HomeMy WebLinkAbout2908 PEPPERTREE LN - Building Permits;;
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 2908 PEPPERTREE LN
Suite:
Vicinity:
Parcel Number: 13920316
Applicanr. GARCIA,FRANK
Address: 21681 IMPALA ST ���._---- — o��
� Phone: 714-96r8-8754
AC/H; CA Zip: 92646( �
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EAN,E TR _ t� �
'DIVAVE � �„�� � �
��� Phon'e: —''-- �0� �
-I,:CA� Zip: 92663-4812 ' �
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ING �l
Zaning: R3 R3
Owner:
Address
ST
Status: ISSUED
Applied: OS/28/2003
Issued: OS/28/2003
ISSUED BY:
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HUNTINGTON BEACH, CA
i «�ii
Zip: �92646
,•�ay
ACCESSORY
PARKING
NOTES:
Phone? 714-968-8754
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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, § 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 abandoned
for a period of 180 days. - �•
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such wbrk must comply with all applicable codes, and all
required inapectlons and final approval must be obtainetl. Failure to obtain inspections antl final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 '
zaas�asc�l
WORKERS' COMPENSATION DECLARA710N: � � � �
I hereby eflirm under penalty ot perjury one of the following tleclaretions: `� �
❑ I have and will maintain e certiticate ot consent to seli-Insure for workers' compensation, es provided for by section 3700 of Ihe Lebor Code, for ihe perfortnance of �he
/ work tor which ihis permit I5 issued.
�y� ve end will meintain workers' compensetion Insurance, as required by section 3700 of the Labor Code, for Ihe pe rmance of the work for which this pertnit is issuetl.
rkers' cqmpe�nsetlon Insuran carrier end policy number are: z'
a'e' i�MN-E� �� olic umber: III.Y �O — 2�1J �
�5 sechon neetl not bg �pm efed �l fhe perm�f is velued at one hundred dollars ($100) or less.)
❑ I�certih/ Ihet in Ihe peAormence ot the work tor which �his permit is issued, I shall not employ any person in eny manner so as to become subject to the workers'
i'/���5 ot Calii n a, and egree t�f I should becoma subjed to the workers' com tion provislons ot Section 3700 of the Labor Cotle. I shall fotlhwlth �
' thes provisi s /
Applicant Signature: r'� l A/CLc� Date: T_�`�7 j'LD 3
. RE TO SECUPE WORKERS' COMPENSATION COVEMGE IS UNUWFUL FND SHALL SUBJECT AN E PLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE MUNDRED
THOUSAND OOLLARE (5100,ppp), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PFOVIDED FOR IN SECTION 3]O60F THE LABOR CODE, If�lrEFEST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
�1 I am
�ic. # _
Signature:
of Chapter 9(commencing with Section 7000) of Division 3 o usiness and Professions Cotle, entl my licanse is in tull
M �—
i.'/ ct.N-- at : .T�2.� 7 �,
CONSTRUC710N,LENDING AGENCY:
❑ I hereby aMirm ihat ihere is a construction lentling agency tor the pertormanca of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eNirtn that under penelty of perjury ihat I em EXEMPT FROM THE CONTFiACTORS LICENSE LAW tor the following raason (Sec. 7031.5, Business antl Professions
Cotle: Any city or county which requires a permit to constmct, altar, improva, demolish, or repeir eny stmcture, prior to its issuance, also requires Me epplicant for such permit
to file a signed statement ihat he or she is Iicensetl pursuant to Ihe provlsions ot ihe Contrectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 ot the
Business end Professions Coda) or thet he or she is exempt therefrom antl the basis for the allegetl ezamption. Any violation o( Sectlon 7031.5 by any epplicam for a permi�
subjects the epplicant to e civil penally ot not more then tive hundred dollers ($500).):
❑ I, as owner ot the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the sWcture is not imentletl or oHered tor sale (Sec.
