Press Alt + R to read the document text or Alt + P to download or print.

No preview available

The URL can be used to link to this page

Home My WebLink About231 24TH PL - Building Permits 449 •5 11 M6 9 CITY OF COSTA MESA BUILDING DIVISION • ra.ru ,r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER Ftwnimpsair � PERMIT 06-00922 st4t.okars, (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa� LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 231 24TH PL Status: ISSUED Suite: Applied: 06/12/2006 Vicinity: Issued: 06/12/2006 Primary Occ: R3 Type of Construction: V-N Parcel Number 11910170 Zoning: Applicant: UNKNOWN Address: Phone: ISSUED BY: Zip: Owner: COLLINS, DAVID L & JENSON, MARY Address 231 24TH PL Phone: 949-631-7904 COSTA MESA,CA Zip: 92627 Contractor: Address: • Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT 450 SQ FT PATIO AND DECK FEE SUMMARY Plan Check: $99.61 Calc Valuation: $7,254.00 Permit: $153.25 Claim Valuation: $0.00 SMIP Res: $0.73 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $253.59 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 10-0 Left 5-0 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 2446.46(WOO) 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 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,end 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 aviL RNES up TOONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(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 4 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: 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 Bus' ess 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 s I cts 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.). ❑ ex:pp under sec. Business and Professions Code for this reason: nature' OS .Si ' res:GT S 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). - CI 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 ❑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 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 ap$ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U 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 ryes",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 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- ibed prop rt.4: 'on pu •oses.I agree not to occupy or allow occupancy of any building authorized by this permLuntil final inspection. eAr Signatu e 0 Leg: a ner( l " D And/Or Authorized Applicant Date CODE N INSPECTIONTYPE au INTITIALS CODE. INSPECTION TYPE PATE )NTRIAL$ 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 e T��_ 204 Final Demolition _ _ _ 250 Final Building/Occupancy /-24$-Op eke N CITY OF COSTA MESA `9p • BUILDING DIVISION Fpg" r 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov t.i FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER: B11-00395 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 11910170 DATE ISSUED: 11/14/2011 ISSUED BY: KJB • JOB ADDRESS: 231 24TH PL CM Suite/Unit: Vicinity: Squares: 3100 Valuation: $7,500.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATHING AS NECESSARY.COVER WITH 30 YR COMP SHINGLES. ROOF PITCH IS 4:12. INCLUDES ATTACHED GARAGE.APPROX 3100 SQ FT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: COLLINS,DAVID L Address: 231 24TH PL Unit: PHONE: 949-631-7904 City/State/Zip: COSTA MESA,CA APPLICANT: COLLINS,DAVID L Address: 231 24TH PL Unit: : PHONE: 949-631-7904 City/State/Zip: COSTA MESA,CA CONTRACTOR: OWNER-BUILDER License No. 000000 &dress: Unit: PHONE: /City/State/Zip: CELL: ARCHITECT: License No. PHONE: Jr ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $153.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 ot TIOTAL FEES $154.25 tr HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 . Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm.Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day ,?,V ;NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related ,regulations. (Ord,No. 92-28, § 1, 12-21-92) 'EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. Coot r INSPECTION TYPE DRT INTRUL$ CODE! INSPECTION TYPE ORT IN1111AL$ 4616 Fixed System Final Fire Prevention 206 Final Mechanical '1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof X /hag'I/ — 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 • 1 204 Final Demolition 250 Final Building/Occupancy _. C__ IS N WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes 0 No I hereby affirm underpenalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership compensation, as provided for by section 3700 of the Labor Code, for the b Y(type of document,i.e.-.property tax bill or deed): 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 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 by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: • or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gly (This scalps need not be completed 11 the permit is valued at on nu red ddiars(SfoO)cress) 2.Art 2,Sec.341,Title 8,Califomia Administrative Code). Policy Nu r: ❑ As owner-builder, I will not employ anyone to do work which would • I certify that in the performance of the rk for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless iss d. 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 Applicants Signature Date the La fjCode,I shall forthwith comply with these provi ' ns. /).% r ��,` Division of Industrial Safety Permit Number: t/V/ / mra Dat -- 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? 0 Yes 0 No (5100,000), 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). wi Section 7000)of Division 3 of the :usiness and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file m license is in full force effect. a registration form for acutely hazardous materials? 0 Yes 0 No c.#CtT , (Section 25533 of the California Health and Safety Code, with some anti 'MN - 'ons, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely -411N7-ca addfs Signature_' Dat_ ems,,: 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? 0 Yes ❑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? ❑Yes 0 No 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 (Section 65850.2 of the California Government Code requires that the requested information be famished 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 penally 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 Safely 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 WITHccity ordinances regarding Hazardous Materials and Emissions. LI ENSED 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 by this permit until final inspection. C 1Gi,�k..-��...� a Signature of Legal Owner(s) Da / 3057-4e(3107) orf--- � — � ( L I! `A VA'ndorAsnhodzed'Mpl¢ant' ter—e- Prescriptive Certificate of Compliance: Residential CF-1.R-ALT Residential Alterations e'age I of 5) 1'i.9JeeOvame: I Climate Zone# Il of Stories mt,/z r6LLrA.- f General Information 011.-- D-0 616- PSite,Address: /� f Enforcement Agency: te: �_. 231 2ti r < <� rig-f 'MII - I4- � l Building Type Single Family ❑Multi Family Circle the Front Orientation:N,E,S,W,or degrees Conditioned Floor Area(CFA): Project Type: 0 Alterations 0 Envelope 0 Fenestration Roof D HVAC Replacement or Change Out 0 Duct Replacement 0 Wet r eater NOTE: This farm is not to he used for Newly Constructed Buildings or Additions - Insulation attires Far Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration .—\ D Opening of framed cavity alone—Alterations that invobuc the opening of thefr aired cavity of a wall, ceiling, atfloor must install the mandatory minimmMI 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-D 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 I II C I - D • E - ' F I G I H I J ' I .1 Proposed bee nO1 _Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly IDs or Types and Size' or Others _ factor's Number's R-value' R-Value' Cell Values U-factory • .Note:For furred assemblies,accounting for Continuous Insulation R-vaiue,see Page JA4-3 and Equation 4-I. For calculating,f rr'ed walls use the Mass and i 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...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; 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 die Climate Zone;enter the Standard IJ facto'j-om Table 15)-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 11-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 B.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 LI-factor, Colunm.1, must be equal to or less than the Standard CI-factor in Column E to comply. Furring Strips Construction Table for Mass Walls Only A B C D 1 E F C H I J IC 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 hunt Appendix Table 4.3.13 U c; .tdu U Il, ,-' v n L ', 0 Assembly "" 3 0 .9. A F Jr o�. 