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Home My WebLink About463 BROADWAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 463 BROADWAY Suite No Vicinity: Parcel Nunmber: 11733713 Applicant: KEVON ZSABO Address: 17390 MT CLIFFWOOD FOUNTAIN VALLEY PLUMBING PERMIT Phone: (714) 241-1414 Zip: 92708 Owner: STELLE, GEORGE TR Address 463 BROADWAY Phone: 949-645-4587 COSTA MESA, CA Zip: 92627-2318 Contractor. COAST ROOTER PLUMBING HTG & A/C Address: 17390 MT CLIFFWOOD Arch / Eng : Address: ISSUE FEE 8ackflow irrigation Backflow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Ezpansion Tank Gas Earthquake Valve FOUNTAIN VALLEY WATER HEATER CHANGE OUT AMT $23.50 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 50.00 50.00 $0.00 $0.00 QTY Phane: (714)241-1414 Zip: 92708 License: 529127 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY AMT Laundry Tub / Washer - $0.00 Landscape I«igation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo 50.00 Sewer Connect 50.00 Sewer Private Line 50.00 Shower $0.00 Sink, bar 50.00 Sink, commercial 50.00 Sink, Floor 30.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 09/24/2004 Issued: 09/24/2004 ISSUED BY: Sump Pump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum BrkrBkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe Water Service AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $12.30 $0.00 SO.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetlona end finel epprovel must be obtalned. Feilure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446-06(&00) WORKERS'COMPENSAnON DECLARAnON: � �� I hereby aflirm under penalty ot perjury one of ihe following tleclarations: ' ❑ I have entl will malntain e cetliticete ot consent to sell-Insure for workers' compensatioq as providetl tor by section 3700 oi the Lebor Code, for the pedormance of Ihe J work for which this permit is issuetl. M I have entl wlll melntaln workers' compensatlon Insurance, es requiretl by section 3700 of the Labor Cotle, tor Ihe partormance of ihe work for which this pertnit is issued. �� My workers' compensetion Insurance carder antl policy number are: Csm''er:1 �T�T-'C ��J f�1 � Poli Number. , � �d � �5 — I�OO� � is section neetl no( be comp/efed il fhe permif is valued et one hundred dollars ($f 00) or less.) �I certity that in t�e pedormance of Ihe work lor which this pertnit is issued, I shall not employ any pereon anner so as to become subject to the workers' compensation laws ol Califomla, end egree that If I should become subject ro the workers' compensation provisions of Section 3700 of ihe Lebor Code, I s�all forthwith coR�ih �hese Provisions7�/� , �l I Applice ig ture: 1\ �..�� - �e: �' 2 � WA NG� URE TO SECURE WORKE ' MPENSATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUflIECT AN TO CRIMINPL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED T}IOU DDOILAflE($100,OW),INA�DIiIpJTOTHECOSTOFCOMPENSATION,DAMAGESA$PROVIOEOFORINSECTIIXJ3'1O60FTHELABORCOOE,IMEREST,ANDATTORNEI^SFEES. LICENSED CONTRACTORS DECLARATION: I herebv atEm�tka[ I am licensed under orovisic CONS7RUCTION LENDING AGENCY: of Chapter 9(commencing with Section 7000) of Professions Code, and my Ilcense is in full ❑ I hereby attirm fhet there is e construction lentling agency for ihe performance of the work tor w�ich �his permit is issued. (Sec. 3097, Civil Coee). Lende/'S Name: Lentlefs Addre55: Signature: OWNER-BUILDER DECLARATIONS: Date: I here6y attirm thet under penelty of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business entl Professions Code: Any city or county which requires e parmit to constmct, alter, improve, demolish, or repair any sfmaure, prior to its issuance, also requires ihe applicant tor such permit to tile a signed statement ihat he or she Is licensed pursuant to ihe provisions of Ihe Contraciors License Law (Chapter 9(commencing with Section 7000) ot Division 3 ot ihe Business and Protessions Code) or ihet he or sha is exempi therefrom and ihe basis tor the elleged exemption. Any violetion of Section 7031.5 by any applicenl for e permit subjecis ihe applicant to e clvil penalry ot not more ihan five hundred tlollars ($500).): � I, es owner of ihe pmperty, or my employees with weges es iheir sole compensation, WILL DO 7ME WORK, and ihe stmcture Is not intendetl or ofleretl for sale (Sec. 7044, Business and Professions Code: The ConVactors License Law tloes not apply to an