HomeMy WebLinkAbout3112 VAN BUREN AVE - Building Permits •
•
Fq CITY OF COSTA MESA
`v BUILDING DIVISION
v.' DEVELOPMENT SERVICES DEPARTMENT
PERMIT PERMIT N ER
B98-02111 V/
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3112 VAN BUREN AV Status: ISSUED
Suite: Applied: 11/23/1998
Vicinity: Issued: 11/23/1998
Parcel Nunmber: 14169302 Zoning: R1 R1
Applicant SCOTT ALLISON
Address:
Phone:
Zip:
Owner: STURDEVANT, CLAYTON R
Address STURDEVANT,JULIE S
COSTA MESA,CA Phone: 714-540-3828
2037 SWAN DR Zip: 92626
Contractor: FAIRWEATHER ROOFING
Address: 03845 E CASSELLE AV
Phone:
ORANGE CA Zip: 92669
License: 515125
Arch/Eng :
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT .
t/off sheath and reroof 2600sf residence w/comp shingles.smoke detectors required
per 94ubc.
FEE SUMMARY
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Plan Check: $0.00 Calc Valuation: $4,695.00
Permit: $99.75 Claim Valuation: $4,695.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
•
Total: $100.25
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:
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
f •
DECLARATIONS I 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 levied.
My workers'compensation Insurance carrier and policy number are: /
Carrier: C Policy Number.
(This section need not be completed if the permit is valued at one hundred dollars(5100)or less.)
kI 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. AL_____
�
> Applicant Signature: ci-... /� /-7]`� Date: /( L 3i S o'
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 LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Sectjprr7000)of Division 3 of the Business and Professions Code,and my license Is In full
force end effect.Lic.» I I).Sn / Class a C 3S
yContractors Signature: ( I' ! l`t. -V Date: t I L)/Ce .-------
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued,(Sec.3097,CMI Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars(5500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the Structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code:The contractors license Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors license Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑Yes 0 No Drivers License No, Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
In 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,An 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 en RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L]No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(II 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: _ Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-deJibed�propqerty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) / Date
And/Or Authorized Applicant
1"----
` Date r
CODE Y IfLSPFCTIONTYPE DAM ItifffieLS Card INSPFMIeN TYPF DATE U®aLS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 7/� 208 Final Plumbing
200 Final Re-Roof //'1V ''IAp 6 210 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
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204 Final Demolition 250 Final Building/Occupancy
244646
PROJECT ADDRESS: 3112 VAN BUREN AVUNIT' CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 054697
OWNERS NAME: STURDEVANT, CLAYTON R ,
ADDRESS: STURDEVANT JULIE S PERMIT NO: M 054697 PLAN CHECK NO: N GOVT: N SUPP: N
2037 SWAN DR
COSTA MESA, CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: OTH
ARCH/ENGINEER: 540-3828 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : REPLACE FAU SQ FT: r
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PERMITTEE: •AARON
VALUE: 1 , 300 . 00 CALC-VALUE: GROUP OCC: R-3 /
P
ADDRESS:TAARON PLUMBING & HEATING ( 714 ) 530-6821
2140 SOUTH ANCHOR ST. - COMMENTS: *
ANAHEIM CA 92802 ****************x*******Ee*Te* **+e***Ee**+t***TE*iE***********AIV10gC oC 1 Cell
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMEN T
7000)of Omsun 3 of the Business and Professions Code,and my license is in full force and effect.
SETBACKS T B A C K S
CmuC.: 022249 SEATTue.: 3 330.4-! CLASS: C-2 (RED
ter— / -c '7 Sign �r—eil_ MAIN BUILDING ACCESSORY B•[7TLIfiNG
.� 5lpnature.
WORKERS'COMPENSATION DECLARATION: I hereby aflirm that I have a cenificate of consent to self-insure or a c• eof Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a cernred copy thereof(Section 3800,Lab.Cf. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL : 14169302 ZNE: REF NO:
r ❑ Certified copy is hereby furnished, ❑ Certified copy is tiled with the city Building Division. , PLANNING NOTES>
>
/
ApDlicanl: ********W*********************************************3F********************f:***
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(S100)or less). DEVELOPMENT S E R',V I C E S REQUIREMENTS
I certify that in the performance of the work for which this perm,y' issued I shall not employ ny pers • ny manner so as to became
subject to the Workers'Compensation Laws of Cali • -" '" employ ny ZONING APPROVED BY DATE:
/� o- .� •�/ Siena• ie.--a /(/;.
