HomeMy WebLinkAbout2985 TEAKWOOD PL - Building PermitsSTOLP RESIDENCE
2985 Teakwood Place
Costa Mesa, CA 92626
E0 (� - 60651
RESIDENTIAL ELECTRICAL LOAD CALCULATIONS
(Single Family Dwelling)
12/10/2008
Air Conditioning kVA Calculation
21 A x 240V/1000 = 5.04 kVA
General Load
1500 sq ft @ 3 VA
4500 VA
two 20amp small appliance circuits
3000 VA
iaundry circuit
1800 VA
garbage disposal
932 VA
dishwasher
750 VA
one oven
2700 VA
vent fan
600 VA
microwave
1450 VA
Jacuzzi
5280 VA
21,012 VA
First 10 Kva @ 100%
10,000 kVA
remainder @ 40%
(11.01 kVA x 0.4 x1000)
4404 kVA
Subtotal General Load
14,404
Air Conditioning
5040
23,848 VA/240 V = 90A (service rating)
CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754.5626
PERMIT NUMBER: E08-00051
PERMIT TYPE ELEC STATUS: ISSUED
APN: 13921227 DATE ISSUED: 02/12/2008
ISSUED BY: RMD
JOB ADDRESS: 2985 TEAKWOOD PL CM Suite/Unit:
Vicinity:
SCOPE OF WORK: E(ECTRICAL PERMIT FOR THE INSTALLATION OF 2 OUTLETS AND 1 SWITCH FOR ANEW A/C UNIT AND
REPLACEMENT OF (E) FAU (ENERGY STAR QUALIFIED UNIT WITH A SEER OF 14) FOR A SFD.,
OWNER: STOLP, THOMAS
PHONE: 714-469-4033
APPLICANT: DOMINGUEZ, ROY
PHONE: 714.901-noo
CONTRACTOR: A PLUS HEATING AND AIR CONDITION
Address: 7600 GARDEN GROVE BLUnit:
City/Slate: WESTMINSTER, CA ZipCode: 92863
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $26.80
Reinspection Fee $0.00
TOTAL FEES $26.80
Address: 2985 TEAKWOOD PL Unit:
City/State/Zip: COSTA MESA, CA
Address: 7600 GARDEN GROVE BLVD Unit:
City/State/zZip: WESTIMINSTER, CA
License No.
PHONE:
154
VWE
pER�
EXPIRES-=
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
CODEC. INSPECTION TYPE DATE INTMALS CODEC INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final _ 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical IT -
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
WORKERS' COMPENSATION DECLARATiu...
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.
❑ 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' compensation Insurance carrier and policy
number are:
Carrier: ��1,<iCi�/I s4% n.0 c� Co
(This cistern need rrolrrol oecrrom/ple�etl RNe p/er�mRa value)al one huntlretl dollars(75100)orless.)
Policy Number: iiy )L Tloi r� �%? Fs— 4 l
❑ 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 if I should
become subject to the workers' compensation provisions of Section 3700 of
the La�b%g�ode, 1 11 forthwith comply with these provisions.
�nt's Si pure , Dale
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF 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. H
L_ic. # L Class # - O` fQ
CAftractor's Sigryi !. - 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:
Lenders Address:
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.).
❑ 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:
Owner ID verified by . pr's IILL
Driver's License No.
❑ Yes ❑ No
Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 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, a 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.
Applicant's Signature
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? ❑ Yes ❑ 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 ❑ 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? ❑ Yes ❑ 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 permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ 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? ❑ 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? ❑ Yes ❑ 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 slate 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
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
gnature of Legal Owners) _ Date
Signature Date
3057-46(3/07)
And/or Auth sd Applicant Data
l2--
Eb Y- ons
W- 000`+(,.0
M O Y- boo 2S�
J. m p2 -C
cIaN 6 2 &
C A -L
7/v X01-05-00
CITY OF COSTA MESA
F BUILDING DIVISION
r 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
r
FOR INSPECTIONS CALL: (714) 754-5626
�O�vne fi
PERMIT NUMBER: P08-00046
PERMITTYPE PLUM STATUS: ISSUED
APN: 13921227 DATE ISSUED: 02/12/2008
ISSUED BY: RMD
JOB ADDRESS: 2985 TEAKWOOD PL CM
Vicinity:
Suite/Unit:
SCOPE OF WORK: PLUMBING PERMIT FOR 1 GAS (1-4 OUTLETS) FOR ANEW A/C UNIT AND REPLACEMENT OF AN (E) FAU
(ENERGY STAR QUALIFIED UNIT WITH A SEER OF 14) FOR A SFO.
