HomeMy WebLinkAbout275 BROADWAY - Building Permits (3)(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
.lob Address: 275 BROADWAY
Suite:
Viciniry:
Parcel Number: 11721219
Applicant: DE6�E DAVIS
Address: 978 N ELM ST
ORANGE,CA
Owner: SCHNIEPP, CATHERINE L TR
Address 515 36TH ST
NEWPORT BEACH, CA
Contractor. DAVIS ROOFING CO
Address: 978 N ELM ST
ORANGE,CA
2ip: 92887
Arch :
Address:
Zoning:
Phone: (714) 628-9525
Zip: 92867
Phone:
Zip: 926633204
Phone: (714) 62&9525
License: 509824
Eng:
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 04/OS/2004
Issued: 04/08/2004
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING COMP. SHINGLES INSTALL 1l2" CDx� 30 LB FELT AND 30 YEAR FELT. �
L, Wtr� v�2ct.ltUl
FEE SUMMARY
Plan Check: $0.00
Permit: $83.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
SETBACKS
MAIN STRUCTURE Fro�t 0. 0
ACCESSORY Front 0. 0
PARKING Existin : 0
NOTES:
Rear 0- 0
Rear 0- 0
Reauired: 0
Calc Valuation: 32,aso.00
Claim Vatuation: Sz,aso,00
PLANNING & ZONING
Lek 0. 0 Right
Left 0. 0 Right
Pr000sed: 0
0.0
0
NOTICE: The work authorizad by this permit shall comply with all applicabte handicap access requirements under�California statutes and reiated
regulations. (Ord. No. 92-28, § 1. 12•21-92)
EXPIRA710N: This permit shall automatically ezpire and become void if work is not commenced wlthin 180 days, or if work Is suspended or abandoned
for a period of 180 tlays.
INSPECTIONS: In order for lhe work authonzed under this permit to be considered legal, such work must comply with all applicabla codes, and all
requlred Inspections and 11na1 approvel must be obtained. Failure to obtain inspections and Final approval will result in the expiration of Ihis pertnit.
FOR INSPECTIONS CALI: (714) 7545626
2446-06(8�00)
WORFT_RS' COMPENSATION DECLARATION: ��
I hereby eHirm under penelty ol perJury ane ot t�e following tlocleraUons: � � � '.
❑ I have end wlll malntaln e cetlilicate of consent to self-Insure br workere' compensatlon, es proviaetl lor by soction 3700 at t�e Labor Code, lor the pedortnence Lf the
ork lor which thls permlt Is Issued.
I have ntl wlll melntain workers' compensetlan Insurance, es reqNrotl Dy sactlon 3700 of Ihe Lebor Code, for the pertortnance ol Ihe work for which this pertnit Is Issued.
worke ' compensatlon Insurence carrler end pollcy number ere:
ertier. ^i-�"u-��C �.b1�1. p�_J 1-� il Po' Number. Z�b,S- O 1 Z'7�.(
(fhf� neetl not be camplefed 1! the permi!!s velued et one hundred dollers ($100) or less.)
❑ I certity that in Ihe peAortnance ol the work lor which Ihls partnit Is issuad, I shall not employ eny person in eny manner so as to become subject to the workers'
wmpansatio t Celifomia, end a9ree that It I should become subJect to the workers' compensatlon proWsions oi Seclion 3700 of Ihe Labor Cotle, I shall forthwith
co lhe5e ons. � r,
B ican�Signet .` � � `t'—�—��
WFR . ILURETO PEWORNEFSdJMPENSATIONCOVEiiAGEISUNIAWFULrWDSNALLSU&IEGfANEMPI.OVERTOCRIMIWILPENALTIESANDCIVILFlNESUPTOONEHUNDNED
. ANDDOLLFFE(5100,000),INADDITIONTOTHEWSTOFCOMPENSATION,DMMGESPSPROVIDEDFORINSECilON3lO80FTHElABORCODE,IMEREST,ANDATTORNEY'SFEES.
