HomeMy WebLinkAbout359 WESTBROOK PL - Building Permits„ . '�
ApP���ant to fill in all spaces except tnosa wifhin heavy GorEer lines antl sign all aDG�opriate tleclardtions.
� ITY OF COSTA MESA CONST UCTION P MI I
Project Address
Applicant'sMailingAddr s
Owner's Name Phon� l`4a�!
Address �����'��
Arch/Eng. � � c^'w G�'"+�--�- License No.
Address
Contrector's Name Phone
Addresslmailing) ('/�*�*-A
Ciry License No. �
LICENSED CONTRACTOR DECLARATION '
1 hereby affirm tna[ I am licensetl untler provi5ion5 of Charter 9(commencing
with section ]000) ot Division 3 of the Busine55 d P ofesslons Cotle, antl
my license is in full torce antl effect.
Llcense Class L o.
�Date Siqnature ' • , ,
WORKERS'COMVENSATION DECLARATION
I hereby aftirm that I have a certificate oi consent to selt-insure or a certiticate
oi Workers' compensation Insurance, or a certi(ietl copy thereot (Section
3800, Lab. CJ
Policy No. ' Company
BCertifietl copy is hereby tutnishetl. ,
Ce�tifietl copy i5 filetl with thE city Builtling DlviSion.
Date AOPlicant '
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
-(Thissection neetl not be completetl it the permit is for one hund�etl ($300) ar
less).
I<ertify that in the periormance of Ihe work i r which this perm�t is issuetl, I
shall not employ any person in any man e� o as become ubject to the �
Workers' Cp mpr��)at�'o ws of Calitomi
. Date ,a —�Y � x�5ignature ���=---
'NOTICE: It, after making this tleclaration, you shoultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
mmply �with suth provisions or this permlt shall be tleemetl �evoketl.
CONSTRUCTION IENDING AGENCV
1 hereby aftirm that there is a construction lantling a9ency�for the performance
of the work tor which thi5 permit is issuetl ,(Section 309] Civ. C.)
LPntler's Name
Lender'sAtltlre55 '
OWNER BUILOER �ECLARATION �
I nereby aftirm that I am exempt from the Contractor's Llcense Law forithe
Pollowing reason (Section �031.5 Business antl Professional Cotle:�Any city or
counry whicM1 requires a permit to construct, alter, improve, tlemolish or repair
any structure, prior to its issuance, also requires tne applicanttor such'permit
to file a signetl statement that he/Sh2 Is Ilcensetl pu�suant to the provisions ot
the Contractor's License Law (Chapter 9(commencin9 with Section �000) of
�Division 3 of the Business antl Professions Cotle) or that he/she is ezempt .
therefrom antl the basis (or the allegetl ex¢mption. Any violation ot Section '
7031.5 ,by any applicant for a permi[ SUbject5 the applicant to a civil
�enalty of not more than (iv¢ huntlretl tlollars ($500). '
1,'as owner of the proper[y o� my employe¢5 with wages as their Sole '
I compensation, will tlo tne wo�k, antl Ihe structu�e is not intentletl or otfe�etl �
' i- lar sale (Section ]044, Business antl Professional Cotle: The Contractor's
License Law tloes not apply to an owner of a property who builds or improves
thereon; anG who CoeS Such wo�k Itimsel//he�self or�through his o��her own
emoloyees, provitletl that such improvements are not Intentletl or offeretl for .
sale. If, howeve�, tM1e builtling or Imp�ovement I5 soltl within one yea� ot com-
pletion, the owner will have the burtlen of proving he/she tlitl nof builtl or im-
prove tor the purpose ot sale). ' ' � .
❑ I, as owner of the proverty, am exclusively contracting with licensetl con-
tracto�s to mnsttuct fhe project (Section ]044, Bu5ine55 and Protessions Code:
The Contractor's License Law tloes not apoly to an owner oi praperty who
builtls or imoroves thereon, antl who contracts for such projects witn a con-
tractor(si license pursuant to the Contracror'S License Law). I am aware that
proof oF their Worke�'s Compensation insurance Shoultl be provitletl to'me.
