The URL can be used to link to this page

Home My WebLink About2904 PEPPERTREE LN - Building Permits(774) 754,5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job nddress: 2904 PEPPERTREE LN Suite: Vicinity: ROOF Parcel Number: 13929611 ApplicanC GARCIA, DAVID Address: 21681 IMPALA LN HUNTINGTON BEACH, CA Owner: KELLEY, EDITH M TR Address 2902 PEPPERTREE LN COSTA MESA, CA Convactor: COAST ROOFING Address: 21681 IMPALA LN HUNTINGTON BEACH, CA Zip: 92646 Arch : Address: Zoning: R3 R3 Phone: 714-96&8754 2ip: 92646 Phone: Zip: 92626 Phone: 714-968-8754 License: 450393 Eng: Address: ISSUED BY: Status: ISSUED Applied: 0?JO&2005 Issued: 02/08/2005 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOFING, INSTALL 2 LAYERS OF 30# FELT UNDERLAYMENT, & REROOF WITH 30 YR. COMP. ON PITCHED AREA, AND TORCH DOWN ON FLAT AREA. (18 SQ PITCHED/7 SQ FLAT). Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 S�TBACKS MqINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: 0 Rear 0. 0 Rear 0-0 Repuired: 0 FEE SUMMARY PLANNING 8 ZONING Left 0- 0 Lek 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 S4,890.00 54,990.00 NOTICE; The work authorized by this permit shall comply with all applicable handicap access requiremenis untler Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72•27-92) EXPIRA710N: This permit shall automatically expire and become vold if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 1 BO days. INSPEC710NS: In order for ihe work euthorized under this permit to be cons'idered legal, such work must comply with all appllcable cotles, and all required Inepectione and final epprovel must be obtalnad. Failure to obtain Inspectlons and tinal approval will result In ihe expiratlon of this permlt. FOR INSPECTIONS CALL; (714) 754-5626 �meae �aoo� WORKERS'COMPENSAnON DECLARAnON: I hereby eHirtn under penalry of perjury one of tha fWlowing Ceclaratlons: ❑ I heve end vnll maintein a ceNficate ot consent to selt-Insure br workers' compensailon, as provided tor by sectlon 3700 0l Ihe Lebor Code, tor the pertortnance ot the work for which this pertnit is issueC. ❑ I heve entl will maintain wofkers' compensatlon insurance, as reQuiretl by section 3700 W the Lebor Code, lor the peRormance of ihe work tor w�ich Ihis pertnit is issueC. My work re'c10 m,.�pansatlon Insuran carder anC pollcy number ere: v� ^^ Cerrier. �� i L �1 �+L'�` Pollcy Number. /� I � Nl�" aL(l (This sectlon neetl nof be �omp/eted Il the permit is valued ef one hundred tlollars ($100J ar less.) ❑ I cortity thet in the pertormance ol (ha work tor which this permll Is issued, I shell not employ eny pereon In eny menner so es to become su6ject to t�e workers' compensetlon laws of C lomle, entl apr he y I should become sub�ect to the workers' compensetlon pmvislons oi Sectlon 3700 oi the Lebor Code, I shell forthwit� comply with thesa pro ' i ns. �_ ApPliceN Signeture: �,( l �� Date: ��r//�/��— WAfiMNO: FAILUFE i0 SE RE WORKERS' COMPENSATION COVEMGE IS UNLAWFUL AND SWLLL SUflIECT AN EMPLOYER TO CRIMfNAL PENALTIES AND CNR FlNES VP TOONE HUNDRED T/IOUSAND DOLIAHE (5100,000). IN ADDRION TO TNE COST OF ODAIPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3'!OB OF THE UBOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm Ihat I em licansetl untler proNsions ol lorce and eflect. Llc. p �% Contrector's Signatura: iepter 9(cammencing with Sectlon 7000) of Dlvision 3 0l the Buslness nnd�rat� ions Catle, entl my Ilcense Is in full CI849 M � . � .'f --- � oate: � .- � �.