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Home My WebLink About904 EVERGREEN PL - Building PermitsCITY OF DEVELOPMENT (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us Job Address: 904 EVERGREEN PL Suite No Vicinity: Parcel Number: 42252102 App�icant: COOTER, LYLE Address: 12922 HARBOR BL GARDEN GROVE, CA owner.� ' LINDER, HARRY H TR Address: 904 EVERGREEN PL COSTA MESA, CA Contractor: JIM WAYNE EICHAMN EMPIRE Address: 12922 HARBOR BL Arch / Eng : Address: STA MESA DIVISION ICES DEPARTMENT Phone: 714-530-7320 Zip: 92640 � Phone: Zip: 92627 PLUMBING HEATING & A/C Phone: GARDEN GROVE, CA Zip: License: REPLACE AN EXISTING FURNACE 1. INST FAU < 100 K BTU ISSUE FEE Inst FAU <700 k BTU Inst FAU >700 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Hir Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping � . Factory Fireplace . Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Ins[ or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> 10000cfm Floor Furnace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 - 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Phone: Zip: License: NOTICE: The work authorized by this permit shall comply with all a{ regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if for a period of 780 days. INSPECTIONS: In order for the work authorized under this permit to t required inspeetions and Iinal approval must be obtained. Failure to ol FOR INSPECTIONS CALL: (714) 7545626 244E46IN00) 714-530-7320 92840 652877 PERMIT NUMBER � M00-00440 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Repair / Alt Absorbtion Unit ' Repair / Alt Refrigeretion Unit - Ventillation System � � EvaporativeCooler.:::.��=,- � �, Commercial Incinerator . =i Domestic Incinerator Compressors / Absorotion Systems � Upto3hp/t00kBTU . , - 3To75hp/SOOkBTU - 15 To 30 hp / 1,000 k BTU � � " 30 To 50 hp / 1,750 k BTU � Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES Status: ISSUED Applied: 10/10/2000 Issued: 10/10/2000 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00, 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $38.30 handicap access requirements under California statutes and related is not commenced within 180 days, or if work is suspended or abandoned considered legal, such work must comply with all applicable codes, and all in inspections and final approval will result in the expiration of this permit. WORKERS' COMPENSATION DECLARATION: - I hereby affirm under penalry of perjury one oi the following declarations: `1 ❑ I hava antl will malntain a certificate of consent to seit-Insure for workers' compensation, es providetl for by section 3700 of the Labor Code, lor the peAormance of the work tor which �hi5 permit is issuetl. � I have and wlll maintain workers' compensatlon insurance, as required by section 3700 of Ihe Labor Code, for the performance of the work for which this pertnit is issuetl. My workers' compensation Insurance cartier and policy number are: Carrier. Policy Number: (7his secVon need nof be wmp/eted il the permit is valued at one hundred tlollars ($100) or Iess.J ❑ I certity tha� in the peAormance of the work for which this permit is issue0, I shall not employ any person in any manner so as to become subject ro the workere' compensation laws ot Califomia, antl egree that if I should become subject to the workers' compensation pmvision5 oi Section 3700 of Ihe Lebor Cotle, I shell lort�with compty with these provisions. ApplicantSignature: � Date: J� / = L-�" ' WARNING: FAILUFE TO SECURE WORKERS' COMPENSATIdJ COVERAGE IS