HomeMy WebLinkAbout233 TULANE RD - Building Permits CITY OF COSTA MESA
2,.1.•
pyBUILDING DIVISION
77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL:(714)754-5626
rr•° r PERMIT NUMBER: E11-00223
PERMIT TYPE ELEC STATUS: ISSUED
APN: 14146104 DATE ISSUED: 10/06/2011
ISSUED BY: RMD
JOB ADDRESS: 233 TULANE-RD CM' " Suite/Unit:
Vicinity:
SCOPE OF WORK: ELECTRICAL PERMIT TO UPGRADE SERVICE TO 200A, SAME LOCATION FOR SFD.
OWNER: KAYA CALVIN M IKEDA/FAMILY TRUST Address: 233 TULANE RD Unit:
PHONE: City/State/Zip: COSTA MESA, CA
APPLICANT: GONZALEZ, ROSIE Address: Unit:
PHONE: 714-476-1373 City/State/zZip:
CONTRACTOR: HAMMER CONSTRUCTION License No. 950985
Address: P O BOX 53301Unit: PHONE: 951-203-1693
City/State: RIVERSIDE, CA ZipCode: 92517 CELL:
ELECTRICAL PERMIT FEES •
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $54.00
Reinspection Fee $0.00
TOTAL FEES $54.00
•
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
600E 0. INSPECTION TYPE DATE INTITIALS CODE I INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical M. it.SI Ett
201 Final Block/Retaining Wall 212 Final Fire Prevention -1
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive._.icense. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
I (.. 10 c-un•-1 by this permit,and that no building structure,scaffolding,falsework,o-demolition
Carrier:' `]i" XR- rlJ l/� or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm
(This seam need not becompleted 11the permit is valued al one hundred dollars($100)or less.)
2,Art 2,Sec.341,Title B,California Administrative Code).
Policy Number: 23E3- ‘514-40- it
❑ As owner-builder, I will not employ anyone to do work which would
El I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California. and agree that if I should
b e subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
he La ode,I shay f hwith comply with these provisions.
ID f CPIII
Division of Industrial Safety Permit Number:
Applicant's Signature — Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNIN . !LURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? El Yes ❑ No
(5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect, a registration form for acutely hazardous materials? ElYes ❑ No
• # 01585 Class# (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
r, - �O t each business which at any one time has on hand a quantity of acutely
Contractor's Signawre Dale. 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
CONST-r- TION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for Mich this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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 acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other •
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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.
Signature offLegal owner(s) Rate
Signature •Date 717 176L I 1 to I I'
305]-n6(3/07) And/or Authorized Applicant V I1to
! y
N. CITY OF COSTA MESA
F � I� BUILDING DIVISION PERMIT NUMBER
r DEVELOPMENT SERVICES DEPARTMENT
PERMIT v49-00532 .
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 233 TULANE RD Status: ISSUED
Suite No Applied: 09/09/1999
Issued: 09/09/1999
Vicinity; .
Parcel Nunmber: 14146104 ISSUED BY: S
Applicant ALESHA BRASON - •' ;^ -
Address:
' /' -,A- - A Phone:
Zip: \
Owner\IKEDA, YOSHIHIKO J
Address, 233 TULANE RD - �,- .' /
/`f/ ( \ /2-$.4-1%-7-:-2 Phone: �''`x,,,„
\� . f( ���\
// / COSTA MESA,CA Zip: 92626 ����VVV//// / \' \\
Contractor - GEORGE BRAZIL PLUMBING, HTG. �: Vj
/✓//Address J 3801 LENAWEE AV . . . . • -. I-
i �`
i/ t/ ii •�/'f� ` �1 �,Ph rte - 310-2537$229 ,� t• �'
I ' / CULVER CITY,CA „,,,12,,i, -'"Zip 90232
�l( _ / /r r ,/ l, , "License: 678898" - -;=;\"- c 4� o�.i � �y
�
ll'
, .)i Arch/Eng /a' - AN �\ r_:. 111A1
! \_i 1'_ .
