HomeMy WebLinkAbout2507 VASSAR PL - Building Permits ADDRESS OF BUILDING: 2507 VASSAR PL UNIT: CITY OF COSTA MESA - BUILDING PERMIT
OMENS NAME IF KNOWN: MINDTE, ROBERT A TR PERM NO: M 08430E
ADDRESS 2507 VASSAR PL
la
COSTA MESA,CA 92626 \j PERMIT NO: M 084306 PLAN CHECK NO: N GOVT: N SUPP: N
241-7559
APPL.MAIl1NG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH
ARCNRECT OR ENGINEER: UC NO.: JOB DESCRIPTION : REPLACE 75KBTU FAU SQ FT:
/ACK OR END'S ADDRESS: UNIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC : /
mmmawswm SOCO AIR CONDITIONING ( 909 ) 944-1340
CaDNaTORSMAILRIO 6892 CARNELIAN COMMENTS : NO OTHER WORK AUTHORIZED BY THISS PERMIT
ADDRESS: ALTA LOMA CA ucND., 333239 ***************************************stat%**3E+t3tdt*tt*1t*at*dti6iE3E***1f**3E3Eitjtii•if-**if3t -***
91701 UNIT: Z ONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter B SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code,end my license is in lull force and ended.
Cm LIC.NO.: 046394 LIC.CLASS: C20 LIC.NO.: 333239,4,22: 00/00 MAIN BUILDING ACCESSORY BUILDING ----
k�/� _ 97FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: conkm«:1, �� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I ern exempt from the Contractors License Law for the
following reason fSedion 7031.5 Business and Professions Code:Any cry or county which requires a permit to construct alter,improve. PARKING REQ: P RO V: PARCEL : 14141206 Z NE: REF NO:
demolish,or repel.any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License Lew]Chapter 9(commencing with Season 7030)of Diana.3 of the PLANNING NOTES>
siness and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section >
.011.5 by any applicant for a permit subjects the applicant to a civil penalty o M more than fee hundred dollars MBA). *******************************************************************************
❑ I.as owner of the property or my employees with wages as their sole oompenealon,will do the fork,and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7046.Business and Professions Code:The Contractors License law does not apply to en owner of property
who bolds or improves thereon,and who does suds work NmseN or henel or through he or her own employees,provided that such
improvements are not intended or offered for sale.N.however.the building or improvement is sold within one year of completion,dor ZONING APPROVED BY DATE:
owner-budder tell have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Stadion 7044,Business end
Professions Code:The Contractors License Law does no.appy to an owner of property who bolus or improves thereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a cmrador(s)licensed pursuant to the Contractors License Law). p
❑ I em exempt under Section: B.A P.C.,for this reason: APPLICATION ISSUED BY: DATE: ( 1 1
****************************oft**************** xir******************** *** ***
DatOwner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
I do hereby certify that I am aware of and understand the requirements of Cal9«nia Health and Safely Code Sections 25505,25533,end
25534,and that I IX any future building occupant will/will not(circle one)need to comply with said stale codes end the requirements for
a permit for construction«modification from the Air yeTltamgamem District.Ibdmrma
dentialtruom
n appiion
a are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 13 . 25
Oats: Appian 25* SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under petWt).of perjwy one of the following dedemtons: ISSUE FEE 22 . 00
❑ Ihave and wiimaimain a certificate of consent to self-insure for workers'compensation,asproiided for by Section 3700 o the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,f«rho ped«nmerceathe w«kf«which this permits®see. TOTALS----> 13 . 25 22 . 00 0 . 00 35. 25 35 . 25 . 00
❑ I have end wit maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this permit is weued.My workers'compensation insurance caner and policy number are:
Caner: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 35. 25 OVER/SHORT: .00
Pdicy Number: u /29688-9 / 02/10/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
s section need not be completed Arhe panne is for one hundred dollen 51001 or lest) 35 . 25
j 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 s to
c.
