HomeMy WebLinkAbout1681 LABRADOR DR - Building Permits CITY OF COSTA MESA
BUILDING DIVISION
:A�: *I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
4. POLIk . FOR INSPECTIONS CALL:(714)754-5626
*
w
PERMIT NUMBER: M09-00009
PERMIT TYPE MECH STATUS: ISSUED
APN: 13918138 DATE ISSUED: 01/15/2009
ISSUED BY: RMD
JOB ADDRESS: 1681 LABRADOR DR CM Suite/Unit:
Vicinity: - ,
SQ. FT: 0
SCOPE OF WORK: MECHANICAL PERMIT=FOR FAU < 100 K BTU CHANGE OUT;LOCATED IN CLOSET FOR A SFD.
OWNER: HUNT, BRIAN.E Address: 1681 LABRADOR DR Unit:
PHONE: , City/State/Zip: ' COSTA MESA,CA
APPLICANT: LAURA YENULONISAddress: Unit:
PHONE: City/State/zZip:
CONTRACTOR: ALLIED PLUMBING-HEATING-AIR CONDITIONING License No. 610780
Address: 422 JENKS ClUnit: , PHONE:: 714-998-4300
City/State: CORONA;CA ZipCode: 92880 CELL:
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $38.30
PLAN CHECK FEE: $0.00
INVESTIGATION FEE: $0.00 '
REINSPECTION FEE: $0.00 -
TOTAL FEES: $38.30
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.
CODES. INSPECTION TYPE DATE INTInALS CODE* INSPEcn0N TYPE DATE IINIRIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical 1-Ai -c 9 F i i
1266 Pool Spa Final _ 208 Final Plumbing
200 Final Re-Roof 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive.. .,tense. 0 Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
0 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. '
itti 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 art (' person is required to descend,will be made in connection with work authorized
Carrier: I l b \p'C t... S - W - by this permit,and that no building structure,scaffolding.falsework,or demolition
(Thiss ranneed not be complete Athe permit is valued at one hundred dollars($100)or less.) or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
y� 2,Art 2,Sec.341,Title 8,California Administrative Code).
UXr
Policy Number: tf0'11cDEAP 3 1 a t
0 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 gppiram's Signature Date
iLabor Code,I sh forthwith comply with these provisions.
- k—\Cr09 Division of Industrial Safety Permit Number:
Applicant's Signature ate HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNI ILURE 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? 0 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 al 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. n a registration form for acutely hazardous materials? 0 Yes ❑No
L'c.# (Q lU'rc00 Class# l�-e'1� (Section 25533 of the California Health and Safety Code, with some
(1 1_1��q exceptions, requires registration with the Costa Mesa Fire Departm
T u_?CA4vla q l each business which at any one time has on hand a quantity of acutely
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds,ent or by
a
CONS TION LENDING 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? 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 0 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? 0 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).
0 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 riot apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 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 comply with all state laws and
❑ I, 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 conuac[a(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ 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 this permit until final inspection.
Signature egal Owner(s) Date
Signature Date \-,--.\ -09
�
3057.46(3107)
ndlor Authorized Applicant Date
1681 LABRADOR DR CITY OF COSTA MESA — BUILDING PERMIT PPPM MO. fel OSSS7S
PROJECT ADDRESS: HUNT, BRIAN E UNIT:
OWNER'S NAME: HUNT, JO A PERMIT NO: M 055676 PLAN CHECK NO: N rnvT• U STIP P• N ll
ADDRESS: 1681 LABRADOR DR
• COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH
- 754-7634
JOB DESCRIPTION : GAS PIPING SYSTEM SQ FT:
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
BRIAN HUNT ( 714 )754-7634
PERMITTEE: 1681 LABRADOR DRIVE COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME
ADDRESS: COSTA MESA CA 92626 *************************** ***************************************************
ZONING REQUIREMENTS
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section S E T B .A C K S
7001)of Division 3 of the Business and Professions Code,and my license is in full force and effect.
