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HomeMy WebLinkAbout174 THE MASTERS CIR - Building Permits �,'i .j v CITY OF COSTA MESA ` BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER ; :PERMIT .. • B05-00718 . (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.cau�LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 174 THE MASTERS CI BUILDING Status: ISSUED . _ Suite: Applied: 05/05/2005 Vicinity: ROOF Issued: 05/05/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 11939119 Zoning: Applicant: WETTENGEL, LEE GLEN - Address: 7861 LIBERTY AV - - ISSUED BY: Phone: 714-224-6506 HUNTINGTON:BEACH;CAJ ) Zip: 92647 i Owner: ORR, IT/JAMES = Address ".174 THE MASTERS'CIR- Phone: COSTA MESA,'CA1 J - Zip: 92627 ,. ;,r Contractor: OWNER;BUILDER ' Address' ' �-i Phone: ,License: 000000 Eng: Address: - -Address: "Phdne: Phone: • Zip: r License: License: 1 :' Ti " SCOPE-OF PERMIT • - TEAR OFF EXISTING ROOF. INSTALL 2-LAYERS OF 30#FEL,50-YEAR COMPOSITION SHINGLES,AND REPAIR/REPLACE SHEATHING AS NEEDED.2,300 S.F. INCLUDES ATTACHED GARAGE. " - - -'FEE'SUMMARY • Plan Check: $0.00 • - - _ Calc Valuation: $11,000.00 Permit: $195.25 1:r ' Claim Valuation: ' Sit,000.00 SMIP Res: $1.10 - SMIP Corn:. $0.00 - Other: $0.00 Inspection: $0.00 • - Total: . $196.35 • . 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" X0;0: PARKING Existing: 0 Required: 0 Proposed:—" 0 . NOTICE: The work authorized by this permit shall-comply with.all applicable handicap access requirements.under California statutes and related regulations.(Ord.No.-92-28,j 1, 12-21-92) EXPIRATION: Thispermitshall.automatically.expire,and.become void ifworkisnot commenced within 180 days;or ifworkis suspended or abandoned for of 180 days. INSPECTIONS: In order for the-work authorized under this permit to be consideredaegal,;such work must comply with all.applicable codes, and all .required-Inspection/and final:approval must be obtained?Failure to obtain inspections andfinalapproval-will result in the expiration.of this permit. "FOR INSPECTIONS CALL: (714)'754-5626 2446-46(6/00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 7 - • ❑ 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: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) -❑'I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,an agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provision?, 1 Apo licant.Signature:— i k. 1,1 MA, .eir .� Date:_ S 'S-2� THOUSWARNIAND DOLLARE L ($l OUR),WORKERS'COMPS ASO COMPENSATION, IS UN,DWFUL AMAGES AND SHALL FOTR I AN EM u0Y36 OF THE AL PENALTIES AND FINESATTORNEY'S N ONE'SHUNDRED, THOUSAND DLARS($100.aW),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF 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.LIc.x Class it Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: . O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors 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 driver's license. ❑Yes 0 No Driver's License No. _ _ Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑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 then 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 en 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ 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? 0 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 state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signatu eaat = rr;l) .er(s) 7 AOd/Orr_uthorized Applicants-^ Dale • CODE Y INSPECTION TYPE . . ' "' PATE ' INTRIALS .CODE# INSPECTIONTYPEDAFT INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 2(22-'0 210 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 DECLARATION OF AUTHORITY Bldg. Permit#....:13:505-rin 1 FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS This Permit# +�I/f� �AI� nI�� ��� � �an Street Address: I I`7 I r� liUac "'A °ALL- AP Number: 1.