HomeMy WebLinkAbout3268 TURLOCK DR - Building Permits�� l5 `�'J
_.�6}A�-OFC-O'S fiA MESA
` '�~Fq BI/ILDING DIVIS►ON
i�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(774) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
f
° � FOR INSPECTIONS CALL: (714) 754-5626
�"°"""� PERMIT NUMBER: 610-00164
PERMIT TYPE B_ROOF2
APN: 41210607
JOB ADDRESS: 3268 TURLOCK DR CM
Vicinity: HOUSE AND GARAGE . -
Squares: 0
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit: ..
� � Valuation>�
ISSUED
0 610 7/2 0 1 0
RMD
$11,000.00
SCOPE OF WORK: REROOF REAR pITCHED AND FLAT ROOF ON AN ATTACHED HOUSE TEAR OFF EXISTING ROOF MATERIALS,
INSTALL 1 LAYER OF 30# FELT AND A MINIMUM OF 2 LAYERS OF 15# FELT ON A 2:12 PITCHED AREA AND
INSTALL LIFETIME CERTINTEED COMP SHINGLES AND BUR ON FLAT AREA, APPROX 18 SQUARES. REPAIR�AND
REPLACE SHEATHING AS NEEDED. COMPCIANCE FORMS ATTACHED TO CITY PERMIT AND JOB CARD. � '
OWNER: BADAWI,ASMAR
PHONE: 714-754-1748 �
APPLICANT: HOYT, BRIAN
PHONE: 714-773•1820 �
CONTRACTOR: HOYT ROOFS
Address: 1809 N ORANGETHORPE PARKUnit:
City/State/Zip: ANAHEIM, CA 92801
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$o.00
$195.25
$0.00
$1.00
Address: 3268 TURLOCK DR Unit:
City/State/Zip: COSTA MESA, CA . �
Address: 1809 N ORANGETHORPE PARK Unit:
City/State/Zip; ANAHEIM, CA -
� ; - � License No. 606711
PHONE: � 714-773-1820
CELL:
License No.
License No.
PHONE:
PHONE:
TOTAL FEES $196.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3N8/2010 - 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. Indeoendence Dav. Labor Dav. Thanksoivina Dav and Christmas Dav
NOTICE: The work authorized by this p@rmit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed 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 fnal approval will result in the expiration of this permit.
COOE%. INSPEL710NTYPE DATE INTITIALS CODEN INSPEC110NTYPE DATE INTITIplS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final _ 208 Final Plumbing
200 Final Re-Roof 30 %)�� 210 Final Eleclriral
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' COMPENSATION DECLARATION:
I hereby aHirm under penalty of perjury one of the following declarations:
❑ I have antl will maintain a certificate of consent to self-Insure for vrorkers'
compensation, as provided for by section 3700 of the Labor Code, for Ihe
performance of lhe vrork for which this permit is issuetl.
��I have and will maintain workers' compensation insurance, as requiretl by
section 3700 0( the Labor Code, (or ihe peAortnance of the work fw which this
permit is issued. My //yyyorkerj ' compens on Insurance carrier and policy
nu % � ����U
��.
eabn neetl iqt De com te`tl d Ine pe�mrt is valued at one nund.etl ddlars (SIDO) w less.)
Pol umber. V� �� � Z Z �O
❑ I certify [hat in Ihe pertormance of the work (or which this permit is
issued, I shall not employ any person in any manner so as to become subject
to lhe vrorkers' compensation laws of Califomia, and agree that if I should
become subject to the workers' compensation pmvisions of Section 3700 of
the Labor Code, I shall forthwith comply with these provisions.
I n_..,-.—Y� � -� �' - c7
�A�--S gnal te
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE L480R CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirtn lhat I am licensed under provisions of Chapter 9(commenting
with Section 7000) o( Division 3 of the Business and Professions Cotle, and
my license is in full force and e((ecl.
�� � %,c9lo(GI ��5�_�/���j
LG �
onVaclor's ' naiure � � e
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm Ihat Ihe2 is a consWction lending agency for the
peAormance of the work fa which this pertnit is issued. (Sec. 3097, Civil Code).
lender's Name:
Lender's Address:
Signa�ure Dale
OWNER-BUILUER DECLARATIONS:
I hereby aKrtn that under penalry of perjury that I am EXEMPT FROM THE
CONTRACTORS UCENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permi[ to
consWct, alter, impmve, demolish, or repair any s[rucWre, prior to its
issuance, also requires Ihe applicant (or such permit to file a signed statement
that he or she is licensed pursuant [o the provisions of the Contrecrors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pro(essions 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 pertnit subjects ihe applicant to a civil penalry of not more than
five hundred dollars ($500).):
� I, as ovmer 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 Contracrors
License Law does not apply lo an owner of property who builds or improves
thereon, and who tloes such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold vrithin one year of
completion, the ovmer-builder will have the burden of pmvinq that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH
LICENSED CONTRACTORS to consWct the pmject (Sec. 7044, Business and
Pro(essions CoCe: The contractors License Law dces not appty to an owner of
property who builds or improves thereon, and who contracts for such project with
a cont2cta(s) license pursuant to Ihe Contractas License laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
. Signawre Date
305]-46(3I01)
Owner ID�verified by driver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ownership by (rype of document, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cert'rfy that no eacavation five (5) or more feet in depth into which a
person is required to descend, will be made in connectbn with vrork authorized
by this pertnit, and Ihat no building structure, scaffWding, falsewvM, a demolition
or tlismantling thereof, vrill be more than thirty-s�c (36) feel high. (Chap. 32, Grp
2, M 2, Sea 341, TM1Ie 8, Cali(omia Administrative Code).
❑ As owner-builder, I will not employ anyone to tlo work which woultl
require a permit (rom the Division of Indus[rial Safery, as noted above, unless
such person has a permit to tlo such vrork from [he division.
