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Home My WebLink About1547 WINTERGREEN PL - Building Permits JPS . CITY OF COSTA MESA 1Pl' r BUILDING DIVISION t �11a��ii 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • sww.ci.costa-mesa.ca.us . 4, t . FOR INSPECTIONS CALL:(714)754.5626 �In bsivinno.. PERMIT NUMBER: B09-00004 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13956133 DATE ISSUED: 01/12/2009 . - . - ISSUED BY: RMD JOB ADDRESS: 1547 WINTERGREENPL CM • Suite/Unit:" • Vicinity: HOUSE AND GARAGE - _ . • Squares: 0 - Valuation: - $3,500.00 SCOPE OF WORK: TEAR OFFJE)ROOF MATERIALS, INSTALL A MINIMUM OF 2 LAYERS OF 15#FELT OMA 2:12 TO LESS THAN 4:12 PITCHED ROOF OR A MINIMUMOF 1 LAYER OF 15#FELT ON 4:12 OR GREATER PITCHED ROOF AND - REROOF WITH 50 YEAR COMP SHINGLES.ON ATTACHED HOUSE AND GARAGE,APPROX 10 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED., . OWNER: KAWATO, JIMMY ' . '7 Address: .1547-A WINTERGREEN PL - Unit . PHONE: City/State/Zip: COSTA MESA, CA APPLICANT: NOH, IN , Address: 2525 W 8TH ST Unit :UNIT 220 PHONE: 323-231-6060 - - City/State/Zip: LOS ANGELES,CA - ' CONTRACTOR: ACETEK ROOFING CO . - . ` ' License No. • 874330 Address: 2525 W 8TH STUnit: - - - UNIT 220 • PHONE: ' 323-231-6060 City/State/Zip: LOS ANGELES, CA • ' 90057 - - - CELL: - - . ARCHITECT: - • License No. PHONE: •' ENGINEER: . _ ' License No. • PHONE: FEE SUMMARY Reroof Plan Check: "$0:00 - - - . Reroof Permit Fee: $97.25. - - . Reinspection Fee: $0.007 . Bldg Std Admin Fund $1.00 - . TOTAL FEES $98.25 - • • 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. CODES. INSPECTIONTYPE DATE INImALS CODES INSPECTION TYPE DATE INTIMLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final '_' 208 Final Plumbing )J 200 Final Re-Roof / /&p�p 4 /✓/414// 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site ; 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivecense. 0 Yes ❑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. _ . O 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 ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: r person is required to descend,will be made in connection with work authorized Cartier: St0tc_ Fvo,C7; • 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 (This sedon need not be completed if the permit is valued at one hundred Collars($100)or less.) Policy Number: o�b�2q — Zoo C' 2,Art 2,Sec.341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would ❑ 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 become subje.li to the workers'compensation provisions of Section 3700 of the Labor Co.' I shall forthwith comply with these provisions. p Applicant's Signature Date j — Z_0 l Division of Industrial Safety Permit Number: app ice s ignature Date- HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE 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? ❑Yes ❑No ($100,000), 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? 0I Yes ❑ No Lic.# - \: .�F"s30 - Class it C—3°t (Section 25533 of the California Health and Safety Code, with some _AJ.. j ^j 1--O Ci ` exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely `y- or's -lure ,-,--- 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 CONSTRUCTION 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 which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 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 Safely Code been fully complied with? ❑Yes 0 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 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished 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 0 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). O 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? 