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Home My WebLink About3093 FERNHEATH LN - Building Permitsr ;� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Addtess: 3093 FERNHEATH LN Suite: Vicinity: Parcel Number: 14104317 ApplicanC MAURER,CYNTHIAANN Address: PO BOX 1362 HONOKAA, HI Owner: MAURER, CYNTHIA ANN Address PO BOX 1362 HONOKAA, HI C o n tra c tor: O W N E R-B U I L D E R Address: Zip: Arch : Address: Zoning: R1 R1 Phone: 808-938-6891 Zip: 96727-1362 Phone: Zip: 96727-1362 Phone: License: 000000 Eng: Address: ISSUED BY: Status: ISSUED Applied: 04/23/2004 Issued: 04/23I2004 Phone: Phane: 2ip: License: License: SCOPE OF PERMIT TEAR OFF COMP. SHINGLES INSTALL 7 LAYER OF 15LB FELT AND 30 YEAR COMP. SHINGLES. INCLUDED IS THE ATTACHED GARAGE. Plan Check: $0.00 Permit: $9725 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Pront 0-0 PARKING Existin : o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0-0 $3,400.00 $3,400.00 I NOTICE: The work authorized by this permit shall compty 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 780 days, or if work is suspended or abandoned for a period of 1 BO days. � INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetione and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 2446dfi (N00) WORKERS'COMPENSATONDECLARATION: T ! I hereby aflirtn un0er penalry ot perjury one oi the following tleclarations: ' � � ) �❑ I have end wlll mpImeln a cenitiwte oi consent to sell-Insure for workers' compensation, es provided for by sectlon 3700 oi the Labor Code, for the pedorm8nce of the work for which �hR permit is Issued. I have end wlll malnt in workers' compensatlon insurence, es raquired by section 3700 of the Lebor Code, for the peAormance of the work for which ihis pertnit is lssuatl. �- My workers' compe�sation Insurence carner antl policy number are: Carrier: Policy Number: ((his sectian neetl not be comp/eted I/ the permit ts va/ued et ane buntlretl tlallers ($100) or less.) ❑ I certily Ihel in ihe peAormence ot Iha work tor which t�is permit is issued, I shell not employ eny person in eny menner so es to became subled ta the workers' compensetlon lews of Caltlornla, and agrae �hat II I shoultl become su6�ect to Ihe workers' compansation provisions of Section 3700 of the Labor Goda, I shall forihwith comply with Ihese pmvisions. - Appllcent SlgneWre: Date: WARNING: FAILURE TO SEWRE WORKERS' COMPENSATION COVEPAGE IS UNLAWFUL rWO5HAl1 SUBIEGT rW EMPI.OVER TO CRINJNAL PENALTIES AND GML FlNES UP TOONE HUNDRED TNOUSAND DOl1ARE (5100,000), IN ADDITION TO THE C0.5T OF COMPENSATION, DMMGES AS PROVIDED FOR IN SECTION 37060F THE IABOR CODE, IMEREST, AND ATTOHNEY'S FEES. LICENSE� CONTRAC70RS DECLARATION: I hereby aMlrm that I em licansed under provisions oi Chapter 9(commencing wilh Section 7000) oi Division 3 of the Business and Pmtessions Cotla, ar�C my license Is in tull fofta an0 BHecL Lit. M CIaSs q , Comractors SlgnaWre: Date: �, CONSTRUCTION LENDING AGENCV: �, ❑ I hereby aflirm t�et there is a construction lending agency tor the pedormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Neme: Lender's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: 1 hereby eMirm ihet under penalry of perjury �het I em E%EMPT FfiOM 7HE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Buslness entl Protessions Code: Any city or county which requires e pertnit to construct, alter, improve, tlemolish, or repair eny structura, O�or lo its issuance, also requires ihe applicant for such permit to file e signed stetement thet he or she Is licensed pursuant to the proWsions oi the Contractors License Law (C�apter e(cammencing with Seclion 7000) ol DlNsion 3 of the Business and Prolessions Code) or thet he or she is exempt therefrom antl the Desis tor