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HomeMy WebLinkAbout3030 MADEIRA AVE - Building Permits CITY OF COSTA MESA 4 BUILDING DIVISION ;w���'„"t, PERMIT NUMBER F 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT s0,� B02-01406 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT - Job Address: 3030 MADEIRA AV Status: ISSUED Suite: Applied: 09/03/2002 Vicinity: ROOF Issued: 09/03/2002 Parcel Number: 13917306 Zoning: R1 R1 —��J���, Applicant: CHURCHILL, RICHARD ISSUED BY: Address: 4425 FOREST GLEN RD Phone: (714)974-0456 ANAHEIM,CA Zip: 92807 Owner: MUELLER, KENT Address 3030 MADEIRA AVE Phone: COSTA MESA,CA Zip: 92626 Contractor: CHURCHILL CONTRUCTION Address: 4425 FOREST GLEN RD CA Phone: (714)974-0456 ANAHEIM Zip: 92807 License: 660990 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL SHEET WITH 7/16 OSB,30 YR COMPOSITION SHINGLES.3,300 SF INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,500.00 Permit: $167.25 Claim Valuation: $8,500.00 SMIP Res: $0.85 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.10 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: KENNE_S 09/03/2002 PER SALEM, OK TO ISSUE PERMIT WITH"B” LICENSE. 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 1 244846(6W) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ! 1 0 1 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' on" compensation Insurance Insurance carrier and policy number are: eiE,. 57AM I Al 0 cPoli[yNumber: I '3(,1575I o O 3 rThis section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro v'sions. y ApApIic�ant.Signature: —J`-""' �^'e�,_� / -3 -o 2 W, N0 FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOlARE(5100,000),IN ADORION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: b I hereby affirm that I am licensed under provisioocr ns of Chapter 9(commencing with Section 7000)of Division 3�e Business arm Professions Code,and my license is in full force and effect.Llc.a Co 0 9 9 WCiess'a JS • . oontractOfsSignature: /' &S&'- � _ tate:- 1/ '3-0 2 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 then 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 properly 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,es owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 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 a eNnll for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes PI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit 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,end authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. bi ature Of Legal Owner(s) Date 9 _ 7 AOnd7Or'Authorized Applicant ,Pate-..,,_ CODE 0 INSPECTIONTYPE RAIL INTIRAL$ LODE( INSPECTION TYPE PATE OflUAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof a-L#-te-- 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WPROIIECT..ADDRESS: 3030 MADEIRA AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 047188 OWNER'S NAME: ROBERT REED ADDRESS: SAME PERMIT NO: B 047188 PLAN CHECK NO: N GOVT : N SUPP : N CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: ALT 549-1269 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF LEGALIZATION SQ FT: 3, 800 ADDRESS: UNIT: CLAIM VALUE: 3, 800 , 00 CALL-VALUE; 3, 800 .00 GROUP OCC; R-3 / PERMITTEE: ROBERT REED ( 714 ) 549-1269 ADDRESS: 30301 MADEIRA COMMENTS: 15#FELT & ASPH SHING 0/EXIST WOOD SHINGL CM CA 92626 ****************************Ear *****+E*********************Ea********************* UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQU IR EMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY UC.: STATE UC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORMERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a cenifiate 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 POUCY NO.: EXP.DATE: ^DMPANY: PARKING REQ: PROV; PARCEL : 13917306 ZNE: REF NO: J Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: **********************************************************************ie******** EXEMPTION FROM WORKERS'COMPENSATION DECORATION: (This section need not be completed if the pemut is for one hundred(5100)or less). DEVELOPMENT SERVICES R EQU IR E M E N .k- S I certify that In the performance of the work for which this permit is ed,I hall not ploy any perso ny mann so as to become 4- subject to the Workers'Compensation Laws of California. /J' ZONING APPROVED BY yf �coms lee '�E% DATE: io �. Date: Signature: NOTICE:II,atter making this declaration,you should becom subject to the Workers'Compensa n provisions of the Labor BUILDING APPROVED BY _ DATE: ,--> Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. ccc � ��� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY, is= DATE; S'3 which this permit is issued(Section 3097,Civ.C). ********************** z• ********** * UNDER: ************************************* ** ************************************ ADDRESS: ' LEGALIZATION;Y F E E S U MARY 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 ELECTRRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 126 .00 5 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 SM I P/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 70W)of Division 3 of the Business ' and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($503). ISSUE FEE -- 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 PLAT;CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 126 . 50 0 . 00 0 . 00 126 . 50 126 . 50 . 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--> COLL EC,TIED • 126 . 50 OVER/SHORT: . 00 improvement s within one year of completion,the owner will have the burden of proving he/she did not build or improve forthepurpose ofBLDG 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 126 0 0 50 ❑ 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).I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL i' F SE BR EAKD O W N ® I am exempt under Section: 7044 B.8 P.C. Q �; for this reason: WORK ALREADY DONE '�/� �( rf.G/( TYPE QTY DESCRIPTIO S C R I P T I O N UNIT COST TOTAL COST / 6 ^� Date: Owner. v SFR 3800 I REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 3, 800 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sectiros 2 n 25533, rid END•'•O F 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 Uualiry Management District.Residential construction applications are exempt from 7");, 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 SMOKE DETECTOR ordinances and state laws relating to building construction and hereby autho'a representatives of this city to ent port the ova-mentioned ; • property for inspection purposes. —....Date: _ _ Signature: l/ { EQU+REP4 01 O0060079-00060080 TOT 126.5`0 Driver's License or Social Security x: DRTE: 05/03/90 TIME: 10:27 181146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor kl/.. 