HomeMy WebLinkAbout153 LEXINGTON LN - Building Permits F` • ' 9 • CITY OF COSTA MESA
•
BUILDING DIVISION
F • ,,,,' •, , ,! DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
' PERMIT
B02-01294
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.Bc UILDING PERMIT n FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 153 LEXINGTON LN Status: ISSUED
Suite: Applied: 08/16/2002
Vicinity: ROOF Issued: 09/27/2002
Parcel Number: TPN98078 Zoning:
Applicant: BLANKS, JERRY ISSUED BY: ( 1P-1 "-----------
Address:
Phone:
Zip:
Owner: MONTICELLO HOA
Address 150 VALLEY FORGE RD
Phone:
COSTA MESA,CA Zip: 92626-6569
Contractor: PREMIER ROOFING AND BUILDING CO INC
Address: 17501 NORWOOD PARK PL
Phone: (714)573-0155
TUSTIN,CA
Zip: 92780 License: 634404
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF FOR 153-161 LEXINGTON LN. INSTALL 1 BASE,4 PLY WITH HOT ASPHALT THEN FLOOD WITH ASPHALT AND
ROCK."MONTICELLO"
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $13,490.00
Permit: $237.25 Claim Valuation: $13,100.00
SMIP Res: $1.35
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $238.60
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 . Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
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(8/0m)
DECLAF2ATPQNS it 11 r ,
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: r
❑ 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 performanceof the
work for which this permit is issued.
❑�I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers cp_mpensatlon Insur ce carrier ep policy number are: �7 q
LCartie (/C/7 17�c- LLQ4- rPoli cyNumber• /`T o?o2,/5/ '—o/
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performanc.of the work for which this pe is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califon ia,and agree that If I s me subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith
comply with these provisio Q�
-Appllca'nt.Slgna�ure /�
WARNING:FAILURE TO SECURE S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P 'ALTIES CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000), ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABO CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under pr.vi ens of Chapter 9 comm=ncing with Section 7000)of Division 3�of the Business e�{r d Proles " ns Code,and my license is in full
1(NCB and effect:Uc:a--� __�i ' ' a Cass
Contractor's Signature:- __i L% �- r--ate_._ Oa-
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 Ucense 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(5500).):
❑ 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 Ucense Law does not apply to an owner of property who builds or Improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑Yes ❑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 live(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health end 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 a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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 end 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.
411
/_ •_: ,- Leeal Owner(s) /e7;?afr
D�te
`-And/OrAuthorized'Applicant
CODE I INSPECTION TYPE UITITIALS CODES INSPECTION TYPE RAIl IIQIIIAL6
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 1D-7-02_ Z 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
ADDRESS OF BUILDING: 153 LEXINGTON LN MT: CITY OF COSTA MESA — BUILDING PERMIT
admERSNAMElf ID1UYN: WARFIELD, PAUL MILTON TR DFPM Mn. n (1777RS
ROOF 153 LEXINGTON LN
COSTA MESA, CA 92626 PERMIT NO; B 072286 PLAN CHECK NO: N GOVT; N SUPP : N
APPL SWUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: OTH
ARCHITECT ON ENONEER: UC.NO.:
JOB DESCRIPTION ; T/OFF SHEATH & REROOF W/COMP SHINGLES SQ FT : 2, 924
ARCH.OR ENO.'S ADDRESS: LINT:
CLAIM VALUE: 2, 924 , 00 CALC—VALUE: 2, 924 , 00 GROUP OCC; R-3 /
cONWACT0RSNAME STOUT ROOFING INC ( 310 ) 923-6775 '
cOImACTORSMNWIO P 0 BOX 4309 COMMENTS ; SMOKE DETECTORS ARE REQUIRED PER 91 UBC
ADORBSS: DOWNEY CA UC.NO.: 402536 + ****+e*** -****4****+ ************,R****>E*v-**44*********r,c*a•************ *sir.** ..>t*sr
90241 we: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby aff under penalty• that I am Mena under• • • .d Chapter 9
(commencing with Section 7000)a Division 3 d the Business and Prof.. .• •..,and my license b m fut force effect. S E T B A C K S
CRY LIC.NO.: r LIC.CLASS: LIC
�g9377 C 39 i�9 S 6 EYrr� 19 , MAIN BUILDING ACCESSORY BUILDING
1 //�// ( /t �j�,� r FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
OWNER BUILDER DECLA ATION:1 hereby affirm under penaly of perjury that I am sump Imes the Contractors '. Law for the
following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to conatmcl,eller,improve,
demolish.or repair any structure,prior lo is issuance.also requires the applicant for such permit to file a signed statement Mat heorshe PARKING REQ; PROV; PARCEL; 41916427 ZNE: REF NO; •
is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)d Division 3 of the PLANNING NOTES>
Business end Professions Code]or that he or shell is exempt therefrom and the basis for the alleged exemption.My violation of Section
7031.5 by any applicant for a permit subjects the applicant to a OW penally or not more than the hundred dais($5000. > .
