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HomeMy WebLinkAbout188 22ND ST - Building Permits II . - • CITY OF COSTA MESA enures BUILDING DIVISION 40111o9@ �5 I IQ 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us v. FOR INSPECTIONS CALL: (714)754-5626 '`ate"" PERMIT NUMBER: B10-00383 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42606113 DATE ISSUED: 12/10/2010 ISSUED BY: RMD JOB ADDRESS: 188 22ND ST CM Suite/Unit: Vicinity: BUILDING 2 AND 3 APT BLDG Squares: 1400 Valuation: $6,120.00 ' SCOPE OF WORK: REROOF SOUTH APRTMENT BUILDING ONLY(BUILDING 2 AND 3).TEAR OFF EXISTING ROOF MATERIALS, APPLY HOT ASPHALT BUILT UP ROOFING WITH CAP SHEET,APPROX 1400 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. OWNER: SALE,GEORGE BARRIE TR Address: 4 SAWGRASS DR Unit: PHONE: City/State/Zip: NEWPORT BEACH,CA APPLICANT: WOLSKY, BRIAN Address: Unit: : PHONE: 714-847-9332 City/State/Zip: CONTRACTOR: TOM BYER ROOFING License No. 575002 Address: P O BOX 771 Unit: PHONE: 714-847-9332 City/State/Zip: HUNTINGTON BEACH,CA 92647 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $139.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $140.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE N. INSPECTION TYPE DATE INTITIALS CODE S INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing A 200 Final Re-Roof Y )-oZ0_// iY)p 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 • WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑ No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized SI 0-c- by this permit,and that no building structure,scaffolding,falsework,or demolition (Carrier:(Carrier: 'T7� or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need nol bemndetedtthe permit a valued al one hundred dollars($100)o less) 2,Art 2Sec 341,the S,California Administrative Code). (}'olicy-Number: ( (P/O-1 7 ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Dale the Labor CetfeT h fort with comply with these provisions. /'LA)/V Division of Industrial Safety Permit Number: AopbcaN's Stgnalure - GDate� HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions. that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No tLicr#-'-5?-cr60'-!— CC -' (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by /27/e i(a each business which at any one time has on hand a quantity of acutely actor' .ignature 05te 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑ No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property. or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon.and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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 b thi it until final inspection. Signature of Legal Owner(s) Date Signature Dale r1A ) Lsf, I t//y/ 0 305]<6(3(07) LAndJor.AulhodzedAp nt -- 31e�,�� Prescriptive Certificate of Compliance: esidential CF-1R-ALT_ Residential Alterations (Page 1 of 5) W;oject,Name: /V 8 �� to O w 4 3 Climate Zone if • 'n I q ot_Stoiies-1 1(/ Z General Information Site Address: !i a r.,D Enforcement Agency: CP I Date: ! Z/to/ft o Building Type D Single Family I$CMulti Family Circle the Front Orientation:N,E,S,W,or degrees Project Type: D Alterations 0 Envelope D Fenestration RI Roof 0 HVAC Conditioned Float Area(CFA): Replacement or Change Out 0 Duct Replacement 0 Water Heater NOTE: This form is nor to he used Jar Newly Constructed Buildings or Additions • Insulation Values For Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration O Opening of framed cavity alone-Alterations that involve the opening of the fr ented cavity of a wall, ceiling, or floor must install the tnandaio t'minimum insulation value per.€150.for the altered assembly.Fill in Columns A-C and enter mandatory insulation value in Column H. 0 Replacement of entire assembly-Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package-U insulation values in Table 151-C. Fill in Columns A-J. • Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. 'A B C 1 D L F C ii - 1 - I J Proposed Sec ha'" Standard Values From JA4 Table • Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- 1A4 Table Cavity insulation Assembly Assembly IDS or Type' and Size? _ or Other' factor' Numbers R-value6 R-Value' Cell Values U-factor9 Nose:For furred assemblies,accounting for Continuous Insulation R-vatue,see Page J244-3 and Equation 4-1, For calculating fumed walls use the Mass and ;Purring Construction table below. 1.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name o"type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space, Doors and etc...Indicate the Frame type and Size:For Wood, Metal, Metal Buildings,Mass, enter 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; IC"or 24"OC;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4.Based on the Climate Zone;enter the Standard U-factor front Table 151-B, C or D for each different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-value that is being installed in the watt cavity or between the f'coning; otherwise, enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly; otherwise, enter "0". S.Enter the row and column of the U-factor value based on Column F Table Number and enter the Assembly U-factor in Column J 9.The Proposed Assembly U-factor, Column J. must be equal to or less than the Standard U-factor in Column E to comply. Furring Strips Construction Table for Mass Walls Only A I B C D I E F L C f H 1 1 3 1 K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5,4.3.6.4.3.7 Joint Appendix Table 4.3.13 U j Y m V Assembly 5- 3p .rt H Is e` d,'? Lau '.4, Final Mass Name or 1A4 Table - ✓. • _ E c o .5 m Assembly Thickness' Type' Number' ui r U-facto ' Comment Registration Number: Registration Date/time: HERS Provider: 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compl : Residential , CP-AZ-ALT- - t Residential Alterations • (Page 3 of 5) Hroje tNa me:f"s a' Climate Zone# #ofS[ories /1/4.,1> z • • ROOFING PRODUCTS(COOL ROOFS)§151(1112 When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 ff, whichever is less,the nein roofing area antst meet the roofing product "Cool Roof"requirements of§152(b)llii, 152(b)lHii, or 152(b)IHiii. Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof:requirements. Note:If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in §118(t)are not applicable.Do nor fill table below. Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. !]Cool Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 51b/ft2. Alternatives to§152(b)IHi and §152(b)Hii,Steep-slope roof(pitch>2:12) 20 Insulation with a thermal resistance of at least 0.85 hrft2'°F/Btu or at least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ Existing ducts in the attic are insulated and sealed according to§151(f)10;or ❑ In climate zones 10, 12 and 13,with 1.W.of free ventilation area of attic ventilation for every 150 ft2 of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§151(02;or ❑ Building has no ducts in the attic;or ❑ In climate zones 10,Yl, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exception to§152(b)1Hiii,Low-slope roof(pitch_S2:12) ❑ Building has no ducts in the attic. Other Exceptions ❑Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. 0 Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ft2 is exempt from the below Cool Roof criteria. Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofin Products"Cool Roof'Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' , 5 2:12 >2:12 < 51b/ft2 > 51b/ft2 Type2 Reflectance3'4 Emittance SRI5 ❑ ❑ 0 0 ❑4 ❑ l 0 0 0 04 ❑ ❑ 0 0 ❑4 0 0 ❑ ❑ 04 0 ❑ ❑ 0 ❑4 1. The CRRC Product ID Number can be obtainedfromthe Cool Roof Rating Council's Rated Product Directmy at www.coolrooliart/products/.seat'ch.php 2.Indicate the type ofproduct is being used for the roof top,i.e.single ply roof,asphalt roof metal roof etc. 3. If the Aged Re/Ieelance is nor available in.the Cool Roof Rating Council's Rated Product Direct my then use the initial Reflectance value front the some directory and use the equation(0.2+0.7(p,,,irint—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check hos if the Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value lm using the SRI- Worksheet at hits://www.enern'.ca.env/lille24/and enter the resulting value in the SRI Column above and attach acopv of the SRI- Worksheet to the CF-1R. To apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in §I180)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other Registration Number: Registration Date/Time: TIERS Provider: 2008 Residential Compliance Forms • August 2009 y FI'rescriptive Certificate of Compliontesidential CF-IR-ALT I Residential Alterations (Pa 0e 5 of S) • . - Projeci.Pla me: • 025 2-a N- Clima teZanc I a; of-Stories HERS VERIFICATION SUMMARY The eatorcwnmu agency should pop special auenrion to Mc HERS Measures specified in this checklist below A completed and signed CF-41t Form for all the measures specified shall be submitted to the building inspector beforc'frnol inspection. Duct Sealing & Testing HE/RS verification is regmredlar rhi., measure. ❑YES ❑ NO YES:In Climate Zones 2 and 9-16,if more Chau 40 linear feet of new of 'enlacement ducts are installer) in unconditioned space,the ducts are to be sealed per§152(b)IDii and the newly installed ducts are to be insulated per §151(1)10. ❑ EXCEPTION:Existing duct systems thin are extended, which are constructed,insulated or sealed with asbestos. ❑YES 0 NO YES:In Climate Zones 2 and 9-I6, if the existing space-conditioning system(HVAC equipment and ducting)is replaced,die ducts are to be sealed per§152(b)1Di. ❑YES 0 NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,of the furnace heat exchanger)the ducts are to be sealed pet §152(b)IE. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS • verification in accordance with prucedures in the Reference Residential Appendix RA.3. O PXCEPPION:Duct systems with less than 40 linear feet in unconditioned space. ❑ EXCEPTION:Existing duct systems constructed,insulated or sealed with asbestos. R- efrigerant Charge- Split System HERS verification is required for this measure. ❑YES ❑ NO YES:In Climate Zones 2 and g-I5,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge measurement shall be verified per§152(b11F. C- entral Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of 4150(o)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is regal red[or this measure. - ❑ YES 0 NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified per§152(b)1Ci to meet the renuire ments of§I51(f)7B. '_Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. -Name: I Sigaaz [-Documentation Wo (ski Company: p ,{� I �^ Date: gav,— tjer UCooc (2 /io (/IO Address: 66 If Applicable 0 CEA or 0 CEPE I 9'� I - /tAt+ .�-� (Certification 1/): City/State/Zip: Phone: ,Responsible Building Designer's Ileclaration Statement • I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify thin the energy features and performance specification:•for the building design Identified on this Certificate of Compliance conform to the requirements of Title 24,Parts I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance are consistent with the information provided to document this building design On the other applicable emmplimtee form:., worksheets,calculationt, plans and specifications 51'bnu tied to the enforeement agency for approval with this building permit application. Nance: Signature: Company: Date: Address. License: City,/StaurGp: I Phone: 1 ) Tor assisuoice or question:. regarding the Energy Standards, contact the Energy Hotline at: 2-800-772-330(1. itcguv arum ldandreer' itegrsannor.bene/Time HERS Provider. 20W:Residential Compliance Forms August 2009 I. • .+ CITY OF COSTA MESA r , ,01w4. BUILDING DIVISION am„fS,l 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. We . FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: B10-00328 • PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42606113 DATE ISSUED: 11/04/2010 ISSUED BY: RMD JOB ADDRESS: 88/22ND SSM Suite/Unit: Vicinity: BUILDINGOAPT BLDG Squares: 1200 Valuation: $4,895.00 SCOPE OF WORK: REROOF SOUTH APRTMENT BUILDING ONLY(BUILDING 1).TEAR OFF EXISTING ROOF MATERIALS,APPLY HOT ASPHALT BUILT UP ROOFING WITH CAP SHEET,APPROX 1200 SF.REPAIR AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. OWNER: SALE, GEORGE BARRIE TR Address: 4 SAWGRASS DR Unit: PHONE: 714-719-0748 City/State/Zip: NEWPORT BEACH,CA APPLICANT: WOLSKY,BRIAN Address: Unit: : PHONE: 714-847-9332 City/State/Zip: CONTRACTOR: TOM BYER ROOFING i License No. 575002 Address: P 0 BOX 771 Unit: PHONE: 714-847-9332 City/State/Zip: HUNTINGTON BEACH, CA 92647 CELL: • ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $111.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $112.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODEC. INSPECTION TYPE DATE INTITIALS CODEC INSPECnON TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final , L 208 Final Plumbing 200 Final Re-Roof u II-11- /O Ff rn 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑ No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. - Expires: f. ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized -.e r F t by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: r+�^C or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Gm (This sector)need 001 be completed tithe permit is valued al one hundred dollars($100)or less) 2,Art 2Sec. 341,Title B,California Administrative Code). Policy I b (O't:- ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued. I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Aoppeanps Signature Date the Labor Code,I shall forthw . •• these provisio s. /,y//V Division of Industrial Safety Permit Number: C 'rat l-'•' _ ignalure Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic. coca_ Class Cl (Section 25533 of the California Health and Safety Code, with some .'// exceptions, requires registration with the Costa Mesa Fire Department by t ./- O`l y U each business which at any one time has on hand a quantity of acutely .Cont Qor's tawre (—Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: _ 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. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8. (If'yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). - information given above is correct. I'agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. ❑ 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 Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. egal Owner(s) PPD ate Signature Date (�a(Oli /I/ O 3057-46(3/07) And/or Authorized Appltcanr ✓'{-- b •I /-i rescril tive Certificate of Compliance: Residential CF-1R-ALT •' I Residential Alterations (Page 1 of 5) Project Na ac 7 Y I Climate Zone itic::::) 1.4 of Stories Sotue 6e 1X4 2 — IGeneral Information / // / Site Address: t s3 -2_)._ s Enforcement Agency: / ' (+/j Date: /1 /y jir o • Building Type 0 Single Family try Multi Family Circle the Front Orientation:NO, W,or degrees Conditioned Floor Area(CM): - Project Type: ❑Alterations ❑ Envelope 0 Fenestration %Roof 0 HVAC Replacement or Change Out 0 Duct Replacement 0 Water Heater NOTE: This form is not to be used for Newly Constructed Buildings or Additions • Insulation Values-For Opaque Surfaces(for Furring use the Mass and Furring Snips Construction table below) Assembly Alteration ❑ Opening of framed cavity alone-Alterations that involve the opening of the framed cavity of a wall, ceiling, or floor must install the mandatory minimum insulation value per§150 for the altered assembly.Fill in Columns A-C and enter mandatory insulation value in Column H. ❑Replacement of entire assembly-Replacement of an entire wall, ceiling, or floor assembly requires the installation of Component Package-D insulation values in Table 15)-C. Fill in Columns A-J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. -A Is 1 C I DE ' F I G H - • .1. . A .J Proposed sae noir Standard Values From JA4 Table ' Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID' or Type' and Size' or Others factors Numbers _ R-value° R-Value' Cell Values U-factor9 • Note:For furred assemblies,accounting for Continuous Insulation R-value.see Page JA4-3 and Equation 4-1. For calculatingfurred walls use the Mass and r Furring Construction table below I.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space,Doors and etc...lndicate the Frame type and Size:For Wood, Metal, Metal Buildings,Mass, enter 2x4, 2x6,or etc... see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"OC;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... 