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Home My WebLink About3013 COOLIDGE AVE - Building Permits(714) 754-5273 • Fax (7�4) 75a-ae56 • www.ci.costa-mesa.c��LDING PERMIT 77 FAIH UHIVt, GOSTA MESA, GA 92626 JobAddress: 3013 COOLIDGEAV ' � � .' Staws: ISSUED Suite: Applied: 07/21/2006 Vicinity: ROOF Issued: 07/21/2006 Primary Occ: R - Type of Construction: V-N Parcei Number'. 14114156 Zoning: npp�icant: LARSON, DEL Address: 1007 GROVE LN Phone: 949-887-8981 ISSUED BY: � NEWPORT BEACH, CA _- " "" - "Zip: - 92660 _.— - -, ;� .,_., ,. .. _ . /i�,•_:-- - - Owner LARSON, ODECL.F TR' : ' � � '- - `�. Address 1007 GROVE LN%%�; �; � � � _ ; � � � `. ,� � `� � / ,. ' , Phone ��,� , ! '� � �` / 'j _ � � EWPORT.BEACH CA� � � L _ a _ Zip 926601 �1 � �'�/- � �� ' 0�� " � � �..., -_ t. � - / �� ntract � �'OWNER-BU�LDERi-j , ��V �� 4ddress�� : _,�� ' - �� ' ,� � ��,A -_ � V/ � ,i %� %„-' Phone: ~ -\�\�`\\\ /` /� .�\ C ✓ �� / `� .�� <-. '� `. , ,, , �' `.� . ; 'Zip: �. i; � � License: 000000 : �� ; �� r„ i:� A-,. �� `� ,....i , I` {,Zip.'\!\ �;1 / f.i i c .. - � , , � , TEAR OFF E: ; �� NEEDED.24 i�ii � � Eng: ��ii � ' � � Address: ` 1 r= rJ � ' Phone: � � r,� -::,,- '� � -�� ._ ' � . . �� .%„ ... . License: � �%!= � ,j 7 � � ; - . � SCOPE OF�PERMIT -. �`-��, ; A, �OF:,INSTALL 2 IAYERS OF 15# FELT, 20 YEAR COMPOSITION SHINGLES'AN �FOR TRIPLEX.-� �-�-�--� i li' �� ' � �� r' _..._ ._ � � �� ' ', � Plan Check " $0.00 � \\ ; � Permit ' � $97.25 � SMIPRes �� $0.50 SMIP.Com`�:��; $0.00 �', ��, '' �Other`ti'a, !- $0.00 � �� Inspection' a ;; <. $0.00 � �� f" 1 �� Total: � � .�� , \ $97.75 � `:�'�. �) � -. `; � Phone: �., �,..'�,�' � i � .� ! �� License:i' \ � l "� ri ` '�FEE SUMMARY- - =-, , �'-- � ., , -�. , r,-,,.. r , ; �/"' ;r• � , � ;,�a " / '-'; 'a � r,7 ,, �� Calo Valuation ! . � �:' =`ga, "'� �_ • _ _ - ` ` > �'-' ` °'�:Claim Valuatwn: � fi�, � - _ ___ , � s3, � c-S' J � I l � N ' �7� i � �. � , - _� w, �,�,�y � r,,, i � • /' \ z ` � r� - .L \� ji�,Ll`Ci _�1 .� f �f � l- ;i 1 -� � - K__ . . �_ ; �� r� r� /f i� '� `�l�I ' -- , �} `,-( \ l�f/h� , { ` � �" ` -b � i P.LANNING & ZONING SETBACKS� ��'' � ''•b`• - �'�, . \ `�\ � .�t��'• . . �, / !. , '��Pront��.0-0 Rear•,,��6-0� �Left� ��0-0'<'.-_ Right '� 0,0�� `� '`�_ � 7 - � ",i, 'e�r�Y rl %� i � ) :� L 5 td " ' - / ��Pront� 0 0� � `�Rear "0 0,` -'L'eft 0 0 � � Right �0 0 � � /�%' �\ O -c - � - ��_ `�� /a �� E ix stina ,, 0 � Reauired 0� � Pr000sed 0 �- j' � �%()/ � . ti. �� v� f •� �.,�vJ�\_\ .. A' �v. . �� "� ��/ �� . : � i�� .. - �c, -�--�- '"�i �C, l �� /< )�1� ; ,v��> %� . �� r �� `C,^�' �'� _ � � � �� .\ , �- � �,`_�l%,�� -. . , -�� !i� ti �;� L-�. ' � . %% �`^��`-.� �'- -;�.��;., . - ��„�'f� ��, � _ - )6 " � _ .