HomeMy WebLinkAbout630 LAKEVIEW LN - Building Permits(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
�obnddress: 630 LAKEVIEW LN
Suite No
Vitinity:
Parcel Number: 93405004
Applicant: BRENNAN,JOHN
Address: 1241 N LAKEVIEW STE J
ANAHEIM, CA -
Owner. WEST,`WILLIAM A
Address: 630 LAKEVIEW LN
�
COSTA MESA, CA �
Contractor. ASSOCIATED HTG AND AIR
Address: � 1241 N LAKEVIEW STE J
ANAHEIM,"CA
Phone: 714-777-8833
Zip: 92807
�Phone: �.. ,.
Zip: 92626 ,
Phone:�7�4-777-8833
Zip: .92807
License:608210 �
Status: ISSUED
Applied: 11/14l2005
Issued: 11/142005
ISSUED BY:
SCOPE OF PERMIT
REPL4CE THE EXISTING FAU AND�AIR CONDITIONING UNIT W�TH SAME UNITS AT THE SAME" '� - �
LOCATION - '
ISSUE FEE
Inst FAU <100 k BTU. �
Inst FAU >100 k BTU
RepairlAlt CoolingMeat
Inst / Rep. Recess Wall Htr.
Refrig Sys <100 k BTU �
Refrig Sys >100 k BTU
Gas Piping `�
Factory Fireplace
Hood w/Mech Exhaust -
VAV Boz
Vent Fan / Single Duct
Appliance
Fire Dampers
SmokeDampers- '� �.
Inst or Relocate Appl Vent
Air Handlers < 10000dm
AirHandlers> 10000dm
FloorFurnace
Floor or Suspend Heater - �
Quantiry
$23.50
, $14.80 .W,7 _- -
$0.00 0
$0.00 0
$0.00 0 -
514.80 .1
$0.00 0
so.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
��' �$0.00 . 0 -
so.00- o' -`
$0.00 0
� $0.00 =�_0 - �
50:00 •0
�� $0.00 �,.0 ..
FEE SUMMARY
� 'Repair/AltAbsortitionUnit
. ' `� Repair / Alt Refrigeration Unit
Ventillation System
Evaporative Cooler
- - -- Commercial Incinerator
. .. Domestic Incineretor
._ �,ComoressorslAbsomtionSvstems
Upto3hp/t00kBTU
3 70 15 hp ! 500 k BTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
,. Over 50 hp I Over 1,750 BTU �
". Boilers �
, � Up to 3.hp
�- � 3 To t 5 hp" ._ --
. " 15 to 30 hp � - '
, � 30�to 50 hp , , ,
, �Over 50 hp
Other Mechaniwl Fee �
'�lnvestigation:Fee.- . �
� � ' .-� Plan Check Fee �. . ,
� Reiuspection Fee .
- ' . TOTAL CALCULATED,FEES
� r- � � Quantity
$0.00 0
^ $0.00 �.0 - '
$0.00 0
$0.00 0
$0.00 0 '
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
so.00 0
$0.00 0
so.00 0
50.00 0
$0.00 0
$0.00
$0.00
$0.00
E53.10
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 7, 1241•92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permlt to be considered legal, such work must comply with ell applicable codea, and all
required Inapectlona and final approvel must be obtained. Failure to obtain Inspections and final approval will resufl in the expira[lon of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
ecno-+a �aw�
WORKERS' COMPENSATION DECLARATION:
I �ereby affirm under penelty of perjury one ol the following tlecleretlons:
❑ I heve end will meintain e certiflcete ot wnsent to sell-Insure lor workers' compensetian, es provided for by seclion 3700 ot the Labor Code, for the pertortnance oi the
work for w�ich this permit is issued.
� I heve end will maintain workers' compensetion insurance, as requiretl by sectlon 3700 of Ihe Lebor Code, for Ihe perfortnance oi Ihe work for which this pertnit is issued.
My workers' compensatlon Insurence cerrler and pollcy number ere:
Carrler: � Policy Number:
%his secfion need not be com t d i! fhe Oermlf is veluetl et one huntlred dollers ($100) or /ess.J
I cetlify that in the peAo e of the work for which this permit i5 issued, I shall not employ eny person in eny manner so as to become subject to the workers'
sation lews of e a, end egree that tl I should become subJect to the workers' compensalion provislons ot Secti n 3700 o e Labor Cotle, I shall forihwlth
Com 'th ihese pro i . /9
(�D a ' neture: Dat �' �� // �� � %� S
WAfiNING: FAILURE TO $EC ORKERS' COMPENSATION COVEMOE IS UNUWFUL MIU SHALL SUBJECT PN EM O CRIMIWILPENALTIES AND GVIL FlNES UP TOONE HUNDRED
TFKKISANDOOLLARE�5100, ),INADDITIONTOTHECOSTOFCOMPENSATION,DMMGESASPROVIDEDPoRINSECfION310GOFTHEUBORCOOE,INTEREST,ANDATTORNEY'SFEES.
LICENSED CONTRA OHS D� LAFA710N:
I hereby eH' I m licens under provisions ol C�apter 9(wmmencing with Section 7000) of Di ' 3 ot Business and Professions Code, and my license is in full
torce a leu s — O
Contr ewre: �; � 7_ n �
CONSTRUCTION L
❑ I hareby aflirtn
Lenders Name:
Signature: _
AGENCV:
3 is a construction lentling agency tor t�e pertormance oF ihe work lor w�ich this pertnit is issuetl. (Sec. 3097, Civil Code).
