HomeMy WebLinkAbout1020 19TH ST - Building Permits0 •
CITY OF COSTA MESA
A`eg,<n MEq BUILDING DIVISION
i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 - Fax (714) 754-4856 - www.ci.costa-mesa.ca.us
F
� FOR INSPECTIONS CALL: (714) 754.5626
PERMIT NUMBER: BX11-00223
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 42253226 DATE ISSUED: 07/26/2011
Zoning: I ISSUED BY: KJB
JOB ADDRESS: 1020 W 19TH ST CM Suite/Unit:
Vicinity: Primary Occ: Const Type :??
SO. FT: 0 Valuation: $9,800.00
SCOPE OF WORK:
2.070 KW PHOTOVOLTAIC SYSTEM. 9 PV PANELS WITH 1 INVERTER
OWNER: BAIRD, EARLE J TR Address:: 1020 W 19TH ST
City/State: COSTA MESA, CA Zip Code: 92627
Phone: 949-645-8170
APPLICANT: KEMME, JENNIFER
City/State: MORENO VALLEY, CA
Phone: 1-800-794-1972
CONTRACTOR: SUNBELT SOLAR SYSTEMS
Address:
26881 PRAIRIE DOG LANE
City/State:
MORENO VALLEY, CA
Zip Code:
92555
ARCHITECT:
Phone
ENGINEER:
Phone
FEE SUMMARY
Building Plan Check:
Building Permit:
Electrical Permit:
SMIP Residential
SMIP Commercial
Bldg Std Admin Fund
Q
Address: 26881 PRAIRIE DOG LANE
Zip Code: 92555
License No. 530809
Phone 1-800-794-1972
License No.
License No.
$117.81
$181.25
$59.90
$0.00
$0.00
$1.00
Cell:
Unit
Unit:
Unit:
TOTAL FEES $359.96
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. Prohibited all hours - Sundays and the following Federal Holidays:
New Years Day, Memorial Day, Independence Day Labor Day, Thanksgiving Day and Christmas Day
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE R. INSPECTION TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTmALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing v
200 Final Re -Roof 210 Final Electrical x B-H—/ 1 rn
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 '/I M
n
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certifrcate 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
ection 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:
Cartier: GQERJi[F, STItrE
(Th¢section needrrol he completed✓the y In volwed at one huntlred collars($100) vhas.)
Policy Number: qi%�3
❑ I certify that in the performance of the work for which this permit is
issued, I shall not emp y a9X person in any manner so as to become subject
to the workers' compa satJuli laws of California, and agree that if I should
become subject to [he �al s' compensation provisions of Section 3700 of
the Labor Code, I SII rt W h comply with these provisions.
Applicant's 4m4ature Date
WARNING: FAILURE SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE 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 licensLunder rovisions of Chapter 9 (commencing
with Section 7000) of Divi onusiness and Professions Cotle, antl
my license is in full force a eLic. # Class # CContractor's ion uDate
CONSTRUCTION LENDINW, AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Clvil 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, 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 contraclon s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
slurp
305]-46(3/0])
Owner ID verified by drivernse. ❑ Yes ❑ 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:
❑ 1 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, a demolition
or dismantling thereof, Aill 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.
Applicant's Signature
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be Constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If "yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penally 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: 1
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 Mesato enter upon the above-described property for
inspection purposes. ag a not to occupy or allow occupancy of any building
authorized by this permit Ell final inspection.
Signa r or eg Iterts) D to
And/or
A"nzeV Applicant
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, GA 92626
Job Address:
1020 W 19TH ST
Status:
ISSUED
Suite:
$0.60
Applied:
07/14/2003
Vicinity:
ROOF
Issued:
07/14/2003
Parcel Number: 42253226
Applicant: FRECHETTE, EDMUND
Address: 944 W HOOVER
ORANGE,CA' -
Owner: BAIRD, EARLE J TR
Address 1020 W 19TH ST
Zoning:
ISSUED BY:
Phone: 714-771-7663
Zip: 91766
Phone
COSTA MESA, CA" Zip: 92627
Contractor: CALIFORNIA ROOF SAVERS INC
Address: 944 W HOOVER
Phone: 714-771-7663
ORANGE,CA
Zip: 91766 License: 727693
Arch Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 1/2" OSB SHEATHING, 30 YEAR COMPOSITION SHINGLES, 30# FELT, 4 SQUARES MANSARD WITH
GAF COUNTRY ESTATES COMPOSITION SHINGLES. 2,200 S.F. INCLUDES ATTACHED GARAGE.