` I (we), _� • C� ,Lt2�l • . lY " , declare that I am the Owner of Title of the above referenced+ ,The:real property,and that II (we))hereby authorize: Name: I LUI7 b�1_- Telephone Number: (7/71) 22�// - IOC Street Address: 1I I SZ a)O c1h21 City: ODOIA& State: J Zip: to obtain permits in my behalf,as owner/builder,for • at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa,as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. Executed this day of 20 , at , California. Pnnt Name: ____--4010101114 401010111/ . C,6 Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attomey to secure this permit in any behalf. • • 077946(rev.11/00) (,`'�MF q CITY OF COSTA MESA }a • BUILDING DIVISION �-��', ' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER °•a PERMIT P00-00032 ebtiosimo (714)754-5273 • Fax(714)754-4856 - 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 174 THE MASTERS CI Status: ISSUED Suite No Applied: 01/18/2000 Issued: 01/18/2000 Vicinity: SIDE/REAR YARD AREAS Parcel Nunmber: 11939119 / ISSUED BY: /! Applicant: MIKE EVAN'S Address: 1720 WHITTIER Phone: (949)646-1185 COSTA MESA,CA Zip: 92627 Owner: ORR, T JAMES Address 174 THE MASTERS CIR • Phone: COSTA MESA, CA Zip: 92627 Contractor: EVAN'S PLUMBING INC - Address: 1720 WHITTIER Phone: (949)646-1185 COSTA MESA,CA Zip: 92627 License: 498867 Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT INSTALL TWO OUTDOOR GAS OUTLETS,ONE FOR A OUTDOOR BBQ AND THE SECOND FOR A OUTDOOR COOKTOP,SUBJECT TO FIELD INSPECTION. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $6.15 1 Sink,kitchen $0.00 0 Water Softener $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS 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 q� work for which this permit is issued. A. 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: Policy Number: (This section need not be completed it the permit is valued of one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califor ia,a agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith a comply with these p Ion Applicant Signature: `-'c- Date: /— (t O 6 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 DOLLARE(5100.000).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.Lic.a •99S' 107 Class# C'3 eta J Contractors Signature: ar /T Ciz Date: j— / `6-6 6 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors 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: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reposed 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 ❑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. is equ.. Sectio the ._...a __.---- ....fully. ....ith.... ... ....... ............. .--....--..... .----..-..- 4 If an RMPP presently required,has Section 25534 of Californiaa Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes LJ 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? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 if a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 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 state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ,r/�� ure eget Owners) Date And/Or Authorized Applicant • Date CODE I INSPECRONTYPE PATE 1NTRIAL6 COPE II INSPECTIONTYPE pita INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical o'v 1266 Pool Spa Final 208 Final Plumbing 02/9/tt d,g17.5.�r 200 Final Re-Roof 210 Final Electrical ( /VI 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 2446-46 9059 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA P MIT NO TRACT NO. LOT NO. BLDG. NO. - CONSTRUCTION PERMIT `f �� 8193 9/24/82 . 6.00 T Project Address 1'74 The Masters Cir . 642 -. TYPE OF CONSTRUCTION Owner Hone - Phone 7588 0 NEW 0 ADD 0 ALTERATION t_/s�J, - Address same - - - - 0 REPAIR 0 CONVERSION ❑DEMOLISH '`� . _ ' Arch/Eng. License No. 0 OTHER ZONING REGULATIONS , i Address " - - DESCRIPTION OF WORK A.P. ' -. 53- water heater replacement ZONE PLNG. REF. ContmcmrGeneral Ins tallatlO[thane 2541 TYPE OF PERMIT BUILDING TTooggl�1L pINC • Address yfr SETBACK C/L$T. PROPE♦iTV LINE . 