Appliwn�§ $ignaWre
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant need to fle and
certify a Business Plan for emergency response to release or �hreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Heal[h and Safe[y Code requires, with some
exceptions, that a Business Plan 6e filed with the Cosla Mesa Fire
Depanment by every husiness which has at any one time dunng a reported
year a quantiry of hazardous materials equal [o or greater ihan a weight of
500 pountls, or a volume o( 55 gallons, or 200 cubic feet oF compressed gas
at standartl [emperaNre and pressure).
2. Does or will the applicant or present or luture building occupant need Io f le
a registration torm tor awtely hazardous matenals7 ❑ Yes ❑ No
(Seciion 25533 of ihe Califomia Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Departmenl by
each business which a[ any one time has on hantl a quantity of acutely
hazardous materials equal to or greater than a weight ot 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standartl
temperaWre and pressure).
3. Does or will the applicant or present or future building occupanl need lo
prepare an RMPP (Risk Managemeni and Prevenlion Program tor acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safery Code provides that the
Costa Mesa Fire Department may require Ihe prepara[ion, certifcation 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 Calilornia
Health and Satety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre builtling occupant require for
the vrork which is Ne subject of Ihis application a pertnit for such consWction
or modification from the South Coast Air Quality ManagemeN District or (rom
any other aii pollulion conirol distnct or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemmenl Cotle requires Ihat the requested
infortnation be fumished on applications fa non-residential building permits).
6. Will any part of the facility to 6e constructetl untler this permit be within
1000 feet (rom [he outer boundaries of a school? ❑ Yes ❑ No
(I('yes", the faciliry must meet the requiremen[ of Sections 25534 and 42303
of the Califomia Health and Safety Code).
7. If a permit from the South Coast Air �uality ManagemeN DisMct or o[her
air pollution control district or agency is required for the work which is the
subject of this application, have all of Ihe disclosures prescnbed by Califomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. pf'yes", attach certifcate of compliance from the appropriate air pollution
control officer).
CERTIPICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is wrrect. I agree to comply with all state laws and
city ordinances regarding Hazartlous Matenals and Emissions.
Signature oaie
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state that
Ihe information given is correcL I agree to comply with all state laws antl ciry
ordinances relating to building wns�ruc�ion, antl aulhorize repre5entatives 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 fi FinspeeEien.
(p-2 L-/b
Signawrea qs) Da�e
(/L CJ
AnElorA 1 ar¢e0 ApP�icxnt Oale
�r�t Prescriptive Cer1
�* �`Resiticietia/ Alterc
PrujeM IVame: (�
�j
General Infurm:�tio�i
Si[e Address: 'Z 7 /_
uf'
a�X � �,�1 �
vr
Building Type � Singic Family ❑ Multi Family
Conditionell Floor Area (CFA):
is unt tn bc used lnr Nerolr Constructed
Climate Zone N
Agenc�•:
Circle tlie Front Orientation: 1�', E, S, W, or degrees /
Prolec� Type: ❑ Alierations O Envelope O Fenestration toof [
Iteplacement or Change Ow ❑ Duct Replacemem ❑ Water Heater
�dldittPs nr Adrliiinns
-1R-ALT
.e 1 or 5) e
lusu/n[ina Vnfues Far Opn�p�c Sur jnces (far Furring usr dee Mas.s and Furring Sn�ips Conslruction mGle Aelow)
Assem6ly Altera6on �
❑ Opening of framed carih' alone— A6eraiions thn� irrvolve the opening of the fi�mned caviry� ojn wall, ceiling, orJloor musl insm(! !he .
mandaior'v minimiun irxndntiai vnlue per §I50 for the al�ered ase�emG(7�. Fi(/ in Colunms A—C and emer mondamr�� insula�iore volue in Coh�mn H.
❑ Replacement of entire assembly—Reylucement ofan entire H�all, ceiling, orJloor assembl�� reguires !he inslaf/ation ofComponenl
Puckuee- D insularion values in Table 751-C. Fid in Columns A— J.
A
No�e: For
: fu
C
Framing
Assembly Name Material
or Tvoe� and Sizez
Walls see Furring Strips Cunstruction Table beloa-.
� � � F G - H -� - �I� - �.1
Standard
Thickness,
Spacing, U-
or Other3 factor"
Insula�ion R-value, see Pa¢�
Values From JA4 Table
Framed Continuous ]A4
JA4 Table Caviry ]nsulation Assembly
Numbers R-value� R-Value' Cell Values
use !he Mass and
Fu�v'inAConsu�rclion �able 6elom.
1. Fw� Tng/ID ir�dica�e die identi/icaiion name tha( mntches the building plans.
2. lndicate the Assembh� Nume or rype: Roo/I'Ceifing, Walls, Floors, Slabs, Crawl Space, Daors and e�c...lndica�e the Frame rype and Size: For
K�ood, Meml, Metal Buildings, Mass', enter' 2x9, 1x6, ar elc... see JA4 for olher possible framc rype asseir,blies.
3. En�er the dvic/aiess:for mass in inches or Spacino benveen framing members en�er; 16"or 24 "OC,- or O�her for a!( other assembl�+ descripriwi
such as Cnncrele Sandwich Panel, Syandrel Panel, Logs, StraH� Bale Panel and e�c._.
4. Bosed on Ihe C(ima�e Zone; enter �he Siandard U fac�or fi�om Table 151-B, C or D for each different assemblp Name w� type.
5. En�er Jhe Tab1e number tha/ closel7� resembles the yroyosed oea�em6lv. �
G. Lmer �he R-i�alue that is being installed in ihe wa11 cavitn a� Letween the (�aming: otheiwise, en�er "0 ".
7. En�er the Continuous lnsidation R-value for !he praposed assemblp; ntherwisc, enler "0".
b'. Lnier �he ror� and cnlwnn o(�he U-fac�or valuc based orv Column F Table Num6er and emer �he As.sembl�� U-fucior in Colunm J
9, The Pronnsed Assembh� U-fuc�or, Column J, musi 6e epiml lo or les.r than �he S�andnrr! U-fuc�or in Column E m conrnh�.
Fuirin Strips Construction Table for Mass Walls Only -
A B C ll C F G H 1 J K L M
1'ropused Properties of Masonr}� and Concrete Added ]nterim' ur Ex[erior ]nsulafion
W:�IIs Trom keference in Purring Space fYum Referencc
Juini A i endia Table 4.3.5, 4.3.G. 4.3.7 JoiN A eudis 7'ablc 4.313
U � o j � c� = o
Asscmbl)' <" � �$ �.� F" m c �a,`� �."u u•.0 Final
Muss N�ti1C Of JA4 Tahle Q_ F v= R F o 't 2 a. _ � � Assembl
ThicknesF� 'I' �r � Numher' 4. � i c� c � �� i? C 4. � C U-factoi�� CoifltneP(
I I
liegi,siru�ian NmnGer: Regis(ru�ion Ua�e/Time: HBRS Prnvider':
200d Residentin] Compliance Fornvs Augus� 2009
� -; lies"edentia! Alternlions
A
a
IY
ROOrING PRODUCTS.(COOL ROOFS) §IS](�/2
Wlaen Ihe areu ojexterior roojsurjace to bc replrsced exceeds urore than 50% ojtbe eristing roojnrea, or inore lHmi 1,000 j�, �ohiche�er is
less, (he new roofng aren nmst nree� (he roofing product "Coo! Roof' requireu�ents oj§152(bJ1Hi, 152(bJlHii, or I52(b)IHtil.
Check upplicable alternative ar ezcep(ion beloH� if the roof a/leration is ezempt from (he rooftng produc/ "Cao! Roof � requirements. No�e: /f ony
one ojthe a/terna�ives or ezcep�iae be/ow is checked, (he AgedSolar ReJlecmnce and T6erma! Emivance reguiremems jor roofing produets in
$l18(i) are not applicable. Do not f(1 table beloH�. �
Not Required in Clima�e Zones 1-12, 14, and 16 with a Low Sloped. Less or 2:12 pimh.
Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs (pi[ch greater [han 2:12) and product unit weight less
�I[erna[ives ro§152(b)IHi and §152(b)Hii, Sceep-slope roof (pi�ch > 2:12)
C7 Insulation witl� a thefmal resistance of at least 0.85 hrft �°F/Btu or ai.least a 3/4 inch air-spaee is added m[he roof deck
over an anic; or
❑ Existing ducts in Ihe attic are insulated and sealed according ro§151(�10; or
. fJ In climate zones 10, ] 2 and 13, with ] ft''.of free ventilation area of attic ventiladon for every I50 ft of attic t]oor erea, and
where at least 30 percent of [he free ventilation azea is within 2 feet vertical distance of the roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
❑ Building has radiant bazrier in the attic meeting the requiremenu of §151(�2; or
C7 Building has no ducts in the attic; or
❑ In climare zones 1Q 1 I, I3 and 14, R3 or grea[er mof deck insulation above vented ariic. �
Exception to §152(b)1Hiii, Low-slope roof (pi[cJi <_ 2:12) �
d Building has no ducts in the attic.
Q RooSng area covered by building integrated; photovoltaic panels and solar thevnal panels are exempt from the below Cool Roof criteria.
Q Roof constmctions that have thermal mass over the roof inembrane wi[h at least 25 Ib/ft is exempt from the below Cool Roof criteria.
Nate: If no CRRC-I label is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwi
Check the aoolicable box below if Exempt from the Roofine Products "Cool Roof' Requirement:
I RoofSlope I ProductWeight I Product
ID Number� 5 2:12 > 2:12 a Slb/ft� > 516/ft� Tvoe2
Aged Solar Thennal
Reflectance�'d Emittanc
❑4
The CRRCYroduc! ID Num6er' cm� Le oblainetlJrou� Ide Cao! 1(aoJ Na�ing Council s KoledYroducl Direcmry al w�ne I� f e/n d I�/ � 1�
Lrdicale Ihe q(>e ofpmducl is heing use� for tlie roof lop, i.e. single-p(p rooj, asphal! roof, memf roof, ele.
/JU�e Aged ReJiec�arse is noi availaGle ln.tl�c Cool RoojNating Coiwcil'e� Ra�ed Producl Direcmp� Ihen use �he /niliof ReJleciance va(ue fi�om t/re same
dr���mn� and use Uie eqimlim� (b1+pJ(p��������- 0.2) m obmin n colculated aged value. Where p is fhe /nilial So(ar ReJleclnnce.
Check Lox i(Ihe Aged Re/Ieclance is n ca(cvlaled vplue using Ihe equotiwi aGave.
Calndme dre SRI value Lr using tlre S!U- Wa�ksHeet a� httn�//iv�v�v.enerm� m env/lide24/and emer !he resuhing vulue in tl�e SR/ Cnlurnn nbovc and attoch aa
Ihe SRI- Iyorkslreel m!he CF-JR.
� apply Liquid Pield Appiied Coatings, the coating must be applied across [he en[ire mof surface and meet the dry mil thickness or coverage
commended by the coatings manufacturer and meet minimum performanee requirements lis[ed in §1 I8(i)4. Select the applicable coa[ing:
Aluminum-Pigmented Asphalt Roof Coating
Cement-Based Roof Coating
Other
Regis�rurian Ninnber: 2egis�ration Da1e/I'ime: NE2S Provider:
2p08 Residen�ia/ Complianrn Forms -
August2009
ce: Residential
Y, ro,jechlVnme: �'--"�--
Cl'
* o1�St�arie�
H�I:S V�IiIF1CAT10I� SUMMARY The enforcemeni ngenel• shoidd yar syeciul unemion to lhr HE/tS fileasm�es specified fri this
checlr(ist Lelmr. A compleied nnd signed CF-41i Fw�m /m� nl/ the mensw�e.r speci/ied shu/! Ge suLmiued io ihe building inspecior before jina!
Duct Sealine & TBStillr HERSVC)'IiICq1101115 PL'[/UU'L'CI�O) llil.l )➢L'CIStU'C.
❑�'�S ❑ NO 1'ES: ln Climate Zones 2 nnd 9-16, if more than 40 liiiear feet of neH� or replucement ducts .u�e insialled in uncmiditioned
� space, [he ducts ure to be se�ded per y�152(6)IDii a�d the newly installed duas are to be insulaied pe� §I51(1170.
❑�XC�PT1Gn: Lxisting duct systems tGa� nre estended; wi�ic6 m�e cuush�ucced, intiulated ur sealed wit6 as6estus.
❑ Y�S ❑ NO 1'ES: ln Climate Zones 2 and 9-16, if tlie exis�ing space-condiuoning sysiem (HVAC equipmem and duciingj is replaced; the
� ducts are to 6e sealed per � 1 S2(bp Di. �
D 1'�5 ❑ NO YES: ]n CJimate Zones' and 9-16, iTthe existing HVAC equipmem is repluced jincluding the replacemeni o1 the air handler,
' outduor condensing unii of n splii spstem, cooling or heating coil, or ffie furuace Leai exchaneer) the ducts are to be
sealed per §152(b)]E.
❑ EXCEPTIOA: Duct sYs[ems that are documented to have been previously sealed ronfrmed throug6 HLRS
� verification iu accordance �vith procedures in the Reference Residential Appendis FA3,
� �� ❑�XCEPTIO�': Uuc[ systems with less than 4U linear teet in unconditioned space.� � .
R�frieerant Charge - Split System HERS veriJica�ion is reguirecl,(or �hi.s measw�e.
❑)'iS ❑ NO YLS: ln Climare Zones 2 and F-15, when the existing HVAC equipmene is replaeed (includin� [he rep7acement of the air
hai�dler, ontdoor condensine unit of a split system A/C or l�eat pump, coo7ing or heating coil, or the fumace heat
Central Fan Inteerated (CFI) Ven6lation S,ystem and Fan 4�'att Drah�
The ven[ilation renuirements of FI SOfo) do not anvlv tn existine residential homes.
Ducted Spfit S,ystems - Air Conditioners and Heat Pumps: AirfloH' HERS verifcarion is required.forlhis measure.
❑ Y�S ❑ NO ]'E5: ln Climate Zones 10 thmugh 15, wlien the existin� space-conditioning system (HVAC equipment and ductii�g) is
replaced, Ihe airflow and ian watt draw shall be veri5ed ner § 152(bp Ci to meet the renuireinents of & 151(f17B.
Company:
tion Author's Declaration
thaf this CertificaIte/ of Com
)/� 1 l. '/`% 1 1 l�}rn '
��
�
�i �/ CJ
Date: � ` �
If Applicable O CEA or O CEPE
(Certification k):
��
oons�blc Building Desi�ner's Leclarutiun Statement �
1 am eligible under Division ? of tlie Californiu Busioess and Professions Codc to uccep� responsibility for the building design fdentified on
this Ceriificale of Compliance.
7 ccrLify thal thc energy fealures �ind perfa�manec speciGc�Lion:�� for the building desigu identiLed on this Cer�iLcnte of Cumpliunce conform
to thc requircments of Title 2a, Yarts 1�ind G of tlie Caliiornlai Cnde of ILegulations.
The building desigu feawres identiGed on thi:�. Ceniiicate oTCompliance tire cansisiem with the in(ornmtion provided to documem this
bulldino design on the other npplieoblc com7�liunec fonn&, worksheets: calculations, plans and specifm�nions eubiniucd Ln the eni'orcemem
;iaeucv fnr annroval with this buildint� nermii aonlication
Name_
Company:
Address.
Cih;'StaielZip�.
Signaturc:
Late.
Liceuse.
Trn� aaa�isumce or questior�s regurrling tlie Energi� Strmdru�tl.t, cnntaet !he Lnergr Hotlinr ut: 7-k011-;72-331i(l.
RegiaararimJJuniGerc I(egi.rn�arion liaie/Time: liEliS' Proricier:
20U81(c.riclen�ial Comp(im�ceForms
n��o��.,� auur
CITY OF COSTA MESA
BlIILDING DIV/S10N
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax p74) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B10-00183
PERMIT TYPE
APN: 41210607
JOB ADDRESS:
Vicinity:
Squares: 0
B_ROOF2
3268 TURLOCK DR CM
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
" Valuation:
ISSUED
06/22/2010
CAC
$4,000.00
SCOPE OF WORK: TEAR OFF EXISTING WOOD SHAKES AT ALL HIGH PITCHED 14:12 AT FRONT OF HOUSE AND INSTALL MONIER
LIFE TILE 7.0 PSF ICC # 1647 '7/ /�'� � S Q . '
��
OWNER: BADAWI,ASMAR � •- Address: 32687URLOCKDR - � Unit
PHONE: 714-754-1748 � City/State/Zip: COSTA MESA. CA - ,
APPLICANT: BRIAN HOYT .� - � Address: 1809 N ORANGETHORPE PARK -� Unit :
PHONE: 714-773-1820 Ciry/State/Zip: ANAHEIM, CA' . . � �,
CONTRACTOR: HOYTROOFS .' . ,
Address: 1809 N ORANGETHORPE PARKUnit:
City/State/Zip: ANAHEIM, CA 92801 -
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$63.21
$9725
$0.00 `
$i.00
License.No.
License No.
. License.No. . 606111
PHONE: 714-773-1820
� , � � , CELL: .
PHONE: .
PHONE:
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3N8/2010 - PER CMMC Sec. 13-279
Monday thru Fnday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibilied all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Indeoendence Dav, Labor Dav, Thanksqivinq Dav and Christmas Dav
NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Califomia statu[es and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
LODEp. INSPECTIONTYPE ORTE INIITRLS CO�EC INSPEGTIONTYPE URTE INiI71AL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
t266 Pool Spa Final //� 208 Final Plumbing
200 Fina1 Re-Roof �a'3� �V ���%LP�L% 210 Fi021 EIOCldC21
201 Final BIocWRetaining 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 Builtling/Occupancy __
�.
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalry of pery'ury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as providetl (or by section 3700 of the labor Code, for Ihe
pertermance of the work for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
ection 3700 of the Labor Code. for the pertwmance of lhe vrork for which this
p i issued. My wod ers' co �pensation Insurance carrier and policy
� mber re:
o� (/':w�
e n neetl rwt De mmpeCted Alhe permrt is valu! af one �untl�etl �llars (5100J wleSsJ
Polic um r: �O �/� Z Z�O
� I cetli(y Ihal in the pedormance o( Ihe work for which Ihis permit is
issued, I shall not employ any person in any manner so as to become subject
lo lhe workers' compensation laws of Califomia, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
lhe Labor Code, I shall forthwith comply vnlh Ihese pmvisions.
� 2L—( Q
A� nl'sSig Wre Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CNIL FWES UP TO ONE HUNDRED THOUSAND DOLL4RS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby that I am licensed under provisions of Chapter 9(commencing
with ion 7000) of Division 3 of lhe Business and Professions Code, antl
m i n is in full force and eHect.
i
Lic. # Cla�
Z �
Conlraclor'S Sign re e
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm lha[ Ihere is a construction lending agency (w the
peAortnance of the �wrk fa wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lentler's Name:
Lender's Address:
Date
OWNER•BUILDER DECLARATIONS:
I hereby affrtn that untler penalty of perjury ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit ro
consWct, alter, improve, demolish, or repair any slrucNre, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuan[ to lhe pmvisions o( the Contracrors
License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of Ihe
Business and Professions Code) or that he or she is exempt iherefrom antl
the basis for the alleged exemption. Any violalion of Section 7031.5 by any
appliwnl (or a permit subjects lhe applicant to a civil penalty of not more �han
flve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with vrages as their sole
compensalion, WILL DO THE WORK, and ihe shucWre is not intendetl or
offeretl !or sale (Sec. 7044, Business and Professions Code: The Coniractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who dces such work himsel( or herself or lhrough his or her own
employees, provided that such improvements are not intended or oftered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner-builder will have the burden of proving [hat he or she
did not build or improve for purpose of sale.).
❑ I, as owner ot the property, am EXCLUSIVELY CON7RACTING WITH
uCENSED CONTRACTORS lo cons[Nd the pfoject (SeC. 7044, BUSine55 and
Protessbns Code: The contractas License Law dces not appy ro an owner of
property who builds or improves thereon, and who contracis for such project vrith
a contractor(s) license pursuant to the Contractas License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signawre - Date
]051-46(]IO])
Ovmer ID verified by drivers license. ❑ Yes ❑ Na ' ,
Driver's License No. Expires:
Venfwtion ot Ownership by (type of document, i.e. - propeny tax bill or deetl):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certAy that no excavation (rve (5) or more feet in deplh into which a
person is required to descend, will be made in connection with wnrk authonzed
by [his permit, and that no building structure, scaHdtling, (alsework, ar demolition
or dismantling thereof, will be more than thirty-six (36) (eet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, TiUe 8, Califomia Administ2tive Code�.
❑ As ovmeo-buil0er. I will no[ employ anyone to tlo work which wnuld
require a permit from the Division of Industrial Safery, as noted above, unless
such person has a permit to do such work fmm the division.
Apphmnl's SignaWre
Division of Intlustrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the appliwnt or present or fulure builtling occupant need �o file and
certity a Business Plan for emergency response to release or threatenetl
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Healih and Safety Cotle requires. with some
exceptions, that a Business Plan be (led with Ihe Costa Mesa Fire
Depanment by every business which has at any one time tluring a repoAed
year a quantity of hazardous ma[enals equal to or greater than a weight o(
50o pountls, or a volume of 55 gallons, or 200 cubic (eet of compressed gas
at standard temperaNre and pressure).
2. Does or will the applicant or present or fuWre builtling occupant neetl [o file
a regis[ra[ion (orm tor acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of the Califomia Heallh antl Safery Code, with some
exceplions, requires registration with the Cos[a Mesa Fire Department by
each business which at any one time has on hantl a quantity of awtely
hazardous materials equal [o or greater than a weight of 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or fu[ure building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Health and Sa(ety Code provides Ihat the
Costa Mesa Fire Department may require the preparetion, certification and
fling with Ihe Fire Depatlment of an RMPP by businesses which are required
[o register acutely hazartlous ma[erials wi[h the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Cali(omia
Health and Safety Code heen fully complied vrith? ❑ Yes ❑ No
5. Does or will Ihe applicant or presen[ or (u[ure building occupant require for
the vrork which is Ihe subject of this appliwtion a pertnit for such consWction
or modification fmm Ihe South Coast Air �uality Management District or from
any olher air pollution control tlistrid or agency? ❑ Ves ❑ No
(Section 658502 of ihe Califomia Govemment Code requires that Ihe requestetl
infortnation be fumished on applications (or nornresitlential building permits).
6. Will any part of the facility to be consiructed under this permit be within
1000 feet from [he outer boundanes of a school? ❑ Yes ❑ No
(If "yes", the faciliry musl meet the requirement of Sections 25534 antl 42303
of the Califomia Heal[h and Safety Code).
7. If a permit from ihe South Coast Air Qualiry Management District or other
air polWtion control distric[ or agency is required for Ihe work which is Ihe
subject of this application, have all of the disclosures prescribetl by California
Health and Safety Code Section 42303 been made? ❑ Ves ❑ No
8. Qf yes", attach certifcate of compliance from the appmpriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE I certify that under penalty of perjury the
intormation given above is cortecL I agree to comply with all state laws antl
city ordinances regarding Hazardous Materials and Emissions.
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty ot perjury that I have reatl this application and state that
the in(ortnation given is correct. I agree to comply with all state laws and ciy
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-describetl property (or
inspection purposes. I agree not to occupy or allow occupancy of any building
authorizetl by this permit until fnal inspection. /�
p.�_�^- lo - L 2'7' �
�ignaWreofLeg Mmer�s) oa�e
AndlO nzea lican `�Dale
Structure
Consulting Engineers
Orange, CA 92865
T 714 998 6441
F 714 998 3403
STANDARD SPECIFICATIONSPOR STRUCTURAL REROOF CALCULATIONS:
� ,�'F �t'�
A. Sketches of deta(Is In calculatlons are not to scaie and may not represent true condttions on plans. Contractor is respons(ble for
Installatlon, whlch represent We freming conditions.
B. The Structural Calculatlons Included here are forthe analysls and design of the roof framing members. To determine whefher the
roof framing hae fhe capacity tor the. new roof assembly loads, due to the added weight of fhe Ules using the guidelines ofthe
uniform buliding code. The aCachment of non-structural elements is the responsibflity o( the architect or designer, unless
speciflcally shown otherwise.
C. The owner and eontractor are avrare that the sWctures has been reviewed for vertical load onty and no analysls orwarranry
expressed or implies included zny lateral analysls for seismic or wind, unless noted othenvise. STRUCTURE CONSULTING
ENGINEERS makes �o xrarranfles in regards to the sWctures end thelr ability to resist lateral.forces, and fhe owner agrees M
Indemnity and hotd hartnless STRUCTURE and their consultante relatlng to any potenUal damage caused by wlnd or eartfiquake.
D. Ovmers are aware fhatthe addHional welght of the tlie material may cause some drywall cracking due to ffie Increase In weight
This Is cosmetic In nature and may be repalred atthe homeowners expense after the roof has been Ins� Installed. ihere may slso be si
deflectlnn ofthe roof rafters whfch is cosmetic In nature and does not Jeapordize the structural intergrity of the roof
E. Oxmer hereby aB« to Iimlt STRUCTURE's Ilabllity to the owner and all constructlon contractora end subcontractors on the
projectsuch as.ftiffi the total aggregate Iiabtlity of STRUCTURE to all those named shall not exceed the cost of the englneedng fee. •
In accepUng Uils report tha owner or ownera agents agree W all of the tertna stated In this report
F. Ovmer hereby agrees to indemnify and hold hartnless STRUCTURE CONSULTINC ENGINEERS, and Its authorized employees from
any action, Ilabllity, clelm dispute, loss, damage; or fnJury to persons and property In any manner arlsing out of construcUon
andlor any Incidents Involving We condltlon or securtty of the premises and its contenCover which STRl1CTURE has no control.
G. Copyright � 7 200 STRUCTURE CONSULTING ENGINEERS. AIU�ghts reserved. This material may not be reproduced in whole
or In part wlffiout the written permission of STRUCTURE All changea made to the sUbJect proJect must be submttted W.
STRUCTUREInwritingfortheirreNewandcomments. •
PROJECT ADDRESS:
OWNER: .
PLAN CHECK:
CALCULATIONS BY:
�Z�g TVYL�.oc,l�.,
G057� M tSA��
�5�0l�w.l �i.esidence
DATE/ 6/ZO �%U
BY:
� � . ' ��
` Structure
Consulting Ert�ineers
2199 N. Batavia Ave "F"
Orange, CA 92865
T 714 998 6441
F 714 998 3403
DESIGN LOADS: Roof:.
Slope:
Roofing 7.2 psf
Sheathing 1.5 psf
Rafters 1.7 psf
Drywall 2.5 psf
Insulatlon R-19 0.5 psf
Miscellaneous 0.6 psf
Dead Load 14.0 psf
Live Load/R 76.0 psf
(Reducedforslope)
Total Load 30.0 psf
COMPOSITION ROOFING:
2-15 Ib. and 1-80 Ib.
3-151b. and 1-90 Ib.
3 ply and gravel
4 ply and gravel
5 ply and gravel.
DOUGLAS FIR SHEATHING:
(Based on 36 pcf)
3/8 in. plywood
1/2 In. plywood ..
5/8 In. plywood
3/4 In. plywood
1 1/8 in. plywood
1 In. sheathing
21n. decking
3 In. decking
4 in. decking
Floor: NA
D.L. of Fin F1
Sheathing
Floor Jotst
Drywall
insulatfon R-19
Mlsceilaneous
Part(tion Load
Dead Load
Live Load
TotalLoad
7.7 psf
2.2 psf
5.6 psf
6 psf
6.5 psf
1.1 psf
1.5 psf
1.8 psf
2.3 psf
3:4 psf
2.3 psf
4.3 psf
7.0 psf
9.3 psf
psf
psf
psf
psf
psf
psf
psf
psf
psf
psf
.,
�Structure
Consulting Engineers
2199 N. Batavia Ave "F"
Orange, CA 92665
T 714 998 6441
F 714 998 3403
ROLL OR BATT INSULATION:
Rock Wool (1 in. thick)
Glass Wool (1 in. thick)
ALPOL (1 in. thick)
FLOORS:
Hardwood (Nominal 1 in:)
Concrete (1 in, thick):
Regular
Lightweight
Linoleum or soft tile
3/4 in. ceramic or qualiry tile
CEILINGS:
Acoustical fiber tile
1/2 in, gypsum board
5/8 in, gypsum board
Plaster (1 in. thick)
\
0.2 psf
0.3 psf
0.1 psf
4.0 psf
72.0 psf
6.0 to 10.0 psf
1.5 psf
10.0 psf
1.0 psf
2.2 psf
2.8 psf
8.0 psf
3 .
�
TRUCTURE
I
CONSULTING ENGINEERS
iLOc�C= i1�4 FZ�
��
SPAN = I Z(o POINT LOAD =
ROOF LOAD =
WALLLOAD =
FLOOR LOAD =
TOTALLOAD =
OAANGE, CA �92865
T 7 7 4 8 9 8 B 4 4 1
T 714 9B8 3403
SHEET
�v b���
s= 2.�x12�.� �;I�� =3,:�c��N3
O " ' ��%5o�c1,2.
� zu hu.� ��UN'
1�/� USE: � �1 � Z�i ��� ��
�
���— ��z�s ��,�T�,
SPAN = � POINT LOAD =
ROOFLOAD = '�
WALL LOAD =
. FLOOR LOAD =
TOTALLOAD =
�./ USE: �C� �� % �C� L/
V= _ #
q_ �,�X�`�-Z�— L� _ �aJ INZ
� '�`�u���� 6 y �NZ
R1 = R2 =
s=�D �c i 6 t�l °� =Gi�b iN'
i�I"Jl���-Z,i _ � � iN3
V= _ #
7�r
A= If J 0.�8 �/zJ =Z� o iN2
cJ. �'� � ' l,��
=��7Lir,2
R1 = R2 =
PRODUCTS(COOL
When the area of exterior roof surface ro 6e rep/aced rxceeds 50% of the eacisting roof area, or
roofing area must meet the roofing product "Cool RooP'requlrementr of§152(b)1Hi, 152(6J1Hii
�heck aoolicable alternative or exceotion below if the roof alteration is exempt from the roofina orodi
1 Hiii.
new
,� Cool roofs not required in Climates Zones t-12, 14, and 16 with a low sloped roof pitch (less or 2:12 pRch).
�' Cool roofs aot reAuired in Climates 7Anes 1-9, and 16 with a steep-sloped roofs (greater pitch than 2:12) and produd weight less than 5llb/ft .
Altematives to §152(b)1Hi and §152(b)Hii, Steep-slope roof (pitch > 2:12) �
❑ Insulation with a thertnal resistance of at least 0.85 hrft �°FBtu or at least a 3/4 inch air-space is added to the roof dedc over an�attic; or
❑ 6cisting duds in the attic are insulated and sealed axording to §151(�10; or
❑ In dimate zones 10, 12 and 13, with 1 ft2 of free ventilation area of at6c ventilation for every 150 ft2 of attic floor area, and
where at least 30 percent of the free ventilation area is within 2 feet vertiral distance of the roof ridge; or
❑ Building has at least R-30 ceiling insulation; or .
❑ Building has radiant barrier in the atGc meeting the requirements of §151(�2; or �
❑ Building has no ducts in the attic; or
❑ In Gimate zones 10, 11, 13 a�d 14, R3 or greater roof deck insulation above vented attic. . �
F�cception to §152(b)1Hiii, Low-slope �oof ( pitch 5 2:12J - .
❑ Building has no duds in the attic.
OtherExceptions � -
❑ Roofing area is covered by building integrated; photovoltaic panels and soiar thermal panels a2 exempt from the Cool Roof uiteria.
❑ Roof constructions that have thertnal mass over the roof inembrane with at least 25 Ib/it2 are exempt from the Cool Roof criteria.
NOTE: If any one o� the altematives or excepuon �s cnecKetl ine Agetl Solar Reflecfance and Thermal Emfttance requrrements for roofing �
pmducts in §118(i) are not applicable. Do not fill table below. .
For assistance or questions regarding the Energy Standards, contact the Energy HoUine at: 1-800-772-3300.
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT N0. G'1�,C� 5�
LOT N0.
ADDRESS 3'�( � �' /��
DATE G��� 73
%
The developer of the above entitled tract desires to sell the above set forth
1ot 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) �ri-s���- 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 of the
aforementioned uncompleted condition.
RECEIVED
CI?';' QF CG�i;I iviESA
�� np_,:.i�.in :�,.�T
�1�..!I\� i�.� Iul�.,�
AA' PM
7i8�9i1tl�llil2ii�2���4�5ig
�
representative
BY
Lender
GP,T.Ix7
AP No.
i GAS
S WATER
PROP. SWR. LINE U HOUSE CON. U
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGN MEATING FND AIR CONOITIONING
TEMPOFFRY SERVICE OR POLE
IINOERGROUNO � POWER �
ROUGN WIRING
TRENCHES FORMS STEEL REINF.
60ND BEAM U STEEL REINFORCE
SNEATHING
FRAME FNO FLASHING
LATHING - IN �] (
PLASTER.BfVOWN COPT
STFUCTURAL FINAL
BUILDING
FINA
FINAI
DATE �_��_��
BUIL' PERMIT N0. 41326
DESCRIPTION of WORK Pa �.� Cover
SUBCONTRACTOR
�-
`l � 4 I 6
F
�
a
Q
r.�+
y
F
COSTA MESA BUILDING-SAFETY DEPARTMENT
PAIU
�EP ?0-76��;<�00 832�+ �***10.50
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
r�PP C ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely - Use Ink Only
R E V DATE RECEIVEO TF�I SSU
BUILDING � �} j � . � � �//�� /
AODRESS a<<.� �✓ "�<-r (_`!�' �t� V
OWNER ,.��r'j��GC� /�/"7 L LU / A.P.N . �Z— I
MAIL (` BUILDING �
ADDRESS tl � �Y�7 r^ ADDRE553 �r
/�-��} /� .� TEL,.; � TPACT ZTS LOT BLOCK
arv l�U,l i f% /i lf_:`('�q No. /Jr!- %�3f�
CAN5TRUCTION W ADD A P
LENDER ��U I'
BRANCH OWNER S//�A�G A O�
ADDRESS VALUE �y��
ARCHITECT y� � TEL. � S $ V�JU/
OR ENGINEER 'J � ' N .
