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1177 KINGSTON ST - Building Permits
CITY OF COSTA MESA . o • 4 I BUILDING DIVISION '-• 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(71144LF75544-4856 • www.ci.costa-mesa.ca.us , "4. 1104111 ! I FOR INSPECTIONS CALL: (714)75b-562GMIT NUMBER: BG07-00276 • I PERMIT TYPE: B_COMBO I STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 10/18/2007 ISSUED BY: 77 JOB ADDRESS: 1177 KINGSTON ST CM .:„ Suite/Unit:, APN: 41204245 i.'.Zoning Rt -",-,.••••••••••••.:.;,-„, . Vicinity: LOFT AND BALCONYPrimaryOcci:>32 Const Type: V-N ' -SQ. FT ';365 =,Valuation: $40,000.00 +i. SCOPE OF WORK: 358SF LOFT'ADDITION.ABOVE THE'EXISTING LIVING,ROOM IN A2;STORY SFD. DECK TO BE PERMITTED AT ATA. TER DATE r r"' rt '.'!s, OWNER: SCHWARZ,JAMES EDWARD)::'":'' Address: 1177 KINGSTON STUnit: Phone: j f. . City/State/Zip: COSTA MESA,CA ` 1 APPLICANT: JIM SCHWARZ VI ^;<p Address 4 c •�� ;, Unit: Phone: 714-719-3235 ,i 4 i -ti u City/State/ziip `i , t y-r` nsA CONTRACTOR '� • :;; '^ _ License NO t r Phone: I' 1 .t..1- ' Address Unit: „ 1 r• Cell: ARCHITECT: ;r e t License No ” - /t PHONE ;• ENGINEER: BRETT T HART _ * _ License No C68791 fir PHONE 949-861-8690 1 • COMBINTATION PERMIT FEE.SUMMARY✓ Building Plan Check: ' '' $353.11 - , :r Building Fees: $543.25 1 Electrical Fees: �•• $41.10 .. - , Mechanical Fees: Plumbing Fees: $0.00 SMIP Residential: �' ( $4.00`1 ', ,t" SMIP Commercial: TOTAL FEES: lf /$941.41i .. "Refer to fee receipts for all fees paid for protect 'frit; Ty; :,) r • Y !1f . I i . i ' , . .3 . • . • . . . t . • . . . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. • ':, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and.all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE INTITIAL$ CODEX INSPECTION TYPE - DATE INOTIAL$ 1616 Fixed System Final Fire Prevention . 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof p 210 Final Electrical • 201 Final Block/Retaining Wall 212 Final Fire Prevention i 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site // pr..y� 204 Final Demolition 250, Final Building/Occupancy .4 '` 9 WORKERS'COMPENSATION DECLARATII. Owner 10 verified by e. S Iii a. 0 Yes ❑ No ,{ I herehy affirm tinder penalty of perjury one of tiDrtver'sCicense No. e following declarations: - ? Exp ares:."'/- / '0 7 O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. C --- -- --- ❑ 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: • permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth'into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (misserfion need nol be completed theperm4s valued at one hundred cbnars(El 00)or less) 2,Art 2,Sec.341,Title B,California Administrative Code). Policy Number: • ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 9 No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). 9 I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No 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 8. (If yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did,not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and rat: 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city -- - - - ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by his pe it til final ins Ilion. )Qp /12 n re of egal Owner(s)=� Date— r,�SlgnatureDate 3057-46(3/07) And/or Authonzed Applicant Date • S. CITY OF,COSTA MESA :' .QQQ BUILDING DIVISIO r°t_ � 11,. 1 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)7 41411A- Fax(714)754-4856 • www.ci.costa-mesa.ca.us . I. FOR INSPEC S 'Y4-: (714)754-5626 I S . PERMIT NUMBERVB07-00976 PERMIT TYPE B_ROOF2 1 S STATUS: ISSUED DATE ISSUED: 10/15/2007 •i _ISSUED BY: SOK JOB ADDRESS: 1177 KINGSTON ST CM SuitelUnit Vicinity: ROOF t -; Squares: 2600 :, "`."