HomeMy WebLinkAbout382 16TH ST - Building Permits�'l PNODELT ROOflESS: j 8 2 E 16 TH ST
I OWNEfl'SNFME: JUDITH OSMER
PDOflESS: 3OGS HARHOR BL, S,A.
754-6445
AflCMIENCINEEN:
n¢c.No.:
uxiT: GARAG
ROOflE55: UNIi:
PEflMITTEE: PRO—SPEC ROOFING (714)744-4541
ROOXESS: 94S N, MAIN
ORANGE CA 92667
LILENSEO CONiflRLTOfl OECIAMTION: I �ereGy alhrm Ila1 I am Iicense0 un0er prov6ions ol CIUD�er 9(commencinp with Stttion
70110� ol Dir.sion 3 ot I�e Busineu an0 PmIeSYons COEe. an0 my I[en5e is in lull force aM e�lttl.
c�rvuc.: 042611 sTn,auc.: 71616 cuIss: C-39
oale: Q� � ���9naturo: /y�—� ` — �
WOflNEBS'COMPENSRTIONOEC BRTIO InereGyatlumtnatlnyl;ace Kale01fAn5enilo3¢INnSURorat ifitaleo�Wwkers
Compensation Insurance. or a certiliea caDY «�eol (�tqn 3800. lab. CI.
POLICY NO.: E%P. DRTE:
COMPANY:
� Certiliee [opY is hereby Iumishe0. ❑ CendieG copy is filed wit� t�e ciry Building Oiv6bn.
Date: Applicanl:
E%FlAPTIONFflOMWOPKENS'COMPENSNiIONOELWUTION: (fFaSecUonneeGirolUemmpkiMitylhpepermliSiamehundrM�5100�Oriess�.
I cenify Ihai in the peAormance ol Ne work loe icn I�6 permit is issyyy tl. I sAall no� employ an erson in manner so as ta �eca�
sublec� Io Ih/eJWorker ' ComOe '+' �� �aw ol Califomia�y _ �
�ate: 7 ��/ Signature: I� ��� �
NOTICE: If, afler making this aeclaralion, you shoWd �e e subjecl to t�e Workers' Comoensation or isions ol IAe La�or
Cod¢. you musl Iorlhrviih cOmply vnlh Suth pmvision5 Or INS p¢rmii 5hall Oe OeemeA fewketl.
CONSTBUCTION LENDINC AGENCY: 1 �ereCy aflirm IAaI Ihere is a conSlmCiiOn I¢nGing agenty lor Ih¢ petlormante ol �he work �or
which I�iS permii i5 i55ued (Section 3097. Civ. C�.
LENDEfl:
aooRess:
OWNEB BWLDEN OECIAflATION: 1 hereGy affirm t0at I am erempl Imm I�e Conlractors' State License Law for ihe lollowing reason
(Sec�mn 7031.5 Business an0 Praf¢ssional CoOe: pny pry ol munty w�ic� repuires a DermA to com�mct, al�er, improva, UemotisA, or
reDart any Slmtiure. pnOr Io i15 i5suante, ali0 r2puirBS Ille a0�ani l0l Sut� pC�mii l0 lil2 a Sign¢J Slatemenl IIIdi hPJShe i5 litensed
pursuant to ihe pmvisions of ine Comracims' State License Law (Cnapte� 9lcommencinp wit� Sectian 7000) ol 0ivision 7 of �he Business
dntl Plotessions Coee) or Inal ne/she is e�empt inerelrom ana iM oa9s lor ine anege0 exemptial. My vialation of Section 7031.5 �y
any aDV�icanl br a permit w0leps Ne appGtant lo a pvil penallY a� �� ��e INn live �unEr¢E Eollars �5500�.
I, as owner of Ine propeny or my empIOyeM witn wa0� �s Ineir Sole COmpenSatqn, wlp Eo tAe xrork, antl Ihe
❑ svucwre is not imeMeA or aflereA Iw sale (Seciwn 70aa. Business anE Pmlcssional CoOe: ihe Contractors' State Liunse Law
aces nm apDly to an owner of a O�oOeny wtw OuilCs or impmves ��ereon, and who Ooes suc� vrork �imself/�ersell or �hmuAh
�is ar �er Own empl0y¢ts, prwkeG Itlat sut� imptwemen6 are Ibt intenEetl a alleretl lor Sale. 11, however Ihe huildinp or
impmvemenl 6 SOIC witnin a1e year ol fAmpleti0n. ine Wmet will Adve Ine OmOen ol provinp he/she Uia not Guila or impmve
tor Ine Dwpose ol sale�.
I, as owner ol tne prooeny. am e.tlusivel canvaciinq witn iirense0 comractors to cansimct t�e Oroject (Section 70C4, Business
❑ an0 Prole55ion5 CaEe: Tlie ConlraCtOrS' �ure Lienu Law uces imt apph/ to an wmer ot properry M1b dnlGs or improves Riereon
an0 wM conlraps lor sucli prol��s mU a contocroqs) ticmu W�suanl Io I�e Coniractor5' State L¢ense Law�. I am aware
Inat oioo� ot 11�¢n Worker's CAmpenSation insurance s1pu10 be proviOeU la me.
� I am ¢nempi un0er $¢tlion: B. 8 P. C.
br IhiS reasan:
Date� Mmer.
I ao nereby cenAy iha� I am aware al ana unaersun0 Ine repuiremenR ot Calilwroa Healih anE Safery Cade $ections 25505, 25533. an0
2553� antl t�at I or any lulu�e OuilOmq occupanl vnlVwill n0 (tirGe ane� n¢e0 io compty with sai0 5laie catles an0 �he repuiremen�510r a
permil �o� tonslmtlian or m00Aitali0n Iwm I�e Pu Ouably Manap¢m¢ni USlnti. !SiOeniial tOnSlNtlion D�itaii 5 ate eR¢m0� ��Om
I�eSe pmvisions
Oa�e: _�q 3- 4� PD am:
I �ere0y t¢rti�y Ihal I have t¢aG �his applitdlio and Slale Illat I�e a�ove in�ormalion is rorretl. I agRe Io tomply wiltl .I Cily an t0unty
ordinancesanUs�aielawsreia�ingio�uildingc nsuuctronanenereeyaut -mreo�esentativesolmn ryto merupont�eabove- entione0
V�aOeny brinsp¢c�ion purposes.
Oa�e._ �' r �� SignaWre:_ _
Onver's License or Social Secuniy +:
i641-<6 W�me—Bwltling�, Green—COEe Enlarcemen�: Canary—ApO�Kan1; Pink—Fevenue; Gol�enroa—Nssessor
I
CITY OF COSTA MESA — BUILDIAG PERMIT PERM NO: B 0
PERMIT NO: B 053697 PLAN CHECK NO: � , N GOVT: N S ,
CONSTRUCTION TYPE: PERMIT TYPE; �TR PURPOSE: OTH
I
JOB DESCRIPTION : REROOF 400SF GARAGE W/COMP SHING SQ FT: 400
CLAIM VALUE; 400.00 CALC—VALUE: 400,00 GROUP OCC; M-1 /
COMMENTS: REROOF W/CLASS A SHINGLES
x�r«�**�r**�er*�*******�r**r�e*�t*�t**�r***�t�t**�t*�**�t�**�****�t�t+��rx �r�e*�r�r*�r****�t�t�r�r�r**�r*�e
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 42618116 ZNE: REF NO;
PLANNING N61'ES>
i
�r�r�r�r�r�e�r*�t*��r**r�r*r�r*�e�t*�t***��e�r�r�e�r�e��r�*+��t�t�*�r�r�e*�*�e�r�r��r**�r*�t**�t�t�r*�t�r��*�r**+t�t�t�r�t�t
D E V E L O P M E N T S E R V I C E S R E(j U I R E M E N�T S
ZONING APPROVED BY DATE: �
BUILDING APPROVED BY : r,. DATE• .
APPLICATION ISSUED BY; !
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LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PERMIT 15.00
DATE:
iFif ik k iF M If if�iFiFif M
iflfiFklFMiFMMffitklFlfkif1F1f1fiF
STRUCTURAL SEGMENT:Y
SMIP/RES GRADING
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15.50 0.00 0.00 15,50 15.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 15,50 OVER/SHORT• 00
BLD15P00 pLUNBING ELECTRIC MECHANIC FIRE SMIP/TO�T GRADING PLAN—CHECR
iFkilllltkkitfFiFMiFkMMltkitikMkkiFkkkitMMMkiFkiFkkMlEkifiElFklfMlfifkifMiFMikMiFitkMiFiFMifiFiFifltltiFMitiFiFkitikMifitif
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 400 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 900.00
END OF FEES
�
9I Ga0962.i4—U00:6i:�`, '�r� � _;.�,
CATE: �?/03/91 'iI��: 13:i�
_F.
.`
CONSTRUCTION AND PLANNING POO' iPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Sernc�cPole 52. Pool & Equipment Location y �'�
f 53. Steel Reinforcement
2. Soil Pipe-Undrgrnd. '� . ,' �, � . + ' ^,
,�Elect�al Con y��^tility'U ��irgmd. 54. Forms ' �
������Electr�al Condp.+nit,�;�ndrgmd/' i' 55. Electrical Bonding f ..�..�
��USteel'�Reinfor�nt 56. Rough Plumbing & Pressure Test S
y pElectrical UF��f�'rnd. ;,. 57. APPROVAL TO COVER�GUNITE �
a
.n7. Footings C�-� �c 58. Electrical ConduibUndrgmd. tr
,..
