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HomeMy WebLinkAbout1180 KINGSTON ST - Building Permits # CITY OF COSTA MESA ,4; 4, BUILDING DIVISION F• -""r t DEVELOPMENT SERVICES DEPARTMENT • PERMIT NUMBER • ' PERMIT no efr 1,699-01058 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1180 KINGSTON ST Status: ISSUED Suite: Applied: 07/12/1999 Vicinity: HOUSE&GARAGE Issued: 07/12/1999 Parcel Nunmber: 41204217 Zoning: R1 R1 Applicant: SELL ROOFING COMPANY ISSUED BY: Address: 17072 ROSEBUD i ' - - Phone: 714-993-3328 - YORBA LINDA CA. - . Zip: 92686 .- - Owner: ,BARNETT, GREGORY,J Address,(-4180 KINGSTON ST_ -- y`, Phone: , ,;;� .c COSTA MESA,CA' - - Zip: 92626 Contractor: SELLLROOFING COMPANY - / /A Address:, 17072.ROSEBUD N,, _ ',.ti,` .; Phone: 714-993-3328 ' • YORBA LINDA CA i i,/ Zip: -92686. License: 323842. • /� Arch r Eng: , A Address: , - Address: - - +. ' , Phone: _ + •Phone: •, - License: Zip: License: SCOPE OF PERMIT ' REROOF-I/O, INSTALL 1/2"OSB BOARD,2 LAYERS OF 30#FELT&INSTALL NEW EAGLELITE ICBO#4660 LIGHT ' / WEIGHT ROOF. - - ,, . ' - FEE SUMMARY. ,`, Plan Check: : $0.00 - . - , Calc Valuation: i s7,9oo.bo Permit: , $137.25 Claim Valuation: , - $7,900.00 - SMTP Res: $0.79 - y SMIP Com: $0.00 ‘‘, *. 'Other - `;''$0.00 ' 7 `In : spection " '-$0.00 - • Total: ' '.$138.04 - - PLANNING&ZONING .' ,, SETBACKS`;. - MAIN STRUCTURE Front- 0-0 Rear 0-0 Left 0-0 Right 0-0,- , ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0- PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: !r 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 willI ain orkers' nation i rance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued, My workersi q� Insur c rrier a alloy number are: Carrier: • Policy Number: (This section need not be complete If the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of t ork for wh' h 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 ee that if out b me subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. /��l Applicant Signature: Date: / `� v 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 DECLARE(5100,000),IN ADDITION TO THE(nST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed un .r •v' s > 9(commencing with Section 7000)of Division 3 of the Business and Professions e,and my license is in full force and effect.Lic.ti Gam/ Class if C? —3 Contractor's Signature: g •/ Date: /6 —5/ 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.). O I, as owner of the properly, 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.). O 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? ❑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 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 Califomia 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes L-I No (Section 65850.2 of the California 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 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all stale 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. • ,‘, ignetur i L Owner(s) DaleApplicant ` CODE It IHSPECTIONTYPE DATE BMW& CODE f INSPECTION TYPE PAIS JNTITIAIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �� 208 Final Plumbing 200 Final Re-Roof 7—a— (rpd, cast-- 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 • 2446-48 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. ' - TRACT NO. LOT NO.. •BLDGrNO: ' - --' " ' . . - ' -• "" ' - - - -- ' CONSTRUCTION PERMIT E��/� ' ' n . • '-'I B31 '12/I'6/132 - ' 4.20 , TL Project Address i/AQ 713 An - TYPE OF CON UCTION;l - _ - . Owner .' 