HomeMy WebLinkAbout913 DARRELL ST - Building Permits� jl
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(714) 754-5273 • Fez (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 913 DARRELL ST
Suite:
Vicinity: RESIDENCE & ATTACHED GARAGE
Parcel Number: 42235311 Zoning:
Applicant: PIKE, GARY
Address: 434WESTAMERIGEAVENUE „�
Owner:
Address
SETBACKS
ACCESSORY
PARKING
NOTES:
FULLERTON,CA
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92632�
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' CLASS A COMP
�OFING
AVENUE
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714 871
92632
Zip: 92627
Status: ISSUED
Applied: 07/23/2001
Issued: 07/23/2001
ISSUED BY:
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4 871-8103
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D?APPCY FECT�PER MFGR SPECS, REI
OWN:ON�,SMALL-FLP,T:AREA. 25 SQ
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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, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for 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 inepeetlons end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
446-a6�N00)
WORKERS' COMPENSATION DECLARATION: ' ' ' ' ' �
I hereby afrirm under penalry of perjury one of the following declarations: � '
❑ I heve end will meintain e cenificate of consent to setl-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, for the pertormance ot the
work tor which this permit is issuetl.
❑ I have antl will maintain workers' compensatlon insurance, es required by sectlon 3700 of Ihe Labor Coda, for the perfortnance oi Ihe work for which ihis pertnit is issued.
My workers' compensation Insurance cartier antl pollcy number era:
Carrier: Policy Number:
(This section need nat be comp/eted i! the permit /s ve/ued et one hundred dallers ($100) oNess.J . . .
�'�certiy ihat in the peAortnance af the work for which this ertnit is issueq I shall not employ eny parson in eny manner so es to bewma subject to ihe workers'
compensation laws of Calitomla and egree that it I sh come suh�ect to ihe workers' compensetlon pmvislons of Section 3700 of the Lebor Cotle, I shell forthwith
comply with �hese prowsio / _
ApplicanlSi9neture: /Yie . �,-( i��� � - Dete: '
WARNING: FAILURE TO SE RE WO RS' COMPENS Tl COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES PND CIVIL FlNES UP TOONE HUNDRED
T}IOUSAND OOLLARE (5100,000),IN ADDITIIXJ TO THE CQST OF COMPENSATION, DAh41GES AS PROVIDED FOR IN SECTION 37060P THE LABOR CODE. INTEREST, AND AiTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am
force and effect. Lic. #
Contrectors Signature:
Chapter 9(cammencing with Section 7000) of Divisian 3 of the Business end Prafessions Code, end my license is in tull
Class k
� _i _ �_.Dete: � 7 27%n/
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that there is a construction lending egency for ihe pertormance of Ihe work ta which this pertnit is issued. (Sec. 3097, Civil Cotle). �
Lentlefs Name: Lentlers Address:
Signature: Date:
OWNER-BUILDER DECLARA710NS:
I hereby aHirtn ihat under penalry of perjury ihat I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business entl Professions
Code: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair eny structure, pnor to its issuance, also requires the applicant tor such pertnit
to tile a signetl statement ihat he or she is licensed pursuent to ihe provisions ol ihe Contrectors Llcense Lew (Chaptar 9(commencing with Sectlon 7000) of Division 3 of the
eusineu and Professions Code) or thet he or she is exempt therefrom and the besis for the elle9ed e:emption. Any violetion of Sectlon 7031.5 by eny applicent for a pem+'
subjecis the applicant to a civil panalry of not more than tive hundred dollers ($500).):
❑ I, as owner of ihe properry, or my employees with wages es Iheir sole compensation, WILL DO 7HE WORK, and iha structure Is not intended or otteretl for sale (Sec.
7044, Business and Professions Code: Tlie Contractors License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work
himsalf or herself or through his or her own employees, provitletl that such improvements are not Intended or offered lor sele. If, however, the building or improvement is
sold within one year ot completion, the owner�builder will have the burden of proving that he or she tlid not build or improve tor purpose of sele.).
