HomeMy WebLinkAbout2320 CORNELL DR - Building Permits(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING pIVIS10N
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Job Address: 2320 CORNELL DR
Suite:
Vicinity:
Parcel Nunmber: 14147317
Applicant: HERMAN, RICHARD
Address:
owner. MATTSON �KENNETH D SR TR
Address 2320 COF2NELL DR�
�iri, .
-' COSTA MESA,CA �
Contractor:- HERMAN ROOFING
Address: 4050 1/2 BROTHERTON
i. . . �►
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PERM�T NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 09/21/1998
Issued: 09/21/1998
Zoning:
Phone:
Zip:
Phone: � , " . � " , � -
Zip: 92626 ' � � . � � �' � ��.
�_. - '. ������� .
'� ' � Phone: 714 736-5677
, , , � CORONA, CA Zip: 91719
. � . � � � License: 348265
Arch / Eng : � ' � �
Address: �
Rlan Check:
' Permit:
SMIP Res:
SMIP Com:
' Other:
Inspection:
Total:
. � . Phone: � � . � - �
� . .. , Zip: , .
License: � � '
SCOPE OF PERMIT '
:T/O EXISTING ROCK AND REROOF W/ 25 YEAR COMP., 3 8 5 PITCH. CERT. ATTCHED TO PERMIT.
$0.00
$87.25
$0.50
$0.00
$0.00
$0.00
$87.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front �0-0
PARKING Existinq: o
NOTES:
FEE SUMMARY ;, ' '
, . Calc Valuation:
_ � � ` �' Claim Valuation: �
PLANNING & ZONING
Rear 0- 0 Left 0- 0
Rear 0- 0 Left 0- 0
Required: 0 Proposed: 0
Right 0= 0
Right 0- 0
�;
`,
;
$3,340.00
$3,340.00
,
'
� EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO;days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inepeetlona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permiL
FOR INSPECTIONS CALL: (714) 7545626
W6RKEFiS'�OMPENSATON DECLARA710N: �� + ✓
I hereby aKrtn untler penalry of perjury one of the followinq declaretions: �
❑ I have and will meintain a certiticele of consent to self-Insure For workers' tompensation, as provitletl for by sactlon 3700 of the Lebor Cotle, tor the pedormenca of the
work for which this permit is issued.
❑ I have antl will maintain workers' compensation insurance, as required by sec1ion 3700 of Ihe Labor Gotle, for the pertortnance of the woAc tor which this permit is issued.
My workers' compensation Insurance wrtier en0 policy number ere:
Cartier. Policy Number.
(71ris section need nof be compleled il Ihe permit is valued at one hundred dollars ($100) or Iess.J
❑ I certiy that in the performance of ihe work tor which this pertnit is issued, I shall not employ any person in any manner so as to become subject to Ihe workers'
compensetion laws of Celitomla, and egree thet If I should become subject to the workers' compensetion provisions ot Sectlon 3700 of the Lebor Cotle, I s�ell fotlhwith
comply wiih ihese provisians. �J
Applicant Signature: �Gh �— Date: `j — 2 I— 4 A
WARNING FAILURE TO SECURE WORKERS' COMPENSAiION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO IXJE HUNDRED
TlIOUSAND WLLARE (5100,000), IN ADDITION TO THE WST OF COMPENSATIIXJ, DAhL1GE5 AS PROVIDED FOR IN SECTION 310G OF TME LABOH CODE, IMEREST, AND ATTORNEV'S FEES.
LICENSED COHTRACTORS DECLARATION:
I hereby ettirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Coda, and my license is in full
force and eflect. Lic. # Glass N C—�j rj
CoNraaorsSignamre: Date: S-2�'F�
�
CONSTRUCTION LENDING AGENCV:
❑ I hereby eNirtn �hat there is a construction lending agency for the pertortnance of ihe work for which this permit is issued. (Sac. 3097, Civil Cotle).
Lentlels Name: Lenders Address:
SignaNre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirtn �hat untler penalry ot perjury that I em EXEMPT FROM THE CONTRAC70R5 LICENSE LAW tor the following reason (Sec. 7031.5, Business and Protessions
Cotle: Any ciry or counry which requires a pertnit to consWct, elter, Improve, demolish, or repair any structure, pnor ro its issuance, also requires the applicant for such permit
to file e signed stetement that he or she is licensed pursuant b the provisions of tha Coniractors License Law (Chepter 9(commencing wiih Sectlon 7000) ot Division 3 oi ihe
Busineu and Professions Coda) or ihat he or she is exempt therefrom and �he basis for the alleged exemption. Any violation of Section 7037.5 by any applicant tor a permit
sub�ecLs fha epplicant ro e civil penalry of not more than five huntlretl tlollars �$500).):
❑ I, es owner�of'the pmperry, or my employees with wages as their sole compensetion, WILL DO TNE WORK, and the siructure is not intanded or oHeretl for sale (Sec.
