HomeMy WebLinkAbout192 THE MASTERS CIR - Building Permits 6 CITY OF COSTA MESA •
BUILDING-DION
4 VISI
> .� ,,,,,. DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER
t., . 4 PERMIT
4'eb+aa.mo 02-01539
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 192 THE MASTERS CI Status: ISSUED
Suite: Applied: 09/23/2002
Vicinity: THROUGHOUT RESIDENCE Issued: 09/23/2002
Parcel Number: 11939123 Zoning: C ��
• Applicant: DEYDEN, MARK ISSUED BY:
Address: 1707 SAMAR DR
Phone: (714)434-4927
COSTA MESA,CA Zip: 92626
Owner: PROWSE, CATHERINE S -- -
Address 192 THE MASTER CIR 1
Phone:
COSTA MESA,CA Zip: 92627-4640 -
Contractor: MARK DEYDEN DEVELOPMENT
Address: 1707 SAMAR DR
Phone: (714)434-4927 - -'
COSTA MESA,CA
Zip: 92626 License: 325027
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CHANGE OUT 11 WINDOWS AND 5 SLIDING GLASS DOORS. DIMENSIONS AND HEADERS WILL REMAIN THE SAME THROUGHOUT THE
RESIDENCE.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $6,500.00
Permit: $139.25 Claim Valuation: $6,500.00
SMIP Res: $0.65
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.90
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(WOO)
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
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.)
5.1:136bI 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 t'o the workers'
compensation laws of Califomia,and 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 provissii9gpae��/�/�/ /f 'J
AppllcantSignatile � ' 7v .4Dete? 47.- 2—/ --cD -�
WARNINNG:RNI
WAG:
FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND COI I ARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full
.force'arM'.effect:LI c:4--, 3 2_`j °7- <clas`s.pra F
Contractors-Signature: —0 2-
v..
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: Lenders 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. 0 Yes ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: '
O 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 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑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.
4 It an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this p_pplication aPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes U 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 end 42303 of the Califomia 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 Califomia Health and Safety Code Section 42303 been made? ❑Yes ❑No
e...attach
certificate of compliancefothe appropriate(If"yes",attach of from 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.
Signature I Legal Owner(s) Date ✓ 2
CA"d/ eriuthodze_ ppi5an \ rTDate-
%IDEP INSPECTION TYPE %dIE INTrIIAL$ CODE N INSPECTION TYPE 128,11 INTITIfL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 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 7 2,-9r' 4,auw
'BMLODG: 192 THE MASTERS CI WIT: CITY OF COSTA MESA - BUILDING PERMIT rr.nrt ill/: ru i.t iu
CARTER, E C f.Q O CK710
DIES& 192 THE MASTERS CIR PERMIT NO: P 071270 PLAN CHECK NO; Nvvv i : nU'i: ; iJ
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V-N PERMIT TYPE; PLU PURPOSE: OTH
UNG/DORESS:
JOB DESCRIPTION ; INSTALL ONE WATER HEATER (REPLACEMENT) SQ FT;
•
REO'OR ENGINEER: UC NO.:
MICH.OR ENG.'S ADDRESS: UMT: CLAIM VALUE : CALC-VALUE; GROUP OCC; R-3 /
COMRACTORSNANE: EARL ' S PLUMBING INC ( 714 ) 642-1753 COMMENTS: WATER REPLACEMENT ONLY
CONTRACTOR'SYNIWG 1526 NEWPORT BL +cgc_Nx*****WIC-************Tc*iF xx u»9*a,at-if ac Mac.Ker->F_r+pa.s*sacac.k'.99ya4gcK *if994944 k41.*x.r49.4c.r.r rasa ac u.><aa,r.r.