CITY LIC.: STATE LIC.: CLASS: MAIN BUILDING ACCESSORY BUILDING
Dale: Signature: FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C).
POLICY NO.: EXP.DATE: PARKING REQ: PROV; PARCEL: 13918138 ZNE: REF NO:
COMPANY: PLANNING NOTES>
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. >
*******************************************************************************
Applicant: D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
%4PTIDNFROMWORKERS'CDMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). _
I certify that in the performance of the work for which this permit is issued, shall not employ any person in any manner se as to become ZONING APPROVED BY DATE
subject to the Workers Compensation Laws of California. .,
Date: signature: BUILDING APPROVED BY : DATE:
NOTICE:II,after making this ply coition,you should become subject permif to the Workers'Compensation provisions of the Labor _
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED BY• 1 /f� if DATE: (/ 3—qD
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for ************************** * **** **** ' *� ***********************lr***1r*ie****
which this permit is issued(Section 3097.Civ.C), ******************************************4***********************************
LENDER: LEGALIZATION:N F E E St A R Y STRUCTURAL SEGMENT:N
ADDRESS:
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason PERMIT 3,00
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or 25% SM IP/NON—RES
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PLAN
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ISSUE FEE 15 . 00
and Professions Code)or that he/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 MOO). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID. DUE
I. as owner of the properly or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 3. 00 1 5. 00 0 . 00 1$ , 00 18 . , 00
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State license Law
does not apply to an owner of a property who builds or improves thereon,and who does such work himsellmerself or through REVENUE DIVISION TOTALS--> COLLECTED; 18 . 00 OVER/SHORT; 00
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
mr the purpose of sale). 18 .00
I,as rotes of the property,am exclusively ate License with licensedr not contractors to construct the project(Section 7044,Business ******************************„*************************************************
.� and Professions pde: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects rtt.7 with Aa contractors)license pursuant to the Contractors'State License Law).I am aware INDIVIDUAL F E E BREAKDOWN
X that proof of their Worker'sCC / ipsurance�shpo,u.l�d belprovided to me.
❑ I am exempt under�,c H, WORK BY- OWNER TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
for this reason:
MI/ /-3 - 9Z owner6-A-tar•-- / -- re MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3 . 00 3 . 00
END OF FEES
1 do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
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
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
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
ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
bale: 4'n ,. :1T1G.5° ,11,-�T,;/ 7-117, 1-
Driver's License or Social Security N: - -
SATE: 01: �3, 9 9F-:
1641-46 White—Budding:Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
-•CON:ITRUCTION AND PLANNING POOLS ,
APPROVALS Permit# te Inspector •APPROVALS Permit # Date Inspector
1. Tcinporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3,.Electrical Conduit.Utility-Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding '
5. Steel Reinforcement 56. Rough Plumbing& Pressure Teat
6.•Etdctrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. .
8. 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
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap •
63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing • 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
-
20. RougltFactoryreplace
FiAPPROVALS' " Permit #
21. Ducts,-in Structure70: Underground Hydro '
22. DUcts,•Ventilating • - ,. 71. ProductPiping ❑Gas 0 Oil
23. Gas Pipe-Rough& Test72. Underground Flush -
24. Roof Framing • - " • 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - T4. Overhead Hydrp
26. T,Bar Ceiling (Structural) & Monocoat - - • 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe •
28. Lathing & Siding - 77. FIXED SYSTEM FINAL
•
• 29. Insulation • 78. FIRE PREV. FINAL - •
•
30. Drywall Nailing r- •HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat : c. 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final•Electric - Notes:
34. Final Heating&Air`Conditioning "12 - _ -
35. Final Gas Pipe•Test / J/qp� -
-
, 36. Hood or Canopy u L . _
37. Final Factory Fireplace
38. Final Plumbing - .
39. Water Service-Final �'- -
40. Gas Service-Final . .
41. Solar Domestic-Final
" 42. Backflow Preventer I
43. Backf low Irrigation • - -
44. Landscape Irrigation System _
_ s
45. Sound Attenuation - - " - -
46. Handicap Regulations - _ ,-
47. FINAL STRUCTURE & BUILDING "
48. FINAL PLANNING
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY . -
No. Date
- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MES CONSTRU TION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. .
