HomeMy WebLinkAbout2391 CORNELL DR - Building Permits' „G. A
� � -�_; CITY OF COSTA MESA
' BUILpING D/YISION
� �
� DEVELOPMENT SERVICES DEPARTMENT
� �.. RAR_019RR
•4 � � PERMIT PERMIT NUMBER
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(714) 754-5273 • Fex (714) 754-4856 gUILDING PERMIT P FAIR DRIVE, COSTA MESA, CA 92626
�ob nddress: 2391.. .CORNELL DR
Suite: � '
Vicinity:
Parcel Nunmber: 14147401
App�icant: � TROY, ALEXON
Address: � '
Owner: BROWN,
Address 2391 COR�
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ACCESSORY
PARKING
NOTES:
75
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Phone:
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A'MESA
Phone:
Zip: 92627
License:� 34968i
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...._ : , . . Status: ISSUED
Applied: 0 711 3/1 9 9 8
Issued: 07/13/1998
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SCOPE OF PERMIT
SHINGLES
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EXPIRATION: This permit shall automaticalty 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 aulhorized under this permit to be considered legal, such work must comply with all applicable codes, antl all
required Inspectlone end flnel approval must be obtained. Failure to obtain inspections and tinal approval will resutt in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545826
WORKERS' COMPENSATION DECLARA710N: .
I hereby eRirtn untler penalry oi parjury one of ihe fdlowing tleclarations: �.� .� , • . ' �
❑ I heve end wlll malntain e ceniticete of consent to self-Insure for workers'� compensetion, es provitleA for by section 3700 of the Lebor Code, for the pertormence of the
work Iw which this pertnit Is issued. ,
❑ I heve entl wlll melntein workers' oompenselion insurance, as required by seclion 3700 of Me Labw Code, for ihe peAortnence oi ihe work for which ihis pertnll is issued.
My workers' compensa�ion Insurenca cartler enO policy numDer are: �,
Cartier. Policy Number.
(Thls sectlar neetl nof be complete0l! MeOe�mi! is velued at one hunared tlollars ($100) or/ess.)
❑ I certify Ihet In the peAormance of iha work for which ihis pertnit is issued, I shall not employ any person in any menner so as to become suhJect to t�e workers'
wmpensetlon laws of Cellfomia, and e t�at it I shoultl 6ecome subJect to the workers'rcompensatlon prodsians of Sectlon 3700 of the Lebor Code, I shell farthwlth
compy with ihese p.ro�visl�on j / C
ApplicantSignature: �/�sI/f✓^ Date: %�.3/`f,7 /
WARNIN6: fNLURE TO SECURE W RKE0.S' COMPENSATIIXJ COVERAGE IS UNUW R1L AND SHALL SUBJECT AN EMPIOVER TO CRIMINFL NALTI 5 AN� qVIL FlNES UP TO ONE HUNDRED
TTIOUSMID OOLLME (5700.000�1 ADDRION TO THE CQST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECfION 3)O60F THE LF90R OODE, IMEREST, AND ATTORNEI^S FEES.
LJCENSED COHTRACTORS DEGLARATION:
I hereby ettirm thet I am Ilcensed under praWsians of
force end effect. LJc. #
Conlractofs SignaWre:
9(commencing with Sectio�-7000) of Division 3 of the Business and Professions Cotle, end my license is In full
Class q
�� Date: `7 /.? �'i�l
CONSTRUC710N LENDING ACENCY:
❑ 1 �ereby atfirtn thet Ihere is e canstruction lentling agenq for Ihe peMortnance oi t�e work for which this Dermlt is issued. (Sec. 3097, Civil Code).
Lenders Neme: Lendefs Address:
Signeture:
Dete:
OWNER-BUILDER DECLARATIONS:
I hereby aftirm ihet under penelry of per�ury Uet I em EXEMPT FROM TME COHTRACTOfiS LICENSE LAW for t�e following reeson (Sec. 7031.5, Business end Professions
Code: Any ciry or wunty which requires e permit to construcl, alter, improve, demolish, or repalr eny structure, prior to its issuence, elso requiras [he applicant for such pertnit
to flle e signed stetement thet he w she Is licensed pursuant to the provlsions of ihe Contredors License Lew (Chapter 9(commencing wlth Section 7000) ot Dlvlsion 3 of Ihe
Business and Profeuions Code) or that ha or she Is exempt therefrom and the besis for the alleged exemption. Any violation of Section 7031.5 by any epplicant for e pertnit
subJects Ihe epplicent to e civil penalry of not more then five hundred tlollare ($500).):
❑ I, as owner ot the property, or my employees with wages as iheir sole compensatlon, WILL DO TF1E WOHK, entl Ihe siructure Is not IntentleC or oHered tor sele (Sec.