❑ I am ezempt untler Section B. & P. C. tor this reason '
Date � Owner
I hereby certify that I nave reatl this apo�ication antl stace that the above �
mtormation �s correcL I agree to comply with all city antl county ortlinances
antl state laws �elating [o builtling const�uc[Ion,�antl hereby authorize repre-
seniatives of this � city to nter on he above-mentionetl property for
inspection purposes � '� `'/ p�
Signature Date ���
Drivers' License or 55 �
CMF 0865-46, rev. 10/84 WM1ite � Builtling; Canary - Applicanh
�i y 5C
TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ OEMOLISH ❑ OTHER Ap *,
DESCRIPTION OF WORK/USE OF BLDG.
� S Main Buildi
TYPE OF PERMIT GaADING FOUrvDATION ❑ 57RUCTURAL T Front
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL 6 Rear
❑ �OTHEIi ' ' A
PROJECT DESCRIPTION Sq: FT, oCCUVANCv C Right
K Left
CONSTRUCTIONTVPE � VA�UATION$ $
. ZONE GRADING CU� NDS. ACRES Ping. Ref. #
Remarks: {% ��(jqQ� - PlanningNotes:
Sink
7reventer
Irrigation
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Lavatories
Drains
0
PLUMBING
Showers
Service Sink '
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank � �
. Swimming Pool w/Spa �
Urinal
Outlets Water Closet
Water Heater .
- Water Service ' -
^ Auto-Wash
_ � LaundryTrays ,
Reinspaction Fee � $75 I I � Issue Fee �
Duct - Under Graund
Duct - Structural
Duct-Ventilating ,
Exhaust System ❑ Multiple
Firepl/Fact. BIL ICBO #
Heating System & Ducting
❑4100,000 BTU 0100,000
Reinspection Fee I $75
Accountin9: GoltlenrOtl - ASSESSor
Hood or TYPeI ❑ �
Canopy Type I I ❑
Refrigeration System �•
❑0-700,000 BTU ❑100,000 Bi
System Repair/Alteration �
Fire Dampers
Registers
luue Fae
FEES
� • t •.. ..Af.� .�.SOS
:1 --� W.^;
4881 6/I�/85 5o0C T�
Zona
Accessory Building: � �
Z
O
N
I
� . N
G
R
Parking'Feq./Provided - E
ry� �
. S '
ELECTRICAL
Automatic Washer Transtormer ❑ 15-50 KW
Construction PoleSub. ❑ 50+KW
Cooking Unit ' � �.
Dishwasher
Dryers ❑Gas �Electric
Fan
F.A.U. �
Fixtures � - �
Device Boxes � �
Outlets
Switches
Garbage Disposal
Generator DO-5 KW �5-15 KW
$ 3 1 Reinspection Fee
FEES
�DEVELOPMENTSER
� Zonin A roved B _
w 9 PP Y
"r- Building Approvetl By
Apolication Isued BY_
$ 3
Meter ❑up to 100amps
�Meter ❑over100amps
Sub Panel
Motors �0.7 HP O1 X- 8
Inc.Solar �9-75 HP 076-15+
Microwave . - -
Pole Light �
Sign
; Standing Sections
Tresh Compactor
� ! $15 Issue Fee
VICES REQUIREMENTS:
$ 3
' �SUMMARV OF FEES �
BUILDING PERMIT $ SMIP � $
PLAN CHECK � $ PERMIT
PLUMBING $ SC�C� ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $ '
PLAN CHECK 50°� $ � MICROFILM , $
MECHANICAL $ TOTAL FEE $ S•��1
PLAN CHECK 25% $ � � j ,
�
�.' CONSTRUCTION AND PLANNING , � POOL &�PA,
APPROVALS � Permit# Date Inspector qppROVALS Permit# Date Inspector
� ' 1. Tem orar Electrical Service or Pole .