6�X/q'- ,/]2,rrn//de . Phone-, 7 -0'NEW 0 ALTERATION - •• '- '- ' Address ,/,y0 a •!'b,'S`v _- - REPAIR ❑ CONVE>•• ADOOM H ZONING REGULATIONS• Aich7Eng. - . - . �" License No.- ❑ OTHER. G� • DESCRIPTION OF WORK _ _ - . Cc-infractor ./'' - - d,eL'-- Phon- C - r2C? ; "TYPE OF-PERMIT '! - ' - ' `•TBA. • -•S Andress y ;w �i( � AI ❑'G RADI NGFOUNDATION"' O STRUCTURAL • •• LICENSED CONTRACTOR-DECLARATION -•-- .- - ' 0 TENANT LECTRICAL..0PLUMBING OMECHANICA SIDEYAR• I hereby affirm that I am licensed under provisions of Charter 9 (corn- `mencing-with-section' 7000)' of-Division 3 of the -Business -and -NU-OTHER-- - - -- - • - - - - - - - - - - Professions Code.; - license is in full f- c- aid effect.), ' ' ' and my d . . . - - -PROJECT:DESCRIPTION License Class / e' _ ,., - '- - '- - _ -• . -PROVIDED Date ../ �- - Signature ' -s _ -- - 1 - SQ.FT. .7 _ . -WORKERS'COMPENSATIONDECLARATION - -'.OCCUPANCYA2- CONSTRUCTIONTYPE .'7E _I hereby affirm that I have a certificate of consent to self-insure ono VALUATION�'� 'ZONE •NRNG WIDTH'STREET APPROVED •- • certificate-of"Workers' Compensation Insurance,-or a certified copy . - - . -erect(Section 3800, Lab.C.). GRADING CU.YDS. • ACRES ConlPdhY `- - • - ... _- . -. _ - ' A certified copy is hereby furnished. - - --- --- • REMA_R KSi ' 53- - - 0 Certified copy is filed with the city Building Division. ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION . ' ` ` `: ' ' - " `• - - ' -- -- - " - •---- ' - ' (This section need not be completed if the permit is for one hundred - -, ._ �. _ ., - _. r •: ' ' ($100) or less). jI certify that In-the performance of.the wortOh.wh'- th'• permit Is . _ _ _ _ _ _ issued, 1 shall not employ any person in a•'v an r o to become ,PLUMBING 1.'+ PLAN CHECK ' ELECTRICAL - PLAN CHECK , Datet•to7h¢.Workers'-Compensation La r. • ni. ._ / - - UW ELLING- - -6ARA0L Date/ is=1z Signature , - ° BATHTUBS SHOWERS ¢ • _ NOTICE: If after making this declaration, you should become-subject ' TOILETS , - ; ' ,'^�_ URINALS 'GENERATOR"'-03 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must _ • TRANSFORMER - • forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-LAVS APPLIANCE 10-50 KW_50 +'KW " - revoketl. _.-... _ . CONSTRUCTION LENDING AGENCY KIT.SINKS - - DISHWASHERS" MOTORS' "'0-1 HP'_1-10'HP- -` -" "- I hereby affirm that there is a-construction lending agency for the per- SERVICE SINKS . , • SUMPS -(IND.SOLAR) - 10-50 HP 50+ formance of the work for which this permit Is_Issued (Section 3097 .• . • . ' ", ' Civ. C.).- -'" - FLOOR SINKS FLOOR DRAINS FIXTURES 'OUTLETSE SWITCHES - -- ,L i Lender's Name Lender's Address _ _ _ _ DRINKING-FOUNTAINS _ _ GAS TUBESIGNS - " ' ._ - OWNER BUILDER DECLARATION - '. INTERCEPTORS CLARIFIERS POLE LIGHTS " '- " . ""` I hereby affirm that 1 am exempt from the Contractor's License Law for . 