HomeMy WebLinkAbout1050 VALLEJO CIR - Building Permits •
•4111 Ms•n CITY OF COSTA MESA -
BUILDING DIVISION
ft ", DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER
PERMIT B05-01569
Iteboacrnoili
•
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.B.IMLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1050 VALLEJO CI Status: ISSUED
Suite: Applied: 09/09/2005
Vicinity: FLAT ROOF AND ATTACHED GARAGE Issued: 09/09/2005
Primary Occ: R1 Type of Construction: V-N
Parcel Number: 41205213 Zoning:
Applicant: WINSLOW, BONNIE
Address: 1050 VALLEJO CIR ,r��t�
Phone: 714-545-1061 ISSUED BY:
COSTA MESA,CA Zip: 92626
Owner: WINSLOW, DONALD LAMOINE
Address COTR EXTENSION
COSTA MESA,CA Phone: 714-545-1061
1050 VALLEJO CIR . Zip: 92626 .L" LLO v D
Contractor: OWNER-BUILDER" PER -AL
Phone: f�
Phone. EXPIRES 7M°6
Zip: License: 000000
Arch : Eng:
•
Address: Address:
Phone: Phone:
•
Zip: License: - License:
SCOPE OF PERMIT
. T/O EXISTING BUR AND INSTALL NEW BUR W/HOT MOP ON ONLY THE FLAT PORTION OF ROOF AND ATTACHED GARAGE.APPROX 1445 SF.
FEESUMMARY
Plan Check: $0.00 Calc Valuation: $3,200.00
Permit: $97.25 - Claim Valuation: $3,200.00
SMIP Res: $0.50
SMIP Com: $0.00
Other $0.00 -
Inspection: $0.00
Total: $97.75 •
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 .. Left 0-0 Right 0-0
ACCESSORY Front 0-0 L Rear 0-0 Left 0-0 Right " 0-0
PARKING Existing: 0 Required: 0 Proposed: 0 •
RRIp
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 it 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 approvaltmust be obtained.Failure to obtain Inspections and final•approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244646(ate)
DECLARATIONS I /-"i
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declaration:;{.
•
❑• I have and will maintain a certificate of consent to self-Insure for workers'compensation,al provided ibr by section 3700 of the Labor Code,for the performance of the•
work for which this permit is issued,
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'compensation Insurance carrier and policy number are:
Carder: Policy Number: •
(Thifrsection need not be completed if the permit is valued of one hundred dollars($100)or loss.)
-'21 certify that in the pert mance 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 California,and afire hat if I should become subject to the workers'compensation provisions of Se lion 700 of the Labor Code,I shall forthwith
comply with these p ions. • / /
Applicant Signature: !1S /I ..Dat - 9 e:
WARNING:FAILURE TO SE RE WORKERS'CompsATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLIARE($100,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
force and effect.Lia# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is
"p!�� 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.).
Y" 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 p suant to the Contractors License aws.).
❑ I am ex' •,under s9a — i r Business and Professions Code for this reason:
Signature: I I' • / )
Owner ID ve tied by drivers'icons:. W. Yes ❑No Dor rs License No: !-Eipires: -Ze AY
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 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater 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 end 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 apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes P 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 SafetyCode).
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? ❑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: I4.q Date:
•
41lo eat
CERTIFICATE OF C."- ;'CE AND AaIrHOR�AT10NijpF ENTGYrI certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply,'io all state aws an'( clty ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
abov scribed property fo spa do purposes.I agree not to occupy or allow occupancy of any building authorized by this permit un it final ins action.
�/`,Gc7„ 9(9/asp
Leinature'OfLegalQs ner(s)"' Date
And/Or Authorized Applicant Date
COeE t INSPECTION TYPE •'' PAIS' ' ' MURALS ' • CODE E IN$PECT1ON TYPE QLIE MGM
1616 Fixed System Final Fire Prevention _• 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final fie-Roof IAN® e% 210 Final Electrical
201 Final Block/Retaining Well 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 ,
February 10, 2006
Mr. Edward Petros •
Chief of Inspectors
City of Costa Mesa
77 Fair Drive
Costa Mesa, CA 92628
RE: Building Permit #B05-1569 - 9/9/05
Dear Mr. Petros.
I am writing to request an extension on the above permit for re-roofing my house until the end of
July.
