HomeMy WebLinkAbout601 LASSEN LN - Building Permits,�,�,'�-� ,
City of Costa Mesa Plam...ig Department
Post Office Boz 1200
77 Fair Drive
I����`� Costa Mesa, California 92626
o f1 � (714) 556-5245
REQUEST FOR OCCUPANCY
(Single Family Residential or
Condominium Units)
Tract No. �� y/ Date �-/G - 77
The developer of the above entitled tract desires to sell the above
set forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(be,, she, tFteql�(was w-werel�advised that this tract has
not been given tinal inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the
City at ihe time the final trac[ map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless
from any claim resulting in damage or personal injury to the undersigned by
reason of the aforementioned uncompleted condition.
By
Representative
S7�ai iRVINE BOOLE�ARD, SUITE 2lU
CMF 0569-26 TdiSii�, CALIFORNIA 92680
�_ I � M��w
- -��•9i,C�_,.��•�:t«
Pfl0.1ELTAD08E55: �'jOI I�ASSEN Lti
c-Odi:i�,SNRME:BROOKViEW CO`�O'S
nooness:HONEOWNERS ASSOCIATION
630 PA[JLARINO
('OSTA N.ESA
I AqCNIENGINEEB:�iB 7—� 3 9 9
ADOflE55:
flEG.NO.:
uNiT:
uniT:
PEflMITTEE:�L'SA ROOFING (7l4)548-30:2
nooncss: 84 3 W 17TH
LICENSEO LONTBPCTOP OECIAPATION: I hereby affirm ��al l am licensetl unAeCr p��roviso � oC O�er 9(commencing wil� Sec�ion
7qp) ol Div.sfon 3 0l Ihe Business an0 Pmiessions LaOe, ana my license is in lull force anJ ell¢c�.
CITY LIL.: SiPTE LIL.r CU1
Q�3;68. �6415.
..Oate'. _p�� � Signature: _ _ —
WOfiNEPS' COMPENSRTION OECLAHRTION: I hereby atlirm ihai I have a cenificaie ol cons��insure or a certilicate af Workers'
Campensalion Insurance. or a certifiee copy Ihereal (Section 3000. Lab. C).
POUCYNO.:�JTpj(.' 2QlEj%j�Q E%P.OpTE:O7IOII94
comraxv:GOLDEN EAGi E
� Cen/ilie)tl copy is �ereby fumished. � Ceni�ied copy�e-frtL�'wiORlle-ei Buil - an
'�Daie: __Ll�L�.[— APVlicanL ���1��
E%EMPTION FBOM WOflNEflS' COMPENSFTION OECLRHATI�N: (ihis section nee� nol be comple�ed il IAe permi� is �or one hunOretl ($1W) or less�.
� I cetlify �hat in I�e pedormance o� t�e work br w�ic� �his Oermit is issuetl, I s�all not employ any person in any manner so as lo become
sublet� lo ihe Workers' CAmpensalion Wws of Calibm�a.
Date' SignaWre:
NOTICE: If, a�ter making Ihis Oeclaration, you s�oultl become su0ject lo ��e Warker5' Compensa�ion pmvisions o� Ne labor
COAe. you mu51 Iorihwilh mmply wil� Suth pmvision5 or �his Oarmit shall Oe Aeemetl revoketl.
CONSTBUCTION LENUING pGENCY: I nereUy affirm ihat inere is a constmction lenaing agenty Ior Ihe pedormance ol Ine work for
wNch t�is ue�mit is i5sue0 (Seclian 3097. Civ. C�.
LENOEN:
PDDflESS:
OWNEH BUIWEB OECLANATION: I �ereEy afiirm Ihai I am erempi �mm �he Conlrac�ors' State License Law for tne fonowinA �eason
(Seclion 703L5 Business anE Prote55ionalCoee: pny ciiy o�cauniy which reQuires a permit�o con5tmci, alier, improve, Gemolis�, or
repair any stmc�ure. prior Io iis issuance, also repuires ��e applicani lor such permit Io file a signe0 siatemenl I�al he/she is licensee
Oursuam ta I�e pmvisions ol Ihe Comrac�ors State Licenre Law (C�ap�er 9 �commencing wi�� Section 7000) ol Division 3 oi IM1e Business
ana Pmlessions Coae) ar Inat he/she is exemo� Iherelmm anA Ine Easis for ine allegeA eKemption. Any violalion af Section 7031.5 Oy
any aDPliwnt �or a perm�i subj¢[t5 Ihe apDlicanl to a civil penalry oi not more Ihan five hunCreO Gollars (E500�.
