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Home My WebLink About926 CORONADO DR - Building Permits�� (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa��TRICAL PERMIT 77 FAIR DRIVE, GOSTA MESA, GA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: ApplicanC Address: 926 CORONADO DR 14132318 MICHAEL PHILLIPS Owner GOMEZ, DANIEL M Address 926 CORONADO DR Contractor Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa .Lighting Fixis � Recept Outlets Switches Non Res Appl Res Appl Service to 200a � Service to t000a Service over 1000a Motors to 1 hp Molors to 'I Ohp Molors to SOhp Molors to 100hp Motors over 100hp , Communication drops Sub panet fo 200a Pole Light Pkg Sign Circuils Temp Pwr Pote Intermed Pole COSTA MESA, CA Phone: 714-981-2089 Zip Phone: Zip: 92626 Phone: 2ip: License: SCOPE OF PERMIT SERVICE CHANGE-OUT TO 200AMP Quantily $23.50 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.50 $0.00 $0.00 $0.00 $0.00 $0.00, � __ 50.00 $0.00 ' . $0.00 $0.00 $0.00 $0.00 50.00 50.00 FEE SUMMARY Temp Dist System�/ Lighting Busway /100 fl , Standing Section - Misc Electrical Equipment Transformers up to � kva/kw . ................up to 10 kva/kw ...:........:....up to 50 kva/kw ..................up to 100.kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit � �- Misa Conductor Cikus.( gen or ride) Circus (mech ride or lights) Christmas Tiee Stand Fireworks Stand, :� �� , ' � - Other Electrical Fee Investigation Fee Pian Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: OS/16/2007 Issued: OS/16/2007 ISSUED BY: Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00. 0 $0.00 0 $0.00 50.00 50.00 $0.00 $54.00 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § t, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a peiiod of 180 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 inspeetlons and final approval must be obtained. Failure to obtain inspections and final approval will resuN in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2ad6-46(N00) WORKERS'COMPENSAnON DECLARAnON: I hareby ettirtn untler penalry at perjury one at the tollowing decleretlons: ❑ I have end wlll meidtain�e cerUjicate ot consent to sell-Insure for workers' compensatlon, es proNded for by sectlon 3700 of �ne L•abor f�otle, for the peAortnence of the work for which this permlt Is Issued. ❑ 1 have and wlll meintain workers' compansetion Insurance, as required by sectlon 3700 of ihe Lebor Gode, tor the perfortnance of the work for which this pertnit is Issued. My workers' compensatlon Insurence certler entl policy number ere: Certier: PoliCy Number: (This section need nol be completed i! fhe permif is valued et one hundred dollers ($100) or IessJ ❑ I certify t�al in t�e pertortnance of the work for whlch this permlt Is Issuetl, I shall not employ eny person in any menner so es to become subjact to Ihe workers' compensatlon laws ot Califomla, end egree that II I ahoultl become sublect to Ihe workers' compensatlon provislons oi Section 3700 oi Ihe Labor Code, I shall forthwit� comply with thesa provislons. Applicent SignaNre: Dete: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL M1D SHPLL SUBIELT AN EMPLOYER TO CRIM�WIL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000�, IN ADDITION TO THE COST OF COfAPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 31080F THE LABOR COOE, INiEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLAHATION: I hereby eHirtn that 1 am licensed under praWsions of Chapter 9(commencing wlth Sectlon 7000) of Divisian 3 at t�e Business end Professions Code, entl my licanse is in full force antl eHect. Llc. p Class M Gontrectafs Signature: Dete: CONSTRUC710N LENDING AGENCY: ❑ 1 �ere6y aflirm ihat Ihere is e conslruction lending egency tor Ihe pedormance of ihe work tor which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Adtlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirtn thet untler penelry of per�ury lhal I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business and Professions Code: Any city or wunty which requires e permit to cons�rucl, elter, Improve, demolish, or repair any structure, pnor to its iwuance, also requires the applicant for such