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Home My WebLink About2211 CANYON DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Add�ess: 2211 CANYON DR Suite: D Viciniry: Parcel Number: 42207114 Applicane SC07 CHAMBERLAIN Address: Owner: ROS�NFELS, YUST Address -PARTNERSHIP II � . " - ORANGE, CA - � � 461 S GLASSEIC � Convactor. SC07'S ROOFING Address:, 1991 JUNIPERO UNIT#C ; � SIGNqL HILL Zip: 90806- Arch : Address Zoning: Phone: 562-986-7661 Zip: Phone: Zip: 92866 Phone:� 562-986-7661 License:- 708960 , Eng: Address - Status: ISSUED Applied: 01/20/2004 Issued: 01/20/2004 ISSUED BY: � /� � � .,�- Phone: - - Phone: Zip: -- � : License: License: -; , --: SCOPE OF PERMIT T/OFF AND REROOF 1500SF RESIDENCE W/COMP SHINGLES. .� � � � Plan Check: $0.00 Permit: $97.25 SMIP Res: . $0.50 . SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 � ,-_ . SETBACKS MAIN STRUCTURE �Front 0-0� ACCESSORY Front 0- 0 PARKING Existina: p NOTES: ' FEE SUMMARY ' Calc Valuation: Claim Valuation: J a : � _ : PLANNING.& ZONING �Rear- 0-0 Rear 0- 0 Required: ' 0 Left 0- 0 Right 0- 0 Left 0- 0 Right 0- 0 Proposed: 0 $3,400.00 $3,400.00 NOTlCE: The wo�k authorized by ihis permit shall comply wiih all applicable hand'rcap access requiremenis 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 180 days, or if work Is suspended or abandoned for a perlod of 180 days. , INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlrad inapeetlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiratlon of this permiL FOR INSPECTIONS CALL: (714) 7545626 2448d818�00) WORKERS' COMPENSATION DECLARATION: I hereby ettirm under penalry of perjury one oi the following declarations: � ❑ I heva entl will maintain a certificate of consent to self-Insure for workers' compensation, es provitletl tor by section 3700 of ihe Labor Code, for the pertormance of ihe work for which ihis permit is issuetl. • I have and will maintain workers' compensetion insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ' My workere' compensation Insurance carrler entl policy number are: Carrier: 57/i�TE /!//(//% Policy Numbar: OO �4i S i—`Z��% �% (This secfion need not be complefed i! the permit is velued ef one hundred dolla�s ($100J oi less.J , , , ❑ I Certify Ihat in the pertormance of Ihe work tor which this pertnit is issueQ I shall not employ eny per5on in any manner 5o es to becoma subject to Ihe worker5' compensation laws of Calitomia, and agree thet If I should become sublect lo the workers' compensation provisions of Sectlon 3700 0l Ihe Labor Code, I shall forthwith comply with these pro ' ons. (/ ApplicaniSigneture: � Date: i�'z0�07 WFRNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEfiA6E IS UNLAWFIIL AND SHALL SUBJECT AN EMPLOVEF TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOIXJE HUNDRED TFIOUSAND DOILARE (5100,000). IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION �Ofi OF THE IABOR COOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAHATION: I hereby aHirm I�a� I am licensed under provisions ot Chapter 9(commencing with Section 7000) of Division 3 ot the Business and Professions Code, end my license is in full force end eHect. Lic. N '�U 3'`� � U Class # C-3 i '�, Comractor's Signature: �� Date: � a � CONSTRUCTION LENDING AGENCY: ❑ I hereDy aNirm that there is a construction lending agency for ihe performance of Ihe work for which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Nama: Lenders Adtlress: Signature: Date: OWNER-BUILOER DECLARATIONS: I heraby affirtn thet under penalty ot perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business ana Professions Code: Any city or counry which requires e permit to constmct, alter, improve, demolish, or repair any sWCNre, prior to its issuance, also requires the applicant for such pertnit to tile e signed statement ihat he or she is licensed pursuent to the provisions of Ihe Contrectors License Lew (Chapter 9(commencing with Seclion 7000) of Division 3 of Ihe Business entl Protessions Cotle) or thet he or she is exempt thereirom and the basis tor t�e allegetl exemption. Any violation of Section 7031.5 by eny appliwnt for e pertnit su6jects the applicant to a civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the structure is not Intentletl or ottered for sale (Sec. 7044, Buslnass antl Professions Code: The Comractors License Law tloes not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided ihat such improvements ere not in�ended or ottered tor sale. If, however, ihe building or improvement is soltl within one year ot completion, the ownerv6uiltler will have the