UNL4WFUL MID SHALL SUBIECT PN EMPLOVER i0 CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND OOLLARE �5100,000), IN ADOITION TO iHE COST OF CAMPENSATION, DPM4GES AS PROVIDED FOR IN SECTIIXJ 31O60F iHE LABOR CODE, INTEREST, AND AiTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: �� I hereby aflirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle, end my license is in full tOrce eatl BNeCt lic. M Class k Contrectors Signawre: Date: �� _ � CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm Ihat lhere is a consimction lending agency for the peAormance of ihe work for which this permit is issued. (Sac. 3097, Civil Cotle). Lentler's Name: Lendefs Adtlress: Signa�ure: Dete: OWNER-BUILDER DECLARATIONS: I hereby attirtn that undar penalty ot perjury ihat I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business entl Professions Code: Any ciry or counry which requires a permit to conswct, alter, improve, tlemolish, or repair any sirucWre, prior to its issuanca, also requires tha epplicant br such permit to flle a signed 5taiement that he or she is licensed pursuant to the provisions of the Conirectors License Law (Chapter 9(commencing with Section 7000) oi Division 3 of the Business antl Professions Cotle) or t�at he or she is exempt therefrom and the basis lor tha allegad e:emption. Any violation of Section 7031.5 by eny applicant For a pertnit subjects the applicant lo e civil penalty oi not more than tive hundred dollars (5500).): ❑ I, as owner ot tha pwperry, or my employees with wages as i�eir sole compensation, WILI DO 7HE WORK, and the structure is not intentletl or oHered tor sale (Sec. 7044, Business and Professions Cotle: The Comractors License Law dces not apply to an owner of pmperry who builtls or improves Ihereon, an0 who does such work himself or hersalf or ihrough his or her own employees, provitled t�ai such improvemenis ere not intended or ottered for sale. It, however, the huiltling or improvemant is sold within one year of completion, iha owner-builtler will have ihe burden of proving ihat he or s�e did not build or improve tor purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consimcl the projad (Sec. 7044, Busines5 end Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves Ihereon, antl who conirects for such pmject with e contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. SignaWre: Owner ID veritied by drivars license. ❑ Yes ❑ No Business and Professions Code tor �his reason: Venfication of Ownership by (type of tlocument, i.e. - property tan bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivers License No. oate: Expires: ❑ I hereby cenity that no excavation tive (5) or more feet in deD�h into which a person is requirea m tlescend, will be matle in connection with work euthorizetl by ihis permit, and ihal no builtling siructure, scaHolding, falsework, or demolition or tlismantling thereoL will De more then Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tille 8, Calibrnia Adminisira�ive COde). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from ihe Division of Indusirial Safery, as noted above, unless such person hes e pertnit to tlo such work trom the tlivision. Signature: Date: Division of Intlustnal Sefery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUiHORVA710N OF ENTRY: I cehify untler penalty of perjury that I have read this application and state Ihat Ihe infortnation given is correct. I agree to compy with all siate laws antl ciry ordinances relating to builtling consWction, antl authorize representa�ives of Ihe City ol Cosia Mesa to emer upon ihe ebove-Oescribad propeny tor inspeclion purposes. I agrea frot to occupy or ellav occupancy of any builtli� authorized by this permit until tinal inspadion. Signature Of Legal Owner(s) Date `�/ /r. . � z .