-� ,'-'-'1,".--;rt":Valuation - $14 485.00 SCOPE OF WORK: TEAR OFF:EXISTING Ropy.; INSTALL 2 LAYERS OF 40#FELT,4:12 PITCH„LIGHTWEIGHT, SAXONY DURALITE SHAKE,#ESR-1647,AND REPLACE,S_HEATHING AS NEEDED.26 SQUARES INCLUDES ATTACHED:::-.. GARAGE. i I , OWNER: SCHWARZ, JAMES EDWARD -.- - Address:. :'1177 KINGSTON ST ''i kt'. Unit: PHONE: 4'j , q }, City/State/Zip COSTA MESA,CA �, ` 1 i. APPLICANT: JOSEPH LANGDON "$'i J -) Address: 16312 ARLINGTON LNC P' "-' i Unit : PHONE: 714-536-1816 F _ - City/State/Zip: HUNTINGTON BEACH CA ;, ( t� C n1 , CONTRACTOR: J N L:'ROOFINGINC ? , a ' - License No i< 648337 Address: 16312 ARLINGTON LNUnit:/ PHONE ' /714-S-1816 — iy ' City/State/Zip: HUNTINGTON BEACH CA • 92649 'CELL:, `j ARCHITECT: I j';'•‘.2., License No. ”" _ i PHONE IST ENGINEER: License No. . PHONE: FEE SUMMARY t' i. Reroof Plan Check: ' '$0 00 . ` ` Reroof Permit Fee: $251 25 ! ��. Reinspection Fee: $0.00- I ' TOTAL FEES $251.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE !NIII1ALS CODED INSPECTION TYPE DATE INITIAL@ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 2006 Pool Spa Final �B•••21‘ / sc 210Final 1ElectricalPlumbing 00 Final Re-Roof 'L ll��^� 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 WORKERS'COMPENSATION DECLARATIOS Owner ID verified by drtill. 0 Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: • •Driver's Incense No. Expires: _ ❑ I have and will maintain a certificate of consent to self-Insure for workers' - .Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 L section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: • • permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized - by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: � � or dismantling thereof;will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This seciun need not be complete—d7if Me pe is valued at one hundred dollars WOO)wless.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: J'L((0 Gek ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall n. employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the wo. Simpensation laws of California, and agree that if I should become t t. the workers' compensation provisions of Section 3700 of the Labo .I S 1.l�rthwith comply with these provisions.' Applicant's Signature Date Jo —� Division of Industrial Safety Permit Number: Cs Signa yr Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNI AILURE TO SECURE WORKERS'COMPENSATION COVERAGE I. Will the applicant or present or future building occupant need to file and IS UN • UL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENAL S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEYS FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is i. full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No C Lic.# I. Class# C y (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by �''1'"L�}♦ `y1 —/S- 7 each business which at any one time has on hand a quantity of acutely vw/ . ' Signature ((..dilate 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 CONSTRUCT s,• ENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fa non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to damply with all state laws and property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. CI I, as owner of the LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of . Signature . Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building . authorized by tpe it until final inspection. -/J .al Own`r(s) Date ` Signature Date - 3057-46(3107) r•— t tk - f D l Nip Authoriz Apar l i Date I S ES 16476 REPORTTM Issued May 1, 2006 This report is subject to re-examination in one year. ICC Evaluation Servicej Inc. Business/Regional Office•5360 Workman Mil Road,Whitler,California 90601 •(562)699-0543 1 Regional Office•900 Montclair Road,Suite A,Birmingham.Alabama 35213 •(205)599-9800 WWW.ICC-es.o rq Regional Office•4051 West Flossmoor Road,Country Club Hills,Illinois 60478•(708)799-2305 I . DIVISION: 07—THERMAL AND MOISTURE PROTECTION These roof tiles are interlocking extruded concrete roof tiles Section:07320—Roof Tiles I having interlocking ribs on the longitudinal edges of the tiles to restrict lateral movement and provide a water stop.All roof REPORT HOLDER: i tiles are designed with anchor lugs except for the Cedarlite and Madera profiles. Mineral coloring oxides are either MONIERLIFETILE, LLC applied to the exposed surface in a cementitious material or 7575 IRVINE CENTER DRIVE, SUITE 100 mixed integrally with the tile mix to produce a through-colored IRVINE,CALIFORNIA 92618 I product. The Espana, Saxony, and Villa profiles are also (949)756-1605 available as lightweight concrete roof tiles, identified as Duralite tiles. www.monierlifetile.com jvandewater(dmonierlifetile.com All roof tiles are cured to reach required strength before shipment.Product designations,dimensions and installed dry EVALUATION SUBJECT: weights are indicated in Table 1 of this report. Roof tile profiles are illustrated in Figure 1. EXTRUDED INTERLOCKING CONCRETE ROOF TILES: 3.2 Extruded Concrete Roof Tiles: Spanish "S": ATLANTIS, CAPRI, CEDARLITE, CLASSIC 100, ESPANA, HOMESTEAD, MADERA, MADERA 700, MISSION S, OLD Spanish "S" roof tiles are extruded concrete roof tiles. The ENGLISH THATCH 900, PLAZA,ROMA,SAXONY,SAXONY roof tile is manufactured in the same manner as the roof tiles 600,SAXONY 700, SAXONY DURALITE,TEJAS ESPANA, described in Section 3.1, except the tile is noninterlocking. VANGUARD ROLL,AND VILLAI The roof tile is designed without anchor lugs. The product designation, dimensions and installed dry weight are EXTRUDED CONCRETE ROOF TILES: SPANISH "S„ indicated in Table 1.See Figure 1 for an illustration of the tile. 4.0 INSTALLATION 1.0 EVALUATION SCOPE 4.1 General: Compliance with the following codes: I Installation of the MonierLifetile roof tiles must be in • 2006 International Building CCode®(IBC) accordance with the Concrete and Clay Roof Tile Installation • 2006 International Residential Code®(IRC) Manual for Moderate Climate Regions, dated July 2006, • 1999 Standard Building CodIe©(SBC) published by the Tile Roofing Institute and Western States I Roofing Contractors Association (hereinafter referred to as • 1997 Uniform Building CodeT1d (UBC) the TRIWSRCA installation manual),and recognized in ICC- Properties evaluated: I ES ESR-2015P, except as otherwise noted in this report. In case of a conflict between the installation manual and this • Fire classification I report, this report must govern. This report and the • Weather resistance TRI/WSRCA installation manual must be available at the jobsite at all times during installation. The roof tiles must be • Wind-uplift resistance installed on a minimum roof slope of 2112:12 (20.83%). Care 2.0 USES must be taken during field installation to ensure that horizontal joints are kept parallel to the eave and vertical The MonierLifetile extruded concrete roof tiles are used as joints are at right angles to the eave in order to ensure Class A roof coverings in accordance with Section 1505.2 of uniform contact between the tiles and proper fit and the IBC,Section R902.1 of the IRC,and Section 1505.2 of the appearance. All cracked and broken roof tiles must be SEC. The roof tiles are noncombustible roof