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Home My WebLink About3491 WIMBLEDON WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 3491 WIMBLEDON WY Suite: Vicinity: Parcel Number: 41204277 Applicant: SELL ROOFING COMPANY Address: 18032 LEMON YORBA LINDA . CA Owner: HOOKER, SHANNON J Address P O BOX 28198 - SANTA ANA, CA Contractor. SELL ROOFING COMPANY Address: 18032 LEMON YORBA LINDA , CA Zip: 92686 Arch : Address: Zoning: R1 R1 Phone: (714) 52&1758 Zip: 92686 Phone: Zip: 92799-8198 Phone: (714)528-1758 License: 323842 Eng: Address: ISSUED BY: Status: ISSUED Applied: 04/15/2003 Issued: 04/15/2003 Phone: Phane: Zip: License: License: SCOPE OF PERMIT TEAR OFF 1/2 OSB. INSTALL EAGLE LITE CONC. TILE ,5.7 PSF ICBO # 4660 FEE SUMMARY Plan Check: $0.00 Permit: $167.25 SMIP Res: $0.89 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.14 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: 0 NOTES: Rear 0- 0 Rear 0- 0 Re uired: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 0 Calc Valuation: Sa,soo.00 Claim Valuation: 5a,so0.00 Right 0-0 Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access raquirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: 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 Inspeetione 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 zaasss �sioo� WORKERS'COMPENSATONDECLARATION: I hereby ettirm under penalty of parjury one n� the following tleclaretions: t ❑ I heve end will malntein a cerliticele o; consent:o self-Insure for workers' compensation, as provitlatl for by 5ection 3700 ot Ihe Labor Co�e, tor ihe pertormence of the work lOr whiCh this pertnii is issued. ❑ I heve entl will mainta rke ' compensation ins ce, as requiretl 6y section 3700 of t�e LEbor Cotle, tor the pedortnance of t�e work for whic� ihis pertnit I51 ued. My workers' compe n I uranc arrler en Ilcy number are: �D ��i � Carrier: . � � Policy Number: �� (Triis sectian need nol be comple d il he OB��t is elued af one hundred dollars ($100) or less.J � ❑ I Cetlity �he� in Ihe pertortnance of Ihe Wa�k tor � ilch this pertnit Is Issued, I shall not employ eny person in any manner so es to become subj d to the workers' compensalion laws oi Californie,,atIq eg�ee Ih 1 I tl become subject to Ihe workers' compensation provislons of Sactlon 3700 of the or bde. I shall forthwit� Comply with these provisions./ / / � / AppllcantSigneWre: ��, �� Dete: WARNINp: FAIWRE TO $ECURE WOFiKERS' COMPENSATIdJ COVEPAGE IS UNLAWFUL AND SHALL SUBIECT PN EMPLOVER 70 CRIMINAL PENALTIES AND qVIL FlNES UP TOONE HUNORED THIXISAND OOI.LARE (El OD,000), IN ADDITIIXJ TO TME COST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECiION 3]OB OF THE LABOR COOE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTHACTORS DECLARATION: I here6y aHirm that I am licensed untler prwisic torce end ettect Lic. M_� Camractols Signature: (commenc�on 7000) of Divislon 3 of the Business end Prof� sion %�_ tjde, antl my license is in full Class x (4, �` 7 Date: / 6 ' CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm thet ihere is a construction lending egency For ihe performance of t�e work tor which this permit is issued. (Sec. 3097, Civil Code). �, Lendefs Neme: Lentler's Address: � SignaWre: Date: OWNEFi-BUILDER DECLARATIONS: I hereby effirtn Ihet under penalry of perjury thet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW tor Ihe lollawing reason (Sec. 7031.5, Business entl Protessions Cotla: Any ciry or counry which requires a p6��t to construcl, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such pertnit to file e