HomeMy WebLinkAbout2416 LESPARRE WAY - Building Permits G• 1 1 CITY OF COSTA MESA
F4V'•I BUILDING DIVISION p
DEVELOPMENT SERVICES DEPARTMENT //_ /
Cr -
• r PERMIT f/ PERMIT NUMBER .
S°40,2”20:4#
P99-00073
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
• PLUMBING PERMIT
Job Address: 2416 LESPARRE WY Status: ISSUED
Suite No Applied: 02/03/1999
Issued: 02/03/1999
Vicinity:
Parcel Nunmber: 4391430$
Applicant: NOCK, RON
Address: 11612 KNOTT ST -
Phone: 714 895-1246
GARDEN GROVE ,CA Zip: 92841
-
Owner MAGETTE, DOROTHY M
Address 2416 LESPARRE WAY -
Phone:
COSTA MESA,CA Zip: 92627
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
REPLACE WATER HEATER• � .
FEE SUMMARY -
AMT. QTY " AMT -QTY AMT QTY
ISSUE FEE $22.00 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 $11.00 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: $33.00
COMMENTS/SPECIAL CONDITIONS
-0\
• EXE ivv
DATE
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if Ark is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS ( 1 I,-}
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.
13 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.
My workers'compensations Insurance carrier and poli number are:/ �/'-) ? 3 14(Lo
Cameo Policy Number.
(This section need 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 as to become subject to the workers'
compensation laws of California,and agree that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions. ' C
Applicant Signature: A �t Date: 7
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE.INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# ---70-7- - 5 Class#
Contractor's Signature: \ ��J ~� Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,es 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 properly 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 driver's license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 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? ❑Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the 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 appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U 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? ❑Yes ❑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 es ❑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 penally 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 Of Legal Owner(s) Ca"-
C,
]l°,R I �6\ d� r? —
Ana7olJAuthorized Applicant - Date
CODE L INSPECTION701F peg MEALS CODE INSPECTION TYPE DAM =NZ
1616 Fixed System Final Fire'Rievention . 206 Final Mechanical �
1266 Pool Spa Final 208 Final Plumbing Lf-sati-n? vT,�
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 _
2446-46
•
A RESsffURMNG: 2416 LESPARRE WY uMT: CITY OF COSTA MESA — BUILDING PERMIT
-DNNERSNAMEIPM4ONN: MAGETTE, DOROTHY M PERM NO: B 07275'
ADDRESS: 2416 LESPARRE WAY
COSTA MESA,CA 92627 PERMIT NO: B 072758 PLAN CHECK NO: N GOVT: N SUPP : N
•
APPL.MMUNG ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0111
ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : T/OFF 6 REROOF W/BUR SQ FT: 767
ARCH.OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: 746 . 00 CALC—VALUE: 767 . 00 GROUP OCC: R-3 /
coNWACTarsluME BRAHMA HERD ( 714 ) 649-2976
COTRACTORSMMUNG 28811 MODJESKA CYN RD COMMENTS: SMOKE DETECTORS REQ PER 91UBC
ADDRESS: SILVEAADO CA uc.No.: 601558 ***********************3Ei(dEititdt*#dtiEdt*iEiEdt-at*jtildtdtif♦E{(*****>***K-*dtdEdtihiEi(-1PikdtitxiElEiE****dt**'*
92676 DMT) Z ON ING R E Q U I R E M E N T S
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I em licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code,end my license is in lull force end effect.
iryLIC.NO.:061060 UC.CLASS: C-39 UC.NO.: 621558 XP: 00/00 MAIN BUILDING ACCESSORY BUILDING
Dela:
r_ -S' --? C'
Convaaor: V24L,,-�. FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ' IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I am exempt from the Contractors License Law for the
following reason(Section 7031.5 Business and Professions Code:Any My o county which requires a pernn to construct,after.improve, PARKING REQ: PROV: PARCEL: 43914305 Z N E: REF NO:
demolish,or repair any structure,pier to its issuance,also requires the applicant for such panes to file a signed statement that he or she
.a licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES>
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exempbn.My violation Of Section >.
