HomeMy WebLinkAbout3128 BOSTON WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: $i2H BOSTON WY
Suite:
Vicinity:
Parcel Number:
Applicant:
Address:
Owner:
Address
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SETBACK:
MAIN STRUC
ACCESSORY
PARKING
NOTES:
Status: ISSUED
Applied: 04/02/2001
Issued: 04/02/2001
14169128 Zoning: '
RONALD ALEXANDER � --- iSSueo ev: Jl�c
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3057�YUKON AVE � � � ' � + ��' �= � ' � ' � '�
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COSTA MESA„C� j �� Zip: 92626 - , �� - � � j' � �
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�: ALEXANDER CONTRACTING
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Phone �'(714) 5223045
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EROOF RESIDENCE•450SF F �LAT ROO
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NOTICE: The work authorized by this parmit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authonzed under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapeetions end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration.of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2446-46 (fi/00)
WORKERS' COMPENSATION DECLARA710N: '
I hereby effirm under penalry of perjury one o� the tollowing declaretions: � �
❑ I have and will maintain e cani0cete of consent to self-Insure tor workers' compensatlon, es provitled for by section 3700 of the Lebor Code, tor the pertormance of ihe
work tor which this pertnit is issuetl. .
❑ I have antl will maintain workers' compensation insurance, as required by section 3700 of Iha Lebor Cotle, for the perto�anca of the work tor which Ihis pertnit is issuea.
My workers' compansatlon Insurence carner end policy number ere: y
Carrier. . S� `N �9 (/ IM�. Policy Number. �J ��'f�� � D7
(This section need no�etetl i/ Me pemut is velued et one huntlretl dollaro ($1 or Iess.J
❑ I certity that in the pertormance of ihe work for which ihis pertnit is issued, I shall not employ any person in eny manner so as lo become subject to ihe workers'
compensetion laws oi Califo a d ree Ihat il I should become subiect to the workars',compensa[ion provisions of Sectlon 3700 of the Labor Code, I shall torihwith
comply with ihese provision ��, � �_ A�
Applicent Signature: ���^7�++�� / Date: T' ��" �
� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND pVIL FWES UP TOONE HUNORED
TViOUSAND DOLLARE (5100,000�, IN ADDITIIXJ TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED f-0R IN SECiION 3]O6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I I hereby aHirtn Ihat I am IicensgQ y��r provisions of Chapter 9(commencing with Section 7 ) oF Division 3 of the eusiness and Pjyfessions Code, antl my license is in tull
force end eHecl Lic. A 9�� •• Ciass a (j
� Contrectofs Signature:�� i� �, Date: �'� ' O�
CONSTRUCTION LENDING AGENCY:
❑ I hareby ettirm ihat Ihere is e consWction lentling agency for the peAormance of the work for which ihis permit is issuetl. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address:
Signature: Date:
OWNER-BUILDER DECIARAT10N5:
I hereby eHirtn Ihat under penalty of perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry which requires e permit to construct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, also requires ihe applicant for such parmit
to file a signad statement thet he or she Is IlcenseG Dursuant to ihe provisions of the Contradors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the
Business end Professions Code) or that he or she is exempt therefrom and tha basls for ihe alle9ed exemption. Any violation ot Section 7031.5 6y any applicant for a permlt
subjecis the epplicant to a civil penalry of not more than five hundred dollars ($500).):
❑ I, as owner ot iha property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not intended or oHered for sale (Sec.
7044, Business antl Professions Code: The Coniractors License Law does not apply �o an owner of properiy who builds or improves Ihereon, end who does such work
himsetl or herseH or through his or her own employees, provided that such ImD�ovements ere not intendetl or oHered far sele. tl, however, ihe building or improvemeN is
sold within one year oi comple�ion, ihe owner-builder will have the burden oi proving ihat ha or she tlid no� build or improve for purpose ot sale.).
� I, as owner of Iha property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS b construct Ihe project (Sec 7044, Business antl Prolessions
Cotle: The contrectors License Law does not apply to an owner of property w�o 6uilds or Improves thereon, antl who coniracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt untler sea 8usiness antl Protassioas Code lor this reason:
SignaWre: Date:
Owner ID venfied by dnvefs license. ❑ Ves ❑ No Driver s License No. Expires:
Veriflcation oi Ownership hy (type oi tlaumenL i.e. - property tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
� I hereby certify that no excavation five (5) or more teet in depth into w�ich a person is required to descend, will be mada in connection wi�h work authorized 6y Ihis
pertniL and that no 6uiltling s�ruIXure, scallolding, ialsework, or demolition or dismantling thereof, will 6e more than ihirry-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec.
345, Title e, California Adminis�rative Cotle).
❑ As owner-builder, I will not employ enyone to do work which would require a permit irom ihe Division of Industnal Sefety, as noted above, unless such person has a
permit to tlo such work from the division. �
Signature: Date:
Division ot Industrial Sefery Permit Number.
