HomeMy WebLinkAbout114 THE MASTERS CIR - Building Permits 4`b9 CITY OF COSTA MESA
BUILDING DIVISION
>y ^ ..4r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
/IrrPERMIT
601-01168
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDIJob Address: 114 THE MASTERS CI Status: ISSUED
Suite: Applied: 07/26/2001
Vicinity: RESIDENCE&ATTACHED GARAGE Issued: 07/26/2001
Parcel Number: 11939104 Zoning:
Applicant: MC EUEN, DAVE ISSUED BY:
Address: 2428 NEWPORT BLVD#5
Phone: (949)722-8846
COSTA MESA,CA Zip: 92672
Owner TEBBS, CLAUDIA
Address 114 THE MASTERS CIR
Phone: 714-545-6638
COSTA MESA,CA Zip: 92627
Contractor THE ROOFING SPECIALISTS
Address: 2428 NEWPORT BLVD#5
Phone: (949)722-8846
COSTA MESA,CA
Zip: 92672 License: 734068
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF:T/O SHAKE ROOF,7/16"OSB, 1 LAYER 30#FELT,APPLY 30-YEAR COMP SHINGLES.
28 SQUARES
FEE SUMMARY
Plan Check: $0.00 •
Calc Valuation: $5,200.00
Permit: $125.25 Claim Valuation: $5,200.00
SMIP Res: $0.52 -
SMIP Corn: $0.00 •
Other: $0.00
Inspection: $0.00 •
•
Total: $125.77 .
„ 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 Existin : 0 Required: 0 Proposed: 0
NOTES:
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 Inepeetiona 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
2446-4(3(6/00)
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 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.
�X
My workers'compensation Insurance carri nd policy n ber are: ���^•''�� � ` ']
Cartier: S wallPolicy Number: (eS ' 6
(This section need not be cm .feted if the::rmit is valued et one hundred dollars($100)or less.)
❑ I certify that in the pe ormance of the w•rk for which ttigm_LellrlN.t• 's ,I shall not. •oy any••rson in any manner so as to become subject to the workers'
compensation laws• California,and ag 'e that if I should become to the work. 'comp: sation provisions of Secti 3700 o the Labor Code,I shall forthwith
complywith these pr•'visions.
Applicant Signature: C) I
Date: 7z L
WARNING:FAILURE TO SECURE '•-I -- .-- .. PENSATION COVERAGE IS UNLA` •LAND S ' UBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($iO0,000), •LION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACT•RS DECLARA •N:
I hereby affirm that I a licensed under•r• .sio of Ch ail
encing with S, Ion 7r.•)of Division 3 of the Business and P 'fess'.• ode,and my license is in full
Or force and effect.Lic.# 4 • t Class#
Contractor's Signature:- �w_� Date: Cra
6 err-
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the perfor . ce of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: _. Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
O 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:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers 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 ❑No
(Section 25505 of the Califomia 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 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 0 No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑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 Ouality Management District or from any other air pollution control district or agency? Yes 0 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
..r. control officer).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 COMPL CE AND • ORIZATION 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 comp with all state la s and city ordinances relatin• to building constnd authorize representatives of the City of Costa Mesa to enter upon the
nal*above-described prope'y for inspection pu.oses.I agree n� low occupancy f any b ing authorized by this permit until final inspection.
�ure Of :gal Owner(s) !D//I/�y//ft V t
r, A , 7/2LDate
CODE 0 JNSPECTION TYPE QAIE INTRIAL$ CODE INSPECTION TYPE QAI JNTmAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa FinalI• 208 Final Plumbing
�r/ D�
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
• 41:De: ..JI 1 // / shill Pr
AQ02 77 - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. " 41 62 5.0 i TI
CITU OF COSTA MEA CONSTRUCTION PERMIT _ / PERMI o. a 77!07 1 TRACT NO. LOT NO. UNIT NO.
