HomeMy WebLinkAbout3105 ROOSEVELT WAY - Building Permits P�ECT ADNIESS: dr UNIT:
OWNER'S NAME: 3105 ROOSEVELT WY . CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067159
ADDRESS: PRICE, JAMES H
PRICE, SUE PERMIT NO: B 067159 PLAN CHECK NO: N GOVT: N SUPP: N
3105 ROOSEVELT WAY
' COSTA MESA{,CA 92626 CONSTRUCTION TYPE : V—N PERMIT TYPE: SIR PURPOSE: OTH
ARCH/ENGINEER: 714 ) 751—B /37 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : T/OFF RESHEATH & REROOF W/COMP , SHINGLES SQ FT: 5, 000
PERMITTEE: CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 5, 000 . 00 GROUP OCC : R-3 /
ADOflESS: SUE PRICE (714 ) 751-8737
((``3105MARROOSEVELT WAY �jjA QQ COMMENTS: SMOKES DETECTORS ARE REQUIRED IN EVERY BEDROOM & HALLWAY
LICENSED CONTRACTOTi OECLAIIATION: thereby affirm that lam licensed undeCOT6visi6nso per 9(commencing with Section
*******************************************************************************
7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. ZONING REQUIREMENTS
CITY LIC.: STATE LIC.: CLASS: SETBACKS
Dale: signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm thatl have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ• PROV: PARCEL: 14169325 INE: REF NO:
❑ Centred copy is hereby furnished. ❑ Certified copy is tiled with the city Building Division. PLANNING NOTES>
.e: Applicant: ********************************************************************”/*********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permt is for we hundred(4100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not gprpigy any person in any mariner so as to become
su ect to the Workers'Compensation Laws of California. V/vJ/"elF))X/ ` '
• [— n ZONING APPROVED BY DATE:
Dat _ 7 13 — 0(�I Li Signature S �Q 1j k( X
NOTICE:It after making this dedlaration.you should become subject to the kers'Compensation provisions of the Labor BUILDING APPROVED B Y : DATE
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. A
CONSTRUCTION LENDING AGENCY: I hereby affirm that(here is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• d DATE: 1 I
which this Permit is issued(Section 3097,Civ.C). ************************************** * ************************* * * **
LENDER: ******************TE******************************************i6*****************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE $MIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,ot
repair any structure,prior to its issuance,also requires the applicant for such permit to lite a signed statement that he/she is licensed PERMIT 72 . 0 0C• -O '5 0
pursuant to the provisions of the ContractorsSM State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business KE SMIP/NON—RES
and Professions Code)or Thal he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN C DETECTO
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($5M. ISSUE FEE R
I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—D IV—> PERMIT ISSUE REPT TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS S----> 7 2 . 5 0 0 , 0 0 4 O 7 2 , 5 0 7 2 , 5 0 00
does nor apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTAL S——> COLLECTED ; 7 2',-50 OVER/SHORT: . 00
for the purpose GI sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner ot the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 7 2 . 0 0 , 5 0.
U and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware
that Drool of their Worker's Compensation insurance should be provided to me. *******************************************************************************
I am exempt untler Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN
BP04 4
for reason: O U,u•ER-BUILDER n\1 , n TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
1diiip S I�— I Owner: V k71lh and
ereby certify that l am aware and understand the requirements of California Health and Safely Code Sections 25505,25533.and SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 000 . 00
25534 and That I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ,
these provisions. .
Date: �� Applicant:
1
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county
ordinances and state taws relating to building construction and hereby authorize representalry s of this city to enter upon the above-mentioned
property for inspection purposes.rp •
-- are —)3_eLy Signature: SU.,
M/( CR 01 00160484-00160485 TOT 72.50
'river's License of Social Security+: DATE: 05/13/94 TIME: 11:29
164146 White—building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
- \
CONSTRUCTION AND PLANNING POOL 'A
Date Inspector I Date 1 Inspector I
1 APPROVALS Permit# APPROVALS Permit; j
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location I I
2. Soil Pipe-Lic1,53. Steel Reinforcement j
3 Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Condu.t•Undrgrnd. I. 55. Electrical Bonding '
5. Stcu Reillforcement 1 56 Rough Plumbing & Pressure Test-_ •
6 ".c,•.uu! ;;FER L•rnd - I 57. APPROVAL 10 COVER-GUN! `F
7. Fuot ngs j 53. Elect- cal Conriu t Undrgnd.
t :
