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HomeMy WebLinkAbout3007 KILLYBROOKE LN - Building Permits 501 S CITY OF COSTA MESA • Aill ) ° BUILDING DIVISION Ari-_ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT J Roo P01-00453 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 3007 KILLYBROOKE LN Status: ISSUED Suite No Applied: 07/25/2001 Issued: 07/25/2001 Vicinity: ISSUED BY: Parcel Nunmber: 14116211 Applicant: ERNST, JEFF Address: 14132 HEREFORD ST ' Phone: 714-890=3886 WESTMINER,CAST Zip: 92663 09 111•• I Owner: WILLIAMS, KENNETH TR �r1'�.s' Address 18342 CHURCHILL AVE Cir - Phone: ci VILLA PARK, CA Zip: 92861 Contractor: QUICK SILVER PLUMBING Address: 14132 HEREFORD ST Phone: 714-890=3888 WESTMINSTER,CA Zip: 92683 License: 698915 • Arch / Eng : • • • Address: , "- Phone: Zip: License: SCOPE OF PERMIT PLUMBING PERMIT TO COOPER REPIPE IN AN EXISTING SFD. 1 WATER REPIPE. • ' FEE SUMMARY AMT QTY- - AMT QTY - . AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 -, Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 ' Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0. Sewer Private Line . $0.00 0 . Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 - Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re-pipe $9.80 1 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $33.30 COMMENTS/SPECIAL CONDITIONS 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 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 provided 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 Labor Code,for the performance of the work for which this permit is iccned. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with the sions. / Applicant Signature: • r / .A.0 . Date: .7/2S-3/0/C1/ WARNING:FAILURE TO CUR •RKER COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE :00,'r:,I ADDRI•• TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.N ) -'PO Class 0 Contractors Signature: CL/ D,.� 2Date: 7/7-0-70 / _/ / CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 pert'+' subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure.scaffolding.faisework,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? ❑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 feel 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 thisapplication a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li Yes U 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 end 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. Sig t Of Legal s) D e gfryz, Out nzed Applicant Date CODE r 1NSPECTID TYPE r ADATE IHRTIALS CODE. l PECTION TYPE PMIS MAO 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof _ 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 �SS CITY OF COSTA MESA ,aiiII' 9 BUILDING DIVISION >:i ,;,,,' .aIf la r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER JI W'"%� I PERMIT � E01-00648 Itbkroams0(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 3444 KINGS CT Status: ISSUED Suite No Applied: 07/18/2001 Vicinity: Issued: 07/18/2001 Parcel Nunmber: 41207403 • Applicant: COOTER, LYLE ISSUED BY: Address: ' Phone: Zip: Owner: GARCIA, LARRY Address 3444 KINGS CT Phone: COSTA MESA,CA Zip: 92626 1+r Contractor0V Illk:.• PREFERRED AIR CONDITIONING SERVICE CO. � t f Address: 11 WRANGER CT. a' Phone: (949)766-9500 Or TRABUCO CANYON,CA : Zip: 92679 " License: 750418 SCOPE OF PERMIT REPLACE NC IN EXISITING DWELLING.ONE OUTLET. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 • - Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 • - up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 • 0' Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0. Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $23.50 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS 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 2446-46(6/00) r : , • A- WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'comper a�t`rypsuiance carrier and policy number are: Carrier: /N Policy Number: z✓cIf4z-oc' "7 (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any porson in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: �- Date: 7 ( (� WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE CAST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Lie.4 7 c5j // Class if C Contractor's Signature: ,,/� Date: 7 