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Home My WebLink About146 21ST ST - Building Permits • 44 �STp p- CITY OF COSTA MESA a. BUILDING DIVISION :J DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1. sa ; leQ• PERMIT ,/06-01852 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cBIJILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 146 21ST ST Status: ISSUED Suite: A Applied: 11/02/2006 Vicinity: UNITA _ Issued: 11/02/2006 Primary Occ: R-3 Dwellings/Gong Res<10 Type of Construction: V-N Parcel Number: 42612108 Zoning: Applicant: BEEMAN, HEATHER Address: 146E 21 ST Phone: 949-233-8990 CELL ISSUED BY: Allia .4 COSTA MESA,CA Zip: 92627-2124 Owner: BEEMAN FAMILY TR Address 146E 21 ST Phone: COSTA MESA,CA Zip: 92627-2124 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT 1 UNIT A CONDO CONVERSION INSPECTION ONLY.NO OTHER WORK AUTHORIZED WITH THIS PERMIT. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $0.00 Permit: $0.00 Claim Valuation: sow SMIP Res: $0.00 SMIP Corn: $0.00 Other $0.00 ' Inspection: $0.00 Total: $0.00 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 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned fora 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 24<W6(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOUARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.N Class N Contractors Signature: Date: 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,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ 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.). El 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. XYes 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: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will le made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more t an tth`thy`siz j36)feet high°(Chan 3'2;Gip 2;Art!,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 end certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes El 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? El Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this.a.pPplication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes 0 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 feel from the outer boundaries of a school? El Yes El No (If yes',the facility must meet the requirement of Sections 25534 end 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes El 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 10 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 abo�-1p�sy'bed property for ins'action purposes.I agree not to occupy or allow occupancy of any building authorized by this pe it until final inspection. 6r ignatureOf0 Legal.Ow :r(s) Dae And/Or Authorized Applicant Date CODE• INSPECTION TYPE PATE I1fJRIALS coot t INSPECTION TYPE PAIS 1 _124 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ' 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention _ 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site /314 �_ I 204 Final Demolition 250 P, � \ - _U'7 JB1s1 � ._ CITY OF COSTA MESA " • BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER PERMIT B06-01853 Sbaftann (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cBuILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 146 21ST ST Status: ISSUED ' Suite: B Applied: 11/02/2006 Vicinity: UNIT B Issued: 11/02/2006 Primary 0cc: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 42612108 Zoning: Applicant: BEEMAN, HEATHER . Address: 146E 21 ST /j Phone: 949-233-8990 CELL ISSUED BY: COSTA MESA,CA Zip: 92627-2124 Owner BEEMAN FAMILY TR Address 146 E 21 ST Phone: COSTA MESA,CA - Zip: 92627-2124 i Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: • License: SCOPE OF PERMIT UNIT B CONDO CONVERSION INSPECTION ONLY.NO OTHER WORK AUTHORIZED WITH THIS PERMIT. • FEE SUMMARY Plan Check: $0.00 - Calc Valuation: $0.00 Permit $0.00 • Claim Valuation: $0.00 SMIP Res: $0.00 SMIP Corn: $0.00 Other $0.00 • Inspection: $0.00 Total: $0.00 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 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and 'related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections 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 2448-46(6'00 DECLARATIONS • • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE MUST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractors Signature: Date: 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,Civil 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 end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is 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 driver's license. es 0 No Drivels License No. Expires: Verification of Ownership by(type of d ment,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O 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 moreTiTritt#fty-six(36)feet'hlgh:(Cfiap.`3.2;Gip 2;Ait 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 materiel? ❑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? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia 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 a_apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes u No (Section 65850.2 of the California Govemment Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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-_des 'bed property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ignature Of Legal Owner(s) D(�� f t And/Or Authorized Applicant Date • CODE 0 INSPECTION TYP€ • • ping INTtTIAL$ CODE! )NSPECTION TYPE • QAIE Q_A6i • 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final • 208 Final Plumbing • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall • - 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site• 204 Final Demolition 250 ) -7-07 aN ' ~ t CITY OF COSTA MESA t ),:;-.i.,..„5„77,tilts:: d BUILDING DIVISION PERMIT NUMBER DEVELOPMENT SERVICES DEPARTMENT PERMIT E99-00939 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 146 21ST ST Status: ISSUED Suite No Applied: 10/11/1999 Vicinity: EAST OF SIDE OF PROPERTY HOUSE Issued: 10/11/1999 Parcel Nunmber: 42612108 q/� ISSUED BY: [/ Applicant: REYNO, LAURA _ Address: 146 21ST ST , , .r ' " - �,,i - Phone: (949)548-1931 " • - - COSTA MESA, CA/ , 4 , Zip: 92627 Owner: ,-REYNO JOHN 8, LAURA ,_ AddressN 14•621ST ST `. ' - - - VI\�►� /7'12 .,/// Phone: A 7 COSTA MESA;.CA,�.' Zip: 92627 ` \ jam;; , pA ,% / j , - /Contractor:2 �'_-� -:-." _ , Address: - /; , Phone: '; • 4. - ,'Zip: - • ��License: SCOPE OF PERMIT UPGRADE EXISTING-ELECTRICAL METER TO 100 AMPS ON EAST SIDE OF HOUSE. - r FEE SUMMARY - ` .' Quantity e. • Quantity ',-ISSUE FEE . -. $23.50 - - Temp Dist System/Lighting , $0.00 0 ,Temp service test . $0.00 Busway 1100 ft • - -. - $0.00 0 ,Res.a/c package . $0.00 - - - - Standing Section' - - - $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 - ' New Res(3.-units) - $0.00 - 0 Transformers up to 1 kva/kw . $0.00 0 - I Pool/Spa ,- $0.00 0 _ upto'10 kva/kw $0.00 0 Lighting Fixts- $0.00 0 - up to 50 kva/kw '. $0.00 0 ) Recept Outlets , $0.00 04 - up to 100 kva/kw . $0.00 0 r Switches \ ., $0.00 0 -- over 100 kva/kw $0.00 0 , Non Res Appl /> $0.00 0 • Low VoltageEquipment $0.00 0 Res Appl:, ',$0.00 . 0 Low Volt Wring System/Ckt ' - $0.00 0 - Service to 2006. $30.50,\ 1 _ - Misc.-Conduit/ _ . $0.00' 0 �. Service to 10002A /2 $OAo' 0"` • Misc.Conductor $0.00 0 Service over 10006'. �% $0.00- . . 0 _ ,- Circus(gen or ride) , y . /$0.00 - 0 Motors to 1hp /// $0.00 N'0 - Circus(mech ride or lights)-' $0.00 , 0 Motors to 10hp / -;,, '", $0.00 0 'Christmas Tree Stand. Motors to 50hp - "$0.00 / 0 • .Fireworks Stand Motors to 100hp N. IN $0.00 - -0 Other Electrical Fee ' $0.00 Motors over 100hp .'$0.00 - 0 Communication drops ' $0.00 0 Investigation Fee - $0.00 " Sub panel to 200a $0.00 - 0 Plan Check Fee $0.00' Pole Light Pkg $0.00 -- - 0 - .. Reinspection Fee Sign Circuits $0.00 0r ,.- Temp Pwr Pole $0.00 0 - , - TOTAL CALCULATED FEES $54.00 Intermed Pole $0.00 0 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections 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 DECLARATIONS - WORKERS'COMPENSATION DECLARATION: \ I hereby affirm under penalty of perjury one of the following declarations: ' O I have and will maintain a certificate of consent to sell-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. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) '- ❑ I certify that In the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($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(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: 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,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-B UILDE R'DECLARATIONS: II P -).', 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 reqUiresa 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 lie or she ls•Ilcejsed 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 thathe or.she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of'not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:.The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is 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.). 14 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 a r - t under s'c. I ft- _ Business and Professions Code for this reason: fin Signatu :: '�' r f OI Expires: 121 CY-j Verification of Ownership by(type of document,i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend, will be made in connect on with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application end state that the information given is corre .4 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 abov described property f• ' spection purpose not to occupy or allow occupancy of any building authorized by this permit un(IIJJ[tai I action. CS 9 MO i 1 (5 t I I(Da !�Signs ,f Lege s) Dai And/Or Authorized Applicant Date CODE L. INSPECTION TYPE Pm INITIALS CODE! INSPECTION TYPE PATE INTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ,pq 200 Final Re-Roof 210 Final Electrical 10—I 5-11 201 Final Block/Retaining Wall 212 Final Fire Prevention• a 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Slte 204 Final Demolition 250 Final Building/Occupancy 2446.46 u CITY OF COSTA MESA t�, BUILDING DIVISION PERMIT NUMBER :' '�:. 'I DEVELOPMENT SERVICES DEPARTMENT ��; PERMIT „ "tro "`O B99-01628 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 146 21ST ST Status: ISSUED Suite: Applied: 10/8/1999 Vicinity: EXTERIOR WALLS OF HOUSE Issued: 10/8/1999 Parcel Number: 42612108 Zoning: Applicant: ALL-ONE CONSTRUCTION CO. ISSUED BY: t Address: 3101 TRINITY DR Phone: (714)546-4718 COSTA MESA,CA Zip: 92626 Owner REYNO, JOHN & LAURA Address 146 21ST ST Phone: COSTA MESA,CA Zip: 92627 Contractor: ALL-ONE CONSTRUCTION CO. Address: 3101 TRINITY DR Phone: (714)546-4718 COSTA MESA,CA Zip: 92626 License: 685632 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REMOVE OLD REDWOOD SIDING AND INSTALL NEW WEYERHAEUSER ICBO#2319 AND ICBG#3567 HARDBOARD SIDING AND NEW R-13 INSULATION IN WALLS OF HOUSE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $4,000.00 Permit: $97.25 Claim Valuation: $4,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $97.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: i • � ,` ` NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections 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 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This secti need not be completed if the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C-Tornio,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 pr. • s. p,.l� Applicant Signature: /^�� Date: , — lJ % 9 WARNING:FAILURE TO SEC 'E WORKERS'COMPENSATION COV GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S 2 000),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 licens d under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business aydfrofessions Code,and my license is in full force and effect.Lic.# 5f S'6 3 z Class# id Contractors Signatur . e- /�(i.c-�« Date: /117-- & gcr LENSING CONSTRUCTION LG AGENCY: O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: 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($500).): ❑ 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes ❑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: O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia 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? ❑Yes ❑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? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .......... e r.... an.,R...- ana.. .tion. .. . .-- 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes I�No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8...-..._....yes.".— compliance 8 (If"yes",attach certificate of cmpiafrom 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-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Oet, �Legal Owner(s) /o_ Date 5:s-- 99 An r Authorized A icant Date CODE / INSPECTION TYPE PAE INTITIALS CODE It INSPECTION TYPE PASS INTRIALE 161. Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 7_16.-19( 2446-46 hex ICBG valuation Service, - Inc. r C'0N 9, m.°rx ° uoitx n cc°° 5360 WORKMAN MILL ROAD " WHITTIER, CALIFORNIA 90601-2299 A subsidiary corporation of the International Conference of Building Officials 'MI lit EVALUATION REPORT ER-2319 Copyright®1997 ICRO Evaluation Service, Inc. Reissued February 1, 1997 Filing Category: WALL COVERINGS (288) WEYERHAEUSER HARDBOARD SIDING PRODUCTS 2.6 Shear Values: COLLINS PRODUCTS When installed in accordance with Section 2320.6 and Table 23-1-0 of the POST OFFICE BOX 16 code,the following shear values are applicable to Weyerhaeuser shiplap KLAMATH FALLS,OREGON 97601 panel products. 1.0 SUBJECT Panel Shear(Ib.lf) Weyerhaeuser Hardboard Siding Products. Thickness rte" Deflection 115" 155 2.0 DESCRIPTION 1/2" 202 , 'Values obtained on aged samples. 2.1 General: The Weyerhaeuser hardboard siding is a fibrous-felted homogenous pan- 2.7 General Application Requirements for All Siding: el made from wood fiber which is consolidated under heat and pressure in Installations must be in accordance with Section 2320.6 unable 23-1-0 a hot press to the desired density.The productis manufactured in!/l6 inch of the code.Vertical framing must not exceed 16 inches on center.A mini- and 112 inch thicknesses and in three finishes:without factory-applied fin- mum 6-inch space must be allowed between the bottom of the siding and ish;factory-applied sealer and primer;and prefinished surface. Lap and the soil.Siding should not be in direct contact with concrete.A118-inch gap panel products are available in a variety of embossed surface patterns. should be provided around all openings.Gaps must be caulked with an ap- The surfaces are machined to a variety of groove patterns. proved sealant All exterior openings must be gashed in accordance with 2.2 Square Edge Panel Siding: the code. The square edge siding is manufactured in 4 feet by 6, 7, 8, 9 and 2.8 Finishing: 10-foot-long panels.The panels are available in both smooth and textured The primed siding must be finish-painted within 90 days after installation. suttee es.These panels may be applied over walls with or without sheath- II exposed for a longer period of lime,the siding should be reprimed with ing.Vertical butt joints on square edge panel products must occur over the high quality exterior grade primer.Follow the paint manufacturer's recom- framing members and should be covered with batten strips. mendafions.The siding must be clean and dry when painted. 2.3 Shiplap: 2.9 Identification: These products are manufactured in 4 feet by 6,7,6,9 and 10-foot-long Collins Rod acts hardboard sidings are identified by the American Hard- panels and are available in both smooth and textured surfaces.There are board Association logo,mill number and a note indicating conformance to several shiplaps available depending on the groove pattern.These prod- ucts may be applied over walls with or without sheathing.Vertical seams the American Hardboard Association product standard ANSI-AHA must occur over framing. A-135.6. 2.4 Standard Lap: 3.0 EVIDENCE SUBMITTED The lap siding is manufactured in6,8,9112 and 12-inch-wide boards 16 feet Material description,installation instructions,test reports indicating com- in length.The lap siding is available in both smooth and textured surfaces. pliance with ANSI-AHA A-135.6 standard,American Hardboard Associ- The siding is installed horizontally over walls that meet racking require- aeon certification informafion,racking lest results and details of the quality ments.If no sheathing is used,building paper must be applied directly be- assurance program. neath the siding.Each course is lapped at least 1112 inches.Vertical joints must occur over framing members.Corrosion-resistant 8-penny box nails 4.0 FINDINGS are used. Nails must be long enough to cover both siding courses and That the Weyerhaeuser Hardboard Siding Products described in this penetrate the framing members at least 1112 inches.Nails should be 5/t to report comply with the 1994 Uniform Building Code",subject to the 314 inch up from the drip edge. Lap products are also available with a following conditions: self-afigning feature on the back of each piece to allow for alignment of sub- sequent courses. 4.1 All window,door and other exterior openings are flashed in ac- 2.5 Specialty Lap: cordance with the code. Cottage lap,channel rustic,V-rustic and colonial lap siding products are 4.2 The products are manufactured at the Collins Products plant nominal 16 or 24 inches wide by 16 feet long with horizontal shiplap joints. by thelocatea at KlamathanHardboard Falls,Oregon, with n follow-up inspections These products are available in a variety of groove patterns and surface by American Association(AA•614). textures.The specialty lap products require three nails per lap on all studs. 