ADDRESS: COSTA MESA CA uc.No.: 217657 Z ONING R EQUIR E MEN T S
92627 utT: S E T BACK
S
UCENSED CONTRACTORS DECLARATION:I hereby arm under penalty of perjury that I am licensed under provisions of Chapter S
(commencing with Section 7030)a Division 3 el De Business end Professions Code,and my license a in full Naw end effect MAIN BUILDING ACCESSORY BUILDING
C/Truc.NG.: 005938 uc.ouss: C 36 Llc.NO.: 217657 i EXP : 06/95 FRNT : FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
f) 2121419 c Contraa«. -- t LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
BUILDER DECLARATION:I hereby under penally pe
y aperjulhall amesemlrorn the Conlrr
OWNERmon Lions law for the PARKING REQ• PROV: PARCEL ; 11939123 ZNE; REF NO;
following reason(Section 7031.5 Business and Professions Code:Arty city or county weld,requires a permit to construct.altar.improve, PLANNING NOTES>
demolish,or repair any structure,prior to is issuance.also requires the applicant for such Permit to file a signed statement that he or she
to licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Dir Sion 3 of the >
Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section 9**9*99**9*9**9lfif#******+4*if9ifjE*if**93F*if4**1F***Y*4******4Y9l*Sf*********3**9iE*tiFM**A(.*9*y.*Y-
703t.5 by any applicant fora Permit subjects the eppltant to a civil penalty of not mon then five hundred dollars POOL DEVELOPMENT SERVICES REQUIREMENTS
❑ I,as owner of the properly or my employees with wages as that sole compensation,will do the work,and the structure S riot intended
or altered for sal,(frim 7014.Business end Professions Code:The Contradon License Law does not applyto an pro
Owner perly
who builds or improves thereon.end who does such work himeseor hersefor through his«her own employees,provided that such ZONING APPROVED BY DATE ;
improvements are not intended or offered or sale.II.however,the building or improvement is sold within one year Of completon,the
owner-builder will have the burden of proving ha«She did mwiu«improefowa
thepirPesale). BUILDING APPROVED BY ; DATE ;
0 I.as owner el the property,am exclusively contracting with licensed contractors to construct the project(Sectin 7044.Business end
contracts
such:The Contractorsswc License Law does not apply to the owner d Licen a labuw).
or improves thereon and who 1 } DATE: 2.4/ _14
`
I«such projects with a cmb.acn(s)licensed pursuant I0Contractors License Lepel. APFLICATION ISSUED fl Y; *[ ��
tem exam under_ B.BP.C.,f«Nis 1° •
- /' 4f************************ *. * *. ***it **** ***4f A.1*************3f* ***1f **
Date: xr241( 1 owner: ( ,�O`,-FSC t **********************it****************** **** *****************************;f*
Ill✓✓✓// LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT:N
1 do hereby certify that I am aware of and understand the requirements of California Health and Safety Code25505.25533,and
25534,and Ora 1 or any Mature building occupant win I Will not(circle one)need to comply with said state codes the requirements lar
emit f«mm
nstnucticnorndif�ionfromthe Ai GuaktyManepsment District ms:nstnaim aeries ere from these BLDG PMT PLUMBING ELECTRIC IC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 7 . 00 .
Date: Applicant: 25% SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dedmatbns: ISSUE FEE 20 , 00
o Ihave and will maintain acertificate aconsent toself-insure for workers'compensatkw,aprovidedfor bySeton3700of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Cede,f«thawdmanwagw
wwl«wrihmpermit TOTALS----> 7 , 00 20 , 00 0 . 00 27 . 00 27 . 00 . 00
Cri have and soil maintain workers'compensate'insurance,as required by Sedkn 3700 of the Labor Code.ler the performance ol the
work for whims this peenni is Sued.My w«[ren.'compensation
errand petty number are: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 27 , 00 OVER/SHORT; . 00
Carrier• Policy Number: 1D]y[GJ—J4 03/01 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed/sire permit is for one hundred dogma(si00)or less) 27 . 00
o I cath that in the performance of the work for with this permit is Sued,I shall rice employ any person in any manner so as to
become subject to the workers'compensation laws a California.and agree the if I shook become subject to the workers' *******************+F*****************jf*******************************4c****i.***AF
compere imp s of Section 3700 a the Labor Code,I Mall forthwith with those provisions.