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a perr41 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.). ❑ I,as owner of the property,am EXCLUSIVHLY 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 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 MesrFire 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,ore 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 end 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,a.ppplication aaPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes L i 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 Califomia 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 COMPUANCE 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. Signyture Of Legal Owner(s) Date ) Yto •al And/Or Authorized Applicant Date CODE I INSPECTION TYPE PEE itlTRIAL6 ;ONE INSPECTIONTYPE DEE INTmALS • 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof _ 210 Final Electrical 201 Final Block/Retaining Watt _ 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 4cf,014o, CITY OF COSTA MESA 7_> ‘,4, ,,,. . ,,!�',_.r. G, CALIFORNIA 92628-1200 P.O. BOX 1200 t• DEVELOPMENT SERVICES DEPARTMENT ai %BPORFIso� '. October 2 , 1994 Dear Costa Mesa Property Owner: In reviewing past permits, we find that work has been done on your property located at 3007 Killybrooke Lane, Permit No. B63267 , for a roofing permit. The permit is valid for 180 days from issuance or your last inspection, per Section 303 (d) of the 1991 Uniform Building Code. Should we not hear from you within 10 days, your permit will expire as stated herein and additional fees will be required to finalize the permit. Failure to final a Building Permit could possibly impact the future sale of your property. • To activate the above permit, please follow these steps: 1. Telephone (714) 754-5626 or 754-5627 . 2 . Request an inspection; state address, permit number, and type of inspection. 3 . Be sure to have working smoke detector' s as required per Section 1210 (a) of the 1991 Uniform Building Code. 4 . Have an adult present at the property at the time of inspection to provide us access. Should you have any questions regarding this process, please contact me at (714) 754-5273 . Thank you for your cooperation. Sinceely, / I/A e � > mlanda Huapaya permit Processing Specialist 77 FAIR DRIVE Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714) 556-7508 • TDD(714)754-5244 1[1:1, PROJECT ADDRESS: 3007 KILLYBROOKE LN UNIT, CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 063267 OWNER'S NAME:w rid,IAms KENNETH TR ADDRESS: 18342 CHURCHILL AVE PERMIT NO: B 063267 PLAN CHECK NO: N GOVT: N SUPP : N VILLA PARK, CA 92667 CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: ALT ARCN/ENGINEER: ( 714 ) 545-9084 flEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION ; T/O ROCK & 3 TAB, APPLY 2/15LB FELT/COMP SQ FT: 2, 970 CLAIM VALUE: 2, 970 . 00 CALC—VALUE: 2, 970 . 00 GROUP OCC: R-3 /M-1 PERMITTEE:JOHNSON' S ROOFING ( 714 ) 971 -7911 ADDRESS: 2301 BERN LANE COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC SANTA ANA CA 92706 *******xkk**±ESE******k****M--** ***k***kx-********k$***-*k****%*M******k#l%k**k***kms `LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 0l the Business and Professions Code,and my license is in lull force and effect. SETBACKS SMOKE D ET E.C to R CITY LIC.:Na8434 STATE LIC.:458857 �„� CUSe S:/�-39 �F") Date: �� ti� Signature: "% MAIN BUILDING ACCESSORY HUILDR.EQU.I e9>..> WORKERS'COMPENSATION DECLARATION: I hereby affirm that I hay certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: r'T 1N Compensation Insurance.or a certified copy thereof(Section 3800. Lab.C). LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL; 14116211 ZNE; REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > Dale: Applicant: *************)6*-********************************k******************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N T S I certify That in the performance of the work or which this permit is issued,I shall not employ any person in any manner so as to become subiect to the Workers'Compensation Laws of California. ZONING APPROVED;B Y DATE: ie-- Date: 7/70/53 Signature: '�fI'/�c� NOTICE:If,atter making this declaration,you should become suit to the Workers'Compensation provisions of the Labor BUILDING AP