I, as owner ol Ihe pmperly or my employees wilh wages as their 5ole compensa�ion, will tlo ��e work, and Ihe
❑ simcture is nol inientletl or allere0lor sale (Seclion 7044, Business antl PmfeSsional Catle: The Coniractors' Siate License Law
tlo¢5 nol apply �o an owner o� a D�operiy who builtls or imDmves thereon, and who does such work himself/hersell or ihmugh
his Or her own empl0yee5, pmvided Ihal SutA improvemenl5 are not int¢ntl¢tl or ollereA fat Sale. II, howevef �he UUiltling or
imDmvement is sold wi�hin one year ol completion. Ihe awner vnll have Ihe �ur�en oi Dmving he/she ditl not �uilU o� improve
lor �he purpase ol sale�.
I, as owneroflhe proper�y, am exclusively contraciing wiih Iicen5e0 conlraclorsto cansimct the project (Section 704d, Business
❑ and Pmiessions CoEe: The Coniractors' State License Law tloes no� apD�Y �o an owner al pmperty who 6w105 or imD�oreS ihereon
antl who conlracis br suc� D�olec�s wi1� a contractor�s�license pursuanito Ihe ConVactors' Staie License Law�.l am aware
Ihat prool ol Iheir Worker'S Compensalion insurance 5�ould be D�oNtled to me.
� I am exempt untler Section: B. 8 P. C.
lor I�is reason'.
oate: Ownec
1 �o here�y cetlily Ihal I am awar¢ al an0 un0er5iantl ��e requirements ol California Health anG Sa�ery COAe $ec�ions 25505, 25537, ana
255Ja ana Iha� I or any INure Guiitling occu0ant will/will no� (circie one) neea to comply with sai0 staie cotles and �he requiremenis lor a
Oe�mil �m constmctian o� motlilica�ion Irom I�e Air Ouah�y Management �istrict. Fesidential constmc�ion appliwlions are exempi imm
IDese pmvisions.
pa�e: ApplicanL
IhereEy ceriilylhatl�ave ieaa t�is application anA 5laleihat�he aboveiniormalionis correcL Iagreeio comply with allcily antl county
or0inancesanUslalelawsrelalingloGuil�mgcon9mtlionandhere � - resentativesallNsdry�oenteruponiheabove�meniionetl
Pmperly �ot inspeQiOn DurOoseS.
Q��%'� !
. �a�e'. _(1._(,6L/_�_ Signature:�7 ��/r—A�
i �
�river'sLicenseor5ocialSecurily+;
16a1-a6 W�i�e—Bmltling', Green—LoEe Enlo¢amenL Canary—Applicant; Pmk—Fevenue; Goltlenrotl—Assessor
CITY OF COSTA NtSA - HUILI)ING PERMIT PER,'y: NO; B 0639�c
PERMIT NO; H 063342 PLAN CHECK NO: N GOV7; n; S;iPI�; N
I
CONSTRUCTION TYPE: V-N PERMIT TYPE; STR PURPO5E: A!,T
JOB DESCRIPTION ; T/OFF RESHT REROOF W/TZMBERLINR 30YR COM SQ FT; 0,64:>
CLAIM VAI,UE: 8,645.00 CALC-VALUE; 8,645.00 GROUP OCC: R-7 /
PE�'QT TATJ.[Ei'S IAII'P{� 601i503�6!Kr�17 i'/?3t6�1 L�SSF[7 L��.
