HomeMy WebLinkAbout2908 PEMBA DR - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.�a��SLDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2908 PEMBA DR
Suite:
Vicinity: HOUSE & ATTACHED GARAGE
Parcel Number: 13926220
npplicant GOODGAME, JACK
Address: 16631 KETfLER LN
HUNINGTON BEACH, CA
Owner: . WALKER, ROBERT
Address 2908 PEMBA DR
COSTA MESA, CA
Comractoc SIERRA ROOFING CO
Address: 16631 KETTLER LN
HUNINGTON BEACH, CA
Zip: 92647
Arch :
Address:
Zoning: R1 R1
Phone: (714)847-1773
Zip: 92647
Phone: (714) 979-5958
Zip: 92626
Phone: (714)847-1773
License: 511172
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 11/29/2000
Issued: 11/29/2000
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (30 SQ). TEAR OFF EXISTING ROOFING 8
RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 1 LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH 25 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
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Ex�stinq: o
NOTES:
Rear 0- 0
Rear 0-0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Lek 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0-0
Right 0- 0
ss,�ao.00
$5,780.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
regulations. (Ortl. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abantloned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
POR INSPECTIONS CALL: (714) 7545626
2aas-as (eroo)
WORKERS' COMPENSATION DECLARA710N:
I hereby eHirm under penalty oi perjury one ot the following tleclarations:
❑ I heve and will maintain a certificate ol consent to selt-Insure tor workers' compensetion, as D�o�itled for by section 3700 of Ihe Labor Code, for the peAormence of Ihe
wark for which Ihis pertnit is issued.
� I have and will maintain woAcers' compensation insurance, as required by section 3700 of the Lebor Cotle, Por tha peRortnance of ihe work for which this partnit Is issuetl.
My workenrs' �c7o-m ensatlon Insur^ance carrier entl policy number are: ��5--� O "OO6 p(�J�,S_
Carrier:- /I/��U�✓/J �oliCy.Number.�
(This seci'on need not be complefe il fhe permit is veluetl e( one huntlred dollers ($ )00) or Iess.J
❑ I cenify that in Ihe pedormance of Ihe work tor which this permit is issued, I shall not employ any person in any manner so es to become su�jecl to the workers'
compensation lev¢�of Calitomia,pnd egree lhat IfySfiould bewme subject to ihe workars' compensation provisions ot Section 3700 of the Labor Code, I shell forthwith
comply with
FAILURE T/ySECURE WORKERS'
LICENSED CONTRACTORS DECLARATION:
%�Y Date: ��—.' � %- O U
GJVEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CFIMINAL PENALTIES AND pVIL FlNES UP TO ONE HUNDRED
' COfAPENSAiION, DAMAGES AS PROVIOED WR IN SEGTIqJ 3106 OF THE UBOR COOE, IMEREST, AN� ATTORNEY'S FEES.
I hereby ettirm that I.am license under rovisions of Chapter 9(commencing with Section 7000) of Division 3 oi.�he Business tl Pmfessions Cotle, and my license is in full
_,_ � �� 3�
force end ettect. Lic..p. h �� Z // Class n- I
contractors.Signature: (� ��„ i.��_ oate: L� — e2 9—D n
�
z
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirm that there is a construction lending agency for Ihe peAormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Atldress:
Signature:
OWNER-BUILDER DECLARATIONS:
Dete:
I hereby ettlrm �het under penelty of perjury that I am E7(EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business end Professians
Gotle: Any ciry or county which reQuires a permit to conswct, alter, improve, demoiish, or repair any strucWre, pnor to ils issuance, also requires ihe epplicaM for such pertnit
ro tile a signed statement that he or she Is licensed pursuant to the proNsions of Ihe Contrectors Licensa Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business and Professions Code) or ihat he or she is exempt Iherefrom and t�e basis tor Ihe elleged exemption. Any violation of Section 7031.5 by any applicant for e pertnit
sublects the applicant to a civil penalty of not more than tive huntlred tlollars ($500).):
❑ I, as owner oi ihe property, or my employaes with wages as their sole compensation, WILL DO THE WORK, end the structure is not Intended or oHeretl for sele (Sac.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner ot property who builds or improves thereon, and who does such work
himself or hersetl or Ihrough his or her own employees, provided ihat such improvements are not intended or oHered lor sale. If, �owever, ihe building or improvemeni is
sold within one year of completion, the owner-6uilder will �ave the burden ot proving ihat he or she ditl not buiid or improve for purpose of sale.).
❑ I, as owner of the property, am E%CLUSIVELV CONTRAC77NG WITH LICENSED CONTRACTORS to constmd tha prolect (Sec. 7044, Business and Protessions
Code: The contracbrs License Law tloes not appty to an owner ol proparty who builtls or Impmves Ihereon, end who contracis tor such projed wlth a contrector(s)
license pursuant to the Contradors License Laws.).
