HomeMy WebLinkAbout142 THE MASTERS CIR - Building Permits •
CITY OF COSTA MESA
-; BUILDING DIVISION
Fy .� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
a. arca FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER: E07-00703
PERMIT TYPE ELEC STATUS: ISSUED
DATE ISSUED: 07/30/2007
ISSUED BY: BJK
JOB ADDRESS: 142 THE MASTERS•CF•CM t '•I Suite/Unit: ' "
SCOPE OF WORK: REPLACEMENT OF A FAU AND DUCT SYSTEM AND INSTALLTIONOF A NEW 110,000 BTU FAU WITH ADDITION OF
NC(1 UNIT 3-15HP). NO OTHER WORK AUTHORIZED WITH THIS PERMIT. - .
•
OWNER: OLSTAD,ARTHUR C TR • ••.-Address: 142 THE MASTERS CIR "Unit:
PHONE: City/State/Zip:. COSTA MESA{CA ' -: '
APPLICANT: CASTELLAW,.REESE; .! - - Address: 4071 E LA PALMA AV Unit:SUITE P
PHONE: 714-630-5001 - City/State/zZip: ANAHEIM, CA
•
CONTRACTOR: THE AIR MAN - License No. 452901_ . -•
Address: 4071 E LA PALMA AVUnit: SUITE P - PHONE: 714-630-5001
City/State: ANAHEIM,CA ZipCode: 92807• - CELL:
ELECTRICAL PERMIT.FEES. . •
Electrical Plan Check Fee: . $0.00
Electrical Permit Fee: $78.00 . ••
Reinspection Fee • $0.00
•
TOTAL FEES •
$78.00
_ .
•
•
•
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.
CODE I INSPECTION TYPEDArJF IN1I1AL5 CODES INSPECTION TYPE, DATE INTIDALS
1616 Fixed System Final Fire Prevention - 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical d/is/o 7 f�y
201 ' Final Block/Retaining Wall 212 Final Fire Prevention /V1
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive nse. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self:Insure for workers' . Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performancepeorof the work for which this permit is issued.
LLy 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feel in depth into which a
number are: person is required to descend, will be made in connection with work authorized
Carrier: .S 7717e v !a _.ZNS• 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
(The section need not be completed rf the permit B valued al one hundred dollars(8100)or less)
2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number: -74-4/3 — C> 0/ S c
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
thew�F-r Code,I she orthwith comply with these provisions. Applicant's Signature Date
-ZJ/3 m p, Division of Industrial Safety Permit Number:
V
Applicant's Signature��� / Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No
Lic.# 7 2-9'0 / Class#_ C —� 0 (Section 25533 of the California Health and Safety Code, with some
?' /�o"0exceptioeachbusinns,ess requireswhich registrationat with the Costa Mesa Fire Department by
!/Lcs.�_ �_.�,r.,�•--�✓ y7 � any one time has on hand a quantity of acutely
Contractor's Signature Date 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
signature Date 4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑ No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
' 8 (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF.COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
• city ordinances regarding Hazardous Materials and Emissions.
❑ 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 Signature .Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
•
Signature of LegalOwnerts) Date
Signature Date
3057-46(3I07) (((
And/or Authonaed Applicant Date
r /
CITY OF COSTA MESA
BUILDING DIVISION
4��
1.141-.1111a_ � 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 M07-00441
•
PERMIT TYPE MECH STATUS: ISSUED
DATE ISSUED: 07/30/2007
ISSUED BY: BJK
JOB ADDRESS: 142 THE MASTERS CI CM Suite/Unit:
Vicinity: _
SQ. FT: 0
•
SCOPE OF WORK: REPLACEMENT OF A FAU AND DUCT SYSTEM AND INSTALLTION OF A NEW 110,000 BTU FAU WITH
ADDITION OF A/C (1 UNIT 3-15HP). NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
•
OWNER: OLSTAD,ARTHUR C TR'- • Address: 142 THE MASTERS CIR Unit:
PHONE: - City/State/Zip: COSTA MESA,CA
APPLICANT: CASTELLAW, REESE - Address: 4071 E LA PALMA AV Unit:SUITE P
PHONE: 714-630-5001 City/State/zZip: ANAHEIM,CA
•
CONTRACTOR: THE AIR MAN License No. 452901 •
Address: 4071 E LA PALMAAVUnit: SUITE P PHONE: 714-630-5001
City/State: ANAHEIM,CA ZipCode: 92807 CELL:
•
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $68.85 ,
PLAN CHECK FEE: $0.00
INVESTIGATION FEE: $0.00
REINSPECTION FEE: • $0.00
TOTAL FEES: $68.85
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 approvalwill result in the expiration of this permit.
