HomeMy WebLinkAbout1169 KINGSTON ST - Building Permits �J' 9 CITY OF COSTA MESA
t BUILDING DIVISION
> %� .4rI DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER
� PERMIT B05-01932
�
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BI1NLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1169 KINGSTON ST Status: ISSUED
Suite: Applied: 10/27/2005 '
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 10/27/2005
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number 41204241 Zoning: RI
Applicant: SELL, RON
Address: 18032 LEMON
Phone 714-528-1758 ISSUED BY: /�
YORBA LINDA,CA Zip 92686•':
Owner NAGLE, GERALDINE TR
Address 1169 KINGSTON ST . •
COSTA MESA,CA . Zip: 92626-1649 - -
Contractor. ; ,SELL ROOFING COMPANY' `t "
•
Address '18032 LEMON -
x_ Phone: 714-528-1758
,
YORBA LjtNDA,CA
Zip: 92686 9,:•,/"."— License: 323842 - - ..
Arch Eng:
Address: - Address: -
• Phone: . - Phone: .
•
License *: License: ,
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE:T/O WOOD SHAKE ROOF,7/16"OSB SHTG,2 LAYERS 30#FELT APPLY"EAGLELITE MALIBU 1
PSF- ; ?,;.
:t:ICBO#ER-4660 29 SQUARES - `
FEE SUMMARY :911
'l! Plan Check ` ' $0.00 . Caic Valuation ` :, n "$8900.00
Permit 'r.., $167.25 Claim Valuation 4t b''$8,900.00'=
S•MIP Res: $0.69.,...„ ,. .L.
.,":'-'A SMTP Com'- $0.00°•'
Other . $0.00
Inspection ', $000
Total: ':$168.14 ,'s
S PLANNING &ZONING
SETBACKS - ,
MAIN STRUCTURE Front 0=0 Y Rear 020 Left 0-0 'Right' - .0-0 "'
ACCESSORY=. Front '0-0 Rear '0-0 ° Left 0-0 ° Right 0-0'
PARKING i .Existinq -_ -0 Required. 0- Proposed "or
t•
. ,." lit i
p .
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)
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 issued.
v My workers'comp nsaaiIon Insure carder and policy number are:
e ycPolicy�t umber: �6 of 6 SS V.
(Thissection need not be completed li 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 agre t if I should come subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions. // /
AppllcanLSignature: Date._ ?'" /—G C .
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 COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under proyislons 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.Lib+u-. '3 z_ S`p Claw —3 7
Contractor:eSignature: ow /J/.(.� Dates..- /d—.5/-CC,
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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: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a 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 drivers 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 B,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, es 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
materiel? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
• business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2' Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Cale,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? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application akEemit 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 Califomia Govemment 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 ❑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 Califorp?Health and Safety Code Section 42303 been made? 0 Yes ❑No
8 (If yes",attach certificate of compliance from the appropria(e air pollution control officer).
CERTIFICATE OF COMPLIANCE:.I certlf1y?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 Emissfoiis.
