HomeMy WebLinkAbout3075 TRINITY DR - Building Permits alOg F 9 CITY OF COSTA MESA
4 BUILDING DIVISION -- -
%-•„ "1I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
+r•u.a,o fi' P02-00009
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 3075 TRINITY DR Status: ISSUED
Suite No Applied: 01/03/2002
Issued: 01/03/2002
Vicinity:
Parcel Nunmber: 14107211 ISSUED BY:
Applicant: NOCK, RON
i
Address: 11612 KNOTT ST -
SUITE 17,C " " - Phone: 714-895-1246 ', - "
GARDEN GROVE, CA Zip: 92841 • .
Owner: WALSER, GLORIA ., -
Address 3075 TRINITY
Phone: T
COSTA MESA,CA Zip: 92626 t p P ` ,'`)
'' )41D6- i/YIw
Contractor: NOCK PLUMBING SE
Address: 11612 KNOTT ST = .
Phone: (714)895-1246 A
GARDEN GROVE,CA Zip: 92841
License: 707775 N • ,
•
Arch / Eng : I - r•
Address:
Phone:
Zip:
License: - , , .
•
r SCOPE OF PERMIT
WATER HEATER CHANGE OUT.
•
FEE SUMMARY
, AMT QTY AMT QTY 'AMT QTY
ISSUE FEE'"• ; $23.50''`` - 1.:_.:-__e,..Laundry Tub/Washer " $0.00; :0.'"; .:.:'rxrSump Pump `.f$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 Printer / .• ; $0.00 0
-
Bathtub • V '-;$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 - Vacuurn.Brkr BkflFlow(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 $12.30 1
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) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease, Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $35.80
COMMENTS/SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(WOO)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
trier which this permit is issued. •
❑- have and will maintain workers'compensapppppp'on insurance,as required by section 3700 of the Labor Code,for the performance of the work for whictj.}h a is issued.
My workers'compensation Insurance carri$r and policy number are: �/
Carrier: /� c o lam- lJ Policy N
(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 at if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: •. — *—
WARNING:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES • D CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($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 u pr vl s Ch ter commencing with Section 7000)of Division 3 of the Business and Professi s Code,and my license is in full
force and effect.Lic.• d Class• <_.5
Contractor's Signature: Date: / �C' —°
CONSTRUCTION.LENDING AGEN
❑ 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,a eroot the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
C6deiThe 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:
❑ 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 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 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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 a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the 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? 0 Yes 0 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.
Signatur= •f Legal Owner(s / Date
And/Or Authorized Applicant Date
CODE• INSPECTIONTYPE PMX INTITIALS ;ODE. INSPECTIONTYK Qdg RirmALa
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Root 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 .
. , 4
`9 ( ' CITY OF COSTA MESA r
4 BUILDING DIVISION
Y:fs .. DEVELOPMENT SERVICES DEPARTMENT PER NUMBER
sb 4 . PERMIT
�„4' 04-00895
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3075 TRINITY DR Status: ISSUED
Suite: Applied: 05/14/2004
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 05/14/2004
Parcel Number: 14107211 Zoning: R1 R1 •- '
Applicant: WALSER, GLORIA ISSUED BY: -Al,
•
Address: 3075 TRINITY - ,
•
Phone: 714434-0739
COSTA MESA,CA- ' " Zip: 92626
Owner: WALSER, GLORIA '
•
Address ,3075 TRINITY - - �
,.-/ %- _Phone: •
, 11'
=COSTA MESA,CA - - Zip: 92626
Contractor: vOWNER-BUILDER • 0 I��
'Address:
Phone:.
Zip: License: - 000000 '
. Arch : •
Eng: -
Address: Address: '
: Phone: • - Phone: •
Zip: - -License: License: , '
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE:T/O EXISTING WOOD SHINGLE AND COMP ROOF,SHTG PER MFGR'S SPECS, 15#FELT,
APPLY"30-YEAR COMP SHINGLES."26•SOUARES - - '
. . • FEE SUMMARY ,
. Plan Check: $0.00 _ _ _ _ __ ___ _ - -Calc Valuation: ,' $4,000.00
'Permit: ' $97.25 Claim Valuation: ; $4,000.00
SMIP Res: . $0.00 - .