4.3 The products are manufactured,identified and Installed in ac- Successive laps are nailed 518 to 314 inch up from the drip edge and in the cordance with this report and the manufacturer's instructions. center of the lap.Corrosion-resistant 8-penny box nails are used.Verfical 1996 Accumulative Supplement:This report is unaffected by the supplement buff joints are to be located over the studs and must be staggered on successive courses. This report is subject to re-examination in two years. Evaluation reports of ICBG Evaluation Service,Inc.,are issued solely to provide information to Class A members of ICBO,utilizing the code upon whichnhe report is based,Evaluation reports are not to be construed as representing aesthetics or any other attributes not specifically addressed nor as an endorsement or recommen- dation for use of the subject report. This report is based upon independent tests or other technical data submitted by the applicant.The ICBG Evaluation Service,Inc,technical staff has reviewed the test results and/or other data,but does not possess test facilities to make an independent verification,There is no warranty by ICBG Evaluation Service,Inc.,express or implied as to any"Finding"or other matter in the report or as to any product covered by the report,This disclaimer includes,but isnot limited to,merchantability. Page 1 of 1 • • • • fi."°"°`°° ICBG Evaluation Service, Inc. 5360 WORKMAN MILL ROAD • WHITTIER, CALIFORNIA 90601-2299 A subsidiarycorporation of the International Conference of Building Officials EVALUATION REPORT Report No. 3567 Copyright®1995 ICB0 Evaluation Service, Inc. Reissued December 1, 1995 Filing Category: WALL COVERING (288) STANDARDS FOR HARDBOARD SIDING AND Top and bottom edges of the panel shag be nailed 312 inch from the edge.Shi- FIBERBOARD SHEATHING olap and lap siding shall not be force Wed.Square-edged panels shag maintain AMERICAN HARDBOARD ASSOCIATION llte-inch gap al the joint.An joints and edges of siding shall be over (Taming 1210 WEST NORTHWEST HIGHWAY members and shag be made weatherresistantwith battens,horizontal overlaps PALATINE,ILLINOIS 60067 or shiplaps to the satisfaction ol the building official.When the hardboard panel I.Subject:Standard for Hardboard Siding and fiberboard Sheathing. siding is installed in this manner weather-resistive barrier requirements in Sec- tion 1402.1 of the code can be waived.Hard board panel siding with a minimum II. Description: A. Hardboard Siding: The hardboard siding is a fibrous width of 48 inches, is an alternate method of bracing required by Section felted homogeneous panel made from ligno-cellulose fibers consobdated under 2326.11.3 ,Item 1, of the code, provid ed it is installed in accordance with this heat and pressure in a hot press to a density not less than 31 pcI.The hard board report siding conforms to American National Standard ANSIIAHA A135.6-1990. Grooved siding shall be not less than 1/4 inch thick. 8.Fiberboard Sheathing: The fiberboard sheathing consists of egnoceau- The nail size and spacing shah be as indicated in Table land shag penetrate losic fibers that have been'Modelled 31 and consolidated into homogeneous pan- P g p els having a density of from 10 to 31 pct.The sheathing conforms to Type IV framing a minimum ol 1112 inches.A 112-inch gap shall be provided around all Class 1 regular density or Type IV Class 2 intermediate density as indicated in openings. Product Standard ANSUAHA 194.1-1985.The sheathing is to be installed in ac- Factory-primed siding shall be painted within 60 days after installation.If ex- cordance with Section 2315 of the code and racking shear values are in act or- posed for a longer period of lime, the siding shall be reprimed with an exterior dance with Table 23-I-P of the code. grade primer which is compatible with the finishing system. Unprimed siding The fiberboard sheathing must be covered with an approved wag covering shall be finished within 30 days after installation.II a paint system is to be used, and when installed in this manner is an approved water-repellant panel sheath- the siding must be primed with an exterior primer. ing as required in Section 1402.1,Item 4,of the code.For exterior lath appfica- The lap siding is a minimum thickness of 3k inch and appfied horizontally to tions,the requirements of Section 2506.4 of the code must be met studs spaced a maximum of 16 inches on center.Lap siding shall overlap 1 inch C.Identif cation:Siding and sheathing products are ideidentified in accordance minimum and shall be nailed through both courses and into framing members with the ICBG ES or NES evaluation report that specifically evaluates manulac- with nails located 1h inch from the bottom of the overlapped course.Butt joints truing and quality control activities.Identification includes the logo of the certify- shall be over framing members and may be covered with fabricated joint covers ing agency and the applicable product standard. or butted and caulked.Aweather-resistive barrierisinstalled under the lap siding as required by Section 1402.1 (a)of the code. III.Evidence Submitted:(haft?control procedures,product standards and Square-edged nongrooved panels have a minimum thickness of 312 inch are installation instructions. appfied vertically to sheathed or unsheathed wags with studs spaced up to 24 inches on center.Square-ed god nongrooved panels shall be nailed 312 inch from Findings the perimeter of the panel and intermediately into studs. IV. Findings:That the standards for hardboard siding and fiberboard Shiplap grooved or nongrooved siding is a nominal%inch thick and is appfied sheathing described in this report comply with the 1994 Uniform Building vertically to sheathed or unsheathed walls with studs spaced up to 16 inches en Code" subject to the following condition: Manuf acture of the panels is center.Shiplapped edge panel siding with 18-inch shiplap must be nailed 12 beyond the scope of this report and must be covered under a specificICBO inch from the edges on both sides of the shiplap. Three-quarter-inch shiplap ES or NES evaluation report. must be nailed 3/2 inch from the edge and penetrate through