•
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not move than fee hundred dollars f$5001). *******************************************************************************
❑ I.as ovnier of the peoPertY or rnY enroloyees with wages as thei sole compensation,will do the work and the structure is not'Mended D E V 'E-tL O P M E N T S E R V I C E S R E
or offered for sale(Section 7044.Business end Professions Code:The Co tregors license Law does not appy to an owner of properly Q U I A E M E N T $
who build or improves thereon,end who does such work himself or herself Of through he or her own employees,provided that such
improvements are not intended cc offered for sale.H,however.the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
•
❑ I,as owner of the propery,em exduseay contracting with licensed contractors to cetINa the project(Section 7044,Business and
Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who BUILDING APPROVED BY : DATE: '
contracts to such projects with a conlndor(s)licensed pursuant to the Contractors license Law).
it
❑ faexempt under B.AP.c.,fon the reason: APPLICATION ISSUED BY: DATE:
Dale: Owner *******************************************************************7FiFF**dE"K'
LEGALIZATION:N F E E SUMMARY STRUCTURAL 'SEGMENT:Y
I do hereby certify that I etre aware of and understand the requirements of California Health end Safety Code Sections 25505,25533.and
r
a5permit andcostructionyomodifihecantUwnhommtthtrQualitylOM Maanegemenle tD)a.dResietiedcoatroctimply watt said ona°codes end pp onsareeexeemma�mthents se BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 21 . 00 . 5.0
Date: Applicant: SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of He following declarations: ' PLAN
' ❑ Ihaw and'AN maintaina certificate of consent lo self-insure for workers'compensation,asprovided fon by Section 3700 d the Labor IUILE FEE
Code,for the performanceofthewarklewhichthispermiisissued. BUILDING—DIV—> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE
FI have and will maintain workers'compensation insurance.en required by Section 3700 d the Labor Code,for the performance d the TOTALS — 21 . 50 0 . 00 0 .00 21 . 50 21 . 50 . 00
work for which this permit is issued.My waken'compensation insurance carrier end policy number are:
Carrier STATF. FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 21 . 50 OVER/SHORT: . 00
Policy Number: 1796976-94 07/01 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need nor be completed y the permit is for one hundred dollars/$1001 or lass) 21 . 00 . 50
❑ I certify that in the performance of the work for which this permit is issued.I shall net employ any penin in any manner so as to
benne subject to the waken compensation laws of California.and agree that d I should .:..•,:,_l•bpd to the workers' ***************************************************************************{(.***
compensption provision Seaton 3700 offbelabes-Code,I shall forlhw4h compywith those.�yR.s.T�
Dale: 6D CIS Applicant: �� fI I N D I V I D U A L F E E BREAKDOWN
Warning:Failure to secure workers'compensation coverage is unlawful,and shall subject an employer to criminal panellise and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil!Ines W to one hundred thousand dollars($100,000),In addldon to Na coat of compensation damages as provided for In
Section 37osodthe Labor Code,Interest,and aromay'alees. SFR 767 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 767 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and slate 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-mentioned property
for inspection purposes.
MIKE PUTMAN
Print N //'�� rye
Date:`L' 01 00133941-00183942 TOT 21.50
��r __ -"Sr
Signature of Owner AgenuApplicantContracd« DATE; 06/12/95 TIME: 10:31
sr mea.
(515146 WP) White-Building 8 Safey;Green-File;Canary-Applicant:Pink-Revenue;Goldenrod-Assessor
I
�
POO- . SPA
CONSTRUCTION AND PLANNING
�4 Date Inspector APPROVALS Permit # Date Inspector
APPROVALS Permit#
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
"3?-,£lectrical ConduitiUglity-Undrgrnd. 54. Forms -
_r4. Electrical Conddit:Uffdrgrnd. 55. Electrical Bonding
1 -
1 c5. Steel Reinforcemeritc' 56. Rough Plumbing & PressureTest _
•
•..6.. Electrical UFER=Gind. 57. APPROVAL TO COVER-GUNITE
•,:7,-.7„;Footings : 58. Electrical Conduit-Undrgrnd. '
8, Foundation - o' 59. Gas Pipe, 0 Undrgrnd.,Test
."9`,Water Pipe-Undrgrnd. 60. Backwash Lines; P-Trap, 0 Undrgrnd.