SMIP Corn: ' $0.84 .
Other ` $0.00 .
Inspection: . $0.00 '
Total: , $98.09 -
PLANNING&ZONING
SETBACKS, ' ii
MAIN STRUCTURE-Front 0-0 Rear- 0-0 '_' • - • Left A-0 - . ' Right 020. ' ->,,,,
'-,
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
fora 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(6/00)
t
s 4
DECLARATIONS' \...i (—. ) F - is
•
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 carder 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.)
YI certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Sec Ion 3700 of the Labor Code,I shall forthwith
comply with these pro I
Applicant Signature: ace,- Qx� 'M Date: I C b //
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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.4 Class 4
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under.penalty of perjury that 1 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 ProfesslonsCode)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 es 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.). •
4 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 a unddr ser. Business and Professions Code for this reason:
Signature: 4r2 I k)O-K-+�\ Date: 0
Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. • Expires: IIi D
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,Gm 2,Art 2,Sec.
341,The 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 tiled with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No _
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 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 akEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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 ❑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 0 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- a ibed pro Jperry for inspectionpurposes.I agree not to occupy or allow occupancy of any building authorized byth /(4
rrnil'ntil�al inspection.
ILII TC_ Signature Of Legal Owner(s) `I Date
And/Or Authorized Applicant Date
CODE X INSPECTION TYPE QATE INTRIALS CODEX INSPECTION TYPE PEE mama
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final ./ , 208 Final Plumbing
200 Final Re-Roof �.7 �la 1. 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
. 13493
• FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT DEC 1 41y6o
P.O.BOX 317 COSTA MESA.CALIFORNIA
•
FINANCE DEPT.°ems
FOR APPLICANT TO FILL IN COMPLETELY APPLICAct FVOM T •
TYPE OR PRINT BUILDING
ADDRESS v'0 7.S TR i NI IT/ ,O .
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. PE�YyT y0O(/
� _/
MAIL RECEIVED BY DATE RECEIVED DATE ISSUED
OWNER KWK "CONSTRUCTION Co .; INC
ADDRESS • - N • `VENUE ,o I /a-/ ' -60I IIF(.9 1 1960
TEL.MM, BUILDING
CITY NEWPORT *BEA CH, CALI FNo. g 227 ADDRESS
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR ENGINEER NO. . FIRE
/ -/
ADDRESS
ZONE TYPE V GROUM OLi-
E APPROVED
CONTRACTOR K. •W. KoLL LIC.STATN0. 1195 BY DATE
ADDRESS 1555 PLA CENT IA NEWPORT
1 BEA CI ZONING
LEGAL I LOT IITO`F1 �`pq'E1 NO.OF USE OF NE
ILL
DESCRIPTION NO. BLOCK TRACT Ate^_ I PLANS I BUILDING i
A.P.NO. — AsPROVED /01/" DI/�y{�� ATE j "44 o
SIZE 60X100 I NO.OF BLDGS.O YARDS !/✓ EVE
OF LOT NOW ON LOT REQUIRED ALLOWED
USE OF (CENTER LINE ST.) _� � �
EXISTING BLDG. FRONT _�FT. L T✓LL- 2414.
SETBACK LINE
CENTER OF STRE TM 6®XAn® 551 REAR YARD 231 �—
51 51
R.SIDE J FT. IN.
SIDE YARD LEFT RIGHT L.SIDE SFT. IN.
DESCRIPTION OF WORK
'REAR ,.-,,. FT. IN.
NEW I X II ALTERATION I II ADDITION I 9//IF-2-k ,•1041, . 1-y7C.e.---,-C,..).a
REPAIR I I MOVING I I DEMOLISH I j L/[J[¢{- yam.
BUILDING 1506 SF NO.OF 7
SIZE ROOMS I STORIES 1 EL-P1 'tin 3 S---1''-n '2ent- � _ WA.i-�C�,
EXTERIORWALISTU CC O COVER COMPO SHINGLES ���""��I`/� Y//y
COVERING • .