-�.� Aulhonzetl Appliwnt � Date GODE �. INSFECTIOHTYPE 1676 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rool 201 Final BIocWRe�aining Wall 202 203 204 Final Factory Fire Place Final Sign Finat Demolition �g COUE I INSPECiION TYVE 206 Final MeChanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinNOccupanc (774) 754-5273 • Fax (714) 754-4856 CITY OF Bl/ILDIN DEVELOPMENT S JobAddress: 904 EVERGREEN PL Suite: Vicinity: Parcel Nunmber: 42252102 Applicant: WHETSEL, BRIAN Address: 17066 PALMDALE ST HB CA Owner: LINDER, HARRY H TR Address 904 EVERGREEN PL COSTA MESA,CA Contractor: PRIMO ROOFING Address: 17066 PALMDALE ST HB CA Zip: 94627 Arch : Address: Phone: . Zip: License: STA MESA DIVIS/ON 10ES DEPARTMENT ,, P I NUMBER 899-00117 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OV22/1999 Issued: Oi/22/1999 Phone: �714-841-4456 Zip: 94627 Phone: Zip: 92627 . - Phone: 714-841-4456 , License: 331120 ' ' Eng: Address: Phone: License: TEAR OFF 2 LAYERS OF COMP. SHINGLES APPLY 15L6 FELT & REROOF WITH 25 YEAR COMP. SHINGLES. � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $74.75 $0.50 $0.00 $0.00 $0.00 $75.25 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING existinq: o NOTES: Rear �0-0 Rear 0- 0 Required: 0 LeR . 0- 0 Left 0- 0 Pr000sed: 0 , C.B�C �/81U7tlOfl: $2,564.00 — Claim Valuation: gz,ssa.00 Right 0-0 Right 0- 0 s EXPIRA710N: This permit shall automatically expire and become void if work is not commenced wi(hin 780 days, or if work is suspended or abandoned for a period of 780 days. I . � 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 inspeetione and final approvel must be obtained. Failure t i obtain inspections and final approval will result in the expiration of Ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby aNirm undar penalry oi p�rjury one ot the tollowing tledarations: ❑ I have antl will maintain a certifiwte oi consent to seli-Insure tor workers' compansation, as provided for by section 3700 oi Ihe Lebor Code, for the pertormence ot the woAc tor which �his pertni� is �suetl. � I have end will maintein workers' compensation insurence, as required 6y section 3700 of ihe Labor Code, tor the peAormence oF the work for which Ihis pertnit is issuetl. My workers' compensation Insurence cartier end policy numDer are: o Carrier. ��}`�(,'��f�y�Q� PolicyNumDer. �,17C,%_ ��17 �� (This section need not be cromp/efed J the permif is valued et one hundred dollars ($100) or less. J ❑ I certity that in the pedormance of the work for which this pertnit is issueq I shall not employ any person in any manner so es to becoma subject to the workers' compensetion laws of Califprnla, and aqree thet it I should become sublect b the workers' compensation pmvisions oi Sectlon 3700 o11he Le6ar Code, I shell forthwith wmply wiih Ihes wision , (��(r� Applicent Signature: �-�, Dare: I—�J Z•"L-1 WMNING FAILURE TO SECUf1E WOpKERS' COMPENSATION COVERAGE IS UNL4WFUL AN� SHALL SUBJECi AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TTqUSAND Dd.LARE (5100,000),IN ApDITIIXJ TO TME CQST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECfION 31O60F THE LABOR CO�E, IMEflEST, AND ATTORNEY'S FEES. LICENSEO COHTRAC70RS DECLARATION: I hereby aHirm Ihat I em licensed under provisions of Chapter 9(commencing wiM Section 7000) of Oivision 3 of the Business end Protessiars Code, and my license is in full force entl ettect. Lic. x Class N_ G— �J� Contractofs5ignaNre: w ��p...