burtlen of proving ��at he or she did not build or improve for purpose olSaleJ. ' ❑ 1, as owner of the property, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions Catle: The coniraciors License Lew does not epply to an owner oi propeny who builtls or Improves Ihereon, and who comrams tor such pmject with a contractor(s) license pursuant to the Contrectors Licanse Laws.). � I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID venfied by dnvers license. ❑ Ves ❑ No Drivefs License No. Expires: Venficatlon ot Ownership by (rype of tlwumem, i.e. - property tav 6ill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify ihat no excavation five (5) or more teet in tlepth into which a person is requiretl Io descentl, will be made in connection with work euthonzed by ihis permit, and �hat no building siructure, scaMolding, talsework, or demolition or dismentling ihereot, will be more Ihan Ihirty-six (36) feet high. (Ghap. 32, Gry 2, Ar12, Sac. 341, TiNe B, California Administrative Code). ❑ As owneo-huiltler, I will not employ enyone to do work which would require e permit irom the Division of Industrial Sefery, es noted ebove, unless such person hes e permit to do such work from ihe division. Signature: Date: Division of Intlusirial Safety Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTMORVA710N OF ENTAY: I certi(y untler penalty of perjury Ihat I have read Ihis applicalion end state that the infortnation given is correcL I agree to comply with all state lews end ciry ordinances relating to building consWction, entl authorize representatives ot Ihe Ciry ol Cosla Mesa to enter upon the ebove-described property for inspection purposes. I egree not to occupy or allow occupency of eny building authonzed by this permit until finel inspection. Signature Of Legel Owner(s) Date Q_ i fv �� o�/ n r Author¢ed Applicant �� Date COUE 1, INSPECTIONTYPE 1676 Fized System Final Fire Prevention 7266 200 207 202 203 Pool Spe Final Final Re-Roof Flnel BIaWRelaining Wall Final Factory Fire Place Finel Sign 204 Final Demolition ORTE INTRIALS COUE� INSPECTIONTYiE 206 Final Mechanical 20B Final Plumbing 210 Final Eleclrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/Occupancy GASE 1[ffIDeL4 � (714) 754•5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT �ob Address: 2211 CANYON DR Suite: C Vicinity: Parcel Number: 42207114 Applicant SCOT CHAMBERLAIN Address: Owner: ROSENFELS, YUST Address . PARTNERSHIP II � � - ORANGE, CA , , , .461 S GLASSELL - . Convactor. SCOT'S ROOFING Address: 1991 JUNIPERO UNIT #C SIGNAL HILL Zip: 90806 � Arch : Address: Zoning: Phone: 562-98&7661 Zip: Phone: Zip: 92866 Phone: 562-986-7661 License: 708960 Eng: Address: Status: ISSUED Applied: 01/20/2004 Issued: 01/20/2004 ISSUED BY: � ! ' A �� -- , � Phone:� � � � Phone: Zip: � � License: License: - . . .- , SCOPE OF PERMIT - , -. T/OFF AND REROOF 1500SF RESIDENCE W/COMP SHWGLES. ' . FEE SUMMARY Plan Check: $0.00 - Calc Valuation: Ss,aoo.00 Permit: $9725 " ' "- Claim Valuation: , $3,aoo.00 SMIP Res: $0.50 � � �, � � SMIP Com: $0.00 Other. $0.00 Inspection: $0.00 Total: � $9Z.75 SETBACKS MAIN STRUCTURE Front 0- 0� �Rear 0. 0 ACCESSORY Front 0-0 . Rear 0-0 PARKING Existin : o Reauired: 0 NOTES: PLANNING & ZONING Left 0- 0 Right 0- 0 Left 0- 0 Right 0- 0 Pr000sed: 0 NOTICE: The work authorized by this 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 permit shall automatically expire and becoma void if work is not commenced within 180 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 requl�ed Inspectlons and final approval must be obtalned. Failure to obtain inspections end final approval will resuN in the expiration of this permit. FOR INSPECTIONS CALL: (774) 7545626 zae�ae �sroo� l WORKERS' COMPENSA710N DECLARATION: � � , I hereDy affirm under penalty of perjury one of the following tleclaretlons: ❑ I heve end will maintain e certiticate ot wnsent to selt-Insure tor workers' compensatlon, as pmvitletl br by section 3700 of the Lebor Cotle, br the pedormance of the work for whiCh thi5 pertnii Is is5uetl. � f� 1 heve and will maintain workers' compensatlon insurance, as requlred by section 3700 of the�Labor Cotle, tor tha pedortnance of the work for which this pertnit is issued. My workers' compensatian Insurence carrier and policy number are: Carrier. �TATE GyN/) PoliryNumber: (X�� S � —�UO`� (Thls secfion need not be comple(ed i/ the permi( is valued at one hundretl tlollars ($100) or less.) ❑ I certity that in the peAormence of Ihe work For which this permit I5 issued, I shall nol employ any person in eny manner so as to become subject