4+ p�'v' Final ii Mass Name or JA4'Fable O N g `u S 3 c R $ t '., e = �u 'a Assembly Thickness' Type' Number' < i s• E tit = ti G r< C S ui U-factor'" Comment ,( I I I I I 1 I Registration Number: Registration Date/Time: HERS Provide, 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CR-IR+.ALT Residential Alleration.h (Page 3 of 5) Project Name: I Climate Zone R', () P of Stories ROOFING PRODUCTS(COOL ROOFS)§151(/)I2 When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 f?, whichever is _less,the new roofing area must meet the roofing product"Coo!Roof requirements of§152(b)111i, 152(1,)I11ii,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 Eminence requirements for roofing products in _rnr i)are not equn noi Tl table below. ❑ ml Roofs Not Required in Climate Zones I-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. of Roofs Not Required in Climate Zones I through 9 and I6 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less — an 51b/ft2. Alternatives to §152(b)1Hi and§152(b)Hii,Steep-slope roof(pitch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hrf12'°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(010;or O In climate zones 10, 12 and 13,with I fl2 of free ventilation area of attic ventilation for every 150 it2 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 ID. 11. 13 and 14.R-3 or greater roof deck insulation above vented attic. Exception to§152(b)1Hiii,Low-slope roof(pitch S2:12) . - O Building has no ducts in the attic. Other Exceptions , . 0 Roofing arca covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. . ,O Roof constructions that have thermal mass over the roof membrane with at least 25 lb/f12 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 Roofing Products"Cool Roof'Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Numbed < 2:12 >2:12 < 51b/ft2 > 5Ib/ft2_ Type2 Reflectance3'4 Eminence SRI5 ❑ ❑ ❑ 0 ❑4 ❑ ❑ 0 0 ❑4 ❑ ❑ 0 0 ❑4 O 0 0 0 ❑4 ❑ ❑ ❑ 0 04' I. The CRRC Product ID Number corn be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolroofs.org/aruducts/search.phn 2.Indicate the type ofproduct is being used for the roof tap,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is mol available in.the Cool Roof Rating Council'S Rated Product Directory then use the Initial Reflectance value from the same directory and use the equation(0.2+0.7(pp,t,ial—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box if the Aged Reflectance is n calculated value using the equation above. S. (Calculate the SRI value by tesisg the SRL Worksheet at hmta//w,vn c,,errwengov/title24/and enter the resulting value in the SRI C'olurnrr above and attach weepy of the SRI- Worksheet to the CF-IR. 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(04. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating I❑ Cement-Based Roof Coating I❑ Other i 1 1 Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms • August 2009 • Prescriptive Certificate of Compliance: Residential 'CF-IR-ALT Residential:4lterations (Prue 5 of 5) Project Na Climate Zone a tr of Stories HERS VERIFICATION SUMMARY The enforcement agency should pay special anemiou io the HERS Measures specified in this checklist below. A completed and signed CF-4l2 Form for all the measures specified shall he submitted to the building inspector before final inspect um. Duct Sealing 5: Testing HERS verification is required for lhi,r measure. ❑ YES D NO 11 ES:In Climate Zones 2 and 9-16,if more than 40 linear feel of new or replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)1Dii and the newly installed ducts are to be insulated pen ✓§151(1)10. D EXCEPTION:Existing duct systems that are extended, which are eo nstrneted,insulated or sealed with asbestos. ❑ YES D NO VES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the ducts are to be sealed per§152(6)1 Di. ❑ 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,or the furnace heat exchanger)the ducts are to be sealed per§152(b)1E. D 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. 0 EXCEPTION:Duct systems with less than 40linear Leet in unconditioned space.• ❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos. • Refrigerant Charge- Split System HERS yen].Italian is required for this measure. ❑YES ❑NO YES:In Climate Zones 2 and 8-15,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(o)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is reguired Jor this measure. D YES D 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(6)1 Ci to meet the requirements of§151(fl7B. • Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and complete. -IJamer -Signature:. D4 L/_ (.0 Company: • l /— iN— / / ,1'/fddresc'k= If Applicable 0 CEA or❑ CEPE / 2 T 2 3Z/ /rd fLg e/.' (Certification 8): aitQitylState/Zip: e-ei "(/'I.4 / G9 , 9 2 6 2 7 ( 74/9) i3/-) 901 y Responsible Building Designer's Declaration Statement • I ani 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 specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 an cl 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance arc consistent wilh the information provided to document this building design on the other applicable compliance fors,woksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this budding permit application. Name: Signature: Company: Date: Address: • License: Cry/State/Zip: Phone: For assistance or questions regarding the Energy Standards, contact the Energy Hotline ut: 1-b'00-772-5300. Itegixuraiaa Huniber: ft cg isva'ian Date/Trane: HERS Prot icier: -. r_..."".. et 231 24th Legend a Buffered By APPROVED 2416 e, 't�Cl'T�''OF QA Ar CS•' ' '�, sr p •. R �' o n Feature Buffer �. / PLANN + .'•�,: :4,,,„ 77` x ;Mdx '�y x, i .u '4 y,. •%. 6,` a Selected U r c 1 •�; j�- g Features SiBJECTTOBL: , ► 'i REGI tc 1 *4,2. Y - L • ; .> ,- % �.j El Parcel 2417• „:11;, "°"' a - i C'S,:' i 231 1 �'' l��v Addresses N• -•,•Au s 'J o)17i P. FTIQN �(r 4v ” ' 4 ,112.2.11116 r . . ` t` • OR ' ' Rr _� / A'LL Ej� � j ' ✓'1•y _ .. ' 1 ,//'. , h�• l,i rr Parcel APNs � ,.4.4 24 ROVg ui_ / A NG t p, •' y x'� ! ,-;,./•\( Street Names J *J �" >/rS� [-r 0 *} 9104 1P rJ7 74:;:!/: ��,,,, - : r J 226. I;, �C 235 r •* ::: Parcel Lines �' D'� f �- ?L ,1910110 11910115 {. Ortho t, , Photography tt .:Y . 1 e1 ytii eianl )�, 1 � i • ,{y.•. i - � •' .t � Parcels 212 .'Z tatter a®&F ,' .y i ❑ 910204/� gy q wa 11910114 ` 1 t) Quo 'o; ,4 "' j?'. :1.2 "--it'''t S" �,i r t - , t ' 239 s / ' * ,'qS"i �Q5 ' yY #' .,,970,n L1 I >F. fro -41113 r( .FI.e`,,\"„,. ,tr r / 1 `�Ca` . r v, cn+. e f// a: V 234 / , 1 .T '11910112 r+�. �`- siozos E i{Lf 2401 / f e .3r^'• f`y�.�c..Y `w. j1 e '� - at ,�+ 'r 1 �I,i r ,iC.\i.. S ��F '� J f`1 P " w • '' i'j • ,"511•0 t0r �r4 � ' lam.. '} '" 4-1,,.,.... c— r a9 � ^ V /r *a '+I 4393370a / r � e r � f' ©©. ` ,�77xr� . ilsml13, . e . .f'-r/ 2 4�. Vt < '� •„ w� ....7:7, '1 YV x 240 S F/' %� '`; 1.,11 2 Q170 f 1 Y r \\_. ', 4 is j',t�+ , 'i� �' ? VV ? _r.44f2r22 > . ! a.N ( f-t ' ,r r.r \� ' 'yA� �� ' �� 4_933 0 •1 t “:'7; . ryi �� VI d` . 235 / `/ x� 2-;rj_„ !' .' //J/' \ "�� . ( T ' `\�41 . o y.07' ., �, W. .. � k' '2t �'•4 F'(j 1 '' 1 43902 ,1 `*s " \'4 3"' /239 `/1 i .t ;..( ' w F.: frit'. f,.✓^. 11910106 /, �� S VV S9tx e it 234 3 ""z. e urr l-. !L.' t�q:. ,1910103 r 1 �,. / / q r s. Y+ '>_,..r', 5 r"' T�F(i 1 9101044 5 '.;,-." \ /'f ' SPP atiti,'p • - w«� ,•'+ . Y 439332424°8.1it* Q /. 11909301' }^} M.` ' ra i. �/ ( y ^.r :r •1^ ...... r V,;,,• 270 i ' , • Y . ,alat> . ,. Net fF . _ , r �, f ,. ft v,,,r � PuwAer b YGe�Smfta«net Printed: 6/12/2006 10:15:51 AM Powered By GeoSma«.net • I 1 • I • I i ' : rICF : IcImr 1 r/Is- I 1 1 L ! 1 1 I 1 , 1 I I 1 I I • 1 _1_ 1 1 1 I ---•— --.- ! I I ! 1 I I I 1 1 ^1 ,4% ! —, -I- I 1 : . , • I 1 I I , ! 1 , . i • • 1 • , ! ! _i !_. 1_!. : • 1 1 I E i I 1 I ' • • I . • 1 ! ! 1 1 I : • il _ I : _.._; 1 , , ! • ! ! ; 1 I 1 • ! I I ; — ! • • 1 : 1 , • • 1 i 1 I 1 1 I ! • I ! Li ! . • I I 1 • ,___I. ; • ; / I I I p I • L__ ; ! _ ___ _ _ , I --I ;; ; -I- --t- ' 1 a , : . 40:— • ! —i— . • --H-1--,—;---,--------T-1---1--r-----1---1 -,--,. 1 , . 1 , __ __Figot , j I 1 1 i Se# bd< [.___, ; ..... ii i , . 50! baciC lit . I 1 . __, , - -- --..- I --'---ic -dec. --i—, riirNii-1-----E--1- -- - , , filik , WO Oin , r . re Ili : aijoi Cbviers tact , i i ! i C. ettee__= I III irt 1 I - -- ' • 1 1 1 ,_ _r__ • _1 1 ! : L ! i : : 1 : i ; I • I I I I 1 ' I I I 1 : I / ; • I I I : . I III IIi : 1 1 1 ' •,___I_ I / I ! 1,_ I li --1 . I I .1-- : I I 1- • ; -I- ' ' I --I- I 1 1 i 1 I I I -I ri• I I I I • " I I • I ! 1 I 1 I • • -- • I I I -I : I ; --I I • I - I ' • I I I : • ."• , • I I , I I I I ' I I • I I I I I I i --I- ! I I / , -I- I ' I I • I • 1 I I I I I ' I 4111.01 : 1 1 I i I I • • I 1 : ' • 1 i 1 i 1 , , 1 I 1 I Hdif 1 •I I. 1 I , I • • I I _____ 1L 1 • 1 . . I _ • I , ge i 1 • RO ; : ! is ! ! • ''. ; _i___L! _14", ! _;__ I ! ; ; 11 1 RI • I ! , ! , • • ! ... •-..- -:.-.1--1- ! 1 • 1 , ! : I , I , ' ----4-- 1 ! I , , • i : 1 I : - •-* - 1 I I, 1 !!--: : I I 1 I 1 ! ; ; 1 , I ! I . ',now! -•?tur, .1,_ - ..„..-r-1,--aj.. .. . . • I 1 • 1 1 • ill'illgWrielltryl 1 at. 1. . .:!, , . • .41,:Au.. .• ..-.0,F BOLLIDING AF:Elen%ir 1 I ,_j _ i_ / ;. f1/4,4t, tr. ____ I , 1 H -1 • I ! v. . , -orrY ortOSTATI4HE$4-1!--T-7- - --67iipib 1 IrI ED 1 I. ;., I ; I I ; I , I il 1 I ; ; • I I I I i -; I II In - • I I : . . I -j I-----i- I I '-'s a; I A_r--,,i I A .A I I. : . ___........._. 0., • _i_____I__A. .: S botc.K.34)_l___ .._ ____LI___I __; _L.___I____1....J.__L._ IAA I ve_crs, ; mos I;i% a ', , A ' mg.IF si ket finktos 0 al au trel—and."u'Wei' ID-. I 1 I - -- i J-- --1. ire:C-3 -1-- ,• ! i i -!--1—i -I- i ! i v kz: C . ! fo • . 1 , I ) ' -i--- j 1 : : .1_ i 1_ t III . th„,easi tateo9ris_on_ s_r_0,71-4_.. 