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Home My WebLink About833 CORTEZ ST - Building Permits, , • (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 833 CORTEZ ST Suite: Viciniry: ROOF Parcel Number: 14131101 Applicant: COFFEY, BRIAN Address: Owner. FOX, CECIL ANN Address 190 OAKMONT AVE LOMPOC,CA Contracror. THE ROOFING SPECIALISTS Address: 2428 NEWPORT BLVD UNIT 5 COSTA MESA,CA Zip: 92672 Arch : Address: Phone: Zoning: R1 R1 Phone: Zip: Phone: Zip: 9343G7311 Phone: (949)722-8846 License: 734068 Eng: Address: Status: ISSUED Applied: 02/14/2003 Issued: 02/14/2003 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16" OSB OVER SPACED SHEATHING, 1 PLY 30# FELT, ELK PRESTIQUE, 30 YEAR COMPOSITION, - MODIFIED RUBBER ON FLA7 AND ALL RELATED FLASHING. 28 SQUARES INCLUDES ATTACHED GARAGE. Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.57 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.82 SETBACKS MAW STRUCTURE Front 0- 0 ACCESSORY Fronl 0- 0 PARKING Existinq: 0 Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Lek 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $5,680.00 $5,680.00 NOTICE: The work authorized 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 7 BO days, or if work is suspended or abandoned for a period 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 Inapeetiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zaasas (s�ool WORKERS'COMPENSAnON DECLAHAnON: I hereby eNirm under penelty of per�ury one oi the following declaratlons: ❑ I have end will mainiain a certificata of consent to selt-Insure br workars' crompensetlan, es provided for by section 3700 of the Lebor Cotle, tor the peAarmence of t�e �wark tot whic� Ihis permit i5 i55uatl. I have and will malntain workers' compensaGon insu2nce, as required by sectlan 3700 of the Lebor Cotle, for the peAormance ot ihe work lor which this pertnit is Issuetl. My workers' �c �m ensation Ins%� nc'e� er and policy number are: / Q ��e�'9 Carrier. %rQ.�L �"v� '/ PolicyNumber. I (p �7��( �L`'`'' T (This section�ol be completetl il the permit is velueC af one hunUred dollers (3100J or less.) ❑ I certity thet in the pertortnance of the work tor which Ihis permit is issued, I shell not emplay eny pereon In any manner so as to become subjact to t�e workero' compensetlon laws oi Celitomia, end gr thet if I should becoma sub�ect to t�e workers' compansation provisions of Section 3700 01 Ihe LaDor Cotle, I shall torthwich comply with these proyi n. � � Z�/�-03 AppliceN Signature: Date: WARNINO: FAI�URE TO SECURE OHKERS' NSATION COVEMGE IS UMAWFUL AND SHALL SUBJELi PN EMPLOVER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE MUNDRE� THOUSANDDOLLARE(5100,000),INADDITION ECOSTOFCOMPENSATION,OAMAGESASPROVIDEDFORINSECTION3]O60FTHELABORCOOE,IMEREST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I herehy aflirm that I em force end ettect. Lic. N_ Comractofs Slgnature: CONSTRUCTION LENDING AGENCY: of Chapter (commencing with Sectlon 7000) of Division 3 of Ihe Business and Prolessions Code, end my Ilcense is in tull Clessq ��?i^] � .. Date: 2—/ —D"� ❑ I hereby eHirtn Ihat thare is e construction lending agency for tha pertormance of the work for which Ihis permi� is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: SlgnaWre: OWNER-BUILDER DECLARATIONS: Date: I hereby aflirtn Ihat untler penalry of perJury Ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (SecJ031.5, Business end Professlons Code: Any ciry or counry w�ic� requires a Dermit to construct, alter, improve, tlemollsh, or repair any siructure, prior to its issuance, also requires the eppliwnt for such permit to tile e signetl statemen� t�el he or s�e Is Ilcensed pursuant to the provislons ol Ihe Contractors License Lew (Chapter 9(commencing wlih Sectlon 7000) ot Divislon 3 of ihe Business end Prolessions Gode) or that he or she is exempt therefram antl the hasis for the alleged exemptian. Any violation of Section 7037.5 by eny applicant for e pertnit subjects ihe epplicant to e civil penalry of not more than five hundred dollars (5500).): ❑ I, es owner ot lhe properry, or my employees with wages as Iheir sole wmpensa�lon, WILL DO THE WORK, and ihe structure is not intended or oMereO for sale (Sec. 7044, Business end Professions Code: The Contradors License Lew tloes not apply to an owner ot property who builds or improves thereon, and who tloes such work himsell or herself or through his or her own amployees, pravided ihet such improvements are not Intended or oHereO for sale. If, however, �he building or Improvement is sold within ona yee� ot completion, ihe owner-builder will have the burden ot provinq ihat he or she did not huiltl or impmve for puryose ot sale.). ' ❑ I, es owner ol the property, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to consiruct ihe projeci (Sec. 7044, Business end Professions Cotle: The contrectors Llcense Law tloes not apply to en owner oi propeny who bullds or Improves Ihereon, end who contracis for such prolect wlth e contrector(s) license pursuant to ihe Contractors License Lews.). ❑ I am exempt untler sec. Business end Profossions Code for this reason: Signeture: Date: Owner ID venfietl by tlriver's license. ❑ Ves ❑ No Drivers License No. Varificetlon of Ownership by (type of document, i.e. � property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION: Expires: ❑ I hereby cenify that no excavetlon Tive (5) or mora feet In dep�h into which e person is required to descentl, will be made in cnnnection with work euthorized by this permit, end that no building sirucNre, scaftolding, talsework, or tlemolitlon or tlismantling thereot, will be more than thirty-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Title 8, Celilomia Atlminislretive Cotle). ❑ As owner�builder, I will nol employ anyone to do work which would require e pertnit from Ihe Division oi Industnal Safety, es notetl ebove, unless such person hes e pertnit to do such wark from the division. Signature: Date: Division of Industnal Safery Partnit Number. CERTIFICATE OF COMPLIANCE ANO AUiHORVATION OF ENTRY: I certity untler penelry of perjury ihat I have read Ihis epplication and state ihat the information given is wrrect I egree Io comply with ell s�a�e laws and ciry ordinences rela�ing Io building construction, and authonze rapresenta�ives ot �he Ciry of Cosle Mesa to enter upon the ebove-described property for inspection puryoses. I agiee not to occupy or ellow occupency of eny building authorized 6y this permi� until finel inspection. CODE �. INSPELTIONTYPE Of Legal Owner(s) IIhonzed Applicant UATE f�¢ 1616 Fized System Final Fire Prevention 7266 � Pool Spa Final 200 Final Re-Root 201 Final Block/Reteining Well 202 Finel Factory Fire Place 203 Final Sign 204 Final Demolition Date � -( �-F-p3 � oate COpE I INSPECTION TYGE 206 Final Mechanical 20B Finel Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planninq Approval 222 Final Site 250 FinalBuilding/Occupenty ��1.