owner of property who builds or improves thereon, antl who does such work himsetl or herself or ihrough his or her own employees, provitletl that such improvemenis are not intended or oHeretl for sale. H, however, ihe building or improvemen� is sold within one yeer of comptetion, the owner�huilder will have the burden of proving ihat he or she did not 6uild or improve for purpose of sela.). ' ❑ I, as owner of the property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to constmct the project (SecJ044, Business and Protessions Code: The conirectors License Lew does not apply to an owner oi property who builds or impmves thereon, antl who contrects for such project wlth a cornractor(s) licensa pursuant to ihe Contractors License Lews.). ❑ I am e:empt under sec. Signature: Owner ID varifietl by tlrivar's license. ❑ Ves ❑ No Business and Professions Code tor ihis reason: Venfica�ion oi Ownership by (type of document, i.e. - property tax 6ill or tleetl�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivers License No. Date: Expires: ❑ I hereby certity ihat no excavetion five (5) or more feet in dep�h into which a person is required to descend, will 6e made in connection with work euthonzed by this permit, antl ihat no building strucNre, scaHolding, falsework, or tlemolition or dismantling thereof, will be more than thirty-sis (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Tiile 8, Califomia Admini5irative Code). ❑ As owner-Duiltler, I will not employ enyone to do work which would require a permit irom the Division of Indusirial Safety, as noted ebove, unless such person has e permit ta do such work from the division. Signature: Date: Division of Intlustnal Safety Peimit Number. CER7IFlCATE OP COMPLIANCE AND AUT110RIZATON OF ENTHY: I certity under penalry of perjury that I have read Ihis application and stata ihat the intortnation given is correct I agree to comply with all stete laws entl ciry ordinances relating to building construction, and authonze representatives of the City of Costa Mesa to enter upon the above-described property tor inspection purposes. I egree not to acupy or allow occupancy oi any building authorized by lhis permit until finel inspection. CO�E 11' INSPECTIONTYPE � 1616 Fixetl System Finel Fire Prevention 1266 Pool Spe Flnal 200 Final Ra-Roof 201 Final Block/Reteining Well 202 203 204 Final Factory Fire Place Finel Sign Final Demolition OATE I�fjJ��^ f�QQ[[ INSPECTIONTYGE 20fi Final Mechanical 20B Final Plumbing 210 Final Electricel 212 Final Fire Prevention � 220 Final Planning Approval 222 FinalSite - 250 Final Building/Occupancy PAIE / a5 � 4 � 0 > " J�� (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 46$ BROADWAY Suite: Vicinity: Parcel Nunmber: 11733113 Applicant: VAFIADIS, GOYA Address: 21681 IMPALA owner: STELLE, GEORGE Address ST�LLE,PRISCILLA D CO$TA MESA,CA 463 BROADWAY Contractor. COAST ROOFING Address: 216811MPAlA H.B. CA 2ip: 92646 Arch : Address: Zip: BUILDING PERMIT Zoning: Phone: 714-968-8754 Zip: Phone: Zip: 92627 Phone: 714-968-8754 License: � 450393 Eng: Address: Phane: License: PERMI� 898-02253 � 77 FAIR DRIVE, COSTA MESA, CA 92626 SCOPE OF PERMIT RE-ROOF: T/O EXIST; NEW t/2" PLY; NEW FELT; 30-YR RATED "GAF" FIBERGLASS SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: Permit: $87.25 Claim Valuatron: SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $87.75 SETBACKS MAINSTRUCTURE Fronl 0-0 ACCESSORY Pront 0-0 PARKING Exi_ stinu: o NOTES: Rear 0- 0 Rear 0• 0 Required: 0 PLANNING 8 ZONING Left 0- 0 lek 0. 0 Pr000sed: 0 Right 0- 0 Right 0- 0 Slatus: ISSUED Applied: 12/17/1998 Issued: 12/17/1998 Phone: License: $3,185.00 $3,185.00 EXPIRATION: This permit ahall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 780 tlays. . INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permi�. FOR INSPECTIONS CALL: (71q) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby affirtn under penalry of perjury one of the followinq tleclarations: � ❑ I heve and will maintain a certi�icate oi consent to seN-Insure tor workers' compensation, es providetl for Dy section 3700 of ihe Labor Cotle, tor ihe pertormance o� the work tor which ihis permi� is issuetl. ❑ I heve and will meintain workers' compensation insurance, as required by section 3700 oi ihe Labor CoOe, Por ihe perfortnance of ihe work for which this permit is issued. My workers' wmpensation Insurence cerner end policy