HomeMy WebLinkAbout897 CAPITAL ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.cos�a-mesa.�,�yjLDING PERMIT
Job Address: SJ7 CAPITAL ST
Suile:
Vicini�y: . '
Primary0cc.' R3 � � '� �
Parcel Number: 422385�2 ,
npp�icant LOPFZ, MANUAL _
Address: 551 INDUSTRIAL RD
SAN CARLOS, CA
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owner CISNI=_�OS�,��A�
Address GO�IZYLEZ:^' �'
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Jr RETROFIT
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� Type oi ConsUuction: V-N
Zoning:
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY: •
Status: ISSUED
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Applied: 02/14/2006 "
Issued: 02/14/2006 _
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Phone: 800-400-0797 ���\ � �
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License: 627475 � � �� \�
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�L'icense: ��--"��.r.-�, , � _x ��
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"" SCOPE OF PERMIT
IE�SAME LOCATION AND SAME SIZE. RETROFITED
;E,1�PATIO DOOR WITHG SAME SIZE AND SAME LC
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I THE BE. REMOVE KITCHEN WIN}D(
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Valuation: � 1����� `--$9,3841C
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n Valuation: � 1� t_ $9,384.0
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NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-2b92) �-
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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inapeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiralion of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
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WpRKERS' COMPENSA710N DECLARA710N: _ �, ` �� '
I hereby aXirtn untler penalry of perjury one ot the followmg declarations: . � � .
❑ have end will maintain a certificace of consent to self-Insura tor workers' campensation, es providetl for by section 3700 of the Labor Code, for Ihe performance ol the
for which �his permit is issued.
1 have nd witl maintain workere' compensation insuranGe, as require n 700 of ��e Lebor G e. rtortnance of ihe work for which ihis permit is issued.
Ca�rier. 7
ction need not
i a
�ompensation la�
/ complywithlhes
Applicant Signeture�
at one hundred tlollers ($100) or Iess.J
padormance of the work for which Ihis permit is
7 of Calitornla, and agrae that if I shoulSj.pecomi
�AND DOLLARE ($100,OW), IN ADDITIdJ TO THE
LICEN ONTRACTORS DECLARATION:
�reby aHirm Ih � I em licensed under pr i ior
(orce a f . ic. k Z%
r's Signature: /'
Policy
Date: `
RAGEISUNLAWFULANDSHALLSU61 aNEMPLOVERTO
PENSATION,DAht4GE5ASPHOVIDEDFO CTION3]O60
9(commencing with Section 7000) of Divis'
� Class k
�o as to become subject to the workers'
f Section 3700 oi the Labor Code, I shall forihwith
2 //4/06
INAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
: LABOR CADE, INTEREST, ANDATTORNEY'S FEES.
Code, and my license is in full
CONSTRUCTION LENDING AGENCY:
❑ I here6y affirm that there is a consiruction lenaing agency for the performance of Ihe work for w�ich Ihis pertnit is issued. (Sac. 3097, Civil Code).
Lender'S Name: Lenders Adaress:
SgRaWre�. Date�.
OWNER-BUILDER DECLARATIONS:
1 he�eby aNirm that under penelty ot perjury that I am E%EMP7 FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professions
Code: Any city or county which requires a permit to constmct, alter, improve, demolish, or repair any strucWre, prior to its issuance, also requires Ihe applicant for such permit
to file a signed statement Ihet he or she is licensad pursuam ro the provisions ot ihe Contractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and P�ofessions Code) or that he or she is exempt thereirom end the besis for the alleged eaemption. Any violation ot Section 7031.5 by any applicant for a permit
sublects the applicant to a civil penelty of not more ihan five hundred dollars ($500).):
❑ I, as owner of the propetly, or my employees with wages as iheir sole compensetion, WILL DO THE WORK, and lhe structure is not in�ended or oHered for sale (Sec.