The fellow I contracted with in September sent back my deposit check and said he was too busy
to do the job at the time. Then I lost my job the end of that month. I have only been able to get
part time work since then. However, I will have money available to me at the end of July to be
able to get the job done.
I will appreciate your approval in this matter and look forward to hearing from you and to finally
getting the necessary work done. Thank you for your time and consideration.
Sincerely,
(0/4-112474)
Bonnie Winslow
1050 Vallejo Circle
costa Mesa, CA 92626
714-545-1061
..
F CITY OF COSTA MESA
4.� - et) BUILDING DIVISION
> r••„ 4.6742
1.104 1. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
F t PERMIT
�• BOO-01690
0
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.�UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1050 VALLEJO CI Status: ISSUED
Suite: Applied: 10/18/2000
Vicinity: RESIDENCE ONLY Issued: 10/18/2000
Parcel Number 41205213 Zoning:
Applicant: WINSLOW, BONNIE ISSUED BY:
Address: 1050 VALLEJO CI
Phone: 714-545-1061
COSTA MESA, CA Zip: 92626
Owner WINSLOW, DONALD LAMOINE
Address COTR
COSTA MESA,CA Phone: I
1050 VALLEJO CIR Zip: 92626 • • • 0, ,
Contractor: OWNER-BUILDER toot,i /
Address: DATE
Phone:
Zip: License: 0
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF:T/O,SHTG PER MFG SPECS, 1 LAYER 15#FELT,APPLY 25-YEAR COMP SHINGLES. 1280 SQ FT
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $1,165.00
Permit: $44.85 Claim Valuation: • $1,165.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $45.35
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
,
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 end 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
2448-46(6100)
DECLARATIONS I
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ 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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE 151 W,WO),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.0 Class 0
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction tending 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:
.r ,1/
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).):
%pYjct
I,as owner of the property,,-or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her,own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑) I am exempt der sec. ,// n Business and Professions Code for this reason:
Signature:—,.. �V,M4LA-�0'Tv \bate. /0-- f 0 0
Owner ID verifiedrby driver's license.17 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 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 ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes Ll No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 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 MID 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 end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above- scribed property ffo�o-' eect'p n purposes. .. .. .. . . . . . ....' -- • • • _ •• •: •: •-. .
( cS natu re Of Legal'Owner(s Date
And/Or Authorized Applicant Date
CODE r INSPECTION TYPE ORIF. INBBAkH CODFI INSPECTION TYPE MTh 1.15Maka
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pod Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place . 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition , 250 Final Building/Occupancy
•tiApplicant to fill In all spaces except those withirLteavy b^ der lines and sign all appropriate declarations. 6.605 4/01/63 t4e '
CITVV F COSTA MESA - PERMIT NO., TRACT NO. • LOT N , BLDG;NO.