PROVED BY : DATE; Code.you must forthwith comply with such provisions or this per it 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: fi C •* flit DATE- 30/"f3 which this permit is issued(Section 3097.Civ.C). ************************ .w ** % '****k*k* ****-**ii****************** £iT�3 E* tt*** LENDER: **************************************** .i*******i(***************************LE* ADDRESS: LEGALIZATION:N F 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 C repair any structure.prier to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 54 , 00 J Pursuant to the provisions of the Contractors'State License law(Chapter 9(commencing with Section 7001)of Division 3 of the Business SM I P/ —RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). 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(3eetion 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself Or through his or her own employees,provided that such improvements ate not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve RE VENUE DIVISION TOTALS——> COLLECTED • 54 , 50 OVER/SHORT• 00 for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 . 50 ❑ and Prolessions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware le*. ,*.x.*************************k***fi**********i(*********************3Fk********** 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. tor reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Dale. Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 2970 REROOF BY VALUE kE5IDENTIAL NOZONE 1 . 00 2, 970 . 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 END OF FEES permit for construction or modification from theAirAir Ohalily Management District.Residential construction applications are exempt from (hese provisions. Dale: Applicant: I hereby certify that l have read this application and slate that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. i�� ...--4...--4Date: 7/56/`1 Signature: 01 00143935-00143936 TOT 54.50 DATE: 07/30/93 TIME: 14:09 Driver's License or Social Security!' / 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION ANDPOOL & SPA PLANNING T I x Date Inspector Date Inspector APPROVALS Permit-rr APPROVALS Permit ;s 1. Temporary Electrical Service or Pole 52. Pum & Egdomznt Lecatie i 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Ur1lty-Undrgrnd. 54. Forms 4 - - 4. Electrical Condu.t•Undrgrnd. I t 55. Electrical Bond rig 5. Steel Reinforcement 56. Rough Plumbing & Prerrurt Test 6. Eic_trical UFER Grrd 57. APPROVAL TO COVE- Gi 'N:IF - - 7. Footings 58. Electrical Conti u,t-Lind,y,nu. II I 8. Foundation 59. Gas Pipe, Urw gr•d . list 9 :':ale, Pipe-Urdrgrrd. 60. R:c!s•.vash Cncr, P.-.-t, -.Lro.u„ 7. -L- - 10. Structural Floor System . 61. APPROVAL TO DECK I _ 11. Property Sewer Line & House Connection 62. Back.vash & Rece;-tc' F,...,! i 12. Sewer Cap • 63. Kauter & Vent-Eral _-' 13. Roof DrainsIr 34 Plumbing System � F. •.I 14. Roug's owmbing 65. Electhcal•Fina ---- - - --- -, 15. Rough Electrical-Conduit 66. Solar System-Final I 16. Rough Electric Wiring 67. Fencing & Access Am:etc..A 17. Rough Wiring Sign i ----- I -�---- - 66- APPROVED .cOA o LASTcNING 18. Rough Electrical-T Bar Ceil.rg 69. POOL'SPA SYSTL1.'S FINAL 19. Rough Heeting & A,r Conditioning FIRE DEPT. REOUIrICLIEtiT ---- - - 20. Rough Factory Fireplace APPROVALS Permit ,Y. - Ifi 21. Ducts, in Structure 70. U'nd.:rgro•mb H' 3 1- - - I -- --- - -- - - ' I -- -- 22. Ducrs, Ventilating - 71. Prod✓ci P n c C.s - 0:, 23. Gas Pipe-Rough & Test _-_ 72. Undergrounds Flies^ 24 Roof Framing 73. Undrgrnd.Stnr. -.•r 'r ' Gas C 2s. Root Sheathing (- g f 3.13 (�a.'11- 74. Oser Fead riycr-, _ 26. T•62r Ceiling IStrt,ct..rali & 70o-oco3t I 75. Cry Cher+ica i 77. Frane and F!ashHq 76. Dry Stanun.rr 28. Lathing & Siding , 77. FIXED SYSTEV FINAL 29. Insulation 78. FIRE PREY. :=I'•.F.L ' 33 Dry..:a'I ,Nailing -�� HEALTH DEPT. REOU:RL-r.IErtT 31. Plaster BrOvrn Coat -, l 7 F . . -- L: v CT C' i .0 32. Electrical Pov-er 6rtter-F.nai i . °• 83. FCU' CERT. . ' .:...-E rrs;,ED 33. Final Electric Notes: 34 Fi' I Heating & Ali Cordmon.-g i 35. Final Gas Pipe.Tet ---- -tl -` - ----- ---- --- -- ----- - - 36. Hood or Canopy I -- ------- -t---. ------ --- -- ---- - - -- - ' 37. Fine' Factory Fvepiace I 38. Fina, Plumbing • �_-_____. __- _ __ - _-__ ._ 39. Water Service-Final - - -- i 40. Gas Service-Ertel 41. Solar Domestic-Final I i I 42. Backflot:' Preventer 43. Backflow Irrigation 44. Landscape Irrigat on 4vsterr. 