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HomeMy WebLinkAbout3129 KERRY LN - Building Permits CITY OF COSTA MESA -..�:,:ai'.ui;•->:` 40-01Mts. BUILDING DIVISION ao yet ( e77 FAIR DRIVE, COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us e. FOR INSPECTIONS CALL:(714)754-5626 • R°"" °" PERMIT NUMBER: B10-00347 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 14163211 DATE ISSUED: 11/15/2010 ISSUED BY: CAC JOB ADDRESS: 3129 KERRY LN CM • Suite/Unit: Vicinity: GARAGE Squares: 0 Valuation: $900.00 • SCOPE OF WORK: TEAR OFF THE EXIST. BUR.ROOF OVER THE GARAGE ----'-' -"- -- AND INSTALL BUR. ' OWNER: BELLO,YELOTZI Address: 3129 KERRY LN PHONE: 714-557-2349 City/State/Zip: COSTA MESA,CA APPLICANT: BELLO,YELOTZI Address: 3129 KERRY LN Unit: PHONE: 714.557-2349 City/State/Zip: COSTA MESA,CA 0 0 ej 47 CONTRACTOR: OWNER-BUILDER License No. 000000 Address: Unit: PHONE: City/State/Zip: CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. • PHONE: • FEE SUMMARY • Reroof Plan Check: $0:00 Reroof Permit Fee: $35.70 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 :'v17c- TOTAL FEES $36.70 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 unix : -;: Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day .--10L).;.04./ 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. CODE O. INSPECTION TYPE DATE INTITIALS CODE INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �7 '�^ 208 Final Plumbing 20 0 Final Re-Roof )4 /2. LIQ 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention '202 Final Factory Fire Place • 220 Final Planning Approval a ,;•:r-.�.,�=:;,i h ..I7 a::<I 203 Final Sign ' 222 • Final Site t`. -_ __..i 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified.by driv cense. ©Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Drivvei s-bicense No. E_pires:' 0 S ❑ 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): compynsation, as provided for by section 3700-of,the Laboi Code, for the performance of the work for which this permit is (1:1,1 I have and wilPmaintain 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\worker'compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,a demolition Ca 17\ or dismantling thereof,will be more than thirty-six(36)feet high. (Chap. 3.2,Grp (This section need riot be completed\nous valued at one hundred dollars($700)orless) 2,Art 2,Sec.341,Title 8,Califomia Administrative Code). Policy-Number/ ❑ 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/1 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 subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date dire Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicants Signature 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 0 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? ❑Yes ❑No Lic.4 Class 4 (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 contractor's Signature Date 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 0 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 Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑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? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the that he or she is licensed pursuant to the provisions of the Contractors permits).requested 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? 0 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�undred dollars($500).): of the California Health and Safety Code). G❑11,-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 0 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 O 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 pur oses. I agree not to ocoppy o allow occupa cy of any building arrt d b,�histy�rnal inlp4cti �� (,i Sig elu a LegaLU+merlst'- Date. tig ature :Date 3057-46(3I07) And/or Authorized Applicant Date I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable fof any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. O. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand • th t I am the party legally and financially responsible for proposed construction activity at the following address: C vp)1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will ab6ie by all applicable laws and requirements that govern Owner-Builders as well as employers. C• 2. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the infoYmation I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. l Signature of property owne(p T t no y, i obi P e I (y Date: /1/ /6 / / (J Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verifythe property owner's sign�t� / �/� Property Owner's Signature: ��YJJ� >iill, /a� 7 Ai Date: ////r J/O 3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2 • • • Cit of Costa ,Mesa Buiwing Division Costa Mesa 77 Fair Drive, Costa Mesa, CA 92626 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit # Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. C\ 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- uilder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. I understand building permits are not required to be signed by property owners unless they are re ponsible for the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I ay protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. I understand Contractors are required by law to be licensed and bonded in California and to list their li nse numbers on permits and contracts. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, a d the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. I understand if I am considered an "employer" under state and federal law, I must register with the state a federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family r idential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 ':1n ITCT ADDRESS: 3129 KERRY LN ' UNIT: CITY OF COSTA MESA — BUILDING PERMIT PEKfv, NU; U (n244 titNER'S YOST, LORRAINE .R" ADDRESS: 3129 KERRY LN PERMIT NO: B 059244 PLAN CHECK NO: N LA/vs ; N 5ver: a . COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT. REROOF W/COMP SQ FT: 4 , 950 ADDRESS: UNIT: CLAIM VALUE: 4 , 950 . 00 CALC—VALUE: 4, 950. 00 GROUP OCC; R-3 / PERMITTEE: WILLIAMS ROOFING ( 714 ) 734-5046 ADDRESS: 3141 BRONCO LANE COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME NORCO CA 91760 #########********M***********************#***************#*#******************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)0l Division 3 of the Business and Professions Code.and my license is in full force and effect, SETBACKS CITY LIC.: 057066 STATE LIC.: 303855 CLASS: C3 • e4 t' 7 1- Signature:_ _ MAIN BUILDING ACCESSORY EAR:BUILDING �� FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN Compensation Insurance,or DECLARATION:ied I hereby Sieof(Seciio that I certificate of consent to selfinsure oracenificate of Workers' LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN Compensation Insurance,or a certified copy thereof(Section 3600, ab.C). POLICY NO.: EXP.DATE: PARKING REQ• PROV: PARCEL: 14163211 ZNE; REF NO: COMPANY: PLANNING N TES> ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. > Date: Applicant: ********************************#*****#****#*****#******************i2********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($10p)or less). DEVELOPMENT SERVICES R E Q U I k E N. E N t'f' $ I certily 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. a/.26,4, ZONING APPROVED BY DATE: •.le: fr/L�/fj Z' Signature BUILDING APPROVED BY : DATE; NOT E:IL afte along this declaration,you shout became sub' o the Workers'Compensation provisions of the Labor p Code,you must forthwith comply with such provisions or this it shall be deemed revoked. _7 V - i7 /"/J �� 7 CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE which thispermit is issued(Section 3097,Civ.C). ************************** ********* ******* -*******frit************ - ** LENDER: ***************************BE********** ****** . ************************#******#* ADDRESS: LEGALIZATION:N F E E SU VARY STRUCTURAL. SEGMENT; Y OWNER BUILDER DECLARATION: I hereby affirm that I 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 72 , 00 50' repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/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 ISSUE FEE applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS � 72 . 50 0 . 00 0 , 00 72. 50 72 . 50 • . , 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State 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 employees,provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED: 72 , 50 OVER/SHORT• 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). 72 , 00 . 50 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business . ❑ and Professions Code: TheContractors'State License Law does not apply to an owner of property who builds or improves thereon *#*#**#*#***#* *#**#***#**#*#************###*************#*****#*#**r**#**ii-##**# and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAKDOWN - ❑ I am exempt under Section: B. 8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 4950 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 ( 4 , 950 . 