: In order tor the work authorized under ihis permit to be considered legal, such work must comply with all applicable codas, antl all requlred Inspections and (inal approval must be obtained. Failure to obtain inspeclions and final approval will result in the expiralion of this permit. FOR INSPECTIONS CALL: (774) 7545626 ?aas-ae ldoo� WORKERS'COMPENSATON DECLARATON: I hereby aHirm under penalry of perjury one of the following declaretions: "� ❑ I heve entl will maintain e cartiticate of consent 10 self-Insure for workers' compensation, es provided tor by section 3700 of Ihe Labor Cotle, lor the pertormance of the � / work for which Ihis permit is issued. +p I heve entl will maintain workere' componselion insurance, as requlred by section 3700 of the Labor Code, lor the pedortnance of ihe work for which this pertnit is issued. \ My worke w nsa n Insur carrier and policy number ere: , / !� 7� Carner: �� i}� PolicyNumber. �ZInV�V�' �� (This sectian need nof be completed i fhe pertnit Is valuetl a( one hundred dWlers ($100) or leu.) ❑ I certity thet in the pertormanca � e work for hich this permit I5 iSsueQ I shall no� employ any person in any manner s� as to hecome subject to the workers' compensation laws of Califom , a d gree y at il I shoultl �ecome sub�ect lo t�e workere' compensation provisions of S ction 700 oi the Labor Cotle, I shall torthwith comply wi�h these provision ^ /_ Applicant Signature: �� Date: �) lL/ D� WARNING: FAILURE TO SECURE WO KERS' COMPENS ION Q�VE OE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMR AL PENALTIES aND GVIL FlNES UP TOONE HUNDflED i1KK15AND OOLURE (5100,000), IN A�DITION TO THE COST OF CqMPENSNTION, OAMAGES AS PROVIDED FOR IN SECTION 37080F THE UBOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm Ihat I em forcB end BAecL Lia M_ Comrectols Signature: of Chapter 9(commencing with Section 7000) of Divislon 3 of ihe Businegs an� ryfessions Cotle, end my license is in tull Class x (Y �� , oe�e: n�3 CONSTRUCTION LENOING AGENCV: ❑ I hereby ettirtn that thera is a wnstruction lending agenty lor ihe peAormance ot Ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Neme: Lender's Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirtn thet under penelry al perjury Net I em E%EMPT FROM THE CONTRAC70R5 LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons Code: Any ciry or counry which requires e permit �o construct, alter, improve, demolish, or repair any structure, pnor �o its issuance, also requires the applicant tor such pertnit lo fila a signed statemant that he or she Is Iicensetl pursuant m the pmvisions of Ihe Contractore lJcense Law (Chepter 9(commencing with Section 7000) of Dlvlsion 3 of t�e eusiness entl Protessions Cotle) or thet he or sha is exempt Iherefrom end ihe basis for the elleged exemption. Any Wolation of Section 7031.5 by any epplicant for e permit subjects the appliwnt to a civil penalry of not more ihan five hunEreC dollars ($500).): ❑ I, as owner ot Ihe properry, or my employees with wages as their sWe wmpensetion, WILL DO THE WORK, entl 1he structure is not intended or otteretl tor sale (Sec. 7044, eusiness and Prolessions Code: The Contractors License Law tloes not apP�Y �o an owner of property who builds or improves thereon, and who does such work himsetl or hersetl