7044, Busineu and Pmfessions Code: The Contrectors License Law tices not apply to an owner of property who builds or improves thereon, and who does such work
himself or herselt 6r through his or her own employaes, provided thet such improvemenis ere not intentled or ottered for sale. If, howevei, ihe building or improvement is
sold within one yedr of complation, t�e owner-builder will have ihe burden of proving that he or she tlitl not build or improve tor purpose of sala.). �
❑ I, es owner oi the p�aperty, am E%CIUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sac. 7044, Business end Protessions
Cotle: The coniractors License Law tloes not epply to an owner of pmpetly who huilds or Improves t�ereon, end who coniracts for such project wlih a coniractor(s)
licensa pursuant tq ihe Contractors Licanse Laws.).
❑ I em eaempt under sec. Business antl Professions Code for this reason:
Signature: Date:
Owner ID veniied 6y tlriver's licanse. ❑ Ves ❑ No Dnver's License No. Expires:
Vedfication of Ownership by (type of document i.e. - property iax hill or UeeU):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify �hai no excevetion fiva (5) or more fee� in tlepth into which e person is required to descen4 will be made in connection with work authorized by ihis
permiL and that no building structure, scaHolding, talsework, or demolition or tlismaNling ihereof, will 6e more than ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, TiNe 8, Calitornia Administrative Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require a permit trom lhe Division of Industnal Safety, as noted above, unless such person hea e
permit to do such Work irom Ihe tlivision.
Signature: Date:
Division of Indusirial Safery Pertnit Number:
CER7IFlCATE OF COMpiJqNCE AND AUiHORIZATION OF ENTAV: I certify under penalry of perjury Ihat I have read Ihis application antl state that the infortnetion given is
wrrect I egree to compty with ell state laws entl city ordinances relating to bullding constructlon, end authorize represent�tives of Ne City of Costa Mesa to enter upon the
above-described properry for inspection purposes. I agree not to occupy or allow ocwpancy of any building euthorized by Ihis Dermit unlil final inspection.
COOE 1• � INSPEC710NTYPE
7676 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Finel BIocWRe�aining Well
202 Final Factory Fire Place
203 Final Sign
204 � Final Demolitiqn �
Q�j� INTRIALS
� �
CQUE1 MSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site .
250 Final Building/Occupancy
onre RIlQJlLS
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.cBUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 2908 PEPPERTREE LN
Suite:
Vicinity: 4 PLEX
Parcel Number: 13929609
App�icant: . SCHWALBE, JEAN E TR
Address: 531 SAN BERNARDINO AVE-�
Owner:
Address
Zoninq: R3 R3
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�/ --, ,Phone:-949-642-8125-��
(J ` Zi pl 92663-4812 t
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j - Zip: 92663-4812��
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$97.25 �
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1 $o.00
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SETBACKS� D
MAIN STRUCTURE. Front
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ACCESSORY \F�ront,
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PARKING Exlstii
NOTES:
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AS NECESSARY�. COVER 1
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Status: ISSUED
Applied: 02/06/2003
Issued: 02/07/2003
ISSUED 8Y:
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� � Phone: ��1 ��
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� License: '
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1 1�'kl �: �, (
ISHINGLES. REPLACEFASCIA'AS P
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j ���il' t� „ � ,�
c Valuation: ��r
„�j,J. : �Sa;000
imValuation:���fl�� �`--$a,00`o
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f�� c� �. �,�
; jfff��` i�,��'7`, ,� �,r
i :1�1�t" � 1 1��/�
� """ �� , ,� �. PLANNING & �ZONING� �� ��,, �`/i�/� , � �� �Q �
//� �� `� �� >J� �/� 9( o� .�f�/// /��i�\ �l!
i0��'�..�Rear��0 0 ��� Left „ 0'0 � �%�Righl.-\V�� 0�� ����
\�. \,�a��?-?C_�.�::�-t....:�-_--_-'r.-!�;i" f��`% `\Ci /./
0- 0��^Rear 0- 0-='.�__-Ceft �::- 0- 0 � Rig\t��0= 0��
\��Required ����� -Proposed � \ � � � /
�i I i �_i : � �. L,� i l/ �
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�.- � — �"i> � i
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, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void ii 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
required inspections and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aasas (e�ool
WORKERS'-COMPENSAnON UECLARATON: , � � , �
I herehy attirtn under penalry of perjury one of the tollowing declarations: , -
❑� I have antl will maintain a certificete ot consent to seN-Insure for workers' compensation, es provided for by section 3700 ot Ihe Lebor Code, tor the pertormence of.the
work for which �his pertnit is issuetl. '
❑ I have antl will maintain workers' compensation insurance, as required by section 3700 ot ihe Labor Code, for ihe Oedortnence of the work for which Ihis pertnit is issuetl.