❑ I, as owner oi the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 704C, Business end Professions
Code: Tlie contractors License Lew does not apply to en owner of propeny w�o bulltls or Improves ihereon, end who contracts for such project with e contrector(s)
license pursuant to ihe Contractors License Laws.).
❑ I am ezempt under sec.
Siqnature:
Owner ID verifiad by dnvers license. ❑ Ves ❑ No
Business antl Professions Code tor this reason:
Veniication of Ownership by (type of document, i.e. - proparty taz bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIfICATION:
Driver's License No.
Dete:
Expires:
❑ I hereby certity that no excavation five (5) or more teat in depth into which e parson is required to tlescentl, will be made in connection with work euthorized by Ihis
permit, and that no building sVucWre, scaflolding, talsework, or demolition or dismanNing thereof, will 6e more �hen ihirry-slx (36) teet high. (Chap. 3.2, Gry 2, Art 2, Sec.
341, Title B, Calitornia Atlminisirative Code).
❑ As owner-builder, I will not employ enyone to do work which would require e permlt irom ihe Division of Industrial Sefety, es noted ehove, unless such person hes a
permit to do such work irom �he tlivision.
Signature: Date:
Division ot Indusirial Safery Pertnit Numbec
CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTTiY: I certify under penalty of perjury ihat I have read ihis epplication an0 state Iha� ihe information given is
correct. I agree to � ply wilh ell state s antl city ordinances rela�ing Io building consiruction, and authorize representatives of the City ot Costa Mesa to enter upon the
above-descnbe for inspecti oses. 1 agree not to occupy or allow occupency of eny building authorized by this permit until final inspectian.
/'�L%=���C'c-7 �
ignA ure O egal Owner(s) ate
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AnNOr Authonzed Applicant Date
COOE �. INSPECTIONTYPE
1616 Fixed System Final Fire Preventian
1266 Poal Spa Finel
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place '
203 Finel Sign
204 Final Demolition � ��
Qdifi �u�eis
COOE 1 INSGECTION TYFE
206 Finel Mechanital
208 Finel Plumbing
210 Final Electrical
212 Final Fire Preven�ion
220 Final Planning Approval
222 Final Site
250� FinalBuiltlinryOccupency
UATE INTITI1l5
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OWNER $r1St01�1+'StBt�S DATE �y-18—CEi -
'
,.IOBADDRESS 913 Darrell St.�" ' BUILDINGPERMITNO.�R��
GENERALCONTRACTOR $.�1.Hunsaker VALUE $ 8�856.Q0
LOT (y9 BLOCK TRACT Z8%3 Sin�le Res. W�att gar -
GROUP I& J TVPE V ZON�7� FIRE DISTRICT 2�il�A
� PERMITS ISSUED
INSPECTIONS D�TE SUBCONTRACTOR
/ DATE NUMBER
Footing Trench �� 6 S� "
Foundation Forms and Grade to Garage . ,�
Plumbing, Rough Complete ��/T J_ Jtj�•
Temporary Pole
Wiring, Rough G"�"
Heating, Rough �n �
Heating, Final �—�/�$
Sewer„Ho su e Sewer, St. 7-G
Septi�ank or Cesspool p •� � ��
Lathing, In Out —/3
Plastering —
Plumbing, Final, Fixtures Corr�plet
Plumbing, Fin,al Gas Test Q �
Wiring,Final � � :,2L
Occupancy �- )�
FONM 210 3M 10�'.15
_ _ _ � _ . _ _ � _ __ — _ _
�GSL�Y�/.1G� H�/ /�JG �f10/U '�
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-�,,, - Gosta Mesa Building Department s r�B��PLIGATION FOR PERMIT
,.• ,. P.O.Boz3�� BUILDING '
r� COSTA MESA, CAUFORNIA ;'
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No.� Permit No. ,
naaae� �t 13 17/�TziZ��.L S . . - .�/��� �
Costa Mesa, California i Rec i d 6y' �Date Rec'd. Dat/e QIssued- ��j
Nearest �i7 �G��
" • .�-� '�� '/ V �� C-�
CrossSt. I' �. //� (f� - Euilding -�
v(� � S O� Address 1 .