Proje / / .33o ► 6a •
Applicant's
s aiss �6 r� .0 S 4/�y�'t11R 6 2 C , 77' TYPE OF CONSTRUCTION ❑ NEW ❑ ADD LI ALTERATION LI REPAIR 4997 9/I1 /87 .23n50 TI.
Applicant's Maili/n{g Agddres�sl S"/ .✓:_
Owner's Name LJ iC /[rN /T K N/ Phone 7SY 7b3Y ❑ CONVERSION ❑ DEMOLISH ❑ OTHER [ A.P.s(6 Zone
/6 �/ X/ 6 ��60 2 DESCRIPTION OF WORK/USE OF BLDG. RP-TOOT
AddressS Main Building: Accessory Building:
� E Z
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ElFOUNDATIONFOUNDATION STRUCTURAL T Front 0
Address ( .q El TENANT 111 ELECTRICAL El PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name 0 (JHC,C a ,,OG,l Phone (:) OTHER
X PROJECT DESCRIPTION SQ. FT. J3 f OCCUPANCY C Right N
Address(mailing) K G
CONSTRUCTION TYPE VALUATION$ i A A O s Left
City License No. R
ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing •
Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and T
my license is in full force and effect.
License Class License No, S
Date Signature - PLUMBING FEES
WORKERS' COMPENSATION DECLARATION Bar Sink Showers
'hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink /
00, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigation Sewer Cap Construction Po le Sub. 0 50+ KW
Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant - -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 a •
(This section need not be completed if the permit Is for one hundred ($100) or Dishwasher
less). Solar Piping Dryers ❑Gas DElectric Sub Panel
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 Drinking Fountains Solar Tank Fan Motors •i 1 HP ❑1'h-B
Workers' Compensat' Laws of Californifl ` / ` _
k Date 9/7—.P'/ Signature -���� !D`C�+�_ Floor Drains Swimming Pool . Spa —
F.A.U.
NOTICE: If,after making this declaration,you should become subject to the _ Inc =•lar ❑8-15 HP ❑16-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. icrowave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Wa - Closet Device Boxes
1 hereby affirm that there is a construction lending agency for the performancePole Light'
of the work for which this permit is issued (Section 3097 Clv. C.) Interceptors ater Heater Outlets Range
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposa Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator P a 5 KW❑5-15 KW Trash Compactor
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 Roof Drains
the Contractor's License Law (Chapter 9.(commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
erefrom and the basis for the alleged exemption. Any violation of Section
31.5 by any applicant for a permit subjects the applicant to a civil
malty of not more than five hundred dollars($500).
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do,the work, and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ a
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: .
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 pipe Approved By Data
•
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type 11 0 d
pLovp n• the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By qs I //x Date (� / J[J�T
prdv for the purpose of sale). �j` // O /
as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Datn
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct- Ventilating Doi 00,000 BTU 0100, TU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) ucense pursuant to the Contractor's License Law). i am aware that y 0 MultipleI BUILDING PERMIT $ Z3 •00 SMIP $ 0 . So
Exhaust System 0 System Repair/ ration I4
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
tam exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire D ers PLUMBING $ ISSUANCE $
y Date 2,.=tk'? Owner _./4.q.L/ LL Ad / Heating System& Ducting gisters PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction and hereby authorize repre- PLAN CHECK 50% $ MICROFILM'• $
sentatives of this city to enter upo the above-mentioned property for
inspection purpfles. MECHANICAL $ - TOTAL FEE $ Z3- ro
Drivers' Licensee 55#
Signature _��'�� •. DateReinspectionF. $15 Issue Fee $ 3 PLAN CHECK •25% $
oraimangmviiimi
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant: Pink -Accounting: Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS .Permit�# Date Inspector APPROVALS Permit# Date Inspector
1"Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms'
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd.; 57. APPROVAL TO COVER-GUNITE