p Y 52. Po_ol & Equipment Location
2. Soil Pipe-Undrgrnd. �8 � 53. Steel Reinforcement _
� 3. Electrical Conduit Utility-Undrgrnd. �� 54. Forms �� ,
4. ,Electrical Conduif-Undrgrnd. 55. Elecfrical Bonding
� 5. Steel Reinforcement ' . 56. Rough Plumbing & Pressure Test
, 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ,
�7. Footings ; . , 58. Electrical Conduit-Undrgrnd. � , . �
�
8. Foundation ' � . � 59. Gas Pipe, � Undrgrnd., Test • i �
9. Water Pipe-Undrgrnd. ' _ 60. Backwash Lines, P-Trap, 0 Undrgrnd. '
10.- Strucfural Floor System �-� �' 61. APPROVAL TO DECK � i
'11. Property Sewer Line & House Connection , ' 62. Backwash-& ReceptorFinal I
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 OEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# ,
21. Ducts, in Structure � 70. Underground Hydro .
22. Ducts, Ventilating i . 71. Product Piping 0 Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd. Storage Tank � Gas ❑ Oil
' 25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .
27. Frameand'Flashing � �76. DryStandpipe. �
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL -
30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION � ' �
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED '
33. Final Electric Notes: L�d� 8'.S� OT l�ZQD�( L.�
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test /' Z�� (.� . �� �
} 36. Hood or Canopy � - �
'� 37. Final Factory Fireplace , � �
38. Final Plumbing � d',� (�iA�
39. Water Service-Final ' �
. 40. Gas Service-Final
. 41. Solar pomesticFinal _ -
' 42. Backflow Preventer '
43. Backflow Irrigation �
� 44. ,Landscape Irrigation SYstem , •
45. Sound Attenuation �
i
46. Handicap Regulations �
�,, 47. FINAL STRUCTURE & BUILDING � �
�r
48. Special Requirements Completed � .
.� 49. Electric Release to Edison. � . � • - � ' '
�,` �50. Gas Release to Southem California Gas Co . � �
;�} 51. CERTIFICATE OF OCCUPANCY. ;
No. Date
:� ,
�
.
0
(M1�A a �1�3t
Aop���ant to fill in ail soaces except tnosa within neavy Eoraer Iines ana sign a1l aoorooriate aeclaratians.
ICIY`YT,F.SOSTA ME$�p5 NST�j CTIO PER IT I
. Pibject Address V�� � _�L
Applicari['s Mailing Add�ess
9wner's Name e �a ��-��%�/�
Address ��^^^ Q-
/arch/Eng. y r�� ���"P License No.
Address
GonVac[or's Nam Phone
Address (mailing) �
City License No.
L�CENSED CONTRACTOR DECLARATION
� hereby afti�m [hat I am licensetl U�tle� p�ovislOnS of Cha�ter 9(commencing
With section �000) ot Division.3 ot the Businezs ntl Profeszions Code, antl
�ny license is in full force antl etfect.
�ICBOSC CId55 - � � C II 0.t`IO.
pate Signature
WORKERS'COMPENSATION DECLARATION
� hereby attirm that I have a certificate ot consent to selttinsure or a certlficate
:-�pf Workers' Compensation Insurance, or a certifietl copy thereol (Seccion
��800, Lab. C.) - i . '
policy No. � �Company'
❑ Certitietl copy is nereby turnishea. � ' .�
�� Certitletl copy I5 (iletl�with the tlty'Builtling DlviSion.