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 specti ps.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
l,��/g�o'nature Oi al Own (s)
// Rat
And/Or
Authorized Applicant 0 �!_IDate---
LODE I INSPECTION TYPE OAIL INTITIAI$ . CODE I INSPECTION TYPE OBIS INTMAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final � 208 Final Plumbing
200 Final Re-Roof 9'2 J""�/y/ ‘604-- 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
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.PROJECT ADDRESS: UNIT:
,. re•OWNER'S NAME: 1169 KINGSTON ST CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 057730
' 0*--, ADDRESS: HANADA BOBBY
1340 DANA PL PERMIT NO: P 057730 PLAN CHECK NO: N GOVT: N• SUPP: N
FULLERTON,CA 92631
CONSTRUCTION TYPE: PERMIT TYPE: PLU r
ADDRESS: UNIT: : PURPOSE: 0TH
ARCH/ENGINEER: 641 1792 REC.NO.: JOB DESCRIPTION WATER HEATER � FT:
SQ
PERMITTEE: CLAIM VALUE: CALL—VALUE: GROUP OCC• ; /
ADDRESS: EARLS PLUMBING ( 714 ) 772-3470 '
1533 W. LINCOLN COMMENTS• SMOKE DET REO PRIOR TO FINAL
nnFF��E��j}��TT]]��''TTFA�A CA 928.p0 ***�LFE�E�E�HiH�E�¢�E�E**�E�F***** **�L�EIE+E�E�E�E�F�E**�EFEEL*kE+EkEFE***�L�E*+E**�EkEkE*�E+E�E�6�E�E�F�E�E*FE*+E�E�EFF******
LICENSED CONTRACTOIYDECCARATfO EI;liereby affirm that I am licensed'under provisions at chapter 9(commencing with Section Z O N I N G R E U I R EMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S E T BQA C K S
CITyuC.: O4 93g STATE LIC.:217657 CLASS: 6 ••
nate: 7—I�—`/e�— Signature: PCIiM_ a MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR:- FT IN FRNT: FT IN REAR: FT IN
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.: UCA-11686 EXP.DATE: 03/01/93 .,3/0 1/9 3 '.'
rvCOMPANY: UNICAREPARKING REQ: PROV: PARCEL: - 41204241 ZNE: REF NO:
-tit] Certified copy is hereby lurmshed. Iii Certified copy Is d with the city Bu cling Division. PLANNING N(3TES>
_Date. Applicant: **********************************************i4********************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($181)or less). DEVELOPMENT S ' E R V I C E 5•;, REQUIREMENTS
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. ;3
ZONING APPROVED BY DATE:
Date'. Signature: i
NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ., r
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: CTI DATE: / L—.
which this permit is issued(Section 3097,Co.C). ************************** ** * ** *** ***************************** ******
LENDER: *************************************** *************************************
ADDRESS: • • LEGALIZATION:N FEE f 5 U M M A R Y STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code. Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 00 r'`
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 70001 of Division 3 of the Business 25% ,• .&--
SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any 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($500). ISSUE FEE 3 . 00 f
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(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 2. 00 3. 00 VI '� 0. 00 5 . 00 5.0 0 . 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 are 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 REVENUE DIVISION TOTALS--> COLLECTED: 5. 00 OVER/SHORT: . 00
mrthe purpose of 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 5• 0 0 r
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon 'C
and who contracts for such protects with a contractor(s)license pursuant to the Contractors'State License Law). lam aware ********************************** ***** ***************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ lam exempt ender Section: B.a P.C. IND I V I D U A 7L i. F E E BREAKDOWN
for this reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date: Owner: •
•
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 • 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 JEND. OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from :1 :�,
these provisions. '.• �-
Yj
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county :-9
ordinances and state laws relating to building construction and he eby authorize representatives of this city to enter upon the above-mentioned .r
property for inspection purposes.
[['' p /������ �����.� liil /2
hale, 7-f 1— !� -- Signature: _�i1YhC_ _ �./�/ '✓'uQ . ..-- j V -
01 10119';;9-0111194:0
T Ci T
Driver's License or Social Security x: , r OA TE r 07/15/92. Tit7@: ET:ver
164146 White—Budding:Green—Code Entorcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
I
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CONSTRUCTION AND PLANNING - - PO, A SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole -„ -
. 52. Pool & Equipment Location
ti _
2. Soil Pipe-Undrgrnd. n • 53. 'Steel Reinforcement
IT' r -
• _3yu ,
Etectrieil CondUOity-Undngrnd •u. - 54. Forms
•
• ,4�Eleetrieal Conduit-Undrgrnd. `r - 55. Electrical Bonding
'5.'steal Rejnforcem'er4jT. 56. Rough Plumbing & Pressure Test
Electrical UEEFliGrnd. 57. APPROVAL TO COVER-GUNITE •
-7FFddtings .-; r'' 58. Electrical Conduit-Undrgrnd.
