HomeMy WebLinkAbout3253 TURLOCK DR - Building Permits,
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CITY OF COSTA MESA
� � pMFq^9 BlIILDING D/VISION
i� $ 77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Faz p14) 754-4856 • www.ci.costa-mesa.ca.us
: �'
�. � FOR INSPECTIONS CALL: (714) 754-5626
�'""'°"°fi PERMIT NUMBER: B10-00135
PERMIT TYPE B_ROOF2
APN: 41210418
JOB ADDRESS: 3253 TURLOCK DR CM
Vicinity: HOUSE ROOF ,
Squares: 1600 -
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit: ..
� Valuation
ISSUED
OS/17/2010
RMD
$6,987.00
SCOPE OF WORK: TEAR OFF. �EXISTING ROOF MATERIALS, INSTALL 4-PLY BUR ROOF SYSTEM, 2-PLY CAPSHEET TO PARAPHET
WALLS ON HOUSE ONLY, APpROX 1600 SF.�COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT.
OWNER: PALLO, GEORGE J TR - Address: 3253 TURLOCK DR �' Unit
PHONE: 949387-9833 City/State2ip; COSTA MESA, CA -
APPLICANT: NIELSEN, JACKI � � -' " - Address: 29222 RANCHO VIEJO RD .- Unit: :UNIT 725
PHONE: 949-6783110 ' � � Citv/State/Zio: SAN Jl1AN CAPISTRANO CA
CONTRACTOR: CRANK 9ROTHERS�ROOFING CO, INC
Address: 29222 RANCHO VIEJO RDUnit: � ��- - UNIT 125
City/SlatelZip: SAN JUAN CAPISTRANQ CA - .
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$0.00
$13925
"�0.00
$1.00
License No.
License No.
License�No. � 903758
PHONE: 949-548-5569
�92675 CELL:
PHONE:
PHONE'
TOTAL FEES � $140.25 - - �
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE-3I18I2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Independence Dav, Labor Dav, Thanksgiving Day and Christmas Dav
NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed under this permit ro 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.
LOOE1. INSPELTIONTYPE DATE INTITIALS COUEp INSPECTIONTYPE OATE INi111RL5
1616 Fixed System Final Fire Pravention 206 Final Mechanical
1266 Pool Spa Final p��, 208 Final Plumbing
200 Final Re-Roof —'"�' ��/ �� 210 Final Eleclrical
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
•
WORKERS' COMPENSA710N DECLARATION:
I hereby aKrm under penalty of perjury one of the (ollowing declarations:
❑ I have an0 will maintain a Certificate of consent to sel(-InSure for workers'
compensation, as provide0 (or by seclion 3700 of the Labor Code, tor the
pertormance of the work for which Ihis permit is issued.
❑ I have antl will mainlain workers' compensation insurance, as required by
sectbn 3700 of the Labor Cotle, for lhe peAormance of [he work for which this
permit is issued. My vrorkers' compensation Insurance carrier and policy
number are: 1 1 _
Cartiei:s STG7� �Ur+C/I
(Ths serlion ne,e-tl, �riolF6e� mmpeled d Ihe ce�4 is value�C Gal rne huntlred tlollars (5100J o� less )
Poff�Number. �JtJ�3 �%� - 71�i� /
❑ I certify lhat in the performance of the wvrk for which this permit is
issued, I shall not employ any person in any manner so as �o become subjecl
lo the workers' compensation laws of California, and agree thai if I should
bewme subject b[he vrorkers' compensation provisions of Sec[ion 3700 of
the Labor ode, I sf all for with comply with these provisions.
-' I Z01�
AOF�^fs Signawre Laty��
WA ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE tABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensetl under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business and Professions Code, and
my license is in full torce and eRect.
���`�� 5 �5 � � �3�
•� J.: ;.:._. _ S I I"1 �� Ol�i
� ConlraCtor 5 $ignature 'Da1e�S'"
C NSTRUCTION LENDING AGENCY:
❑ I hereby aHirm that there is a construction lending agency fw the
peAortnance of the �+ork ta which this permit is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Signature Date
OWNER-BUILDER DECLARATIONS:
I hereby affirtn that untler penalty o( perjury that I am EXEMP7 FROM 7HE
CONTRACTORS LICENSE LAW for the (ollowing reason (Sea 7031.5,
Business and Pro(essions Code: Any ciry or county which requires a permit lo
construct, alter, improve, demolish, or repair any strucWre, pnor lo its
issuance, also requires the applicant for such pertnit to file a signed statement
thal 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 Cotle) or lhat he or she is exempt therefrom and
the basis for the alleged exemplion. Any violation o( Section 7031.5 by any
applicant for a permit subjects the applicant [o a civil penalty of not more [han
five hundred dollars ($500).):
❑ I, as owner of the pmperty, or my employees with wages as their sole
compensalion, WILL DO THE WORK, antl the structure is not intended or
offered for sale (Sec. 7044. Business and Professions Code: The Contractors
License Law does not apply to an ovmer of propeny who builds or improves
Ihereon, and who does such vrork himself or hersel( or through his or her own
employees, provided ihat such improvements are not intended or offered tor
sale. If, however, the building or improvement is sold within one year ot
completion, the ovmer-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 CON7RAC71NG WITH
LICENSED CONTRACTORS to cons[ruct the project (Sec. 7044, Business and
Professbns Code: The contractors License Law dces not apply to an ovmer of
property who builds or improves thereon, and who contracts for such project with
a conl2ctor(s) license pursuan[ ro the Contractors License lavrs.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
SignaWre Date
3051-66(3I0))
� 1. . .
