HomeMy WebLinkAbout1168 KINGSTON ST - Building Permits •
' CITY OF COSTA MESA
BUILDING DIVISIONI
%j .�I DEVELOPMENT SERVICES DEPARTMENT
PERMIT /B03-01
RMIT PNUMBER
v
326
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. .a.us. NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626BUILDI
•
'Job Address: 1168 KINGSTON ST Status: ISSUED
• • Suite: Applied: 08/05/2003
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 08/05/2003
•
Parcel Number: 41204211 Zoning: R1 R1 •
•
4-
_�
Applicant: SELL, RON -
- --_-- ISSUED BY: // s .
/i/Address: 18032 LEMON - "�--- -:—- ��
'9.G C'- Phone: (714)528:1758 -J -
YORBA LINDA,CA� Zip: 92686 '
• l r
Owner: D/AY'TWILAT c
Address /1168.KINGSTON ST _ -
//
0;;/
\ :-Phone -- `•/ •
�A�
C\TA MESA,SCA Zip. 92626 ',\ ,�‘f>.. \‘`
// ///\�\T
Contractor: SELL ROOF,INGtOMPANY - � \V% /�
'Address: 18032-LEMON;/ - --`
;: / -i Phone:,(714)528-1758 =\.- '
- 1 <, , iv' v /V` A i A;t t
YORBA-LINDA,CA 6'
Zip: ,' 92686/ ' License: 3.23842 - J ;���
- r , z
�. - - -` . _ --, ..7 'i
Arch, :-" Eng' . )•,' i • - .\ 1,
/ Address:- ' . •t ,. - Address.„•
�_ ,,, .,Phone:-- - - - ' / • Phone: : -
_/ ' `N / License: ,License: _ - ;,
`Zip: �/( a . i
)
SCOPE OF PERMIT :•.,.e 1\ ,
REROOF AND RESIDENCE AND ATTACHED GARAGE:T/O WOOD SHAKE-ROOF, 1/2"OSB-SHTG,2 LAYERS 30#FELT,APPLY"EAGLELITE
, 1, MALIBU TILES."ICBG#4660 27 SQUARES - -- . -` `-"-:-- x ' -'' ` - ' '` /'N
• . . FEE SUMMARY /-) �_,
•Plan Check:/I'-• , ' $0.00 __ _ _ _- -/L- ' `� Calc Valuation ;, . t: $81900.00
Permit: , '$167.25 / / Claim Valuation: ,,,;, _$8,900'00
, `;'SMIP„ReS: ' $0.89 - • i%r %,/ � �J l e l
V �SMIPCom ' ''V° $0.00 iilj !i/ /`
` Other \,x$0.00 F - , '/) l
\ Inspection i `$0;00
tiTotal: -. %$1681,40 - r 1 '�� i,
2/
. / ,i
N PLANNING &ZONING / \
SETBACKS N.;, �-
MAIN STRUCTURE•Front 0-0 .-� Rear. 0T0 __
ACCESSORY Front 0-0 'Rear '0-0 .„ Left 0-0- ,, . Right 0;0 ,2,.-,-/
PARKING Existinn:' -o - -` Required: .,0 _ . - Proposed:, -0: -
•
•
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS r ("--\
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
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'comp1nsat sur carne policy nu are: AP �S�
Carrier. - i/ Policy Number:•
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that In the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and a hat if I shouldane subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
coni with these Provisions. 0�/L ' !�
!/�,�1� ! V
Applicant Signature: AA, F.>iC� Date: / O
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 DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed undprovisions t Cyha ter 9(commencing with Section 7000)of Division 3 of the Business and Prr fesslo C de,and my license Is in full
forne and effect.LIc.a 7-L<�r� Class: a rs7r
Contractor's Signature: Date: 1 /0 — 3 /-
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: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
1 hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ 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. ❑Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,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 preset 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 U 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 mat-lanais? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required.has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
e Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade).
._ ._.._ .._ ._ — hich I....._.._-
7 If a pDatron haveathe—South Coast s Quality ed Management a Healthal or and Sr airtpollution coon 4l district03bn agency is required for the work which is the subject of this
eppllcatlon, all of the disclosures prescribed by Celifomia Safety Code Section 42303 been made? ❑Yes ❑No
..____.._
8 (If yes",attachocompliancefrom
certificate of from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
. Of Legal r , Date
And/Or Authorized Applicant - Date.
