HomeMy WebLinkAbout300 PAULARINO AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856
� , CITY OF COSTA MESA
� BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
JobAddress: 30O PAULARINOAV
Suite:
Vicinity:
Parcel Nunmber: 42709115
Applicant: BOB ALEXSON
Address:
Owner: TH
Address 260
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Address:
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BUILDING PERMIT
Zoning:
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PERMIT N ER '/
698-01705 v
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 09/23/1998
Issued: 09l23/1998
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Zip:) 92627 ...� ' ''���
License�,349686 -'��- ���'� ��-
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.. License: ' �� `
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� � � �" � " SCOPE OF PERMIT `, � '
�� . � .T/OFF AND REROOFSOOOSF�MANSARD OF COMMERCIAL BUILDING: -� �: �A �
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� . � FEE SUMMARY •, f '
P.lan Check: - � $0.00 ,. _ �� `�;.�;�,�,,..- � — 1`,':,' ;1G.: , Calc Valuation: � �
� Permtt ' $16225 °- —_ . � ' Claim Valuation ,
�SMIP Res �'�, $0.92 �� _' ' '
SMIP�Com. , � $0_00 �
�`� Y
��;.Othec' , ,' $0.00 — _ — % �'
Inspection: � , �$0:00 � �'�'-��` ' �
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Total: �$16317�� '� �
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`� � � � :�'��..�� ` F � PLANNING &�ZONING . '
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SETBACKS _ � 'r., \ -, ' r _ ..._ / � ,
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MAINSTRUCTURE Front 0 0, -� Rear 0-0 � � � LeR ' '0-0 � Right � � 0-0 � � ,�
ACCESSORY Pront �� � 0- 0 .� � � , �,. Rear �0= 0 - � , Left . 0- 0 �� , Right 0- 0� i �
PARKING Existin : 0 Required: o , � Pr000sed: 0 ;/ �
NOTES: � . � � . - �
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$9,223.00
$9,223.00
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 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
required inspactlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 ,
WORKERS' COMPENSATION DECLARATION:
I hareby eftirm untler penalry of perjury one oF tha following declerations:
❑ I have antl will maintaln e certificete of consent to self-Insure for workers' compensetion, as provitled for by section 3700 of ihe Lebor Cotle, for the pertormance of Ihe
work For wNc� t�is permit is issuetl.
❑ I have and will maintain workars' cwnpensation insurance, es requiretl by section 3700 of [he labor Code, tor the peAortnance of Ihe work for which this pertni� is issued.
My workers' compensa�ion Insurance carner end policy number are: / „_
Cartier. C Policy NumGer.
(This sectian need nat be cnmp/eted i! the permit is velueqat one hundred dollers ($100) or less.)
❑ I certify that in ihe peAormence of the work for which ihis permit is issued, I shell not employ any person in any menner so es to become subject to tha workers'
compensatlon laws of Celifomia e tha shoultl become subJect to ihe workers' compensation provisions of Section 3700 of the Labor Code, I shell forthwith
comply with these provi io ,
ApplicaN Signatura: �� E� ti� � � Date: ��z 77 "'��f
WAFNINQ: FAIWPE TO SECURE WORKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHA1L SUBJECT AN EMPLOVER TO CRIMINQ PENALTIES AND CIVIL fINES UP TO ONE HUNDREO
TFIOUSAND DOLLAHE ($100,000), IN ADDITION TO THE COST OF WMPENSATION, DAhL1GES AS PROVIOED FOR IN SECTION 3/OS OF THE IABOR CODE, INTEREST, MID ATTOHNEV'S FEES.
LICENSED CONTRAC70RS DECLARA710N:
I hereby affirm ihet 1 am licensed under pr vi� ions of Chapter 9(commencing with Secf�Dn 7000) oi Division 3 oi the Business and Profe:
force and ettect. Lic. # _ � r Class u C—
Contrectofs SigneWre: ,,�^ � Date: �
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CONSTRUCTION LENDING AGENCY:
❑ I hereby aftirm ihat ihere is a construction lending egency br the performence of the work for which Nis permit is issued. (Sec. 3097, Civil Cotle).
