HomeMy WebLinkAbout820 CENTER ST - Building Permits�
1;�7
;,�p 2 i 1960
DATE
iOilT'y COLlt, VALUE $ 7
THACT FIHE ZONE DESCRIPTION OF WORK
DATE I GROUP TYPE
— ---I SUBCONTRAGTOR I _ PERMI7
OCCUPANCY � I I I I
Form 21�SM-11-59 5-B P : _ 1�,Z,7
(714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla-mesa��DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 820 CENTER ST
Suite:
Vicinity:
Primary Occ: R3
Parcel Number: 42419115
TypeofConsWction: V-N
Zoning:
Status: ISSUED
Applied: O6113/2005
Issued: O6I13I2005
Applicant: BERNIE REED _ - .
Address: PO BOX 291 . - � - - , ISSUED BY:
CA � _ - - - � ' . Phone: (310) 32&6108 `
GARDENA ' ��i � --- , Zip: '90248 _ - -
Owner. COCE;'ROBERT-J TR ' � ' • ' � . _ ;' � � �j�(F.i'
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Address /BJOHNSCANYONRD,%��i -�_' _���_, -� �,�L' ..
/ .��� � � � � � � �� � � Phone. ,. �
- �ROLLING HILL9,�CA � - Zip: 90274 � � � �
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Contrector. SKYCRAFT ROOFING INC ����
:�� .-
Address: '. PO BOX 291;� , "
" � �'CA ; ,��' � 'Phone: (310)329-6108 .� „ �
'r,i:
� �OARDENA ' � .
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, � , Zip: �90248 ;� License: 400212 , - . � ,
. � r -� i. .4' . .
Arch : - _ , S . ,� �.. . . � . Eng: �- . - �.
Address: ' � ���� ' ' - '� A'; .. . _ ' . — - - Address: ,.- � � �
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TEAR OFF EXIST. COMP. AND ROCK ROOF �. INSTALL;1y30L8 FELT AND,40�YR-0OMP. SHINGLES
Plan Check;
Permit:
SMIP Res:
SMIP Com:
� Other:
Inspection:
�,. •.
`Total:
SETBACKS,
MAIN STRUCTU
ACCESSORY
PARKING
NOTES:
$0.00
$411.95
$2.63
$0.00
$0.00 ,
$0.00
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$414:58.
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, � Phone:
License:
FEESUMMARY ,
' ' „� _ ' . , . ` % � �. - Calc Valuation:
' - � Claim Valuation:
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statules and related
regulations. (Ord. No. 92-28, § 1, 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 period of 1 BO 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 Inapeetiona end finel epproval must be obtained. Failure to obtain inspections and final approval wlll result In the expiralion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
;�,�^.+I(:r:):
WORKERS' COMPENSATION DECLARA710N: '
I hereby enirm untler panelry of perjury one of the following tleclarations: '
❑ I heve and will meinteln e cetliflcate of conseN to self-Insure for workers' compensatlan, es provitle0 for by section 3700 af t�e Lebor Code, far ihe peAortnence of Ihe
tor wNch Ihis pertnit is luued.
t he e entl will mainleln woAcers' compensalian insurence, a5 required by sectlon 3700 of Ihe Lebor Cotle, for Ihe peAortnance of ihe work tor which Ihis pertnit is issued.
Ce My orl��sR �n��U�ns�ance carrler end polry number are: -
Sf y� �sa 33-o?G�o�l
liry Eer. _ _ r%.
!s sectlon need nof be completetl il the peimit 1s velued at one h�nCreC Oollers (5100) or less.)
❑ I certiy ihat in t�e peAormence of Ihe work �or w�ich ��is pe ' ed, I shell not amploy any person In eny manner so es to becoma subjed to Ihe workers'
com i CalNornla, en gree Ihet tl I shoultl e sub ct to the workers' compensatlan provislons of Section 3700 of ihe Lebor Cotle, I shall fanhwlth
�Y wi,h �he5e P h�i Gd — l 3- US
App nt SlpnaNr � ate:
WARNI URE TO SECU E WO ' COMPENSAT�Of�1 COVERA Nl"AW R1L rWp SHALL 5U91ECT AN EM RIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDRED
TVqUAMlDDOIIARE(5f00, , ITIONTOTHEL�".+T��.iPEf�1SAT10M.DMM0ES0.5PfiONDEDFORINSECfION3lO80F7HEUBORCODE.INTEREST,MlDATTORNEYSFEES.