CODE/ INSPECTION TYPE pAn INITIALS CODES INSPECTION nn DATE y INTIMAL
1616 Fixed System Final Fire Prevention 206 Final Mechanical 8-IS -0
1266 Pool Spa Final 206 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final-Site
•
204 Final Demolition 250 Final Building/Occupancy
• N
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivse. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the f g,declarations: Drivers License No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
[3�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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
STA 7z / by this permit,and that no building structure,scaffolding,falsework,a demolition
Carrier: ( oM/6 y/tJS• I uNZ2 or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
(Thisseabn need not be completed A the perm,'is valued at one hundred dollars($ 00)or less.)
2,Art 2,Sec.341,Title B,California Administrative Code).
Policy Number: o/ as o�
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California. and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
the -bor Code,I shall forthwith comply with these provisions.
r. /i' /oa Division of Industrial Safety Permit Number:
Applicant's Signature Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file
my license
,itstin� full force and effect. a registration form for acutely hazardous materials? 0 Yes ❑No
Lic.it CIL
't ?-moo/ Class tt C _ _2 a (Section 25533 of the Califomia Health and Safety Code, with some
a� � n ^ exceptions, requires registration with the Costa Mesa Fire Department by
n 4 C7,-- UL1+a+v 0/0�._ each business which at any one time has on hand a quantity of acutely
��ll
Contractor's Signature Dale 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the Califomia Health and Safety Code provides that the
Lender's Address: 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.
Signature X10 4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes".the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the Califomia Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No.
thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. • the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature of Legal Owner(s) Date
SignatureSignature • Date / o
0057-46 13/07) 7— And/or Aulhonzed Applicant Date!!
r` • J
Le 4-Et-777110. FSC
. / %esti 2,$ r &,mss (7a cLE
0- FA Q
pemiEL
far. v )• ^
11 APPP..OYEI) eL�T ��Ai✓
CITY OP Co'STA MESA (Nor To SCALED
PLANNING DI"ISION 1
S[4 BJ ECT TO B L l)G. DEPT. REG.
NOTE: ADDITIONS. DPI
OR CORRECTICNS SHALL P•E
APPI COVED BY THE PLANNING DIV.
4/C C 0 A/PENSER
A06-- DA E:7/ft SLR6 FST GRA OC
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
r .F COSTA a(pI�fp,I ESA nCONSTRUCTIO_N PERMIT P, IT NO.Q�� TRACT NO. LOT NO. UNIT NO.
roject Address l.Ja-(�P,rV1as�8r5 Lf r. s Main Building: Accessory Building:
Applicants Mail'•g A•.re55 TYPE OF CONSTRUCTION r NEW N ADD MI ALTERATION I� REPAIR
',���•�},� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER (��/nI a
Owner's Name d 1► . • IOW P one I DESCRIPTION OF WORK/USE OF BLDG. r'rOP {`G5( i't
Address.'. ; IA III �I / L _ 0_a(i. li '1 a
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION STRUCTURAL
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL s Left
Ow
Contractor's Name �� I L . V �/��L� R.I C • • 4✓t..4 A/ S ❑ OTHER
Ping. Ref. # Parking Req./Provided E
Address(mailing) • - u I/Ii GIICJ'1t it i ,I lid. i I PROJECT DESCRIPTION SQ. FT. OCCUPANC�',cr. a
CONSTRUCTION TYPE VALUATION $
b600 O�
City License No. 337 2.31 T
ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DECLARATION hale
I� �/, /��� 'y`'s1 .p `1��jA
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /car
I I 60a Sl ale o, ` L" •obi ''` • ' 00.