Date 'APPlicant
�XEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thi55eCtlon neetl not be com0�etetl it the permit k tor one nuntlrOtl (EI00) or
IR55j. . ' .�
I[ertify tM1at in the pe�fo�mance Of Ihe wo�k fof whlch this Pe�m�t IS ISSueB, I
shall not employ any. per5o 9 in any manner z;�t(��e �e subcpq _ jec[ [o Ihe
Workerz' �p m �p qq laws at Calitornia. }- fJ_
pate S'P4"�'t Si naturo �— L'�
'NOTICE�If, diter making this tleClatation; you Shoultl become subj¢ct to the
Wo�kers' COfnPensatiOn provisions OI lhe Labb� COtle, you mus[ forlbwith
�omply wi[h Such p�ovisions or tM1ls permit SM1all be tleemetl �evoketl.
CONSTRUCTION LEN��NG AGENCV
� hereby affirm Ihat tnere is a construction lentlin9 agency for the performance
o� -lhe work far whicn this p¢rmit is issuetl (Section 3097 Civ. C.)
�Rntler's Name
4entler's Aatlress
pWNER BUILDEH bEGLARATION
� hereby affirm that I am exempt irom the ConVactor's License Law for the
following reason ($ectio� �031.5 Buslnesz antl 7rofassional Cotle: Any city or
�ounty whiGb requires a Permit to [onsl�uct, alteq Improve, tlemOliSh or �epair
yny st�uctur¢, prior [o its issuance, also requir¢5 the aOPlicant for such permit
(o file a si9neE statement that he/she is licensed pursudnt to the provisions of
Che Contractor's License law (Chap�er 9(commencing with Section ]000) of
pivision 3 of tM1e Business antl PrO�e55ions Cotle) o� that he/She i5 ¢xempt
Cheretrom antl Ihe basis for the allegetl exempt�on. Any violatlon of Section
%�31.5 by Lny appliCant for a petmit subjeCtS Ihe apPlicant to a civil
�� al�t -.of not more than five huntlretl dollars (E500).
�I.�u'fas owner of tM1e Proper[y or my employees wi[h waq¢5 a5 thel� sole
� �ompensation, will tlo tlte work, antl the structure is not intentletl or ofieretl
(or sale (Section 7044, Business antl Protessional Cotle: The Conlractor's
�icense law tloes n0[ apPly to an owner of a prOP¢rty who builtls o� irriProves
[nereon, antl who tloes such work nlmself/hersetl or ihrou9h his or her own
Rmployees, provitletl [hat su[h improvements are not intentletl o� ofleretl tor
5ale. If, howe�er, lM1e bWltling o� ImO�ovement i55oltl within one year of com-
pletioq the o`.`��er wlll nave the burCen of provin9 ne/she tlitl nof builtl or im-
nrove for [he PurpoSe ot sale).
❑ I, as owne� ot the ptoperty, am exUusivery contracting wilh licensetl con-
[ractors to wnSVuct [he project ($eCtion 7044, Businesi antl Professlon5 Cotle:
7he Contrac[or's License Law does not appry to an owner ot oropertY who
Uuiltls or improves thereon, antl wno contracts for such projects with a con-
{rattor(sl lic¢�se pursuant�to lhe Contractor's LRense Law). I am aware that
proot o( their Worker'S Compensa[lon inm�ance zhoultl be provitletl to me.
� I am ezemOt untler Section B. & P. C. (or this reason
date '- — Ownei �
� hereby�certity that I have �eatl tnis appiication antl state that the above
ipformation IS Cprrect. I agree to comply wrtlt all City antl County o�tlinances
and state laws relatin9 to builtling construction, antl hereby authorize repre-
SCntative5 of this clty Sy en � ,4,�On the above-mentio0etl p�operty for,
IPSOQCIIOfI pU(pO5C5�. /' �/�-� r1
yignature X.P.(x` - ��'YIU/�oLr.� Da� G�
privers' Li o 55 � �� ��
2 �a�
TVPE OF CONSTRUCTION Ll NEW LJ ADD L'J ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH .❑ OTHE ` �
D SCRIPT ON OF WORK/USE OF BLDG.