become subject to the workers'compensation laws of California, end agree that e I should become subject lo the workers' *******************************************************************************
compensation provisions of Section 3700 of the Labor Code.I shall forthwith comply with those provisions. .�
_sDate /irrIp l 9-7 (UApplicant: - /�jd INDIVIDUAL ' F E E BREAKDOWN
v
Warning:Failure to secure workers'compensation coverage is unlawful,and shall subject en employer to criminal penalties and TYPE QTY DESCRIPTIO N, UNIT COST TOTAL COST
civil lines rpt to one hundred thousand dollars(SI 04000),In addition to the coat of compensation,damage s provided for In
Section 6706 e1 Me Labor Cotler,Interest,and etromeys less MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 13 . 25 13 . 25
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there e a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS: EXPIRED
Ind statethat I reeregdtheeppgcnvq aatnthat eb threw iApmutionec«naf tagree edtyt c«npywith nt aband ooumndirorau Incomplete I. spect}ons
• 1,
and alma laws relating to building construction end hereby authorize repreaentativs of the city to enter upon the above-mentioned property
f«inspection purposes. Ta }..; ^
WILLIAM F CLARK 3 S} •
08-19-1997/12:52 Pfl/535.25
(�(//�.,,/ /,'/'r//I�/J� Print �± O ''] •at6 �.:�._ - FrERh1I TRT0843616
31093
" - gddOrlrb( Date:�/7 7 /
sig Owner/Agent/Appicant/Contred« 1
(5151-46.WP) White-Building A Safety:Green-Ne;Canary-Appicant;Pink-Revenue;Goldenrod-Assessor -
•
�i
CONSTRUCTION AND PLANNING - POOL 'sA
APPROVALS Permit # Date. 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 _ , t .
• 15. Rough Electrical-Conduit - i ' ' • 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 I - -69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning - -' FIRE DEfrT. REQUIREMENT - - • - - -
20. Rough Factory Fireplace , . APPROVALS Permit 4
21. Ducts, in Structure 70. Underground Hydro ,
22. Ducts, Ventilating- i - 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing ' - - ` 73. Undergrrid.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 PREY. FINAL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat , - , 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •
33. Final Electric : 4 ' Notes: p {
34. Final Heating& Air Conditioning - 'S/ 1/9.7 �J6 y --a ss /61.)7L-----___
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 •
r
42. Backflow Preventer
43. Backflow Irrigation --
44. Landscape Irrigation System •
45. Sound Attenuation - - '
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
•
•
44. Electric Release to Edison .
•
•
•
50. Gas Release to Southern California Gas Co ' _ ,
51. CERTIFICATE OF OCCUPANCY -
No. Date
:PROJECT ADDRESS: 2507 VASSAR PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 068196
.4'2 OWNER'sNAME: MINDTE, ROBERT A
ADDRESS: 2507 VASSAR PL PERMIT NO: B 068196 PLAN CHECK NO: N GOVT: N SUPP; N
COSTA MESA, CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
241-7559
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT. REROOF W/COMP SQ FT: 5, 00 '
ADDRESS: UNIT:
CLAIM VALUE: 5, 000 , 00 CALL—VALUE; 5, 000. 00 GROUP OCC; R-3 /
PERMITTEE: PACIFIC COAST CONST. ( 619 ) 590-0193
ADDRESS: P .O. BOX 20468 COMMENTS: SMOKE DETECTOR REQUIRED PRIOR TO A FINAL
EL CAJON CA 92021 • *************** *****s6;E**** acd6aEk6 -*yr;:yl*y6**d6**#*a6aE*yE*** ******yE***k *********r*-x**
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONINGS E RT EB QA UC I SETBACKS EMENTS
7000)of Divisio 3 of a usiness and Professions Code.and my license is in full force and effect.
( CITYLIC.:CP49 STATE LIC.:42570 1 LASS: F EXP ;
` Date: Z ^22 1 t �� MAIN BUILDING ACCESSORY BUILDING
Signature.
