HomeMy WebLinkAbout288 BUCKNELL RD - Building Permits(714) 754-5273 • Fax (77q) 754-4b56 • www.ci.costa•mesa.�.IdLDING PERMIT 77 FAIA DRIVE, COSTA MESA, CA 92626
JobAddress: 2$$ BUCKNELL RD
Suile:
Viciniry: ROOF
Primary Occ: R-3 Dwellings/ Con9 Res <10 Type of Construction: V-N
Parcel Number: 14141116 Zoning:
Applicam; DANIELLE MOLISE
Address: 1653 SUPERIOR AVE
COSTA MESA, CA
Owner: RILEY, JAMES G
Address 288 BUCKNELL RD
COSTA MESA, CA
Contractor: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
COSTA MESA, CA
Zip: 92627
Arch :
Address:
2ip:
Phone;
License:
Phone: 949-642-7222
Zip: 92627
Phone:
Zip: 92626
Phone: 949-642-7222
License: 349686
Eng:
Address:
ISSUED BY:
Slatus: ISSUED
Applied: OB/09/2006
Issued: OB/092006
Phone:
License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 7/16" O.S.B., 1 LAYER OF 30# FELT, AND 30 YEAR, CLASS A G.A.F. SHINGLES. 29 S�UARES.
FEE SUMMARY
Plan Check: �0.00 Calc Valuation: S�,eoo.00
Permit: �15325 Claim Valuation: s�,eoo.00
SMIP Res: S0.78
SMIP Com: §0.00
Other: $0.00
Inspectian: $0.00
Total: $154.03
SETBACKS
MAINSTRUCTURE Pronl 0-0
ACCESSORY Front 0-0
PARKING Existin : 0
PI.ANNING & ZONING
Rear 0- 0 Lefl 0- 0
Rear 0- 0 Lefl 0- 0
Reauired: 0 Pr000sed: 0
Right 0-0
Righl 0- 0
NOTICE: The work authorized by ihis permil shall comply with all applicable handicap access requiremenis under Califomia statutes and related
regula�ions. (Ord. No. 92-28, § 7, 72-21-92)
EXPIRATION: This pertnit 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 dayg. ' '�
INSPEC710NS: In ortler tor the work euthorized under this permit to be consldered legal, such work must comply with all applicable codes, and all
requlred Inepeetiona pnd tinal epprovel must be ob�ainad. Fellure to obtaf� ��nspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (774) 754-5626
�
WORKERS'COMPENSAnON DEGLARAnON:
I hereby aflirtn under penalry af perjury one oi Ne tolbwing deGaretions: „ � I�I ���
❑ I �ave entl will maintain e cani�kate at wnsent to sell-Insure tor workers' compensation, es providetl lor by section 3700 0l tha Lebor Caae, for lhe peAormanca ot Ne
work for which ttiis pertnit is issue0.
� I fave entl will maintain workets' compensatbn insurance, es repulretl by soction 3700 of the Labor Cotle, for lha pertormance of the work tor wNch this pertnit is L55uetl.
�My workers' m ens tion Insurence carder tl policy number ere: ���y�r
Cerclei: � � �l/�� � 1Pblicy�Number._�- !d}CIJFVYd'
�R�Is secNon need not be comp/ete4 �� the permit is valued e! one hundred dollers (S /00) or Iess.J �
❑ I certily that in t�e peAormance of the work tor which this pertnit Is issuod, I shell not employ eny person in any manner so es to bocome subject to the workeB'
compen5ailon laws af Cnlifomia, entl agree thai if I shoultl �etome sub�eCl to Iha warkere' compensatlon prOvisions ol Sec�lon 3700 oi Ihe Lebor Cotle, I 5hell forthwith
comply with t� vi ' . . � ��� �n �
Aodi�jt�SigneWre: �� �� � Date:.
WA/,4 . FAICGf1E TO SECURE 1YOWCERS' WMPFNSRT�OM Cd/ERAGE IS UMAWFUL AND &fALL SUBIECT AN YFA-ZOCW WNAL PENPLTIES AND CML FlNES UP TOONE HUNDRED
AND DOLIARE (5100,0OO�.IN AOdTqN TO THE 00ST OF COMPENSATipN, OMNGE50.S PROVIDED FOR IN S�+TION 31O00F THE LABOR CODE, INiEREST, qND ATTORNEVS FEES.
