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Home My WebLink About250 COSTA MESA ST - Building Permitsr �• � (714) 754-5273 • Fex (714) 754•4856 . www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT �ob Address: 250 COSTA MESA ST Suite: Vicinity: ROOF Parcel Number: 42628224 Applicant: KELLY WILLIAMS Address: 613 SHASTA LN COSTA MESA, CA Zonin9: Phone: (714)444-1'111 Zip: 92626 Owner: HEBERT, DONALD AND SONYA Address 250 COSTA MESA ST COSTA MESA, CA Contractor: ALL COAST ROOFING Address: 613 SHASTA�LN COSTA MESA, CA Zip: 92626 Arch : Address: Phane: 949-646-6106 Zip: 92627 Phone: (714)444-1111 License: 598440 Eng: Address: Phone: ISSUED BY: Slatus: ISSUED Applied: 11/Ot/2004 Issued: 11lOt/2004 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 30# FELT, 30 VEAR G.A.F. TIMBERLINE, FIBERGLASS SHINGLES. 23 S�UARES INCLUDES ATTACHED GAR.4GE. � � . FEE SUMMARY Plan Check: $0.00 Calc Valuation: Sa,000.00 Permit: $97.25 " Claim Valuation: Sa,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 .' Inspection: ' $0.00 � �Total: $97.75 ' � � � � � � � . - PLANNING & ZONING � - SETBACKS � � � � � � MAINSTRUCTURE�Front 0-0 .' ��Rear � 0-0 Left 0-0 Right- .0-0 ', " � � ACCESSORY � F.ront 0- 0 Rear 0- 0 Left 0- 0 Right 0- 0 , PARKING Existin :. 0� Required: � 0 � Proposed: 0 , "�. NOTICE: Tha work authorized by Ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) �' EXPIRATION: This permlt shall automatically expire and become void if work is not commenced wlthin 180 days, or ii work is suspendad or abandonetl fo� a period o� 180 days. � INSPECTIONS: In order tor the work authorized under this permit to be considered legat, such work must comply wilh all applicable codes, and all Irequlred Inspeetione and final epproval must be obtained. Pailure ro obtain inspections and final epproval will resN� in �he explration of tNs pertnit. FOR INSPECTIONS CALL: (714) 75M5626 244Bd8 (fi/00) WORKERS'COMPENSAnON DECLARAnON: � ' . _ 1 hereby attirtn untler penalry of perjury one of lhe followinq declarations: ❑ I have and will maintain a cenifiwte ot Gonsent to self-Insure for workers' compensation, es providetl for by section 3700 of ihe Lebor Code, for ihe pertormence of Ihe �work tor which this permit is issuetl. ' I.have antl will maintain workers' comper�salion insurance, as :equired by section 3700 ot the Lehor Cotle, for Ihe peAortnance of the work tor which this permit is issued. AAy worker ' com ensalion urance c8�ner and policy num6er are: �mer: �.�� .C]�-a.. � �l Y\ �. �'Pollcy Number..-�.� C7 � � q �C — �-OU �_ QTi/s�sectlbn need not be completed i/ the peT��t is valued et one hundred dollars (3100) or less.) ❑ I certify Ihat in the performance ol ihe work for w�ich Ihis pertnit is issued, I shall not employ any person in any manner so as to bacome subjecl to the workers' compenution laws ot Califomia, end epree ihat il I should become su6ject to Ihe workers' compensation provisions of Section 3700 of the Wbor Cotle, I shell torthwith comply with these r sio%� ` AppFeent_Slgnaiure=�'O V�� Q Q � at�`�� t I I D � _-� � _ r°- __-- � `1 W�JING-FA1[URE TO SECURE WORK S' COMPENSAiION COVERAGE IS UNLAWFUT AND SMALL SUBJECT AN EMPlOVER TO CRIMINAL PENALiIE AND CML FlNES UP TOONE HUNDRED TFKKISAND OOILARE (5100,OW�. IN ADDRION TO TME COST OF