VOOF F. INSPECTION TYPE PAM MEALS V.VPEI INSPECTION TYPE PAM 0110:1A1$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Finale_ 208 Final Plumbing -
200 Final Re-Roof � /v - 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire PIaCe 220 Final Planning Approval
203 Final Sign 222 Final Site •
•
204 Final Demolition 250 Final Building/Occupancy
• .. Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. .
fCITY-OF COSTA-MESA -' _PERMIT N '_-_.. 'TRACT'NO: "-LOT NO:" BLDG.NO._. _ _ . . .. .. _ _._ ._ _.. _ -.._ _ _, ._
C9NSTFtUCTION PERMIT - d1// ICS (� 10 ' �, 4.9522- I 31 .85 . It
7.
Project Address e O' ,�Lm L. . . 17 1,4 •
TYPE OF CONSTRUCTION I.._ 3 " ( it _ -v ,�'
Owner' DPtr,i- '-U,C Phone ygq_393f a NEW 0 ADD 0 ALTERATION' - - -- -
V O� 4 1 �r
' Address'it 63 -, •k 4(r crc4 -c-r- ' -- ' "- - • 0 REPAIR-D CONVERSION_D,DEMOLISH_ - -
Arch/Eng." - • -- - License No.2q :0OTHER . ' + •' /J LLyy ZONING REGULATIONS. „
py p �] aa((���''��} DESCRIPTION•OF WORK Dl I� [7(-FZ �'�''�- •
..Address-700 1 -rte Oise- i S!r -`h.ln-c-/b]/si' - !06 - rr- , .. • , . . 2_ Fe- ZONE-• - 'W e,-`MD PLNG REF,:. ,_I -.
`Contractor K�.y 'K• M'\m o To Phone4R l/.--1)�'�{� TYPE OF PERMIT ' + ' --� c• + +` — eUILOING - �'� BUILDING!.....-:' _
AddrEss p /,nn__ pp q q 1-.''''''. (\ \s- +',.l.\ SETBACK CIL_ST.
PROPERTY LINE.'
958/ ,et sE, _$ i3g . h. o 3 -0 GRADING O'FOUNDATION --D STRUCTURAL- - SIDE YARD' _
LICENSED-CONTRACTOR DEC L/AR ATION- - _- i. F _ - IL
❑ITENANT ❑ ELECTRICAL ❑PLUMBING, ❑MECHANICAL LE - __.. / -
I hereby affirm that I am licensed under provisions of Charter,9 (corn- n , {' i- s ` - '\-,, : RIIGHTA R.-- - .+ �'1� `r ,
mencing with `section 7000)- of Division 3 off the-Business-and 0 OTHER • -- - -• - -. -• f`- c • • [
Professions Code', and my license is In full force a tl-.¢(fe t. I' + REAR YARD (TO P/L
- - - - - - - _ � - PROJECT DESCRIPTION - /_�1t1' (tn,
License Class _ License of PKG.SPACE R `'mss! PRO IDED \-(1 '
Date ..I el Signature' ` a.'L 4- al �.. - , SQ"FT, .. ..- . .. .. - fffddd �.1W[ - __.
WORKERS'COMPENSATION DECLAR TION OCCUPANCY" CONSTR CT N TYPE STREET WIDT PAR 'FEE$.
hereby affirm that I have a certificate of consent o self-insure ora �.Vl','N,, jd - - ZONING APPROVED By D'ne)l s t 10.1 DATEIO 'n)fil
certificate-of Workers' Compensation Insurance,-or-a•certified copy VALUATION' S. - ///WdJ 15" / _
SPECIAL CONDITIONS:
•rcy (Section 3800,pb.CJ.. uGRADING CU.NDS. - ACRES
cy No:)2011- I Company � tP�C" �f�7fdtJ;Yf✓ -.. _ _ _. .. _ ._ _-. _ _ _ • - - - . . . . -
Certified-copyishereby-furnished. _. ._._ --- •i =.REMARKS:•: .'- -- 5 - _ _ - ' r 0 '- • •
.. -. . .. _ _ _ -
LJ Certified copy Is fled with the city Building Division. - - - - - ..