. � � /�
TVPEOFPERMIT GRADING FOUNDATION STftUCTURAL
❑ TENANT ELECTRICAL / PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION SQ. FT. 2e�� ocCuaAta� ���/�
CONSTRUCTION TVPE VALUATION $ '�'��
ZONE GRAOING CU. V S. ACRES '
Remarks: . � (�(p, Qp
Sink
Preventer
Irrigation
qarifiers
Dishwasher
Drinking Fountains
Floor Dreins .
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
P—Trap
Roof Orains
Reinspection Fee"
Shawers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecfors
Solar Piping
Solar Tank
Swimming Pool w/Spa
� Urinal
Water Closet
Water Heacer �
Water Service
AUIO-W35I1
Laundry TraVs
$15
Duct- UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
F i repl/Fact. BI t. 1 CBO #
Heating SYstem & Ducting
❑ ai oo.000 sru � i oo,00a ar
Reinspectian Fee � $15
CMF 0865-46, rev. 10/84 White - Bulltling; Canary - Applicant; Plnk - Accounting; Goltlenrotl - Assessor
Issue Fee
Hoodnr Typel ❑
Canopy Typell ❑
Refrigeretion System
❑0-100,OOOBTU ❑100,OOOBTU
System Repair/Alteretion
Fire Dampers
Registers
Isue Fee
A.P. # _
S Main Buildinc
E
T Front ��
g Rear �
A
C Right �
S Left � �
Ping. Ref. #
Planning Notes:
Automatic W:
Construction
Cooking Unit
Dishwasher
Dryers �Ga�
Fan
F.A.U.
Fixtures
oevice Boxes
Sub.
Electric
3607 5/28/i;D
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+�KW
' Jwitcnes •
�j� .� Garbage Dispoul
Generetor 00.5 KW 05-15 KW
/,
i..
$ 3 i, '
�Rainspection Fee $75
FEES
�DEVELOPMENT SERVICES RE�U
- Zoning Approved By "
/
"Builtling App�ovetl By
Meter IJup m 100 amps
Meter �over100amps
Sub Panel
Motors �0.1 HP �1'h-8
Inc.Solar �9-75 HP Oi6-15+
Microwave
Pole Light .
Range
Si9n
; Standing Sections
Trash Compacror
luue Fee
I:Oo� c
FEES
$ 3
2
O
N
I•
N
G
R
E
Q
M
T
�
' � - '. SUM/MARY �F PEES � � / p
� .BUILDING PERMIT $ �(s �I, c)� SMIP 3 �1�.
'�lPLAN CHECK. %� 'S ��r PERMIT
PLUMBING ' S =_� ISSUANCE 3
� PLAN CHECK !25% $ a-J ENERGY P.C. $
ELECTRICAL $ GRADING $
'�_ .PLANCHECK 50% s /. Pn MICftOFILM $� ,��n
' ' MECHANICAL $ TOTALFEE $ �L(/�
$ 3 s, PLAN CHECK 25% §
/1 ' a
CONS7RUCTION AND PLANNING �
'�s4PPROVALS Permit#
�j i
,1. Tvmporary Electrical Service or Pole
�
2. Soil Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgrnd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
6� Electrical UFER Grnd.
7. Footings ,
-8. Foundation ���(A
9� Water�Pipe-Undrgrnd. � - ,
10. Structural Floor System "
i i.' Property Sewer Line & House Connection
12. Sewer•Cap
13.-�Roof Drains
14. RougFi Plumbing
�
15. Rough Electrical-Conduit
�16. Rough Electric Wiring
.17. Rough Wiring Sign
A8. Rough Electrical-T Bar Ceiling
19.,Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. �Frameand Flashing -
zs. Lathing & Siding
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat '
32. Electrical Power Meter-Final �
33. Final Electric '
34. Final'Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
i .