or �hrough his or har own employees, providetl thet such improvements ere not intendeC or ottered for sale. If, however, �he building or improvement is sold within one year oi complelioq lhe owner-builder will have�the burden ol proving that he or she ditl not builtl or improve lor purpose oi sale.). � ❑ 1, as owner oi the property, em E%CLUSIVELY CONTRACTNG WITH LILENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pmtessions Code: The contractors Llcense Law does not appry to en owner oi propehy who builds or Improves thereon, end who contracis for such prolect with a contrectoqs) license pursuant to the Coniractors License taws.). ❑ I am exempt under sec. Business antl Professions Code lor this reason: Signature: Date: Owner ID venfietl by tlnvef5license. ❑ Yes ❑ No Drivefs License No. Expires: Verllication ot Ownership by (rype oi daumenL i.e. - properry tan bill ar tlaetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: ❑ I hereby cenify ihat no excavation live (5) or more feet in Oepih into which e person is required to descenq will be made in connection with work authorized by this permlt, and ihat no building simdure, scaHolding, falsework, or tlemolition or disman0ing thereoi, will be more ihan thiny-six (36) feet high. (Ghep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifornia Atlministretive Code). ❑ As owner�builder, I will not employ enyone ro do work which would require a permit irom the Division of Intlusinal Safery, as noted ebove, unless such person hes e permit to do such work irom fhe division. SignaWre: Dale: Division oi Intlusinal Safety Permit Number. CERTIFICA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I cehify under penalty ot perlury �hai I have read ihis epplication and state Ihat ihe intormation given is wrrect. I egree to comply with all state laws and ciry ordinences rela�ing to building cons�ruc�ion, antl authonze represematives of Ihe Clty ol Costa Mesa to enter upon Ihe ebove-descnb§d-qroperty for inspection purposes. I agree not to occupy or ellow occupancy of eny building authorized by Ihis permit until final inspection. LegalOwnar(s) /O� / _�� oate �O �rized Ap0lican� Date CODE 1. INSPECTIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Well 202 Final Factory Fire Place 203 FinalSign 204 Final Demolition OATE f�j$f�¢ !-'—''— � COOE♦ INSPECLIONTYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Electricel 212 Finel Fire Prevention 220 Finel Planning Approval 222 Finel Site 250 Finel Building/Occupancy �g �� CI1Y OF COSTA MESA HUILDING SAFEIY DEPARTMENT CERTIFICATION Ae the imdersigned, I am fully aware of the responaibilities as amer builder. I hereby certify that the personnel listed belw, vho are presently performing vork at G/l�f�L)L�Fu � are employed by me. I vill vithhold Social Security deductions, State and Federal income taxes. They are also covered by Workmen's Compensation Insurance as preacribed by the State lavs of California. tlAl� S ADDRESS OCCUPATION � ^ �O -�� Signed: `�S. ��. Addreea• �� i� �a�Au�� , Co s-�-� �1�,zs� C G �a�a � � uwrvtK CANA JOB ADDRESS 2 _GENERAL CONTRi A�o. I 39-272— $ � I F�"��;;: C TI ON 5 SOi`L GAS � WATER ROUGH �LUMBING PROP. SWR. LINE � SPFINKLING SYSTEM MISCELLANEOUS ROl1GM MEATING AND TEMPORARV SEFVICE UNOERGROUNO � ROUGH WIRI G TRENCHES FORM FLOOR $YS EM BONO BEAM � ST SHEATHING FRAME ANO FLASNING LATHING - IN n PLASTER, 6ROWN COA au HOI15E CON. LJ AIR CONOITIONING OR POLE POWER I-I ST" -TURAI, FINRL HL .G, VENT., REFflIG. ANO A. PLUMBING. FINAL AND GRS TEST FINAL DATE SUBCONTRACTOR F � W a ¢ � � S F G w .