pertnit ro file a signeA statement thet he or she is Iicensetl pursuent to Ihe provisions oi Ihe Contrectors License Lew (Chepter 9(commancing with Section 7000) af DiNslon 3 of Ihe Business and Prolessions Code) or ihat he or she Is exempt therefrom enA the Desis for ihe alleged exemption. Any violation a� Section 7037.5 by eny applicant tor e pertnit subjects Ihe applicent to e civll penalry at not more then tive hundred dollers ($500).): ❑ I, as owner ot Ihe property, or my employees wlih weqes as thelr sole compenutlon, WILL DO TME WORK, antl ihe siructure is not intended or oHeretl lor sale (Sec. 7044, Business and Pmtessions Code: The Contractors License Law does not apply to en owner of pmperry who 6uilds or impmves Ihereon, and who does such work �imselt or herself or through his or her ov+n employees, provitletl that such improvemenis are not Inlentletl or oHeretl tor sale. It, however, iha building or improvement Is sold within one year of completioq t�e owner-builder will heve the burden ol proving that he or she did not Ouiltl or improve tor purpose ot sale.). ' ❑ I, es owner ot �ha property, am E%CLUSIVELY C NTRACTING WITH LICENSED CONTAACTORS to construct t�e project (Sec. 7046, Business and Professions Cotle: The contrac rs LlyYnseJ�w does�qt a�n�ewner of property who bullds or Impmves Ihereon, end who comracis tor such pmject wlth a wntractor(s) license pursu$q �he �ontrBElbre Licenss / / ❑ I em evem er s ' BuSinesS end Prole55ion9 Code lor this reeson: SignaWre: � � ,� 1l r� ' � DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTFICA710N: ❑ I hereby certity that no excavation Ilve (5) or more feet in depth Into whlch e person Is required to tlescend, will be made in connection with work euihodzed by ihis permit, antl thet no builtling sWcwre, scattolding, felsework, or demolitlon or tlismentling thereot, will be more than Ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tille B, Celitomia Atlminisirative Code). ❑ As owner-6ullder, I will not emDloy enyone to do work whlch would require e permit imm �he Oivision oi Intlustnal Setery, es noted above, unless such pereon has e permi� �o do such work irom ihe division. Signeture: Dete: Divislon of Industrial Safery Permit Numbar: CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF EHTRV: I certity under penalry of perjury that I �ave read this application entl state ihat ihe infortnation given is correct. I egree to compty with ell state laws entl iry ordinances releting to builCing conswction, end authorize representatives of the Ciry of Costa Masa to enter upon t�e abova-descnbed properry tor insyqction p r�gb� eyqefqt to occupy or ellow occupenty ot any Duilding authorized by Ihis Dermit until linal inspection. "', I r Aut�ari. CODE �• INSPECTIONTYPE 1616 Fized System Finel Fire Preventlon 1266 Pool Spe Finel 200 Finel Re-Roof 201 Finel BIxWRetelnlnp Well 202 Final Fecfory Flra Place 203 Final Sign 204 FinalOemolition �g �� GOpE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final ElecMcel 212 Final Fire Preventian 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAIE IIIIID�LS DECLARATI�N OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMfTS Bldg. Permit # This Permit # Street Add�ess:_ � �Z � Cv /Lp �/� �u �/Lt �'e `OS� ��S [A-- qp Number. �__( ) ,�V I�uUQ^'Z � '{ ��l �n,� c..+e •'�"�. 1 s—I• we , �' N% l6i � ��v�'-�^i , declare that I am the Owner of Title of the above referenced real property, and that 1(we) hereby authorize: Name: TLi// /��771 LL� � / ' <w /�� Telephone Number. !� �g� -z �8� �a��' / / /Q � �F l ` � �.5 /`f� Street Address: � /Cl ��/� ` �G �,/ � • City: l//��/� State: Zip� ! !� ( � �� lo obtain pertnits in my behalf, as ownerlbuilder, for at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do nol transfer to any other person, company or corporation. 4. I agree to indemniy and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other paAies as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of pery'ury that the foregoing is true and correct. Executed this day of Prl. int�Name� - '- � Signature natP� - — �-/6 -O 20_,at /U!