Lenders Address:
Date: _
OWNER-BUILDER DECLARATONS:
I hereby atfirtn Ihet under penelry ot per�ury Ihat I em E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business antl Professions
Code: Any ciry ar counry which requires e permit to wnstrucl, alter, improve, Oemolish, or repair any structure, pnor to its issuance, also requires the appliwnt tor such pertnit
to file a signed statement that he or she is Ilcensed pursuant to Ihe provisions ol Ihe Cantrectors License Lew (Chepier 9(commenGng wiih Section 7000) of Division 3 ot the
Business and Professlons Code) or thet he or s�e Is exempt t�eretrom entl the besis for the ellagetl ezemption. Any violetion oi Sectlon 7031.5 by any applicant for a pertnit
subjects the applicant to e ciWl Denalry of not more Ihan five hundred dollers (5500).):
❑ 1, as owner of the property, or my employees with waqes as thelr sole compensation, WILL DO THE WORK, anOlha structure is not intentled or oflered tar sale (Sec.
7044, Busineu antl Protessions Cotle: The Conlractors License Lew does noI apply to an owner of Oroperry who builds or improves Ihereon, antl who dces such work
himsell or herself or through his or her own amployaes, provitletl that suc� impmvemenis are not INenAetl or oflered for sale. If, however, Ihe buildinq or impmvement is
sold within ona year ot completion, the owner-builder will have ihe burden ol proving t�at he or she did not 6uild or improve for purposa of sale.). '
❑ I, as owner at the pwperry, em E%CWSIVELV CONTRACTING WITH UCENSEO CONTRACTORS to conslruct the pm�act (Sec. 7044, Business and Profeuions
Code: The contrectore License Law Does not epply to en owner of pmperty w�o builds or improves t�areon, and who contracts lar such pmject wifh a wnirector(5)
license pursuent to lhe ContraC�ors LicenSe LewS.).
❑ I em exempt under 5et.
SignaNre:
Owner ID venfietl 6y tlrivefs Ilcense. ❑ Ves ❑ No
Business end Prolession5 Code tor Ihis reason:
Venficetlon of Ownership �y (type oi tlacument, i.e. - property tax blll ar tleetl):
UIVISION OF INDUS7RIAL SAFETV PERMIT CERTFICATION:
Driver's License No.
Date:
Expires:
❑ I hareby certify that no exwvatlon flve (5) or more feet in dept� into which e person Is required to descen4 will be made in connaciion with work euthodzed by t�is
pertnit, entl that no Duilding swcture, sceMolding, falsework, or demolition or dismantling t�ereot, will be more then thirty-si: (36) teet high. (Chap. 32, Grp 2, Atl 2, Sec.
341, 7tle 8, Califomia Adminisiretive Code).
❑ As awner-builder, I will not employ enyone to tlo work which would require e permit irom the Division of Intlustnel Sefery, as noted above, unless such persan hes e
permit to do such work from the division.
Signature: Date:
Division of Industnal Safety Pertnit Number:
CERi1FICATE O� ANCE'"�7D AUTHOR�'ZA'�IbN OF QRlR�'7�I?cenity under penelry ot perjury that I have read Ihis application antl state thet Iha intortnalion given is
correct. I a9ree � with all stete lawsb'�at�tl�iily, ortlinen�vBl�g to Cuiltling construction, end euthonze representatives of ihe Ciry ot CaSte Mesa to enter upon the
above-described oro � tor inspection Durpo4es. I egree not to.otc'�ipy or ellow occupancy of eny building authorized by this permit until final inspection.
COUE I,
1616
1266
200
Fix System Final Fire Prevention
P 1 Spa Finel
inel Fe-Roof
207 Final Block/Retaining Well
202 Final Factory Fire Place
203 Finel Sign
204 Final Demolition
PAIE ItIIIDeLi
CODE� INSPEGTIONTYPE
206 Final Mec�anical
208 Final Plumbing
210 Final Elecirical
212 Final Fire PrevenUon
220 Final Planning Approval
222 Final Sita
250 Final Building/Occupancy
���
Applicant to fill in all spaces except those within heavY Oortler lines anG si9n all apDroOriale tleclardtioni.
CITY OF COSTA MESA CONSTRUCTION PERMIT
' (O�Lri(�f' V �P.w
Project Address
%apP�iCant's Mailing Address /����'7'�
Owner's Name � L L �ST Phone7l V-�X�
Address (�� y�,��^ ��
Arch/Eng�. �r��) ,o�t=l_L-� License No
Addre4s Up�l� Cjbr �. �u� _ � �
'Addre:s (mailin - • �- ' ""-�
City License No .� �
LICEhSED GONTRACTJOR DECLARATION � ` J •��(�
I here4y affi�m that I am lioensetl u er provi5i 5 ot Charter 9(commencing
with section 7000) oi Oivision 3 ( he Bu ' es antl Protessions Code, antl
my license is in lull rce a effect
Lice e Class � se o
"`ate_' ' Si9nat
)RI(ERS' COM7ENSATIO CLARATION
.ierepy attirm tnat I have a certiticate ol consent to sell-insura or a certiticate
of Worke�s' Compen5alion Insu�ance, Or a cerpifie� copy there0f (Secllon
3800, Lab.