USE OF BUILDING AND WORK TO BE PERFORMED
SINGLE FAMILY RESIDENCE AN
ATTACHED GARAGE PLAN' NO .7 Q _ 75-0 6 �� �J "it 60 ,
Oa n .
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
I
AND STATETHAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT OWN UNDER VALUATION IS FOR THE _�/
PLY WITH ALL CITY ORDINANCES AND STA LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. AN/`
BUILDING CONSTR TION (. ///'7 VALUATION _
PSIGNATURE ERMITTEE Oy ' Yi PERMIT FEE $ ,3S d'-o
�j3 /yq
111,
�/1' /✓/I- $ / GS `PLAN CHECK $ 7 ,JPO
AUTHORIZED AGENT
TOTAL FEE $ 5:7, CO .
• PROJECT ADDRESS: 3075 TRINITY DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06148tH`
OWNER'S NAME: BAUMBUSH, BRUCE
ADDRESS:
3075 TRINITY DR PERMIT NO: B 061486 PLAN CHECK NO: 00967-93 S GOVT: N SUPP : N
COSTA MESA, CA 92626
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 40 LIN FT OF RCMU WALL @7�//' HIGH SQ FT: 40
y ADDRESS: UNIT:
PERMITTEE: CLAIM VALUE; CALC—VALUE: 800 . 00 GROUP OCC: R-3 /
ADDRESS: B • ME7.A ( 619 ) 360-9784
43518 VIA MAGELLAN COMMENTS : *
PALM DESERT CA 92260 Ir******%4%********acs%+EiF>F%*xat****% *+tit*******Tr********* *****x%T6Trir **** ********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)0l Division 3 0l the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: � STATE LIC.:335804 CLASS:C_29
Date:__5/Z-X7153 Signature: _ •
MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm)hal I have a certificate of onsentA Tell-insure or a certificate of Workers' FRNT; 20 FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
TLICY NO.: EXP.DATE:
OMPANY: PARKING REQ• PROV: PARCEL: 14107211 ZNE; R1 REF NO:
.J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> 40 LF OF AN 80 LF 6 ' HIGH BLOCK WALL TO BE CONSTRUCTED ON
y� .• > THE RIGHT SIDE PROPERTY LINE TO THE BACK PROPERTY LIN.E•,
Date: Applicant: *********%***********%************ %**************************************aE** iE
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:.-(This section need not be completed if the permit is for one hundred($lOO)or less). DEVELOPMENT SERVICES R E Q U I R E M E -N `T- S
I certify that in the performance of the work for whichlhis permit is issued.I shall not employ any person in any manner so as to become /
subject to the oekers'C m ensation Laws of California.. / /
Q° ✓ ZONING APPROVED BY ►,E) Rk DATE: 3 2-
Date: 12-11 I/ _ Signature: Q
os
NOTIC :II.after making this declaration,you should.tiecome subjecWoralrs'Compensation provisions of the Labor BUILDING APPROVED B Y evil* DATE;/13 a -.3
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. J 7
CONSTRUCTION LENDING AGENCY: I hereby affirm'(hat.fhere is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• l,ew 3E, DATE: 1 / Z'a (//�
which this permit is issued(Section 3097.Civ.C).J,% **)(.%**s*****%*oe*%%******A-*****-X. Pt x*** E* * Y****************%***!F***+r- *it 1.r�r **
t
LENDER: et *****************************************%3®F%%*******%************* 3f/*********
ADDRESS: LEGALIZATION; N F E E SUMMARY STRUCTuR{A' SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES! GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 2 1 .0 0 ', . 5 0 ,
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
SM I P/NON RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 13 . 65
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I, as owner of the property ar my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN-'CHECK TOTAL PAID DUE
J structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 21 . 50 0 . 00 13 . 65 35 . 15 35 . 15 . 00
does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through •41
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: 35 . 15 OVER/SHORT: ,00
for the purpose of sale), BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 21 . 00 r- , 50 13 . 65
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contractsfor such protects with a contractor(s)license pursuant to theContractors'State License Law).l am aware **%x.***********%*****%************************%******************x.********%****
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date' Owner: SFR 40 RES—CONCRETE BLOCK WALL / FT. 20 , 00 800 . 00
I do hereby certify that l am aware of and understand the requirements of California Health and Safely 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 far a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
-
these provisions.