1 1 l Address:,>,- / N' 1 . , ' ll
, . Phone: "V A L _
License:
` ` j
1 .1',' - 1 SCOPE-OFPERMIT.,• pj I i.�, i ---,__J I�I
\ N WATER HEATER CHANGE OUT _ _-- ' 1, ��/
�1 t ;.�1
� - I' . - - FEE SUMMARY; r� C p 1
�' AMT)) QTY
� ' ' VA A�`-;•1AMT QTY _ - AMT - ( i J
ISSUE FEE\y,, 2 v A'$23;50 _. Laundry Tub/Washer $0.00 0 Sump Pump/7,j ?� - . /$0.00/ 0
Backflow irrigation,, $0.00 0 .."° . .Landscape Irrigation , , $0.00 0 Swimming"Pool s/ $0.00 0
Backflow Preventer $0,60 0 • P-Trap r er• $0.00 0 Trap Primer/ $0.00 0
Bathtub VA`� \ . $0 00'�r 0 Pressure Regulator ` $0.60';'.:- 0 -'Urinal'/' •, i %$0.00 0
Clarifier System f`. $0 00v A-0 1Process Piping(per 10 ft)(-„':$0.00:(24.! 0 y . Vacuum Brkr Bkflow(1-4)/4 0 •
Connect(Ice,Soda,etc) $0.00 \"0� Y�' p'Receptors -•' � • ,„-$6.00,',' 0 >' "<) Vacuum Brkr Bkflow(5.) 'J/$0.00 0
Dental Units \ $0 00 "-0 ;Septic Tank ' 111/740.00�'''0 ,,, ..Wash Basin �J $0.00 0
Dishwasher 'N 1/$0.00' 0\ -,�y�Seweer Cap'46).Demo $000 `-0 ""fir Wash'Basin Set f,/ $0.00 0
Drain, Floor '�� f$0.00•1/7.0 \ Sewer Connect. ',/,' ,' $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater " $0:00/ / 01/ - N -Sewer.Private Line_ , >$0.00. "0 -�. Water Closet("Toilet) $0.00 0
Drain, Roof V`$0.00v' 0� ; Shower- $0.00 - 0 AA Water Heater/vent $12.30 1
Drinking Fountain 'N$0.00� 0.",. J ' ''„l'Sink-bar $0.00 -;0.-vA Water Pipirig:(Inst or Rep.) $0.00 0
Expansion Tank $0.00"„•-...0 ' '\ •`Sink,commercial ' $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 .-- 0'; -Sink, Floor ' $0.00 • '0',.. -' Water"Service $0.00 0
Gas(1-4 outlets) $0.00 '.6,\y_• Sink, kitchen. ; 'C , $0.00- 07"Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 . - . Sink,service/mop $0.00 - 0-,.'%'-:. OTHER $0.00
Gas Repipe $0.00 0 --Spa(private). , $0.00!(-''0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0 •
TOTAL CALCULATED FEES: $35.80
COMMENTS/SPECIAL CONDITIONS
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
DECLARATIONS (Th
WORKERS'COMPENSATION DECLARATION: r "
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
work for which this permit is issued.
r
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 Trier and policy number are: �/er. 0 �Ala a AJ Q ' R±tA .)G Policy Number OE 1._.(� C� S . ")section need not be completed it the permit is va u at one bundredaollars($100)or less.) " ' .. `
❑ I certify that In the performance f 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,an ree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these p vis'
A Ii
a C,
Applicant Signature: iwe Date: L /
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100.000),IN ADDITION TO 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 I am lice a under provisions Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professi ns Code,and my license is in full
force and effect.Lic.# ��I al Class# C Z.O C-3' C
Contractor's Signature: Date: 9 —
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 property,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 en 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 contractor(s)
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. 0 Yes 0 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,falsework,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 a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 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? ❑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,ore volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the Califomia 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 acutely hazardous 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 agermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes D No
(Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 ❑No
6 (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.
Signat Of Le ale el Og wner(s) ei — G Date e
And/Or Authorized Applicant ! Date /
CODE 4' INSPECTION TYPE . 'PATE INTRGLS' CODEI INSPFCTIONTYPE ' • LUTE ' MTRIAL5
1616 Fixed System Final Fire Prevention . . • 206 Final Mechanical p,� ///�����_,,,,,,,,,,,,/Iv
1266 Pool Spa Final 208 Final Plumbing 91 ' i 7 4✓,�
200 • Final Re-Roof 210 Final Electrical
v
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 •
2446-46 .