7044, Business�antl•Professions Cotle: The Contractors Licensa Law tloes not apply to en owner of property who builds or improves thereon, end who does such work
himsalf oi fiers`elf;ogthiough his or her own employees, provided that such Improvements are not intendetl or otteretl (or sale. tl, however, the bulltlinq or improvament Is
sold within one year of comp`t��� theqowner-bwltler will have the burtlen oi proving that he or she did not build or improve tor purpose of sale.).
❑ I, as owner of tha property, am EXCWSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to construd the project (Sec. 7044, Business antl Protessions
Code: The contractors License Law Coes not apply to en owner of property who builds or Improves ihereon, and w�o coniracis for such project with e conirector(s)
license pursuant to Ihe Con�ractors�License LawsJ.
-'�"l
❑ I am exempt under sec. Business and Protessions Code for Ihis reason:
Signature: Date: �
Owner ID venfied by dnvers license. ❑ Yes ❑ No Drivefs License No. � ' Eapires:
Verification of Ownerohip by (rype at dacument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ 1 herehy ce�ify that no excavation five (5) or more teet in depth Inro which e pereon Is required to descend, will be mede in connection with work euthonzetl by this
permit, antl thet no builtling structure, scaffoltling, talsework, or tlemolition or tlismentlinq ihereof, will be more ihan ihirry-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Celitomia Administrative Code). '
❑ As owner-builtler, I will not employ enyone to do work which would require a pertnit from the Division of Inaustnal Safery, as noted above, unless suc� person has e
pertnit to do such work tmm Ihe division.
Signature:
Division of Indusinal Safery Permit Number:
Date:
CERTIFlCATE OF COMPLIANCE AND AUTMORQATON OF ENTRV: I certify under penalry of perjury that I have reetl this epplicetion and stete that the infortnetion given is
correct. I egree to comply with all sWte laws and ciry ordinences relating to building construction, and euihonze representatives of the City of Costa Mesa to enter upon ihe
ebove-descnbed properry tor inspecGon purposes. I agree not to occupy or ellow ocapancy of any building authonzed by this permit until final inspeclion.
SignaNre Ot Legal Oaner(s) Dete
, � --ic 9-2.�- �1s�
And/Or Authonzed Applicant Date
COOE 1. INSiECTIONTYVE
1616 Fixetl System Finel Fire Prevention
1266
200
201
202
203
Pool Spe Final �
Finel RaRoof
Finel BIocWRelaining Wall
Finel Fedory Flre Place
Final Sign
204 Final Demolition
244&48
� I��
� �W
LOpE� INSPECTONTYPE
206 Finel Mechanicel
20B Finel PlumDinq
210 Final ElecMcal
272 Final Fire Preventlon
220 Finel Planning Approvel
222 Final Site
250 Finel BuildingiOccupency
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JOB ADDRESS y 2320 Cornell Drive BUILDING PF.RMIT NO. 2�
GENE&AL CONTAACTOR pwner-��idler DESCRLPTION OF WORK jriteTlOP A1'b6T8'C10R __
ar xo. i 4i _�.q3_i 7 LOT TRACT FIRE ZONE VAI.UE $ �}00.00 _
INSPF.CTIONS I Sienature I Date � GROUP T TYPE V ZONE R—1
SUBCONTRACTOR
`'r' !D ' 24694
�'�'�►
COSTA MESA BUILDING-SAFFfY DEPARTMEPfi
V.O. BOX 1P00 � COSTA MESA, CALIFORNIA 92618
For Applicant fo Flil In Completaly
TYPE OR PRINT
a�����a oZ326 C��tit �� ��� �
aooResa
COSTA, MESA, CALIFORNIA
owNert S""-2R T l': N= S
MAIL n 7� .� � _ .. . _. . �..
�_i / n 1 .� . I NO.Or�Lp00.
