HomeMy WebLinkAbout140 YORKTOWN LN - Building Permits 9 CITY OF COSTA MESA
4Illt. BUILDING DIVISION
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'. • PERMIT
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B02-01252 kb 0
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 140 YORKTOWN LN Status: ISSUED
Suite: Applied: 08/12/2002
Vicinity: Issued: 08/12/2002
Parcel Number: TPN98078 Zoning:
Applicant: BLANKS, JERRY ISSUED BY:
Address: 6351 SAN ROLANDO CIR - ' •" ' - ' - -
•Phone: 714-745-9829
BUENA PARK,.CA ' Zip: 90620
Owner MONTICELLO COMMUNITY ASSOC.
Address /150 yALLEY FORGE _ - :
i . _ Phone: -
' "COSTA MESA,CA - - - Zip: 92626 , -
Contractor: 'PREMIER ROOFING AND BUILDING CO INC . ,
Address: 17501 NORWOOD PARK PL ,
Phone: - (714)573-0155
TUSTIN,CA
Zip: 92780 • License:-, 634404 _
Arch : Eng: •
Address: _ Address: -
Phone: - Phone:
'Zip: - License: License:
SCOPE OF PERMIT
ROOF WITH BUR ROOFING. MULTI-UNIT CONDOMINIUM BUILDING:INCLUDES 108 THROUGH 148 YORKTOWN LANE.
FEE SUMMARY -
Plan Check: $0.00 Calc Valuation: $14,322.00
Permit: $251.25 - - Claim Valuation: $14,322.00
SMIP Res: $1.43
SMIP Corn: $0.00
Other: $0.00 -
Inspection: $0.00
' Total: $252.68 -
PLANNING &ZONING '
SETBACKS.v ,
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)7545626
2446.46(6/00)
DECLARATIONS
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 ovided 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 bor CMP,for the performance of the work for which this permit Is Issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
•
O I certify that in the perform- ce of the work for which ' ermit is issued,I shall not employ any person in any manner so as to b come subject to the workers'
compensation laws of Ca'ornia,and agree that if I uld become subject to the workers compensation provisions of Section 3 0 of the bor Code,I shall forthwith
comply with these pro°2 ons. n
Applicant Signature: V� Date: (2(D 2_
WARNING:FAILURE TO SEHAL
RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND IVIL 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 em licensed un.'r provisions of Chapt. commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
�
force and effect.Lie.0 iClass k
ii
Contractor's Signature: III✓ Date:
r'
CONSTRUCTION LENDING•GENCY:
❑ 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).):
O 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.).
O 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. ❑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 et 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? 0 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 i pection purposes.I agree n• to occupy or allow occupancy of any building authorized by this permit until final inspection.
411/ 111
//�I •nd/Or Authorized Applicant Date
CODE If A Jl" l' ME INT ALS CODE If INSPECTION TYPE DISE WITRALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final � 208 Final Plumbing
p 2
200 Final Re-Roof 7 '(-/`ce `.4^ �" 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
1 PROJECT ADDRESS: 140 YORKTOWN LN UNIT CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069637
OWNER'SNAME: DIX ELIZABETH C TR
ADDRESS: 20761 HOPETOWN LN PERMIT NO; B 069637 PLAN CHECK NO; N GOVT: N SUPP ; N
( HUNTINGTON BEACH,CA 92646
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : TIO RESTH & REROOF W/COPM & HOT MOP SQ FT: 2, 508
ADDRESS: UNIT:
CLAIM VALUE; 2, 508 , 00 CALC—VALUE: 2, 508 . 00 GROUP OCC ; R-1 /
PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775
ADDRESS: P 0 BOX 4309 COMMENTS : REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. REQUIRED
DOWNEY CA 90241 ******+r*******BH****Fr*Br********+r********+r** ****Be*******Br+E*****Be Sr***************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIR EMENTS
70001 of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS
CITYLIC1.:F-�059377 TATE MC.: 402536 sS• CC 39 EXP; 10/95
Date:JC2 Signature. MAIN BUILDING ACCESSORY BUILDING
wORNERs'C6MPEN5 TION DECLARATION: thereby affirm that have acenifiwte of consent to self-insure oracenificale of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation 1psgWdge2dr a.pedlged copy thereof(Section 3800.Lab.W.5/19/9 5 LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: 7 O L G 7 7 EXP.DATE:
COMPANY: Of
PARKING REQ: PROV: PARCEL; 41916257 INE: REF NO:
❑ Certified copy is h.thy tarnished. Lf Certified copy is led with the city Building Division, PLANNING NOTES>
>
•
Date: a.
