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Home My WebLink About1038 SEA BREEZE DR - Building Permits PROJECT ADDRESS: 1036 SEA BREEZE DR "UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B ' 054087 JADDRS; R'SNAM : PACIFIC TERRACE H.O.A.1500 ADAMS AV PERMIT NO: 2 054087 PLAN CHECK NO: N GOVT: N SUPP: N • COSTA MESA• , CA - 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: .STR PURPOSE: ALT • ARCH/ENGINEER: REG.NO.: • JOB DESCRIPTION : REROOF DUPLEX W/3—TAB .ASPHALT SHINGLES SQ FT: 2, 156 ( ADDRESS: UNIT: CLAIM VALUE: I2, 156 . 00 CALC—VALUE: 2, 156. 00 GROUP OCC: R-3 / • PERMITTEE: ELLIOTT ROOF MAINTENANCE (714 )997-4938 • ADDRESS: 324 S EARLHAM COMMENTS: INCLUDES OF SEA BREEZE" ALSO ORANGE CA 92669 **********+FAL***�rRF�ESE+ESL** FSE*�G*�F�E+E******Rf*RE***RF�E******�E�E*TESL LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Protessfe s Code.and my license is in lull force and effect. SETBACKS REQUIRED • r CITY LIG.: 03 965 STATE LIC.: 5344 CLASS: C.39 / Date: 7` 15,9/ Signature: ;- ! MAIN BUILDING ACCESSORY BUILDING WORKERS't.` PENSATIDN DECLARATION: I hereby affirm that l have a certificate of consent setainsure 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 38000.Lab.C. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT iN • POLICY NO.: 571785 EXP.DATE: 07/01 /92 COMPANY: STATE FUND . 74ARKING REO: PROV: PARCEL: 93529006 ZNE; REF NO: ❑ Certified copy is hereby furnished. a Ce copy is filed with the city Building Division. LANN ING NOTES> Qf/mak / can �7 > late // f�/�/ Applicant- ********If**************************************M*iE*K*****************R******If** EXEMPTION/FROM WO/KERS'COMPENSATION DECLARATION: (this section need not be completed if the permit is for one hundred(57110)or less). DEVELOPMENT SERVICES REQUIREMEMT S I curtly that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become ' • subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE; Dale: Signature: • NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED 'BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 44- , • CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction fending agency for the performance of the work for APPLICATION ISSUED BY: 5t, DATE: which this permit is issued(Section 3097.Cry. ****.**-****{L************.*it.**1L*.****iLM.*********.* iF**.M.******LE*** ATE * • *44 ' LENDER; "DUPLEX" STRUCTURE ******************************************************************************* • • ADDRESS; "DUPLEX" STRUCTURE . LEGALIZATION:N ! - F E E S U M M A 'R Y . STRUCTURAL SEGMENT:Y . OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG,PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ' (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve,demolish,or PERMIT 54 . 00 50 i repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RE$ • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that ne/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by , any applicant Ior a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ' ISSUE FEE I. as owner of the properly or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT 'ISSUE PLAN—CHECK TOTAL PAID DUE . ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code' The Contractors'State License Law TOTALS----> 54 . 50 ' 0. 00 0. 00 54 . 50 54 . 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,one year that such improvements are not intended or offered for sale. If,did not however the building vor e REVENUE DIVISION TOTALS--> COLLECTED• 54 .50 OVER/SHORT: 00 imforptheepurpose of sae/.nt is sold one year of completion,the owner will have me burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 00 • 50 ' ❑ and Processions Code The Contractors'State License Law does not apply to art owner of property who builds or improves thereon , and who contracts for such protects with a contractor(s)license pursuant to the Contractors'State License Law). lam aware ***************************************************************M*********34*if*** that proof of their Worker's Compensation insurance should be provided to me. : INDIVIDUAL F E E BREAKDOWN 9 I am exempt under Section: B.8 P.C. for this reason TYPE QTY :DESCRIPTIO N UNIT COST TOTAL COST • t Date. Owner SFR 2156 'REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 156. 00 ' Ido hereby curtly that 1 am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need 10 comply with said state codes and the requirements for a , Permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from i • these provisions. ' Dale: Appli ant: • ,r ,.. I hereby Certly that I have read this application d slate that the above information is correct.I agree to comply with all city an ounty Ordinances and state laws relating to budding struction and hereby authorize representatives et thiscity to enter upon the above entioned property for inspection Purposes. I, L:,�;_:' .r;;.,i..::(." =.L; `_'L`1'•( !,-.4.51.1 Dale: y/�'�j y! Signature: - ( Drivers License or Social Security. , • 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • - —.