HomeMy WebLinkAbout1917 LANAI DR - Building Permits a--- CITY OF COSTA MESA
4
• BUILDING DIVISION
> : ,-z. ; 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
/ PERMIT
Se...".,�,,04'
M04- 46 '
(714)754-5273 • Fax(714)754-4856 • wviw.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA ME A,CA 92626
MECHANICAL PERMIT .
Job Address: 1917 LANAI DR Status: ISSUED
Suite No Applied: 10/18/2004
Issued: 10/18/2004
Vicinity: //
Parcel Number: 13951406 _ ISSUED BY: - . , +'`_�
Applicant: YENULONIS,LORA- ' ' - -
Address: 422 JENKS,CI, •- _
• - , ' Phone: •714-998-4300 -�
CORONA;CA - Zip: 92880 - :'
Owner • = KNOCHE,KAREN
Address: ' 1917 LANAI DR , - ,' �`� �
, _ Phone: 714-546-2439
COSTA MESA,CA Zip: 92626 ,
Contractor: 'ALLIED PLUMBING - HEATING -AIR CONDITIONING
Address: 422,JENKS CI . ' - _ _
, - - Phone: 714-998-4300 - .
' ,CORONA,CA' - . Zip: 92880 -
License:610780
SCOPE OF PERMIT ,
' ' CHAMGE OUT OF EXISTING FAU TO A NEW< 100-K BTU. _ • - -
` ' 'FEE SUMMARY -i ' - - "
Quantity - Quantity ,
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit ,$0.00 0
Inst FAU<100 k BTU $14.80. 1 _ - /, Repair/Alt Refrigera_tion_Unit
Inst FAU>100 k BTU $0.00, 0 _ _ Ventillation System ' $0.00 0
Repair/Alt Cooling/Heat " $0.00 '0- - ' " - Evaporative Cooler
Inst/Rep. Recess'Wall Htr $0.00 0 Commercial Incinerator /,,, /$0.00 0
Refrig'Sys<100 k BTU $0.00' 0 Domestic Incinerator j ! $0.00 0
Refrig Sys>100 k BTU .'• • $0.00 0 Compressors/Absorption Systems ,<.; ' j
Gas Piping - _ $0.00 0 ..Up to 3 hp/100 k BTU 2'/',� .. $0.00 ,. 0' •,'/
Factory.Fireplace` $0.00 0 .-; ,, 3 To 15 hp/500 k BTU ' / $0.00/' 0 , ;
Hood w/Meeh Exhaust $0.00 0 , , ^%- - 15 To 30 hp/1,000 k BTU Y /' $0.00 0 /
VAV Box = ^ $0.00 0 30 To 50hp,/.1,750 k BTU /it/ $0 00 0,
Vent Fan/Single Duct $0.00- •0_ Over 50 hp/Over 1,750 BTU j j , - $0.00 ' 0
Appliance - $0:00 0 ' - ''Boilers 6 . ,1r ` '' "
Fire Dampers' , , $0.00 0 ' �Up to 3 hp ' . ''{/2 ( $6.60.'" 0
Smoke Dampers, `. . $0.00 'o- '3 To 15 hp ' --/-''' ='> ,i%j /$0.00 0
Inst or Relocate Appl Vent ` $0.00 0:'='-- `, " - 15 to 30 hp _ "- -/,-.‘“/ %/$0:00 0
Air Handlers< 10000cfm;\v $0.00 -.0 _ - _ _ - ;30 to 50 hp_ i '-''N; ',' �,'/$0.00 0
Air Handlers> 10000cfm, " $0.00 - 0- - - - Over 50 hp ,y -'/ ` ,- % $0.00 0
Floor Furnace $0.00 "0 Other Mechanical Fee L
Floor or Suspend Heater N
- $0.00 4 0 .- ., 'Investigation Fee . -i $0.00
.. •
Plan Check Fee , . ' $0.00
- - . , -Reinspection Fee i'. r-'` $0.00
,___---
.- . 7 -,- - - _ TOTAL CALCULATED FEES $38.30 •
•
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: 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(6/00)
DECLARATIONS ( ) t )
WORKERS'COMPENSATION DECLARATION: -
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
I have and Mil maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performanceof the work for which this permit Is issued.