LICENSED COHTRACTORS DECLAHATION:
I hereby eff�setl untler proNsions jt� Chapter 9(cAm�np with Section 7000) of
Code, and my license is in full
-�
CONSTRUCTION LENOING AiiENCY:
❑ 1 hereby atflrtn ihat there is e wnsiruction le�ding agency for the pertortnance oi the wodc tor which Ihis pertnit is issued. (Sec. 3097, Civil Code).
Lentlers Neme: Lenders Address:
Signeture:
Date:
OWNER-BUILDEN DECLARATIONS:
I hereby eXirtn that under penalry of perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Professions
Code: My dry or caunry which requires e permit lo construM, elter, improve, demolis�, or repair eny sWcture, prior to its Issuance, elso requires the appliwnt tor such pertni�
to file e signed stetement Ihat he or she Is licensetl pursuent to ihe praWsions of ihe Contrectors License Lew (Chapter B(commendng with Secllon 7000) ot Dlvision 3 of the
Business enO Professions Code) or that he or sha is exempt iherefrom end the besLq for the allegeE axemptian. My vidation of Sealon 7W 1.5 by flny epplicent for e pertoit
su6�ecMs ihe applicaM to e civil penalry of not mor0 than tNe �untlreA tlollars (SSW)J:
� I, as owner of the property, or my employee8 w��h wages as t�eir sole compensetion, WILL DO 7HE WORK, end the struccure Is not intended or offeretl for sele (Sec.
7044, Business entl Professions Cotle: The Conirectors License Lew does not aDPly to en owner af properry who bullds ar impraves t�ereon, entl who does such work
himsetl or herselt or Ihrough his or her own employees, provitled ihet such improvements are not IntendeE or oHeretl for sele. N, however, the building or improvement Is
sold within one yeer of complation, ihe owne�-builtler will heve Ihe burden ol proving t�at he or ahe did not builtl or improve 1or purpose of sale.). '
❑ I, es owner of the properry, em EXCLUSIVELY CON7RAC71NG WITH LICENSED CONTRACTORS to wnsiruct the project (Sec. 7044, Business and Prolessions
Code: The contrectors License Lew does na� eppy ro en awner of Droperty wha builtls or Improves ihereon, and who contrects for such pmject wlth e coNrectar(s)
license purouant lo lhe Contractors License Lews.).
❑ I am exempt under sec. Businass and Pmfessions Coda tor t�is reason:
Signafure: Oate:
Owner ID verified 6y tlrivers Iicense. � Ves ❑ No Drivefs License No.
Vetlflcetlon oi Ownership by (rype of documenL i.e. - property tex bill ar tleetl):
Ezpires:
DIVISION OF INDUSTRIAL SAFE7Y PERMR CHAnFICA710N:
❑ I hereby ce�ify Ihet no excavatlon fve (5) or more feat in depth into whic� e person is requlred to descenC, will be metle In connectian with work euthorized by this
pertnit, and that no builAing siructure, scaHo�tling, lalsework, or demolltlon or tlismaniling thereof, will be more than thirry-slx (36) feet high. (Chep. 32, Gry 2, Art 2, Sec.
341, Title 8, Califomia Administrative Catle).
❑ As owner-builder, I vrill not employ enyone to Go work which would require e pertnit iram ihe DMsion af Industrial Safery, as noted ebove, unless such person hes e
pertnit ro tlo such work from the division.
Signeture: Dale:
Division of Indusinel Sately Permit Number:
CEHTIFICATE OF COM7LUWCE IWD AUTHORIYA7�ON OF ENTRY: I certify under panalry ot perjury Nat I have read ihis applicetion enA s�ate Uat Ne IntortneUon given is
correcL I agree to comply with ell s[ete laws end ciry ordinances relsling to bullding constmctlon, antl aut�odze represenWtives of the Ciy at Costa Mese to enter upon Ihe
ebovadescribetl properry for inspection puryoses. I egree no� to occupy or ellow accupancy at eny building authorized by this permit un�il final inspection.
CODE �. INSPECTIONTYPE
1816 F�cetl System Final Fire Preventlon
1268 Pool Spe Finel
200 Final Re-Roof
201 Flnal BIacWRetelninp Well
202 Final Feclory Fire Plece
203 Finel Sign
204 Flnal Demolitlon
�ff. I�L�
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COOE� INSYECTIONTYPE
206 Final Mechanical
20B Final Plum�ing
210 Flnel Eledncal
212 Finel Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupanq
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wk s not commenceC and r+a�rna�nec aa�ve pei U6C §3G3 (a� wnnm �80 days I issuance.
