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Home My WebLink About1090 VISALIA DR - Building Permits CITY OF COSTA MESA - - .,` Ai BUILDING DIVISION Y 4t,,....,•,,,„. �,�. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER • PERMIT B03-01420 ' 443*PoRrin db (714)754-5273 • Fax(714)754-4856 • www.ci.costa-masa.BtLDI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 • Job Address: 1090 VISALIA DR Status: ISSUED Suite: Applied: 08/21/2003 Vicinity: Issued: 08/21/2003 Parcel Number 41210522 6 Zoning: R1 R1 ' Applicant:ddressCOFFEY, BRIAN Address: 2428 NEWPORT BLVD _ _ __ ISSUED BY: UNIT 5 %i= ?hone: (949)722-8846 -' ' COSTA MESA,-CA,-,--:- - - Zip: 92672 ; - Owner ALFI SAMSON J moi. Address 1090 VISALIA - � r');COSTA MESA,CA -; " : Zip. 92626 c-j� '- j N� // f / \ i ',/,..17, �- • - ty 2 � ' 'f- \ Contractor ,,THE,ROOFING SPECIALISTS '•',7 v - `- y V'- ‘ Address: 2428 NEWPORT BLVD \-.\-•- `, - - UNIT 6/1.-/ Phone: 7(949)722-8846 ,, y;� ,-. ' .,,<,\, 1,1, / -h COSTA MESA,CA ``\ i / -Zip: 92672,,,' ,License:-734068 - Arcli - , - Address:, (] - - ---- , Address:- ",1 - '' - i r c ' Phone: •-.7 -'- - Phone: � ‘ ) f 1 _ Zip: , , N License: - License: ( _ ..- - SCOPE OF PERMIT -- � QTEAR,OFF EXISTING WOOD SHAKE;COMP AND'B:U.RrINSTALL 30 LB'FELT, FIRE FREE'SLATE,TO MANSARD PORTION,COMP.SHINGLES 1.0N-PITCHED PORTION OF THE ROOF AND B.U.R.;ON SHE FLAT PORTION. i:_: .. L . FEE SUMMARY ,`,. ,- . PIanCheck: ' $0.00 '- - r= '-�= �• -"' Calc Valuation: `C$9,375.00, — - `-Permit $181.25 i L Claim Valuation: ,• ' • ' $9,375.00; 2 SMIP Res ', $0.94 T r - , .t 'SMIP Com '� .$0.00 _ j!'/ , , \ Other: \'‘',?a$0.00 __ _ �' = ` / Inspection $0.00 r: i ( 1 I i, v. Total: $182.19 , - ' PLANNING &ZONING SETBACKS" ',/ = �; . ;' v MAIN STRUCTURE Front 7O 0 -- `Rear--,0-0. Left `0-0 - Flight",^ 0-0 • --�, / ACCESSORY Front.v 0-0Rear - 0-0 Left 0-0 - -,r Right . .0.0 -',/ - _ PARKING Existing 01 - . Required: ' 0' Proposed: �0- -' ' -;�'�- _ • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes 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 180 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(5/00) DECLARATIONS (`h c ) WORKERS'COMPENSATION DECMRATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit is Issued. I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number. (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the wo for which this permit is issued,I shall not employ any person in any manner so as become subject to the workers' compensation laws of California,and agr e hat If I should become subject to the workers'compensation provisions of Sect' 37000 f the Labor Code,I shall forthwith comply with inose pro s. l Z/ O G Applicant Signature: ? ( Date: WARNING:FAILURE TO SkCURE WORKER�S// PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL NALTIES AND G IL FINES UP TO ONE HUNDRED THOUSAND Joni I ARE(6100.000).IN ADDITIfl T THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am license. n.'r p . ' IOD5 - Ch..-r 9(commencing with Section 7000)of Division 3 of the Busi a esslon Code,and my license is In full force and effect:Lic.