to Ihe workers' compensation laws of Califomia, antl egree that If I shoultl become sub�ect to the workers' compensation pwvislons ot Saction 3700 of the Lebor Cotle, I shall forthwitb comply with ihese provisions. Applicenl Siqnature; � / Deta: / /2 0 /U �J � WARNINCa: FAILURE TO SECURE WORKERS' CAMPENSATION CAVERA�E IS UNLAWFUL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TOONE HUNDRED THOUSAND DOILARE (5100,000�, IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMA�ES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR WDE, INiEREST, AND ATTORNEV'S FEES. LICENSED CON7RACTORS OECLARA710N: I hereby eHirm Ihat I am licensed under provisions oi Chapter 9(commencing with Section 7000) ot DiNsion 3 0l the Business and Pmfessions Code, and my license is in tull force and afled. Llc. # 708r'/ 6 U �� Cleu a C-3 ContrecmfsSigneWre: � / Date: i�zv o�/ CONSTRUCTON LENDING AGENCV: ❑ I hereby aRirm that there is a constmction lending egency for tha peAormence of the work tor whic� ihis permit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lentler's Address: Signature: Date: OWNER-BUILOER DECLARATONS: 1 hereby aHirm thet undar penalry oi Der�ury ihat I em E%EMPT FROM TME CONTfiACTORS LICENSE LAW lor the tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or wunty which requires e permii to construct, alter, improve, demolish, or repair any strucWre, prior co its issuance, also redulres ihe epplicant tor such pertnil to file e signetl statement that he ar she Is licensetl pursuant to ihe provislons of Ihe Coniractors License Lew (Chepter 9(commencing with Sedlon 7000) of Division 3 ot ihe Business end Protessions Code) or ihet he or she is ezempt iherelrom end ihe basis for the alleged exemption. Any violation ot Section 7031.5 by eny epplicant for e pertnit sub�ects the epplicent to a civll penalry of not more than five huntlreA tlollars ($500).): ❑ I, es owner of lhe property, or my employees wl�h wages as t�eir sole compensa�ion, WILL DO THE WORK, entl Ihe s�ructure is noi In�entletl or oHeretl for sale (Sec. 7044, Business and Professions Cotle: The Contractore License Lew tloes not apply to an owner of proparry who builtls or improves t�ereon, end who tloes such work hlmselt or herself or through his or her own employees, providetl that such improvements are not Intended or oflered tor sale. If, however, tha bullding or improvement is sold within one year of completion, the owner-6uilder will heve the burden of proving that he or she did not build or improve for purposa of sele.). • ❑ I, es owner of the property, em EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRAGTORS to construa tha project (Sec. 70a4, Business antl Protessions Cotle: The contractors License Lew does not apply to an owner ol proDerty who builds or Impmves thereon, entl w�o wntracts for such project wit� a coniractor(s) liCense pur5uenl lo lhe Contractors License LewsJ. ❑ I em exempt untler sec. Business and Proleuions Code for this reeson: Signature: Date: Owner ID venfied by drivers license. ❑ Ves ❑ No Drivers License No. Expires: Verification of Ownership by (type ol dwument, i.e. - pmperry tax blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excevetion tiva (5) or more fee� in tlepih into which e person is required to descend, will be made in connectlon wlih work euthonzed by Ihis permit, antl ihat no huiltling stmcture, sceHolding, falsework, or demolition or dismentling thereol, wiil be more ihan thirry-six (36) teet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Title e, Califamia Atlminisirative Code). ❑ As owner-builtler, I will not employ enyona to do work which would require a pertnillrom ihe Division of Industnal SafeN� as notetl ebove, unless such person has e pertnit ta do such work from �he tlivislon. Signature: Date: Division of Intlustrial Safery Pertnit Numbar: ICER7IFICATE OF COMPLJANCE AND AUTHORVATION OF ENTRV: I certify under penalry of perjury that I have read this applica�ion end state that the intorma�ion given is I correct. I agree ro comply wit� ell stele laws end ciry ordinances releting to builtling consiruction, entl auNorize rapresenta�ives of the City ot Cos�e Mesa to enter upon t�e above-described property tor inspection puryoses. I egree not to occupy or allow occupenty ot any building authorized 6y this pertnit until final inspection. COOE �. INSPECTION TYPE 1616 Fized System Final Fire Pravention 1266 Pool Spa Final 200 Finel Re-Root 201 Final BIocWRetaining Well 202 Fina� Factory Fire Place 203 Final Sign 204 Final Demolition � OATE IXTRIALg i � �i/.ai� COUE I INSPECTIOX TYVE 206 