WORKERS'COMPENSATION DECLARATION: hereby affirm that have a certificate of consent to self-insure or a certificate of workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
Compensation Insurance:or a certdied copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT; FT IN P.GHT; FT IN I
'OLILY NO.: YJV LVJ..rud EXP.DATE: V4 /15/95
COMPANY: CA INDEMINITY PARKING REQ• PROV: PARCEL : 14141206 ZNE: REF NO:
1 I Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
•
Date''1-1-2_—s f Applicant: '—nA0 . Ill& *************}9c******)E********************** ********************.***-***********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V $�;L' O P M E N T SERVICS Z E !1 ET a MENTS
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. ZONING APPROVED BY ; �'_ DATE:
Dale: signature: BUILDING APPROVED BY
NOTICE:If.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor r •
-e_ DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. / ���/( /'
CONSTRUCTION LENDING AGENCY: I hereby affirm that mere is a construction lending agency for the performance of the work for APPLICATION IRSU ED B Y; DATE; ,ly
which this permit is isE
issued 3097,Civ.Cl.CI- *********** **** * 3t
*** *** ******r 4":";rrt****ft*** D•it ***, 4-***3t******************* **'h
LENDER: **********sE ******3e*********e **************.. `******.'*************************3t
ADDRESS: LEGALIZATION :N F E E S U M M A R s STRUCTURAL SEGMENT:Y
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 72 . 00 , 50
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—R E S
pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 o1 the Business PLAN
and Professions Code)or that he/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). ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID •
DUE
I. as owner of the properly or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 72 . 50 0 . 00 0 , 00 72 . 50 72 , 50 . 00
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State 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 employees.provided that such improvements are not intended or offered for sale. If.however the building or REVENUE DIVISION TOTAL S——> COLLECTED ; 72 , 50 OVER/SHORT• - . 00
imforptheepurpose of sold one year of completion,me owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
72 . 00 . 50
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of properly who builds or improves thereon
and who contractsfor such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware ****'**'*'*'**'***************************************************!t*****************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
D I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner — SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 000 . 00
I do hereby cernly that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and slate that the above information is rrect.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby autpor' represe, ves of this city to enter upon the above-mentioned 01 00164596-00164597 To-r 72,50
\ property for inspection purposes.ur (A(/1-\W) y'`y1�!(%//. • DATE: 07/22/94 TIME: 15:27
Date: Z—`7-2^ I 1 Signature: 0
Driver's License or Social Security e:
1641-46 White—Building;Green—Code Enforcement,Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING ! L & SPA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit
1. Temporary Electrical Servide 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 OF 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, ❑ 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 p, 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 FFraming �J 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 7 7fy - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat ! �' �''`'f75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing &Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace -
r
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
F
45. Sound Attenuation
46. Handicap Regulations ��
47. FINAL STRUCTURE& BUILDING ,yd 'q //�r 3
l /lam
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
-- Applicant to fill in all spaces except ltipse within heavy border lines and sign all appropriate declarations. (j fD'Qt) ,r,'�Q�U i - -'"
CITY OF COSTAJ�(IES� ON$TR UCTION P.F�II�AIT ?ERjIjIT NO. (y 'TRACT NO. LOT NO. UNIT NO. l ��
Project•Address at U (•/q-JsKv ✓/ .1J�� �6 �� _
Applicant's Mailing�.. ess f#_ - :. •• ' TYPE OF CONSTRUCTION IwEW''U ADD. U ALTERATION U REPAIR ` s - - -e
Owner's Name .� Phone' - ❑ CONVERSION. ❑ DEMOLISH ❑ OTHAR A.P.# . - I Zone ..
++'''�1
.
' Address "=,..-..1-0 ) ' aJs^d' - - I • " S Main Building: -' Accessory Building:- Z
Arch/Erig. • - License No. - TYPE OF PERMIT ❑ GRADING FOUtJDATION LI STRUCTURAL T Front ' 0
Address - . '_El TENANT-;❑ ELECTRICAL ❑ LUMBING ❑ MECHANICAL .A Rear - - • N
Contractor's Name J, 4/�) ,•P :n�7®3�i 37A1 "ll OTHER I - - N
PT - IPROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right • _ G
•
Address(mailing) - - ire gas •,� _ - , - R
• CONSTRUCTION TYPE VALUATION$ I� s Left
City License No. - - ZONE ' ' GRADING CU.YDS. , ACRES Ping. Ref. # ' • Parking Req:/Provided E.