My workers' compensation Insurance carner and policy number are: .
Carrier. Policy Number:
(This section need not be cromp/eted il the permit is valued et one hundretl tlollars ($100) or less.)
y I certity ihat in tha pertormance ot the work for which ihis permit is issued, I shall not employ eny person in any menner so as to become subject to the workers'
� compensation laws of Calitomia, and a ree thet if I shoultl become sub�ect b Ihe workers' compensation provisions of Saction 3700 of ihe Labor Cotla, I shell forthwith
comply with these pro isions.
Applicant SignaNre: . �- �'e�� Dete: � � �— � �
WARNING FAILURE TO SEC RE WORKE ' COMPEN ATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDPED
THOUSANDDOLLARE($1 ),INADDITIONTOTHECOSTOFfAMPENSATIIXJ,DAM4GE5ASPROViDEDFOPINSECTION3]O60FTHEL4BORCODE,IIJrEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I am licensed under provisions oi Chapter 9(commencing with Section 7000) ot Division 3 of ihe Business entl Professions Code, end my license Is in tull
force and eRect Lic. q Cless #
Coniradofs Signature: Dete:
CONSTRUCTON LENDING AGENCY:
❑ I hereby aHirm ihat there is a constmction lending agency for ihe performance of the work for which this permit is issued. (Sec. 3097, Civil Cotle).
Lendefs Name: Lender'S Address:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby attirtn that under penalry ot perjury ihat I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business entl Professions
Code: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires ihe epplicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chepter 9(commencing wlt� Sectlon 7000) ol Division 3 of tha
Business entl Protessions Code) or that he or she is exempt therefrom and Me basis tor ihe ellegetl exemption. Any violation of Section 7031.5 by eny epplicent for e permit
su ects the applicant to.a civil penalry of not more than five hundred dollars ($500).):
I, as owner of Ihe property, or my employees with weges as iheir sole compensation, WILL DO THE WORK, end the simcture Is not intantled or oNered for sale (Sec.
� 7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves thareon, antl who does such work
himself or herself or through his or har own employees, provided that such improvements are not intended or oflered for sale. If, however, ihe building or Improvemant is
sold within one year ot completion, the owner-builder will heve the burden of proving ihat he or she did not build or improve Por purpose oi sale.). '
❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo consiruct ihe projecl (Sec. 7046, Business end Profassions
Code: The coniractors License Law tloes not apply [o an owner ot property who builds or improves ihereon, end who coniracts for such project with a coniractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt
� Signature:
Owner ID verifie I
Veritication of
sec.
and Professions Code for this reason:
Expires: �
by (type of tlocument, i.e. - propeny tax bill or deed)
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I here6y certify ihat no excavation tiva (5) or more feet in depih into which a person is required to descend, will be made in connection with work authorized by ihis
permit, and ihat no building strucWre, scaHolding, falsework, or demoli�ion or tlismantling thereoi, will be more then ihirty-six (38) feet high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Califomia Atlminisirative Code). ,
❑ As ownerbuilder, I will not employ anyone to do work which woWd require a permit irom the Division of Intlustriel Satety, as noted ebove, unless such person hes e
permit to do such work from ihe division.
Signatura: Date:
Division of Industrial Safery Permit Number:
CEBTFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENfAY: I certify under penalry oF perjury that I have read this application and state that ihe information given is
correct. I agree to co ply with all state laws and ciry ordinances relating to builtling consiruction, and authonze representatives of Ihe Ciry oi Costa Mesa to enter upon ihe
above-descnDed pro S for inspedi urpos $. 1 a ree not to o� y� w occupanq of any building authonzed 6y this pertnit until finel ins ection.