'the following reason (Section 703115 Business and'Professions'Code:- -SWIMMING POOL 'P TRAP - - wrorHULIIUrv_ . . Any_.city or county which requires a permit to construct, alter, - POLES METERED _ SUB .. Improve, demolish or repair anyrstructure, prior'to its'issuance;also re WATER SERV ICE ALTERATION `PANELS . MAIN ; SUB- -, - : - '• quires the applicant for such permit to file a signed statement that he Is licensed pursuant-to the provisions of the-Contractor's L'icense'Law' GAS SERV - - ICE OUTLETS -' '^hapter 9 (commencing with Section 7000) of Division 3 of the - ' - -- ' iness and Professions Code) or that he-is exempt therefrom and the- - WATER HEATERS 'BTU OUTPUT _ - . " - .. --'- s for the alleged exemption. Any violation of Section 7031.5 by 'applicant or-a 'permitrsubjects the applicant to"a civil penalty SEWERCONNECTIONS - -not more than five hundred dollars ($500). _ _ _ _ _ ' _ ' 0 I, as owner of the property, or my employees with-wages a5 their SOLAR TANK COLLECTORS -` - --"" . ' orsolecompensation, will do 7044,he rk,and the structure is not intendedThe' ' _ _ . or tl for sale. (Section Business and Professions Code: The' SOLAR PIPING SYS: ISSUEFEE' ,,, ,. _ Contractor's License-Law does not apply.to an owner of a property - - -- -'APPLICATION'APP ROV ED.BV "-' ";DATE-' who builds or improves thereon, and who does such work himself or ISSUE FEE through•his own-employees, If, however, that such improvements are not. - ___ - _ - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMA RV.OF FEES - I . is.soltl within-one year of.completion, the owner will have the burden -BUILDING - '- - - - �\/ of proving he did not build property, a rove for the purpose-of Sale). HEATING SYSTEM 0-100,600 BTU PERMIT $ 'SMTP. ''$ "0 I, as owner of the property, am exclusively- contracting -with -AND DUCTING - - - -nV ...licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK $ ;PERMIT <' and.Profesoion5 Code: The-Contractor's-License'Law does not apply to - - - - -- - -- - ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - _ - GRADING-A ' ^ • _ tracts-from'such projects with'a-contractor(5)-'Iicesned'pursuant-to- 'SYSTEM "' """• " - " ' - - - - - -- -$ V` the C_ m eontractor's License Law). _ 100 0,000+BTU PLAN CHECK $$ ' " ' 7 ' ^: ! ' - It 0 I axempt'under Section -B.8 PIC.for this - . - ELECTRICAL $ ••-$ BOILERS BTU reason ""' - PLAN CHECK $ 'Date--- •- - Owner- - ._ - - . .. .. _SYSTEM REPAIR,ALTERATION . -I _TOTAL FEE S' , .1 hereby.certifythat.l have read s a lication and.state that the,above EXHAUST SYSTEM MULTIPLE MECNANICA L, $ - ._ " ._- - '' VAN E information ordinances sis correct. I agr to omplystru with all city and county 'PLAN CHECK $- VANCE PC $ ' representatives nces and state.) s rel q construction,and hereby authorize. 1 represof s t enter upon the- above mentioned - - - - • - , Signature 'ISSUE FEE - - -- - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNINGGCPOOL&SPA , , - ' � G • APPROVALS Permit# g�l! 9 Date Inspector ' APPROVALS Permit# ' Date : Inspector' 1. Temporary Electrical Service or Pole i -, : 43. Pool & Equipment Location - - - --- - - -- • ----- - . a 2. Soil Pipe-Undrgrn '- '., - - L - 44. Steel Reinforcement -- - •- --- ----• - - - . . - 3. -Electrical,Conduit Utility-Undrgrn _- • • - 45. Forms - - - _ - ' . 4,_, Electrical Conduit-Undrgrn _ __- _ 46. Electrical Bonding - -. -- - - - - .- . - . _ ' 5. _Steel Reinforce 47. Rough Plumbing & Pressure Test - -- •- - - . . . _ __ ' _ 6. Electrical UFER Grn -. 48, APPROVAL TO COVER-GUNITE ' - - •• •• ' 7._ Footings 49. Electrical Conduit-Undrqrn ,. - . . - . . 