\1��1111.14. � JOB ADDRESS GEN�RAL CO7 AP No. ],f,�1T: INSPPCTIONS OCCUPANCY 'OFM Bllb-SM — F. nnTc 6-8-62 R Q4rriAT' VALUE $ 41.VU LOT TRACT PIR� 7.ONE DGSCRiPTION OF NORK �Signature DATG CROUP J TYPE 1TI 7.ONE SUI3CONTRAC'1'p12 .�. pET� . ��' i�Z�o COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MEBA. CALIFORNIA For Applieani fo Fill In Complefely TVPE OR PRINT COSTA M�Sh CALIFORNIA �� CITY STATE L14 NO. s�ze�r iJ ��f iiG� �EE RECEIl��D �,i �uri i i �ss� . �` FINANCE DEPT. �iTY ��7STA MESA APPLICATION FOR PE Bue�ui�� For Office Use Only RECEIPT NO. I _ PCNMIT NO.� _ NEC V OY BUILDING G _� ZONE L6GAL oescxi NO. OP 61DG6. 1 BeTBACK L�NE PPOM �1 �� CI!NTER OP BTRaBT �/ ��' REAR YARI SIDE YARD (LEFT � -' IRIGHT � DESCRIPTION OF WORK IRIOR�WALL� ROOF iRING STUCti COVERING S b 1 A OF BUILDING AND W�RK TO BE PERFORMED COSTA MESA. ZONING NO. OF q U8E OF NEW PlAN3 / . BUILDING YARD6 APPROVEO (CEMBR LIN6 BTJ FRONT �' ,. _ n APPROVED — J�/— v/ EVES � � � �3 ALLOWEo _ / � �r. �L � iN. � FT. IN. � Fi. IN. � DATE l � ' �c,�c.� w'�w _ �., X� i 5�.. b', X b,`S,, :3 .i n X � .� i, I HEREBY AGKNOWLED6¢ YHAT 1�HAVE RGD IB APPLIWTION ' THC AMOUNT 9HOWN IINOEH VALUATION IB FOR THE ANO BTATE THAT TXE ABOVQ 18 CORRHCT ANO AGREE TO COM-. pUflP08E OP EBTABLIBHINO A PEqMIT PEE ONLY. PLY WITH A4 CITY ORDINANGEe ANO BTATE LAWB fiHGIIGATNO ewLDINa coN6TRUCi N. VALUATION �(� SIGNATURE OF �� PERMIT FEE $ � PERMITTE � �- �^ a S / �� PLAN CHECK $ AUTHORIZED AGENT � Q�, � rc TOTAL FEE LL �.';�'' 123�4 COSTA MESA BUILDING-SAFETY DEPARTMENT ` P. O. BOX 917 C08TA MHBA. CALIFORNIA Fo� Applieanf fo Fill In Completely TYPE OR PRINT BUILDING COSTA MESA CALIFORNIA Su ■ SIZE TEL. Levanas ;�`flr 37010 FE�RECCiil�D JUN 1 � �9so FINANCE DEPT. APPLICATION FORY PERMrIiSTA MESA Lot � 69 BUILDING Plaa R 4B For Office Use Only NECEIPT ND. PEqMIT NO. RECEIV6O BY DATE RfCEIVEO ��6�� i5� �DI /h'—�'�`�SL IILDING g33 Cortez Street )DRESS " COSTA MESA, CALIFORNIA FIRE ZONE APPROVED E. Coast Highway aoNeN� del Mar IONE J I NO.OF I UBE OF NEW ` PLAN9 9UILDIN6 � Nobr 3-4220 ��a�e.e..,,.. Lot 69 T,.s. , 66TBACK LINB FROM 45 .H,eu c^uetnae. 0 DESCRIPTIOM OF WORK SIZE utrvc6O R 3% ROOMS � STORIES EXTERIOR W L �C11CC�OOF P COVERING � 'Id ne I covEew�Wood Shin USE OF BUILDING AND WORK TO BE PERFORMED ConstrucC Single Family Reaidence with attached garage 1 XEREBV AGKNOW�DOB THAT I HAVQ R6AD THIB APPLIG AND BTAT6 THAT THE ABOV IB RRECT AND AGPEC O PLV WITH ALL C�T'( ONDIN CE9 N� 6TATE W9 R GU BUILDINO CONBTRUGTION.� BIGNATURE OP I A A / .} I YARDS APPROVED 40 (CEMER L�NC 9i.1 � APPROVED 1 EVES —� � COM- THE qMOUNT BNOWN UNOEfl VALIIATION 18 POR TXE LATIN6 PUPP08E OF EeTABl19HIN0 � PERMIT FEE ONLY. VALUATION PERMIT FEE $ 34.00 $ 14,563.00 p�pN CHECK $ L�•oo Project Manager TOTAL PEE SL.00 I