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 i 25534 and that I or any future building occupant willwill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from 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 t0 building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. ideeZie /— y.ar Signature: r Drivers"License r Social Security N: "C=: -'1 _ - 4�!I•i7. _ . r , 1641-46 White—Budding',Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor SO r`�eONSTRUCTION AND PLANNING POOL & SPA "?>PPROVALS Permit# - Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • • - 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property 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. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas 0 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 t ! 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , `/,. 79. FINAL INSPECTION 32. Electrical Power Meter-Final i ! a 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning j !� .1 35. Final Gas Pipe-Test 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 I 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING x_10_12 6w41 - 54c,e Ac °eel: 48. FINAL PLANNING L L� 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ` r 51. CERTIFICATE OF OCCUPANCY No. Date OWNER HARBOR HALL OF FAME HOMES INC DATENOV 3 0 1962 JOB ADDRESS 3129 Kerry Lane - - BUILDING PERMIT NO. . 18306 GENERAL CONTRACTOR Lifetime Residential Bldg. Corp. VALUE $ 12"890.00 AP No. LOT 56 TRACT 4356 FIRE ZONE DESCRIPTION OF WORk Res/Att.Gar. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-1 S *QS /y.IS/.ez PERMITS ISSUED / Jc .& SUBCONTRACTOR -L DATE NUMBER Water 2"..-14.00IJJO'GA Rough Corn. Refrig. 0 Air Cond. 0 _ Rough Heating Lu/ 2-/S'C.3 _ ! - e. —.l. _ -&}1A.�,3 Rough Plumbing _JW/lfJ lear. r'n , .�G_/2: - 17- 1/497.2o- Miscellaneous Prop.Swr.Linev House Con. 0 St.Swr. EL LWore71,14.4,4a-St 2-2/-o3 _31,3117_ /1 VV� fvy1' Sprinkling System 7 onstruction Pole eit.w (g /f-219-4t " e � jg2. //-a 7-G7�_ 412'N - Underground 0 Power 5 Rough Wiring 44X-11-13 ,MG.0.6.S.,AF !-7j las X9 a Trenches Lh- Forms Er Steel Reinf. .1/.9.-p-62 Floor System R /9..-.30-6.--- Bond Beam 0 Steel Reinforce ❑ Sheathing reer,� .'t,-//f-( Frame and Flashing 0,4{63Lathing — In VOut Com' W g-7'-( Plaster, brown coat 4-//-03 Refrig. 0 Air Cond. 0 Final T,,ng, Final —,._ C `%bing Fixtures, Final li_�f7 Final Gas Test' r j# -�/ �U�� Electric Fixtures, FinalIffi 1 17 Building, Final �ly�.V 7 i/j`413' OCCUPANCY FORM 6U4-5M — 7-61 _ 18306 •• 18306 Lot 56, Tract 43 , laIRI8fIVED COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA. CALIFORNIA NOV 3 1962. For Applicant to Fill In Completely IRT DEPT. PP P Y APPLICATION FO61p�EMICOSTA MESA TYPE OR PRINT BUILDING BUILDING 3i a 9 Merry 4„„C ADDRESS COSTA MESA. CALIFORNIA For Office Use Only Harbor Hall of Fame Homes Inc. 1 RECEIPT NO. I PERM{T.4 L` a. OWNER (!/ ]Af •"95 MAIL P.O. �Ci Box 2066 RECEIVeY one RSCHIV6-D_ ,,, DATE ISSUED ADDRESS I /[ a7�'-C/ 7- "ai J (1 CITY Santa Ana N -I 9-2204 BUILDING ^11^ ADDRESS ARCHITECT OR ENGINEER NO.Jamison TEL.544-0040 COSTA MESA. CALIFORNIA /) ADDRESS 225 "D" St. , Tustin FIRE 1/ ZONE TYPE GROU CONTRACTOR Lifetime Residential Bldg COrrAPPROVEDBY DATE ADDRESS 2131 So. Artesia St. ZONING �0J2 ZONE NO.OF USE OF NEW re s — s CITY Santa Ana O ^,. ,/,AN I I PLANS 7..----.-BUILDING w/�. fr, STATE 208676 TEL. KI 9-2204 LEGAL v/1 ^�--�-� GcN(/ LIC.NO. NO. DESCRIPTION „4 �/ / (/�1 11,� SIZE � 6000' I NO. OF BUDGE. 0 J OF LOT NOW ON LOT A.P.NO. USE OFNone YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE FROM , • (CENTER UNE ST.) CENTER OF STREET SO REAR YARD S0, FRONT t0 FT. --- IN. SIDE YARD I LEFT 9' I RIGHT 91 9 R.SIDE FT. —' IN. DESCRIPTION OF WORK _� IN. L.SIDE FT. NEW I FII ALTERATION I II ADDITION I REAR 3ti`r—FT. IN. REPAIR I V MOVING I II DEMOLISH I BYPROVED YY. / C DATE /U -20"--6.2. BUILDING 1185 NO. OF ROOMS 7 STORIES 1 SIZE COVERING ERIOR WALI-Plasterl COVERING ROOF Shake USE OF BUILDING A WORK BE PERFORMED Singe family residence i/i/d.-(ir - c0- i/G9°11-- yes a., I HEREBY ACKNOWLEDGE^-HAT I HAVE READ THIS APPLICATION THE AMOUNT SHOW NDER VALUATION IS FOR THE ANO STATE THAT THE AB B IS CO AND AG TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY CES D LAWS GULATING BUILDING PERMITTEONGTRU• I- . VALUATION SIGNATURE •tv.'al Jtic �J�) PERMIT FEE $ ypZ 'L $ /d 7 ✓ PLAN CHECK $ 4//Y = AUTHORIZED AGENT \ TOTAL FEE $ ,C 2