Plan Check:
$0.00
Permit:
$125.25
SMIP Res:
$0.60
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $125.85
SETBACKS
MAIN STRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existing: o
Rear 0-0
Rear 0-0
Required: 0
FEESUMMARY
PLANNING & ZONING
Left 0-0
Left 0-0
Proposed: 0
Calc Valuation: $6,000.00
Claim Valuation: $6,000.00
Right 0-0
Right 0-0
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) 7545626
2416-46 (6/0a)
DECLARATIONS
WORKERSCOMPENSATION DECLARATION: ,
I hereby affirm under penalty of perjury one of the following declarations:
❑ 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' cornpensmon Insurance, as required by section 3700 of the labor Code, for the performance of the work for which this pemut is issued.
My workers' compensation Insurance carrier and policy number are:
Te�T.o n T4ns� fG�vlc4 Policy �(�0.® 10j-00
Carrier: AtNQtc r<�
(This section need not be completed d the permit Is valued atone hundred dollars (8100) Or less.)
❑ 1 certify that In the performance of the work for which this permit i5 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 became subject to the workers' compensation provisions o1 Section 3700 of the Labor Code, I shall forthwith
comply withthese Bions.
Applicant Signature:t•.Fge� —Y_l0 Ply Data:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF OOMPENSATION, 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. Uc. a `) 2 b9 Class x O _ 3cl
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER -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 appy 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 appy 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 Ucanss Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 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, falsawork, or demolition or dismantling thereof, will be more than thirty-six (36) teat high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, 1It1e 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a pernit 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 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions. that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
.or 200 cubic feet of compressed gas at standard temperature and pressure).
.
................................................... ................................................ _._..................................................................................................................................................................... .............................................. ... ..............
.............
2 Does or will the applicant or present or future building occupant need t0 file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume o1 55 gallons, or 200 cubic feel 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
Rection 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
partment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
...4 It an.................sently...._..._.._....__............._...___ ._._._.._._... Health
an......_........._._......................................................................... ............................_........
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Cade been fully complied with? ❑ Yes ❑ No
5 Does or will the applicant or present or future building occupant require for the work which is the subject ofthis a plication aaPermil for such construction or rtwdi0cation
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ Na
(Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
8 WIII any part of the laciliry to be constructed under this permit be within 1000 feet from the outer boundaries of a school? Ll Yes ❑ No
(It "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health antl Safety Code).
....................................................._.._.............................................................._.._................_......._.__......................................................._..._..__..........__........_....
........ ___.__....._
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
.................................................._............................................._..........._._._._.__._....................._................................................................................._..._..........._................___.................___....__ ..
8 iff..5 s", aIIach 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 cemly under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
2+V'�-"�'�" Signature Of eget Owner(s) �Date
AO�uth �yJo`3
And/Or Authorized Applicant Date
CODE r. INSPECTION TYPE 20 INTITAL5 OM INSPECTIONTYPE PATE INTmAL4
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 200 Final Plumbing
200 Final Re -Roof Z. 210 Final Electrical
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
JApplicant to fill in all spaces within heav -170-S mall appropriate declarations.
CITY OF COSTA MESA
PER T NO.
T T LOT NO. BLDG. NO.