6558 :west Bl rd. . J. 90043 . 0GRADING 0 FOUNDATION '0 STRUCTURAL SIDFEYARD LICENSED CONTRACTOR DECLARATION ' - 0 TENANT_ 0 ELECTRICAL ®PLUMBING DMECHANICAL .LS IIQEE YARD - - - • - - • I hereby affirm that I am licensed under provisions of Charter 9 (corn- ,' I . • RIGHT .. • mencing with-section 7000) of Division 3 of the Business and 0 OTHER. . . - Professions Code, 'and my license is in full force and effect. - • REAR YARD(TO P/L) License Class f''3 Fi - - - G� qq ' PROJECT DESCRIPTION _ - - - - Lip a No,- _ 9 PKG.SPACE REQ. PROVIDED Dale a/5/55 Signature-4i•ei /je-Burr - _'sQ.FT. _ . . . . _ .. _ . WORKERS'COMPENSATION-DECLARATION .- f_ .STREET WIDTH .PARK FEE$ ., OCCVPANCV_CONSTRUCTION TYPE .1 hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ,ZONING APPROVED BY • -DATE - - , r-tsficate of Workers' Compensation Insurance, or a-certified copy • - -- - - _ - '",ke'-{ SPECIAL CONDITIONS: „s (Sectyo C.). _ __ . GRADING CU.YDS. ACRES • LV kJlh P Y 0ILertified copy is.hereby furnished. - REMARKS: . - - L' ®Certified copy Is filed with the city Building Division. - I •f EXEMPTION FROM WORKERS'-COMPENSATION DECLARATION t•v^ .. ._. .__- t • - • - - - - ' - - - (This section need.not be completed if,the permit is for-one hundred r.v r i y,)r 1 I1'...:1 LV I ail••J - ' ($100) or less). ' - - - - - "-- --- I certify that In the performance of the work for which this permit Is - ' issued, I shall not employ any person in any manner so as,to-become PLUMBING -- PLAN CHECK ' - - .ELECTRICAL - - PLAN CHECK - - subject to the W _orkers'_Compensation Laws of California. _ _ _ ” - - BATHTUBS SHOWERS-` -- - ISO FT NG - GARAGE Date • Signature SO FT 50.FT. - _ NOTICE: If atter making this declaration, you should become subject TOILETS . 'I. URINALS' - - GENERATOR 0-1 KW_1-10 KW • - to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS ' ' . APPLIANCE 10-50 KW_50+ KW 'r-- -- _ - - - revOketl. - _ _f CONSTRUCTION LENDING AGENCY - KIT.SINKS' - - DISHWASHERS - ' - _ -- - +MOTORS -- - -'0-1-HP=1-10 HP - - ' - I I I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - "' - - -- (INC.SOLAR) • -10-50-HP=--50+HP - - - -• - formance of the work for which this permit is Issued (Section 3097 - _ - - - - —• FLOOR SINKS FLOOR DRAINS - - - - . 'FIXTURES "- OUTLETS_- SWITCHES - ' ' Lender's Name' - - - - - - Lentler's Address DRINKING FOUNTAINS -j.- - ' GAS TUBE SIGNS-- ' - - ' - . - OWNER BUILDER'DECLARATION - - - INTERCEPTORS CLARIFIERS - I hereby affirm that I am exempt from the Contractor's License Law for the following reason"Section 7031.5 Business-and-Professions Code: SWIMMING POOL -- -P TRAP ' •- ' - LUNSI HUL IION - - - - -- - I r. Any city o .county.which requires a permit•to construct,, alter, - - POLES METERED SUB improve,demolish or repair any'structure, prior to its Issuance,-also re-- WATER SERVICE - ALTERATION "' ' . - PANELS- "' 'MAIN - "SUB _ - quires the ap,tient for such permit to file a signed statemenbthat,he • is licensed'pursuant to the provisions-of the Contractor4.LicenseCaw -GAS SERVICE OUTLETS - SERVICE' - - "`-:•pter 9 (commencing with Section 7000) of Division 3 of the ess and Professions Code) or that he is exempt therefrom and the ' WATER HEATERS -1 -- BTU OUTPUT' -- - - 3-.O0 - - - . -for the alleged exemption. Any violation of Section 7031.5 by r " - _ T-'applicant-for a permit-subjects the applicant-to-a-civil-penalty' SEWER CONNECTIONS- '•I, - -_ -- _ _- - _ _ - - - -- -- -. _ of not more than five hundred dollars ($500). - ' ❑ I, as owner of the property, or my'employees with wages as their SOLAR TANK _ COLLECTORS'. ' ' - "' - - - - - - -- - - - , sole-compensation, will do the work"and the structure is not intended " - - - or offered for sale. (Section 7044, Business and Professions Code: The - _ __ • _SOLAR PIPING SYS. i'' - V ' I - - ISSUE FEE - -- -- - - " - ' Contractors. License