CONSTRUCTION PERMIT 7( � ()cosi J��
I
.
•
Applicant's Mailing Address �I� �-rs• TYPE OF CONSTRUCTION ® NEW U ADD U ALTERATION U REPAIR • -
Project Address /Th5' V,.is 1--1--& V ai/e. _ �I ❑ CONVERSION ❑ DEMOLISH v❑ OTHER� HEL x - ` , . - '
W/A�'c-V k" Phone`a TS /Ob` DESCRIPTION OF WORK g.f'•p(%r`- /10
owner's Name - _ '1 /J q - ZONINGNIREGULATIONS
Address; /DSD VA' 0 �e - TYPE OF PERMIT U GRADING H FOUNDATION V.STRUCTURAL .A.P.# Ai(� - OG[,— 1$ ZONE e., 1 '
Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 0 MECHANICAL PLNG. REF.# \ BUILDING ,
eFTRnrx r/r CT
Address Q - ❑ OTHER - ' TO BUILDING ' • REAR YARD(TO P/L)
Contractors Name 0,s`.��! �7� Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY /1 'PROPERTY LINE
Address(mailing) J•^�s& 7•� ��• CONSTRUCTION TYPE VALUATION$ C*t? V LEFT SIDE YARD �� %)r(/� RIGHT SIDE YARD
' ZONE GRADING CU.YDS. ACRES PKG.SPACE.REQ. -At., PROVIDED I -
LICENSED CONTRACTOR DECLARATION • Remarks: . STREET WIDTH 3 (+ PARK FEEfff$
I hereby.affirm I am licensed3 under provisions of Charter i9(commencing �s{ �. �� ir ,�Le G C
with section 7000) of Division 3 of the Business and Professions Code, and • SPECIAL CONDITIONS: I I l
my license is in full force and effect.[Jeanie Class Class• • License No. PLUMBING , I 40 r— [[ r
Date Signature
' `' N ( Loki .1 h ( �T'6 .J'� C�
' ' KERS'COMPENSATION DECLARATION 68r Sink Sewer Cap ELECTRICAL
. --..x•aaby affirm that Lhave a Certificate of consent to self-Insure or a certificate '' Backflow Preventer - Sewer Connection --- -- • Automatic Washer Meter Dover 100 amps•
'.-' Workers' Compensation Insurance,.or a certified,copy thereof (Section - •_ ' Construction Pole Sub Panel, •
-
3800, Lab. C.) I ' • Backflow Irrigation Solar Collectors - '
Policy No. - ' Company ' _- CookingUnit 'Sub Pole ' -' ' • •
8 Certified copy is hereby furnished. ' 1 Bathtubs Solar Piping • •
Certified copy is filed with the city Building Division. Dishwasher 'Motors D0-1 HP 0114-8 •
, Date - Applicant I ' Clarifiers Solar Tank
E%EM PTION,FROM WORKERS'COMPENSATION DECLARATION • Dishwasher , Swimming Pool w/Spa Dryers ❑Gas• ❑Electric Inc.Solar D9-15 HP D16-15+ ,
(This section need not be completed if the permit is for one hundred($100) •or •
less). ' I l- - Fan Microwave
I certifythat in the DrinkingFountains Urinal -
any person
in of the work fso•
as to this permit is issued, I _
shall not employ person In any manner so as to become subject to the - - F.A.U. Pole Light '
Workers',Compensetlonl Laws of California. Floor Drains Water Closet -
Date Signature •- - •
NOTICE:If,after making this declaration,you should become subject-to-the - ; Floor Sinks r - - Water Heater - - Fixtures _ __ Range --
Workers'. Compensation provisions of the Labor Code, you must forthwith Device Boxes •
comply with- such 'provisions or,this permit shall be'deemed revoked. . ' Gas Service Outlets. -Water,Service ,- iSign I ,
CONSTRUCTION LENDING AGENCY - - Outlets Si •
I hereby affirm that there is a construction lending agency for the performance Interceptors - - Standingectons
of the work for which this permit -is'issued .(Section 3097 Civ. C.) Switches '
Lender's' Name - Kitchen Sink I - _ Trash Compactor
Lentler's Address t - - - • '
OWNER BUILDER DECLARATION - Lavatories , - . - • Garbage Disposal ,
1 hereby affirm that i am exempt from the•Contractor's License Law for the p-Tra - •
Generator, ❑0.5 KW ❑5-15 KW • I
following reason (Section 7031.5 Business and Professional Cotle: Any city or P •
- '