1FTORS DECLAFATION:
9� licensetl under provisions ol Chapter 9(commencing with Section 7000) ot
a •C—��1� S77 �l ,tf a-�-/'
CONSTRUC710N LENDING AGENCV:
3 of Ihe Buslness and Professions Cotle, enC my license is in tull
❑ I hereby ettirtn that there Is e constructlon lentling agency for ihe peAortnance of Ihe work tor whic� ihis permit is Issuetl. (Sec. 3097, Civil Code).
Lenders Name: Lendefs Address:
Signetura:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirtn Ihat under penelry oi per�ury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry whic� reqWres e permit to construct, eltar, Improve, demdlsh, or repelr eny structure, pdor to Its issuence, elso raquires the applicant lor such pertnit
to file a slgned stetement thet ha or she Is Iicansed pursuent to Ihe provisions ol ihe Contrectars LJcense Lew (Chepter B(commendnp wlth Section 7000) af Dlvision 3 of the
Business and Professions Code) or thet he or s�e Is exempl themlrom entl the besis tor tho alleged e:emption. Any videtion o1 SecOon 7031.5 by eny applicam tor e permit
sub�ecis tha epplicani to e clvll penelry af not more lhan flve hundred dollers (5500�.):
❑ I, as owner ol iha properry, or my employees wlth weges es thelr sole crompensation, WILL DO 7HE WORK, antl the stnicture is not intendetl or oNere0lor uie (Sec.
7044, Business and Professlons Cotle: The Contraciore lJcense Lew does no1 appty to an owner ot propeny who builtls or improves thereon, and who does such work
himsetl or herself or thraugh his or her own employees, provitled that such impravements are not intentlatl or oHeretl for sele. II, howaver, the building or improvement is
sold vrit�in one year ol completion, the owner-builder will have �he hurden of proving that he ar she did not huild or improve tor purpose ol sele.). �
❑ I, as owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS Io conslruct t�e project (Sec. 7044, BuSiness end Protessions
Code: Tha contractore Ucense Lew tloes nat eppty to en awner ot pmpeny who builds or impmves thereon, end who camrects tor suc� pra�ect wit� a wniracror(s)
license pursuant to the Camractors License LewsJ.
❑ I em axempl untler sec.
Signature:
Owner ID ventied by drivefs llcense. ❑ Ves ❑ No
Bu5ine55 entl Profe55ion5 COde lor �his ro85on:
Verlficatlon oi Ownership by (rype ol document, i.e. - properry tac GIII or OeeA):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION:
Drivefs LJcense No.
Date:
Expires:
❑ I hereby ceNfy that no excevetion tive (5) or more feet In tle0�h Into which e person is requiretl to descend, wlll De matle in connectlon with work euthodzed by this
permii, and �hat no building strucWre, scaHoltling, falsework, or tlemolition or dismantling thereot, will be more than thirry-sin (36) teet high. (Chap. 3.2, Gry 2, Art 2, Sec.
347, Title e, Califomia Administrative Cotle).
❑ As owner-builder, I will not employ enyone to tlo work which would reqWre e pertnit Imm the Division ot Industrial Satery, es rwred ebove, unless suU persan has e
pertnit to do such work from the division. , .
Signature: Date:
Division af Indusinal Setery Pormit Number:
ICERTFlCA7E OF COMPLIANCE AND AUTHORVATION OF ENTRY: I certity untler penelty ot perjury Ihet I have reatl lhis application end stato that the inlortnetion given is I
wrrecL I egree �o comply with ell stete lews end ciry ordinences relaiing to bullding cons�ruc�lon, end suthodze representaiivas of ihe Ciry of Coste Mesa to enter upon Ihe
ebove-descnbed pmperty lor inspection puryoses. I agree nol to occupy or ellow xcupancy of eny builtling authorized by this permit until tinal inspection.
�gneture
cooe �. insrecnoxrrve
7616 Fixed System Final Fire Preventian
1266 Pool SDe Final
200 Final Re�Roof
201 Final Block/Refaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
ceie ¢umets
� �
COOE 1 INSPECTION TYPE
208 Finel Mechanical
20B Finel Plumbing
210 Finel Electdcel
212 Flnel Flre Preventlon
220 Final Planning Apprwal
222 Flnal Site
250 FinalBuilding/Occupency
V�15
PN0.1EC7AOOflES3: �'�S BROADWAY
owNea�sxarne: WALTER SCHNEIEPP
�oosess: z�5 BROADWAY
CUSTA MESA
CA 92627
�.,,,,...�.,�..,,�,,. ( 719 ) 6 7 3— 8 2 6 6
AOOHESS:
NEO.NO.:
uxiT:
UNR:
-�
PE"MinEE` CALDERON ROOFING, INC. ( 714 ) 542-7023
�oosess: 1027 N, LOGAN
SANTA ANA CA 92703
LICENSED CONiMCTOP DEttAMT10N: I hereby aflirm ttut I am licensea unEer provisions oi CAaO�e� 9lcammencinA �th Sectlan
7000) ai Oivision 3 of the Busineu an0 Prolessions COEe, anA my license is in lullforce anE ettect.
arr uc.: 0 3 4 2 61 sTnre uc.: 3 B S 10 7 cuss: �3�� r,
�ate: �—^_� �'�_Q Signatura: � ������(�
WOqKEB3' COMPENSATION DECUMTION: I �ereby affirm that I have a certitiwta of consent ro selFinsure or a certitica[e of Workers'
Sampensation Insurance, or a cetlifietl coDY ��ereof (Section 3800, LaD. C�.
nicr xa.: q 3 0 8 61— 8 9 IXP. ��TE: 1 O� O S� 9 O
cornrnNr: STATE FUND
❑ Cerlifie0 capY is hereby Iumishe0. �{` Certife0 coOY i5 filed with t�e ciry 8/uiltl�inp OiNsion.
Date: ��9 — � � �� MDlicant� �/�� C.+'1.E9�s'��
E%EMP�ION FBOM WOHNEBS' COMPENSA➢ON OECIAIWTION: (Ihis section neeA not he complete0 il the permit is far one hu�retl �$100) or leu�.
I certity ihat in the pedormance oi the work for which this permit is issueQ I s�all not emDloy any persan in any manner so as to Cecoma
su0lect m Ne Workers' ComDensation laws ol Califamia.
Oate: SiAnature:
NOTICF: If, atter maltinq this tleclara6on, you shoul0 Oecome subiect to the Wotrcers' Campensation pwNsionS of the Labor
CoGe, you must IartAwitA comply with sucA prodsions or t�is permit sAall be �eeme0 revokeC.
CONSTBUCTION LENOING RGENCY: I hereby aflirm Ihat t�era is a constmction IendinA a0ency tor ihe Oehormanca of the work for
whic� Ihis permitis iuue0 (Section 3097. Civ. C).
IENDER:
�'. RO�BESS: "
OWNEB BUILOEB OECIAMTION: I �ere6y attirm t�at I am exempt tmm tha Coniroctors' State License Law for the tollowinp reason
(Section 703t5 Business anE Pm7euionat CaOe: My ciry oi counry w�ich requires a Dermit to construct, atter, impmve, Oemolish, or
repair any stmcture, D�or lo its issuance, also requires the apDlicant for such permit to file a siAneU statement t�at Ae/she is Iicenu0
pureuant ro Ihe Dmvisions of the Comractors' State License Law (Chapter 9(commencinq wit� Sectian 7000) of Division 3 ot t�e Business
anE Protesslons Catle) or IAat he/she is eKempt theretmm antl t�e Oasis for the alleAeO exemption. My violation ot Section 70.31.5 6y
any aOVlicant for a permh suUlecis the aODlicant to a ciNl Denalry of nat more tAan five hunA2tl Oallars (E500).