LICENSED CONTRACTOR DECLARATION - • Q
I hereby affirm that I am licensed under provisions of Charter 9'(commencing Remarks: , I Planning Notes: . • - . , M
with section 7000) of'Division 3 of the Business and Professions Code, and - - •
my license is i• fu orce and effect. �/ >> q I ., •
'cense Class c - iAcen se Nd ej4•� • , ' i - - $'
to i — - Signature •s - PLUMBING t 'FEES - •-
.iORKERS'COMPENSATION c CLA•ATION Bar Sink - Showers
I hereby affirm that I have a -rtificate of consent to se insure or a certificate —� ELECTRICAL FEES ,
-of Workers' Compensation Insurance; or a certified jopy ereof (Section - T - - • - Automatic Washer • Transformer ❑ 15-50fKW
3800, Lab. Cif. )�1 /� 2Q __ ry)� Backflow Preventer • Service Sink
Policy No - WC �I/o3r+3o y �i %- - -� • Backflow Irrigation Sewer Ca : ❑ 50+ KW
1 p Construction •Pole Sub. •( I
'tied copy is hereby furnished. . - / ,
CertifJ' qz is;aid with the city Buil• •,,/ on, I Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps I • ,
Date J ' •SCJ-a Applicant `� ms I
EXEMPTION FROM WORKERS'C• •PENSATION DEC ARATION - Clarifiers ' . Solar Collectors _ . . -.. Dishwasher - - --. .Meter Clover 100 amps -- -4 - -,
(This section need not be complet-. if the permit is for one,hundred ($100)or ,.
less). - Dishwasher • . Solar Piping I Dryers ❑Gas ❑Electric i Sub Panel ' ? '
I certify that in the performance of the work for which this permit is issued, I •- '
shall not employ any person in any manner so as to become subject to the ' Drinking Fountains Solar Tank ' • Fan • - Motors❑0-1 HP 01'/x-8 • '
Workers' Compensation Laws of California. • • ' ••
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP.016-15+
'NOTICE:If,after making this declaration, you should become subject to the - - _
Workers! Compensation provisions of the Labor Code; you must forthwith " Floor Sinks Urinal Fixtures .Microwave •
comply with such provisions or• this permit shall be deemed revoked. - i I
CONSTRUCTION LENDING- AGENCY -. • - - '• Gas Service , :Outlets i 'Water Closet T - g
•
I hereby affirm that there is a construction lending agency for the performance D¢viC¢BO%¢$ Pole •Li ht ,
of the work for which', this permit is issued .(Section -3097 Civ. C.) •• Inte •rce tors -Water Heater -
Lender's Name - - p / - - • - _ Outlets Range •
Lender's Address - Kitchen Sin< .-• " , Water Service . Switches , Sign '
OWNER BUILDER DECLARATION ' ' • '
hereby affirm that I am exempt from the Contractor's License Law for the Lavatories I Auto-Wash • • _ 1 Garbage Disposal •
Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or -
-zounty which requires a permit to construct,alter,improve,demolish or repair' P=Trap , _ .. .Laundry Trays , - Generator ❑0-5 KW ❑5-15 KW '
;rszy structure, prior to its issuance, also requires the applicant for-such Hermit Trash Compactor • ,
-;',„,.f file a signed.statement that he/she is licensed pursuant to the provisions of 'Roof Drains -- r •
r„ a 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 - '
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 i - , - . ' - ' • •
enalty of not more than five hundred dollars($500).. - •
I t '
• I, as owner of the property or my employees with wages as their sole ' Reinspection-Fee $15 Issue Fee -' $ 3 • ' I