� Za �— Aod�m. I N D I V I D U A L F E E B R E A K D O W N
Date: / ( 't /�` f��
Warning:Failure to secure workers'compensation coverage la unlawful,and shall aublect an srnpl to criminal venelno and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil gnus rpt to one hundred thousand dollars(5104000j,In addl/lon to Iia cost of compensation damages as pavkbd ler/n
S.d/on 3706 of the Labor Code,Interest and ttttorney'a' PLU ATER HEATER AND/OR VENT 7 . 00 7 , 00
CONSTRUCTION LENDING AGENCY:I hereby Won under Penh of pantry that there is a Ccnatmdnn landing NAM,for the S a END OF FEES
performance of the work for Aid,this permit is issued(Section 3097.CS.CI.
LENDER'S NAME:
LENDER'S ADDRESS: BAS e if
/ / 1, 4
I certify that I have read this application and Satelliteall d
the above information Is correct.I agree to comply with ry and county ordinances D
and state Laws relating to building conwudion and hereby authorize representatives of the dry to enter upon the ebovsmentioned properly
for inspection purposes. r '
1C9oaf, - /
Name
nt � Y/ 4z1
Dale: •
• SS rea}mwdAgen ntrsd« 01 001772430-00177260 TnT 27.00
DATE: 02-24/97 Tlfic: 1:.:00
(515l'46,WP) White-Building 6 Safety;Green-File Canary-Applcant:Pink-Revenue:Goldenrod-Assessor
IIIPtICTION AND PLANNING PO SPA
ALS Permit# Date Inspector APPROVALS Permit # Date Inspector
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 I
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
1. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Uhdrgrnd.
•
10. Structural Floor System • 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final
12. Sewer Cap . 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final .
14. Rough Plumbing 1 65. Electrical-Final
15. Rough Electrical-Conduit t66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-I 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 : 5
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:
34. Final Heating & Air Conditioning 3-z1} ct- G c472-O � >°K:''J i
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
• Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. •
PERMIT NO. - TRACT NO. LOT NO. UNIT NO. 8039 8/05/85 -
- CITIOFCOSTA�MESA `'CONS�TRUCTIIpONP/ERpMIIT /yP _ ;DO IL
Project Address I`ll` 71-IE 1 "ASTE1�� l .iR.CLE $F2' oZeicA o/ r� l
Applicant's Mailing//A��ddres3 Y] TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION LI REPAIR I - �,
Owner's Nam `/l l . ' ( •HIZTF'2 - Phone 914 o
ED CONVERSION El DEMOLISH ❑ OTH E-R „ P - A.P.# Zone DE CR WORK/US555E Qm L /`�Ll L
Address m�S -' K- (,V� V� 1 - 5 . S Main Building: Accessory Building: '
Arch/Eng. License No. i TYPE OF PERMIT U GRA ING L I FOUNDATION ❑ STRUCTURAL T Front _ ' ' _ O
Address ' CI,]^ / / ❑ TENANT ❑ ELECTRICAL LI PLUMBING ❑ MECHANICAL BA Rear . N
Contractor's Name PT mom' Cn/Y1�KT �aPhone¢233-53 0 CA Right N
R63
PROJECT DESCRIPTION SQ. FT. OCCUPAN Y
Address(mailing) R63 N nT�'VIp- , 0efl NIGE D K Left - -
7j/g2/ , CON ST RUCTION TYPE ' 'VALUATION$ $ R
•
City License No. r�'TG" / ZONE GRADING CU.YDS. ACR 5
( LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
`{l, I hereby affirm that l am licensed under visions•f Charter 9 (commencing Remarks: Planning Notes: M
•
U1\
with section 7000) of Division 3 of th: 5ines5 .n� PrOf¢s5I•o5 Code,and PC-'-'
-�� _ •
my license Is in full force a 54 f ct. �/ l LJ BI �Q e�� 1• S
Licen{gdlass I .y,�, 11 •
CJ
Date_Ya I I • -- Signature • �41�• �/r PLUMBING FEES
WORKERS'COMPENSATION DECLARATION
Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure o ertificate ELECTRICAL FEES
-of Workers' Compensation Insurance, or a certified copy th.� (Section Backflow Preventer .Service Sink - - -.. '-
3800, Lab. Cil �•1�(y �j / '
Automatic Washer Transformer ❑ 15-50 KW-
\I Policy No. C� /CFlil('0 Come I L S . Backflow Irrigation Sewer Cap - Construction Pole Sub. ' - 0 50+ KW '
Certified copy is hereby furnished. •
Cerci ' c fled with the city :ui Di • 1 _ Bathtubs Sewer Connection • Cooking Unit .Meter Cup to 100 amps
ale - Applicant — `4 ._.