I, as owner oi ihe D�oDertY or my employees wit� wages as Meir sole compensation, will do the work, an0 t�e
� swcwre is not inten0e0 or olleretl for sale (Secuon 7044, Busmess anA Prolessional CaOe: t�e Cantracrors' State Licenu Law
does not appy to an owner ol a properry who OuilAs or improves t�ereon, anU wha aoes suc� work himutl/Aerulf or �hrouAh
his or her own employees, D�a��tled that suc� imD�ovements are not intended or offere0 for sale. Ii, Aowever the 6uilUinp or
imD�ovement is so10 vnt�in one year oi comDletion, tAe awner will have ihe burEen oi pmvinA he/s�e Uitl not build or Impmve
for the puryose al sale�. ,
I, az owner of the pmOehY. am exclusively wntracting with liwnsad coniractors to consimct tAe Orolect (Sectlon 7044, Business
❑ anE Professions COEe: The fqmracmrs' State Licenu Law Uces noi apply to an owner oi DropeM �o Dmlds or imprwes therean
an0 w�o cantracts lor such pmle��s ci?� a caniractor(s)license Dursuant ro ihe Contractors' State License Law),I am awaa
�ha� Droof ol �heir Worker's Compens:tion insurance s�oulA Ue provitled ta me.
� I am exempt untler Section: 8. 8 P. C.
tor tAis reazon:
Date: P.mar.
IOa AereUy certiytha�lam aware ofan0 untlerstan0 Ine repuiremenis ofCalifornia Health an0 Safety Cade Sections 25505, 25533, an0
25534 anU that I or any future �uiltlinp occupant vnNwill not (circle one) need ro comply with sai0 state wdes and ihe requiremenis for a
permitforconstruclion or moAificatian imm ihe ar�ualiry ManaOement Disinct. NesiAentialconstruction aDPlications are exemptfmm
t�¢Se provisions.
Oate: Nppliwnt
I herehy certiry that I have read this aDDlication antl state Ihat the abava information is correct. I apree to comDly with all ciry anE counry
ordinances and state Wvrs relaGnA �o builEinq construction an0 �ereby aN�orize 2D��ntatives ol Nis Nry ro enter upon the a6ove�mentianetl
OroDenY �orinspection purposes. �^/ L a n
Date: 6` l �� A O Sipnat r�{ "�y'��s��/i�
oriver's Licensa or Social Security x:
1641-ab W�ite--Builtling; Green—Cotle ENortemem; Canery—MV����C P��k—Revenue; GOIGenrotl—Aveemr
CITY OF COSTA MESA — HUILDING PERMIT PERM NO; H 047786
PERMIT NO: B 047786 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : RE—ROOF SFD/HUILT—UP/HOT TAR S ROCK SQ FT: 2,800
i
CLAIM VALUE: 2,800.00 CALC—VALUE: 2,800.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME,
�r�r*��*�r�r*x ��*�***� x ���x *x�*�r� **�*******� x �r**� ��**�e�****�c*� *******�x *+t*»*�r****�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGAT; FT IN
PARKING AEQ: PROV: PARCEL: 11"721219 2NE: REF NO:
PLANNZNG NOTES>
>
iE it iE 1F 1E iE iE ik iE ik iF �f tE iE if iE iE 1E iE if if if jE if iE iE if iE jF iE if iE i! i!'lf iE fk iE ak it iE ib ib jF iE if iE iE if k it �k �k if iE it if iE i! i6 iE ib iF iE iE 1E if �F iE iE �f iF �E iE if jf if iE iE
D E V E;L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE; '
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE; (�'�����
',EiEifjEiFiFifitiEiEikiEjFil�7EiEikiEififi(�iF �?FiEiE9FifdllEiElfiEif ifi6
1EitiElEiEiEiEiEiEiEiEiFiFifiE3EiEiEdFi4ikiEififiEjEjEiFjEiE�1EiE*1EiE1E1ElFi 1liE1Ejj iEiEiEiEiE3EiEikjEikffitlFiElEdEiEitifiEikiF3E9EdF�F3lifiFlFiEjfjEiEiE
LEGALIZATION:N F E E S U M"M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 .50
SMIP/NON-RES
PLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CAECK TOTAL PAID DUE
TOTALS----> 59.50 0.00 0,00 54.50 59.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
54.00 .50
�1f iE iE �)E it jE i(� if 1(� if iF ik iE jf �lE �E �lE if if iE 1f # if 1E if iE ik jE 9E �E iE if� �lf iE iE if it iF iE it iE iF iE iE 9E �1f iE iE iE iE �1E iE if �E iE iE if iE d(� iF iE iE if if if ik if iE * iE �IF iE �E jE iE iP if iF *
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2800 AEROOF bY VALUE RESIDENIAL NOZONE
