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Home My WebLink About253 CABRILLO ST - Building PermitsJobAddress: 253 CABRILLOST Suite: Vi�inity: ROOF Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 42546103 Zoning: Applicam: KIM MCCLAIN Adqress: 12812 VALLEY VIEW ST STE 33 GARDEN GROVE CA _ Owner: GROSS, DAVID Y" Adtlress 2595 IRIS WAY LUGUNA BEACH, CA Contractor: MCCLAIN ROOFING INC. Address: 12812 VALLEY VIEW ST - STE 33 GARDEN GROVE CA ... ' Zip: 92845 . , Arch : Address: Zip: Phone: LiCense: -Phone: (714)897-1780 �:.' Zip:. 92845 Phone: - �� Zip: 92851-4014 Phone: (714)897-1780 License: 625013 Eng: Address: Status: ISSUED Applied: 09/30/2005 Issued: 09/30/2005 ISSUED BY: '� Phone: License: SCOPE OF PERMIT �- TEAR OFF EXISTING��ROOF. INSTALL t LAYER OF 30# FELT, 30 YEAR COMPOSITION SHINGLES AND REPAIR/REPLP,CE SHEATHING AS ' NEEDED. FLAT ROOF ON ATTACHED GARAGE. WSTALL BUILT UP ROOF MATERIAL, HOT ASPHALT. 22 SQUARES FOR S.F.D. ANb 5� � �SQUARES FOR ATTACHED GARAGE. - - ' -. PEE SUMMARY : Plan Check: $0.00 Calc Valuation: 3s,000.00 Permit: $125.25 Claim Valuation: Ss,000.00 SMIP Res: $0.60 " SMIP Com: $0.00 — Other:. , � $0.00 Inspection: $0.00 Total: $125.85 SETBACKS MAIN STRUCTURE Front 0- 0 -. ACCESSORY Front 0-0 PARKING Existin : 0 PLANNING & ZONING Rear 0- 0 Left 0- 0 Rear 0- 0 Left �- 0- 0 Reauired: 0 Pr000sed: 0 Right 0-0 Right 0-0 NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements 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 tor a period of 780 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetiona and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaas�ae (rvoo� WORKERS'COMPENSPnON OECLARA710N: � I hereby ettirtn under penelry ol perjury one ot Ihe tollowing tlec�arations: ❑ I heve end wlll main�ein e certlficete of consent to self-Insure tor workers' compensatlon, es proviAetl for by section 3700 of the Labor Coae, for the peAortnence ot the wOrk for which Ihis pennit 15 i5suetl. � 1 have an0 wlll meintain workers' compensation insurance, as required by �c167e�,�700 of I�e Lebor Coda, for ihe peAortnance oi the work for which this pefmit is Iuuetl. My workers' compens�a[�on Innsurence carrier end policy num6er ere: � .(.+-,' j, `. �';i :��4:' ' /I �1 Cartier. � �i�� f ��iJ �� . f � . � . Poyicy Numb9 � � I �711 V '� D DS (Thls sec0on need nof be �wnp�efed il the permi( B va/ued et one huntlretl dWlers (S]00) or Ie4sJ ,� :,�( '`v- . . �i7.. .j:g� it� .�J� t: ❑ I cartity that in ihe partortnance of ihe work for which this permit is issued, I shell not employ eny person in any mennei so as'lo becoma subject to the workars' compensatlon laws oi Gallfomia, entl egree that it I shoul0 become sub�ect to t�e workers' wmpensatlan provisions oi Spctlon 700 oi the Lebor CoAe, I shell forthwit� comply with �hese p o IonS `/\ /J �n^ � Applicent SlgnaNre: ��1� �� Date: �/' F MJ �S WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION G1�VERAGE IS UNL4WFUL lWD SHALL SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000). IN ADOITIIXJ TO THE COST OF CAMPENSATION, DAMAGES AS PiiOVIDED FOR IN SECTION 3]O60F THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSEO CON7RACTORS DECLARA710N: I hereby aHirm ihet I am