$— CONSTRUCTION LENDING AGENCY: ❑ I herehy aNirtn that there is e consWction IenCing agenry tor the pertortnance ol iho work lor which I�is permil is Iss�od. (Sec. 3097, Civil Cotle). LenOera Neme: Signeture: _ OWNER-BUILDER DECLARATONS: lentlers Address: Date: I hereby eflirm Ihet under penelry ot perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor ihe followinq reason (Sec. 7031.5, Business entl Professlons Code: Any ciry or counry which requires e permit to consiruct, alter, improve, demolish, or reDeir eny strucWre, pnor to Its Issuance, also requires t�e epplicent tor such permit to tlle a signed statement that he or she Is licensed pursuant to the proNsions ol Ihe Contrectors License Lew (Chepter B(commencing with Sectlon 7000) ot Dlvision 3 ai Ne eusiness end Professions Code) or Ihel he or she is exempt tharalrom entl tha Oesis for the allegad exemption. Any vlolatlon of Section 7031.5 by eny epplicant far e Dertnit sub�ects the epplicant to e civll penalry oi noi more than live hundred dollers (5500).): ❑ I, es awner at t�e property, or my employees with wages es lheir sole compensaGon, WILL DO THE WORK, and iha strucWre is not intentletl or ofleretl for sele (Sec. 7044, Business and Protessions Cotle: The Coniractors License Lew does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself ar through his or her own employees, provided Ihat such improvements ere not intended or oHered for sale. If, however, the building ar Imprwement is sold within ona year ot completion, the owner-builder will hava the burden ot proving ihat he or she ditl not Duild or improve tor purposa of sale.J. � ❑ I, es owner ot the property, em EXCLUSIVELY CONTRAC7INC WITH LICENSED CONTiiACTORS fo construct the prol�� (Sec. 7044, BuSiness enC Pratessi0n5 Code: The wniractors License Lew does nm appty to an owner of property who huilds or improves t�ereon, end who contrects lor such D�olect with e wntrecmr(s) licensa pursuant to the Contractors License Laws.). � I em azempt untler sec. Business antl Professions Coda lor this reason: Signature: Date: Owner ID venfied by dnvers license. ❑ Yes ❑ No Drivefs License No. VerNlcation af Ownership by (type oi tlocumem, i.e. - property ta: bill or deed): DIVISION OF INDUSTFIAL SAFETV PERMIT CERTIFICA710N: Expires: ❑ I hereby certity ihat no excavation flve (5) ar mora teet in tlepth into whlch e person Is required to descend, wlll be made in connealon with work authodzetl by this permit, and that no builtling sWcture, scaHWtling, talsework, or demditlan or tllsmentlinp ihereof, will be moro than thirty-six (36) leet �igh. (C�ap. 3.2, Grp 2, Atl 2, Sec. 341, Tltle B, Calilomia AdmlNstreuva Cotle). ❑ As owner-builder, I will not employ enyone co da wark which would roqulre e permit Irom the Divislon ol Induslnal Sefery, es noted ebove, unleu such person has e pertnit to tlo such work trom the drvision. SignaWre: Date: Divislon ol Indusinal Safery Permit Numbar: CERTIFICATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: I ceriify untler penalry of perjury ihet I heve read this epplication end state ihet the inlortneiion given is correct. I egree to wmpty with ell stete laws end ciry ordlnances relating to bullding cOnswction, and authotlze representetives of the Clry of Costa Mesa to enter upon the ebova-tlescribed propeM tor inspecGon purposes. I agree not to oaupy or ellaw occupenry ot any building authonzed by this permit until final inspection. SignaWre CO�E �. INSPECTIONTYPE 1616 Fixed System Final Fire Preventlon 