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Home My WebLink About3445 KINGS CT - Building Permitse t� o �J ``�m''`' (714)754-5273 • Fax��ia��sa-aess Job Address: Suile: Viciniry: 3445 KINGS CT HOUSE & GARAGE ParcelNunmber: 41207408 CITY OF COSTA MESA BUILD/NG DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Applicant: ISLAND PACIFIC ROOFING Address: 17762 CAMERON ST , . . ' H.B. CA ' � . " " / , �,' - . Owner MERGEANIAN, PERSSY M Address ,3A45.KINGS CT � � � � - �� . ��. �. � , i.�;�COSTAMESA'CA �' ",� ��i.�/ i " � � Contiactor. '� ISL`AND PACIFIC ROOFING � Addiess: 17762CAMERON ST n,i j i/;.- < �• � i � ,� r ,/ -_ � H.B. CA; ' ,,., ;;;��,' � �ZiPt,i 92647' ,,, ' Arch � ,� � ' - � �Address: ; � , � �� Zoning: R1 R1 .Phone: 714-557-6516 -�� , � Zip: 92647 . � : , Phone: ` Zip: 92626 � PERMIT NUMBER �/699-01207 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 08/03/1999 Issued: 08/03/1999 ISSUED BY: , ' . �� =� j�� - - i �� . ��; � � � �- � �� > \��, ��✓ �, �\ ; �� Phone_ 714-557-6516 ��.�,�, �-- License: 631472 � � � .:�. � � . - �� .-' � ��, � ' Eng: Address:_ � _ .\ r)� � � ' . , i ' - � Phone: � � Phone: � . �.:: j - - _ .�� .ti ��rt , . � • , , _, !, \ Zip � � �,' '� ' ��-� License: Zip: � - '�License: �. �h� ��A � ,i � i �r �'�! / r� " SCOPE OF PERMIT r � '�1 / REROOF,=T/O, INSTALL 1/2" CDX PLYWOOD SHTG, 2 LAYERS OF. 40 #FELT AND NEW ICBO #2093 MONIER 2000 � ROOF TILE 5.85PSF ROOF. - ' ` � �� ' � ' � � ' '' � � � � � ' ' FEE SUMMARY � � � V �,� , � � . ` �. .,•_' .,- . �_ � � � ' ��Plan Check>', $0.00 - • � ' , Calc Valuation: . t' ss,000.00r '��' ��.'� Permit � , �$149.75 - � ' �� Cleim Valuation� ,,�„ � Ss;000.'oo' ' �;, SMIP Res , ' $0.90 '� r � ' ti �� `SMIP Com: $0.00 ' „ ----. � ,�, � � '� ` � r , �`\ Other. � ` �'.$0.00 ' t , � . • ,' -; Inspection'. � �� ,$0.00 � `" � ti� , �:��Total: $150.65 � � � , � � . �� , �- ` -` � � � PLANNING & ZONING �� • � � �� h ' �\� �� , . � . - .' _. _ . . , . � SETBACKS � � � _ � � . ' . MAIN STRUCTURE Front 0- 0 Rear 0- 0 � � Lefi � 0- 0 Right 0- 0� ., ACCESSORY Front"_ 0-0 Rear 0-0 Left 0-0 Right 0-0,'-� '� PARKING Existin : 0-. . Required: 0 NOTES: Proposed: 0 EXPIRED �� a °�`�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 780 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 requlred inapeetlone and flnal approvel must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSATON PECLARATION: � � . �l hereby aflirtn untler penalry of per�ury one of the following declarations: . ❑' I heve end will maintain e certlticete ot consent to seN-Insure for workers' compensation, as pravidetl tor by sectio� 3700 of ihe Labor Code, for the paAormence of the wOrk tor which Ihis permit is i55ued. ❑ I have flnd will maintain workers' compensation insurance, as requiretl by section 3700 of the labor Code, for tha pertortnance ot the work tor whicli �hls pertnit is issuetl. My workers' compenj�ti n�,I1nhsu�ra�n�e carrier end policy number are: n/Jn Carrier. �h��ii� �IV�Y1t�YfN� PolicyNumber: ��7L1//�L�I (This section need nof be wmplBtetl i/ the permit Is valued at one hundred dollars ($700) oNessJ ❑ I cenify that In the pertormanca of ihe work for which this pertnit is issued, I shall not employ eny person in eny manner so es to become subject to ihe workers' compensetion laws of Cali�o�nie, antl egrae that If I shoultl bacome subject to ihe workers' compensation provisions of Section 3700 of ihe Labor Code, I shell forihwith comply with ihese�ion� /� ,�� , � /� I�� Appliwnt Signawre: �� y�l /%i�i� Date: / E WARNING: FAILURE TO SECURE WORKERS' COMPENSATIIXJ CAVERAOE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CFIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED TNOUSAND DIXIARE (5100,000�, IN MDfTION TO THE CQST OF COMPENSFTION, DAMAGES AS PROVIDEO FOR IN SECTION 3]O60F THE LABOR COOE, IMEREST, AND AiTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm that I am torce end effecL Lic. a Contrectors Signawre: of Chapter 9(commencing with Section 7000) of Division 3 of ihe eusiness�d Professions Code, antl my licanse is in full Class # � � -L' Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm Ihat there is e conswction lending agency For the pertortnanca of Ihe work tor which ihis pertnit is Issued. (Sec. 3097, Civil Code). Lentler's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm ihet under penalry of perjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Busineu end Professions Code: My city or wunty which r�quires a permit to construct, alter, improve, demolish, or repair any siructure, prior m it5 issuance, also requires tha appllcaN tor sUch permit to tile e signad statement thet he or sha is licensetl pursuant to the pmvislons of the Con�rectors License Lew (Chapter 9(commencing with Section 7000) oi Division 3 of the Business and Professions Code) or thet he or she is exempt thereirom and the basis for Ihe alleged exemption. Any vlolation ot Section 7031.5 by any applicant for e pertnit sub�acts the epplicant to e civil pOnalry of not more then five hundretl dollars ($500).): ❑ I, as owner oi �he property, ar my employees with wages as their sole wmpensation, WILL DO TME WORK, and the siructure is not intended or offered for sale (Sec. 7044, Business and Professions Cotle: Ttie Contrectors License Law does not apply to an owner ot properry who builtls or improves Ihereon, and who tloes such work himself or herselt or through his or her own employees, provided that such improvemants are not intended or ottered for sale. It, however, the builtling or improvement is soltl within one year of comp�etion, the owner-builder will have the burtlen of proving Ihat he or she ditl not build or improve for purpose of sale.). ❑ I, as owner oi t�e property, am EXCLUSIVELY CONTRACTING WITH LILENSED CONTRACTORS to constmct tha proiect (Sec. 7044, Business entl P�otessions Code: The coniractors License Law does not apply to an owner of property who builtls or improves thereon, and who contracts for such prolect with a contracbr(s) license pursuant to the Con�rectors License Laws.). ❑ I am exempt under sec. Business and Professions Cotle for Ihis reason: SignaNre: Date: Owner ID veri(ied by drivefs license. ❑ Yes ❑ No Drivers license No. Expires: Veritication oi Ownership by (Iype ai document, i.e. - property ta< bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON: ❑ I here6y certity thai no exce�ation five (5) or more feet in depth into which a person is requiretl to tlescend, will be matle in connection with work authodzed by this permi�, antl t�at no builtling structure, scattolding, falsework, or tlemolition or dismantling Ihereof, will 6e more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Ar12. Sec. 347, Title B, Celitornia Administretive Code). ❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit from ihe Division of Intlustnal Safety, as noted above, unless such person has a permi� to tlo such work from the division. Slqneture: Deta: Division of Industrial Sefery Permit Number: CO�E �. INSPECTIONTYPE 1616 Fixetl System Final