;� 8�'Foundation 5 `�' f 59. Gas Pipe, O Undrgrnd., Test '�
9:.'VJater Pipe�Undrqrnd. t v+� 60. Backwash Lines, P-Trap, O Undrgrnd. �/ �
tO�Structural Floor System �}� ` 67. APPROVAt TO DECK ' �'
11. Property Sewer Linq & Hwse,�Connection � 62. Backwash & Receptor-Final ' ry�'
:.n / ' �
12. Sewer Cap '-�% � 63. Heater & Vent�Final � �
� � �
13, floof Drains r� � '� 64. Plumbing System - Final �
J
14. Rough Plumbkt� � • J 65. Electrical-Final �!'� �. ��
15. Rough Electri � I-Conduiy�,� "� 66. Solar System-Final ./�
76. Rough Electri�Wiring "' 67. Fencing & Access Approval �Yj
17. Rough Wiring $ign 68. APPROVED FOR PLASTERING
.78. Rough ElectrieHl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning F�RE DEPT. REQUIREMENT
20Y-iRo h cmiy �lr.eplace � �•�r �� '� � C t++'��bF u� x� y n;
1I9 � : -� v7 # O tr'� ?. [ %aPPFTQVA7C6'�O Patvnit # C^
r �c- m �--. r n r �-s
21�Dti'�45, in St Ct�GO': i FF :AS # t-i �;.R + �: '" 'y •i .t. r.y
� i. s � � S � S r;�z z�'.70. �lJnd2�7gyxiatl H��iro *
22. D4cis, �en;ifating; t (JS xc � �" ^ �;,s. xc �.7�, �producC�ping �.^cas �Oil
23;�Ga.yPi�Ry�gh Ei�est � �� T�.� c v# � E' 7Z, Underg�r�d Fl��.� * � a,
24�Rqs7 Fwmirag p-;x t[ (� V� a � J �-t. ; 7377 Undergriirl. Stor Tenki'O Gas ❑@+I
25. RabYf S�athing�� S N:� `� r N� �• 7���erheatl�Hydr�"G 'a`�.'
26:�T� r Ceiling (S iuGturaq 8e.�ylonocoat x lv ma� � 75� Dry Chemical � ?: H,.�-) rx
2T"Frame and Flashj,n� 'a �' � =� ** 7g;'`�'pry Sta � i�e �'��- w� �� �
h, u^ o�.c r' :+ v � x. * c. �17 o C
r� -z i-.�7[.� :K :K.• . � i� v
.,28� Lathin' Siding;;.� ;� y�;,;y, � : s ••.t :z 77*' FIXED S'?!'STFMtiINA13 r-'
..
29. Insulat n � n;* � ' ' .:'.. �' n �=1 ' :+: .~ � „ R . ,• 'a7
� a z S :r. i . K 78f FIRE PREV. FI�1.fjL *, a�
r30.DrywalliNarhng� �� � +�� s ri �-HEALf_�DEP.F.,..RE(�WIR,�EMENT
�31. Plaster'�(o Coai' �, � x' {r,'. t 7g" FINAL I�{,SpECTF('� N'`� �' '�
RJ � 1 IT:: :K M:r 1� C% .T.
� 32�y Electrical Pqver�R�e,r-Fina{ E'F x p; ` K� �SQ� FOOD CE IF�FC�yTE I� E ��
33�Fin I �ctrj,c `•� < r i 7 *�� y� Ntaes: Q' '='S � M
f� �: 2'S - �:tv R^ O Nm
L3�Fi l e tin & F.0 �4ditib"'r�n� �-� _ '� � � :�Y, * S ��
39�Firxal Gas Pipe�TesC r� - � H N�� �� �� C� * tT' 'SO
r
n38�H��d �Canopv �:i� i:r�-� a M n � �* s; no ` +��� �Gt�.
y37.-Fii��l �ctory Fire�lace i s�r '� �[h �. -�. y x } ��
�38. F�al,Pt��,,,b,�g �`��, i.. .. q * � X s �� x m �
'�39 Was2r Service�Final �� i ro � i �. x �l -i!n x�R p
n. x ' 7 CI'. 9: N * S
40. Gas Service�inal '' "� x �,� � n; '.�T� �,v v�� * °7 � �
.7 .� 'ic h'i Qt��r' S r.
'41. Solar pomesicFinaK � �• * Uc G< vc dv �� :K
- .� i Y� a n� D CI' 'n .
42SBackflow Prevente�; F N .K :7 ( y (! %� H i •K S
� . J 7 � Nc S: U'. :3:-' • l: C N
43. Backflow �ritgatior+ �� �x5S F �'!� � xI-o * O � -+
r. 'r x x w J .� v n
:�44. Lands�Pe,t'xriqatiQn Systerq,K� � y n� :� 7 G*'r �+ N N P'�� x n1 0
� J t' .
..45�Sound Atte3�uation t� tT• x',�. !-� !-� x i i-i �� rrn: t�� ?�
�, ^, x rr n m. .;r ;. r- tr i,
5-. � w r.. .. s �_ ih .. .. ..� x c� i i �--iv � i-,
.�4�:'Handica,p Rq�julatipns � .� *. Y; � a•;S t�o 5 w
r47;�;F1(�ALST5t1CTU�.RE&BU�LDING ��/,�% .' NOS i:
' �� 4f[1l- ' v. I C .x r-.
1; i[� t� :r. .:� : u, i �
4$�jFI�AL PLAIVNiNG ����� �; tv � �: ;K �� �,y S :� r..,
49;rElectric Retease to,Edison ; � �: x; i� � i ic y a
•n z n
`; 50._Gas Rel�ase to So �them Califo nia Gas Co * w� � c' o;e x: n a
J �i. 1_ r � I i�: q. �.. r-+ G• o ti; �Y O •
�,51JCFpTIFICATEO�OCCUPAN Y ��`r. ;j Inc ., F o , ,
No. Date
4
`.�icr nooness: 382 E 16TH ST
OWNEN'SNRME: JUDITH OSMER
AOOflESS: 3OGS HARBOR BL, S.A.