Date: Applicant: .-
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and ereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
r,___ Dater-13-AI (93 Signature: -� -
Drivers License or Social Security°:
164i-46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
_ CONSTRUION AND PLANNING F - & SPA
CT
, APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspe;for
, t
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 3 s7. ;A:, 58. Electrical Conduit-Undrgrnd. ..
8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. •
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
•
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69.. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation - i - 78. FIRE PREY. FINAL
30. Drywall Nailing - I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat -. -* . 79. FINAL INSPECTION
32. Electrical Power Meter-Final ;;r : 80. FOOD CERTIFICATE ISSUED •
33. Final Electric Notes:
34. Final Heating & Air Conditioning 1 I',, Sik)_/-94S OX geth.)(1-44,1-
35. Final Gas Pipe-Test. - -'j,` '-
36. Hood or Canopy t
37. Final Faetoty"Fireplace I
•
38. Final Plumbing L r,
39. Water Service-Final I .i
40. Gas Service-Final I '
•41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING 3.1L pp I ,i
48. FINAL PLANNING �s
49. Electric Release to Edison ; • -
50. Gas Release to Southern California Gas Co •' ' .r
51. CERTIFICATE OF OCCUPANCY
No. Date
Ntil
APPROVED
ADDITION'S. _. TE
C�-i
` ®E APF�; ' , , RECTIONS SHALL'
City of Carta Mesa Building Dept. ` P' ;;
!.,L_PARTMENT
BY I,�_` �Sf� DATE ���f 19 J�3P
THESE FLANS ,;CO-,T GE 0'! OE: AT ALL-FIMES MAK It®�j�
NO Ci-L HCLES 'WITHUL.'r APPROVAL OR T. Clay OF COST: �.
- ISSUANCE OP. GRAN"; : ONII CI? Au . OVAL OF _ " -I. . 1 .
7hG DEPT.
l= . „!:ND SI'FCIi'ICA71�y(g COOSIP;ED TO 9F.A 6UDJE
„•' FOR, OR AN t F- f i OF ANY OF ` CT TO BLDG. DF�r- £ o.
- I Olhr]NS OF TI -S MINE TCCIVE l . q ��/
r -� tl r -I c, ' �L t ' - t. ,I pus OF THIS '� DATE__ 3 /.3 Permit
( c, SHALL BA VAL IX7 >.0 'I S.1 1H 5 THE VORk OR USE DU O[ OP
•
. rnM:h:fAU?'IORrCSISLA:,f ;:- PLANNING)
THIS NUMBER M
Ts ISSUAM:E: :N A PH-ii4ir SAEEO _,PON -LANs AND $Q� UST ACCOMPANY
SPECtrr::4H0NS SUAIi. IS:- P;if.VENT THE BUILUIU OFFICIAL
'� .�� ALL INSPECTION REQUESTS
FROMIDTR B NS 6N0 RC EC UIC O �O DOP E ,ORS'TING IN
l” /
SAID P'.AmS AND £ ,EC9'ICA7fO71S :;R FROM oRE4 ' NG
RUILHP-3 OPEAAI ION,.BEING CAER:ED ON THEREUNDER N
IN ViQLATiC:2 Or I IcI: COOL OH OF ANY OTHER.ORDINANCE 6' •
(HE CRY. - •
. IL
-3
I FOR INSPE TIONS
CALL RESrotact RESIDENCE . RESIDENCERES �I
ID[NC[
754-56 W 307 S S /307
• OT 1. W
. 754-562 ,
N
i
•
. + -77-7,-,,,,, pz STREET e. `
•
TYPICAL 611 CONCRETE BLOCK -FENCE . _ _ . __
® - •
•Cement Coping Optional !.:-.11 ` I : 'GENERAL— NOTES 1111
Channel Block With 1-3/80 I'; •
f
Horizontal Top of allI - •
FencesI MORTAR: One and
Part Plastic Cement,
Three Parts Sand •
For Fences 5'or Less SQ — GROUT: One Part Cement Three and
f �' One Half Parts Stand . '
Vert.Bars 3/8"0 at 4' -0"O.C. III - COPING'
_ — ' One Part Cement, Three •
f--For Fences Higher Than 5' : 1 4 ' Parts Sand
Vert. Bars 3/8"0 at 32" O.C. , I > w -- - _ CONCRETE: Well Mixed 1:2-1/2:3-1/2
= Max. of 7- 1/2 Gallons of
' . Fill Cells Solid With Grout - '•' 11 ' I > z ell Water Per Sack of Cement
WhereSteel Occrs _- .. „ . �+■ . a -Reinforcing Steel Shall- !Ye If 10 I GROUT MAY BE POURED FROM THE TOP
t 'c ..I t IIIYYYY���� _ t OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec-A-15-39 •' w 01. ------ OCCURS.