CERIIFICATE OF COMPLIANCE AND AUiHORIZATION.OF EMAY: I cenity under penalty of perjury ihat I have read tnis applica�ion antl sta�e ihat the infortnation given is
correci. V agree to wmply with afl state laws a`M city ordinances relaling to Cuilding consiruction, a� autfiorize representatives ot �he City of Costa Mesa to enter upon the
above-described property for inspection purposes. I egree not Po occupy or ailow occupency of any building authonzed by this permi� until final inspection.
I ignature Ot Legal Owner(s) Date --
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And/Or Authorizetl Applicant Date
COUE t. INSPECTIONTYPE
1616 Fized System Final Fire Preven�ion
1266
200
201
202
203
Pool Spe Finel
Final Re-Root
Final Block/Retaining Wall
Final Factory Fire Place
Final Sign
204 Final Demolition
Q'i�,' T R
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CODE� INSVECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecirical
212 Final Fire Prevention
220 Final Pianning Approval
222 Final Site
250 Final Building/Occupancy
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GAS
ER KASELL, John K.
ADDRESS Bost
No. 141-691-28 LOT 42 TRACT 5005 F1RE ZONE
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SPpINKLING SVSTEM
MISCELLaNE0U5
ROUGH HEPTING RN� AIF CON01T
UNOERGROUNO LI POWER
ROIIGH WIRING
BOHO BEnM � STEEL REI
SMEATNING
FRAME ANO FLASMING
L�TMING — IN n 1
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STRUCTUR1l. FIN�L
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ING. FINr1L ANO WS TE
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fpl in Completely — Use I�ilc Only
OWNER cJQE'fI
MAIL
ADDRESS ��
CITV ��%/t
CONSTRUGTION
LENDER
BRANCH
ADDRESS
ARCHITECT �
K KffSELL
B�J/ (N�( Wf�%
���Q TEL
J!T NO.
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BUILDING
ADDRESS
OWNER
L. S
FIRE
CONTRACTOR (�W [(.L�lL �
ADDRESS
TEI. �
CITV NO.
STATE CITV
LIC. NO. LIC. NO.
SIZE NO.OF BLOGS.
OF LOT NOW ON LOT
USE OF
EXISTING BLDG.
Separate permits are required for
' electric, plun�bing and heating work.
USE OF BUILDING AND �NORK TO BE PERFORMED
��
�W
��
1 hereby acknowledge that I heve reatl this epplleation and stete
Mat ihe above Informatlon is correct and aprae to comply wiih
all laws regulatinp buildi�B construetlon, and I shall not employ
any person In vlolation of the workman's compenzation laws of
Me Stau of California.
I �ereby certify That I am D/oDarly Iicansetl as a contractor under
ihe Stete o7 Calffornia BYs�ness end Professions Code, Division 3,
Chapter 9, antl that such Iicenses are in full force antl effect, or I
am exemDt 11om tha pro�Isions of the State o4 California Bus{neaq
and Profeuions Cotle, DIV�sion 3, Chapter 9.
Sfpnature of�// ,(�`�^�i i p// '
Permittee ��1_L %KJ
Authorizetl ABeni �
VAR. �
FORSTRUCTURAL
DATE RECENED pp�
/ NO.OF USE OF NEW
PLANS gUILDING ��� pL
'APPROVED VARDSAPPROVED
IUILDING ACCESSORV BUILDIN
STREET)
IDATE
APPROVED
N
n
m
i
m
SQ. FT. cmi
THE AMOUNT SHOWN UNDER VA�UATION IS FOR m
THE PURPO6E OF E5TABLISHING A PERMR FEE ONLV:
n
VALUATION PERMIT FEE E a
♦ in
DO PLANCHECK S '�� o
$ �'�—� TAX E �O �
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TOTALPAID § �S�
. - �� �o�;�, � FEE RECEIVED �
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GOSTA MESA BUILDING-SAFEfY DEPARTMENT � J
P;o. Bo= 9;� =o�A Meap. �A�,FOR��A FINANCE DEPT.
f�ITY OF COSTA MESp
For Applican► fo Fill In Complefely PPLICATION FOR PERMIT
TYPE OR PRiNT ' � BUILDING
For Office Use Only
BUILDING
,ADDRE55 l28 BOStOY> >�?�v �
R6CEIPT NO.
. COSTA MESA, CALIFORNIA ' j
. RECBIV GY pAT[p6C VED DATEIBBUED
owr,ee i�orth ate a nartn�rshin d' ^� �—
� � BUILDINO �� -
MAIL 15939 ADDRE59
ADDRESS L�S Flores v � ' /�
�� TELr� / FIRE � / � _ (/ ✓
C�7y -'r� OULZti`C3,j.Y� V�� 1? V NO. 1 O '� =�NE TYPE �i GROUP O� !-
ARCHITECT C. HSller .��F.S%��'l. APPROVED
BY DATE
ORENGINEER NO.
ADDRE33 � a=�3hE' 3-m � ZONIN(i - `
ZO 6 NO.01 U860FN
. ' + � PLANB pYILDINs
V
CONTRACTOR B���BeT' COY1S t.. _T?j.0 • . T (''
�59j9 LasFlores oeecRimox� O ) ' I - J o Q �
ADDR689
QTV
�ountain V�l�ev A.P.NO.