Ovmer ID venfietl by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Venfcation o! Ovmership by (rype of document, i.e. - property [ax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify [hat no excavation frve (5) or more feet in depth iNo which a
person is required to descen4 will be made in connection with work authorized
by this permit, and that no building simcture, scaffdding, falsework, a demolition
or dismantling thereof, will be more Ihan ihirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, Califomia Administrative Cotle).
❑ As ovmervbuilder, I will not employ anyone to do work which woultl
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the tlivision.
Appllcanfs SignaWre
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant o� present or fuWre building occupant neetl to file antl
certi(y a Business Plan for emergency response [o release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of lhe California Health and Safery 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 tlunng a reported
year a quan[ity of hazartlous materials equal to or greater than a weight o(
500 pounds, or a volume o( 55 gallons, or 200 cubic feet ot compressed gas
al standard temperature antl pressure).
2. Does or will Ihe applicant or present or future building occupant neetl to file
a registra[ion form for acu[ely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Healih and Satery Code, with some
exceptions, requires regisiretion with the Costa Mesa Fire DepaAment 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 o( 55 9allons, or 200 cubic feet of compressed gas at slandard
remperaNre and pressure).
3. Does or will the applicant or present or future building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safe[y Code pmvides that Ihe
Costa Mesa Fire Department may require the preparalion, certification and
filing with the Fire Department of an RMPP by businesses which are requiretl
to register awtely hazardous matenals with Ihe Pire Department.
4. It an RMPP is presently required, has Section 25534 of the California
Health antl Safely Cotle been fully complied with? ❑ Yes ❑ No
5. Does or will the appliwnt or present or future builtling occupant require for
the work which is Ihe subject o! Ihis application a permit foi such construction
or modifcation !rom the South Coast Air Qualiry Management District orlrom
any other air polWtion control tlisMct or agency? ❑ Yes ❑ No
(Section 6585Q2 of the Cali(omia Govemmeni Cotle requires that the reques[ed
in(ormatbn be fumishetl on applications tor non-resitlential building pertnits).
6. Will any part of the facility to be conslructed under this permit be wi[hin
1000 feet (rom the outer bountlaries of a school? ❑ Yes ❑ No
Qf "yes", Ihe facili[y must meet Ihe requirement o( Sections 25534 and 42303
of the Cali(ornia HeaIN and Safery Code�.
7. If a permit from the South Coast Air Quality Management Dislnct or other
air pollution control district or agency is requiretl for the vrork which is the
subject of this application, have all of the disclosures prescribed Dy California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certificate of compliance from the appropriate air pollution
control otfcer�.
CERTIFlCA7E OF COMPLIANCE: I certi/y 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 antl Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I
certify under penalty of perjury that I have read this application and state that
the in(ormation given is correct I agree to comply with all state laws and city
ordinances relating to building construction, and au[horize representatives of
the Ciry of Costa Mesa to enter upon the above-descnbed pmperty for
inspection purposes. I agree not to occupy or allow occupancy o( any builtling
authorized by mis permil until fnal inspection.
Si nawre f L al ovm s) oale
_ S �I� %Z01�
'Antllor ALlhbnzed Applicanl �Oe�e
c Certificatc ui'Cu
Aderatirurs�
G e n c ra I I n(u r m:� t i o � i
Si[eAddress: ^� 1�
Building7ype LXSingle Faniily O Multi Pami)y
Conditiuned Fluor Area (CFA):
Thi.v /nrm i,e uo! to Ae
L�s�dnfinn V�dues Fm'
Rcsidenti�l
Climate
Gnfarcemenf Agenc}�:
U»te:
Circ)e F)�e Froni Orien[ation: N, E, S, V��, or degrees _
Prqlect Type: ❑ Aiterations ❑ Lnvelope O Fenesvation
Cnn.etrue�ed 6uildin�snrfldditinns'
use Ihe Mass und Furring Strips Cons7ructioir mble
:F-1R-AI;7'
Pa�e ] of'S)
N of Sturies
Rnoi' O HYAC
tieater
❑ Openin� 01' 1'rumed carvil�� alone—ALera�ions Iha� irrvnlve the ope�ving ojlhe framecf cnvib� ofp wa/l, ceiling, or'Jloor mus7 insml/ the
ma�daiori� minimmn inszda�ion ��nlaie per �I50 Jor Ihe allered assenvb7��. Fi71 ira Columns A—C and enter mandulor'p insu]atio» value in Cofumn H.
❑ Replaicement ol' entire nssembly— Rep]ucemenl ofav entire wall, ceiling, nr flom-assembly regaiires lhe inslallotion ofCompone�v
Pucknpe- D nasidntion value.r iiv Tnblv 75/-C. Fill in Columns A— J. .
Surface Details �or tl�e furred
Praming
Tag/ Assembly Name Material
ID� orTy e� andSize'
No�e: For jurred assembliee, accounting fa' Con.
of Mass W:�IIs see
... n � �o r -.. p
)I Stamdard p
Thicla�ess,
Spacing, LI- 7A4 Table
or Other' factor" Numbers
see
Constructiun Ts�ble below. ��
G I . H... .._.. �.......... ..�.. . _
Velues From JA4 Table
Framed Continuous JA4
Cavity Insulation Assembly
R-value� R-Value' Cell Value�
use !he Mass m�d
Furring Consnvcliou io67e bela�o.
1. For Tag//D indicate Ihe identi(cation name ihal mn�ches �he building plans.
2. Indicate �he Assemblv Nnme w� rype.' RooT/Ceiling, Wa(!s, Floors, Slabs, Craw! Spuce, Doors and etc...lndicate the Frmne type and Size: For
V'Vood, Meml, Metal &iildings', Mass, enter ?z4, ZxG, or ete... see JA4 for other yossiblc.fi�ame tyye assernblies.