10. Structural Floor System - - '61. APPROVAL TG DECK .
11. Property Sewer Line-8: Hous&Connection 62. Backwash & Receptor-Final. '
' 12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final '
14. Rough Plumbing. T 65. Electrical-Final
15. Rough ElectricatConduit ,: 66. Solar System-Fanal
16. Rough Electric Wiring = - 67. Fencing & Accets-Approval
17. Rough Wiring Sign '..768I . APPROVED FOR"PLASTERING
18. Rough Electrical,T Bar Ceiling' I 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning }, FIRE DEPT.:REQUITEMENT L
20. Rough Factory Fireplace ,;. -5` „t -_ ;, !Jr' ' APP'OV,ALS:t', Piimit # '' t`!
21. DuctsinStructur&l- _� F _J ,--4:1, ` 70.LUnderW ji d yydro
Ducts, Ventilatin . '3 ; - ":' t'
22. Duct
. 4:; - r-- . 71. Producl;Pipingt-Gas OOiI
23. Gas Pipe-Rough & Test _ t7F7 r., z: .54 O., 72. Underground F,iush C.
24. Roof Framing =z-r `'' , j ` 7T. Undergrnd.Storag"eTank-OGas ❑Oil
25. Roof Sheathing `. ; ( * 74:=Overhead Hydro;
26.;T-Bar:Ceiling (Structural) & MdnT - 5:�D
MOT-goat _ r t 7ry Chemical t.-,:
27. Frame and Flashing _c. •:^ r Y 76. Dry Sta idpipe =
•. 28. Lathing& Siding F ' "" t11-:;.IF i •••* 77.: FIXED SYSTEM-FINAL,_ c '
29. Insulation . _ •• - •• r L 78; FIRE PREV. FINAL -
30. Drywall Nailing• ; t . �:. •---; �HEALTki DEPaT. REQUIREMENT
31. Plaster Brown coat - . tr'.- I `r r 79. FINAL INSPECT.ION -
`: 32.;Electricai Power Meter:Final + 11. if r b 801; FOOD CERTIFICATE ISSUED
, _ -•.
33.,,Final-Electric- c. , Notes: N -ar !in
34. FinalHeating_& Air Conditioning'-- c S E-- t
l p - -
r
35.,Final Gas Pipe-Test , .: t
` c +-•4+
-
36. Hood or Canopy - 3 .le " r
37. Final:Factory Fireplace .. . ;.T-. ._
38. Final Plumbing " ` - ° , r, r' r
39. Water Service-Final . : `, . -_, - . ._ -
40. Gas Service-Final - -'.
1 • : _
' , 41. Solar Domestic•Final - -
Lt
42.•Backf low Preventer - • _ c JE- �-
14
43. Backflow Irrigation,` a ' ` - .i
.44. Landscape Irrigation System Z,' _ 7 r X v • ;at.
- .. ...,1 -fir.:7 J
45. Sound Attenuation;. �'., `4.t F � _ �_
'1,46.'Handicap•Regulations J 6 _ °-;Ci
47.•FINAL STRUCTURE & BUILDING ���' t t
48.:FINAL PLANNING; . , 1• :;
I 49.:Eledtric Release to Edison {
•
.50. Gas Release to Southern California Gas Co -
I
E o-
.51. CERTIFICATE OF OCCUPANCY •
t. F•
No Date
•
- /
:
—stF03ECT ADDRESS: 2416 LESPARRE WY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 070547
.' OWNERS NAME: MAGETTE DOROTHY M
ADDRESS: 2416 LESPARRE WAY PERMIT NO: B 070547 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; OTH
ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF & REROOF W/BUR SQ FT: 725
ADDRESS: UNIT:
CLAIM VALUE: 725 . 00 CALC—VALUE: 725 . 00 GROUP OCC: R-3 /
PERMITTEE: BRAHMA HERD (714 ) 649-2976
ADDRESS: 28811 MODJESKA CYN RD COMMENTS: SMOKE DETECTORS REQ PER 91UBC
SILVERADO CA 92676 **************+ta6+t*+t**rr+t+r** ***+t+t* aE*+r+t**+E+r********aE********* *****+r+6+reEr+E+ ****+E+e
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing wit ection ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS
CITY LIC.:061060 STAT IC.:601558 SS: — E . 12 4 .
�� /2—LZ" Signature. _ MAIN BUILDING ACCESSORY BUILDING —
• ""'KERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY:
R'r PARKING REQ: PROV; PARCEL:
ARCEL; 43914305
3914305 ZNE; REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is ly� •iDiv � PLANNING NOTES
;
/�,Z7- /�� •NOTES>
uf ** ft***I *
*yAPDlican. / CDEVELOPMENT SERVICES REQUIREMENTS FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)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, ZONING APPROVED BY •
• DATE:
•
Date: Signature: .
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shallte e e v k 1� ^ �/E Q 1y
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction _ , , f ttie DETECT'°APPL ICAT ION ISSUED BY: (/ '• \ DATE: `i �� 1
which this permit is issued(Section 3097.Civ.C). V ' ! /10�''l�KL.KE.{E{Ett.{F{F{(.{(•*K(.*il.*i(.*.{(.{I.ih.k**il.*..N.**{P*{F.Itil.*{E*,*�P it iF�F iEiei *****IE**1E**ifitiFiE{f1E{t*{E{p{p .9E{f.