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CONSTRUCTION AND PLANNING POOL - 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. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56, Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe,0 Undrgrnd.,Test '
9. Water Pipe-Undrgrnd. I 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line& 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
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 •
i - I 77. FIXED SYSTEM FINAL
29. Insulation t ! 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32.' Electrical Power Meter-Final i 80. FOOD CERTIFICATE ISSUED
33. Final Electric j Notes:
34. Final Heating&Air Conditioning eal f
•35. Final Gas Pipe-Test
36. Hood or Canopy
'
37. Final Factory Fireplace 1
38. Final Plumbing ) •
39. Water Service-Final I
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer I '
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation .3e
46. Handicap Regulations
I 47. FINAL STRUCTURE & BUILDING ! '
1
48. FINAL PLANNING
• 49. Electric Release to Edison I -
.
50. Gas Release to Southern California Gas Co -1
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 233 TULANE RD UNIT: o CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062474
OWNER'S NAME: IKEDA YOSHIHIKO J /.5--
ADDRESS: 233 TULANE RD •
PERMIT NO(5i) 0624/74 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE:' 5—N PERMIT TYPE: STR PURPOSE: ALT
(714 ) 549-2568
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O ROCK ROOF & APPLY NEW 25YR COMPO SQ FT: 4, 600
ADDRESS: UNIT:
� . PER :LEE ROOFING (714 ) 642-7223 CLAIM VALUE: 4,600. 00 CALC—VALUE: 4, 600 . 00 GROUP OCC: R-3 /M-1
'', ADDRESS: 1653 SUPERIOR , COMMENTS• SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC.
COSTA MESA CA 92627 ********4*********** *******it,**************x*****x*****************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 1Z 'OJ N I N G REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.a tly s-in4ve a and effect, SETBACKS
CITY LIC.:928751 STATE LIC.:349686 CLASS: 9
Dale:_A-`1-43 Signature. MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-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. Cf. LEFT: FT IN RGHT: FT IN LEFT: ‘ FT IN RGHT: FT IN
POLICY NO.:13 0 0 9 4 8-92 EXP. DATE: 06/30/93
COMPANY:STATE FUND �� "' PARKING REQ: PROV: PARCEL; 14146104 ZNE: REF NO:
0 Certified copy is hereby furnished. XI Certified copyaa+ued, the city Bu n ' ision. PLANNING NOTES> /
Jale: C 9' ""q1 Applicant: /[J/ �-� *********************************************************************.**********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This Reed not be competed it the permit is for one hundred($100)or less). D E V E ..L O PMENT SERVICES R E Q U I R E M E iN -T•, S
I teddy 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 /27.
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: '�lr
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; //9 DATE:r� v Y
Code.U TIO must NG with such firm that
this Dermic shall be d revoked. �r�?,I^C/L'��;Yi( - , i` %
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE; 1.6
which this permit is issued(Section 3097, Civ.Cl. ************************* ***** * * ** **** **** **************** * **
LENDER: ********************************************** ********************r**********
ADDRESS: LEGALIZATION:N F E E S U M M A Y STRUCTURALUSEGMENT:Y
' '.5
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 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 72 . 00 . 50
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 for the alleged exemption Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 1
I. as owner of the property or my employees with wages as their sole compensation, will 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----> 72. 50 0 . 00 0. 00 7 2 . 50 72 . 50 Si • 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through i..
•
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• 72. 50 OVER/SHORT: P 00
improvement pl ie sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for
the purpose sf sale).
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72• 0 0 50 ✓�
❑ 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 proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST 'TOTAL COST
Dale: owner: SFR 4600 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 600. 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES /
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
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions. oe
Date: Applicant: ��9
I hereby certify That I have read this application and slate that the above information Is correct. :ree to comply with all city and county `' k
• ordinances and stale laws relating to building construction an ¢e representatives r ' 'y to enter upon the above-mentioned x
' property for inspection purposes.
// 01 00140442-00140443 TOT 72.50
i r/ Dale': (�- ' �9 3 Signature;
Driver's License orSocial ( DATE: 06/04/93 TIME: 11:46
1641-46 White-Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL . A •
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Servioeor'PoIe. :: 52. Pool & Equipment Location
.2„Soil Pipe-Undrgrndr ' 52` ` 53. Steel Reinforcement
a ..
