HomeMy WebLinkAbout131 WILSON ST - Building Permits F CITY OF COSTA MESA
4 BUILDING DIVISION
> ;� ..� DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
b. t n.ii
PERMIT
V B03-00542
44'4.o
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.c.a.usLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUIJob Address: 131 E WILSON ST Status: ISSUED
Suite: Applied: 04/02/2003
Vicinity: Issued: 04/02/2003
Parcel Number: 43927128 Zoning:
Applicant: MILLER, DALE ISSUED BY:
Address: 13781 NEWHOPE ST
Phone: (714)534-6398
GARDEN GROVE,CA Zip: 92703
Owner: TSAI, JEN MIEN TR
Address 7 QUIET MOON
Phone:
IRVINE,CA Zip: 92614-5438
Contractor: DALE'S ROOFING
Address: 13781 NEWHOPE ST
Phone: (714)534-6398
GARDEN GROVE,CA
Zip: 92703 License:, 503508
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REMOVE ROCK ROOF AND INSTALL NEW ROCK ROOF ON FLAT AREA. REROOF OVER EXISTING COMP ROOF WITH 20 YEAR FIBERGLASS
SHINGLES. - -
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,500.00
Permit: $97.25 Claim Valuation: $3,500.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
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
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
2448-46(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 provided for by section 3700 of the Labor Code,for the performance of the
wfor which this permit is issued.
I have and will mai i works s'co cation insura ce,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'co ens io I r e c rrier and pol(cd`y numb are:
Carrier: Policy Number:
(This section need not a completed if the pe it/s valued et one hundred dollars($100)or less.)
O I certify that in the performer e of the rk for whic/i permit is issued,I shall not employ any person in any manner so es to become subject to the workers'
compensation laws of C. orn:,an r at if ,fir•uld become subject to the workers'compensation provisions of Section 370 of th Labor Code,I shall forthwith
comply with these provi I•ns. �T /§ /J
Applicant Signature: _ Date: if .2 (J J
WARNING:FAILURE TO SECU' • ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALT S A 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 lice -:. . der)"is'• s of r 9(commencing with Section 7000)of Division 3 of the Business and Professi ns Code,and my license is in full
force and effect.Lic.# r. Class# n
Contractors Signature: �'aMINT Date: � 2
f _j '-7)
a, r.' r
CONSTRUCTION LENDING AGENCY:
O 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).
Lenders Name: Lenders 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 toe 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.).
O 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:
I 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 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 aUermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 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? ❑Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No
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 in pection purposes I :gree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
/
igne re Of". •.-er(s) Iz / Q ate
If 1/ //
r • ...bnz=, Applicant Date
CODE I INSPECTION TYPE PAg INTIRALS CODE I INSPECTION TYPE • MI INT11tAL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final ,rf 208 Final Plumbing
200 Final Re-Roof ''7_V 3 a- 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
• ?�� CITY OF COSTA MESA
n/ �+ BUILDING DIVISION PERMIT NUMBER
r r .I, DEVELOPMENT SERVICES DEPARTMENT
�• PERMIT
B99-00531 '
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 131 E WILSON ST Status: ISSUED
Suite: Applied: 04/19/1999
Vicinity: WHOLE HOUSE Issued: 04/19/1999
Parcel Nunmber: 43927128 Zoning:
Applicant: ALEXSON, TROY ISSUED BY:
Address:
Phone:
Zip:
Owner TSAI, JEN MIEN TR
Address P 0 BOX 19184
Phone:
IRVINE,CA Zip: 92623
Contractor: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AV
Phone: (949)642-7222
COSTA MESA CA
Zip: 92627 License: 349686
Arch : Eng:
Address: Address:
Phone: Phone:
Zip License: Zip: License:
SCOPE OF PERMIT
REROOF-T/O, INSTALL 1 LAYER 30#FELT,USING EXISTING SHEATING&INSTALL 25 YR COMPOSITION SHINGLE
ROOF(1600 SF).
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $3,200.00
Permit: $87.25 Claim Valuation: $3,200.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00 •
Total: $87.75
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)7545626
0 .
DECLARATIONS
l
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
/Fork for which this permit Is Issued.