CONSTRUCTION PERMIT
► - /'j 9
a
TYPE OF CONSTRUCTION
❑NEW 00 ADD ❑ALTERATION
❑REPAIR,`❑CONVERSION ❑DEMOLISH
El OTHER
j
6.906_ - 10/ 15%5_ 11.7.OSi
ZONING REGULATIONS
Project Address
&10
Owner p Phon
Address
Arch/Eng. License Np. QOsf9
DESCRIPTION OF WORK
A P
Address
ZONE PLNTG.. REF. 9F
Contractor Phone
TYPE OF PERMIT,.,
UUILUIN�pgOBPEIR'f
SETBACK T.
p#
VNLIN !0y
_
Address
❑GRADING IC FOUNDATION I�STRUCTU
13 TENANT 1-1ELECTRICALPLUMBING
RAL
OMECHAN ICA
I YARD
SIpE V V
LICENSED CONTRACTOR DECLARATION
1 hereby affirm that I licensed
am under provisions of Charter 9 (com-
mencing with section 7000) of Division 3 of the Business and
❑ OTHER
.RIGHT' .• -
Professions CodeZand my license is In full force antl fact.
REAR YARD (TO P/L)
PROJECT DESCRIPTION
License Class License No.�
PKG. SPACE REO.
PROVIDED
Date Signature
SQ. FT.
OCCUPANCY CONSTRUCTION TYPE-
_
STREET WIDTH
—
PARK FEE E
_
WORKERS' COMPENSATION DECLARATION
I hereby affirm that 1 have a certificate of consent to self -Insure or a
���,
ZONING APPROVED BY
DATE
certificate Of Workers' Compensation Insurance, Or a Certified copy
,�
VALUATION ZONE
-
thereof (Section 3800, Lab. C.).
GRADING CU. YDS. ACRES
SPECIAL CONDITIONS: '
'y No. Company
' -
ertified copy Is hereby furnished.
REMARKS:
�7
- -4o
eye-ep-ld
Jertifled copy is filed with the city Builciing Olvlsl n.
/
-
EXEMPTION FROM WORKERS' COMP SATI DECLARATION
�s
17 IL —,
(This Section need not be completed if is per s for ane huntlretl
-
-
(§3001 or less,.
I Certify that n the Performance of ork in ch this pe it is
Issued, 1 shall not employ any person ny o as to oma
n
PLUMBING PLAN CHECK
ELECTRICAL PLAN
CHECK
subject((7o�t hjWOr�I(�� S Compensation 5 Of fn
BATHTUBS SHOWERS
Date fac.—u_y..F_Signat ure
NOTICE: If after mlking this declar you s le come subject
TOILETS URINALS
GENERATOR 0-1 KW_
1-10 KW
to the Workers' Compensation provis s Of t e or Cotle, you must
TRANSFORMER
-
torlhwith comply with such provisions or thl a It shall be deemed
LAVATORIES DOUBLE LAYS
.APPLIANCE 10-50 KW -50
+ KW
revoked.
KIT. SINKS DISHWASHERS
MOTORS 0-1 HP -1-10
HP
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is constr uctlon ending agency for the per-
SERVICE SINKS SUMPS r -
-
��
(INC. SOLAR) 30-50 4P-50,-
HP
formance of the work for Ich this permit - Is Issued (Section 3097.
FLOOR SINKS FLOOR DRAINS
FIXTURES OUTLETS
SWITCHES
Civ. C.).
Lender's Name
Lender's Address
DRINKING FOUNTAINS
GAS TUBE SIGNS
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from.the Contractor's License Law for
INTERCEPTORS CLARIFIERS
,POLE LIGHTS
the following reason (Section 7031.5 Business and Professions Code:
SWIMMING POOL P TRAP
Any city or county which requires a permit to construct, alter,
POLES METERED
SUB
WATER SERVICE ALTERATION
PANELS MAIN
'SUB
improve, demolish or repair any structure, prior to its Issuance, also re-
quires the applicant for Such permit to file a signed statement that he
GAS SERVICE OUTLETS
SERVICE
AMP,
Is licensed Pursuant to the provisions of the Contractor's License Law
(Chapter 9 (commencing with Section 7000) of Division -3 of the
WATER HEATERS BTU OUTPUT
9usiness and Professions Code) or that he is exempt therefrom and the
b-"', for the alleged exemption. Any violation of Section 7031.5 by
SEWER CONNECTIONS
applicant for a permit subjects the applicant to a civil Penalty
A more than five hundred dollars (4500).
