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Home My WebLink About642 CENTER ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 642 CENTER$T Suite: Viciniry: ROOF Parcel Number: 42421234 Applicant: ALCANTRA, KENNETH DEAN Address: 24781 WINTERWOOD DR . LAKE FOREST, CA � � Owner: ANDERSON, JOHN W TR Address . 26955 FLORESTq'LN - - , MISSION VIEJO; CA � Convacfor. 'KENNETH DEqN ALCANTR,4 Address: 24781� WINTERWOOD DR �.4KE FOREST, CA Zip: 92630 Arch : Address: , , � � . �' Zip: Zoning: Phone: (949) 837-5376 Zip: 92630 Phane: Zip: 92691 _ � Phone:� (949)837-5376 License: 544282 _ _, � � `i:: �� -E�9. ,� - � � _ . Address: Phone: License: Status: ISSUED Applied: 01/29/2003 Issued: 01/29/2003 . : I �i.�. Phone: License: .- - ;� � - SCOPE OF PERMIT- , REMOVE EXISTING WOOD SHAKE ROOF. INSTALL 1/2" SHEATHING, 30# FELT, CLASS A,�50 YEAR COMPOSITION SHINGLES. 3,800 S.F. INCLUDES ATTACHED GARAGE. � � � � FEE SUMMARY ' Plan Check: $0.00 Calc Valuation: S�,soo.00 Permit: $153.25 Claim Valuation: S�,5oo.00 SMIP Res: SMIP Com: Other: Inspection: Total: $0.75 $0.00 $0.00 $0.00 $154.00 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existinq: o PLANNING & ZONING Rear 0- 0 Lefl 0- 0 Right Rear 0-0 Left 0-0 Right Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulatlons: (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become voitl 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 consideretl legal, such work must comply with all applicable cotles, and all requlred Inapaetione end final epproval must be obtained. Failure to obtain inspections and final approval will result fn the ezpiration o( this permit. FOR INSPECTIONS CALL: (714) 7545626 zaaaee (erool WORKERS'COMPENSAnON DECLAflAnON: _ � ' ' I hereby eNirm under penalry af perjury one oi the following decleretions: ❑ I �eve end will meimeln a ceniBcete at consent to selt-Insure for workers' compensatlon, es prodded for by section 3700 at the LeDor Cotle, for Ihe pertormence of the work tor which this pertnit Is IssueC. , ❑ I have end will malntain workers' compensatlon Inwmnce, es requireA by sectlon 3700 oi Ihe Lebor Code, lo� Ihe peAortnance of the vrork for whid� UJs pertnit is iswetl. My workers' compensetlon Insurenca carder antl policy number ere: Certier: Policy Num6er: (_T�/Is sectlon need nat De completetl !! Me perml! Is velued ef one hundred dWlers ($100) oi less.) . y� I certity Ihat in ihe pertormence ot t�e work lor which Is pertnit is issued, I shell not employ eny person in eny menner so es to become sub�ect to the workere' compensetlon laws of Cal entl egr t t if I Itl beca a b�ect to yIhc workers' compensatlon provislans of Sect 3700 0l the Labor Code, I shall forthwith Comply wilh these proN r� � � /� �� / ApDlicenlSlOneture: ��'�''"""'� Dete: z-�% 03 WAqNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERA�E IS UNIAWFUL AND SI/ALL SU9IECT Ml EMPLOVER TO CRIMINAL PENALTIES AND CNIL FlNES UP TOONE HUNDRED TIiOUSAND DOLLARE (5100.OW�, IN ADORION TO h1E W5T OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3108 OF TME LABOR CODE, IMEREST, Ml� ATfORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eillrm thet I am Ilcense �u%�d�ej provislons at Chepter 9(cammendn8 with Sectlon 7000) of DlNsion 3 of ihe Bi lorce entl eMect. Lic. a �'/" `i �—� Z Cless a CONrectoYs Signeture: � �ete: _ CONSTRUCTON LENDING AGENCY: Catle, entl my Iicense is In tull thet t�ere is e conswction lending epenty for the pertormenca ol I�e work tor wNch t�ls permit is Issuetl, (Sec. 3097, Civll Catle). LentleYs A4Aress: Date: OWNER-BUILDER DECLARATIONS: 1 hereby eflirtn t�et untler penelry ol perJury ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for t�e tollowing reason (Sec. 7031.5, Business entl Professions Code: Any Uty ar wunty which reQuires a pertnit to consifuc�, elter, Improve, demdish, or repair any structure, prior to Its issuance, elso repuires the epplicent tor such pertnit to tile e signed statemeN that �e or she b Iicensetl pursuant ta Ihe provisions ol the Contrecton Llcerue Lew (Chapter 9(commendng wit� Section 7000) ot Dlvision 3 of the Business and Professions Code) or thet �e ar she is exempt theretrom anC the besis for t�e ellegetl exemption. Any vloletlon of Secibn 7031.5 by eny applicant for e permit sub�ects the applicent to e civil penalry of not more t�an tive �undretl tlWlers (5500).): ❑ I, es owner ot t�e properry, or my employees wlth weges es thelr sole compensation, WILL DO T1E WORK, antl Ihe structure is not Intendetl or oXered lar sale (Sec. 7044, Business end Pmtessions Code: The ConlreMors LJcense Lew tloes not aDPN �o en owner ot Omperry who builds or imprmes theraon, antl who does such work hlmsell or herself or through