Law does not apply to-an owner of a property_ _ _ _ __ -"- who builds or improves thereon, and who does such work himself or ISSUE FEE - __ - r - 3 ,00 APPLICATION APPROVED BY-- - - - - -DATE - through his own employees,-provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK -SUMMARY OF FEES, is sold within one year of completion, the owner will have the burden i of proving he did not build or improve for the'purpose of sale). IBUILDING '- -'- -- - - - - - - - HEATING SYSTEM 0.100,000 BTU PERMIT $ •SMTP- - E I 0-f,-as owner-of the- property, am-exclusively contracting. with- AND DUCTING - - - - - - - M - - -• licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ VV PERMIT. n, ' and Professions Code: The Contractor's License Law does not apply-to- - - - -G _ ISSUANCE -$ an owner of property who builds or Improves thereon,and who con- REFRIGERATION 0.100,000 BTU 1 PLUMBING $ r• ' r tracts from-such projects with a- contractor(s)-Ilcesned pursuant. to SYSTEM ---- - • - _ •GRADING. $ _ the Contractor's License Law). 100,000+BTU IPLAN CHECK E ❑ I am exempt under Section - - B.6-P.C.for this BOILERS BTU • - $-(ELECTRICAL E 'reason - - - - - - - - - - MICROFILM E •I SYSTEM REPAIR,ALTERATION PLAN CHECK $Date. ' Owner - •TOTAL FEE$ ' ' 6 00 I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ information is correct-I agree to comply with all 'city and-county - - PLAN CHECK $ CESSFiD- VANCE ordinances and state laws relating to construction,and hereby authorize , representatives of this city to nter upon the above mentioned _ • 6 .00 property_ for inspection Bur po . __ ee.�. p� • Signature '4/ .Q• -�uiti Date 94;22-4 2 ' FINAL FEE $ 1 Drivers' License ' - ISSUE FEE - - - - - - - _ _ CMF 0865-46 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING � / POOL&SPA• � (If� - - APPROVALS Permit# II Date Inspector APPROVALSPermit# • Date Inspector • 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location • .1 •2. Soil_Pipe-Undrgrn44. Steel Reinforcement -- 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit-Undrgrn - _ _ - _ _ 46.- Electrical Bonding , • . .. - ' i _ 5. _Steel Reinforce _ - _ 47. Rough Plumbing & Pressure Test -- - - 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE - - - • -- • 7._Footings _ - - _ 49. Electrical Conduit-Undrgrn .• . 8. Foundation _ ' - __ _ - 50. Gas Pipe, Undrgrn:Test •• •" • __ 9.. Water Pipe-Undrgrn- _ - _ _ _. 51. Backwash Lines. P-Trap. ❑ Undrgrn ' - ... - _10. Structural Floor System . . 52. APPROVAL TO DECK - - _ 11.. Property Sewer Line & House Connection53. Backwash & Receptor-Final s 12. Street Sewer Connection _ 54.._- 54.. Heater &Vent-Final. - _._i3. Rough Plumbing _ _ _ 55. - Plumbing System - Final - • �' - 14. Rough Electric-Conduit - - • .56.- Electrical-Final • - • 15. Rough Electric-Wiring - - - - 57-. Solar System-Final ' . - ` 16. Rough•Heating & Air Conditioning 4 . - - - - _ 58. . Fencing & Access Approval . • 17. Ducts, in Structure __ _ 1 - . . • - . _ - . 59._ APPROVED FOR PLASTERING 18. -Ducts, Ventilating - - . _ _ - •• - - _ _ . . - 19. Gas Pipe-Rough &Test _ 160. POOL/SPA SYSTEMS FINAL ' 20. Roof'Framing: " . - - . - . ' . • • 21. Roof Sheathing . - -- ' 22. Frame and Flashing- - _ ' - - - - NOTES:_ - , 23. Insulation - : ,--2,'"-•91------ NO DIVF. AT./45.ti6• .--L�i7' .0e0/!---7 24. Lathing & Siding .. _ . _ - _ _ /4��- - - 25i Drywall Nailing - _ - - : 26. Plaster Brown Coat /D-82iO Apn,.-o 27. Electrical Power Meter-Final _ - [ni i012� 28. Final Electric -- - - - • -- - • ' 29. Final Heating &Air Conditioning - . _ • 30.- Final Gas Pipe-Test • 31. Final.Plumbing _ - - 1.2,90 (0-2-')•j61! 32: Water Service-Final - - - _ _ _. _ - _. - - . • . . ' 33. Gas Service-Final - _ - _-_. . -- . - - - i 34. Solar Domestic-Final. '• • - -' .