37. Final FactorY Fireplace
38. Final Plumbing
39. Water Service-Final �
40, Gas Service-Final '
41, Solar pomestic-Final �
42, Backflow Preventer . '
43, Backflow Irrigation
44. ,Landscape Irrigation System �
45. Sound Attenuation ;
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric F�elease to Edison
50. Gas Release to Southem Calitornia Gas Co
51. CERTIPICATE OF OCCUPANCY
lo. �� Date
7 ��
�
POO� �PA
APPROVALS Permit'#
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plum6ing & Pressure Test-
57. APPflOVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVAI TO DECK
62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLqSTERING
69. POOL/SPA SYSTEMS FINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
'71. ProductPiping�Gas OOiI
72. Underground Flush
73. Undergrnd. Storage 7ank � Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77r FIXED SYSTEM FINAL
78' FIRE PREV. FINAL
i HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FpOD CERTIFICATE ISSUED
Notes: 6�('��� ��,i 2Ci5D s�
Date Inspector
;
�
i
i
�i
i
i
u
� •
CiiyofCostaMesa INSULATIOIV CERTIFlCATIUN� euildingSafetyDivision'
�S� l/(/ed�.�i��;� ��� l��
Number and Street City l:ounty
Subdivision
3�
Lot Number
DESCRIPTION OF INSTALLATION
ROMateri3LY��""^�" \!'�'-P� Brand Name ���^A W��'�"�'x �'%� I b,l/` z� I
Thickness (inches) � � � -�ti'- Therma� Resistance (fl Value) � � �
4
EXTERtOR WAL�L�s/ �" ��� 1 rn / ,,��,, � � �(� rf
Materiai � �X�1 /l'�[�-�R'Ins�"g Brand Name L���� �`"' �'1���'I � i� ��%�3�(
Thickness (inn'ches) �-��� Thermal Resistance (R Value) iQ I l
CEILING �Ntq,y�7,�,! (�c�Qc/y�y[ -J
Batt or Blanket Type 7�'1� A-� �b Brand Name
.�
Thickness (inches)
Loose Fill Type —
Minimum Thickness (inches)
Area Covered (ftZ)
FLOOH,ELEVATqED'
Material ' v
Thickness (inchesl
FLOOR,SLAB ��-}'�
Material ���%"`�""�
�Thickness (inches) ���
Width (inches)_
FOUNDATION WALL
Material N �
Thickness (inches)
Thermal Resirtance (R Value)
Brand Name _
Number of bags Weight per bag Ib.
Thermal Resistance (R Value)
Brand Name
Thermal Resistance (R Value)
Brand Name
Thermal Resistance (R Value)
Brand Name
Thermal Resistance (R Value)
DECLARATION
I hereby certify that the above insulaiion was installed in the building at the above location in conformance with
the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24
of the California Administrative Code�.
General Contracror (Builderi
Signature entl Title
Sub Contractor (Insulation Applicator)
�'.�-� c��M,�.--
Signature antl Title
CMF 1306-30
License Number
Date
License Number
- ��--8�
Date
.)
CITY OF COSTA MESA
DEVELOPMENT SERVICES DEPARTMENT
P. 0. Box 1200
Costa Mesa. California 92628-1200
�. �� •:.
. i -u.i
� u• 1' •
Re: Subcontractors List
We note that you have recently been issued a City of Costa Mesa Building Permit to do construction
or home improvements at same d5 above
❑ The Building Permit indicates that you are the General Contractor. Our Municipal Code re-
quires that all subcontractors working on your job purchase a City business license. We are
requesting that you complete the enclosed Subcontractors List and return it to the Planning
Division. It is your responsibility to see that all subcontractors purchase a City business
license prior to your request for final inspection. final inspections will not be given until
all subcontractors are licensed.
�X The Building Permit indicates you are the Owner/Builder. If you are acting as the General
Contractor, our Municipal Code requires that all subcontractors working on your job purchase
a City business license. Please complete the enclosed Subcontractors List and return it to the
Pianning Division. It is your responsibility to see that all subcontractors purchase a City
business license prior to your request for final inspection. Final inspections will not be given
until all subcontractors are licensed.