I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My worrkkee 5'compensation/7� In fence carrier and policy number are:
Carrier: ...C•767, enA9�/!� Policy Number: /30C 9Y R
(This section need not be cortlpleted 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 shell not employ any person in any manner so as to become subject to the workers'
compensation laws• Califor•':, •a•ree t t if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with f -_ • • . G
Applicant Signature: r /A — Date: /7/-19 9 7
WARNING:FAILURE TO SECUR • O', 'S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100.••'.IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
A 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 end effect.Lic.# �� Class x L 19
Contractors Signature: /7rillin.' Date: y—/9-9?
CONSTRUCTION LENDING AGENCY:
/.
El hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Coda).
Lenders Name: Lenders 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 dvil 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 wit 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 drivers license. 0 Yes 0 No Drivers 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,wit 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 Wit 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 Cade 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,ora 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 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 akemit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 8 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 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.
Sf "etureOj}egalOwner(s) /9 9 y
/....y
/.�
And/Or Authorized Applicant Date
CODE A g15PECT(ON TYPE PATE MALI CODE4 INSPECTION TYPE MTh 1NIIILALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final /,� 208 Final Plumbing
�j4q 6
200 Final Re-Roof L' f -L f> 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.
2448-46
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
_ _
CITY OF COSTA MESA CONSTRUCTION PERMIT PEWIT NO. TRACT NO. LOT NO. • UNIT NO. 6F62 7/15/63
2 (9 �„� I5o0' IL
. Project Address 15,5010011-5010 I
Applicant's Mailing Address s�,��.�� .r�S _, •✓Ctt .. .k TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION U REPAIR 1 '
\1141 -5". GV��'-✓y - Phone ❑ CONVERSION 0 DEMOLISH 0 OTHER A.P.# Zone
Owner's NameDESCRIPTION OF WORK/USE OF BLDG.
Address 1' i 0- 14)11. 0 S Main Building: Accessory Building:
Z
Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL E Front 0
Address
0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N
.r {��� ❑OTHER A _ I
Contractor's Nam- ra: Phone 71'x' ' C Right N
Address(mailing) Z4 ag-A.4-4=nt 1ltl• PROJECT DESCRIPTION SQ. FT. OCCUPANCY K. G
�� CONSTRUCTION TYPE VALUATIONS S Left
City License No. �33//aaT7� ZONE GRADI NG CU.YDS. ACRES ..• R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
D
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and .
my license is in full force and effect. •���/ 8 T
License Class / al e No. o S
Date '14' Signatur- MIN PLUMBING FEES •
WORKERS'COMPENSATION DECLA- T aP
Bar Sink Showers ELECTRICAL FEES
J hereby affirm that I have a certificate o consent to self-Insure or a certificate
' Workers' Compensation Insurance, Or a certified copy thereof (Section Backflow Preventer Service Sink -
"800, Lab. C.) Automatic Washer Transformer .0 15-50 KW
Policy No. Company I Backflow Irrigation Sewer Cap 1-fp Construction Pole Sub. 0 50+ KW
Certified copy is hereby furnished.
-Certified copy is filed with the city Building Division. Bathtubs - Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel
1 certify that in the performance of the work •r whic s per• it is Issued, I
shall not employ any person in any mann/o a taro subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8
Workers' Compensation Laws of Californ�
Date ' - 1y- Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar D9-15 HP 01615+
'NOTICE:If,after making this declaration,yo 5,• Id •'come subject to the
Workers' Compensation provisions of the •or Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this pe it shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet • Device Boxes Pole Light
I hereby affirm that there is a Construction lending agency for the performance •
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater ' Outlets Range
Lender's Name
Lender's Address Kitchen Sink. Water Service - Switches Sign
OWNER BUILDER DECLARATION •
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ;Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Tra
any structure, prior to Its issuance, also requires the applicant for such permit p Laundry Trays Generator ❑O-5 KW❑5-15 KW Trash Compactor ,
to file a signed statement that he/she is licensed pursuant to the provisions Of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000)of -
Division 3 of the Business and Professions Code) or that he/she is exempt _ - - - - —
lerefrom and the basis for the alleged exemption. Any violation of Section
•
331.5 by any applicant for a permit subjects the applicant to a Civil '
anally of not more than five hundred dollars($500).