R�G.IX9W�II-i�, RlARYARD
HIT `1' I RIQHT '�
DESCRIPTION OF WORK
I . I ,ill
SIZE "� I�� � ROOMH .6T RI
EXTERIORWALL ROOF 1ZUCk
COVERINO I.ICCJ� COVERINO
USQ OF GUILDIf�Y AND WORK TO 05 P[RFORM[D
1 HlRClY ACKNOWL6O06 TMAT 1
AND 6TAT8 TXAT TH6 ASOVt �O
PLY WITX ALL CITY ORDINANCO
BUILOINO CONBT
SIGNATVREOP �_ �
PERMITTi
AUTHORIZiD AG[NT
eirv �� c�� �� �Fs�
SEP 14 1965
APPLICATION FOR PERMIi
eu��o�no �3 Z.� C O�/%Z/ 1,�.�/-�R-'
ADDREBH
RIR6 •�� �
ZON! TYP GROUP
APPROV[D /'
BY ( I DATE �I'7
7� ING � ��
xoN no. o� I uos or xew �
�un� qm�ciwo
�a.� R a��-
o�acmmon
A.P.NO. �I"" T��� �I
N0T6: N08AV60V6RMAN6SXALLB8LE88TMAN
YARO9 MPROVED
MAIN BUILDINO
vw�x. #
YARDS MPROVE�
- ACCES80RYBUILDIN6
DATE
� ATC � �� �{�S
P�
07
�
�
e
Ti6 AYOUNT 6NOWN YNOBR VALUATION le POR TX6 �
■YRP088 OP [BTApL18MIN0 A PlpMIT PB8' ONLY.
VALUATION �' ba �
� PERMITREE p
l/L/ o
s ' f
� m�
TOTALFEE S
-OWNER PRINCETON, IriC• - DATE 1],-13-5%
iOB ADDRESS �9a20 Cernell Drive � BIIILDING PERMIT NO. 6001 �
GENERAL
AP. No. LOT
GR011P I & J
INSPECTIONS
Dike &
TRACT Z
rnr. V
vAcus s 13,690.
FIRE ZONE DESCRIPTION OF WORR Residence W/Stt
ZONE PLAN NO. CO 2
DATE I gUBCONTRACTOR PERMITSISSUED
DATE NUMBER
�
I r},
Y � . '
� / � �} C1�V�� ,
COSTA MESA BUILDING DEPARTMENT
P. o. eox 31-�
• COSTA MESA, CALIFORNIA
c=LE ��c�ivE�
ii-i3�-�'7
�lf�A(�CE DEPL � �"
FOR APPLICANT TO FILL IN APPLIC�AT OfVUFORrPERMIT
a���o��� BUILDING
ADORE55
' - COSTA MESA. CALIFORNIA ' FOR OFFICE USE ONLY
" pECEIPT NO. PERMIT NO.
OWNER
. PECEIVED BY OATE FECEIVE� O 5
AOORE55 1 East 1 th Street �� Z� �� 1 7
� TEL. BUILOING �
QTV NO. ADDRE55
ARCHITEGT C8I'1$ ���� ' COSTA MESA. CALIFORNIA
OR ENGINEER NO.
FIRE
AD�RE55 ZONE
CITY LIC. 20NE pOA'OS TYPE GROIIP
CONTRACTOR ike and ole ove �o. �✓ x
ADDR�S E Sti 17 Street � NO: ByPROVED � DATE
�E�A� �or CORRECTIONS
OESCRIPTIOrv NO. BLOCK TRACT
A.P. NO.
SIZE . MO.OF BLDGS.
OF LOT �O ��OW oN toi -
USE OF
EXIST�NG BLDG.
SETBwCK LINE FROM
ceNTea ov STFEET � � REAR YARD i
SIDE YARD RIGHT I LEFT � �
DESCRIPTION OF WORK
NEW ALTERATION AODITION
REPA�R MOVING DEMOLISH •
BUIL�ING NO.OF �
SIZE ROOMS STORIES
E%TERIOR WALL ROOF �
COVERING COVERING '
USE OF NEW
BLIILDING
lan
� HERE9Y PCKNOWLEOGE THPT I HnVE RERD TMIS APPLICnTOrv wNp
$TATE THAT TME ABOVE IS RRECT FNO RGFEE TO COMPLV W!TH ALl
CITY OROINTNCES ANO $T L/�WS REGUTAT NG Bl11LOING CONSTRUC-
iiorv. VALUATION
SIGNATURE OF PERMIT FEE $ 2 OO
PERMITTEE • �• rv�
$ 13,690�uV, �'�AN CHECK $
AUTHORIZEO AGENT Dike and Colegrove � Inc. TOTAL FEE $
W!