county which requires a permit to construct,alter,Improve,demolish or repair ' .. , Transformer ❑75-50 KW •
any structure, prior to its issuance,also requires te applicant for such permit • , Roof Drains .. - •
to file a signed statement that he/she is licensed pursuant to the provisions of i - ' e • 050+KW Reinspection Fee
Contractor's License Law-(Chapter 9(commencing with Section 7000)of • . - I , ' P $75' S
>>�zzton'3 of the'Business and Professions Code) or that he/she is exempt Showers Reinspection'Fea 515'
r ^a from and the basis for the alleged exemption. Any violation of Section Meter ❑up to 100 amps Issue Fee ' '$ 3 I
x31.5 by any applicant for a permit subjects -the•applicant to a- civil Service Sink Issue Fee 4 '$ 3 ' -
malty of not more than five hundred dollars($500). e' Zoning Approved By rom Date --24---.L-1—t..—
,
AI, as owner of the property or my imployees,with wages as their joie ` MECHANICAL ' '
compensation will do the work,and the structure is not intended or offered .1 r Application Approved By nate
' for sale (Section 7044, Business and Professional Code:.The;Contractor's - -- -- -- --- -- - --- - ---- - — - _ a71 1, 2
License Law does not apply to'an owner of a property who builds or improves ' ' Boiler - Refrigeration System - s', a• Application Issued By I ``r' C • Date tri'e
thereon,'antl who does such work himself/herself or through his or her own ...,
. employees, provided that such improvements are,not Intended or offered for 1 ❑0-100,000 BTU ❑100,000 BTU •
' sale. if, however, the building or improvement Is sold ithin one year of com- Duct-Under,Ground , , , • , SUMMARY OF FEES
pletion, the owner•will have the burden of proving he/she did not build or im-
prrove for the purpose ofsale). I - I Duct-Structural I I System Repair/Alteration - ., ;BUILDING PERMIT $ 3 Z, 5o SMIP - $ �O
•
O I,as owner of the property, am exclusively contractingiwith licensed con-
tractors to construct the project (Section 7044,Business and.ProfessionsCode: `. Duct-Ventilating - ,- -, _ ` t; - PLAN CHECK $ - I • /i- PERMIT
The Contractor's License Law does not apply to an owner of property who , ISSUANCE ' j $
. builds or Improves thereon,and who contracts for such projects with a con- . Exhaust System 0 Multiple❑' ,PLUMBING $ ,
tractor(s) license pursuant to the Contractor's License Law), - v PLAN CHECK 1 $ ' GRADING ' ' $
0 I am exempt under Section ' _ i 8.& P.C.for this reason i Firepl/Fact.Bit.ICBG# •
• $ I
Date/ , I Owners -a aa.- I - , Heating System& Ducting ' 1 j j r ELECTRICAL $ - I • I
I-hereby-certify that•i have read this application and state that the above- -� 00-100,000 BTU 0100,000BT -- • - -
PLAN CHECK $ ' MICROFILM $
information is correct. I agree to comply with all city and county ordinances .. I TOTAL FEE. $
and state laws relat ng to building construction, and hereby authorize repro- 1 .MECHANICAL $ • ,
' sentatives of'this -ity/tO enter-upon he above-mentioned prop rt for Hood or Type 0 Reinspection Fees ' •.-$15- • • LESS a
' Cano T e II 0' PLAN CHECK 5
inspection ourpo ,� • / ADVANCED PC • $
Signature Lis 2A__' La_ ._./ -� Date Registers Issue Fee FINAL FEE; 1 $ /L
•
Drivers' License or 55# �� � •
__ _ 9 j _ I $ 3 ��L
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod'-Assessor -
1 - - v r - r.1 - POO ti PA• . -- - `Ll'inCONSTRUCTIONN AND PLA NI G, J K P•j
''‘;'APPROVALS, ,� Permit-4i; .07/81_,„ _'Date -t, " 'Inspector ,. • Date•• Inspector , -
- 4 -J/rY - ='APPROVALS . Permit-# _
rr 1 Tempor-ary.,Electrical Service or'Pole i :v..; -• _ o' - 52.' Pool &.Equipment Location