❑ I em ezempt under sec. Business and Professions Code br ihis reason:
Signature: Date:
Owner ID venfied by dnvefs license. ❑ Ves ❑ No Dnvers License No.
Verification of Ownership by (type of document, i.e. � property tax bill or tleetl):
Eapires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity ihat no excavation live (5) or more feei in depih into which a person is required to descend, will be made in connection with work euthonzea by this
permit, antl t�at no building siructure, scaHolding, talsework, or demolition or dismantling thereoi, wili be more ihan thitly-six (36) feet high. (Chap. 32, Gry 2, Ari 2, Sec.
341, TiHe B, California Aaministretive Code).
❑ As owner-builder, I will not employ anyone �o do work which would require a permit from Ihe Division of Indusirial Safery, as noted above, unless suc� person hfls e
pertni� to tlo such work irom Ihe division.
SiqnaNre: Da�a:
Division oi Intlustnal Safety Permit Number:
CER71FlCA7E OF COMPLIANCE IWD AUTHORIZATION OF ENTFiV: I cenity under penalty of Oeryury that I have read this epplication antl state that the infortnation given is
wrrecL I agrea to comply with ell state laws and ciry ordinances relating to Duiiding constmction, end authonze representatives of ihe City of Coste Mesa to enter upon the
above-described property tor inspection purposes. I agree not to occupy or allow occupancy of any building authorized by �his permit un�il final inspec�ion.
COOE t. INSPECTIONTYPE
1616 Fixed Sys�em Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolilion
UATE �NTRIALS
� �
//- �9"-00
�Date
COOE 1 INSPECTION TVPE
206 Final Mechanical
208 Final Plumbing
270 Final Electncal
212 Final Fire Pravention
220 Final Planning Approval
222 Final Sita
250 FinalBuilding/Occupancy
owxER BRADFIELD, V.L.
DATE 1-19-61
AP. No. LOT 11}- THACT j7Ly FIRE ZONE DESCI2IYTION OF WORK tilOCK W811
INSPECTIONS DATE I GROUP TYPE ZONE R1
Z� 'Tgt'011[Id Soil U.G. Watei pERMITS ISSUED
: ___,__...__ ---I SUBCONTRACTOR I
OCCUPANCY
Form 410—SM-11-59 5-B p
13731
� � _ 1�'731
.�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIFORNIA
For Applieanf to Fiii in Comptetely
TYPE OR PRINT
BUILDING �jCG � ��
ADDRE55 O°'7
i
COSYA MESA. CALIFORNIA
�
■ 9ETBAGK LINB PROM
�t�� BUILDING
NO. ✓ qDDRE65
TEL.
NO.
FIRE
ZONE
APPROVEO
BY
ZON
TEL. �cae� �
NO. DEBCNIPTIOp
INO. OF BLpG6.
OF WORK
E%TERIOR WALL ROOF
GOVERING GOVERING
USE OF BUILDING AND WORK TO BE PERFORMED
I HH0.EBY ACNNOWL
ANO 6TATE THAT TI
PLY WITH ALL CIlY
BU�LDINO CON6TIiUi
SIGNATURE OF �
PERMITTEF
AUTHORIZED AGE!
THAT 1 HAVE HGD TMIB APPLIGTION
>V8 IB COPRECT �ND AGRE¢ TO COM-
iANCEB ANO 9TATE LAWB REOULATING
FEE RECEI�E:�
,� �aN � y �ss�
�' fiNANCE DEPT,
APPLICATICEN'FSR P�fF��TM��
BUILDING
For Office Use Only
PECEIPT NO. �GI(M�IJT N�
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ii� � /_� I�CE�E/ I ��Te /`fE61
MESA. CALIFORNIA
ZONING
NO.OP uee or rvew
PLANB BUILDIN6
YAROS
APPROVED
ICENTBP LINH 9TJ
APPROVED
t
�� X�oi �(�/i
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THE �MOUNT BHOWN UNDER VALUAT
PURPOBE OP 88TABLIBH�NG /� pER
VAWATION
PEftMIT FEE
S /�% � PLAN CHECK
TOTAL FEE
I9 POq TH¢
FEE ONLY.
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BRADFIELD, ERATON L.
DATE
JOB ADDRESS 2908 Pemba Dr. BUILDING PERMIT N0. �(;��
GENERAL CONTRACTOR OWri2T-B1dT. VALUE SiK9_nn
AP. No.11i-6S2-20 i.OT TRACT FIRF. ZONE DF,SCRIPTTON OF WORK �lOCk Y1311
IN�PEGTIONS DATE GROUP TYPE ZONE R].
