HomeMy WebLinkAbout519 PIERPONT DR - Building Permits(774) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Jab Address: 519 PIERPONT DR
Suite:
Vicinity: ROOF
Parcel Number: 41803403
App�icant ICHIKAWA, CLIFFORD MARK
Address: 519 PIERPONT DR
COSTA MESA, CA
Owner: ICHIKAWA, CLIFFORD MARK
Address 519 PIERPONT DR. �
- COSTA MESA, CA
Contractor: OW N E R-BU I LDE R
Address:
Zoning: R1 R1
Phone: 949-855-4283
Zip: 926263108
Phone:
Zip: 926263108
Phone:
Zip: License: 000000 .
Arch : , Eng:
Address: - :. Address:
Status: ISSUED
Applied: 12/26/2002
Issued: 12/26/2002
Phone: � Phone: �
Zip: " License: ' � License:
SCOPE OF PERMIT-
EXISTING ROOF WILL REMAIN (1 LAYER) AND INSTALL, 30 YEAR COMPOSITION ROOF. AFPROXIMATELY 1,250 S.F. INCLUDES ATTACHED
GARAGE. , - �
FEESUMMARY
Plan Check: $0.00 Calc Valuation: S3,7oo.00
Permit: $97.25 Claim Valuation: , 33,�00:00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: ' $0.00 •
Total: $97.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existinp: o
Rear 0-0
Rear 0-0
Required: 0
PLANNWG & ZONING ,
LeR - 0- 0 Right 0- 0
LeR 0- 0 Right � 0- 0� -
ProPosed: 0
NOTICE: The work authorized by ihis permit shall comply wilh all applicable handicap access requiremenis 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 work must comply with all applicable codes, and all
requlred Inspectlons and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 .
�aaere (a�oo)
WORKERS' COMPENSATON DECLARATION: ,. '
I hereby aflirtn under penalry of perjury one of Ihe following tleclerations: ,
❑ I heve end wlll maintain e certificate of consent to self-Insure tor workers' compensatlon, es provided for by section 3700 of t�e Labor Cotle, tor the pertormance of the
wOrk for whiG� ihis permlt 15 issuetl.
❑ I heve end wi�l maintain workere' crompensatlon Insurance, as required by section 3700 of the Lebor Cotle, for ihe pertortnance of the work for which Ihis permit is issuetl.
My workers' Compensation Insurenca carrier entl policy number are:
Carrier. PWicy Number:
(Thls s need not be comp/eted i/ the permit Is ve/ued ef ane hundred dollars ($100) or /ess.)
I cenity ihat in the pertortnence ot Ihe work for which Ihls permit is issued, I shell not employ eny person in any manner so es to become subject to the workers'
compensatioP lews of Callfo pia, ^tl ree het IfJ� shyulU )�acome subject b the workers' compensetlon provisions ol Section 3700 oi ha Labor Cotle, I shall torthwith
comply wi�h ihese pr vi i ����,.� /// {' �/�y�� Date:
Applicant SlgneNrB: ����{ ' 17�I%/t�� '�- O'��
WAPNING FAIIURE TO SECURE VOORKERS' COMPENSATIIXJ COVERAGE IS UNLAWFUL AND SHP1L SUBJEGT AN EMPLOVER TO CFIMINq PENAL S ANO CNIL FlNES UP TOONE HUNDiiED
TFKKISAN�DOLURE�5100,000),INADDITIONTOTHEC0.STOFCOMPENSATION,OAMAGESlSPROVIDEDFORINSECTION37060FTHELABORCOD ,IMEREST,ANDATTOHNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aXirm Ihat I am Ilcensed under provisions ot Chapter 9(commencing with Section 7000) of Divislon 3 of the Business and Protesslons Code, end my license Is in full
lorce end effect. LiG� a Class #
ContrectoYs Signature: Dete:
CONSTRUCTION 4ENDING AGENCY:
❑ I hereby aflirrP ihet there is a construction lentling agency br the pedormance of the work for whlch ihls permit is issuetl. (Sec. 3097, Civil Code).