�� 2d Soil Pipe=Undrgrnd.' r mac; , 53C Steel Reinforcement • .
- 31 Electrical Conduit Utility Undrgrnd: -, :. ' 54i Forms ;. ' • - r..:
CI 4. Electrical.Conduit-Undr rnd, - ' - a, •_ - < •
g . . I - ,._ _ ;_55:. Electrical Bonding •. -
5: Steel Reinforcement _ - iters "56. Rough Plumbing& es
Prsure-Test;_ - , ._
6 .'Electrical OF ER Grnd. . 2 re ' ' 57: APPROVAL•TO COVER-GUNITE
7. Footings ; 1 i , ' -• _ ' , •: tr_f.83i + '� onUn
i58: Electrical Cduit- drarnd: " . -
8. Foundation • . , 1 ' ' t _ • t59. Gas Pipe, .Undrgrnd_,Test: •
9. Water Pipe-Undrgrnd. ‘ - I - ' , ,60. Backwash Lines,P-Trap, 0 Undrgrnd. `
10. Structural Floor System ; " ' I R ' -61. APPROVA• L TO;DECK - - .. ,
11. Property Sewer Line& House`Connection , '' X62. Backwash &°Receptor-Final
12. Sewer Cap ; i j - •6-I -^ 63. Heater &-Vent-Final. - '
13. Roof Drains ".64. PlumbingSysteni- Final r , . • -
14. Rough Plumbing - - -65. Electrical-Final-- . " - . -
15. ,Rough-Electrical=Conduit •'- - -'r- ---I ,-1- - . - ,`r' '',66. Solar Systern:Final : -- : --- - `
t i,3T16. 'R6ugh Electric Wiring , is '-, i 'l-: Q -' 11. i B7.'-Fencing & AccessrApproval - - - - - "
E --17. JRough.Wiring Sign:' r, _ ; - ' • I. 681 APPROVED FOR PLASTERING
= ;'`i 8. lRough�Electrical.T,Bar Ceiling; . I . I I 69.I POOL/SPA SYSTEMS FINAL , ' -
r g 19.'Rough-Heating&:Air'Conditioning I l i I ' I FIRE DEPT.,REQUIREMENT
' ! 20. 'Rough,Factory Fireplace, ' , , ' ' , APPROVALS Permit# - -"
•
21. D'ucts,`in Structure" ' ' I r' r ' 1 ' , ;70.' Underground Hydro
`_22. 'Ducts;-Ventilating •; ,-, J I i l , I , X71. Product Piping 0 Gas ❑Oil -
';,:i3. 'Gas Pip -Rough & Testa i , j 72.' Underground Flush ,
+•-24. ,Roof Framing', ' . ' I ii-' `, I o'r _ -! 73. Undergrnd. Storage Tank.0 Gas l ,Oil • '
r •25. Roof Sheathing ' : i I • ii,., '1 . (;, I ; - i. 74.1 Overhead Hydro I
,T
-26. -Bar Ceiling (Structural),& Monocoat' { ; I I '` : ' 75.' Dry Chemical • = ,
i•-21,1. 'Frame and Flashing .I - I : I , ;76. Dry Standpipe , : , . - I , ,
.6 •• 28. RLathing &Siding ' I Il _ I ' I ,',; I ! {77.' FIXED SYSTEM"FINAL • ; - ,
_• ` 29. Insulation _• n I I I I l ' i I 1781 FIRE PREY. FINAL ' • I '
• 30.'D� wall Nailing ' '• .I 1 ! ' 'Notes' '
Y 9 I I ,4! a=sem 'Z'r., ►v cf ryuk.�e d'r�' _
31.;Plaster Brown Coat`
c[ c , y I I _ Staa.( -te1^ow ear 'Nt k.arrtG1"12Q.44 too
' Ii 32.;Electrical:Power Meter-Final •; 1 • i '
i ! I rhi tUowI 2artelt:14 114 Rot ?rotLr y
.. 33._Final Electric „:„_..it ' I .
34. Final Heating &)Air Conditioning [., ' ' ' I 1 ; '' ' '
35. Final Gas Pipe-Test + 17: i , 1 r. I . -r _ - - - ,. .,
36. Hood or Canopy; i ,....-; I ', . - 1 2 I .: . ,
1 , ..r ., i I ; 1 Its � ,l,
+
37. Final Factory Fireplaces • _
38. Final Plumbing ••••-•,-t••••-•,-tr"
i " -' : ,
�� I ,. I I ,
39. Water Service-Final: • , ' ': I 1 t I - 7- n
40. Gas Service-Final t.,...,,, ' I ' ; ' . ' . _
41. Solar Domestic-Final" ' • ' ' • : 1 •
-
42. Backflow Preventer
43. Backflow Irrigation' .„ - _ • I -
' 44. Landscape-lirigation"System- Ilt• ' -? - - -
45.-Sound Attenuation +° ' _1 • .F ,i - I _ I I _ , ' - - :.
46. Handicap Regulations 1 'I ' °,
47. FINAL STRUCTURE & BUILDING- -t1-li-g-S -+$f '\ i
48. Special Requirements Completed' ; 1 -'I I ' .•
49. Electric Release,to Edison ' I 1 ,
. . ,
50. Gas Release to Southern California Gas Co I , ; � I 1 . I
51. CERTIFICATE.OF OCCUPANCY i- 1 ' - _y
No � • Date I s I I ! ' I ,
\: .!"
I
citie VALI.ESO GIS. — '
9 Co /.. -1.g cosbietai MEsa " I
PLANNING DEPT.