3. Emer the thiclu�ess for' mass in inches ar Spacing Gehveen fruming mem6ers enler; 16"or 24 "OC; ar 0(her for a// other assembl�� description
such as Caocrete Smadrvich Punel, Spandrel Panel, Lags, Sn�aw Ba/e Panel and etc....
4. Bas'ed on Uie Clinm�e Zone; emer Ihe Slandard U facmr fr�om TuGle 151-8, C ar D(w� eacli differ'en1 assembl�� Name a� rype.
5. Eirter t/re Table irumber thal closelr resemGles the propos�ed as.semblr.
6. Emer Ihe R-vo7ue d�nt Fs being inslu7led in the wall cai�itp or be�ween the fi'unring; olherwise, enier "0".
7 Enler lhe Co��t6mnus Insula�ion A-i�alue (or (he proposed ussen�bly; o(herwise, en�er "(P'. .
b'. Gn�er �he row aid cnlunm ojlhe U-facior value bascd on Colurm� F Table Namber ond emer �he �lssenvbl�� U-fuc�or in Column.7
9. TheYropnsed daa�emGlr U-jac�or, Colu�mi J, mu.s! be eyuo7 7u m� less' than !he Stundnrd U-facim� in Colunm E io cmnpl��.
Fwri��g Strips Constniction Table for Mass Walls Only
A B C D P A' G H 1 J K L M
Prupnsed Proper[ies of Mnsonrp :md Cunerete Added Interiur or Exterim� Insulsrtiun
Wails Prum Rcfcrence in Turring Space from Iteferencc
Juinl A i�endiz 9'able d.3.5. 43.G_ 43.7 � duinl A i�endix Table 43.13
v � _
U VV �...1 1 v� U
✓� li U o 'V `L r u y
Asxcmbl}, �� j � �.4 � r c u,'v i" .>'m F)na)
Mass Name or JA4 7'able � v� v R � c '� F Q_ ` a ASSeinb�Y
'P6ickness� T e' Nmnber' �`° ' �. c i_ � �'� �? C <':° ��' U-(uclor�''� �:ommenl
I
� � I �
Ifegis�ru�ion Num6er: Re�i,strulion Ua�e/Time: HERS Proi�ider.-
200b Re.sidential Complicuice Fmm.r Augaest 2009
ROOFINC PRODUCTS (COOL ROOFS) §151(pl2
When tl�e aren of ex[erior roofsurface m bc repluced eYceed.�' aiorc Ihan 50% of tbe eristing ronjaren, or iuore lba� 1,000 j�, rvhichever is
less', the ne�n roafii�g aren u�usl n�eei thc ronfing prodiic/ "Coal Ra�f 'requireiuenls nf,�I51(b)7Hi, 152(b)IHii, or l52(b)IHiii.
ChecA opplicnb/e niternntive or exception be/oN� if ihe rnof a6erutio�v (s exemp/ fi'om fhe roofing produc! "Coo7 Rooj" re9uireme�vts. Note: /f any
nne of 1he a6ernutives nr ezception 6eloH� is checked, �he Aged Solar ReJlectance and Thermul Emitrance reyuiremenrs for raofing products in
ure not npplicable. Do nol,fi/I /ab/n belo��.
�Cool Roofs Not Required in Climatc Zones 1-12, 14, and 1( with a Low Slopetl. Less or 2:12 pitch. , �
�Cool Roofs No� Required in Climate Zones I through J and I6 with a Steep-Sloped Roafs (pitch greater than 2: I Z) and produa uni� weight less
than 516/ft�. -
klternatives [o §152(b)1Hi and §152(b)Hii, Steep-slope roof (ptich > 2:I2) `—
❑ lnsulation with a themial resistance of at least 0.85 hrfi��°FBtu or at least a 3/4 inch air-space is added to the mof deck
over an attic; or
❑ Exis[ing ducts in the attic are insulated and sealed according m�§ I5l(� 10; or
O� ln climate zones I Q 12 and I3, with 1 ft'- of free ventilation area of attic ventilation for every 150 ft' oFattic floor area, and
� where at ]east 30 percent of Ihe hee ventilation aren is within 2 feet vertical distance of the roof ridge; or � �
❑ Building lias at least R30 ceiling insulation; or
❑ Building has radiant banier in the attic meeting the requirements of §151(�2; or
❑ Building has no ducts in the attic; or
❑ ln climate zones 10, 1 l, l3 and 14, R-3 or greater roof deck insulation above vented attic.
Ezception to §I52(b)IHiii, Low-slape ruof (pi(c/i <Z:[2J
❑ Building has no ducts in the attic.
Other �xceptions �
❑ Roofing area covered by building integrated; photovoltaic panels end solar thermal panels are exempt 4om the 6elow Cool Roof criteria.
: O Roof constructions that have thermal mass over the roof inembrane with at least 25 Ib/ft is exempt from the below Cool Roof criteria.
[c: If no CRRC-1 label is nvailable, this compliance method cannot be used, use
Check the avnlicable bos below if Exemot from Ihe Roofine Products "Cool Rc
Roof Slope
2:12 > 2:1'.
❑ ❑
Product Weight
< 516/ft' > Slb/ftZ
❑ ❑
❑ ❑
❑ ❑
❑ ❑
��
to show
Product Aged Solar
T e' Reflectance3'd
❑4
�4
❑4
impliance, o[herwise,
Thermal
Emittance SRIS
Tke CItRC Praduc� IU Number can Ge riblained J'an Jlre Caal HaoJRo�ing Cuuncil's Ru�ed Praduc� Uireela�7� al �o�mr cn�lronfi� arn/nrndacis/s�o�rb�
L�dim�e Ihe type oJproducr is Leing userl (orlhe roo((op, i.e. single-p!p roaf, asphal! roof, mela! rnof, elc.