lentlefs Name: Lendefs Adtlress:
Signature: Date:
OWNER-BUILDER OECLARATONS:
I hereby afllrm thet under penalry of perjury thet I am E%EMPT FROM 7HE CONTRAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Cotle: Any city or counry which requires e permit to construct, elter, impmve, demolis�, or repair any structure, prior to its issuance, elso requires Iha epplicani for such pertnit
lo lile e signetl stat9ment Ihat he or she is Ilcensed pursuanl to ihe proNsions of the Contrectors Llcense Lew (Chapter 9(commencing with Sectlon 7000) o} DiNslon 3 ot the
Business entl Prof655ions Coda) or ihat he or she Is exempl iherefrom and Ihe Dasls for Iha allegetl exemption. Any violation of Section 7031.5 by any applicant for e pertnit
subjecis ihe epplicent m a civil panelty of not more ihan five �undred dollers ($500).):
❑ I, es owner oi �he propeny, or my employees wlth weges es their sole compensation, WILL DO THE WORK, and (he structure Is not Intendetl or oHerad for sale (Sec.
7044, BusineSs and Professions Cotle: The Coniractors License Law does not apply to an owner ol properry who builds or improves thereon, and who does such work
himsell or hersell or through his or her own employees, provided Ihet such Improvemenls are not Intentletl or oHered for sale. If, however, Iha builtling or improvement Is
Id wi�hin one yeer of completion, �he owner-builder will heve ihe burden of Droving thef he or she did not build or improve for purpose of sele.).
I, as owner ol the property, em EXCWSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044. Business and Pmfessions
Coda: The contwctore License Law tloes no� eppty to en awner ot pmperry who builtls or Impraves Nereon, antl who coniracts tor such pro�ect with a contractor(s)
license pursuant to ihe CoNractors License LewsJ.
❑ I em examp 1derpec.� � eusiness and Professions Code for t�is reason:
SignaWre: 7�� �LA��� Date: � �.
Owner ID venlietl by drivers licensa. - ❑ No Drivers License No. �/ � Expires: ?—i �—d�
Verificetion ot Own9rship by (type of document, i.e. - property tez 6111 or tleed):
DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hareby canity that no excevetion five (5) or more teet In depih into which e person Is required m descend, will be made in connectian wlt� work euthorizatl by Ihis
permit, end that no building siructure, scaHolding, lalsework, or damolition or dismaniling Uereof, will be more ihan ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Tltle B, Calilornia Administretive Code).
❑ As owner-builder, I will not employ enyone m tlo work which woultl require e permit irom the Division of IntlusMal Selety, es notetl e6ove, unless such person hes e
pertnit to tlo suc� work trom the division.
Signeture: Date:
Division ot Intlusinal Safery Pertnit Numbec
CERTIFlCATE OF COMPLIANCE AND AUTHORIlATON OF EMRY: I certify under penalry ol perjury that I have read this apP���elion and state ihat the infortnation given is
correct I egrge to cPmpty vn�h II sta I���yyy s en ciry ordinances relating to building consiructlon, and au�hodze representatives of Ihe Ciry ol Cwta Mesa to enter upon the
ebov ��cn'�p� pry$erry/o i p� o(/roo s. I egree not to occupy or ellow occupancy of any builtling authonzed by �his perm%it 'ntil final jaspection.
XkN' (14Y l� l�t �w' � �--/ '�i�G'�'�
Sign ure Ot Legal Owneris) —� te
And/Or Authonzed Applicent
COOE I. INSPECTIONTYPE
1618 Fixed System Final Fire Praventlon
1266 POoI Spe Fi�el
200 Finel Re-ROoi
201 FIna1 61ocWRetaining Wall
202 Final Factory Fire Place
203
20d
Finel Sign
Final Dem
Qdjf, RIr1L5
CODEX INSPECTIONTYPE
206 Finel Mechenical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
PdIE ItIIIDaLS
VIYIV CK
AP No. LOT hA TRACT
INSPECTIONS
SOIL -
GRS
W ATER
ROUGH PLUMBING
PROP. SWN. LINE 1
SPqINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND P
TEMPORARV SERVICE �
UNDERGROUND � I
ROUGH WIRING
TRENCMES � FORM:
FLOOR SYSTEM
BOND BEAM n ST'
SHEATHING
FRAME AND FLASHING
LATHING - IN �
INF.
�ENT., REFR�G. AND A.C., FINAL
FINAL AND GAS TEST I
FINAI
FINAL
va�a
SUBCONTRACTOR
ERMIT N0.
ece W/At
28086
COSTA MESA BUILDtNG-SAFETY DEPARTMENi
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92828
For App11mM fo F(11 In Completa/y
TYPE OR PRINT
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