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Home My WebLink About1726 LABRADOR DR - Building Permits t, `,s� ID CITY OF COSTA MESA all a BUILDING DIVISION F y r,,,, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER o• 11.4 i PERMIT 41.(b„e o°44 P01-00327 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1726 LABRADOR DR Status: ISSUED Suite No Applied: 06/04/2001 Issued: 06/04/2001 Vicinity: WATER HEATER Parcel Nunmber: 13915214 ISSUED BY: 1. Applicant: NOCK, RON li Address: 11612 KNOTT ST • Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 Owner: NAKABARA, M GEORGE Address 1726 LABRADOR DRk I $ Phone: COSTA MESA,CA Zip: 92626 ' ISIC I 0 Contractor: NOCK PLUMBING - Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 License: 707775 Arch / Eng: Address: Phone: Zip: License: SCOPE OF PERMIT WATER HEATER CHANGEOUT FEE SUMMARY AMT QTY AMT QTY - AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 - Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00. 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain. Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS 1 SPECIAL CONDITIONS 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 2448.46(aoo) DECLARATIONS C_ :i WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I hve 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 �,— rk for which this permit is Issued. __I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. v My workers'compensation Insurance carrier an policy are: - - n � -79 (? �/�� i-- Carrier, 1; 9M7 J 1—Policy Number: A9 "7 3 � Y-C/1 _(This section-no not be completed it the permit is valued at one hundred dollars($100)or less.) --— ❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person In any manner so es to become subject to workers' compensation laws of ' :nd agree that II I should become • - 0 the workers'compensation provisions of Section 3700 of t�bor�,I shall forthwith W� comply with these prove at C -Appdcent Signature:' Date: ^WARNING:FAILURE TO SECURE 'COMPENSATION COVERAGE IS UNLA , D SHALL SU:A H - . • ' NAL PENALTIES AND CIVIL FINES UP HUNDRED THOUSAND DOLLARS(5100.000).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS-ROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that'I am•licensed u0der-prpvjslons,Chep{pr 9 m ening with Section 7000)of Division 3 of the•Business and PrpIa551ayyGode,end my license is In full force and effect..Uc.117 !/(//) / J Class t/ / C�_J Co //_' (Contractors Sig-nature: Ipate:` �p je9/ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for whr ja___________r issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Lew(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ i hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or 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,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 0 No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this 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? I0 Yes 0 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 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 state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized,by this permit tuuntil nfinal inspection. _Signature Of :.: Owner(s ate 2T11�thodzed Applicant'sr / ataj - CODE G INSPECTION TYPE MIL IffIDAIA CODEC INSPECTION TYPE WI INKS 1616 Fixed System Final Fire Prevention 206 Final Mechanical // 1266 Pool Spa Final 208 Final Plumbing S Y-c, h•hd (RS 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 4` 9 CITY OF COSTA MESA BUILDING DIVISION Y 4 r,,.. ;r ,r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT "^ .r"b. 1P411 LPOS-00141 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1726 