HomeMy WebLinkAbout2893 ELLESMERE AVE - Building Permits�:
(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BI/ILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�obnddress: 2893 ELLESMEREAV
Suite:
Vicinity: HOUSE & GARAGE
Parcel Number: 13926113
Applicant: MIGUEL ENRIQUEZ
Address: 1420 E. EDINGER AV #111
SANTA ANA, CA
Owner: LEUM, JACK N
Address 2893 ELLESMERE DR
COSTA MESA, CA
Contractor: BEST VALUE ROOFING
Address: 1420 E. EDINGER AV #111
SANTA ANA, CA
Zip: 92705
Arch :
Address:
BUILDING PERMIT
Zoning: R1 R1
Phone: 714-542-5222
Zip: 92705
Phone:
Zip: 92626
Phone: 714-542-5222
License: 715903
Eng:
Address:
Phone:
�
�
NUMBER
)737
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 05/24/2000
Issued: OS/24/2000
Phone:
Zip: License: License: .
SCOPE OF PERMIT
REROOF - T/O, INSTALL 7/2" OSB BOARD, 1 LAYER OF 15if FELT AND 30 YEAR GAF COMPOSITION SHINGLES.
Plan Check: $0.00
Permit: $139.25
SMIP Res: $0.65
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.90
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Existin : 0
NOTES:
Rear 0- 0
Rear 0. 0
Reauired: 0
FEE SUMMARY
PLANNING & ZONING
LeR 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
56,500.00
$6,500.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 72-21-92)
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 penod of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetlona and final approvel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSA710N DECLARATION:
I hereby aHirtn untler penalry oi perjury one of the followinq declarations:
❑ I have entl will maintain a certificate ol consant to seli-Insure tor workers' compensation, es provitled for by section 3700 of the Labor Code, for the pertormance of the
work for which this permit is issued.
� I have and will maintain workers' compensation insurance, as requiretl 6y section 3700 of Ihe labor Code, for ihe peRortnance oi the work tor which this permit is issued.
My work rs' compensation Insurence carner and policy number are: �n
Carrier: �Clj� 0✓l L✓�5 PolicyNumber: ��P��CJ roi �
(This section need not be completed ii Me permll /s valuetl et one hundred dollars ($100) or less.)
❑ I certity that in the peAormance ot ihe work for which ihis permit is issuetl, I shall not employ any person in eny manner so as to become subject ro Ihe workars'
compensation laws of Califomia, and agree ihat if I should become subjeq to the workers' compensation provisions of Section 3700 of ihe labor Code, I shall fonhwith
comply with ihese provisions.
� �
ApplicenlSignature: Date: .ri—a �'G�
WARNING FAILURE TO SECU OR <ERS' COM SAT CAVEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSANDDOLLAFE($100, 0),INADOITIONT�HECOSTOFfAMPEN$ATION,DAMAGESASPROVIDEDFORINSECTION3]O60FTHEIABORfAOE,IMEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, antl my license is in full
torce and aHecL Lic. q I � � Class N G- 39
ContrectorsSignaWre: �fp�� Date: S—,94^�O
T' J
CONSTRUCTION LENDING AGENCV:
❑ 1 hereby aHirm Ihat ihare is e constmction lending agency tor ihe pedormance of the work tor which this permit is issued. (Sec. 3097, Civil Cotle).
Lander s Name: Lender's Address:
Signature:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby aHirm Ihat under penalry of perjury ihat I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or counry which requires a permit to constmct, alter, improve, demolish, or repair any simcture, pnor to its issuance, also requires ihe applicant tor such permit
to file a signetl statement that he or she is ticensed pursuant to the provisions of the Conirectors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business and Professions Code) or ihat he or she is ezempt therefrom antl the basis for the alleged ezemption. Any violation ot Section 7031.5 by any applicant for a permit
subjects the appiicant to a civil penalry ot not more ihan live huntlretl dollars ($500).):
❑ I, as owner oi the property, or my employees with wages as their sole compensation, WILL DO TME WORK, and ihe siructure is not Intendetl or ottered for sale (Sec.
7044, Business antl Professions Code: The Contractors License Law does not apply to an owner of property_who builtls or improves thereoq and who tloes such work
himself or herself or through his or her own employeas, provitled �ha� such improvements are not intentled or oflered for sala. If, however, the building or improvemen� is
sotd within one year ot completion, the owner-builder will have the burden of proving that he or she did not builtl or improve for purpose of sale.).