3*-Iectr1cal Cond'u rlity-Undrgrnd-_ r 54. Forms
_
''4;-yc'_ bctrigal Conc iiC=iidrgrnd. - LL,S 55. Electrical Bonding
S.cSteel.8einforce-melir '1 _ 56. Rough Plumbing & Pressure Test
�-S.rffecvical UFER r`Srd. r„ 57. APPROVAL TO COVER-GUNITE -
• ' ,%;3 c'otittgs r� 58. Electrical Conduit•Undrgrnd. 1
f£i. Foundation + / 59. Gas Pipe, 0 Undrgrnd., Test i,
' r. G./ ' t`. .,
,B. Water Pipe-Undrgrnd. ,i i 2 , 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System, 61. APPROVAL TO DECK '
, 11. 154perty Sewer Lirr & Ijoj efConnection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
Le.
13. Roof Drains J,, I 64. Plumbing System - Final •;,
14. Rough Plumbing 65. Electrical-Final
• 15. Rough Electri4al•Conduit 66. Solar System-Final 1
•
16. Rough ElectriCi..Niring 67. Fencing & Access Approval
-
+11. Rough Wiring Sign 68. APPROVED FOR PLASTERING
'18. RoughElectrie&-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Roclgh Heat g& Air Conditloniny r �,F1g�[��t,T. F.EOUIR MENT
r r= Cln it K^ .t..• a. r+ ,tr C
20jRo 'hractoy place � S`Y ,- a•7.c {A PPRWVP,Fsr_`_:Pee• sut# tie r .4-
21 Ouqis, stAktt✓tat; i S+• S- r +=. r.,3:< a 70. Wnderg*ogiE Hybro xx
4.
22rOu s, tr.ent iatir`,a:: 'Y r
[„ I ,; �. :� Q -, M . 71. Productri3,Pping ❑'Ges ...
23.:GasPi R h & Test I - � .S ,, in - C Ga a: R-t x T
P r- ,72. Undergrotrtd Flit;. t-
24. Root Framirig ,- Y p• ,. > x ..73:=UndergrnF�.Stor'gty-Y6nk Gas ❑(9i
25. Roof Sl athing .c z 44J 'l .�r t• �74C-Overhead Hydrdt 44 ,
26t,T Btir Ceiling (StFiKturall &ivtpcacoat 71 " `'` �' 1 ' > ,- - .-
- < �; y =?x •< 75rOSY Chem;caf ._ •x �•
27;-.Frame and Etashing< -X+ > A 76. Dry Stance', oe ',r7, '; ,
. i'28. La sing=& Sdints: �T.� O : • -•) " -i. > 77c=_FIXED SY.bSEN;gINAt r r.
_• 29. Insulation --•••• :V sc s_ k , el,c, x 78EFIRE PR EV. FII�!fli_ * > 7. -'
''30. Drywall Naifeng ^r x fr. I HEALTIirDEPI R ODIR• DENT
.;31. Plaster crown Coats S ' trrr y K :g 79.E FINAL IfC$SECTI•-MN ?c
N . . . _ - CO__--4 Y _ ._
• 32�yElectrioil P9eyer49$ter-Final - '= i r'80, 000 CERTIFE ISti'ED,_
33,;Finel Electrfo - I
- _ r': • ¢ - a Notes: - ,� (: ;i+rr
•,34:-FirrrdlHeting& , r'C,4Rditidniiiip rI - - i+_ V. 'S
135;,Firial Gas Pipe -Testes r- •- x cc , ` -.r
•p36.Hoed otiCanopy.": •-� l '- Cl - r l• - Z '-o
' 4t•'
s.
TA.
',37..Final Factory Ficeplacec I `- - - . a I. . - "x: K
_38. Firj3i PCthnb.,- aing • -x -ti I+ < > t
n a r1- rz - v-
(39. Water S&vica-Firat s• I n < < r t r.
i.40. Gas Seruce•61nak-" •.n :,.. ‘",:r S `" •T•
- `� Y `vv
'
r
It
''41. Solar D`mecic-inalcrI . rr e` ki .
7C '
-I ' P. .:
- '
42. Backflow Prevent/a. r•
'> - • - "+
n t,
43. Backflow IrjCatEor><> Y S -r a:
544. Landscape Irrigation Systerir;-!_L ` K • 0`K' x ,' '� _C C.
_: s
'-45'-Sound Qttgnuat1q .. .. - .r ic r titT -At - 1 . r.. _ - . •
646.•-Handicap Regulations r. �:) ' 40p10 •S =c *
R _r. x
r47~FI-' L STRr-CTU E & BII•LDING + "6 '
48. FIATALPLANNING. I - ` I I .. r :f ¢ -
`
-
°49 f
Electricel(ese tox£dison I Y n r -.