Fire P�eveniian 1266 200 201 202 203 Paal Spa Finel Final Ra-Foof Final Block/Retaining Wa�l Final Fec�ory Fire Place Final Sign 204 Final Demolition 2a4&a8 29IE ixTm�Gs �QOE� INSPECTIONTYGE 206 Final Mechanical 208 Final Plumbing 210 Final Elecincel 272 Finel Flre Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinyOccupancy �ATE �NTITIRLS J �ooxessovem�wr�c: 3445 KINGS �CT uxr: OWNEFSN.WEIFqlpWN: MERGEANIAN, PERSSY M FLOOD: AHL38 .00x�ss: MERGEANIAN, SHEILA R 3445 KINGS CT Z�,�- COSTA MESA,CA 92626 �vri. �uuNc �uuxess: AIICNRECT OR FNtlNFEH: L1C. Np.: ARCX. ON ENG.'S ADUFESS: UNT: conm�cTarsmwe: PACIFIC PLUMBING CO/SANTA (714)547-6967 CONfNACi0A3Y11WIG P O BOX 1494 aooness: SANTA ANA CA �G�,; 266807 92702 uxr: LICENSED COHfXACTONS DECLAflATION: I hereby eflvm unew peneliy W pa�ury ihel I em IicanseE uMer yoviaians d Cheqm 9 (oommendip wilh Seclion ]000) d Divieion a d �he Bueineaa end Prafeeaione IIEe, eM my lioenx ia in Wli lace uM �Ilw. cm� ..: 005998 uacuss: C 36 uc 266 07 EXP: 06/ o �. comma«: X BUILDEN OECLRHA710N: I Mreby elfirm unCer penelly parjury thet I em exemq i �M iredws License lew la Ilro iwmp neaonl5edion ]031.5 Busiwea ud Proleasiona Code:AnY cXY a�nry which �ui a n�o conaM1uct.ellm.improve. ,md'oh, a repei e�ry evucwre, pnor m ns ewence, elco rayuires tha epplifsnt lor euch permn to file a eqrwE atmemam thm M a eM n licenaed W�� lo ihe qwiebna d IM Cenve�tae Limnae Lew �Chepter 9(wmma��p wilh Setlion )aao) d D'vown 3 d tb Businew eM Prdes�una COEa� ar t�et he a ehe ia mempt �hxelran end �M beab lar iha ellepeE memqion. My videlion d Setlion 1W1.5 by enY MDliran� fa e permn eublede �ha eGol"cenl lo e dvil penelry W ml more ihen �He huMred dollua �150011. ❑ I,movmerdthepeapeM�myempbyeenwihweqessviMieolammpenulian,willEothawuM,endiMeVudunendintended a dlmeE br sab (Sx�ion 10a1. Butimsa enE Prdesaiona Coda: The Conirenon Licema lawdon rwt �pp1y loen ownard popeiry who Wlda or'un0�� hareon, end who doea euch woM Mmaell m MneM ar �hrou0h he a Mr own empbyeu, pwidatl thet euch imqwemeMe ere not inienEed ar oifered lor sele. M, however, the buikinB a inprtrvement n edd wdhin me yaer d mmplNion, the owner-buiWer wi�l heve the buNen o/ provirp he or eM did iwl EuiN a impmve Iw IM WN�e ot aeb). � I. m ovmer d iM prapery. em utluaively oonlredinB w+lh linneed convmlon ro conYrua IM P�Ia (�ia� ]M0. Bu+irims eM Proleeaiaia Code: TM Conlredm L'crose Law tloas na eppty to en owrwr d pmpeM ��ilda a impwp the�eon entl who wnirecb tw a h proleqa wi�h a mmrufor(e) Icemed punuent to iM Comreaon Liwms Lew�. � I em exemq uMx Senim: B. 8 P C., fa Ihia reeaon: De�e: Ovmer: I do hereby uniry the� I em ewere ol end undentend Ihe reQuiremenm d CelLomu Fbellh eM Salery COEe Sed'am 25505, 25533, eM 25534. enE Nel I w eiry lulure builEirq oocu0��'M�I / wil na (arcb me) need lo canply wih eeid mtle codw e�M IM rpuiremenb la ova: nooi�,c WOflKEN'S GOMPENSATION DECLAHATION: I Mreby elfirm uMer penel�y ol pe�jury aw d Ihs Idlovnip EMutliom: � I hew end wiA meintem a cerlJiWs d mmeM to eWtineun br MVMare' eompenealon, u W�� w by SWpn 3)00 0l lha Lebar CaEa, lar Iha peRormarica d tM work lar which thie pemin ie IwueE. r] I havs vM vnE meintein wo�ken' mmpenaeton inaurws, m ipuilsE by Seaion J)00 d �he Lebor Cada, lar tM perlormuiw d tM woM tw which ihie peimn ie iaueE. My warkeie' mm nsetion imurenw umx and policy number ue: c�«: C�,LIF. IND. EXPIRES vo�ky N�mw�: — 0 3/ 01 / 9 6 (lhia settion rreed rrof bs romplefel7 fM prmk /s M on� hundied ddlue /Stool w lese.) ❑ I cenAy