� . '-' 35. Landscape Sprinkling System • i L r -:. . , _ 36:- Sound Attenuation i 37. Handicap Regulations' ' - - • • - -J - 38. FINAL STRUCTURE& BUILDING - 39. Special Requirements Completed " 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. . ' 42. CERTIFICATE OF OCCUPANCY - - ' No Date • PROJECT ADDRESS: 174 THE MASTERS CIUNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 056741 OWNER'S NAME: MR. JAMES ORR ,5-P--0tP3) ADDRESS: 174 THE MASTERS CIRCLE PERMIT NO: B 056741 PLAN CHECK NO: N GOVT; N SUPP: N COSTA MESA • CA 92626 CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: ALT 1x ARCH/ENGINEER: ( 714 ) 754-0431 REG.NO.: JOB DESCRIPTION : REROOF— 2PLY SYSTEM 6 72LB. CAP SHEET SQ FT: 1 , 600 400ADDRESS: UNIT: . PERMITTEE: CLAIM VALUE: 1, 600.00 CALC—VALUE: 1 , 600.00 GROUP OCC: R-3 / • • ADDRESS: CRANK BROTHERS ROOFING ( 714 ) 548-5569 126 COMMERCIAL WAY COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME. OVeI-9iS �gnET `-r . pp R COSTA MESA CA 92627 ****************************** *********************** *** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I .m licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and x y license is in full force and elf• SETBACKS REQUIRED CITY LIC.: 005993 STATE MC.:408677 CLASS: C39 Date: 3 '-grU---9Z Signature:_. '� MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby ��t ave a certificate of ci Hit to self-insure or a -•'' .le of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof :- 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: 2 8 5 2 2 4 9 2 EXP.DATE: 01/01 /93 COMPANY: STATE FUND PARKING REPROV: PARCEL; 11939119 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0X Certified coilh the y BuildingDivision. /J / 1 PLANNING N TE Date:3 ' c 2 Applicant .�C,Q � **************** ************************************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($t00).efessl. DEVEL PMENT SERVICES R E Q U I R E M E N.T S I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to became subject to the Workers'Compensation Laws of California. ZONING APPROVED BY) DATE: ; LA Date: _ Signature: - NOTICE:If.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : • DATE: . 1' 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 APPLICATION ISSUED BY• ;;:441. " O DATE which this permit is issued(Section 3097,Civ.C). *.*.*.**. **.**.*.****.*****{(.{(.*.*. * *.*.{I * iE*{E 3E*******{p**{E{O{E*{E{t*- '� 3E iE LENDER: REROOF DOES NOT INCLUDE ************************************** . * .a*************************Ji********* ADDRESS: THE GARAGE. LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING EL ECTR ICT MECHANIC FIRE SMIP/RES , GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 37.00 A r ,5011 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON-RES pursuant to the provisions of the Contractors'Slate 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 PLAN , any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE / ' til I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID ,c DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 37. 50 0. 00 Q00 37 . 50 37. 50 .00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ,'} his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 37. 50 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK--- I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 37.00 • • .,u • 50 G k ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I art aware *.*.**********************j1-.*.{p**{E{L.****.******************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F ,E E BREAKDOWN ❑ lam exempt under Section: B.8.P.C. .T : y for reason: TYPE QTY D E S C R I P T I O N UNIT COST • .TOTAL COST Dale: Owner: SFR 1600 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 ' 1 , 600 . 00 Ida hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END' OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt fromd ^ / 1 these provisions. el .x Date. Applicant: I hereby certify that I have read this application and state than •above information is cor,.. gree to co • with all city and county h '� rofr instetemwpurbuilding construction am ebyautoorize represen. esu is cit •y to above-mentioned _ _ , propert for inspection purposes. 