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES -
License Law 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 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 , -Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By • Date
rove for the purpose of sale). _ ///�����^ ,��� (((���
I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat _
tractors to construct the project (Section 7044,Business and Professions Code: f/
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds Or Improves thereon,and who contracts for such projects with a con-
tractors) Ilcense pursuant'to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ _ PERMIT
❑ Lxempu d r. qq `�' B.& P.C/.for this reason Firepl/Fact.BIL ICBG# Fire Dampers PLUMBING $ 'L� ISSUANCE $
Date �— �Ow✓✓ner �g�•-{-� ti-D✓skAV✓ Heating System& Ducting Registers • , PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑0100,000 BTU 0100,000 BTL •
ELECTRICAL $ GRADING $
information is correct. I a• a to comply with all city and county ordinances
and state laws re .tin• o °ding construction and hereby authorize repro- , • PLAN CHECK i 50% $ •
MICROFILM $
sentatives of t..., cit t. nter upon the above-mentioned property fo z
n
inspection pur MECHANICAL $ TOTAL FEE $ S-�O
Signatur- a Date F
Drivers' License or .Sr / , . Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10 84 White - Building; Canary -Applicant; Pink -Accounting;Goldenrod -Assessor
•
CONSTRUCTION AND PLANNING POOI PA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil PipetUndrgrnd. 53. Steel Reinforcement -;
3. Electrical Conduit_Utility-Undrgrnd. 54. Forms -
4.-Electrical Conduit-Undrgrnd. 55. Electrical Bonding -'
5.:SteelReinforcemerit I 56. Rough Plumbing & Pressure Test•
6.;Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. 'Footings .' 1 58. Electrical Conduit-Undrgrnd. i; •.
8: Foundation ' _ am , • 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrndt - 60. Backwash Lines,P-Trap,O Undrgrnd. •
10. Structural Floor System ' 61- APPROVAL TO DECK
•
•
-
11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap i • , 63. Heater & Vent-Final
13. Roof Drains "' 64. Plumbing System - Final . /
14. Rough Plumbing;: 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18.'Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: 6_Y-77�'F,u..,741J4,u7i 4,4
34. Final Heating & Air Conditioning •
---;;9,
'7 rd- ��f A" Jug- fir
35. Final Gas Pipe-Test / G/ iY./ �Y�'
36. Hood or Canopy
37. Final Fa i
r
38. Fi I Plumbing
39. er Servi nal
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
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
1
CITY OF `STA MESA
PAk.. FEES N2 202
Fee Payment Receipt
Project Address /3/ 4'1/SGdr, Park Area
A. P. No. //9 - oil - 027
G
Building Permit No. rap 7
•
Owner's Name gay CS 9tMlban75
Mailing Address 3 9sS Si'ral, 5* NLS
FEE
Single Family * No. of Units @ S455.20 =
Multiple Family ** No. of Units .3 @ 5321.32 = /63. 94.
TotalFee / /p63. pt
Planning Department App ova C to D A a� Byv �"
Applicant's Signature
• City Ordinance 72.44
•• City Ordinance 72-45
••• city Resolution 74-124 I{(,�'�
White-Planning;Canary-Planning;Pink•Finance;Goldenrod-Applicant CMF 0174-26 Ole,(1 , NO
- UUAVGUU W.LL1[tPIJ "^'- 0-1U-10
JOB ADDRESS 131 East Wilson Street BUILDING PERMIT NO. 42471
GENERAL CONTRACTOR Mead FTgp Birk en DESCRIPTION of WORK ilomn RPG
AP No. 119-011-27 LOT TRACT FIRE ZONE VALUE $ 400.0n
Irxk:tsSCTIONS Signature Date TYPE V GROUP i ZONE R-2
et BV':'IYA
SUBCONTRACTOR PERMITS ISSUED
GAS
Date I Number Signature
WATER Plumbing�/
ROUGH PLUMBING rf/p�-1O �4! ak (,„ _l6.,4 6 goy y<
PROP. SWR. LINE n HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER fl
ROUGH WIRING Heating and Vent.