Applicant: t
EXEMPTION ERIN WOR EBS'COMPENSATION DECLARATION: (This section need not be completed if Me permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U T A E M E N' T S
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. ZONING APPROVED BY DATE;
Date: Signature: BUILDING APPROVED BY
NOTICE:If.atter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: • DATE; C
which this permit is issued(Section 3097.Civ.C). **************************** * ****************************.**.****; ;F;' **� *
LENDER: **************************** **************************************** * ****
ADDRESS: LEGALIZATION:N E E SUMMARY STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that l 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 54 . 00 , 50
repair any structure.prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/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). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT 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----> 54 50 0 , 00 0 , 00 54 50 54 5 0 00
does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT; , 00
fm theepurpoda
s of ft.
is sold withinone year al completion,the owner will have the burden of proving he/she did not build or improve
or the mentBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
i
I.as owner at the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 O 0 5 O
❑ and Professions Code: The Contractors'Statelkenselaw does t apply tan hCortfctors'y who censor improves thereon
and who contracts for such projects with a s)license pursuant to the Contractors State License Law). 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.8 P.C.
lor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date.• Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 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 2, 508 . 00
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 Iron the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and herebyaut:orae representatives of this city to enter upon the above-mentioned DA 00170/22/94170667 TOT 54.50
property for inspecno urposes, DATE: ±Q/?g/94 T1ME: 7
%/Dri �/��/7 13:_4
Date'.I 67 Signature. P2/1".1----
Driver's
ver's License or Social Security e:
164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL PA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or-Pole 52.,Pool & Equipment Location
I
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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8.:foundation 59. Gas Pipe, D Undrgrnd., Test
•
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System • 61. APPROVAL TO DECK
11. Pioperty 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#
21.1Ducts, in Structure • 70. Underground HyfIro
22. Ducts, Ventilating 71. Product Piping 0 Gas D'Oil
23.,Gas Pip&Rough &'Test '72. Underground Flush, ,
24.,Roof Framing 1 : `: �73r'Undergrnd..StorageTank OGas OOil
25. Roof Sheathing `z,-7'-qY tc ' r74.-,Overhead Hydro:' '
26.iT-Bar Ceiling (Strueturall &Monocoat i' 75. Dry Chemical '
27.•Frame and Flashing _ , . . 76. Dry Standpipe , -
•
28.'Lathing& Siding- , • . :. 77. FIXED SYSTEM FINAL
29. Insulation 78,-FIRE PREY. FINAL
30. Drywall NailingHEALTH•DEPT. REQUIREMENT
.1
31. Plaster Brown Coat .79. FINAL INSPECTION .
32. Electrical Power Meter-Final •• i 80.- FOOD CERTIFICATE ISSUED
33. Final Electric • . ' r Notes: '
•
34. Final Heating.& Air Conditioning
35. 'Final Gas Pipe-Testi '
36. Hood or Canopy
37. Final Factory Fireplace . - '
38. Final Plumbing . '
39. Water Service-Final
40. Gas Service-Final •
41. Solar Domestic-Final ,
42. Backflow Preventer .
43. Backflow Irrigation- . .'
44. Landscape Irrigation System . • `
45. Sound Attenuation ',:
'46. Handicap Regulations • - -
47. FINAL STRUCTURE & BUILDING &lq S ‘wp- . • i '
48, FINAL PLANNING. - ' I ,
.
49. Electric Release to Edison - ' '
50. Gas Release to Southern California Gas Co -- ' . _ ..
51. CERTIFICATE OF OCCUPANCY •
No. Date
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ` '
CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. \ O 1 D . --- . , •
CONSTRUCTION PERMIT /� Si ,RV
/Uor D - .. : '
Project Address 140 Yorktown, CM TYPE OF CONSTRUCTION I I. / .
Owner Sydney & '�' iz N X Phone 0 NEW 0 ADD 0 ALTERATION Cr'J J
,f
Address 10302 Meredith. Huntin 0 REPAIR 0 CONVERSION ❑DEMOLISH " —
Arch/Eng. License No.tQ5.7 1❑ OTHER ZONING REGULATIONS Ti
DESCRIPTION OF WORK e �O \ vc A.P.vjt .
