HomeMy WebLinkAbout265 WAKE FOREST RD - Building Permits PROJtTaoofless: 265 WAKE FOREST RD UNIT:
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CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B . 054437
OWNER'S NAME: CLENDENIN SUSAN - -
ADDRESS: 265 WAKE FOREST RD PERMIT NO: B 054437 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V—N PERMIT •TYPE: STR PURPOSE: ALT
557-7490 '
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF W COMP - ' •
SQ ET 3, 500
ADDRESS: UNIT: •
CLAIM VALUE: 3, 500 . 00 CALL VALUE; 3, 500 , 00 GROUP OCC: R-3 / •
PERMITTEE:' SUSAN BOLLINGER ( 714-) 557-7490
ADDRESS: 2546 W CAMDEN PL COMMENTS: T/OFF REROOF W/ COMP - ' •
SANTA 'ANA CA 92704 * ESE**�E�E�E�E*�E�Ex�E�P>E�E�E�E*�E*+E+EkE**�E�E�E�E�E�E�P�P***EE� E�E*�E*x kE*�E*�E+ESE�E*****�E*+E�E�E�E****�E*>E***o***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS •
CITY LIC.: STATE LIC.: CLASS: '
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Dale. Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FLINT: FT IN REAR: FT IN FRNT: FT IN REAR: -FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Q. , LEFT: FT ' IN RGHT: FT IN LEFT: ' FT . IN RGHT: FT ' .IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 14146302 ZNE: REF NO:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. - PLANNING NOTES> ' , ••
- > . . . .. .
Date: Applicant: 4 ******7P***************)f*************************************************If3E1f1F***
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less)., • D E V E L' O P M E N T ' S E .R V I C E S REQUIREMENTS . .
I certify that in the performance et 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 BYDATE:
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Date: Signature: - - -, -
NOTICE:If.after 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.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: _ u - al. DATE• f' U� J
which this permit is issued(Section 3097.Civ.C). ********************** - ********** ** * **
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LENDER: . *************************************** ' **************************************
ADDRESS: LEGALIZATION:N • F E E SOMMARY ' STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: .1 hereby affirm that l am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELEC '' IC 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 63 , 00 :r5 0
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—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis Tor the alleged exemption.Any violation of Section 7031.5 by PLAN " ..`. y
any applicant Iola permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE • =
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUr PLAN—CHECK TOTAL • PAID: DUE t
❑ ' structure is not intended or offered for sale(Section 7044.Business and Professional Code:. The Contractors'State License Law TOTALS----> 63. 50 0 . 1 1 • 0 . 00 63; 50 '163..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,.provided that such improvements are not intended or offered for sale. If.however the building or REVENUE DIVISION TOTALS--> COLLECTED: % ' 63. 50 OVER/SHORT: - 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
•I .as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 633 •, 0 0 . 50 '- .l 2._
❑ i and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon %—
and who contracts for such protects with a contractor(s)license pursuant to theContractors'State License Law). l am aware ******************************************************************************'*
mal proof of their Worker's Compensation insurance should be provided to me. , I N D I V I D -U A L F E E B R E A K D O W N;" - •
am exempt under section: B P 704 4 B.a P.C. ". ~ ;.:
foam ason ALL WORK BY OWNER Q m� nn TYPE QTY DESCRIPTIO N • UNIT COST• '' '� TOTAL COST
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Dale. /�r/�/i Owner: .S•41 �t rl SFR 3500 jREROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 •
3, 500 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 2550 25533,and } END OF.1FEES '
25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a J, '
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
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these provisions. EXPIRED
Date: Applicant: co
Inmplete Inspections
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county - 491/ ,
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned Date �,' - -- •
properly for'Mope non/poses. ��/x/�o ' ,,,,,, ��• ))) _ Sig
Date: 0��/ / Signature: ��[.�J�iYr /�rU//l1
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3194273761. `:- TIT.Driver's License or Social Security a' 01 nnL�j .- (I++!, : a
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t6a n46 white—Building:Green—Code EnbrcemenC Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING _ POOL & SPA
APPROVALS Permit# Date Inspector Date Inspector
, APPROVALS Permit #
lit/ 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3ir£lectrical Conduit;Utility.Undrgrnd. 54. Forms .