754-6445
AflLH/ENGINEEN:
ROOflFSS:
flEG.NO.:
UNIT:
UNIT:
PEflMITTEE: pRO—SPEC ROOFZNG ( 714 ) 744-4541
aoonEss: 945 N. MAIN
ORANGE CA 92667
LICENSEO CONTflRCTOfl DECLAilAT10N: I �eleEy atlirm itul I am Iicense0 un0er provisians ol CAaO�er 9(commencing with Sectian
7000) o� Diwsion 3 0l t�e Busineu aM Prol 5fOn5 COGe. anG rtry licen5e is in lull lorce and ellecl. /
c�Truc.: 042611 s,nEu :471616 cus$ C-39 i
�7 �(p�p �
oaie: q! J— �..�_ Signature: � r—' _ —•_ _ — —
WOflKEflS'COMPENSATIONDECLI RTION: I�ereUya�lirmlAall�avea enil¢ateofconsemmselbinsureora licareaiworkers'
Compensalion Insurance. or a cenAieO copy inereol (5¢cti0n J800. �ao. C�.
POLICY NO.: E%P. U�TE:
COMPANY:
7 Cetlifietl coDY is �ere�y fumisheU. ❑ CertilieA copY �s �ile0 vnt� t�e ciry BuilAinA Oivision.
oare�. nooi�ca�c
E%FMPTIONFAOMWOflNEflS'fAMPENSATIONDF TION: (ThisSxtionnCMiwiGetomplet¢EifNepermi�ii�wonehunGreU�3100�ar1e55)
I cetlily Iha� in I�e Dedormante o� ��¢ work lor hich t�is permit is iSsue� s�all noi ¢mploy any : son in a manner so a5 io Ilecom�
sublect �o �hP�orkers�mLn/tion Laws I Galifornia.
ai. si
�aie: I � SiAnamre: _
NOTICE: II, atter making ��is Oeclaration, you sMWE Decai.. � subject �o t�e Wo�ners Compensauon Oro ons of ihe Labor
Coae, you must tonhwith comv�y wltn suc� D�o�isions ar tlris permit stutl oe UeemeA reroke0.
CONSTHUCTION LENDINC AGENCY: I frer¢Oy allirm Ilwi I�ert i5 a ConSlruciion 1¢nGinq apency lor the pe�Ormance ol lhe work br
whic� ihis Dermn is issue0 (Setlion 3097. Gv. C�.
LENOFfl:
aoon¢ss:
OWNEB BUILOEfl DELLRfUTION: 1 �ere0y afli�m Ilui I amlxemD� ��om t�e Contratlors' State License Law Por the lallowing reason
(Sttibn 7031.5 Busineu anE Prott55i0nal CaEe: Any cily ol c0unly wkc� rCpuir¢5 a permil to consiruct, alter, improve, Oemolish, or
�¢Dair any SIruClure. 0�� �0 i6 �uuantt. als0 r¢puire5l�e aOW���� �Or SUC� Oerrttil Io Ii10 a SipneG Slalemen� IAai Oelshe i51it¢nsetl
pursuant io tne O�ovisions o� tne Contracmrs' Sia�e license law (Ctwpter 9lcommencin0 ��� �cuon 7000) al Division 3 of tne Business
ana Pmlessions fAael or Inal helsne is e�empt tneRlmm ana Ine oaas lai Ine atl¢pe0 eeemption. My violation ol Section 7IXi1.5 by
any applicam br a Oermii su0jttts Ihe applitant m a civil penalry ol nm mom Itwn INe nuMred edWrs (351101.
I, as owner o� iM o�oceny w my employees witn wayes as theu mle wmpensaiqn, will Ea the woM, an0 the
❑ slruclme a nol intenaea ai oltereA lor sale (Sepion 70aa, Business ana Pmtexsional CoAe: T�e Comractors' State License Law
aoes not aDoly �o an owner of a DroOeny wtq Uuilds ar impwves tMRon, ana wno Ace5 sucn work him5ell/herself or tnroup0
MS Or �er own empl0y¢¢5, prOviOeG IIWI SutA imD�avemenl5 are n01 inIMGeE Or o�hfed far Sale. II, �wMv¢r l�! GuilEing ar
improvemenl rs SalO witkn one ytar ol tampiflqn. I�e owner will tWVC t�e 6ur0en ol plOvinp hel5�e EiG nOt Glnk oi impmve
lor Ine ourpa5e ol Satel.
I, as owneiul Ina D�oDerly, am e.cluzively Conlraciinp vnl�licen5ltl conlractOrsio Con5lmcli�e D�oiec1�5ection 7044, Business
❑ an0 Prole55ian5 CaOe: Tl�e CAntraziors State L[er5e Law OOes not apply la an ovmer ol prop¢rry whp EmIGs or improvM Ihereon
ana wtw comracts for sucn o�qK�s w+�n a contracmqsllicense pursuam to tne Comractors' Sia�e L'uen5e Law�.l am aware
t�at prool ol t�eir Worker's Campensatan insurance stwul0 Oe D«N io me.