Owner ' '
Costa Mesa, California �
Mail ' '
AddressQFJZCp �, �fESTU�iES ��L• rvearest i �
/� Tel. Cross St � /
Cfty E" L� l. � No. %� f�- (1 � Zone , I No, of I 7ype Group
Architect or Lic. Plans
Engineer . No. Approveil '
by � Date ,
Address � � CORRECTIONS � i/ I
� ✓ t /�v S��C City Lic. -
Contrector ff �/Z,No. 'Z�p�/ j
Address �
Legal I Lot a� I � 2$�13 —
Descriptioo No. T Block I Tract
(Attach Metesand Bounds)
� � I No. of Bidgs i
Size of Lot ia> O X I E=0 Now on Lot � '
Useaf � I No.of I No.ot '
Existing Bldg. Familles Rooms F
Setback Line from c-� � Rear Yard 'Z ��-f— _
Center of Street J � Side vard c c� 4 �
r
oemolish I
Steries I
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APPROVALS
Faundation Location I Inspecto
Forms, Materials,
Bracing, Boltsr
I hereby acknowledge that I have read this Application .
and state that the above is correct and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building rnnstruction. Lath. Ext.
� Signaturaot '"
Permlttee Plaster, Int.
Authorized Agt Plaster, Ext.
Valuatlon � Pe� it Fee $ Z Z- � � Masonry Reinforced
�p ry�� O � 'Plan Check $ � � ' � � gond Beam
$ � / �S Total � O
Fee $ 3� • FINAL
FORM 309 10�55 D. P. h 5. �
Date
. . . �����)M'.
"" Street
PLOT PLAN .
Show location and distances from -
property Iine and between buildings.
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JOB ADDRESS ylj ua�
GENERAL CONTRACTOR
INSPECTIONS
OCCUPANCY
Form 410—SM-11-59 5-e P
DATE
SUBCONTRACTOR
VALUE
. t0
PERMITS ISSUED '
.•
5.
11586
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COSTA MESA BUILDING-SAFETY DEPARTMENT ', �/�S/� o
P. o. aoX 9�, �o�„ M�,,, ��Po��„ ,. fINpNCE �EPi
For Applicanf to Fill In Complefely ��pppLICATIOt� FOR`�PERMii
TYPE OR PRINT � BUILDING
a���o� /3 jZ _ � �ti��enY�
AD�RE55
COSTA MES �ca, - o �a . For Office Use Only
� � . / � / •• aeceiar NO. PEF
d ARCHITECI'
cin
STATE
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TEL.
NO.�
TEL.
TEL.
NO.
❑ . I NO. OP BLD69.
68TBALK LIN6 FROM
cerrrew oc erneer � REAR YARD
SIDE YARD I LEFT I RIGHi
DESCRIPTION OF WORK `
BUILDING /� '`� L ROOMS STORIES
SIZE
EXTERIOR WALC ROOF
COVERING ICOVERING
USE BUILDI G AND WORK TO BE PERFORMED
!
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A-�� a
1 �PEBY AGKN Le�a �THAT HAVE RPaO 19 A lAGT10N
A 9T/�T¢ THA THE OV¢ I GOPRECT AND AOPEE TO COM-
PLY WITH ALL GT( ONDINANCE6 AND BT TE {AW8 RE6UUTING
eU1LpIN0 CONBTRULTION. ��. _n % i % ��
� AUTHORIZED AGENT
FIRE
ZONF
APPF
BY
ZONB
COSTA MESA.
Z�IVING
xo, or � use or
ruNs em�om
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- THE'{AMOUNT X, /1 / OER �f0 {
��T N'IB-PON'Tpi�'
-PORP6H�07!-EBTqBL19XING-A PERMIT pEE ONLY. -
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CHEGK $ O �