7044, Business and Professions Code: The Contrectors License Lew does not aDP�Y �o an owner ot property who huiltls or improves thereon, end who tloes such work
hlmself or herseli or Ihrough his or her ov.n employees, proNded ihet such Impravements ere not intentletl or otteretl for sale. If, however, Ihe bullding or Improvement Is
sdd wlt�in one year of complellon, the owner-bullder will have the burden of proving ihat he or she did nm bulld or improve for purpose of sale.).
❑ I, as owner of the properry, em E%CLUSIVELV COHTRACTING WRH LICENSED COHTRACTORS to construct the projad (Sec. 7044, Business and Professlons
Code: The contrectors License Lew tloes not epply to an owner of praperry who builds or improves t�ereon, flnd who contracts for such proJect with e contractor(s)
Ilcense pursuflnt to the Coniraclors License LewsJ.
❑ I am exempt under sec. Buslness antl Protesslons Code For this reason:
Signeture: Date:
Owner ID venfied by drivefs license. ❑ Ves ❑ No DnveYs License No. Expires:
Vedflcetion of Ownership by (type of document, I.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFlCATION:
❑ I hereby certity the� no excavetion five (5) or mare feet In tlept� into which a persan Is required to descend, will be made In cronnectlon with work euthorizeA Cy this
pertnit, end ihet no bulltling structure, scattolding, falsework, or tlemalition or tlismantling thereof, 4rill De more ihen thirty-six (36) feel high. (C�ep. 32, Grp 2, An 2, Sec.
341, T�le 8, Celifomia Atlminlsirative Cade).
❑ As owner-bullder, I will not employ enyone to Oo work which would require a pertnit from the DMsion ot IntlusMel Sefety, es noted ebove, unleu such person hes a
pertnit to Co such work imm Ihe division.
SigneNre: Date:
DiWsion ai IndusMel Sefery Pertnit Number.
CEHTIFlCATE OF COMPLI/WCE AND AURIORQATON OF EHTHY: I certity untler penelry of perjury that I hava reed this epplication entl state Ihet Ihe information given is
cortect I egree to comply with all stale laws and ciry ordinences relating to building constructlon, antl authorize representetivas of the City of Cwte Mesa ro enter upon t�e
ebove4escdbed properry for inspecfion purposes. I agree not to occupy or allow occupanq ot any bulltling autliorized by this permit until final inspection.
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caoe �.
1616
1268
200
201
202
Fixed System Finel Fire Preventian
PtiofSpe Flnal �" � � � �
Flnel Re-Roof � '
Finel BIocWReteining Wall
Finel Pectory Fire Place ,. , _
203 Finel Sign
20A Finel Demolltlon
z.nsae
GAg U1iIDdL4
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COOE� INSFECTONTYPE
206 Final Mechaniwl
� 208 ' Final Plumtiing "
210 Final ElectriceP ' � -
212 Final Fire Preventlon
220 Final Planning Approval'_ �
222� Final Site
250 Flnal Building/Occupancy
I� ��'
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: COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31]
�a�� �rC���E�
Q�r• �-, ��s�—�.c,�
FI�!,�l�GE �EPT.
COSTA MESA. CALIFORNIA �,�ry �F CO5'.��'I' �?I�=SA �
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
eui�oiNc BUILDING
ADDRE55
� COSTA MESA. CALIFORNIA � FOR OFFICE USE ONLY
PECEIPT NO. PEAT�I>1jC1(1
OWNER ^»ikr.i
lJIJIJId'
MAIL � . RECEIVEO 6Y DTTE PECEIVE= (.Dr�T' I�SSVED
ADDRE55 Q� �� v�'� 1 0195
TEL. BUILDING
CITY NO. ADORESS
ARCHITECT Cg � ��c. COSTA MESA, CALIFORNIA
OR ENGINEErZ' NO.