LABRADOR DR Status: ISSUED Suite No Applied: 02/16/2005 Issued: 02/16/2005 Vicinity: WATER SOFTENER ISSUED BY: Parcel Nunmber: 13915214 Applicant: SCOTT,JEANET Address: 502 S LYON ST Phone: 714-750-2233 SANTA ANA,CA Zip: 92701 Owner: NAKABARA, M GEORGE TR Address 1726 LABRADOR DR Phone: COSTA MESA,CA Zip: 92626-2316 Contractor: CULLIGAN WATER Address: 502 S LYON ST . Phone: 714-750-2233 SANTA ANA,CA Zip: 92701 License: 663091 SCOPE OF PERMIT INSTALL WATER SOFTENER. • FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $9.80 1 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: 533.30 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) DECLARATIONS 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. _fvl?l 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. 'YY My wgxkers'compensatioory{{nsurance carrier and policy numb are: -ca der-`v N;ch f I M?Rl e R 2N5 O iL Pol •icy Number.:_L e. 3 7R 5/ _Clo _ 00 -(Yids section need not be completed l/the permit is valued at one hundred dollars($100)or less.) "^ ❑ I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and egrhat if I sh Id become s ject to the workers'compensationprovisionsSection 3700 of the Labor Code,I shall f of drthwtth comply with these ions. �-, Applicant Signature: N,t� Dam-' / // /'j WARislOG:FAILURE TO SE WORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS(SIM IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license•under provisions pf Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effecactor's Signature: P - t'EIE ah ' i . I — / CIc ' '-° " --- Contractors a rata: 2/i OS CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097.Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a chill 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,end the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 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 then thirty-six(38)feel high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia 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: I 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,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 Califomia 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 Califomia 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 Cade been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes El No (Section 65850.2 of the Califomia 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? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South-63,73-ilkir 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 state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. Signature 1 Legal Ow (s) D e , o2,/70,5 L_LAnd/OLAut rued Applicant Date --,y., CODE I INS(CTIONTYPE PANE ILLS CODE INSPECTION TYPE PATE INIIDAL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 6127Or1 SAS 200 Final Re-Root 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 • _ • Applicant to fill in all sgaces within heavy border lines and sign all appropriate declarations. . CITY OF COSTA MESA RFT MIT.V TRACT NO. LOT NO. . -BLDG:NO. - - • - _ - __ ; CONSTRUCTION PERMIT ,6 " `f6070`:-: sae 6J'Z I ' Project Address '%2(t � r)r ��.., �b" f/ TYPE OF CONSTRUCTION - • ' ' - .. ! _ - . 1` t /// M " 7013 -8/3.1/82 " f Ovaher 4„�t G��s�-7pPT AS �./ n y hone47,Lli O NEW 0 ADD ALTERATION -!� - - . .- - - 17a QQ, Address '-] �.�Jy t? - - • - -0 REPAIR 0 CONVERSION ❑DEMOLISH v r` _ •' T V ZONING'REGULATIONS r Arch/Eng.- O-,1SL - - i - - License No._ _ - 0 OTHER `' • • - - A:P.# - p +� / - Address- - - - -_. - - - DES IPTIO ll WORKT�� J O ` _�� 6 It - 2a C 6, I 1/t,) C E- ZONE' PLNG. REF.