thet in Iha parloimence N the wak M xfich thia pemiil b iee ', I Mell 1 amploy eny pemn in eny manrw ro u to become aubjeq Io ihe worken' canpnealion lew� d Cdibm' . laprse �h H I Mould bacoma wbpe to IM worlmre' ompenxlian provisone o/ Sadion 3'!00 d iha Lebor COEe, I ah I� Hlh com �til Ihoee n, �ieioru. � ov nod��: �minp: Fallun ro��c�n wont�ri romperuetlon rowrep� I� unhwNl, ma �lull w6/�et en qw b MrNml pm�Mu �nJ c/vll flMs up ro on� hwtlrW fMuuM doll�n lSIOqOW1, M Wdltlon ro M� coat ol romprrutroR �Mm�Du u provkNJ ror In 9�cHon 91(I6 0l Me LWOr Cob, /nfxwf, Ind Itbm�Y�1 /Iu. CONSTpUCiION LENDINO AOENCY: I Mreby elFrm unEer penely ol perjury IhU iMre le e mnNruaion bMi�q epenry for tM parlormence W iM v.wk for which Ihe pefmi ia owed (Sqion 3p9]. CN. C�. LENDEP'S NAME: LENOEX'S ADONE55: I cenily t�el I heve reaE Ihia epplicelion eM etate ihm Ma ebave inlormetion ia mriep. I epiee io comply vnlh all dly eM munry ordinenoee entl slme kwa relmiip ia buiWmp consvuqbn eM hwaby eNhorae repreaenletivea W ihia tllyto enter upon the ebore�mentioned popeM m, ��wnroo wm�. KANA NGUYEN P n/l Na�m�e (� q� •---• /I dyl . ��^' .�irl�ri �� / ov. d %� � (5151-16.WP) Whne-Buildiip 8 Selety:areeo-Fle:Cenery-AppicanC Pink-Revenue;GokenroFbaeeaor CITY OF COSTA MESA — BUILPING PERMIT PERMIT NO: P 074020 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU JOB DESCRIPTION : GAS METER SHUT OFF VALVE CLAIM VALUE: CALC—C'ALUE: PERM NO: P 0"74020 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: R-1 / COMMENTS: ZX *�at***+��*��**+�+��+�****�***�� *� � ��*�� *****at*�� iE+e**��*��*�+�*******+�****� *** ��** Z O N I N G R E Q U I R E M E N T S S E T B A C K S ----------- MAIN HUILDING ---------- --------- ACCESSORY BUILDING ------- — FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT ZN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 91207408 ZNE: REF NO: PLANNING NOTES> -, i � _ �- � iE iF 1E iE iE �Flf dE 3E if if !E if ik iklE iflf if jf iE iE iE �E �ElE 1E �E 1E �)E fE 3E 3E aF fE fElE 1E iE iE iElE iE �E if iE if fE iE IE 1E iE,� �E 1E 1E iE 1E iE iE iElE iE!! fE �F 1E 1f �)E if iE jF if �E iE **** D E V E L O P M E N T S E R V I C E S%. R E-`Q U I R E M E N T S �-� %S/ ZONING APPROVED BY . HUILDING APPR06�ED BY : APPLICATION ISSUED BY: *******�t�*�*�-*��****at�c LEGALIZATION:N 0 F E E S U M M A R Y DATE: DATE: • DATE: �-+e**�*�* STRUCTURAL E � 7 :N BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7,00 25� n "" SMIP/NON-RES PLAN � '' ISSUE FEE 20.00 ' � BUILDING-DIV-> PERMIT ISSUE PL�1N-CHECK TOTAL PAID DUE TOTALS----> 7.00 20.00 � 0.00 27.00 27.00 .00 f.� REVENUE DIVISION TOTALS--> COLliECTED: 27.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 27.00 ,�� 1F iE 1E if iF 1Flf iElf iE iE iE iE �E iE iE iE iF iE 9ElF iElElE iE �E 7E iElE 1E iE iE iF 1E 1F'iF iE 1f If 1f i� iF iE iklE 1F 9ElE IF ik jE 3f 3ElE if iF 3f ik iElE aE iE 3ElE fE If jE dE �E 9F iF if if if �I4 {E 1E if iE I N D I V I D U A L'.'. F E E B R E A K D O W N TYPE QTY D E S C R I P T I O;iN UNIT COST TOTAL COST �1. PLU 1 FIXTURE SET/TRAP W/,P�IPING 6 BACKFLOW 7.00 7.00 EMD OF FEES �� i �+ E�.1 Q^ui"oS427-D0189427 T SaT ?�.�� D�T'c: CE13./'�� 1';1iE� i3:4'7 ' CONSTRUCTION AND PLANNING , � P� - & SP!}' ' � - APPROVA�S Permit# "/ Date Iqspector qppROVALS Permit#"' � Date Inspector t. Temporarv Electrical Service or Pole 52. Pool & Equipment Location - , 2. Soil Pipe�Undrgrnd. � " 53. Steel Reinfoicement - � 3.� Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding • � 5. Stee� Reintorcement 56. Rough Plumbing & Pressure Test ` �� 6. Electriwl UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 7. Footings 5$. Electrical ConduirUndrgr�d. - ,•� 8. Foundatio� 59. Gas Pipe, O Undrgrnd., Test �, 9. Water Pipe-Undrgrnd. � �' . _ 60. Backwash �ines, P-Trap,"�y Undrgmd. 10. Structuro� floor Syscem . ,i - 67. APPROVAL TO.DECK �" 15. Property Sewer Line & Ho�se Connection -. 1 62. Backwash & Receptor-Firtal-� � . 12. Sewer Cap � � � 63. Heaier & Vent-Fi�al • � 13. Roof Ora�ns - � 64. Plumbing System - Final . 14. Rough Plumbing � ' 65, Electrica6Final ^� , 15. Rough Elecvicat-Conduit � 66. Solar System-Final 16. Rough Electric Wiring . 67. Fencing & Acceis Approval ,'� ,: 17. RoughlNiring 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 ,� '. .� APPROVQLS. Permit # 21. Oucts, in Structure � '" . " � = � 70. Underground Hydro _�_. . � 22. �Ouc[s, Vsntilating "- 71. Product Piping � Gas ❑ Oil 23. Gas Pipe•Rough & Test ' 72. Underground Plosh 24. Roof Framing' � , - 73. Undergmd.StorageTank �Gas ❑Oii 25. Roof Sheathing � - �' 74. Overhead Hydro � 26. T�Bar Ceilin9 fSiructural) & Monocoat �� 75. Dry Chemicai -. � 27. Frame and Flashing . � �• 76. Dry Standpipe� -" 28. Lathing & Siding ' ' � � � 77, FIXED SYSTEM�FINAL - 29. Insulation � ' 78�. FIRE PREV. F,INAL � � 30. Drywall Nailing - �- -� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . ` 79. FINAL INSPECTION 32. Electricai Power Meter�Final -' � 80. FOOD CERTIFICATE ISSUED. 33. Final Electric � � Notes:0� ' . /-��!_9_Sk��,��0�'� �tz=� 34. F,inal-Hea<ing.& Air �ond'+doning �,., a_ ,� '� (J�__ 35. Final Gas P�Pe.Test •� �� - 36. Hood or Canopy � V _- . l' " • 37. Final Factory Pireplace - , 38. Final_Plumbing �� ' _ � 39. Water Service-Final . 40. GasService-Final ' �-' ' � '�i/Q ' � l�L- - 41. Solar porneStioFinal .. - -. � 42. 8ackflow Preventer ' � ' i 43. Backflow Irrigation � _ 44. LandscapelrrigationSystem ' „ � r . �� 45. Sound Attenuation� � . - �. � - � �. 46. Handicap Regulations � � . � , 47. FINAL STRUCTURE & BUILDING _ �=-" � 48. FINAL PLANNiNG y�. ` ° � 49. Electric Release to Edison ,v,�,,,,,� ' 50. Gas Release to Southern California Gas Co ' �`'�'" � �' , . 51. CERTIFICATE OF OCCUPANCY � � - No. Date � Aoo�icant to fill in all spaces encept those within neavY bor0er Iines antl sign all appropriate aeclarations. CITY OF COSTA E AG[� N TR UCTI PERMIT PERMIT NO. ' TRACT NO. . � LOT N0. UNIT NO. 1 Project Address � / /'�7 � ��'� � �/' . Applicant's 'I' g Add es5 /� ' ' `-^-'- Owrner's N m ' J •' � P nes C� � Address� L%"'� • .S' 6:�cr-'%�c'u`c � - Arch/Eng. - , Lic nse No. Address �y Contractor's Name `� -� " Phodi 'S -'SS K Address (mailing) n �J---`1- , Ciry License No. � •� �-� " I LICENSED CONTRACTOR DECLARATION � � 1 hereby'afflrm tnat I am licensetl untler provi5ion5 of Charter 9(commencing witn section ]000) of Division 3 oi the Business antl Professions Cotle, antl my Ilc¢nse is in %i� t�j ce a tl e(Tect. C. License CIi3s y C V �License No� �• Date ' - r Si9nature C—�—� ' - VORKERS' COMPENSATION DECLAftATIOf�I� ' ' hereby atfirm that I have a certilicate ot consp to self-insure or a certificate of Wotkers' Compensation Insurance, or a cer i ietl tOpy theieof (Sect on 3800, lab/. C. / �j �(� ' - - " � Policy No�`��`' / C� (�—'. CompaR `� �Certifietl coDY is he�eby /urnishetl. � - ' Cel� fie6 cQP y is �Etl with the cit �Itling pivision. Date,_/�-� r �� Applicant �/� EXEMPTION FROM WORKERS' COMPENSATI N DEC ARATION , (This section neetl not be comDletetl it the permj is tor One