HomeMy WebLinkAbout3495 QUEENS CT - Building Permits�
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(714) 754-5273 • Fex (714) 754-4856
CITY OF COSTA MESA
BUILDING D/VISION
, DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
.lobnddress: 3495 QUEENSCT
Suite:
Vicinity:
Parcel Nunmber: 41204262
npplicant: KIRBY,KEVIN
Address: DBA: FOUNTqIN VALLEY ROOFING
FOUNTAIN VqLLEY, CA
11237 SLATER AV
Owner: PARSONS,TERRY
Address 3495 �UEENS CT
COSTA MESq, CA
Contrecror FOUNTAIN VALLEY ROOFWG
Address: 11237 SLATER AV
Zoning: R1 R1
Phone: (714)775-1947
Zip: 92708
Phone: 714-893-2979
Zip: 92626
,; .
PERMIT NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/13/1999
Issued: 04/13/1999
ISSUED BY: ��G—`
Phone:
FOUNTAIN VqLLEY CA
Zip: 92708 License: 675247
nrch : Eng: LARRY GARRETf
Address: Address:
Phone:
Phone:
Zip License: Zip: License: 2366
SCOPE OF PERMIT
TEAR OFF EXIST. WOOQ SHINGLES INFILL SHEATHING INSTALL 30LBS ASTM ND 35 1l2 SQUARES OF EAGLITE TILE
ROOF 7.OPSF , ICBO# 4660.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$154.21
$237.25
$1.53
$0.00
$0.00
$0.00
$392.99
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existin : o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING 8 ZONING
Left 0. 0
Left 0. 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0-0
$15,316.00
$15,316.00
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall aulomatically ezpire 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 ell
required Inapectlone end finel epproval must be obtained. Feilure to obtain inspections and tinfll approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754�5628
WORKERS'COMPENSATIONDECLARATON:
I hereby eXirm under penelry ot peQury one of Ihe following decleretions: - �
❑ I heve entl wlll maintein e certlficeie of cansent to self-Insure tor workers' compensetion, as providetl for by seclion 3700 of ihe Lebor Code, for �he peAortnance of Ihe
work for whlch lhis permll is issued.
❑ I have enA wlll maintain workers' compensation insurence, as requlred by section 3700 of the Lebor Cotle, for Ihe peAormence ot the woAc for which ��Is permit is issuetl.
My wGor�kers' compensatlon In rance carrier antl pollcy number ara: �7�
Cerrier: //�%C �Z/A/� �i�7 �%/b/�flfl PolicyNumber: -La✓�'� yj
(Thls secfion need nof be comp/etetl il the pertnit is velued et one hundred dollers ($100) or /ess.)
❑ I certity Ihet in the peAortnence of the work for which this pertnit is issued, I shall not employ eny person in eny menner so es to become sub�ect to the workers'
compensetion laws of Celifomia, and agree that if I sho Id b e subject to tha workers' compensatlon pmvisions of Sectlon 3700 of the Labor CaCe, I shell lorthwith
comply with these pr vi 'o . � /
Applicent Signawre: � -� Date: �/'/ � 3 �1�
WARNINO:FNLURETOSECU EWORKERS'COMPENSA ONCOVERAOEISUNLAWFULANDSHALLSUBIECTANEMPLOVERTOCRIMI PENPL�FlNESUPTOIXJEHUNDRED
TNOUSAND DOLLARE (5100,000), IN AODRION TO iHE COST OF COMPENSATION, DAMAGES PS PROVIDED FOR IN SECfION 3]OB OF THE UBOR ODDE, INTEREST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirm ihat I am licensed under provisions ot Chepter 9(commencing with Section 7000) of Division 3 ot ihe Business entl Professions Code, antl my Ilcense is In full
force entl eHect Lic. a � 7l7_ ��f C �//! Cless x G— 3,
Contrectors Signeture: �s,�.— ' Dete: _� /'i � 3 �%9
—� 7'.
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn Ihet ihere is a construction lending egency for the peAortnance af the work for whic� this Oermit Is Issuatl. (Sec. 3097, Civil Code).