signed statement Ihat he or she Is IlGensetl pursuant to ihe proNslons of the Conirectors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of the Business end Professlons Code) or ihat he or she is ezempt theretmm and the besls tor the alleged ezemption. Any violetion oi Section 7031.5 by eny applicant for e pertnit suhjects ihe epplicant to e civll penalry of not more fhen five huntlretl dollers ($500).): ❑ I, es owner of the propeny, or my employees with weges as thelr sWe compensation, W tLL 00 THE WORK, antl ihe structure fs not intendetl or oHered for sale (Sec. 7044, Business an0 Professions Code: The Contracrors License Lew does not apply ta an awner of pwperry who builds or impmves thereon, antl who does such work himseN or hersetl or through his or her own employees, providetl ihat such improvements era not Intendetl or oHered for sale. If, however, the building or improvement is sold within one year oi completion, tha owner-builder will have Ihe burden of proving that he or she tlid not build or improve for purpose of sele.). � ❑ I, es owner of the property, am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business and Professions Cotla: The conirectors License Lew tloes not epply �o an owner ol property who Oullds or Improves ihereon, end who coniracts tor such prqeci with a contractor(s) license pursuant to the Contractors Licd�se Laws.). ❑ I em ezempt under sec. Signature: Owner ID verified by drivefs license. ❑ Yas ❑ No Business end Protessions Code tor this reason: Verificetion ot Ownership by (rype of dacument, i.e. - property tax 6ill or deed): DIVISION OF INDUSTRIAI. SAFETV PERMIT CERTIFICA710N: Drivers Licensa No. Date: Expires: ❑ I hereby certify �hat no e:wvation five (5) or more feet in depth into which e person is requiratl to descend, will be matle in connection with work authonze0 by Ihis pertnit, end that no building structure, s�i�olding, lelsework, or demolition or dismantling �hereot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 361, Title 8, Califomia Administrative Code). ❑ A5 owner�builder, I will not employ enyone to do work which woultl require e Dermil irom ihe Division ol Industnel Sefety, es noted abova, unless 5uch parson has e permit lo do such work from tha division. Signature: Date: Division of Indusirial Sefery Pertnit Numher: CERTFlCA7E OF COMPLIANCE AND AllTHORVA710N OF EHTAY: I certity under penalry of perjury that I have read Ihis application and state that the informa�ion given is wrtect. I egree to comply with all sWte laws and ciry ortlinances relating to building construction, antl authorize representatives ot Ihe Ciry ot Costa Mesa lo enter upon the ebove-descnbed proDerty lor inspection purpPses. 1 egree not to occupy or allow occupency of eny building authorized by this pertnii until fnal inspection. Si re Ot Lega wn /!`� a�} �_1` / A�MIOr A ih zed ApWI nt te COOE I• INSPECTIONTYPE 1616 Fixed System Finel Fire Prevention 1266 Pool Spe Finel 200 Final Re-Foof 201 FInaI Block/Retaining Wall 202 Final Faciory Fire Plate 203 Finel Sign 204 Final Demoli�ion Pd�f. IMRIALS � � COOE I INSPEC110N TYVE 206 Final Machanical 208 Final Plumbing 210 Final Electrical 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final BuiltlinryOccupancy �� ADP�icant to till in all soaces ezcept those within heavy Eortler lines anE sign all approvriate ticelarations. i nT nin Ci7Y0FCOST M1E1SA CONSTRUCTIONPERMIT Project Address � �'�" � _I Q+ Applicant's Mailing Address � Owner's Name �Q.'%Y` —Phone �'_b_Ia=�L4�' Address Arch/Eng. License No. Address Contractor's Nam � r4-�Phone � Addreu (mailingl � i.