COMPENSATIOft, DAANGES AS PROVIDED FOR IN SECTIIXJ 3%OB OF THE IABOR CODE, ItJrEREST, AND FTTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 9(commencing wit� Section 7000) ot Division 3 of tha Business and and my license is in full CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm that there is a consWctiOn lending agency br ihe performance of �he work for which �his permit is issued. (Sec. 3097, Civil Cotle). lenders Name: Lenders Atlaress: SignaWre: OWNER•BUILDER DECLARAT10N5: Date: I hereby affirm that under penalry ot perjury Ihat I am EXEMP7 FROM THE CONTRAC70RS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires e pefmit to construci, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the apD�icant for such pertnit [o file a signed statement ihat he or she Is IicBnsed pursuent b the provisions oi ihe Contrectors License Law (Chepter 9(wmmendng with Section 7000) of Dlvision 3 ot ihe Business and Protessions Code) or thet he o� she is exempi therefrom and the besis for iha allaged exemption. Any violation oi Sectlon 7031.5 by any epplicent for e permit sublecis the applicent to e civil penalry oi not more than tive hundred dollars (5500).): ❑ 1, as owneo ot the property, or my employees with wages as their sole compensation, W1LL 90 7HE W ORK, end the siructure Is not intendetl or otfered tor sala (Sec. 7044, Business and Professions Code: The Coniractors License Lew tloes not apply to en owner ot properry who builtls or improves thereon, antl who does such work himself or hersetl or �hrough his or her own employees, provided Ihat such improvements ere not intended or oNered for sale. If, however, t�e building or improvement is sold within one year of complelion, t�e o�+'ner-builder will have the Duiden of proving that he or she did not builtl or improve for puryose of sale.). ' ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Protessions Code: The coniractors License Law Coes not apply to an owner of propeny who �uilds or Improves thereon, and who coniracts for such projeci with e coniractor(s) license pursuant to the Contreaors License Laws.). ❑ I am exempt untler sec. Signalure: Owner ID verifietl by dnvers license. ❑ Yes ❑ No Business antl Professions Code tor this reason: Venfiwtion of Ownership 6y (type of tlocumeni, i.a. � property tax bill or deed): Dnvar s License No. Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify ihat no excavation tive (5) ar more feet in depth into w�ich e person is required to descend, will be mede in connection wi�h work authonzetl by this pertnit, and t�at no building simaure, sGeholding, lalsework, or demolition or dismamling thereof, will be more than thirry-six (36) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle e, Celitomia Atlmin15ir8live Coda). ❑ As ownerbuilder, I will nof employ anyo�e to do work which would require a pertnit trom the Division of Industrial Sefery, as noted ebove, unless such person has e pertnit to do such work trom ihe divisian. Signature: Date: Division of Industrial Safery Permit Number. CER7IFICATE OP COMPLIANCE AND AUTHORIZA710N OF ENTHY: I certify under penalty of perjury ihat I have read this epplicetion end state ihat the information given is correct. I agree to comply with all state laws and ciry ordinances relating to building constructlon, end euthonze representatives ot the Ciry ot Gosta Mesa to enter upon the above-described properry tor inspeclion purposes. I agree not to occupy or allow occupancy of eny building authorized by ihis permit until finel inspection. COOE t. INSVECTIONTYPE 1616 Fixed Sys�em Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining W ell 202 Final Factory Fire Place 203 Final Sign 204 Pinal Demolition PAIE . 