EXEMPTION FRO-NI-WORKERS' COMPENSATION DECLARATION' _ " - - - - - - _ F-- -- - -' '- -- �- -- - '--'- -- - - - - - -
(This section need not.be.completed.if.the permit Is for one hundred _ - _ 'i - -
($100) or less). :, i. _ _ _ _ _ _ . . .
I certify.that in the.performance of.the work for which this permit Is _ _ _
_ 1
Issued, I shall not employ any person in any manner so as to-become ,PLUMBING .',-A - P IV EC - - ' ELECTRICAL' "' "PLAN CHECK
-subjectto the Workers'Compensation Laws of..Califor nia._.- _ BATHTUBS SHOWER$ �Wt CLlN6 •' - - GA HH(aE _ ._ - --
Date _ Signature( - - T SO FT SO FT --
NOTICE: If afterlmaking this declaration, you should become subject ',TOILETS. URINALS- "' - " "GENERATOR--''0.1 KW_1-10 KW' -- -"
to the Workers' Compensation provisions of the Labor Code,you must - - - 'TRANSFORMER [, n
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'CAVS -- ' `-"- ' . ""APPLIANCE . -10-50 KW_50+KW- _ - --
•revoked. _..- • . _ _ - _ .
• CONSTRUCTION LENDING AGENCY KIT.SINKS ' -' " -" DISHWASHERS - ' MOTORS 0:1 HP-_1-10 HP-" ` - ' - "44 i
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS' r Gln SUMPS' -' - - -- - - -' - (INC.SOLAR) - 10-50 HP=50 +HP -
formance of the work for which this permit is issued (Section 3097 - - , - - - •
_ - - _- _- - -.._ _ _ _ _ _ _• _ .
FLOORSINK$ FLOOR DRAIN$' ' -FIXTURES -- "OUTLETS SWITCHES -" _" "
Lender's Name • ___ _ _ ___ _ ^
Lender's Address — DRINKING FOUNTAINS '-- -- - -- -- - GAS TUBE SIGNS _ ' ' '- • _ -- " --
OWNER'BVICDER DEC L'ARATION- _' -" - - -- INTERCEPTORS CLARIFIERS POLE LIGHTS "_- -- - •" ` -
I hereby affirm that 1 am exempt from.the Contractor's License Law for •. -
the following'reason-(Sectlon-7031:5'Business-and Professions Code:' 'SWIMMING POOL- -- 'PTRAP ' - - - - -- ' - LONSI.HUL i ION _ _ _ __ __
Any city or county which requires a permit to construct, alter, POLES - METERED • SUB. . .. •
'improve,"tlemolish-or repair any'struci ure;prior to-its issua nce,`also're ` WATER SERVICE ALTERATION - -' -"' - ' '-PANELS "--- -MAIN -SUB' - •
quires the apilicant for such permit to file a signed statement that he - -'� -
is-licensed pursuant'to'the provisions of'the•Contractor's'License Law' - SERVICE OUTLETS - - '- 'SERVICE
• (Chapter 9 (commencing with -Section 7000) of Division 3 of the
siness and'Proiessions Code)'or that'he'is exempt therefrom-and-the WATER HEATERS - BTU OUTPUT - - " '- '" - - - - i
s far the alleged exemption. Any violation of Section 7031.5 by - - -
1 ' applicant for--a- permit'subjects'the-applicant to a civil'penalty SEWER CONNECTIONS ' - - -' -" - -
_ not more than five hundred dollars ($500). I
0 I. as owner of the property,or my ernliloyees with wages ai their -SOLAR TANK ----COLLECTORS "- - -
sole.compensation,.will.do the work,.and the structure.is.not intended — _ ___
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. .;) ISSU EFE E ., '-- '- o
Contractor's License.Law.does.not apply_to an owner of_a property. APPLICATION APPROV ED'BV - - - DATE
who builds or improves thereon, and who does such work himself or ISSUE FEE It _ - ,
.through.his own employees, providedthat such improvements are not - _ _ _ _ ___ _
intended or offered for sale. If, however, the building or improvement MECHANICALPLAN CHECK • SUMMARY OR FEES., -
is sold,within one year.of completion, the owner will have the burden_ __ p 1 n�
of proving he did not build or improve for the purpose of sale). BUILDING
HEATING SYSTEM 0-100;000 BTU $ /9•' _ ' SMIP' - ' '$.. '5 I
-0-1;+-as-owner -of the-property, 'am exclusively contracting with - - - - - - - -
licensed etl Contractors to construct the project (Section 7044', Business 100,000 + BTU PLAN CHECK $ /IX• -- • •PERMIT^. -
'antl Professions-Code: The Contractor's License es not apply-to - •- --- - - - - - -- -- -- -:1ISSUANCE $ I
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ + •�. N G i
theCofrom•such-projects-with-a-conVactor(s).licesned-pursuant-to - SYSTEM - -- - - -- - - -- - GRADING '$`• • 1
the Contractor's License Law). 100,000+BTU ( PLAN CHECK p:S' - it.