the alleged ezemption. Any Nolation of Section 7031.5 by any epplicent tor e pertnit subjects ihe applicant to a civil penelry of not more then five huntlred dollars (5500)J: ❑ I, es owner of lhe property, or my employees with weges es their sole compensation, WILL DO THE WORK, end Ihe structura I5 not intentletl or oXered lor sale (Sec. 7044, Business and Pmfessions Code: The Contractors License Law does not apply to an owner of property who builds or improves Ihereon, and who tloes such work himself or herself or through his a her own employees, p�ovitled ihat such improvements ere not intended or ofle�ed for sale. If, however, the building or improvement is sold wi�hin ono year of completioq the owner-builder will have iho burden ot proving ihat ha or she did noI build or improve for puryose of sale.). � � I, es owner ol the pmperry, am EXCLUSIVELY CONTRACTING WITH UCENSED CONTRACTORS to constmct the pmject (SecJ044, Business and Prolas5i0n5 Code: The contrectors License Law tloes not apply to en owner of property who builds or improves �hereon, and who contrac�s for such project with e contractor(s) license pursuam to ihe Contractors License LewS.). z pt under sec. n Business entl Professions Code lor ihis reason: � b�vner�erifj6�6y dnver's license. es ❑ No D' r's License Venficetlon ol Ownership by (type of document,'. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: ❑ I hereby certify t�et no excavation five (5) or more feet in Cept� in�o which e person is required to tlescend, will be made in connec�ion with work authorized by this permit, entl that no builtling structure, scaHolding, lelsework, or demolition or dismantling Ihereof, will be more ihan ihirty-six (36) feet high. (Ghap. 3.2, Grp 2, Art 2, Sec. 341, Title B, California Atlminis�raiive Code). ❑ As awner-buildar, I will not employ anyone to do work which would require e pertnit from the Division of Indusinel Sefery, as notetl above, unless such person has e pertnit to do such work from ihe tlivision. Sipnature: Date: Division of Industdel Safety Permit Num6er: CERTIFlCA7E OF COMPLIANCE ANU AllTHORIZA710N OF EMAY: I cenity under penalty ot perjury iha� I have read ihis epplication and state that ihe inlortnation given is wrrecL I egree to wmpty with all state laws and city ordlnences relating to builtling construction, end euthodze represematives of the Ciry oi Costa Mese to enter upon the ebova-descnbetl property for inspection Durposes. I egree �o occupy or ellow occupancy of eny building authorizetl by this permit until tinal inspection. ' �s� „ 9�/ �'�3-�Y� Sign ure Ot Legal O Dai And/Or Authorized Applicant Date GOOE�, INSVECTIONTYPE 1616 Fixed Sysiem Final Pire Prevention 1268 Pool Spe Final 200 Final Ra-Root 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition Pdif. ItIIIDdLfl � ✓a� /�..ad COOE 1 INSPELTION flPE 206 Final Mec�enical 208 Final Plumbing 210 Finel Electrical 272 Final Fire Preven�ion 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �ZE It�Lfl � L'',it.�y o� L.�ta ��eda �'u�:��ccuy Dwia�o�s OWNER-BUILDER VERIFICATION A city or county, which is rcyuired to give nutice pursuant «� Scction 19R30, shall attach to such notice, and, as a condition precedent to issuing a buiiding permit, reyuire the completion and reyuire the rewrn of, an ownervbuildcr vcri�cation. At[ention Prnperty Owner: An 'owncr-builder' building permit has becn applicd for in yuur name and bcaring your signalure. Please complete and re[um this informa�ion in �he cnvclupc providcd al yuur earliesl oppoRunity lu xvoid unnecessary delay in processing and issuing your building permil. No buildine nermit will he issued unlil this verification is received. I. I personally �lan to provide the major labor and mn�crials for construction of the