TRENCHES n FORMS fl STEEL REINF. El
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HI G, VENT., REFRIG. AND A.C., FINAL
PL. .ING. FINAL AND GAS TEST n
ELECTRIC. FINAL
BUILDING, FINAL j .0 s.47-7A
SPECIAL REQUIREMENTS
/ "Jr 16 76Pw- �C)t�1199't a+ a15.5O
4247•
i
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
/sr/
REC EIVEj7 BY ATE - )L,RECEIVED TE ISSUED
BUILDING +� E WLLSO N (�J�Jhjtl 1/!�_ 1L/_ 11../6
ADDRESS � �J J e � J
t A.P. NO.�/7-cv/-t�/ 9 l
OWNER f3i,Q,6ass -- WI Lt , I4II45-
MAIL ADIDRE S IC I € L''5115003 ci-
ADDRESS TEL. q
CITY NO j4�_I�T TRACT?QL7 I LOT°LBLOCK
CONSTRUCTION NEW ADD ALTER!REPAIR I MOVING DEMO(ISH
LENDER I //� � • % �
BRANCH OWNER s. KD€% W///,AMi �/ I.
ADDRESS J/n////� rani-
149.,/
ARCHITECT TEL. USS A �i- $ /(Jf/
OR ENGINEER NO
FIRE
ADDRESS ZONE TYPE/ GROUP je
APPROVED Iy
CONTRACTOR MPAD NSL1 WIZKG. Co . BY DATE//k/7
ADDRESS 2 gy55,6 az Gen en AJDE, ST. ZONE NO.OF� USE OF
ty--� �+y-�s� �t TEL. PLANS BUILDING
F I CITY I e JI--)f.�EIin 64 . N°'7%-4051 ��Z
STATE • CITV / / / YARDS APPROVED YARDS APPROVED
gLIC.NO.500595 - C a/ LIC.N0e��6� MAIN BUILDING ACCESSORY BUILDING
izI SIZE 1J- NO.OF BLDGS. (FROM C/L STREET)
O. OF LOT NOW ON LOT I FRONT
/� FT. FT.
a USE OF / /EN {}s� 4 j-/iJ
ch EXISTING BLDG. e's (o GIV C . 9.S kY. FT.
Cl)
FSeparate permits are required for L.SIDE FT. FT.
G electric,plumbing and heating work. REAR FT. FT. /- `
F- OF BUILDING AND WOR Opgc�p�ERFORMED DISTANCE BET. BET.MAIN& --
CI •/I MOI -i T I 0 AJ li...Jo _MAIN BLDGS. ACCESS. BLDGS.
VAR.# DATE
-� C.V.P.# APPROVED> 114
7�
> RYP61)4 DATFO ( 76
CC
RI
O0 I hereby acknowledge that I have read this application and state
N
SC that the above information is correct and agree to comply with N.
0• all laws regulating building construction, and I shall not employ m
Z any person in violation of the workman's compensation laws of 2
the State of California. m
z I hereby certify that I am properly licensed as a contractor under SQ. FT. cm
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR os
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business co
and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE $ . 0"0 J,
m
Signature of Qfie PLAN CHECK S '^
0
Permittee LP•-V.
. 9-.4 $644e, u.
TAX $ 2
`,e U
Authorized Agent TOTAL PAID S „6
' et JP 'I" —3-7H-."'
t nQ 129 ` *** 185.11-1
^ �
42077
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A'PL 'A ION FOR STRUCTURAL PERMIT
For ApplicantgFill in Completely— Use Ink Only
RE El ` D 'Y D TE RE E EO
ADDRESS BUILDING IIJN/ _ i~ A. —� Lo•2.— �•�
er 4., ` ._,z.�, �� A.P. NO. '—01)l-- - I PERMIT NO.
• v �I!
MAIL
ADDRESS n .^5
5- TEL. FMEM' QT _MEM II
' CITY JEW?e /rb NO. /
MIPrliMPI
CONSTRUCTION/ LOS BANK •• �t+s'+u • •..•
• LENDER L I7� /'V{�
BRANCH 111P,11.11.