#'-' s (� ii Class# ' Contractors-Signature: ` W Date: if•------ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properry,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or 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-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the Property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044•Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: - Signature: - Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,talsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has e permit to do such work from the division. • Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ _ _ i Does or willthe he ant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutelyhazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • owl`'gnature Of Legal Owner(s) 424 l Date / /And/Or Authorized Applicant Date / SODS! INSPECTION TYPE / PATE IdGEN,P MU INSPECTION TYPE PALE ICAbq 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof ( `1. O3 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy NJ 17 CITY OF COSTA MESA REQUEST FOR OCCUPANCY cte- i T ��& ern-- TRACT NO. ('A �/ S DATE "Z/,/// LOT NO. I 1/0_ADDRESS ct rC 1-,.ctst__ nce c,2,,r The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) - ��,��.� advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. r ~ BY f Purchaser 1 RECEIVEDBY 14 CITY OF COSTA MESA Developer and/or a .4rized PLAN IUG DEPT. representative JUL 5 1973 AM PM BY 71819110111112111213141516 Lender 1 A 0 Zs �� 1 (t,, Twining Laboratories 0f _ ou 2,2 eaeifov2ia, in=c. • j? ' 3 . O- P.O. BOX H . 3310 AIRPORT WAY . LONG BEACH, CALIF. 90801 • (213) 426-3355 . (213) 636.2386. (714) 828.6432 BRANCH OFFICES: TESTING ISH0 J.,tk Her .Sr. Non DuboFlb.L,lno 5.•I.An. 97703 /Lc. P.O.Bo.0 VRI 531•7045 'd hell xl ca Long e..a,e.rl.voam I1131 exaaee • flyF November 10, 1976 Examination: 76-6705 GUNITE COMPRESSION TESTS ON iQgjft CYLINDERS Jack Hubbard 3106 Ostrcua Avenue Long Beach, California 90808 ?ROjECT SWIMMING POOL •. J. L. MADORY g3 8085 a ADDRESS 1090 Visalia Dr. , Costa Mesa, California SAMPLE FROM Shallow end, deep end, bond beam • ARCHITECT CONTRACTOR Anthony Pools ENGINEER SUBCONTRACTOR R. J. Kolodziej Anthony Pools • SPECIFIED .MIX 4.2 to 1 STRENGTH 2,000 DATE CAST 10/27/76 SLUMP DATE TESTED . 11/3/76 11 3 76 11/3/76 0 76 11/10/76 / / 11/1 / CYLINDER NO. 1 2 3 4 5 COMPRESSION - 7 days 7 days 7 days 14 days 14 days 4t TOTAL LOAD, LBS. 48,000 47,000 45,000 78,000 72,000 700 665 3 ,59 2.760 2,545 POUNDS PER Su. ii:. ., ,,..: c4 _ 14 day average: 2,652 COMPLIANCE 14 day tests comply with specifications. MADE By DELIVERED lY R CEIVEO ON CYLINDERS McBee Hubbard #1,2,3 - 10/28/76 #4,5 - 11/5/76 DISTRDUTION: Jack Hubbard - 3 • Costa Mesa Bldg. Dept. • ALL REPORTS ARL SURNITTCO AS THE CONFIDENTIAL PROPERTY OF CLIENTS. AUTHORIZATION FOR PUBLICATION OF OUR REPORTS, CONCL TRACTS FROM OR REGARDING THEN IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS,THE PUBLIC AND OURSELVES. N30.12 rl OWNER R »TERRRIES DATE 8_28_722 JOB ADDRESS 1090 Visalia Drive BUILDING PERMIT NO. 35277 GENERAL CONTRACTOR Heltzer DESCRIPTIONaiWORK Res, wj att. gar. AP No. LOT 33 TRACT 621+5 FIRE ZONE VALUE $ 33,700.00 INSPECTIONS Signature Date GROUP T R` J TYPE 5 ZONE ET /rte /0,7.27- SUBCONTRACTOR — PERMITS ISSUED _ Date Number I Signature WATER ROUGH PLUMBING Er- ��%��" / PI, mbin., PROP. SWR. LINE 1HOUSE CON. u //l.L�¢ 2 Q', / - MalEa SPRINKLING SYSTEM datIMI MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING lrra mayor TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ') ROUGH WIRING /3 Heatin• and ent. TRENCHES ❑ FORMS ❑ STEEL REINF. red /6-11:72 In. , d [�„/�� FLOOR SYSTEM /o rr-7j / , ��G"ag(/,�S4r j BOND BEAM ❑ STEEL REINFORCE ❑ SHEATHING FM FRAME AND FLASHINGT /j"(�/,5LATHING - IN ® OUT LIJ 73 PLASTER, BROWN COAT /{p/"t? '14-73 STRUCTURAL, FINAL / V-y yyEI/-/cmc �r/ HF'TING, VENT., REFRIG. AND A.C.. FINAL I / /7 4ry14 /�0�, 2/81.1 AJJ oZ,' ' ' ING, FINAL AND GAS TEST �nn''-- )477 V1 L. .