-_ � .'i/: . . . �•� � ` . , NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia stalutes and relaled regulations. (Ord. No. 92-28, § 1, 12-21•92) E%PIRATION: This permit shall automalically 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 ordpr for the work authorized under ihis Dermit to be considered legal, such work must comply with all applicable codes, and all requlred inspeetlona ahd finel epproval musl be obtained. Failure to obtain Inspectlons and final approval will result in ihe expiration of this permlt. FOR INSPEC710NS CALL: (774) 754-56�6 zaaa�as (eroo) WORKERS'COMPENSATION DECLARATON: . . ' ., . I hereDy eHirm under penalty ot perjury one oi ��e following declaretions: '•' � • � � ❑ I have entl will maintain e ceNlicate of consen� to selFlnsure br workers' compensetion, es Orovided for by section 3700 oi Ihe Lebor Code,lar ihe pertortnence of t�e work for which this pertnit is issuad. ❑ I heve enA wlll maintain workere' compensatlon Insurance, as requlred by secGon 3700 ot Ne labor Cotle, for the pertormance of the work for which t�ls permit Is issuetl. My workers' compensatlon Insurence carder and policy number ere: Certier: Policy Number: (^�� ec^uon neea nor ne compierea n me permrt is vewea at one nundretl tloners (Sioo) or Iess.J 1 .. .21.' I.Certity ihet in the pedormence ot Ihe work tor which this permit is issueq I shall no� employ eny parson in eny manner so es to 6ecome suDject to the workere' �' compensatlon laws of Celtlomle, entl egree th if I should become subJect to Ihe workere' compensatlon provisions o1 Sedlon 3700 0� the Labor Cotle, I shell fanhwlth comply wit� these prav�s} �s�. �y. ApptlwnYSlpnewre: � - �f�G / � . ...,Date:'"'�- �lAEWNKirFAILUPETOSECUREWIXiKERS'COMPENSATIONCOVERAGEISUNLAWFULANDSHALLSUBJECTAN PLOYERTOCRIMIW�LPENALTIESANDGVILFlNESUPTOONEHUNDPED THOUSAND OOILARE (5100,000�. IN AODRION TO THE COST OF COMPENSATION, DAANGES AS PROVIDED FOR IN SECiION 3/08 OF THE LABOR CODE, IMEREST, AND ATTOfiNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am licensed under provisions of Chepter 9(commencing with Section 7000) of Division 3 ot Ihe Business end Professions Cotle, and my license Is in full torce end eMecL Lic. p Class k Contractofs SignaWre: Date: CONSTRUCTION LENDING AGENCY: � ❑ I hereby aMirm that ihere is e construction lentling egency for the peAormance of ihe work for which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lendels Neme: Lendefs AUtlress: Signeture: Da�e: OWNER-BUILDER OECLARAT10N5: ' I hereby eHirm t�et under penelry of perjury thel I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness end Protessions Cotle: Any ciry or counry which requires e permit ta construct, elter, improve, tlemolish, or repeir eny strudure, prior to Its issuance, also requires the epplicent for such pertnit to file e signed slatement thal he or she is licensed pursuant to the provislons of Ihe Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) of Dlvislon 3 0l the Business end Professions Code) or ihet he or she is exempt theratram and the basis for the elleged exemption. Any Walation of Sectlon 7031.5 by eny applicent for a pertnit '� su �ecis iha appllcant to a civil Denelry of not more ihen flve hundred dollars ($500).): as owner