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Home My WebLink About662 CENTER ST - Building Permits_ , . .,,: . • l" � e � J�� (714)754-5273 • Fax(714)754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 622 CENTERST Suite: Vicinity: HOUSE 8 GARAGE Parcel Nunmber: 42421229 npp�icant: PEARSON, VESS Address: Owner: SIGMAN, LEWIS W Address 630 S 9TH AVE BEECH GROVE, IN Contractor: G M ROOFING Address: 4872 CANDLEBERRY AVE SEAI BEACH, CA Zip: 90740 Arch : Address: BUILDING PERMIT 2oning: Phone: Zip: Phone: Zip: 46107 Phone: (714)761-8173 License: 472566 Eng: Address: M1 PERMIT NUMBER 899-00695 77 FAIR DRIVE, COSTA MESA. CA 92626 ISSUED BY: Status: ISSUED Applied: 05/18/1999 Issued: OS/18/1999 � Phone: Phone: 2ip License: Zip: License: SCOPE OF PERMIT REROOF - T/0, USING EXISTING SHEATING, INSTALL 1 LAYER 30# FELT 8 20 YEAR COMPOSITION SHINGLE ROOF. FEE SUMMARY Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $74.75 $0.50 $0.00 $0.00 $0.00 $75.25 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0. 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0. 0 Required: 0 PLANNING & ZONING Left 0- 0 Left 0. 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0. 0 0 $2,250.00 $2,250.00 NOTICE: The work euthorized by this permit shall compty with all epplicable handicap eccess requirements under Califomia statutes and related regulations. (ord. No. 92-ze, § 1, 1z•z1•sz) EXPIRATION: This pertnit shall automaticalty 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. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all appliceble codes, and all requlred Inepeetlone and tinal approvel must be obtained. Feilure to abtain Inspections and final approval will result In the expiration of this permi�. FOR INSPECTIONS CALL: (714) 754-5628 WORKERS'COMPENSAnON DECLARAPON: I hereDy eMirm under penelry of perjury one ol t�e lollowing declaretlons: ❑ I heve entl wlll meintaln e c9rtlllcete of consent to selFlnsure tor workers' compensetion, es proNded lor by sedlon 3700 of ihe Lebor Code, tor the pertortnance of t�e work for which this pertnit b issued. l� I have entl wlll meintaln workers' compensetbn insurence, as required by section 3700 of Ihe Lebor Cotle, for the peAortnence ot the work for which Ihis perml� Is issued. My work�e%� compensetlon Ihsurence cartier anC pollry number ere: Carrler. V t �� Rn O V(k Policy Number. W L Z'- � q 8� 77 �— (Thls sectlon neetl not be crompleted if the permit Is veluetl el are hundred dWlers ($700) or IessJ ❑ I certlly Ihet In lhe DertormBnce ot the work for w�lch thls permlt is Issued, I shell not employ eny pereon in eny menner so es to become subject to Ihe workers' compensation laws ot alifomla, nd agree thet ii I shoulA become subject lo Ihe workero' compensetion proNsions oi Sedlan 3700 ot the Lehor Cotle, I shall forihwith complywlththese ov lon9. Applicent SlgneNre: ��— oaie: S—( P— C g WARNIN�: FFILURE TO SECURE WOPoCERS' GYkAPENSATION COVEMOE IS UMAW R1L AND SNALI SUBIECT M! EMPLOVER TO CRIMINAL PEW�LTES AND CML FlNES UP TO ONE HUNDRED TTIOUSMID OOLLARE (5100.000), IN FppRIpN TO TNE GO6T OF COMFENSRTION. DMIAGES AS PipVIDED FIXi IN SECfION 3]OB OF TN& LABOR CODE, IMEAEST, AND ATTORNEYS FEE$. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn t�et I em Iicensed under provisions ot Chapter 9(commencing with Sedlon 7000) of Divislon 3 of Ihe 8usiness 9nC Prateulons Cotle, end my Iicense is in tull forca and eflecL Lic. a `'11'�- S l. Cless N `�^� � i ComrectaYs Slpnature: - Dete: S^ l Y- i � CONS7RUCTION LENDINO AGQNCV: ❑ I hereby eHlrtn that Ihere Is 4 construcUon lending apenq for the peAortnanca ol the work lor whlch Ihis permll Is issued. (Sec. 3087, Clvil Cotle). Lendefa Neme: Lentlels Address: SIg�aNre: Date: OWNER-BUILDEH DEClARA710NS: I hereDy ettirtn Ihet under penelry vt perjury ihat I em EXEMPT FHOM THE CONTRACTORS IICENSE LAW tor the tollowing reeson (Sec. 7031.5, Business enO Professions Code: Any ciry or counry which reduires a permit to construct, alter, improve, demolish, or repair any structure, pnor lo its issuence, elso requires the epplicant tor such pertnit m Ole a signed sfetement that he br she Is I'rcenseC pursuant to the provisions of Ihe ContreMors Llcense Lew (Chepter 9(commendnp wiN Section 7000) of DMsion 3 of the Business and Professians Cotle) or Ihet he or s�e Is exempt Neretrom en0 t�e besis tor the elleped exemptlon. Any Noletion of Sectlon 7031.5 by eny epplicant tor e pertnit suD�ects Ihe epplicant to e cMl penalry of not more Ihen Trve huntlretl tldlen ($500).): ❑ I, as owner of the property, or my employees wlth wages es Iheir sole compensatlan, WILL DO T1E WORK, and the structura Is not intended or oflereC br ule (Sec. 70a4, Buslness and Prolessions Code: The Cantrectoro Llcense law does not eppty �o fln owner ol praperty who bulltls or Impmves thereon, end who does such work himself or herselt or through his or �er ov.n employees, proWded that such ImprwemenLs are nat iniended or ottered for sele. If, hovrever, the 6uilding or improvement is sold within one year ot completlon, Ue ownerbuilder will heve Ne burden of pmWng thet ha or she tlltl not bu11G or Improve for purpose of sale.). ❑ I, es owner at ihe property am E%CWSIVELY CONTRACTING WrtH LICENSED CONTBACTORS to canstruct the proJect (Sec. 7044, Business end Pmtessions Cotle: The contractars License Lew does not appry to en owner of property who builds or improves thereon, and who contrects for wch prqecl with a contraMor(s) license pursuant to the Coniractors License Laws.). ❑ I am exempt under sec. eusiness end Professlons Cotle for t�is raesan: Signeture: Date: Owner ID verified by drivers IlcenSe. ❑ Yes ❑ No Dhvers License No. Expires: Verlficetion of Ownership by (rype oi tlacument, i.e. - property taz blll or tleetl): DIVISION OF INDUSTRIAL SAF�7Y PERMIT CERTIFICATION: ❑ I hereDy cenly thet no excevetion Iive (5) ar more feet in depth into whlch a person Is required to descentl, wlll be metle In connectlon with work euthorized by this pertnit, entl that no bulltli� structure, scettWtling, telsework, or Cemdltion or Olsmentling ihereoi, will be mora than ihirty-six (38) teet high. (C�ep. 32, Grp 2, M 2, Sec. 341, Ttle 8, Califomia AdministretNe Code). ❑ As owner•bullCer, I will not employ enyone to tlo work whlch woultl reQulre a pertnit irom Ue OlWslon ot IndusMel Selery, as noted ebove, unless such person has a portnit to tlo such work trom t�e tliNsion. Slpneture: Dete: DlWsion of Industriel Safery Permit Number: CERTIFlCATE OF COMPLIANCE qND AUTHOR¢ATON OF EHTAV: I certlfy under penalry of pe�jury that I have reaA this epplication end stete ihet the inlormation given Is correct. I epree ro comply with ell slete laws entl ciry ardlnances releting to Dulltling canstructlon, enA euthodze representetives at Ihe Ciry of Coste Mese �o enter upon t�e above-descdbe� property 1a inspectlon purposes. I apree not to occupy or eUow occupency of eny 6uliding euthodzed by lhis permil unIlllinal Inspection. � nature Of Legal Owner(s) Dete ,�,. — s � � s� � s S ndlOrAuthodzed Applicant Date COOE I, INSPECTIONTYPE 1616 Flxetl Sy9tem Flnel Fire preventlon 1268 200 201 202 203 204 2al&46 Pool Spa Finel Flnel Ra-Roof Flnel BIocWRetelnlnp Well Flnal Fectory Fire Plece Flnel Slgn Flnel Demolition PAff. Itl�li � � COOEt INSPECTIONTYVE 208 Finel MOChenicel 208 Finel Plumbing 210 Finel Electdcal 212 Finel Flre Preventlon 220 Flnel Plenning ApOrovel 222 Finel Site 250 Finel BulldingiOccupency, PAg Itl�LS