HomeMy WebLinkAbout2534 ALDER LN - Building Permits�,'��1
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� COS�TA MESA BUILDING-SAFETY DEPARTMENT
PfO. BOX 1200 COSTA MESA, CALIFORNIA 92626
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For Applicant to Fill in ompl 1el
BUII.DING Z5 30
ADDRESS
own,Ea Monte Vista Townh
aooaEs901 Dove St. #225
c�rv Newport Beach
CONSTRUCTION
BRANCH
A�DRE55
ARCHITECT
OR ENGINqEER ]
ADDIiES81EW�
CONTRACTOR
ADDRESS
CITY
STATE
LIC. NO.
SIZE
OF LOT
USE OF
Ise Ink Only
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es, Inc.
nTio`752-507
TEL.
NO.
CITV
LIC. NO.
INO.O LBF�D(3 .
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
OF BUILDING ANO WORK TO BE PERFORMED
I hereby ecknowledBa that I have read this application antl sxate
ihat the above iniormation is correct antl agree io comply with
all laws regulating builtling construction, antl 1 shall not employ
any person in violation of the workman's compensation laws of
the State ot California.
I hereby certify that I m properly licensetl as a contractor untler
the State of Celifornia usiness antl Professions Cotle, Division 3,
Chapier 9, and a licenses are in full force antl effect, or I
am exempt f r visi ot the S e ot Calltornia Business
and Pro4ession Di 's' a
Signatura of
Permittee
Authorized Age t
77843 0/2717B 16.5-I TI
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7784 ' 0 O�AG69 46 I A
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ICA FOR STRUCTURAL PERMIT
RECEWEDBV D CEVED 4qTE SUED
(b'�7'� .
ADDR
TR
FIFiE
APPFOVE
ZONE � NO.OP
PLANS
YARDSAPPROVED
MAIN BUILDING
(FROM GL STREET)
DISTANCE BET
MAIN BLDGS.
VAR.# —�r
oare �D-Z�%'
USE OF NEW
BUILDWG �
VARDSAPPROVE�
ACCESSOFV BUILDING
FT.
BET. MAIN &
ACCESS. BLDGS.
APPROVED /; � %�
� /� �.�
��T� 10-a�-�5'
THE AMOUNT SHOWN UNDER VALUATION IS FOR m
THE PUPPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
VALVATION � PERMIT FEE 5 p
�1 M
/ ^ / ��j�j PLAN CHECK $ o
1 LL
� �_/ TAX $ � t
TOTHLPAID $ �j�i �i I U
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa. BUILDING PERMIT T� FAIR DRIVE, COSTA MESA, CA 92626
Jab Address: 2534 ALDER LN
Suite:
Vicinity: THROUGH OUT HOUSE
Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construction: V-N
Parcel Number: 43917272 Zoning:
App�icanc KABAN, LAWRENCE W TR
Address: 19982 CATO CIR
ISSUED BY:
Status: ISSUED
Applied: 07/26/2005
Issued: 07/26/2005
Phone:
HUNTINGTON BEACH, CA . � � � Zip: 926463801
Owner KABAN, LAWRENCE W TR ��T�N��O�
Address 19982 CATO CIR - �� /�� �T ��jj�T�����j
�.� � - � ��:Phone: �: .L'...YJ�� 1JL
HUNTINGTON BEACH, CA . -' � - � � 2ip � •926463801 � � � ��A1
PER".�-
Contractoc OWNER-BUILDER; �XPIRES
Address ` �
Phone:
Zip: '
Arcti.: . "',. .
Address: � .
Zip
Phone:
License:
License: 000000
E�9
. Address: � �
Ptione:
� iicense: � -
SCOPE OF PERMIT
REPLACE ALL WINDOWS CIKE POR�LIKE THROUGH OUT�HOUSE;� NO CHANGE IN-SIZE'AND 2 SLIDING GLASS D,OORS; �LIKE FOR LIKE WITH
DUAL PANE VINI'L WINDOWS TO��.MEET 1997 UBCEGRESS-REQF `� ` . , -. - � � - �'' " � � . � -� ��
� FEE SUMMARY �'_ �
Plan Check: �$0.00 � �`" ` � -. --. . � ___ - �Calc Valuation: - - � Ss,3oo.00
Permit: $181.25' - ' Claim Valuation; <- Ss,3oo.00
SMIP Res: $0.93
SMIP Com: $0.00 .�
Other: ,:' �$0:00 . �
Inspection: $0.00
Total: $182.'18
RLANNING & ZONING
SETBACKS " � z ' �� ;, � � � i- . � �
MAIN STRUCTURE Front ; .0- 0�-.' ,`�- .Rear � �0- 0� '-�' _Left, 0- 0- � � � Right ;. 0= 0 " .