both overlaps and underlaps. This report is subject to re-examination in one year. Evaluation reports of ICED Evaluation Service,Inc,are issued solely to provide information to Class A members of ICBG,utilizing the code upon which the report is based.Evaluation reports an not to be construed as representing aesthetics or any other attributes not specifically addressed nor as an endorsement or recommen- dation for use of the subject report, This report is based upon independent tests or other technical data submitted by the applicant.The ICBG Evaluation Service,Inc,technical staff has reviewed the test results andlor other data,but does not possess test facilities to make an independent verification.There is no warranty by ICBG Evaluation Service,Inc,express or implied as to any"Finding"or other matter in the report or as to any product covered bythe report.This disclaimer includes,but is not limited to,merchantability. Page 1 of 2 Page 2 of 2 Report No. 3567 TABLE 1—HARDBOARD SIDING NAIL SPACING FRAMING MINIMUM (r x 41 NOMINAL MAXIMUM NAIL SIDING THICKNESS SPACING SIZE1 General Bracing Panels3 LAP SIDING Direct to studs 3/8" 16"o.c. 842 16"o.c. Not applicable Owr sheathing 3/8" 16"o.c. 1042 16"o.c. Not applicable SQUARE EDGE PANEL SIDING Direct to studs 3/e" 24"o.c. 642 6"c.c.edges 4"o.c.edges 12"o.c.at 8"o.c. intermed. intermed. supports Over sheathing 3/8" 24"o.c. Sd2 SHIPLAP EDGE PANEL SIDING Direct to studs 318" 16"o.c. 642 6"o.c.edges 4"o.c.edges 12"o.c.at 8"o.c.intermed. intermed. supports Owr sheathing 3/8" 16"o.c. 842 6"o.c.edges 4"o.c.edges 12"o.c.at 8"o.c. intermed. intermed. supports For SI: 1 inch =25.4 mm. tAll nails must be corrosion resistant and comply with Federal Specification No.FF-N-105B. 2Minimum acceptable nail dimensions arc: Panel Siding Lap Siding (Inches) (Inches) Shank diameter .092 .099 Head diameter .225 .240 3When used to comply with Section 2326.11.3,Item 1. • el MF 9 CITY OF COSTA MESA • r 4 BUILDING DIVISION :4t .111 DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER e. nil ' PERMIT !o B01-01091 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 146 21ST ST Status: ISSUED Suite: A Applied: 07/16/2001 Vicinity: PORCH AT FRONT OF DWELLING Issued: 07/16/2001 Parcel Number: 42612108 Zoning: Applicant: REYNO, JOHN & LAURA ISSUED BY: ______yr, Address: 146 21ST ST Phone: 949.548.3000 • COSTA MESA,CA Zip: 92627 Owner: REYNO, JOHN & LAURA Address 146 21ST ST Phone: 949-548-3000 COSTA MESA, CA Zip: 92627 � Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: . Zip: License: License: SCOPE OF PERMIT CONSTRUCT A SOLID COVER PORCH FOR THE ENTRY AT THE FRONT OF THE EXISITING HOUSE.41 SQ. FT.WORK TO BE DONE IN CONJUNCTION WITH A RE-ROOF OF EXISITING RESIDENCE. RE-ROOF WILL CONSISIT OF A TEAR-OFF AND COVER WITH 25 YEAR COMP. . - FEE SUMMARY _ ' Plan Check: $0.00 Calc Valuation: i $4,975.00 Permit: $111.25 Claim Valuation: $4,975.00 SMIP Res: $0.50 - 1 SMIP Corn: $0.00 t Other: $0.00 Inspection: $0.00 Total: $111.75 - '/. ' PLANNING &ZONING: SETBACKS MAIN STRUCTURE Front 25-0 ' Rear 0-0 Left 16-0 Right 24-0 ACCESSORY Front 0-0 - - Rear 0-0 Left 0-0 Right, 0-0 PARKING Existing: 0 Required: 0 Proposed: .0 NOTES: • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections 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 2446-46(NW) DECLARATIONS r1 .C., • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: T ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier end policy number are: Cartier: Policy Number: is se ion need not be completed if the permit Is valued at one hundred dollars($100)or less.) I certify that In the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Sec'on 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: -2 /CO/0 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($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(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In lull force and effect.Llc.R Class# Contractor's Signature: Date: 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,Civil Code). Lender's 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 a d 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 fore permit ubject e applicant to a civil penalty of not more than five hundred dollars($500).): 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: n Signature: Date: ---7(/i.-0l/ Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. /Expites: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework.or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully compiled with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit horn-the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (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: r 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 end 'y ordinances relating to building construction,and authorize representati es of the City of Costa Mesa to enter upon the above-described property for', ction purpose agree not to occupy or allow occupancy of any building authorized by thi pe,/L/^rmit un' final inspection. .ID• J/C?SLS / 7 01 ignature Of L • ner(s) D to And/Or Author :d Applicant Date CODE I. INSPECTION TYPE WAIF INTBIAI$ CODES INSPECTION TYPE RATE INTRLALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site +� /� 204 Final Demolition 250 Final Building/Occupancy 7 6 k-81 s-6L D N±R-- . v poi - olari N/ J- � \ ADDITIONS,EAPPROVED BYI PROVED O CITY OF COSTA MESA G 17 vi ELANNING DIV. S V BJECT, TO BLDG. DE REG. BY DATE //(, 10. .....----. 0 /Y& 2( Sr ISC- r CA u, \ 11°1)-- 1 ,0„ I LIHN z'1',, C1 4. pOr gUiLDi MESA SPAIN1 DI istO_,OF RSV$D �i O �J� �J AYYa L�dv Sys Gdlplymro060016 w so9w-e01aa, 51o0' V10 • Os Khooti YNOYtr> Q. (toe in":' Mrs / pt1R ?� f1W,am.. . 3' .,,,,i(}xi 1fire nov 34 8xf/vvv-- • � � • I t • Se .P.. COn'/RJ5/7""c'rocFbM OvcR. 3006 FELT" 2X Th riDSC ,_, Ani 51 Eta [i/ELL) OF.EX/Sr/h/0 K005 A,JD 9/IFTER.S / Zx6 CC;VIA) 3u 111 f l 6 V' //2" zrevwv OwR z1( 6 vF RnrrExs IZ"OVE oiAN6 . l:°°°°°°°°°°°°°°°°°°<:' litamellIMIMP q7 \ 5/n/run/ CCT94 /zm/e/3EnCING• .1 Dom FIR 41W/ 1. Po9 5 m,PSON 6894 Poli BIS( EX/ST/NC, BRICK ,' i/C I� I I I 117 �� 6rFDa . ,•,1:-3 /Zx/2' POURED CO,Jc rC Fool/NC7 /tee, Z.i 3TRer • CO//N R VA/O . ScfL2 I/4"= /Z" • . .y • • • • • Z. . ., • • hr. ��it i. 1Aitok•-. 