coverings in replaced. accordance with Section 15014.2 of the UBC. 4.2 Adhesive Set Systems: 3.0 DESCRIPTION 3.1 Extruded Interlocking Concrete Roof Tiles:Atlantis, The MonierLifetile roof tiles may be installed with roof tile adhesives that are recognized in a current ICC-ES evaluation Capri, Cedarlite, Classici 100, Espana, Homestead, report for use in concrete roofing tile applications.Installation Madera,Madera 700,Mission S,Old English Thatch 900, of tiles using these adhesive set systems must be in Plaza, Roma, Saxony, Saxony 600, Saxony 700, Saxony accordance with the adhesive manufacturer's ICC-ES Duralite,Tejas Espana,Vanguard Roll, and Villa: evaluation report. •Revised April 2007 REPORTS" are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as an endorsement of the subject of the reporrl or a recommendation for its use.There S no warranty by ICC Evaluation Service,Inc..express or implied,as to any ANSI finding or other matter in this report,oras to any product covered by the report ANSI x foroorn.no Copyright©2006 Page 1 of 12 Page 4 of 12 ESR-1647 TABLE I—TILE DIMENSIONS,WEIGHTS AND MANUFACTURING FACILITIES TILE DESIGNATION I INSTALLED DRY DIMENSIONS'(in.) MANUFACTURING FACILITY WEIGHT'(psi) LENGTH WIDTH Atlantis-Shake and Slate 1 10.4 1678 10 Boca Raton Capri I 10.1 17 12'/, Lake Wales Cedarlite 5.9 13'/, 13 Gilroy Classic 100 I 9.5 16'/, 13 Tacoma Espana-Barcelona I 9.0 17 12'/, Henderson Espana-Barcelona 9.0 17 12'/, Lake Wales Espana-Barcelona 9.0 17 12'/8 Lathrop Espana-Barcelona i 9.0 17 12'), Rialto Espana Duralite-Barcelona 5.9 17 12'/, Rialto Homestead-Shake 9.8 16'/, 13 Tacoma Madera I 9.5 13'/, 13 Gilroy Madera 700 I 7.2 13'/, 13 _ Gilroy Mission S-Barcelona I 10.3 164, 13 Phoenix Old English Thatch 900 ! 9.8 17 13 Stockton Plaza 10.8 164, 13 Kansas City Roma I 9.3 16V, 13 Tacoma Saxony-Country Shake ; 10.3 164, 13 Katy Saxony-Country Shake 10.3 17 12'/, Rialto Saxony-Country Slate 10.3 16'/, 13 Katy Saxony-Country Slate 10.3 17 12'/, Rialto Saxony-Country Split Shake 10.3 16'/, 13 Katy Saxony-English Thatch 10.3 16'/, 13 Katy Saxony-English Thatch 10.3 17 12'I, Rialto Saxony-English Thatch 10.4 17 12'/8 Lake Wales Saxony-Shake 11.2 16'/, 13 Kansas City Saxony-Shake 10.3 16'/, 13 Katy Saxony-Shake 9.5 16'/, 13 Phoenix Saxony-Shake 10.5 16'/, 13 Tacoma Saxony-Shake 10.3 17 12'/, Rialto Saxony-Shake 10.4 17 12'/, Lake Wales Saxony-Shake 9.6 17 13 Denver Saxony-Shake 9.1 17 13 Lathrop Saxony-Shake 9.1 17 13 Stockton Saxony-Slate 11.2 16'/, 13 Kansas City Saxony-Slate 9.5 16'/, 13 Phoenix Saxony-Slate 10.3 16'/, 13 Katy Saxony-Slate 10.5 16'/, 13 Tacoma Saxony-Slate 10.3 17 12'/8 Rialto Saxony-Slate 10.4 17 12'18 Lake Wales Saxony-Slate 9.1 17 13 Lathrop Saxony-Slate 9.1 17 13 Stockton Saxony-Slate 9.6 17 13 Denver Saxony-Slate Vermont 11.2 164, 13 Kansas City Saxony-Split Old English Thatch 11.2 16'/, 13 Kansas City Saxony-Split Shake 1 10.5 161/, 13 Tacoma Saxony-Split Shake 10.3 17 12'/, Rialto Saxony-Split Shake i 10.4 17 12'/, Lake Wales Saxony-Split Slate I 10.5 164, 13 Tacoma Saxony-Split Slate I 10.3 17 12V, Rialto Saxony-Split Slate i 10.4 17 12'/, Lake Wales /-x Sax -Split Williamsburg ( 11 16'/, 13 Kansas City A Saxony Duralite, ate,Shake,Split Shake).- 5.9 • 16'/, 13 Stockton Sa ony 600 I 5.7 17 13 Stockton axony 700 I 7.2 17 13 Stockton Spanish"S" i 9.5 18 10'/8 Boca Raton Tejas Espana-9arcelona 1 - 9.0 16'1, 13 Katy Vanguard Roll I 8.4 164, 13 Pompano Villa 1 9.6 17 13 Stockton Villa I 9.6 164, 13 Phoenix Villa Duralite 5.8' 17 13 Rialto For SI: 1 inch=25.4 mm, 1 psf=4.88 kg/m'. 'Installed dry weight is based on a 3-inch headlap. 