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�-.COSFA-M A BUILDING-SA ETY DEPARTMENT
P.O. BOX 31] COSTA MESA, CALIFORNIA
FOR APPUCANT TO f/LL /N COMPLfTfLY
TYPE OR PRINT
eui�oiNc�Kl VE,/��%6 �C .S/. /—�f!/�
AODRE55
COSTA MESA. CALIFORNIA
A�DRE55 ' �il� �
CITY ���� {��J� / �L�/J NO.�
ARCHITECT ../ n LIC.
OR ENGINEER�j��jf�/R� NO.
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ADDRE55 �/7!J/) ��. D�,?t2iSi'
LEGAL LOI /� /�
oescnirnoH NO. BLOCK TRAC
A.P. NO.
SRE / 1/ /� NO.OF BlOGS.
OF LOT ��[/J �f �/�O rvow orv �oiN�
USE OF
EXISTING BLDG.
SETBFCK LINE FHOM 2C
cErviER oF STREET � REAR YARD '`
� / /
SIDE YARD LEFT � RIGHT S
DESCRIPYION OF WORK
NE4V I II ALTERATION I II ADOITION I
BUILDING
SIZE
U.yE OF BUILDING AND WORK TO BE P
5
� TS S',4
l°r92 �i �2 � S
1 HEREBY qCKNOWLEOGE TNAT 1 HAVE RE
ANO STATE THAT TH ABOVE IS CORRECT
PLY WITH AlL CI O OINANCEB M1N� STP
BVILDING CON9T Oy:� �
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!�_�7-.S � �'t.�
fIRfANCE DEPT.
�ITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
S
�b) faR officE usF oNcy
I HECEIPT NO. I PFRMIT.
'�) C` EiYT�ie $ % , .
COSTA MESA. CALIFORNIA
20NE NO.OF USE OF NEW
PUNS � BVILOING /i
�� � �J /�
APPROV�� % �/ / - /(
BY G�/J`.�/�� � DATE (�
NARDS S
REqUIRED ALLOWED
�CENTER LINE 8Td /�/,
FRONT '/ FT.
R. S�DE .� FT.
L.SIDE �FT.
REAR ��/ FT. C .
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APPLICpTION qHE AMOIINT 9HOWN IINOER VALUATION I$ FOR THE
iEE TO OM- pURPOBE OF EBTABLISHING q PERMIT FEE ONLY.
REG ING
VALUATION
PERMIT FEE $ /� i�y S
--�,J f $ / A�O � �S' PLAN CHEGK $ S�. �
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TOTAL FEE $ �S (�, �
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. �� �
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 817 COHTA MEBA. CALIFORNIA
For Applieanf to Fill ln Complefely
�ry TYPE OR PRINT
BUI�DING t/��% C%CA/ tic/� ��
A�DRE65 C7
COSTA MESA. CALIFORNIA
� MAIL
TEL.
NO.
TEL.
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LIC.TNo`J���BG NO.��:tJ��
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BIZE ^ I �a. oF e�oae.
� 96TBAC1( LIN! FROM
DESCRIPTION OF WORK
WALL I ROOI
COVI
IILDING AND WORK TO
/ r/ f
2 ���
� xeneer ACK� tEnae rra�r i Hwve rtenn �rxie MPLIGTION
AN� BTATE �HAT TXE ABOVB 18 CORHECT ANp AGftEE TO COM-�
PLY WITH ALL CIiY PDINANC28 AND 9TATE LAWe q80U41TING
BUILDINO �N ON. e��/j�j /
BIGNATLIRE OF � AA �/fA v/1�..,_ �./"�
A AUTHORIZEU AGEM
FEE R�CEIVED :
�-- `57 � c� � �.
FINANCE DEPT. .
AP$17pC�WE10Et��i(�W14e�11T
BUILDING
For Office Use Only
NECEIPT NO. PlPMIT. NO..
�i•:iai s
pY IOATfi qECEI ED OATE �BSl1E
a-✓/-�7-�o � .�2-,r'-���
/.�c�-f� (. %.�/L/ j £ .Ci .S / ,
COSTA MESA. CALIFORNIA
FIRE
ZONING
Z `` I NO. �. I UBE OR NHW
� PLANB BUILDIN6
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DHBCPIPryN L �
A. P. NO. II/� �V /�'� �
fCCNT6R
APPROVED
TM6 AMOIIM BHOWN UNDER VALUAT�ON IB FOR TXE
PURP09E OP EBTABLIBHIN6 • PENNIT FEE ONLY.
VALUATION �J
^ O� PERMIT FEE $ .�(. �� v
S // �/ PLAN CHECK $
Z
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TOTAL FEE LL
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