Final Mechanical 208 Final Plumbing 210 Finel Elec�ncel 212 Final Fire Prevention 220 Final Plannin9 ApProval 222 Final Site 250 Finel Bulltling�Occupanty PAIE 1t�Lfl w pta) 75a-5273 • Fax (77a) 754-a856 • www.ci.costa-mesa.ca.us // YAIM UMIVt, GVS IA MCSA, GN `JLOZO BUILDING PERMIT ,lob nddress: 2211 CANYON DR Suite: B Vicinity: Parcel Number: 42207114 Applicant: SCO7 CHAMBERLAIN Address: Owner: ROSENFELS, YUST Address PARTNERSHIP II ORANGE,CA �- 461 S GLASSELI , Convactor: SCO7'S ROOFING Address: 1991 JUNIPERO UNIT qC SIGNqL HILL Zip: 90806 Arch : Address: Zoning: Phone: 562-986-7661 Zip: Phone: Zip: 92866 Phone: 562-98&7661 License: 708960 Eng: /' Address: �SSUED BY: Status: ISSUED Applied: 01/20/2004 Issued: 01/20/2004 � Phone: � � Phone: � Zip: . License: � License: � - - , ,� ��- .—� SCOPE-0F PERMIT - —. T/OFF AND REROOF 1500SF RESIDENCE W/COMP SHINGLES. ' � Plan Check: Permit: SMIP Res: SMIP Com: Other. Inspection: Total: $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAIN STRUCTURE Front 0-�0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: FEESUMMARY `4.' � PLANNING & ZONING Rear 0- 0 Rear 0- 0 Required: 0 Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 S �. $3,400.00 $3,400.00 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) EXPIHATION: This permit shall automatically expire and become void if work Is not commenced within 7B0 days, or if work is suspended or abandoned for a perlod of 180 days. , INSPEC710NS: In order for the work euthorized under this permit to be consitlered legal, such work must comply with all applicable codes, end all required Inspectlons and final approval must be obtained. Failure to obtain inspectlons end final approval will result in the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 244&48 (8�00) WORKERS'COMPENSAnON DECLARAnON: - I hereby eHirtn under penalry oi perjury one of the following declaretians: ❑ I have end will maintein a certificate ot consent to self-Insure lor workers' compensalion, es provitlad for by section 3700 of tha Labor Cade, for the peAartnence oi Ihe wark for which Ihis pertnit IS Issued. ,� I have entl wlll malntein workers' compensation Insurence, es required by section 3700 of the Lebor CoOe, for t�e peAormance of ihe work for which thls permit Is issuetl. My workers' compensation Insurance carrier entl policy number ere: Carner: 57/arC�°'N�.n PolicyNumber. CJOKl�3-7-2oNN- (This sectlon need nof be cromplefed i! fhe Oermit Is velued af ane bundred dollers ($100) or less.) ❑ I certify that in the pertortnanca of the work for which Ihis permit is Issue�, I shall not employ eny person in eny menner so as lo become suCject to Ihe workers' compensatlon lews of Celifomla, end egree that If I should become sublect to the workers' compensation provislons of Sectlon 3700 ot the Lebor Cotle, I shall iorthwlth comply with these provisions. Applicam Signawre: ��— Date: ___ �/z U/U �"/ WARMNG FAILURE TO SECURE WORKERS' COMPENSATION WVEMOE IS UNUWFUL AND SHAl1 SU6)ECT AN EAIPLOYER TO CRINJNAL PENALTIES FND qVIL FlNES UP TO IXJE MUNDRED TMOUSAND OOLLARE (5100,000). IN AODITION TO THE COST OF COAIPENSATION, DAMAGES AS PROVIDED FOR IN SEGfION 3lOfi OF THE IABOF CODE, IMEREST, AND ATfORNEV'S FEES. LICENSED CONTPAC70RS DECLARATION: I hereby aHirm Ihal I am Ilcensed untler proNsions of C�apter 9(commencing with Section 7000) af Divislon 3 at t�e Business entl Professions Code, end my Ilcense is in tull torca end ettect Llc. N 7 o fr9 G U Class p C–'> ContrectaYs Signeture: � Daie: _� Zo�v<� CONSTRUC710N LENDING AGENCY: ❑ I hereby aNirm that there is a cronstruction lentling agency for �he pedormance of ihe work br which thls permit Is Issued. (Sec. 3097, Civil Code). Lender's Neme: Lender's Address: Signemre: Date: OWNEF-BUILDER DECLARATIONS: I hereby aflirm Ihel under penalty of perjury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business an0 Professlons Cotle: Any city or counry which requires a pertnit to canstruct, aller, imprave, demolish, or repair any siructure, prior ta its issuance, elso requires the epplicant for such permit to tile e signetl statement that he or she is licensed pursuent to the provisians of the Contrectors LJcense Lew (Chapter 9(commencing with Sectlon 70W) of DMsion 3 of the Business end Professions Code) or Ihet he or she Is e:empt t�eretrom end the basis for the allegetl e:emption. Any violetion oi Section 7031.5 by eny epplicant for e pertnit sub�ects the epplicant to a civil penalry ai not more then five huntlred dWlere ($500).): ❑ I, as owner oi the property, ar my employees with wages es Iheir sole