LICENSED CONTRACTORS DELLARATION:
Chapter 9(commencing with Sec�lon 7000) ol DlNsion 3 o4�he.Business entl Prolessions Cotle, end my license Is In full
, �rCla9s.Y� i�— ni �%
CONSTRUCTION LENDING AGENCY:
❑ I hureby aHirtn that thoro is e censtruction lending agency tor t�e poAormence ol �he work lor which ihis parmit is issueQ (Sec. 3097, Civil Code).
Lender's Neme: Lentler's Adtlress:
SigneWre:
OWNER-BUILDER DECIARATIONS:
Date:
I hereby ettirm ihat under penelry of Per�ury �hat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for lhe foilowing reason (Sec. 7031.5, Business end Profeulons
Code: Any ciry or wunry which requires e permit to consWct, alter, Improve, tlemolish, or repair any simcWre, prior to ils issuance, elso requires Ihe applicant tor such permil
lo file e signetl stetement Ihet he or she is Iicense0 pureuant to Ihe provisions of the Contrectors License Lew (Chaptar 9(commencing with Sectlon 7000) ol Division 3 at the
Business entl ProFessions Coda) or thet he or she is e:empt therefrom end the Uasis for the ellegetl ezemption. Any violetion of Section 7031.5 by any epplicant for e Dertnit
subjects the epplicant to a civil panatly ot not more Ihan fiva hundreA dollars (3500)J:
❑ I, es owner ot t�e properry, or my employees vrith wages as their sole wmpensation, WILL DO TME WORK, and Ihe siructure Is not Intendetl or oHeretl for ula (Sec.
7044, Busineu and Professions Coae: The Contractors License Lew tloes not appty to an owner ol properry who builds or Improves I�ereon, and who tloes such work
himsetl or herself or Ihmugh his or her own employees, pmvided that such improvements are no1 inlen0etl or offered tor sale. If, however, Ne 6uilainq or improvement is
sold within one year oi comple�ion, ihe ownerbuilder will have the burden ot pmving tha� he or she did not build or improve for purpose of sale.).
❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sac. 7044, Business antl Professions
Code: The contractors Llcense �ew does not appty to en owner ol propeny who build5 Or improves iharaon, and who contracts br 5uth prqect with e conlracior(s)
license pursuent to the ContreF�ors Ucense LawsJ.
❑ I am exempt under sec. Business and Professions CoAe for this reeson:
Siqnature: Date:
Owner ID verified by drivef51it0nse, ❑ Yes ❑ No Drivers License No.
VenliceUon ol Ownership by (type of tlocumenL i.e. - properry tax bill or tleetl):
Expires:
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICA710N:
❑ I hereby certity Ihat no excevaU� �h'e (5) w more feet in tlepth into which a person is require0 Io Cescend, will be me0e In connectlon with work authodzed by Ihis
permit, end that no building slNctura, scaHoltling, falsework, or demoliiion or tlismamling Ihereoi. will be more Ihan thirty-six (38) feet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Califomia Atlminfs«ative Cotle). .
❑ As ownerbuilder, I will not employ enyone to tlo work which woultl requim e permit fmm lhe Division of Intlusiriel Setety, es noled ebove, unless such person hes e
pertnit to do such work irom the tlivision.
SigneWre: Date:
Division of Industnal Salery Pormil Numbar:
CERi1FlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMRY: I certity under penalty of perjury �hat I have read ihis epplication and state ihat t�e infortnation given is
correct. I agree to compty wilh ell stete laws arW ciry ortlinances rela�ing m building consiruction, en0 eNhodze representetives of ihe Ciry of Coste Mesa to emer upon Ihe
ebove-descnbed propetly for inspecdon purposes. I agree not to occupy or allow occupancy ol eny builtling eu�horized by ihis permit umil linel inspection.