B. Foundationit 59. Gas Pipe. .: U! LEE-id •Tcst
9. dater P•pe•Undrgrno. 60. 6ack.'rsh Lee, - rap.PTGne^ no r j • -- -
10. Structural Floor System - 61. APPROVAL TO UI CK
11. Property Sewer Line & House Connectiontrs 62. B.ck,:ash L Race;. ✓'ural •
_J i
12. Sewer Cep 63. Hater & Vent-Final
- _ -- ~
73. Roof Drains
64. Plumbing System Fi-al
14. Rou'l''i Piurnomg 65. Electrical.Finui -
r -H-
I {
15. Rough E.ectrica'-Condu&t 66. Solar Syst:itr'Fina.
16. Rough ElectricV. r
11rin -�-
9 --� 67. Fonc`nq & ACC!ss Approval
17. Rough W.rirg Sign 08. APPROVED FOR PLASTERING -1--
18 Rough Electrical-T Bar Ceiling 69. POOL 'SPA SYSTEMS FINAL
19. Rough Heating & Air ConditioningFIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace r APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydra '
•
22. Ducts. Ventilating -- 71. Prcdnct Piping l Gas [Ji Oil '
-it_-_
23. Gas Pipe-Rough & Test I /2. Unai^grouiicl Hush I '
24. Roof Framing - -t_---
i3 Undarecn•u.Sr �rar, - i,nir Gas .3. ----t----- -
25. Rear Sh[Lthing / (7-9e{ 16w /4. O'-e-, :'u' ih•n,in
26. r•Ber Cuing 'Structural, & Monoco't - --1 75. Jry Cnemu,:
--- - - - -- - --
27. Frame and Flashing I 76. Dry Sturiop pc
28. Lath•ng& Siding _ _ ---- -I 77. FIXEDSYS-1E_:1 FINAL ---_
29. Insulation I 78. FIRE PREV_FINAL 1
33. °rvv;eil 'slailing Ir j FI_ALTH DEPT. REQUIREMENS
31. Pa.t:r &o,sn Co.' 1, J 179_i=.C.01_ li.':L'ITC-IC -_ _- - 1-- .
32 Eye c[ncc' Pou.rr cep-Fina -__ _ 13J. F,^. Cin E ISSi.ED_
33. ru E ec:r e , Not:.c. . -
firT34 Fn_. Heating n• A•r Co -citon.r_ I ('Y1
35. Firs! Gas Pio. .Teat _ - __ - t -_ _ _-___-.
-1----- I ....1_ .rn/
,
33. Hoori or Canopy - „
37. Final Factory Fireplace ------ ----- --'II tit --------- . ..- ----- - -
-- ---- -' --V�- -- --------- - - -- - -- - '
38. Final Plumbing
I3R. `::afar Service-Final - - _ t, l----- -- -- '_-- --1
40. Gas Sery cc F.nal - --~ _ -_-__ _ __ - ,
' 41. Solar Gamer' c.F.,' ±-- - - -- --- - -- -----
42. Bacisf low Preventcr
43. Backflow Irr:cat:on Fea _
44 Landscape Irrigation System �4„•,..VA
45. Sound Attenuation - --- -- ---- _---- -_ -_ -- ---
46. Handicap Regutatlons ---- ---- -----_ ----_--_ -
47. FINAL STRUCTURE & BUILDING -Zq 6Ls., i --- -
48. FINAL PLANNING r . -
49. Electric Release to Edison - -
50. Gas Release to Southern California Gas Co ________
51. CERTIFICATE OF OCCUPANCY •
No. Date
i�
\.
- ? 1347, FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 1'7' 1964
P.O.BOX 917 COSTA MESA,CALIFORNIA FINANCE DEPT.
• CA4T� q�F COSTA MESA azo
For Applicant to Fill In Completely AP I A ION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING/J �05 TL) 1 ��y1 For Office Use Only
ADDRESS 3 pOo-. c_k . `A 1
RECEIPT NO. 2t&47
COSTA MESA. CALIFORNIA J
\11 L RECEI [D er OAT REFEE 177/ J[7ATE ISSUEDOQ
OWNER 11(X/�ti\c,cit-Q. gnSfV12S / / _.- An
�nitl 6 19R
[[�� ((��I BUILDING
ADDRESS I. 13-I J-.O`S Pe V e__S ADDRESS
I ��--yy�� (Jh FIRE /
CITY J \ Ol\V\ UCLA el NO. (4j]cS ZONE TYPE
Vel
APPROVED Or
AR1F"ITECT \E1( NO. - P}co BY DATE
OF IINEER .c_...5
/cI^/��1 r1(1_ ZONING
arfrr
ADDRESS !T\1 C �'\E ) \�\ ZON / NO.OF�1 USE OF NEI '
/1 rA-11\
I PLAN[ / /I BUILDING I�a. (/ _ '
CONTRACTOR L1Ser l�"0•...•\nci A\(F'_, VVV"L V /
c DESCRIPTION /
CITY ["��fIIO`QVl `Yk \.:C49-..., /�•� v� NOTE: NO EAVEOVERHANG SHALL BE LESS THAN
STATE
LIC.NO./'\1¶0�ci N0. 6-31-1G )1 .. SO"TO SIDE ft REAR P.L.
EAVES
SIZEI
OF LOT !I1 a 0/� `,X \ e(/I '9 No.OF SLOGS.
NOW ON LOT ALLOWED (U.B.C.REQUIREMENT)
IIII YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. ���
(FROM C/L STREET)
SETBACK LINE FROM L' ^ 1
CENTER OF STREET l� REAR YARD 1�Q r FRONT S OFT. FT.
SIDE YARD I LEFT S' 1- I RIGHT S 1' R.SIDE FT. FT.
DESCRIPTION OF WORK L.SIDE C FT. FT.
N. 1/ ALTERATION ADDITION REARM• J FT. (VIFT.
DISTANCE BET. BET. MAIN&
REPAIR nMOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
BUILDING 1� Y / NO.OF VAR.# DATE
SIZE I d UU I ROOMS 7 STORIES C.U.P.# APPROVED
EXTERIOR WAL I ROOF / APPROVED /p
COVERING .A COVERING S )1 EY 't"\,1 . aAVS DATE / d LII-
USE OP BUILDING-AND WO K TO
BE ERFORNED
SihOltrnLJ �..(i21
v1
cAn' 01avok9e
i fI N
—Iwo—IwoSQ.FT. /{"mo�� T
I HEREBY ACKN• THAT READ THIS APPLICATION THE AMOUNT SHOW NDER VALUATION IS FOR THE F'
AND STATE T T THE AB* - S CORR- T AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH AL CITY ORDI. L. AND - ATE LAWS REGULATING
BUILDING WITH CO -CITY OR� VALUATION /6 n m
SIGNATURE • 0l// ,Y�^' PERMIT FEE $ (!J 1rT� in
in
P ERM ITTEF /� / 050-6 X
$ /Y•I /7 i.�1 l L C C 0
AUTHORIZED AGENT V/ t,
((//�� E
TOTAL FEE $ 7 ?/re