'f •� CONSTRUCTION AND PLANNING POL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole , 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding _ 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation59. 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 ConditioningFIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace . - - . - APPROVALS ' --:Permit # 21. Ducts, in Structure 1 -t' 70. Underground'Hydro 22. Ducts, Ventilating - - - . - , -'71. Product Piping OIGas 0 Oil 23. Gas Pipe-Rough& Test - . - 72. Underground Flush ' • a.24. Roof Framing - - - 73. :Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monbcoat 1 - -. 'may• 75..,;Dry Chemical - - 27. Frame and Flashing - . - 76. Dry Standpipe -r' 28. Lathing & Siding ' 77.• •FIXED SYSTEM FINAL., 29. Insulation 78. :FIRE PREV. FINAL • 30. Drywall Nailing . ' ' 1 HEALTH'QEPT. 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 : . (' Q 5, . G e-. �t,LG�` - 0,C 35. Final Gas Pipe-Test - ", '. -y c aP�/�t-' 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 Iriigation System - _ 45. Sound Attenuation - - r 46. Handicap Regulations - _ 47. FINAL STRUCTURE & BUILDING •7 /..2 6ct - 48. FINAL PLANNING - 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co 1 51. CERTIFICATE OF OCCUPANCY / No. Date PROJECT ADDRESS: 3030 MADEIRA AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 060645 OWNER'S NAME:MUELLER KENT ADDRESS: 3030 MADEIRA AVE PERMIT NO: M 060645 PLAN CHECK NO; N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH ARCH/ENGINEER: ( 714 ) 754-4060 flEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : FORCED AIR UNIT CHANGE OUT SQ FT: PEflMITTEE. CLAIM VALUE; CALL—VALUE: GROUP OCC: R-3 / ADDRESS:GRAHAM BROTHERS ( 714 ) 546-1653 2952 CENTURY COMMENTS: FORCED AIR UNIT CHANGE OUT/FORCED AIR UNIT CHANGE OUT! COSTA MESA CA 92626 *****+H**4*+t*********sr*****se*R *****************x**+r*****+r*****;r*;r****sr*;e******** 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 Professions Code.and m license is in lull force and e SETBACKS CITY LIC.:.? S 6 L /3� SipTE IIC.:2 4 ; � . cutss:C—2 0 �' Date:_1_ Signa, gilli. _ _ _ _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENS TION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section MO Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.:WC7161030226012 EXP.DATE: 08/01 /93 coMPANr:LIBERTY MUTUAL PARKING REQ: PROV: PARCEL: 13917306 ZNE: REF NO: ❑ Certified copy is hereby furnished. X.I Certif opy is tiled2•h the city Building Divi PLANNING NOTES> Date: LOM �.J✓ LAPP V� ******************************************************************************* EXEMPTION F WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(5100)or less). DEVELOPMENT S E R .V. I C E S 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:It.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : 7 DATE: 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 for APPLICATION ISSUED BY, DATE which this permit is issued(Section 3097.Civ.C) ***************{E********** ** * *'` LENDER:CHANGE OUT ONLY ******************************************** ********************************* ADDRESS: CHANGE OUT ONLY 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 9 00 repair any structure.prior to its issuance.also requires the applicant for such permit to life 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$ 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 PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). 