REF#: M08-00025
OWNER: STOLP, THOMAS J Address: 2985 TEAKWOOD PL
PHONE: City/State/Zip: COSTA MESA, CA
APPLICANT: DOMINGUEZ, ROY Address; 7600 GARDEN GROVE BLVD
PHONE: 714-901-0500 City/State/zZip: WESTIMINSTER, CA
CONTRACTOR: A PLUS HEATING AND AIR CONDITION License No. 763154
Address: 7600 GARDEN GROVE BL PHONE: 714.901-0500
City/State: WESTMINSTER, CA ZipCode: 92863 CELL: Y
ARCHITECT: License No. _ rPHONE:z=_
ENGINEER: License No. % \ , -PHONE:
PLUMBING PERMIT FEE SUMI1Qh"`�jSI®N
PLAN CHECK FEE: $0.00 LO All
i� +� 7
PERMIT FEE: $29.65 S lFl ii�
TOTAL FEES: $29.91, 3/�
EXPIRES
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
OE I.
INSPECTION TYPE
1616
Fixed System Final Fire Prevention
1266
Pool Spa Final
200
Final Re -Root
201
Final Block/Relaming Wall
202
Final Factory Fire Place
203
Final Sign
204
Final Demolition
DATE INTmALs
CODE f
INSPECTION TYPE
206
Final Mechanical
208
Final Plumbing
210
Final Electrical
212
Final Fire Prevention
220
Final Planning Approval
222
Final Site
250
Final BuildingrOccupancy
��DAT �Q �I�NTITTIIAALLS
`� OL � I_��
1I
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.
❑ 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' compensation Insurance carrier and policy
number are:
fTlvs sertm needraf be mmyeted Jl�he/p/eyrm,) us va/uee of w9e nurgrM dol ars (SIM) or fess.)
Policy Number:
❑ 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 if I should
become subject to the workers' compensation provisions of Section 3700 of
the Lab Co1 shall forthwith comply with these provisions.
/Z [57- 5 -/ e ,-�-
V / Applicant's Si fe Date_
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF 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. R
Class 4
antratlor's Si t re
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
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.).
❑ 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 tices 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
3057-46(3/0)1
Date
Owner ID verified by driver's licc. . []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:
❑ 1 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, a demolition
or dismantling thereof, will be more than thirty-six (36) feel 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.
Applicant's Signature
Division of Industrial Safety Permit Number:
Date
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? ❑ Yes ❑ 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 ❑ 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? []Yes ❑ 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 permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ 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? ❑ Yes ❑ 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 comect. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
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
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
ature of Legal eds) qOI GateAV
A �1—� /O'- �r✓U
AndAwlM1pnzetl Appiradint /-Gate
V_
ADDR1 2985 TEAKWOOD PL UNIT:
K'SNAMt. STOLP, THOMAS J
ADDRESS: 2985 TEAKWOOD PL
COSTA MESA,CA 92626
ARCHIENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: PETRONELLA ROOFING (714) 548-1645
ADDRESS: 2626 NEWPORT
COSTA MESA CA 92627
LICENSED CONTRACTOR 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.
CITY uc.: 260. STATE uc.:004607 CLASS: '
Adte: Z Signatur
WORKERS' &OMPTICRAMN DECLARATION: that y alfir at I have a cedificate of consent to self -insure or a certificate of Workers'
Compensation Insurance. or a certified copy Ther Ion 3800 Lab. C).
^gLICY NO.: PWC 115706 EXP. DATE: 12/01/94
OMPANY: GOLDEN EAG3aE
J Conflict copy is hereby furnished % Certified copy is filed with the city Building Division.
Date: 2' Applic �'fir
EXEMPTION` MWORKERS'COMPENSATION DEG ATI +(I hle section need not becompleted fund permit later one hundred ($10o)or less).