y workers'compensation urance carder and policy number are:lP
Carrier: - \)°C )/� 1 n �3 /
—0 Xi(� .r Poi Number. '-1^I
(This section need not be comple ed i/the permit Is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work i which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of alifornia,and agree t if I should become subject to the workers'compensation provisions of Section 3700 of the Labor gods,I shall forthwith
elfcora lywl,ihdese p ow ion 1O ^'8_O�
SIgI aturr$: I ( ( V`V'1 -Date:, `-1
WARNING:FAILURE TO SECU WO- -S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN,r41 ON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eff,irm- at I am licensed under provisi n 0 er.S,(commencing with Section 7000)of DiviSiom:3,of.t e Business and Profe °'J code,and my license is in full
for irefffecLic.x `f1v' `N) ssit (� ) lam�(Q
Contr ct 't tura: X . bfVLO y,';D te: �Q• 1lW
CONSTRUCTION LENDING AVVAGENC : /
❑ 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 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.). '
O 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. ❑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 Califomla 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 end Safety Code been fully complied with? ❑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 aEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? ['Yes LI 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 Alr 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? ❑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 inspectioilln purposes.I agree not t occupy or allow occupancy of any building authorized by this permit until final inspection.
_4
-1,nature Of Leal Owner(s),
XI:
l IfteQfler;s)o Atl rodze3ApPhtMt
D'ate'04
000E 0 INSPECTION TYPE Q J )1NTITIRLS you f INSPECTION TYPE PAIL
1616 Fixed System Final Fire Prevention 206 Final Mechanical (U-2
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
•
n •
PROJECT ADDRESS: 1917 LANAI DR 0NIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 0597531
OWNER'S NAME: BROUWER, KENNETH E TR
ADDRESS: 1917 LANAI DR PERMIT NO: B 059753 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
540-5723
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT, REROOF W/COMP, SQ FT; 6, 215
ADDRESS: UNIT:
CLAIM VALUE: 6, 215. 00 CALC—VALUE: 6, 215 . 00 GROUP OCC: R-3 /
PERMITTEE: TOM BYER ROOFING ( 714 ) 894-9618
ADDRESS: 15641 PRODUCT Al2 COMMENTS: SMOKE DETECTOR REQUIRED
9e
HUNTINGTON BEACH CA 92647 ********** ****x'*********** x***--X'*> ****.>E*.*'>t><.-yt* ***********-N>E:6>E%.E>F>E>E****eta *i** '
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is inhull irce and effect. SETBACKS
CITY LIC.: ,47 STATE LIC.:474t `,ss: ,$9
....----57, IP (z— Signature i iMAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby all' 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
k POLICY NO.: 1137424 EXP.DATE: 04 /01 /93
'lOMPANY: STATE PARKING REO: PROV: PARCEL; 13951406 ZNE: REF NO;
J Certified co• is he eby furnished. El Certified copy is filed with the cit/Bui Division. PLANNING NOTES>
Applicant: q *************9f**!F******iF********#****fFfF1E*iF*#******)(***3E***#*#*******3k ik*iP*1F Nff1E*
EXEMPTION PIM WO' ERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N ';3x. S
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 tome Workers'Compensation Laws of California. ZONING APPROVED BY DATE: „. .,-
Y/
Date: Signature: ..-
NOTICE:
NOTICE:It.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 shall be deemed revoked. �/y�/� ,
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: 1 1 l l��J//� • DATE: I'Vi�a—% 1---
whichthis permit is issued(Section 3097,Civ.C). ************************x-it*iEtE- **4-3c-tx It*lc it**************ir)'t 3F*********ftk. ,.w-ft x Rtst-+eX*
LENDER: ***************************************** -* 'a************************4 •*********
ADDRESS: LEGALIZATION;N F E E S U M ,ti A R Y STRUCTURA SEGMENT: Y
.4
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 0 , 0 0 — ,62
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business .1)"`
and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN J" ;1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PIAN_CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 90 . 62 0 , 0 0 '", '; 0 , 00 90 , 62 90 , 62 , 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
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 90 , 62 OVER/SHORT: , 00
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 90. 00 ' `i 5 . 62
❑ 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 Contractors'State License Law). I am aware *..**.7(..)[..N..)c..x.{t•*****.**.7()(.*.*.****-7(.x.*.*.**-N.*i(..K.-M.*.*,*..lf.*.3E*.le.i(-*.Ifif.fr*.*.***.leiE**{t.*.**.**.y.*-*K.***.*.********
that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A It —F E E BREAKDOWN
o I am exempt under Section: B.&P.C. T•
for this reason, TYPE QTY D E S C R I P T I O-'N UNIT COST TOTAL COST
Date: Owner: SFR 6215 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 6, 215 , 00
Ido hereby certify that 1 am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from t1
these provisions.