compensation, WILL DO THE WORK, and Ihe siructure is not imandetl or ottered lar sale (Sec. 7044, Business and Proteuions Code: The Contractors License Law tloes not appty to an owner of Droperry who builds or improves thereon, antl who Ooes such work himselt or hersetl or through his or her own employees, proNdetl that such improvements are not InlenCetl or oHereO for sale. II, however, the 6uiltling or improvement is sold within one year of completion, ihe owner-builder will heve ihe burden of proving that he or she tlitl not build or improve tor purpose of sele.). ' ❑ I, es owner ol the property, em E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to con5iruct t�e project (Sec. 7044, Business antl ProfesSionS Code: The contractors License Lew tloes not apply to en owner of pmpeny who builds or improves theraon, end who comracts for such project wlth e comractor(s) license pursuant to tha Camractors License Lews.). ❑ I em eaempt under sec. SignaWre: Owner ID vertlietl by tlnver's license. ❑ Ves ❑ No Busine5s end Profe55ions CodB for IhiS reeson: Verillcation of Ownership by (type ot tlocument, i.e. - property tex 6111 or deed): Driver's license No. Dete: Eapires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certlty ihat no exwvation tive (5) or more feet in dept� into which a person is required to descend, will be made in connection wilh work euthorized by Ihis permit, antl t�et no building strucWre, scaflolding, talsework, or demWition or dismantling thereof, will be more than t�irry-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calitamla Adminisiretive Code). ❑ As owner-builtler, I will not employ anyone to do work which wauld require a permi� trom the Division ot Intlustrial Safery, es noted ebove, unless such person hes e pertnit to do such work irom ihe tlivision. Signeture: Da�e: Division of Industrial Safery Permit Number. ICER7IFlCATE OF COMPLIANCE AND AIIIHORQA710N OF ENfRY: I cenity under penalry oi perjury thet 1 have read this epplication and state that the informatlon given is I cortect I agree to comply wlth ell siate laws enC ciry oMinances relating to building construction, end authadze representatives ot the Clry of Costa Mesa to enter upon Ihe above-descnbed properry For inspection purposes. I egree not to occupy or ellow occupancy of eny building au�horized by Ihis Dermit until tinel inspection. COUE Y, INSPECTIONTYVE 1616 Fixed System Final Fire Prevention 1266 200 207 Pool Spe Final Final Re-Root Final Block/Retaining Wall� 202 Flnal Factory Fire Place 203 Final Sign 204 Finel Demolition �f, INTRIALS � z-9 �t.G✓r Date i /w/� y �� Date COUE I INSPECTION TVYE 206 Final Mechanlcal 20B Finel Plumbing 210 Finel Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 FInelSite 250 Finel Bulltling�Occupancy Odg UIImSLi (714) 754-5273 • Fax (774) 754-4856 • www.ci.Costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 2211 CANYON DR Suite: A Vicinity: Parcel Number: 42207114 Applicant: SCOT CHAMBERLAIN Address: Owner. ROSENFELS, YUST. Address PARTNERSHIP II � ORANGE,CA 461 S GLASSELL Contractor. SCOT'S ROOFING Address: 1991 JUNIPERO UNIT #C SIGNAL HILL Zip: 90806 ArGI : Address: Zoning: Phone: 562-98&7667 Zip: Phone: Zip: 92866 Phone: 562-9867661 License: 708960 . Eng: Address: ISSUED BY: Status: ISSUED Applied: 01/20/2004 Issued: 01/20/2004 • � Phone: Phone: Zip: � License: License: , SCOPE OF PERMIT TlOFF AND REROOF 1500SF RESIDENCE W/COMP SHINGLES. ' Plan Check: $0.00 Permit: $97.25 ' " SMIP Res: $0.50 � SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 SETBACKS MAIN STRUCTURE Front 0-�0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: FEE SUMMARY Calc Valuation: Sa,aoo.00 Claim Valuation: $3,aoo.00 PLANNING & ZONING � Rear 0- 0 Left 0- 0 Right 0• 0 Rear 0- 0 Left 0- 0 Right 0- 0 Reauired: 0 Proposed: 0 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 ii work Is not commenced within 180 days, or if work is suspended or abandoned � tor a period of 180 days. I INSPECTIONS: In order for tha work authodzetl under this permit to ba considered legal, such work must comply with all epplicable codes, and all Irequlred InapecUons end flnal epprovel must be obtained. Failure to obtain inspectlons and final approval will result in the expiratlon of this pertnit. I FOR INSPECTIONS CALL: (714) 754-5626 easas �eroo� WORKERS' COMPENSATION DECLARATION: ' � , I hereby aHirm under penelty ol perjury one ol lhe following declara�ions: '- ❑ I heve end will meintain a Cetliticete of Consent to self-Insure br workers' compensation, es pmvided for by section 3700 of the Lflbor Code, for Ihe performflnce ot Ihe work for which lhis permil Is issued. i �' 1 heve antl will maintain workers' compensation Insurance, as requiratl by section 3700 ot Ihe tabor Cade, for Ihe pertartnance of the work For which Ihis permit is iuued. . My workers' compensation Insurance carder antl pollcy number ere: Carrier. 