4- -k , , • „ „ , i 1 .i____,_ • . i ffiaiParlY,---r meta. i i I -I- .4.4eiticieinitotto 0774070---1 1 it iI I I 1 I .. I 1 I ' and Ss*Mid ' H tLt4P1b14- raOce mitt/magi. 1 ____i__l___.1 is stow, ca,this,arspectirssiont; 0 _y_otv eta.mes,3_, .___, -01--I it. • I i ,• . 1 1 ! • anc void . 1 I. -of the vickli°9° / I- . limitalion MCP-a:" • - ------1-------1- ' I ' ' i shall alue Nr i. 1 , , I I 13/4. - I I ; ' I 'MINIS and rilliTtit ; • • adii,Per4BC • '' . - ' • w 1 • , , ' _i i ' .r_ . _;._ 1 • . , , , , ' ;gel ' ; . ; ,. i- . ct1t ! , lits:,, ! 1‘ I"- 1 , i , , ! , : ! ? : . ; - I • lti I '1 ! 1 1 1.11111111111.— ! ! , F __ ! Friaav! ' Dar- • : , , ! 1 I Eiasisitib Fre%%ch i I i ! P 1 1 , • • i , , , , --- - , , , -- - -- • I 1 , i • I " i , • : i I .b...1 I I fterkesi_. i • n I 1 i , . pinta L...1.,V% el noorn 1 : 1 1 • . . , : i : Cy-esi . . I • 1 an. Ink w . . I .i.. , • : . . , 1 . ! 1 1 ! i. 1, 1 : ! , i } , . 1 , • 1 , ---:- 1—:: 1 tEsearoo : 1 • i I - I 1 ! : , , • i , : , 1 1i i I t • , 1 , ---1-------- -; 4-- - ,_ _ • ! 0 i 1111 ; . t ' 1 I . • , i ; , ; 1 i _ ._. .__ ., . _Al_ I ,\.kc.4...„,_I_ii.___!___ 1_ . , - -- : --i-- --i - i , , , . , , 1 1 , , , . ; I i 1 : ) 1 i 1 1 1 . , 1 ; , , . i 1 , 1 . 1 : 1 : I i 1 , ! 1 1 : I i I ! i I I., I I I • i • ' I I I I I —L.._t _ , 1 Y !-- ! I I 1 I I . 1 • tiscbr� 1 I -' -• ;-- •—L I I I I r m I ,LH I . i — • I II .•. • 1 — I • fs Q'�'J — L. i i. • • .. I I i I HtJL ' ' • i -.,_ — .t ! I � � -Th _. ... . _ —__ • •.. ... _!• _EL .I. P•11.13_.=V— boi•C_ —I_ 4 I 3 I. C9 R .f:A :'it00✓/ Z, i ..._ _...1 1 i P i ST on I s 0 ala r+e, D�.11sion b BuHle9 — o • ... ... _.._..i:. ..—. •-..._ ... _ .t_ •.-. sandsp?t_ilicatbnI 2v '1 S. fi • f - -- -- I 111,�eanY '{e<aaueratwluon --wll f '. .� - - - M ._. ... ._.. ..._...._ _-...1; ' _.-I ........... _.__—. __ _- 1 • ents aOSI3Ja3sa-.. . I nr : kc, 1 , Safety, 'SHA`� �: • toteav .... I.... ... ._ 1 '..._.i It I stampng&trds•prd dicrwns a 0 dma ce•and of IState Wrr.j • I + I o f o".14 sluts o anY CItY . v I :.._ . •_ :a ..�..... D F__I° T ;t �p �,R; ! c.1 �rH - E • -9 - Ji tatlo andj r( 6 • _i . -. _- I _ _1.1 _11:e. �_. r . j Cil _ i -._ I -DIVISION ORBUILDQNIG SAFETY 1 I — j ; I I 1 I CI1IY OF COSTA MESA EP(1511Nb L I • I • ' i? PPROVED-a I ; i I I L. L. I , bate m ~�` -" 1 1 ,J t to . n an�n SPeaiCalwpsM ST be on Ala at all tines and daerda lb ri � .. I I,_ ..:. CL_F&. I_e4)( gl,f•,I:6Ai�-Q.__II'SUJ� • . ,... 7'?aeraflans sarriewe lwrilenPae.d'otlle9;vlrapl.o(Biil3^B C; , ',\.` 11-1-7-1-'''';f1-: i..':;41:•:-.'•' 1 .. I..-. I I _ .. I �,71�,,-� L: .C Of:'iS;o AlgSa ' i _I I t11. —` -1 ...: _�71fe•:. ,r,�of in* en aro sae•cdralions SHALL NbT be hHdto parrs it dct0 be an appal I NI j —Y . _ - ,._ I- I ___ I I vro twr :Ta1y s ens of : y City of: a Mesa Ordinance and/or State tat 1 1 I • —`—'- 1 e „rt b j mitaian become nW and void it the buidirg a i.-U. b a 4 _ N a rAp : - 6 i_ t .B:,::.- b I S,10' .' .mam t :. , BOrtaysdissuslce `r� I I ri. d)wih n, D I • ! • • • __ .... II . i.... .IE. .. .. --_..-._..._.......... .... -- -- .... . —_ I I. . ..!_. .7_.15-- ._ •. ....I -'I--- -' 1 .._-._ ;. ! I •I I I 1, _. - . .1 .. • C.�-cax` I I I I l t'7 I • I• I-.I 1 — 07 • Is 1 I 1 I I � -. . ..I .'r E~ I _ a I I ... N i I,I ! _ _I.. 1 : . • ,:X I! ,,n,td-L-1 b_/115 i /Jh(,)O 1.1X : ei G•y— e X Lj �?°� c . i -. 1 1 y,_ ..l f% I �__� / I__/rtr li�✓��f rJf a. �.. -. H No \\ n 1 Ci � o 1 42:_..,....-. (. L K I s� ^.<.< <,ra 1 ( ! Qa I I I I I I I _ 1 • • 1 I • _ I f7 c ^ :X)_$3'iNb N I x,� 'C(3rX . l<IYJb • bvC_6� I A I WWW i 1. � , w, nl b ;.l�C- < __, 4 i5T_I�-� I b �. — —' I `.{1y1}{� �JI ' lQ1x 21 •—• L-(K - !__6t�Z�2£-4�t_- __ I ! I 19 IT .} C®illr_...Ipu - :.�. 51±, � ) _ ,I _.A1rff .. �I. ' _ Ij .-.-I - � h(.hiio ;_ _ _ iI- .- L1- I t!f'_ Li I•ii_ - ._ ._I I I ! I i _ : t . - . c9'MF CITY OF COSTA MESA • 4 ► pe BUILDING DIVISION >. tga ; tI $ DEVELOPMENT SERVICES DEPARTMENT PER NUMBER 4. PERMIT es 06-00888 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesastLtCTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 231 24TH PL Status: ISSUED Suite No Applied: 08/09/2006 Vicinity: REAR SFD Issued: 08/09/2006 Parcel Nunmber: 11910170 Applicant: COLLINS, DAVE i. Address: 231 24TH PL /' ISSUED BY: Phone: 949-631-7904 , COSTA MESA,CA Zip 92627 • • Owner: COLLINS, DAVID L Address 231 24TH PL Phone: • COSTA MESA,CA Zip: 92627 Contractor: OWN ER-BUILDER Address: Phone: Zip: License:000000 SCOPE OF PERMIT ELECTRICAL PERMIT FOR 2 GFI OUTLETS AT THE REAR OF AN EXISTING SFD. REF:B06-00922(, ', ) FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 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 Pool/Spa - $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $2.20 2 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 - 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 • 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $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 $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $25.70 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 . • 2446-46(6/1)0) • 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 if the permit is valued at one hundred dollars($100)or less.) 'I certity 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 olifornia,and agree that if hould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these Ions. _ c7 6 Applicant-Signature: ./.�.or- -, .....47 i- t-Date:�- - WARNING:FAILURE TO SEC E WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOI NAND DOLLARE(5100,000),IN ADDITION TO THE COSI'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). 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.). 1❑—teas owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions v--Code:The contramors 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 pursua tto the Contractors License Laws.). ❑ I am exempt n r sec. Business and Professions Code for this reason: p • Signature:, ��_.e [ Date:- CT� - Y - v 6 �// Owner ID Verified b drivers license. ❑Yes 0 No SDriver's'Cicense No../ -"- - Expires:,S--9 - °(Y Verification of Ownership by(type of document,i.e.-property tax bill or deed):r --a 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,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? 0 Yes 0 No (Section 25505 of the Califomia Health end 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)?- 0 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? 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes LI No (Section 65850.2 of the Califomia 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 from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑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 com y'wlih all state laws and city ordinan es relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described prop yr i do ses gra t to occupy or allow occupancy of any building authorized by this permit unt�inal inspection. Signature i. eget. wner(s) ,_�. C-Date.J And/Or Authorized Applicant Date CODE N INSPECTIONITN COTE 1NTRIALS CODE II INSPECTION TYPE GATE INTmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical /r'7°-� 1266 Pool Spa Final 2 0 Final Plumbing • r' - / 200 Final Re-Roof 210 Final Electrical S201 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. i • PROJECT ADDRESS: 231 24TH PL UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 045930 OWNER'S NAME: MARY KATHERINE JENSON ' • . ADDRESS: 231 24TH PL PERMIT NO: P 045930 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA CA 92627 T • CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU PURPOSE: OTH ( 714 ) 631-7904 ARCH/ENGINEER: REO.ND.: JOB DESCRIPTION : REPLACE SEWER LINE • SQ FT: . ADDRESS: UNIT: • CLAIM VALUE: CALL—VALUE: GROUP OCC: R'- 3 / PERMITTEE: MARY KATHERINE JENSON ( 714 ) 631-7904 ADDRESS: 231 24TH PL COMMENTS: NO "B" PERMIT . "P" WORK ONLY . COSTA MESA CA 92627 ********sr*>Eai*aa*-********et*******er*sten***x-*+cx-** *xx-et+tai•)r*ar**ea************TE**** -**+t* LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 am Bcensed Linder provisions of Chapter 9(commencing with Section Z O N I N G- R .E Q U IR EH EN TS 7000)of Division 3 of the Business and Professions Code,and my license Is in fun force and effect. S E T B ACK S CITY LIC.: STATE LIC.: CUSS: Date: Signature: MAIN BUILDING ---------- --------- ACCESSORY BUILDING — — WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure ora certificate of Wolters' LEFT: FT IN REAR: FT IN FENT: FT IN REAR: FT I N 'Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT I N LEFT: FT IN RGHT: FT IN POUCY EXP.DATE: COMPANY:PANY: PARKING REQ: PROV: PARCEL : 11910170 ZNE: REF NO: Certified copy S hereby furnished. CIa fl Certified copy ed with the city Building Division. PLANNING NOTES> ******************************************************************************* _me: Applicant: DEVELOPMENT SERVICES - REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Dissection need not be completed B she permit is for one hundred($100)or less). I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of Calilomia. _ ZONING APPROVED B Y _—_ . DATE: _•_—_ - Date: Signature: BUILDING APPROVED BY :_ - _ 'DATE: NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor - — CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y : .DATE: — -- Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. . r% 2 -2. --�Q which this permit is issued(Section 3097,Civ.C). ****************'******+' ; 4t* ef - FiF******************7F*** LENDER: ********************************************* *************it****************** ADDRESS: LEGALIZATION:N F F E SUMMARY • STRUCTURAL SEGMENT: N • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5 ,00 , repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed 25% •• SHIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN . and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My viotation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 3 . 