I cer ity that in the performance of the work for whi is permit is issued, I shall not employ any person in any manner so as to become
subject to the WorkersCompensation Laws of California.
Date'. Signature'.
NOTICE: If atter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or This permit shall be deemed revoked.
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 (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed
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
any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500).
I, as owner of the property or my em loyees with wages as their sole compensation, will do the work, and the
13 structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors State License Law
does not apply to an owner at a properly no 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
for the purpose of sale(.
I. as owner of the progeny, am exclusively contracting with licensed contractors to construct the project (Section 7044. Business
11 and Professions Code: The Contractors' Slate License Law does not apply to an owner of pmperry who builds or improves thereon
and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Date: Owner
I do hereby termly 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
permit for construction or modification lead the Air Quality Management District. Residential construction applications are exempt from
these provisions
Dale: Applicant'.
I hereby certify that have read this applicalion and state that the above information is correct. I agree to comply with all city and county
ordinances and state laws relating 10 building construction and hereby authorize representatives of this city to enter upon the above mentioned
propertyfor insp ction purge es.
D3 e' �� Si nail
/Dri'ver's I icruse or Snnal Securifv k
Applicant, Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06505£
PERMIT NO: B 065058 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/OF S REROOF W/COMP. SHINGLES SQ FT: 3,996
CLAIM VALUE: 3,996,00 CALC—VALUE: 3,996,00 GROUP OCC: B-2 /
COMMENTS: SMOKE DETECTORS ARE REQUIRED AS PER 1991 U.B.C.
Z O N I N G S E T B A C K S R E Q U I R E M E N T S
------------ MAIN BUILDING ---------- ---------
ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT:
FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT:
FT IN RGHT; FT IN
PARKING REQ; PROV: PARCEL: 13921227
ZNE: REF NO:
PLANNING NOTES>
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ZONING APPROVEDS BY
DATE:
BUILDING APPROVED BY
DATE.-
ATE;APPLICATION
APPLICATIONIS§UED BY:
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if iE yE if*fE%iE>E iE iE 3liEiE*iE BE jE ah i4 aE BF iE ie1H*9E jE iE iE if iE iH Bf*af iE if iE is iE iE if iE iE if iE BE if yE
3E if aE MY ie Bf ie eH iT eE TE 4E jE 4E of ek iE' TE *Bf: of iE ie 4e iE Bh
LEGALIZATION:N F E E S U M M A R Y
STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
FIRE SMIP/RES GRADING
PERMIT 63,00
50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTAL PAID DUE
TOTALS ---- > 63,50 0.00 0,00
63.50 127,00 —6.3.50
REVENUE DIVISION TOTALS--> COLLECTED: 63,50
OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
SMIP/TOT GRADING PLAN—CHECK
63.00
.50
!E iE iE *!e IE iF a(-iE Be if if iE BE if iE * iE iE iE 4e ie iE 3E 1E # * 3c of aE iE 9(- lf iE iE iE * * ie if aE !E is iF iE BE 4F 4E i(� iF
iE 1H aF ie eE BF iE ie iE !e if * jf ie � jE eF i(- iE Y' a%9E aE iF iE aE * jH iF
I N D I V I D U A L F E E B R
E A K D O W N
TYPE QTY D E S C R I P T I O N
UNIT COST TOTAL COST
SFR 3996
REROOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
SMOKE DETECTOR
R,ECNd1IRi®
1,00 3,996.00
01 00151295-00151296 T'CIT 63.50
DATE: 11/24/93 TIME: 14:50
i CONSTRUCTION AND PLANNING
h. APPROVALS Permit #
Date
Inspector
PL . & SPA
-
APPROVALS Permit #
Date
�-
Inspector
1, Temporary Electrical Service or -Pole
�2. Soil Pipe-Undrgrnd.
52. Pool & Equipment Location
53. Steel Reinforcement
3. Electrical Conduit Utifity-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd, 7'
55, Electrical Bonding
5. Steel Reinforcement
56, Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
,
8. Foundation
59. Gas Pipe, O 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 -Fina!
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. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70, Underground Hydro
22. Ducts, Ventilating
71. Product Piping El Gas I00il
23, Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank ❑ Gas ❑ Oi!