SOLAR TANK COLLECTORS
LL I. as owner of the property, or 'r
will do the work, and the structure is not Intended
or offered for sale- (Section 7044, Business and Professions Code: The
SOLAR PIPING SVS. T
ISSUE FEE
Contractor's LlCense-Law does not apply to an owner Of a property
who builds or Improves thereon, and who does such work himself or
ISSUE FEE
APPLICATION APPROVED BY
DATEIV
through his own employees, provided that such improvements are not
MECHANICAL PLAN CHECK
SUMMARY OF FEES
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 did not build or improve for the purpose of sale).
HEATING SYSTEM 0-100,000 BTU
BUILDING ��,�,,�� �
PERMIT $ to,
SMIP E 1
❑ I, as owner of the property, am cl uslvely c ntracting with
licensed contractors to construct the p ect Secti 7044, Business
(
AND DUCTING
—' 100,000 +BTV
PLAN CHECK $ / . J
PERMIT
and Professions Cotle: The Contractor' Icedse oes not apply to
ISSUANCE E
an owner of property who build, or proves on' and who ton �
REFRIGERATION 0-100,000 BTU
PLUMBING E
tract, from such Project, witha c n rector ned, pursue t%tO.
t SYSTEM.
'� ,
GRADING E
the Contractor's License Law). - -�
- 100,000 + BTU
.PLAN CHECK E
❑ I am exempt under Section B- : C.f this,'
_
E
-BOILERS7' BTU
ELECTRICAL $_
reason
PLAN CHECK E
MICROFILM E
Date � ^ O
SYSTEM REPAIR, ALTERATION
EXHAUST SYSTEM MULTIPLE
MECHANICAL E
TOTAL FEE E
LESS
1 here y certify I he v a i Iica pion and tale that the above
information is rect. r e MIR with II city and county
PLAN CHECK E
E P
- VANCE PC E
Ordinances antl s ¢ la e t on,l tion, no hereby authorize
'
to
r¢prosentaIII ve, IhiS to en <r n e above mentionedpro
f or P.L I v s
Signa o e Date O`er/�
ISSUE FEE
'
FINAL FEE E
Drivers' Lice or SS
CMF 0865-46 White- iltling; Canary -Applicant Pink -Accounting; Goldenrod -Assessor
TL'
a/
CONSTRUCTION AND PLANNING
,APPROVALS Permit # Date
Inspector
POOL & SPA
APPROVALS Permit # Date Inspector
1
,Wt\ ITemporary Electrical'Servic'e or Pole
43.
Pool &'Equipment Cocaiionil-
2.
Soil Pipe -Un rgrn
44.
Steel Reinforcement
3.
Electrical Conduit Utility-Undrgrn
45.
Forms -
4.
Electrical Conduit-Undrgrn -
46.
Electrical Bonding
5.
Steel Reinforce -
47.
Rough Plumbing & Pressure Test
6.
Electrical LIFER Grn
48.
APPROVALTO COVER-GUNITE
7.
Footings ick„ -
49.
Electrical Conduit-Undr rn
8.
_
Foundation - -
- --
50.
Gas Pipe, ❑ Undr rn, Test
9.
Water Pipe-Undrgrn
51.
Backwash Lines P-Trao. ❑ Undrarn
10.
Structural Floor System - -
52.
APPROVALTO DECK - -
' 1.1.
_
Property Sewer Line & House Connection
53.
Backwash & Receptor -Final
12.
Street Sewer Connection -
54.
Heater & Vent -Final.
13.
Rough Plumbing - - - _
_
55,
Plumbina System - inal -
"f4.
-'Rougb Electric -Conduit _
56..
Electrical -Final
15.
•Rough Electric -Wiring- - -
57.
Solar System -Final a• "'
_ 16._
Rough Heating & Air Conditioning _ _Fencing
& Access Approval -
17.
Ducts, in Structure.
APPROVED FOR PLASTERING -
18.
Ducts, Ventilating ,
60.