Policy No. L+Z� ompan , �
BCer({�ietl copy iz hereby fumish tl.
Certif tl co.py 15 illea with the c y 'Itli vis
�ate ����T/ ��ifi Appli<an
EXEMpTION FROM WORKEp CO ENSA ION DECL RATI N
(Tnissection nced not be compl ted if he permit is for one huntlretl ($100) Or
less).
1 certi�y lhat In the perfo�mance ot Ihe wo�k for which thls pe�m�t is issuetl, I
snall rlol em0loy any person in any manner so as to becomE 5ubject to t�e
Workers' Compensation Laws of California.
Date Signature
NOTItE: It, atta� mdkinq lhis tleclara[ion, you Shoultl becom¢ subj¢c[ to [he
Wo�kers' Comp¢nsation provisionS of the Labor Cotle, you must forthwitb
comply wilh such provisions or thi5 permit shall be tleemeC rewketl.
CONSTRUCTION �ENOING AGENCV
1 hereqy affirm Ihat there is a constru�tion lentling aqency fo� the per(ormanCe
of [ne wo�k for which this permit is i55uetl ($ection 3097 Civ. C.)
Lentler's Name
Lentler's Adtlress
OWNpR BUILDEH UECLARATION
I her@by affirm lM1al I am exempt ftom the Contrdclo�'s Llcanse Law for [he
follov,�ing reason (SecHon �031.5 Business antl Profassional Cotle: Any ciry or
county which requires a permit to wnstruct, alter, improve, tlemolish or repair
any struclure, prior to its issuance, also r¢quires the applicant for such permit
to tilp a signetl slat¢menl Ihat he/sne is Iicensetl putsuan[ lo the provi5ions of
the Conbactor's License Law (Chapter 9,(tomme�cing wi[n Sec[ion 7000) of
DiviSion 3 0l the Business antl Professions Cotle) or tM1al be/she is exempt
the�efrom antl the basis fo� the dllegetl exemptlon. Any violation of Section
7031,5 Dy any applicani for a permil SubjNc[5 lhe aOP�icant to a civil
�enalty of nol more than tive huntlretl tlollars (y500).
�, as owner of tM1e property o� my empioye25 wilM1 wages as their sOle
�, compensalion, will Eo Ihe work, antl the sVucture Is not inl¢ntletl o� oHer¢tl
' for sale (Section J044, Busine55 anE Professional CoCe: The Contractor's
I Liceng¢ �yw tloes not apo�Y �o an owner of a property wbo Duilds or improves
th¢reon, and wno tloes sucn work himsell/herseli or tnrougp his or her own
¢mplOyees, prOvitletl lM1at such improvemen[s are not inientletl or offeretl for
sale. H, howevet, t0e builtlin9 0� improvement is soltl within one year of com�
pletiqq the own¢r will have [he burCen Of PrOving hC/she tlitl not builtl or im-
�rOvO for thC PurpoSe ot sale).
�, a5 own¢r of Ihe property, am exclusivery cont�acting witM1 licensetl cOn-
tractOrs td wnstruc[ tne project (Section 7044, Businezs antl Professions Cotle:
. The Contracto�'s l.i<ense Law tloes not apply to an ownm oi property who
builds or improvez thereon, antl who conVacts (or such proiects with a con-
IrattOr�51 I¢ense pursuant [o the ConVactor'S Li<ense Law�. I am aware Iha[
proof o( their Worke�'s Compensation insurance shoultl be provitled to me.
❑ I am exempt untler Section B. & P. C. for this rea5on
Oate Owner
I hereby cert(ty that I nave reai
inforTation I correc agree to
antl state la s elat' to buildir
s¢ntatives 0 f ' y to er
in5pe�tlan p .
Signa�ur
Drivers' nse or 55 � _
TVPE OFCONS7RUCTION %�`I NEW LJ ADD LI Al_TERATION U REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OT�ij R� r
`ENSCJRIPhIp(VpF,�QRK/USEOFBLDG "l�[�c.l • c %LL
/1I3V ll
TVPp OF PERMIT LJ GRA�ING LI FOUNDATION LJ STRVCTVRAL
❑ TENANT �ELECTftiCAL ❑ PLUMBING ❑ M�'CHANICAL
❑ OTHER
PROJECT DESCfi1PTION Sct. F7. OCcuPANCv_
CONSTRUCTIONTVPE VALUATION$ '
ZONE GRADING CU. VOS. ACRES__
Remarks:
Bar Sink
Backflow Preventer
eackflow Irri9ation
Bathtu�s
Clarifiers
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Intetceptors
Kitchen Sink
Lavatories
P-Trap
Roof �Drains
Reinspection Fee $15
Duct - Under Ground
Duct - $tructurel
Duct- Ventilating
Exhaust System ❑ Multiple
FirepllFact. BIL ICBO,1`-
Heating System & Ducting
❑o-iao.000 sru Oioo,000
Reinspec[ion Fee � $15
0865-46, rev. 10/84 White - Builtlin9: Canary - Applicanp Pink - Accountin9: Goltlenrotl - HsSesso�
Sfiowers
Servite Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑o-ioo,000sru ❑ioo,000
System Repair/Alteretion
Fire Dampers �
Registers
Issue Fae
FEES
A.P. #
S MainBuildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Fief. #
Planning Notes:
Automatic Washer
Construction Pole Su6.