'•• ") • ) .
•
❑ I an-real-mot untlei-Section - - -- -' "B.-&-'10.C:for this- 'ELECTRICAL-S- - - -
a BOILERS BTU , - o _
r¢dsbn _ __ _ _. ._..__ --- _-- _ -- - - - MICROFILM S,
-PLAN'CHECK- S^ VI
•Date- - -- Owner - SYSTEM REPAIR,ALTERATION -TOTAL FEEL$ ^ ' (9,
"MECHANICAL" $ - -
l-hereby certify-that,I,have read this application and state that the above EXHAUST SYSTEM _MULTIPLE 1.'4 LESS AD- •• ' (
information is correct- I agree to comply with all city and county - - - -PLANCHECK" $ — ' • VANCE PC ' $_- -
.ordinances and_state laws relating to constru ion,and boveby_auihorize i; 'i ( "( -i ` L, , = C
representatives of this city enter n the above rtlpntionetl i , t
,property for_lns on p s. `i „ FINAL FEE g �/ �� it
Signature ' Date _
Drivers'License or SS � . . .. _ _.. .__... ._ _ .
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
. •
CONSTRUCTION AND PLANNING _ POOL& SPA x. - ' . -;^�
't/ Date Inspector
- Date Insor
APPROVALS Permit# �'2 07 APPROVALS . . Permit# „
pct
- _ ,.••,
_ 1. Temporary Electrical Service or Pole ,43. Pool & Equipment•Location -. - --- - `-•'- -
2. Soil Pipe-Undrgrn _ •- . 44. Steel Reinforcement - , -- I ' •
3. . Electrical Conduit Utility-Undrgrn _ _ _ _ - , 45. Forms. . -' • . -- - - - - -
. 4. Electrical.Conduit-Undrgrn-, _ . _... ' ' . _ _. - - ,_.. _ 46. Electrical Bonding' _ - - • . . -- .- - -
_•••5. Steel Reinforce J.•a a-S1 8 211 47. Rough Plumbing &Pressure Test - • - - . - - . . . _ - -
,- 6,.;Electrical UFER Grn __ _ 48. APPROVAL TO COVER-GUNITE • • -- _ - -
' _ 7, Footings _ cr� /2-/g-g/ 73M 49. Electrical-Conduit:Undrgrn .
8..^Foundation,. , _,_ -; _r. -, ` 50. Gas Pipe, ❑Undrgrn,Test ' ' • • .
-_..9.: Water_Pipe:Undrgrn_ • _ _- -„ _ • 51. Backwash Lines. P-Trap_E Undrern • - . • - - • ' '
10.- Structural.Floor System . . - .• _ . , .52. APPROVAL TO DECK• " - ' - .
..,1.1._:Property.Sewer Line & House Connection ___ - :- "` -53':Backwash.& Receptor-Final '
. 12. Sireet.Sewer.Connection. 1"• ' '''.‘: ' . - - r a ' , 54. Heater & Vent-Final
_. 13.- _ Rough Plumbing _ . - - _ -' - ' - 55. Plumbing System •. Final - - ' - -�
14. Rough Electric-Conduit --•' - -.56. Electrical-Final . . - . • - •
15. Rough Electric-Wiring - - - - - -•- - -57. - Solar System-Final.' •
•- 16. Rough Heating'&Air-Conditioning .- r, -. . - - - -- - .t. = 58. Fencing &Access Approval • . ,
• 17.- Ducts, in Structure - . . r . ,59• APPROVED FOR PLASTERING . ,' ' " ' ' '
18. - Ducts, Ventilating S _ _ .. .. _ , -_ _ ' " . . _ _ , . , _ •
19. Gas,Pipe-Rough &Test. ' ' . h " .. . . : - 60. POOL/SPA SYSTEMS FINAL .
20.- Roof Framing - .. - -: ,_ ... ___! ._. _. _ . _ _. ..