�il � � n �'� 3 City License No. LICENSEO CONT0.ACTOR OECL I itereby aftirm tM1at 1 am licensetl untler provislons of Charter 9(commencinq with section �000) of Dlvision 3 of Ihe Business antl Pro(e55ions Cotle, antl my Iicenze is in f SII force antl effect. C� p !1 `;�O- Licens Class - ' ense No L(, �� T \Date� $i9nature � WORKERS' COMPENSATION DECLARATION \ I hereby attirm tnat I nave a certificate ot consent to se 'n re or a certificate ' workers' Compensation Insurance, or a certifietl cooY lnereot (Seclion C 00, Lab. C. l < � � � 7� � �� 1 ccNo��licy No. �� Oy�� R^I Company '�� p.�:1p• �ertified copy is hereby tumished. Date�ertit'etl co y is i�Gtl witb the cit y' i - ivision. j,�._ Applica EXEMPTION FROM WORKERS' C MPENSHTION DE ARATION (Tbis section neetl not be completetl if t�e permit is t huntlretl (E100) or IC55). I certify [hat in the pe�formance ot [he wo�k fo� whicn tM1is pe�m�t is issuatl, I shall nol employ any person in any manner so as to become subject to lhe Workers' Compensation Laws of California. Date Si9nature NOTICE: 11, aiter making lnis tleclaration, you shoultl become suDject to the Wo�kers' Compensation provizions Of [he Labor Cotle, you musl torthwith comply with such provisions or this pe�mii sttall be tleem¢tl revok¢tl. CONSTRUCTION LENDING AGENCV 1 hereGy af(irm tha[ there is a const�uction lending agency fo� the performance of the work for wM1ich this permit i5 issuetl (Section 3097 Civ. C.) Lentler's Name lxntler's AOtlress OWNER BUILDER bECLARATION I hereby attirm that 1 am exempt from the Gontractor's Litense Law for th¢ following reazon (Section 7031.5 Buziness antl Professional Cotle: Any city or county which requires a permit to const�uct, alter, im0�ove, tlemolish or repai� any structu�e, O�io� to if5 issuance, a150 requires IM1e applicant f0/ SucM1 permit [o file a signetl sta[ement t�al he/sh¢ I5 Ilcen5e0 pur5uant to [he Orovisions ot tne Conva<tor's Lfcense Law (Chapter 9(commencinq with SecUon ]000) of Division 3 of Ne Business antl Professions CoOeJ Or that he/she iz exempt -`erefrom antl tlte ba5i5 for the allegetl exemp[iOn. AnY violation ot Section 31.5 by any applicant fo� a permit suDjects the appliGanl to a civil nalty ot not more than five huntlretl tlollars (5500�. L� I, as owner of Ihe O�oPerty or my emplay¢es witlt wagei as their sole compensation, will do the work, antl Ne structure is not intentletl or otieretl tor sale (Section ]044, Business antl Pwfessional Cotle: The Cwtractor's License Law tloes mt apply to an owner of a properry who builtls or improves thereon, ana who tloes such work nimzelf/herseli or chrou9h nis or her own employees, provitletl that such improvements are not intentletl or ofteretl for sale. I(, howeveq [M1e builtling or improvement is soltl within one year o( com- pletioq the owner will have the burden of oroving he/she tlitl not builtl or im- provefo�tM1e purpose of sale). ❑ I, as owner of ihe prOPe�ty, am ezclusively cont�acting with Iicensetl con- t�acto�s to wnstrut[ the Dwjeci (Section ]044, Busine55 antl Profesiions Cotle: The Contractor's License l2w doez noi apply [o an owne� ot pro0erty who builtls or improves thereon, antl who contracts tor such projects with a mn- tractor(s) I¢enze pursuant to the Contractor's License Law�. I am aware that proof of lM1eir Wo�ke�'S Compensation insurance shoultl be Provitletl to me. ❑ 1 am exemp[ under Section B. & P. Q for this reason cr , �., „ ...._. .._. __. .._. ,,,.,, ,.,,. TVPE OFCONSTRDUCT� NEW ADD ALTERATION IJ REPAIR ❑ CONVERSION ❑ OEMOLISH ❑ OTTH�E,R, �np