45. Sound Attenuation 46. Handicap Regulations-- - 47. FINAL STRUCTURE,&.BUILDING /Q�1Lt 444#• 1 48. F,NAL PLANNING .. 49• Electric Release to Edison:,i 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date - HALECRES'l YANK CLUB "^ /—b—/b JOB ADDRESS 3107 Killybrooke Lane BUILDING PERMIT NO. 42234 GENERAL CONTRACTOR Harbor Roof DESCRIPTION of WORK Re—Roof ,GENERAL No. 141-030-12 LOT TRACT FIRE ZONE VALUE $750.00 INSPECTIONS Signature Date TYPE V GROUP J ZONE R-1 SOIL SUBCONTRACTOR PERMITS 1554W GAS Date Number umber I Signature WATER Plumbing - ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE^ OR POLE UNDERGROUND LJ POWER El ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS El STEEL REINF. FLOOR SYSTEM BOND BEAM [l STEEL REINFORCE 7 _ SHEATHING FRAME AND FLASHING • LATHING - IN [l OUT fl PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.G., FINAL f PLUMBING. FINAL AND GAS TEST l l ELECTRIC, FINAL BUILDING, FINAL 1 OWNER College Mesa Co; DATE 8-19-55 JOB ADDRESS 3007 Killybrooke Lane BUILDING PERMIT NO. 1675 GENERAL CONTRACTOR The Hale Cn VALUE $ i on .. LOT 16 BLOCK TRACT 2341 Residence • GROUP I TYPE V ZONE Rh FIRE DISTRICT #1x;99 PERMITS ISSUED . INSPECTIONS /� t�DATE SUBCONTRACTOR DATE NUMBER Footing Trench )j -. p '3o Foundation Forms and Grade to Garage t -3 Rough Framing I - 6—�O-�A-1 Plumbing,Rough to Sl ab 11', , '�" -1 // Plumbing, Rough Complete Vt^--y5 /' ` l9 �•>>L�.^..�+5 ® ' 7—e—SC y'7.rsL/ Temporary Pole �� pp�� A V a / Wiring, Rough /C."t/ 0-1 -33 /54_4_,_,-,-, ttc-' /0 - 9-s1 /S Heating, Rough // Heating, Final �LAar-/J �_ / to- 7-� --;1 YSewe- j{4J�eN- 7 Sewer,St. (�Q /LA ?IV 6->t- 4 //_�,3:S'S-_Y'f'6 r• • Septic Tank or Cesspool _ Lathing, In\ /0 2.'Out rat /p-20 .- Plastering r /A-,f-Sr Plumbing,Final,Fixtures Co •let.b -/g- t AIF Plumbing,Final Gas Test/ /P 5 -/6.f•6 \ /fJ ee2c /4 i l A� 1��� Wiring, Final ` ran% 2-9 /) CSL f t/ Occupancy 7Lc� 3 Form 210 G-H 1500 1-55 J Costa Mesa Building Department )G4 PLICATION FOR PERMIT �� - -" 111 EAST 20th STREFrT 6M BUILDING 1 r COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. -Building 3007 Killybrooke Lane / 60 7 r Address Costa Mesa, California Received by Date Recd. Date Issued Nearest - - , -Xl�/Is-S-5- Cross St. Baker Street Building // , Address.� O 7 iC..(..(�C, /,�,�j...A� _ Owner College Mesa Company Costa Mesa, California Mail Address 8002 Central Avenue N ons rest Tel. City Garden Grove No. LE 9-2158 Zone n I No.of I Type Groupj- Architect or Lic. - ,cam Plans Engineer Davis & Quigley No, C-1790 Approved by Date Address 43 Malaga Cove Plaza,Palos Verdes:, CORRECTIONS City Lic. 3422 Contractor The Hale Company No. Address 8002 Central Ave., Garden Grove ' Legal " I Lot I I Description No. 16 Block I Tract 23411" (Attach Metes and Bounds) ;�rr illt�ril( No.of Bldgs. I,r -- -rte Size of Lot 7529 S. . Ft. I Now on Lot _ 0 Use ofNo.of No.of 70 Existing Bldg. I Families I Rooms ,i AUG 13 1355 a Setback Line from I Rear Yard 49 r Z Center of Street 50•- Side Yard � - y DESCRIPTION OF WORK OF COSTA MESA New I X I Alteration I I Addition I CITY Repair I I Moving I I Demolish I Building No.of Size 1270 Rooms 6 Stories 1 Exterior Wall I Roof Covering Stucco Covering Rock ., APPROVALS Use of New • Building Single family dwelling with Foundation Location Inspector Date Forms,Materials, attached garage. 1 Under-Pinning _ • Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application •c' and state that the above is correct and agree to comply Lath. Int. with all City Ordinances and State Laws regulating building construction. . Lath.Ext. Signature of_ 211ALE COMPANY Permittee// --, �` 7 Plaster, Int Autho rued•-. •• , ////� "�,; Piaster,Ext. 'erma '. 'a e Valuation Permit Fee $ ...14, Masonry Reinforced s�.05�J o o!', Plan Check$ 3 Bond Beam $ '�f a 's Total SI.I . -\ Fee $ c2 % FINAL FORM 204 S-RP 2M 8-55 t •t'2,7.-..,. a . .a ,,,.,.,,_. . yti m. . . JC . . J d. _ . _ o n i.a a . .. COSTA. llt1 9-55 P11E � 5m /1.°"::-73.Q0VSA 3a '' .. • • - - - _ • Street -- , PLOT PLAN - Show location and distances from - - - property line and between buildings. - • . f'. .. • 1 . . .