ACCESSORY Front �0;0=> - �"� Reac '-0- 0-�t ,-- - Left 0 0"�� ��' " Right 0.�0
' - � - d , +�z �
`" . . ..>n -' ,
PARKING Existing: 0 a.Required: 0 - .Pioposed:" " b ,
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Orcl. No. 92-28, § t, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectlons and flnel epproval must be oblalned. Failure to obtain inspeclions and final approval will result in the expirallon of this permit.
FOR INSPECTIONS CALL: (774) 7545626
zaawela'ool
WORKERS'COMPENSATON DECLAFiAnON:
I hereby ettirm under penalry ot perjury one ot the following declarations:
i
❑ I have antl will maimein e certificate of consent to self-Insure for workers' compensation, as provided tor by section 3700 ot the Lebor Code, for �he performance of the
work �or whiCh �hi5 permit is i55ued.
❑ I have and will meintain workers' compensatlon insurence, as raquired by sedlon 3700 of the Lahor Code, for the pertortnance ot the work tor which this pertnit is Issuetl.
My workers' compensation Inswence cerrler and policy number are:
Carrier: Policy Number:
(lhis section neetl not be completetl i! the permi( is veluetl at one hundred dollars ($f 00) or less.)
❑ I caniy ihat in Ihe pertormance of ihe work tor which Ihis pertnit is issuetl, I shall not employ any person in any menner so as to become subject to t�e workers'
compensation laws oi Califomia, antl agrea ihel il I should become sub�ect to Ihe workers' compensetion provisions of Saclion 3700 ot the Lebor Code, I shall forihwlth
comply with Ihese provisions.
Applicant Signeture: Dete:
WARNING FAIIURE TO $ECURE WOFKEF$' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CHIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
hKK/SAND DOLURE (E100,000), IN FDDITION TO THE COST OF fAMPENSATION, OAMAGES AS PROVIDED FOF IN SECTION 3]O60F THE LABOR CO�E, IMEFEST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihat I em licensetl under provisions of Chapter 9(commencing with Section 7000) ot Division 3 oi the Business and Professions Coda, and my license Is in full
force antl eHect. Lic. q Cless N
Contractofs Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn Ihat ihere is a constmction lending egency for the pertormance oi the work for which this permi� is issued. (Sec. 3097, Civil Coda).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby ettirm that untler penalty of perjury that I em El(EMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or county which requires a pertnit to construct, alter, improve, demolish, or repair any siructure, pnor to iIs issuance, also reQuires �he applicant for such pertnit
to file a signed stetemant that he or she is licensed pursuant b the provisions of tha Contrectors License Lew (Chaptar 9(commencing with Sectlon 7000) of Division 3 of ihe
Business and Professions Code) or that he or she Is exempt therefrom and the besis tor the allegetl exemption. Any violation of Section 7031.5 6y any applicant tor e Oermit
subjects ihe appliceM to a civil penalry of not more then tive hundred dollers ($500).):
❑ I, as owner of the pmperry, or my employees with wages as their soie compensatlon, WILL DO THE WORK, and the stmcture Is not intended or oHered for sale (Sec.
7044, Business end Professions Code: The Conlractors License Lew does not apply to an owner of p�operty who builds or improves Ihereon, and who does such work
himselt or herselt o� ihrough his or her own empioyees, provided ihat such improvemenis are not intended or oflered for sale. H, however, Ihe building or improvement Is
sold within one year of completion, the owner-builder will have ihe burden of proving ihat he or she tlitl not build or improve for purpose of sale.).
I, as owner of Ihe property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct ihe project (Sec. 7044, Business antl Protessions
�Ccfe: The coniractors License Law does not apply ro an owner of propeny who builds or improves thereon, antl who contraas tor such proJed with a comrector(s)
�•license pursuant to ihe Contractors License Laws.).
❑ I am exemp�undersec.. i Business and Professions Code for this reason:
dnverslicen58. LIV85
Venfication ot Ownership by (rype of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cartity that no excavation five (5) or more fee� in depih into which a person is required to tlescentl, will be made in connection with work authonzed by ihis
permit, and ihat no builtling sWdure, scaflolding, talsework, or demolition or Oismantling Ihereot, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Califomia Adminisirative Code).
❑ As owner-builder, 1 will not employ anyone to do work which would require a pertnit from the Division of Industnel Safery, as noietl above, unless such person has e
permit to da such work Irom the division.
Signature: Date:
Division of Intlusinal Safety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUfHORIZATON OF EMRY: I cetlify under penalry of perjury that I have read this application and state thet the intortnation given is
wrrect. I agree �o comply with ell stata laws end city ordinances relating to building construdion, and authorize representatives of the Cily of Coste Mesa to enter upon Ihe
ebove-d cribed operty for i ection rposes. I egree not to occupy or ellow occupency of any building authorized by this pertnit until tinal inspection.