❑ I, as owner oi the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The contrectors License Law tloes not apply to an owner of property who builds or improves Ihereon, end who contracts for such project with a coniracbr(s)
license pursuant ro the Coniracmrs License Laws.).
❑ I am exempt untler sec. Business and Professions Code for ihis reason:
Signawre: Date:
Owner ID verifietl by tlriver's license. ❑ Yes ❑ No Oriver's License No.
Ventication of Ownership by (type ot tlocument, i.e. - property tax bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: '
❑ I hereby certify that no excavation five (5) or more feet in tlepth into whic� a person is reQuired to descentl, will ba matle in connection with work authorized by ihis
permit, and that no builtling structure, scaffoltling, taisework, or demolition or dismantling thereoi, will he more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Ttle e, Califomia Adminisirative Code).
❑ As owner-builder, I will not employ anyone to do work which woultl require a permit from (he Division of Intlustrial Safety, as notetl above, unless such person has a
permit to do such work From the division.
Signawre; Date:
Division of Industrial Satety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTFiY: I certify under penalry of perjury ihat I have read this application antl state that the iniormation given is
cortecL I agree to comply with all stete laws and ciry ordinances relating to building consimction, antl authorize representatives of the City ot Costa Mesa to enter upon ihe
above-described pmpeny for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit umil tinal inspection.
COpE;I, INSPECTIONTYPE
1616
1266
Of Le al Owner(s)
�
i zed f an�
oa�r IMRIALS
Fizatl Syslem Final Fire Prevention
Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2446-46
b-3i-°`� �
CODEt INSPECTIONTYPE
206 Final Machanical
208 Final Plum6ing
270 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
�
pA�F INTRIpLS
�'g
. . ,_� ���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31] COSTA MESA. CALIFORNIA
fOR APPL/CANT TO F/LL /N COMPLETECY
TYPE OR PRINT
BUILDING 2� � 3 � LL�Srh��2E ���
ADDRESS
COSTA MESA, CALIFORNIA
� ARCH ITECT
1
T
ADDRE55 (� 55 PGacEu-r� e
ocscn�rrtiorv I NO. /� I a�o�K � I 35C'�
A.P. NO. JQQJ� /
SIZE ]qryy/�� Y U/��'2 L1 SQR�G ]�I �O.OF BLDGS.
OF LOT �/ �/'\ 1!��/ \ 'I NOW ON LOT
USE OF
E%ISTING BLDG.
BETORCK LINE FROM /,.� �
CENTER OF STFEET �J O REAR YARD I'
SIDE YARD I LEFf f V' I RIGHT J /
DESCRIPTION OF WORK
REPAIR I II MOVING I II DEMOLISH I
BUILDING Q�n NO.OF �'�J
SIZE � C/�'� ROOMS / STORIES
EXTERIORWALL57vG.IROOF /��'1.��`�
COVERING COVERING 5 W
USE OF BUILOING AND WORK TO BE PERFORMED
S NG LE F'oM. QES. �`
G'T TaT� (f pQpq P
1 HEflEBY ACKNOWLEDGE THAT 1 HRVE READ THIB APPLICATION
/�ND STATE THAT THE ABOVE IS C RNECT ANO AGNEE TO COM-
PLY WITH ALL DINANCES !D ST TE' FEGIILATING
BUILOING CO Tfl CTI N.
SIGNATURE O �
PERMITTEE
AUTHORIZED AGENT
��� �ECE9V��
�-� u-g-��
FINANCE DEPT.
APPLIGATION��FOR� PE�RIv11T�E�
BUILDING
FOR OFFICE USE ONLY
-�-/U I �-2 Ga
COSTA MESA, CALIFORNIA
TVPF �/ f.R(]IIP � �
ZONING
ZONE NO.OF USE OF NI
I PL/�NS � Bl11LDING
c�
APPROVED, _
BY � DATE
VARDS
REpU1RED AL OWED
ICENTEN L�NE ST.)
L.
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i L, ' �
�� � ���o�n �iF �-�-�
THE AM NT SHOWN UN�ER VALUqT10N IS FOR THE
PUHP08 OF ESTABLISMING A PENMIT FEE ONLY.
VALUATION
PERMIT FEE $ 3�
$ /� �j/ ^C PLAN CHECK $ �7 �
TOTAL FEE S � / �
I