❑ Lasowm1 e(Sepennl my,BmpbyesewVhwesmes Code:TheC
compensation,will do the work,and the structure b not intended *********************************************************************.******** *
woad mteOVaa thereon,
Business arid Podmwrkcede:Tr Iaasiedon Lkarne Law or her own employees.
plyteenowiol tpmpedy D EVEL OP MEN T SERVICES REQU IR EM E N TS
who ads or impaci tended,and who does such work amen«henafl or nptoyeh his is her own hoyear iprovided that mit
improvements are not intended or offered for sale.I.however.the bolding or knp«.wrn,rtl sold within one a completion,the '
pvmhb 'def will haws the burden of paring M or the did not build a improve to the purpose a we). ZONING APPROVED BYDATE:
•
1.0 I.as owner of the property,am exclusively Pontredig with licensed contractors to construd the poen(Section 7044.Business and
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
__ I, ❑ lant exempt tinder Section: B.&P.C.,for this reason: APPLICATION ISSUED BY;
DATE; fl
Dale: Owner. ***************************************3f**M44*****aFY***1F*********iR***air*aL**364-N***
Idohereby c«uytrotlmnaware ofand uderstadthe requirements oCaltl«nial4eatmadSafety Cdesedbns25505,Peen,ad LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y
p c,4,end that I deny More building 000man will/will not(dib one)need to comply with said date codas and the reauuremards for
a permit turcanslmcuan«modi5cwtionhom the A'faite vngernent District.Residential construction appiretiomere exempt Mom time BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING
prOer°'a PERMIT 54 . 00 . 50
Date: Applicant:
WORKER'S COMPENSATION DECLARATION:I hereby affirm order panty of perjury one d the'clardng declarations: P LAN SMIP/NOP]—RES
❑ I have and MI minter a certificate of consent to self-insure for workers'compensation,as provided for by Section 3700 of the Labor ISSUE FEE
Code.fortheped«manceoftheworkfowhichthispermiisimued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
/I have and will maintan workers'compensation insurance,as required by Section 37004 to Labor Code.ler the performance of the TOTALS----> 54 . 50 0 , 00 0 . 00 54 . 50 54 . 50 . 00
\for which this permit is issued.My waken'compensation Insurance carrier end policy number are:
Carrier: ' Tr EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 , 50 OVER/SHORT: . 00
Policy Number. m m m m m m 05/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This'salon need not be completed r the Lerma Is for aria h rallniJ Afars IS1001 Drina.)