� I am eeempt un0er Section: 9. d P. C.
lor ��is reason:
�a�e: Qwnec
I Oo �ere�y certily I�at I am awar¢ al an0 un0erstantl t�e tepuirements ol Cdlilomu Health and Salery CaAe Settions 25505, 25539, antl
255Ja antl ��ai I or any Imure �mimng acupam wilVwill nol (tircle one� neeE �o compty wit� sai0 sta�e Waes tl IAe repuiremenis for a
permil br constmclion or moaih[a�ion hOm I�e Air Ouably Manapemenl Ois�ncl. esiaenlial wnSVuclion a icatio are eKempl �mm
Inese Omvisions/.�
�ale: I ! �' �' FpPlicant:
I hereby cerlily I�ai I �ave read I�is ap01ita1ion ntl SIaIe Ihal Ihe a�Ove iniormali0ni5 cOrreCL Iagreei0 Com01y wilh Iltity an0 toUnry
artlinancesanastalelawsrelalinglo�wltlingc stmclionantlhemUyt �¢erepresentalivesof iscitylo feruponthea�ove�me�iioned
piopetly IOrinSpCtlion puipO5C5.
� ��J/��(r
Oale'. 9 � � � / Signa�ure."���—Pr — �
Oriver's License a� Socul 5ecurny ,:
t64LE6 Whne—Butltling: Green—CODe Enlo¢emenl: Canary—Applicanl: Pink—Revenue: Gobenr00—ASSes50r
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05369
PERMIT NO; H 053696 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE; OTH
JOB DESCRIPTION ; REROOF 12005F SFR RESIDENCE W/COMP SHING SQ FT: 1,933
CLAIM VALUE: 1,933.00 CALC—VALUE: 1,933.00 GROUP OCC: R-3 /
COMMENTS• REROOE W/CLASS A SHINGLES �������
�r****��*i�r*�e*�r****�e*rx***�r***�e*�r**�e***�e�r�e�r�r**�e**�r**�e�e*r�r *
Z O N I N G R E Q U I R E M E N T
SETBACKS REQUIREi7
------------ MAIN BUILDING ---------- ------ ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PLANKNZNGRN��'ES> PROV: PARCEL: 42618116 ZNE; REF NO;
i
�r�e«�r**�e�r+e****�e*�e�e*«**�r*****�r**�r�e***�r��r�r+e�r�e�r*�r*�r�***�e**�r�e�r�e*�r�r�r*��r�r**�rie*�r�r�e***�e*
D E V E L O P M E N T S E R V I C E S R E(J U I R E M E N.T S
ZONING APPROVED BY DATE; '
HUILDING APPROVED BY : DATE; !
APPLICATION ISSUED BY; DATE; � 3 C
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LEGALIZATION:N F E E S U M M A R Y STRUCTUAAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 45,00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 45.50 0.00 0.00 45.50 45.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 95,50 OVER/SHORT; ,00
BLD45p00 pLUMBING ELECTRIC NECHANIC FIRE SMIP/TSO GRADING PLAN—CHECK
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I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 1933 REROOF BY VALUE RESIDENTIAL N020NE 1.00 1,933.00
END OF FEES
`�
OS OCG46i50—QQ09f�251 � G Ti ,5 ���
oares 09/03/41 ?IllE: .'s:?3
�
CONSTRUCTION AND PLANNING P�� �PA
� APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole �. 52. Pool & Equipment Location �'
2. Soil Pipe•Undrgmd^ 2 � 53. Steel Reinforcement W� �sJ
�3 lecti I Con ilit `Onbr rnd. i�' �
4,G� jCa �at�,�i y' g ,.. 54. Forms �
c�n:-4. Electrical Conduit��drgrn y� 55. Electrical Bonding ��• �
���uSteel,i}eintorc�fiFnt ^ 56. Rough Piumbing & Pressure Test
(c GElectrical UFEl3Xirnd. � 57. APPROVAL TO COVER�GUNITE �
�
=Ul..�ootings O�' y 58. Electrical Conduic�Undrgrnd. �
i" 8. Foundation � ` � 59. Gas Pipe, O Undrgrnd., Test � x
/
9^ANater Pipe�Undrgrnd. �� -� 60. Backwash Lines, P�Trap, O Undrgmd. �/°
70. truttural Floor System i `'�� 61. APPROVAL TO DECK j �
�
11. Property Sewer Lir�e:& HQnsryConnection � 62. Backwash & ReceptorFinal ✓!-"
� �
72. Sewer Cap '� •
;,� o, � 63. Heater & VenbFinal ��•
13. Foof Drains rn ��, 64. Plumbing System � Final ' �
r
74. Rough Plumbi�ig � • , 65. Electrical-Final ���
15. Rough Electricy7-Conduit � • "
l, �- � 66. Solar System-Final
16. Rou h ElectrieaNirin '+ �t =�
9 4 9 r 67. Fencing & Access AnProval �- =
17. Rough Wiring �jjgn i 68. APPROVED FOR PLASTERING
18. Rough Electricai�T Bar Ceiling 69. POOI/SPA SYSTEMS�FINAL
19. Rough Heating & Air Condiiioning FIRE DEPT. REQUIREMENT
�
20%+7RoG�h Eactony F�7eplace i ii;n: �� v: ;; p cT:r. �s � p,ppROVAIiS�OPermit #» >+ rr
x' � �r r H ..`^. Yt :t �F-I•-. �7'
21,_ u�{s, nSt�ct �' � FF '�t H � 7A. Y• -e� �-!
l� '� � i• �.5 +: s c��< �c � 70. . de geqg�w H�Iro i.