oi the properry, ar my employees wlth wages es iheir sole compenselion, WILL DO 7HE WOHK, end ihe sWdure is not IntentleA or oHered lor sale (Sec. 7044, Business and Profeuions Code: The Contractors License Lew does not apply to en owner of property who builds or improves Ihereon, entl who does such work himself or hereelf or through his or her own amployees, prwided that such improvemenis are not intended or oXered for sele. If, however, the building or Improvement is eold wiihin one yeer oi complation, the owner-buildar will have the burden of proving ihat �e or she did not build or improve for purpose ot sela.). • ❑ I, as owner o1 the property, em EXCLUSIVELY CON7RACTNG WI7H LICENSED CONTRACTORS to consimct the pro�ect (Sec. 7044, Business end Profeseione Cotle: The contrectors License Lew does not appty to an owner ol property who builtls or improves thereon, and who contracts tor such pro�ect with a contrector(s) .�-licanse pur5uant to the ConlreCtors License LewS.). Business and Professions Code for this reason: OwnerlD'verified by dnvefs licensi� Ves ❑ No Vedfication o1 Ownership 6y (type ot Cocum , i.e. - properry tax bill or DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATON: ❑ I hereby certHy ihat no excavetion frve (5) or more teet in depth into which e person is requiretl lo tlescend, will ba made in connection wlih work euthorized by �his permlt, entl that no builtling siructure, scatfoltling, telsework, or demolition or disman�ling Ihereoi, will be more then thirry-six (36) feet high. (Chep. 32, Grp 2, Ar12, Sec. 341, Titla 8, Cellfornia Administrative Code). ❑ As awner-builder, I will nol employ enyone to do work which would require e parmit from the Divlsion of Indusinal Sefety, es nated ebove, unless such pereon has a permit to tlo such work trom the tlivislon. Signeture: Date: Division of Indusirial Safery Pertnit Numbar: CERTIFlCATE OF COMPLIANCE AND AUTXORIZATON OF ENfAY: I certify under penalry of perjury ihat I have read this epplication and stete that the Infortnation given is conecL I agree to comply with all state laws enG ciry ortlinences relating to building construction, and authonze representa�ives oi Ihe City ot Costa Mesa to enter upon Ihe ebove-described properry 1or i c n purp�s�„ I agree not to wcupy or allow occuDency of eny building authonzed by t�i perm' until (inel inspection. .��`li i��L��-_ 7�'�/�� ,: Siqnature.0 I Owner(sl�_,._.: � :Dete r .. �. AnNOr Authonzed Applicant Date SOpEI, INSPECTIONTYPE pp1E 1618 Fixetl System Finel Flre PreventlOn 7266 Pool Spe Final 200 Finel Re-Roof 201 Final BIocWRetaining Well 202 Finel Fectory Fire Place 203 204 Finel Sign Finel Damolition -[o-a') � � GOOE� INSPEGTIONTYPE 206 �FinalMec�anical 208 210 212 220 222 . ,. 