54 . 00
❑ d certify that in the performance the work for which this permit b I shell rot employany Woos rson In ane'manner so as to5 0
become subject to the workers'compensation laws of Cafdomia, •ree that if,I shdd become to the '
compensation Prows ofSean 37 [o�he{bor Code.l shall l comply/• Nose **************************df**********+l**********i4*4**********************4*****
Cates j 9 J Applicant: t f INDIVIDUAL F E E BR EAKDOWN
Warning:Callum tO secure workers'compensation coverage is unlawful,and shall subject an employer to atm/ penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars($104000),In addition to the cost of compensation,damages a pnvldad ler In
Section 3700 of the Labor Code,Interest,and attorney's leu.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency fa the SFR 2924 REAOOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2, 924 , 00
performance of the work for which this semi is issued(Section 3097.cis.C). END OF FEES
LENDER'S NAME:
LENDER'S ADDRESS:
I catty that I have red this application and date that the above information is cored.I agree to comply with an city end cony ordinances
end state laws
r•i to bang construction anhereby authorize dives ebc
d I" to enter upM the avementioned progeny
forinspection Wit•.. iiiiw
..//nn I✓—JJ�
, V
41, S ma Ny'
me: /Z/CIS 01 00131302-00181303 TOT 54.50
pnmure of OwnMAg pplcan vactr DATE: 05/12/95 TIME: 15:32
(5t51-46.WP) White-Building A Safey:Green-Fla:Canany-Appicant:Park-Revenue:Goldenrod-Assessor
ret
-t`- POC SPA
• CONSTRUCTION AND PLANNING,r
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, ❑ 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 "1 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final e
16. Rough Electric Wiring 67. Fencing & Access Approval. •
17. Rough Wiring Sign 68. APPROVED 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. 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 - (4-,7-15- 64. 6t 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 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
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING a-7--9/
"&
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
Applicant to fill in all spaces within heavy border tines and sign all appropriate declarations.
CITY OF't.^OSTA`MESA PF�M1 Q,_�� TRACT NO. LOT NO. BLDG.NO. - •
-
CONSTRUCTION PERMIT o _l 1F I f, I 1 /i / :o : T'
•
Project Address 153 Lexing ton, COS to Mesa TYPE OF CONSTRUCTION • . .
Owner Paul Warfield PhO3 /-1269 0 NEW 0 ADD 0 ALTERATION -
Address 153 Lexington • ❑ REPAIR 0 CONVERSION ❑DEMOLISH sf- }
LJ /� - ZONING REGULATIONS
Arch/Eng. License No.(5, ,lit l 0 OTHER r-�,, A P # — -- 1
Address
DESCRIPTION IPTION OF WORK e--c,® 1 n0) . -- ..
n^ f '� n ZONE PLNG. REF.q{
Contractor £�}�- Krdl ,CJn Phonfd4L-$'7,G�'VPE OF PERMIT BUILDING - 'TrOo 6g[t111L DING •
Adores Jps /,, SETBACK C/LST. PROPERTV LINE
J a2 .St . A rn-- JOrt reulh 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD
EFT
LICENSED CONTRACTOR DECLARATION ❑ TENANT 0 ELECTAICAL ❑PLUMBING ❑MECHANICAL/ SIDE YARD
I hereby affirm that I am licensed under provisions of Charter 9(com- /� /.�r RIGHT '
n
mencing with section 7000) of Division 3 of the Business and 0 OTHER ant f 5 -
Professions Co.e, and y license Is • - f. - .u. f - REAR TARO(TO P/L) ,
7 i / PROJECT DES ¢LPi ON •
�-L
.Licens ,_, P� ` (�J 5% • 7 PKG.SPACE REQ. PROVIDED
DM- • • Signature E . �i i .fi SQ. FT' n STREET WIDTH PARK FEE$
INORKERS'hhereby affirmf COMPENSATION has ON DEC !,e of• lwosent to self-insure ora OCCUPANCY VALUATION
Lr CONSTRUCTION ZONE TYPE .ZONING APPROVED BY 1 DATE
certificate of°/Workers' Compensati.n Insurance,}9-r a ceerr�rsf Tied copy
VALV ATION _
+roof
No c' ( ? k2tl Company 0 4-
/ t/`-'r P/f `-'-�� GRADING CU. YDS.• ACRES SPECIAL CONDITIONS:
Certified copy is hereby furnished. - REMARKS: r faQ V' , .
LA /Certified copy is filed with the city Building Division. - .
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section need not be completed if the permit is for one hundred _
($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 PLUMBING - PLAN CHECK '' ' • ELECTRICAL - PLAN CHECK
subject to the Workers'Compensation Laws of California.' UW tLLINro VAHAGE - -
Date Signature BATHTUBS SHOWERS Sri FT - SO FT - •
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW- - •
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER '
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS -" APPLIANCE 10-50 KW 50+ KW _ '
revoked. . .
