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Home My WebLink About210 BROADWAY - Building Permits� (714) 754-5273 • Fa�c (714) 754d856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 BUILDING PERMIT Job nddress: 210 BROADWAY Suite: Vicinity: Parcel Number: 42540303 Applicant: CRISTIN, MICHAEL Address: 70951 S WONDERVIEW DR OR4NGE, CA Owner: CRISTIN, MICHAEL Address 10951 S WONDERVIEW DR ORANGE,CA Contractor. O W N E R-B U I LD ER Address: Zip: Arch : Address: Zoning: Phone: 714-871-4300 Zip: 92869 Phone: 714-871-4300 Zip: 92869 Phone: License: 000000 Eng: � Address: ISSUED BY: StaWs: ISSUED Applied: 11/30/2004 Issued: 11/30/2004 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF INSTALL 1/2" PLYWOOD, 1-30L6 FELT AND 30 YEAR COMP. SHINGLES Plan Check: $0.00 Permit: $63.15 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $63.65 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pro osed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $1,600.00 $1,aoo.o0 NOTICE: The work authorized by this pgrmit shall comply with all applicable handicap access requiremenis 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 for a period of 180 days. INSPEC710NS: In order for Ihe work authorized under this permit to be considered legal, such work must compiy with atl applicable codes, and all requlred inepeetiona and final approvel must be oblained. Failure �o obtain inspections and final approval will result in Ihe ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 taaase �e�oo� WORKERS' COMPENSATION DECLARATION: . '� � �' � I hereby attirtn untler pena�ry ai per�ury one of the tollowing tleclaretions: ❑ I heve entl will maimeln e certificate of consent to setl-Insure tor workers' compensatlon, es Orovided tor by section 3700 of the Labo� Code, tor ihe pertormance of the work for whic� t�is permit is issued. ❑ I have end wlll main�Bin workers' compensation insurance, as required by sectlon 3700 ot t�e Lebor Code, for Ne pedortnance of t�e wodc br w�ich this pertnit is issued. My workers' compensatlon Insurance carrier end policy number are: Carner. Policy Number. (This secflon neetl not be Gomple(ed i! fhe permit is valued af one hundred dollars ($100) or Iess.J ❑ I certify that in the p9dormance of t�e work for which this Oermit is issued I shall not employ eny pereon in any manner so as to becoma subject to Ihe workers' compensation lews 0� California, entl agree that Ii I should become sub�ect to �he workers' compensation provislons of Section 3700 0l ihe Labor Code, I shall forthwith comply with �hese O�ovisians. Applicant Sipneture: Date: WARNIN�: FAILURE TO SECURE WORKERS' fAMPENSATION COVERAGE IS UNUWFUL rWD SHALL SUBJECi AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED TMOUSAND OOLLARE (5100.OW). IN ADDITIW TO THE COST OF COMPENSATIqJ, DMMGES AS PROVIOED FOP IN SECiION 31060F TME LABOR CODE, IMEREST, AN� ATTOFW E1"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn Ihat I am Ilcensed under provisions of Chapter 9(wmmencing with Section 7000j ot Division 3 ot Ihe Business and PmfesSions Code, and my license Is in tull force antl ettect. Lic. N Class x Contrectofs Signe�ure: Oate: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that tdere is a consiruction lending agency for the pertormance ol the work br which this pertni� is issued. (Sec. 3097, Civil Code). Lenders Name: .. LendeYs Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aftirm Ihet under penalty of perjury thet I am E%EMPT FROM TME CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Protesslons Cotle: Any ciry or county which requires a pertnit to construct, elter, Improve, demolish, or repair any strucNre, pdor to its issuance, elso requires the applicant tor such pertnit m file e signetl stetement Net he or she Is licensed pursuent ro Ihe provislons of the Conirectors License Law (Chapter 9(wmmencing wlth SecNon 7000) ol Division 3 of the Business antl Prolessions Cotle) or �hat he or she is exempt therefrom and tha besis for the elleged ezemption. Any violation af Sectlon 7031.5 by eny applicent for a pertnit s ects the aDP�icent to e civil penelry of not more than five hundred dollars ($500).): 1, as owner af Ihe D�aDerty, or my empinyeas with wagas as thelr sole compensatlon, WIIL 00 7HE WORK, and lhe strucluce Is not intentletl or oftered tor sale (Sec. 7044, Business antl P�otessions Cotle: The Contraciors license Lew does not epply to an owner of propeny who builds or imDrovas ihereon, an0 who does such work imsetl or hersell or through his or her own employees, prohded thet such improvements are not intended or oHeretl for sele. If, however, ihe building or improvement is sold within one year o� completion, the ownar�builder will have the burden of pmving UaI he or she did not 6uild or improve for purpose oi sele.). ' ❑ I rape , USIVELY CONTRACTING WITH LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business entl Professions Co e: The conKectors License Law do not epply to an owner ot propeny who builtls or Improves thereon, antl who conirac�s tor such prolec� with e comractor(s) lice e D4�suapryo tbe Contracbrs �can Laws.). _ � eusiness end Professions Code far this resson: Date: IICen58. ��s ❑ No Verification ot Ownership by (rype of tlocument i.e. - property taz 6ill DIVIStON OF INDUSTPIA4 SAFETY PERMIT CER7IFICATION: Expires: ❑ I hereby cartity tha� no excavetion fiva (5) or more feet in dapth into which e person is requiretl to descend, will be made in connectian wi�h work euthorizetl by this permit, and Ihat no builtling siructure, scattoltling, lelsework, or demolition or dismantling thereof, will be more than thirry-six (36) leet high. (C�ep. 32, Grp 2, Art 2, Sec. 341, Title B, Celilornia Atlminlsirative Code). ❑ As owner-builder, I Will not employ enyone to tlo work which would require e permit irom the Division of Industriel Safety, as noted ebove, unless such person has a permit to tlo such wofk Irom the tlivision. SignaNre: Date: Division of Industrial Safery Parmit Num6er: CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTRY: I cenify under penalty of perjury tha� I have read this epplicatlon end state that the intormation given is correct I agree ro comply Wlih all state laws a ciry dina s relating lo tuilding consiruclion, end amhodze r resentatives of I�e Clry of Casta Mesa to enter upon Ihe e6ove-descnbed property for inspection purpose I agr not cupy or ellow xcupancy of eny building thoriz d by this permit until tinel inspection. t. GR� oe� And/Or Au�honzed Applicant Date �Qljfij, INSPECTIONTYPE 1616 FixeG System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Finel Re-Root Finel BIxWRetaini�9 Wall Final Factory Fira P�ace Final Sign 20a Finel Demolitian P�ff II�lALS L— y—oK .� COOEA INSVECTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final euiltlinyOccupancy P9g II�dLS