with section 7000) of Division 3 of the Business and Professions Co•e, and s'C.w V"
my license is in full f• c: .0• effect. `'I�/� �r(�,,L,, /� Q�/'� Y/ FEES
Lcen - • - - Y _i • _ o. / T1"Vlt a )IWI,LY/ C00 * . I* l
lh) Date a'i '••L Signature er%'! "•' ..+���� PLUMBING FEESAco : t a
1 WORKERS'COMPENSATION DECLAR•rIONBar Sink Showers
I hereby affirm that I have a certificate of consent to s- nsure ora certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter • to tt
amps
I 3800, Lab. �•) r �/� G' pp Dishwasher Eover• tt
PolicyNo-FVllYnflWn��p "' Company '' LtfU Backflow Irrigation Sewer Cap
Certified copy Is hereby furnished. �() Dryers ❑Gas ❑Electric
Cerliifi y led with the city Buil•i.t r. ' jor . Y" Bathtubs Sewer Connection
Date Applicant it__..--- Fan ■t ■
l .
EXEMPTION FROM WORKERS'COMPENe ATION DE•I-; RATION Clarifiers Solar Collectors
(This section need not be completed if the permit is for on- unfired ($100) or Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP
less). 016-15+
I certify that in the performance of the work for which this permit is issued, I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank
Microvvave ..
Workers' Compensation Laws of California. Pole Light
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes
NOTICE: If,after making this declaration,you should become subject to the - Outlets
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches
Sign
Standing Sections I. :
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.) Garbage Disposal
Lender's Name Interceptors Water Heater
Lender's Address _ Kitchen Sink Water Service Generator 00-5 KW ❑5-15 KW
Trash Compactor
OWNER BUILDER DECLARATION
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
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays
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 Drains
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of -
Division 3 of the Business and Professions Code) or that he/she is exempt • Reinspection Fee I $15 Issue Fee $ 3
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). DEVELOPMENT SERVICES REQUIREMENTS:
3
0 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ Zoning Approved By Date
compensation, will do the work,and the structure is not intended or offered •
for sale (Section 7044, Business and Professional Code: The Contractor's. MECHANICAL FEES Building Approved By ' Date
License w does not apply to an owner of a property who builds or improves _ ••__ -_.-- -- /
pin ' l
thereon, a d who does such work himself/herself or through his or her own ApplicationIssued By DdL
employees, ovided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. If, howe r, the building or improvement is sold within one year of Com- Canopy Type II ❑ SUMIVMY OF EES ,
pietion, 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 PERMIT $ .0 SMTP s
$ ' 0
LII, as owner of the property, am exclusively contracting with licensed con- t Refrigeration System PLAN CHECK $ PERMIT
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 a 00-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon. and who,contracts for such oroiects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that ■Exhaust System • Multiple ■ System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me.
ELECTRICAL $ GRADING $
❑ I am exempt under Section B. & P.C.for this reason . :• ■ Fire Dampers MICROFILM $
_ PLAN CHECK 50% $
Date OwnerH00-100,000
- e ■ Registers MECHANICAL $ .1A-1W
j
I hereby certify that I have read this application and state that the above , ■t •0t tit•: ■ ts,tst TOTAL FEE $
Ell
information is correct. I agree to comply with all city and county ordinances
In
information PLAN CHECK 25% $ ! a
and state laws relating to building const uction, .nd hereby authorize repre-
sentatives of this city to,
e t-r up • .y "entione• property for
inspection purposes. I !__._../ ,/ - • ■
Drivers' u•1'�
Goldenrod - Assessor J TE: 06✓2612? Tlukz 15 ;J(}
•
i\F , _. .'...>•I CONSTRUCTION AND PLANNING POOL &SPA
• APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pol r., ,,, 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 '
1 - .