(RIC, FINAL /v'/ ( V2--7'S • BUILDING. FINAL J14'-) :17 -I//ry L I • 35277 floc, 30 n '°oO206sl� • . —• t�sA 169.61 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely ' RECEI�`�//'' DA,T�REC VEDCr BUILDINGED AR !a 2O - V(SAL (L4 (>!L' f_D D?f'�I 'r/ . PERMIT NO. OWNER Heltaer Enterprises-Costa' Mesa A.P.NO. ^,—^--• • BUILDING 1Q, 0 'r'sn Ll ,S L.>L.)/rc ADDRESS740 No. La Brea Avenue ADDRESS r V W /� ( ) CL U CITY Los Angeles 90038 NO. 937-2171 TRACT 6245 LOT 33 BLOCK ZZNEW ADD ALTER, REPAIR MOVING DEMOI H 1 CONSTRUCTION California Bank �/ O N LENDER/ \ LS - am J 0 BRANCH Main Office J N OWNER m ADDRESS 600 So. Spring St. , Los Angeles — VALUE ARCHITECT TEL. (213) J < OR ENGINEER David Freedman NO. �SE ,_ $ _ O 65.3-�$92 FIRE w CC ADDRESS 113 N, San Vicente, Beverly Hills ZONE TYPE GROU Y— a_ [L W APPROVED 7r�/ W Z CONTRACTOR George J. Heltzer . BY • DATE JO CO Z ADDRESS, 740 No. La Brea Avenue W W TEL. (21-3) ZONE RI INC.OF USE OF NEW .. b J Z CITY Los Angeles NO. 937-2171 PAs eul DING �' .rr CA- O .STATE CITY YARDS APPROVED YARDS APPROVED N CC LIC. NO. 3144 LIC.NO. 1900 MAIN BUILDING ACCESSORY BUILDING 0 O - (FROM C/L STREET) SIZENO.OF BLOCS. OF LOT I NOW ON LOT FRONT 51 FT. FT. USE OF EXISTING BLDG. B—SIDE 5 FT. FT. j I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES VI''" L.SIDE l7 FT. FT. _ ROOF V COVERINGEXTERIOR ALL P1aS to r COVERING REAR 3G• FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE RET. BET.MAIN& • LL a MAIN BLOCS. ACCESS.BLDGS. _ DATE Q Single Residence Plan 408A C U.P.# APPROVEDy� // 0 / l��y--J-- '' I —H ROVED �� DATF U / Z[-/ 7 Z _ Z L„. , LLi... Y STATE 0 I hereby acknowledge that I have read this application and state ° 3 — -OR SPne'T REQ[1TP5 that the above information is correct and agree to comply with S��av y all laws regulating building construction, and I shall not employ Fany person in violation of the workman's compensation laws-of TAX h the State of California, cous Z I hereby certify that I am properly licensed as a contractor under Q`�' / SO. El-1.R — �pU 6 the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: R am exempt from the prov'+ons of the State of California Business VALUATION I • and Professions Code, Div'�•n 3,Chapter 9. /// LW CO PERMIT FEE $ tv `! _ D Signature of ��% 7 PLAN CHECK $ V J ' E Permittee ' /i ems' $�� /�� , cis LL Authorized Agent - 1 4 TOTAL FEE S/6/ — onlyLR VMIl SSAD4EYy-11-_1.. � p JOB ADDRESS l09_0_V�isaliaariv� BUILDING�ER N0. 42586__ • GENERAL CONTRACTOR Anthony Pools DESCRIPTION of WORK Pvt. Swim Pnol_&_Spa_ U AP No. 412-105-22 LOT TRACT FIRE ZONE VALUE $4.800.00 INSPECTIONS Si.nature Date ' GROUP TYPE ZONE ._ P .ocation c )9'1 �flo SUBCONTRACTOR PERMITS ISSUED • • Date I Number _T Signature Forms - Main Drain Steel Reinforce c , Elec. Bond / Electric p Y ,/ Approval to Cover a•e--- /D'L5'Xo aAtt �vIt r 8'a0t 4inD Underground Electric see. it-R--74 U Gas Piping Test ,Sc. 1t-c7z ///JJJ ��ppp Plumbing \` ^�/ Filtering System Lines /Q G /a 6 7/s __enn .) 8' 36)C, 70059 ----- Backwash Lines and Recep. RC- N%-c-i& Q • Electrical Final _ /QC /t_/ 74 Heater and Vent Final • Filter System Final • r 'ash and Recep. Final F. ,ng Final c S ' A____.._,_ e,...LL BOG /L-/-S. I I • I , p 4L5U6 • `,I IG 30-764-002151* *,rt:ra18.