COMMENTS: SMOK� DETECY'Ox xt�iUiKEil YR1UH 1'U F'1NH
#St7F3t1fiEifiEltiFiEfEit#ik#N-iklEiklt3hlFfEi41t1E ifiEif�lFiF#iE#iEiE*if#%)F}ElFM�iFif#I(�#1l1PiElf'7(�#!F#iFiElfiE9E-%-lE1F#f(#!flEi(3f%#if#}:�
Z O N I N G R E Q U I R E k E N T S
S E T H A C K S
------------ MAIN BOILDING ---------- --------- ACCESSORY BUILDINC; ---------
FRNT; FT IN REAR; FT It3 FRNT; FT IN REAR; FT ZN
LEFT; F'P IN R6HT; FT IN LEFT; F'T IN kGHT; FT LU
PARKiNG REQ; PROV; PARCEL; 93405196 ZNE: REF NO;
PLANNING NdTES,>
iE it# it k iE % fE lf IF ft t! �+t X�� N� N- # it # ih H� 1t i6 # St rt N� Ik k IE iF ## ib it 36 N� f6 iF # tt� IF lf iE lE ## tF ri ft # lt it # ih iE±t� it� ff iE it # if # ih x� ji �1(�f i6 it M� 3f� # i( # tt 3E
ll E V$.'. �, O P M E N T 5 E R V I C E S r2 E Q U I R E M � N T. S
ZOiUZNG APPROVED BY DATE; -
HUILDING APPRO}%ED BY : _ DA1'E; ' �
APPLICATION I55UED HY• - DATE:' �_��3
iE1f#%ifiFfE1E#!F1liE1Ff('1E7Elf1fiflf%�1f 1 i- F R% eiE •1t 9tft P H ef r - Rif!f#3l'ibif'}fiiiE# � R�eiF{j'�f
#±E-lt fE it ik iE k## ik it it /F fF ft iE# k# iE # 1E iF )F iE 1! if i(� 1E fF iE iF ir w�t %#� ik # tF %� 1F iF iF 1t M ib if 36 if 1f # i! # k iF K� #!k iE iE !F iF it iE if jY 3f �!F M# 3F it # i(• ## jE
i.EGALIZATION;N F L' E S U M M A R Y ST'RUCTURAL SEGN.EN'C:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC F1xE SN.IP/RES GRAI�.'NG
PERMIT 108,00 ,$6
SMIP/NON-RES
PLAN
ZSSUE f'EE
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 108,86 0,00 0,00
REVENUE DIVZSION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
SO8.00
TOTAI, PAID DUE
108.86 108,86 .00
108,86 OVER/SHORT; ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
.86
#kiE1E1F#IE%ikfEfEik#1kll�kiEiC#EiFiEifiEitN�lEitiEihlFihiEi4iE#kiEi(iPfF#ftffiEiEfk##if###ffiE##iPiE#iEiE%iEiEN-3E#itiE9EfF%�iEiE##%�#+k
I N D I V i D U A L F E E H R t: A K D O W N
T'YPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 8645 REROOF BY VALU�: RESIUENTiAL N07.ONF: 1,00 8,645,00
END OF F�.ES
01 OO1S4447-DQ144443 T�C�T 30�.86
DATE: 07/U6/43 TIMf: 15:04
i
� -- - --��---
CONSTRUCTION AND PLANA9NG
� L APPROVLILS Permit �'>
,7, Temporary ElectnCal Service ar Pole
2. So�l PiRe�Undrgrnd.
3. Elcctrical Conduii Utihty•Undrgrnd.
4. Elect*�cal Condwt�U�tlr�md.
5. St..'- Rainfarcement
, 6. t . :�����.w"JFER G•rd
7. Facr�ngs ---
B. Fou^ddt�On
�J. V�eter Pipe�Undramd. _ _ T.