8, . Foundation.. . •_ . 50. .Gas Pipe, D Undrgrn,Test •••-.• •- _9. _Water Pipe-Undrgrn _ - -. 51. Backwash Lines, P-Trap,'0 Undrgrn•d' . - - - - ( - 10. .Structural-Floor System • ' 52. APPROVAL TO DECK -' - . -• 11. Property Sewer Line & House Connection _ - . -. 53._ Backwash & Receptor-Final - r . . 12. - Street Sewer Connection •• , . ' - - _ 54. Heater &-Vent-Final 111 ,13. Rough Plumbing - ,_ . - `55: Plumbing System-Final - - - - • -- - - 14. Rough Electric-Conduit - - /- � ' --Q- --- - -56.i'Electrical-Final -`I • 15. Rough Electric=Wiririg- - - / DI/ L . 57. Solar-System-Final ' + . ' - _ `-16. -- Rough'Heating & Air Conditioning -_ - _ - __58. Fencing,& Access Approval. , - . 17.- .Ducts, in Structure - ' ._ - _. ts. . _•: '. . . . I • 59. APPROVED FOR PLASTERING \':•.. ''•. ' ' - . ' -. . --18. .Ducts, Ventilating-' -. -_ --. _.- _.. - _ •_ - _-- -> _ _ ,:�, -.._ 19. Gas Pipe-Rough &Test _ - 60. __POOL/SPA'SYSTEMS FINAL • . 20.- Roof:Framin9 . ._ _ . o.. • 21. Roof Sheathing ' - - ' NOTES: 22, „Frei-he-and Flashing_ - _._. . - _. _ •_ . . -_. -_ _ _ �• - ' 23,--=Insulation - , - . .I . ---,. .__ _ .. , -25._..Drywall Nailing_ - -- -- _ - . _ - , -26. Plaster Brown'Coat . _-' . . . . . _ �- - _ . . _ _ _ - ,. , - 27. Electrical Power Meter-Final- ': . _ _: _- `" - _ - 28.--Final Electric - - - �J/�;/D!/ •ems . r - . i"��iff .29.---Final-Heating & Air.Conditioning_ . ' - - ' - " ' - .30._ _Final.Gas Pipe-Test. . . ._ _ - .. �. - " . - .` .. - ., . 31. Final Plumbing. . _ . - _ . - "32. =Water Service-Final . - _.._ . , •- 33.- -Gas Service-Final- _ _ . - ._ ". - .. 34. Solar Domestic-Final - •' ; .- I - - . '' . . - S. 35, Landscape Sprinkling System • ' 36. Sound Attenuation . - - . • - ., - - - • - t 37. Handicap Regulations . . - -. , ' - - , 38. FINAL STRUCTURE & BUILDING • - • - I - ,• 39. Special,Requirements Conipleted - - " ' - - 40. Electric Release to Edison - - - "' - "- -- - -- • 41. Gas Release to Southern California Gas Co, ' . ... , . . 42.- CERTIFICATE OF OCCUPANCY - ' _ _ _ - ' �',.•No - - Date - I '�I -- _ - -- _._. . - _. - - - a,,\,-`•,. '_. - 1• - / Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA PERMIT NO. - - TRACT-NO. LOT NO. •BLDG:NO. ' - l' - - •_-.,Gf NSTRUCTION PERM( '5333 • ' '-c 1DZi8 /la r ' Project Address W I 9r -fO�J TYPE OF CON�RUCTION , n "• Owner &-V2s.. (rte tiJE11_ !_, Pho•n�e'�jC.k�e�-� 0 NEW ADD " ❑ ALTERATION (iv 0.'.• - "- _ - 971010/26/B2 :I 23.55 Address t1 .) t LILTS•V N a WJIf--'cI "�Q4'" ❑ REPAIR ❑ CONVERSION.❑DEMOLISH - - 1 ZONING REGULATIONS - Arch/Eng. _ ., License NO. _ ❑OTHER_ A P DESCRIPTION OF WORK otic( Ja/C� . Z^r'itZ"I7 • - Addfe- //�� � � /Sart." �,,,, ZONE `'Q PLNG. REF.7 Contractor(9 yw,1 I ✓ -YSa/v Phone. TYPE OF PERMIT • - _ " - -- - 'r BUILD' , - SETBACK C/L ST.. 2OgILG NE Ale-450 Address _ • ,- - ❑GRADING 0 - FOUNDATION 0 STRUCTURAL se VARD /_/OH - ;n . LICENSED CONTRACTOR DECLARATION '❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICAL SIDE YARD r! I hereby affirm thatil am-licensed under provisions of Charter 9 (corn- RIGHT "- mending with section 7000) of Division 3 of the Business and' .,❑ OTHER - -- �� - - Professions Code, and 'my license is in full force and effect, REAR YARD(TO P/L) Co - ' PROJECT DESCRIPTION_ - _ License Class License No. - , — - PKG.SPACE REQ. PROVIDED ' .. Sq, FT. - - - , Date - Signature. STREET WIDTH . PARK FEE $ WORKERS'COMPENSATION DECLARATION ' 'OCCUPANCY CONSTRUCTION:TYPE ' — 1 heYeby affirm that 1 have a certificate of consent to se It-insure or 600- t ZONING APPROVED HY ), DATE JO�7" (`�/q-Z certificate of Workers' Compensation Insurance, or a certifietl copy VALUATION ZONE ./.f•,M7 /NL - thereof(Section 3800, Lab.C.). - ,GRADING CU.YDS. ACRES SPECIAL CONDITIONS: . , ' No. - Company • - .