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 1 j APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY �p�.TE RECEIVED DATE ISSUED BUILDING 16r307� ADDRESS X 1090 VISALIA DR ` �1f{1j �Qy OWNER J L MADORY A.P. NO.BUILD 5i/Z��OrZ 'e/'/`- gA MAIL ADDRESSING DDRIE S 1090 VISALIA DR Z ADDRESS SAME 9 Lu ui TE . 0-0 CITY NOL TRACT 624 I LOT 33 BLOCK I—Z ZQ CONSTRUCTION NEW (ADD(ALTER REPAIR MOVING DEMOI ISH OI- LENDER CASH am X JD BRANCH J ca OWNER ADDRESS J L E?ADORY m UE m ARCHITECT R KOLODZIEJ TEL. SP322II USE SWIM POOL t $PIn 4800. 00 J Q OR ENGINEER NO. FIRE wcc< ADDRESS 5871 FIRESTONE BLVD. SO GA'LtzoNE TYPE GROUP W ANTHONY POOLS APPROVED W Z CONTRACTOR BY DATE J O CO Z . CC ADDRESS 5871 FIRESTONE BLVD. ^� 0w= SO GATE TEL.SP3221O -RN)._ Bull BUILDING O�' Z F- CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED jO LIC. NO. 190179 LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF SLOGS. (FROM C/L STREET) 1 OF LOT I NOW ON LOT FRONT FT. \\ FT. EXISTIING BLDG. RES AND GAR - [x� t R SIM FT. s� FT. _ Z SIZE OF NO.OF \i I/ Z NEW BLDG. ,�74 ROOMS STORIES L.SIDE FT. 1 FT. UEXTERIOR WALL ROOF c _ COVERING COVERING REAR FT. s5 FT. J USE OF BUILDING AND.WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL MAIN BLDGS. ACCESS. BLDGS. CL Q PRIVATE SWIM POOL VAR.# DATE 0 �I- / /L//��//� C.U.P.g 0 APPROVED 2/'� '^ cA T r I - Y'- ♦ ,� •, f)AT F 8,...a0:.-71, J_1.�1J�O , 2 0 C.p.) I hereby acknowledge that I have read this application and state p that the above information is correct and agree to comply with . EC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of N the State of California. co Z m I hereby certify that I am'properly licensed as a contractor under SO. FT. ,_ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a co am exempt from_the provisions of the Sta . • .Iifornia Business VALUATION and Prole '.ns Coat,Division 3,Chapt PERMIT j • /� 4 CO PermlSignau a of ' $ // yew• PLAN CHECK $ a E Permltt= si—__�J�✓ / TO Authorized Agent n a z(l,/ •� r/ ' TOTAL FEE $ �e Sr) ADDRESS OFBMLONO: 1090 VISALIA DR . um: CITY OF COSTA MESA — BUILDING PERMIT_ — a*TIER9NAMEIFIDGWN: BIEGEL, JOHN M _ PERM NO: B 080139 ADDREss:BIEGEL, KATHLEEN H 1090 VISALIA DR PERMIT NO: B 080139 PLAN CHECK NO: N GOVT: N SUPP: A) :OSTA MESA,CA 92626 ( 714 ) 432-8799 APM.11MUNO ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: STR -\ PURPOSE: OTH 1` . r ARCHITECT OR ENGINEER: DC.NO.: JOB DESCRIPTION : REPA'IR WIND DAMAGE TO COMPOSITION ROOF SQ FT: 1 , 500 ARMOR ENS'S ADDRESS: WIT: ` CLAIM VALUE: 1 , 500 . 00 CALC—VALUE: 1, 500 . 00 GROUP OCC : R-3 /U-1 CONTRACTORS NAME: CONTRACTOR'SMMUUO COMMENTS: PARTIAL REROOF ONLY TO REPAIR DAMAGE CAUSED BY WIND / • COMPO ROOF ADDRESS: UG NO.: 1E lE 1E 1E lE lE if fE#fE 3E lF if ff if iF lE lE iF if iE lE lE lE 1E 1E 1E lE lE lE lE dE if 1E#lE lE iE fE lE if#iE iE fE-0E lE fE?'(-iE iE lE 1F fE N-fE fE iE lE iF iE iE SE fE 1E lE iE iE i(-1f ff 1E fE 1E lE1F 1E 1E iE inn ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby afirm under penally of perjury that I ern licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Cade,and my license is in full force and effect. CITY GC.NO.: LIC.CLASS: LIC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dale: Contractor; LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I am exempt from the Contractors Limine Law for the fdm lowbg reason(Section Business and Professions Code: o county which requires