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Home My WebLink About861 CAPITAL ST - Building Permits; r E , S � (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us � 77 FAlii DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 861 CAPITAL ST Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Parcei Number: 42239207 Zoning: Applicant: ELLIS, DAVID Address: 02012 PORT WEYBRIDGE -� , - - " . � � - _ - . � �Phone' (949)759-5088 - � � Status: ISSUED Applied: 17/07I2001 Issued: 17/07/2001 ISSUED BY: NEWPORT BEACH CA, ��-' Zlp: 92660 � �� , � , owner. LABBITT;:STEVEN R � � � � � , ; ,� Address 861, CAPITACST � - � � ` - , , - - � ,� �'�� . .�.�. . . . Phone: - ' . _ . , _ �-��.�� ' COSTA MESA, CA - _ . Zip: 92627 � - - - � � . . � � � Contractor: �D R�ELLIS ROOFING � �,� ` � ` �� Address:- 02012 PORTWEYBRIDGE � � � � - - Phone: '(949) 759-5088 � � � � � � NEWPORT BEACH CA � , - � Zip: , 92660 � License: ; 504943 , � ` ' � . Arch : � � � _ � Eng: � . . . Address: , � � � Address:� . � . . , � ,. - �Phone: � . . - � '- � Phone: � � � � . / , . " . " .. . . � . Zip: , ' � License: - �License: . �r - _ SCOPE OF PERMIT_ _ , , _; _ . , . � ' REROOF: T/O EXISTING SHAKE ROOF, 1/2"OSB SHTG, 1,LAYER 30# FELT, INSTALL 30-YEAR "TIMBERLINE" COMP � SHINGLES. 27 SQUARES ' ' FEE SUMMARY ' - ., - Plan Check: $0.00 - — - Calc Valuation: $e,000.00 Permit: $125.25 " Claim Valuation: , gs,000.00 � SMIP Res: $0.60 � �� SMIP Com: $0.00 Other: $0.00 Inspection: - $0.00 _ , Total: $125.85 �. - _ . � �� . : � . . SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: ' o NOTES: Rear 0- 0 � . Rear � 0- 0 Required: 0 PLANNING & ZONWG , _ Left 0- 0 Right 0- 0 , Left 0- 0 Right 0- 0 ' Proposetl: 0 � 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 it work is suspended or abandoned for a period of 1 BO 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 Inspectlons and final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 '6d&46 (8�W) WORKERS'COMPENSATION DECLARATON: � � � I hereby aHirm untler penalry of perjury ona of the tollowing tleclarations: ❑ I heve end will maiNain a certifiwte oi consent to self-Insure for workers' compensetion, as providetl for by section 3700 ot the Wbor Gode, tor the peAormance of Ihe work for which ihis permit is issuatl. ❑ I have and will maintain workers' compensation insurance, as reduiretl by section 3700 of Ihe Lebor Cade, for the pedortnance ot the work fw which this pertnil is issued. My workers' compensation Insurance carner and policy number are: Cartier: Policy Number: (This section neetl not be comp/eted /l (he permit is ve/ue0 a! one hundred dWlars ($100) or less.) � I cenity thet in the peAormance of the work for which this permit is issued, I shell not employ any person in any manner so as to becoma suDject to tha workers' compensatlon lews ot Califomia, end egree that ii I should bewme sub�ect to t�e workars' compensatlon provisions of Sedion 3700 oi the Labor Cade, I shall torthwlih comply with Ihese prov�is�ions. %�p �' Applicent Signeture: �`�'+`i/ � Da�e: �Ilr%`C � WARNINO: FAILUFiE TO SECURE WOHKERS' COMPENSATION OpVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIWIL PENALTIES AN� CIVIL FlNES UP TOONE HUNDRED T/N)USAND DOLLARE (E100,000), IN ADDRIIXJ TO THE COST OF CAMPENSATION, DAMAGES AS PROVIOED WR IN SECTIIXJ 3lOfi OF THE LABOR CODE, INTEREST, AND ATiORNE'fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eXirtn that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of fhe Business and Pmfessions Cotla, end my license is in full torce and eflect Lic. R CfJ4C(�i3 qass k L"�'1 ContractofsSigneture: 1 ll�.L�.