250 Finel Plumbing Pinal Electrical � Finel Fire Prevention Finel Planning Approval � Final Site Final Building/Occupency aeiE I�e�s JOB ADDRESS G�NERAL CO] AP No.11ll—lI INSPECTIONS OCCUPANCY �ORM BU4 - SM — KOI,L, K. W, 1�7 DATE 6-8-i>2 BUILDING PERMIT vnLUE S 288. LOT TRACT PIRE ZONE D�SCRIPTION OF WORK Signature DATP GROUPRet.WaYa.YP� III 7.ONE 1 PLRM] —� SUBCONTRACTOR ,_,,,,,,�.T Ret.Wall ;� ' � • I 7236 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 377 COBTA MEBA. CALIFORNIA For Applieanf fo Fill In Complefely. TYPE OR PRINT BUILDING � � Q/ ADORE55 COSTA MESA. CALIFORNIA OWNER A i� !� e I I FE� RECEI.��D �y'� �uri e tss2 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT eui�uiw� For Office Use Only FECEIPT NO. N OR ENGINEER �—� No. COSTA MESA. CALIFOF#NIA ADDRESS FIRE ZONE TYPE GROUP I.tJL� � APPROVED �� CONTRACTOR pSGx� 'Gti. �. BY � DATE - C ADDRESS I V S C '�'U�'� ZONING ^, � ZONE I NO. OF I U5E OF NEW /r�/� CITY �� v�� t�-� �� PLANB �7-� BIIILDING h`. �j R�/� ( STATE TEL. �Ecw� � LIC. NO. � s No. J� ya � DESCRIPTION � 43 %/� / L 8/ SIZE NO. OP BLDGB. ) ��, _ 3 OF LOT — Now oN LOT / q. p, Np, �� I— � USE OF . YARDS EVES EXISTING BLDG. �M � APPROVED ALLOWED 9HTBACK LINE FROM ! C� (GENTER LINE STJ , csHi¢n oF eTrseET -/ �/ REAR YARD � FRONT �—' IN. SIDE YARD ILEFT 6 IRIGHT � R.SIDE FT. IN. DESCRIPTIOPI OF WORK L.SIDE -�-FT. / ?� ,N. NEW I IIALTERATION I'JIIA�DITION I REAR � FT. � IN. REPAIR I_—II MOVING I-- II OEMOLISH I ByPROVED�n DATE `"/ /� � R BUILDING NO. OF ,� SIZE ROOMS STORIES ' EXTERIOR WALL ^� ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED /O$ �/�s �o� 6 x S x/ �"��'��s I HEREBY ACKNOWLHD68 THAT 1 HAVE R6AD THI6 APPLIGTION THE AMOLINT HHOWN UNDER VALUATION I6 FOH THE ANO BTATE THAi TXE ABO E 19 COR�� ANO AGREH TO COM- pUPP08E OR, ¢8Tp0L18HING A P¢RMIT FEE ONLY. PLY WITH ALL GIiY O A CE6 ANP T¢ 8 REOUTATIN6 BUILDINO'CONBTiU VALUA710N� ' � SIGNATURE OF PERM17 FEE S �� PERM17'TE q p p % �� $ '� � � PLAN CHECK $ AUTHORIZED AGENT - � A�'. TOTAL FEE (� Lor 4 TRacr 428t .. s, . ��0� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX S17 C08TA MEBA. CALIPORNIA For Applicani fo Fill In Complefely 0 MAIL COSTA MESA. CALIFORNIA , _ „ _ KENNETH W. ,KOLL EWPORT BEACH� BALIFNo.MI E)�Z TEL. z NONE No.------ t """"' _"""' _' _""" 1.. C/� 1 I NO. OP BLp08. U88 OF EXISi1NG BLDG. aerencK uxe vaorn cerireR o> srneer h7 � REAR YARD 2�! 81OE YARD I LEFT � O� I RIGHT H� DESCRIPTIOId OF WORK iAR: 4 SF No. oF t i n • OOMS WALL IROOF APPROVED LEOAL FE� RECEIVED \ JAN q 1962 ; FINANCE DEPT. CITY Of COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO. PERWT/Nd� owre ieeueo COSTA MESA. CALIFORNIA I � ZONING "Y INO. OF U8H OF NEW % i PLANS � BUILDING �/� n�ox � `/3 'T�C vtifi O. YARD6 EVES APPROVED <Qnren uHe sr.� � FT. � � FT. ��( FT. � � ��.d� IIATF � 1 HEREBY ACKNOWLPOGE TXAT � NAVE READ THi9 APPLIGTION THE AMOUNT 6HOWN UNDER VALUATION IB POR TH¢ AND BTATE THAT TXE ABOVE IB CORRELT AND AGRE6 TO COM- pUqp08E OF EeTABLI8HIN6 ♦ PERMIT FEE ONLY. PLY WITH ALL CIiY OPDINANCES AND 9TATE LAWB RE6ULATNO BUILDING CONBiAUCI'ION. VALUATION SIGNATIIRE OF PERMIT FEE $ �� PERMITfE �/(y� ��_ �J $ ✓ % � PLAN CHECK $ � l '' AUTHORIZED AGENT ^� "' p ��`