CQOE 11. NISPECTIONTYVE -
1818 Fiaed System FinalFim Pr6�ention
12fi8 Pool Spa Final
200 Finel Re-Rooi
201 FIneI BIocWRetalnlnp Well
202 Final Fectory Fire Place
203
204
Finel Sign
Finel DamoliUon
.mt
jiQQE� INSPECTI�NttPE
206 Final Mechanical
20B Final Plumbing
210 Finel EleciriCel
212 Finel Fire Prevention
220 Final Planning Appraval
222 Final Site
250 Finel Building/Occupency
■�
QALF V�9
PBOJECT AUOflESS: 2 B 8 H U�-{� NF.LL RD UNIT:
OWNEH'SNRME:RILEY JAMES G
aooeess:?.88 BiJCRNELL RD
COSTA MESA,CA 92626
(714)540-5595
APCH/ENGINEEX: flFG.NO.:
ADONE55: UNIT:
PEHMITTEE:DIAL ONE SONSHINF. PLMB. (714)523-•9219
aooness:10537 DALE AV
STANTON CA 92626
LICENSEU CONTBACTOP OECUNATION: I here�y aifirm tha� I am lic¢nsed under Orovisions of ChaD�er 9(commencing wii� Sec�ion
7000) o� �ivisan 3 oi the Business antl Pmlessions Code, antl my license is in Wlllarce antl efleci.
ciTvuc.:0�45�48�9q sTnreuc:?50716 ��,5 C36
Oa�e: 1—�_� Signature: _ _ _ —
WOPNEBS' COMPENSATION OECIANATION: I here�y a��if � t I nave a cenilicate ol consent to se -ins a nilicate al workers'
'ompensalio � te. �- Cep1lied coOY �heteof (Seclio W. LaE
OLICY N�. ��4 � p Y V E%P. DRTE: � I O I I9 �i
comrnNv: H E PUB L I C
❑ Certified toDY �5 h¢reUy lumishetl. � Certitie0 toOY is IileU wilh �he C y Buil DivisfOn.
Daie: 1 �Z-2�� J ApDG�anl:
E%EMPTION fROM WOBKEBS' COMPENSATION OECUflpTION. Qh section nee0 noI be comple�M it ihe perrin is im o nOreO �5100� or iess�.
I ce�ily ��at in Ihe pedorman[e ol Ihe work �or wnich I�is pe �5 issuetl. I s�all nol emDloy any perwn n ner so as �a become
su�ject Io I�e Wo�kers' ComOensalion Laws ol Cah�omia.
Date: SignaNre:
NOTILE: II, aller making I�is declaralion, you s�oultl become su�lect Io Ihe Workers' ComDensalion provisions o� Ihe La�or
Cotle. you musl Iori�with comply wilh such pmvisions or Ihis permil shall be tleemetl revoketl.
CONSTHUCTION LENDING pGENCY: I here�y allirm thai �here is a cons�mc�ion lentling agency for ihe Oerlormance oi Ihe work lor
which I�is 0crmil is issuetl (Semion� 3097, Civ. C�.
IENOEX:
nooness:
OWNEP BUILOEB OECIAflFTION: I hereby allirm ��a� I am e�empl Imm the Conirac�ors' State License Law �or �he lollowinp reason
�Seciion 7031.5 Business anG Pmfessional Cotle: Any city ol county whicM1 repuires a permi� ro cons�mc�, alter, impmve. demolis�, or
�e0air any slmcture. �rior to its issuanw. also r¢Quires ��e aD0licant br such permii �o lile a signeG 5latemenl that �e/s�e is Iicen5e0
Dursuan� to I�e pmvision5 0l t�¢ Cantracrors' Stare License Law �Cnaple� 9(commencinp vni� Sectian 7000) o� Oivition 3 0� t�e Busineu
and Pwlezuon5 CaOe� or I�ai �e/she is ezempi �hereimm and ihe basis lor ih¢ all¢geG exempiion. Fny dolation o� Seciion 703t5 Gy
, any applitani lOr a p¢rmii Su�le��s I�e applicani lo a tivil penalry ol not more t�an Irve hunOr¢E tlollars (SS110�.