1t�E45 COOE 1 INSFECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Flnal Fire Preventlon � 220 Final Planning Approval 222 Final Site " 250 Finel Building/Occupancy QAg It�ELfl . . _.. ,. . . I . �Jj . ` . •� , r CITY OF COSTA MESA �' nur, 22-�3PA�°00� �ss ��'r=338.27 1_�� PAR 3ES r.w_'- d.,.- �� l�, Fee Payment Receipt ?�Ta i� (� 6 I P� �/ / � Projec[ Address iX �Z� �-' • �ir S/-i1 1�.� S C� � Park Area �� A. P. No. / �R — ��' - f� � Building Permit No. � �� %� %� `*. Owner's Name v �/ Mailing Address �r-�� . —�.� �� -�1�'� _. FEE �< ^ , Single Family * No. of Units ' � � @ 5338.27 = ` � �� a �% Multiple Family ** No. of Units @ 5238.78 = Total Fee . � � �• � � Planning Depaztmen[ Approval Date /� —....'�' �l —� � By G(/L. %� �� ' Applicant's Signature ' City Ortlinance 72-44 � " Clty Ortlinance 72-45 . �� 0 �� I A � 24900 COSTA MESA BUILDING-SAFETY DEPARTMEM P.O. BO% 7T00 - GOSTA MESA. CAIIFORNIA B262E For App(lcant to Fill In Completaly TYPE OR PRINT COSTA MAIL AOOHHHC Z � [y O6TpACK LIX[ IROY CALIFORNIA ✓ No, or ��nw. DESCRIPTION OF WORK LRIOR WALL ERINQ oR eu��in ' 1 HERCBY ACKNOWL8D08 THAT, 1 XAV[ 116A0 TN�i APPLICATIOH AHO 8TAT8 TXAT TM6 ABOV[ IY CORR6CT�AHO /�ORB[ M COY. PLY WITFi ALL CITY OpDINANCi� AND /TAT6 LAW/ RiOULATINO eu��o�wo <oNernuGpitb A Un // � AUTHORIZiDAGQNT C�TY �� ,:��,� ��SA NOV 12 1965 APPLICATION FOR PERMf ZONIN(i wo.o� � uaaorr+nv �ux� C ew�oixo L�, 7 / � 1� � � X—/ 31 - (Y,[ OV[RHANO SHALL E6 LEBB THAN YARDH MPROVED MAIN BUILDIN6 VM. �I YARC9 MPROV6D ACCEiSORY BUILDINO BHT. MAIN Q ACCEBD. BLI CATH ., - - � �� , - � � ea. v'r. � TH8 AMOUNT BNOWN I1ND[R VI1lUAT10N 18 FOR TNC j ■UHPOG6 OP [BTABLIBMINO A PHpMIT F8H ONLY. l. VALUATION Qa- .00 ?� �, PEXMITFBH p s 1.7.� ` w VVVIYGR rySI�1,LlVV HLVIDIV� 1•1. LA'1'C: --'-�-'�`--`�l JOB ADDRESS •250 C06ta. Mesa Street BUILDING �PF.RMIT NO. GENliRAL CONTRACTOR owner DESCRIPTION OR WORK dem. res. !'O.l1A-1�2_pl LOT TRACT FIR� ZONE VALUE $T75.00 Ih„�ECTIONS I Sienature I Date � GROUP S TYPE V ZONE Rl SUBCONTRACTOR Brown U�nCK OB ADDRESS � ROUGH PLUMBING � PROP. SWR. LINE HqUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO Alp CONDITI TEMPORARV SERVICE OR POLE UNOERGROUND � PbWER � ROUGH WIRING TRENCHES � FORMS � STF FLOOR SVSTEM BONO BEAM ❑ STEEL REINF( SHEATMING FRAME AND FLASHIN ' LATHING — IN OUT � PLO'-4R,BROWN COAT S1 URAL, FINA� HEAi iNG, VENT., REFRIG. AND A: PIUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL, SPFCIAL REOIIIREMENTS UAIC BUILDING $UBCONTRACTOR �"• �7DB f Z . a cwj Z ZQ ON am J � J V1 Q1 J J m Q U N ZQ W � aw WZ J Q m Z J � W W O= Z F- w� N ¢ 70 COSTA MESA BUILDING-SAFETY DEPARTMENT o n anx »nn rncTn nncsn cni iFnan�in a�a�e dliG'7_?_-73��,5�001193 c�'+****9�.50 PL ION FOR BUILDING PERMIT For Applicanf to Fill in Completely qE iv DATE (7ECEIVED DATEISSUED BUILDING % AODRE.