70. 5-�ucturai Floor Sys'en
���_ �11. Prop-*ty Scr.er L�re & 1'��,0 ;annection
ll 2, 5��.•iBr CaP ---
L - :
'�3. RoatDra��ns
14. R�ugh Plumbing
15. Rough Electnwl-Co^a.-t T
i6. Rouyh Electric�Afiring
i-.._ _
� 1%. li�;h�::'n�g5gn
� 78 R�;.gh Elecrica�-T Bar C_.;���
+'^. R��..g� Hect;ng & A.r G-d�t�o^. ng
i -
� 20. Rough Factory Fire�lace
� 21. D�Cts, in Structme
i2 D rt.^�s, Vont�lating _
IZ�. G_ r=e�Rc.:g'� &: 7.9:
�24. ilaof Framing
--- - --
` 75. Rco� Sheati�ing '
r26. T�Bar Ceihng (Structurall $ Nmnomat
r 27. F�: n: ar.d F!ash'^.,
i--- ---
� 7.D. ;J.t.i;ng ;x S'tl r.g -
I 29. �n�ulat o^.
�' ?�, D�v�.a�� Na:�,�ng _ -_-
� 3' P�,dsu� Bro�:n Coat ----
�----32 EL cincal Pov.er �liexr F�.^e�,
--- --- ----
� 33. �: •: t'ecb c
�'- -3a F �w! Heat�rc � <„� Co-d :�cr,r.:,
3' 5. F��rcl Gas P�pe�Test
�-- -- --
3u. Hccd or Canopy
37. F���.cl Fsctory Frep'acc-- -
� 38. Pin��,l P�umbing
I 39. lYa!er S�n�iee�Final - �-
i
I:,0. GdsS^.'c.c,.F�,na� -----
�41. So!a• DomestioF�,ral
��D�CKfloyv Preventer
ad�flow lrrigation
��4. �,,;dseaFe Irngauon Syst�.r
� 45. So�nd Attenuatior
'` 46. Hard�wP Reyulauo:•.s _-� -
I 47. FINAL STRUCTURE � BUILDING
� 48. f-INAL PLANNING
4I 9• Electric Release to Edison
' 50. Ga: Peiease to Soutnern CaliforniaGasG
51. C�RTIFICATE OF OCCUPANCY
Oat:
-r--
Date
Inspector
a
!I I '
POC SPA I � �
APPROVALS Permit'= Date I In�pector i
52. Poolik Equlpmeni Locaton I �,
I
53. Stecl Reinforcement � .
54. Forn,s
- �--�
55. EVectrical6onding
5G. Rough Plum6ir.g & Pres•ure iest I �~
+-- -
57. APPFlOVAL l0 COVEP�G' �`,'-E � '
58. Electrical Car�.amt�urd�gma. �
59. Gas P�pe. � UrU�gr�,d . T.St i � 4.-i'�
60. Bachwash Lines, P-Trap, C' Ur.drq�nd. j- I
-�'- i-----i
67. APPFOVAL TO DECK I �
--- ----- - -L -�-- --r
� 62. 8scic:.�s� & Reeap;c � � .. ; �
�- , - _ �'-' _ .
� 6' 3. He..tm i4 Ve�t-Fin�' - ----� �
� 04. Piumbing Sysem _F �•..: -_- __� ___ __ �
, 65. Electrical�F�r.al �
66. Solar SYst�m�Pinal _ __ �_ _
67. Per.cing & Acczss Ap^�oval �
_-_ ___' � _ _ .-- _ -
68. AP�ROVED �OR P:.�S7ER�`.G I ;
G9. POOL�SPASYSTE'J;Ff�Ht i i `
FIRE DFPT. RE�U�REA�_!cT ;'
APPROVALS Perm!t .: _- �
__---- �__ _--,
70, Undergiou^� Htiu o
71. Pruduct P�P�ng ,: i G.�s �.] Oil _ � _____
-_ _ ._ _, �__ -
� 72. Undmu•o..'.. ..., �
'-- - -- -- --- -- +------ - ---
I 73. Undcrgrno. Storac. T.:•�Ic "' Ge:� :� Od I L
F------ ------ --- -----�-----
74. O�mnc�a:; H��c.- ' i J
75. Dry Chemicai '
I 76. DryStanc^,n---- ----� ---�-'- - --
�
77. FIXED SY_r,-�\" f���IAL�
78. FI�E PRE\' F'��A,- ----- � .� ..-.
HEALTH DEPT. FlE�UIREC7ENT
7' 9. FIf:AL I^i5": CTI;:'� -..'- � - - --- -�-- � -----
--. . 1- - ---.