6: Electrical UFER-GThd. 57. APPROVAL TO COVER-GUNITE
7. •Footings' - 58. Electrical Conduit-Undrgrnd. '
8. Foundation - , I r 59. Gas Pipe, 0 Undrgrnd.,Test ••
9.'Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. I r;
10:Structural Floor System I 1-.. 61. APPROVAL TO DECK
11. Property,Sewer Line & House Corinection ' - 62. Backwash & Receptor-Final •
•
12. Sewer Cap ,-' ' - 63. Heater & Vent-Final
13. Roof,Drains - _ 64. Plumbing System - Final .�
14. Rough Plumbing I 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final
1'6.� Rough Electric Wiring - 67. Fencing & Access Approval
:/ J
t•7. 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
120. 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 . - Oreftlin 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 "., 1 HEALTH DEPT. REQUIREMENT
31. Plaster'Brown Coat - r 79. FINAL INSPECTION
32. Electrical Power Meter-Fin-a; 80. FOOD CERTIFICATE ISSUED
33. Final'Electric Notes:
0.10r No acc,Fss FOR SrNOKE cwt.( �"
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. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System t_'
45. Sound Attenuation •
•
_ 46. Handicap Regulations •'"
47. FINAL STRUCTURE & BUILDING 7 Z3. ( abe -7_- q/ Steric J/ i /,'
48. Special Requirements Completed ! w'�� Gc�/! e//
49. Electric Release to Edison (O
50. Gas Release to Southern California Gas Co --i ,
-51. CERTIFICATE OF OCCUPANCY .
No. • Date --' ?.j '
314 ' PAID
FEB 20-700-Ts-TOO 609* *t*159.75
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
RECEI D BY 14.JlATF7 RECEIVED DA E ISSUED
BUILDING aK)j90 `7`)��
ADDRESS I4Z The Masters Circle �CJc
IF�- rry9RIA IT IBJ.
OWNER United Savings 8 Loan Assoc. A.P.N I /
MAIL BUILDING J f' to ende„
e„
Z ADDRESS 9800 S. Sepulveda Blvd. ADDRESS 7. /7, li(lj�j�
D O CITY Los Angeles, Cal i f. NNwui O`'670-7550 TRACT ca% LOT"y BLOCK
1— Z
Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVINn DFMnf ISH
OI- LENDER Owner 1/
0- 03
J r BRANCH
J N OWNER
ADDRESS \ �.
lTl•m ARCHITECT TEL. USE
��jr7LU§ lIJL4D• •�
JQ RENGINEFR R.J. Marvick No. 839-3840 J ✓ 1
U N V
FIRE
WCC ADDRESS 1538 N. Century, Santa Ana ZONE TYPE GROU13
it
CL IL APPROVED
cr). j—�9— 11.E
J O CONTRACTOR Ryness-Smith Co. BY (J DATE �/ C9
m
W¢ ADDRESS 140 E. Industry Ave.
Q
Uf TEL ZONE NO.OF Y USE OF NEvw
ZI- CITY La Habra, Calif. NO. 879-3111 t•a 4- A I PLANS BVILDINCp,4-'14
W0 STATE CITY YARDS APPROVED YARDS APPROV
C/)2 LIC.NO. 167538 LIC.NO. 1964 MAIN BUILDING ACCESSORY BUILDING
D O (FROM C/L STREET)
SIZE INO.OF BLOCS. /
OF LOT 43 x 102 NOW ON LOT w RONT t / FT. FT.
USE OF
���777
EXISTING SLOG. SIDE FT. FT.
I— SIZE OF NO.OF /
2 NEW BLDG. Z I OO ROOMS 7 STORIES 2 L.SIDE Ir. FT. FT.
Q EXTERIOR WALL ROOF 9
R
_0 COVERING StUCCQ _COVERING Wood Shake REAR (Q FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
CL C MAIN BLOCS. ACCESS.BLDGS. •
a Single family dwelling 8 two car VAR.# L�II_Yb 0,..7,„, DATE t /��
O 9 C.U.P.#�i& /5---{p 9 APPROVED l -.C,9
CO attached garage APPROVED / / A/J�) DATE a- fivpo
o Lot 39 Plan 6-A ll� w
UI hereby acknowledge that I have read this application and state .
D 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
f/J the State of California. / m
�({/ C y m
Z I hereby certify that I am properly licensed as a contractor under
`�- I�SQ. FT. J ///� O
the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 6i
Chapter 9, and that such licenses are In full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: l[
am exempt from the provisions of the State of California Business VALUATION ,S�
�s m
and Professions Code, Division 3,Chapter 9. r PERMIT FEE $ 1R/ Cl
Signature of /�/ / • �r D
Permittee :aa�� Sr, - r- .J.. / `�+r $
`/\ PLAN CHECK $ S �• "'^�• E
Authorized A en r / - / t 3 iI�VO\r\v , G/ LL
Ape', J TOTAL FEE $ / �/y ��