DESCRIPTION OF WORK/USE OF BLD.G. �i' l�'I��i } � TVPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ.FT. ocCUPANCv_ CONSTRUCTION TVPE VALUATION $ ZONE GRADING CU. VDS. ACRES— Rema�kz: Date Owner I I hereby cer[ity that I have reatl thls apv��caiion antl state that the above information is mrrecL I a9ree to compry with all dty antl county ortlinantes antl state laws relating to builtling construction, antl hereby authorize repre- Sentatives ot lhis city to ente� upon lM1e above-mentionetl p�operty tor in5pection pur o /y �y p Si9nature �C�J /� %� i D te ��S (1 Drivers' � y i �f ��-. ' G' � Sink Preventer Irrigation Dishwasher Drinking Founiains Floor Drains Floor Sinks Gas Service Outlets Kitchen Sink Roof�Drains Reinspection Fae � $15 Duct-UnderGround Duct - Svuccural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting �700,000 BTU 0100,0006T Rainspection Fee � $�5 IF 0865-46, rev. 10/89 Whit� iltling; Canary - Applicant; Plnk - Accountinq; Golaenrotl - Asseszor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal � Water Closet � Water Heater Water Service Auto-Wash Laundry Trays Issue Fee iANICAL Hood or Type I ❑ Canopy Type II ❑ Refrigeration Sys[em ¢pioo,000eTu ❑ioo,000 System Repair/Alteration Fire Dampers Registers FEES 5 3 FEES Issue Fee lS I $� A.P. #�' S Main Building: E T Front A Fear C Right S Left Ping. Ref. # Planning Notes: Zone Accessory Bui Parkiny Req./ProvideJ ELECTRICAL Automatic Washer Transformer ❑ 15-SO KW ConstructionPoleSub. � SO+KW Cooking Unit Merer ❑up to 100 amps Dishwasher Meter ❑over100amps Dryers ❑Gas ❑Elecvic Sub Panel Fan Motors �0-7 HP �1 X- 8 F.A.U. Inc. Solar �9-15 HP 016-15+ Fixtures (J Device Baxes OuUets Switches Garbage Dispoul Generator �0�5 KW 05�15 KW Pole Light Range Sign Standing Sections Trash Compactor Fee f$15 � � Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By �a� FEES $ 2 O N I N G R E � M T S SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING g �SSUANCE $ PLAN CHECK 25% 3 ENERGV P.C. 3 ELECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM $ � MECHANICAL 5 TOTAL FEE $ PLAN CHECK 25% $ � CIiY� OF r,�STA i1ESA� r,a CONSTRUCTION AND�PLANNING � �" POOL & SPA � � Date Inspector �J Date Inspector APPROVALS Permit# '`� '.APPROVALS Permit# i�.Temporary Electrical.Seivice or Pole 52. Pool & Equipment Location - � �'� i�. 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms .e 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . � 7� F.00tings 58. Electrical Conduit-Undrgrnd. �. .8: ��Foundation �: .•� 59. Gas Pipe, � Undrgrnd., Test '9,,Water,'�Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. r 10. Structural Floor System 61. APPROVAL TO DECK 17. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 76. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough�Wi.ring Sign, , 68. APPROVED FOR PLASTERING ..1�8. Rough�Electrical,T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �. 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 1 20. Rough Factory Fireplace APPROVALS Permit# , .21 . Ducts, in Struciure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush , 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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 � r' 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT �:�� 31. Plaster Brown Coat 79. FINAL INSPECTION ��;. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •'Ci 33. Final Electric �(�/% Notes: ' tl 34. Final'Heating & Air Conditioning �� [,j�j � '� 35. Final-Gas Pipe-Test 36. Hood or Canopy _. . � � " 37. Final Factory Fireplace - , i. - 38. Final Plumbing � , , 39. Water Service-Final ' ! 