-'• _ _ - - . ' ertifled copy Is hereby furnished. - ,. REMARKS: . _- .. • . . -- - - - L Certified copy's filed with the city Building Division. _, - _ _ - - 74EXEMPTION FROM WORKERS'.COMPENSATIONDECLARATION (This section need not be completed if the permit Is for one hundred _ - - .. -. . - . $100) or less). - - - - -- .-. _ 1,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, -PLAN CHECK - ELECTRICAL PLAN CHECK .• ' _ subject[ th r Compensatlo ws fCation" UWLLLTIVu t�RRHUt _ Date`/t/ "Signature BATHTUBS - - —SHOWERS . , SC) FT Sq FT " ' ,`s' • - NOTICE: If after making this tleclaration, you should became subject TOILETS;;;; URINALS - . . GENERATOR 0-1 KW__1-10 KW' - -' to the Workers' Compensation provisions of the Labor Code,you must' - _ _ TRANSFORMER .__ _. _ .- - -, forthwith comply with such provisions or this permit shall be deemed LAVATORIES DO UBLE'LAVS` -- - APPLIANCE 10-50 KW�_50+ KW - - • revoked. , _ - - - _ _ _ _ - • • CONSTRUCTION LENDING AGENCY- _-' KIT.'SINKS - ' . ' DISHWASHERS - - - MOTORS ^ 0-1 HP 1-10 HP. -- I'hereby affirm that there Is a construction lending agency for the per- SERVICE.SINKS ^SUMPS -- ` '- j - (INC:SOLAR) 10150 HP_- 50+ HP ^- formance of the work for which this permit is issued (Section.3097 - - - _ Civ^CJ: F. ,�-- - _ fo,. _. _ - FSLOOR'SINKS` '- 'f FLOOR DRAINS ; - ; - FIXTURES OUTLETS SWITCHES , -!,'' : Leho2rY Name _ _ ___ • � ^-__ I'=``s'''-' DRINKING FOUr-FAI'N5-- ".t' ^' - "" "GAS TUBE SIGNS • Lender's Address " s . 4-i OWNER BUILDER DECLARATION..... )'..u_ e s- '''! - -' _H - _ - POLE LIGHTS ! I hereby affirm that I am exempt from.the Contractor's License Law for - INTERCEPTORS - CLARIFIERS • ). ,,., , F.4 the following reason (Section 7031.5 Business and Professions Code: SWIMMING'POOL - 'P TRAP )„) Any-city or county which requires a permit to construct, alter, POLES METERED SUB- ' - improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE - " ALTERATIONS - - - - .PANELS MAIN SUB a- ;1` quires the applicant for such permit to file a signed statement that he _- isllicensed pursuant to the provisions of the Contractor's_License Law GAS SERVICE OUTLETS SERVICE AMP,;; (Chapter"9'(commencing with Section7000) of Division 3 of the _ _ •"''-a ' B ess and Professions Code) or_that_he is exempt therefrom and the WATER HEATERS ' _ -BTU OUTPUT- - - - , "-Ie.:" ,for the alleged exemption. Any violation of Section 7031.5 Dy ' ;.h> licant for a . . ._.. _ __ _ p permit ed dollars applicant to a civil penalty SEWER CONNECTIONS"-� "- - - i,, - 'q more than five hundred dollars ($500). - ...., y , as owner.of.the property(or. my•employees•with wages as their -SOLAR:TANK COLLECTORS " ito ole compensation will do the rk, and the structure is not intended ____ __ _ __ - -, • or,offered for sale-(Section 7044;Business and Professions Code:'The SOCAR•PIPING SYS. - _ , ISSUE FEE "7l. '.