^�S S �� `�� PERMIT NO. OWNER �1.P. NO. MAIL BUILDING % �5,� ADDRESS ADDRESS � �� TEL. TRACT LOT BLOCK CITV NO. CANSTRUCTION W AD A E P LENDER BRANCH ,I .• c OWNER '(� (,y� ADDRESS VALUE ARCHITECT TEL S �S�Q �,.�+�� $ OR ENGINEER N FIFE ADDRESS ZONE TVPE ROUP APPRO V E � CONTRACTOR BV DA � ADDRESS TEL. ZONE NO.OF USE OF NEW CITV NO. P�� BUILDING STATE CITV �'ARDSAPPFOVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SI2E NO.OF BLDGS. (FROM C/L STREET) OF �OT NOW ON LOT FflOM FT. FT. USE OF EXISTING BLDG. FT. FT SIZE OF NO. OF NEWBLDG. ROOMS STOFIES L.SIDE FT. FT. EMERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUIIDING AND WOFK TO BE PERFORMED DISTANCE 9ET. BET. MAIN & MAIN BLOGS. ACCESS.gLDGS. VAR. � DATE C.U.P.# IWPROVED APPROVED 1 horeby acknowleOBa that I have read this application antl sta[e 1./ that the above in7ormation (s correct antl apree to comply with � a11 lews repuloting builtling construction, and I shall not employ any person in violation of th¢ workmen's compensation laws ot th¢ State of Calitornia. a �j�, u I hereby certify ffiet I am prop¢rly licensetl as a contracior untler SQ. FT. Gv ' the State ot Calitornia Businass antl Professions Cotle, Divisicn 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR Chapter 9, and i�er such licenus are in full torca antl etfect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Q am exemp[ (rom tl e provisions ot SheState of Californla B�siness VALUATION and Profossions Cnue, Division 3, Chepter 9. PERMIT FEE S �- = Si8^ature ot `- a Permlttae $ PLAN CHECK E S•-7J c Authorizod ABent � � TOTAL FEE 5 � 3708I ' COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant ip Fill in Completely BUILDING � �� /// ADDRESS Q/.F � OWNER \Ii�• 1—�UlJV � MAIL �j ADORESS l{ ✓ E �" � C_�j%� ��T� C� S'�4 M�s:a- No`. CANSTRoUCiION � �n ��i BRANCH ADDRESS ADORESS � Z J �G� �/�[!-��I v�Z� / C/' I CONTFACTOR�(.l��G� �L�� ADDRESS 3 v E� Z� /4D ^ TEL. CITV � � �h/� t, SK � NO.��`ZI) STATE CIT V IIC. NO. LIC. NO. SIZE NO.OF BLIX't5. OFLOTS��I �� INOWONLOT IV VSE OF EXISTING BLOG. NEW BLDG. ��" � FOOMS S STORIES / EXTERIOR WALl�- ii00F COVERING J�%�-L' � COVERING I�G��' USE OF BUILDING AND WORK TO BE PERFORMED A.P. NO. BUILDING ADDRE55 R ROVE � PAIO 1111.31-73cMsa002899� *�•**:47.58 FOR BUILDING PERMIT `'E��CEA� DQF�IS�U / S� r-. LL- VALUE 1 NO.OF USE OF NEVyr/ivG PLAN� BUILDING S. VARDSAPPROVED VAROSAPPPOV MAIN BUILDING ACCESSORV BVII ROM C/L STREET) VAR. �I`- C.U.P. # FT BET. MAIN & ACCESS. BLU DATE APPfiOVED _ I hereby acknowledge that I have reatl this application entl state �� '�"�""'�" �/ Ax that Me above information is correct and aB�ea to cOmply with �(�y.e all laws regulating builtling construction, and I shall not employ / . any person in violation ot the workman's compensation laws ot the State of California. � ! � 1 hereby certify that I am properly licensetl as a contracmr under SQ. FT. o tha State of Calitornia Business entl Professions Code, Dlvisicn 3, THE AMOUNTSHOWN VNDER VALUATION IS FOR � Chapter 9, and that such licensez are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m am exempt from the provisions of ffie Stete ot Calitornia Business ¢ VALUATION m entl Profess' ae, Division 3, Chapter 9. PERMIT FEE $ '�— � � Signatura ot �/ ///�� ,,,��, '7 6 m Permittee �� G � $�� PLAN CHECK $ E �F� `o Authorizetl Agent � _LL TOTAL FEE $