❑ 1, as owner al ihe D�oVetly or my employees wil� wages as their Sole compensation, will do �he work, and I�e
stmcmre is not imenaea ar oneretl for saie �Seclion 70aa, Busineu ana Pmiessional Cotle: ihe Cantracmrs' Stale License Law
Eo¢5 nol aODN Io an owner of a pmperly wM �uilas Ot impwv¢5 I�ereOn, anG who dDeS SUth wofk �imsel�/�er5elt af ��wugh
nis or ner own employees. pmvitle0 that such impmvemenls are nol inlen0etl or oflered tor sale. Ii, however ine huiltling or
im0�ovement is 5014 wilhin ane year ol completian, ihe owner wi0 have t�e burtlen o� pmving he/s�e di0 no� Euild or imD�ove
lor ihe purpose ol sale�.
I, as owner oi �he pmperiy, am exclusively con�racting wilh licensed conlraclors Io consimc� �he pmlec� (Seclion 7044, Business
❑ antl Pmlessions Cade: The Contractars' Slate License Law Qaes noi apply �o an owner oi propetly who bui105 or impmves lhereon
and whn cnnVacis lar Suth O�ole��s wii� d LOn��ac�o�(s�liC¢n5¢ pU�SUan�tO Ih¢ Co�Irdtb�5' $�ate License Law�. I am aware
�hal pioo� o1lAeir Wo�ker's Compensation in5urance ShoWG Oe pmvi4e0 lo me.
� I am exempl unAer Section: B. 8 P. C.
�of IhiS rCd50n:
Date: Ownec
I do hereby ceriily ihal I am aware al and unaer51an0 ihe re0uiremenl5 0l Cahiomia Heal�h an0 Salery Cotle S¢ctions 25505. 25533, anE
2559C an0 I�alloranyluiure builtling oaUpanlwilVwill noi�tirtle one�neea l0 tampty vnih saitl Slaie taUeS antl Ih¢ r¢Quir¢menlstOra
permi� toi consimction or mo0dica�ian imm �he Pir Oualiiy Managemenl Districi. flesiaen�ial cans�mction aDPlications are eeemD� �rom
I�ese pmvisions.
Dale: ApPliCani:
1 �ere0y cerbly ��a� I �ave rea0 Nis appAcation anU s�ale itut t�e a�ove inlormation is mrr¢cL 1 agree Io compty vnlh all ciiy anA couniy
oremancesanUstatelavrsr¢Ialinglo�uil0ingcon5imctionan0�ereEyauRwr¢ere0resenla�ives IA¢ciiytaen�eruponiheabove-men�ionea
pmpeny lar inspeclian purposes
oa�e� ���� signawre:
orivers �mense ar Socia� Securi�y x:
i6nL46 Wlnb—Builtling: Green—Cotle Enbrcemenl'. Canary—Appl¢anl; Pink—Revenue; Goltlenrotl—Assassor
CITY OF COSTA MESA — BUILDING PERMIT P�xM N; Y Ubs14y
PERMIT NO; P 063149 PLAN CHECK NO; N � i; rv Surr; n
CONSTRUCTION TYPE; PERMIT TYPE; PLU PURPOS�:; OTA
JOB DESCRIPTION ; COPPE}7 REPIPE OF POTABLE H 6 C WATER SQ FT:
CLAIM VALUE; CALC—VALUE; GkOfJP OCC; /
COMNENTS: WATER REPIPE OF EXIS'I'ING SFD
�%# iE i(- %� �lE �l( k iE iE �1E iF iE i( lE iE iF i( �)F if �k� #%�M� if K�%# #-lE iF X- M� if �M� i( i( �lf 7F �N �lE-1E i( #±(� %9F iE �N� # K lf i( �%�Jf i( 1( %�% �7Fi( lf lf �k �#� �ff iE 3( df 9E �% )(� iQ 1E # 1( iF #
Z O N I N G R E Q U I R E M E N'f S
S E 7' B A C K 5
------------ MAIN BUILDING ---------- --------- ACCESSORY HUII�DING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN AGHT: FT ZN LEFT; FT IN RGHT: FT IN
PARFtING REp • PkOV; PARCEL; 14141116 ZNE; REF NO;