21. Roof Sheathing ' - . .. ' . _ - �' an. •r
22. Frame and Flashing -- - - - _ NOTES:' - _- . . "';. ..
23.--Insulation. ,. : . ' .. .. , , ..,. .� _ . ,
24.- Lathing &.Siding _ -. -
25. Drywall Nailing_ . . - . ..... : ,
26.- Plaster Brown Coat • ' - _ _. '': . _ . _ . ' . . . •-
27. -Electrical Power Meter-Final __ __ . - _l_ _ .. . - _ _ ' - - ., • " '
28.- Final Electric - "' •• __
- 29. Final Heating & Air Conditioning. -_. .-.- _ . ' ',. .
t' ;ax
30. Final Gas Pipe-Test -' - "
31. _ Final Plumbing _. _ _ - • _ _
- 32. Water Service-Final - . - ,r .. - .- - - . - - • ' -
-33. .Gas-Service-Final - _ - - _ - . _. _ __ . " . .
34. Solar Domestic-Final"'•- - . . ' '
35. Landscape Sprinkling System - - - - •>- - ' ' -
36. Sound Attenuation . . -� .. . -_ - -
1 37. Handicap Regulations - . - y_ . - , , , , ,. - - •• r
38. FINAL STRUCTURE & BUILDING• _ ' ' 2,2i-,„/VSi J1' '2 - ' . . ' ' .
39. Special Requirements Completed ' ' " ,; -'_"- • - -
40. Electric Release to Edison - - . . - - - - - -
41. Gas Release to Southern California Gas Co. ' ' i ' _ • ,
42. CERTIFICATE OF OCCUPANCY _
' No. - - Date ' . 1 - - - - - ` , , ` . .
_ - - _ - Applicant to fill in all spaces except those within levy bgrtlel hoes and sign all appropriate declarations. :1 Q4�c 6/08/66--- I-56-.77 .TL
PERMIT NO. TRACT N . LOT NO.; UNIT NO
OF COSTA MESA/ (�CONSTRUC�TION PERMIT •� Q/ /}/-��,(7 } ) I ' " i
dress i k� iAfrfedd , / -�� / I� ' ,EG LJ I •I•• , nY '
,. e 1 TYPE OF CONSTRUCTION NEW ADO' ALTERATION Li REPAI R
APP fling Address ��pc.t+..,L � �' .. '. _ •, :
❑ CONVERSION• ❑ DEMOLISH OTHER t _' ( _ ', A.P.# 9/•,/. (,ISI• a` -i D _ - _ .zoneMA�MaOwner's Na �A�D:f IJQ Phone •DESCR IP31Q,lJI Q F WORK/USE OF BLG. •• "1
Address ��'`'-�-t ' �. p- S' Main Building: 'Accessory-Building.'
Arch/Eng. -�- i4i /-&�-N� ,Q ' License No. .e�+ 11N��3- .TYPE:OF PE MIT Ell GRADING CI FOUNDATION ❑ STRUCTURAL T Front. -(6,/ _ --•,•_ - O
Address /30 7 •KAr.,A- ' •�.fQ.CS.J �P••i•�1 w ❑ TENANT ❑ ELE�RICAIE ❑ PLUMBING III MECHANICAL • .B Rear •,r ,y. ' ,•.,,1 y,�,•, N
// ❑ OTHER.