compensation, will do the work,.and the structure is'not intended or offered - - - Reinspection Fee •! $15 Issue Fee I • 1 $ 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 I ❑ I
sale. If,-however, the building or improvement is sold within one year of com- Canopy' Type II ❑ Zoning Approved By Date Q'�
pletion;the owner will have the burden of proving he/she did not build or im- ' Duet Under Ground -.--:2-4"-54
prove for the'purpose of sale). ' - - Building Approved By L Date_
❑ I, as'owner of the property, am exclusively contracting with licensed con- Duct-Structural , Refrigeration System - Application Issued By - VI 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 - --- - �❑0-100,000 BTU:❑100,000 BTU - ' ' ISUMMAR •• 'EES
builds or improves thereon,and.whocontracts for such projects with aeon-, •- _ `- /
tractor(s) license pursuant to the Contractor's License Law). am aware Ghat Exhaust System ❑ Multiple ❑ • System Repair/Alteration BUILDING-PERMIT , $ .i _
proof of their Worker's Compensation insurance should be provided to me: PLAN CHECK , $ �- PE'' IT '
❑ am exempt under Section • B.& P.C.for this reason • Firepl/Pati.BIL ICBO'# Fire Dampers PLUMBING $ I . •.NC; I, I r•
_I,..,'. •
Date Owner, Heating System&Ducting Registers I PLAN CHECK 25%I $ _ E ✓ ' $'
I-hereby-certify`that I have read this application and state that the above 00-100,000 BTU ❑100,000BT: n- • flING
information is correct.'I .- e •comply with all city and county ordinances 1 ELECTRICAL : $ 4 �I
and state laws relatin• o r,��.�yr''''•ng construction,and hereby authorize repre- I "�) t'
-CFI 1I''\( $
sentatives of this' - •/meter. upon the above-mentioned property for ; ; i PLAN CHECK '50% $ 1
•
inspection pure. •
$=Zo-8C MECHANICAL - $ • r I TO • FEE , $S _
Drfverure �� Date •
Reinspection Fee $15 • Issue Fee $ 3 PLAN CHECK - 25% $ •
Drivers'%Li• nse or,SS7P � ' . - - l , _--. 1 _ - ,` '
CMF 086 .6,rev. 10/84 White • Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNIN. ,L&SPA
APPROVALS Permit# . • Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -
2. Soil PipetUndrgrnd. 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 - r
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
'7. Footings /p4/� yr 58. Electrical Conduit-Undrgrnd: - .
8. Foundation ✓ 59. Gas Pipe, 0 Undrgrnd., Test
9. Water I
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 80. FOOD CERTIFICATE ISSUED •
4
33. Final Electric Notes:
34. Final Heating & Air Conditioning -
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
44. Landscape Irrigation System '
45. Sound Attenuation
46. Handicap Regulations ,,//
47. FINAL STRUCTURE& BUILDING Y�L-.9' C�/ii� .
48. Special.Requirements Completed �'yy��JJ44��
49. Electric Release to Edison -
150. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY
No. Date - '
1
•
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY'OF COSTA MESA . - PERMIT O. TRACT NO. LOT NO. BLDG.NO: - - - • �----
lCONSTRLCTIOfV PERMIT $ cg 3F r
Project Addressa3 p 7 U9ssA7e p4 • -C'OSYA /r1 ESP TYPE OF CONSTRUCTION _ 0053 7/ ]/f3I '. 5.00 Tl.
;Owner aaefr',eo 1 - Phobetw_c 39f3 DT NEW ❑ ADD7 DALTERAtION - -• ' -
Address,QSd 7.' /Asp,51/2 ,L-. LQ$'/j9 j�F.S`A ` - -O:REPAIR-O CONVERSION•-O DEMOLISH - -
/ - ❑•OTHER 1 ZONING REGULATIONS; I .
Arch/Eng. - - ' • - - " ' License No. . - ' .