5 7AT � FU�L � Policy NumDer. UO �� s%— ZUU�"� (Th/s sect/on neetl not be comp/eted i/ Ne permit is veluetl et one huntlretl dollers (8100) or less.) ❑ I cenity that in the pertartnance ol the work tor which this pertnit is issued, I shall not employ eny person in eny menner sa as ta become subject ro t�e warkers' compensetlon laws ot Califomia, entl agree Met if I shoul0 become subject to the workere' compensation provisions of Section 3700 ot the Labor Code, I shall forthwith comply with these provisiqps. AppliCan151pneNre: �y�-- Dete: /,ZO/O�/ WAHNING: FAI�URE TO SECURPWORKERS' COMPENSATION COVERAGE IS UNIAWFUL PND SHALL S1161ECT M! EMPLOYEP TO CRIMINAL PENALTIE$ ANO CML FlNES UP TO ONE HUNDRED THOUSAND OOLLARE �5/ W,000). IN AD�ITION TO THE WST OF COMPENSATION, DAFUGES AS PROVIDED FOR IN SEGTION 3]Ofi OF THE IABOR COOE, IMEREST, M10 ATTORNEY'S FEES. LICENSED CONTRAC70RS DECLARATION: 1 hereby aNirm thet I am Ilcensed under provisions of Chaptar 9(rnmmencing with Section 7000) ot Division 3 of the Business antl Professions Code, and my license is In full torce entl eNect. Lic. N �oXR 6G Class q �'39 ��I Contraaofs SigneNre: �— Date: /� � o i CONSTHUCTION LENDING AGENCY: ❑ I hereby aNirtn ihat Ihere is a construction lentling egency lor the peAormance ot the work for which this permit is issued. (Sec. 3097, Civil Code). Lendars Name: Lentlefs Atltlress: Signature: Date: OWNER-BUILDER DECLARATONS: I hereby aHirm Ihet unCer penalry of perjury Ihet I am EXEMPT FROM THE CONTRAC70RS IICENSE LAW for ihe following reason (SecJ031.5, eusiness entl Professions Cotle: Any ciry or caunry which requires a permit to construct, elter, imprave, tlemolish, or repair any struciure, pdor to its issuance, also reQuires the ep0licant tor such pertnit to file e signed siatement that he or she is licensetl pursuent to Ihe provisions of ihe Contraqors LJcense Law (Chapler 9(commendn9 with SecUon 7000) 01 Division 3 of the Business entl Protessions Code) or that he or sha is exempt iherofrom end the basis for the allegetl exemption. Any violatlon af Section 7031.5 by any epplicent for e pertnit sublects the epPlicent to a civil penalry of not more than tive hundred tlollars ($500)J: ❑ I, es owner ol ihe property, or my employeas with weges es their sole compensation, WILL DO THE WORK, and the structure Is not Intentle0 or oHeretl for sele (Sec. 7044, Business antl Professions Code: The Contractore License Lew does not apply to en owner of property who builds or improves Ihereon, antl who does such work himsell or hersel( or through his or her own employees, provided Ihet such impwvemenis are not Intentled or oMered tor sale. If, however, tha builtling or Improvemem is soitl within one yeer o� completion, iha ownar�builder will heve the burden ot proving ihat he or she tli0 not builtl or improve for purpose ot sele.). ' ❑ I, es owner ol the D�oDerty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to canstruct the project (Sec. 7044, Business and Professlons Cotle: The conirac�ors License Lew tloes not epply to en awner of propeny w�o builtls or improves Ihareon, and who con�recis for such pro�ect with e contrector(s) licen5e pur5uant m the Contrectors License Lews.). ❑ I am exempt untler sec. _ Signeture: Business end PmfeSsions Code for this reeson: Owner ID verified by dnvefs licensa. ❑ Ves ❑ No _DnvefS License No. Verificetlon of Owners�ip by (type at document, i.e. - property tex blll or dead): OIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: Date: Expires: ❑ I hereby certily ihai no axcavation five (5) or more feet in depth into which a person is requiretl to tlescend, will be made in connection with work euihorized by thls permit, antl t�at no building sirudure, scattolding, telsework, or demolitlon or tlismantling thereof, will ba more than t�irry-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Galifomia Atlministrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permit irom the Division ot Intlustrial Safery, es noted above, unless such person �as e permit to do such work from the divisian. Signature: Date: Division ot Industrial Safety Permit Numher: CERTiFlCATE OF COMPLIANCE AND AUiHORIZATION OF ENTRY: I certiry under penalry ot perjury that I have reatl thls epplication and state ihat the intormatlon given is correct. I egree to comply with all state laws end city ortlinances releting to builtling construction, end authodze represeniaiives of the Ciry ot Costa Mesa to enter upon the ebove-descnbed property for inspection purposes. I agree not to occupy or allow occupancy of any Duilding euthorized by this pertnit until final inspection. gn re Of Legel Owner(s) Dete //z�Oy AnNOr Authorized Applicant ata COOE�. INSVECTIONflPE � 1618 FI:eA System Final Fire Preven[ion 1288 Pool Spe Final 200 Finel Re-Root 201 Flnal BIocWRetalning wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition Pdg II�ELfl .