1286 Poal Spa Finel 200 Finel Re-Raol 201 Finel BIacWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Domolition ae� uffme�s 3 !O '�, �� ' ; _, i _ �ate � tri a '6`-7—� Date COOEA INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plumbinp 210 Finel Eloctdcal 272 Finel Fire Prevantion 220 Finel Planning Appro�al 222 finel Site 250 Finel Bulltling/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.cos�a-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 lob Address: 2904 PEPPERTREE LN Suite No Vicinity: Parcel Nunmber: 13929611 Applicant NICHOLS,JAMES Address: 3058 CEYLON RD COSTA MESA, CA Owner: NICHOLS, ARLENE K TR Address 3058 CEYLON RD COSTA MESA, CA Contractor: Address: Arch / Eng : Address: ISSUE FEE BackFlow irrigalion Backflow Preventer Bathtub Clarifer System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve OWNER-BUILDER RELOCATE GAS LINE AMT $23.50 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 PLUMBING PERMIT Phone: 714-979-9577 Zip: 92626-2306 Phone: Zip: 92626-2306 Phone: Zip: License: 000000 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY QTY AMT � Laundry Tub / Washer $0.00 0 Landscape Irrigation 50.00 0 P-Trap 50.00 0 Pressure Regulator $0.00 0� Process Piping {per 10 ft) $0.00 0 Receptors $0.00 0 Septic Tank $0.00 0 SewerCapforDemo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 Sink, commercial $0.00 0 Sink, Floor $0.00 �TY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 03/20/2003 Issued: 03/20/2003 ISSUED BY: SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr BkFlow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service AMT $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The woik authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or it 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 requlred inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244&48 (N00) WORKFAS' CO +�ENSATION DECLARATON: I hereby eHirm untler penalty of perjury one of the followinq declarations: ❑ I have end will maintein a cenificata ol consent to self-Insure lor workers' wmpensetion, es provide0 tor by section 3700 0l the Labor Code, for �he pedortnanca of the work for which this permit Is issuetl. ❑ I have antl ��I maintain workers' compensation insurance, as required by section 3700 of Ihe Lebor Code, br ihe pertortnanca ot Ihe work for which Ihis pertnit is issued. My workars' compensetion Insurance carrlar ena policy number ere: Carrier: Paliry Number. (T �s ctian nead not be completetl il the permit is velued ef one hundred dollars ($700) or less.) •. I certify th9� in the peAormanca of the work for which Ihis permit is issued, I shall not employ any person in any manner so as to become subiect Jo the workQrs' �compensallon laws ot Calif ia, end eBree Ih If I oul suD�ect to Ihe workers` compensetion proNsionS of Saction 3700 of Labor Code, I sh511 forihwith comply with these ' ' s. //� Applicant Signature: � Date: �/��1� /l ��f-v U � WARNINGFAILUPETOS REWORKERS'COMPENAT COVEPAOEISUNLAWFULrWDSHALLSU&lECTPNEMPLOVERTOCRIMIWILPENALTIESANDCNILFlNESUPTOONEHUNDRED TINJUSFNDDdlARE ,OOO�,INa�D1TIONTOTMEC0.STOFCOMPENSATION,DAMAGESASPRWIDEDWRINSEGTIdJ3l050FTHELABORWDE,INiEREST,ANDFTTORNEVSFEES. LICENSED CON7RACTORS DECLARA710N: I hereby aKrm tlrat I am licensatl under prodsions of Chapter 9(wmmencing with Section 7000) ot Division 3 of ihe Business and Professions Code, antl my license is in tull torce and eflect. Lic. a Cla'ss a Contractors Signatura: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby aHirtn ihat there is a conslruction lending egency for ihe pertormance oi Ihe work tor which t�is permit is issued. (Sec. 3097, Civil Code). Lendefs Name: LenAets Address: Signature: Date: OWNER-BUILDEF7 DECLARATIONS: I herehy attirm ihat under penalry ol perjury that I nm EXEMPT FROM TME CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Buslness antl Professions Cotle: Any ciry or counry whic� requires a permit to construct, alter, improve, demolish, or repair eny strucWre, pnor Io its iuuance, elso requires ihe applicant for such pertnit b tile e signetl statement the� he or she Is Ilcensad pursuent to ihe provlsions oi the Contractors LJcense Lew (Chepter 9(commencing with Section 7000) of-Dhnslon 3 0l the Business and Professions Code) or that he or she is exempt therefrom end the basis lor ihe ellegetl ezemption. Any violation ot Section 7031.5 by any appliwnt tor a pertnit subjects t�e appl�cant to a civil penalry of not more Ihan live hundred tlollars ($500).): ❑ 1, as owner M ihe properry, or my empfoyees wilh wagas as their sole compansation, W ILL DO T11E WOAK, antl ihe struciure is not intentletl or oftered tor sale (Sec. 7044, Business antl Professions Code: The Conirectors License Lew does not apply to en owner ot pmperry who builds or improves ihereon, and who dces such work himselt or nerself or ihrough his ar her own employees, provlded ihat suc� improvements are not intended or oHeretl for sale. If, howaver, ihe building or improvement is sold within one year ot completion, the owner�builder will have �he burden of proving that he or she did not build or improve �or purpose of sale.). � ❑ I, as owner of the pmperty, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Profession5 Code: The contrac ors License Lew does not epply to an owner ol property who bulltls or Improves ihereon, antl w�o coniracts for such pmject with a contractoqs) � .._____ _ _.__..�.�_�__'___'__':_""�_.__, ,I em exa tler SaC. ignature: Owner ID ver' d by drivers license.� Verificetion Ownership by (type oi c / DIVISION OF INPUSTRIAL SAFETY Business and Professions Code far this reason: ves ❑ No i.e. � pmpeey tax bill or deed): Drivefs Ucensa No. Eapires: ❑ I hereby cellity �het no excevetion five (5) or more feet in depih into which e person Is required to descend, will be mede in connedion with work authonzed by this permit, and tha� no building sirudure, scaHolding, falsework, or demolitlon or dismantling Ihareof, will be more than Ihirty-six (36) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, Tltle B, Californie Atlminlstreilve Code). ❑ As owner-6uilder, I will not employ anyone to do work which would require e permit from the Division of Industrial Safery, es noted above, unless such person has e permit to d0 such work irom the division. SignaNre: Date: Division of Indusinal Safety Permit Number. CERTFICATE OF COMPLJANCE AND AUTHORVA710N OF ENTAV: I certity under penalty of perjury �ha� I have read this application antl state ihat ihe inlortnation given is correct. I egree to �mpty with all state laws entl ciry ortlinances relating to building consiruction, entl authonze representatives of ihe Ciry ot Costa Mesa to anter upon Ihe above-d cnbe ropeny tor insp tic pur ses. gr not to occupy or ellow occupancy oi eny building authonzed by ihis permit until tinal inspection. ��_ S��dyX//L/� � %- .