proposed property improvemen[. � Yes ❑ No 2. �/have not) signed an application for a building pertni� fnr thc proposed work. , 3. I have cuntracted with thu following persun (tirni) �o provide Ihe proposeJ conswctiun: Name Address Phone ( City _ Contraciur's Lic. Nu. 4. I pl,m to provi�e purtiuns o(the work, bul I havc hired the fnlluwing person to cuordinate, supervise and provide the major work: Namc Address Phone ( City — Contractor's Lic. Nu. 5. I will provide some of the work but I i�ave cuntracted (hirecq ihc folluwing persons to pruvide [he work indicated: Namc �fuP�a6 (REV 95fl� Address Phone 7'ypc of Work OWNER SOUTHWARD� HARVEY DATE 6-17-59 JOB ADDAESS 3093 F8T'ril'iEBth Lan8 � BUILDING PERMIT NO.. 965C GENERAL CONTRACTQR ence O. VALUE $ .00 AP. xo. 113-303-17 T,OT TRACT FIRE ZONE DESCRIPTION OF WORK �OCk w811 I' 'ECTIONS � DATE I GROUP " TYPE SUBCONTRACTOR Form 210-3M-4-59 _1 . - 9�:�� ° i� �� iC �, s V �1 � L� �.�i�Js`+vw- COSTA'�Iv1ESA BUILDING-SAFETY DEPARTMENT FIf�AI�CE DEPT. �� P.O. BOX 31] GOSTA MESA. CALIFORNId. �i�TY Q� CnCTfl MES� FOR APPC/CANT TO F/LL /N COMPLETELY APPLICATION FOR PERMIT , TYPE OR PRINT BUILDING ADDREISS JO� (j FCI� � I�C/QTI�, L%�It�E COSTA MESA, CALIFORNIA Fa,e officF usF oNcy OWNER �� S()IiTN /VL] I NECEIPTNO. I � MAIL RECEIVEO 6Y I DATE RECEIVED f A E IS: ADORE55 �RME I cirr SAME TNO. BUILDING ! I ADDRESS necHiiec7 � ��a COSTA MESA. CALIFORNIA OR �NGINEER NO. AL�..cSS FIRE ZONE CONTRAGTOR� STATE qPPROVED � �iL-Gt u�. No. ��i4� i By DATE � ADDRESS i. w.. 4 ST SqH qjq /j�r ZONING LEGAL I LOT QO I I y-� �� f ��HE NO. OF VSE OF NEW OESCPIPTION NO. O BLOCK TRACT IPLANB BUILDIN6 A.P. NO. , C -� 1 / APPROVED BY � OATE � ' SIZE �� r NO.OF e�ocS. ypRDS ' EVES OF LOT .:� I I rvow on wT REQUIRED � ALLOWED USE OF � ICENTER LINE ST.) EXISTING BLDG. FRONT ��FT. SETBNCK LINE FROM �M � /( CENTER OF STREET �{ REAR YARD D R. SIDE FT. SIDE YARD I LEFT O�( I RIGHT C1 �� L. SIDE FT. DESCRIPTION OF WORK __._ _ /� � n.e BUILDING � NO.OF SIZE ROOMS STORIES ' EXTERIOR WALL IROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED �1-• fl " Sv 3 ' I HEFEBY ACNNOWLE�GE THAT I HRVE READ THIS APPLICATION THE AMOUNT SHOWN UN�ER VALUATION IS iOR THE qN� STATE THAT THE PBOVE IS CORliECT qNO AGREE TO COM� pURP09E OF .E9TABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITV OR�INANCES ANO STATE LqWS REGULATING euLLoine coHsieuci N. VALUATION SIGNATURE OF � PERMIT FEE $ � �'� PERMITTEE � � $ [/_`SC a PLAN CHECK $ T� AUTHORIZEO AGENT TOTAL FEE $ �� i � ' '7.��3 «C�TA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA, CALIFORNIA FOR FILL IN f� rernneacn i.ane COSTA MESA. CALIFORNIA OWNER COLLEGE MESA COMPANY ADDRE55 P.O. Box 2277, Brookhurst Station r� u� Y�I 6• Y J Fa ✓ ��:_.�.��r�.t � APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY PECEIPT NO. P£AM1T�N0. �'�+1 Aj �� 7 ECEIVE� [�AiE�i[Iti ED SEr E ISSU±( v v' 8 ARCHITECT UU1VL� UL 1CY LIC. OR �";irvEER and C IIL No. RE 7191 COSTA MESA. CALIFORNIA ADDnc55 1102 W. 17th St., Santa Ana FIRE ZONE The Hale Com IEGAL ILOT fj �DESCRIPTION ry0�. "O BLOCK ♦ 1011 � A.P. NO. OF LOT O/ : USE OF E%ISTING BLDG 7350 2ONE 3161 B�PR( 2671 NO.OF BlDGS �,ow o„ �o, None SETBnCK LIrvE FROM cErviee oF sinE[i SO� REAR YARD SIDE VARD HIGHT I.O� LEFT LO� DESCRIPTION OF WORK NEW X ALTERATION ADDITION . .. — _ --__ .. REPAIn �I �MOVING IOEMOLISH BUILDING 1 53'-Liv. �o.oF SIZE � � ROOMS STORIES EXTERIOR WALL ROOF anvcaiun Cf�innn COVERING Cmm�n � ST/.TE THAT TME �BOVE IS CORRECT �ND /.GREE TO COMPLY WITM nLL CITV OROIN4NCE5 �NO BTATE LwWS NEGUL�TING BUILDING CONSTflVC- T'o" COLLEGE MESA COMPANY VALUATION SIGNATUR � � TIlE Hale Com an en. Partner PERMITTE ( /I nA.__/� �// � 5 12,890 CORRECTIONS PERMIT FEE S 3O. OO PLAN CHECK S yS� OO TOTAL FEE g4S.00 ,x4