/t�14 - �CDegQ,(� „ c�, 7 Note: This authorization does rrot grant authorization to perform the work as owner, fl solely provides for limited power of attomey to secure this permd in any behalF. 0�]9-a6 (rev.11/�0) � , California. WbHiEEfl6' CO`MPENSATION �ECLARATION: . 1 hereby ettirm under penelty o( perjury one of the following tlecleretions: ' ❑ I heva end will meintain e certificete of consent to selFlnsure for workers' compensatlon, as provitled for by sectlon 3700 of the LaDor Code, tor ihe pedormance of ihe work for which thi5 pertni� is issued. I have antl will melntain workers' compensation insurance, es required by section 3700 ot the Labor Cotle, for ihe pertortnance of the work for which ihis pertnit is Issuetl. My workers' compensadon Insurance carrier and policy number are: Cerrler: Polity Numher. (Th/s secfion need not be comp/eted i/ the peimit is veluetl et one hundred dollers (5100) or Iess.J ❑ I certity Ihat in ihe pedormance of the work tor whlch this pertnit is issuad, I shall not employ any person in eny manner so as to become subject to ihe woMers' wmpensation laws of Celifomia, entl egree that if I should becoma subject to the workers' wmpensatlon provislons of Sedion 3700 ot ihe Lebor Cotle, I shell tathwllb comply with Ihese provi ' ns. /] Applicent Signature: �QQ/, . Date: '�I -2� -�� ' WARNING FAILURE TO SECURE WORKERS' COMPENSATIqJ ppVERAGE IS UNLAWFUL ANO SNALL SUBJECi PN EMPLOYER TO CRIMINAL PENALTIES PND CIVIL PINES UP TOONE MUNDRED T�bUSAND DOLLARE (5100,000), IN ADDITION TO iHE COST OF COMPENSAi1pN, DAMACaES AS PROVIDED FOR IN SECf10N 37060F THE LABOFi WDE, IMEREST. AND ATTORNEV'S FEES. UCENSEDCONTRACTORSDECLARATON: � �ereDy eHirtn [hat I em licensed under provisions of Chapter 9(commencing with Sectlon 7000) of Division 3 at Ihe Business enG Protessions Cotle, antl my license is in full lorce and ettecL Lic. N Class A :' -7i�1 ContractorsSignature: iNnf�/a _ Dete: q..i�- 8 CONSTRUCTION LENDING AGENCV: ❑ 1 hereby affirm tAa! there is a conshuction lendinp apenty fa tne peAomrance o1 t�e work los which lhis pem+i! is issued. (Sec. 3097, Civil Catle). LenOels Name: Lender's Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm that under penelry of perlury ihat I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the followln9 reeson (Sec. 7031.5, Business end Professions Cotle: Any ciry or counry which requires a pertnit to construct, etler, Impwve, tlemolish, or repair any strudure, pno� to IIs issuance, also requlres the epplicant lor such partnit to flle a slgned stetement thet he or s�e Is licensetl pursuant to the provisions of Ihe Contractors License Lew (Chepter 9(commencing wl�h Sectlan 7000) of Divislon 3 of Ihe Business antl Protessions Code) or thet ha or she is exempt Ihereirom and the basls for the elleged ezemption. Any violation ot Saction 7031.5 by any applicant tor e pertnit sub�ects ihe applicant to e cWil penalry of not more ihen fiva huntlretl tlollars ($500).}: ❑ I, es ov.ner of Ihe proPerty, or my employees wlih weBes es their sole compensatlon, WILL DO TTIE WORK, and the strudure is not intentled or otferetl for sale (Sec. 7044, Business and Professlons Cotle: The Contractors LJcense Law does not apply to en owner ot properry w�o builds or improves thereon, entl who does such work hlmself or herself or t�roug� hIs or her own employees, providetl Ihat such improvements ere not intentletl ar otlereC for sale. If, however, Ihe bulldin9 or Improvement Is soltl withln one year ol completion, the owner-huilder wlll �ave the burden oi proving that he or she did not bu110 or improve tor purpose ol sale.). ❑ I, es owner at Ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to conslruct the project (Sec. 7044, Business end Professions Code: The contractors lJcense Lew tloes not apply to en owner of property who builtls or impmves Ihereon, and who contracts tor such project with a ConUecior(s) license pursuaN to the Conirecbrs License Laws.). � I am exempt under sec, Business and Professlons Code for this reason: SiqneNre: Date: Owner ID verified by dnveYs license. ❑ Ves ❑ No Driver's License No. Expires: Vedflcetlon oi Ownership by (rype ot document, i.e. - pmperry ten bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby cenify ihet no