NOTICE:If.atter making this declaration,you should become subject to the Workers'Compensation provisioi. he Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. Iy�T"^1
) '
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• 1 . 1,'3 - DATE• JO 'Z
- 3
which this permit is issued(Section 3097.CH.Cl. * *****.***********SF****.****{(•*
LENDER: ************************************* *****************y.************)4********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve.demolish,or PERMIT 9 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
I pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5% SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15. 00
I. as owner of the property or my em loyees with wages as thein sole compensation. wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale rection?044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 15 . 00 0. 00 24 . 00 24 . 00 .00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or
improvement is sold within one year of completion,the owner wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 24 . 00 OVER/SHORT: . 00
for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******.**********************LeN.**x.***.*.%*.***.**.)(.3e*************.**.**.******W)e*****.**.y.
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: owner: MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25St3,and END OF FEES
25534 and that I or any lottue building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Ouality Management District,Residential construction applications are exempt from
these provisions
Date: Applicant:
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and her ry authorbe represenlative5 of(his City r enter upon the above mentioned
property for inspection purposes.
a�6t\•1U-2-3 -r// Signature ♦.� ..�Ia_- .
Driver's License or Social Security r:
1641.46 White—Budding:Green—Code Entorcomont:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING 1 ' POOL A
APPROVALS Permit,# bate Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service'or Pole - - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
. 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10:-Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing • 65. Electrical-Final
•
15. Rough Electrical-Conduit - 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign ' . 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • APPROVALS Permit #
21. Ducts,in Structure - - • 70. Underground Hydro
22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test •
72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage.Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - • 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding • 77. FIXED SYSTEM FINAL
29. Insulation - • . 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • 79. FINAL INSPECTION•
32. Electrical Power Meter-Final -'1• 80. FOOD CERTIFICATE ISSUED
33. Final Electric I, Notes:
34. Final Heating & Air Conditioning /Q'24 / (QED
35. Final Gas Pipe-Test ( •
36. Hood or Canopy - -
37. Final Factory Fireplace
38. Final Plumbing '
39. Water Service-Final •
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer .
43. Backflow Irrigation - .1
44. Landscape Irrigation-System
45. Sound Attenuation,' - -
46. Handicap Regulations
47. FINAL STRUCTURE-& BUILDING -
48. FINAL PLANNING
49. Electric Release to Edison-t
.50. Gas Release to Southern California Gas Co "
•
51. CERTIFICATE OFOCCUPANCY •
No._ Date
•
_- — Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF OSTA MESACONSTRUCTION PERMIT PERMI NC TRACT NO. LOT NO. UNIT NO. 8976 VI 9/0r, 5081 TL
Project Address SIJ.//7 kin 't{/rf /3C l/-
1 TYPE OF CONSTRUCTION LI NEW LI ADD LI ALTERATION JG REPAIR
Applicant's Mailing Ad.ress /a ►. . �-
/�j�� /0 • g El CONVERSION ❑ DEMOLISH ❑ OTHER AP # I Zone -
Owner's Name y Ara Phone Ilii DESCRIPTION OF WORK/USE OF BLDG.
L i
Address .5ft S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT Li GRADING El OUNDATION Z
�' ❑ STRUCTURAL T Front O
Address El TENANT ❑ ELECTRICAL PLUMBING El MECHANICAL B ' N
4 0 !!,,^^ ❑ OTHER A Rear I
Contractor's Name InA/A S .,J4 .e If'hone. efav
Address(mailing) d 1 t , C/nh• ff-6< m PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
/ G
-i. CONSTRUCTION TYPE VALUATION$ S Left
City License No. 1 , .7 R
LICENSED CONTRACTOR DECLARATION ZONE' GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full I. +. S
License la •/d effect. i -nse ^o-/ I Xi r RF .�:IVED APR
Date . - `7; Signature Ana ` i PLUMBING FEES
WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
•hereby affirm that I have a certificate of consent to self-insure or a certificate -
Workers' Compensation Insurance, or a certified cop thereof (Section Backflow Preventer Service Sink
I J 0o, Lab. //'�J O OP Automatic Washer Transformer 0.15-50 KW
�NU//"1111 / i / A/ 0 50+ KW '
Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub.