FIRE
AO�RESS ZONE
CITYI_IC. ���E PLFNS TYPE �/ •GROUP
coNTRA�ToaDike St]d Cole I'ove �o r�
IT1Gr�� APPROVED
ADDRE55 Ti� NO. BV DATE
�E�a� � � .esa CORRECTIONS
DESCaivTiON NO BLOCK TRACT
A.P. NO ` �
SRE NO.OF BLDGS.
OF LOT � ��Ow oN �oi
USE OF
E%ISTING BLDG.
SEiB4CK IINE FROM
CENTER OF STREET � REAR YARD �
SIDE YARO � RIGHT' 1.LEFT 1
DESCRIPTION.OF WORK
NEW ALTERATION ADDITION '
REPAIR MOVING DEMOLISH
BUILDING NO.OF .
SIZE 1 ROOMS STORIES
EXTEftIOR WA�L ROOF �
COVERING COVERING
USE OF NEW
BUILDING
lan �
I HEPEBY ACKNOWLE�GE TNAT I HAVE REAO THIS APPLICATION ANO ,
STTTE THPT THE ABOVE IS COFAECT FNp PGREE TO COMPLY W!TM qLl
CITY OROINPNCES AND STATE/LAWS REGULATING BUIIUING CONSTFUC-
TiON.' —� � VALUATION
SIGNATURE OF / � � ' PERMIT FEE $ `z��
PERMITTEE ` �-/ '� (�(�
� PLAN CHECK � lb�yy
a 13,690.00
nurHoaizEo ncENTD1�C@ and Cole T'OV8 IriC.
TOTAL FEE $ L��OO �e'�F
� �
� ' 359u�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
' For App/icant to Fill in Completely
ADORESS X�/� C.-f�`BA/E�.L 1J� •
MAIL C
CffflRFSS� ✓
TEL.
NO.
CON5TRUCTION
BRANCH
ADDRESS
ARCHITECT TEL.
O
CONTRACTOR����MG%//�Q �fIN/Ill'
ADDRESS��Q-p ` , ��QL(f L �'� I�
TEL.
arv/%NA� £�.�. NoG3%�"l
LIC. NO. �G Cf ��� � p.eG� LICVNO.
SI2E � NO. OF BLDGS.
OF LOT I NOW ON LOT
USE OF
EXISTING BLOG.
SIZE OF NO. OF �
NEWBLDG./O� ROOMS STORIES
EXTERIOR WALL ROOF
COVERING COVERING
USE OF BUILDING AND WOFK TO BE PERFORME�
,i � � . " . i � _ aa . . �
.i `: y� . .-� . `
IUL -6-73PA7o00 548# �*��*5.50
casn
TION FOR BUILDING PERMIT
OWNER
FIRE
20NE
��� IPLANS� I BUILDING EW �/�
VARDSAPPROVED VARDSAPPFOVEO
MAIN BUILDING ACCESSORV BUILDI��,
VAR. #
C.U.P.�I
I hereby acknowletlge that I have reatl this application and state
that tha above intOrmation is cotrect and agree to comply with
all lews regulaUng builtling consvuction; antl I shall mt employ
any pe�son in violation of the workman'S comp¢nsatiOn laws of
the State ot Calitornia.
I hereby certity that I am properly licensetl as a conttactor under SQ. FT.
the State of Califomia Business antl Professions Cotle, Divisicn 3, T E AMOVNTSF
Chapter 9, antl that such licenses are in full force antl effect, or I THE PURPOSE OF
am exempt trom Uie provisions of the Sxa2e of Calitornia Business VALUATION
antl Protassio Co<ie, Divi(sio%n 3, Chapte 9.
SiB^ature ot� /��(9% �L��
Perm(ttee ��J_�� $ /!� 6�
i f- � �
Authorizetl Agent /
BET. MAIN &
m
N
O
UNDER VA�UATION IS FOR �
LISHING A PERMIT FEE ONLV: m
¢
m
RMIT FEE $ �
7
m
4N CHECK $ E '
O
LL
TOTAL FEE