END OF FEES
1.00 2,800.00
03 00053�50-OOOd3?51 TL+-P' `4.�:9
DATE: �bJ]u/4C1 TIrF: i`J:C��
CONS�CTGON AND PLANNING
APPROVALS Permit #
1. Temporary Electrical Service or Pole
2. Soil Pipe�Undrgrnd. ;
3. Electrical Conduit Utility-Undr9md.
4. Electrical Conduit-Undrgrnd.� �
5. Steel Reinforcement
6. Electrical UFER Gmd.
7. Footings
8. Poundation
9. Water Pipe-Undrgrnd.
10. Structural Floor System �
11. Property Sewer Line & House Connection
12. Sewer Cap
13. Foof Drd�ns ;
14. Rough Plum6ing
15. Rough Electriral�Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign .
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
27. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Foof Sheathing
26. T�Bar Ceiling IStructural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final HeSting & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final
41 . Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL 5TRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas C�
51. CERTIFICATE OF OCCUPANCY
No. � Date
Date
L&SPA
Inspector qppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
77. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergrnd.Storage Tank O Gas ❑ Oil
(yL(/ 74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
i
78. FIRE PREV. FINAL
. HEALTH DEPT. REQUIREMENT
�. 79. FINAL INSPECTION
�. � 80. FOOD CERTIFICATE ISSUED
�'
, ' Notes:
%i '
,y
6
Date � Inspector
U14NER COURY� FRID
-- ---'- .,.�� ..__.
GENliRAL
VALUE
N'IRE ZONE
SUBCONTRACTOR
JAN E 1965
PERM IT
i
R -.
2�359
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BO]C i17 COBTA MEBA. CALIFORNIA
For Apppcant to Fill In Completely
TYPE OR PRINT
BUILDINO . �
AODRE58
COSTA MESA, CALIFORNIA
OWNER Cll � OV R
MAIL ., -, � !� . _ n.
TEL.
NO.
TEL.
LEo�L
FEE RECEIVED
�IYANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
�C.TNO. d 0 b N�L � a �� 90' T03IDfi 4 R6AR
EAVES
SIZE �D� v� no.ore�ooc. / ALLOWED
OF LOT /1 �O � D NOW ON LOT ypRDB MPROV ED
USE OF MAIN BUIL�ING
EXISTIN6 BLDQ.
(FROM C/LSfREET)i
9ETGACKLIX6IROM Qe�ur I/JR �O
HFT �/ ��
RIGHT
DESCRIPTION OF WORK
— ��� �� — ��
HAN6 6HALL BE LE3S THAN
P. L.
( U. B. C. REQIIIREMENT
YARDSAPPROVED
ACGESSORY BUILDING
�
VAR. #
/ 3 J� IG.� ROOMS
�
WALL �/ / ROOF
_�{��� COVER
ILOINCMlD O KnTOBE
DATE
i� s4. �. sro �v�R �� m
1 HEREBY ACKNOWLEOGE THAT 1 HAVB RBAD THI6 M1PPLICATION TNE AMOIINT 6HOWN IINOER VALl1AT10N IS FOR THE ��',
ANO 6TAT6 TH�1T TH8 /�BOVB IH CORRECT ANU AOq TO COM- PU0.POBE OP HBTABLIBXINO A PEFMIT FEE ONLY. p
PLr wITX ALL cITY ORDINANc88 ANo T[ uWe [ uuTlNa ypLUAT10N S/ r p
eu1LolNa CONSTR ION. pERMIT FEE $ ✓ �
SIGNATURE OP � �
PERMIttE - C. m
� ' �V / �~ o
AUTHORIZ6D A6CNT � a
TOTALFEE $