40. Gas Service-Final � '. � , 47. Solar pomestic-Final •�42. Backflow Preventer � ' � � 43. Backflow Irrigation � - ' � 44. Landscape Irrigation System ' i 45. Sound Attenuation . , � . 46. Handicap Regulations ' 47. FINALSTRUCTURE&BUILDING . " � ..48: Special Requirements Completed _ . . � - � ' � 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . No. Date _ - � * � _ \ -. ,, � ' �r. F � [r] a a � h S F � ta] I—' Q > >- .� a v� a O � 4 Z 'S' 3 6128 I/21/BI 232e35 T� COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT ••vVV,••`VV vvV•^•••`V^•V^`••V•••••^r`VLV RECEIVE BV PERMIT N� 47779 For Applicant to Fill in Completely — Use Ink Only BUILDING 3491 Wimbledon Way A�P� N0� /�� (/ ��y �SS ADDRESS OWNEROR Wimbledon Assoc °.D�RE55 3491 Wimbledon way TENHNT MAILING 1470 JambOre2 Rd sPace°rvo. 5 ADD R E55 Newport Beach re�b40-680 TR.yC},275 �or 5 eLK. lu CITV NO. ooNsraucno�mperial Savings & Loan NEW ADD LTER REPAIR MOVING DEMOLISH IENDER X BRANCH Pasadena wl e OIl $$�i.'. OWNER ADDflE55 1 S Lake Ave VALUE , ARCHITECT TEL. USE EG ,3 OF ENGINEER N J ��/_— ,p ADDFESS ZONE FD TVP�C"��GROUP 1�-3 APPPOVED CONTRACTOR BV DATE Q.p �j ADDRESS 1470 JambOree Rd TEL. CITY Ne ort Beach No640-6800 STATE CITV APPROVEDSETBACKS LIC.NO. Z%3$%,�j uc.No. 18873 SI Z E NO. OF BLDGS. ( F ROMSYC3TREEf) PL OF LOT NOW ON LOT O RONT FT. USE OF EXISTNG BLDG. Separa[e permi[s are required for L SIDE v FT. elec[ric, plumbing and heating work. / REAR G'� FT. USE OF BUILDING AND WOFK TO BE PERFORMED PLqNIVING ACTION PRD - New Construction ZE- zs-a�- P�FlOVED a a2 � Single-family dwelling � ovo �� 3!{D FOR SPECIAL REQUIREMENT; I heraby acknowledpe that I heve reatl this application entl ctate t�at the abova intormation is correct antl apree io comply wit� all laws reBuletin8 builtllnB conrtruction, antl I shell not employ any person in violation ot tha workman's compensetion laws of the Siate of Celitornia. /�� . !/ I hereby cartify that I am proparly licansatl as a contractor untlar SQ. FT. 7� the State of Calitornia Bustness antl Professions Cotle, Dlvlsion 3, THE AMOUNT SH N UNDER VALUATION IS FOR Chapter 9, antl that such licenses are in full force end effect, or I THE PURPpSE OF 67ABL6HING A PERMIT FEE ONLV: am exempt tram the provi5ions ot the Stete ot Celitornia B�siness antl Professions Code, Division 3, haptar 9 VALUATION PERMIT FEE S Q � PLAN CHECK E Signature ot q� _ / Permittee �% $/ y <<�D TAX E s or / .� (O � Authorizetl ABent Date . TOTAI PAID _ .3 7 m 4 m 0 f U � OWENS•CORNING t' Fiberg'las Blanket Insulation The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance and that the Blanket Insulation is in- stalled in conformance with current energy conservation regulations, California Administrative Code, Title 25, State of California, in the building located at: � "il I , l��vnll�n/�tm, ��h,., .T 1�J�7�' �� LodNumber hact Number Exterior Walls �/ �� Owens-Coming Fiberglas Blanket Insulation .� � Thickness R-Value Ceilings „ - Owens-Corning Fiberglas Blanket Insulation _� __��_ Thickness R-Value Floors Owens-Corning Fiberglas Blanket Insulation � �ndation� Walls Manufacturer Type General Thickness R-Value � � , Thickness R-Value _.License No. By Title Date �Signawre) A �— • Insulat ontractor. ��/J�l�.?/�v �lifsA//�/J/�.f�*J License No. �� '� v /� 8y— —�sx,..�.""" — Title ��/" Date�n�/ � / ( gne�ure� Homeowner Copy (White) _ � State Copy (Yellow) . pWENS-CORNING FIBERGLAS CORP. Builder Copy (Pink)� Insulation Operating Drvision a�e. No. �s-e��ssssn . wno �� us.n.. ��ir isn - Fiberglas Tower, Toledo, Ohio 43659