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS •
"MOTORS 0-1 HP_1-10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP'50-+ HP -
fdrmance of the work for which this permit is issued (Section 3097 ,
Civ. C.). - - FLOOR SINKS FLOOR DRAINS ' - FIXTURES' OUTLETS SWITCHES' - '
Lender's Name '
—
Lender's Address DRINKING FOUNTAINS ' ' • .. GAS TUBE SIGNS - -' _
t.
OWNER BUILDER DECLARATION - INTERCEPTORS - • CLARIFIERS POLE LIGHTS . j
I hereby affirm that I am exempt from the Contractor's License Law for •••
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL - ' P TRAP - , LUNSI RUL I writ _ .
Any city or county which requires a permit to construct, alter, • - POLES METERED - SUB
improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION . PANELS MAIN - SUB .
quires the ap,Iicant for such permit to file a signed statement that he " • • -
Is licensed pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETS SERVICE AMP -
(Chapter 9 (commencing with Section 7000) of Division 3 of the -_ - • .
`'ness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT ' '
z� for the alleged exemption. Any violation of Section 7031.5 by - -
Wit.,
for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS '
firhot more than five hundred dollars ($500). - ,
❑ I, as owner of the property, or my employees with wages as their SOLAR TANK • COLLECTORS - - . '
sole compensation, will do the work, and the_structure is not intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. - . • ISSUE FEE • -
Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED BY DATE
who builds or improves thereon, and who does such work himself or ISSUE FEE
through his own employees, provided that such Improvements are not - —
intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES '
is sold within one year of completion, the owner will have the burden
of proving he did not build or improve for the purpose of sale). BUILDING /�HEATING SYSTEM 0-100,000 BTU S�
❑ I, as owner of the property, am exclusively contracting with AND DUCTING _ PERMIT E SMIP 'E
• PERMIT
and
contractors Lord to nthe sr Lice[ (Section e044t lness 100,000 + BTU PLAN CHECK $
and wn r of property.Code: The uidsorContractor's prov se hew tloes not apply to ISSUANCE E
oo of chprwho builds contractor(s)
improves thereon, and whoa ton- REFRIGERATION RATION 0-100,000 BTU PLUMBING E
tractsC from suchprojectswith a cont ra C[or(s) Iicesnetl pursuant to SYSTEM • GRADING S
the Contractor's License Law). 100,000+BTU PLAN CHECK $
❑ 1 am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $
$
reason - - MICROFILM $
SYSTEM REPAIR,ALTERATION PLAN CHECK $
Date Owner TOTAL FEE E
EXHAUST SYSTEM MULTIPLE MECHANICAL S
I hereby certify that I hay read tww application and state that the above LESS AD •
-
Information is torr ago comply with all city and county PLAN'CHECK $ VANCE PC E-_ _
ordinances and at a rel. to construction,and hereby authorize
representativ t ci to enter upon the above mentioned�s _
property fo on • r. // ��_/ ✓�
Signature Date'�!/CFINAL FEE $`_
Drivers'Lice a or 55 �� -�� _ - ISSUE FEE - .
CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNIN POOL&SPA
APPROVALS Permit# PI a9 Date , Inspector
APPROVALS -Permit# Date Inspector
1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location - - - -
2. Soil Pipe-Undrgrn 44. Steel Reinforcement--- - - - -
3. Electrical Conduit Utility-Undrgrn - - 45. Forms - - - - - -
4. Electrical Conduit-Undrgrn . _ 46.- Electrical Bonding ,_ - - - - --- - --
5. Steel Reinforce - - 47. Rough Plumbing & Pressure Ted - - . - . .,
6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE - - -
7. Footings 49. Electrical Conduit-Undrgrn • •
. 8. Foundation _ 50. --Gas Pipe, ❑Undrgrn;Test •
9. Water Pipe-Undrgrn . 51.. Backwash Lines, P-Trap;❑Undrgrn ' ' - • - - - -
10. _ Structural Floor System . 52. APPROVAL TO DECK - - '---. - . •'
11. Property Sewer Line & House'Connection - 53. Backwash& Receptor-Final - - -
12. . Street Sewer Connection - _ - . • 54. Heater& Vent-Final ' • . - • •
13. Rough Plumbing _ - - 55. -Plumbing System -Final - . . - -
14. Rough Electric-Conduit • -56. Electrical-Final ,-
15. Rough Electric-Wring - 57. Solar System-Final •
16. Rough Heating& Air Conditioning - 58. Fencing &Access Approval
17. Ducts, in Structure • 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating • -
19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing - .
21. Roof Sheathing • - -
22. Frame and Flashing _ NOTES:
23. Insulation
24. Lathing &Siding - -
25. Drywall Nailing
26. Plaster Brown Coat _ .
27. Electrical Power Meter-Final _ -
28. Final Electric - _
29. Final Heating &Air Conditioning
30. Final Gas Pipe-Test _
31: Final Plumbing _ _ -
32: Water Service-Final _
33. Gas Service-Final - - •
34. Solar Domestic-Final -
35. .Landscape Sprinkling System
36. Sound Attenuation - .- - - . '
37. Handicap Regulations - . .
38. FINALSTRUCTURE & BUILDING
39. Special Requirements Completed - • . .
40. Electric Release to Edison - . . -
41. Gas Release to Southern California Gas Co. .
42. CERTIFICATE OF OCCUPANCY -. _
No Date - -
27786 PAID
IUOV 13-67%SA00 530* ****90.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 02020
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
euILDINa _ y^ /,{v� For ONin Use Only
ADDRESS 1 1/�O'IL /�(T,LI¢
yy / RECEIPT NO. PERMIT NO.
COSTA MESA, CALIFORNIA
R[C[ Y pA76R/4%[d7
OWNER
San Vista Bldg. Co. '`I1//7/_ AI� G
BUILDING
ADDRBS! 7749 Wanderer Drive
ADDRESS // �y/-^
TEL- ZONE TYPIV onouP�T'/ (/(TI,J�
cure San Pedro NO. 833-3320
APPROVED DATE
ARCHITECT
RENGINEER Clif Olsten NO. 923-1221
ZONING
ADDRESS S 90254 E. Florence, DownL ////-� n - A 1—
ZOT PO.OF 2 U[[OP N[W;1 1 y L4_
Same p Z� PUW GUILDINO JIII/ 11 (XJ (AV^`
CONYSMGTOR -----i9YY f� r ^�4.� /'
LEGAL - I • 7 i 'izt SIO✓
ADDRESS Same DESCRIPTION •p• '
cm," Same A.P.NO. F- I —7°/ --3
NOTE, NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. SO'TO SIDE a REAR{+.L.
LIC.NO. NO,
/ EAVES
SIZE
n
OF LST '1O jc 1 O I NO pN LOT • ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF- MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
\ (FROM C/L STREET)
SETDACK LlN[mar FRONT (2 PT. PT.
CENTER OP STREET REAR YARD -
SIDE Y&RP LEFT RIGHT R.SIDE 0 PT, PT.
DESCRIPTION OF WORK L.HIDE b FT. PT.
NEW I/ALTERATION ADDITION REAR O �' FT. F
DISTANCE BET. BET.MAIN& Z
REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDOH.
BUILDING q �1 NO.or /..t--
BUILDING VAR.# �l ( � DATE / 6 t11
SIZE .,Lo
�C 1 (� ROOMS i STORUS!2 C.V.r.# (1( 7 APPROVED (v 0 ) CC
30- G7
EXTERIOR WALLROOF AFFRDVSD N DATE A.-9-. d
COVERING (31-1/4104 COVERING !Y l i
USE OF BUILDING 0 WORK/�T,O GS PERFO MED
I.
W
3 Y SQ.Fr. ! YDIO.
I HEREBY ACKNOWLEDGE THAT-I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER LUATION IS FOR THE O
ANDSTATE THAT THE OVn.IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. Q�
PLY WITH ALL CITY • NEES AND STATE LAWS R[OULATINS
BUILDING CONSTRU VALUATION D u.
OF A, PERMIT FEE IS O42� E 0
SIGNATURET , 1eA.� y'`-/
8 // /// PLAN CHECK S rRe� u
AUTHORIZED AGENT p n
TOTAL PEE S 9D/