a peruse to construct alter.improve, PARKING REQ: PROV; PARCEL: 41210522 INE: REF NO: __ ern dish.or repair any structure:prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES>licensed the pronelod the e Co tredoaenee Lew(Chapter 9(commencing withd Section 7000) Divisiond the '- Business and Professions Code)or that he or she is exempt therefrom end the basis for the alleged exempun.My volition of Section > 7031.5by anYeppOmnt for a Penne soi ds the applicant to a cvilpenehy of not more than five hundred ddlms($500 dEfF9EfE9E3E1EfE9EdEfEfE1EyE9E#1ElEiE*lElE1E1I1E****#lflk#iF####!E#1E#lFIE#l(-fEfEiEfF1E1E1E********%if****3E'1E iE3E1EfE#1EIf'*** )❑ I,as owner of the propeny or my employees with wages as their sole compensation,will do the work.and the stnicture is not intended DEVELOPMENT SERVICES R E Q U I R E M E NGT S or offered for sale(Section70SW Business and Professions Code:The Contractors License Law does not apply to an owner of property //.2 who bufds or improves thereon.and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or dlered for sale.If.however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: • owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.es eeerote praperty,am excluiydymmredigwmlioweedcommcore tocrra`idtheprajee(Seeon 7044,Businessmen BUILDING APPROVED BY : DATE: r_, Professions Code:The Conwradaa License Law does not apply to an owner of properly who builds or improves Thereon and who is for such prologs with a comreno(sl licensed persuant to the CantraodLicense Law). ❑ Iamexempt under Secti/q�: B.AP.C.,for this reason: APPLICATION ISSUED BY: DATE: �0027 —' Date: /0/Z.3/ y�T owner. S 4+SE iE iE*9E 9E iE 5E 1E********1E*fEiE 9E yE iEfE9E 9E *SE 9i*iE if iE iE 9E iE**dE 1EfFdE iE 9EeE iE 1E* IEfE *if7FiE li LEGALIZATION:N F E E SM R Y STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of erd understand the requirements of Celiomie Health and Safely Code Sections 25505,25539,and 25534,and that loany Mumbuildirgoccupntwill/wdtnot(dmlene)needtocomplywitheddmtecodesandtlereguiremenabe BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e permit for construction or modification from the Ai Ossa ryyenegemem District.Residentialconstrucon applications areexempt ns afonew these PERMIT 48 . 50 . 50 Dale: Applicant: SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE Ihave dwifmaletailacfimteconsent toself-insure for wafters'compensation.as provided for bySectoC Section 3700 BUILDING—DIV—> ' Elnno PERMIT ISSUE' PLAN—CHECK TOTAL PAID DUE Code. dthe widthapennulsaaaed. TOTALS----> 49 . 00 0 . 00 0 . 00 49 . 00 49 . 00 • . 00 o I have and wil maintain waders'mmpensmon insurance,as required by Section 3700 of the Labor Code.for the performance of the work(or which this permit is issued.My workers'compensation insurance carrier and policy number are: • Come: Porky Number. REVENUE DIVISION TOTALS--> COLLECTED : 49 . 00 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need nor be completed xtle genera for one hundred dollen Armor less) 48 , 50 , 50 —mss 2 I codify that in the performance o the work for which this pemnk is issued.I shall not employ any person in any manner ea w to ' became subject to the workers'compensation laws of California.and agree that f subjectI .hound becomsubject94 tote workers' *********** *****#*****1E*k1EiEf4****3E#1Eit1F****ifif*iE***3E**if3E3E*****9E4E3E*****1f1E*****tf**4f compensation ions of Section 3700 o the Labor