Lentler's Neme: Lender's Address:
Signature: Date:
entl my license is in tull
OWNER-BUILDER DECLARATIONS: -
I hereby aiFirm ihet untler penalty of perjury thet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Cotle: Any cily or county which requires e pertnit ro construct, alter, Improve, demolish, or repalr eny structure, pnor to its Issuance, also requiras the epplicant for suc� permit
to fle e signetl statement that he or she is Ilcensed pursuant to the provisions ot ihe Cantrectors License Lew (Chepter 9(commencing with Section 7000) at DlNslon 3 oi the
Business and Professions Code) or ihat he or she is exempt ihereirom and the basis for the elleged exemption. Any violation of Section 7031.5 by any applicant for e partnit
sub)ecis the applicent to a civil penalry of not more ihan five hundred dollars �$500).):
❑ I, as owner of the property, or my employees wlth wages as t�eir sole compensatlon, WILL DO TME WORK, and the stmcture is not intended or oHered for sale (Sec.
7044, Business antl Protessions Gotle: The Contractors license Law does not apply to an owner ot property who builds or improves thereon, end who does such work
himseli ot herself or Ihrough his or her own amployees, provitletl that such improvemenls are noI intendetl or ottered for 5ale. It, however, lhe building or improvemant 15
sold within one year of completion, the ownerbuilder will have the burtlen oi proving that he or she did not build or improve for purpose of saleJ.
❑ I, es ownei of the property, am E%CLUSIVELY CON7RACTNG WITH LICENSED CONTHACTOHS to construct the prqect (Sec. 7044, Business entl Protessions
Code: The conirectors license Law does not epply to an owner of property who builtls or Improves thereon, and who contracts for such projed with a contractor(s)
license pursuant to the Contractors License LewsJ. �
❑ 1 em exempt under sec. Buslness antl Professions Cotle for Ihis reason:
Signeture: Date:
Owner ID veritietl by drivefs license. ❑ Yes ❑ No Orivers License No.
Verificetlon of Ownership by (rype of document, i.e. - property t� bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Ezpires:
❑ I hereby cenHy ihat no excavation tive (5) or more teet in depth Into which a person is requiretl to descend, will be mada in connection with work euthodzed by Ihis
permit, and Ihat no building structure, scaHolding, falsework, or tlemolition or tlismanlling Ihereof, will be more then thirty-5ix (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celifornia Atlministrative Code).
❑ As owner-builder, I will not employ anyone to do work which wou10 requlre a pertnit trom Ne Division of Industrlal Sefery, as notetl above, unless such pereon has a
pertnit to do such work imm Ihe division.
SignaWre: Date:
Division ot Industnel Setety Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORQATION OF ENTAV: I certity under penalry of peryury ihat I have read this application antl state thet ihe informetion given is
correct. I egree to comply with all state lews end ciry ordinances relating to building construction, entl euthorize representalives of [he Ciry of Casta Mesa to enter upon the
ebove-described property for inspection purposes. I egree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
.�
LOUE I INSPECTIONTYPE
1616 Fized System Final Fire Prevention
1266 Paol SDe Final -
200 Flnal Re-Roof
201 Finel BIocWRetaining Well
202 Final Fadary Fire Plece
203 Final Sign
204 Final Demolitian
zaasae
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COUEI MSVECTIONTYPE
206 Finel Mechenicel
208 Finel Plum6ing
210 Finel Eledncal
212
220
222
250
Final Fire Prevention
Finel Planning Approvel
Final Site
Finel 8uilding/Occupancy
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CIN OF COSTA MESA
,` _ � BI/ILDING DIVISION
: DEVELOPMENT SERVICES DEPARTMENT
J _" .
•�� PERMIT PERMITNU BER /
� - - - - - - 898-01607 �
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 3OO PAULARINOAV
Suite:
Vicinity:
Parcel Nunmber: 42709115
Applicant: BOB ALEXSON
Address:
BUILDING PERMIT ,
Zoning:
Status: ISSUED
Applied: 09I08/1998
Issued: 09/08/1998
. . .PliOne: . ' .. .
. � Zip: ' � . - ..
; , :
owner. THOMAS;.FETER R � _
Address 260-15TH AVE � � � ' � � �
� � i� ' � ' � . � Phone: . . -- . � - _ �
% SANTA CRUZ,CA . Zip: 95062 � ��� . - , �
, �:i. � . - ' .�� .�.� � _
Contractoc � LEE�ROOFING OF COSTA MESA � � � � ` � � �
Address: 01653 SUPERIOR"AV �-� ' ' . •
.. - � Phone: . � �•� •
• COSTA MESA CA Zip: - 92627 , '
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�. ' � License;:, 949686 i . . " . . �, ,
�ArchlEng: � . . .. . "�' �'A .
� Address: � � � � � � ' � .
" ' � - Phone:� . - .
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. � License: , � '
SCOPE OF PERMIT
� ,• VoB and reroof 92005f commercial building wlbuil4up. ;, �� , �
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Plan Check:
P.ermit:
SMIP Res:
SMIP Com:
Other:
Inspection:�
Total:
$0.00
',$249.75
$1.62
$0.00
$0.00
$0.00
$251.37
SETBACKS
MAIN STRUCTURE Front , 0. 0
ACCESSORY Fronf � 0-�0
PARKING Existin : 0
NOTES:
FEE SUMMARY ;,I '
� _ _ ;� . — -. -. , � ' ? � � � , Calc Valuation: �
, � ,
` - J j . Claim Vaivation: ;
_ _ — � / /
�
Rear
Rear
PLANNING & ZONING.
0. 0 ' Left 0. 0
ao
Required: 0
Left 0. 0
Pr000sed: 0
�=
R�gni a o
Right 0-"0 �
.
St s,zoo.00
sis,zoo.00
0
EXPIRATION: This permit shall automatically expire and become void iF work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTtONS: In order for the work authorizad under this pertnit to be considered legal, such work must compfy with all applicable codes, and all
requlred inspeetiona and Flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARA710N: � �
I hereby etfirm under penalry of perjury one ot the following decleretions:
❑ I have entl will meintein a certificate ot consent to seli-Insure for workers' compensatlon, es provided for by seaion 3700 af the labor Cotle, for the peAortnence oi ihe
work far whlc� this permit is issuetl.
❑ I heve anA wlll maintain workers' compen, ion surence, as reQuired by section 3700 oi the Lebor Cotle, far the perfoimance of the woAc for which Ihis permit is isSueC.
My worker�s' jU�eyns�(i�on nce ca ier e policy number ere:
Cartier. ...i7Lc..[�, / Pdicy Numbec /
(Th/s section nBBtl not be completed i/ fhe pe/miNs vB/ued af ale hundred dollar5 ($100) or less.)
❑ I ceRiy Iha� in t�e peAor ance oi th ork lor which this pertnit is issued, I shall not employ any person in flny manner so as to become subJect to the workars'
compensetlan laws oi Calii ia, a r thal I s�oultl Eecome suh�ect to the workers' compensetion provisions af Section 3700 ai the Lebor Code, I shell forthwith
comply with these pro� � � / Dete: � D— `� �
�Applicent Signeture: /iC�� �
WARNINO: FAILURE TO SECURE WORKERS' CAMPENSATION COVERAOE IS UNL4WFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUN�REO
TFiOUSAND DOILARE (5100,000), IN ADOITION TO THE COST OF COAIPENSATION, DAMAGES AS PROVIDED FOR W SECTION 3�OB OF THE IABOF CO�E, INTEPEST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I here6y eHirm ihet I am licensed under pro
farce end eHect. Llc. p
� ConUactors Signeture:
9(commencing wit� SectiaM000) oi Dlvision 3 of the Business ay{1 Pryje�5s'u�s Code, end my Ilcense is in full
� Class N � � J ( .
� / Date: 9—k— �
CONSTRUCTION LENDING AGENCY:
❑ I hereby eMirtn Nat there is a wnstruction lentlinp apen�y for ihe Dertormance of ihe work for w�ich ihis partnit is issued. (Sec. 3097, CMI Code).