'All dimensions are nominal. • RECORDING REQUESTED This Document , electronically recorded by '3Y STEWART TITLE IRVINE btewart Title PREPARED BY Stewart Title Guaranty Company Recorded in Official Records,Orange County 1980 Post Oak Blvd Tom Daly,Clerk-Recorder Houston,TX 77056 M111'1119IB11OW1®ifi®illimUil 15.00 Moat i044S'�r�iC.+fwl�,� ' WHEN RECORDED MAIL TO 2007000571341 12:35pm 09/19/07 Name James Edward Schwarz 119 59 G02 4 Address 1177 Kington Street 494.45 494.45 0.00 0.00 9.00 0.00 0.00 0.00 City Costa Mesa State/Zi. Io O 7—2-.cl to 09 SPACE ABOVE THIS LINE FOR RECORDER'S USE RvnY. ytt-owl-4l5 GRANT DEED The undersigned Grantor(s)declare(s): Documentary transfer tax is$ 988.90 [ $computed on full value of property conveyed. Or [ ] computed on full value less value of liens and encumbrances remaining at rime of sale.. [ ] Unincorporated area: {t1] City of Costa Mesa [ ] Realty not sold. FOR A VALUABLE CONSIDERATION,receipt of which is hereby acknowledged, DAVID J. WILL AND STEPHANIE D. WILL,HUSBAND AND WIFE hereby GRANT(S)to James Edward Schwarz and Georgianna Schwarz, husband and wife as joint tenants. that property in the City of COSTA MESA,ORANGE County, State of California,described as: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF. APN: 412-042-45 Subject to easements,restrictions, covenants,agreements,and mineral exceptions, if any of record. Mail tax statements to 1177 Kinston Street, Costa Mesa, CA 92626 N. t�%w�-`p CITY OF COSTA MESA y ,.4,0 BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER iltbftevamost PERMIT // I 1/1:::: 11911 (1 (714)754-5273 • Fax(714)754-4856 ; 77 FAIR DRIVE,COSTA MESA,CA 92626 I BUILDING PERMIT Job Address: 1171 KINGSTON ST Status: ISSUED Suite: ii I Applied: 07/19/1999 Vicinity: HOUSE&GARAGE Issued: 07/19/1999 Parcel Nunmber: 41204242 !I Zoning: R1 R1 yyyyyy��� i ISSUED BY: r - ' J Applicant: SELL ROOFING COMPANY ,- - Address: 17072 ROSEBUD .' . i i+ . / - Phone: 714-993-3328 • DA YORBA LINCA Zip: 92686 - - Owner: :CANE, GAI di' Addressn')17J KINGSTON ST. - - : i ,iv '7 - \ yI1 -." - Phone: _ _ - _ ,� �. .7 COSTA MESA,CA - Zip: 92626 • . `� N / • A i6'= ' Contractor SELLROOFING COMPANY 1^Address: 17072-ROSEBUD ' '-v" Phone: 714-993-3328 YORBA LINDA CA . Zip: , 92686 I. : : 'License: 323842- ' " ' \ • Eng: ,i Address: / - . Address: +" .N i e.. Phone: \,•<. Phoe: _ ,y l a„ iV �- / v v,, .� � V'• \ vZip - , License: Zip: License: ' i , �' / I 7 - • PERMIT SCOPE OF. REROOF-T/O, INSTALL NEW 1/2"OSB BOARD,2 LAYERS OF 30#FELT&NEW ICBG#4660 EAGLE LITE LIGHT `a , WEIGHT ROOF. . / FEE SUMMARY . , " ,, ' `,,Plan Check:. $0.001. - - ; / Calc Valuation: '• , $9,900.00 Permit $162.25 Claim Valuation:/ ss,908.00 /SMTP Res: ':, •• $0.991 _ _ ' / ,SMIPContCo ""$0.00 - v 'y- 'OtheL Inspection:' x$ 0.001 , ' / �y:Total:`', -- $163.24,_. - ' . , N, PLANNING:&ZONING - SETBACKS-, h,. l< . . MAIN STRUCTURE`Front' }F 0-0 Rear 0-0 Left 0-0 Right 0-0 • ACCESSORY Front 10-0 .Rear 0-0 Left 0-0 , Right "0-0 PARKING Existinq, 0 Required: 0 Proposed: 0 NOTES: J I 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,§10,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned fora period of 180 days. 1 INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and alt 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 DECLARATIONS n n q. i 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. My worker ' p sation Inn nce car and policy number are: t"G 6,s-5-54Carder: /'ter—L Policy Number: (This section need not be completed it the pe it is valued et 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,a gree that if I ould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: 47.