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.,�'4:Electrical ConduiLUndrgrnd. - 55. Electrical Bonding
tis.rSfeel Reinforceinentr 56. Rough Plumbing & Pressure Tests -
6:I,Electrical UFEFir id. ' 57. APPROVAL TO_COVER-GUfflite
• _'74'SO ootings '_ 58. Electrical Conduit-Undrgrnd.
n
j81"Foundation I':' 59. Gas Pipe, 0 Undrgrnd.,Test c,
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---9..Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. '
110. Structural Floor System • 61. APPROVAL TO DECK a'
11. Property Sewer Line-84 House Connection - 62. Backwash & Receptor-Final
12. Sewer Cap 63. 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-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '
19. Rough Heating & Air Conditioning • - FIRE DEPT. REQUIREMENT
t
20.-nfiough Factory Fireplace , [APPROVALS: '_'Permit# - -
21."b udFS, in.Structu[e,, , .. .. _ • ` -79 yX -.70. Uhde-r'grouhq Hydro p. II
22. Ducts, Ventilating':- • _ C: r ? ;'71. ProductrPiping O.Gas OiOil
23.CGas Pipe Rough&Kest ^ . ? -'72Underrund F Dash:
, �. Ij,t • T
24.1Roof Framing i-- r • -y - -. .r c73xUndergrntf.Storage Tank a Gas''-0 Oil
25. Roof Sheathing ' 03; t 74. Overhead Hydro: ;.
26.,T-Bar Ceiling (Structural) &.Monocoat r r _ 75_.D'ry Chemical hi t - w
27.-Frame and Flashing. r to:. = i / 76. "Dry Stant�pipe "i C rJ
' 28..Lathing--; Siding-; „ e' ..x 77.: FIXED SYSTEM'EINAL" y t• �?
n
'29. Insulatidn ° �, • = ""' ? �. i t ,r, 78_:FIRE PREY. FINAL _ rJ; r. r_
"r-30. Drywall Nailing - t 1 `� ,, - HEALTHr'DEPTS REQUIREMENT,: at
_31. Plaster Brown Coati r 1 • Y Er t•79FINAL INSPECTION - - :•
;`�
•y x F r n r U .. .-
' 32.<Electrical Power Meter-Final: . • � .I, ..--180,:.7F OOD CERTIF{GATE ISSUED" `'� 01
33:'Final Electrics ! I I" ` rNdies: a `-'s* .. r; p i
,34;Final Heating& R.it Conditioning, I .1 ;i . t. ,� ,Thi.
c-, - ' 3
-35.rFinalGasPipe-Test - - C^ =?.5 tits
36�rHood or CanoPY 1-• - ' I i* • :a.........: --`- :`„
•,37 _Final Factory Fireplaces 1 '� • r I f 'It t r- r, _ t ;U7 ••'I
38. Final Plumbing .0 •-- I 1"l t t j ,y :, m El
539. Water Service•Finafr • ( I i i - . .-. :1,n; : . - -
r I )a lc .+ • ♦_ 41 �].
40. Gas Service- nal .-C.:1-' .- I 1 t! T . ' "?
+41. Solar Domestic-Finales •• 1 �• " i• 't
42,backflow Preventersit ` - S.
` -
43. Backflow Irrigation J.`�S ._ • x I�i--^ ,- -
;44. Landscape IFiigatiin Systern,?s ,F -• =y C .�? ,. .a _� J
"` ._ F x P'LR F D .-1
s'45.fSound Attenuation r= s v _ • _ 1r Inc mp)ete'Ihspections
�46..Handicap Regulations 7 op
47:.FINAL STRUCTURE & BUI'LDING v 1'0,-3....
I L[ X
48::FIN-AL PLANNING `I•.'- _' ' y{`y L" - • - j'
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-49=Electric Release to Edison ! • - -p, x ,_i, 1q
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;50. Gas Release to Southern California Gas Co I N ' " _ ..