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 Processional Code: The Contractors'State License Law TOTALS----> 9 . 00 15. 00 0 .00 24 , 00 24 , 00 .00 does not apply to an owner of a property who builds or improves thereon,and who does such work himsellherself 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: 24 . 00 OVER/SHORT: 00 tor 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 24 , 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).I am aware *****************,********,*.****.******.*.**,*.. ****.***,*.****************.******.*,*,***,*** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN 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 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 Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I herebycertifyy that I cos relating td mo uitdrngtion snd tiole that the above information is correct. a e to cand county a hereby andsgate lawsead lo buildmgiconstruction and i 'rile representativesol this cit ocompl upon withha aboyandc county property for inspection urposes. e ------ Date:_1 7 L ✓/ + 5 Signatur al. - . • Driver's License or Social Security a: 1641,46 White—Building:Green—Cade Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor ' CONSTRUCTION AND PLANNING PO(.- a SPA • j APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service qr Pole. -. 52. Pool & Equipment Location 2.,-Soil Pjae-Undrarnd.- . . , -63. Steel Reinforcement ' 3. Electrical Conduit'-Ut,+ity-Undrgrnd r-' b4. Forms ¢1?Electrieal Condyit-Undrgrnd. _ - `1:;,55. Electrical Bonding S 5:Steal ReinforcementL. _ C.. 6. Rough Plumbing & Pressure Test v 1. - -r, : ,tii-ctucal UF ER Grid. C t 57. APPROVAL TO COVE R-GUNITE -'7. Footirtgs •- .',t. • <-58. Electrical Conduit-Undrgrnd. 1 , 8. . oundation • 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& HOUre Connection • 62. Backwash & Receptor-Final J 12, Saner Cap -t o ' _ 63. Heater & Vent-Final ! 13. Roof Drains - _ , _ 1 64. Plumbing System - Final .1 14 Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit ' 66. Solar System-Final 16. Rough Electriciyiring 67. Fencing& Access Approval , 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &Air Conditioning • ,r -FIR .9 ,EPT. RIEOUIREMENT r 1 r r r 20, Routh Eactoe, Fireplace -, n c..� , - . .. tkPPROVAkst ..Permit# - - _ - -- "- 21. Ducts,in Str&tur ' " -• .. . ' t-'- • i/0. Undergrb't1;1diJHydro r ., r 1 1 r. r„ti.' ,i.7 22._ducts,Ventilating'; r. - S n r• _ .71. ProducteiPlrg 0 C-.js C... v 23. Gas Pipe-Rough & Test 1 -r : +k T - S .. ' •' 72. Undergro&n{1,FIJh= 'r 24.-Rot Framing u i r- '- '• - a C _ ; '73=JJndergrnd.Storage sank bGas ❑Oil 1 -' 25. Root Sh thing d + • - - ' -74 Overhead Hydro' y' ,en4c • - ,r 'k 75.yDry Chemical 26. T-Bar Ceiling (Structural) &SFi� oat �. --- « ,. .. - . - = S , - •- - _-•-ti ti 27.Frame and Flashing- ..:::C^ :• t ' • } i 76. Dry StandpiOe - _ .28. t.athingi& Sidindy A ,, ti ..i K ,, 77.;FIXED SY$jEMjF;NAL> -. r •_� 29. Insulation ' ` \ l '! 78?FIRE PREV. FINAL W `C 30. Drywall Nailing '. _ a - HJ4LTHZJEPT,REQUIREtNIENT t 3.• 1. -a r .. '31. Plaster Brown Cost' t. e w 779. FINAL INSPECTION i T e . . . •--�. t.-_, .. - 732.'Electricat Power tWe`Jcrr-Final! y x .. "g0. `FOOD CERTIFICATE IS$,UED , ::33.:-.?MA Electric. ::::g .rS ' r Notes: - r -_, - .rte•-s1 34.' Final Heltin & Ai/Conditioningr- f; q� /Ag/Ago':3 � p ' r • - -� _I - 35.