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Home My WebLink About2033 BALTRA PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2O$$ BALTRA PL Suite: Vicinity: HOUSE & ATTACHED GARAGE Parce�Number: 13945307 App�icant: THREE D ROOFING INC Address: 19532 GREENWILLOW LANE ROWLAND HEIGHTS, CA Owner: TATMAN, LISA LYNN TR Address 2033 BALTR4 LN COSTA MESA, CA Contractor THREE D ROOFING INC Address: 19532 GREENWILLOW LN Arch : Address: ROWLAND HEIGHTS, CA Zip: 91'748 Phone: Zoning: R1 R1 Phone: (909) 598-1474 Zip: 91748 Phone: Zip: 92626 Phone: (909)598-1474 License: 617467 Eng: Add�ess: ISSUED BY: Status: ISSUED Applied: 11 /28/2000 Issued: 11/28/2000 Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING 2-STORY SINGLE FAMILY RESIDENCE WITH ATTACHED GARAGE (18 SQ). TEAR OFF EXISTING SHAKE & RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 1 LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH 30 YEAR GAF ASHPHALT SHINGLES. 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 Ex�scn : o NOTES: Rear 0- 0 Rear 0-0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 ss,000.00 $s,000.00 INOTICE: The work authorized by this permit shall comply with all applica6le handicap access requiremenis 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 180 days, or ii work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order �or �he work au�horized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required inspectlons and tinal approval must be obtained. Failure to obtain inspections and tinal approval will resufl in the ezpiiation of this permit. FOR INSPECTIONS CALL: (714) 7545626 aaar6l&oo� WORKERS'COMPENSAnON DECLAflAnON: � I hereby ottirm undar penalty oi perjury one of ihe following declarations: ❑ I have and will meintain a cenificate of consent b selt-Insure for workers' compensation, as provided for by sec�ion 3700 of the Lebor Cotle, tor the peAortnence ot Ihe wark tor which ihis permi� is issuetl. —� ❑-1 h@va and will maintain workers' compensation insuranca, as requiretl hy section 3700 of Ne Labor Cotle, for ihe pertortnance of the work for which Nis pertni( I5 Issued. My workers' compens ion Insuranca cartier and policy number are: Certier _� S71a'l'� �� PoIlcyNumber: %��S-��uN !T O� L2?S (This secfion need not be completed il the permit is veluetl af one hundred dollars ($100) or less.) �-- -- - - ' ❑ I certify ihat in ihe peAormance ot the work tor which t�is permit is issued, I shall not employ any person in any menner so as to become subject to iha workers' compansetion lews o�o�an gree thet if I should become sub�ect to the workers' compensation provlsions ot Section 3700 oi the Labor Code, I shell fonhwith comply with these pr vis ns. ApplicenPSigneWre: � Date �.�' ��+ �t � WARNING. FAILUFE TO SECUFE WORKERS' WMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CFIMINAL PENALTIES AND CIVIL FINES UP TOONE Hl/NDRED TFKKISAND DOLLARE �E100.OW), IN AODITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]Ofi OF THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hareby attirtn t�al I am licensed un�/ provisions ot Chapter 9(commencing with Section 7000) of Division 3 of.the$usiness and Professions Coda, antl my license is in full �, force end ettect�.Lic: #—i0' �� / �Class N � e3 � ' Contr�ofa Signeture: - (Dete: - 1 {—�9—�CJ CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm ihat Ihere is a constmction lending egency for the pertormance of ihe work for which this pertnit is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Adtlress: Signetura: Oate: OWNER•BUILDER DECLARATIONS: I hereby oHirm Ihe� under penelry of perjury that I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires a permit to consWcl, alter, improve, tlemolish, or repair any s�rucNre, prior to its issuance, also requires �he apD�icant tor such pertnit to file e signed statemeN that he or she is licensed pursuant b the provisions ot ihe Contractors Licensa Lew (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Code) or that he or she is exempt theretrom and ihe basis for the alleged exemption. Any vlolatlon oi Section 7031.5 by any applicant for e Dermit subjecis the epplicent to a civil penalry ot not more than five hundred Oollars ($500).): ❑ I, as owner of Ihe properry, or my employees with