excavetlon five (5) or more feet In depth into which e person is requiratl to descentl, wlll be matle in connection wlth work authotlzetl �y Ihis pertnit, end that no Dulltling 51rucWre, scaflolding, falsework, or tlemolition or dismantling thereof, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Celifornie Adminlstretive Code). ❑ As owner-builtler, I will not employ enyone to tlo work w�ich would require a pertnit irom ihe Division of Intlustriel Sefery, as noted above, unless such person has e pertnit to tlo such work }rom (he division. Slgnelure: Date: DMsion of Indu5Ma1 Satery Pertnit Number. CEHTIFlCA7E OF COMPLIANCE AND AlliHORIZA710N OF EMRY: I cenity untler penelry of perjury thet I have read this epplicetion entl stete thel ihe infortnation given is WnecL I agree to comply wit� all state laws end ciry ordlnances releting to building consiruction, and authorize representatives of the Ciry o1 Costa Mesa to enter upon the above-d�roperty tor Inspection purposes. I ag�ee not to occupy o� allow occupancy of any building au��orized by ihis permit until finel inspeqion. � I`I I� SI naNre Of Leqal Owner(s) �_ (� � Dat9N �� 1 X An0/Or Aulhorized Applirant �ate CQQE,j, INSPECTOXTYPE 1g16 Fized System Finel Fire Prevention 1288 Paal Spe Final 200 Flnel Re-Roof ZOt Finel BIocWReteining Well 2D2 .Final Factory Fire Place 203 Final Sign 2pd Final �emolitlon 2d4&OB �g �� GODEI INSPE[TONTYPE 206 Final Mechenical 208 Final Plumbing 210 Finel @IecMcal 212 Final Fire Preventlon 220 Fi�fll Plenning Approvel 222 Final Site • 250 Final BuilCing/Occupency �ff �� CITY OF COSTA MESA -� +- - ` BIIILDING DIVISION /��,, �� e f DEVELOPMENT SERVICES DEPARTMENT ( /}'J � _✓ ° � PERMIT P RM� �T NUMBER �� 698-01738 (714) 754-5273 • Fax (7/4) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 926 CORONADO DR Suite: Vicinity: Parcel Nunmber: 14132318 Applicant: RASOA, ODILLE Address: Owner: GOMEZ, DANIEL M Address 926 CORONADO DR COSTA MESA,CA Contractor. NGG ROOFING COMPANY Address: 00939 SERRA WAY Arch / Eng : Address: COSTA MESA CA BUILDING PERMIT Zoning: R1 R1 Phone: Zip: Phone: Zip: 92626 Phone: 714-434-2525 Zip: 92626 License: 722805 � Phone: Zip: License: SCOPE OF PERMIT TEAR OFF & REROOF WITH 30 COMP. SHINGLES. Plan Check: $0.00 Permit: $99.75 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $100.25 SETBACKS MAIN STRUGTURE Front 0- 0 ACCESSORY Front 0-0 PARKING existinq: o NOTES: Rear 0-0 Rear 0- 0 Re uired: 0 FEE SUMMARY i PLANNWG & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 Status: ISSUED Applied: 09/28/1998 Issued: 09/28/1998 $4,500.00 ga,soo.00 0 �XPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or ff work is suspended or abandoned (or a pariod of 180 days. INSPECTIONS: In order tor ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit. �OR INSPECTIONS CALL: (714) 7545826 �� s COSTA MESA BUILDING•SAFETY DEPARTMENT P. O. BOX 917 COB'TA MHBA. CALIFORNIA Fo� Applicani to Fill In Complefely TYPE Of2 PRINT COSTA MESA. CALIFORNIA Mesa Del h�ar Development Co. ARCHITECT OR BNGINEER �CCO (�i0i oration •IlI]PFR'C ��W �. Coast Hi�;hwa; FEE RkCEIVkU Lot 87, Tract lt285, Plan 300 �EP 6 1�6f �fiNaNCE OEP1. CITY OF COSTA MESA APPLICATION FOR PERMIT suaciN� For Office Use Only HECHIPT NO. _ P.ERWT_NO. R8C81V�O BY I �ATEyBG��O�II DATE 189U8D /C � i BUILDING ADDRE66 COSTA MESA. CALIFORNIA FIRE s 3a00 E. �oast Hi hvra ZONING Comna del diar CHlf. �o" ' i� I vur+e �� BUILDINO 988o8-SB-1 NEo`: oR 3-4220 �°"� -f- _ 11_J (i oeacn�rnoH LCnL n e� I NO. OP 6LDp9. _. ,�o�. none ��q�¢1M 7�� REAR YARD 2' � �E� 6� � R��HT 6�;�� DESCRIPTION OF WORK - - BUILDING NO. OF 81ZE r9' 9"x5�' ROOM6 6 STORIE6 1 EXTERIORWALLR�d IRDOF COVHRING C�VERING CO111 . ravel USE OP BUILDING AND WORK TO BE PERFORMED S� w attached ara e 1 H8li8BY ACNNOWLBDO¢ THAT 1 HAVE RHAD THI9 MPIJGTION AND BTATE TMAT TXB AlOVE IB �AR6GT �NO AGRE6 TO COM- PLY WITN ALL CIlY ORDINANCH9 AND 9TATH LAWp p80ULATIN6 BUILDINO CONGTRURION. ]33r AUTHORIZED LINB 9TJ SD Fr. — �/ FT. � r FT. Z3 — F7. ED (� p �.i _ nsTv O. Li F `i THE �MOUNT eHOWN UN�ER VALUATION IB POR TH[ PURPOBH OP 88TpBLI8HIN0 p PBRMIT FHE ONLY. VALUATION PERMIT FEE $ �`� ' $ PLAN CHECK $ /�� 15,326.00 r� r„