34 . / ly • -- — — P - ' rrr - 2 • • JO/JA/ RcxVo %Y " -/2' irc� /YG2/ 57 • .:__ . . . ry) Cxls1— moo:l'I • . • L -1-\:"aci,,� 3 m.ra 'pk i-i--r \ . • . . • 50'4' i�-e...T' u l, 1 ` • am \ I •• _ II -- - . ,- 4\WS �.�..��-f .. . .. � ` __' �1 /'• / ,- . ( . 1 i '1 C. . . • . . . ., Y � I 1 � . . . . . - . .:„. ?Aril, tis—• i .1�]•. _ -- tr • r t -P.T..1. • 7 .3I(Iia • . m,v -r-1 -Digit- . ' IJj n ,p.cn L {)- )1IZ` a�C.0\-4... • JONN RC:rcln 751 " -7/21/ .. ..,qt, 1( rlr Applicant to flll'n.._.-___ - - -...,nn heavy border lines and sign all appropriate declarations. --- F COSTA Nl S l(�jON�S-T/R/U ON PERMIT PERMITG-,21/3. 7 p2N1i$ .7 TR;,c�; q rb UNIT.B r. Projeq%Address ( O�C�Ct /� []( �y 21470 10/17/85 0 .!r/.dc AV . N.a. 2440 TYPE OF CONSTRUCTION NEW LV\DD LI ALTERATION Li REPAIR 16�OIL' T� • - ••ent•rfvlailin ddress�t17_ 9 L7 ❑ CONVERSION ❑ DEMOLISH OTHER • A.P.#.1-7,..47+1Ofi c I Zone Z O •ner•s Name s .4-ti r.(/A a Phone`.#J—(,I-4,4 'r/17/ I) / �` .I( DESCRIPTION OF WORK/US OF BLDG. Address MO 1t✓/"/c Av fCa /9•Q. 9/460 / a 11/7 r01 S Main Building: Accessory Building: �0� Arch/Eng. License No. TYPE OF PERMIT U -RAIDING 111 Fe- •DATIO flW U(TURAL E Front - i efatie,i 7270 ZO Address ❑ TENANT L LECTRICAL V. 'LUM GING ❑ MECHANICAL BB Rear A-�7'� N s ❑ OTHER . _ _ �S/ (' I Contractor's Name O ' Phone C Right • 1 N Address(mailing) PROJECT DESCRIPTION SQ. F / �� OCCUPANCY � ' K Left 3�s�/!j�-�sywQt G CONSTRUCTION TYPE VALUATION $ /0y !2'23 S :/- T� /•�T • 1—, City License No. ZONE �— GRADING CU. 'US. �- ACRESR LICENSED CONTRACTOR DECLARATION � � _ Ping. Ref.# Parking� /Re1gL./Pro`vided� E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: zzei/ Planning Notes: 9 � �Ra �C � M with section 7000) of Division 3 of the Business and Professions Code, and c•Y/ my license is in full force and effect. 7t S— �S s J TS License Class License No. PLUMBING FEES OLD FOR SPECIAL REQUIRE EN'r,9 Date Signature . ORKERS'COMPENSATION DECLARATION Bar Sink Showers - ELECTRICAL FEES rereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink . r 3800, Lab. C.) f Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap - Construction Pole Sub.H ❑ 50+KW>' Certified copy is hereby furnished. - _ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit r ' Meter pup to 100 imps' Date Applicant •• r - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors -Dishwasher - Meter Dover 100 amps (This section need not be completed if the permit is for on&hundred($100) or less). • Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I v J• �I/1 shall not employ any person in any mann so a to be me subject o the Drinking Fountains Solar Tank - / Fan . Motors❑0.1 HP ❑1'h-Br Id/ Workers' Coy�,e f)cn Laws Of Calitoryyyf �-- Date /.0 /� t Signatury, ' .e Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP,0.16-15+ 'NOTICE: I after making this declaration, you should become su tact to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 4 Fixtures Microwave 1 Q comply with such provisions or this permit shall be deemed revoked. — Q I S CONSTRUCTION LENDING AGENCY t Gas Service Outlets apo Water Closet • d.✓0 p 8 Device Boxes - Pole Light I hereby affirm that there is a construction lending agency for the performanceof the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater "ti Outlets Range Lender's Name s L' Lender's Address Kitchen Sink Water Service s 2 Switches r - Sign 0 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 00-5 KW 05-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for Such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains he Contractor's License Law (Chapter 9(commencing with Section 7000)of ^. , )ivision 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 psnalty of not more than five hundred dollars($500). '.. ' 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 I - 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 DEVELOPMENT SERVIC RE UIR MENTS: Boiler Hood or Type thereon, and who does such work himself/herself or through his or her own ADA / employees, provided that such improvements are not intended or offered for0 Zoning Approved By D C Hate 7 K 5 _ sale. II, however, the building or improvement is sold within one year of com- Canopy Type II 0 � pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date/titer/5- prove for the purpose of sale). J '/ ❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By / Date . 25— 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- - BUILDING PERMIT $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration $ F 6 ' .5-0 SMIP II I Proof e their Wounder S Compensation insurance should.& P. C. pfor dedthis to me. PLAN CHECK PERMIT ❑ I am exempt under Section B.& C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING ISSUANCE $ ''// Date owner _Ss-.as ?- /eb Worre 0 seating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00,000 BTU 0100,000 BTL ELECTRICAL $ • GRADING $ information Is correct. I agree to comply with all city and county ordinances 0 MICROFILM $ and state laws relatin o building construction, a hereby authorize repre- PLAN CHECK 5096 $ 1 sentalives of this to ter on the ab entionee pr er y for t� ) f�Ai/�J • F� Signature Date // /inspectlo laW� �Ui0.C+� MECHANICAL $ � + TOTAL I <4 Drivers' License or SS air _ Reinspection Fee $15 - Issue Fee $ 3 PLAN CHECK 25% $ 1 CMF0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod •• Assessor ' ////- // J • • I - cONSTTUCTION AND PLANNING P. & SPA Gate Inspector APPROVALS Permit# APPROVALS Permit# • Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . • 2r Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4' Electrical Conduit-Undrgrnd. 