J ,
- '-B. Foundation - " 59. Gas.Pipe, 0 Undrgrnd., Test `
•
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System _61. APPROVAL TO DECK --I
11. Property Sewer Line;& House Connection . 62. Backwash & Receptor-Final • • •
ter If •
12. Sewer Capn, 63. Heater & Vent-Final •
w
13. Roof Drains x ' - 64. Plumbing System • Final
14. Rough Plumbing_ ' _ 65. Electrical-Final
15. Rough ElectricaLConduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval •
17. Rough Wiring Siion 68. APPROVED FOR PLASTERING
18. Rough Electrical T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
• ...T".1:....T".1:.20. Rough Factory Fit place • C r '.1 Y = T+' APPROVAL -u :Permit# + _>•
S. �•Y. . u- i_-)i •. .> v o
•
21. Ducts, in.,Struoturej Y •�'ti •? a .. Cr0. Underground�Hydco
.
•22. Ducat Vedtilafingtl- (a- -, -t r C' _71. Product Pip'eng O'Gas 0 Oil
. . 23. Gas Pipe-Rough &Test ti,c r ,,, e- ... J- , 12. Underground Flush;-,-
24. .Roof;Framing-- Y'_ - -- - ' > ...
33. :Undergrnd:Storage Tank 0 Gas 0 Oil
25. Roof�Sheathing `_ v :;,. - t.,., . '74. Overhead Ffydro
26. T-Bar Ceiling SStructurall & Monocoat . _. ro _. t' 75. Dry Chemical C
27. Frame and Flashing ;
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' _ - _ _ - __� , Applicant to fill in all spaces except those within heavy border lines and sign,all,appropriate declarations. - - _
l . CITY OF COSTA MESA •
, PERMIT.NO.I, I , • • , TRACT NO. -.LOT NO. - BLDG.NO. - ,;
102 835 : • ' 1843 .•6/08/84 ,. Imo• . TL
CONSTRUCTION PERMIT . . ? - - "" • ' _
Project Address 1169 Kingston 'Gt Costa Mesa TYPE OF CONSTRUCTION 'U LJ NEW . ADD U ALTERATION ❑'REPAIR ' ' " ' - '
Applicant's Mailing�4 Address I ' ❑ CONVERSION -CI DEMOLISH ❑ OTHER AP #_ I, Zone ' r i -
Owner's Name ♦'tu1,�1"•].Ce Allard phone 751-5 SOH DESCRIPTION OF WORK - _
- .. S}, Main Building: , Accessory Building: Z
Address. • SaIl1P - - E -- - 0 •
TYPE OF PERMIT ID GRADING El FOUNDATION U.STRUCTU RAL :T. Front _- N
• Arch/Eng." ' ' License No., •• ❑,TENANT ❑ ELECTRICAL ❑,PLUMBING ❑ MECHANICAL B Rear • I
Address - - - - ❑ OTHER �• N
D W Payne Phone 545-5542 PROJECTDESCRIPTION. SQ. FT. • ' OCCUPANCY C Right G
Contractor's Namr K -
3005 S. HalladaySt. r Santa Aha CONSTRUCTION TYPE VALUATION$ S Left R
Address(mailing) - E
ZONE GRADING CU.YDS. ACRES Q
City License No. 6315- Ping. Ref. # Park.Fees $ - U
LICENSED CONTRACTOR DECLARATION Remarks: Parking. Req./Provided
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
with section 7000) of Division 3 of the Business and Professions Code,and . . . Use of Building: 1 -' ( E
my license'is in ful ffect. PlanningNotes:
t`2�j7°� 280319 - E
license Cass License No. PLUMBING FEES
' ,:e'5�2 S7 H4 Signature -
ll',RKERS'COMPENSATION DECLARATION Bar Sink Showers • N
•' -
:nereby'affirm that I have a certificate of consent self-insure or a certificate Backflow Preventer - Service Sink . S
of Workers' Compensation Insurance, or a certified copy t ereof (Section _,__
3800, La C,)`�/ �� , ) 0. Baikf low Irrigation' Sewer Ca ,
Policy Not"' Company _�-1 p - ELECTRICAL FEES
Certified copy is hereby furnished. • Bathtubs '
Sewer Connection 4' '-AuAutomatic Washer Transformer 0 15-50 KW '
4SI Cer rti�p gy,ig filed with the city Builtli ivisyyffp�r']7�� �� � 1 _ •
-
Date �/L�/ i54 Applicant a�"Z Clarifiers Solar Collectors ' Construction Pole Sub. 0 50+KW