4.Based on the Climate Zone:enter the Standard U factor fr oar Table 15)-B, C or D for each different assembly Name or time. 5.Enter the Table number that closely resembles the proposed assembly. • 6. Enter the R-value that is being installed in the wall cavity or between the framing;otherwise, enter "0", 7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0". 8.Enter the raw and column of the U-facto'value based on Column F Table Number and enter the Assembly U-facto'in Column J 9.The Proposed Assembly U factor Column J, must be equal to or less than the Standard U-factor in Column E to comply. _Furring Strips Construction Table-for Mass Walls Only A Is C D ] E _ F _ C H I .1 K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference Joint Appendix Table 4.3.5,4.3.6.4.3.7 Joint Appendix Table 4.3.13 V c u e E _ � ._ u t.2-6 U L t F S 3 - w Assembly 2- D E .g. C, L U "-„ Final Mass Name or JA4 Table . :> _ � , c "Ir. "e, 't q V r, G Assembl Thickness' Tyne' Number' :- S ° ui c_ n u` G a? C 4 i W g U-factor' Comment I I I I I 1 I Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compli. :: Residential _ CF-IR-ALT il Residential Alterations' XrProject , (Pae 'pr 5) Nngrc� } --D Climate Zone# , ,t o 1! AP ROOFING PRODUCTS (COOL ROOFS)§151(/)12 When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area, or more than 1,000 ft', whichever is less, the new roofing area must meet'he roofing product "Cool Roof"requirements of§152(b)IHi, 152(b)1Hii, or 152(b)IHiii. Check applicable alternative or exception below if the roof alteration is exemptfrom the roofing product "Cool Roof'.requirements. Note:If any one of the alternatives or exception below is checked,the Aged Solar Reflectance and Thermal Emittancc requirements for roofing products in §118(i)are not applicable.Do nor_fill table below. ,Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. ❑Cool Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 516/fi2. Alternatives to§152(b)Illi and§152(b)Hii,Steep-slope roof(pinch>2:12) ❑ Insulation with a thermal resistance of at least(185 hr-112-7/Btu or at least a 3/4 inch air-space is added to the roof deck over an attic;or ❑ Existing ducts in the attic are insulated and sealed according to§151(1)10;or . ❑ In climate zones 10, 12 and 13,with 1,fit.of free ventilation area of attic ventilation for every 150 ftt of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or ❑ Building has radiant barrier in the attic meeting the requirements of§151(02;or ❑ Building has no ducts in the attic;or ❑ In climate zones 10, II, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exception to§152(b)111iii,Low-slope roof(pitch S 2:12) ❑ Building has no ducts in the attic. Other Exceptions . ❑Roofing area covered by building integrated;photovoltaic panels and solarthermal panels are exempt from the below Cool Roof criteria. .❑Roof constructions that have thermal mass over the roof membrane with at least 25 lb/fl' s exempt from the below Cool Roof criteria. • Note:If no CRRC-1 label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofing,Products"Cool Roof-Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number' < 2:12 >2:12 < 51b/ft2 > 51b/ft' Type2 Reflectance" Emittance SRI5 ❑ ❑ 0 ❑ ❑e ❑ ❑ 0 0 04 . ❑ 0 0 0 ❑4 ❑ ❑ 0 ❑ ❑4 ❑ ❑ ❑ 0 ❑4 I. The CRRC Product ID Number can be obtainer/from the Cool RoofRating Council's Rated Product Directory at www.coolraofr,ort/oraducts/search,nha 2.Indicate the type of product is being used for the rooftop,i.e.single-ply roof asphalt roof,metal roof etc. 3. If the Aged Reflectance is not available lathe Cool Roof Rating Council's Rated Product Director'then use the Initial Reflectance valuefrom the same directory and use the equation(0.2+0.70,,,ir;at—0.2)to obtain a calculated aged value. Where p ii the Initial Solar Reflectance. 4. Check bar lithe Aged Reflectance is a calculated value using the equation above. 5. Calculate the SRI value by using the 510- Worksheet at hitp://wwuterrerel'.ca,eav/litle24/and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF-JR. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in§I 18(1)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms - August 2009 • Prescriptive Certificate of Compliau..e: Residential CF-IR-ALT ; Reside/»ial Alterations (Ya2e. 5 015) , Project Nanme: , ^ ^ "1? Climate Zone I t of Stories C8 L —I— HERS VERIFI CATION SUMMARY The enforcement agent should pay special altenlian to the HEIS hdeasures specified rn this checklist helms A completed and signed CF-41(Faun for all the measures specified shall be submitted to thr building inspector heforr'final inspection. Duct Sealing & Testing HERS verification is required for this measure. ❑ YES 0 NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feel of new ur replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)IDii and the newly installed ducts are to be insulated pet §151( )l0. O EXCEPTION: Existing duct systems that are extended, which are constructed,insulated or sealed with asbestos. Q YES ❑ NO YES:In Climate Zones 2 and 9-16, if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be seated per§t 52(6)1 Di. Q YES ❑ NO YES:In Climate Zones 2 and 9-16, if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed pet §152(b)IE. ❑ EXCEPTION: Duct systems that are documented to have been previously sealed confirmed through HERS • verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION:Duct systems with less than 40 linear leet in unconditioned space.• .... ❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos. Refrigerant Charge - Split System HERS verification is required for this measure. Q YES ❑ NO YES:In Climate Zones 2 and g-I S,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge measurement shall be verified per§152(b)1F. Central Fan integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150(0)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. - ❑ YES ❑NO'YES:in Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified per§152(b)l Ci to meet the requirements of§151(f17B. Documentation Author's Declaration Statement 4N7 • I certify that this Certificate of Compliance documentation is accurate and complete, Name:� wok, ^^ Si<te. 1 rnL ,n WY m Company: ore\ 9, i« b0I? s tt��1l Address: '' � " L ! - If Applicable CEA or O CEPE vats 1 -3'Vr (Certification t!): Cit 1St te/Zip: ho ne_: Y A 1 C ,Qr X26 i i- � a-f ci3)• 2 Responsible Building Designer's Declaration Statement a I ant eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • I certify that the energy features and performance specification::for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Ports 1 and 1'of the California Code of Regulations. • The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this building design on the other applicable compliance forms, worksheets,calculations,plans and specifications submitted to the enforcement aeeney Iia approval with this building permit application. Name: Signature: Company: Dote: Address. I License: City/State/Zip: Phone: ( For assistance or questionr regarding (lie Energy Standards, contact the Energy Hotline at: 1-8011-772-330. Registration Hu nher- Registration Lae/Time HERS Provider: '1 200':Residential Compliance Forms August 2009 UWN CK AWAtJU , wl.l UAIt 7 iv Iv JOB ADDRESS 188 E. 22nd St. BUILDING PERMIT NO. 35969 . GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Legalize Carport ':A 118-081-07 LOT TRACT FIRE ZONE VALUE $ 1,000.00 ::INSrECTIONS Signature Dote TYPE IV GROUP J ZONE Rd tSGAIL SUBCONTRACTOR PERMITS ISSUED [ Date I Number Signature L.IW ATER Plumbing ROUGH PLUMBING PROP. SWR. LINE 0 HOUSE CON. EI SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE�TOR POLE UNDERGROUND LJ POWER 0 ROUGH WIRING Heating and Vent. TRENCHES El FORMS ❑ STEEL REINF. 0 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT in PL' FR, BROWN COAT Si URAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING. FINAL AND GAS TEST n ELECTRIC, FINAL 1 ,' p� BUILDING, FINAL �i'> r PAID 38VL9 %FP 10-74D .00 38” *** ZC.SC COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely 'PP IC TION FOR BUILDING PERMIT `' J SEC /IV� /Qi DATE RECEIVE• D•TE ISSUED BUBUILDING ORENS VA`/• 579 w„.7..cd.sit . all / l �jQ— 0-i 1, -- 0 A/ OWNER Yi'tn \LNWilift.l . A.P.NO.IIg'+ 6a /-07 P R 7 coL BUILDING �^ _/^/l� ,'•-d`/.