7. Footings '58. Electrical Conduit-Undrgrnd.
•
8. 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
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar.System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS' Permit # _
21. Ducts, in Structure 70. Underground Hydro '
22. Ducts, Ventilating 71. Product Piping O Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush `
24. Roof Framing 73. Undergrnd.Storage Tank 0Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame-and Flashing 76. Dry Standpipe
28. Lathing & Siding •
77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
J
41. Solar Domestic-Final
42. Backflqw Preventer
43. Backflow Irrigation , . •
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING /vim v •
48.,Special'Requirements Completed
49. Electric Release to Edison ;
50. Gas Release to Southern California Gas Co
51. CERTIFICATE'OF OCCUPANCY
No. Date
PRDJECTADDRESS: 1681, LABRADOR DR UNIT: CITY OF COSTA MESA BUILDING PERMIT PERM NO: B 051 /6c
G0VT: N SUPP: N
OWNER'S NAME: HUNT, BRIAN E
onus: HUNT, JO A PERMIT NO: B 057762 PLAN CHECK NO: 02231-92 S
1681 LABRADOR DR
COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 430SF OPEN TRELLIS PATIO COVER SQ FT: 430
ADDRESS: UNIT:
CLAIM VALUE: 6, 000. 00 CALL—VALUE: 5, 934 . 00 GROUP OCC: R-3 /
PERMITTEE: BRIAN HUNT ( 714 )754-7034
ADDRESS: 1681 LABRADOR DR COMMENTS: X
C.M. CA 92626 **************r+E***sr*****"F****sr******+E*** ******************4•*7E*l� *�
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS �"jF r V L, E 0 A
7000)01 Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS � I
CITY LIC.: STATE LIC.: CLASS:
RED
MAIN BUILDING ACCESSORY BUILus
Date: Signature:
FRNT: 20 FT IN REAR; 15 FT IN FRNT: FT IN REAR; FT IN
WORKERS'COMPENSATION DECLARATION: Ihereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: 11 FT IN RGHT: 19 FT IN LEFT: FT IN RGHT: FT IN
Compensation Insurance,or a certified copy thereof(Section 3800.Lab,C).
POLICY EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 13918138 ZNE: R1 REF NO:
,
PLANNING NOTES> APPROX, 430 SQ, FT, PATIO COVER ADDED TO REAR OF EX
$ale.7ceniem copy Is hereby fgrnsnea. ❑ Ce ified copy a filed wth the city Building U Sion. > SFR•,
Applicant: DEVELOPMENT SERVICES R E Q U I R E M E N 'T S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). r
I certify that in the performance of the work for nth this permit is issued,I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws California. -'C.1 - u/ / ZONING APPROVED BY r• SCC__ DATE: �_ (�L� t_
Date: ‘'— Id —F ,2_ Signature: fV (QnLJ ✓ BUILDING APPROVED BY : '
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor ,
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE: (i (2
which this permit is issued(Section 3097.Civ.C). **'!k*************** ******'IE***********if***' *' 'k ********************** **+++ttE* ***
LENDER: ******************)k************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMAR Y STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRAD ING
(Section 7031_5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 81 .00 59d
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON-RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 52 . 65
and Professions Code)or that he/she is exempt therefrom and the basis for thuAlleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not mor than five hundred dollars($500). ISSUE FEE
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 A DUE
❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 81 . 5 9 0. 00 5 2 . 6 5 134 . 2 9 134 , 24 / . , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building orI
REVENUE DIVISION TOTALS--> COLLECTED• 134 , 24 OVER/SHORT:. 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING ELAN—CHECK
for the purpose of sale). ,
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
81 , 00 . 59
_ 52 . 65
and Professions Code: The Contractors'
withState License Law does not apply to an owner 01 property ate s or improves thereon ***************************.****************************************************
and who contracts for such projects with a Lice contractor(s)license pursuant to the Contractors'Slate License Law), I am aware
that proof of their Worker's Compensation insurance should be provided to me. I N D 'I V I D U A L F E E BREAKDOWN • 'r
o I am exempt under Section: B.B P.C.-
mnn¢reason: (// �����_` TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
!a—P
Date: 6— i owner: Q SFR 430 RES—PATIO COVER—POST 6 TRELLIS 13 . 80 c 5, 934 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES ,/ r
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
permit for construction or modhication from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
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
' ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mention •
property for inspection purposes.