4S
3151, q�SUBJECT TO BLDG. DEPT. REt
/� ! art--- ' DATE..4/"t lS 3
., sr 1 / I DIREQ+PLANNING . •
�Q�GPIS7Mit ,n.5`°
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' . (`i coI ctsicb)` t4,m4 Ba4ccM - , --- -- - — - - -•
ED tutvo C•wits $0' LAMM D(¢N4a ,
ce lose VAu-EIO cto
,
r ALt Tl
APPROVAL
BEH APPROVM
CONSTRUED
ORANy FRMIOT PPRE.
10, cmca THE
1R1zE ra LAN, So
UPON lia
ETU1LO1N0 O OAND
EROON OF ERRORS
THEREUNp�ENTING
OTHER rm. yEN
,
TYPICAL 6U CONCRETE BLOCK FENCE 4
Cement Coping Optional - -- I GENERAL- NOTES
Channel Block With 1-3/8 ■,M_�
0 Fences Top of all
Fences MORTAR: One Part Plastic Cement, and
_ _ Three Parts Sand
GROUT: One Port Cement Three and
--
For Fences 5'or Less ''-> One Half Parts Sand
-> f �'--'�
Vert. Bars 3/8"Oat 4"-0"O-C.. o
• COPING: One Part Cement, Three
For Fences Higher Than 5' S ' -'i� Parts Sand
Vert.Bars 3/8" Oat 32" O.C. >- w CONCRETE: Well Mixed 1:2-1/2: 3-1/2
Fill Cells Solid With Grout
I
K j z NIS 11 I Max. of 7- 1/2 Gallons of
_ _ Water Per Sack of Cement
WhereSteel Occurs w o -- -�
Reinforcing Steel Shall f 'o GROUT MAY BE POURED FROM THE TOP
Conform to Sec.A-15-39 —� -- OF THE FENCE IN CELLS WHERE STEEL
A.S.T.M. u r I OCCURS.
_ E.
CELLS AND AREAS OF HORIZONTAL REIN-
All Steel to be Lapped ' M •- FORCEMENT SHALL BE CLEAR,CLEAN&24"or to Code ', —M I FREE OF ALL MORTAR DEBRIS,ETC.
PROVIDE CLEAN-OUT AND INSPECTION
HOLES AT THE BOTTOM OF CELLS CON-
NATURAL GRADE ms I �� -�� ��� TAMING VERTICAL REINFORCEMENT.PROVIDEDLAYING
1 BONDS SHALL BE BY
���-y'0. i•.***'i* „ BLOCKS IN STRETCHER COURSES SO THAT
//- •'r.b,: / "4 , . - Or • - - VERTICAL JOINTS ALTERNATE IN EACH
v7?i ."am. \ . n , a COURSE.
TWO 3/8"0BARS �l 'i' �. b ,� a ♦_. y .
CONTINUOUS TOP
. . _ _ &BOTTOM WIDTH TO 15 0 C. MAX.
t,' ' - SEE CHART •b �"
ALL STEEL MUST BE TIED IN ' T BELOW a DE PTH OF E ARTHTOOTH
PLACE AT TIME OF TRENCH • I I t 1/3 THE HEIGTH OF FENCE
INSPECTION. oI L -e. L J. L SOW BOTTOM OF FOOTING.
IO
1_4.1-12 .---1 '.� SCALE: I/2" = I'
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6 ' 5' 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'
OWNERS NAME:
City of Costa Mesa, California JOB RE SS:
• PERMIT DNUMBER:
Building Department SIGNATURE:
I-OR&% IMQ5-2M-8-142
4.. ,.
4
_ STREET 6 . _ - -- — "-'
STRUCTURAL APPROVAL ONLY
•
SEPARATE PERMITS ARE REQUIRED
I• FOR ELECTRICAL, PLUMBING,•HEATING, 11Ef:TILF.T'i:'@ AND
REFRIGERATION WORK
a _
a
en 1 Permit # l36 7(
THIS NUMBER MUST ACCOMPANY
_ ALL INSPECTION REQUESTS
FGn b� LJIiIGS 'i:nc.,.c PL'SCTS ARE TO
BE EMPLOYED, PdE SUS@EST INAT THE
StATc QF CnLIFUR,:n L:✓ISiON OF
a Di ti SAE€TY BE COAISDLTED FOR
ea
ADDRIONAI REQUIREMENTS.