-1 3 Q 7 r � a m a � �. a Z W x 3 .4f) COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUII.DING ��IS PH�--��`-'V 1—`• ADDRESS OWNEF 1Z�R GAn�la(J�}. MAIL 2q�S ph�a� �L. A�DRESS CITV lN �p �/ TEL. � i rT MC ��. NO. CONSTRUCTION BRANCH ADDRESS ARCHITECT TEL. ADORESS CONTRACTOR QWU13YL/ f5�.I7�� ADDRESS TEL. CITY NO. STATE CITv LIC. NO. LIC. NO. OF lOT I OO � gf G I/2 NOW ON LO� 1 USEOF �-/m1��C EXISTING BLDG. �� Separa[e permits are required for electric, plumbing and heating work. USE OF BUILDING ANO WORK TO BE PERFORMED t�ODl�ll, �liM(�L, i2�o I heraby acknowl¢dpe ihat I hava reatl this applicallon end smta thet the ebove in}ormetion Ia correct and agree to compiy with all iews repulatlnp bulidinp eonettucHon, antl I shell not employ any person in vlolotlon of the workman's eompensnilon lews oi the Stata of CaIHOmle. 1 hereby certify thet 1 am properly Ilcansetl as a contrector untler tha State ot Celifornie Businasa antl Protesslons Cotle, Dlvislon 3, Chapter 9, antl that such Ilcensea era in tull torca entl et}act, or I am ozompt trom the provlsiona of tha Steta of Celifornla Businoss antl Profe55iOns Cotla, DlvisiOn 3, Chap 9. SIB�eture�of . .I \ p � / �� Permlttae � �� r j �/. �.� Authorizatl ABent R A.P. NO. J BUILDING / ADDRESS ` TRACT. Ff I0 DEC 70-75�Msn�� 479� ��+��72.63 FORSTRUCTURALPERMIT �LAu P� lOT Y BLOCK VALUE DATE 1 Z NE NO.OF y � USE OF NEW _ � PLAfS [/ BUILDING VARDSAPPROVED YARDSAPPROV MAIN BUILDING ACGESSORY BUII // b VAR. qW c.�.v.9W VALUATION g q� & DATE APPROVED PERMIT FEE E (�.(� PLAN CHECK 5 TAX S TOYALPAID E IS FOfl ONIV: � n m i m m � m e 0 N n n 0 LL i u 1�_.�i�8 COSTA MESA BUILDING-SAFETY DEPARTMEN7 P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPL/CANT TO F/L[ /N COMPLETELY TYPE OR PRINT � no�RE'ss 297-5 P81au P1aCe COSTA MESA. CALIFORNIA R ARCHITECT OR ' �NE AOORFSS LEGAL DESCNIP' A.P. NO. 86x108 ir: IVU.`� LIC. NO. �EE RECEIVED CGL�. .-` = .� - �C FINANCE DEPT. �CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR Off/CE USE ONCY RECEIPI NO. P.BRPTf M �_0._i�47� I�VE,D,�Y OATE jiECE1VE� OATE 195UE� !✓/ I e?^/-60IFFR R �n� NG iS COSTA MESA, CALIFORNIA ZONING I�5 CC� ZONE I NO. OF USE OP NEW • PLqNS BUILDING APPROVED BY I � � DATE NO.oFeL�cs. O yqRDS 'EVES Now onLoi RE�UIRED ALLOWED USE OF none ICENTER LINE ST.) EXISTING BLDG. FRONT SETBACK LINE FROM �O � nO ( CENTER OF STFEET REAR YARD LJ R. SIDE � [t SIOE YARD' LEFT � I RIGHT % L SIOE DESCRIPTION OF WORK - v REAR NE�' I h II ALTERATION I II ADDITION I REPAIR I�IIMOVING I IIDEMOLISH I S Z'E DING 1800 S1 ROOMS O STORIES 1 E%TERIORW IROOc OO BS '°�`tun�n a,.,,. - and Attached Garage aac - 1 HENEBY ACK � L GE THNT 1 HAVE NEAD THIS APPLICATION AND STATE AT TH ABOVE CORRECT /.ND A REE TO COM� PLY WITH L CITY OINAN AN ST TE LA REGIILATINp 9VILOING ONSTRUC ON. SIGNATUR OF PERMITTEE �� AUTHORIZED AGENT .� ,� THE AMOUNT SHOWN VNDER VALUATION �IS FOR THE PUFPOSE OF ESTpBLISHING A PEFMIT FEE ONLY. VALUATION PERMIT FEE $ ,��.� $ /� ��S— pLAN CHECK $ � /'� TOTAL FEE S �7—'