❑ The Building Permit indicates that you are the Owner/Builder. If you are acting as Owner/
Builder, please complete the Certificate of Exemption which is on the reverse side of the
Subcontractors List and return it to the Planning Division. It is your responsibility to see
that all subcontractors purchase a City business license prior to your request for final
inspection. Final inspections will not be given until all subcontractors are licensed.
❑ Not all Subcontractors at the job site have obtained City business licenses, therefore, as of
, the Building Division will no longer respond to your
requests for inspections. This is the only reminder you will receive from this office.
Should you have any questions in this matter, please do not hesitate to call the undersigned at
754-5623. Thank you for your early response.
Sincerely,
Nancy Bunge, C e Enforcem§�nt
CMF 1115-30 White-Atltlressee; CanaryQntl Notlte Adtlressee; Plnk-File
�
cosGa mcsa
OWNER COLLEGE PARK "- DATE 12-2�-56
JOB ADDRESS 359 Westbrook Place BUILDING PERMIT NO. �(�2�
G�NERALCONTRACTOR Harbor COIISt. CO• VAWE a ZZ�IIOO.00
LOT 3(� BLOCK TRACT Q7Q(� Res. W�Btt g3I'
GROUP I 8[ J TVPE V IONE �l FIRE DISTRICT Ii1E1Q
INSPECTIONS
Footing Trench
Foundatfon Forma and Grade to Gare a
Rough Framing o-��
Plumbing,RoughtoSlab �e� wt[
Plumbing, Rough Complete li�1G'
Temporory Pole �I
Heating, Final
YS°ewer, House
S : Tank or Cessp
La...mg, In
Plas[ering
Plumbing, Final, Fix1
Plumbina. Final Gas
Occupancy
FORM 310 3M 10�•v6
Out
St.
DATE I SUBCONTRACTOR
PERMITSISSUED
I NUMBI
�osta Mesa Bnilding Department ' APPLICATION FOR PERMIT
o n a,,.��� d1Rc] e���� n���r �
�" ;�.., �OSTA MESA,VCALIFORNIA � � V��. V a�� v �
'� FOR APPLICANT TO P`II.L IN FOR OFFICE USE ONLY
Receipt No. Permft No.
Building y/a�
Addresa WESTBROOK PLACE �
Costa Mesa, California Rece�ved by oate Redd. oate tssued
Nearest _Yh�� I�a -a -s� �a-a�-sz
CrossSt. HARBOR BLVD, Building
Address
Owner C O L L E G E P A R K N o. 2 Costa Mesa, California
Mail
Address 2 � �( SO . MA I N $T , Nearest
Tel. Cross St.
City T iiN A i�, A L I F No. �( � Zone I plans I Ty e Gro'p r
Arohitect or� Lic.
Engineer No. Approved
b Date
'dreu CORRECI`IONS
Contractor C City Lic. 61
ARBOR CONST. ONo.
Address $ M E
Legal Lot �
Description I No. 3( I Block � Traet27z6
(Attach Metes and Bounds) �
No. of Bldgs
Size of Lot �j� X Q Now on Lot
useof No.of No.oT A
Existing Bldg. I Families I R oma �
SetbackLinefrom RearYard Z
Center oT Strxt � Sida Vard y
DESCRIPTION OF WORH �
New I X I Alteration I I Addition I
Repair I I Moving I I Demolish I
Bullding No. of
xe � �2 � Rooms Stories
.cterior all I Roof
Covering Covering ApPR.QVa��s
Useof New Foundation Locaiion Inspector � Date
Building RESI DENCE c�c ATTACHEO Forms.Materials,
Under-Pinning
Frame: Fire Stops,
, Brecfng, Bolts
I hereby acknowledge that I have read this Applicatlon
and state that the abwe is correM and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building construCtion. Lath. Ext.
Signatureaf �
Permittee HARRnR CONSTRU(',TION CO Plaster,�nt
Authorized Agt Plaster. ExL
Valuatlon PermiS Fee $� O �- Masonry Reinforcetl -
Plan Check $ /3 � Bond Beam
s iz,400. To��
Fee $ y`� FINAL
a
c7
v:
�
PLOT PL.AN
6how loeatlon and distancea Trom
__:
propgrty lina and between buildings
v;
y-
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y :?'i
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1
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. �' �.