� _ Date: tl�"7�C� CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm that there is e construction lending agency for the peAormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lendefs Neme: Lentlefs Adtlress: SignaWre: Date: OWNER-BUILDER DECLARAT10N5: I hereby atfirtn that unCer penalry oi perjury Ihat I am EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl ProFessions Code: Any ciry or counry which requires e permit to construct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, elso requires the applicaN for such permit to file e signetl stetemem that he or she Is licansed pursuant b the pmvisions of the Contredors License Law (Chapier 9(commencing with Sectlon 7000) oi DlWsion 3 of the Busineu end Profeuions Code) or thet he or she is exempt therefrom and the basis for the elle9ed eaemption. Any violation of Section 7031.5 by eny applicam for a pem+. subjects Ihe epplicant lo a civil penalry of not more Ihan five hundred dollars ($500).): ❑ I, es owner of the property, or my employees with wages as their sole compensetlon, WILL DO THE WORK, antl the structure Is not intentletl or oflered tor sale (Sec. 7044, Business antl Professions Cotle: The Contractors License Law does not apply to an owner of properry who builds or improves ihereon, and who does such work himself or herseN or through his or her own employees, provided ihat such improvements are not Intended or oHered for sale. H, howevar, the builtling or improvement is sold within one year ol completion, the owner-builder will have Ihe burden ol proving that he or she did not build or improve for purpose of sala.). ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to consiruct the project (Sec. 7044, Businass and Protessions Coda: The coniractors License Law does not apply to an owner of property who builds o� improves thereoq and who contracis for such proJect wlth e contractoqs) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Protessions Code tor this reason: Signature: Date: Owner ID venfied by dnver's license. ❑ Yes ❑ No Driver's Licensa No. Verificatlon of Ownership Dy (typa at tlacument, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICATION: Expires: ❑ I hereby certify that no exwvation tive (5) or more teet in depth into which e person is required to descentl, will be made in connec�ion with work euthorizetl by Ihis pertnit, and that no building siructure, scattolding, talsework, or tlemolition or dismantling thereof, will be more ihan thirty-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, lltle 8, Celifomia Atlminisirative Cotle). ❑ As owner-6uilder, I will not employ enyone to do work which would require e partnit irom the Division ot Indusirial Safety, as notetl above, unless such person has e pertnit to do such work trom the division. Signature: Date: Division of Industrial Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZ4710N OF ENTRY: I certiy under penalty of perjury that I hava reatl this epDlication end stete Ihat the informa�ion given is correct I agree to comply with ell state laws and ciry ordinances ralating to building construction, end authonze representatives of tne Ciry of Costa Mesa to enter upon the ebove-tlescnDed property for inspection puryoses. I agree not to occupy or allow occupancy of eny building authonzed by this permit until finel inspection. ��sj�eture Oi Legal Owner(s) Date ` ��=�i�_.�Tl�'dl _ i I 7'a � And/Or Au FidfliS�Applicant Data CODE �. INSPEGTIONTYVE 761fi Fixad System Final Fire Preven�ion 1266 Pool Spe Finel , 200 Final Ra-Roof 201 Final BlocklReteining Wall 202 Final Fectory Fire Place 203 Final Sign 204 Final Demolition D�re llIIQ1eLi � COUE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final euilding/Occupancy PdIE lI�E49 .. ,_� � ^. �6�� COS'f`A MESA BUILDING DEPARTMENT P.O.80X 31� � COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN COSTA MESA. CqLIFORNIA owNeRFabre Construction Ccrp. aTv ^Iermort Beach ARCHITECT OR ENGINEER pj� AD�RE55%O� W� Wk]1 LEGAL LOT DESCRIPT�ON ryQ, A.P. NO. 51ZE 6o x l02 OF LOT USE OF E%ISTING BL�G. LIQ NO. 3. TY LIC. 7• No. TEL. TRACT NO.OF BLDGS. lIOW ON LOT B/�CIt LINE FROM � Jj c[rvr[R oF sincci �Q REAR YARD �Z �Z '— �� N / SI�E VARD ' RIGHT � Z LEFT DESCRIPTION OF� WORK NEW X ALTERAT�ON I ADDITION REPAiR MOVING DEMOLiSH SIZIE 114�Lt5 SO f li ROOM$ p STORIES 1 FEE RECE111ED J �a.,..�_,�L� . `' fINANCE DEPT. � CITY OF COSTA MESA ' APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY /.'%iV/" I.J'Q '.] /I ' BUILOING �I �— ADORE55 ' COSTA MESA. CALIFORNIA FIRE ZONE [ BV CORRECTIONS 1 I XEREBV P C HEAD THIS APPLICATION ANO STAiE THAT TME I�BOVE IS COFRECT ArvO qGREE TO COMPLY WITH wLL CITY OROINFNCE$ ANO STTTE LAWS flEGULATING BUILDING CONSTRUC� nON. VA W ATION $ /� SIGNATURE OF PERMIT FEE S J(/ � PERMITTEE � � PLAN CHECK S ��S/ Li.do Co nstructi �orp. $ /�� AUTHORIZED AGENT � /� � TOTAL FEE S �L,s � i vers