EXEMPTI N ROM WORKERS'COMPENSAT•` DECLARA •N Clarifiers Solar Collectors �CK� • Dishwasher Meter Dover 100 amps
(This section need not be completed.if the permit is for one hun• $100)or - - - - - - - '
less). Dishwasher Solar Piping �- Dryers or ,_.
0Electric Sub Panel - '
I certify'that in the performance of the work for which this pe issued, I
shall not employ any person in any manner so as to become .• ect to the Drinking Fountains / Solar Tank .3 Fan 'Motors I$41 HP ❑1 h-8
Workers' Compensation Laws of California. .
. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. 09-15 HP 016-15+
'NOTICE: If,after making this declaration,you should become subject to the Inc.$plat
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 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 Outlets •
Lender's Name ' '. - Range
Lender's Address _ _ Kitchen Sink • Water Service •
OWNER BUILDER DECLARATION Switches Sign -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories
following reason (Section 7031.5 Business and Professional Code: Any city or Auto-Wash Garbage Disposal ;Standing Sections —
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays - Generator OM ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit - • - Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains '
the Contractor's License Law(Chapter 9 (comma ing with Section 7000)of -• r
Division 3 of the Business and Professions Code r tha he/she is exempt ' •
ierefrom and the basis for the alleged exemption. olation of Section
• 031.5 by any applicant for a permit subjects the applicant to a civil •
enalty of not more than five hundred dollars($500). . - l
I, as owner of the property or my employees with wages as their sole Reinspection Fee -$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 ownDEVELOPMENT SERVICES 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 I (late
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground - Building Approved By P/ Date • ,moi
prove for the purpose of sale). - r ill❑ 1,as owner of the property, am exclusively contracting with licensed con- Duct-Structural ^Refrigeration System - Application Issued By A f t • Dat '
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- ' //11 {/ _50tractor(s) license pursuant to the Contractor's License Law). I am aware that - Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ .S /c, SMIP $
•
proof of their Worker's Compensation insurance should be provided to me. • • PLAN CHECK $ PERMIT
ISSUANCE
tam exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ � � /j ISSUANCE •
$
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. '$
I hereby certify that I ve ead this ap• icatlon and state that the above 00-100,000 BTU 0100,000 BTU- /� GRADING $
information is correct reel o amply Ith an city and county ordinances ELECTRICAL $ 7(/
and-state laws relatim bui •in- constru•tion,and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM 1$
sentatives of this cit • e�er Upon V.
..cave-mentioned proggqerty for q o
Inspection purposes. I')1 ( W1/4S-
� _, • MECHANICAL $ O--- .S6/ •
Signature Date K I TOTAL FEE $
Drivers' License or SS# • - (, Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ _
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor .
'--- P06 . SPA -
•
i CONSTRUCTION AND PLANNING
� 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
X12. 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 UN/ co
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 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 - ' $s7/3-/rr 6(0 Notes: 41/415"-- ear-0020 . Leo
34. Final-Heating & Air Conditioning
35. Final Gas Pipe-Test '
36. Hood or Canopy '
37. Final Factory Fireplace
38. Final Plumbing *der Ceti
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 i
47. FINAL STRUCTURE & BUILDING. 9/,54 �‘j
48. Special Requirements Completed '
49. Electric Release to Edison - p -
•
50. Gas Release to Southern California Gas Co I. p ,
51. CERTIFICATE OF OCCUPANCY •
No. Date - .