A• aa-� VALUE / ��t�
r OM _prueiro TELI_.I�Ar. US-30017Arl 1 Ara_ $ `/ IT°
.R ENGINEE s �sNO.tUct'I�LI�
ADDRESS coo N .N t I.cdp. r{'� i • • . -ni
APPROVE. ,"
CONTRACTOR 07 BY �� DATE r -
ADDRESS
TEL. Z 40 NO.OF ^ USE OF W
CITY NO. _ PLANS 2 BUILDIN rC I J �i •
l••• STATE CITY ' YARDS APPROVED YARDS APPROVED O
• LIC. NO. / LIC. NO. MAIN BUILDING ACCESSORY BUILDING'
(FROM
�• OF LOT �jI�J X (� .lQ y INOW ON LINO.OF T ' FRONT Cl FFTJO tI cZ a. GC/1•{S Q�
USE OF
• EXISTING BLDG. %� '��QQtl R.SIDE 57T. FT.
rn ��
FSeparate permits are required for L.SIDE 5;7 FT.
electric,plumbing and heating work.6. REAR /--.21c.�. rT. FT.
RAUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
0 GS
MAIN BLDGS. ACCESS.CLO .
VAR. DATE
" 3 naOtN& 0 C.U.P.dAPPROVED VED
2-aa- enArcaP9 APPROVE
�J
T
f
La ( PKI LREQUIREMENT.
La
Q I hereby acknowledge that I have read this application and state N
n
to that the above information Is correct and agree to comply with e
A• all laws regulating building construction, end I shall not employ co i:
Z any person in violation of the workman's compensation laws of m
fel• the State of California. A 2 ��
I hereby certify that I am properly licensed as a contractor under 347 JSD. FT. -• 121 CT
the State of C •rnia Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, a •y.t such licenses a in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt f •m t . pro islons oft State of California Business
1 VALUATION PERMIT FEE 5 0
' and Professi• Co•: •'vision 3, ter 9, m
m
O�tt I� .�'�,�tt���I I PLAN CHECK $ I -7 ^
Perneture of / )/�/I/I � A - [/�j� 17� ) o
-j Permittee 1U/WW�V�� �J_ v//���� $ '9 SOD TAX $ .6-37
LL
/� Sap f
Authorized AgentU
TOTAL PAID y , , I
i
'f
e
1::‘
- L 42 077 'n^ —3-7FP;,1000 270 Yrs,.-°275.('O
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 II�
APP ICr TION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
�''^ \) REGI I ED Y DATE RECEIVED D TE ISSUED
G
ABDDA ESS I3J WI LSOI�I. VT �- �^�
11:71)RCaESS WILl.6AM bc—
PERMIT NO.
OWNER A.P. NO. ^/, 1 ' '
MAIL
ADDRE S 131 UM Ls oki tar
ADDRESS
TEL.
CITY NO. TRACT l LOT BLOCK
CONSTRUCTION NF`W ADO ALTER I REPAIR MOVING nEMOLISH
LENDER MESS
t, 1
BRANCH OWNER M1 ESS ,�I LI.t-AM 11.1 r- r
ADDRESS 2 �/ ? /y� (y VALUE f 0
ARCHITECT TEL. USE " 1 FINI1 A/1 i &AC $ '
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS
TEL. ZONE INO.OF USE OF NEW
CITY NO.
PLANS BUILDING
F STATE CITY YARDS APPROVED YARDS APPROVED
5 LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
b.1 SIZE NO.OF BLDGS. (FROM C/L STREET)
p. OF LOT I NOW ON LOT FRONT FT. FT.
Q USE OF
in EXISTING BLDG. Ft—SIDE FT. FT.
V)
F Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work. �
Ci REAR FT. FT. I
(.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& -__-/
-'d
MAIN BLDGS. ACCESS.BLDGS.
VAR.# DATE
— C.U.P.# APPROVED
> APPROVED
> —B_Y DATE
IY
Le
o I hereby acknowledge that I have read this application and state r
n
Cd that the above information Is correct and agree to comply with
am
all laws regulating building construction, end I shall not employ
Z any person in violation of the workman's compensation laws of o
Lu the State of California. m
I hereby certify that I am properly licensed as a contractor under SO. FT. 91
the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR to
Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; n
am exempt from the provisions of the State of California BusinessVALUATION PERMIT FEE o
and Professions Code,Division 3,Chapter 9. ��— JL
PLAN CHECK $ n
Signature ofc
e.
Permittee $ TAX $ 2
e.
�1fro U
Authorized Agent TOTAL PAID s / 7 /