Lendefs Neme:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lentler's Address:
Date:
I hereby eHirm thet under penelty oi perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe iollowing reason (Sec. 7031.5, Business antl Professians
Cotle: Any ciry or counry which requires a pertnit to consiruct, elter, Improve, damolish, or repalr eny siructure, pnor to its issuance, also reduires ihe eppllcant for such pertnit
to tile e signed stetement that he'or she Is Ilcensed Oursuent to the provisions of tha Contrecbrs License Lew (Chepter 9(cammencing with Sectlon 7000) of Divlslon 3 of the
Business and Professions Cotle) or Ihet he or she Is exempt therefrom antl the �asis tor the ellegetl e:emptlon. Any violation of Section 7031.5 by any applicant far a permit
sub�ects Ihe epplicant to a civil penalry ot not more ihen five hundred dollars ($500).):
❑ I, es ownei of Ihe property, or my employees wlth wages as their sole compensation, WILL DO 7HE WORK, end iha structure is not intended or otteretl for sale (Sec.
7044, Business antl Protessions Cotle: The Cantrectors License Law does not eppty to en owner oi property who builtls or improves Ihereon, and who does such work
himsetl or herself or through his or her own employees, D�aWded that suc� Improvemenis are not Intendetl or otteretl tor sele. H, �owever, the bulltling or Improvement is
sold within ona year oi completlon, the owner-bullder will have the burden ot proving ihe� he or sha did not build or improve for puryose oi sale.).
❑ I, as owner of the property, am E%CLUSIVELV CONTAACTNG WITH LICENSED CONTRAC70RS to consiruct t�e projecl (Sec. 7044, Buslness and Professions
Code: The contractors License Lew tloes not epply to en owner of property who bulltls or Improves thereon, antl who wntrads for such proJect wlth a coniractor(s)
Ilcense pursuant to ihe Coniractors License Lews.).
❑ I em exempt under sec. Business enC Protessions Code tor this reason:
Signeture: Date:
Owner ID venfietl by tlnver'Slicensa. ❑ Ves ❑ No Drivers License No. Ex0lres:
Vedflcetlon of Ownership by (rype of dwumant, I.e. - property tae DIII or deed):
DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION:
❑ I hereby cently that no azcavation five (5) or more feet in depth imo which a person Is reQuired to descend, will be made in connectlon wit� work euthotlzetl Dy Ihls
perml6 anO thet no builtling siructure, scaXoldinp, felsework, or demolition or dismantling theraol, will be mare then thirry-six (36) feet high. (Chap. 32, Grp 2. An 2, Sec.
341, Tltle 8, CelNomia Atlministralive Code). .
❑ As ownarvbuilder, I will not employ enyone to do work which woultl require a permit trom Ne Dlvlsion of Industdal Safery, es noteC ebove, unless such person hes a
permit to tlo such wark trom the division.
Signeture: Date:
Division of Induslrial Satery Permit Number:
CERTIFlCATE OF CAMPW WCE AND Al7TTtOR¢A710N OF ENTAV: I certify undar penaly of perjury thet I heve read this application entl state t�et the infortnetion given is
cortect. I egre o c��n wit �te lews and ciry ordlnances relating to building consiruction, end euthorize representatives of Ihe Clry ot Costa Mese to enter upon the
ebove-tle bed (e on purposes. I egree not to occupy or allow occupency of flny bulltling euthorizetl by Nis pertnit unlil final inspection.
SI ature Of Legel Owner(s) Date � �
� �' �=�-�'� /
And/OrAuthadzed Applicant Date
COOE 1. INSPELTIONTYVE
1616 Flzetl Sys�em Finel Flre Pravention
1266
200
201
202
203
Pod Spe Final
Flnel Re-Roof
Finel BIocWRetaining Wall
Flnal Feqary Fira Plece
Final Sipn
204 Finel Demolilion
2MBJ8
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LpjjF2 INSPECTION TYPE
206 Finel Mechenicel
208 Finel Plumbing
270 Finel Eleadcal
212 Finel Fire Prevan6on
220 Flnal Plannlnp Approval
222 FIneI5lte
250 FInalBuilding/Occupancy
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