� - ,�-4���'J
/ -�� Sig Wre Ot egal Owner(s) Date
AntUOr Aulhonzetl Applicant Daie
COOEI, INSPECTIONTVPE �
1616 Fixed Sys�em Final Fire Prevention
1266
200
Pool Spa Final •
Final Re-Root
201 Final BIocWRataining Wall �
202 ' Final Factory Fire Place
203 Final Sign
204 Final Demoli�ion " " "'
o"re
��
IMRIAL
�
CODE� INSPECTIONTYPE
206 Final Mechanical
.208 Final Plumbing
270 Final Electrical
2tt Final Fire�Prevention
220 � Final Planning'Approval
222
250
Final Site �
Final Building/Occupancy
QSIE It�fl
�
,
� � ` �°��� d:EE RECEIUED
CO�TA MESA' BUILDING-SAFETY DEPARTtv1ENT � q
P. O. BOX 317 COSTA MESA. CALIFORNIA "'�� /� -'7 3_�/ '
FlNAhCE DEPT. �
FOR APPL/CANT TO F/L[ /N COMP[ETE[Y ,{�PPLICATION fF�ORi,PE,RMIT ,
TYPE OR PRINT �� @UILDING �
ADDRESS 2908 Pepper Tree Lane , .
- COSTA MESA, CALIFORNIA � fOR OfF/CE USf�ONLY �
�• VD e rove, Inc. I RECEIPT NO. f� �pE Mv N.
OWNER ��
MAIL �,y E. 1%th St• AECEIVEp BT DAT6 RECENED �TE 195UE;
ADDRE55 i � � � --- " .,,a.i- �GT
CITY Costa. Pdesa TNO. ��1'�'JS BUILDING °
ADDRE55
AR� CGT Carlson & 1 ��a �� �� � COSTA MESA. CALIEORNIA
OR NEER NO. '
ADDRE55 Gat'ueTl Gl'OVC � - FIRE 1 / ,[
�f� T ZONE TYPE J�GROUP Y
' --D1ne & Colegrwe, 111C. STATE 1�j7'ZG� � pppROVED ' '
CONTRACTOR LIC.NO.'. BY DATE
ADORESS H�9 E. 17th St• COst3 P4esa ZONING �����.w(,�� ��
LEGAL LOT 2 22 ZONE ,NO. OF . -0BE OF NEW
DESCRIPTION I NO. � I BLOCK . I TRACT '� �I PLANS yl BUILDING /O ��/� .
A.P. NO. ' BYPROVED / / i '., r� � � �. . DATEIC/ '.�. I—S/� .
��V
SIZE C � rvO.OF eLocs. ypRDS � �EVES� �
OF LOT �l X 100� I rvow orv ioi none REOUIRED ALLOWED
USE OF (CENTER LINE BT.J `�-T�
EXISTING BL�G. FRONT `� VFT. IN.
SETBACK LINE FROM �O� - ZO ��
c[rviea OF STREET REAR YARD /. R. SI�E ./ FT. IN. -.
SIDEYARD ILEFT lO� IRIGHT � L.SIDE I C��, "' IN.
DESCRIPTION OF WORK ' REAR %JC/Fr. �'I�GfU,.a-°�rv.
NE\ IX IIALTERATION I �IIADDITION I / //
REPAIR I IIMOVING I IIDEMOLISH I ' �
SIZ�E DING 3516 ROOMS STORIES 2
EXTERIOR WALL ROOF ' .
COVERING S'tl1CC0 COVERING
I HEfiEBY ACKNOWLEDGE THAT 1 HAVE REAO THIS APPLICqT10N THE AMOUNT BHOWN UNDER VALUATION 18 FOR THE
�qNO STqTE TH/�T THE ABOVE IS CORREQ AND' AGREE TO COM- pUNP08E OF ESTABLIBHING q PERMIT FEE ONLY:'
PLY WITH ALL CITY OROINRNCES AND STRTE LAWS REGVLRTING
eui�owc corvSieuGnorv. /� • � ypLUAT10N
SIGNATURE OF //� � � PERMIT FEE $ SO��
PERMITTEE L� ' '
$ .�n' PLAN CHECK $ 25�00
Dike & olegrove, Inc �� ��'�'� • r�
AUTHORIZED AGENT - TOTAL FEE $ IS�OO