��(�-' ADDRESS JMAIL A E27 al Sl • ADDRESS /Se? `j, 7V cr d U CITY J ;to._ 'VtLLI�CI . NOL 4'g5-p t I I TRACT,4(.j LOT I BLOCK Z I CONSTRUCTION NEW AOQJ ALTER REPAIR MOVING: DEMOI ISH O co LENDER J D BRANCH OWNER J 1ft,J NADDRESS 2'''mJ LL{ , / ALUEC.:2ARCHITECTTEL. USE ( / S/ �� J OR ENGINEER NO O< FIRE ' V WQ 20NE TYPE } y GROUP lL ADDRESS 1 ///��� d w /� APPROVE y_/c _�/ JO CONTRACTOR OW')LUL Li4.44.61P4 BY DATE / V /sf- CO Z73 6 - A/spec z v lir ADDRESS W W TEL. zoNp I NO.OF USE OF NEW O= CITY NO. � � PLAN BUILDINCrn Orf Zr W O STATE CITY YARDS APPROVED YARDS APPRO ED to m LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING — OO 512E tNO.OF BLDGS. (FROM C/L STRE(FZ!y OF LOT id I NOW ON LOT FRONT l$r/ F9`" G_ ,P- FT. USE OF `` EXISTING BLDG. , R SIDE AFT. FT. I— SIZENEW al V,11,& NO.OF A �^ r// C ^/ I- NEW BLDG. ROOMS STORIES L.SIDE Gt[ (F� n V FT. EXTERIOR WALL ROOF / \i V COVERING I COVERING REAR 9/Fc--- FT. �- J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& a MAIN BLOCS. ACCESS.SLOGS. Q / ILS. & - 4tg-r L/ Z_ VAR.* DATE O ` V L� _C.U.P.#W APPROVED I- APPROVED ✓V A/// / /) v cn —a DATE BTAI 0 I hereby acknowledge that I have read this application and state E O that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ any parson in violation of the workman's compensation laws of t TAX CO the State of California. WtW0 ? I hereby certify that I am properly licensed as a contractor under SQ. FT. d the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Z Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2 am exempt from the provisions of the State of California Business and Professions Code, Division 3,Chapter 9. VALUATION �t tj-9- N /}jf PERMIT FEE $ U Signature of `� " - dl Permittee .. f.//,42,11C4_444 . $ /I O " PLAN CHECK $ E ((//(�/CV/ , o Authorized Agent —ALL \ TOTAL FEE $' "n^L^ EBERLE, Jake vAIc o-Ty-76 ;JOB ADDRESS 188 22nd Street BUILDING PERMIT NO. 42679 GENERAL CONTRACTOR Owner/B1dr, DESCRIPTION of WORK normo PPS e r.,/tea,-rte,-r LOT TRACT FIRE ZONE VALUES yin on ' IN CTIONS Signature Date TYPE ' GROUP ZONE SOIL SUBCONTRACTOR PEf2MITS ISS4ED GAS Date I Number I Signature WATER Plumbing O ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. w SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ _ . ROUGH WIRING Heating and Vent. TRENCHES U FORMS ❑ STEEL REINF. 1] FLOOR SYSTEM BOND BEAM n STEEL REINFORCE in ' SHEATHING FRAME AND FLASHING LATHING - IN n OUT In PL'-'ER, BROWN COAT SI URAL, FINAL Flertric HEATING, VENT., REFRIG. AND A.C., FINAL rJ PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL (, BUILDING. FINAL ate f,44 .7; CC PA30^ {:it:i:.{: 4<^6Z� P 16 7f cm- UO 737 = S.SG COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill int Completely —Use Ink Only RECEI/G DATE RECEIVED' yT� �D� BUILDING 8 '� I/ %7/ ADDRESS / / I't y! /- A.P. NO. PER2 OWNER ♦ YYK��� `h MAIL ''7 /}/�{'' ,.� �y� BUILDING ADDRESS 20 L — i4 --W t-a ADDRESS /��� Z_Z -51! - i I CITY C s M ( NOlcy'H , TRACT LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING: DFMOI ISH LENDER BRANCH .;�� OWNER _Gc�_ ADDRESS VALUE ARCHITECT TEL. USE $ i ; OR ENGINEER NO. FIRE ADDRESS ZONE TYYPPEEGROUP/ S CONTRACTOR APPROVED /?".61----DATE '7 _`'—',' ADDRESS f TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. F^ STATE CITY YARDS A''',ROVED YARDS APPROVED gLIC.NO. LIC.NO. MAIN BUI '.ING ACCESSORY BUILDING Ora SIZE I NO.OF BLDGS. (FROM C/L STRti.T) B. OF LOT NOW ON LOT FRONT FT. \ FT. USE OF VI EXISTING BLDG. $,SIDE FT. FT, (-• Separate permits are required for L.SIDE FT. FT. G electric,plumbing and heating work. REAR FT. FT. PaUSE OF BUILDING AND WORK TO BE PERFORMED Q DATABLE BET. BET.MAI ' MAIN BLOC'S. ACCESS. S. BL P C _ aDE�ot/J "' /v . VAR.# C.U.P.# DATE APPROVED APPROVED/ 4 / /Q� —B _DATE ce 0 I hereby acknowledge that I have read this application and state in p4 that the above information is correct and agree to comply with m Q+ all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of Ld.1. ' the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION e PERMIT FEE $ and Professions Code,Divi Ion 3.Chapter 9. ♦ to m '� l PLAN CHECK $ ^ o Signature of '�1 ' LL Permittee $ 5 ©V TAX $ ¢- I 5---6 U Authorized Agent TOTAL PAID $ h a 6-19 CITY O" 'OSTA MESA PA nit FEES N2 16 5 Fee PaymentnReceipt /7 r� Project Address jg p �(� d 57 4, 6 , C Park Area v A. P. No./Ig /—/©P / /—,07 Building Permit No. '7 / 3 e-/6 Owner's Name _kiOl 14.P. `ihe l e_, Mailing Addresse/O7 /Q/10 Ger (I:, 14 ' FEE Single Family * No. of Units @ $455.20 = Multiple Family ** No. of Units S @ $321.32 = /g 7------q—,A p Total Fee ,/� %6 3, 7Panning Department Approval Date ft7 t0 By e6t.) /F' 19�IApplicant's Signature ,� / �O * City Ordinance 72-44 / ** City Ordinance 72-45 *** City Resolution 74.124 rtl�li; ON -Planning;Canary-Planning;Pink-Finance;Goldenrod-Applicant CMF 0174.26 IU' 7 UU a . PAIL Y -k..