huntlretl ($300) or less). ' � I te�tify that in the performance of the work tor which thi5 pe�mk is i55uetl, I- shall-not employ any pe�son in any manner so as to become subjec[ to the , Workers' Compensation LawS ot California. � Date � Si9nature NOTICE: If, after making this tleclaration, you shoultl become subject to the Worke�s' Comp¢nsation provisions of -the Labo� Cotle, you must /orthwi[h comply witti such p�ovisions or thi5 permit'Shall be tleemetl revoketl. CONSTRUCTION�LENDING AGENCV �.' I hereby affirm that there is a�construction.lentlin9 agenq for the performance : oi the work tor which this permit is'issuetl (Section 3097 Civ.� C.) Lentler's Name lentl¢r'S Atltl�e55 � , OWNER BUILDER pECLARATION �� ' ' - I hereby affirm that I am-exempt trom the ConVactor's Liwnse Law toi th¢ tollowin9 reason (Section 7031.5 Business antl Pro(essional CotleEAny city or county which �equires a permit to consVuct, alter, improve, tlemolish or �epal� any Structure, priOr to its-issuance, also requires the applicant for Such pe�mit to file a`signetl statement that he/she is licensetl pursuant to the provisions ot , 6:=3he Contractor's License Law (Cnapter 9(commencing with Section 7000)bf ":��Division 3 of the Bu5ine55 antl P�ofessions Cotle) or that he/she is exempt , 'therefrom antl the basis tor.[he allegetl exemption. Any violation of Section ]031.5 by any applicant fo} a pe�mit Sublect5 [he:'applicant to a civil ��enalty ot not more than five huntlretl tlollars (5500). ' I, as owner ot the properly.or my-employees witn wages as their sole � compensation, will tlo the work, antl the�SVucture is not intentletl o� otferetl for sale (Section 7044, Business antl Grotessianal Cotle: The Contractor's � License Law tloes not apply to.dn owne� ot a pwperty who builtls or improves � thereon, antl who tloes such wo�k himzelf/herself or through his or her own . employees, provitletl lhat such improvements are not in[entletl o� ofteretl for sale. If, howeveq the builtlinq cr improvement is sold wi[M1in one yeai of com- ' Dletion, tbe owner will have the bu�tlen ot proving he/she tlitl nOt builtl or im- �ova for the pu�pose of sale). ' � , LI I, as'owner of the property, am ezclusively contracting with licensetl com tractore ro wnstruct tbe project (Section �044, Business antl Prolessions Cotle: The Con[ractor's License Law does not apply to an'owner ot'Oroperry who ' builtls o� impwves thereon, antl who contracts for such proiects with a con- , tractor(sl Iicense pursuant to the Contractor's License Law). I am aware that o�oof of their Worker's Compensation insurance 5hou1G ba provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason i Date Owner Certify Ihat I ha m is co�rect. I ag laws relating to of ATiS city to [ion and all city ; i. antl h p�a �n E z-o t I S T1�T�TT �� VPE OF CONSTRUCTION rvELJ w lJ aoo aL7LJ eaqriorv L CONVERSION ❑ DEMOLISH ❑ O IER q�CRIPTIONOFWORK/USEAFBI,DG.� C� C. J �,..Ja2 / / TVPE'OFPERMI7 Ganolnic ❑ FourvDATio 57 cTue ❑ TENANT .