22. D�i^ts, t^kntSfatiri�. t CJ S Y S�t? .R .71. ProdudfT Ing �C9as O�OiI
23CGa4�ipt�Ro�h &'�esc � a �` �' •�x M h i i C'� � Q� -.
i tT'S ;[*� T G pa. � i72• Undergr4�F� Fi4�jc x - o�
24mRo� Ftami�g R;M i E-. = .•�� s. p+ O b' H* :t 73A Undergrri�. Stoda; Tank� Gas ❑ EII
25. Ro i S"athin �'}: $- :'i �:n [*: O N>a >. t7 v i-�:-o w
. ��i 9.r�..' M S v��r. e7 > v�:�. +. 7qe��,verhead HYdrPj �,
262�T•@ar Ceiling (SGueturall &�vk�nocoat �+ m C n1s� +� 75T pry Chemical ��: •� �-+ J�
�,
27�Frame a�d Fl�sh�i�: � � m '� * 'a u> * ti ts7 rX
qc�[� * �' �. m:. :k 7�II�ry Stanj�,pe t-u� Y O
H28. lathin ��cling=i� n ��y;t; t� :� �' ••+� v' 7T•: FIXED S'i'9TENl-'FINAC v � ir
�y 1 'rl /1
� � Nx � N•• •• > �w th Y� 7'� FIRE PREV. FI L � J �
29. Insulat�'n .� s • � . W g� �� y 7 i� �,,
^�30. DrywaN-Naitfig �:i � z� i: :� :HEALThiiDEP'R; R•.E�JIIREMENT
p n y .t
l'31. Plaster8�ov�q C��, s � r,�r T �� � 7�.�FINA� I�ECT�N �� ��;
�-32sElectri�al Po�ver etEl�-Fina4 �� + s N x W 780g7FO0D C T Fl�f'6RT: 19SUED
33'=Fi `I ��yctri �': � c x. t� A� N,[ri,s; s '7� �^ t�:
>' �. � `t+' .� N� [*. 1 :r. :. "1" '-] �[9 *'" O N!'7
N34nFi _ eating& Aik opditipr�g ;j x � . M � 5 .^.` � S c�.
�
35lT�Firial � Pi�e-Tes� d `" �' '* * '� � !�� � r.. SO
a. :� X' � :Cc G:-� x ��.
�p36�1-loyd ojCanoPY �: � i rry a X(1 x.. � :�o w�� a[�'
.�, �
�-a37�?FirSS! F Mtory Fire aL`e � St� �o X� R7 .: � :l a M
-] � � ;L t ;-� E v. »: � . J
x ��
i-+38. Fir�aj P�mbing � �� � �� � .: � x S •-� * � O
CJ39. Wai9r Service'FinaK � 2 � �a x� :l a.[� x� t� C
n, � x cC I ;x � nJ -k 5
,.�„40. Gas Ser ce:�inal �x � ,Qp.�r s x [*f � � * Ov n�N � � �
F.47. Solar pomesFicFirre6 C1� � �• x Ck ��� K^� ��
�• a: .�r+ * * "'!C "" 7� SC r
'r� N i •� . �-i V i .t.
-'42:sBackfld Prevent _ 1
� �. N � x:,: cC 7... . vC
43. Backfldw Irijgati 'XSS �� � � r �KHo �r O -�
=a *a o � :. � •
�n44. Landscape �s�ripat � S s,[enb��r,�,�j � r[n t7 O ox � N N tC:) �� N o
�45;�6ound Att6nuati� (n �`cSF M � E '- i-�M .r � r+ Cv c[¢ :�
'� �� a� [n ':7�.. � 7 cC • (�Cy :K
�46`Nandicap Re9ulatf�Trs ��,,, � »: .. .•;: �:' t�K S Co tS .t�
47:SFIPts�LSTRI'ICTU B�UiLDING '�/�� G�•P'7 No� ^
�, ._ .. /1�. f? IlJC�x i C z [--
48�FII�MLPLkN'NINC�„ ^liF•h +N � �.r. � b� y t :- -�
o49:Y�Elaetric Releese toxfi� isbn! i x � �� :K ' x � � �- �
�Y
o50.SGa�iel�pse to Soufhern Californip Gas Co w � �j ;., • H G• oh � O�
�p51. C�TIFICATE 0.00CUPA l� � ', v' �,�, �np � a c. � �
No. Date
ApD���ant to fill In all spaces except ihose witnin heavy Doraer �ines anG sign all avDrooriate Oeclarations.
CITY OF COSTA ME a� CON�TRU T�N PERMIT
Project Address �
Applicant's Mailin Ad
Owner's Name , hone
Address
Arch/Eng. Licenu No.
Atldress 1 —
Contracmr's Name � � ��' ho1n'e^
Addreu (mailingl � � vv `
Ciry License No.
LICENSED CONTRACTOR DECLARATION
I hereby attirm that I am licensea untler provislons of Charter 9(commencing
witn section ]000) ol Division 3 of the Business antl Protessions Coae, antl
my license is in /ulPtorce ��] e c ��� 1��
Ucense C� ense No. �
Oale S9 t
`NORKER COMPENSATION DECLA ATI N
hereby aftirm that I nave a certifica[e f co sent to self-insure or a<ertificate
of Wo�ke�s' Compensation Insurance, Or a ce�tifleC coOY tne�eof (Sectlon
3800; Lab. CJ .