number are: Cerrier: Policy Number: (ThIs sectian neetl not be crompleted i! the Oertnif is va/ued ef one hundred dollars ($ f00) or less.) ❑ I certity thet in Ihe pertormanCe ot the work tor which ihis permit is issuetl, I shall not employ any person.in any manner so as to become subject b the workers' compensation lews ot Califomie, end agree ihel lf I shoultl 6ecome sublect to the workers' compensation provisions ol Section 3700 of the Lehor Code, I shell forthwith comply with these prov�is1ions. - Applicam SignaNre: i"/ /,�en i% ian i(.,� Date: t 1��'1 � R 8 WARNING: FAILURE TO SECURE WO FRS' COMPE ATION COVEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED TIqUSAN� DOLURE (5100.OW), IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOF IN SECTION 3/O6 OF THE LABOR CODE, INiEflEST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECl4RATION: I hereby aflirtn thet I em licensad untler provisions ot Chepter 9(commencing with Section 7000) ot Division 3 ot Ihe Business and ProFessior�s Cotla, end my license is in full force and eNecL Lia # �7 "� Class a ContradofsSignaNre: 4�ev�� a�� _r Date: 1� �7 � qB CONSTRUC710N LENDING AGENCY: ❑ I hereby aNirm ihat ihere is a construction lending agency for the peAortnance of iha work for which Ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lenders Name: Lenders Addreu: Signature: O WNER-BUILDER DECLARATIONS: Date: I hereby aflirtn that untler penalty of perjury that I am EXEMPT FROM THE CON7RAC70R5 LICENSE LAW tor ihe tollowing reason (Sec. 7037.5, Business and Protessions Code: Any ciry or counry which requires e pertnit ro constmct, alter, improve, tlemolish, or repair any simcture, prior to i45 issuance, also requires the applicant tor such permit to tile a signetl statemant Ihat he or ahe Is licensed pursuant Io t�e provisions ot the Conireclors License Lew (Chapter 9(commancing with Section 7000) of Division 3 of the Business end Proteuions Code) or Ihat he or she is exempt therefrom and tha basis for Ihe elleqetl exemption. Any violation of Section 7031.5 by any applicant for e pertnit subjecis the applicant to a ciwl penalry of not more Ihan tive hundred dollars ($500).): ❑ I, es owner ot lhe propeny, or my employees with wages as iheir sole compensation, WILL DO 7ME WORK, and the structure is not intended or ottered tor sale (Sec. 7044, Business end Professions Cotle: Tha Conirectors License Lew does not apply to an owner of property who builds or improves theraon, end who tloes such work himself or herselt ar ihraugh his or her own employees, provided Ihat such improvements are not intended or otlered for sale. If, however, the 6uilding or improvement is soltl within one yeer ot completion, the owner-builder will have the burAen ot proving that he or she did not Duild or impmve lor puryose of sale.). ❑ I, as owner ot Ihe property, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS �o consiruct the praject (Sac. 7044, Business and Professions Code: The contracrors Licensg Lew tloes not apply to an owner oi property who builds or improves Ihereon, and who contrects for such pwject with a contractor(s) license pursuant to the ConireCtors License Laws.). ❑ I em ezempt under sec. Business and Professions Code for this reason: Signeture: Date: Owner ID venfied by dnver's license. ❑ Yes ❑ No Drivers License No. Venfication ot Owners�ip by (rype of daument, i.a. - properry tax bill or tleatl): DIVISION OF INDUS7RIAL SAFETV PERMI7 CERTIFICATION: Espires: ❑ I hereby certity ihet no ezcavatlon fiva (5) or more feet in depth into which a person Is required to descenQ will be metle in connection with work euthorized by this pertnit, and ihet no building slrucNre, scaRoltling, felsework, or demolition or dismantling thereot, will be more ihen thirty-six (38) feet high. (Chep. 32, Gry 2, Art 2, Sec. 341, Ttle B, Galifomia Adminisiretive Cotle). ❑ As ownervbuiltler, I will not employ enyone to do work which would require a pertnit from the Division of Industnal Safery, es noted ebove, unless such person has a pertnit ta do such work from the division. Signature: Date: Division ot Indusirial Safery Permit Number: ICER7IFlCATE OF COMPLIANCE AND AllT}iORVATION OF ENTRY: I cenity under penalry ot perjury that I heve read this application and state thet the information given is I correct I agree m comply with all state laws and ciry ordinances relating to building construaion, and auihorize represeniatives oi the Ciry of Costa Mesa to enter upon the ahove-descnbed property tor inspection purposes. I agree not to occupy or ellow occupancy of any building authorized by this permit until final inspection. �gp�j, ixsvecrtoNTrrc 1616 Fixed System Flnal Fire Prevention 1266 Pool Spe Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition 2446 a6 Qd7E .uu: 'T�q � _ Date LODE) INSVECiIONTYPE 206 Finel Mechenical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 250 Final Sita Final Building/Occupancy PdtE .