1 OWNER ATNSLIE. Dr. DATE 8-19-75
oy JOB ADDRESS 192 The Masters Circle BUILDING PERMIT NO. 40439
K' - -NERAL CONTRACTOR Lile Construction DESCRIPTION of WORK Spa
3 No. 119-391-23 LOT 27 TRACT 6508 FIRE ZONE VALUE $ 1.500.00
INSPECTIONS / Signature Date GROUP j TYPE tL ZONE R1
a
Pool Location R-,L 4t-7-.> SUBCONTRACTOR PERMITS ISSUED
,` r Date Number I Signature
� Forms
Main Drain • K
Steel Reinforce \•
I`
Elec. Bond ) Electric
Approval to Cover I / b4Pe 6-7to/i& ?1/9-75—Ings-,--''
Underground Electric A.---c--- 51 -7_
Gas Piping Test :Zs.c c,. ..,5 Plumbing ,/
Filtering System Lines AA 1.-q0-55t-�nl 0,c• t.jq- c (/7I�L/J
Backwash Lines and Recep. d2�-c� T—" '
Electrical Final
ter and Vent Final
Filter System Final
Backwash and Recep. Final
Al
49439. PA18 23.0(
r; PA to„,„ *xa,
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only • RECEIVED BY DATE RECEIVED �•
BUILDING , >�:.
ADDRESS //��/�� �IJ1Ar�'1� �,/ �j
OWNER Y{�/ ./1 /77,e_/ Ins, f /nI ) A.P. NO. I•NG Q'- S° I —t3 PE�439
ADDRESS /`-7p` t/ Il-! r l ? ADDRESS l` iii bra- 1i. -�,_
MAIL
TE .-
CITY / t1..14•�
/ Q, Nov - '. �� LOT/J BLOCK
CONSTRUCTION t NEW AD• ALTER REPAIR MOVING DEMOLISH
LENDER '
BRANCH . 1 ' !"••r.-LCJ
OWNER
• ADDRESS ARCHITECT rr �`/�� � VALUE
OR ENGINEER as '.. . . ..� 14NOLII • USE U[.s " $ /
_ FIRE
ADDRESS `*' E /4a hI AP r I ZONE TYPE I( GROUP
APPROVE•
CONTRACTOR K_:)' BY �u. DATE/0. ' 2!
•
••- # s A
NO.OF USE OF NEW�A
- ::11'
PLANS BUILDING h
STATE /� CITY YARDS APPROVED YARDS APPROVED
LIC. NO. _l�Q � LIC.NO.)//%}y MAIN BUILDING ACCESSORY BUILDING
0.W SIZE r X I NO.OF BLDGS.: (FROM C/L STREET) r ,fr
0.. . OF LOT NOW ON LOT FRONT FT. Ftzit
a USE OF t'
V) EXISTING BLDG. B �
,SIDE FT. :fa.
Ca . p�
FSeparate permits are required for 3 L.SIDE FT. p f/-FBF.
C electric,plumbing and heating work. REAR FT. ' FT.
W
F USE OF BUILDING AND WORK TO BE PERFORMED I \
DISTANCE BET. BET.MAIN&
aCI
MAIN BLOCS, ACCESS.BLOCS.•
Q ,\p/Ai /, sj �oft M�) VAR.#
C.U.P.#
AATE
APPR
APPROVED
APPROVE
DATE iii 17".
q 25
-
-
r1
0 I hereby acknowledge that I have read this application and state inn
N
C: that the above Information is correct and agree to comply with , m
0. all laws regulating building construction, and I shall not employ •
Z any person In violation of the workman's compensation laws of
B
Ws,
. the State of California. m
I hereby certify that I am properly licensed as a contractor under SO.FT. N
the State of California Business and Professions Code, Division 3, T AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. to—
am
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE $ N
and Professions Code, Division 3,Chapter 9. / �- I
n
n //•�/�/lj� f- 1 PLAN CHECK $ bye✓ o
Signature of 11 r q .l Of .U_/ �iC� OP ' / $ /�(/ L Zl LL
Permittee c�lL , TAX $
0
' Authorized Agent . ,`f` �_O.•- #�/a `L • TOTAL PAID $ 5
OWNER AINSLIE, Ernest E. DATE 7-18-75
4 JOB ADDRESS 3.92 The Masters Circle BUILDING PERMIT NO. 40286
{GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Add Recreation Room
• A ]. 11.9-391-23 LOT TRACT FIRE ZONE VALUE $ 4,000.00
I INSPECTIONS Signature Date ' TYPE V GROUP I ZONE B-1
.ce SOIL PERMITS ISS ED
ji• GAS SUBCONTRACTOR Date I Number 1 Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE E HOUSE CON.