.40 1,.,
r +
Date: Applicant: _.. fi
•
I hereby certify that I have read this application and state that the above information ora r a, • : , ply with all city and county J.1'
ordinances and slats aws rel.ing to building construction and hereby. epres i city to enter upon the above-mentioned •
property for inspe@ ion pur oses.
Dale: Signature: •••• _ �, _ _ -2
,,
Driver's License or Social Security k jr r r I:1 s J I,C6TE: -i '' C;- 1.I^r. •14''y'.4;
I
164146 While—Building:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor '�L' •
CONSTRUCTION AND PLANNING I PO SPA
. APPROVALS Permit # Date Inspector APPROVALS Permit # _ Date Inspector
Y
1. Temporary Electrical Service.or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement . '
3. Electrical Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE -
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. ' - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • , .
• 12. Sewer Cap 63. Heater & Vent-Final
.
13. Roof Drains 64. Plumbing System - Final ,
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval '
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling - 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning - FIRE DEPT: REQUIREMENT
20. Rough Factory Fireplace APPROVALS - Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil
-
23. Gas'Pipe-Rough &Test • 72. Underground Flush •
24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing • 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation I ' i 78. FIRE PREY. FINAL
30. Drywall Nailing 1 k-•-1 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat I I-1 79. FINAL INSPECTION
32. Electrical Power Meter-Final I I,'J 80. FOOD CERTIFICATE ISSUED .
33. Final Electric I i `� Notes: fr�. • 1 e /ry��//r�/
34. Final Heating& Air Conditioning . ! , i�
iii-Lii NIA,. 0Ma-14 --
35. Final Gas Pipe-Test ' -?
- 1
36. Hood or Canopy I ` ;,`
37. Final Factory Fireplace I I I '
38. Final Plumbing 1 I
39. Water Service-Final ( l
40. Gas Service-Final j I i
41. Solar Domestic-Final I l
42. Backflow Preventer j
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations 1
47. FINAL STRUCTURE & BUILDING w e 1/ /�
46'. FINAL PLANNING L'T ! I I
49. Electric Release to Edison I I I- -
50. Gas Release to Southern California Gas Co I '`I
51. CERTIFICATE OF OCCUPANCY
No. Date
PACIFIC INSTALLERS, INC.
7541 Anthony Avenue
Garden Grove, California 92641
P. 0. Box 728
Westminster, Calif. 92683
Date 970 - z�
Director
Dept. of B S1din and Safety / L/T
City of (�(� /92,0,4,4„,/92,0,4,4„, Permit No. 36 C)
Type of Permit?41/26 '&2t
Dated F--aa '2s
Dear Sir: /]
Please be advised that as of `�'/o ` 75 our work on above-
named permit has been cancelled, and as of that date we would like the permit
cancelled; so that our responsibility for any work accomplished at: /1917
66,99A i for customer:i jrl,iZ/.tui 4d-4,(J&L_- will be ended.
Very truly yours,
For: Pacific Installers, Inc.
BUILDING SAFETY DEPT.
7541 Anthony Avenue
SEP 141973
Garden Grove, California
State Lit. ;k °wnO7
City Lic. ¢
P.I. 264 Rev. 1/71
•;TAORESS: UNIT:t'fl'.541AME: 1917 LANAI DR CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 06701
ADDRESS: BROUWER, KENNETH E TR •
1917 LANAI DR PERMIT NO: B 067015 PLAN CHECK NO: 01546-94 S GOVT: N SUPP: N
COSTA MESA, CA 92626
714 ) 540-5723 CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE; OTH
ARCH/ENGINEER: y REc.xD.:
ADDRESS: UNIT: JOB DESCRIPTION : REMOVE ALUMINUM & INSTALL NEW WOOD SLIDE SQ FT: 5, 000
PERMITTEE: CLAIM VALUE: 5, 000 . 00 CALL-VALUE: 5, 000 . 00 GROUP OCC: R-3 /
ADDRESS: BARTWOOD CONSTRUCTION ( 714 ) 963-3549
10540 BECHLER RIVER AV COMMENTS : A SLIDING DOOR & "2" WINDOWS, SMOKE DETECTORS IS REQUIRED
FOUNTAIN VALLEY CA 92708 **VF+r**** v6+EBF***** ***v6*************** ***vF****VF***+C+6******** *****+F****+E*,F****
LICENSED CONTRACTOR DECLARATION: I hereby affirm Ilidt I am licensed under provisions of Chapter 9(commencing with Section ZONING R E QQ U I R E M E N T S
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect.