•
Project Address (C 77/•2 isg/ C T aril S �/£44' r . - II
TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR
Applicant's Mailing Address /�
Owner's Name -d&.4 S4//T/-f Phone 2 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p Zone
/9- Th-0 47a T E-Rs e /�. DESCRIPTION OF WORK/USE OF BLDG. gAccessory Building:
AddressS Main Building:
E Z
Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION ❑ STRUCTURAL T Front - 0
Address ❑ TENANT 0 ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear N
•"J��
Contractor's 'n?D��
J -/ �ISTQ���-T/A l7 Phonez� �3' 7 y/ ❑ OTHER - - C Right N
p m%a PROJECT DESCRIPTION SQ. FT. OCCUPANCY_
Address(mailing) `� yl ����T 10 CONSTRUCTION TYPE VALUATION$ ' s Left
City License No. CO 41) S 3 L R
ZONE GRADING CU.YDS. • ACRES Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and .f
my license is in/ n)for e .nd effect. /]
f� Y o7 2 S
' ` License CI. s ` i 1 icense No l�/a •7
(Sr 'nate --` Signature Atrarart4E ii- _ - PLUMBING FEES
OR KERS'COMPENSATION DELLA RA`ON. Bar Sink Showers ELECTRICAL FEES
1 hereby affirm that I have a certificate of consent to self-insure or a certificate _
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
Automatic Washer. Transformer 0 15-50 KW
3800, Lab. C /// Q /
Policy No, / / /.(� Company S� Z� Backflow Irrigation Sewer Ca 0 50+KW
r P Construction Pole Sub.
❑.Certified copy s hereby furnished.
�1 •
Certi co y Is d vith the ci IItlIn9g Dlvii on. / Bathtubs • Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date 9'I ` , APPlica -,10/<�4-L 7r/c?o//
EXEIv1P ION FROM ORKERS'COMPENSATION DECLARATION Clarifiers . - Solar Collectors• - - i - Dishwasher •.1 -Meter Cover 100 amps- •
(This section need not be completed if the permit Is for one hundred ($100) or
less). ' Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 Drinking Fountains Solar Tank ,Fan Motors❑0.1 HP ❑i'c-8
Workers' Compensation Laws of California.
—
Date Signature ' Floor DrainsSwimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
'NOTICE: If,after making this declaration, you should become subject to the - _ - -
Workers' Compensation provisions of,the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. - - Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets II Water Closet Device Boxes .
I hereby affirm that there Is a construction lending agency for the performance Pole Light
of the work for which this permit is Issued (Section' 3097 Civ. C.) Interceptors Water Heater ��11 qC Outlets
Lender's Name - -.aC !/ Range
Lender's Address - Kitchen Sink - 'Water Service Switches
OWNER BUILDER DECLARATION - Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal 'Standing Sections
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap - Laundry Trays Generator 00-5 KW❑545 KW Trash Compactor
any structure, prior to Its Issuance,also requires the applicant for such permit
-, file a signed statement that he/she Is licensed pursuant to the provisions ofRoof Drains
e Contractor's License Law(Chapter 9(commencing with Section 7000)of
vision 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
enalty of not more than five hundred dollars($500).
• I, as owner of the property or my employees with wages as their'sole Reinspection Fee ' I $15 Issue Fee $ 3
-
-compensation, will do the work,and the structure is not intended or offered ' - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES •' .
License Law 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 DEVELOPMENTSERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ - -- Zoning Approved By Date •
Welton, the owner will have the burden of proving he/she did not build or im- Duct'Under Ground '
rove for the purpose of sale). Building Approved By Date
• I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System I Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code: - •
The Contractor's License Law does not apply to an owner of property who , Duct-Ventilating 00-100,000 BTU 0100,000 BTU - SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- ._tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof o// their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ PERMIT �'�y�rG
O I,am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING ' $ • 0 O ISSUANCE $ K�
Date Owner Heating System& Ducting Registers ` - PLAN CHECK 25% $ ENE RGY,P.C. $
I hereby certify that I have read this application and state that the above ❑0100,000 BTU ❑100,000 BTL • ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances •
and state laws relating to•blding construction, and hereby authorize repre- MICROFILM $
sentatives p tpis t /t• Enter upon the above-mentioned property fo PLAN CHECK 50% $
inspection,pyyt po / _
Signatures(/ �_ /
- Applicant; Pink -Accounting; Goldenrod - Assessor
'CONSTRUCTION AND PLANNING PC &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 UFER 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. 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 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 PREY. 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: 6--/3457 Later G4R0. L.Q.O
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 4124/17 Gil)
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
48. Special Requirements Completed •
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 except those within heavy border lines and sign all appropriate declarations. _ -
CITY OF COSTA MESA CONSTRUCTION PERMIT - – PERMIT NO. - TRACT NO. LOT NO. UNIT NO.
Project Address 111' Ti}E mios es Ci et1,1 € _Q 2-:31c1,2-. �,,{ �� l -80I 5/15/87 600 13 'TL
Applicant's Mailing Address TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION 1 ea' +r
❑ CONVERSION El DEMOLISH ❑ OTHER F A.P.# Zone
Owner's Name "� Srn 1'-fl4 Phone S4 ,I - I - '• -
JESCRIPTIONOFWORK/ EDF =LDG. a QSlp
Address es I - a - An' S. Main Building: • Accessory.Building: - .