Address - •`
C\//�� ZONE PLNG. REF.+q
Contractor Phone c ,' 7IPE OF PERMIT To gL� �p
�a. 4• ��cFin L �Z 3 •SETBACKC/LST. PROPEIRTVNL NE
Address .� ,. , 31""S1 • 4l1uDoott i3-C&C1^ 0 GRADING 0 FOUNDATION 0 STRUCTURAL 0 $IDFFj,YARD
(((tLICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICAL/ LSS IEYAW.)DE VAH
U '
I rnencing with section 7000) of Division 3 of the Business and 0 OTHER Lief C)('1cS
ll Professions Code, • my license is I full orce and, �effecctt. REAR YARD(TO P/L)
J" 0 73k2.. (4PROJECT DESCRIPTION
License C ass gyp ca. a No L PKG.SPACE REQ. PROVIDED.
Date — - Signature Seir Sq. FT. L"L�� I- ,
WORKERS'COMPENSATION DEC RATION OCCUPANCY /-� CONSTRUCTION TYPE STREET WIDTH _ PARK FEE S
I hereby affirm that I have a certificate of consent to self-Insure or a �O ZONING APPROVED BY - DATE '
4J�
certificate of Workers' Compensation Insurance, or a Certified copy VALUATION ZONE
thereof(Seglq�tp,La C.�mpanY 5+o-ft fwd- GRADING CU. YDS. ACRES SPECIAL CONDITIONS:
^.y No.-f' 1155/1lLJJ •• -
ertifiedcopyisherebyfurnished. REMARKS: ✓e /cin.Oc - ' -
y.,Certified copy is filed with the city Building Division. '`sl -
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - • - • . - •- - .
(This section need not be completed if the permit is for one hundred .
($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 PLUMBING, PLAN CHECK ELECTRICAL PLAN CHECK' '
subject to the Workers'Compensation Laws Of California. -
BATHTUBS SHOWERS UWtLLiNb (,MkMIa .
Date Signature SQ FT. SO FT
NOTICE: If after making this declaration, you should become subject TOILETS . URINALS GENERATOR 0-1 KW�1-10 KW •
to the Workers' Compensation provisions of the Labor Code,you must • TRANSFORMER - '
forthwith comply with such provisions or this permit shall be deemed LAVATORIES •DOUBLE LAYS APPLIANCE 10-50 KW 56+ KW
revoked. '
CONSTRUCTION LENDING AGENCY KIT.SINKS' DISHWASHERS MOTORS 0-1 HP_1-10 HP '
I hereby affirm that there IS a construstlOn lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP_50+ HP
formance of the work for which this permit is issued (Section 3097 .
Civ. C.). - - FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES
I Lender's Name
( Lender's'Address DRINKING FOUNTAINS GAS TUBE SIGNS '
OWNER BUILDER DECLARATION- 'CLARIFIERS POLE LIGHTS - '
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUN I RUL i JUN
Any city or county which requires a permit to construct, alter, POLES METERED SUB _
improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB •
quires the ap,licant for such permit to file a signed statement that he
Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE •
" AMP
(Chapter 9 (Commencing with Section 7000) of Division 3 of the •
Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT
q = for the alleged exemption. Any violation of Section 7031.5 by _ '
a
:T E.'_ypplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - - '
"t more than five hundred dollars ($500). • .
Li`9, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - T
sole compensation, will do the work, and the structure Is not intended 1
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE
Contractor's License Law does not apply to an owner of a property - '
who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE
through his own employees, provided that such improvements are not
Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK
is sold within one year of completion, the owner will have the burden SUMMARY OF FEES
of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING _ ••S Q
❑ I, as owner of the property, am exclusively contracting with AND DUCTING PERMIT $ �� $MIP E '
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 BTU PLUMBING $
tracts from such projects with a contractor(s) licesned pursuant to SYSTEM -GRADING - $
the Contractor's License Law). 100,000 +BTU PLAN CHECK $
❑ I am exempt under Section B.& P.C.for this -BOILERS BTU ELECTRICAL E - ' $
reason MICROFILM S
PLAN CHECK E
SYSTEM REPAIR,ALTERATION
Date Owner TOTAL FEE$
I hereby certify that I • r. 1this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL S
AD-
information is •rr ,/I :gr4e to comply with all city and county PLAN CHECK $ LESS E P
f 3 VANCE PCS_
repordres eta iv.an- o ) Sting to t construction,t end hereby authorize
b
property
f' O - • rty to enter upon the above mentioned
L I .-• „iixs /
Signature• -� --
ISSUE FEE -
CMF 086 -46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING ' cPOOL&SPA
APPROVALS Permit# r)z),-).41 Date Inspector APPROVALS Permit# Date Insp)ictor -'
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil Pipe-Undrgrn 44. Steel Reinforcement-
3. Electrical Conduit Utility-Undrgrh . 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-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test
9. Water Pipe-Undrgrn 51. Backwash Lines.P-Trap. ❑Undr-grn ' '
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-Wiring 57. Solar System-Final