EXEMPTION FROM WORKERS'COMPENSATION DEC RATION RATION Dishwasher ; Solar Piping
(This section need not be completed if the permit is for on undred ($100)or ' P 9 '! Cooking Unit Meter °up to 100 amps
less). _
I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank - Dishwasher Meter Cover 100 amps
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California. • Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel '
Date Signature
NOTICE:If,after making this declaration, you-should become-subject to the ' Floor Sinks • Urinal Fan Motors 00-1 HP,dy
1'/:-8 3 00 '
Workers' Compensation provisions of the Labor Code, you must forthwith ' . -
•
comply with such provisions- or this -permit shall be'deemed revoked., , , Gas Service Outlets - Water Closet - '
CONSTRUCTION LENDING AGENCY
F.A.U. Inc.Solar 09-15 HP 016-15+
I hereby affirm that there-is a'construction lending agency for the performance ' Interceptors ' • Water Heater Fixtures Microwave
of the work for which this' permit is Issued (Section 3097 Civ. C.) '
Lender's Name - - Kitchen Sink Water Service ' .' Device Boxes ' • ' • Pole Light'
Lender's Address •
- • - Lavatories
OWNER BUILDER DECLARATION - - Outlets Range , •
I hereby affirm that I am exempt from the Contractor's License Law for the - p—Tra ,
following reason (Section 7031.5 Business and Professional Code: Any city or p' _ ' Switches • Sign
county which requires a.permit to construct,alter,improve,demolish or repair ' '
v.:7,7g structure, prior to its issuance,•also requires the applicant for such permit I Roof Drains' - Garbage Disposal Standing Sections I
?'ile a signed statement-that he/she Is licensed pursuant to the'provisions of : '
" -'Contractor's License Law,(Chapter 9 (commencing•with Section 7000) of - - , -
i'lslon 3 of the Business and Professions Code)'or that he/she is exempt 'i • -, - , .- - i • Generator 00.5 KW ❑5-15 KW Trash Compactor. '
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects applicant to a-civil I •
penalty of not more than five hundred dollars($500). .Reinspection Fee .1 $25 Issue Fee : , - $ 3 '
I; as'owner off the property or my employees with wages as their sole - Reinspection Fee $25 Issue Fee ! , .$'3
compensation, will do the work, and the structure.is not intended or offered • • , MECHANICAL FEES'
for sale•(Section 7044, Business;and Professional Code: The Contractor's T PUBLIC SERVICES REQUIREMENTS: - I i
License Law does not apply to an owner of a property'who builds or improves Boiler , .i 'Hood or Type I I D I
thereon,land;who does such work himself/herself or through his or her own - Zoning Approved By I Date • '
employees, provided that such improvements are not Intended or offered for " - - :Canopy Type III 0 , - ,
sale. If, however,the buildingor improvement is sold within one year.of com- • Duct-'Under Ground , _ ,
P _ Building Approved;By. Date ,
oletion, the will have the burden of proving he/she did not build or im- •-- ����� yj��C{�/��.,
prove for the purpose of,sale). ' I ' d i , i Duct-Structural Refrigeration System } Application Issued By ✓ ' Dat; 1
Ll I, as owner of the property,am exclusively Business
sed con _ _ 10Q000 BTU_0100 000 BT,U //////-----��, ,
tractors to construct the project-(Section:7044,.Business and Professions Cote; ' Duct_Ventilating - - - 7 ;j� ' SUMMARY OF FEES