�-� Date: � —Z% �aCY CONSTRUCTION LENDING AGENCY: ❑ I hereby affirtn thet ihere is a wnstruction lentling agency tor the Derfortnanca of the work tor which ihis permit is i55ue0. (Sec. 3097, Civil Code). Lendefs Name: LentleYs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm that under penelry o} perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Protessions Code: Any ciry or counry which raquires a pertnit to consirucL alter, improve, demolish, or repair eny structure, pnor to its issuance, also requires the applicent for such permit to file e signed slatement Ihat he or she is licensed pursuflnt to the pmvisions of ihe Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) oF Division 3 0l the Business and Professions Code) or t�at he or she is exempt theretrom and ihe basis tor the alleged exemption. Any violetion of Section 7031.5 Dy any epD�iwnt for e permit subjects the epplicant to a ciwl penelry oi not more ihan five huntlred dollars ($500).): ❑ I, as ov+ner ot the D�operty, or my employees with wages as iheir sole compensetion, WILL DO THE WORK, entl iha structure is not intended or oHered for sale (Sec. 7044, Businew entl Professions CoCe: The Coniractors License Law does not flpply to an owner oi proparty who builds or improves thereon, and who does such work himself or herselt or IhrougM1 his or her own employaes, provided ihat such Improvements are not intended or ottered for sale. It, however, the building or Improvement is soltl wlthin one year oi completion, Ihe owner-builder wlll have ihe burden of proving lhat he or s�e ditl not build or improve tor purpose of sele.). ❑ I, as owner of ihe property, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRAC70RS to construct the projact (Sec. 7044, Business and Protessions Cade: T1�e contractors Lic4nse Lew does not eppty to en owner ot property who builds or Improves thereon, antl who coniracis for such project with e conirecbr(s) license pursuant to the Coniractors License Laws.). ❑ I am ezempt untler sec. SignaWre: Owner ID venfied by tlrivels license. ❑ Yes ❑ No Business and Professions Cotle tor this reason: VenFlcetion of Ownership by (ryp@ of dwument, i.e. - property tax bill or dead): Dnvefs License No. Date: Expires: CEHTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTAV: I certify under penalry of perjury ihat I have read this epplication and state thet Ihe infortnetion given is correct. I agree to comply with dll siate laws and ciry ordinances relating to building construction, and authonze representetives ot the Ciy ot Coste Mesa to enter upon ihe ebove-descnbed propeRy for inspection purposes. I egree not to occupy or ellow occupancy of any builtling authonzed by this parmit until final inspection. �j(1,� _ LN\ nFatu a LeL Owner( 5^�� '^ � Dete �'Ji!k.� � �.1 Antl/ r Auihorized Applicant Dete GOOE �. INSPECfIONTYPE 1616 Fixetl System Finel Fir4 prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Finel Block/Retaining Wall 202 Final Fectory Fire Plece 203 FinalSign 204 Final Demolition 20a6 46 �0¢ I[�ELS LOOE� INSPECTIONTYPE 206 Finel Mechanical 20B Final Plumbing 210 Final Elactncal 212 Final Fire Prevention 220 Finel Planning Approvel 222 Final Site 250 Final Builtling/Occupancy oWNER LINDER. _�� JOB ADDRESS qp1��Z � GENERAL CONTRACTOR � AP No. ] 15_I}91-pp LOT \ ? 