•
Address - - - -- •- - - _ DESCRIPTION OF WORK-- - _ _, - '_A.P. • . -
ZONE PLNG. REF. • ,
Contractor ,4C /F/G ,jnY7`9LAE,CS Ph6nf35 7/770 TYPE OF PERMIT- - - - BUILDING - - Top BgUILDING "-
SETBACK C/1_$T. GROPERTY LINE
Addres5
7-r✓/. W/ //A7Y 4.-2.A•QOE4' /,�,¢G"E • .0 GRADING_ .O FOUNDATION '❑ STRUCTURAL LSIDE YARDEF , • -
LICENSED CONTRACTOR DECLARATION ' -O-TENANT'0 ELECTRICAL 'PLUMBING ❑MECHANICAL SIDE YARD - --
I hereby affirm that I am licensed under provisions of Charter 9 (com- - RIGHT -
mencing with' section- 7000) of Division 3 of the Business and - LiOTHER - - -
Professions Code, and my license is In full force and effect. - REAR YARD(TO P/L) ..
License Class Q-/ - Lice a Ny?L��'g'r� PROJECT DESCRIPTION' - - -
�� • PKC.SPACE REQ. PROVIDED
Date 7//d/P/ Signature -. �
- - w SO. FT.+ -
WORKERS'COMPENSATION DECLARATION - -- OCCUPANCY:CONSTRUCTION TYPE ,STREET WIDTH PARK FEE$
reby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY I DATE -
Icate of Workers' Compensation Insurance, or a certified-copy ,SPECIAL CONDITIONS:
of (Sectio 890. Lab.C.). GRADING'CU.YDS. ACRES
Policy Nead1-7b Or - Compan 4C'2dSt4XLE,FS - _ - -- • .. . - . - . _ -_ _ . - - - ., .
❑-Certified copy Is hereby furnished. • - - REMARKS: - - -- - - - ,
Q(Certified copy Is filed with the city Building Division. - - - -
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - ' - - -
(This section need not be completed if.the permit is.for one hundred. _ _, _ _ _ _ _
($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 PLUMBING, -PLAN CHECK ELECTRICAL PLAN CHECK - l
subject to the Workers-Compensation Laws of California. _ pW ELZTN[. - isARAGL
Date - Signature BATHTUBS SHOWERS SO FT SQ FT '
-
NOTICE: If after making this declaration, you should become subject TOILETS URINALS • -- GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must _ _ TRANSFORMER .
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE ' 10-50 KW-50+ KW - '
revoked. - -• - - . _ - - _ - _
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS - ' MOTORS 04'HP ' 1-10 HP
I hereby affirm that-there is a construction lending agency for.the per- `'.SERV ICE SINKS SUMPS -' ' - - • - - (INC.SOLAR) -- 10-50 HP=50 + HP •
formance:of_,the work for'which t hls.permit:is`issued (Section 3097- _
Civ:-.C.). '� �,�>. ,F•LOOR SINKS FLOOR DRAINS .FIXTURES OUTLETS SWITCHES "'
Lender's Name _ •,
Lender's Address OR INKI NG FOUNTAINS - GAS TUBE SIGNS
OWNER BUILDER DECLARATION - - - INTERCEPTORS CLARIFIERS - POLE LIGHTS '- -
I hereby affirm that lam exempt from the Contractor's License Law for •
the following reason(Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP -_ - - -•LUNS I HUL HUN
Any city or county which requires a permit to construct, alter, POLES METERED SUB -
improve,demolish or repair any structure, prior to its issuance,also re_" - WATER SERVICE ALTERATION a co PANELS - - MAIN ' SUB '
q"^es the applicant for such permit to file a signed statement that he
nsetl pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETS SERV ICE - AMP -
:er 9 (commencing with Section 7000) of Division 3 of the
As and and Professions Code) or`that he is exempt therefrom and the WATER HEATERS . BTU OUTPUT - - ' - - - _ - -
for the alleged exemption. Any violation of Section 7031.5 by _ - ` •
any applicant for'a permit subjects the applicant to a'civil penalty SEWER CONNECTIONS - • - - `-
of not more than five_hundred dollars ($500).