The Contractor's License Law does contrply to an owner of property who, 'I S
builds or Improves thereon,and who contracts for such projects with a con- I Exhaust System 0 Multiple 0 'System Repair/Alteration - BUILDING PERMIT $ - SMTP '$ '
tractor(s) license pursuant to the Contractor's License Law). i I PLAN CHECK $ I PERMIT i i
- 0' I am exempt unbar Section B.& P.C.for this reason j I Firepl/Fact.BIt. ICBO# I - - I ISSUANCE '$ 1-,• PLUMBING ; r i$
Date ' ' • 'I Owner I • I I Heating System&Ducting , ' • j•. PLAN CHECK 25% $ . - - ENERGY P.C. i$ i
•
(.hereby certify.that I have read-this application and-state that the-above ❑0.100,000 BTU-0-160,0008TU- '-- -r'- -- I - (TJ GRADING' $
Information Is correct. I agree to comply with all city and county ordinances 1 .. . I r ' • ELECTRICAL $ �, , • t
and'state laws relating to building construction,and hereby authorize repre- , , MICROFILM '$ '
, sentatives of,this city,t enter upon the above-mentioned property for - PLAN CHECK 50% $ '
inspection purpose - ( _ I TOTAL FEE $ /(„`S a
' Signature - �$,J� -- -- =Date 5/25/84 , - •- MECHANICAL $ �C�+l
✓' • , . .,. `Reinspection Fear----- -- - -$25- - -. — '-.Issue Fee - $ 3 PLAN CHECK 25% $ ' -1 -
' • Drivers' License or SS - - - _ - _ - - - - -
- - - . -I _ • _ _ _ _
CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod.-Assessor ._, _ - - _
CONSTRUCTION AND PLANNING - PC &SPA _ • p'. . -
APPROVALS . Permit#)VE-�. 3SZ?Date Inspector. APPROVALS. Permit# - •Date dnspector •
1. Temporary Electrical Service or Pole _ 52. Pool & Equipment'Location -,:', -Y,- r t 1
2 Soil Pipe-Undrgrnd: I 53. Steel Reinforcement _ . • • I i
3. Electrical Conduit 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 Coriduit-Undrgrnd:. _ - ; -4
8. Foundation - ,59. Gas,Pipe, O`Undrgrnd.,Test . r . -t _ '
9. Water Pipe-Undrgrnd. 60. Backwash Lin-es,:P-Trap, O-Undrgrnd.••'
10. Structural Floor System '•61. APPROVAL TO;DECK - 5
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final •, .-
12. Sewer Cap - - - • 63. Heater & Vent-Final - - • .
13. Roof Drains 64. Plumbing System - Final--- '-- . .
.l
14. Rough Plumbing 65. Electrical-Final" -• - ,-1 ' - '1
15. Rough Electrical-Conduit • 1 - 66. Solar System-Final • - -'- - -I• �; "- --i• -
16. Rough Electric Wiring 1 • r - 67. Fencing & Access Approval - 1 _ -
;
'17. Rough Wiring Sign • - - - 68. APPROVED FOR PLASTERING •• ; .
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS'FINAL • _ - . . i ( - .
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT, ' . ' ' rr
• 20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro -
22. Ducts, Ventilating - 71. Product Piping O Gas 0 Oil , ,-t -
_ _. _.____
23. Gas Pipe-Rough & Test 72. Underground Flush 1 1 -
24: Roof Framing , • 73. Undergrnd.Storage Tank O'Gas O'Oil : ' ' i
-
25. Roof Sheathing , 74.,Overhead Hydro • _ ;
26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical
• 1
-27. Frame and Flashing 76.: Dry Standpipe ' ' . _
28. Lathing & Siding 77. FIXED SYSTEM FINAL ' • ' ' ,
29. Insulation . 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT '
31. Plaster Brown Coat 79. FINAL INSPECTION '
32. Electrical Power Meter-FinalJ r; 80.•FOODCERTIFICATE_ISSUED ,i, 1
33. Final Electric 69Jy ifj Notes: - r 1 i
34. Final'Heating & Air-conditioning. /, MP( 1 •
. .