LENDER: **************************************************************************** **
ADDRESS: REQUIRED LEGALIZATION;Y F E E SUMMARY STRUCTURAL• SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve,demolish,or PERMIT 42 . 00 • 50
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed $MIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more Than five hundred dollars(3500). ISSUE FEE
I. as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 42 . 50 0 . 00 0 . 00 42 • 50 42 . 50 . 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 or REVENUE DIVISION TOTALS--> COLLECTED• 42 . 50. 50 OVER/SHORT
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve 0 0
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 42 . 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the ContractorsState License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me.• INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 725 REROOF BY VALUE RESIDENTIAL NOZONE - Y•="& 725 . 00
I do herebycertifythat I am aware of and understand the requirements of California Health and Safel Code Sections 25505,25533,and s'
25534 anthat I r any future building occupant will/will not(circle one )need to comply with aid state codes and the requirements fora END OF FEES :�i;., Y;,,—
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from �¢'
these provisions. DEC 2 71994
Date: Applicant:
I hereby certify that I have read this application and stale that the above Informs I. is correct.I agree to comply with all city and county ���. OF COSTA M
ordinances and stale laws relating to building construction and hereby oath.i • nese tabus . r i try k. m
pon the above entioned 4
property for inspection purposes.
12 'x7`^9,signature: /�nIr .,,et/3 /. L_
• 5 License or Social Security n:
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
II
d 'CONSTRUCTION AND PLANNING P00 $PA
APPROVALS Permit# - • Dae Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Servge,Sc Pole ;✓ 52. Pool & Equipment Location 1 .
2. Soil Pipe-Undrgrnd. '' 53. Steel Reinforcement
�,. ._ (ictrico1 Con4it Utility• ndrgrnd. 54. Forms •
mr4. P4 ctrical Condtit'CJhdrgrnd. ` 55. Electrical Bonding
t.0,..7tS;iel Reinforce > 1; 56. Rough Plumbing & Pressure Test -
1 1 • ., :t -
e' B:=Efectrical UFBH�Grnd. 0 57. APPROVAL TO COVER-GUNITE --+
rtn•
:i0�4Fdotings at r' • 58. Electrical Conduit-Undrgrnd.
,'P, oundationI 159. Gas Pipe, 0 Undrgrnd., Test /tt
>"i4.?Water Pipe-Undr )td. •4 V 60. Backwash Lines, P-Trap, 0 Undrgrnd. //2,. j
10. Structural Floor System ' r' i, ti': 61. APPROVAL TO DECK I !civ
-� • .i /4
1. PPOperty Sewer Line•& House Connection., 62. Backwash & Receptor-Final r
12. St ,...:Cap f. 1. �' 63. Heater & Vent-Final . ,v�•y
13. Roof Drains rn i11 -- , ' / - 64. Plumbing System - Final .
14. Rough Plumbing - : 65. Electrical-Final ea
• 15. Rough Electrical-Conduit- - '66. Solar System-Final t.