b^
1p--5 / ////�((�� /! /
Date: lignature: �V ! ;t -- - .
'
Driver's License or Social Security x: -,t4 _• r-..
164146 White—Buildmq:Green—Code Enforcement:Canarv—AnolicanL Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING a- POa.
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
•
.3._Electrical Conduit.Utility-Undrgrnd. 54. Forms
4•. Electrical Conduh•Undrgrnd. 55. Electrical Bonding
5.-:Steel Reinforcement 56. Rough Plumbing & Pressure Test
: G. Electrical UFER.Grnd. 57. APPROVAL TO COVER-GUNITE
- 7. Footings 58. Electrical Conduit-Undrgrnd.
8. 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
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing ' 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
-
16. Rough ElectricWiring 67. Fencing& Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- _
20.-Rough Factory Fireplace I. - 7. - APPROVALS • i Permit # ;
21:Ducts,in Stcuct+ire, -- • -70. Underground Hydro
22. Ducts, Ventilating , _' ' _71. Product Piping 0 Gtas 0Oil
23. Gas Pipe-Rough & Test ,i, ` s 72. Underground Flush,
24.;Roof Framing • ' `•73;-'Undergrn8.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing _ ' i:" `74r Overhead Hydro-'T
- t
26. T-Bar Ceiling (Structural) &-Monocoat - - 75. Dry Chemical 4
27'.'Frame and Flashing "' " C26'- J 4wa, 76. Dry Standpipe s -- '
28. Lathing& Siding ._ . + •• 77. FIXED SYSTEM FINAL*
29. Insulatibn = - 78,FIRE PREY. FINAL .
.30. Drywall Nailing - HEALTHDEPT. REQUIREMENT
31. Plaster Brown Coat - ; l', ` - 79.- FINAL INSPECTION • - ,
32, Electrical Power Meter-Final . -;- i ,,80,. FOOD CERTIFICATE ISSUED
33. Final Electric - - ' Notes:
34..Final Heating& Ail' donditioning -. - ', 1, .
35.-Final Gas Pipe-Test -. '
.36. Hood or Canopy ., - , - ; _
37. Final Factory Fireplace, '
.
38, Final Plumbing , .
39. Water Service-Final , - _ • - •
A0. Gas Service-Final '
•41. Solar Domestic-Final- -
42.'Backflow Preventer ' ' -r - • -
43. Backflow Irrigation - • r - .
-
'44. Landscape Irrigation System r z , . i, ' -
3
45.'Sound Attenuatiot s'
-46. Handicap Regulations - ; - / .
47. FtWALSTRIICTURE & BUILDING gyp• �2 / _ - des, i, -
48. FINAL PLANNING - rG•
•n Q"� ,�'vl_ 6�G
49. Electric Release to Edison IL is
50. Gas Release to Southern California Gas Co I r, • - ,
.'51. CERTIFICATE OF OCCUPANCY ,
No. Date
OWNER MESA VEPT)E FSTATFP DP'—' 12-9-5R ._
JOB ADDRESS 1681 Labrador Dr. BU. .ING PERMIT NO. 8231
GENERAL CONTRACTOR L. G. Robinson VALUE § 15,1195•OO
AP. No. LOT 133 TRACT 3�i5 FIRE ZONE DESCRIPTION OF WORK Res & Att/gar
GROUP 1 & J TYPE V ZONE Al PLAN NO. 8231
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches k Forms Steel L Sr /-Q'il?