90. POODCERTIF�GnTF �SSU�D
------- ---I---- L-- - -
� Not,.s: -�----
�--- ------- ------- ------- - --� - - --
- _-� . _-+
-_-_____ -1
"" " CIGLLL6R 6lV1Gt(Ci(1JGJ "' O-GV-/V
,�JOB ADDRESS 601-611 Lassen Lane BUILDING PERMIT N0. 42505
m.Fi�x���.sE�
G
W ATER
ROUGH PL
MISCELLANE005
iVOUGH MErITING NND FI0. CONOITIONING
TEMPORARV SEFWCE OR POLE ' �
UNOERGROUNO [� POWER �
FOUGH WIRING
TRENCHES � FORMS � STEEI REINF.
FLOOR SYSTEM
FRAME AND fLASHING
LATHING - IN OUT
PLASTER,BROWN COAT
STRI/CTURAL, FINAL
HEATING, VENT., FEFRIG. AN� F.0
P� 'ING. FINAL ANO GAS TEST �
EL lilC, FINAL
BUILDING, FINAL
F INAL
SUBCONTRACTOR
✓
./ � / � � �/ / �
.� / I � � ' /
� � � , '
� � / '
i� • / / i � � /
F�
�
a
Q
y
h
.'C
F
G
W
F
Q
A
�
Q
7
i
.�
x
w
0.
0
ir.
n.
Z
W
x
3
42505
COS7A MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely — Use Ink Only
cnlnacSS �d_brb'.GoS_ Go7Lo9L// SSE
OWNER!
MAIL
ADDRE?'
CITY
CONSTRU
LENOEP
BRANCH
ADDRE3
ARCHIYE
CONTRACTOR
ADDRESS
CITY
STATE �
LIC. NO,
SIZE
OF LOT
TEL.
NO.
i�
a,r, �r�-�����.,'0(�ts�B>r �,�.,�g,2�.5�
APPLICA7�fON POR STRUCTURAL PERMIT
FECENED BV DATE RECEIVEfJ DATE ISSUEC
� o .4-�O. %
A.P. NO. �'(p" (��� �
BUIL�ING
ADDRES
TRACT Q �
NEW ADD ALT R P
X
OWNER GCI �E
�SE �` vn,/ir- o�
FIRE
ZONE TV E
APPROVED
2G
TEL. � NO.OF USE OF NEW (p V�
NO.
PLANS 2 BUILDING
CITV YAR�SAPPROVED VARDSAPPROVEO
LIC. NO. MAIN BUILDING ACCESSORV BUILDIN
INO.OF BLDGS. (FqOM C/LSTREET)
NOW ON LOT FRnNT FT. FT.
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILOING AND WORK TO BE PERFORMED
rJ
I hereby acknowletl8e that I hava reatl this application antl state
ihat the above informailon fs co�rect and agree to comply with
all laws fe8ulating buildinp construction, and 1 shall not employ
any perso� in violation of th¢ workman's compensation laws of
th¢ StaSe of California.
I hereby certify that I am properlV licensetl as a contractor under
the State of California Business antl Professions Code, Diviston 3,
Chapter 9, and that such licenses are in tull torca and affect, or I
am exemPt from the provisions of the State of California Business
antl Profpssions Cotla, Division 3, Chapter 9.
Signatura of 1
Permittee �• ��TZE� �y ��
Authorizad Agent
DISiANCE BET.
MAIN BLDGS.
VAR. �` -
C.U.P. #
APPROVEDi�I1 �C
BEf. MAIN &
APPROVED
THE AMOUNT SHOWN UNDEq VALUATI
THE PURPOSE OF E5TAeL4SHING A PERMIT
VALUATION PERMIT FEE $
PLAN CHECK $ 3
$ 23�aOD TAX $
TOTALPAID $ �
n
m
i
x
m
N
IS FOR m
ONLV: �
•�Q �n
%m
.Lo B
LL
..3d' �