35. Final Gas Pipe-Test _1 •
•-- , _
•
36. Hood or Canopy • ' ,� -- -
37. Final Factory Fireplace t • - ;P • m - .S c; •
_
38. Final Plumbing
39. Water Service-Final • - . -
40. Gas Service-Final 1 '
41. Solar Domestic-Final - -- - - - ,
42. Backflow Preventer • i '
43. Backflow Irrigation t • _ .� 1
•
44. ,Landscape Irrigation System i ' , -
45. Sound Attenuation - • I ' ,' I i •- . m _ l..
•
46. Handicap Regulations - ' • u - .
47. FINAL STRUCTURE & BUI LDING• . ' -- :t.1.1
•
48. Special Requirements Completed - : 111
1 1 ,
49. Electric Release to Edison - - I ii
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY • {- 1
•1
No. Date t •- , I.- • l - '
6695 II /f4/7P 306.80 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT 'z SP 1
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIVED BY 'PE Iiia�e 474 JJ
For Applicant to Fill in Completely - Use Ink Only ''//Y7//��(U//J
BUILDING A.P. NO. ''CfkC/-•--�-a...-�)
ADDRESS Tract 10278, Lot 47
OWNER OR BUILDING
ADDREss fLI Kaki jitdh 5±•
TENANT McLain Development Co.
UNIT OR
MAILING SPACE NO.
ADDRESS 1470 Jamboree Rd. TR.tJQ,Cb� ?9 LOTfi BLK.
TEL. ``
CITY Newport BEach No. 640-6800
CONSTRUCTION
NEW
ADD ALTER REPAIR (MOVING DEMOLISH •
LENDER y
BRANCH
OWNER
ADDRESS - VALUE
ARCHITECT Corbin/Yamafu i TEL. 752 -556 USE $
•
OR ENGINEER NO. rp(J�p rI�
ADDRESS 3661 Spruce St. , Newport Bch. ZONE It/I\htir,TYPE GROUP
APPROVED •
CONTRACTOR McLain Development Co. BY DATE
ADDRESS 1470 Jamboree Rd.
TEL.
CITY Newport Beach NO. 640-6800
, F STATE CITY APPROVED SETBACKS
LIC. NO. 273875 LIC.NO. 18873
SIZE NO.OF BLDGS. (FROM Ce/ STREET)
',' I e �L OF LOT NOW ON LOT FRONT .3.STREET)
FT.
Q USE OF
r EXISTING BLDG. R.SIOF 5 ET.
cn
FSeparate permits are required for L.SIDE FT.
electric,plumbing and heating work. REAR /1 FT.
]
kUSE OF BUILDING AND WORK TO BE PERFORMED PLANNINGACTION
ii
DATE
..i Single family residence APPROVED
I: 'C Aix �1/ dI
��„ New house APPROVED l' r' DATE to/i$l-2q
w
w Qa I hereby acknowledge that I have read this application and state a
E4 that the above information is correct and agree to comply with J
Ow ell laws regulating building construction, and I shall not employ „ `,
Z any person in violation of the workman's compensation laws of m J
Tw. the State of California. tm`+ l .s
((��
SO. FT.
I hereby certify that I am properly licensed as a contractor under �C.!!
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business �t
VALUATION PERMIT FEE Sine S
and Professions Code, Division 3,Chapter 9 f% n
Signature of /LAN CHECK $ ii ID "I
Permittee ,� �t�` `� ut'�'^� $
/�� TAX $ U �1
or ) fff/// x5-e) -
Authorized Agy Date I l TOTAL PAID $ -
304 '• o