'ECTIONS Gas f. �q brown coat e TRACT � Signature FIRE ZONE DATE GROUP BUILDING PERMIT NO. VALUE DESCRIPTION OF WORK A1Um,Pg'tl0 TYPE v ZONE SUBCONTRACTOR is$so COSTA MESA BUILDING-SAFETY DEPARTME P.O. BO% 917 C097p MEBA� CALIPORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT BUILDIN� �O, G� r�� ` � ^ ADDRE53 L L. KJ COSTA .MESA, CALIFORNIA OWNER �ARR �1NDE�� ADDRESS �O� �IJERC`�REEIID PL• �kt, i�tl;tivtu MAA 5 1963 ' FINANC[ DEPT. Cf[Y Of COSTA MESA APPLICATION FOR PERMR BUILDING For Office Use Only RGCHIPT NO. I I p.�lyT [i0� !J O��l !Y DAT[ pCCHN[� OATE 198NED CITY �SrA 'M�S^A NO. M) =ONE �///��TYPE � "GROUP ARCHITECT ��.S�R 1�LC` TEL.��1 ' BYPROVED . J� DATE.� .� �i � , ORENGINEER NO. �� 90 �'Y �+ , A ZONING ADDRESS �1 �� IZ N, - E2rno,v � � I' ZO NO.OP UB80FNEW lJ�lG PLANB � 9OILOINO +�Q CONTRACTOR � U NUM I � - � tsaw� �.Q�- �S�'J � �%�� ADDRES3��Y�5�.-. AQt�p� UE. .I' °`�`"'P"'" �(Cj c�rv .��U- f0 C�` A I.\ R I A. P. NO. II�— `( /� '—' d Z STATE /� TEL. I 90TT0 S�IDE 8 REAR PHLN� SHAL6 B8 LESS THAN LIC.NO. /�I� Q7 NO. �:O�L�IS SIZE /�-�y �/ 7Z.X(�% No, oP BLoae. ALLOWED <U. B. C. REQUIREMENTI OF LOT /''� J I� NOW oN �oT YARDSMPROVED YAROSAPPROVED USEOF T,�,�`�1�^ I " MAINBUIL�INCS ACCESSORYBUILOING EXISTINGBLD6. 1Jl.YJ CY- ' � (FROMC/Iaf'jREET ��/� 8ET6ACK LINB FPOM FR NT ffYr '`F� CENTER OP BTREhT 1 ( REAR YARD ��t - SIDEYARDI LEFT 'S� I RIGHT S( R'g��P `c �'� , DESCRIPTION OF WORK I �. eioes� � NEW ALTERAT�pN ADDITION X REAR �Ff. � REPAIR MOVINO OEMOLI6H DISTANCEBET._ /Q ACCESS'B DG9. MAIN BLDGS. VAR.�C DATE 5 ZE�1N6 �� Z RpOMS � BTORIES � C. U. P. SC APPROVED EXTER�ORWALL�_ I ROOFe'� AL�m� qyPROVfi ' /%�/�'� rrnico r_ .-....e �[I�}-- �ATE I O � 6Q. FT. 1 HEREBT ACKNOWLEO68 THFT � HAyQ REA� TXI9IAPPLIGTION TNE AMOUNT 9HOWN UNDEP V�LU�TION 18 FOP THE E AND STATE TNAT TX8 ABOVE IB CORRECT ANO AOqEE TO COM. PUPP08E Op 68TFBL�eH�NO A PERMIT FEE ONLY. p PLY WITH ALL CITY OHOINANC89 AND BTATB LAWB RHOULATINO yqLl1ATION /' �, m BUIL�INOCONeTRU . /J_� _ /� � � �� - PERMITFEE $ L N SIGNATURE n �Y! ��•I � � m PERMITTE � SU Z $ � 2000 E� �7J. � AUTHORIZEDAGENT ' TOTALFEE� $/� ' . ORANGE COUNTY BUILDING DEPAR , 636 North Broadway �• SANTA ANA, CALIFORNIA FOR APPLICANT TO FILL IN BUILOING nooRess 904 EvPr�PPn PlaeP SCHOOL DIST. OR TOWN (�nR'rA MP. SR NEAREST CRO55 ST. T.dnnrntti o ��TM Aeve rlv ARCHITECT O�j ENGINEER CA1TS nooRess Q11C CONTRACTOR ]Qp?W A�DRE55 g363 LEGAL ��T ]ESGRIPTION NO. AENT APPLICATION FOR PERMIT . � � � �V .�� , —FOR OFFICE USE ONLY i� RECEIPT NO. PERMIT NO. ' �3 3 � �0/�3' RE%ZJ//�6Y Y'�R/'JJ /A�E�S�'�/ Vlt� I RHTOWN ISL /�q j�j�p,iC �/I rL /[ I N� CR I54361 NEAREST �%,�////-��/ ��J�� y � CRO55 ST.' i�'//////I!/!/ N/K�� I ZONE N. OF TYPE I PLANS I asadena qPpROVEO No l 35882 BY � i CORRECTIONS K I NO. OF E SIZE OF LOT 'J'[, X 1 I(J 1 NOW ON l USE OF NO. OF E%ISTING BLDG. FwMiLies CENTERKOF'STR E�TM� 5(� Pt_ SIDE YA DESCRIPTION.OF WORK NEW I 7[ I ALTERATION REPAIR I I MOVING 6ZIEOING lna�4 sn �4M5 EXTERIOR WALL o f F COVERING ptiI1CCO I � USE OF NEW BUIIDING D..ni.i..v.r..._! lJ ea I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY�ORDINANCES ANO STATE LAWS REGULATING BUILOING CI NSTRUCTION. SIGNATURE OF �T,� T^n PERMITTEE—lYtiui AUTHORIZED AG I PEflMIT FEE $ /� VALUATION S 4830 00 � � • �Puu Guvc¢ R / APPROVALS ,TION INSPEC IALS. �/� EXT. REINFORCED — o I � — � z _ D r �� STREET PLOT PLAN • Show location and distances from property line and between buildings. �. - =; - . � . - - ... �- . � . � . �_". .�J_`_."___"-._ . . . . . _ _. � . � ' _ ' ' . , _ .. . . �� . ... Y . . . ' " � ~ �1` ' '? . . . . ... _j... .. . _ . . . . _. _ '. . .. . . _ . _ _ � . � _