weges es Iheir sole compensation, WILL DO TME WORK, and ihe siructure is not intendetl or ottereC for sale (Sac. 7044, Business and Professions Code: The Contractors Licensa Law tloes not apply to an owner of property who builds or improves thereon, and who tloes such work himself or herself or through his or her own employees, providetl t�at such improvements are not intended or offered tor sale. If, however, ihe builtling or Improvement is sold within one year of completion, the owner-builder will have ihe burtlen ot Dmvinq ihat he or she did not build or improve tor purpose oi sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions Code: The cornrectors License Law does not apply to en owner of property who builtls or impmves thereon, end who comracts tor such project with a conirector(s) license pursuant to the Contractors License Laws.). ❑ I am ezempt under sec. Business and Professions Code tor ihis reason: Signaturo: Date: Ownar ID verified by dnver's license. ❑ Ves ❑ No �river's License No. Venficatiun of Ownership by (type oi document, i.e. - property ta: blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Ezpires: ❑ I hereby certify that no excavation five (5) or more teet in depih into which a peroon is required to tlescend, will be mede in connection with work euthorizetl Dy this permit, antl that no builtling sWdure, scaHolding, talsework, or tlemoli�ion or tlismantling ihereoi, will be more �hen ihirty-six (36) feet high. (Chap. 32, Gry 2, Ah 2, Sec. 341, T�le B, Califomia Administrative Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permit irom Ihe Division of Industnal Safery, as noted abova, unless such person has e permit to do such work irom the division. Signaturo: Date: Division of Industrial Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AIffHORIZA710N OF ENTAY: I cehity under penalry of perjury ihat I have read ihis epplication antl state ihat the infortnation given is correci. I agree to comply wi�h all state laws and city ordinances relating to 6uilding construdion, and authonze representatives of the City of Costa Mesa to amer upon the ebove-doscribed property for inspection purposes. I agree not to acupy or allow occupancy of any building authorized by ihis permit until final inspection. CODE «. INSPECTIONTYPE 1616 Fised System Final Fira Prevention 1266 Pool Spa Finel 200 Final Re-Root 201 Finel BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition QAjE Tn [L -L6-A� �u CO�EN INSPECTIONTYPE 206 Final Mechanical 208 Final Plum6ing 210 Final Electrical 212 Final Fire Prevemion 220 Final Planninq Approval 222 Final Site 250 Final Building/Occupancy Date PAIE IIIIIDdLB COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 3H GOSTA MBSA. CALIRORNIA ' For Applicant to Fill In Completely TYPE OR PRINT AD'RES$ ..?033 �a�l�'a- I �• COSTA MESA, CALIFORNIA SIZE / / NO.OF OF LOT zO X / o O rvoW oi USE OF EXISTING BLO6.�� 6ETBACK LINE FROM % CENTER OF BTPEEI' �'3 REAR YAF SIDEYARDI LEFT � I R16HT DESCRIPTION OF WORK ..�... � ✓ II ....�e....,... � �� ......-.. BUILDIN6 j� NO.OF SIZE a b��' ROOMS STOP EXTERIORWALL I ROOF �o�� COVERING SY-uCCD COVERIN6 3/�a USE OF BUIIDING AND WOWC TO BE PERFORMED �E^ RECEIUED � MAR 2_ 2 1963 FINANCE OEPT. APPLICATION FOR�PERA+R�ESA BUILDING For Office Use Only REC81VBp�9Y {��li BUILDIN6 ADDRE68 FIRE ZONING rvo, ov use or ruxa � euaou DATE188UED osscx�rrwn �/� / V �� 1 � V A. P. NO. -�C/ NOTE: NO EAVE OVERHANG SHALL BE LE58 THAN 90' TO SIDE Q REAR P. L. 5 EAVES y ALLOWED fU.B.C.REqUIREMENT; YARDSAPPROVED YAR�SAPPROVED MAIN BUILOIN6 ACCESSORY BUILOIN6 ( FROM C/L STREET ) �� N FRONT FT. FT. / e n.�e 7 � e-' 1 HEREBY ACKNOWLEO08 TXAT 1 X�VB READ TX19 APPLIC�TION ANO 6TATH THAT THC AB�V IB CORPECT ANO AOqEE TO COM� PLY WITH ALL CITY ORpiNAt E6 AND BTATB WH RHOULAi1N0 BUILOINO CONSTROGT 6N. SIGNATURE OP PERMITTE Q AUTHORIZE� AOENT � 6 // REAR FT. F DISTANCE BET. BET. MM�N 8 MAIN BLD65. ACCE55. BLI VAR. # OATE a ��Q6Q THE AMOUNT PURPOSE Op s �a, S r J _O`o� � , o VALUATION 19 FOR TXH F /� PERMIT FE6 ONLY. Q m x 1T FEE $ � �� j / m GHEGK $ b " 0 /y/ d _FEE $ /D O � JOB ADDRESS 'LU;j;j E GENERAL CONTRACTOR INSPECTIONS Form BU4--5M-3-83--5-H P DATE var.v� S 22, 59z.00 'LONE U�SCRIPTION OF WORK tOUP I$cJ TYPE V ZONE PERMI7 SUBCONTRe1C1'OR .,,,�,.� i G �