7044, Business antl Profe55ions Code: The Contrector5 License Law does no� apply to en owner of pmpeny who builds or improves ihereon, and who does such work
himseN or herselt or through his or her own employees, providetl that such improvements ere not IntefMetl a ottered br sale. If, however, the building or improvement is
sold within one yeer ot completion, the owner-builder will have the burden of proving that he or she did not build o� improve for purpose of sale.). '
❑ I, as owner ol ihe property, em EXCLUS��ELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the projed (Sec. 7044, 8usiness antl Professions
Cotle: The Gontrectors LicBnse Lew tloes not apply to an owner ot property who builds or Improves �hereon, and who coniracts for such project with e contraCtor(s)
license pursuant to ihe Conirectore License LawsJ.
❑ I am ezampt under sec, eusiness antl Proteuio�s Cotle tor this reason:
Sigr�ature: Date:
Owner ID venfied by dnveYs license. ❑ Yes ❑ No � Driver's License No. Ezpires:
Vedfication ot Ownership by (�ype ot document, i.e. - properry tax bill or tleed):
DIV�SION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certify that no axcavation five (5) or more feat in tlepih in�o which a person is requiretl to descenq will be made in connection with work authorized by Ihis
permit, and ihat no builtling sWCWre, scaHoltling, talsework, or demolition or tlismantling thereoi, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Titla 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit irom the Division of Industnel Satery, as noted above, unless such pereon hes e
permit to do such work from the division.
SignaWre: Date:
Division oi Intlusirial Safety Permit Number.
ICER7IFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: 1 certify untler peoalry ot perjury that l have read this application and state that the informatioo give� is I
corrBct I agree to comply with all state laws and city ordinances ralating to building construction, end authodze representatives of the City of Coste Mesa to enter upon the
aboVe-describetl property for inspection purposes. I agree not to occupy or allow occupancy of eny building euthorized by ihis permit until final inspeclion.
C�ii
yQpj�, INSPECTIONTYPE (
16y6 Fizetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Root
201 Final BIxWRetaining Wall
202 Final Fectory Fira Place
203 Final Sign
204 Final Demoliiion
2/K
INTITIRLS COOEI INSPECTIONTYPE
� ' 206 Final Mechanical -
20B Final Plumbing
� 210 � Final Electrical
212 Final Fire Preveniion
, 220 Final Planning Approval
222 Final Site _
, _ , , 250 Final Building/Occupancy
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.G�,4SLDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
isui
Job Address: 897 CAPITAL ST
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 42238502
Applicant' DAVILA, ELIAS
Address: 19651 EDUCATION LN.
HUNTINGTON BEACH,
Owner. CISNE
Address GONZAI
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Check:y r $0.00
Permih?', $111.25
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CA
2oning:
ISSUED BY:
Phone:_..f714)968-6135
Status: ISSUED
Applied: 10/25/2002
Issued: 10/25/2002
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Phone: (Z14) 968-6135 . � :.� ° •'�/', .� -,i� A
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SCOPE OF PERMIT ' � �e
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LACE SHTG AS NEEDED, 1 LAYER 30# FELT, APPLY "30-YEAR PRESTIQUE:COMP SHINGLES " 24 y
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.4v'�nTtYl .eT^F rv^nTlov !e'."1 �•"Y , i`.�li �' �� �
PRes��s�y���$0.�50 �,
� Com:�,`��4;n:$0�00
Other. �l��$0 00'
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✓aluation: ` ;��� � $a;aoo.00
Valuation: ' �� � Sa,aoo.00 �
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NOTICE: The work authorized 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 if work is not commenced within 180 days, or if work is suspended or abandoned
tor 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 Inspeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
..» o ��.�,�
WORKERS' COMPENSATION DECLARATION: �
I �ereby eHirtn under penalry oi perjury one oi ihe Following declarations:�
❑ I heve end will maintain a certiticate of consent to self�lnsure for workers' compensation, as provitled for Dy section 3700 of the Labor Code, tor the peAortnanca of the
/work for which this pertnit is issued.
�( I heve entl will malntain workers' cnmpensation insurance, es required by section 3700 of the La6or Code, br ihe pertortnance of the work tor whlch this permit is issuetl.
My workers' compensation Insurance carriar antl policy number are: I �����
Carrier. �� ��/---� � PoliCy Number, l �
(This section need not be cromplered i/ the permrt is va/ued et one huntlred tlollars ($100J or less.)
❑ I certify ihat in ihe peAormance of the work for which this pertnit is Issued, I shall not employ any person in any manner so es to become subject to the workers'
compenutlon laws of Californie, antl egree that it I should become subje he workers' compensation provisions oi Section 3700 of tha Labor Cotle, I shall fonhwith
comply with these provislons. �n �---y., �, �7
Applicant Signature: �X�r �� I� / Date: �. LS� ��
WARNING: FAILURE TO SECURE WORKERS' CAMPENSATION CAVEfiAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
TVi0U5AND DOl1ARE ($100,000), IN ADDITIqJ TO THE COST OF CAMPENSATION, �AM4GE5 AS PROVIDED FOF IN SECTION 3]W OF THE LAeOR CODE, IMEPEST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm ihat I am licensed untler provisions of Chappter�+q-7{(c��Lmm^�en^�cin rth Section 7000) ot Division 3 of ihe By� e rofessions Code, and my license is in full
force and eflect. Lic. #�E –�- •.�� Class aL� ��
Comraaors Signawre: �Q,�.� Date: � A�_ 7s� �02
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CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm that there is a consiruction lending agency for the peAormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lentler's Name: Lender's Address:
SignaWre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby attlrm ihat under penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business entl Profeuions
CoUe: Any ciry or county which requires a permit to consimct, alter, improve, demolish, or repair any stmcWre, prior to its issuance, also requires the applicant tor such pertnit
ro file e signetl statemant t�at ha or she is Ilcensed pursuant to the provisions ol the Coniractors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of iha
Business and Prolessions Cotle) or that he or she is exempl therefrom and 1he basis tor the alleged exemption. Any violation oi Section 7031.5 by any applicent for e permit
sublects ihe epplicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the propeny, or my employees wi�h wages es iheir sole compensation, WILL DO THE WORK, and Ihe sirudure is not intendetl or oHered tor sale (Sec.
7044, Business and Professions Code: The Coniractors License Law does no� aDPly Io an owner of pmperty who builds or improves thereon, entl who does such work
himself or herselt or thmugh his or her own employees, provitletl that such improvements ere not intendetl or oHered tor sale. If, however, the building or improvement is
sold wit�in one year oi completion, ihe ownerbuilder will have the hurden of proving thet he or she did not build or improve for puryose oi saleJ.
❑ I, es owner of the Droperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CON7RACTORS to consiruct the prqect (Sec. 7044, Business end Professions
Cotle: The coniractors License Lew does not apply to an owner ot property who builtls or improves thereon, antl who coniracts for such prolact with a conirector(s)
license pursuent to the Coniractors License Laws.). �
❑ I em ezempt under sec.
Signature:
Owner ID verified by dnvefs license. Ves ❑ No
Business end Pmtessions Code for this reeson:
Verification ot Ownership by (type of daument, i.e. - pmDerry tan bill or deed):
DIVISION OF INDUS7RIAL SAFE7Y PERMIT CERTIFICATON:
Driver's License No.
Date:
Expires:
❑ I hereby cehify that no excavation five (5) or more feet in depth into which e person is requiretl to descend, will be made in connection wlth work euthonzed by �his
pertnit, and that no 6uilding structure, scaHoltling, falsework, or tlemolition or dismantling thereof, will be more ihan thirty-six (36) faet high. (Chap. 3.2, Grp 2, Ar12, Sec.
341, Title 8, Celifornia Atlminisiretive Cotle).