IICe sed,�j d�er$ rovisions of Chapter 9(commencing with Section 7000) oi Divislon 3 of the Businegs�ry� Professions Code, entl my Ilcense is in full torce end eHect. Lic. # Z7 ti l 5 Class q ii �i Comradofs SigneWre: ��7 � Date: �A � � 0\� CONS7RUCT10N LENDING AGENCY: ❑ I hereby eHirtn that there is a wnstruction lending agency tor the pedortnanca ol the work lor which this permit is issued. (Sec. 3097. Civil Cotle). Lenders Neme: Lentler's Address: Signature: Date: OWNER•BUILDER DECLN�AnONS: I hereby atfirm that under penalry ol perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professions Code: Any ciry or county w�kh requires a pertnit b cons(ruct, alter, improve, tlemollsh, or repair eny structure, pnor to its issuance, also requires Ihe ap0�icant br such pertnit to file e signed stetement t�et he or she is licensetl pursuent to Ihe prodsions ot the Contredors License Law (Chapter 9(commencing with Section 7000) of Divislon 3 of ihe Business end Pmlessions Code) or Ihet ha or sha is exempt iherefrom end Ihe basls br the elleged exemption. Any violation of Section 7031.5 by eny applicant tor e pertnit subjects the epplicant to e �� Penalty of not more than five hundred dollars (5500).): ❑ I, as owner of Ihe property, or my employees wlih weges as iheir sole compensation, WILL DO THE WORK, and ihe sWcture Is not intended or otteretl ior sale (Sec. 7044, Business end Professims Code: The Contractors License Lew tloes not apply to en owner of properry who builds or improves Ihereon, and who tloes such work himself a herself or through his or her own employees, providetl ihat such impmvements are not Intanded or oHered for sale. If, however, ihe builtling or improvement Is sold within one year ol completion, Ihe owner�builder will have the hurtlen of proving that �e or she did not build or improve for purpose oi sale.). • ❑ I, es owner ot the propeny, em E%CLUSIVELV CONTRACTNG WIIN LICENSED CONTRACTORS m constmct the project (Sac. 7044, Business and Protessions Code: The conirectors License Law does not apply to an owner of pmperty who builds or Improves ihereon, and who contracis lor such project with a contractor(s) license pursuent to the Contractors License Laws.). ❑ I em ezempt under sec. Business and Protessions Code for this reeson: Signeture: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivefs License No. Vedlicetion of Ownership by (rype ol tlocument, i.e. - pwperry tax bill or tleetl�: DIVISION OF INDUSTRIA� SAFETY PERMI7 CERTIFICATION: Espires: ❑ I hereby certily thet no excavaGon tive (5) or more teet in depth into w�ich a person is requiretl to descand, will be made in connec�i0n with work authorizad by Ihis pertnit, end that no building structure, scaRolding, falsework, or demolition or tlismamling t�ereof, will be more ihan thirty-six (36) faet �igh. (Chep. 32, Gry 2, An 2, Sec. 347, 71t1e 8, Celifomia Adminislretive Cade). ❑ As owner-builder, I will not employ anyone to tlo work which woultl require e permit from the Division of IndusMal Satety, es noted above, unless such person has e permit to do such wtlrk ��am Ihe division. Signeture: Date: Division of Industrial Sefery Pertnit Number: CER7IFlCATE OF COMPU�UICE AND AUTHORIZATION OF ENTRV: I certity under penalry of perjury that I heve reatl this application end state thet ihe Informatlon given is correct. I egree to comply wl�h all sia�e laws and city ordinances relating to bullding consiruction, entl authorize representatives of the City ol Coste Mesa to enter upon the above-descnDed properry lor inspection puryoses. I agree not to �cupy or allow occupancy of any building authonzed by this pertnit until linel inspection. ��Si�nature Oi Legal Owner(s) Dpte1� / i'G"�_ G��zO � o AnNOr Authonzetl Applicant � ate COOE I. INSPECTIONtYPE 1616 Fixed System Flnal Fire Prevention 1268 Pool SDe Finel 200 Finel Re-Rooi 201 Final BIocWRetaining Well 202 203 204 Flnal Factory Fire Place Final Sign Final Demolition PAIF 1[�d65 1 ' :._ COOE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plum6ing 270 Final Electncal 212 Finel Fire Pravention 220 Final Planning Approval 222 FinalSi�e 250 Final BuildinyOccupancy PAg �5 K. W. KOIS, CONST. C0. fOB ADDRESS G; Street A DATE �10-'j-` PER1l3IT NO. GENERAL CONTRACTOR S�me � VAL[IE S 27af361.00 � AP. No. LOT 2p TItACT 32p� FIRE ZONE • DESCRIPTION OF WORK Trip x w�att garagQ_ GROUP $& J TYPE V ZONE R�F PLAN NO. ' PERMITSISSUED INSPECTIONS DATE gUBCONTRACTOR DATE NUMBER coat S n�a/ r� .a�%LO c�tt.+�� •�' � ��,� i � -OwNER K• N. KOIS, CONST. C0. , JOB ADDRESS 253 Cabrillo Street GENERAL CONTRAC'TOR SaIDe ' AP. No. GROUP INSPECTIONS wa[ Pinal 22 �cr 3202 c�e zo & J TypE V ZONE DATE � FOR SPECiAL SUBCONTRACTOR DATE l0-7-58., BllILDING PERlvtiT NO. VALUE $ 2'7, 1.00 �VORR PLAN PERM � � �OWNER K. W. I{OLL CONST_ Cn_ DATE lp-�-T(j - — JOB ADORESS 2,� Cabr;�l'I o. Straa+ � BUILDING PERMIT NO. 7762 GENERALCONTRACTOR S3mE' VALIIE $ Q7�$61.00 AP. No. LOT 22 TRACT 3202 FIRE ZONE � DESCRIPTION OF WORK Triplex w�2,tt garage GROUP H&�`� TYPE V ZONE R PLAN NO. INSPECTIONS ' I DATE I SUBCONTRACTOR I DATE � NUMBER In . Final Gas Test � • '"( . ;�► " _ '7'��2,: Ct�STA MESA BUILDING DEPARTMENT - P.O. 80% 31] COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN aooR �s"s 253 CABRILLG STREET `L .�j%yr COSTA MESA. CALIFORNIA OWNER K.?•I. KCLL CGb,ST. CO• ADDRE55 �LV�L6 1�"1PORT BLVD. C17V ;;EWrORT �ACH No OR 36600 ARCHITECT py,mer ��' OR ENGINEER NO. A�DRESS CITV LEGAL LQT DESCRIPTION NO. A.P. NO. S�ZE 55•39'X 140.06� �° °F ��OG6. O OF LOT NOW ON lOT USE OF E%ISTING BLDG. SETB<CN LINE FROM �^ ccNi[w or sine[j ��/ �'J D REAR VARO ��, I��-2�1 C SIDE YARD y�1�RIGHT �.U� �FT DESCRIPTION OF WORK NEW X ALTEFATION ADDITION REPAIR MOVING DEMOLISH 5 ZIE DING 1 07 ROOMS STORIES �L COVER'INGWALL StuCCO COVERING HBt I'iOD USE OF NEW J. -_ %' �—� � / � B111L�ING ADLS. l�—�l e_ . ►-�E 6�ECE1�� F! �.��n�S.p�T AP C�f�BU�I?LpD�I NGPERM IT FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO. ECErvEO BY OATE RECENEO �p_.j$ F � p _�� VI f _DING RE55 COSTA MESA, CALIFORNIA FIRE ZONE 2ON�R� APPROVED BY CORRECTIONS J I XEREBV 1CNNOWLE�GE TMST I N�VE RE�� TNIS 4PPLIC>TION RNp STiTE TM4T THE 490VE IS COFRECT ANO AGNEE TO COMPLV �'/ITM nLL CITY OROINf�NCES ANO ST L�W$ FEGULATING BUILOINCi CONSTRl1C� iION. VALUATION SIGNATURE OF PERMIT FEE 5 o-� PERMITTEE � ' � �J � /%�j� PLHN CHECK $ cZ 3. S § Of Q AUTHORIZED AGENT TOTAL FEE 8 %�. 'f � "°M� I I