I __certified copy Is hereby furnished.
er(/i�{.l-ep/ c�,� is filed with the city�Oj/4Ir)g "sl 1 Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps
Date "/ l r r Applicant��[d X
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit Is for one hundred ($IOO)or '
less). Dishwasher , Solar Piping Dryers ❑Gas DElectric Sub Panel
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 Drinking Fountains Solar Tank Fan
Workers' Compensation Laws of California. Motors❑0-1 HP ❑i'h-8
-
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE:If,after making this declaration,you should become subject to the _ -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked. Fixtures - Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors / Water Heater Outlets •Range
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION
-
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator ❑
any structure, prior to its issuance, also requires the applicant for such permit ❑0.5 KW 5.15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000) of •
Division 3 of the Business and Professions Code) or that he/she is exempt
herefrom and the basis for the alleged exemption- Any violation of Section
• 031.5-by any applicant for a permit subjects the applicant to a civil
.tnalty of not more than five hundred dollars($500). I
U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work,and the structure Is not Intended or offered —_,
Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type 1 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground
prove for the purpose of sale). _ Building Approved By Date
❑ I. as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System r- Application Issued By A./y Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or Improves thereon, and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that ❑Exhaust System Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof o their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ ll -PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers j PLUMBING $ J. 0-ISSUANCE $
Date Owner Heating System& Ducting Registers
-et PLAN CHECK 25% $ ENERGY P.C. $
l
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000BTU GRADING $
information is correct. I agree to comply with all city and county ordinances / ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- f PLAN CHECK 50% $ MICROFILM $
sentatives of is city to enter upon the above-mentioned property for /'
inspection pu os,/Jnn�e . P-/p p / MECHANICAL $ TOTAL FEE $
Signature /• ` _Bake L d
Drivers' License or SS "� Reinspection Fee $15 / Issue Fee $ 3 PLAN CHECK 25% $
- -
CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod -Assessor - I"-
CONSTRUCTION AND PLANNING POOL& SPA
APPROVALS Permit-# Date Inspector APPROVALS Permit Date Inspector
1.' Temporary:Electrical Ser"vice or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd- 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms .4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings : j 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O'Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
• 16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling; 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# _
J
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ver7tilating 71. Product Piping CGas El Oil
23. Gas Pi -Rough & Test 72. Underground Flush
24. R164Framing 73. Undergrnd.Storage Tank O Gas G Oil
. 25/Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT ^ I
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: s'/ei/ef Gen-clap '
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing y/27/if 1.6
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final '
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co f
51. CERTIFICATE OF OCCUPANCY
No. Date 1 - I
rtt KLGLIVEU
20730 OCT r Iasi
-'- COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE COSTA I
P.O.BOX 917 COSTA MESA,CALIFORNIA CITY OF MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING
ADDRESS 3112 IranPII in en Ax RECEIPTNO, o
COSTA MESA• TION FOR PE•
RECHIV pT DATA i�j IVfD DATE ISS ED
OWNER Northgate,a partnersh in / 7-- /67-9.-4,'L
BUILDING
ADDMAIL 9"
RESS5 J 9 l LasFiores St. ADDRESS
TEL. (�, FIRE
CITY Fountain Valley N0.5316792 ZONE TYPE / GROUP �,
APPROVED
OR F^IIGINEER Hiller No XE52007 BY DATE
ZONING OOF Nniya44-'_AD._35S 4naheim ZOElIPNO. S i____ OSNO V AwLCONTRACTOR Bonser Const. Inc.
LFlLEGAL I Or I TR C b OS
15939 asores St.
DHSCpIPfION
OS—
ADDRESS /
�
CITY Fountain valley A.P.NO. ,--
�- O')
NOTE: NO EAV EEE OVERHANG SHALL BE LESS THAN
STATELIC.NO.21504'9 NO..' 5316792 3O TO SIDE B REAR P.L.
q EAVES
OF LOT102X60 I NOW ON LOTrinna, • ALLOWED U.B.C. REQUIREMENT)
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. none. MAIN BUILDING ACCESSORY BUILDING
(FROM C//L�STREET)
SETBACK LINE PROM 50 I REAR YARD 32 1 FRONT (/-5 FT. PT.
CENTER OF STREETr
5 1 pCFT.
FT.
� SIDE YARDI LEFT I RIGHT )1 R.SIDE
DESCRIPTION OF WORK L.SIDE 5--
Fr.
/ 1 /
NF X ALTERATION ADDITION REAR 3' FT. 3 FT.
DISTANCE BET. BET.MAIN C
MAIN BLDGS. ACCESS.BLDGS.