FIRE
ADDRESS � ZONE TVPE GROUP
APPROVED 7/�„
CONTRACTOR �} '�1��� . i+Z-� Q - BV DATE �v
AODRESS � �J�=� �JI'�'ItS~'� /�(= .p�
CITV �� •✓• TEL.. Z� pLOANS� 6UILOING EW '�" O �
No. �-l(�� �'/G 91
STATE 1 CITV �'ARDSAPPROVED VARDSAPPROVED
LIC. NO. G� L f��iJ.� LIC. NO. �"� MAIN BUILDING ACCESSORV BUILDING
SIZE �� NO.OF L (FROMC/LST EET)
OF LOT �� 6 Jr � L' (� NOW ON LOT � RONT FT. FT.
USE OF ,� ,l�� T /� �
EXI5fING BLDG. �2',r -�I �� r-,� K. F. FT.
Separate permits are required for L. SIDE G� FT. FT.
electric, plumbing and heating work. /�
REAR G— FT. FT.
USE OF B �NG ANO WORK TO BE PERFORME� D45TANCE BET. BET, MAIN &
MAIN BLDGS. ACCE�. B�DGS.
/ VAR.� DATE
C.U.P.# APPROVED
APPROVED�/ ' J /J _�.�i/
L[ G /U
I hareby eeknowladge that 1 have reatl this applicetion antl stata �
ihat iha ebove Informatlan is correct antl aprea to comply with �
m
all laws rBguletlnB.Cuiltlinp conrtruction, antl I shell not employ .
any person in violailon of the workman's compensation lews oi o
the State af Californie. . �D �
I hereby ceriify that I am properly Iicansetl as a contractor under SQ. FT. N
the State ut California Business entl PlofeSsions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chepter 9, entl that such licenses ara !n tull to�ce antl attect, or I � THE PVRPC6E OF E5TAa�ISHING A PERMIT EE ONLY:
em exempt trom the provislons of the Stata of Cal(fornia Business >
antl Professions Code, Division 3, Chepter 9. VALUATION � PERMIT FEE $ N
t _� ...���--- m
SiBnefine of I n} n/� ��l I � PLAN CHECK $ o
Permlttee lxh.0 ,� l IJ A A.� . C/� $/�� TAX $ LL
f
U
Authofized Apent � TOTAL PAI D S d'�
OWNER ���g ENTERPRISES DAT� 8-2872
GENERAL GONTRACTOR H
AP No. LOT 9
INSPECTIONS
SOIL
GAS
W ATER
HOUGH PLUMBING '
PROP. SWR. UNE HOUSE CON.
SPRINKLING S1'STEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CON�ITIONING
TEMPORARV SERVICE OR POLE
UNOERGROIJND ❑ POWER �
ftOUGH WIRING
TRENCHES FORMS [—� STEEL FEINF
FLOOR SYSTErM�
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P.O. eOX 7200 COSTA MESA. CALIFORNIA 92626
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:,u�; 30-72��;s„002oa3,= �** 169.61
- - APPLICATION FOR BUILDING PERMIT
ForA'pplicani to Fill in Completely qEGEI v on RECEIVED o e issueo
ADDRESS :J2G � (V' �� �0.�� � �� 7
P.ERMIT NO.
OWNER Heltzer Enterprises-Costa Mesa A.P.NO.� ��'� �
MAIL ADIDRE s 3��5� v�2LocKvvr� "
nooREss 740 No. La Brea Avenue
cirv Los Angeles rTio� 937-2171 TRACT 6245 �or 9 BLOCK
oorsrRucnoN� United California��Bank W '° °
LENDER
BRANCN , Ma'n Office . �
OWNER
nooaEss 600 So. S rin St. Los An eles VALUE
ARCHITECT David Freedman TEL. E $
ORENGINEER n, . 653-3852 ^
FIRE.' � � // �
nooaEss113 N. San Vicente Beverl H111S ZONE TVPE GROUP cx
� �APPROVED
CONTRACTOR George J7 Heltzer . e�. � oare �
ADDRESS 740 No. I.a Brea Avenue �
TEL. ZONE NO.OF USE OF NEW 5'�/J FA �U
arr Los An eles No.937-2171 P�� BVILDING
STATE � ' ' CITV �'ARDSAPPROVED VARDSAPPROVEO
LIC. NO. ,31Q4 � �IC.�NO. 1900 MAIN BUILDING ACCESSOPV BUILDING
512E ' " NO.OF BLDGS. (FROM GL S/TREET)
OF LOT NOW ON �OT ROfYT S I FT. FT.
USE OF
EXISTING BLOG. FT. FT
� SI2E OF ' NO. OF �
NEW BLOG. ROOMS STORIES ^2 L.SIDE 7 FT. FT. �
E%TERIOR WALL ROOF �
COVERING Plaster COVERING REAF S.SFT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISiANCE BET. � BET. MAIN &
MAIN BLDCS. ACCESS. BLDCS.
Single Residence Plan -0k408A Rev C URP # APPROVED
�i/ /17T r APPFOVED �/ ��a g�2Y�)i
uri �.��.�� . R�
STATE
nn n.-�� r r.-� iin.-...-.. _
I hereby acknowledge that 1 have reatl Mis application and state � •`
that the above information is correct and ag�ee 2o comply with
all laws regulatin8 building wnsiruction, and I shall not employ -
any person in violation of the workman's compensation laws of
the Stata of Calitornia. � � � �
I hereby certify that 1 am properly licensetl as a contractor untlar SQ. FT. D b o
rhe State ot California Business and Professions CoCe, Divisicn 3, . THE AMOUNT SHOWN UNDER VALUATION IS FOFi ��
Chaptar 9, antl that such licenses are in full torce and effect, or I THE PURPO6E OF ESfABlISNING A rERM1T FEe oN�v: �
am exempt from the pr isions of t�e S2a[e of California Business VALUATION fb
�i �
antl Prof¢ssians Cotle, i on 3, Cheptar 9. PERMIT FEE $ � �
]
Siqneiura ot ���555 S m
Pe�mittee $�� i�D � P�N CHECK $ S� E
AuthorizetlABent �/ / a_s ° �
TOTAL�FEE $ /(O