00 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I, as owner of the properly or my employees with wapes as their sole compensation, will do the work, and the T'O'TALS--r— > 5 . 00 3 . 00 0 . 00 8 . 00 0 . 00 . 00 ❑ structure Is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a properly who builds or Improves thereon.and who does such work himselfAlersell or through • his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 8 .00 OVER/SHORT: . 00 for theep*se sold e). one year of mmpktion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK ( for the purpose of sale). , I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 8 . 00 ,v el and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with acontractor(s)license pursuant to the Contractors State License Law).l am aware *'*'*******'*'*'******************************************************************** That proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. • for this reason: _ TYPE QTY DESCRIPTIO N - UNIT COST TOTAL COST Date: a -' 2--- 90 Owner: 52%r--, - PLU 1 BUILDING SEWER / TRAILER PARK SEWER 5.00 5 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safely Cade Sections 25505,25533,and • END OF FEES 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a • permit for construction or modification from the Air Ouallty Management District.Residential construction applications are exempt from these provisions. Date: 2—2- — 9'0 Applicant: 9 -`i ,-...."--t-„2:7__. . I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. � ��'� -� Date' 2..-- 2'--•ro Signature: Gr.,-,...-, C . 01 00053194-00053194 TOT 8.00 Driver's License or Social Security it: DATE: 02/02/90 TIME: 10:20 1841:46 White-Bulldine;Green-Code Enforcement:Cenerv-Aporlcant:Pink-Revenue:Goldenrod-Assessor - . I�' CONSTRUCTION AND PLANNING - • POOL 'A 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 r 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding V. r 5:Steel Reinforcement 56. Rough Plumbing & Pressure Test , •6._Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection (0n 62. Backwash & Receptor-Final t V, 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT.REQUIREMENT 20.:Rdugh 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 - ' t '1 ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final80. FOOD CERTIFICATE ISSUED ;33. Final Electric • ,��- Notes: -: - 34. Final Heating & Air Cdnditionirig * - . 35. Final Gas Pipe-Test - - / . 36. Hood or Canopy i,.-• - ' - 37. Final Factory Fireplace - ' • - 36. Final Plumbing '(-17-9) 39. Water Service-Final ((- !;X i • 40. Gas Service-Final - L- 41. Solar Domestic-Final -- - - - 42. Backflow Preventer - _ ' • - 43. Backflow Irrigation - - 44. Landscape Irrigation System - - - - - - - . ' , - • • 45.. Sound Attenuation , . - . i 46.-Handicap Regulations - V 47. FINAL STRUCTURE & BO!LDING t 48. FINAL PLANNING ` 49. Electric Release to Edisonir e ' 50. Gas Release to Southern California Gas Co 1. 51. CERTIFICATE OF OCCUPANCY Np. Date LIMITED STATEMEN _ OF RESPONSIBILITY Bldg. Permit # /VOWS- TO 'C,t/S. TO WHOM IT MAY CONCERN: This Permit # p4,s p3o 1 23 / 24 7/-1 PLMci Street Address AP Number I /"t , /C,4 T F//_ _L. "1-- , as Owner in Title of the above referenced property, do hereby authorize: DAvE Co cL2 .- s 63 / - qoy Name Telephone No. 2-. 3 / Z N TF - P LA-6-49: Street Address COS Tcft �/ 2 62 � City State Zip to obtain permits in my behalf, as owner/builder, for i r'~` g " C at the above referenced property. Should any person become an empinyee engaged in the improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties. /'-1 k4 .7/a r J -so - 2 - 2 - c Printed Name Date Signature FEB 2 1990 077946,rev.6/87 u I PROJECT ADDRESS 231 ?,4TH PL UNIT:• CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 058772 OWNERS NAME: • JEICSON- ' MARY KATHERINE nom: 231' 24tH PL PERMIT NO: B 058772 PLAN CHECK NO: 02319-92 L •, GOVT: N SUPP: N COSTA MESA,CA92627 CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: ADD ARCHTENGINEER: SCOTT WALLACE REG.NO.: S3613 JOB DESCRIPTION : 877SF 1ST FL ADDITION SQ FT; 877 ADDRESS: 25271 BENTLEY LN UNIT: fr• LAGUNA HILLS CA 92653 CLAIM VALUE: 60, 000 . 00 CALC—VALUE: 60, 513. 00 GROUP OCC: R-3 / (' PERMITTEE: REUTERS GEN CONTRACTING (714 ) 251-0181 ADDRESS: 2698 WHITE RD- 100 COMMENTS: ADD FAMILY ROOM 6 MASTER ROOM IRVINE CA 92714 *****+E**4**************+E+r*iE********+rRE****(E******NSE******k6***********+E*****+ESE*** LICENSED CONTRACTOR DECLARATION: I hereby aflirm that I am licensed under provisions of Chapter 9(co ng with Section Z ONING REQUIREMEN TS 7000)of Division 3 of the Business and Professions Code,and my license is in full I rce and a ct. SETBACKS CITY LIC.: 54371.°.-- 4 3& SS: Date: / t3,//t'{�- Signature'��8 STATE LID.:58483 CLAMAIN BUILDING ACCESSORY BUILDING FRNT; 21 FT IN REAR; 25 FT 5 IN FRNT: FT IN REAR: FT IN WORK RS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: 11 FT IN LEFT; FT IN RGHT: FT IN Compensation s cb tdi py thereof(Section 3800.Lab POLICY NO,: 14obg EXP.DATE: 7 101 /9 3 COMPANY: STATE PARKING REQ PROV: PARCEL: 11910170 ZNE• R1" - REF NO: Certifie PY fisher y furnished. C cemgedcopy islKed with di\gBlois' PLANNING NOTES) EXPANSION OF AN EXISTING SINGLE FAMILY RESIDENCE• Ogle: APPlican • D E V E•',7. 0#:13 MAA• E N,fT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:-QMs section need not be completed if the permit is for one hundred(5100)or less). -t , 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 2. - subject to the Workers'Compensation Laws of California. I . r' ZONING APPROVED; BY -A ;,,� — . " (f DATE: 9)(2 7 (ci 1 Date: Signature: _1 r� BUILDING APPROVED NOTICE:If.after making this declaration.you should become subject to.the Workers'Compensation provisions of the Labor BY, ., DATE: Code.you must forthwith comply with such.provisions orrthis permit shall he deemed revoked. n n -- ,. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY.: . :. ' �Gte1 -k'**************** 14— DATE• G '2 9 which this permit is issued(Section 3097,Civ.C). w * ***************** ** * ** LENDER: % ***************************..iE*************************************************** f, ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRICMECHANIC FIRE SMIP/RES GRADING •• (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct;alter,improve,demolish,or PERMIT 464 . 00 / 6 05 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed re• SNIP/1740N—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 301 . 60 -- - and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE - t/ I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law 7 OTAL S——--> 470 . 05 0 . 00 '. 301 . 60 /771 . 65 771 . 65 .00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intend or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: - 470 .05 OVER/SHORT• 00 improvementorthepurposeis sold within one year of completion,the owner will have the bu of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC ' IRE SMIP/TOT GRADING PLAN—CHECK for the of sale). 464 . 00 C 6. 05 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contraCtor(s)license pursuant to the Contractors'State License Law). I am aware ***************************************4** *********************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F`E Y BR EAKDOW N o I am exempt under Section: 8.8 P.C. a far this reason: TYPE QTY D E S C R I P T I.O N UNIT COST TOTAL COST Date: Owner: SFR 877 DWE—TYPE V—WOOD FRAME —GOOD 69 . 00 60, 513 . 00 I do hereby certify that tam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. t! Dale'. Applicant: I hereby certify that I have read this application and state that the above information is correct.I agr•to comply with all city and county } ordinances and state laws relating to building construction and hereby authorize represe fives of tn'•:y to enter :m the above-mentioned / property ection put ses. s .co.) Date' at 12- Signatur: .(,./ / Driver's License or Social Security v: , `\641 46 White—Building:Green—Code Enforcement:Canary—Aoolicant:Pmk—Revenue;Goldenrod—Assessor 1tr'' POO SPA CONSTRUCrfRON AND PLANNING Date Inspector Date Inspector APPRp1/ALS` Permit # APPROVALS Permit # • • 1. Tempdrary Electrical Service or Pole ' , 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement 3. Electrical,Conduit Utility-Undrgrnd: 54. Forms ' 1 4. Electrical Conduit.Undrgrnd. 55. Electrical Bonding • J ;5: Steel Reinforcement - 9/, yy £34 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Gtnd. 57. APPROVAL TO COVER-GUNITE .7. Footing§. • 58. Electrical Conduit-Undrgrnd. 