REPAIR MOVING DEMOLISH
(i)� VAR.# DATE
SIZE N.L' 3 ROOMS
SIZE 1 6 STORIES 1 C.U.P.# 0 APPROVED
EXTERIOR W I.L, ROOF l APPROY ((} U J (fr)_
COVERING 014../UC� I COVERING shinale try 1' 1}-�M/NAA DATE /(/� / I
USE OF BUILDING AND WORK TO BE PERFORMED �(
\single fam. res w/attach. sara¢e p, �FJ�i'//
/y2t/
N
SQ.FT. _B
I HEREBY AC -'. - H. HAVE EAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Z
AND STATE AT THE J ORRE AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH LL CITY OR• A. • S TE LAWS REGULATING /�
BUILDING ONSTRUCTI• VALUATION PERMIT FEE $ I J / 91j
SIGNATU c E OF _
PERM ITT - al, PERMIT
A� �jy+y/ a
_— �� b /CI) / • LA C EC •-.5.75-° c
0
AUTHORIZED AGENT �j/6 H
TOTAL FEE $ / ��
JOB ADDRESS 31J2 Van Buren Ave. BUILDING PERMIT NO.37741
GENERAL CONTRACTOR ucmer-rilar. DESCRIPTION of WORK also cr
AP 441-693—O2 LOT TRACT FIRE ZONE VALUE EG50.0u
E :CYTONS Signature Date TYPE V GROUP J ZONE
SOIL
SUBCONTRACTOR PERMITS ISSL4ED
GAS
Dote I Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SwR. LINE Q HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES [j FORMS 0 STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM [l STEEL REINFORCE Il
SHEATHING
FRAME AND FLASHING
LATHING •— IN 7 OUT ri
PLASTER. BROWN COAT
S' -TURAL, FINAL Electric
H NG, VENT.. REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST I]
ELECTRIC, FINAL
BUILDING, FINAL ?
SPECIAL REQUIREMENTS
p` H 19-73;5;00 717 t`**c*7.50
37 241
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
RECEIVED V DATE RECEIVED DATE^ ISSUED
BUILDING , y� ,{ 1/g 1/47—lig--7 trt - '!t,
ADDRESS ,�j //.Z I/.dpr L7cl/`E/L' �f✓/-. /I (act
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OWNER •C A.P. NO.14(-(D13—02— PER
/�<1//N 5 / �i+1 r r/¢— - BUILDING /,j� /J/MAIL
Z ADDRESS ,3,//,.7 iYn/ �G/r `i✓ /t 11LADDRESS. / rJ' �`7/4-CLPLCiL
S r
'
Ulla TEL.
a U CITY 615;r A- Mc,5 it- NO 6-5/3773 2.; r TRACT Sco LOT`p BLOCK
ZC CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH
Q N LENDER 4,001-)a
a m )
J DD BRANCH ") / ,r / f
OWNER E � � 4 JI
< ADDRESS /fir. s, /VALUE n�f•+
•4' ARCHITECT TEL. LISE 1 L/./ 67,,x/• $ /I
J Q
UN OR ENGINEER NO,
•
Q FIRE %./y-�
W IX ADDRESS ZONE TYPE GROUP �//Q
a W /
APPROVED ) / �]
1.11z CONTRACTOR �a BY DATE/ � /3
m- O
Z
J m ADDRESS
W W TEL. ZONEtz I NO.OF USE OF NEWCpA k 3
Z= CITY NO. , PLANS 2 BUILDING C CVa
_ F -
STATE _ CITY YARDS APPROVED YARDS APPROVED
N it LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
7 SIZE NO.OF BLDGS. (FROM C STREET) f �
OF LOT I NOW ON LOT FRONT ,1 / /
/L ,\ l , FT.
USE OF
EXISTING BLDG. 1 R.SIDEFT, FT.
I— SIZE OF ''77 • f r
ZZ NEW BLDG /J47/F ROOMS STORIES L.SIDE / FT..� FT.
< EXTERIOR/WALL ROOF
COVERING COVERING A1_C,M• REAR?-9/ FT.y /r FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
/I MAIN BLDCS. ACCF R BLOCS.
Q PIS-a(,/.x (-6464-9 _,
- `r / VAR.#
C.U.P.# DATE
0
APPROVED
F- APPROVED t� •L' Q _iy3
V) ABY �1 V DATE l I'
IS
O SO*
VI hereby acknowledge that I have read this application and state, Irl
D that the above information is correct and agree to comply with 5 JV/
CC all laws regulating building construction, and I shall not employ-
F-'
mploy y.(�
H any person in violation of the workman's compensation laws of a ZW-
z the State of California. ,• s m
` �j b
_ I hereby certify that I am properly licensed as a contractor under- SO. FT. o
the State of California Business and Professions Code, Division 3,_. THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
CC
am exempt from tl a provisions of the State of California Business
Chapter 9. - VALUATION �� to
and Professions C e, Division 3, - PERMIT FEE $ ry
Signature of /(//'`/. `1l\/�. �t D
Permittee /�4`.���c, ,v /_4 7' • '� $ 4s0 .' PLAN CHECK $ E
7
Authorized Agent 0
/ u_
TOTAL FEE $