(p • 7 S
Contractor•'s Name ?:'- nµr d1s76 tz • P00/5 Phone L3?'-�'i0 L.tpl y - - A g _ - -. _ -'
C Ri ht �/ , , G di'
„rr PROJECT DESCRIPTION SQ. FT. y L ' OCCUPANCY / '
Addre551mailing) 4'I6S - = •iPSRs"i LJM.t • Ir°P Q�+A..�'a `CONSTRUCTION TYPE VALUATION'S /a/P&G $ Left J4/ R
City License No. '.31��2 ' '
ZONE I GRADING CU.VDS. ACRES - I E
LICENSED CONTRACTOR DEG LA RATION- .. .Flog. Ref.# Parking Req./Provided , ,
I hereby affirm:that I am licensed under provisions of Charter 9 (commencing Remarks: r0 41
/_ ` , ' ! O
with section 7000) of Division 3 of the Business and Professions Code, and I \�*V I V7 I� Pia nning Notes: _ l M
my licenselis in full force and effect. - - - -3
- T
Lic •4.a+-114i�! =t” - i ;SPA ' /N *FAA 'y/t/RD I
License Class - i o. s L.
Date - Signature �� �� .✓ , I • 1 PLUMBING , , . , FEES ' • ' j ..
'ORKERS'COMPENSATION D�• �ATION ' I Bar Sink , . . ,Showers ' ' '• ELECTRICAL, ,s ' FEES
• ereby affirm that 1 have a cert cafe of consent to self-insure or a certificate - ' - '
Workers' Compensation Insurance, or a certified copy .thereof (Section Backflow Pfeventer, I Service Sink ' r i .
3800, Lab. C.), - ' — - i _ t .. _ Automatic Washer - • i 'Transformer`U115.50 KW
Policy No. I Company t ' Backf low•irrigation' Sewer Ca , !0'50,
SO+ KW .
ti, _ P i Construction Pole Sub.t,
Certif ietl copy is hereby furnished. i :` •
er I�f'ietl�qpy,is filed with the city B 9 pj,yls{on+. . Bathtubs • Sewer Connection Cooking Umt - - Meter;❑up to.100 amps
1, Date • Y/ /,p - Applicant/�/{{7Ip'C -///a.cs.c/y.�-• - _ „ _ -
EXEMPTION FROM WORKERS'C AI NSATION DECLARATION Clarifiers' - - •Solar Collectors - - Dishwasher, ' i . Meters Dover.100 amps.
(This section need not be complete f t e permit is•f or one hundred ($100) or - - - '
less).. I • I I Dishwasher- , - . Solar Piping' ' Dryers DGas ❑Electric
V 'Sub Panel -
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 --- Drinking Fountains I 1 Solar Tank a I Fan, 1 -
Workers' Compensation Laws'of California. . . _ - : . ... - ' -_ Motors 06-1-HF) ❑1b' BI -
Date • Signature Floor Drams' ' ' Swimmin Pool w/S a- `'� - ' - .. '
NOTICE:-If,-after making this decimation, you should become subject to the-- - I . P J F.A_U!. _ .-- -Inc_Solar ❑9.15 HP ❑16-15+
Workers' Compensation provisions'of the Labor Code, you must forthwith Floor Sinks - I { Urinal I
comply with such provisions or,thisI i , Fixtures Microwave 1
permit shall be deemed revoked. r
CONSTRUCTION LENDING' AGENCY ,
Gas •Service ;Outlets Water Closet Device Boxes I
I hereby affirm that there is a construction lending agency for the performance .�� I • i , ' i • Pole Light , t
of the work •for which this permit is issued (Section 3097 Civ. C.) - -
Interceptors ,Water •Heater ` Outlets
Lender's Name t ,J�' 1 Range i -
-Lender's Address �d'v`-167 : _ .. - . - Kitchen Sink.-- - --- -'Water Service • • - -L - - i - -- - -- - -_-
' OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories , ,Auto-WashGarbe a Disposal
following reason (Section 7031.5 Business and Professional Code:'Any city or 1 9 P t l Standing Sections ,
county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' ' Laundry Trays I Generator ❑0-5 KW ❑5-15 KW ' •
, any structure, priorito its issuance, also requires the applicant for'soch permit 4- Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of ROOF Drains
she Contractor's License Law (Chapter 9 ons Code)
or with Section 7000)of ' 4 5/✓A- 7_- p0
vision:'3'gf the Business'and Professions or that'he/she Is exempt '-- '— - - - - -
arefrom and'the basis for the alleged exemption. Any violation of Section
' .031.5-by any applicant for a permit subjects the applicant to 'a civil , _ ' - _
, •penalty;of not more than five hundred dollars ($500). ; 4 I - : j ,
• l '
• 1,.as owner. of the. property or my. employees with wages as their sole Reinspection Fee : I, $15 'Issue Fee $
!compensation, will do the work, and the structure is not intended or offered __ 1 ' - Reinspection Fee -.:1!$15' Issue Fee , .. ?$ 3
•for sale (Secion 7044, 'Business and Professional Code: The Contractor's - - , MECHANICAL , FEES ' , - -
• thereoe-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 - - I DEVELOPMENT SERVICES ' CIUIREME" / t , - . .