55. Electrical Bonding „ 5. Steel'Reinforcement /43/1.5_ Byi 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings • 84.34.5. ��,� 58. Electrical Conduit-Undrgrnd. • • 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test • i 9. Water Pipe-Undrgrnd. ' . 60. Backwash Lines,P-Trap,0 Undrgrnd. • ' 10. Structural Floor System (ad,QiS „431/26_ .632...2.761. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final ' 13. Roof Grains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring .734 e& 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 0 71. Product Piping 0 Gas 0 Oil e', () 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing //)/Y 4-7,iz '73. Undergrnd.Storage Tank 0Gas 0Oil 25. .Roof Sheathing iktim44-i7 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing' r rya l',40 )97...-Li 76. Dry Standpipe ', 28. Lathing &Siding n't /,/ 77. FIXED SYSTEM FINAL 1 29. Insulation , 62-1/1....77�, 78. FIRE PREV. FINAL 30. Drywall Nailing ?� ((11.th& C''1 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION I 32. Electrical Power Meter-Final ^fts. 80. FOOD CERTIFICATE ISSUED I} 33. Final Electric Y Notes: I34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test z/4/g -00C . ftbLD.FOR SPECIAL REQUIREMENTS .//20.4 !%"� <<� '/ I-. 1- •3•Gmn..r >1i�- c</ /f g ,e't.”,L l•.a7.->• • 36. Ho-od.br Canopy • ^1. /..I i//'� � 1 I/e:77 T // f 0- /•///`�L• 4 (r?i TFC',•7i e,r:7.: 37. Final Factory Fireplace .1-i / '/ 'Jr. • 38. Final Plumbing /ale 7. 7--// r ' A / / l �/ r r / �:rJ T < c' 4l i /?/�d ��L 39. Water Service-Final e/ ' 40. Gas Service-Final '1b_-co I Cg C-t 41. Solar Domestic-Final b dt. � vt 42. Backflow Preventer I, 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 5'/// ' Styli •_ / 48. Special Requirements Completed. � ' L5 49. Electric Release to Edison �'!! _// 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY - - No. •- _ Date _�' , • City of Costa Mesa Building Safety Division Permit No. G21187 Address : 146 "B" East 21st Street Costa Mesa, California 92627 Contractor: Paul ' s Construction - License #Bl 254724 Subject: Building Code Sec. 7012, (d) Disposal I hereby certify that all drainage facilities are in accordance with the subject Building Code Section. L::::‘,746-‘;:dm am R. Howard 0 er NAY 11 1933 City of Costa Mesa INS' '.ATION CERTIFICATIC ) Building Safety Division - .I 84 071 Sr ts7-4f— ,4k11 Number and Street City County Subdivision Lot Number DESCRIPTION OF INSTALLATION / ROOF MaterialV � Thickness (inches) Thermal Resistance (R 1/774/1/ Value Brand Name /LG) EXTERIOR " LL / Material A-1/ Brand Name /m'744," /W/ Thickness (inches) 3 Thermal Resistance (R Value) g—/ CEILING Brand Name /7761/ Batt or Blanket Type v/GG/� q Thickness (inches) �' )/Z Thermal Resistance (R Value) R---r/ Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb. Area Covered (ft2) Z /7 " Thermal Resistance (R Value) "/9 FLOOR, ELEVATED Material Brand Name Thickness (inches) Thermal Resistance (R Value) FLOOR,SLAB Material Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R Value) V-A Mp °1 ° 1988 DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). 57Qeil/ fila3firi .4 (76 Con rector Builder) License Number 2 - �C. Signature4nd Title Date Sub Contractor (Insulation Applicator/ License Number Signature and Title Date CMF 1106-30 MAY 1 0 1®88 MpY 10 1rc8 • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C17V&.f COSTA MESA CONSTRUCTION PERMIT a PER TRACT NO. LOT NO. UNIT NO. l a,' •/ �" •a/ aS ` °�7oZ 6B•(o 93 909 s 0/10/65 I 1 ••Project A dress r t 7// Applicant's Mailin ress _�fi/, � TYPE OF CONSTRUCTION LJ NEWL4ADD ❑ ALTERATION U REPAIR • Owner's Name �z.�•4LJr/�� Phone.SG ❑ CONVERSION ❑ DEMOLISH OTHER A•P•# 4 4 /l/—Op (Zone �So ��✓/fir Q fa4c DESCRIPTION OF WORK/USE OF BLDG. �+�v Address A. S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT�t U GRADING U FOUNDATION U STRUCTURAL E Front 0 e Address El TENANT Ai ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 8 Rear N Contractor's Name ©e _ /-e2 /I(y7s&i / PV1 IF•: ❑ OTHER C` I W M- C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address(mailing) K Left G CONSTRUCTION TYPE VALUATION$ 5 R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I herebyaffirm that I am licensed underprovisions of Charter 9(commencingJ' Q d Remarks:x v Z//�ir Planning Notes: M withysectionIs n full of and effect.3 of the Business and Professions Code,and I`` 67 ! T my license is in lull force and License Class License No. - $ Date Signature PLUMBING I FEES TORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES -,hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW •Policy No. Company Backflow Irrigation - Sewer Cap Construction Pole Sub. 0 50�KW 8 Certified copy is hereby furnished. _ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit i Meter Kip to 100 amps _5 00 Date Applicant -- 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($100) or less). Dishwasher - Solar Piping Dryers ❑Gas ❑Electric Sub Panel - 1 certify that in the performance of the work which this mit is issue I 's Wort not employpin aEany person in any mann o as be/`subject he ' Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1"h-8 Workers, e n Laws of Calilorni _� • Date Signature Q+• Floor Drains Swimming Pool w/Spa --F,A.U. Inc.Solar❑g-15 HP ❑1G-15+ 'NOTICE.If,a er making this declarati n, you should become subj ct 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. CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance + Pole Light whichof the work for this permit Is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets �`� Range J" Lender's Name // s J Lender's Address - Kitchen Sink Water Service Switches a.) Sign • y0 OWNER BUILDER DECLARATION I hereby affirm that 1 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 ❑0.5 KW ❑5-15 KW any structure, prior to Its issuance,also requires the applicant for such permit Trash Compactor o file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains • re Contractor's License Law(Chapter 9(commencing with Section 7000)of .)