A
z
H nA
a
Mill
z .
in i
0
A
s
es
A
Ic:.y of Costa Mesa Building
S DATE-
__..._....._
JOB 40
c THESE PLANS MUST BE ON p0.1(
i n.,A:CE NO
CHANGES WITHOUT
E+ r F DEPT.
A iPERP
'
TIE AS•D CE OR GRANTING OF AL NO
L. PLANS ASCD SPECIEIC:TI Nr;APFH:-,LL O
�TO EE A FERdIT FOR, OR
Of
CF ANY CF THL FROVISIONS Ci THISIOCOODE
SLIMING TO GIVE AUTHORITY TO IO VA
LATE
FROYI`_IONS CF THIS
CODWSSHALL
A LBE IT ALM FS THE WORK
_ STREET
THE ISSUANCE OF A PERMIT BAS
' E
^.CATIONS SHALL NOT PREVENT TM
1 . - I 'SEEE,'.FTER REQUIRING THE CORI
-"'J FLANS AND SPECIFICATIONS 01
'••••',I-NG CFERATIONS BEING ONG ARRR DIED UI
'jr'. OF
ft 29581 PAID
COSTA MESA BUILDING-SAFETY DEPARTMENT JAN -7-69tfS1OO 213* ***108AK
P.O. BOX 1200 COSTA MESA, CALIFORNIA 22626
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING
ADDRESS 1050 Vallejo Circle )
RECEIPT NO. / p/.LMO1
COSTA MESA. CALIFORNIA �IJJ tFJ�ILJI
RECCEiVED ST DATE RECEIVED DA ISSUED
OWNER Heltzer Enterprises-Costa Mesa """� �� �-�'� � O3./e�, �
MAIL ADDREISS /GSD `/a_le• �� C.�
ADDRESS 144 South La Brea Avenue lJ,jJ yn
TG FIRE 3 TYPE GROUP QT/'/,
CITY Los Angeles 90036 NOt936-J104 ///
II�� APPROVED
ARCHITECT
ENGINEER Frank Gonzales No3 216 78 BY DATE
1336 E. Chapman Avenue ZONING r
ADDRESS Orange, California 97668 ZONE I NO.OF I
IMI or NEW Kes. w/
Rl PLANS 2 BUILDINB
CONTRACTOR Cenrge .T Meltzer & Accor„ Attarh_(;ara8e
DESCRIPTION Lot 56, Tract 6637
ADDRESS 144 South La Rrpa AVPnIIP
CITY Los Angeles, California 90036 A.P.NO. None
NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
STATE 201098 TEL• 936-1104 BO'TO SIDE b REAR P.L.
LIC.NO. NO.
SIZE I NO.Or[LOOS. VES
ALLOWED (LI.B.C.REQUIREMENT).
OF LOT NOW ON LOT 0
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. (FROM C/L STREET)
SETBACK LIN[FROM jYl (J
•
CENTER OF STREET REAR YARD 201 PRDNT i) FT. �a ry f�/�j//$}T/,
BIDE YARD LEFT 15 ' RIGHT 101 R.SIDE JO FT. PIt /Y/�" """*1.
DESCRIPTION OF WORK L.Lox /,,S1�Fr. FT)
NEW X ALTERATION ADDITION
REAR >V FT. 6 FT.
DISTANCE BET. BET.MAIN B
MAIN BLDQ$, ACCESS.BLOCS.
REPAIR _MOVING OEMOLISN
BUILDING NO.OF VAR.iC DATE
SIZE ROOMS STQRip 1 C.U.P.* APPROVED
EXTERIOR WALL ROOF APPROVED(/�/'q
COVERING StuCCO I COVERING wood shingle BY
y� DATE I
).-[. a �G�_
USE OF BU ILDING AND WORK TO BE PERFORMED
P.
Dwelling_ and Attached Garage 9
Plan 403DX - Lot 56 /f
>2/690sa.Fresi3dL.49op' 1
B
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT NO UNDER VALUATION IS FOR THE j
AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY. N1
PLY WITH ALL CITY ORPJNANCES AND STATE LAWS REGULATING VALUATION 02 — I
BUILDING CONSTRUCTION. PERMIT PEE $ /
SIGNATURE OF 5,141
PERMITTER .A21
7� ?6 — a
[ $ ) / PLAN CHECK $ J
AUTHORIZED AG ee�'J �/G O
�r �� '(/ l�lTw'� TOTAL FEE $ /�O
v