16. Rough Heating& Air Conditioning • 58. Fencing&Access Approval
17. Ducts, in Structure 59. APPROVED FOR.PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathing
22. Frame and Flashing • NOTES:
23. Insulation
24. Lathing& Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test
31. Final Plumbing
32. Water Service-Final
33. Gas Service-Final
34. Solar Domestic-Final
35. Landscape Sprinkling System
36. Sound Attenuation
37. Handicap Regulations
38. FINAL 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
27800 IDOv 13-67 SA00 544* ****58.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620 - .
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
—euILDINa / (/ A1^ ., _ For ONke Use Only
ADDRESS I r0 /�I�Lto
RECEIPT NO. CILIA!!NO
COSTA Al A. CALIFORNIA oC ye 0
RECEIV zt, DATR=[C{LV: ; ip(¢H .5. 6G7
OWNER San Vis to Bldg. Co. �� //[!/� cj( VT 1 i/ 1-A�I
MAIL BUILDING
ADDRESS 2249 Wanderer Drive ADDRKIil '/
San Pedro NOL833-3320 ZONA TYPE {� GROUP • pit--
CITY
APPROVED
r ARENGINEER Clif Olsten 923-1221 BY' DATE -
II ZONING /•
„0DRESe9025/ E. Florencet Downey
TONE/ NO.OF2 USE OF NHW y�/ .
ZONE,/
PLANS I SUILDINO C/ 1 -
CONTRACTOR Same -
LEGAL kainet 4(t¢4� g/ G0 V
ADDRESS Same Dn[DCRIRION
CITY Same A.P.NO. I l
IJ--7UI -3
TEL. SO'
NO SAVE OVERHANG SHALL BE LESS THAN
SIC.STATE NO. SO'TO SIDE&REAR e.4
NES
SIZE J� NOWO ONTE. ALLOWED (U.B.C.REQUIREMENT)
OPLOT 4oL70+-22K._ I ON LOT
YARDS APPROVED YARDS APPROVED
USE-OF- - MAIN BUILDING I ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET)
SETBACN-bNHPROM FRONT 0 le{, FT.
CENTER OP STREET REAR YARD
SIDE YARD LEFT RIGHT R.SIDE 0 Fr, Fr.
DESCRIPTION OF WORK LSIDE 0 PT. FT.
�
' F
-
ALTERATION_ ADDITION REAR I/ PT. T. z
DISTANCE BET. BET.MAIN& ILI
REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.BLDOS.
BUILDING y�NO.OF VAR.3T `/ DATE / /9 / cd
SIZE 4T1 X2af2 K4 OOMS t STORIES ' C.U-P.#p i V / APPROVED b (j -b. D
EXTERIORTrAI4._ ROOF A/r���� AFPRO I a
COVERING lI )4{�L{*./tO COVERING SY [ DATE j J 3 ���� LYL•J
USE OF EDI Icc4 /O/NI(YO BE PERFORMED�• ••
_ a.
G
L cL}(J,3�^ X r iAL+n (A//CLL! /3) o . ; TU
P 5.3."
/ /
I HEREBY ACRNO.i DOE THAT.' NAVE READ THIS APPLICATION THE AMOUNT N MH UNDER VALUATION lS FOR Tia
O 1x
ANS STATE TH ABOVE.1D CORRECT AND AGREE TO COM- PURPOSE OF ASLISHINO A PERMIT FEE ONLY.
PLY WITH ALL CITY •-•TRANCES AND STATE LAWS REGULATING U.
SUILDINO CON-- UCTI•N. VALUATION 39 -
SIGNATURE OF PERMIT FEE S �7 / E j
PERMITTEr �� -�
Y /0/43 /,7l �
� PLAN CHECK S /��`'TO IT. g
AUTHORIZED GE '
.r. _ .,:• - .- -. TOTAL FEE 5 157.501