052562 592681 B S E T B A C K S
1 C STATE LIC.: C S:
/ Dale: $- - Signature: MAIN BUILDING ACCESSORY BUILDING
,✓ .'KERS'COMPENSATION DECLARATION: Ihereby affirm 1atIhave acertifi .kWsnto f- sure 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.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: 046-94UNIT02690 EXP.DATE: 01 /01 /95
COMPANY: STATE FUND PARKING REQ• PROV: •
PARCEL : 13951406 ZNE; REF NO:
Certified copy is hereby furnished. E Certified copy is filed with the city Building Divisio . PLANNING NOTES>
eale' — .-.9L/ Applicant: ill W-5/4.11 V gel ************************ ******************************************** ***if****
PTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed mad is for one hundred($1001 or less). D E V E L O P M E. N T S E R V I C E SR E Q U I R E M E 'N .T -'S
I certify that in the performance of the work for which this permit is issued.I shall not employ a son in any manner so as to become •
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY
DATE:
Date: Signature: C..13^.„ q
NOTICE:If,aver making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ;% '0 r DATE: x" l4f
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. ,
CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency for the performance of the work for r''
which this permit is issued(Section 3097.civ.C). APPLICATION ISSUED BY- DATE: / 5" Oz--
e
LENDER: ***********************************************************************' *******
ADDREss: INST. NEW WOOD TO DINNIG LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
ROOM & KITCHEN yyr �./�
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ESMOE� E...MCI�YA�V�.'1l _TOR RE SM I P/RES GRADING
(Section 7031.5 Business and Professional Code: Any-city of county which requires a permit to construct,alter,improve,demolish,or 1`L V V. E 4.V
repair any structure,prior to Its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 72 .00 5 0
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the BusinessE����I[]� SM I P/NON-RES
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 46 , 80 1,-{e `j •
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING-DIV-> PERMIT ISSUE `-PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for safe(Section 7044.Business and Professional Code: The Contractors'Slate License Law TOTALS----> 72 . 50 0 ,00 46 . 80
119 . 30 119 . 30 . 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
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 119 . 30 OVER/SHORT: , 00
• 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 72 . 00 , 50 46 . 80
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts tor such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *,*,*,****,**,*„ *,*,*,*,*,***,**,*,**,***,*X,*** ****,******,***„ ,*****************,**, ,x,*,*,*,K,* N,.
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. INDIVIDUAL FEE BREAKDOWN
tor hls reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 5000 ALTER BY VALUE RESIDENTIAL NOZONE 1 , 00 5 , 000 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and stale That the above information is correct.I agree to comply with all city and county
ordinances and stale laws relating to building construction and he'byauthorize representatives o e s city to enter upon the above-mentioned 01 0015'844-00159846 TE]T 119.30
pro erty for inspection purposes. _ / I ,
G
/� q,�/ I DATE: 05/02/94 TIME: 10:44
Date' �7 —a9' /x/ Signature'. AtA 4_..• / .�
river's License or Social Security 4: ,'
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING - POC SPA
APPROVALS Permit# • ,Date Inspector APPROVALS Permit # Date Inspector
1?). Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd:. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56, Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. footings 58'. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test •
9, Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. •
I 10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line& House Connection - 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater& Vent-Final - -
13. Roof Drains - .- 64. Plumbing System - Final ' -
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-I Bar Ceiling 69. POOIJSPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT _
20. Rough Factory Fireplace - ; APPROVALS Permit#
21. Ducts,in Structure _ ' • •70. Underground Hydro
22. Ducts, Ventilating - . - 71. Product Piping OGias ❑Oil
23. Gas Pipe-Rough& test • -- 72. Underground Flush • •
24. Roof Framing , ; 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - • ' 75. Dry Chemical ' -
27. Frame and Flashing • �•-4_q'•L( 6Wgi 76. Dry Standpipe
•
28. Lathing& Siding . ' 57 6- q C(. 6w6,1 77. -FIXED SYSTEM FINAL
29. Insulation - ". 6-c[ / 6/s-k 78. FIRE PREY- FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Piaster Brown Coat - 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. final Electric - r -
. •=4 .1.