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam L-4,Ar x5 . - .y7 sg
Frame and Flashing .')& .. --1 4-1 •
Lathing, In Out4 5-/3 -S
Plaster, brown coat gg.--- 4 .a./ -..'e
Underground soilftjg'S W/G Pipe Test LW. /...%.-„4-9' ,
Top Out /1.193.. h/n`9b ;P ;_ . ' - !Ag /1 ilii/i i/ .0 ... . .- - - _ '26 ?�yy 3 1(1\Furnace S 3-'t—fl `!r'W 40-5 -� C ' l7a 7 y L� I
Gas Ventsi r t
Rough Plumbing /PP< 2--24'4", ,i�r>�-1-tlt / c u - L,-LG'--CJ ) 40 7 V to L l N1
Cesspool Septic Tank r .
Prop. Swr ine' H Coa ll5� P..Q
St. Swr. 3/ .. r eat"- ria,ISI Ifir,i--k—
' Sprinkling SystemI 1
Heating Final ,Aa4.S s'-//-33P t
Plumbing Fixtures, Final /VKS {%//-!7
Final Gas Test /r 44./C r,,- 4
Construction Pole •
Underground Power { �}/ ./
Rough Wiring 7. 1 7 2 7:)'l 94/.A/7,0e&,, L[S4k a c2c/-3y 2 Z '£ f 4---'- T
Fixtures, Final .-//_y
•OCCUPANCY -//./9 1
Form 210—SM-1-57
Vii.
8231 DEC 9 1958 CY
11r.'r(nr
.0 .
COSTA MESA BUILDING DEPARTMENT rii, OFT.
P.O.BOX 317 1.1 'I 11 IC r ..'-ri 1 CI'
COSTA MESA. CALIFORNIA '
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING 1681 Labrador Dr. BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. ERMIT O.
OWNER Mesa Verde Estates b'''3_ ` /(
RECEIVED BY DATE RECEIVED DATE ISSUED
MAIL
ADDRESS 1701 Gisler St. Oj - /a-- 9-sr' /)-- 5 -s f
TEL. BUILDING
CITY Costa Mesa No.gi 5-1751 ADDRESS
• G
OR Y cVEER J. R.Shelley
NO. C-2170 COSTA MESA. CALIFORNIA
FIRE I
ADDRESS Long Beach Ge 9-0908 ZONE
IOrvE NO.OF ♦T yy pp�¢�� GROUP
CITY LIC. , PLANS o-�
CONTRACTOR L. G. Robinson No. 1123
TEL.P� APPROVED
ADDRESS 17101 Gisler St. NO.a`r 5-1751 BY DATE
LEGAL ILOT
DESCRIPTION NO. 133 BLOCK TRACT 31
CORRECTIONS
A.P.NO. .
SIZE
70 x 100 NO.
NOWOFON BLDGS.Loi none
SFFLOT
USE OF /�I
EXISTING BLDG. LI1u'1I
SETBACK LINESFROM- X1/1 plus
CENTER OF STREET re,' REAR YARDµ'
SIDE YARD RIGH15 plus LEFT 51plus
DESCRIPTION OF WORK
NEV X ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BIBLE:Au 4140 FJ NO.OF
SIZE 1560 I04.Ft. ROOMS 6 STORIES 1
EXTERIOR WALL. ROOF
COVERING stucco pbCOVVERINGAaalt & Rock
�
USE OF NEW
BUILDING Residence & Attached Garage
I HEREBYLEDGE THAT I HAVE READ THIS..APP-.1L -ATION AND
ABOVE• THAT THE ABOVE IB CORRECT'AND AGREE TO/COM V WITH ALL
CITY ORDINANCES AND STATE L % REGULATING COIL G CONSTRUC-
TION. VALUATION
PERM• ITTEE OF / N1-XL / iC!L}1-.-./ PERMIT FEE $ S O -
✓✓ ( CO
A I U PLAN CHECK S / 7. V'..
AUTHORIZED AGENT TOTAL FEE S S c2 . "S....1-1 NBMr