❑ As owner-builtler, I will not employ enyone to do work which wouid require e permit irom the Division of Industrial Safery, es noted above, unless such person has e
permit to do such work from the division.
SignaNre: Date:
Division of Industrial Safety Permit Number.
CERTiFICATE OF COMPLIANCE ANO AUTHORIZATON OF EMRV: I certify under penalty of perjury that I have read this epDlication and state that the infortnation given is
correct I agree to wmpy with all state laws and ciry ordinances relating to builtling construction, end authorize representatives of the Ciry of Costa Mese to enter upon ihe
above-described property for inspection puryases. I egree not to occupy or allow occupency of eny building euthorized by this permit until final inspection.
SignaWre Ot Leg ner(s) Date
p . `'� �c� _ ��, —
AnNOr Authorized Applicant • at�
COUE 1, INSPECTIONTYPE
1616 Fixed System Final Fire Preven[ion
1288 Pool Spa Final
200 Finel RB-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 - Final Demolition
PAIE IMRI�LS
��—�1-02 �
CODE� INSPEC710NTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 FinelSite
250 Final Buildina/Occuoan�
PAIE
U�LS
� . �:. ' .
', :' .�. `' ;.. s��� � . � � .FEE � RECEIVED
� COSTA MESA BUILDING � DEPARTMENT � D4pY Z 1 t957 �-� �
P.,o. aox 3�� ! . FINANCE DEPT.
, COSTA MESA; CALIFORNIA � ` �CITY OF COSTA MESA�
FOR APPLICANT TO FILL IN � APPLICATION FOR PERMIT
BLIILDING g.t�- _ a� �,�� ST. � BUILDING ' -�
ADDRE55
COSTA MESA. CALIFORNIA. • FOR OFFICE USE ONLY
' 'l RECEIPT NO. pE L '
OWNER� ' ONS
RECEIVED BY �wTE RECEIVEO �pATE ISSUED
ADDRE559 L,¢ � ,v�-s � � � -a,- ��AY 31 195
TEL. I BIIILIJING
QTY �` �% NO./Y��7 %�� , qDORE55 � '
qRCNire - - ��c. , � ,COSTA MESA. CALIFORNIA
OR ENGINEER � ' ' � NO. � ,
. . , � . FIRE . � . .
A�DRE55 � ' ZONE � �
' ZONE NO.OF TYpE : GROUP
QTV LIC. ��/+�'�.. PLnNS'. . //
CONTRACTOR " NO. ���P �� pt
ADDRE55 ����I� TNO. ' � B�PROVED . DATE � �
�E�A� �or � � CORRECTIONS '
oescaiPnoN NO. �Z BLOCK ' TRACT�� '
A.P. NO. . ' . .. � . .
SIZE �/�'�/y �l } � ' No:oF e�oc5. �' ' •
OF LOTY • ��� /OC ���� NOW ON LOT. �
USE OF • , _ ' '
E%ISTING BLDG. �
SETBACN LINE FROM � ' � �
cervien of' sra[[i - � REAR YARD '�
. . -� / - . ' .'/ .
SI�E VARO RIGHT � LEFT /'
: . DESCRIPTION,OF WORK , - �
NEW A�TERATION � ADDITION
REPAIR MOVING DEMOLISH
BUILDING �J NO.OF � c •
ci�r �/�R ROOMS� .l STORIES / �
' � �1,�,�
I HEREBV TCKNOWLEDGE THPT I HR E REhO THIS
STATE THAT THE ABOVE IS COFRECT 4rvO AGREE TO
CITY OROINFNCES AND STATE L4W5 REGVLATING l
.�a� �/l ,
SIGNATURE OF C
PERMIT,TEE J
AUTHORIZED AGENT
i
LION AND
WITH'FLL � ,
9NSTRUC
�A��A1�oN a
� /? PERMIT FEE �S �
. / /(/ � PLAN CNECK $�. ��Z ^ ,
�
� � ' TOTAL FEE S 3 L — v°"'