Cooking Unit
Dishwasher
Dryers QGas ❑Elec
Fan
F.A.U,
Fixtures
Device Boxes ,
Outlets
5562 9/18/87 .
Zone
Accessory Building:
Patking Req./Provided
ELECTRICAL
Transformer ❑' 15-50 KW
❑ 50+KW
Meter ❑up to 100amps
Meter Qover 100amps
Sub Panel
MotorsDO-1 HP�,7h-8
Inc. Solar �9-15 HP �76-75+
Garbage Disposal
Generator �0-5 KW �5�15 KW
$ 3 I
—1— Reinspection Fee $15
FEES
DEVELOPMENT SERVICES REQ�
Zoning Approved By�y�
Building Approved By�.T�El11n
Appliwtian Issued BY
$ 3
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compactor
Issue Fee
SUMMAfiV OF FEES ' �
BUILDING PERMIT 5 SMIP
PLAN CHECK $ pERMIT
PLUMBING $ ISSUANCE
PLAN CHECK 25% $ ENERGY P.C.
ELECTRICAL $ � GRADING '
PLAN CHECK 50% § MICROFILM
MECHANICAL S TOTAL FEE
PLAN CHECK 25% �y
$
13a40
FEES
$ 3
��
2
O
N
I
N
G
R
E
Q
M
T
S
S '
S
3
S �
S
\ '
CONSTRUCTION AND PLANNING �' r � , POOL & SPA � � '�, �
APPROVALS Permit #- ��_ Date Inspector AQPROVALS Permit # • Da[e Inspector
1. Temporary Electrical Ser,vice or Pole 52. Pool & Equipment Location ,
�
2, Soil Pipe-Undrgmd. �• . 53. Steel Reinforcement
3. Elec[rical Conduit Utility-Undrgrnd. 54. Forms � �
4. Electrical Conduit-Undrgmd. 55:t�Electrical Bonding .
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE
7. Footings �' ,�� 58. Electrical Conduit-Undrgrnd.
8. Foundation ��i 59. Gas Pipe, O Undrgrnd., Test �
e
9. Water Pipe-Undrgrnd. '� 6b. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System: i 67. APPROVAL TO DECK
i t. Property Sewer Line & House Connection �.; 62. Backwash & Receptor-Final ,
!�
12. Sewer Cap �f ,� - 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. P,PPROVED 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. Ducis, Ventilating 71. Product Piping OGas ❑Oil �
! '
23. Gas Pipe-Rough & Test 72. Underground Flush �
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathin9 74. Overhead Hydro ' -'
� �
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical
27. Frame and Flashin9 76. Dry Standpipe .
28. Lathing & Siding 77. FIXED SYSTEM FINAL ' i
�
' 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 i�^ "
� �
��;� .
37. Final Factory Fireplace � ' ',�,� �-'�
38. Final Plumbing , - , ` ' " � '
39. WaterService-Final ' , • . ' ;�:��_.` ^�
40. Gas Service-Final � • !' � '
- ti- i ' li
.41�. Solar pomesticFinal ' � , � - • -
- ' ' ,. ).: . . �
�42. Backflow Preventer � - . � � � � , '� -
�43. Backflow Irrigation � - '' `
i
'4,4. Landscape Irrigation SYstem � �''� - - -• � "' '' -' � ` ,
��: t\r
^ �. .
45; �Sound Attenuation � � , � .. ' '
46. Handicap Regulations � � � i .�� � _ _ � :
47. FINALSTRUCTURE&BUILDING � ' :(..� �;.�`• . ' .
i
48,�;Special Requirements Completed � �• '' �+"' � : .. '
i. i �•.�,, .
49:-Electric Release to Edison ��� _ � y.-- - .�
50. Gas Release to Southem California Gas Co " ' .
51. CERTIFICATE OF OCCUPANCY . ' " � - . ,�
No. Date - • �
-. i
0
aecrnoosess: 630 LAKEVIEW LN
OWNEP'SNFME:BROOKVIEW CONDOS CONDOS
ROOflE5S:63O PAULARINO
CM., CA.,
AflCHIENGINEEN:
ADOflESS:
flEC.NO.:
UNIT:
UNIT:
PEHMITTEE:MESA ROOFING CORPORATION (714)548-3012
aooness: gq3 W. 17TH ST
COSTA MESA CA 92627
LICENSEo LONTBRCT�fl OECLANATION: I nere0y alfirm tnat I am IicenSea unaer o�ovivons of Cnapter 9(commencinp with Section
7WU� 01 Drv1p00 3 0� ih2 9U51t1¢55 dlltl PfO7C55100�5 C�0`0¢ d�d�1�w fCTT1RTPl �CC�.
c�Truc.:035681 STPTELIC.1'j(¢�jl CIASS:C—
ffale: ��i.���� Signat` �—
WOBKFHS' COMPENSATION OECLAPRTION: I Aereby a irm mat I have a cenificate onsent o sel4insure or a cenilicate af workers'
Compensalion Insurance. or a cenilie0 copy t�ereof �Seclian 3800. La0 C)
�;�ucvr+o.:PWC29167500 EXP.UATE:O%IOlI99
r.omrnxr:GOLDEN EAGLE
'L] Cenifietl copy is hereby lumis�etl. � Ce�if Copy i5 �iletl wi�� IAe Ci m rv'
Date: / U� �/J Ap . �
E%EMPTION FPOM WOHKEPS' COMPENSATION OECLAflATION: Qhis sttiion nee0 not be comDleteA if tAe perm� b lor ane �uMreE (Stql) or less�,
I ceNfy I�ai in the pedormance oi Ihe work �or w�ic� �his permi� is issuetl. I shall noi employ any person in any manner so as to Gecome
Subjetl lo ��e VJarkers Compensalion Laws o� CaiifOmia-
�aie: Signature�
NOTICE: If, alier making Ihis Ueclaralion, you shoWd become SUGIeci lo Ihe WOBeR' ComDensa�ion provisions o� Ihe LaLor
Code. you musl �arthwiih comply wilh such pmvisions or Ihis permit shall be tleemetl revoketl.