Arch/Eng. - License No. - TYPE OF P:�•MIT I♦ GRADING ❑ FOUNDATION ��yy T ' Z
12--STRUCTURAL RUCTU RAL E Front Q
Address __._ - - /'1 _ _ _ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear . N
Contractor's Nam , o l MSA�IL�* +•h¢ b ❑ 'OTHER p .� C Right —
. N
Address(mailing) S I_O LC�1C ock pjujd- � PROJECT DESCRIPTION SQ. FT. OCCUPANCY__q K • G
/6Q_s/O'L�J-L� C O N ST RUCT ION TY)EWar- VALUATION Scp0 UGC $ Left
City License No. ZONE GRADING CU.YDS, ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided - E
0
I hereby,affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ♦ st•,. Planning Notes: NI
with section 7000) of Division 3 of the Business and Professions Code, and 1r1 r`lOs-S 'e 'R-0p0.(/� �h %I.,. •KtM
my license is in full fo a and effect. I ,,('� J 1 T
Lice Class License No? 33-7 C7 _ rAd"'i?Ai • S
Date P3'$) Signature "O • PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers '
I hereby affirm that I have a certificate of consen f-insure or a certificate • ELECTRICAL FEES
N. of workers' Compensation Insurance, or a cer • copy thereof (Section Backflow Preventer • Service Sink -
3800, Cab. C.) Automatic Washer Transformer 0 15-50 KW
NII:�\• Policy No.FS-3efru 3.a_ Company Lim,S4 Amer -I-he Backflow Irrigation - Sewer-Cap Construction Pole Sub. • 0 50+ KW
V` Certified copy is hereby furnished.
Cerlifietl.4opy 's filed with the city B Ivision. • Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date S•13 4-3 ' Applica
EXEMPTION FROM WORKERS' ENSATION •.a LA RATION Clarifiers $OIar,C011¢CLOrs - Dishwasher Meter Dover 100 amps - ._
(This section need not be completed if the permit is e hundred ($100)or • -
less). Dishwasher Sblar Piping Dryers OGas ❑Electric Sub Panel, •
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 Drinking Fountains Solar Tank Fan Motors❑0.1 • ❑1`h-S
Workers' Compensation Laws of California.
Date Signature - Floor Drains Swimming of w/Spa F.A.U. Inc.Solar G9-15 HP 016-15+
NOTICE:If,after making this declaration, you should become subject to the - - ,
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • - Urin Fixtures - - ' •
comply with such provisions or this permit shall be deemed revoked. N),icr•• ave tax 41.
CONSTRUCTION LENDING AGENCY . - Gas Service ,Outlets afar Closet Device Boxes • '
I hereby affirm that there is a construction lending agency for the performance 'Ole Light j
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Dutlets Range � •
-
Lentler's Name - _ - C?
Lender's Address -- _- - - -_ - -- Kitchen Sink Water Service Switches Sign •
' OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ',Standing Sections`-.
following reason (Section 7031.5 Business and Professional Code: Any city or '
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0.5 ' ❑5-15 KW Trash Compocctor
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 Roof Dra '^
the Contractor's License Law(Chapter 9(commencing with Section 7000) ofR. T
• 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 / — u; - •. ,
7031.5 by any applicant for a permit subjects the applicant to a civil I
penalty of not more than five hundred dollars($500). I 1' ^ 1
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 -•
compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $15 Issue Fee: A $ 3
for sale (Section 7044, Business and, Professional Code: The Contractor's MECHANICAL FEES' - •'
License Law does not apply to an owner of a property who builds or improves C`
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: _ .