-7 —00 WARNING:FAILURE TO SECURE WO ERS'COMPENSATION COVERAG IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED • THOUSAND DOLLARE($100,000),IN ADDITION TO THE MST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. r LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions ofChter 9(commencing with Section 7000)of Division 3 of the Business and erofes Code,and my license is in full 3 n force and effect.Lic.# y 2/4 Class# C� Contractor's Signature: .` "e Date: JO —3 —$ 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). Lender's Name: _ Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a 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. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa 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,ora 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 ❑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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apP,ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes u No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No B (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with al :te laws an 'ty i nces relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for on purpos .I a e of to occupy or allow occupancy of any building authorized by this permit until final inspection. 7-/7 - 9 Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE I INSPECTION TYPE D9TE INYmAIa CODE INSPECTION TYPE PATE lNTITIALE 1818 Fixed System Final Fire Prevention 206 Final Mechanical ' 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof /,?—p /'q 1 cf.,— 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 • 2448-48 1 Ili 7 -440 llQ'i.e.'s.' COSTA MESA BUILDING-SAT?ML DEPARTMENT APPLICATION F. ,fRUIETU;2A'LPERMIT_-_✓:. -,11 P.O.P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED BY PYjL� T6 For Applicant to Fill in Completely— Use Ink Only J4 7 4 5 4 BUILDING Tract 10278, Lot 43 A.P. NO. ..4-11 -04-.)_---O ADDRESS TENANT TOR McLain Development Co. ADDRESS I ' 77 h.( 5'0,` 5`(- R MAILING SPACEUNIC N ADDRESS 1470 Jamboree Rd. NO. TEL. TR.Nlo _ LOr1_3 (BLK. CITY Newport Beach NO. 640-6800 NEW VV ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER I l/ BRANCH OWNER ADDRESS I VALUE ' ARCHITECT , I TEL. USE 6 OR ENGINEER Corbin/ NO. 640-680C— • ADDRESS 3661 Spruce St. . Newport Beach ZONEl7Ji}�iI-'t/ TYPE GROUP APPROVED CONTRACTOR Me-Ta-in Ir)evelnpment rn BY DATE ADDRESS 1470 Jamboree Rd. TEL. CITY Newport Beach ; No.640-6800 I-1 STATE CITY APPROVED SETBACKS LIC. NO. 273875 I LIC. NO. 18873 e N SIZE I O.OF BLDGS. (FROM C//I EET) OF LOT I I NOW ON LOT FRONT /•"SFT. hUSE OF - EXISTING BLDG. I R SIDE .rr FT. rn F Separate permits are required for L.SIDE FT. G electric,plumbing and heating work: _REAR 53 FT. 9.7 USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION a 1 0 TE a Single family residence .APPROVED a n �{ } new house APPROVED DATE fo//v/7C I F4 14 L • I hereby acknowledge that I have read this application and state °i that the above information is correct and agree to comply with O G. all laws regulating building construction, and I shall not employ Zany person in violation of the workman's compensation laws of the State of California. 3 I hereby certify that I am properly licensed as a contractor under SO. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m cis 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 Divisiioris of the State of California Business VALUATION PERMIT FEE S pga �- eth s and Professions Code, Division 3,Chapter 9. C J PLAN CHECK $// ( [alt o, Signature of .A c�S C r �� too/LAIC! `7 r.�L/ 2 evnl\ Permitteeo i/"9 Alt [�� ' Vl L $ /1� TAX $ U V Authorized Ag Vr/ Date �.l/. TOTAL PAIDit4it / J