CONSTBUCTION LENUING RGENCY: I �ereby allirm ��at there is a con5�mciion lentling agency �or Ih¢ petlormance o� �he work �or
w�ic� Ihis permit is issued (Section 3097, Civ. C�.
LENOEN:
AOOflESS:
OWNEB BUILOEfl DECLAHRTION: I �e�eby allirm ��at I am exempt Imm ihe Conlrac�o�s' S�a�e License Law for the followinA �eason
�5¢clion 703L5 Business anU Prohssional Co�e: Any city ol munry whic� apuire5 a permi� lo conslruc6 alter, impmve, Oemdish, or
repair any slmcWre. Orior to ils issuance, alm requires �he applicani for suc� permii �o �ile a signed stalemen� �ha� �e/s�e is licensed
pursuant lo Ine pwvisions oi Ihe ConVacmrs' Siate License Law (Chapter 9(commencing wilh Section 7000) ol Division 3 of the Business
an0 Pmfessions Coae) or t�at he/sne is ehempl ihereftom and ihe hasis lor t�e allegeU exemption. Any violation of Seclion 703L5 Ey
any appbcant �or a permit sublec�s Ihe applicanito a civil penalry of not more IAan five huntlred dollars ($500�.
I, as owner of ihe pmpeny or my employees wilh waAes as tneir sole compensation. will eo ihe work, an� the
❑ 9mcWre is noi inlentletl or offere0 br sale (Section 70Ca, Business antl Prolessional Cotle: The Conirat�ors' SIa1e License Law
Ooes no� appty to an owner ol a pw0any w�o Uuiltls or impmves thereon, and who Aoes such work himself/hersel� or lhroug�
�is or �er own employees. pmviDeA thal 5uch improvemems are noi intenaeG o� aHeretl lor sale. Ii, Irowever the OuilJing ar
imD�ovement is 5old wM1hin one year al complelion, Ihe owner wiil �ave Ihe Gurtlen ot Oroving he/She UiA nol builtl or impmv¢
lor ine oWpose ol 5a1e1.
I, as owner of ine propeny, am erclusively commcting wiih Iicense0 comraclors �o constmct t�e D�ole�� (Seclion 704a, Business
❑ anG Pmlessions CoEe: T�e CoNraclors' SW�e LicenSe Law aoes not appty Io an ovmer o� praperty who Ouilas or imprwes Ihereon
antl who coniracls br suc� p�ojetls wilh a conVac�or�5�iicense pur5uanito I�e Contractors Slaie License Law�. I am aware
�hat pmol ol their Worker'S Compensalion insurance 5�ou10 be D�oviaetl to me.
� I am exemp� untler Seclion: B. 8 7. L.
lor Ihis reasan:
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 064023
PERMZT NO: B 064023 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: ,�✓� PERMIT TYPE: STR PUAPOSE: OTH
JOB DESCRIPTION : T/OFF, Si�lFF� 6 REROOF W/COMP SHINGLES SQ FT: 8,645
CLAIM VALUE: 8,645.00 CALC—VALUE: 8,645.00 GROUP OCC: R-1 /
COMMENTS: REROOF W/COMP SHZNGLES INCLUDED 632-634-636 LAKVIEW LN
w�rwrrr*�********rrwx+r�r�r*�**w�r�r+r*(rrr*+r***�rrrr*r***�r***w*�r*+�**+r+r*w�r�r�r**r�r*�rx*�r*�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
FRNT:
LEET:
-- MAIN BUILDING ----------
FT IN REAR: FT IN
FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL:
PLANNING NOTES>
>
— ACCESSORY BUILDING — —
FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN
93405004 ZNE: REF NO:
M M!f M iFlf M!F M 1tlf 1k 1klf 1t 1k 1f M M!f M 1f M 1F If 1f ik 1f M IE 1f M 1! 1f Ik if 1! 1k fE if !E 1f iE 1t 1f M!F if iF 1f It iF M 1f 1f 1f 1f if 1t 7F ff %M if if fE if fF M M it iE
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
ZONZNG APPROVED BY DATE;
BUILDING APPROVED 8Y : DATE:; �
APPLICATION ISSUED HY: DATE;
**w***�r�*�*�***«*****� **r**�**�r*�*�
MMMMMMMMMKkMMMMMMM1tMMikifMiFMMMMiFMMMififMMKMMMMMMMKMMMiFifKMiFiFIFMMMiF1FM%ifMifffMMiFiFiFiFiFifMiEiF7F
LEGALIZATION:N F E E S U M M A R Y STRUCTUR'ALiSEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES� GRADING
PERMIT 108.00 86
PLAN SMIP/NON—AES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 108.86 0.00 0.00 108.86 108.86 .00
REVENUE DIVISION TOTALS--> COLLECTED: 108,86 OVER/SAORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
108.00 .86
1f 1f 1F 1f 1f 1f 1f if 1f if 7! 1f ik 1f iF if 1f 1f 1f 1f 1F 1f ii 1i iFlf 1F iE 1F 1k 1f 1f 1F if if if 1f 1f 1f 1f iF 1f 1f 1f %1E 1f it iflt 1F if 1F 1E M 1f if 1f 1f 1f 1E iE 1f 1f 1F M 1t 1f 1F 1F iF iE IF IF if 1k 1E iF if
I N D I V Z D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST i0?AL COST
I oate: Owner: I SFR
I do �ereGy cenily t�at I am aware ol anE un0erstan0 Ihe reQuiBments of Calilamia HealtA an0 Safety CoGe Sections 25505. 25533, anG
25534 an0 �hat I or any fuWre builtling occupanl wiiVwill nol (circle ane) nee0lo compty with saitl state co0e5 antl Ihe �epuiremenis lor a
permi� lor cons�m[�ion or moailicaiion Imm ��e Air Oualily Managemenl DiSVicl HevEeniial consimction aD0licaiion5 are eKempt �mm
tnese pmvisions.