8. Foundation 51,/,.,,,_;,52, - c c c.1.2,( uC 1 c.1.2, /, f f 59. Gas Pipe, 0 Undrgrnd., Test - - 9. Water Pipe-Undrgrr.d. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System f-fj( .1 bail 61. APPROVAL TO DECK 11. Property Sewer,Line & House Connection c--- 62. Backwash & Receptor-Final _ 12. Sewer Cap , 63. Heater & Vent-Final 13. Roof Drains - , 64. Plumbing System - Final 4 ' 14. Rough Plumbing ' • 65. Electrical-Final , • 15. Rough Electrical-Conduit' ' a 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sjgn 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 Fiteplace _ - - • 'APPROVALS • :Permit # ` 21. Ducks,in Structure. - • - ' JO. Underground Hydro 22. Ducts, Ventilating i " - 71. Product-Piping 0 Gas OOiI 23..Gai•Pipe?Rough & Test _ 72. Underground Flush 24. Roof Framing ' -1 .{ 73. Undergrnd.StorageTank 0Gas 0Oil 25. Roof Sheathing . /p.9-41 . Gaga.. 74. Overhead Hydro .. 26. T-Bar Ceiling (Structural) & Monocoat 7 75. Dry Chemical 27. Frame and Flashing' /6-1r-92.45444: dpi 76. Dry Stanpe ' ' 28. Lathing& Siding. - ..,2A--t(Z4c 4- 77,- FIXED SYSTEM FINAL - , '29. Insulation - p12�2_I f0,r 78. FIRE PREV. FINAL • 30. Drywall Nailing • - ' cj„Z/ Q� - HEALTH:DEPT. REQUIREMENT r31. Plaster Brown Coat 4'4Jl2, 4(6. , 79. FINAL INSPECTION - - I 32. Electrical Power Meter-Final .. v • 80. FOOD/// CERTIFICATE ISSUED 33.cFina1 Electric : - - , I '' - - Notes:: 7 ft- _c9 etr et- I 34. Final Heating& Air ConditioningI ` // 35. Final Gas Pipe-Test - ' - 1 ( l/-f7-TI -(S+. se.- 1 ,i G--x.•� 36. Hood or Canopy - r 1 I •( ! L B /C -� `• c 37. Final Factory Fireplace,, • t 1 I - : ' A :38.-Final Plumbing I i - e ' . �-.'+- •• / -- v ,- tie r '39. Water Service-Final i I . >, _,) , 40. Gas Service-Final i _ I - , ' 41. Solar Domestic-Final , � �_ _ 42. Backflow Preventer - I I - . - 43. Backflow Irrigation - - 44. Landscape Iriigation System - - - -- 45. Sound Attenuation '46. Handicap Regulations """ ��/ 47. FINAL STRUCTURE & BUILDING to/f) _. ^ - 48::FINAL PLANNING - , . 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co rj _ - 51. CERTIFICATE OF OCCUPANCY I No. Date CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT—MESA UNIFIED SCHOOL DISTRICT Developer/Applicant :77D�� Gp li �� S L Address : i t ZIT4- /IncC (_ 77'/ Telephone Number : 7I1 (OZ 9-90 7 \Tr-amt/'Ra-rael .and Lot Number(s) : Location of Project : SaleiI I-- Number of Square Feet of Residential Space _ 7/7 x "$1 . 50 Total / �S 670 Number of Square Feet of Commercial and Industrial Space x $0 . 25 Total Commercial/Industrial Project is : (Check One) Mini-storage Motel Preschool Movie Theater Bank Auto Repair Racquet/Health Neighborhood Shops Hospital Warehouses R & D Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park Fast Food The provisions of Government Code Section 53080 are not applicable. This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . Checks are to be made payable to N port-Mesa Unified School District . Business Manager Newport-Mesa Unified School District The above representation as to square footage is true . Developer/ Applicant agrees that if it is later determined that such representa- tions are not true then this certificate shall automatically terminate and the appropriate City/County shall be notified . / Date : 01- /a eei4. Developer/Applicant City of Costa Mesa California 92628-1200 P.O.Box 1200 Insulation Certificate r , Permit Numberffint 5 s- /,P/ 43/ 2V12 /Mt' �S rrrrrf umber• and Street City MM "Ar(yr County Subdivision Lot Number / Description of Installation ROOF rte' `\ Material I \ Brand Name \� Thickness (inches) Thermal Resistance (R-Value) EXTERIOR WALL ,[ tag Material �7 1 Brand Name_ — Thickness (inches) ((((�� Thermal Resistance (R-Value) CEILING !Vi Batt or Blanket Type " "i Brand Name iV Thickness (inches) 3A- Thermal Resistance (R-Value) /9 • Loose Fill Type Brand Name Contractor's minimum installed weight/ft2_ lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) RAISED FLOOR Material �1 SI Brand Name &MISva , Thickness (inches) G Thermal Resistance (R-Value) SLAB FLOOR MaterialMaterialBrand Name Thickness (inches) \ Thermal Resistance (R-Value Width (inches) FOUNDATION WALL • Material Brand Name Thickness (inches) Thermal Resistance (R-Value Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Adminstrative Code. • "f%zL�""v— Con actor(Builder) License Number Signature and Title Date /9S A6 D✓� Sub-Contractor(Insulation Installer) r License Number • Signature and Title Date 1907-A6 PROJECT ADDRESS: ,231 24TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B Oti, 181 OWNER'S NAME: JENSON MARY KATHERINE ADDRESS: 231 24tH PL PERMIT NO: B 059181 PLAN CHECK NO: 03677-92 S GOVT: N SUPP : N • COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD ARCH/ENGINEER: SCOTT WALLACE REG.NO.: 53613 JOB DESCRIPTION : POP—OUT 11SF TO ACCOMODATE TUB SQ FT: 11 ADDRESS: 25271 BENTLY LN UNIT: • LAGUNA HILLS CA 92653 CLAIM VALUE: 800 . 00 CALC—VALUE: 814 . 00 GROUP OCC: R-3 / PERMITTEE: REUTERS GEN CONTRACTING (714 ) 251-0181 ADDRESS: 2698 WHITE RD 100 COMMENTS: RE:11B58772 IRVINE CA 92714 ##****************************#*****##yE##**##*TE###*TL####*##*#*#*####*****#*#*;E# LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)ol Division 3 of the Business and Professions Code,and my license is in full force and elle and elf c�� . • SETBACKS CITY❑ �7436 STATE uc,,584836 Ss: c-3 Date; / (/ `Ile Signature: /%%% MAIN BUILDING ACCESSORY BUILDING • FRNT; 20 FT IN REAR: FT IN F'RNT: FT IN REAR: FT IN WORKERS' OMPENSATIONDECLARATION: Ihereby affirmthallhyeacertificateofconsenttoselfiinsureoracertificate01Workers' LEFT: FT IN RGHT: 14 FT 6 IN LEFT: FT IN RGHT; FT IN Compensation NSuuttaannccp,01Wrtified py thereof(Section 3000,Lab POLICY NO.: 1 L V V /b O—7 L EXP.GATE: 7/01 / O S /9 3 (NCOMPANY; STATE PARKING REQ: PROV: PARCEL: 11910170 ZNE: R1 REF NO: I Certifiedd. L Certified copy is filed with the city BuilDivisi PLANNING NOTES> MODIFICATION TO PREVIOUSLY APPROVED PLANS TO ALLOW A g � "�4�Py is her yfurnishe �/ / > FURTHER 1 ' POP—OUT ON A BATHROOM ADDITION. Date. ! / Applican ************************#*******************************JE********************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5l00)or less). D E V E L O P M E N T S E R V I C11,, E,,((��S R E Q U I R E M E 1-14212,1q 'N,` ^T� �S 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 ZONING APPROVED B Y V V T��L DATE: { tr/��'L subject to the Workers Compensation Laws 01 California. Date: Signature: BUILDING APPROVED BY : DATE: • NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. t r n _ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; #A�' DATE• 7 i9. L which this permit is issued(Section 3097,Civ.C). **********************'****************** *'*********'************** ** *'****** LENDER: ***********#*****************************************************************#** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 23 . 00 50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 14 . 95 and Professions Code)or Thal he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 23. 50 0.00 14 , 95 38 . 45 38 , 45 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 38 . 45 OVER/SHORT• . 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 23 .00 50 14 . 95 ❑ and Professions Code: TheContractors'State License Law does not apply to an owner of property who builds or improves thereon ******#***************************************************#*****************#*# and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner. SFR 11 DWE—TYPE V—WOOD FRAME —GOOD 74 . 00 814 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives this cit Oenter Lipo the above-mentioned property for in e�cclio�n purpoosse`s. lin Date:,JvJ192 Signature'.A�%%� f f !' - - -_ . _ _ Driver's License or Social Security a: !! 164146 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING POG 4 SPA APPROVALS' Permit - Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. •r 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ., 62. Backwash & Receptor-Final 12. Sewer Cap - - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduits • • 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas OOil 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 PREY. FINAL 30. Drywall Nailing ( I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 1 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric I I I Notes: i 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy •• 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System • 45, Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 4113 '-48. 48. FINAL PLANNING (/l ( 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY No. Date • .... -1•• STERLING PACIFIC MUM M '° BUILDING MATERIALS •• ONO• 'Me M I 2920 Redhill Avenue ""- ••r.•% Costa Mesa, CA 92626 STERLING PACIFIC (714) 545-7991 A BMD Company (800) 262-9700 (714) 545-1132 FAX December 16 , 1992 Re : Collins Res . 231 24th Place Costa Mesa , CA To Whom it May Concern : Sterling Pacific has provided Reuters General Contractor with 4 pieces of 1 /4 " laminated glass for the purpose of fulfilling code requirements . The glass units are 8 11 / 16 x 12 3/8 x 1/4 ( 1/8 " clear annealed- . 