-* , - " Contractor tiAgue,e - -- •'Phone - TYPE OF PERMIT - " . - '- . -BUILD' Tp BML INC . �,r 'SETBACK C/L ST. PROPS RTV LINE' '' - • - 'Atltlress -- - - '- - -' - - 0 GRADING .-O FOUNDATION- gy STRUCTURAL-•- • SIDE YARD _ - ' LICENSED-CONTRACTOR DECLARATION . : .-O TENANT 0 ELECTR• ICAL'-OPLUMBING ❑MECHANICAL IDE YARD _ '1 hereby affirm tint I am licensed under provisions of Charter 9(corn- „ i ' RIGHT • mencing with -section 7000) of Division 3 of. the• Business and 0 OTHER -- Professions Code, and my license Is in full force and effect. REAR YARD(TO P/L) - l PROJECT DESCRIPTION ' .License Class 'License No. . _ - ' -- - " - PKGCSPACE REQ. - PROVIDED - - • tate , _.Signature.-' _ _ . . !�- • ..•SQ. FT. _77 1 _ WORKERS'COMPENSATION DECLARATION _ . OCCUPANCY-,3CONSTRU CTION TYPE ✓ STREET WIDTH - / PARK FEE E .1 hereby affirm that I have a certificate of consent to self-insure.ora • •/SO•�ZONE 'ZONING APPROVED BY �/�J'Jt6#1 DATE�a�/e2L :certificate-of Workers! Compensation Insurance,.or a certified-copy - VALUATION - IIICCC��_ �� whereof (Section 3800, Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: - ' 'Company '. -.. - '___ _ _. ._ _ .,,.-_- _ __ _ - ertitied.copy.is hereby_furnished. ,, -- - . REMARKS: ''-1' '_ .- • - - _ _ _ _ ' -- ' - L.. Certified copy is filed with the city Building Division. .i - - - _ - '- -' - 'EXEMPTION FROM-WORKERS'COMPENSATION-DECLARATION - .- - . - • — -- - • - - - - - -- - • - - - - - - --- ---- - - �' ' - .(This section need not be completed if the permit Is (or one hundred • '� ' ._•n.-• 'I ($100) or less). __ r ____ ._-. .. . • __ - _• _ .. _ -- - _. _. _ - . .__ _ - _-. _ .._ . 11 certify,that in the performance of the work for which this permit Is , rl. • issued, I shall not employ any-person in any'manner so as to become ' PLUMBING' - -;PLAN-CHECK -- -- - - - 'ELECTRICAL- — PLAN• CHECK - - 'subject t0 the Workers;Compensation Laws of California.• - • - - '- - .. UW b R RR_ tLLiN _ t, E I I 1- - - ' -BATHTUBS- SHOWERS"- SO FT SO FT Date Signature !NOTICE: If after making this declaration, you should become subject, -TOILETS i ,,..URINALS- r •- -- - - ..GENERATOR 0-1 KW. ..- 1-10 KW - - - -- - to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER , t ' forthwith comply With such provisions or this permit shall be deemed LAVATORIES DOUBLE LAWS — - - _. - $APPLIANCE- .10-50 KW__56+ KW - _ , _. 1 revoked. _ _ _ _ _ _ _ .CONSTRUCTION LENDING AGENCY "KIT:—SINKS - "DISHWASHERS - -• - - • - MOTORS -- 0-1HPy7-30 HP - • - -- - ) 11 hereby affirm that there is a construction lending agency for the per- SERVICE SINKSSUMPS - - - - - -- - . UNC.SOLAR) 10-50 HP 50_+ HP _ • 'formence of the work for which this permit is issued (Section 3097 ' - Civ. C.). - -' . .- -- -"- -' FLOOR SINKS ` . 'FLOOR-DRAINS- - -: •• -- -- FIXTURES- OUTLETS SWITCHES - 1.0 Lender's Name _ Lender's Address ' ' - DRINKING FOUNTAINS '-- -' - - - -- GAS TUBE SIGNS - - 'OWNER BUILDER DECLARATION - - •' --- -' INTERCEPTORS CLARIFIERS- POLE LIGHTS - -- - • • I ,1 hereby affirm that I am exempt from the Contractor's License Law for the-following reason-(Section 7031.5-Business and Professions Code: SWIMMING POOL - P TRAP _ _ _ LUINSI NUL I ION !Any city or county which requires a permit to construct, alter, - :PDL"ES' METERED SUB - ' improve, demolish or-repair any-structure, prior to its issuance,also re- -WATER-SERVICE - ALTERATION -- r - 4-PANELS- - MAIN quires the ap,licant for such permit to file a signed statement that he - - is-licensed pursuant to the-provisions of-the Contractor's License Law- - GAS SERVICE .. .. OUTLETS' - .SERVICE - - - - - - AMP _ (Chapter 9 (commencing with Section 7000) of Division 3 of the - Business-and Professions Code) or that he is exempt therefrom and-the - WATER-HEATERS - -- BTU-OUTPUT - - - l• - - - ----• - -- - .. - - - - 's for the alleged exemption. Any violation of Section 7031.5 by - - --- ' applicant-for- a-permit subjects-the applicant to a civil-penalty • SEWER CONNECTIONS--= mt more than five hundred dollars ($500). - - - .. - - 4 ,..