Oa�e: Appiicani:
I hereby [eililytha� I Aaverea0 I�is apPliw�ion antl Slate thai Ihe a0ove inlorma�ion is correcL lagr¢e lo comply wi�� allci�y and counly
ortlinante5antl5lalelawSBla�inglo�uiltlingtonslmclionanOherebyauNor ryCSPStalW �hiscilytoenlerupOnlAea�Ove-meniion¢e
pmperly �in�r m+speclian pur�pos.e/s. Z {�
7� �ate: /�/ l Sig ����C��
Driver's License m Sociat Securiiy >:
Ii64b<6 W�ae—Builtlmg: Grecn—CoOe EnlorcemenC Ganary—Appl¢anl; Pink—Revenue; GoWenroC—Assessar
8645 REROOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
SfvIOKE D.ETEGTOR
. REQUiR�D
1.00 8,645.00
O1 0014?4d0-0014i501 TO T 103.86
�ATE: 09/23/43 T1tIE: 11:47
�
I CONSTRUCTION ANDPLANNING
y� AP'ROVALS Permit K= Dote
� 7. '.�emporary Electncal S��cioe or Po;r;� _
_�1 �
?�,-pij��Pipe�Undrind,, � ���,�
'-'- -
I.ctrlqi COndksTFU}ihty�Ui
c<._.
i�Urcal Gondkif�llAd�y�nr,'
IeCI RCr�� tiO�C'.�18rt:•!
_ -,1_:.t
:cr.tr;c:.' UF�57'r�iid. 'a;
�otings �� w. v
�'�. F�wCut�on �F
^ Q� :.at::r ��pe-U�Lrgrr.d.
-.t+ -
1�. S�r�„ct�•a�� Fioc�SYcterc�.
--� �-
i�",.. F-opi�!y SQl'+z!�in�&.HGJ�e Co
` '2. S��.vcr Cep �•
�-- - " -
"�3. "�,�,t7ra:r�s � "o .
:�
�-- - - -��'-
�. ...a� G,umh:^g
, �--F� �ahh Elcctric��Cond�rt
1----- --^�--
'u. ?�.�h FieCtri2y`!ir��ng
i
I 17. Hough tN�ring SLyn
�J
"J `�,
'..'�
iE'cton
G
I'17. �lr�ah EleGtric33-T Rar Ceil�ng __
I'9 �ic �:h F�eci07 & Ah Cpnr�itionina
i`7 � 7 f. i 1 n••
r �„S''�-T�-7 �..�..�ca ��"^F'f'
i -z!i-'i�'' �-�C.c�l i i S?�
� - . . .� _� :-i-�i-
�7! F7. �. �rVS'rirct��S M i .. ..
�iZ.ci���'y. �iPr1i��,•T-�-
-Li-�-C^- �:�'��--}-
� : 3. •Gas>'iparRo�h & '�_st i
�-_-__ �-: -,• c: � � n�.T,
i '?4 "ioG� F�lT'i^9 cr,+ . ;-•�.,
i____-.�„ . -H}___ `_
� �J'RO'i"Sti3thit13 O�t J:
i- ��� a -i
�?; y��E,�'! Ce,�;�ngl5t:or�ura;i 3:S.y�
_�. T_.g.__
�2/:_f: aire :i-1d Fiasn:rkit � � �F
'1�_ � • n.. -.L*I.CJ
I�1-S;. Lah�nrYi5iifin�,�.'' ��F,
rX __-"� ��_���..-..
��. �!`SU�dIi6h ' �'U A -
� .,,3 � :,
I-�`---
�` 30. D��'�•.a:.a.e;f7ng �r �-� i
� -- . ��.�.-�-
��i3' . P a: te, 3Eo:•�..i,Coe'7 j.� i a� -•
�:J.__-�+--�^-Rli._-- �f` __
`"�`,37.;�:e � �.c�� Po�.;er .�er F f,a, �
y�-ZT T :-�T
,�33.S=�n.tElectri�- �.� p; t
a�,34<<�:r,R� Ht;ltin��: A'�C���rt��onr7t§75 �
-:T-��-\J . _•'�_�J7-^ 77
i35 c'+,n.,� G� P�pv-Teaz� , � ..