�+'• 41340 r° 95 76�>>icroo 964'• 141-�8 ' COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • 'PL.I •TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink 0 y _ REF I Es BY DATERECE DA 'EI SU 6 BUILDING (J l �"L : • / - , 2s ADDRESS 5 / L / I • C S 'ER IT N•. OWNER ''.��``''�JJG.-Q� i Ge p A.P.NO. `�Q tY��F /� n(' �-�• _ BUILDING 61 OM rn MAIL ADDRESS ' /2// ' • L7 LI,'f ADDRESS `5 C _posy/—,�. At,A4c' , CITY C. (11 f N o`s'—q.S—iL.6.SJ TRACT ,� LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH LENDER BRANCH X 1 / p` n OWNER V Of Err ADDRESS j Vsod / � $*g, Ow ALUE ARCHITECT TEL. US OR ENGINEER Nom/' ADDRESS ZONE TYPE GROUP `/ IV / APPROVED /// CONTRACTOR 62/14. BY DATE ./� ADDRESS 50-1/...-..-Q____ ZONA NO.OF h USE OF NEW 3Lifac.t' � 2 CITY NOL ot PLANSOC- BUILDING W,S F STATE CITY YARDS APPROVED YARDS APPROV ED LIC. NO. `I LIC.NO. MAIN BUILDING(FROACCESSORY BUILDIN TTAA((QQ(( 14 SIZE Bs OF LOT /37 / }F 6(J/ INOWONLOTS FRONT WET. C/LSTRET TY7 ' ^•,�/ T a USE OF '` /W�O��`Y_•• f-• d.ly. co EXISTING BLDG. R.SIDE SFT. FT. C0') I-. Separate permits are required for L.SIDE ST. FT. electric,plumbing and heating work. WREAR �.JFT. FT. \I (..i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDGS. 74-05- ACCESS.BLDGS. �/ �y 'et '�/�'��7R / C UVARP. APPROVED d l/%/�d >-. 7471.74-4,/�� nuC L43VIt -flPPROVED�� y )/\ t DATE1-1-1-7(� ed VCS n - Mfflttb` S, r. .� O I hereby acknowledge that I have read this application and state (X that the above information is correct and agree to comply with m Lall laws regulating building construction, and I shall not employ 72 Z any person in violation of the workman's compensation laws of � �� d •5 the State of California. /j]A� �/ //F}/,� I hereby certify that I am properly licensed as a contractor under � "tD. FT. / tared �(,� the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION k-4 < and Professions Code,Division 3,Chapter 9. �5 n Signature of /j/' ��]] PLAN CHECK $ �VV/ rio Permittee `r $ Q� /�rsi TAX $ / ]�i U. 2 �JTB U Authorized Agent TOTAL PAID $ 1 ..• f 4 ( 3 4APR -,-7EP„s`.00 082 =:*•Z71.ro COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PP CA ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Inc Only R C I ED DATE RECEIVED O T,EQ//sld�SUE ADDRESS�BUILDING I s.S'� Q,�/� �~ `t �t ER IT N�� OWNER t$ E s e R.I..c ,l A.P. NO. A rys /s MAIL 1"-- ADDRESS ( 1 2 Z ' sr V t�y ADDRESS ADDRESS fXJ O G TEL. TRACT I LOT BLOCK CITY NO. CONSTRUCTION NEW (ADD ALTFR REPAIR MOVING OFMOLISH LENDER v`Y\' BRANCH OWNER I I Kc p�.�Ba z,.,_e ARCHITECT TEL. US IJ I)11 rQrt"t gsai: C7 ----_, OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE INO.OF USE OF NEW PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED gLIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING (4 SIZE NO.OF BLDGS. (FROM C/L STREET) 0. OF LOT NOW ON LOT _ FRONT FT. FT. Q - OF 4 EXISTING BLDG. A SIDE FT. FT. rA I-. Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. W_ REAR FT. FT. E... USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& k$ MAIN BLDGS. ACCESS.BLDGS. VAR.+ DATE :1C.U.P.# APPROVED a APPROVED 3-1 BY DATE a w A. I hereby acknowledge that I have read this application and state n N IX that the above Information is correct and agree to comply with m 0v all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of o the State of California. m I hereby certify that I am properly licensed as a contractor under SO. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:i^ ve am exempt from the provisions of the State of California Business VALUATION ERMIT FEE $ / 71 and Professions Code,Division 3,Chapter 9. N Signature of PLAN CHECK E o u. Permittee $ V_ TAX E U I7 U Authorized Agent ` TOTAL PAID S—(! —