�_,�' �i FODE� INSVECTIONTYPE 208 Finel Mechanicel 20B Flnel Plumbing 210 Finel Electrical 212 Finel Fire Preventlon 220 Finel Planning Appraval 222 Flnal Site 250 FIneI BuildinyOccupancy PdIF Iti�dLB A7G�icant to tiil�in all soaces witnin heavy borCi nll appropriate eeclarations. CITY OF COSTA MESA PERMIT NO. J � TR .. . LOT NO. -BLDG. NO. CONSTRUCTION PERMIT (p ProjectAddress Z,Z�� C,.qN OnJ '. ' TVPE OF CONSTRUCTION OWnef ' W E�(�N � Phone 73p-(S7J ❑�� NEW- ❑ ADD ❑ ALTERATION Addfess �'j S %". o/jIA ' L'lREPAIR ❑CONVERSION ❑DEMOLISH ArCh/Eng. �— ' LiCense No. ❑ OTNER. Address _�. ' . . . DESCRIPTION OF WORK Q �o � ♦. a•�c .�n^�n��•cry�� e.ao-c�ir TVPEOF_PERMIT ,. . , ress � N� ��R09. sT 'Tus`j//� ( a O GRADING ❑ FOVNDATION ❑ STRVCTURAL LIGENSED CONTRACTOR DECLARATION ❑ TENANT-�O ELECTRICAL ❑PLVMBING�-�MECHAN I hereby atfirm that I am Ilcensetl untler provislons of Gharter 9(com- �0 0 i. � mencing wlth section 7000) ot �Ivision 3 ot �the Business anG�� -6THER - � Professlons Cotle, ntl m Ilcense is in tull force antl ei(ect. pR0.1ECT DESCRIPTION Llcense Class �d N� Ucense No. . Date Signature SQ' �' Qyq�� ' ' ' WORKERS'COMPENSATION�EC�qRAT10N OCCUPANCVJ-• CONS]'RVCTIONTVPE �e�rE SziP I M1ere�y atflrm that I hdve a certi(ICate of COnsent to selt-InSura Or,a OQ /�- Z certifl�to' Of WOrkerS' Compen5ation urance, or a certlBetl Copy VALUATION�T' ZONE thereot (Sec[lon Bp Lab.L.). rl GRADING CU. VDS. '� ACRES �" Po�I�I y No. � � COTPahy �Y�"�'�'�'� ' ' - ' '�SCertifietl copy is hereby furnishetl. . . . . REMARKS" � . . � Certifietl copy Is filetl wilh the city BWltling DiviSion. . , EXEMPTION FROM �WORKERS' COMPENSATION �DECLARATION - " "' � � -(Thls sectlon ne9tl, nOt b¢ COTpletetl i{,�he permi[ Is to� one nunarea ..._ • (Eloo) or less). . � � ' - I cartify that In che pertormance of tha work for whi<h this permiLis Issuetl, I shall not�emPloy any persoq In any manner so as to become PLUMBING .. • PLAN CHECK SubjOct [o the Wofkef5� CAmpanSdtlon �y�y5 ot CdllfOrnid. . Date � Signature BATHTVBS � SHOWERS NOTICE: 1f after making thls tleclardtion, you shoultl become zubject '.^TOILETS. � • URINALS ' ' to the Worker5' CompenSdtion prOvis{Ons of Ihe Labor Cotle, you must LAVATORIES DOUBLE'LAV$ forthwith comply with tuch provisioqs or this permit shall be tleemetl revokeG.. .. .. . . ___ . CONSTRUCTION LENDING AGENCV KIT. SINKS DISHWASHERS " I hereby affirm that tbere is a constructlon lentling agenty for the per- SERVICE SINKS SUMPS '--�' '"- formance of the work tor whith this permit is issuetl (Sec[ion 3097 �Civ. C.). � � �-' � - � FLOOR SINKS FLOOR DRAINS� .LenGer's Name Lentler's Atltlress �DRINKING FOUNTAINS �`� � � - ' -' ' OWNER BUIL�ER DECLARATION ' -" " - - - - INTERCEPTORS CLARIFIERS � � Y I h¢r¢by at(irm that I am exempt frorri Ihe Contracior'S License Law for �the tollowin9 reason-(Section 7031".S-Bustnezs antl'Professions-Coae:' SWIMMINGPOOL '�-PTRAP " ' - Any ci[y_ or _county which requires a permi[ to construct, alter, "improve, tlemolish'or repa�r any structure; prior'to its issuance,also-re- - y�rqTER SERVICE � 'ALTERATION-` �� '" ' quires the applicant tor such permit to file a si9netl ztatement that he is licensetl pursuanY to the provizionzbt the Contractor'S'License law' GAS SERV ICE OUTLETS � (Chapter 9(commencing with Sect�on 7000) of Division 3 Of the '6usines5 antl PrWessions Cotle) or-thdt �e is exempt therefrom antl tbe -' yyqTER HEATERS � �BT�V-OUTPUT "' ' basis for the alle9etl exemption. Any violation of Secilon 7031.5 by � ny'applicant -for'a'permit suCjects the appliwnt [o a civii'penalty �SEWERCONfVECTIONS � � ' _ �more than five hundretl tlollars ($500). I, as owner of the property, or rqy employees with wa9es as t�eir � SOLAR TANK COLIECTOliS �sole Compensation, will tlo the.work,.antl the st[ucture is not intentletl or offeretl for sale. (Sectlon 7044, B45iness anA Prote55ion5 Cotle: The SOLAR P�PWG SYS. �Cont�actor's-License-Law�tloe5 nof dpply_to..an owner of a p�operty. _ . ..... ... _. . . .. who bulltls or imprOves thereon, anq who tlOes such wo�k himself O/ ISSUE FEE th�ou9h� bis Own employees, provitleq t�aLsuch Imp�oveme0l5.arE not intentletl or offeretl tor sale. I(, howe�¢q the bWltling or Improvement - MECHANICAL PLAN CHECK is soltl wlthin one yea��ot comple[lo�, lhe owne� wlll have tne burtl¢n of proving he tlitl not builtl or irt�prove for IhE purpoze of sale). HEATING $VSTEM 0-100,000 BTU '� I, as 'owne� Of tM1e prope�ty, dm exclusively contratting wilh qND DUCTING � �- - -' ' "'! IlcenseG contractors to construct lhe project (Section �044, Business 100,000 * BTU � antl Professions Cotle: The'Con[ra<tor'S License Law tloes not appry [o an owner o/ proper[y who builtls or improves t�ereon, antl who con- REFRIGERATION 0-300,000 BTU VactS'fwm such'pro�ects wlth a'cOnt�acto�(s) IfttSnetl purivant to '�SVSTEM'- ' - ' '� ' "' ' ' - - � [he Contrattor'S License Law). 300,000 + BTU ❑ I am exempt untler Sec[ion �� B. & P. C. toi this - llAwpciaG A4tn�T � I(��T I�HG� • BOILERS aT� reason' -Dato�- Owner SYSTEMREPAIR,AITERATION I he�¢by ce�tify that I have �eatl thls appp�(�On antl 5[ate [ha[ [he dbOve E%HAUST SVSTEM MULTIPLE information is correcL 1 agree to cemply wit� all city antl county ortlinances antl state laws r atlng to ebnstruction, antl hereby aul�odze_ �ep�esentatives lhis y to ente� upOn the aDOve menti0netl proporty,tor i g�tio ur o5e5. _ �/ '� Signa[ure � Date � Drivars' License or SS � �� ; � i55UE FEE " - - � CMF 0865-4fi White-8uiltling; Gnery-Applirznt; PInk�Accountin9: Goltlenrotl-Assessor i' �47I I/25/b3 I�o50 TL 20NE PLNG. REF. �, _ IUt YHYfU' IGHT REAR VARD (TO P/L) � � PKG.SPACE REQ. PROVIDED - STREETWIDTH� - PARKFEES �� .� ZONING APPROVED BY SPECIAL CONDITIONS: ELECTRICAL PCarv CHECK GENERATOR' - 'py KW_1-30 KW - TRANSFORMER .. , APPLIANCE - " ��'S0 KW_50-t'KW � 'MOTORS - 0-1 HP__1-30 HP ' "' pNC. SOLAR) 10-50 HP_5P+ HP -� ' - FIXTURES ' �OUTI_ETS - SWITCHES' ' ' "GASTVBESIGNS -' ' " ' ' ' '--^- - ' - POLELIGHTS - -'•_ _..__. _. . .. ' ' "_ POLES METERED �SUB � PANELS"-' MAIN '. " --'_SUB' - - ' ' � ' SERVICE' -' ' "' "" - -' ' AMP ' ' ' " ISSUE'FEE' - -- " ' - -" -" - " " " APPLICATION APPROVED BV -� --� DAFE� '�d SUMMARV OF FEES BUILD�NG � �'/� PERMIT _S •OO ••' SMIP . 8_!�2lL PLAN CHFCK E •� PERMIT. �. ' - � - -ISSUANCE-�4-! PLVMBING § � .. ''.GRADING .$ PLAN CHECK,; 5 _ _ , � , ' ELECTRICAL 5 � � �� a . ' PLAN CHECK E' � � MICROFILM S _ MECHANICAL 5 ' � TOTAL,FEE E _ LE55 AD- ' PCAN CHECK E • VANCE PC S� - � FINAL FEE S L O• S� CONSTRUCTION AND PLpNNING APPROVALS Permit # _ 1. Temporary Electricai Service or Pole POOL & SPA _ .� Date Inspector qpPROVALS � Permit # Date -Inspector -� •- � 43. Pool & Equiprr�ent �ocation � 44. Steel Reinforcement 45. Forms 46. Electrical Bondin � 47. Rough Plumbin & Pressure Test � � 1 , 48. APPROVALTOCOVER-GUNITE� ��I•: .� . 49. Electricai Conduit-Undr rn ' 8. Foundation � 50. Gai Pipe,-❑ Undr rn, Test � 9. Water Pipe-Undrgrn ' 57. Backwash Lines P-Tra ❑ ndr rn - 10. Structural Floor System -• 52. APPROVAL TO DECK � � ' 11. Property Sewer Line & Housp Connection _53. . Backwash & Rece tor-Final 12. . Street Sewer Connection . ' - � 54. Heater & Vent-Final . � : ' ' 13. Rough Plumbing ' - � � - � • � �'•= 14. Rough ElectrioConduit �56. Electrical-Final - ` 15. Rough Electric-Wiring 57. Solar SYstem-Pinal �' - - 16. Rough Heating & Air Conditioning - - � • Fencing & Access Approval • � 17. Ducts -in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - , 19. Gas Pipe-Rough & Test .� � 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing - -� - ` � � ' t 21. Roof Sheathin ' � . � 22. Frame and Flashin � - ' NOTES: - . 23. Insulation- � � � . - � � � ' � � , - - - - - 24. Lathing & Siding- ' ' � 25. Orywall Nailing _ - � - ' ' 26. Plaster.Brown Coat - � � � � � } 27. -Electrical Power MeterFinal" � ' ' ' � � � - � � � 28. Final Electric - ' 29. � Final Heating.& Air Conditioning ' ' � • ' 30. -Final Gas Pipe-Test - - � �- - -31. F.inal Plumbing ' � , 32. Water Service-F.,ina1 . _ 1 � ' '� :�335 � Gas Service-Final - . - � � ' ' ' � 34. Solar pomesticFirial � � � � � ' � ' ' � 35:-'� Landsca S rinklin 5 stero] \ � � ' ' ' � " ' " � 36. Sound Attenuation . - . � � � � � , ' ' 37. Handicap Regulations � � ' ' � � - - - ' 38. FINAL STRUCTURE & BUI LDING ' �- � � - � � ' ' 39. Special Requirements Completed - ' ' ' � ' "" � ' � ' 40. Electric Release to Edison � � �� -'- ""' �' ' "' ' "' ' " ' ` "' ' 41. Gas Release to Southem California Gas Co: ' � � - - � � , 42. CERTIFICATE OF OCCUPANCY _ - _ � _ '- ' �No � ' Date - , - - �