/(Ure dged RcQec(anee is noi ovnilnhle irr.the Coo( Roa(Ra(ing CmmciY.r IZa(ed Pr'oduc! Direcloi�� (hert use lhe /ni(in! Aeflec/nnce voluc fi�oni !he snme
direr.lm7, ��i�l vse the er�un(ion /01+p.7((l���i�iul– �.1) In nGl�rin n cnlcidoted agcd voL�e. Where p is Ihc h�iliu( So/nr Reflecfance.
Check boz i/'U�e dged Re/!eclnnce in n culc�dmed ��olue vsi+rg fhe eqim�inrr aLove.
CalciJale7Le SI{/ vafue bn using Ure Slil- lVw�kshee! n1 hlbr// viv�r energr cnYnv/�ille24/pnd enrer Ihc resulfing value in Ihe SHI CoLnnn abnve and atmcb acop�� of
�he SRI- INor•k.fhcei io the CF-1 f2.
o apply Liquid P'ield Applied Cuatings, the coating must be applied across the e�itirc roof surf'ace and meet the dry mil thickness or coverage
:commended by [he coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable wating:
Aluminum-Pigmented Asphalt Rnof Coating ID Cement-Based Roof Coating �LJ O[her
Regish�utio�v Number: Regi.rtration Da[e/Time.�
2008 Re,sidentiul Compliance Forms �
HEXS Provider:
Augusr 2009
�
c:�te o7�Cumpliance: Residential
m,�'
GIb
cr-i iz-AL�r
'P�i�e 5 uf 51
�;� ol:Stqrie,s�
FI�RS V�12IF1CATI01� SUMMARY Tl�e en(orcemenr �igenc.r shmdd pur speciul cmemim> to �Ge HLKSNIeusm�ea� speci/ied in dais �
checklis� Lelmr. A cromple�ed nnd.sioned CF-4R Fm-m {or nll the inen,sin�ea� specified shn(1 be suLn:iAed ro tiie 6uilding inspecim-be1��'e finul
insneciion. � �
llOCt sEd�lll�e t�: ��eStlllp HGRS vei'iJicniian ia'regzrired fm' dfis nfem'in'c.
❑ �'ES ❑ NO YGS: ln Climate 'LoueS'_ and J- I G, if more tlian 40 linear feet of new or repincement ducts are installed iu uncondilioimd
space; the ducts are to be sealed per Z152{b)IDii aud the newly mstelled ducts are to be insuluied pei § I51(1110.
1] LXC�PTIOA': G�istind duct systems lLat �re estended, ivhicl� w'e emistrneted, iacuJflted or se:ilecl �veth asbestos.
❑�'CS ❑ NO YIIS- ]n Climate Zo��es 2 nnd 9-16, if tlm eristinE apace-conditioning system (HVqC equlpmenl and ductingj is replaced, the
ducta are to 6e sealed per § 1 S2(bp Di,
❑ TES ❑ NO ]'ES: In Climate "Lones 2 aod 9-1 G, if tlie exisiing HVAC equipmeN is repluced (including th� replacement of the ai� handler,
� outdooi condensmg unii of a sulit system, coolii�g or heaung coit, or the fumace Leai ezchange�y [he duets are to b:
sealed per §152(b)lE.
❑�XC�I'T10N: Duct sysiems thn[ nre ducumenled ta htrve been previuusly sealed cont7rmed Hiruugh I-(EP.S
. � � verification in �ccordnnce with procedures in the Reference Residential Appendia RA3.
. ... _ . _ . . . . .
, ❑ iXC�PT10�: Duct systems with less hhnn 4Ulinear teet in uncondiiioned spnce. � � . .
❑�RC�f'T70�`: Gxisting duct srstems constructed, insulated or senied �vith ushestns. � �
RPt�I'1v0Y3RY Ch�Cee - SF711t 5)�Stelt� HERS verif�cation is required.for thi.s measm�c. �
❑ Y�S ❑ NO YES: In Climate Zones 2 and S-li, wlien the existing HVAC equipment is replaceJ (including the replacement of the air
hai�dler, outdoor condensing unit of a split system A/C or lieat pmnp, cooling or heating coil; or the furnace heat
exchaneeri n refriserant charee measurement siiail be veritled oer § I52(bl l F.
Central Fan Tntecrated (CFI) Ventilation S}�stem and Fan W att Draw
The ventilation reauirements of F150(o) do noc anolv to eaistin� residential homes.
Ducted Split S,ystems - Air Conditioners and Heat Yumps: Airflow HERS ve,-i/icar;on is requirerl for rhis measurc.
❑ Y�S ❑ NO PGS: ln Climate Zones 1 D through 15, wl�en the existing space-conditioning system (H VAC equipment and ducting) is
- reulaced the aSrflow and fan watt draw shall be verified oer § 152f 611 Ci to meet the reauireinents of 6] i I(fl7B.
Auti�or's Declarztion Statement
of Comnliance documentation is accurate and
� I �.S
lnG� �ar��ti�✓ti�o [J3- ��b7,5
Da��:� �� 7� z o i �
]f Applicable O CEH or � CEPE
(CeniGcation il ):
Phone:
aa� -s�r� -ssr� y
�on'sible Buildine 7)esi���ier's Declaratiun Statement (r�'
1 um eligible under Division 3 of the Califomie IIusiness �mcl Professions Code to acceyi responsibility (or the'nuilding design identified on
Ihis Ccrtificate of Compli�incc.
I cerlify thal the eneisy Cealwes un[I pedormance specific. uons- for the building design identiiied ou this Certificate of Compliance confom�
to therequiremenls ofTitle 24, 7'tirls 1 and G oi'thc Califomlti Code of Regulotious.
Thc buildin� design feutures ideniified on this Certifica�e of Compliance tire consisiem with lhc informauon prm�ided tu douumem tlds
bulldino design ou the other �ii�plicnble cumph�mce I'onns, woi Lshcets, eulculation&, plans aud speeifmu�ions subnutted tu the enforeement
u¢enct' 1'or aonrovul wiih thie buildin�� ncrmit tinolicution.
Name:
Comptmy:
Address:
Si�nalure:
Iiate:
License:
Phune�.
I�rn� as.vi.ctanee or guastimss �•e�mvlin� ihe Energp Sumdnrrl,s, contacl !he E'nergr Hn(line a1: 1-k11D_i72-�90G.
7(egia'irnrinu l��wnGer: l(egi,tu�aiion Daie/Tmie HBRS' Nrorider:
?OOb' Residei�tinl Comp[ia»cc Fnrnts flztgtbr! 2009
. _ _ T �
. Applicant to fiil in all spaces except tnose wilhin heavy oorEer Iines ana sign a11 approo��ate Ceclarations.
CITY OF COSTA MESA � � ' _, PERMIT NO. � TRACT NO. LOT NO. BLDG. ' . . , .
CONSTRUCTION PERMIT' ' � �jZ � ' � " � '
� • ' �573 5/IB/B4• 13.50 TL
P�OjCct Add�¢SS � L � F TYPE OF CONSTRUCTION ' rvEW � ADD ALTFP,ATION REPAIR �
Applicant'S MailingAddre55 ; t2 COIIIID@T�l�1C . M. - - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER �' A p # . ' ' Zone ' �
Owner's Name G00Y'ge P2110 pho�e -2 z1i' DESCRIPTION OF WORK - _ . -
5 Main Buildin9: Accessory Building: O
naa.d:�' 3253 Turlock Dr. , Costa�Mesa � e � . _ .
. �- - . TYPE OF PERMIT GRADwc FOUrvDA7iON ❑ 57aUCTUR.a�� . T Front N
Arch/Eng. LiCenSE No. ❑ TENANT ❑ ELECTRICAL� ❑ PLVMBING O MECHANICAL B �
- , - , -.. ' ' A Rear N
Address - ' � - � � ❑ OTHER - ' � ' C Right ' ' G
CY'311K Bi. � ROOf1Y1 -S 6�� . PRQIECT DESCRIPTION SQ. FT. • 1300 ocCUPANCV � � �
CoMractor's Nam Phone -
Addresslmailing) �� Commercial; Costa Mesa CONSTRUCTIONTYPE re`S• VALUATION$ 1 1.� 'g LCft _ R
E
0o599'i ZONE GRA�INGCU.YDS. ACRES Ping.Ref.# ' Pafk.Fees $ �
Cicy Licenu No. ' - � U
LICENSED CONTRACTOH DECLARATION Remarks: � Parking Feq./Provided . ' . . �
� I h¢reby aTfirm that I am licensetl untle� p�ovi5ions of Cha�ter 9(commencin9 , R
with section ]000) of Dlvision 3 ot the Buziness antl Professionz Cotle, antl , Use of Building: • E
my license is in full �orcaan ect. /J p . � ,
License la s-p- �-� yls I o �O � r � - � PLUMBING FEES Planning Notes: ' � . ' ' M
Date V $i9natu � - � � � E
Bar Sink � ' Showers • ' N
'�ORKERS'COMPENSATION E LARATION ' ' . � T .
=reby atfirm tnat I have a cer ' cate ot consent to selt-insure oi a certificate Backflow Preventer ' ' Servite Sink ' "' - � - � S
Workers' Compensation Insurance, or a cerUfietl coOY thereof (Section
.eo0, Lab. c ' � Backflow Ir�igation Sewer Cap ' � ' ' E�ECTRICAC .y+ FEES
�Policy No. ��2�� Company 2enith . . ; : � •
❑ certitietl copy is hereby turnisried. ' . Bathtubs : � Sewer Connection Automatic Washer - � Transformer ❑ 15-50 KW
XXCertI,s�ep led with tne city Bui i a� �vis' ❑ 50 + KW�
Date � 7/ f��$�' Applicant V���lx ��OS . Roofin� Clarifiers Solar Collectors , � � Construction PoleSub.
EXEMPTION FROM WORKERS'�COMPENSATION DECLARATION '
(This section neetl not be completatl it the permit is tor one huntlred ($100) or I Dishwasher Solar Pipin9 ,. Cooking Unit Meter ❑up to 100 amps�, �
iess). • i � ' ' Drinkin Fountains ' � ' ' �
. I certify that in the performznce of tM1e work for which tnis permR i5 izsued I 9 . Solar Tank . Dishwasher � Meler �over 100 amp5
shall not emplOy any pe�son In any manne� so a5 to betOme subject to t�e , � , � , � '
Workers' Comoensation Laws o( Calitomia.� Floor Drains � � �, � Swimming Pool w/Spa � DryeFs ❑Gas � �Electric Sub Panel j s � ,% '
. Date - Signature � • '
� NOTICE: If,iaTter making this tleclaration, you shoultl become subject to the Floo� Sinks � ' - Urinal - --- Fan ���+- . - . -Motors'041 HP 01-'/x ° 8�� �--
. Workers' ComOensation provisions,of the Labor Cotle, you musttorthwith " ' � � : -
comply wi[h such provisions b� thi5=pe�mit shall be tleemetl revoketl. GdSSErvic¢ DUtI¢t5 - Wat¢l,CIOS¢t . � � it !' F.A.U. � � InaSolar 09-15 HP �16-15+ •
CONSTRUCTION LENDING AGENCV' �� '• '- ' ' ' ' ' '
I hereby affirm that there is a,construction lentling agency�for the'performance � Intercept0�5 � Water H¢ater - � Fixtures . ' � Microwave � •
at the work for whi<h this permit is'issuetl (Section 3097� Civ: CJ ' __ _
lentler's Name , Kitchen'Sink - Water$ervice � � Device�Boxes ' ' PoleLight ' � �
LentleYs Atltlress� � ��atories. '� '
OWNER BUIIDER DECLARATION� - � ' � ' ' - ' �utlet5 � � � Range � � � •
I hereby affirm.tbat I am ezempt from the�ConVactor'S`Llcense Law for the p-T�a �
following reason (Section ]031.5 Business antl Professional Cotle: Any oity or ' P � � ' Switches ' . Sign '
COunty which r¢quire5 a permif t0 construct, alteq improve, tlemop5h or repalr ' .- , _, � . . �
.any structure, prlor to itslssuance,ialso requires the applicant for sucn permit j� Roof Drains, ,'- ��• � �' � � ' • Garbage Disposal . . + �Standing Sections '
.to tile a'signetl Stdtement 4hat he/ihe i5 Iicensetl puisuant to the provi5ion5 of ' , , .. . '
. the Contractor's.License Law (Chapter 9(commencing with.5ection�7000) of °• Generator;�0.5 KW 05-75 KW ' Trash COmpactor �
t:';,7ivision 3'of che;Business antl Professions Cotle) or that he/5he is�exempt ' � � ' 1 ' '
*t„�ieretrom an0 t�e basis tor the allegetl exemption:-Any'violation ob Sectlon ,_ � , � � ; 1. � _ � . . � . �
� x.031.5. by any applicant for�a permit 5ubjects,tne�epplicant to a civil-' % � � � „ '_� , -3 ' • � .I •
�� �°�enalty of not more than five huntlretl tlonars (E500�. • i� . , � .- '..Reinspectiou F,ee .$25' '�: , lesue Fee �, - $ , . � ,
LJ I, as+owner of the�properry or my emv�oyees wim wa9es�as their sole�' � Rainspection Fee. � $25 JssueiFee � � � �$'3�
compensation, wi11 tlo the work, antl me structure is not inten0etl or otferea - .�MECHANICAL .i . ,'� FEES � -
for sale' (Section 7044, Business and Pro�essional Cotle:� The. Contractor's ; - . . � . . PUBLIC SERVICES REQUIREMENTS: ' ' � . . � - � �
License Law tloes not apply fo an owner ot a property,wM10 builtls or improves � goiler ' ' ' Hood or �• Type I�❑ �':� � � .! �
�� thereon, antl �who tloes such'wOrk himself/hetself orthrouqh.his or her own � � 2aning Approved 8y ' natB' ' '
OTployees, provitletl thdt such Improvementz are:nOt intentletl o� o(feretl for • � ��Opy Typ211 ❑" � - . , i I- • � '
saie. It, however, the bulltling or improvement is soltl within one year.of com- Duct - Under Ground . . � , ; � ,`_ $uilding�Approved By i ' ' Date �
pletion, the owne� will have tM1e burtlen Of proving he/she tlitl not builtl or irn- � ��.�. ' '� ��� � � ' -� �
�rove tor the purpose of sale). � ; �, ' . ` , L : � , :. � � Duct - Structural . Refrigeration System �- � i� ; ; APPlication Issued By �"^-' ' � ' ' Date
LJ I, as owner ot the property, am exclusivery tontractin9 with Ilcensetl con- � ❑0.100,000 BTU ❑100,000 BTU
tractorst8 construct Me project�(Section 7044, Business antl Professionz Coae: ' ' Duct - Ventilating _ _ � _ , . _ _ , - _ ,A � , ` ;� , . SUMMAR,Y OF FEES , �
The Contractor's �icense Law does nof appry to an owner ot property who , � ' BUI�DWG PERMIT �$ � 3.0� SMIP'. � $ `'�
Duiltls or imoroves thereon,'antl who contracts tor such projects with a con- • Ezhaust System ��� MWtiple �� . System Repair/Alteration !� � I �
tractor(s) Iicense oursuant to the Contractor's License Lawl. ; . ' ' ' P�AN CHECK � t$ � . PERMIT - � -
�� ❑ I;am exempt untler Section , B. & P. C. for thiz reason � Firepl/Fact. Blt. ICBO # PLUMBING � .$ ' ISSUANCE �$
. Date ' � • Owner ^ ' , � '� • t �. HeatinglSys[em & Ducting � � PLAN CHECK 25% � $ ENERGY P.C. �$ i
I�hereby-certify•thaA I�have reatl thii�appli ation aritl�ztata that the•above- - � ❑6100;OOOBTU 0100,0008T�--, _. . � .. . .___ • . i ' GRADING $
Information is correct. I agre t comply all city antl county ortlinances , ELECTRICAL .. $ � � . ,
antl=sta laws relafing to b il constr tt" n, antl heretiy authorize repre- . � � - � PLAN CHECK 50% I$ ' MICROFI LM $ ;
Senta ves f tnls city� < n above- Onetl p�op¢rty fo� , ' � � ' " , � , • ' � �
Inspetion . � � . , ' ' . � MECHANICAL $ � � � TOTALFEE ,$ 13.SO �
Sign'at '` Date � 5/18/$ � • ; � , • �
Drivers' enze ori55 � �. Reinspee[ion Fee �$25 � laue Fee $ 3 �PLAN CHECK 25% $ . �
CMFO865-46rev.12/83 White-Builtlin9;Canary-Applicant;Pink-Accounting;Goltlenrotl-Assessor�" , � � - ' ��' �� �� ' � " � �� � � ' � � '
\� ,.
�
" CONSTRUCTION AND'PLANNING�. ' i' .- '''�:-- : _.. -POOL � �PA � � _�;i �..a��: "c-J ir � ' �.: , �-, r
�3 /3�� Date I nspector ' � - _ "' ° J � ' -.:Date d I n'specior • �_
APPROVALS Permit# -� -=�APPROVALS '�Permit�#` ��.� ��
- ._ - o
° 1 Temporary Electrical Service or Pole� � � '�� �, 52., Pool & Equipmen£ Lo`catiorn': � G" ���t � •�c ; ` ' � , = �, �_,.'r.'� :
2: Soil Pipe-Undrgmd. . - � }, � ;53r Steel Reinforcement � _-�=� - "��^� ' � �
� . , . �, '= , - _ i
�N
3. Electrical Conduit Utility-Undrgmd. � - - ' 54: Forms � � - _ = _ _ - �' � ; ,:�; � L ' �
° 4.. Electrical ConduiDUndrgmd:: ` � � :�� ` ���55.� Electrical Bonding :' - a=�..a�: %�._ '� t i `'iy, _
5. Steel Reinforcement - -. _ �� , � �56. Rough Plumbing'& Piessure T.esf • �r: � ' � - "
6: Electrical UFER Grnd. � � ' � � - - �`57t APPROVALTO�COVER-GUNITE_ � ':; � ' ' ` �'� ; p
� �: � ..
��
7. Footings � . ' � _ .!'f , �.'58: ElectricaLConduitUndrgrnd.:"'� ,�� c , � ; ':�>_'� r' :i:
. . _ _ . � . . . . _ _ . .. .. . : �
8. Foundation " _ . � 59. Gas�Pipe„O Uridrgrnd.,Test= - `' "• - i � - ,� �� '-
. �
9. Water Pipe-Undrgrnd. � - . - ' . "60. Backwash'Lines,.P.-Trap PO Undrg�nd.-`�� - _ � ! ,
.�
10. Structural Floor System ' � ' �61. APP.ROVA�L TO DECK �' ��"`� � - � '
• C f �i f
11. Property Sewer Line & HouseConnection . � �` "~ ,' _ *; � ,c ' �
, 62. BackwasR&�Recept'or-Final: ".��- `
12. Sewer�CaP ' � . . . ' �•-63. Heater &Vent-Final. " .���; � : � @L . . ^ '� - � i �
13. Roof Drains . ' ',' �'64. Plumbing:System �Final�,. - - - �, i � �
14. Rough Plumbing . �65. Electrical=Final'� ' ' � - • •�£�' � . � i •�.�' ' "
15. Rough�Electrical-Conduit � , - � '66.��Solar System=Final w r � -j i i~
16. Rough� Electric Wiring � - _ � � , � ' �67. Fencing &�Access Approval' s'� ' - ' "� �T'-- I ` ' �'
17. Rough Wiring Sign . � • _ � �68. APPROVED FOR P,LASTERING ,'� � " � "' ` : � ' � ' -
,i :�
18. Rough Electrical-T Bar Ceiling� � � . . � � � 69.' POOL/SPA SYSTEMS,FINAL � r � � ; � � � , � �
I�
19. Rough Heating & Air Conditioning 'FIRE DEPT.�REQUIREMENT-' � � v ; =� i ^. � �� � ' �r i `
20. Rough Factory Fireplace � � APPROVALS; � Permit # �� � � � - � �J t� i �, , i
21. Duc[s, in Structure � ; , , ' � 70. Underground Hydro ', ' i i ;�+ : � ;
22 Ducts, Ventilating � � � ,�71' Product Piping OGas53O0i1 ; � � ��i � � � � ! � •
F
,_ _�- ,' �. .
23. Gas Pipe-Rough &`Test � '' 72. Underground Flush� ���: i; , � j � i j �
24. Roof Framing 1 ��,73. Undergrrid. Stoiage,Tank''O;Gas� O, Oil- � - �
p
i n.
25. Roof Sheathing - � �� ' � ' � . � �74 � Overhead Hydro � � ; ` ' '0 � � � ' �
26. T-Bar Ceiling (Structural) & Monocoat - � ' i75. Dry. Chemical '" �; � ' � �` ' I I �.
27. Frame and Plashing � � � �76. Dry Standpipe . '' , �
�
. 28.'Lai�iing & Siding ' �� � ' ' . 77.' FIXED SYSTEM FJNAL ." � � ; c; ' ` � i �
-i i
29. Insulation ' � � � � �78: FIRE PREV. FINAL ' � � , ��
30. DrywallNailing �_ ' ' . ' �HEALTH�DEPT�.REQUIREMENT� � � � {
� . � �f --- - - .-- -- -� ._�_.. '
31. Plaster Brown Coat � �79. FINAL INSPEGTION '' I � � r �
32. Electrical Power Meter-Final � 80.� FOOD CERTIF,ICATE �SSUED • � � ���
33. Final Electric ' � � � �Notes: ' � 1 � � � � � �
1
' 34. Final Heatiny & Air Conditioning . � . � , _� ' � -
35. Final Gas Pi�pe-Test � _ i : , i - � �- • - ` . " � r. � -� : . �
36. Hood or Canopy; . . � , t . � - � - "I � . , t .. ` �' � .. . = i .
� : � c u
37. Final Factory Fireplace � � ' �, � 1 � ; ; � `� f i � . :;i� . ;r. ? . � -
38. Final Plumbing . ' j "' ' ' i � : I ! ���_ � .. �Y . . -_
39. WaterServlce-Final � � � � � ' ' � ' ;. � � � ', - � ' � "' . '`
� �.: � � ��{ b .
40. Gas Service-Final . � � - � � � i � � � I � ,: � � *'�! �y ; �, � � �
41. Solar pomesticFinal . '_ - - - - - � �- - ,-.- � - � -.-�- !_ � , h� ' ' ; . � : �
42. Backflow.Preventer ; r � - -' � �- - -'-' -� -+ ---_ � �.{ `' � ' .
'i - I '
43. Backflow Irrigation � . � _ � ; I. . { : ; . . ' �, " , i y ; 5 ,-j . �. ,i p . � � i � ,
� , 1. � , � , i , . .: � � ! ' i G � � � . I ;1� 1� ' ; ; .
44. ,Landscape Irrigation System � � � . ' _ i � � . . „ i _ ; ;� �� �j+„ ;
� �. ; . � . . . . _
45. Sound Attenuation � � � ' ' � W � � , N � � � � � I r - c �u -.; 2 . '
46. Handicap Regulations ' - � ,� -. � i � � � �' j � �� � �%' . • • � : . -
47. FINAL STRUCTURE & BUILDING �� l > ?' � � � ! � � � ;` ` � �y ? ' " ��
�.
48. Special Requirements Completed , � ' � t ; ;, � ! � � ' � �� � ,' .��i� � �
�
49. ElectricRelease�to Edison' � � �'"--� '-�' " �� �'��"�"�'` �` -�" �� . ; � i ' �
. � -i--� � i -
50. Gas Release to Southem Califomia Gas Co . ' � � � , ' i ( �. ' I'� � � � � i -
i � { i I�' f���l - i�
51. CERTIFICATEOFOCCUPANCY - -',-� �--j--'- '-,' �'-(-''-'- ; , 'iI i � ' ``
No. � Date ,,. . --- � - - � - � � � ;- `- � _ ' - - - - - -
. .. - - - ..._ . .�.-- - - . ._.____ ._ _.. .. _ ..' - -
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT N0. G�l.fS�
LOT N0. Cr' S
���� i� �J
DATE `7 � �
The developer of the above entitle@'tract desires to sell the above set forth
lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that (he-she-they)
\
(was or were) ��-' advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnif� and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason o£ the
aforementioned uncompleted condition.
R �T �_���..�.�.�
C.1 i �r C.i � �.J11
�
`��qi ' F2 E.'ni!.l
PM
AAh � �, ,; i,2F3�d;��6
�dt�tg3���.'�wi �
BY �/. G2� �.�GG�O`''
Purchaser
BY - v/�c1i(� �
r Developer',and/or a orized
representative
�
Lender
OWNER ��,TZER ENTFF➢. ,zSES
JOB ADDRESS �2 Turloar";�,�P�ive
GENERAL CONTRACTO�� ��T
AP No. LOT TRACT
INSPECTIONS Si nat�re Date
SOIL
GAS
WATERj( C i
ROUGH PLUMBING
PROP. SWR. LINE NOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH MEATING ANO AIR COP
TEMPORARV SERVICE OR POL
UNDERGROUND � POW6R
ROUGH WIRING
TRENCHES [J� FORMS �'
FLOOR SVSTEM
BONO BEAM � STEEL RE
SHEATHING
FRAME ANO F�ASNING
LATHING - IN n 1
PLASTER,BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRI
PLUMBING, FINAL AN�
ELECTRIC, FINAL
RIIII f111Jl: GIIJGI
ONING
REINF.
,N� A.0., FINAL
TEST �]
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SUBCONTRACTOR
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COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Complete/y
BUILDING
ADDRESS 3a -s 3 7"�r a��o c K
OWNER Heltzer Enterprises-Cost
MAIL _' _ __ _ _ '
TEL.
CITV IpS Angeles, CA 90038 N��93
CONSTRUCfION United California Bank
LENDER
BRANCH �lll Office
ARCHITECT David Freedman TEL. "'
OR ENGINEER NO nT _ i
ADDPESS 113 N. San Vicente,Beverly H
CONTPACTOFi George J. Heltzer
ADDFE55 740 N. La Brea Avenue
TEL.
cirv Los Angeles, CA 90038 ^'o q47_
uc No. 3144 uc�No. i9
512E NO.OF BLIX'�S.
OF LOT I NOW ON LOT
USE OF
EXI5iING BIDG.
SIZE OF NO. OF
NEWBLDG. ROOMS STORIE:
EXTERIOP WALL ROOF
COVERING COVERING
USE OF BUIIDING AND WORK TO BE PERFORMED
SinQle Residence P1
I hereby acknowleAOe thet I have�reatl this application antl state
ihat the above informaiion is correct and agrae to comply with
all laws ragulating buildin8 consvuc[ion, and I sha�l not employ
any person in viola[ion ot the workmen's compenution laws of
the Stafe of Califomia.
I hereby certify that I am properly licensetl as e conttactor under
rne State ot Calitornia eusiness antl Protessions Cotle, Divisicn 3,
Chapter 9, antl that such licanses ere in tull force antl etfact, or I
am exempt trom the provisions of t�e Stafe of California Buainess
antl Professions Cotle, Di i on 3, Chapt r 9.
Signature ot
Permittee
Authorizetl Apent
`'°`0 142.56
aus 30-���>,sA00z�oo��+ �:�*
APPLICATION FOR BUILDING PERMIT
RECEIVED BV QA REC VED nnrri.in
A.P. NO. �—
BUILDING �� �
ADDRESS
TPACT 6245
W ADD A
OWNER
USE V '--'�s'�
�
FIRE
ZONE T
APPROVED
BV
ZONE NO.OF �
PLAN$ �
VARDS APPROVED
MAI N B V 1 LDI NG
DISTANCE BET
MAIN BLDCv.
VAR. 3k
QU.P. #
APPROVED
srare �
�3
VALVE
DATE
USE OF NEW 'S�//'� /`!9
BUILDING �� /,/Tr � f
�FS
VARDSAPPROVED
ACCESSORY BUILDING
BET. MAIN &
/�� SQ. FT � � �J �D w //�
THE AMOUNTSNOWN UNDER VALUATION IS FOR
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