$54I, as-owner df'th-e-property, - --SOLAR-TANK---- - - COLLECTORS - -,- •- - �- . - - - ' - . _ _ ._ - . '• erro,, e4 a,rswill do the work, and the rue ure is not intended ' 'or offered for sale. (Section 7044;-Business and-Professions Code: The SOLAR PIPING SYS. - "--'44 - . ' - -- ISSUE-FEE - - •- _ - ; 'who uiLicense Law tlreo not apply t0 ansuch cowner r a property APPLICATION.APPROVED.BY - DATEsel who buildsior improves thereon, and who does mph vement are not _ l intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK - - - ' / is sold within one year of completion, the owner will have the burden 1 SUMMARY OF FEES - 1of proving he did not build or improve for the purpose of sale). ' _ - - -- - - BUILDING ,,,..sss ' ✓ .0. 1,-as owner- of the property, am exclusively contracting with HEATINGDDUC SYSTEM 0-100,000 BTU:— PERMIT $ $�•O e� SMTP. $ D• -, licensed contractors to construct the project (Section 7044, Business AND DUCTING - 100,000+BTU P RMIT PLAN CHECK $ O E • fang Proep pert Thebuild orContractor's License hew does not apply to • - ... . ISSUANCE ,$" ' • l ;an owner of property who builds improves thereon, and whoa con- REFRIGERATION RATION 0-100,000 BTU PLUMBING $ ' :tracts Contractor's such projects with a. contractor(s) Ilcesned pursuant to SYSTEM _ _ •I '''GRADING E '[he COn tra c[or's License Law). 100,000+BTU ' PLAN CHECK $ -- 0'I am exempt under Section- - ' --B.& P.C.for this ' BOILERS BTU ELECTRICAL $ $ reason M _ _ ' ' MICROFILM $ ' Date Owner • SYSTEREPAIR,ALTERATION ' PLAN CHECK $ - TOTAL FEE$ I hereby certify that 1 have read this application and state that the above EXHAUST SYSTEM MULTIPLE -MECHANICAL $ information is-correct. 1"agree to comply with all city and county- - PLAN CHECK $ LESS EAPC - VANCE PC $_ ordinances and state laws relating to construction,and hereby authorize repres¢ntatl of-this +ly 't• dote up0 the above en 'oned - . - / properly •ns•e tion Hiroo s. -/ // 7, , srI� /1v a_ a FINAL FEE $_ 00 Signature - Drivers' License or 5S# -' ISSUE FEE .. _ _ _ - , CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor -. CONSTRUCTION AND PLANNING -' _,• : POOL&SPA" •' - • , - - APPROVALS Permit# g`Ito)tb Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - -2. Soil Pipe-Undrgrn , - .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 USER Grn 48. APPROVAL TO COVER-GUNITE _ - _. 7. Footings -.. t - _ _ 49. Electrical Conduit-Undrgrn ' • 8. Foundation -- - - . . . ' 50. , . Gas.Pipe,0 Undrgrn,Test .1 - 9.- Water Pipe-Undrgrn . - - _- . 51. Backwash Lines. P-Trap. ❑Undfnrn ' . - - - - - " - - : ' 10. - Structural Floor System- « •- . .- _. 52. APPROVAL TO DECK . -.: . . . - -. - ' ---1.1. •Property Sewer..Line`&House Connection . _ - --.. ._. • 53: Backwash & Receptor-Final • . . ' - ' ' 44 12.- -Street Sewer Connection - - - - 54.- Heater & Vent-Final 13.. Rough Plumbing. . _ . - . - - _55. Rumbling System -Final • - 14. Rough Electric•Conduit - - 56. Electrical-Final • • 15. Rough Electric•Wiring - - 57. Solar System-Final . . . ' 16. Rough Heating & Air Conditioning .- - - - - - b8. 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 - - - 22. Frame and Flashing - - - - NOTES: 23. ' Insulation - - --- - 24. Lathing & Siding • - - . - • - - - - - 25. Drywall Nailing - - - 26. Plaster Brown Coat - - -- - - - - - • - - I. 27. Electrical Power Meter-Final - - ' 28. Final Electric - - - - - - 29.