his or har own employees, prwided ihat such impmvemenis are not intentled or oNered lor ule. It, however, the building or imprwement is sold within one yeer oi completion, the owner-Duiltler will have the �urden ol proving that he or she did not builtl or improve for purpose ot sale.). ' ❑ 1, es owner oi t�e praperty, em E%CLUSIVELY CONTRACTING wITM LICENSED CONTRACTORS to construd Iha prqect (Sec. 7044, Business entl Professions Code: The contrectors Ucense Lew tloes not epPty to en owner ot Droperty who �uiltls or improves ihereon, enA w�o contraqs br such prqect with a coniractor(5) license pursuent t0 the Contractors UcenSe LawS.). ❑ I em exemp� untlor sec. Business end Professions Code lor Ihis reason: SignaWre: Oate: Owner ID veritietl by drfvefs license. ❑ Ves ❑ No Drivets Llcense No. Fxpires: Vedfcation of Ownership �y (rype of document, I.e. - property ta< bill ar deed): DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICATION: ❑ I hereGy certily that no excavetlon tNe (5) ar more laef In depth Into which e person is reQulretl to tlescend, wlll be made In connecllon wlth work eufhorized by ihis permit, end that no buil0ing siructure, scafldding, falsework, or demoli0on or dismantling Ihereol, wlll be more Ihan thlrty-six (36) feet �ig�. (Chap. 32, Grp 2, An 2, Sec. 347, Tltle 8, Celitomie Atlministrative Cotlej. , ❑ As owner-bulltler, I will not employ enyone to Co work wNch waultl require e pertnit trom the Division ot Indusiriel Satery, es notetl ebove, unless auch person hes e pertnit to tlo such work trom t�e tlivision. Signatura: Date: D'Msion ol Intlustrial Sefey Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORQATON OF EMRY: i cenity under penalty of perjury tha� I have read ihis epplicaUon antl state that Ihe infortnatlon given is carrect I egree to ly wil� all stete laws entl ciry ordinances relating to bulltlinp constructlon, anA euthadze representatives at the Ciry af Costa Mesa to enter upon Ihe above-descnbetl pert Inspection oses. I egree not to occupy or ellow occupancy of eny building euthorized by thi� p9�Z it until inel inspection. / y os Signeture OI LeBal Owner(s) Dete � i�'Lc_.t.-✓ri�.t /�i.9�'3 AnA/OrAuthodzetl ApPlicant Dale GOUE I. INSPECTIONTYPE 1616 Fl:ed System Finel Fire PrevenHon 1266 Pool Spe Final 200 Final Re-Roaf 201 FIneI Block/Releining Well 202 Flnel Facrory Fire Place 203 Final Slgn 204 Final Domolitlon ' Pdg U�ELg � � GOOEI INSPECTIONTYYE � 206 Finel Mechanlcel 208 Flnel Plumbing „ 210 Finel Elecirlcal 212 Finel Fire Preventlon 220 222 250 Flnel Plenning Approvel Finel Slte ' Finel Building/Occupancy QdiE U�Lfl )� ly'7�PAIOQO 385� ***-1�86.00 crasr ��ri� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEI D B DATE RECEIxEOD DATE ISSUED BUILOING � /,- (� �� ` /// O ADORESS ( c� i �IJ`/ OWNER �� A.P.NO. ��`"O� �� P IG� �[/ MAIL y�/ fn� � AD'DRE 5 � y ��y�,/[ '� I Z AODRE55 I/ /�{, ./� d U CITV � . NO��_ AC� �� '"�� BLOCK zZ Q CANSTRVCiION NEW ADD A P O � LENDER � , am � J � BRANCH J � OWNE D� m J ADDRESS VALUE X(� ' J m ARCHITECT � TEL. $ � $ !J /�� a OR ENGINEER N . } wa � E Q v� � FIRE ,�/ � ADDRESS ZONE TVP GROUP"�'� d W APPROVED W Z CONTRACTOfl BY TE / I D J � m Z J � ADDRESS � w TEL. Z NE Y NO.OF USE OF NEW L(/ i z? CITV Q�T NO� P�� BUILDING � 7 w � STATE �. CITV !yp VARDS APPROVED VARDS APPROV D j O IIC. NO, if �' LIC. NO.�/v % MAIN BUILDING ACCESSORV BUILDING SI2E NO.OF BLDGS. (FROM GL STflEET) OF LOT jL � NOW ON LOT �N FRONT � FT. FT. USE OF EXISTING BLOG. SIDE FT. FT Z NEW BLOG. D/"/� � FOOMS STORIES � � L. SIDE FT. FT. a EXTERIORWAL ROOF (7�� / �% COVEFING FiPO COVERING� Ji'i+Y'.L� REAR T. FT. * J VSE OF VILDING AND WOF O BE P RFORMED DISTANCE BET. BET. MAIN & a MAIN BLDGS. ACCESS. BLOGS. a �,�/' - a .�(/V CURP � APPROVED 0 ~ APP V ' Cl • _ (�_ �^� (q bL- C/ z HOLD FOR SPE AL REQUIREMEtvT: 0 ~ I hereby acknowledge ffiet I have read this apPlication and state �� ( � ihat the above info�mation is correct antl agree to comply with � � all laws regulating building constr�ction, and 1 shall not employ F any person in violation of the workman's compensation laws of y the State ot California. !— .{ � a^ � Z I he�eb ce�tit that I am J �� SQ. FT. �� o y y properly licensetl as a contractor untler the State of California eusiness antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDE ALUATION IS FOfi � Chapter 9, antl that such licenses are in full torca and eftect, or I THE PURPpSE OF ESTABLISHING A PEFMIT FEE ONLV: ¢ am exempt trom the provisions of the S ate of Celif rnia B�ne VALUATION �� antl Professions Cotle, D'vis'6n 3, hap r 9. � � N PERMIT FEE $ ] Signature of �j /Wr m Permittee � $ PL.AN CHECK $ �^ � E �/D�; f'�' � ' Authorized Agent � ,� LL TOTAL FEE $