� � 6l� ' Signa re f Legal Owner(s) � Dat Antl/Or Aut�orizeA Appliceni Date CODE t. �ueomnnN7ypE � Q� �NiIiIFLS 1616 Fixetl System Final Fire Prevention 1266 200 Pool Sp8 Final Finel Re�Floo� 201 Finel BIxWReteining Well 202 Finel FaC1ory Fire Place 203 Finel Sign 204 Final Demoiition - COOEI INSYECTIONttPE � 206 Final Mechanical 200 Final Plumbing 210 Finel ElecMcal 212 Final Fire Prevention 220 FinelPlanning Approvaf 222 Final Site 250 Final Builtling/Occupency DATE �$ -31-p3 �- � (� �b' (� %� �uu�i�ut f �iek� OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such noticc, and, as a condition precedent to issuing a building permit, require the completion and require the retum of, an owner-builder veri�ication. Attention Propetty Owner. An 'owner-builder' building permit has been applicd (or in yuur name and bearing your signature. Please complete and retum this information in the envelopc provided at your earliest opportunity to avuid unnecess�ry delay in processing and issuing your building pennit. No buildine nermit wili be issued until this I. I crsonally plan to provide e ma�or labor and materials for conswction of the pruposed p��perty improvemen[. � Yes ❑ No 2. (have/have not) signed an application for a building permit for hE proposed work. 1 have contracted with the following persun (fimi) to provide the proposed conswction: Name i Ad�ress .� City Phonc (��y) — Conlrac�ur's Lic. No. �-- -- 4. I plan lu provide ponions of the wnrk, but 1 havc hirod [he following person to cuurdinale, supervise and provide the major work: Namc �7/,R Address � City � Phone ( ) —�— Contractor's Lic. No. 5. I will provide some of the work but I have contrac[ed (hired) the following persans [o provide the work indicated: Namc Address Phonc Type of Work � �(F� tM2.d6 (AEV. 99B) � 1a5`3� COSFA MESA BUILDING-SAFETY DEPARTMENT 'ib.0. BOX 31] COSTA MESA. CALIFORNIA �=�� t�ECEiUED ��_ a3-J°� , FINANCE DEPT. fOR APPUCANT TO f/LL /N COMPLETELY I �LIGATIONCFOR PFSRMIT TYPE OR PRINT v�BUILDINGi7� AODRE55 2�4 Pepper Tree Lane COSTA MESA. CALIFORNIA � FOR OFFICE USE ONLY o e rove, c. I PECEIPT NO. I '.f[�MIJ1j0� OWNER MAIL L, RECEy/Gp.BV I OATEFECEIVEO ',J bRT�IG6�� ADDRE55 E. 1 tial St� v—i %0 �/ CITY COS t�I s TNolIB-11 BUILDING ADDRESS ARCHITEGT Carlson & �� COSTA MESA, CALIFORNIA OR ENGINEER NO. �ii e ADORE55 FIRE � -i ZONE TYPE GROUP i ��& Calegrove� TIIC STATE u,729$ pppROVED CONT LIC. NO. BY DATE ADDRESS �9 F'• 17th' St� ) Costa Mesa ZONING 2 22 ZONfi NO.OF /'USE OF NEW //_ L OESCRIPTION I NO. � BLOCK TRACT �J� vl P�'ANS � I 9UILOIN6 �� L ��1///�� /" �( f A.P. NO. A�YPROVED//� y" . A^ �. _DATE I�-� .'1 /z.�/ A. v 11 SIZE � X 10C I NO.OF BLDGB.nOne V/' / J NOW ON tot YARDS EVES OF LOT REOUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT �Ff. IN. serowcK �ine vwoni �t REAR YARD 1/ CENTER OF STREET R.SIDE � FT. IN. SI�E YAR� I LEFf 5, I RIGHT /' L SIOE -�J FT. / IN. DESCRIPTION OF WORK REAR �.�'`I Fr. ��/L ICCL �iN. NEW I X IIALTERATION I IIADDITION I / / REPAIR I II MOVING I II DEMOLISH I � v S=�EDING 3516 5C11 ROOMS STORIES 2 EXTERIOR WALL RO -1' COVERING StuCCO COVERIN T'Ot;a�- `�ui�ip�e ��amiiy °c�we�Qlir�gEiuith Y � 0 A attached garage. (four living units) I HEFE9Y ACKNOWLEOGE THAT I HAVE REpD THI9 APPLICpTION THE AMOUNT SHOWN UNDER VPLUATION IS FOR THE AN� STATE THRT THE ABOVE IS CORRECT /ND AGREE TO COM- p�RPO6E OF E9TABLI6HING q PERMIT FEE ONIY. PLY WITH RLL CITY OFDINANCES RND STRTE LAWS REGULATING OUILDING CONSTFUCTION. VqLUATION M SIGNATURE OF � PERMIT FEE $ SO�W PERM177EE $ 3a�97��ByJ� PLAN CHECK $ 25�QQ Dike & legrove, Inc. .�� AUTHORIZED AGENT TOTAL FEE 5 75•