030 liner- 1/8" clear annealed) to be installed by Reuters in a single verticle column in item #13A Mark C one the contract spreadsheets . Carolyn Krause Service Manager Sterling Pacific Bldg Materials PROJECT ADDRESS;' 231 4TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 059450 • OWNER'S NAME: JENSON MARY KATHERINE ADDRESS: 231 24tH PL PERMIT NO: P 059450 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: SCOTT WALLACE REG.NO" S3g1SQ 3 JOB DESCRIPTION : RELOCATE LAUNDRY&WATER HEATER TO GARAGE FT; ADDRESS: 25271 BENTLEY LN NRr LAGUNA HILLS CA 92653 CLAIM VALUE; CALL—VALUE: GROUP OCC: R-3 / PEflMITTEE: REUTERS GEN CONTRACTING ( 714 ) 251-0181 ADDRESS: 2698 WHITE RD 100 COMMENTS: ADD FAM RM & MAST BED RM/RE-B58772 IRVINE CA 92714 ***##****##*##***###*##AE#*#**############****#***##**#********kF######*######*** LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(comm ting with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full fore d effect SETBACKS CITY afe LIG.),54 58 STATE LIC.:584836 B NWle0442 Signature:. MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: Ihereby affix that I ve a certificate of consent to self insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY ND.: 12 0 0 7 0 8-92 EXP.DATE: 07/01 /93 comma: STATE PARKING REQ• PROV; PARCEL; 11910170 ZNE: REF NO: 0 Certified copy r hereby furnished. Certified copy is filed with the city Build' Divisio . J PLANNING NOTES>> Date:`41✓( 'L� Applicant: , **#*****************#***#******************#*1Fi6**#*************#*********###*** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred 1100)or less). DEVELOPMENT SERVICES C REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become /, subject to the Workers'Compensation Laws of California. ZONING APPROVED BY . DATE:• Date: Signature: • NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. l CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; .' f DATE: f°SP which this permit is issued(Section 3097.Civ.C). ************************* ** *.' 4**�F*# ** ****************** " - ** UNDER: ******************************#**************** ****************************** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the followingreason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 1 4 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business . 5% SMI P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred donors(5500). ISSUE FEE 20 . 00 I, as owner of the property or my employees with wages as their sole compensation, win do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 14 . 00 20 . 00 0 . 00 34 . 00 34 , 00 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 34 , 00 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 34 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware . *****.**il,**.N.*,x..If**.x.**.*******il.1e*********.*.*,.lt,**.**.lE**i0*.*****!(,14*****,**,x)Fx,*)E3f*##****** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 LAUNDRY TUB OR WASHER 7 . 00 7. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 WATER HEATER AND/OR VENT 7 . 00 7, 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representati r of this cit .enter u.in the above-mentioned property for sppeccttiiQn purposes. / 4 Date: F' t/ q Z-- Signalur �/_ ✓ 1., f t_ - m . Driver's License or Social Security 4: ' - • 1641-46 While—Buildinp:Green—Code Enforcement Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit#T Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '6. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit•Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 16. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit • 66. Solar System-Final 16. Rough Electric Wiring- 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure - 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test • 72. Underground Flush • 24. Roof Framing 73. Undergrnd;Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding ! l 77. FIXED SYSTEM FINAL 29. Insulation I 78. FIRE PREV. FINAL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: • 34. Final Heating& Air Conditioning II 35. Final Gas Pipe-Test I I • 36. Hood or Canopy I 37. Final Factory Fireplace 38. Final Plumbing l�(r? 'Z t 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING I I 48. FINAL PLANNING I - -I 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co I • 51. CERTIFICATE OF OCCUPANCY • No. _ Date • PROJECTADDRESS;• 231. 24TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 0ba902 OWNER'S NAME: JENSON- MARY KATHERINE ADDRESS: 231 24TH PL PERMIT NO: P 058902 PLAN CHECK NO; N GOVT: N SUP?; Y COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE; OTH ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : 877SF 1ST FL ADDITION, RE; #B58772 SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: REUTERS GEN CONTRACTING ( 714 ) 251-0181 ADDRESS; 2698 WHITE RD 100 COMMENTS: RE; B58772 PRIMARY BLDG. PERMIT, IRVINE CA 92714 **�r�E�L�P*+tsr�L�E�E�P**�E****srsL+t***�t**+t*�t*.4 ******* **********ars;*****+BSE******+t*** ***>E LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQUIREMENTS 7000)of Division 3 of the Business and Processions Code,and my license is in full force and effect. SETBACK S CITY uc.: 054368 STATE LIC.:584836 CLAss: B —9 2 �G^ T LG.Cil� MAIN BUILDING ACCESSORY BUILDING Date: -3 Signature: FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN Compensation ifswapcp,�b ifiep AWppy thereof(Section 3800.Lab. 7/O1./93 POLICY NO.: +LVV7t. EXP.DATE: COMPANY: STATE PARKING REQ PROV: PARCEL: 11910170 ZNE; REF NO: r ❑ Cemfied copy is hereby furnished. IS Certified copy is filed with the city Building Division. PLANNING N TES> > Date: I_ 3 _ 92 Applicant: P `L . ************3K*********************************'!f**************************3E***ii* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICESREQUIREMENTS 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 ZONING APPROVED B Y DATE subject to the Workers'Compensation Laws of California. Date: Signature: BUILDING APPROVED BY : DATE: NOTICE;It,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor �^v_ Cede.you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED B Y / • CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for •` DATE: which this permit is issued(Section 3097.Civ.CI. *************************te *** i(iF * ** ******************* *'* LENDER: ************************************** *** ************************************ ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 15 , 00 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 10 . 00 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 15 . 00 10, 00 0 . 00 25, 00 25. 00 . 00 - ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED • 25. 00 OVER/SHORT• 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). 25. 00 I,as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'Mate License Law does not apply to an owner of property who builds or improves thereon *****,**,*****,*****,*_,N,******ih*,********,lEie**,1k*************************************** and who contracts for such protects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. for this reason; TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 SEWER, BUILDING / TRAILER 15 . 00 15 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. ylrl �� Date: ' 3 — 9 Z Signature: ! 6.— —c_ Driver's License or Social Security e: - ;641-46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • • CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .i2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding b. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final ' 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • 20. Rough Factory Fireplace APPROVALS - -Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating _ - - 71. ProductPiping 0 Gas 0''Oil 23. Gas Pipe-Rough & Test 72. Underground Flush. 24. Roof Framing =73. Undergrnd.Storage Tank'O 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 i I i - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION - ti 32. Electrical Power Meter-Final ! t • 80.. FOOD CERTIFICATE ISSUED 33. Final Electric -{ r Notes: 34. Final Heating& Air Conditioning -I - , 35. Final Gas Pipe-Test I ,I 36. Hood or Canopy • 37. Final Factory Fireplace - - 38. Final Plumbing 39. Water Service•Final 40, Gas Service-Final I. - 41. Solar Domestic-Final 42. Backflow Preventer 1 I 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co i I I • 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 231 24TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 058775 OWNER'S NAME:'J•ENSON MARY KATHERINE ADDRESS: 231 24tH PL PERMIT NO: P 058775 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ADD \1 �CHIENWNEER: REG.NO.: JOB DESCRIPTION : 877SF 1ST FL ADDITION, RE:4B58772 SQ FT: • ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / PERMITTEE: REUTERS GEN CONTRACTING ( 714 ) 251-0181 . ADDRESS: 2698 WHITE RD 100 COMMENTS. ADD FAMILY ROOM 6 MASTER ROOM IRVINE CA 92714 ********4********** **>E******** ****+t*****->E**+e***x*******x******+ra************* a LICENSED CONTRACTOR DECLARATION: I hereby altirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)ot Division 3 of the Business and Professions Code.and my license is in full force and effect. — SETBACKS CITvuCC 0.5543 8 STATELIC.:584836cuss: B(/[� a Dale:. 