7 ro� �r'pYr��-..., i Q:r .
�-. � .+7i--'�->-F� �--S._�
-37.•rinolFgisOrV Fir�piace ^ i e-�F J
� _� ., „
538. Fin.�Pl�nb`P' , � :'7 i c?
..9 'S. Dt 1 .=�
;r �- .�
"39. '.Vattr Se:v�c�,Fir�)i T �
�, �, ti�_ .
?tl�. Gas Ser:�it6-F.1�al"� • '� e,?�,r �
'x1. Sa!ar p"3y-��es-`'-,�-F�n�-�'.�i
' _�•i ^Y_...
i2. Bac�.�loW Pre� nt�r �; c�%
r,��
p• ��; a;�.�
�3. Bacbfiow Irrlgatiw�* y�
� '1.;;. 'Ndnh i C2 (7 Ney:
�'-=� � r
,n � "FIn�3,L STR�n
P3-+i
I �8 � I�laL PLANI
�-. �,�L
� :a9.�"�lec?±ic,-?eleas
��"5�.'�'ia?�'ete3 tse o
A ��
-57. CEfFiIFICATI
Sys[err�'�%,`,? ,,,,
����; �;....
- a
atloTt -
� S
TU!�E t� BU�DIN
-r • .-•-T
ING? � -'�'
i
to �`tlison
-t--r--
iout��em Calito;��fg
OF�CCUPA'NCY
_ Oate _
POOL & SPA
Inspector qppROVALS Perm�t -,'?
52. Poo� & Equipment Locatiun
53. Steel Reinforcement
54. Forms
55. E�actricai B�nd ng
50". rlor.yti Piumb�ng !S Preseure Test
5/. APPROVAL TO COV[H�GUNiTE
58. Electrical Condwt_Undr9rnd.
59. Gas Pipe, ;� U�drgrrd., leit
C0. Hac!tcJash L'r,es, P-'frap. -' Undrgrrd.
� GL A?PRO�fALTODFCK
' 62. B„ck•::a;h � R�czp�or�Fi�a!
63. Heatar & V�nt�F;nai
6". Plumbing SVs!rm Fnal
, 35. E�ctric3l-Ff�al
u'6. Svlar S�st:n�i-���C!
-- 67. Fcnc�ng & Ar-rc, Aap�o�; al -.
68. APPROVED �OR PLASTERING
69. POOUSPASYSTEC':SFINAL
FIR._F P Y'�QUIREft9EN7
Date I Inspecmr �
"' s vl � 2 X XJ'7 ^ . �-7'� ?-t ' �y .. �-a �ti � I �
:�' ! �-��y �} Ir r �� J�-�� .7. 'F } j I i
�: r S , : o�s a (�PPRE��`.V%�,PJ--�t�'ur��it �. _ .
� �^7_7a-w_�. ;__Y-5.�'=y�:, f ^ + F7 T '
H t CJ i.-�•, llk Y��d. l�d�,:rg.dY-i'I�IyH��"7 a � ��
i S�S.F-k"''�7--`.:��T�T7�C0-�f'-- --1
.'J �� � tt J F t t C71. ProJuc:�t,�f�ir9 ti C.•'7s .�R'7il I
t--_rn � :-i n =i-!-�t3c�.-:l-E.
> � T C V� �'� '1�r'1 � n1 �(;i F (� �
� ^_ H�a.� � 72. UnderqrO�SvFiI��J�I� � 1 } a
t^ F .`.• �l . :L typ�� .-v .�� _ -_�
p7 e �.., r-�a r�73.^jJndergmG.Stor,p;�.�Tpil<�G�s .7dil
44��{�_��I i-v�+�- �--i-O-# �
� �___
'� I_ �� � z�_p� � 7A'r'�erhead HYtl�n�c-' ! �
�r D � �-9 p �r �-- '-�,.y - : `. p -
O � .3x . � 75:�Y Ct,enty'., H7 s -,i 1 - -- - - -.
-Y��- z-'��---'*10� �c9�i=!-.`.:i�:-�C -
x� : ;q'x I ��..t, F S Y O �
•' 76 Dry Stanc� .
1:_ ���_�L' y"": .3r+ �+ �u -1
y � •.� ..1 ..M ;I 77.-�-iFIXED S�`m��E�i�i�yNAL� ,..i :�; r
x-(+y-' i�-�'��`:3�----�-•-v
_*. _, N� 78�FIRE PREV. Pli�,..f. «'' r�' I
. i- • Rt A� � �'p�' LTF��EPT..H�Q�11Rc�4iENT .. � ;'~�
S
s -fY=U. ._..__f,.-a�3.._� _'1- . . �
-+ � i � » ^73. FI��AL;N'7i�GTITd �F � '
'� �i* iT:.'• _ _ y _ �� ..^: � 1--i
t li 1 ; �:� �, ._ - R.