0 Yes ❑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 ❑ 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. , , Sign- "e d Legal Owner(s) Date Signature Date 3057-46(3107) j. I2-0 Anil• :n.. A•• t `, Date • t . - . 0515I M S CITY OF COSTA MESA t. liAilliks, BUILDING DIVISION F x / .41 DEVELOPMENT SERVICES DEPARTMENT PERMIT IT PE NUMBER 4. iiiKik _ � 00-01469 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesathytDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1547 WINTERGREEN PL CSU Status: ISSUED Suite: • Applied: 09/19/2000 Vicinity: UNIT A(DUPLEX) Issued: 09/19/2000 Parcel Number: 13956133 Zoning: R2 R2 Applicant: ESLAMDOUST, ARASH ISSUED BY: 7.91;1. ..-01 Address: 2201 W WILLOW ST STE D134 Phone: 562-427-4742 LONG BEACH,CA Zip: 90806 Owner: KAWATO, JIMMY Address 1547 WINTERGREEN PL - Phone: COSTA MESA,CA Zip: 92626 Contractor: RESTOTECH WATER & FIRE DAMAGE SPECIALISTS Address: 2201 W WILLOW ST STE 0134 Phone: 562-427-4742 LONG BEACH,CA Zip: 90806 License: 692689 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT RESTORATION FOR FIRE DAMAGE: REPAIR ROOF FRAMING(APPDX 2+RAFTERS), SHTG,FACIA,SHINGLES. IN FIRE AREA, REPAIR PLASTER(EXTERIOR)&"POSSIBLE WATER DAMAGE TO INSULATION&DRYWALL AT INTERIOR OF LIVING ROOM. NOTE:WOOD ROOFING TO BE CLASS"C"MINIMUM. SEE ATTACHED REPORT PER GARY HOOK. 44-AvG[ FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,500.00 Permit: $54.00 Claim Valuation: $1,500.00 SMIP Res: $0.50 • SMIP Corn: $0.00 . Other: $0.00 Inspection: $0.00 Total: $54.50 PLANNING &ZONING SETBACKS . MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 244646(6/00) • DECLARATIONS it `t, fl WORKERS'COMPENSATION DECLARATION: 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 carrier and policy number are: Carrier: SS Aerif inti A) b Policy Number: { c/g /9 2 ( - O (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify 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 subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith Comply with these provisions. Applicant Signature: � Date: 9_/?- 200b 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($100,000),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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# r A Class 11 Contractor's Signature: ��.��✓/- Date: Y_/7- 2c'0 d-+ 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 an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a 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? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of en 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes".the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. n-. u -..al Ow -:d Date And/Or Authorized Applicant Date CODE# 111,5110.01=1 DATE If]IDALS CODE E INSPECTION TYPE GATE BOIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 210 Final Electrical 201 Final BlocldRetaining 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 /- . "-9( 4c Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -CITY OF COSTA MESA--- - PERMIT NO. TRACT NO. LO-G,NO. • BLDG. O. . _ CONSTRUCTION PERMIT /v] (q ,9 • , i r Project Address�,5"T,L7��e�q/!� �Ey,p eee et� �•Q` TYPE OF CONST`RUCTION r 7552, 4/20/83 . 7.00 4L Owner S_' - g ;/G't`e^��Phone e- rte NEW ❑ ADD 0 ALTERATION - - _ - 'V Addre i - -_ -- - - - - •0 REPAIR 0 CONVERSION ❑DEMOLISH - ., - ZONING REGULATIONS, - - " - 1 Arch/Eng. _ - License.No. . 0 OTHER' DESCRIPTION OF.WORK _ - - - - A.P.54C -_..i - - - - _-- , -- -- • \ Address _ ._ -. _. p}r, _ - - - - ZONE - - PLNTGpgRUEFL: -- . Contract - � ',) PhonSG. 