1� 1 i.. 1 x, :p. Ir • ,t 7 -� Date- '� `—?( _ Signature �� .— _ 17(5/2'fes O . ' -_ _ -r .. Driver's License or Social Security Pink—Revenue:Goldenrod—Assessor St CONSSPra:+Wt'AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Lodation 2. Soil Pipe-Undrgrnd. ,'' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd./' -r- 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - r 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 A 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, Ventilatingo - •71. Product Piping D Gas 0 Oil 23. Gas Pipe;Rough& Test r . 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 PREV. FINAL , •30. Drywall Nailing .? HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' 79.-FINAL INSPECTION 32. Electrical Power Meter-Final . •80.-FOOD CERTIFICATE ISSUED L - �33. Final Electric 1 _ No'tes:?LZ_Cr2_ •At0 es,if / 4 i'sr • 34. Final Heating & Air.Conditioning E4`l� /t' ; Gr T_J AAye- a C/' 35. Final Gas Pipe-Test / /'`f'• ' ey- 36. Hood or Canopy-_ - 37. Final Factory Fireplace - •• • .. I 38. Final Plumbing v . _ 39. Water Service:Final r 40. Gas Service-Final , , . 41. Solar Domestic-Final . -• - 42:Backf low Preventer i I _ 43. Backf low Irrigation ,. - • . 44. Landscape Irrigation System , - y - - 45. Sound Attenuation • '46. Handicap Regulations - - c -I 47.-FINAL STRUCTURE& BUILDING 7-22-1.2.:- ‘-!A-k- 48. FINAL PLANNING, . - ' ' - 49. Electric Release fo-Edison i . ' 50. Gas Release to Southern California Gas Co I I I - . 51. CERTIFICATE OF OCCUPANCY . No. Date • 3 : )9 PAIR FEB 20-70cp$rO0 601* ***141.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT REC I ED B DATE RECEIVED DA E ISSUED BUILDING ADDRESS 174 The Masters Circle _/y_70 ag. D 1 PERM7 OWNER United Savings S. Loan Assoc. A.P. O. - Oi4h3 MAIL BUILDING /9 eV �yt/I�: .fj g.. ' /„ Z ADDRESS 9800 S. Sepulveda Blvd. ADDRESS / �� F/�✓cdL!! 'L� 0- U CITY Los Angeles, Calif. No. 670-7550 TRACT 6 cV S LOT V BLOCK I- Z Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING fFMOLISH -l- LENDER Owner 17 _I• D BRANCH ♦ )2, I/ _J to OWNER I CO-I _ADDRESS 1..c0 ARCHITECT VALUE `� JQ OR ENGINEER R.J. Marvlck NQ�'839-3840 USE ��c� +�t $�� 6'��w Uv) FIRE Jyj—, 2 < ADDRESS 1538 Century, Santa Ana ZONE TYPE GROUP • a Ly APPROVED Ci ll y LB Z CONTRACTOR Ryness-Smith Co. BY Q`rt f 7,� DATE"�/.� ,D W• ¢ ADDRESS 140 E. Industry Ave. vv As 'cr., {f' W w TEL. ZONE NO.OF USE OF NEA (f/� Z I- CITY La Habra, Calif. NO. 879-31 1 I C? A I 'PLANS STATE CITY YARDS APPROVED YARDS APPR ED CCC LIC.NO. 167538 LIC. NO. $964 MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZE NO.OF BLDGS. OF LOT 40 X 107 I NOW ON LOT 0 FRONT //0 FT. FT. USE OF EXISTING BLDG. - R SIDE J FT. FT, I- SIZE OF NO.OF Z NEW BLDG. I78I ROOMS 6 STORIES 1 L.SIDE 3 FT. FT. _ - Q EXTERIOR WALL ROOF / t_.1 COVERING STUCCO COVERING Wood Shakes REAR f/` FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CL CL MAIN BLDGS. Al�f ACCESS BLDGS. Q VAR.,4C2 Li, '/ DATE / 6 - � p Single family dwelling 8 two car c.u.P.#ZE 3--- (o q APPROVED - T- 9 I- attached garage —ABPPRovED�11W /�� !iv h a l / GATE p Lot 31 Plan 3-BR 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 /- any person in violation of the workman's compensation laws of (n the State of California. //7 / m Z I hereby certify that I am properly licensed as a contractor under / ✓ SO. FT. S7o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDE VALUATION IS FOR • Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: l[ am exempt from the provisions of the State of California Business and Professions Co.�/Division 3,Chapter 9. VALUATION /� :.sem co / t PERMIT FEE S % f - n Signature of • m Permittee / / JrT101" : S 6/'O\ J ♦1 PLAN CHECK $ "/ / ! E Authorized Agent Iii , .. TOTAL FEE $/ J ` LI.