O I, as owner of the property,or my employees with wages as their SOLAR TANK..
- COLLECTORS -" - - ' /- -
sole compensation, will do the-work,and the structure is not intended _ _ _-
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. - ISSUE FEE _ ' e_.
,�� - - t.
Contractor's License Law does not apply-to-an owner of a property •s7d' APPLICATION APPROVED BY V _ DATE 7 SIN
who builds or improves thereon, and who does such work himself or ISSUE FEE POO, '�
through his own employees, provided.that such improvements are not .T
intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY F FEES ,
is sold within-one year of-completion,the owner will have the burden BUILDING- - -
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $
❑`I, as-owner-of the property, am exclusively contracting with AND DUCTING - - • - - - _
licensed contractors to construct the project (Section 7044, Business 100,000+BTU ,PLAN CHECK $ PERMIT•-
and Professions Code: The Contractor's License Law does not apply to - - / m\ ISSUANCE $ -
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ •••••
tracts'from such projects with a contractor(s) licesned pursuant to 'SYSTEM - - - GRADING $
the Contractor's License Law). _ _ 100,000 +BTU ,PLAN CHECK $ '
O I am exempt under Section B.& P.C.for this - - $
BOILERS BTU ELECTRICAL $
reason' - - " - - -- TPLAN CHECK $ - MICROFILM $
Date - - Owner - - - SYSTEM REPAIR,ALTERATION `TOTAL FEE$ '•
MECHANICAL $ - -
I.hereby certify that I have read this application and state that the above. EXHAUST SYSTEM MULTIPLE - LESS AD-
information is correct. I agree to comply with all city and county PLAN CHECK $ - VANCE PC g_ -
ordinances and state laws relating to construction,.and hereby authorize
representatives of this city to enter upon the above mentioned, gr.-/-sem
property..f° section. urpos�y - q/ p/ - t FINAL FEE $ Ov t
Signature f% -.C• �`lYl-a_iK/ Date//��a- - -ISSUE FEE -' - - • -- - - - -- -- - __ '
Drivers'License or SS*
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Gol or
CONSTRUCTION AND PLANNING POOL&SPA - - ,�•- -
APPROVALS Date ' Inspector - • •• • • • • Date . - Inspector . --
Permit# APPROVALS _ . _i Permit#
1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location- -• - - -
_ 2. Soili ndrgrn - • - 44. Steel Reinforcement - - - .
3.. Electrical 'Utility-Undrgrn - - - 45. Forms - - - a
4. Electrical Conduit-Undrgrn _ • . 46. Electrical Bonding - - - - -
5. Steel Reinforce 47. Rough Plumbing & Pressure-Test' _ _
B. Electrical.UFERGrn 48. APPROVAL TO COVER-GUNITE - _
7._ Footings '• 49. Electrical Conduit-Undrqrn • . ,
8. .Foundation - - - - 50. Gas Pipe, ❑Undrgrn;Test - - -
9. Water Pipe-Undrgrn - _ _ 51: Backwash Lines, P-Trap. ❑ Undrgrn . -
10. Structural'Floor System52. APPROVAL TO DECK - "' I .
11. Property Sewer Line & House Connection ' _ 53. Backwash & Receptor-Final• ' •
- 12. Street Sewer Connection - 54. .Heater & Vent-Final •
13. Rough Plumbing . . - 55. ' Plumhinn Svctem-- Final -
14. Rough Electric-Conduit .56. Electrical-Final . • •
15. Rough Electric:Wiring - 57. - Solar System-Final ' ,
16: Rough Heating& Air Conditioning . - - _ . . . . . - 58. Fencing & Access Approval
-1.7. Ducts, in Structure - - 53. APPROVED'FOR PLASTERING ' -
18. Ducts, Ventilating • . - •
-
' 19. Gas Pipe-Rough &Test , - 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing - - •
21: Roof Sheathing ' p .