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' FEE RECEIV�U
.� �. _�..�.4'��_
%" DEC 4 19fi9
CC)STA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
". °. a°" "' COeTA'"�". °"'-'"°`�"" CITY OF COSTA MESA
Fo� Applieanf fo Fill In Comple+ely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING `�{ � Q �/�� `3�� �%,�L
AOORESS � � /r
COSTA MESA CALIFORNIA � FOr O�IC@ US@ OIII�I
� Ii6CCIPT NO. P qNIT NO.
OWNER /L-f- Y PHo/'� l/, %ii'JQ. � �
MAIL [� ) [J RC VHD BY I OAiE RECB � I A/�6 IBBU[D
ADDRE6/5 � l SS� }Ji!�7 / ��A ��C� - ( // i'�
CIT' L G� S/� //�� � G� NO. BUILDING ^l. G�' � �/, _ �.�
�/ /� ADDRESS o� �J �/--�a-2t-K/
OA .GINEe /GhQY �//DOIG� No. �'� A�� C05TA MESA CALIFORNIA
ADDRESS/-DYJ �C•S'�G�/�/- Y�VG =ONE TYPE �OUP I
CONTRACTOR J � � APPROV c� Q
'J� BY DATEI�G O -
AODRESS \O U /(/.i � � (�f � ZONING
CITY �, (� �l(j(�L �.( �_ �ONH NO.OF UB8 OP NHW G���rJI'J
•f -� I PlAN9 � I BUIlDINO K/�J�. �
LIC.No.G�3 d / / /�// I NOD�r 3-�5'�5 E6CRIPfiON Z� �6 " � � �Z �
81ZE / / / 1, /\ / Ho. OP etDGe. � _ /�/ � ^
OF LOT /��� �L O � NaW oN LOT A, p, q0 �� 3 3 G g m G
USE OF YARDS EVES
EXI ING BLOG � W2�/�� APPROVHO ALLOwEG
BBTBACK LIN6 PROM ICiNT�R YH[ 9T.j_,O / f
CeNTBR OP BTRaeT REAR YARD FRONT � FT. IN.
SIDE VARD I LEFf I RIGHT R. SIDE r� t FT. IN.
DESCRIPTION OF WORK S– —
L. SI�E FT. IN.
h, I IIALTERATION I IIAD�ITION I� REAR ,I ����� �F�T. tr�j�4 IN. ,
REPAIR I IIMOVING I IIDEMOLISN I BYPRo�D W�! � DATE. /z/�/�
gZE1N��/�,/ �•� 9ROOM8 BTOHIES �°� .
EXTERIOR WALL ROOF ,
COVERING ICOV6RING
US8 OP BUILDING ANp WORK TO BE PERFORMED
a u- She 7 t- v� /.���
/L D 0 7�Y7 � �� 1^1 r l C ^�C Fa . S' G i��L,�
[ ,S . ,z-c�L �-a t-L.
1 N8R6BY ACKNOWLCD68 THAT I HAVC R6AD THIB APPLIWTION Tryg AMOUNT BHOWH UNDeR VALUATION 16 FOR THe
AND BT.�T! THAT THE A00VE 18 CORR¢GT AND AORH6 TO COM- pUflP08H OP lBT�lL18HINp A PERMIT P¢6 ONLY.
PlY WITM ALL CITY p11DIMANCE9 ANC 8iAT6 U1W8 REOULATINO
Bu1tnlNa coNeTauYcTb // VALUA710N
SIGNATURE OF AG+, / / � �LQ PERMIT FEE S/� �
PERMI7TE �!i �� � J �
0
� - S� B-'� PLAN CHEGK $
V' F
AUTHORIZED A6EN7 � 7 v p
TOTAL FEE �s LL