SPRINKLING SYSTEM I
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER ❑ `
ROUGH WIRING FORMS-QR-1 RLC. I� �rp2 Heating and Vent.
TRENCHES [] FORMS fl STEEL REINF. ❑ / o j/ Ic
FLOOR SYSTEM '
BOND BEAM n STEEL REINFORCE n
SHEATHING (J�� T-1-)5
FRAME AND FLASHING \.G $-A-)5
LATHING — IN AiOUT _ _ aL — /3-75
PI "ER, BROWN COAT
5'. !URAL, FINAL ��[i IN�5 Elec ric
HEATING, VQNT., REFRIG. AND A.C., FINAL .--Atr 4./.G${cJ;Y2 7-/B-75-392.60
PLUMBING, FINAL AND GAS TEST IT
ELECTRIC. FINAL
Y
s 4028
' G18-75",,P°``'
!Ill OOt777 ****142.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
[[,�//�� / ��]]�t //•� �.t REC/FSI VJF��JBY G%9TE R�Ff/iEIV D p�,7�TE ISS E�D.�/L` `
ADBUILDING DRESS //f r i r//acierl (i.-elC C,'/Y' Yom' / -IC/- /�'I,V_ ✓/✓
/` /� / ` PERa4EIf INA
OWNER YNe�jf /�, n//t/6L/`' A.P. NO.II9�J�9�� Z3 86
MAIL ��ss`- BUILDING /?2 TyF MAsrE,¢r cacsE
ADDRESS C{W 0 V e ADDRESS
CU CITY NOL/7? 77,0-z
w ill TEA
TRACTds�B I LOT2'7 BLOCK
Z
-
CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DFMOLH
N S
LENDER
cLm
J D BRANCH JL/E
In v,vesr E, 4-/N '
OWNS E
m J ADDRESS //'/'�/j,��VALUE //, . j/J
-CO ARCHITECT TEL. i�S_E !/!%e /Vlnr� $�"✓ �
N OR ENGINEER NO .
V to FIRE
W Q ADDRESS 991 - `''t' Jjj��,{) ZONE T JTYPE y- GROO�UP/
tl Z �/�1��W7�V X6,2, / APPROVED / /�I 7 i'5
J O CONTRACTOR BY // DATE
CO Z
:Ito ADDRESS
W w TEL. ZONE NO.OF USE OF NEW rEtele erica'
Zr CITY NO. Z....../ PLANS Z BUILDING popes(
F
W W STATE CITY YARDS APPROVED YARDS APPROVED
7 cc LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING -
SIZE ` (FROM C/L STREET)
OF LOT 7 .(„ x 6 (c>' I NOW ON LOTS / FRONT e FT. OtTet e''E FT.
USE OFA..I 7O ("tel' Xi
EXISTING BLDG. r)(Ad ea. 1 V\ 1 R SIDF /T 9 FT. FT,
I- SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES 2 L.SIDE /� FT. FT.
Q EXTERIOR WALL ROOF rr. .
O COVERING S M0 I COVERING ] t 1C _REAR �-5 FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET,MAIN&
1
a MAIN BLDGS. ACCESS.BLDCS.