• _ - ' Contractor's License Law does not apply to'an owner of a property - __ who.puilds or improves thereon, and who-does such work himself'or" -- "ISSUE FEE j •' LICA ON _•V D a r ��. DATE1' et through his own employees, provided that such improvements are not 1_ - intended.or offered for sale. If, however, the building or improvement- "-MECHANICAL • PLAN CHECK ' i.' is sold within one year of completion,the owner will have the burden SUMMARY OF FEES""'f'__ - _ ' of.-proving.-he.did not-build-or improve•for-the purpose-of- sale).- - BUILDIN�,ar.,// L'. as owner of theproperty, dm exclusively, HEATING SYSTEM 0-100,000 BTU _ } PERMIT._ 5 ..$ 'SMTP. . �$ f 4,3„ o 1, contracting with -ANO DUCTING - - -- ( licensed^contractors to-construct the project (Sectien 7044, Business 100,000 + BTU _ s PLAN CHECK_,$__ PERMIT _- - and Professions Code: The Contractor's License Law does not apply to - - ,ISSUANCE $ an owner fromf property"who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ _ _ tracts such projects with a contractor(s) Iicesned--pursuant_to SYSTEM - - - -- ^ "-- GRADING'-t".•$" - - Ithhe Contractor's License-Law). n '/ 100,000 +BTU • x _ - [PLAN CHECK $ '" _ _ - '' • y_rrl am exempt under Section / �7 `�K - B.&-P.-C.-for this. - BOILERS BTU ELECTRICAL $ • - _- reason _ D Ui/Y'Pt 134-14f _ .. - --• -- - •MICROFILM $ - - - Y 4op nis SYSTEM REPAI R,ALTERATION PLAN CHECK $ ''TOTAL FEE$' -- Date Owner r -MECHANICAL $ - •- I hernia certify that I have Yead this application and state that the above EXHAUST SYSTEM MULTIPLE f --$ _ LE55 AD- - --. - information is correct.-1 agree to comply with all-city and county PLAN CHECK $ LANCE PG $ - repes ordinances and state laws relating to construction,and hereby authorize - - - representatives of. this .city-to enter upon the above men ned a� Property or i P ti rposes, - i , -, - �J_Ca�• . Signature ' Dat O -' FINAL FEE' $.1•S�vJ v7 • o�-i� ISSUE.FEE --_ `_.- . Drivers'License or SS � � __' _ •_ _ _ _ . a • CMF 0865.46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - CONSTRUCTION AND PLANNING - POOL&SPA '. -. ._ Permit # CJ .:,•k. APPROVALS 2 3-'33 3 Date Inspector - APPROVALS Permit# • Date " ,•'I Inspector` 1. Temporary Electrical Service or Pole LOCation - - ' . F y .. - 43..- Pool &-Equipment Location r'- 2.•' Soil Pipe-Undrgrn .-. ,'11,•1 " - 44. Steel Reinforcement - -3. Electrical Condult-utility_Undrgrn •. - _ „ ,. - ' . . .- 45. Forms ' - - - - - . . ' 4. Electrical Conduit-Undrgrn .` ,..• s.,J .. - • _ - _ _ - 46. -Electrical Bonding- ' - -" - '-• -• - - - • ' _ - \ - - - -� 5. ,Steel Reinforce- ,• .. 47. Rough Plumbing'& Pressure Test' - - --- 6." Electrical UFER Grn _, - " .' - 48. APPROVAL TO COVER-GUNITE" . - • • 7. Footings - 49. Electrical Conduit-Undrgrn . . • �- 8. Foundation ":� . -"- - _ 50. '-Gas Pipe, IllUndrgrn,Test " • ' - - 9. Water Pipe•Undrgrn - -• ' • 51. Backwash.Lines, P-Trap, 0 Undrgrn , : 10. Structural Floor System .. _ _ , - 52. ' APPROVAL TO DECK • . - • ' 11. Property'Sewer Line &House Connection • _ 53.,7 -Backwash & Receptor=Final " ' . •- - 12: Street Sewer Connection • - __.__ 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 - - - - - 58. Fencing &Access Approval •. - 17. Ducts, in Structure .. . 