� ELECTRICAL ❑ PLUMBING � MECHANICAL � ❑ �OTHER . ' . ' PROJECT DESCRIPTION SO.FT. OCCUPANCV_ � CONSTRUCTIONTVPE VALUATION$ ZONE GRADING CU. VOS: ACRES_ Remarks: • . Bai Sink , ` eackflow Preventer. _ . Backflow Irrigation Bathtubs ' Clarifiers . Dishwasher { Drinking Fountains Floor Drains floor Sinks Gas Service Interceptors Kitchen Sink Lavatories , P-Trap - Roof Drains �• Outlets 1 - � IReinspection Fee" ' E , $15 Duct-UnderGround ' Duct - Structural Duct � Ventilating � Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # Heating System & Ducting ❑ 0.100,000 BTU O 100,000 BT ins0ection p ses. ^-a� / � Signature ' � C�' / T � Drivers' License or 55 - Heinspactian Fee $15 CMF 0865-46, rev. 4/84 White - Builtling; Canary - Applicanh Pink - Accounting; Goltlenrotl - Assessor PLUMBING ' ShOw¢r5 Service Sink � Sewer Cep � i Sewer Connection Solar Collecmrs Solar Pipin9 , � Solar Tank � � Swimming Pool w/Spa � Urinal Water Closet ' Water Heater Water Service Issue Fee Hood or Typel ❑ Canopy Type 11 ❑ Refrigeration System 1�-100,OOOBTU ❑100,000 Sys[em Repair/Alteration Issue Fae REPAIR a E FEES $ 3 FEE $ 3 �� A.P. # 5 Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. �k Planning Notes: . � Automatic Washer _ _ Constructior Pole Sub. Cooking Unit � ' Dryers LJGas' LJElectric Fan � F.A.U. Fixtures. � Device Boxes Outlets Switches� � Garbage Disposal . Generami �0-5 KW �5-15 7488� 7/26/85 ' �O.p� �TL Accessory Building:" , 2 � -0 • N I ' N , , G R Parking Req.%Provided � " E Q � '. � M T S. ELECTRICAL � �Transformer. 0 15-W KW. , ❑50+KW Meter ❑up to 100 amps ' Meter ❑over 100 amps '$ubPanel � Motors�0-7HP�1h-6 ' � Ina Solar, �9-15 HP 016-15+ Microwave . � - Pole Light Range ' Standing'Sections Trash Compacmr � Reinspection Fee I$15 � � luue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By � Buitding Approved By � � Application luued By � FEES ' a '$3 � SUMMARV OF FEES . . B,UILDING�PERMIT $ � SMIP ' ' $ PLAN,CHECK . $ PERMIT , PLUMBING $ �SSUANCE $ PIAN CHECK 25% $� ENERGV P.C. $ ELECTRICAL $ Q •O('� GRADING $ PLAN CHECK 50% $ MICROFILM $ � MECHANICAL $ II .�O TOTALFEE $ ��1Q� PLAN CHECK ZS% $ , CONSSRUCTION AND PLANNING , ' � P�---&SPA_ APP.ROVALS Permit #' � Date Inspector AppROVALS Permit # '. Date � Inspector 1. Temporary Electrical Service or Pole ' . � 52. Pool & Equipment Location , 2. Soil Pipe-Undrgmd. • � �� 53. Steel Reinforcement .' '' -3. Electrical Cond,uit Utility;Undrgrnd. ' " 54. Forms ' ' . ' 4. Electrical Conduit-Undrgrnd. - . ' . _ 55.-Electrical Bonding _ � 5. Steel Reinforcement, � - . . � 56. -Rough Plumbing & Pressure Test � � • � ��'�.6. �Electrical UFER Grnd. , . . 57.-APPROVAL TO COVER-GUNITE . � . 7. Footings � ' - � _ � 58. Electrical Conduit-Undrgrnd. � . ' 8.'Foundation ' � � - c59.GasPipe�,�Undrgrnd.,�Test � � ' � 9. Water Pipe-Undrgmd. � • . 60. Backwash�Lines, P-Trap, O' Undrgrnd.� - 10. Structurel Floor SYstem 61. APRROVAL TO�DECK` . i t. Property,Sewer Line & House Connection � 62. Backwash & Receptor-Final . � 12. Sewer Cap . . , 63. Heater & Vent-Final . 13. Roof Drains : � 64. Plumbing Sysfem - Final.�. -. ' 14. Rough Plumbing � 65:�Electrical-Final , - ' ' 15. Rough Electrical-Conduit � "�� ' '" } 66. Solar'System-Final � ' ' ' i 6. Rough Electric Wiring . _ - - - - � 67. Fencing & Access Approval � � , . 17. Rougli 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 � Gas. ❑ Oil . � 23: Gas Pipe-Rough & Test � 72. Underground Flush � � ' - 24. Roof Framing ' �� , 73. Undergmd. Storage Tank � Gas ❑ Oi6� 25. Roof Sheathing � � 74. Overhead Hydro 26. T-Bir Ceiling (Structuraq & Monocoat , 75. Dry Chemical - � � 27. Frame and Flashing � •, � 76. Dry Standpipe � '_ . 28. Lathing & Siding � � '' � 77. FIXED SYSTEM FINAL � ' 29. Insulation � 78. FIRE PREV. FINAL � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � � 79. FINAL INSPECTION � � - , � 32. Electrical Power Meter-Final , � � 80. FOOD GERTIFICATE I$SUED 33. Final Electric 7 (,� Notes: � � 34. Final Heating & Air Conditioning a ' �(,j� . � , 35. Final Gas Pipe-Test � • " , . 