22. Frame and Flashing - NOTES: edig ....4,44.,=-.2_40...r 1 x ;(/1 '
23. • Insulation _. .- 4c r//
AA --7 1. '% /""'
24. Lathing & Siding .. . _... - - - -
25. Drywall-Nailing . _ • . . _ - _ '
26. Plaster Brown Coat ' ' . ' - .
27. Electrical Power Meter-Final _ _ ' - '
-28. Final Electric . - _ _ - .
29. Final Heating & Air Conditioning _ .
30. Final Gas Pipe-Test - . . . . .
31. Final Plumbing, - . . -
32. Water Service-Final ' - - ._.__ . ' - •• . . - - -
33. ''.Gas Service-Final - - _ . - . . . -
34. Solar Domestic-Final _ . : - '
35. Landscape Sprinkling System •
• 36. Sound Attenuation . . '
37. • Handicap Regulations - . . . • •
• 38. FINAL STRUCTURE & BUILDING -
. 39. Special Requirements Completed • _ - -
40. Electric Release to Edison • - - - -
41. Gas Release to Southern California Gas Co. • .
42. CERTIFICATE OF OCCUPANCY -•
No • • • Date - - - .
9032 b_ EE REP 9.IV ED
APR a .d59
fit
COSTA MESA BUILDING_ DEPARTMENT - • FINANCE •DEPT.
P.O. BOX 317
COSTA MESA. CALIFORNIA GUY OF COSTA MESA
, FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
ADDRESSDI507. Vassar Place BUILDING
Crown
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
Homes, Inc. RECEIPT NO. ERMIT NO.
OWNER
fTE 3a2
MAIL
RECEIVED BY DATE RECEIVED ATE ISSUED
ADDRESS 1555 Ms colitis- ' /1-'7'54-377 - ,2../ -5)7
CITY Newport Beach, Cal. TNO. I'll 6-3227 ADDRESS
G
ARCHITECT ENGINEERGI
NT sane NO.
O.
ORCOSTA MESA. CALIFORNIA
ADDRESS same -
FIRE
j�(r /� r�-� ZONE
C ACNtRICTASSP11 Const. Co. CITY LIC.C1217ZONER.YPLANS TYPE / GROUP /` I
ADDRESS Name TN O. same APPROVED DATE -!/7//
LEGAL LOT p CORRECTIONS
DESCRIPTION NO. 1/ BLOCK TRACT 2882. 'f- 1'R� q
A.P.NO. U P A n.y i;1{1 A •',”r,v tAn IP
SIZE NO.OF BLDG'S. 0 ti
eAi, C., :1 •�'-1 I�i yl [1
OF LOT 63 x 127 irreg. NOW ON LOT .�)} W A.J
USE OF •- Y<I I' J Y - I'•tI
EXISTING BLDG. I I { f y
SETBACK LINE FROM [� :, 1 , .R_ �� k.'3 L.: �L1
CENTER OF STREET 6D REAR YARD 13 T i / ,
SIDE YARD RIGHT 5 LEFT 10 /. D"T':
DESCRIPTION OF WORK VAR. No.r 0e APPROVED 2O--�5,
NEW X ALTERATION I ADDITION
REPAIR MOVING I DEMOLISH
•
BUILDING
SIZE ROOMS 1574-469 NO.OF 6 STORIES 1
EXTERIOR WALL ROOF
_COVERING stucco COVERING wood shake
USE OF NEW
BUILDING residence and att. garage •
Plan 3—C •
Thefimount ahowp under vatuatioa s fur the
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL purpose of establishing a permit fee only.
CITY ORDINANCES D STATE LAWS REGULATING BUILDING CONSTRUC-
TION. ^/ //q ,// VALUATION I
SIGNATURE O / l'` /r`� rV�Z,%�'/ '_ / PERMIT FEE $ 35.00g
PERMITTEE IIIJJJ 44 ��1. 6 Ir'-^�."V PLAN CHECK S 17.50
5 15)747.DC
AUTHORIZE GENT TOTAL FEE 5 52.50. "ME