34. Finat Heating& Air Conditioning ;
35. Final Gas-Pipe-Test - '': U._, ..
ir-r'e
36. Hood or Canopy ' .�^
• w � -
+� -4-1,
37. Final'Factory Fireplace • -- c
38. final Plumbing r- !-, •
39. Water Service-Final _ 1-t-,
40. Gas Service-Final .
41. Solar Domestic-Final '�„ .
i
42. Backflow rr am
-
43. BackflowIrrigation
44. Landscape Irrigation System -
45. Sound Attenuation ' . ' .
' 46• . Handicap Regulations •
a7. PrN.iL S7RUC7URE& BUfLDfNG L (� --
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY - :
No. t Date
i
— • o I AROUND EXTERIOR OF ALL WINDOWS THERE •
o ; WILL BE A THREE INCH CASING . THERE ARE 1
o TWO WINDOW THAT ARE NOT SHOWN . ONE 1
a
1.0 rn ' IN THE MASTER BEDROOM, AND ONE IN THE ,
1 DINING ROOM THAT WILL ALSO HAVE THE � n
-
EXTERIOR CASING s` '"(� ,;r."'-',,,
LL - ti'' '1;;' 4:470.4'.4) '
Master tet room
// die , 5- 0EA9C D ;ing room
o^ 13'X e' Permit # (� �4�O ) t =' I .' X 4'
N 1 I .if"di t
Q' THIS NUMBER MUST ACCOMPANY 1 r c-1a .. " r " .
ret r al:rte r-r.�..�n ,c; 1
Z ALL INSPECTION REQUESTS — U ' '-' °1�
1111111 . I ..,>w : rnrw of any . ai
tiE
w O� � ! aimed active per UBC§303
J GVT
Q > G TILE WOR' ^ m - • ._ .
P issuance.
' 15 Z V� •
3 ,0
cS'�` 72" 46" r---- 72" - t
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REMOVETOP &BOTTOMALUMWINDOWS REMOVEOLDALUM. SLIDEN- ----3
ALLBAY
INSTALLNEWANDERSENSLIDER & INSTALL NEWANDERSENSLIDERto
T. CLOSE IN BOTTOM WITH NEW WALL -5440(4-17 . 51AS L---�tMe- c�53
a
R.
± SOUTH LOOKING NORTH
Lot 14 - Tract 6384
Plan 1-AR
27090
PAID
MAY 2:.., 07E1 7001406IF ***1 714 p
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
'. ADDRESS 1917 Lanai Drive C.M.
COSTA MESA. CALIFORNIA For Office Use Only
•
owNERClub House Road Joint Venturi I RECEIPT NO. I P , �'�
�
MAIL - 0.ECE 40• _- DATE RECEIVE ATE 188 ED
Costa
ADDRESS 2850 Mesa Verde Drive
CITY TELqnBUILDING
ADDRESSARCHITECT
TE
_ _• 1 ;3 COSTA MESA. CALIFORNIA
+ FIRE
' I ' ll ' ZONE TYPE VGROUP4 /
CONTRACTOR Republic Homes Corp. APPROVED
BY DATE
ADDRESS 2850 Mesa Verde Drive ZONING /-Ly„�,
ZONE NO.OF USE OF NEW ((//Q
CITY Costa Mesa S N-PLANS 2 IUILD I NG `` �_'
STATE
No. 197838 TEL
549-0395 LEGAL
' �� /4 -�-� 4 ry
UV
DESCRIPTION /+ -'7
SIZE NO. OF SLOGS.
OF LOT 60 x 100NOW ON LOT A.P.NO.
USE OF YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE,(S��TTJ/)
CENTER OF STREET 23 ' REAR YARD 24 I FRONT l 3 . . IN.
SIDE YARD I LEFT _ 5' I RIGHT 51- R.SIDE 1, J FT. IN.
DESCRIPTION OF WORK
L.SIDE 5 FT. IN.
NEW I X V ALTERATION I V ADDITION I REAR //V.cr'FT. IN./
REPAIR I MOVINGV DEMOLISH I BYPROVF)D,� y/ / ] ^ATE t7 _. 09
SIZE
BUILDING 2008 SCI . ftRNO. OF oome 7 STORIES 1 (��11 //0 66.!!! /J
EXTERIOR WALLWOOd ROOF
COVERING StUCCO COVERING Wood
USE OF BUILDING AND WORK TO BE PERFORMED
/1
S1AMMO f ,2 o 0./ % 75-
1
HEREBY ACKNOWLED E THAT 1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
• AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
' PLY WITH ALL CITY ORDINANCES AND SQSTTAATSE LAWS�/ REGULATING
BUILDING SIGNATURE OB • VALUATION
`�/�/L"'
/ el PERMIT FEE $ �� D U
PERM ITTE /�/ J w"� 3-6) m
/ $too, 377 PLAN CHECK $ /ill..`'! F
AUTHORIZED >' �LI%�
TOTAL FEE - DZ 'J"5t' 4E