9Z, Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS OMPEN ATION DECLAReAATION: (hereby affirm that lh eacerbOcale of consent to self-insure oracenitiwte of workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Man a)brill COpy thereof(Section 3800,Lab.t.1 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: I L U `J G EXP.DATE: 0 7/0 1 /9 3 cuMPANY: STATE PARKING RE PROV: PARCEL: 11910170 ZNE: REF NO: ❑ cenili OPY is h eby furnished. IN Certified copy is Med with the city ' ing D" . PLANNING N TES> )ale: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This se lion need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY , DATE: Date: Signature: BUILDING APPROVED BY ode,NOTICE:u,atter making this lywideclaration.you should become subject mit s the Workers' Compensation provisions of the Labor : DATE: Code,you must lorthwilh comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency far the performance of the work for APPLICATION ISSUED BY• 'd x DATE: 2-7 I which this permit isiesued(Section 3(97.Civ.C). ******************************************jF* ************************ ***** .*** LENDER: **********************************************'********************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: thereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter.improve,demolish,or PERMIT 42,00 0 repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ot not more than five hundred dollars($5Lq). ISSUE FEE 20, 00 • I, as owner of the property or my emvloyees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or oftered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS---—> 4 2 , 00 20. 00 - 0, 00 62 , 00 62, 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himsellMersetf or through . ' his or her own employees,provided that such improvements are not intended or offered for sate.If.however the building or REVENUE DIVISION TOTALS--> COLLECTED: 62 . 00 OVER/SHORT: . 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 62 ' Q 0 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ' and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ***************************************iE*************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUA L. F E E BREAKDOWN o I am exempt Ander Section: B.&P.C. for this reason: TYPE QTY DESCRIPTION ' UNIT COST TOTAL COST Date: Owner: PLU 1 BATHTUB • I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and PLU 1 DISHWASHER • 7. 00 7, 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a 7 . 00 7, 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from PLU 1 SHOWER 7.00 7, 00 these provisions. PLU 2 WASH BASIN 7, 00 14 , 00 PLU 1 WATER CLOSET (TOILET) 7. 00 7, 00 Date: Applicant: END OF FEES I hereby neatly that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and slate laws relating to building construction and hereby authorize tepresentatt sof this 'y to enter ,in the above-mentioned property for'nspeclio ur7oses. LitAl 1 - Dat 'fri-- - Signature: . Driver's License or Social Security a: • 1641.46 Whee—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor - CONS �UCTION'AND PLANNING POOL & SPA Date Inspector Date Inspyotor APPRO �w Permit# Lry 1 APPROVALS Permit # 1. Temporary Electrical Service;9S Pole 52. Pool & Equipment Location r -2. Soil Pipe-Undrgrnd. ars 53. Steel Reinforcement 3. Electrical ConduftUtility-Undrgrnd_ r 54. Forms ` r 4..Electrical Conduit-UPdrgrnd. 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-. Foundation59. Gas Pipe, 0 Undrgrnd., Test ' • 9. Water Pipe-Undrgrnd. e i 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11t 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 - w 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. 'Rough Factory Fireplace - - - ' APPROVALS. - *Permit#j. 21. Ducts,in.Structure -. - - 70. Underground Hydro 22. Ducts, Ventilating,; -_- - ' 71. ProductPiping OG-as 111.,,011 23. Gas Pipe:Rough& test • _ , t - - J2. Underground Flush. 24. Roof Framing - - - •• •J - x73. 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 T • 76. Dry Standpipe - - . 28. Lathing.& Siding - 1 I • - 77. FIXED SYSTEM FINAL , 29. Insulation I f 78. FIRE PREY. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat, , I 79. FINAL INSPECTION 32. Electrical Power Meter:Final • 80. FOOD CERTIFICATE ISSUED -r ,33. Final Electricr. Notes: .r..../..; !' r2 J.iatzt)' it le Tn_GWc' v 34._Final Heating & Air'Conditioning • • - 35. Final Gas Pipe-Tett . i _ r Mr -36. Hood or Canopy 37. Final Factory Fireplace - 38. Final Plumbing f.j/��,/yLf �� 39. Water Service-Final "j' ! �f�/ 40. Gas Service-Final - , '41. Solar Domestic-Final 1 ! 42. Backflow Preventer I I ( - 43. Backf low Irrigation • - - " 44. Landscape Irrigation System . _ • -45. Sound Attenuation • - =46. Handicap Regulations - __ • 47. FINAL STRUCTURE & BUILDING ' i - , 48. FINALPLANNING - i 1 . - - - 49. Electric Release to Edison _ 50. Gas.Release to Southern California Gas Co j I 1. - - - • • 51. CERTIFICATE OF OCCUPANCY . - No. Date PROJECT ADDRESS: '• 231., 24TH PL OWL CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 058 / 14 OWNER'S NAME: JENSON MARY KATHERINE ADDRESS: 231 24TH PL PERMIT NO: M 058774 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: ADD MCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 877SF 1ST FL ADDITION, RE:#B58772 SQ FT: - ADDRESS: - UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: REUTERS GEN CONTRACTING ( 714 ) 251-0181 ADDRESS: 2698 WHITE RD 100 COMMENTS: ADD FAMILY ROOM & MASTER ROOM IRVINE CA 92714 ********************************+E*** **********:ESE*****+E**********+E******IES¢***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Processions Code.and my license is in full force and elle . SETBACKS CITY uc Z��,8 STATE UC.:584836///./{��)cuss: B Date: �� Signature: %/ MAIN BUILDING ACCESSORY BUILDING FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: Ihereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation sof °., Ili py thereof(Section 38O,Lab. POLICY NO.: i L " � EXP.DATE: 7/01/9 3 COMPANY: STATE PARKING REQ: PROV: PARCEL: 11910170 ZNE: REF NO: ' ,;;,{ PLANNING N TES> ( ❑ Cemf o is ereby lumished. L'1 Certified copy is filed with the city Buildinr,a".4n > Date: y Appliwnr -al ' DEVELOPMENT S E R` V I C E S REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Nus section need not be completed if the permit is for one hundred($100)or less). I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become •• subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Dale: Signature: it BUILDING APPROVED BY : DATE; NOTICE:IL youshould after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor . Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. • CONSTRUCTION LENDING AGENCY: Ihereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE• e)(Li% C1 which this permit is issued(Section 3097,Civ.Cl. ******'#**'*'lk**********************'**'N'*** * ***** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 22 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15. 00 I. as owner of the properly or my employees with wages as their sole compensation, will do the work. and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS--———> 22 . 00 15, 00 0 . 00 37,00 37. 00 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 37, 00 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve foror the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 37, 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 I do hereby certify that I am aware of and understand the requirements of Califomia Health and Safety Cade Sections 25505,25533,and MEC 2 FACTORY FIREPLACE 6. 50 13 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify That I have read this application and state that the above information is correct.I agree to amply with alt city and county ordinances and state laws relating to building construction and hereby authorize representativ (this cit e'nter upon l� above mentioned Dale:property In},yns� n Duro es.�� (4Y% ,) Dale: r SignaWr �'/ Driver's License or Social Security a: - 164 i-46 Mae—Building:Green—Code Enforcement:Canary—AoolicanL Pink—Revenue:Goldenrod—Assessnr CONSTRUCTION AND PLANNING POOL & SPA -APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location • . 2. Soil Pipe•Undrgrnd. e _ 53. Steel Reinforcement _:i. Electrical Conduit Utility-Undrgrnd. 54. Forms _•4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 51 Steel Reinforcement 3- 56. Rough Plumbing& Pressure Test • 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Ccnduit•Undrgrnd. 8. Foundation - • 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 1 i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing , • - 65. Electrical-Final • . 15. Rough Electrical-Conduit , _ 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval ' • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT.REQUIREMENT _ - - .f. _ - i - 20. Rough Factory Fireplace - ' - APPROVALS -r Permit 4 -. - ' 21:.Ducts, in Structure I `.70. Underground Hydro r 22. Ducts, Ventilating - -" ' ;71. Produc(Piping ❑Cru ❑Oil 23. Gas Pipe:Rough &Test ,; - 72. Underground Flush i- • 24.-Roof Framing _ 73j5 Undergrnd'.Storage,Tank p Gas 0 Cif 25. Roof Sheathing . • < c '74^Overhead Hydro_ 26. T-Bar Ceiling (Structural) & Monocoat - ':' - 75. Dry Chemical -- ' 27. Frame and Flashing - - - . 