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Home My WebLink About209 AMHERST PL - Building Permitsr � . • (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 209 AMHERST PL Suite: Vicinity: RESIDENCE & ATTACHED GARAGE Parcel Number: 14146509 Zoning: App�icant: ENTENZA, KENNETH KEATING Address: 209 AMHERST PL COSTA MESA, CA Owner: WHITE, GLADYS MARIE TR Address 209 AMHERST PL COSTA MESA, CA Contractor: O W N E R-B U I L D E R Address: � Zip: Arch : Address: Phone: Phone: 714-540-1831 2ip: 92626 Phone: Zip: 92626 Phone: License: 0 Eng: Address: ISSUED BY: Status: ISSUED Applied: 10/11/2001 Issued: 70/11/2001 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: T/0 EXISTING ROCK, REPLACE WITH CLASS A 25-YEAR-"GAF TIMBERLINE" COMP SHINGLES. MINIMUM PITCH 2-V2:12 25SQUARES Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existin : o NOTES: Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0-0 $4,200.00 sa,2oo.ao 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, 12-21-92) EXPIRATION: This permit shall automatirally expire and become void if work is not commenced within 1B0 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 inapeotlona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2b66-48(8�00� WORKERS' COMPENSATION DECLARATION: — I hereby attirm under penalry of perjury one of Ihe following tleclarations: ❑ 1 have entl will maintain a certificata of consent to sel(-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, for the pertortnence of Ihe work for whiCh IhiS permii is issued. ❑ 1 have end will maintain workers' compensetion insurance, as requiretl by section 3700 of the Labor Cotle, for the pedortnanca oi Ihe work lor which this pertnit Is issued. My workers' compensation Insurance carner antl policy number are: Carrier: Policy NumDer. (This sec6on need not 6e campleted il the permit is ve/ued et one hundred dallers ($100) or Iess.J ❑ I canity that in the peAormance ot the work for which this permit is issued, I shall not employ eny person in any manner so es to become subject to Ihe workers' compensation lews of Califomia, entl agrea that it I should become sublect to ihe workers' compensetlon provisions of Section 3700 of the Labor Cotle, I shall forihwith comply with ihese provisions. Applicant Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATIdJ CAVERAGE IS UNLAWFUL AND SMALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND qVIL FINES UP TOONE HUNDRED i/qUSAND DOLLARE ($100,000), IN ADOITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTION 31O80F THE LA00R CO�E. INiEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn Ihat I em licensed under provisions of Chapter 9(commencing with Saction 7000) of Division 3 ot ihe Business and Professions Code, ana my Ilcense is In full force and ettect. Lic. a Class # Contractor's Signatura: Date: CONSTRUCTION LENDING AGENCY: ❑ I �ereby aHirtn that there is a construction lending agency for Ihe peAormance of tha work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lender's Address: Signature: Date: OWNER•BUILDER DECLARA710NS: I hereby eNlrm ihat untler penalty of perlury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business and Protesslons Code: Any ciry or counry which requires e pertnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signetl s�atement ihat he or she Is licensed pureuent to the provisions ot ihe Contractors License Law (Chepter 9(commencing with Seclion 7000) of Divislon 3 of the Business antl Protessions Code) or ihat he or she is e:empt therefrom and the basis tor the alleged exemption. Any violetlon ol Section 7031.5 by eny applicant for e pem.+' subjects the epplicant to e civil penalry ot not more ihan five hundretl tlollars ($500).): ❑ I, es ownar of the properry, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the sWCWre Is not intendetl or oHered br sale (Sec. 7044, Business end Professions Code: The Conirectors License Law tices not apply to an owner oi property who builds or improves thereon, and who tloes such work himsetl or herselt or through his or her own employees, providetl that such improvemenis ere not Intended or oHeretl for sale. If, however, the bullding or improvement is sold within one year of completion, Ihe owner-builtler will �ave the burden of proving Ihat he or she did not build or improve for puryose of sale.). �I, as owner of ihe roperry, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct the project (SecJ044, Business and Professions Cotle: Tha co r ctors License Law tloes not apply m an owner oi propeny who bulltls or Improves thereon, and who comracts for such pmlect with a contractor(s) license pursu� to Ihe Conirac)orq Licensa Laws.). ❑ I am exem der ec Business and Professions Code for ihis reason: SignaWre: ��i _ Owner ID venfied by dnvers Iicense.T ❑ ls No Driver's License No. Veniication ot Ownership by (rype oi document, I.e. - properry ta+c hill or aeetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTFICATION: Date: ! — Explres: ❑ I hereby certify ihat no excavetion fiva (5) or more teet in depih into which e person Is required to descend, will be made in connection with work euthodzed by this permit, antl ihat no building structure, swHolding, talsework, or demolition or dismantling ��ereof, will De more ihan ihirty-six (36) teet high. (C�ap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Adminisirative Cotle). ❑ As owner-builtler, I will not employ anyone to do work which would require e permit from the Division of Industnal Satety, as noted abrne, unless such person has a permit to do such work from ihe tlivision. Signatura: Date: Division of Indusirial Safery Pertnit Number: CER'f1FICATE OF COMPLIANCE AND AUTHORIZATION OF EMAY: I certity untler penalty ot perjury ihat I have read ihis epplication and state that ihe information given is correct I egree to c�ply wlih all state laws entl ciry ordinances relating to builtling consiruction, anC euthonze representatives of the Ciry ot Costa Mesa to enter upon Ihe above-descnbedpr arty for inspection purposes. I agree not to occupy or ellow occupancy of eny building authorized by ihis permit until final inspection. COpE �. INSGECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Finel 200 201 202 203 204 Final Re-Roof Final BIxWRetaining Wall Final Factory Fire Place Final Siqn Final Demolition Owner(s) Date /n- //-�, / Applicant � Date ' Q�SE II�IDA4S .. t�.� !� CODE� INSPECTIONTYPE 206 Final Mechanical 20B Finel Plumhing 210 Final ElecMcal 212 Finel Fire Prevention 220 Final Planning Approvel 222 Final Site 250 Finel Building/Occupancy P�jf, INTITULS CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Property Address � U�pyr �� 2 c 7'" Pt Owner ,�� 'G/ L� � r,r �- � �Gc„cf Contractor State Contractor License Number Permit No. �/J�/ �� Classification I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 15, and Appendix 15 of the latest adopted edition of the Uniform Building Code, and the installation instructions ot the manufacturer. � I further certify that I am the owner of the property. (Owner-Builder permittee only). ❑ I further certity that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certity that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: ni�iel /�_� 089PO6MW6W White-Buildirg0iv.;Canary�Cmvx�or;Pink-Owner Company or Corporete Nema Address i6 ii- Signa�ure Date or Typed Name C�i � C.�. �;� ��:�� D�� OWNER-BUILDER VERIFICATION A city or county, which is reyuired ro give notice pursuant to Section 19830, shall attach [o such notice, and, as a condition precedent to issuing a building perntit, require the completion and require the remrn of, an owner-builder verification. Atten[ion Property Owner. An bwner-builder' building permit has been applied for in your name and bearing your signature. Please complete and remm this information in the envelope provided at your eazliest opportunity to avoid unnecessary delay in processing and issuing your building perntit. No buildingpemut will be issued until this verification is received. l. I personally plan to provide the major labor and materials for conswc[ion of the proposed property improvement. ❑ Yes � No 2. 1(have/have not) signed an applica[ion for a building permit for the proposed work. 3. I have convacted with the following person (firtn) to provide the proposed construction: IVame lM /!S'iz,e CRq Fa' Rnn, �� t�a Nti w•e c Address City Phone (YDy) 7 4 57 - t,2 6/_ Contractor's Lic. No. `� 7�J �� /� 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide [he major work: Name Address Phone ( City _ Convactor's Lic. No. 5. I will provide some of the work hut 1 have contracted (hired) the following persons [o provide the work indica[ed: Name Address Phone Type of Work ioaz�as �aev. sise� r • � � '7��_ COSTA MESA BUILDING DEPARTMENT P. O. BOX 3I� COSTA MESA. CALIFORNIA FOR APPLICA�N�T/I/1TO FILL IN BLIILDING �� . . . CJfJI/ MAIL AOORE55 CITY ARCHITECT OR ENGINE ADORE55 CONTRACT( AODRE55 LEGAI DESCFIPTION A.P. NO. COSTA MESA. CALIFORNIA Princeton, Inc. 419 E. 17th St. LIG �� T,� CITY LIC. 111C• NO. TEL. NO.OF BLDGS. NOW ON LOT SETBACN LINE FFOM CENTEF OF STREET �O� REAR VARD /. SIDEYARO RIGHT �O' LEFT S� DESCRIPTION OF WORK NEW X ALTERATION AODITION REPAIR MOVING DEMOL�SH BUILDING NO.OF SIZE ROOMS STORIES E%TERIOR WALL i ROOF COVERING SUUCCO COVERING CO �� ECEI�IE� Io-i�I-s-� flNANCE DEPT. CiiY OF COS1A �!E&A APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY er nni[ nEceiv[o [ isSU[o ./ i�-i�i-.r� 0�� 1 � 19 COSTA MESA. CALIFORNIA FIRE ZONE APPROVED BV USE OF NEW a��o�� Single faffily residence with attaehed garage. Plan 760B I MEREBY ACKNOWLEOGE THAT I HPVE REAp TMIS APPLICFTION ANO STnTE THAT TME ABOVE I� OFRECT nNO vGPEE TO COMPLY W!TH ALL CITV OPDINFNCES l�NO TATE LAW$ FEGULATING BIlILO1NG CONSTRUC- iiON. / VALUATION SIGNATURE OF/ � PERMITTEE ✓ l_�/ r AIITHORIZED AGENTi41.nG O[ u I CORRECTIONS $ 16,598.00 PERMIT FEE $ JO�W PLAN CHECK $ �" �Vv TOTAL FEE $ S�I�OO VBM! :: OWNER �TNCETON, INC. DATE 10-17-Sg - )OB ADDRESS 209 �erst BUILDING PERMIT NO. 7821 GENERAL CONTRACTOR D1k2 & ColePPOV2� VALUE $ 16.598.00 AP. No. LOT 2h TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Res. & Gar. t IN coat E��_ . Gas DATE PERMITS�SSUED SUBCONTRACTOR ____ ________ �