36. Hood or Canopy ; • � � ' - :" 37. Final Factory Fireplace � ' � . " .� ' ' " . 36. Final Plumbing� � � - " � � 39. Water Service-Final � , ' - 40. Gas Service-Final � ' - � -' . 41. Solar:DomesticFinal � , _ __ , � '` � � , � 42. Backflow Preventer ' � . , � �' � 43. Backflow Irrigation � . � � � ' �,� �� ' � . ,. 44. �Landscape Irrigation System� ; � � � ' ' ,' � 45. Sound Attenuation � � . 46. Handicap Regulationr ' . , . 47. FINALSTRUCTURE�&BUILDING � . � ' . � 48. Special Requirements Completed � ' ' ' � � 49. Elecvie Release to Edison . �, •� - 50. Gas Release'to Southern California Gas Co � � . 51. CERT,IFICATEOFOCCUPANCY " . , . . ,' . No. � Date � � . � F'berg as B anket Insulation The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance and that the Blanket Insulation is in- stalled in conformance with current energy conservation regulations, California Administrative Code, Title 25, State of California, in the building located at: 3=/ %S I�i , � c 5�� !" J J` %D�7s V Street� Lot Number Tract Number �'xterior Walls Owens-Corning Fiberglas Blanket Insulation Ceilings Owens-Corning Fiber las Blanket Insulation Floors Owens-Corninq Fiberglas Blanket Insulation Foundation Walls Manufacturer General ��/a`'- i/ Thickness Fi-Value � � �y TFiickness R-Value Thickness R-Value Type Thickness R-Value License No. gy Title Date _ �5�9�a,�,e,� // D .�i�.. � ��r Insula � ontr ctor ��/3��/a��!G7�-�� `�� /� License No. �� gy �(��2d_C-a� Title b F' Date (�C "/ ( IgnaWra) � Homeowner Copy (White) . �i ' State Copy (Yellow) OWENS-CORNING FIBEqGLAS CORP. Builder Copy (Pink) Insulation Operating Division PuO. No, I6�BL6995�A wno �� u.sn.. d�iy isn Fiberglas Tower, Toledo, Ohio 43659 F � a Q � h S F 4 W F. .a a > r a a w o. � a M z s 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADDRESS 3445 Kings Court OWNER OR TENANT Wimbledon �iSSOC. ADDRIEs 1470 Jamboree Rd CITV Newport Beach No`640-680 CONSTRUCTION Im erial Savin s& Loan LENDER P 4 BRANCH Pasadena ADDRESS 61 S. Lake Ave. ARCHITECT..__._._i..____�__.. TEL.�.. -.�.. CONTRACTOR MCLain DeV. Co. ADDRESS 1470 Jamboree RCl. c�rv Newport Beach No`.640-680 uc No. 273875 �ic�No. 18873 SIZE NO.OF BLDGS. O OF lOT NOW ON LOT USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and hea[ing work: USE OF BUILDING AND WORK TO 8E PERFORMED PRD-New Construction Single-family dwelling I hereby acknowletl8e thet I have reatl this application entl state that the ebova infotmation is correct antl agrea to comply with all laws regulating builtlin8 consvuction, and I shell not employ any person in violation of the workman's compensation laws of che State ot Californle. I hereby certity that I am pro0arly licensed as a contractor untler the State of California Business antl Professions Code, Oivision 3, Chapter 9, antl that such licenses are in full force antl etfect, or I am exempt trom Ne provisions of the Stata of Calitornia Business antl Protessions Cotle, Division 3, p. r 9 Signature ot � Permittea of Authorizatl Agent Date 6094'��iMV2i/BI f 289.81 T!,' APPLICATION FORSTRUC-TURAL PERMIT -- - - RECEIVED�V PI A.P. NO. `�� B UI LDI NG ADDRE55 �aa� UNIT OR SPACE NO. TR.NO. LOT NEW ADD ALTI N° 47739 REPAIR IMOVINGIDEMOLI OWNER Wimbledon P.SSOC. �� use PR1� VALUE�.rs APPROVEDSETBACKS (FROMLyi3l14EET)(�l PLANNING ACTION ctoLD FOR THE AMOUNT S THE PURPOSE OF VALUATION $q7 3ao �' -3 3 ✓N UNDER VALUATION IS FOR ABLISHING A PEflMIT FEE ONLV: PERMITFEE. $ �� PLAN CHECK $ TAX $ TOTAL PA1 D $� yq p m � : /� .. �.� N �j m �d a \ N n m o � ��U