'TYPE OF PERMIT--- - -- - --- - - . ' BUILDING _ _ CROPEIR DVNGNE � . - i 3Cbc/Ce Tj/, :SETBACK D/L$T. -- -_ - - - - Address, '�C/ ''/��- / CL/IUC.> - • �0 GRADING '� •❑ FOUNDATION -_�,STRUCTU RAL -. IE.OE YARD -- FT LICENSED CONTRACTOR DECLARA, ON "J - '_(]-TENANT ❑ELECTRICAL ❑PLUMBING 1$AECHANICAL' SI DE YARD. -- . _-- _ _ --• _ . I hereby affirm that I am licensed under provisions of Charter 9(corn- 5 mencing with section 7000), of I Division 3 of the Business and ' 0 OTHER -' I RIGHT Professions Code, 'an•- my license is in full force .nd of ••ct. .PROJECT DESCRIPTION . REAR YARD(TO P/L) " - -7 'License as -_� O License • -.48. __ . _ _ • - • --..- _ ' - _. - �r i SQ. FT: PKG.'ST WI REQ. -PROVIDED Date " �' . Signatu . --% - �+y -�+ _ —' - - _ ._ , WORKERS'COMPENSATION DECLARA�ION 'OCCUPANCY_CONSTRUCTION TYPE - STREET WIDTH - _ .PARK'FEE$,- - .I hereby affirm that I have a certificate of consent to self-insure or a • - ,_ - ZONING APPROVED BV- '-^-• - DATE - - - - certificate of Workers' Compensation_Insurance, r_a certified'copy *VALUATIONZONE .. .. i 'thereof(SBry icj0 80 b.C. /� A A.,q.. GRADING CU. YDS. - - ACRES SPECIAL CONDITIONS: - - -- '-_ -' — '1 ;Policy No.01 tie /YO6' ompany esti (44la U..I- - -_ _ -- _ _ _ 4 n,Certlfied copy is•hereby furnished.— ( - i CI REMARKS:- Y V lertlfied copy is filed with the city Building Division. " ' - -' - --- - - - - -- - - LMPTION FROM.WORKERS'-COMPENSATION-DECLARATION - -- -- - • -- _-_ - ... _ ' ''� - ' (This section need not be completed if the permit is for one hundred - - +I$100) or less). _ . _ _ . _ _ - .___- .._ . . . __ - _ - _ . _. _ . -- _ - - 'I certify that in the performance of the work for which this permit is t Issued, I shall not-employ any person in any manner so as to become- . -PLUMBING - •-- - -- PLAN CHECK - - --- ELECTRICAL - -- -PLAN CHECK - -- '- ----1 subject to the Workers'Compensation Laws of California..' ' 1 _ - ' _' - -" -"-- -' - ,'BATHTUBS- - -SHOWERS - •_ - __ - tLLINC, Date Signature SCJ so FT. • GO FT - - NOTICE: If after making this declaration, you should become subjectl . TOILETS,. _,URINALS- ----• - -- 'GENERATOR -- O=1"KW- 1-10 KW - - ' do the Workers' Compensation provisions of the Labor Code;•you must - - - TRANSFORMERy i -f''' t{' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS I--- - - •• 'APPLIANCE -10.50 KW_50-+ KW - - - - revoked. _ __ - _ •CONSTRUCTION LENDING AGENCY _ - -KIT.-SINKS - - - DISHWASHERS- - - MOTORS =-O-IHP'_1-1OHP - - - - - -- I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS • .,SUMPS--- - — - ! -- - - - :(INC.SOLAR) • 10-5 O.MP 50.,HPl' ^'" _ _ ,formance of the work for which-this permit is issued (Section-3097 • -' '- Civ. C.). - - - - - - -- - •_. _ . - -- "FLOOR SINKS - FLOOR DRAINS- - -- -''FIXTURESOUTLETS- SWITCI-IES - - -- - -Lender's Name- - . Lender's Address - -- - - DRINKING FOUNTAINS - - •- - GAS-TUBESIG NS -- - - -- - - - - OWNER-BUILDER DECLARATION - INTERCEPTORS - • CLARIFIERS-- ' - POLE LIGHTS- fl hereby affirm that I am exempt from the Contractor's License Law for, - the following reason-(Section 7031:5.Businesszand .Professions Code:: SWIMMING POOL- P TRAP- - •LUNS i Hut.IIVry .. 'Any city-Or -county 'which requires a permit to' construct,babel., - • . _ POLES METERED SUB- - Improve,-demolish-or repair any structure, prior tgits issuance,also re- . WATER SERVICE !ALTERATION - - - • 'PANELS -- - MAIN -- 'SUB - - --- i quires the api.licant for such-permit to•file a signed statement that he - Is-licensed pursuant to the provisions of the-Contractor's License Law' _ • GAS SERV ICE is- OUTLETS -' - ' - - ,SERVICE - - -• • -- 1 AMP - -- •--- - '(Chapter 9 (commencing with Section 7000) of Division 3 of the c - - - Business and Professions Code) or that he is exempt-therefrom and the WATER-HEATERS- ---BTU•OVTPUT--- •-- - • -- • I basis for the alleged exemption. Any violation of Section 7031.5 by I - any-applicant-for- a-permit subjects the applicant-to-a civil penalty SEWER CONNECTIONS -- -- - - c _ le of more than five hundred dollars ($500). . 