I employees, ever.:ed that such improvements are not intended or offered for Boiler CanopyHor 'Type I ❑ - - .rr •r,u ' '
Sale. If,'however,ahe building or improvement is sold within;one year of coin-' — ,Type II ❑ - 1 i Zoning Approved By • - r id L ' -Dater �`I li.
-Motion, the owner will have the burden of proving'he/she did not build or im- Duct- Under.Ground - - i .� �� `i '
. Lirove for thWpurpose of sale).' - - Building Approved By _ j - Date mo�ii// .L I'
i, as owner of the property,am'exclusively contracting with licensed-con- Duct-Structural Refrigeration System • ' Application Issued By - ' �` Dat: .0947-7_••
i tractors to'construotthe project (Section'7044,Business and Professions Code: - — - , _ -
' ' The-Contractor's-License Law does not apply to an owner of-property who Duct-Ventilating ' 00-100,000 BTU 0100,000 BTU 1 • ' • , $Ufy�MARY OF FEES '
- builds or improves thereon, and-who contracts-f or such projects with a con- - _' a+
• 'tractor(s) license!pursuant to the Contractor's License Law). I'am aware,thatBUILDING PERMIT _ $ n. V - .-SMIP $ ' ' 0.70 .
proof of their Workers Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 , 'System Repair/Alteration " i .-
PLAN CHECK $ _ Sr • ;'/_• PERMIT' - - , -
❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.BIL ICBG# ' Fire Dampers ' • / •-ISSUANCE - $ --
_ _ _ PLUMBING ' $ t�'r m� _
Date'' - " owner - - - '- , . Heating System& Ducting - Registers - PLAN CHECK 25% $' • 'ENERGY P.C. $ -_
hereby certify t•at i,have read this application and state that the above, El 0-100,000 BTU 0100,000 BT - - ELECTRICAL - $ : GRADING $ -
information is cor jct agree to.comply with all city and county ordinances - _ • • ' ' '
.and,state iaws r, ti y to buil. action, and hereby authorize'repr - _ - - { ' MICROFILM• $ '
sentatives • •i 4 y• 1T�upon!tin above-mentioned' prop/sj ty f r - • - _ PLAN CHECK 50% $ . �i
inspection pur••� - ../ - • MECHANICAL $ ., .. /'
•Signatu _. , et.:44 ' ��- - . Date - - - _ TOTAL FEE $ /S(Cr�7
•Drivers'Lii or-SS# ' • - . - -, Reinspection Fee $15 Issue Fee 1 -$ '3 PLAN CHECK 25% $ -
CMF 08;5-•'• .v.10/84 White - Building; Canary - Applicant; pink -Accounting; Goldenrod - Assessor
.CONSTRUCTION AND PLANNING POOL &SPA
-APPROVALS Permit# 1 (Date Inspector •APPROVALS Permit# Date . Inspector
jy
1_. Temporary Electrical Service or Pole 52. Pool & Equipment Location 1 a/ /C.--- •
1, r$
2. Soil Pipe-Undrgrnd,' r 53. Steel Reinforcement
r
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
, 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , ,
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
5
6. Electrical UFER Grnd.••- .: : -- 57. APPROVAL TO COVER GUNITE •/i3/( LIC7. Footings ( . ' ' 58. Electrical Conduit-Undrgrnd. t
g
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap,•O Undrgrnd. " / 6 ve.,,
10. Structural Floor System ; 61. APPROVAL TO DECK ;. Yl V(j
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 1 / (.., tic_
12. Sewer Cap .i 63. Heater & Vent-Final ;i'
13. Roof Drains . • 64. Plumbing System - Final, _ •
14.'Rough Plumbing 65. Electrical-Final , I
15. Rough Electrical-Conduit 66. Solar System-Final -
•
16. Rough Electric Wiring - 67. Fencing &Access Approval
17: Rough Wiring-Sign - 68. APPROVED FOR PLASTERING 9///ig 7 / fZ
18. Rough Electrical'T Bar Ceiling -69. POOL/SPA SYSTEMS FINAL 4/0/81
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '-
20. Rough Factory Fireplace - APPROVALS Permit# i _
21. Ducts, in Structure 70. Underground Hydro,
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush ,
24. Roof Framing 73. Undergrnd.Storage Tank 0 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 . 78. FIRE PREV. FINAL