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I
•
sale. If, however, the building or improvement is sold within one year of com- — Canopy Ty.• ' 0 Zoning Approved By Date _ • _
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale). / S'/���
O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refri•- .tion System Application Issued By '•pits..• ��,: w Date �_ ,
tractors to construct the project (Section 7044,Business and Professions Code: ((,�
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating •••0-100,000 BTU 0100,000 BTU SUMMARY-OF.F ES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware thati - BUILDING PERMIT $ '3 ff•� SMIP - $ 'S C.J
proof oftheir Worker's Compensation insurance should be provided to me. —Exhaust System 0 Multipl- System Repair/Alteration
PLAN CHECK $ 24 • /3 PERMIT •
0 I am exempt under Section B. & P.C.for this reason ' Firepl/Fact.Blt. ICBG Fire Dampers PLUMBING $ ISSUANCE $
Date - Owner Heating Syste Ducting Registers PLAN CHECK 25% $ ' ENERGY P.C. $
I hereby certify that I have read this application and state that the above ' - ❑o-100,a.; :TU 0100,000 BTL. • ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city.and county ordinances _
and state laws relating to building construction,and hereby authorize repre- ' PLAN CHECK 50% $ MICROFILM .$
sentatives of this city to enter upon the above-mentioned property for /����
•
inspection • rpos ; C_
-Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd,i 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undigrnd. 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, 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. 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 4./lt/R.-( W✓ 73. Undergrnd.Storage Tank OGas OOil
25. Roof Sheathing S/Zf/1t��` Gr/ 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 7 i
44. Landscape Irrigation System EXPIRED
45. Sound Attenuation Incomplete Inspections
46. Handicap Regulations ���'�
47. FINAL STRUCTURE & BUILDING Date •
_`�SI$
48. Special Requirements Completed
49. Electric Release to Edison - '13
50. Gas Release to Southern California Gas Co 'd
51. CERTIFICATE OF OCCUPANCY
No. Date
31424 •
COSTA MESA BUILDING-SAFETY DEPARTMENTFEB ?O-700 616•++ ***163.50
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 Cfl$d
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEI%ED B'I DATE RECEIVED Dq%TE ISSUED
BUILDING CTy r-11T/' a-/� / (/ . .2D--/
ADDRESS 114 The Masters Circle
PEfl IT NO.
OWNER United Savings 8 Loan Assoc. A.P. N . --------- -4IA94
BUILDING
MAIL ADDRESS ,/
ADDRESS 9800 S. Sepulveda Blvd.z
Lu ui /�T �J � ' //
a.c) CITY Los Angeles, Calif. NO. 670-7550 TRACT 65-0 E3 LOT / v BLOCK
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Z Q CONSTRUCTION NEb✓ ADD ALTER REPAIR MOVING DFMNI ISH
O- I- LENDER Owner Y./
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J7 BRANCH (� y / D
J N OWNER r✓I�w^/�/(( ^aA�'il�-_ C1-06 /Y1/
CO J ADDRESS '�/�//((�/ VALUE 'J J
J CO ARCHITECT TEL. - USE $�"�i /��
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UN OR ENGINEER R.J . Marwick NO. 8393840
w T ADDRESS 1538 N. Century, Santa Ana FIRE
ZONE TVP GROUP
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APPROVED VAth
J O CONTRACTOR RynesS-Smith Co. BY d , DATE 77 - •y.
CO fly
:cc ADDRESS 140 E. Industry Ave. t
W W TEL. ZONE NO.O USE OF NE /1 /
Z 1- CITY La Habra. a l i f. NO. 879-3111 h 0- ,---A i PLANS BUILDING 4o- Wr fa�
w- O STATE CITY YARDS APPROVED YARDS APPROV D
NCC LIC. NO. 167538 LIC. NO. 19f4 MAIN BUILDING ACCESSORY BUILDING
0 O (FROM C/L STREET)
SIZE NO.OF BLOCS.
OF LOT 43 x 1 1 0 NOW ON LOT - FRONT ((A-FT. FT.
USE OF 3
EXISTING BLDG. R SIDE FT. FT.
H SIZE OF NO.OF ' I
Z NEW BLDG. 2165 ROOMS 7 STORIES 2 L.SIDE `I FT, FT.
Q EXTERIOR WALL ROOF ^^ /',1I
C.) COVERING Stucco _COVERING Wood Shake REAR TV FT. FT. '
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
CL 1 MAIN SLOGS. ACCESS BLOCS.
Q VAR.# L L�4 " DATE l0 b
O Single family dwelling 8 two car C.U.P.# ZC/} -6 / APPROVED �!%'
I- APPROVED OV
Z attached garage -.--ELY �y A DATE V?P
p Lot 46 Plan 4-D /
UI hereby acknowledge that I have read this application and state
O that the above Information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I- any person in violation of the workman's compensation laws of
1q the State of California. Qj SO. FT. CO m
ZI hereby certify that I am properly licensed as a contractor under / �/ o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UN VALUATION IS FOR •
Chapter 9. and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISH G A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business CC
and Professions Code ivision 3,Chapter 9. VALUATION
PERMIT FEE $ //D�/7 Q J itn
/ D
Signature off S� E
PermitteeSO$ /{1 PLAN CHECKS V E
%Cys i 3 13�, - )4 a-
Authorized Agent a
TOTAL FEE $ ,