�m: �� COSYA M:�A BUILDING-S FETY DEPARTMENT P.O.BOX1200 COSTAMESA,CALIFORNIA92626 For Applicant to Fill in Completely — Use Ink Only aui�oiNc r�i-, a0..,.ryv.�tLi_I F � W a a � � S F � F�' a 0 � Q � ..l a w o. � 0. Z [al x 3 OWNER MAIL GITV � CANSTRUCTION BflANCH � ADDRESS ; ARCHITECT ADDRESS GONTRACTOR �) ADDRESS CITY STATE �IC. NO. OF LOT 6V' X ��.�� .L Y1� TEL NO. � SANI/F TEL. TEL. NO. CITV LIC. NO. NO.OF� NOW ON LOT EXISiING6LDG. ��SID��%��- Separate permits are tequired for electric, plumbing and heating work. u V r�.'1.,,�v "AD:t�. :�pv.�tR�T iJBGC I i1F.,1 I hereby acknowledge that I have read this application antl state that the above intormation is correct antl agree to comply with all laws reguleting building constructian, antl I shall not employ any person in violation of the wOrkman's compensation laws of the State of Californie. I hereby certify that I am properlV �icensetl as a contractor under the Staie of California Business antl Profassions Cotle, Divislon 3, Chapter 9, antl that such licenses 5�e in full torce antl affact, or I am axempt from the provisions of the State of California 8usiness antl Professions Code, Division 3, Chapier 9. Sie�amre of� � 1��CL. Perm(ttae ��5 � «�'�3 Authorizetl Age 1,271 8/17/79 109.05 TL• APPLICATION FOR STRUCTURAL PERMIT ftE E E BV DATE RECEIVED DATE ISSUED "��'! i�'/ 7-%� A!p. NO. I I / ��' BUILDING /� /_ � ADDRE55 �tQ TRACT ,I� FIRE 20NE i APPflOVED ZONE 0 NO.OF PLAN$ VARDSAPPqOVED �OT 7 � I B SI�CL�� ALUE l 3 ROVP / DATE � USE OF NEW BUILDING VARDS APPflOVED ACCESSORV BUILDING R. SIDE � � FT ?) F L SIDE � FT. F' REA(i � FT. C! F' DI5iANCE eET. BET. MAIN & MAIN BLIX3S. ACCESS. BLDGS VAR.# DATE C.U.P.# APPROVED � APPROVEO /6 � r� . .J� � _ THE AMO THE PURP� VAIVATION , n m > : m FT. cv f SHOWN UNDEA VALUATION IS FOfl m OF E5iABLISHING A PERMIT FEE ONLY: � PERMIT FEE $ `T Z�o-D N m PLAN CHECK $ � �, o rt/(/ .TAX ' $ � �� TOTAL PAI D S b � O � � COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT '-►. P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVEDBY PERMIT *j0 49163 For Applicant [o Fill in Completely — Use Ink Only �' BUILDING (�.6� �¢.('� � , ^ A,P, NO. �i � � �3I � �� ADDRESS �-R�)r��,(�v7 g OWNEROR � �� ADDftE55 .67 � �{f TENANT VNIT OR ADDRE 5 yb3 g�i f��,J SPACE NO. ��rr '`�,C�S7 NOL��I�� TI�.� � LOT `2 BLK. � J J dTV CANSTFUCTIONO C Pl✓T/y� /,p��y. � y�i.� NEW ADD ALTER REPAIfi MOVING DEMOLISH LENDER ��1�/y LCL � ll" \. S��na Ar� A � BRANCH /��6� (3�CL�. r'7.1/j OWNER C� �� ADDRESS � ILZ�J. ' S' �^• LUE ARCHITECT TEL. USE ESQD OR ENGINEER N ADDRESS 20NE TVPE GROUP CONTRACTOR �l![�J�Q'(�'T (L CO�..%SI • BV vE DATE I( �� 3' ADDRESS � I b �. 20� S�, /� ',�^ TEL. CITV L(J� r-1 E� No. (�4�y9r ^��r APPROVEDSETBACKS LIC. NO. �J�I J 2( LICVNO. SIZE � � NO.OF BLDGS. (FROM C/L TqEET) OF lOT � O � Z 2�� NOW ON LOT � FROM FTI EXISTINGBLDG. \�E51'��NJ� IAZ Q Separate permits are required for L SIDE FT. � electric, plumbing and heating work. REAR Fr. VSCO�F BUILoy�Tn SL�43� 7 P�'` VLW PLANNING ACTION �L DATE APPROVED A APPR ' �/� / 7 I hereby acknowletlge that I have �eatl ihis application and steie °i n that the ebove information is corract antl agree to comply with all laws regulatin8 building construction, and I shell not employ any person in violation of the workman's compensation laws of : the State of California. �� ` " m I hereby certify that I em praperly Iicensed as a contracto� under �J SQ. FT. � 7 the State of California Businezs antl Professions Cotle, Diviston 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In tull force entl effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLv: � am axempt from tha provisions of the Stete ot California Business VALUATION PERMIT FEE $ q antl Protassions Cod Divisi C pter . S D �n n Si neture of - �� 7LAN CHECK $ � �^ 0 Permittee S�aD TAX $ LL or ` � ( �� a U Authorizad Aga Date TOTA� PAID $ s� �O