� _� �;. , d0.y-OODCEH�iiF�G��.�E iSxU�eD�, ,�; '--` �-,
[�- R;.-_[�7_`..__ ,y.2"_-fi -.+'1 '---y
� 1
'r � t° No(ls: '7 �7m a. �: t� tu[n
- � '�" � I E. . K.-. �:7CL. __t -f..�r' �'._
i � � i, c". S l.; ! � O 7! ..
i > � ��� N r, • F �S �t n_ � � i
=_ri._ :�f�x___:tw V:T---- ' �
fi ., ' � � a � -..c r+�! : _E-'��' -I
• 4r�r m.__ ••Cl_ <:n �,
'.___j tr x� z-. i��,a � wrr .
s I p• n r. -� •;*± -� m j
' ! �� �-- '-------'�-en-., .- -
� - < :v
� t • �._Y' S �--_ _ _ _^� - � �`-_�_--. __ '
! � h .r �. :� x m .,
i . �* �. H -�:.: f i I
r,.' � , � Cy�---t-:.;-��--Q-�
? :: � i ' a� . •-. oc , s
�� t.�-E f'�'.2___'___7-[+J_!3i
� I �r v C�G .e,; t ,
. s l�� I.._� t� i H• r,•_ • ti;
Y � � i i� :
,+
.�
YCC i S
� :r._a
t n� n r p. v
r a. :; r x .
� �- -�
s ,n �* 'n+ r
�-.�-.. ._ �
� �
: n' !
1
Gas Cn �
:
�_
:�7
N
� f
R-r
_ �.
y .c
:T7 = i
��;<
� �
�,.
Y
� :i:
[7-
�y
`7
O
ST, � -_�-
r +
�.Z' __H a
�':' S 1
n r
-- - Y
C' � !-
-� s n
ct, � fr A
.s x v: •
t-t--7-*�J
•�l 1 t.
r � h ^�.
Ci • C !7 r C) •
�. _ , fi , �
JOB ADDRESS"��"'f= "`
GENERAL CONTRACT George J
AP No.141-061-03 LOT
INSPECTIONS
$OIL
cns
WATER . / 2a 76t'L9
ROUGN PLUMBING �'
PROP. SWR. LINE Q HOUSE CON. �
SPFINNLING SVSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CONOITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND � POWER �
ROUGH WIRING
TliENCHES � FORMS STEEL HEINF.
FLOOR SVSTEM '
BONO BEAM ST EL REINFORCE
SHEATHING
FRAME ANO F�qSHI !G �
LATNING - IN � OUT I /�j ,_��
PLASTER,BROWN COAT
DATE �� �
BUILDING PE
SUBCONTRACTOR
�
�drt,v�i✓4' �.Z ; �..
� �. . A.� '• ��ar .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
Fnr dnnlirant tn Fill in ('nm�/ntalv t
z .
ww
o- U
Z Q
0 N
a m
J7
J �
Q W
p] J
J m
Q
U �
Z a
W �
aw
W Z
J Q
m Z
J �
W w
� _
z�
w�
N �
� 0
H
Z
Q
U
J
a
a
a
�
�"'
�
z
Q
�"'
U
�
�
H
N
z
BUI
OWNER HELTZER ENTERP�
MAIL
o��AF« 740 N. La Brea
cirv Los Angeles, CA 90038 No 9
CANSTRVCTION United California Bank
LENDER
BRANCM j"j$1R Branch
OR ENGINEERT' le.1C15 & Silverman rypL� C7
ADDRESS 113 N. San Vicente, Bever
CONTRACTOR George J. Heltzer
aooREss 740 N. La Brea Avenue
TE�.
cirv Los Angeles, CA 90038 No. 93
� c No. 3144 uc�No.
SIZE I NO.OF BLC
OF LOT NOW ON LC
USE OF
EXI5TING BLDG.
S12E OF NO. OF
NEW BLDG. ROOMS $TOF
EXTERIOR WA ROOF
COVERING �laster COVERING WOOd
USE OF BUILDING AND WORK TO BE PERFORMED
Residential
��t! Ts �//,i
''kis i8-7�irr;c00 517'+ '��''125.38
C. ��
APPLICATION FOR BUILDING PERMIT
RE'l'�51VEDBY DA7EflECEIVED r.�r��ee��i
BUILDING
OWNER
�16 5
FIRE
H7.1 �ONE TVF
APPROVED
BY
O�E � P�tO�F �
1%1
VAPDS APPROVEO
MAIN BUILDING
(FROM GL STREE�) ,
PE
DATE
E OF NEW L� �p
ILOING + � �
VARDS APPROVED
REA(i �-GJ FT.V'C ' FT.
DISiANCE BET. BET. MAIN &
MAIN BlOGS. ACCESS. BLDCS.
C URP #� �.J��� ApPROVEDO r" � —
APPROVED
I hereby acknowledge that I have reatl this application and state
that the above into�mation is correct antl agree io comply with
all laws regulatinB building consnuction, and I shall not employ
any person in violation of t�e workman's Compensation laws ot
the State of California. /J/�;�
I hereby rertify that I am properly licensetl as a contractor untler � SQ. FT. `4%��
the State ot California Business antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UN
Chapter 9, antl that such licenses are in full force antl etfect, or I THE PURP06E OF ESTABLIS
am exempt trom Me� ovisions of the State of Celifornia Business VALUATION
antl ProfessiOns Cod , �ision 3, Chapte 9.
� a PERM
Sig^afure of _ // p� �R�
Permittee - $ ��%/ //%�%J PLAN
/ l�vr
Au[horized ABent TOTA
� �
rq
n m
O�s� �
O
EF VA�UATION IS FOR r
NG A PERMR FEE ONLV: m
FEE $ VJ�,,,/ �
HECK $ �/ � / �/ E
`o
LL
FEE $
♦
I