PLANNZNG Ni3'1'ES>
i �
iE if IE iE iE if 1E iE 1E iE iE if if if !k iE iF 1E ih iE It 1E 3E !E IElf it iE fE IE iE if 1E 3f ff # fh k iE fE 1E iF # i! # iF iP fF iE if lklh #�IF if�iF fE 1F !f 1! i(� iE if 3E # 3E iE 1F # iF if iE 1E Ik iE ##f # iF
D E V E L O P M E N T S E R V I C E S��R E Q U I k E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPkOVED BY ; DATE;
APPLICATION ISSUED BY: � DATE; �
lkiE�7lit3FiFif�ifiElE7ffFiElEiflFiFlf!(�iFihlE�aiE i 3Fii3li2 � 7FiF�iFiF3F F�S�1� TF3e F1��iF �it�'Fit7F14fEif1kll�lFi(�iFK�il-n- - lEif
ifitiEitk7EiEiE3E1E%ifi41Fif1EiE7f%�N�K�iEifih##kif-ItiE#fEifif!llkiFiEiEiFihitk iEiE#�iE#iFi(fE1fiFIF1FIhHffif#iPifit�#iF�f�1EiliflEiEiFiEi4iE!(•�F
LEGALIZATION:N F E E S U,M M AfR Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHA�IIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
7.00
25%
2�.0�
SMIP/NON—kE5
Bt1ILDING—DIV—> PERMIT I5SI]E PLAN—CHECK TOTAL PAID D[JE
TOTALS----> 7.00 20.00 O.UO 27,U0 27.00 ,00
REVENUE DIVISIUN TOTALS--> COLLECTED; 27,00 OVER/SHORT; ,00
BLDG PMT PLUMBIN6 ELECTftIC MECHANIC FIRE SMIP/TOT GRADING FLAN—CHECK
z�.00
Ik if 1k 1E iE if 1f 7F !F 1f �h !F')E iF ik il' M' 1(� if !k 1F iElE %' 1f 1f iE 7E If lE if 7k 1f iE ik 1E 1f'll' iE iF iE ih 1F i!' 1Fif 3E iE if iE 1f 1E IE if �lf' k 1hlE 3E i(' IE # if 74 i%?F iE iE ib # 1E ikl4 #!E K' iE if- iE
I N D I V Z D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 WATER RE—PIPE 7,00 7,00
END OF FEES
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JUL 2 21993
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\0. - Date �- -I- -I�- - - - -- --- ----',
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COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31]
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
ADD EI55 2�� �C�3�' • �•
COSTA MESA. CALIFORNIA �
OWNER hiesa Highlands, Inc �
MAIL 1555 P1.acen ia.
CITV +�
ARCHITECT
nooa
K.
AOD�
LEG�L
OESCflIPTION
A.P. NO.
Beach, Cal. No: hiI 6
9$IIB LIC.
NO.
98i0E
ons . Co CITV LIC.
NO.
$B�I18 wEn� 99IfIB
NO.OF B10G5.
USE OF
EXISTING 9LDG.
SETBRCN LINE FROM C ,
ccHrEa or s�ncer JO REAR VARD 2S
SIDE YARD RIGHT 5'-6�� LEFT J��On
DESCRIPTION OF WORK �
NEW ]� ALTERATION AODITION
REPAIR � MOVING DEMOLISH
5 ZIE DING ��� � O ROOMS 6 STORIES 1
EXTERIOR WALL i ROOF L�1�
COVERING SYuCCO COVERING HOOd SlaGneS
USE OF NEW
BUILDING Residence & att. garage
�I� �55�
,�- �-��
. . ._ l�_. .
-�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
L �
BUIL9ING
ADDRESS
COSTA MESA. CALIFORNIA
APPFOVED
ev onre
CORRECTIONS
STaTE�TH.�T THEvA80VE IS CORRECT��ND^�GFEE TO COMPIY WITM ALl pwpose ot eslablishing a permit fee only.
CITV OROININCE9 ANO ST<TE L<WS REGVL�TING BUILOING CONSTRUC�
iior+. . V qLUATION
'SIGNATURE OF PERMiT FEE S 3S�OO
PERMITTEE 15,967��� 1 / � J�
PLAN CHECK S
g �/�
AUTHORIZEO AGENT TOTAL FEE $ 52�]y �µ