76. Dry Standpipe . • .28. Lathing.& Siding. • - ( ••; ' 77, FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing r ' 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 . • ./Hil ' . - . • 35. Final Gas Pipe-Test `, _36. Hood or Canopy - - I 37. Final Factory Fireplace 38. Final Plumbing - - - '39. Water Service-Final- - - 40. Gas Service-Final -41. Solar Domestic-Final 42. Backf low Preventer I 1- - - - 43. Backflow Irrigation - - I. 44. Landscape Irrigation System - 45. Sound Attenuation - - - _ ' 46. Handicap Regulations - - _ • I 47.sFINAL STRUCTURE & BUILDING I - - 48. FINAL PLANNING . . . .49. Electric Release to Edison , ' I . `50- Gas-Release to Southern California Gas Co 1 ! I. - - - - 51. CERTIFICATE OF OCCUPANCY - No. Date 414/ [ OV E:PflO3EC', Ms 231. 24TH PL JENSON MARY KATHERINE UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 058773 ADDRESS: 231 24tH PL PERMIT NO: E 058773 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE: ADD ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 877SF 1ST FL ADDITION, RE: #B58772 SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE; GROUP OCC; R-3 / PERMITTEE: REUTERS GEN CONTRACTING ( 714 ) 251-0181 ADDRESS: 2698 WHITE RD 100 COMMENTS; ADD FAMILY ROOM & MASTER ROOM IRVINE CA 92714 ***************+E********+6**+E* >t**x*EH********xlt*** **+r****** -x** **FH************ LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS clnu p_54�68 srATEuc:58483 cuss- a4. uss Date: / i7.--- Signator . MAIN BUILDING ACCESSORY BUILDING — — FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm th have a certificate of consent to self-insure or a certificate of Workers' LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN Compensation I s��aI��r4�c(py�,p[ r�M1lfie�yppy thereof(Section 3800.Lab. ) POLICY No.: f L V V /b tl—`11 EXP.DATE: V 7/O 1 /9 3 coMPANy: STATE �n PARKING REQ• PROV; PARCEL: 11910170 ZNE; REF NO: 0 Cenitie copy is h by furnished. LJ Certified copy is filed with them siding is nn. PLANNING NOtES> Dale: 4/ Applicant' „/4Y`�— - - A ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DE VELOPMENT S E—R V ICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner,so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: BUILDING APPROVED BY : "• DATE: NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions1of the Labor Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. - • / CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance Of the work far APPLICATION ISSUED BY• DATE; Z �F l . which this permit is issued(Section 3097.Civ.C). .(� ******************************************* ********************* * * ***** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 4 9 , 25 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant far a permit subjects the applicant to a civil penalty of not more than five hundred dollars(SSW). ISSUE FEE 15. 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS S ---—> 49 . 25 15. 00 0 .00 64 . 25 64 . 25 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sate.It,however the building or REVENUE DIVISION TOTALS--> COLLECTED; 64 , 25 OVER/SHORT; 00 forptheepa pose of soldsaei)nln one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECKK as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 64 . 25 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ********'****'*'************'****'****'********************************************** that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BR EAKDO W N ❑ I am exempt under Section: B.d P.C. tor this reason: _ TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: ELE 18 FIXTURES, LIGHTING 1 ST 20 EA. . 75 13 . 50 I do hereby certify mat I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 13 RECEPT/OUTLET 1 ST 20 EA. . 75 9 . 75 25534 and that I or any future building occupant wil0will not(circle one)need to comply with said state codes and the requirements for a ELE 10 RECEPT/SWITCH 1 ST 20 EA. . 75 7. 50 permit for construction or modification from the Air Ottality Management District.Residential construction applications are exempt from these provisions. ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50 END OF FEES Date: Applicant: I hereby really that I have read this application and state that the above information is correct.I agree to comply th all city and county ordinances and slate laws relating to building construction and hereby authorize repress lives of this to enter u the above-mentioned properly r ./spection urposes. Date: f v1in— Signature. Driver's License or Social Security N: _ - 1641-46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # - Date Inspector APPROVALS Permit # Date Inspector . TemporaryElectrical Service of Pole -'-. , ,li52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • :s. Electrical Conduit Utility-Un3}grnd_ 1 54. Forms -.S. Electrical Conduit:-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6: Electrical UF ER Grnd. c 57. APPROVAL TO COVER-GUNITE - 7. Footings 58. Electrical Conduit-Undrgrnd. .8. Foundation i 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. t0. Structural Floor System 61. APPROVAL TO DECK .1 11. Property Sewer Line & Hoose Connection- • 62. Backwash & Receptor-Final _ 12. Sewer C ' 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 `i 5942 /L 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 . •J r 20.•Rouljh Factory Fireplace . - - • APPROVALS = -Permit # • - - ) ♦ ♦ - tt ♦ J 21. Ducts, in,Structure. - - _ - t7O. Underground Hydro 22. Ducts, Ventilating, ; . 1._ _ - Product Piping OGas ClOil 23. Gas Pipe:Rough & fest , .t 72. Underground Flush-. • 24. Roof Framing - ' ' -73. Undergrnd:Storage:ank ID Gas 0 Oil • 25. Roof Sheathing r - 's. , -74. Overhead Hydro- 26. T-Bar Ceiling (Structural) & Monocoat _ ' 75. Dry Chemical - - 27.:Frame and Flashi0g. - t ; - . 76. Dry StandpiRe 28. Lathing & Siding I • 77. FIXED SYSTEM-.FINAL' • ' -29. Insulation " I I L , 78.:FIRE PREV. FINAL - - 30. Drywall Nailing HEALTH DEPT:REQUIREMENT 31. Plaster Brovgn Coat' r. - 1.- ' -79! FINAL INSPECTION'. . . 32. Electrical Power Meter-Final r . i -80. FOOD CERTIFICATE ISSUED 33.'Final Electric- ill li , Notes: -. , 34. Final Heating & Air Conditioning_ , . _ • . 35.-Final Gas Pipe-Test c. I - 36. Hood or Ch Canopy - - - . 37. Final Factory Fireplace , '. i 38. Final Plumbing - e - - • • 39. Water Service-Finan ! • .. 40. Gas Service-Final • . . I j - - ' •41. Solar Domestic-Final • - ` 42. Backflow Preventer. 43. Backflow Irrigation - _ .... - 44. Landscape Irrigation System - .. . 45. Sound Attenuation - ; r . 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 1 48. FINAL PLANNING I . 49._Electric Release to Edison 50. Gas Release to Southern California Gas Co � 1 r . 51. CERTIFICATE OF OCCUPANCY - -- No. Date COUNTY OF ORANGE Application for Building Permit - BUILDING DEPT. Permit No....4/A 517 636 No.Broadway AND FOR A Santa Ana,Phone:K 2-621nia Certificate of Use and Occupancy Phone:KI 2-6211 p y Date Sa,Dt....2z.,...13..s2w 1. OWNER'S NAME F. 1j...21341S9911 PHONE:B§.60911 6749j MAILING ADDRESS 258...3anta,..lea4ei..Sta CITY 9Git4..MQM Name Droner Name Owner (Architect or Engineer) (Contractor) I Address Address City City State State Lic. No Phone Lic. No Phone PROPOSED USE• Dwelling and An/Wiled g4rage 2. JOB LOCATION --231 24th Place- Costa--Mesa.----- (House No.) (Name of Street) (Town or School District) NAME OF AND DIRECTION FROM NEAREST CROSS STREET Weatitans ter Plage &1st 3. LEGAL DESCRIPTION: Lot..........2r8 Block Tract 1442 (Metes and Bounds Description—Use reverse side of form) 4. CORNER LOT ( ) INTERIOR LOT (x ) THROUGH LOT ( ) SLOPE OF LOT ( ) i. SIZE OF BLDG • 36x41 AREA• 900 SIZE OF LOT41.34..1.34 AREA- 72-0-o 6. HEIGHT OF BLDG - 14 CEILING HEIGHT 8-4 NO. OF STORIES 1 7. NO. FAMILIES 1 Size of Smallest Bedroom 1042 Size of Kitchen 9-6 x 16 . 8. EXTERIOR WALL CONSTRUCTION- atueco INTERIOR WALL COVERING Narita: (Frame, Stucco, Etc.) (Plaster-Drywall,Etc.) ROOFING COVERING Compcaition..Shinglea 9. STATE HOW MANY BUILDINGS NOW ON LOT AND GIVE USE OF EACH none 10. SETBACKS: Front Yard From Center Line of Street 90 LO" Nearest Side Yard ,5' Rear Yard .25' Distance in Feet Between Bldgs. on Same Lot none (Property Line) (Property Line) 11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 12. (a) Footing: Width 14" Depth in Ground 12" Width of Wall 6" (b) Size of Studs- 2x4 Spacing .16 "CC Material of Floor woot (c) Size of Floor Joists 2x$ Spacing 16 - "CC ' (d) Size of Rafters• 2x4 Spacing 24 "CC 13. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $ 6300e00 2Y.00J - 14. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFOIA PPLIC SLE THERETO. Signed- *f I IL�Ly (Owner) Plans Filed• SEP....2..9...1952 By. (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: CHECKING BY Bldg. Permit • $ bre 0 GROUP..Tire, -r APPLICATION. HEALTH Plan Check ,Y-----'$ 2 0 0 TYPEZONING ✓ FIRE Total • • - $ .� / 0 U DIST. L MARSHAL Receipt No. G SPANS AND . d?Y-7 7 MAP _ PEC'S STATE Paid to SHEET NO...:....D CORRECTIONS ENGINEER Date SER .24-452- wi ;•..` tie, P .-._. "R1v1ITT SUED :Y: ppk - SEP 2 4 1952 {•. __t _i-I° f fi DATE � -' soon--9-s9 - C