1 fgCpllfld $011 U.G. Walcr _I PERMITS ISSUED
— SUBGONTRACTOR
F
L
21
, � ` �.��.�C62
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 WBTA MEBA. CALIR0�1U
For Applican� to Fill In Compiefely
� TYPE OR PR1NT
BUILDING /i �O� /' �L
ADDRESS -•L /f�L✓
COSTA MESA. CALIFORNIA .
� MAIL
� CITY �jQj� /i�[j,o G(,� NO.
ARCHITECT TEL.
� SIZE I NO. OP B1D08.
■ 88TBACK LINB
DESCRIPTION OF WORK
'EXTBRIOR WALL IROOF
COVERING COVERING
� USE OF BUILDING AND WORK TO BE PERFORMED
1 HEREBY ACKNOWLEDGE THAT 1 HAVE R¢AD TH19 MPlJGT10N
AND BTATE T{IAT TXE A9�VE 18 CORRECT AN� AGItEH TO COM-
PLY WITH ALL OiY ORD�NANCEB AND eTATE UWB RBOULATIN6
BUIlDINO CON9TRUCTION� �
SIGNATURB OF Yj ���� �
PERMITTEG 6�
AUTHORIZED AGENT
FEE RECE6V�D
�'� APR 18 �9
FINANCE OEPT.
APPLICATION FOR���tJFI� COSTA MESA
BUILDING
For Offiee Use Only
PHCEIPi NO. P¢RMIT NO.
/S�a'a o7
,gY DATE RECEIVlD �ATC 188U8D
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BUILDING �GD J� �//.f�
ADDRESS / v �-J
COSTA MESA. CALIFORNIA
FIRE
ZONING
zoyr � I xo. ov I uee ov'xew
�{� — ruNe �}� euitou+o
VE
L80AL � //� � _
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EVES
(c¢rmx uxa er.>
/
THE AMOUNT BHOWN UNOER VALUATION �! POR TXE
PUfiPOBE OP E6TABLIeHING A PERMIT PEE ONLY.
VALUATION OG �J �
��( PERMIT FEE $ �J(
$ ��J ` _PLAN CHECK $
C
0
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rr3
�-� � � • ��.���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C06TA MEBA, CALIPORNIA
For Applieani fo Fill In Complefely
TYpE OR PRINT
BUIL�ING 29 a� P�m Bb �� .
ADDRESS
COSTA MESA. CALIFORNIA
OWNER V C'K�� � Ky ST L D .
MAIL ��. �L,!„GL�1/ /"�G
AODRE55
TEL.
CITY i NO.
ARGHITHCT TEL.
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"i.li,i �II'1_ li�-�;.�
�PPLICATION��FOn�I pERM'T"�,'.i�C�
BUILDING
For Offiee Use Only
RBCEIPT NO. �PSjtNIT�NO�
1d��
� I DA�^C7 �C CI D�./''�u `r O
� �% O e� . _�izl�s.,_ �� ..
ZON¢ NO.OF U6E OP NEW • reS.
c�n R_], I PLAN9 2 I em�nmc w 8tt. &g0
STA7E � TEL. LEGAL 1� ^ C
UC. NO. ('' NO. DEBCRIPTION � 7
OF LOT � V � S �N D I NOWOONBLOTB
A. P. NO. NONE
USE OF YAROS EVES
EXISTING B DG APPROVED ALLOWED
6fiTBACK LIN6 PROM ��7 [�NTeR YNe 9T.>
cexrew ov srnear � D REAR YARD L FRONT FT. IN.
SIDE YARD LEFT W I RIGHT (I � R. SIDE FT. IN.
DESCRIPTION OF WORK
L.SIDE FT. � IN.
NEW I ALTERATION I IIADDITION I REAR FT. IN. •
REPAIR MOV�NG I IIDEMOLI6H I B,,PROVED / 1 , DA� C�
L/
BUILDING NO. OF /� .��
SIZE O ROOMS STORIES �9��
EXTERIOR WALL ROOF �/ .L
COVHRING � � COVERING SI �\ �-
USE OF BUILDING AND WORK TO BE PEBFORMED
m
G- ,e ..
I HHReBY ACKNOWLEDOH THAT 1 HAVE READ THIB MPLIGTiON 7HE AMOUNT BHOWN UNOER VALUAiION 1! FOR TXe
ANO BTAT¢ THA E ABOVe 19 COPRECT ANO I1GR86 TO CON- pURP08E OP EBTABLI8HIN6 A PEpMIT FEE ONLY.
PLY WITH A CI OPDIN B AND BTAT U�WB R60ULATING
BU�LnINa N8 CTION. VALUATION �j
SIGNATU F PERMIT FEE S J��
PERMITTE L - Q e
$ �i /�J � PLAN CHECK $ / / '
AUTHORIZED AGENT � � ,� �
TOTAL FEE ,y