'as owner of'the property; or my employees with•wages as'their -SOLAR K' --- ' -COLLECTORS-- -- ' - - - --- _ Compensation, will do the work,and the structure is not intended or,Contractor's for is n (Seaw dnot pinontl Professions-Code: The -SOLAR PIPING SYS. - - '- - "'- _ - - ISSUE FEE-- _ -- ----- ^- - - - - who builds- License Law does not apply to ansuch owner a propertyif 1 who builds-or improves thereon, aril-who tloes'supr work himself or' - .-ISSUE FEE - - ll - I - -• - ' -APPLICATION APPROVED BY.---7245- - -DATE . 2^I through his own employees, provided that such improvements are not - intended or offered-for sale:If,'however, the building-or Improvement MECHANICAL __ PLANCHECK ` - - "-- - - is sold within one year of completion, the owner will have the burden i SUMMARY OF FEES , of proving he did nor build or improve for-the purpose of sale). - BUILDING- - - - - - - --- - I HEATING SYSTEM 0-100,000 BTU- OS PERMIT $ .SMTP $, ❑ I, as-owner. of the property, am-exclusively contracting.with -AND DUCTING.' - - - - -- - - - f .- - - - . licensed contractors to construct the project (Section 7044, Business 100,000'+BTU PLAN CHECK $ PERMIT. „ ,? and Professions Code:The Contractor's-License-Law does not apply to _ _ :ISSUANCE.$ ' - an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTUPLV MBING $ -s tracts-from-such.projects-with a.contractor(s) .licesnetl-pursuant to, .SVSTEM - ---- k __ ,GRADING-' $ the Contractor's License Law). 100,000+BTU I •PLAN:CHECK $ �, - -- I 0 I am exempt under Section - - - • B. &'P:C.for this BOILERS BTU $ - - reason - - -- • .'MICROFILM;V -' I , - - 'PLAN CHECK- E' - Date Owner SYSTEM REPAIR,ALTERATION 00 TOTAL FEE $'•' 1"• 1 I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTI E I • MECHANICAL $�. - •- - - - PLAN CHECK •.LESS AD- - ordinances Id' tatrela agreeito comply with all cityry acountyuthorze !!,,$ j,' $ -VANCE'PC $_-ordinances and antl state laws relating to construction,and hereby authorize 3CJ"1�rpAGN ' . represents Ives of this city"to ,enter upon- the above' m ntipnetl- ' ' " t ' property i p arise py s�$fs, _ ,v - - __ /`T _ .- Signature -CO alGtli/Gd�j / -ISSUE FEE • 3 QD _ - -,. CMF 0865.46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA '• - Date Inspector - -.'Date- - Inspector APPROVALS Permit# APPROVALS Per-mit# .1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn . . - - 44. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrn - - 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding - • - -- - -• - • 5. Steel Reinforce - 47. Rough Plumbing & Pressure Test"-- •• •- •- •• . •• •• - •• . . - . - . 6. Electrical UFER Grn . - - , 48. APPROVAL TO COVER-GUN ITE" • 7. Footings - - - �+ 49. Electrical Conduit-Undrgrn . ' 8. Foundation • . -. - - • . - 50. Gas Pipe, El Undrgrn,Test :•.-.: •- 9. Water Pipe-Undrgrn 51. Backwash Lines,P-Trap. ❑Undrgrn ' ' - .. 10. Structural Floor System . 52. •• APPROVAL TO DECK . . - 11. Property Sewer Line & House Connection - 53. Backwash& Receptor-Final ' • _ 12. . Street Sewer Connection. . - . . - - - 54. Heater &Vent-Final - • - • ' 13. Rough Plumbing _ - __ .