30. Drywall Nailing 1 . . HEALTH DEPT. REQUIREMENT ' ..
31. Plaster Brown Coat79. FINAL INSPECTION :� • .
32. Electrical Power•Meter=Final 80. FOOD CERTIFICATE ISSUED '
33. Final Electric Notes: Q I ''
34. Final Heating & Air Conditioning S/ cryo- fc Ib_ o�
35. Final Gas Pipe-Test .0 'iY/o ,• I�`6�9`'�'\ ('J{,�'
36. Hood or Canopy �1
37. Final'Factory Fireplace ,
38. Final Plumbing - -
39. Water Service-Final
40. Gas Service-Final -
'41. Solar Domestic-Final -
42. Backflow Preventer • - -
43. Backflow Irrigation- • " -
44. Landscape Irrigation System -
45. Sound Attenuation -
46. Handicap Regulations .../
..
47. FINAL STRUCTURE & BUILDING - - - • '
48.'Special Requirements Completed - _
49:Electric Release lo Edison : • ' ' •
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY -
No. - Date .
1 r'
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATIONF9RISTRUCIIUR'ALPERMIt6_9e I'4 111'
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIVED BY PERMIT _J ie
For Applicant to Fill in Completely -Use Ink Only </1/ s/ I�'+.'I V �t 44-L.4.2.0
.BUILDING A.P. NO. ') D__-o4-a.. - aI
ADDRESS Tract 10278, Lot 10
BUILDING v,� nl}Ly, C+
TENANTTOR McLain Development Co. ADDRESS I '6 M h—/ J
UNIT ORMAI LING
✓/
ADDRESS 1470 Jamboree Rd. SPACE NO.
TEL. Trerco..apa LOT to BLK.
CITY Newport Beach NO. 640-6800 II
CONSTRUCTION I�NEW ADD ADD ALTER I REPAIR MOVING DEMOLISH
LENDER
BRANCH
OWNER
ADDRESS VALUE
ARCHITECT TEL. USE $
OR ENGINEER Corbin/Yamafuji NO. 572-5567 '�j�7y�)�p tyI nI�
•
ADDRESS 3661 Spruce St. , Newport Bch. ZONE(1) 1.V TYPE GROUP
APPROVED
CONTRACTOR McLain Development Co. BY DATE
ADDRESS 1470 Jamboree Rd.
CITY Newport Beach TEL.. 640-6800
F, STATECITY APPROVED SETBACKS
LIC. NO. 273875 LIC.NO. 18873
SIZE ' LOGS.
(FROM cit.STTR ET)
0. OF LOT NNO.OF OW ONBLOT FRONT 16 /St.
Q USE OF
'Ci,�—• EXISTING BLDG. R SIDE FT. _
h
F Separate permits are required for L.SIDE 5 FT.
C electric,plumbing and heating work. REAR )3 .147. —
FW+ USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
TE
Single family residence , / APPROVED .
New house APPROVED /./N// DATE I O//(It/�{/7�
CC
oI hereby acknowledge that I have read this application and state • n 0
Z that the above information is correct and agree to comply with Di Q
6, all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of • E
5 the State of California.
SO.FT. w qr
N
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR al
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ �j �f.� Y
and Professions Code, Division 3,ChapteL99 a�( �V §14,1
Signature of PLAN CHECK $/ 3,s0 0
Q` z1� F �n /Js / _ o
Permittee _,— /�,Rl. $�`f' D1�v' TAX S r� O
Authorized Age Date / TOTAL PAID
. 369•/