(vision 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 enalty of not more than five hundred dollars($500). • • I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee 5 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 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 Hood Type I 0 DEVELOPMENSERVICES REQUIREMENTS: Boileror employees, provided that such Improvements are not intended or offered foryp Zoning ApprovedBy sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ Date pie Ion, the owner will have the burden of proving he/She did not build or Im- Duct-Under Ground Building Approved By Date r ye for the purpose of sale). / I^� , I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By l�/ sx� Date -/0--610 rectors 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 ❑o-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 D System Repair/Alteration BUILDING PERMIT $ SMIP § proof of their Worker's Compensation in ranee should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers / PLUMBING • $ ISSUANCE $ Date yy/Q/��S Own Heating System D0100, Registers ENERGY P.C.. $ E . t' PLAN CHECK 25% § I hereby ertif that I have read'th p app all and state that the above ❑0.100,000 BTU ❑100,000 BT GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relati - to building construction, and hereby authorize repre- sentatives of this '"y to er •.n the abov ^nlionetl pro rty or inspection •urp•.- MECHANICAL $ TOTAL FEE ' $ /1. / Signature_;��.. - • •� Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ - • CMF 0865-46.rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor _- - -- - ----- '- "- - -- - -- _ • CONSTRUCTION AND PLANNING P . & SPA I • Date Inspector Date Inspector • APPROVALS Permit# APPROVALS Permit # 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 UFER 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, 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 Zj/ '7C. 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 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 ,! 47v FINAL STRUCTURE & BUILDING SNIT P� 1.n 48. Special Requirements Completed o �Xl�� 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No.. Date :3 75C 4 PAI 103u'35.E 0 COSTA MESA BUILDING-SAFETY DEPARTMENT :ow -2-73 < - • P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - A'P • ION FOR BUILDING PERMIT For Applicant to Fill in Completely AEC= V e p DATE RECEIVED DATE ISSUED BUILDING y� L ,Z - -2. 2 ADDRESS deL,/ G - dr de K/ r�/J7ir l P iiirie. OWNER /r /..w1 c.4. 2r u. _ .._ A.P. NO. — / / MAIL L ` BUILDING A_ *, Z ADDRESS ADDRESS f� `� - CL U CITY T NO.LB LLI TRACT go �j LOT BLOCK Z �G ^ u N KS. CONSTRUCTION NEW ADD ALTER AFFAIR [ VINGI ISH O N LENDER �� /\J(`� j Ci m J D BRANCH // p _i m OWNEREL).p fas,�ji S eo4u ,.J CO J ADDRESS — J/ l/..11//¢¢ / VALUE y///�}}7s�/ m ARCHITECT TEL. USE/AF {(�) �CJ/I Gs /74 J W OR ENGINEER ITECT `- N �� UQ FIRE W CC ADDRESS — ZONE TYPE fr ROUP tlul APPROtC.J 'L 3WZ CONTRACTOR OJ � BY _- DATE/fj2///77- O • Z ¢ ADDRESS W lL W TEL. ZON NO.OF USE OF NE . Z CITY NO. co PLANS a BUILDIN Ea.- '''A/ >��G w-0 STATE CITY YARDS APPROVED YARDS APPROVED co tt LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D 0i SIZE NO.OF BLDGS. �-s (FROM C/L STREET) // /L,o OF LOT /35-; C>5 .1' CZ. C 41 NOW ON LOT v- FRONT FT. /g "6//,6G'7; USE OF n EXISTING BLDG. ?i w�T/S R SIDE FT. , 24 FT, I- SIZE OF NO.OF .// Z NEW BLDG. oc OX el a ROOMS STORIES / L.SIDE FT. 5--F-16 Q EXTERIOR WALL ROOF //// L U COVERING /y 0 o� COVERING pp/ njeo ./REAR FT. - O�CJ �o FT 6e./ J USE OF BUILDING AND WORK TO BE PERFORMED �� DISTANCE BET. BET.MAIN& 1 a .IJ...1 .9 2 6BLDGS.MAIN ACCESS. BLDGS. Q VAR.# DATE O C.U.P.# APPROVED I- Z APPROV �/ +n DATF //tea^�-5 O , \ G=L/ ��F I- I hereby acknowledge that I have read this application and state !V— that the above information is correct and agree to comply with /V/ I- alln laws regulating buildingionf workman's construction, and I shall not laws employ � any person in violation of the workman's compensation laws of N the State of California. 0 m Z I hereby certify that I am property licensed as a contractor under SO. FT. TAX e O the State of California Business and Professions Code, Divisicn 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: o CC am exempt from the provisions of the State of California Business and Professions Cnde,Division 3,Chapter 9. VALUATION C - to 1 ��, r� _ PERMIT FEE $ -r3 Signature of `' �j I/ co Permittee $e:2520 PLAN CHECK $ ‘V. / _ E � LL Authorized Agent TOTAL FEE $ NI COSTA MESA BUILDING—SAFETY DEPARTMENT P. 0. BOX 1200 Costa Mesa, California ELECTRICAL PERMIT APPLICATION .II" _/_-/rCtIrUU 1(z.luVtGtt:'.•TiL{.�U TRACT NO. RECD BY/j1;41.4-4. €�RMIr,No....2.",--'L.-*ELECTRICIAN LOT NO DATE ISSUED CITY ADDRESS BUILDING USE STATE LICENSE NO, CLASS. / BUILDING - CITY LICENSE NO. ADDRESS / . - - ,J/ +- / l ' .c .//,: NO. ITEM EACH FEET COSTA MESA, CALIFORNIA Dwelling, Ft. S NEAREST / Sq. ( ^ CROSS ST. / "y .- _ 0 LU e Garage, Sq. Ft. .. r .T-> O 7--G OWNER/4� - .. ��- n.. ,. A / O First 20 Outlets, each aL,/E S -J- __ - Outlets /, Additional Q - CITY d . ,- , + - TEL. NO. First 20 Fixtures, each I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- } 1 CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE .J Fixtures, Additional TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REG. ULATING ELECTRICAL WIRING. SDryer O _ CALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF D- Fan / TIE SINGLE FAMILY RESIDENTIAL PROPERTY DESCRIBED ABOVE. CL _ / �' i Signature of ,./ • W Heater PERMITTEE �'4' - ' • 2 y _ Oven, Domestic / NO. ITEM EACH FEES f- Pole, Construction / Sign& 1 Trans. 2.00 2 Ct Range, Domestic / Transformers KW LU CL Misc. / ' ,,./..3:51'. P D " f Generators KW 0 (13 Motors (See Schedule) L CO • _ / HP C I- I I ti HP Sub-Total Fees 1 HP APPROVALS r INSPECTOR DATE Meters, ea. TEMP. POLE UNDERGROUND CONDUIT Permit Fee 2 00 ROUGH Sub-Total FessFIXTURES /� POWER r Total Fees �r) UTILITY CO. NOTIFIED FINAL I I r °°" a BLDG. PERMIT NO. For items not listed refer to Fee Schedule -