- 55. Plumbing System - Final 14. Rough Electric-Conduit - - - - - --56. Electrical-Final 15. Rough Electric-Wring - - 57. Solar System-Final 16. Rough Heating & Air Conditioning -- - • 58. Fencing &Access Approval 17. Ducts, in Structure- - - - 59. APPROVED FOR PLASTERING r• • 18. Ducts, Ventilating - -- - 19. Gas Pipe-Rough &Test - - - 60. POOL/SPA SYSTEMS FINAL - - , , 20. Roof Framing - . . - - - - - ' 21. Roof Sheathing 22. Frame and Flashing - - - - NOTES: 27 a n h r/Ate Y - h /?C'a1ra/ i%3--/,:=s .-rt. 23. Insulation - - - '• - - • 7% <.brwgY i &r/ /1'a rr�rll,,e7c-r, .a 7-/6/s7 ,Vff -24. Lathing & Siding - - 7,,i.,f-�atm," z 5'�/ J- ,. y� . 25. Drywall Nailing � a.vt-e'•.(iiZIC �`Q� f7U.obf�1-04et '..SJ,l 6r ti 27. Plaster eri al Coat y 27. Electrical Power Meter-Final -ail _..t�L ��f�/C-�fI - ' 28. Final Electric -- - - - - -- ' 29. Final Heating &Air Conditioning - - - I - 30. Final Gas Pipe-Test - - - - -31. Final Plumbing - - .- - - ' 32:. Water Service-Final - - - - •- - 33. - Gas Service-Final' ' - . -. - - • - - . . , 34. Solar Domestic-Final _ ' ' • s • • 35. Landscape Sprinkling System• - . - - 36. Sound Attenuation - .. -- • ' • - 37. Handicap Regulations - • - • 38. FI NAL STRUCTURE& BUILDING __ _ - 39. Special Requirements Completed - - 40. Electric Release to Edison - - - 41. Gas Release-to Southern California Gas Co. - - ' 42. CERTIFICATE OF OCCUPANCY - - - No. Date - - - - - . _ - , ` ptV "^.Y ?'•7r,Pa,9nn1135 cal*;.***:, [ns: COSTA MESA BUILDING-SAFETY DEPARTMENT 0' P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECTIFY DATER CEIVED DAT ISSUED BUILDING 4vy -7D sT4 `f0 ADDRESS 1547 Wintergreen Pl. • OWNER Harbor Mesa Corp. A.P. NO. PER -Ricci MAIL BUILDING �{ '�d,�" ��1 1 v Z ADDRESS 15117 Ventura Blvd. Rm 6 6 ADDRESS /6-17/-7-1 (�1GELV i 0 0 CITY3herman Oaks.Cal 91403 Nx986-5077 TRACT(Qc /#J LOTgs. BLOCK ZZ Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH O- V) LENDER 0- CO (/ J D BRANCH J CO OWNE / LU ADDRESS m JLWITIa/ VALVE J N OR ENGINEER Rappoport 1 )652-5578 Uco ARCHITECT $ 5'aa Q FIRE dw ADDRESS }L ii,Ay N_/��RoJheert"ann Plod- ZONE TYPE ' GROUP.�� W Z CONTRAC�ACiyyss�l{y�ny�yp�.niUID$t Inc. APPROVED J 0 ]Li.S�EXA11IlII BY DATE mZ J C ADDRESS 155117 Vant ll ra Al vr1. W Lu TEL. 2 E O.OF USE OF NEWC.. 0_ �_(0 LANS y"BUILDING Z 1— CITY Sherman 0nka . • NO. •.b-4077 3 K - 0 STATE fi. CITY YARDS APPROVED YARDS APPROVED w O LIC. NO. 8991 LIC.NO. MAIN BUILDING ACCESSORY BUILDING SIZE 'NO.OF BLpG$• (FROM C/L STREET) • OF LOT 66.5 X 96.6 NOW ON LOT None FRONT 'SOFT. FT. USE OF // en/ EXISTING BLDG. None R.SIDE S FT.Ce.- FT. I— SIZE OF NO.OF c ZZ NEBLDG. 56 X 59 ROOMS 9 W STORIES 1 L.SIDE J FT.(L tr FT. EXTERIOR WALL ROOF o COVERING Stucco COVERING Rock REAR i FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED CL DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS. BLDGS. CL / /_ !j O a_s-d_ C.UP — ±L APPROVED/0—(o—"'/ N a A"4P t' lC2C-1 S-7C) U P��X Gm/,/ a �"t A / DATE :Nill Z cr�yr tti UI hereby acknowledge that I have read this application and state BOLD FOR SPECfAL RPQ •r`.- ✓ that the above Information Is correct and agree to comply with U-•.etif CC all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of to the State of California. m 2 yf T / / ft Z I hereby certify that I am properly licensed as a contractor under ��tl SO, FT. f (O(C 0 the State of California Business and Professions Code, Division 3. THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from t provisions of the of California Business VALUATION and Professions .de,Division 3, Ch er 9. / ry O PERMIT FEE $ / r 6� D Signature of / mss,/ 7 m Permittee a<zi $ K71I22 PLAN CHECK S .�/ E Authorized Ageneitti 1 7/t ea LL .... TOTAL FEE $