Poliq No. Company
ACer[ifietl copy i5 M1ereby fumishetl.
Cerllfietl wpy is filetl with the tlty Builtling Division.
Da[e APplicant
EXEMPTION FPOM WORKERS' COMPENSHTION DEGLARATION
(Thissection neetl not be completetl if the permi[ is for one huntlreE ($100) or
less).
I certify Ihat in the pe�(o�mance of th¢ work fo� wM1ich this De�m�t is issuetl, I
shau noe empioy any person in any � er so as t become subAe<t m me
Workers' �p m s laws of Calif ni
Date C7����� Si9nature ��^
C7"
'NOTieE: I(, atter making this tleclaration you �oultl become subject to the
Wo�kers' COmpensallon Orovision5 of th Ldbor Cotle, you must forthwith
comply wilh such orovisions or this De/mit shall be tleemetl revokea.
CONSTRUCTION LENDING AGENCV
I hereby afflrm that [here is a con5buction lentlinq agency fOr the performance
of [he work far which IhiS permit is issvetl (Sectian 309] Civ. CJ
Lentler's Name �
Lenaer's Adtlres5
OWNER BUILDEN fiECLARATIOfJ -
I hereby aHirm that I am exempt trom tne ConVactor's License Law tor the
tollowinq reason (Section ]031.5 Business antl Professlonal Cotle: Any ci[y or
county whith requires a p¢rmi[ to const�uct, alter, im0�ove, demolish o� �epair
any Structure, prlor to its issuance, a150 r¢quires the applicant for such p¢rmil
t0 tile a signeC stalemen[ that h¢/Sh2 I5 Iicensetl pursuant to ihe provisions of
tne Contractor's License Law (Cnapter 9(commencing wiro Sec[ion 7000) ot
Division 3 O( t112 6U51�855 antl P�otes5ion5 Cotle) o� that he/She I5 exempt
lhere/rom ana the basi5 iOr the allegetl exemD��on. Any violation ot Section
7031.5 by any applican[ for a permit subjects the applican[ to a civil
�enalty of not more tnan five huntlretl tlollars (y500).
I, as owne� of the prop¢r�y o� my employees with wages as [heir sole
componsallon, wi11 ao the work, antl the structure is not intentletl or ofieretl
for sale (Section �044, Business antl Pmfezsional Cotle: The Contractor's
LiCenSe Law tlOes not apOty to an ownCr oi a prope�ty who builtls or imp�oves
thereOn, antl who tloez such work himself/h¢rseH or through his or her own
2mployees, provitletl tttal such improvemen[5 a�e no[ intentletl o� offeretl for
sale. 1f, hOweve�, th¢ builtlinq or improvemen[ is soltl within one yea� of com-
Oletion, [M1e owner will have tne bur0en of proving hE/She Oitl not builtl or im-
prove forthe purpose of sale). ,
❑ I, as own¢r ot the property, am exclusively contracting with licensetl Con-
tractors to construct the project (Section ]044, Business antl Professions Cotle:
The Contractor's License Law does mt apply to an owner of property who
buiitls or Imo�oves thereon, antl wno contracts for such proje<ts with a con-
tractor(s} license pursuant�to�the ContractoYs Llcense Law). I am aware that
proof pf Iheir Wo�ke�'s Compensalion insurance zhoultl be provlGetl to me.
❑ I am exempl untler Section B. & P. C. for tM1is reason
Date
I hereby certlty that
1lI/Olrtld[I00 �5 COflCC[
and state law 'n
SCOId�IV¢5 O Lh�S �I
inspection ur
Signature
Drivers' License r 55
CMF 0865-46, rev. 1 /84
Owner
Whit¢ -
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System ,
❑0-t00,000BTU ❑100,000
System fiepair/Alteration
Fire Dampers '
Registers
Isue Fee
$ 3
A.P. ;1`-
S Main Building:
E
T Front
A Rear
C Right
SLef[
Ping. Ref. #
Planning Notes:
5020 6/17/85
Zone
Accessory 8uilding:
Parking Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Sub. � 50+ KW
Cooking Unit ,
Dishwasher ' '
Dryers ❑Gas ❑Elec[ric
Fan ,
F.A.U. � "
F i xtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator O0.5 KW 05�15 KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel
Motors�0.7 HPOi'f.-6
Inc. Solar 09-15 HP �16-75+
Microwave
Pole Li9ht
Range
$ign
; Standing Sections
Trash CAmpactor
� Reinspection Fae I$15 � � Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2onin8 APP�oved By
Building Approved By
Aooliwtion Issued Bv
9oQ�.