Lenders Neme: �entlers Atltlress:
Signature: Dete:
OWNER-BUILDER DECLARATIONS:
I �ereby eNirtn that under penalry oi Oerjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reeson (Sec. 7031.5, Busineu and Professions
Cotle: Any ciry or counry which requires a pertnit to consiruct, elter, Improve, demolish, or repair any structure, prior to Its Issuence, elso requires ihe epplicant tar such permit
to lile e signed statement that he or sha is licensed pursuem to tha proNsions of tha Contractore License Lew (Chepter 9(commencing vrith Section 7000) of DiNslon 3 of Ihe
Business end Professions Code) or Ihat he or she Is exempt t�eretrom entl �he basis for the elleped exemption. Any Wdatlon o1 Section 7031.5 by eny epplicant for a permit
sub�ects the ap011cant to a ciWl penelry ot not more then fiva hundred tlollars (5500)J:
❑ I, es owner oi ihe property, or my employees with wages as their sole compensation, WILL DO TME WORK, entl Ihe structure Is not intended or otteretl lor sale (Sec.
7044, eusiness end Prolessions Code: The Contrectors License Lew does not apply ta an owner ot propeM w�o builds ar improves thereon, and who does such work
himself ar herself or �hrough his or her own employees, provided thet such Improvemenis are not intended ar affered tor sale. It, however, ihe bulltling or Improvement is
sold within one year oi completion, the owner-builtler wlll heve the burden oi proving that he or she did nol build or improve tor purpose of sale.).
❑ I, as owner of tha property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe pro�act (Sec. 7044, Business antl Professions
Code: Tha contrectors License Lew does not epply �o an owner of proDerty who builtls or improves Ihereon, end w�o contracis for such pro�ect with e conhector(s)
license pursuaN to the Conirectors License Lews.).
❑ I em exempt under sec. Busineu and Professlons Code for Ihis reason:
Signature: Date:
Owner ID veritied by dnvers license. ❑ Yes ❑ No �river's License No.
Venfication ot Ownership by (rype of document, i.e. - property tax bill or deed):
6cplres:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I here6y certity Ihet no excevation five (5) or more teet In deD�h Into whlch a person Is reQUlretl to descentl, will ba mede In connection with work euthonzed by t�is
permit, entl that no building sWcture, scaHoltling, felsework, or demolition or dismantling thereof, wlll be more than Ihirry-six (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec.
341, Tille 8, Celitomia Atlministrative Code).
❑ As owner-builder, I will not employ anyone to do work which woultl require a pertnit irom the Division oi Intlusirial Sefery, es noted above, unless such person has a
permit to do such work trom �he tlivision.
Slgnewre: Date:
Divlsion of Industrial Setety Permit Number:
ICER7IFlCATE OF COMPLIANCE AND AllTT10RIZATION OF ENTitY: I certify under penalry ot per�ury t�at I have read this epplication antl state that the information given is I
correcL I agree ro comply wilh all state laws antl ciry ordlnances releting to building consirualon, and euthonze representetives of the Ciry of Caste Mesa to enter upon the
aDove-tlescribed property for inspaction purposes. I agree nol lo xcupy or allow occupancy of eny �ulltling euthorized by ihis permit until final inspection.
CODE �. INSVECTIONTYPE
1616 Fi:ed System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roof
201 Finel BIocWRetaining Well
202 Finel Fectory Fire Placa
203
204
2na&a8
Finel Sign
Final Demolition .
QgjE INRIIALS
`Z � �
/ Date
�ii1 %'� 9%
Dal
COOE� INSPECTONTYVE
206 Final Mechanical
208 Final Plum6ing
210 Final Eleclncal
212 Final Flre Preventlon
220 Finel Planning Approval
222 Final Site
250 Finel Builtling�0aupancy .
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INTITIpLS
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J PIIIOfl WpIREN CONSENT OF GAIIqEfT ENGINEEPING ASSOLUTE8.�1LL RIGXTS HESENVEU.
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NOTICE THESE CALCULATIONS AND/OR DRAWINGS TO
BE VALID MUST BEAF THE PFINCIPALS SIGNATUHE IN
FE� INK. p REPRODUCED SIGNATUHE IS NOT VALID.