=50, Gas.Release•to Sou hern California Gas Co +' I I ' .I.,:' - C.
-
.' ' 1 -
}. ♦ % .. - -. _.
151- CERTIFICATE OPOCCUPANCY x 7- r t�
No. Date
1
r
• OWNER AMHERST DEVELOPMENT CO. DATE 6-13-58
JOB ADDRESS 233 Duane Road BUILDING PERMIT NO. 6926 .
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 13,690.00
'7o. LOT 126 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Res. & At. Garage
.IP I & J TYPE V ZONE R1 PLAN NO. 6926
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
p ;I- DATE NUMBER
Trenches Forms �1 Steel (/i( -- /5�,SG
Floor Sys m Il "
Steel Reinforce Chimney Re-Rod
Bond Beam f
Frame and Flashing nS/F/a
Lathing, In Out 9 6/Sr
Plaster, brown coat /Ofz1ct
Underground soil MIAS`WIG Pipe TestnMc? -//-Sr
Top Out 7.4-St 1A1
Furnace 44 5 y-`-7-{"�i ,./enS / )0a. " JUN 2 6 1958 1/1' "S7-.4 (���
Gas Vents J
Rough Plumbing J
M �-s7 1-,Ce cg--- All 1 9 195$ 1X34
Cesspool Septic Tank -7
Prop. Swr. Line,nl�-louse Con.a/JSt. Swr. ''�Q >% .11 Gy,t"„/' • JUL 2 8 195 I �CA3®
c 'cling System - -. _ 1
. g Final /Yy-S '0-3/-sV
1-.__.ping Fixtures, Final /444-5 /0-y/-Sr' 1 \
Final Gas Test /,S /)7-/,S /0-3/-5 '
Construction Pole -
\.
Underground Power a 1
Rough Wiring flfi / � Zt[t��
Fixtures, Final , uw ,y
OCCUPANCY NOV 5 195s urn 1
Form 210-5M-1-57 6926
692 tl 1' E �L,t,�..`! ��
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O. BOX 317 D �`,.�F
COSTA MESA, CALIFORNIA CITY C. C ..a P.�FCA
FOR APPLICANT TO FILL IN APPLICATION OR PERMIT
ABUILDING
DDRESS 233 Tulane Road BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. PERI,IF92G
OWNER Amherst Development Co. \\IIA iiYff�A•4W��I
MAIL RECEIVED BY /DATE RECEIVED DATE ISSUED
ADDRESS 419 E. 17th St. t,N'-r- / (� —,..2,-.,,\ 0'2 II IRI t q
Costa Mesa TELLi 81159
BUILDING
CITY NO. ADDRESS
ARCH-ECTCarlson & maddlebrookIC
OR ' JEER NO COSTA MESA. CALIFORNIA
FIRE
ADDRESS'1- Garden Grove ZONE
Dike & Colegrove, Inc. CITY LIC. 7333 ZONE)h/ NOANS TYPEpezGROUP
CONTRACTOR 1. TNO. /t G(�
419 E.ADDRES17th St., Costa MesiiNEL Li 81159 BY DATE DATE
LEGAL LOT CORRECTIONS
DESCRIPTION NO, 126 BLOCK TRACT 2955
•
A.P. NO.
SIZE 70 x 99 NO.OF SLDGS. none •
OF LOT 'NOW ON LOT r
USE OF none C
EXISTING BLDG.
SETBACK LINE FROM
CENTER OF STREET 551 REAR YARD 261 —
5' S'
SIDE YARD RIGHT LEFT
DESCRIPTION OF WORK
NEW b ALTERATIONADDITION
— - I
REPAIR MOVING - DEMOLISH
SIZE DING 1601 sq ft ROOMS NO.OF 6 STORIES 1
EXTERIOR WALL Stucco ROOF Comp
COVERING COVERING .
USE OF NEW Single family residence
BUILDING
garage attached •
plan 750 C .
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCESND STAT LAWS REGULATING BUILDING CONSTRUC-
TION. A VALUATION PERMIT FEE $ 32.GG
SIGNATURE OF /c�j
PERMITTEE �` �—CB 13,690 00 PLAN CHECK S16.00
AUTHORIZED AGENT niko RP Cnl Agrnir , Tnr. TOTAL FEES 48.00 N9wI