FEES
$ 3
Z
O
N
I
N
G
R
E
U
M
T
S
SUMMAHV OF FEES
BUILDING PEFMIT $ SMIP $
PIAN CHECK $ PERMIT �
PLUMBING $ 9•OD ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM S - Q
MECHANICA� $ , TOTALFEE $ ./'(�
PLAN CHECK 25% $
CONSTRUCTION AND PLANNING ' • PO.,� & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
i. Temporary Electrical Service or PPI� 52. Pool & Equipment Location _
2. Soil Pipe-Undrgrnd. � " 53. Steel Reinforcement ,
3. �Electrical Conduit.Utility-Undrgmd. ' � 54. Forms �
4. Electrical Conduit-Undrgrnd. �� 55. Electrical Bonding - ,
5. �Steel Reinforcement �; I 56. Rough Plumbing & Pressure Test ,
6. El2ctrical UFER Grnd. �'. 57. APPROVAL TO COVER-GUNITE �}•
7. Footings - � � ,, _. 58. Electrical Conduit-Undrgrnd.
6. �Foundation � , 59. Gas Pipe, O Undrgrnd., Test
: 9. Water Pipe-Undrgrnd. � ' 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor Sysiem � 61. APPROVAL TO DECK �
11. Property Sewer Line & HouSe Connection 62. Backwash & Receptor-Final �
72. �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. Duc[s, in Structure �, 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test '�' 72. Underground Flush
24. Roof Framing , 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Freme�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
33. Final Electric Notes: i �
34. Final Heating & Air Conditi0ning
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 pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison � '
50. Gas Release to Southern California Gas Co .
,
51. CERTIFICATE OF OCCUPANCY � �
No. Date
i� ,. " � ��
REPORT OF INVESTIGATION
Variances:
C. U. P.'s:
.,�
Received by: _ `��!j"1� .
J � �Z` ��
Complalntant
��� f /6�
Atltlra55
� �� - �X�'�'
Telepnona Number
Nature of Complaint:
Assigned to:
❑ Building Division
❑ Planning Division
❑ Joint Investigation
Case No.: ���
Assigned to: E� � �S
Date: J ��D_ /�
�� � � / � �
Complaint Address
/� Name o4Ten nt (if applicable)
Y�A.��� n /7/Y/2P/7
Name of Prope Owner � Telephone
�/3- 3��=y�3 7
Owner's Residential Address / ��.' _ D��/
Y b
Investigation by:
Inspector
Building Permii Files Reviewed:
Initial and Date
Assessor's Parcel No.
Violation of C.M.M.C. Section (s�:
Time of Day (if applicable)
Zoning Files Reviewed:
Initial and Date
Map No.
Findings: ������Nu org �ry�Jw �rr _��r � ��%.�nz,n�ry l�,L.?�yT ✓/r� rTc%/ %�
�ii.�r.�..iar ..wr Tr,�%-1ii- /��Nn�.%r fn c.^ac.�a� iin�ra �i.n� �n r0 �/"�'�
NOTICES:
1st Given:
Date
2nd Notice:
Time Allotted for Correction
5-day maximum time
Certified letter advising that if violations are not corrected, the complaint and all supporting data will be forwarded
to the City Attorney's office with request for prosecution.
Date Mailed Date Received 7-day recheck of site
Files forwarded to City Attorney's office with request:
Initia� and Date
CMF 0829-30 rev. 4/83
: � � 1
Method
Date Time of Contact Initials ' Comments
3v
C�'y //— o�-r s,r ..%�� • o�� s'wer rT�v,�r
C�7 I� o� T�����n ��� �� Q � r- S.�P .�� �—�
..(,�JU)/ L:�'L/ � /n� Gu( CJ'9 /T
- (j �� L S l.�rl/
� � � � r�
� ti k �
� g����
COSTA MESA BUILDING-SAFETY DEPARTMENT
P, O. 90% 957 COBTA MEBA. CALiFORN1A
For Applicanfi io Fill In Complefely
TYPE OR PRINT
BIIILDING
ADDRESS �
�COSTA MESA, CALIFORNIA
1 MAIL
1 ARGFi1TEGT
J'
1 SIZE
F
TEL.
NO. OP BLDOB.
NOW ON LOT �.
6GTBAIX LIN¢ pPON
CENTen OF ain6ET REAR VAR.
SIDE YARD ILEFT I RIGHT
DESCRIPTION OF WORK
�
!RIOR WA4�. •�J I ROOF
:RING V JU��J COVERit
OF BUILD�NG AND,y✓ORK ZO BE
; �� ��CEI!!E�
�OCT 18196i
" FIIVANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
HECE�PT NO. � F[RMIT1jp.,
)�6 vY
9Y I DATE RECEIVEO. I �pA I68U .
� iS ,< G.• i b �
COSTA MESA. CALIFORNIA
FIRE
��NING
ZONB^ I NO. OF U96 OP NEW
({� �'� rLANB �l BUILDINOA_
v � s . ir, i¢u•
L60AL /n� � 0
oescn�Pr�oH !i� � �,-
A.P.NO.'�/— ��/ ,�
YARDS EVES
APPROVED ALLOWED
ICHNTHq 4NH 9TJ ��
FRONT IO FT
y
1 HERBBY ACKNOWL8�G6 THAT I NAV6 qBAD THIB APPLIGTION Tryg AMOUM BHOWN UNDER VALUATION �8 FON TH¢
ANO 6TATE THA� TXE IIBOVE i8 CORfiHCT ANO AORBH TO COM• pypppB6 OF EBTABLIBXING A PERM�T FEe ONLV.
PLY WITH ALL CIiY OfiD CE8 �ND HT�TB WB ODUTINO
BuiLDINo CON9n+ 10 VALUATION '/
61GNATURE OF ,� �^ � AO� PERMIT FEE $.j `%' �`
PERMITTE �� �%
S �j � PLAN CHECK $ /p'�/ �
AUTHORIZED AGENT /� /
TOTAL FEE 10
l