Coda,I shall Inhwfh mw oprovisions. INDIVIDUAL F E E BREAKDOWN Dale: /023/9 6 Applicant: . Warning:Falun m secure'foram'compensation coverage Is Unlawful,and she subject en employer to criminaln pelu»and TYPE QTY,.. DESCRIPTIO N UNIT COST TOTAL COST chill fines Uig to one hundred thousand dollars($104000),In addldon to the cost of compensation,damages as provided for In Section 3706 of ON Labor Code,Interest,ndafromey'a fees SFR 1500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 500 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction Irrdng agency for the END OF FEES performance of the work for which this permit is issued(Section 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certifytw I have read this application and state that the above information is coned.I agree to comply with all oily and county ordinances ces end state laws relating to building construction and hereby authorize representatives of This city to enter upon the above-mentioned property for inspection purposes ALFI rint Name . 0100217749-00217750 TOT 49.00 • S`• Date: Ib/23JYb, DATE: 10/23/95 TIME: 12:37 _'01 Signature Owner/AgenVApplica VCnlredr 1 (5151-4S.W P) White-Building&Safety;Green-Fie:Canary-Appicant;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING POI SPA APPROVALS Permit# - Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _- 53. Steel Reinforcement - ' 3. Electrical Conduit Utility-Undrgrnd. I 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ..� s 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • - ' • 6. Electrical UFER Grnd- 57. APPROVAL TO COVER.GUNITE 7. "Footings 58. Electrical Conduit-Undrgrnd. , L. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. b 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection • 62. Backwash & Receptor-Final 12. Sewer Cap63. Heater & Vent-Final 13. Roof Drains • 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final . 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - • 68. APPROVED FOR PLASTERING , 18. Rough Electrical-TOar Ceiling 69. POOL/SPA SYSTEMS F I NA L - • .. 19. Rough Heating & Air Conditioning - - FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - - - APPROVALS Permit# 21. Ducts,in Structure - • 70. Underground Hydro 22. Ducts, Ventilating - - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test " .- 72. Underground Flush - 24. Roof Framing _ - 73. Undergrnd,Storage_Tank 0 Gas 0 Oil 25. Roof Sheathing •' _ . • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical - 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL ' 29. Insulation - 78. FIRE PREV. FINAL - - 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 1 31. Plaster Brown Coat . . 79. FINAL INSPECTION 32. Electrical Power Meter-Final • . : • 80. FOOD CERTIFICATE ISSUED 33. Final Electric - _ Notes:t ,,�� . 34. Final Heating'& Air Conditioning • _ 6(•17,/i rJ •e'rctt- CD -Q•I-t --ry'v 35. Final Gas Pipe•Test' d �' 36. Hood or Canopy - _' _ 37. Final Factory Fireplace I' 38. Final Plumbing 39. Water Service-Final• -/. , 40. Gas Service-Final - - • _ 41. Solar Domestic-Final - • 42. Backflow Preventer. - • 43. Backflow Irrigation . ' 44. Landscape Irrigation System - - _ . , . ,_ 45. Sound Attenuation , • . - - • 46. HandicaplRegulations , - - - ~47. FINAL STRUCTURE & BUILDING It-,-1-76 Ac.# _ 48. FINAL PLANNING . . - 49. Electric Release to Edison • . 50. Gas Release to Southern California Gas Co - . 51'. CERTIFICATE OF OCCUPANCY No. Date