7-Z6-D5�
� ig" ne(ure:0 aLOwner(s) ��,y,. Dat��_
And/OrAu� onzed Applicant Date
COOE�. MSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demoli�ion
PflIF IMITIRLS
LOpE I INSPECTION TYYE
206 Final Mechanical
208 Final Plumbing
210 Finel Elecirical
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Buildin¢/Occupancy
PAIE
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`��K�r- COSTA MESA B WGSAFETY DEPARTMENT AP} .'I'ION FOR STRUCTURAL PERMIT 5�
lt'"'�� `� PO BOX1200 "AMESA CAIIFORNIA92626
' REC BV PERMIT AIO 50237
For Applicant to Fill in Completely — Use Ink Only � �
BUILDING n��I/ A•P• Np. � a �
ADDRESS � T
��(/��� ��� BUILDING ��?./
OWNER OR eC`�"K„'✓"„ ADDRE55 �7T
TENANT
MAILING � SPACE NO.
ADDRE55
TR.NO. LOT BLK.
TEL.
dTV NO.
CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDEfl
BRANCH n Q � �_ �
OWN�ER� f�/�w'v
ADDRESS USE ���a. �Q� VALUE$ SOO
ARCHITECT TEL.
Oft ENGINEER N � �
AD�RESS
20NE TVPE V GROUP 't
,�,I��, � APPROVED y
CONTRACTOR .f�N�{ BV DATE �3 p �
ADDRESS
TEI.
CITV NO.
STATE pTV APPROVEDSETBACKS
LIC. NO. LIC. NO.
SIZE NO.OFBLIX'�S. (FROMC/LSTR
OF LOT NOW ON LOT ROM F.
VSE OF
EXISTING BLDG. � F
l/
Separate permits are required for L. SIDE FT. �
electric, plumbing and heating work. / /j
REAR F
VSE OF BVILDING AND WORK TO BE PERFORMED PLANNI G ACTION
/ n � DATE
{r .4PPFlOVED
APPRO E
I heraby acknowledge that 1 hava reatl this application and state
that the above intormation is correci and agree to comply with
all lews regulatin8 building consttuction, and I shell not employ
any person In violation of the workman's compensation laws of
the State of California.
I herebY cartify that I am properly licensed as a convactor untler SQ. FT.
the State of Calitornia Business entl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
C�apier 9, antl that such licenses are in full torca antl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am exempt from the provisions ot the State of California Business VALUATION PERMIT FEE
end Protessions Cotle, Division 3, Chapter 9. $ • �Q
PLAN CHEGK $
Sig^atura of �,p y [�`OO
Pe�mittee `�4 �� �+ 8 J TAX $ D,�O
or
Authorizetl Agen Date / TOTAL PAIO E S, �
E� TI_
� �:: .
DATE
JOB ADDRESS 2534 Alder Iane BUILDING PERMIT
SUBCONTRACTOR
ROUGH PLUMBING
PROP. SWP. LINE � NOUSE CON. �
SPRINNLING SVSTEM
MISCELLANEOUS
ROIIGH HERTING P.NO �IF CONOITIONING
UNOERGROUNO U POWER U
ROUGH WIRING
TRENCHES � FORMS STEEL flEINF. ❑ -
EL
MING - IN � OUT
STER.BROWN CORT
Y
CITY OF CDSTA MESA
e�u�oreNi� vzate �.o. �ox �:oo
FROM TME OFFICE OF TME DIRECTOR OF BUILDINO SAFETV
Project Address �Sa �� j3/�,(�r .�, a„ e
Project Name ��i%^ o-- �
Owneis .Ndlil2 �arv�., %a ba..
c)wne-s ,Address ��Jti�,� C-�i.; C`�r�le�./1...,��,ti l3�.c�.
cbmezs Telephone y( 7- J c 1�-
��t # So 23�
��
City Us= Chly
I L�irr.q K� bd,-. as owner, eartraeters +�ogerrt (strike out all
except or ) do hereby attest that e�loyn�ent of any person, or persons, is not
anticipated at the time of seeking the abovrreferenced permit. In the.event that
any person, or persons, are err�layed under the provisions of this permit, I shall
imnediately cause a valid Certificate of Fbrkmens Cctcy�ensation to be filed with the
Costa Mesa Building Division.
T agree to defend at rty own wst, ard to indenmify arc3 hold harmless, the City,
its officers, agents and/or e�g>loyees, fran and agairtst, arry and all liability,
darrage, costs, losses, claims and expenses, haascever caused, resulting directly
or indirectly fran, or ooruiected with the ingxovement iur3er this peimit.
I further state that I have cead and fully imdeistand the implications arrl re-
sporUibilities of the above statements, and will crniply with all provisions of the
Contractors State License Iaw found under the Business arrl Professions Code,
Aivision 3, (2iapter 9, of the State of California.
_� � rr..� �, . /�ei �,QY.
�i rint Na�
�•,,,,,. L� • G 6— 1 3-- 6=0
ignature Date