!. A.S:T:M:---• Z ,- • I^ CELLSANDAREASOFHORIZONTALREIN-
IiI w n -1 J FORCEMENT SHALL BE CLEAR,CLEAN&
All Steel to be Lapped ii. LL �i - 71 FREE OF ALL MORTAR DEBRIS,ETC.
24”or to Code llll
NATURAL GRADE
III /�
'III v
i`.��� .i,� _ s
�l/A*..� ,7�0\' •LA0• 0
. o .
TWO3/8••L�+BARS • '[3� n
CONTINUOUS TOP 'MIS
& BOTTOM -sI-{ F-.—WIDTH TO 16 O.C. MAX. _e'
SEE CHART 's �. -
BELOW - - . .
HORIZSTEEL MUST BE TIED IN • OE PTH OF E4RTHTCOTH ,
PLACE AT TIME OF TRENCH e I 1/3 THE :HEIGTH OF FENCE'. 1.''. '
INSPECTION. e + . l
1 - VLOW BOTTOM' OF: FOOTING' . •
410
o 1- 2.._.1_ SCALE: 1%2" : I'
FOOTING REQUIREMENTS CHART
L WALL HEIGHT 6 ' S 4' •
3' - ' - -
WIDTH 14" 14" 12' . . . . . . --- -12" - -'
THICKNESS 10" 10" 8 " . 8 "
DEPTH OF EARTHTOOTH . . . 24" . . . . . . . .20" 16" . . . . 12"
SPACING OF EARTHTOOTH. . 12' 14' 16'. . . . . . . . 16'
•
City of Costa Mesa, California
Building Department •
- • 1ZFVt5E0 Nov.e:.
•
•
PARTY WALL AGREEMENT
• THIS AGREEMENT, made and entered into this 3 day of
/ 73 , by and between
hereinafter referred to as "LANDOWNER," and
hereinafter referred to as "ADJACENT PROPERTY OWNER"
• It is hereby agreed that a party wall will be constructed on the property line
between 3e 7.9 7iu-44-c 3 0 l
57,
ddress of Adjoining Properties)
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
075 $ 3° t ?
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER ADJACENT PROPERTY OWNER
(Signature) nriaA
(Signature) ,�,/
erE
Name(Typed or Printed) NamdYPrinted)
3c1S I Rt►J * j CoSkA MESA o � J' e c •,cid ( m.
(Address) (Address)
• / qua
•
r LIQ NOTARIZATION REQUIRED .� OFFICIAL SEAL
P I)A) • t !�fQ PATRICIA LYONS
•
�,� _ ^ rJ.9 NOTARY PUBLIC-CALIFORNIA
C�/� a ` .r.. OSAN ELOFFiCEIN
V 19r -6 A_\�,,�,�/� � 1 LOS ANGELES COUNTY
"aD \y%AC; ?Pat. �1J�i14-)'I.i/ ,w�...�:YCan.ns._n-Expirs June 2C.1CW