+ -
POOL/SPA SYSTEMS FINAL
19. Gas Pipe -Rough &Test
20. RoofFraming
21:
Roof Sheathing•'
_ _ ,,,
NOTES:
22. Frame and Flashing -- •2,$'
23.
Insulation
24.
Lathing & Siding
25.
Drywall Nailing
-
26.
Plaster Brown Coat
i
27.
Electrical Power Meter -Final
- -
28.
Final'Electric'
29.
Final;Heating & Air Conditioning
"
30.
Final'Gas Pipe -Test -
•_
31.
Final.Plumbing
•-. - -
I 32.
Water Service -Final j
33.
G'a's Service -Final •'
.. z "" �
34.
Solar Domestic -Final -
-
t 35.
Landsca e Sprinkling System -
-7,-,
- - -•
36.
Sound Attenuation
37.
Handicap Regulations
38.
FINAL STRUCTURE &"BUILDING
3rd --5
39.
Special Requirements Completed
40.
Electric Release to Edison
-
41.
Gas Release to Southern California Gas Co.,
-- - - - - '
42.
CERTIFICATE OF OCCUPANCY
'No _ Date
- - -
4.1.708
COSTA MESA BUILDING -SAFETY DEPARTMENT 1
P,O. BOX 1200 COSTA MESA, CALIFORNIA 92626
PAl0
TR7.7_-76C,,, .001155 *****7.50
For Applicant to Fill in —Use Ink Ord
ppCompletelyy
P ICA ION FOR STRUCTURAL PERMIT
REO"r I DATE RECEIVED
E �
BUILDING —
ADD RE 0 mss 6!J
P MTN
OWNER
A. P. NO.�IJ�J✓�'
ABUILDING
MAIL ^�sJ�// fi4 /-/ _
DDRESS yzp V�s^p
ADDRESS
CITY /Y (rte NO. t4f—V7
flv
TRACT Cy
np
LbY�' BLOCK
CONSTRUCTIONrCQ
LENDER r
PAIR
MOVING
/�'j
BRANCH ` -
OWNER
ADDRESS
L LVE 04
USE
$yAf6
ARCHITECT
OREN INEER ?OT^� 0. _
/
FIRE
ZONE TYPE GROUP
/
ADDRESSN U ( lrt, of
APPROVE //
CONTRACTOR ex
BY ` DATE
ADDRESS
TEL.
CITY NO.
ZON
NO. OFUSE
PLANS
OF NE
BUILDING
,
STATE CITY
LIC. NO. LIC. NO.
YARDS APPROVED
MAIN BUILDING
YARDS APPROVED
ACCESSORY BUILDING
512E
OF LOT J�
NO. OF BLDGS.
NOW ON
(FROM C/L STREETI
FRONT FT.
X- ,
USE OF
EXISTING BLDG.
R. SIDE T.
FT -
Separate permits are required for
L. SIDE FT.
REAR FT.
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMECI
DISTANCE BET.
BET. MAIN 8&
MAIN SLOGS.
ACCESS. SLOGS.
A'/A/ Nf� ✓� �
VAR. 06
C.U.P.+
DATE
APPROVED/
AA-,
DATE
I hereby acknowledge that I have read this application and note
that the above Information Is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation lows of
the State of California.
I hereby certify that I em properly licensed as a contractor under
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that sucl licenses or In full ce an effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the visions of o California Business
and Professlona Co Ivlsion 3, hep 9 �' A
-VALUATION
PERMIT FEE E
PLAN CHECK E
Signature of
lVTIVI
TAX E
Parminee
$
Authorized Agent
TOTAL PAID E .55
41.1.4.4
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
7Applicant Fill in Completely — Use Ink Only
BUAD0 Q.
OWa,LSRMADW
//jj ^/f,� TEL. /�t�p�.-.