JIn .
51. CERTIFICATE OF.OCCUPANCYI.__ Z.:
No. Date
OWNER PRINCETON, INC. DATE 1-20-58
JOB ADDRESS 265 Wake- Forest Road - BUILDING PERMIT NO. 6318
GENERAL CONTRACTOR Dike & Colegrove VALUE $ . 114,1l46.00
AP, No. LOT 43 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Single res. w/att. gar.
GROUP I & J TYPE V ZONE R1 PLAN NO. 6318
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenche. orms Steel =Qj
Floor Sys
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing ' /
Lathin In Out 419/#
Plaster, t r 4
Underground soil m H-S WIG Pipe "jj++ek� y.f 1-St 1-3r
Top Out /-2.-7--S? C _-g_f?.
Furnace /8/-/--S 1-/1-S� .,..zeEr.�.. '. . . / : I • $12iJtq
Gas Vents
Rough Plumbing */+r{ 3 -/2-6 r /�i7'-6u, -• JAN 2 3 191 . 124S
Cesspool Septic Tank ■
Prop. Swr. Line House ConhJ//bSt. Swr.• 2y/--g'7 �,,,.„„,�,�d 0........r.„, .0-/3-Sr /J237 1/
Sprinkling System
Heating Final L. W��)e 4—q-POy�-
l /
J
Plumbing Fixtures, Final i-. [e/ .*.C*' /J S
Final Gas Test L.L. tA/t ( 4 g'% ( yU
Construction Pole /, /
Underground Power - a . / V
Rough Wiring ...4 - ; G , 9 MAR 1 1959 -� ^ / /' W
Fixtures, Final _1"- -C c 11 / F
-OCCUPANCY -/ 'yy. tr.0
e4 %t I
Form 210-5M-1-57
' $ Gals -.. . . .
;I_ ril-�Lo l� �v
COSTA MESA BUILDING DEPARTMENT 1' ° - S 8 Lk_
P.O. BOX 317 FINANCE DEPT.
COSTA MESA. CALIFORNIA •
• C!TY Cr COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING 265 Wake Forest Road BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. TIME OWNER Princeton, Inc. - •vv��Il
MAIL RECEIVED BY DATE RECEIVED DATE ISSUED fi
ADDRESS 419 E. 17th Street ---=t---7c) /— "6 -Se JAN 2 0 195
TEL BUILDING
Li
CITY Costa Mesa ' . NO. 8-1159 ADDRESS
ARCHITECT Carlson and LIC.
OR ENGINEER Middlebrook NO. COSTA MESA. CALIFORNIA
Garden Grove FIRE
ADDRESS ZONE
ZONE NO.OF TYPE GROUP
CONT�ai ec,R& tColegrove, Inc:TY NO 7333 p� °L""B {� v
ADDRESS419 E. 17th St. , C.M. NO,Isi 8-1159 APPROVED
BY DATE
LEGALLor
DESCRIPTION ND. 43 BLOCK TRACT 2955 CORRECTIONS
A.P. NO.
SIZE 71 NO.of BLOCS.
OF LOT X 100NOW ON LOT none
USE OF C •
EXISTING BLDG. none
SETBACK LINE FROM
CENTER OF STREET 55! REAR YARD 201
SIDE YARD RIGHT 5? LEFT 51 '
DESCRIPTION OF'WORK
NEW X ALTERATION ADDITION
REPAIR • MOVING DEMOLISH ,
5 ZIE DING NO.OF
1658 sq. ft. ROOMS 7 STORIES 1
EXTERIOR WALL StueCS ROOF
COVERING COVERING Comp.
USE OF NEW
BUILDING Single family residence and •
garage.
Plan 760A
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL .
CITY ORDINANCES AND STA AWS REGULATING BUILDING CONSTRUC.
TION. VALUATION
PERMIT FEE S 34,00
SIGNATURE OF
PERMITTEE • , PLAN CHECK S 17.00
S 14,146.00
AUTHORIZED AGENT
DIKE 84 CoLFGROVEINC. TOTAL FEE s 51.00 ,err