-Final Gal Pipe•Teit-. _- •- 1 1. - - - - - - - 4 - . X36. Nood or CanoPY ,r ' _ x F ti , -37.:Final Factory Firctlace.- - --i I I s ! - -- --J I 38. Finis Plumbing a I y - _ '' : - -' " rt. - I I - t i.+.} _, .. 39. Water Service-FinAl- •N. 4 X ti. a, r 1 J- „ • 40. Gas Service-Final- ' 'r ' r I K T� - 7STM '41. Solar Domestic-Filial --t• - - II • - - r: i . �- Y -� r • - 42.Backflow Preventer I le - . - > 43. Backflow Irrigation, I ion J cr44. •Landscape IrrigatSystem- ` • `- =�T ; _ - 45.=Sound Atte(tuatigrk .. - r . 'r= - - Kms. .�•_ ' _46. Handicap Regulations - -.- -47.'FINAL STRUCTURE & BUILDING I (_ , - -, 48. FINAL PLANNING t - '_ T f • 49.-Electric Release to Edison ' 1• - '' ` :50.-Gas_Release to Southern California Gas Co I i; - r• 51. CERTIFICATE OF OCCUPANCY •- , - No. Date OWNER SYCAMORE LAND CO DATE 6_29_59 __ JOB ADDRESS 3030 Madeira Ave. . BUILDING PERiMIT NO. Q738 GENERAL CONTRACTOR Malgren Cont. VALUE $ 16,936 _ AP. No. LOT bD TRACT FIRE ZONE DESCRIPTION OF WORKr es att gar I' 'ECTIONS f�lr / ,. DATE I GROUP. I & J TYPE V ZONE R1 L. _rground Soil Jy7U.G. Water I�rica..gzev SUBCONTRACTOR PERMITS ISSUED Underground Gas _DATE NUMBER Overhead Water and Gas Rough HeatingumiS -,L 3; / ' , _ _ O- `j „99 z---- Rough Rough Plumbing /,(/_ _ L 't __ : ,a._� 7-/7-3-.7- i 9p ✓ _ Miscellaneous , Prop. Swr. Linc' House Con!/ St. Sw-ik7L, ci/6-5/ .,2t.`�a.y'F L.�.eti 9-//- s9 Jd' • Sprinkling System // cetib_ Heating, Final ��9.�PQ _ —eO Plumbing Fixtures X11 ea— gr,a _i3 i/'� Finalt Gas Test .//. u/ '•Tf'•G'n a ii'" Construction Pole Underground Power P-7-- � Rough Wiring YT1 7-l/-47 %l ,i, ynp-s9 /6°60 I/ Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Sh^+thing 0144 _i I _.5• I e and Flashing J(1'; 9 • i-if ',awing, In7Q Out e Q •n^17 Plaster, brown coat t c p-j -19 Plumbing Fixtures, Final f(}j .' 2-&6k, Electric Fixtures, Final "2, h eti a Building, Final Gtr Q -/1•6.11 OCCUPANCY I Form 210-3M-4-59 W9735 .:3 0 6'. COSTA MESA BUILDING-SAFETY DEPARTMENT Y I ' IL • T 1_I j, P.O.BOX 317 COSTA MESA. CALIFORNIA • ' '' '•T'• , e. fOR APPLICANT TO f/LL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING 3b 7,^ntr-/2 ^ `/ COSTA MESA, CALIFORNIA fel OFFICE USE ONLY Land I RECEIPT NO. I [PERMIT NOI/ OWNER Sycamore Land Co. I 3 e(/ AMAIL DDRESS l0835 Santa Monica B1Qd.. RECEIVED,BY I ;DATE RECEIVED�J 6DAT IU ED Los Angeles TEIBr23287 BUILDING /`/ V4,{I CITY NO. ADDRESS CT OR i EER L. C. Major NO. COSTA MESA, CALIFORNIA ADDRESS 11015 S . Paramount B1 FIRE ZONE TYPE GROUP Malgren 117onst. STATE 153335 APPROVED CONTRACTOR LIC.NO. BY DATE ADDRESS 10835[ Santa Monica Blvd. ZONING DESCRIPTION I NO.LEGAL V O I BLOCK I. ZONERI I PLANS NO.OF I BUILDING /am am y APPROVED / DATE //�S (.� ,A.P.NO. b SIZE NO.OF YARDS EVES OF LOT 111 .10 X 67 .00 I NOW ON LOTS O REQUIRED ALLOWED USE OF (CENTER LINE ST.tel/ EXISTING BLDG. FRONT f/ FT, IN. SETBACK LINE FROM 50 34 CENTER OF STREET REAR YARD R.SIDE . FT. IN. SIDE YARD I LEFT 5 I RIGHT 5 L.SIDE ._[ FT. IN. DESCRIPTION OF WORK Z y • REAR FT. IN. NE I X II ALTERATION I II ADDITION I REPAIR I II MOVING I II DEMOLISH I BUILDING NO.OF SIZE 1 707 ROOMS 7 STORIES I EXTERIOR WALLStuccjROOF Wood. shinlf COVERING YCOVERING 4 Uf Jfliflrftl*W2 h33ifut n,Yh° Win. Att.Gar. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT BROWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY ORDINANCES AND STAT[ LAWS R80ULATINO PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUC �, VALUATION Set SIGNATURE OF /v PERMIT FEE $ ► PERMITTEE) �< ' ne �-O" f 931 $ /6j PLAN CHECK $ /C/� AUTHORIZED AGEN /t //�/ ,. _ \ TOTAL FEES 4,. :1DwNtat. nrJ;D, nooert DATE 2-21-67 3, JOB ADDRESS 3030 Madeira Avenue BUILDING PERMIT NO. 26712 GENERAL CONTRACTOR Wayne Howard, Inc. DESCRIPTION OF WORK Add'Fam.Rm.to res. Nn.139-173-06 LOT TRACT FIRE ZONE VALUE $ 3,937.00 I ECTIONS I Signature Date GROUP I TYPE V ZONE E-1 Son PERMITS ISSUED Gas SUBCONTRACTOR I Date I Number I Signature Water Plumbing Rough Plumbing Prop. Swr. Line 0 House Con.0 Sprinkling System Miscellaneous Rough Heating and Air Conditioning ,fVWtC 7 s2.9'di7 Temporary Service or Pole _ Underground 0 Power 0 _ Rough Wiringj`. -s`E1 Heating and Vent. Trenches ® Forms ® Steel Rein/. E1 eti 3 -/6-67 p4// . 6. yy, ?-a7-/'' Floor System ?3'61 9 -,4_67 J '7 Bond Beam 0 Steel Reinforce 0 Sheathing J"!3/9 3n9.--c7 Frame and Flashing 4.01 4-7—G7 Lathing—In E Out 0 eat- y-/y-€y Plaster, Brown Coat y-3-7-6,7 S. `ural, Final _/�_ lectric __ _ E .ng, Vent, Refrig. and A.C., Final Jl/jf,$ 3-2-r-0 -0.1 '„_i_, _�,�p_.a-.254-6y (o Plumbing, Final and Gas Test 0 I O /� _ /' Electric, Final 11716 5,5-:C Building, Final rpr-b )",,i£7 Mr26912 FEB 21-67cwg,00 812* ****22.50 • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92020 - For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING /� /�/�/� /� /�^ - For Office Use Only BUILDING 3030 / '//j S/�•• /1 X' ADDRHDS RECEIPT NO. PERMIT NO. COSTA MESA. CALIFORNIA _ / REC VID Sr DATE RECEIVED DATE ISSUED OWN[ ?,o/aar—Re ed . I yea. &mGJ�67� 2-z/-6/ MAIL �^ 3a �W,J -d /I /L • BUILDING raj n30 / / ket 12A J ADDR r l ✓ /�/ FY ADDR[AB�j �) (-(%C// �, ,/� TEL•1 y �/q ZONA �} TYPR Air GROUP r CITY LT* /44,01.4 NO..J /2I ",^.HITECT /��1 a�0I1 TEL 6a 1 APPROVED ///'3 ` DATE 2 �_�/ INGINEER / LJ A 4 NO�-1 (n 7 rer /, v` ADDRESS//id 11/41764 R. .J / 4,VA ZONING ZONA[ NO.OI USE OF NEW y CONTRACTOR II/E¢yNe/rla W#1RO' .4 �� PLANS BUILDING �/ V ADDRESS /I/��/6 /7<//M�Mbe4 8///V 1..) LEGAL ./� 3 3�iJ -,rJj(k.�'�n� CITY�5t41 /1,125.057 •(91ti 'b AA.P.NO. EAV/59-)73-de 59 173NG SHALL BQdLQ�TNAN LIC.40...2042:d .'704 n O QL. 6/?/— / �/�/� 80'TO SIDE O REAR e.L LIC.NO✓/( �J I� OC / J (A / !j' EAVES OFLOT 1O/ /� / e(p ' I NOW rOLDGN LOT . / ALLOWED - (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE EXISTTFING BLDGCF/9NI/1/Y 7©D,`�/ (FROM C/L MAIN BUILDING ACCESSORY BUILDING SETBACK LIST FROM .'I 9 Io/ as�T REAR YARD.3//f7tl no t4u h" SENTEII Or NESTREIT .DC 7 1. (J �• SIDE YARD I LEFT a / RIGHT 5/ R.SIDR / Fr. f0 FT. DESCRIPTION OF WORK L.SIDE 5 R, Fr. X ALTERATION ADDITION REAR / FT.� - Fr. /- — DISTANCE BET. BET.MAIN a REPAIR MOVING DQMOLIBN MAIN SLOGS. ACCESS.BLDGS. BUILDING �/ NO.OF 8 / VAR.# DATE SIZE ID./X ROOMS L/ STORMS C.U.P.# APPROVED /�/ EXTERIOR WALL CI•�u�•pI COVERING e/ /IT •PROVED . /n.,. DATE O.-4/'/� / COVERING .J/ L./lX�� USE OF BUILDING AND WORK TO BE PERFORMED O. G 62,46/ Y - - /-4,/y r77 i 1 _ 3�, . 3J5. .FT. 1 A I HEREBY ACKNOWLEDGE THAT.1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 2 AND STATE THAT THE ABOVE,IS CORRECT AND AGREE TO CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. APLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION } BUILDING CONSTRUCTION. 1 Ee/Q(/(/jf16Q S� PERMIT FEB /5. 5v SIGNATURE OFLI '/' //���` ,/ �7 ///��� 7 /� E PERMITTEr [�CGIR}ti.1•- 'I $ �}/ �J�7�� PLAN CHECK E �L/ w AUTHORIZED AGENT �/ / / , .c0 .N. - o•. - r - - TOTAL PEE S C/