U '
16. Rough Electriiring a, . - '.67. Fencing & Access Approval
I
-
17. Rough Wiring Sign •. . ' •..68. APPROVED FOR PLASTERING
0)
18. Rough Electric-6"T Bar Ceiling ' - 69. POOL/SPA SYSTEMS FINAL •
19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT
,-. - - '-J C c'-4 r.1:',--• tr. H N
20.tr?Roe hh F3cteirry F='i lace I o,t+7 Q'-t i:l =o t' ' ` :tPPRC'VAg,%•-4CPerit # ` >. t''
Y _ •-
4 i i •• • < r
27.i ur,:a, ie0.Strgctu+^Y ' •- s- * c, F- Fit u .-1 '-Ihdergf6' ;LII Tiro •
In S'• , <. ..int
22_,puei}, 04.. nt tin't�"• •I l' s 0 a :4171. Productc.-Prigi ig i' as 0;0i1
r .a c• ...* .r L.-- Cr • ' .._......id'
23 'Gas` ip®-Ropgh 8&.test CIS -* to e" k0 r * '-172. Undergrottlid Flesh-34. # H -
24 cRoo'L Fr%ming G. `"F' 1-::•- • -.1?-4:, -÷"
I cp-. . < 773?,Undergrnd'.Stora !apk �]Gas 0 0i(
r i [a v .v . r !•
25. Rog Sheathing rj.; v f.A C' > N r r' 74 ;overhead Hydro?r a
26.--B'2t Ceiling (Surae ural) &:fvicilticoat x sis r.-I. 'Li* 7 75Z�D.r"y Chergipal 1,., '-' `1 pj
27.c-rame aptl Flashcrp; pa:c .; C' >, 01* * 76. Dry Standgpe if,It - p
- . '- 'C- - . ^ r,
;22B. Lathing& Sidingu} r- ric E-; ^J s 3. •••„ • 1 ••N y 77EFIXED SV''S�''Et N;NAL; N ,-1tit
m n). ft; S. .. - qC:1 xi ) 1 >1
29. Insulation n , h- x 78�FIAE PREY. FIN,SL r > >1
11
030. Drywall,lalaiYritg K.r ._ e F # NEALTFNEPTiREQdIREyMENT
;41. Plaster E$wriCo•�t, , 1 to 0• _ r79 C)FINAL l PECTlO]V r p
I i-'i "yam•- : •
2.';Electric,l'Poii)er IHerJE,al I ` •'5 I I b 4. 080.FrOOD CERTIFICATE IS U D ti
rr �• r
'^ i t !:.• t t': t t - r:] C' 417_ Y :n
s 4_,, n El_.,.. ar m 1 a: a I �`- �loier. .--1 : -, a n7:.7
.. :Y ri L .,.. S
nE4.CFinal:Heating7& FAtr'•Corfditionittg Cl i n` a; Ct^.: » ,: CO
" T -- -) W. -r m •., 7• *i t ci; o-: 7 L-•e; a n;
0 inal'Ga3'Pi "7 Testy 1 + I 4 4 LI i1 ot_:
135.C5 ISR-Telt t].V .. } r-. t 4 7 o _.r-1 t- ,
:•1 t3 - -1 . .
oS6. Hoad or Canopy . ,• 'r:-, r ( t F z r',o + c:0'
--, ' r-. r I dart .j * I.. r Pt . .0 t p7 `+P:
:.37. flnaj,Factory Fireprace -. t :,F, itil --1 i it)
I-38. FinallPlumbing :14i : H i x : .. o;
,.. 1 I x f ¢ `.
39. Water ( +Service:Final2 -.t I , u; L • ,�IC o'
C
'AO. Gas Service-Fa'nel , -t C..tr0' r :: I 2Lt Iva t
741. Solar Domes t, -Final -`-• .. * CA 1 1 0 t �.a.: >ti
4 _ r <- 10 r �4 `�
2. Backflow Preventer, 01 I I r e r. 7H • i CJ 1-1 l---•
' tT� q .F r r.•r-,o c ;i -' •-
43. Backflow Irrigation' • -
1
r44. Landscape lteigatioe Systemattnc) > t4 t, r7 ,a • h: Cu C; :r..3 sr Z: 'o . .:T `
••,--- n, • •e , ,. F 7 c. Oc r S E- . i-• ' c.1•
Zi54ound A(ter4ationy s-i lilt- tr• * E H H F• . Ci 1-1 y 17.t.1 0; .r -
I.
746.rHandicaP Regulations <t t 7; •5 -!o S ;. S,.. :
• •_ .:' m•I�,^i , . till '
. 47.TIN'Zs'L STRfftTURE & BUJbDING i ,Werb.. .4;4 :-o:; •
48.t(;IN4 L PLANNING= 7 E•E-• u I I -# • tri 7: ic
r49.tEledLiic Release to Edison 1• x I I -. .r x Z: tr, c -
.7 .. I .r i I 1r a ._ ••
iLa0.'Las,f6eleate to Southern Califpraia:G&s 1 1 11 -J c r4 C' -1
:51. CERJTIFICATE OF OCCUPANCY x • -_ 4 >I n n70 r• c.
No. Date
OWNER DOYLE & SHIELDS DEVeopment Co. ,Inc. DATE 6-3-63
JOB ADDRESS 2416 Lesparre BUILDING PERMIT\NO. 19695
GENERAL CONTRACTOR Doyle & Shields Dev.Co. ,Inc. VALUE $ 19_1540:00
AP No. LOT 111 TRACT 3433 FIRE ZONE DESCRIPTION OF WORK .:Res.w/att.gar.
INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-2
Soil /_ 7-2].zT 3 PERMITS ISSUED
SUBCONTRACTOR d - 4. DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. ❑ t
Rough Heating A4+S /6-23-6.3 ,�, «< -Ju .2 b_1 Gi r 031
Rough Plumbing Mit< /0-23-(4 ,,rdr 4-ho--.3 %4251/ i
Miscellaneous
Prop. Swr. Line ZiHouse Con. 0 St. Swr. 0 i,d , liCtia
Sprinkling System /`.-R.4-4.3 -1/4),2 4 �4
d
Construction Pole .
Underground D Power ❑ �,, i/' 4/7.Gi
Rough Wiring f=, �f % i/-c ec.e , ir. . "3 O �,� �
Trenches� Forms� � Steel Reinf. 0 �r�-""�,/r�, IX, �
Floor System /�./T-
Bond Beam 0 Steel Reinforce ❑ I A
Sheathing /f+ 4 /(I -_/ e6 3 ill
Frame and Flashing .0 -.:C .- 3 I II/u/ ar
Lathing — In & Out li4' iter -7 - .7 1"j An
Plaster, brown coat %,'afl r-7" IV _
Refrig. 0 Air Con. 0 Final
Heating, Finalti✓ 2'/v.�� �� i f
Plumbing Fixtures, Final l��s Z/$'-��4' J
Final Gas Test/J� /Yt�- A��tiy
Electric Fixtures, Final 2. _27.-a,
Building, Final r y_arc54
OCCUPANCY
Form BU4-5M-3-63-S-B P ULD rvn a clJna. itclw1KtiV1C1V r3
•
I qhq^ UE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 3 196
P.O.BOX 317 COSTA MESA.CALIFORNIA FY!VANGE DEPT.
For Applicant to Fill In Completely CITY OFACNIMMESAFOR PERMIT
•
TYPE OR PRINT - BUILDING •
�` I j r For Office Use Only
BUILDING b
ADDRESS
RECEIPT NO. PET I_T NO.
_r
COSTA MESA, CAL) ORNIA �
R EI ED BY D TE RECEIVED DATE ISSUED
OWNER Doyle & Shields Dev.Co.Inc. • 43 .IUN 3 1963
MAIL B DING ili// _ �g �y L_!,._C%/, �, , .
ADDRESS 831 So. Manchester Ave. FIRE
A RES9 (X !O ��/r Lt///�C! i[/�7�<//{�
ZONE TYPE r GROUJ
CITY Anaheim, CaliforniNo.PR 2802
AR L.ITECT TEL APPROVED • DATE
AR ?:'$)NEER Hai C. Tan N087l-28l
ZONING
ASS 4100 West Commonwealth ' r L,
i NO.OF� / UEEOF NE /1
a. l PLANIf I EUILDIN G
CONTRACTOR Same !!! ��` VI ` I
DESCRIPTION Lot 111 Tract 343
ADDRESS Same
CITY Same A P NO
• NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE LIC.NO.sSl-250-B-1 NO. PR 28020 30"TOSIDfi@REAR P.L.
EAVES
SIZE
OF LOT 33 x 53.50 I,NO.OF BLDGSNOW ON LOT .-- ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
' (FROM C/LSTREET)
(L5)
SETBACK LINE FROM
CENTER OP STREET 20.50 ' REAR YARD . . ••• FRONT 1 + FT. FT.
SIDE YARD) LEFT• ---- I RIGHT - R.SIDE O FT, FT.
DESCRIPTION OF WORK L.SIDE 0 FT. FT.
NE' X ALTERATION _ ADDITION REAR 0 FT. FT.
DISTANCE BET. BET.MAIN ft
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
VAR.* - DATE
BUILDINSIZE .s 3x53.50 Rooms 7 STORIES 2 C.U.P APPROVED
EXTERIOR WAtt
APPRO Ili
.�^^,, c /`•
COVERING DtUCCO I COVERING Compo y '\AIN\ DATE iJ �-I/��
USE OF BUILDING AND WORK TO BE PERFORMED .C{X�
Residence with attached garage
Model ' 42-G
. 1833 so.FT `>``t l a ti11
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SH `A'( UNDER VALUATION IS FOR THE 1
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ES BLISHI NG A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION m
BUILDING CONST UCTION, ^, �^/� / AD N
SIGNATURE OF I�L.'n� '/l- ^ y PERMIT FEE $ (J3 "7 m
PERM ITTEF L IIRTT(II,�.�WWW//)CCT---CCC /%� OW. \ $ 5* 3 S
f 1 . '/ • SV
X
G
AUTHORIZED AGENT / / L
C Zcvi. s
TOTAL FEE $