CITY l � pp y'A I' tF_S H . NO. 64k5 4' /i
BRANCH
ADDRESS
ADDRESS
PAIL ,s #irft*,
uli ?A-�h�l;r.00� oor•• 93.E5
4L&ION FOR STRUCTURAL PERMIT
IEW,
..1, EA
• .
wpy
VALUE
}�/. �i/��
ZO
NI
TEL.
i
0
CITY NO.
m
PI
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/ OWNER
TEL. (T]J-.3,7G0
NO. bl
FIRE
ZONE
APPROVED
LL
ADDRESS S' -57 ,
VALUE
ZO
NI
TEL.
i
0
CITY NO.
m
PI
r
STATE.+') CITY
YARDS APPR
BUILDING
LIC. NO. /iO r!.�-�� LIC. NO.
MAIN BUILI
PERMIT FEE 3
SIZE(/LI(
gO
NO. OF BLDGS._�
(FROM C/L STR'
A.
OF LOT
NOW ON LOT
FRONT 1
Q
USE OF
r4
EXISTING BLDG.
cing l0
y
TOTAL PAID $ �,S
4
Separate permits are required for
L SIDE 1
REAR 2-71
electric, plumbing and heating work.
�.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
QQ
MAIN BLDGS.
a
/'S/Or=rwG GV 0
VAR. q�--
C.U.P.
/'9_ �.
APPROVED
w
L
hereby acknowledge that I have read this application and state
Q1
W
that the above Information Is correct and agree to comply with
O.
all laws regulating building construction, and 1 shell not employ
Z
any person in violation of the workman's compensation laws of
the State of California.
3
I hereby ceKlfy that I am properly licensed as a contractor under
50.
THE MOUN'
the State of California Business and Professlons Code, Division 3,
Chapter 9, and that such 1((ooenses are In full o send affect, or 1
THE PURPOSE
em exempt from the pr Gfslcns of....* St f allfornle Business
VALUATION
end Professions Code, vision 3, aps
Signature of
Permittee
S /
- v
Authorized Agent
LL
FT
r7 DATE
-1
( APPROVED .., a 1
(
VALUE
m
TYPE
GROUP
i
0
^
�(%
m
DATE
N
USE OF NE
m
BUILDING
D
YARDS APPROVED
FT
r7 DATE
-1
( APPROVED .., a 1
m
i
0
^
�(%
m
_
T.
N
SHOWN UNDER VALUATION IS FOR
m
,F ESTABLISHING A PERMIT FEE ONLY:
u
PERMIT FEE 3
n
•
PLAN CHECK 6 O
e
TAX s 3
`
f
u
TOTAL PAID $ �,S
.2908
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
RECEI DATE RECEIVED DATE ISS ED
BUILDING /,/ Ji.
ADDRESS Zo A/ s /„ / f
—2
OWNER L
/.� PERMIT NO.
A.P. NO. 5 G
MAIL .7 _
ADDRESS O //J:/ I ! /
BUILDING
ADDRESS
'i
D/n�
�OT�.
CITY r NO. Ci
BLOCK
CONSTRUCTION
W
A A
P
LENDER
f
BRANCH
OWNER
ADDRESS
VA —
US $ Do
ARCHITECT TEL. .
FIRE
ADDRESS r I /
ZONE TYPE GROUP
APPROVED
O
CONTRACTOR r
1
BY DATE
J
n
ADDRESS
TEL.
ZO
NO.
USE OF NEW
CITY NO.
PLANS
Sa_k
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE �it / l
OF LOT UU L i's
NO.OF BLDGS.
NOW ON LOT
(FROM C/L STR EET)
FRONT
FT.
USE OF
EXISTING BLDG.
S
FT
/ !!
C
Separate permits are required for
L. SIDE FT.
electric, plumbing and heating work.
REAR
T.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLDGS.
ACCESS. BLOW.
i1-,
VAR.#
DATE
Q
C.U.P.#
APPROVED
APPROVED
I hereby acknowledge that I have read this application and state
that the above Information Is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
1 hereby certify that I am properly licensed as a contractor under
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
VALUATION
PERMIT FEE E 0
and Professions Code, Division 3, Cnapter 9.
PLAN CHECK E
Signature of
TAX E Y B
ee
$ 6—OD
TOTAL PAID E Q
ized Agent /
IL