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating • - - _ - - . •- - _ - - -- ' 19. Gas Pipe-Rough &Test . . • - 60. .POOL/SPA SYSTEMS.FINAL ' ,) • ' ' 20. Roof Framing - - ., 21. Roof Sheathing • - ' •- ._ - -.- -. . - __ . _ ... ' NOTES: �t ' • 22. Frame'and Flashing ' ___ _ . .. _ . !' N Zsi� ]�. /A�ll�.ru /• u .23. - Insulation _ ' - _ • , ,\r. v�i � F•� .4:x.:4 -�r•.� ': . �V- . 24. Lathing & Siding _ - , ._ - .. _ e.o�r] 5- s%] ID C• 1/- "S-•-•S'4 - r, • r 25... Drywall Nailing • • '- , ' 26. ; Plaster Brown Coat - - - '27. Electrical Power Meter-Final •' -- - _ - - _ '- „ :28. • Final Electric . . ti- -- - • • ' - ' •29. ' Final Heating & Air Conditioning _ - • • - • _ - - .. - 30. - Final Gas Pipe-Test •, . - -. - - •• "' • !31. Final Plumbing - ' , ` - - • - 32. ; Water Service-Final _ _ . - _ _ __ - - _ - '';Y_ - ' • . '33.`-VGas Seri/ice-Final. - ' • - - _ . . -- ._ ,. , 134. Solar Domestic-Final . . - . -, ,35`.'•.'Landscape Sprinkling Sysfem::-_=.;2: . ' .• . - • - - ' ' .•- . . . •36. Sound Attenuation -•-_ . ',', . , - _ - • - - " - - ' • 37: Handicap Regulations - - , , - , ' - ' 38. FINAL STRUCTURE & BUILDING . - -3S q••xt_V - ' 39. Special Requirements Completed ,-t -i, . 40. Electric Release to Edison. - • - -- • ,. 41. Gas Release to Southern California Gas Co. 4 ' ,/, ,42. CERTIFICATE OF OCCUPANCY - . ' • -;Nd Date - -` _ • M6704 II / 14/79 369: 14 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT~ , P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - - . RECEIVED BY 1P )O2'Te a — '�-�j For Applicant to Fill in Completely -Use Ink Only TTT d t�' � BUILDING A.P. NO. .L^Qq--L^O, ADDRESS Tract 10278, Lot 16 OWNER OR BUILDIRESS NG 1180 .in9,s�r1 5± TENANTMcLain Development Co ADD UNIT OR MAILING SPACE NO. ADDRESS 1470 Jamboree Rd. TR.NQ�7 LO (O T 1 / IBLK. TEL. 11 CITY Newport Beach, NO. 640-6800 • CONSTRUCTION NEW ADD TT REPAIR I MOVING I DEMOLISH LENDER V •1 BRANCH OWNER ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER Corbin/Yamafuji NO. 752-5567• pp ' ADDRESS 3661 Spruce St. Newport Bch. zoNE�p-�R) I TYPE GROUP APPROVED CONTRACTOR McLain Development Co. BY DATE ADDRESS 1470 Jamboree Rd. CITY Newport Beach TEL (-1 APPROVED SETBACKS g• LIC.NO. 273875 LIC.NO. 18873 {y SIZE NO.OF BLDGS. (FROM IL'�STREET) 0. OF LOT - NOW ON LOT FRONT 77 / FT. Q • USE OF ‘15ti- EXISTING BLDG. R.SIDE FT. y Separate permits are required for L.SIDE l 5 FT. CI electric,plumbing and heating work: REAR 2-v T. (W. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE "It Single family residence, �1 / APPROVED p' !� YNew house _ Y APPROVED AI,//r li DATE IQ/IO /7 / .-1 l Wiv I W 0. I hereby acknowledge that I have read this application and state g4 that the above information is correct and agree to comply with A, all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of v .IU the State of California. - 'T' co SQ. FT. o I hereby certify that I am properly licensed as a contractor under D the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR D (i_ Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e a VT am exempt from the provisions of the State of California Business VALUATION �r (,� < and Professions C de, Division 3,Chapter 9. PERMIT FEE $ �,/_ en JAI JI ^ $ PLAN CHECK $ —7 �f� 11 �� Signature of !I'.[' `/�Jl (Y' �� / f� �/ Permittee /��/ TAX $ / f y or / / I U Authorized Ag t Date TOTAL PAID 5.41-it