VAR.+ DATE
Reece a4-
1-4)44 1 I /< O v"\--t_ _ C U.P# APPROVED
1- s\ APPROVED kite 7_/ar-_ 7S-
(/7 _BY DATE
Z
O
UI hereby acknowledge that I have read this application and state STATE
that the above information is correct and agree to comply with
CCall laws regulating building construction, and I shall not employ /
F any person in violation of the workman's compensation laws of 572
N the State of California. /41az
Z I hereby certify that I am properly licensed as a contractor under SO. FT. o
TAX
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER 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: Y
CC
am exempt from the provisions of the State of Californi Business
and Professions Code, Division 3( ter VALUATION ��
' PERMIT FEE $ N
D
Signature of 7�, „, ' p/�)� 4(040.0....---
/ - e) B
Permittee '!r/3'vG $( 0O®� PLAN CHECK $ /J(fi/•' Z LL
_/ ._ 7 G
Authorized Agent t (—//
` TOTAL FEE $
T7
7
� P410
' Q + 405FEB 20-70tASr00 597* *t*159.75
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.00X 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
REA VED BV DATE RECEIVED
DATE ISSUED
BUILDING • '% a -i9-2o �_aP:- 7o
ADDRESS 192 The Masters Circle dl
OWNER United Savings & Loan Assoc. A,P, N , PERMVEN
MAIL BUILDING �%� / /�,,. -�
ADDRESS 9800 S. Sepulveda Blvd. ADDRESSlil U.1 GT—ZIT
i '/ c 'u
- O CITY Los Angeles, Calif. TEL
670-7550 TRACT G S� 27 LOT;7 BLOCK
Z C CONSTRUCTION NEW ADDALTER REPAIR (MOVING DEMOLISH
LENDER Owner i,
0- in
am
J D BRANCH r I
—IN OWNER { - i
Q w ADDRESS (/n'-
CD-CC ARCHITECT TEL. USE/x at U%! A' - VALUE S7/I _w
J N OR ENGINEER R.J . Mary i ck ND. 839-3840 „»
U FIRE �7� L
IL C ADDRESS 1538 N. Century. Santa Ana. Cal ZONE TYPE-y GROUPr2p
APPROVED
Z J Z CONTRACTOR Ryness-Smith Co. BY Cid DATE 2—.1/_�-
0.J
CO
.7.1cc ADDRESS 140 E. Industry Ave. A tti
W W TEL. ZONE NO.OF USE OF w( J
z I- CITY La Habra, Calif. N0.879-3111 C a t / PLANS ).---
BUILDIN( f
- 0 STATE CITY YARDS APPROVED YARDS APPRO ED
NCL _LIC. NO. 167538 LIC.NO. 1964 MAIN BUILDING ACCESSORY [jU DING
D0 SIZE NO.OF SLOGS. (FROM C/L STREET)/ / ,��-✓-'Ij-
OF LOT 75 X 80 NOW ON LOT 0 FRONT Q Cf FT. CJi )2S- 1 FT.
USE OF ..---
EXISTING BLDG. 0 A SIDE / 5 FT. FT.
I— SIZE OF NO.OF _.
ZZ NEW BLDG. 2100 ROOMS 7 STORIES 2 _ L.SIDE / FT. FT.
V EXTERIOR WALL ROOF
COVERING Stucco COVERING Clay Tile REAR i ii FT. FT.
JUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 MAIN BLOCS i. ACCESS. BLDGS. L
Q Single family dwelling 8 two car CARP/MG -AC-% aCJ DATE APPROVED le 6 CI
o ,3—(7-6%
1-- attached garage. APPDATE ROVED ( L //J
w a 17170
ZO Lot 27 Plan 6-B
U I 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 workmen's compensation laws of
in the State of California. I d CO
zPC: I hereby certify that I am properly licensed as a contractor under �/� SO. FT. �J / 0
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER V ATION IS FOR o
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A P RMIT FEE ONLY:
CC
am exempt from the provisions of the State of California Business VALUATION
s�
and Professions Code vision 3,Chapter 9. PERMIT FEE $ lot N
/ N
Signature of �1n ���( / 51 Si iS D
Permittee _ '�% <//��4/ •. $ PLAN CHECK $ o
_1 S6G- s-y, LL
Authorized Agent ,/ TOTAL FEE $