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GARRETT ENCINEERING ASSOCIATES
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OWENS•CORNING
Fiberglas
Blanket �lnsulation
The contractor named below certifies that the Owens-Corning Fiberglas
Blanket Insulation used carries the NAHB Research Foundation, Inc. label
for assured thermal performance and that the Blanket Insulation is in-
stalled in conformance with current energy conservation regulations,
California Ad'ministrative Code, Title 25, State of California, in the building
located at:
w3 1!�rno l��f /� l4� ?�-`
Street Lot Number , ' T�act Number
Exterior Walls
Owens-Cornin�Fiberglas Blanket Insulation
Ceilings
Owens-Corning_Fiberglas Blanket Insulation
Floors
Owens-Corning Fiberglas Blanket Insulation
Foundation Walls
Manufacturer Type
General Contractor
� " �/
Thickness R-Value
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Thickness R-Value
Thickness R-Value
Thickness . R-Value
License No.
By. - i Title Date
, Is�g�amrel„/ ( / _ _
Insul n on to ����/����-J- r�i%�ff�L.'i�-+-�-LicenSeNo. 3%%'� 5
�(f��,,,� � � /G -�
By_ . _ ��f2�"-- Title \!, :. Date
I �gnaWre)
Homeowner Copy (White)
State Copy (Yellow)
Builder Copy (Pink)
Guo. No. I6-BL-6995�A LMo In U.S F.. July 19>)
OWENS-CORNING FIBERGLAS CORP.
Insulation Operating Division
Fiberglas Tower, Toletlo. Ohio 43659
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200, COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING ' �
ADDRESS 3495 Queens Court �
OWNER OR
TENANT Wimbledon p.SSOC.
ADDRE s 1470 Jainboree Rd�
c�Tv Newport Beach Tn,�'40-6800
CAN5TRUCTIONImA2Tld1 .SdV111QS & LOdTl
i oninco
BFANCH Pasadena �
ADDRESS 61 S. Lake Ave. � �
Ae �.I.,TE«o .T.�.h�d Q—% �
_ ('nrhin/Vamafnii -
CONTRACTORMCLalll li2V. i.0.
ADDRESS 1470 JambOree Rd � �
c�rv Newport Beach" No`640-6800
�ic No. 273875 �ic�No. 18873'
SIZE � ' ' � NO.OF BIDCS.
OF LOT � NOW ON l0T O-
USE OF _
EXISTING BLOG.
Separate permits are required for
electric, plumbing and heating work:
USE OF BUILDING AND WORK TO BE PEliFORMED
PRD - New Construction
, Single=family dwelling
I hereby acknowletlge that I have reatl this application antl s[ate
that the above information is correci and agrae So comply with
all laws regulatin8 builtling construction, antl I shall not amploy
eny person in violation of the workman's compensation laws of.
the State ot Celifomla, .� . '
I hereby certify that I am properly licensetl as e contractor untler
the State oi Califomia Business antl Protessions Code, Divisfon 3,
Chapter 9, and Shat such licenses are In full force antl effect, or I
am ezempi from ihe provisions ot the State of alitornia Business
and Professlons�Code, Division 3, C pta 9. -
Signatura of � -
Permittae � '
or � / g i'I/�
Authorized Agent Date � '�/�
. ,� . ,�;
• 60�5 1�2a/BI;. . 306"s51 TL�'
APPLICATION FOR STRUCTURAL PERMIT ^
REC�;EC%�V PERMIT *T° 47793
Y i�
A.P. NO. �`�/_���
B UI LDI NG
ADDRE55 .� n n r ..__ _
TR.NO. LOT BLK.
in��� i4
NEW ADD ALTER REPAIR IMOVING DEMOLIS!
OWNER
use P�
—hIJ TViPE —I� GROUP I `� �
/ DATE I /ZO //J I
APPROVEDSETBACKS
0
PLANNING ACTION
- 7s� -3y1 APPROVED a a
QULD FOR SPECIAL REOOIREMEN� I
m
> I
il� 7 SQ. FT. /�O 7' �O �`!
THE AMOUNT SHO N UNDER VALUATION IS FOR m 4
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: � V_
VALUATION PERMIT FEE $ �' a �
n \
m
PLAN CHECK $ "�
�On,�2�� - TAX S �J,J l � V�
_` �� �l
TOTALPAID $