25. Roof Sheathing
26, T -Bar Ceiling (Structural) & Monocoat
3rd_
^ppp ��'
/ 174.
Overhead Hydro
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
11
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUEDr'.
33, Final Electric
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
i r=
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
P'
48. FINAL PLANNING
`" i
49. Electric Release to Edison
50. Gas Release to Southern California Gas Go
J
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER HOMES VALLEY, INC. DATE 7_9_5,9
JOB ADDRESS 2985 Teakwood P1. BUILDING PERMIT NO. 9855
GENERAL CONTRACTOR Dike & Colegrove, Inc. VALUE $ 15.571.00
AP. No. LOT 223 TRACT 2822 FIRE ZONE DESCRIPTION OF WORK ReS. watt. ear.
INSPECTIONSx_27 S�
DATE _I
GROUP I & J TYPE V ZONE RI
Underground Soil /t/}/"j U.G. Water/*"15
J-7.Gi-5
SUBCONTRACTOR
PERMITS
ISSUED
r round Gas
DATE
NUMBER
C= ,iead Water and Gas
Rough Heating
Rough Plumbing S
W -9-Y-$9
_
la
Miscellaneous
Prop. : Line' Ho Con. St. Swr.
21 C4
//L�.'ti,r(T f'._
7 0 5 C/
1 �" G % ✓
Sprinkling System
Heating, Final
Plumbing Fixtures i
♦9' .Cw
Final Gas Test
Construction Pole
Underground Power
Rough Wirin / �S
��iti
i A n I A
trxhn ' Formsj
Floor System
Steel Reinforce Chimney Re -Rod
Bond Beam
Sheathing
z -97
Frame and Flashing
Lathing, In,
PI 4:"; brow coat �ipI1L�-
�r -d'
q-1-
,*
Phi- ",.'ng Fixtures, Final
4iT
Electric Fixtures Final
Building, Final
OCCUPANCY
I
Form 410-3M-4-59
9 55
9855
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA, CALIFORNIA
fOR APPLICANT TO f/LL /N COMPLETELY
TYPE OR PRINT
ADDRESS 2985 Teakwood Place
COSTA MESA, CALIFORNIA
JUL 13 1959
C!'MANCE DEPT.
APPLICATION FOR PERMIT
BUILDING
MR OffiCE vsE ONLY
omeCJ Valley Inc.
RECEIPT NO. PERMIT NO.
OWNER ✓
MAIL c�
ADDRESS 419 E. 17th St.
CEIVED BY DATE RECEIVED 46
I — -5-2 I --2 ,5 C•
Costa Mesa TND. LI81159
B GILDING
CITY
ADDRESS
ARCHITECT Carlson & LIC.
COSTA
MESA, CALIFORNIA
OR ENGINEER Ili
I dtillSu-_,, ,,t- NO.
Garden Grove
FIRE
ADDRESS
ZONE
Dake & Colegrove, Inc. STATE 167293
APPROVED
CONTRACTOR LIC. NO. ]J
BY
DATE
/�
419 E. 17th St., Costa Mesa.
ZONING
ADDRESS
LEGAL
(LOT
22
I
ZONE
NO. OF
(PLANS
USE OF NEW
(BUILDING
DESCRIPTION
NO.
BLOCK
TRACT
WJI
APPROVED
-
A.P. NO.
BY
DATE J
SIZE LO JC 1 5
NOnOn. of BLDCS.
YARDS
EVES
OF LOT O 1,1.
ryow ory LOT
REQUIRED
ALLOWED
USE OF
(CENTER LINE ST.)
EXISTING BLDG.
FRONT D
FT. IN.
SETBACK LINE FROM
46!
50l
CENTER OF STREET REAR YARD
R. SIDE
FT. IN.
SIDE YARD I LEFT 51
(RIGHT 51
L. SIDE
FT. IN.
DESCRIPTION OF WORK
REAR
FT. IN.
yI�
NEW i
ALTERATION I
I ADDITION
REPAIR I
II MOVING
II DEMOLISH I
BUILDING
1 �^ NO.OF
1
SIZEROOMS STORIES
W
EXTERIOR WAL4
ROOF rock
COVERING 9T.11'C.
COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
S' Dle
attached garage.
1 HEREBY ACKNOWLEDGE THAT I 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 STATE LAWS REGULATING
BUILDING CONSTRUCTION.
VALUATION
SIGNATURE OF
PERMIT FEE $ 35.00
PERMITTEE
$ 15,571
PLAN CHECK $ 17, 50
TOTAL FEE 5 52*50
AUTHORIZED AGENT Dike & Colegrove, Inc.
�WNER HATCH, Dg B. DATE 4-11-78
J,JOB ADDRESS 2985 Teakveod Place BUILDING PERMIT N0. 45789
P No. 119-212-27 LOT 223 TRACT p8pp FIRE
N a,�. TIONS Signature Date
ZONE VALUE E
TYPE v GROUP ZONE
o-"-_'
SUBCONTRACTOR
PEP M 5
AS
VANumber
DataSi nature
iER
Plum bin
ROUGH PLUMBING
PROP. SWR. LINE HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER
ROUGH WIRING
Heatina and Vent.
TRENCHES U FORMS 0 STEEL REINF. Lj
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
PLASTER, BROWN COAT
STRIIrTURAL, FINAL
HE 1. VENT., REFRIG. AND A.C., FINAL
PLUS dING. FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL i
�J789
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
GILDING n p p
)DRESS � 'gyp[ / tl �5 /t' �)^(t+V"iJ h
JNER
CITY
BRANCH
ADDRESS
TEL.
NO.
ARCHITECT TEL.
OR ENGINEER NO.
moc
8948 4/11/78 10,50 TL
AP]ILIg4ION FOR STRUCTURAL PERMIT
DATE s' —//@�rc[J
USE OF NEW
BUILDING
YARDS APPROVED
DATE
APPROVED
A L A PERP
WOMIVE
PLAN CHECK $
TAX $
TOTAL PAID $
5
m
i
m
m
N
ON IS FOR m
FEE O
m
m
0
LL
U
CONTRACTOR {/(/
DATE RECEIVED
O E I SU
-E �}
' L7
PERMIT NO.
1t z -,-'f
ffeA
TEL.
LO ''
BLOCK
W
A P
'/� I
OWNER I ,10-' R /-/"
V �)
S ti $ t17/
DATE s' —//@�rc[J
USE OF NEW
BUILDING
YARDS APPROVED
DATE
APPROVED
A L A PERP
WOMIVE
PLAN CHECK $
TAX $
TOTAL PAID $
5
m
i
m
m
N
ON IS FOR m
FEE O
m
m
0
LL
U
CONTRACTOR {/(/
BY
ADDRESS
TEL.
ZONE
NO.OF�J
PLANSZ
CITY NO.
F
STATE CITY
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
W
SIZE
NO. OF BLDGS.
(FROM'C/L ST EET) „
d
OF LOT
NOW ON LOT
gONT
Q
USE OF
EXISTING BLDG.
ti
FSeparate
permits are required for
L. SIDE FT.
50
electric, plumbing and heating work.
IM
REAR FT.
I.W.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
<
MAIN BLDGS.
Q
Nr
VAR. •,$
C.U.P.*
0!9Y)
APPROV
^
Y�
}
G I O C
By
�i
w
a
0
I hereby acknowledge that I have read this application and state
(Y,
that the above Information Is correct and agree to comply with
0.
all laws regulating building construction, and I shall not employ
W
any person In violation of the workman's compensation laws of
the State of California.1*6
3
1 hereby certify that 1 am properly licensed as a contractor under
SO. FT.
THE AMOUNT SHO'
the State of California Business and Professions Code, Dlvislon 3,
Chapter 9, and that such licenses are in full force and affect, or I
THE PURPOSE OF ES
am exempt from the provisions o the State of California Business
and Professions Coda, Division hapter 9.
VALUATION
Slgnattee of
Permittee
$
Authorlx Agent
DATE s' —//@�rc[J
USE OF NEW
BUILDING
YARDS APPROVED
DATE
APPROVED
A L A PERP
WOMIVE
PLAN CHECK $
TAX $
TOTAL PAID $
5
m
i
m
m
N
ON IS FOR m
FEE O
m
m
0
LL
U