11 . -' l - NOTE: NOEAVEOVERHANOBHALLBELE85THAN -
LIC. RO.G �. O'Y N�L �]_ n Z 90" TO HIDB B REAR P. L. ' '
9� XIZ I NOWontbt�ne EAVES
SIZE � � NO.opoLDa. ALLOWEO (U.B.C.REQUIREMENT)
OF LOT
YARDSAPPROVED YARDSAPPROVED �
USE OF � � YLOYJ@ MAIN BUIL�INO ACCESSORY BUILDING
EXISTING BLDO. - '
(FROM C/LSTR!!T1 '
SETBACK LfN¢ PROM FRONT FT. FT.
CENTER OP STREi REAR YARD
SIDE YARD I LEFT � I R16HT K� R. SIDB �-S FT. FT.'
' DESCRIPiION OF WORK �. s�oe .S Fr. F-r.
NEW X ALTERATION _ ADDITION REAR � I.S �. ' F7'. '
DISTANCi BET. BET. MAIN d
REPAIR MOVINp OEMOLISN MAIN BLDGB. ACCESS.BLDG9.
BUILDIN6 NO OF Vp'R�# � DATE�
SIZE 1259s f tROOMB BTORIE9 1 C. U. P. � APPROVED
EXTERIOR WALI� I ROOF MPR .
COVERING r�r.n COVERIN6, l�i � Br vw. OATE <o' `�" �
'USE OF BLJILDIN6 AN� WORK TO BE P6RFORMED"
sin 1e fam, res. with attach
garaae o
sq. Fr:
1 HEREBY ACK WL¢OO 1 HAVB p O THIB APPLIC�TION THE AMOUNT 9NOWN UNDEp VALUATION �8 FOR THH
ANO BTFTE T AT TXE AB 1 COqq6CT AND AOREE TO COM. PURPOSE OF HBTABLI6NIN0 A PEFM�T FEE ONLY. 0
PLY WITX A L CITY ORO NC ANO 6T 6 L�WB PiOUTATINO ypLl1AT10N m' �
BUIL�INO C NHTPOCTIO . , �. / � //�
N
- � PERMIT FEE $ �� �
SIGNATUR 'OF '� '
PERMITTE //� %�L � //,� m
s // ��� LA CHECK 7� o
+� e
AUTHORIZfiD A6ENT ' ` � TOTAL FEE $ �e� ^
1 r.ih,Y21-75��s�0� 8II4� *t**10.50
4000�
� " COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEI ATEf
BUILDING
� ADDRESS �/
OWNER � . `, O� A.P. NO �
MAIL BVILDING� /J(�� I
ADORESS A\ ADDRES Glf �
W W TE�. TFACT OOi
d U CITV NO. - ,
Z Q CANSffiU�lON W ADD A P
O N LENDER
am
J � BRANCH ' �
J � OWNER
m J ADDRE55
m ARCHITECT TEL. SE O
J a OR ENGINEER
U a FIRE
� w � ADDRES$ 20NE TV �.
a w APPROVEO
W Z CONTRACTOR Q �J� BY
J Q
m Z
J'� �+DDRESS
p w TEL. ZONE ^� P�� 2
Z � CITV NO. �'�
w O STATE CITY YARDS APPROV ED
y� LIC. NO. LIC. NO. MAIN BUILDING
7 O (FROM C/LSTflEET)
SI2E NO.OF BLDCaS.
OF LOT NOW ON LOT RONT FT.
USE OF
EXI5TING BLDG. g � � F
F SIZE OF NO. OF
Z NEW BIDG. ROOMS STORIES L. SIDE FT.
a EXTERIOR WALL ROOF
V COVERING COVERING REAR FT.
J USE OF BUI��ING ANO WORK TO BE PERFORMED DISTANCE BET.
a MAIN BLOGS.
a
a F�A�/Z� o c u.P.#w n
y APPROVED /1 �•�/�
C/
Z
�
UI hereby acknowletlga thet I have reatl this applicaiion antl state
� that the abova inSormatfon is correct and sgrea to comply with
� all laws �egulating bui101nB �onstruction, antl I shall not employ
F any Derson in violation of the workman's eompansation laws of
N ihe State ot Calitornia.
? I hereby certify that I em properly Iicansetl as e contractor under O SQ. FT.
i�e State ot Califomia Businesn antl Professions Cotle, Divisicn 3, 7 E AMOUNT SHOWN
Chapter 9, and that such licenses ara in full forca antl effect, or I THE PURPOSE OF ESTAE
am exempt from tha provisions of the State af Calitornta Business VALVATION �
antl Protessions Cotle Di 'sion 3. Ch2pte� �
/' ' PE
SIB�ature ot �
Parmittee $ p�
Authorizetl ABeni
TC
LOT �/ � CK
r' f�- G`�O�
VALUE
$
GPOUP ✓
�
DATE
USE OF NEW n Q
BUILDING �� �i7�
VARDS APPROV ED
BET. MAIN &
•
� w•
0
VALUATION IS FOF �
A PEFMIT FEE ONLV: m
¢
✓$ //� ,,,�� N
V ]
m
K g � E
0 � o
LL
$