- Final Heating & Air Conditioning - - - - 30. Final Gas Pipe-Test W 31. Final Plumbing .- - .. - " ' . ,, 32. Water Service-Final - - , .• 33. Gas-Service-Final. - - - 34. Solar Domestic-Final - - 35. Landscape Sprinkling System 36. Sound Attenuation ' - , 37. Handicap.Regulations • • - - 38. FINAL STRUCTURE & BUILDING ' q i7-6 tv - - ' 39. Special Requirements Completed - _ - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. .CERTIFICATE OF OCCUPANCY ' No ' • Date - (Q PPRo-lo^/s ) • APPR VED CR!OF COST MESA PLANNING EPT.• • - ' hour TO KM VT. R!0. GA , MCI OP . • -- -- -- _ - :! F- ADOr(rwN AT SIPS OF 4AP I IAf4F ARAM M.GF.f e F1AM 'APA t 11169 L U-ADofz DTE I, ecsTA MESA, C. cow, o" j f ' t d it d' calx vaLK Avd�l -� i.. 034 2 ,(6'-S" uv �fouovJ , . - I I I �core v : • ' L ii • • hitifivr/ I (opv&voy I 0•or (-WEs ? 1 1 1 � I - - L., 5P4fl2 - - D(z IvR. 4:1AArokt A ii- ----------- II.= 1 1 I Psct1 a'Kv S+IR _v 1 ciort-e (fid' -u? fags -�I I i \ i-toIJ Pi>4L-C.I I ' 'I 4. I eat WI. II (i ; a „ _D SSP ° 1 8 5tLL RR'(, ' n \9 L AT C?Fl ' i1 I \\it I1. V 1 Ii il Nati) ccoc. Ui6 AC. p -' - - — lir 9,15D1.1 p 3e� Tod ✓eatJ�. CtIM� . . �f(i I r'(!9, aili6 t 51 cib9 eArtief i L- it3 A i {, . a o ccm,& gC Ci i o KL Ao sr a:Lt; i ,j S ,o' r. Y 1 y %Ca .i: 1 ✓:..� N.J-., 2 1 n 1 s f AppRovE ® STRUCTURAL APPROVAL ONLY, • SEPARATE PERMITS ARE REQUIRED : jCitir of C Mesa Building Dept. FOR TRICAL, PLUMBING. " Y HEATING,.VENTILATING-AM..: } ' . .t..:-zr, ELEC BY DATFl/3/ T REFRIGERATION WORK THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. Permit B#ER 7n THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL THISPNUMBER (MUST ACCOMPANY OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED ALL INSPECTION REQUESTS TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION OF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE- - SUMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO FOR BUILDINGS WHERE PERSONS ARE TO FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL. BE EMPLOYED, WE SUGGEST THAT THE STATE OF CALIFORNIA DIVISION OF THE ISSUANCE OF A PERMIT BASED UPON PLANS AND INDUSTRIAL SAFETY BE CONSULTED FOR SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL ADDITIONAL REQUIREMENTS._ FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHER OROINANCE OF THE CITY. gCtlOnS - Tot lnsQ Ca11 627 OWNER MESA VERDE ESTATES , DATE 12-9-58 _ JOB ADDRESS 1726 tree�• (7 k' ✓ A ).1 w4. BUILDING PERMIT NO. #8187 GENERAL CONTRACTOR I,', u_ Robinson VALUE $ 15,r495.o0 AP. No. LOT 52 TRACT 3115 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar. GROUP I (Sr J TYPE V ZONE Al PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED _ DATE _ NUMBER Trenches /..../Forms L- Steel /W'S to -2q- Floor System _ Steel Reinforce Chimney Re-Rod Bond Beam / -9 CT ill Frame and Hashing 9S/r ...;"0-4..:• l Lathing, In Out , : - Plaster, brown coat �_k- .- 4,/O-5-` Underground soil Mit-,^W/G Pipe Tes04/g /2-2-3-St Top Out /a t Furnace 44,t .2—/e �'.S9 �./y2� /3'o)7 / - Gou Vls _( Rough Plumbing 44-74C2- --5--.5-q/:/.r.ip s(l.z• / 9N( /c)--/0-ca /G is a, i AAI Cesspool Septic Tank Prop. Swr. Line- Hotg on. St. Swr. .g1,2.1/5--f //J"..t„.6- f', i— g fi)—( l3"? o Y li Sprinkling System Heating Final iejklS '/t7S9 Plumbing Fixtures, Final /t4,LS y-$?-61Final Gas Test bS MOS i%-2.j-69Construction Pole Uoughground Power7 �� / 1Rough Wiring yr- r y- lu-f7l jNCL-(�GbYI �➢-C �2�l0'.$3 Y/43 c� � Fixtures, Final 1/. 27. OCCUPANCY /— !/y7:fl Form 210.-5M-1-57