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HomeMy WebLinkAbout126 19TH ST - Building PermitsNM4 CITY OF COSTA MESA � BUILDING DIVISION ZMUMBI DEVELOPMENT SERVICES DEPARTMENT,PERMIT 0649 (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT Job Address: 126E 19TH ST Suite: Permit: Vicinity: WHOLE ROOF Parcel Number: 42626301 Zoning: Applicant: WARD, CAREY D T MAIN STRUCTURE Front 0-0 Permit: Address: 25281 VIA PIEDRA BLANCA SMIP Res: $0.00 SMIP Com: -Phone: (949)631-2242 Other: LAGUNA NIGUEL; CA Zip: 92677 ' owner: WARD, CAREY D T Total: $83.78 Address 25281 VIA PIEDRA BLANCA Phone: (949) 631-2242 • LAGUNA NIGUEL, CA" - - Zip: 92677 Contractor: OWNER -BUILDER Address: Phone: Zip: License: 0 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 05/09/2000 Issued: 05/09/2000 Arch : Eng: Address: - Address: Phone: Phone: Zip: - License: License: SCOPE OF PERMIT REROOF EXISTING COMMERCIAL BUILDING (25 SO)'. TEAR OFF EXISTING LAYER OF COMP SHINGLES & REPLACE SHEATHING AS NEEDED. INSTALL 1 LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH COMPOSITION SHINGLES. Plan Check: $0.00 MAIN STRUCTURE Front 0-0 Permit: $83.25 Rear 0-0 SMIP Res: $0.00 SMIP Com: $0.53 Other: $0.00 Inspection: $0.00 Total: $83.78 SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 ACCESSORY. Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 NOTES: -FEE SUMMARY Calc Valuation: $2,500.00 Claim Valuation: $2,500.00 PLANNING & ZONING Left 0-0 Right 0-0 Left 0-0 Right 0-0 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:cdmmenced 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 DEhARATimis WORKERS' COMPENSATION 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. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: . Carrier: Policy Number: (This section need not be completed it the permit is valued of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. # Class # Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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 two hundred dollars (3500).): 1, 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 contractors) license pursuant to the Contractors License Laws.). ❑ 1 am exa ppl under sec. Business and Professions Code for this reason: Signature: C `r Date: Owner ID verified byfiv Ifs license. ❑ Yes ❑ No Driver's License No.?�� '- Expires:—�.I �2—cXSli 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 feel 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? ❑ 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 Cade provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication epenmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permll 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 penalty of perjury the iniornation 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 AN AUTIiORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agr 0 comply with all sta laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described! roperty for Ins 'a (tion urposeg. I agree not to occupy or allow Occupancy of any building authorized by Ihis_pe/nnit until final inspection. igneture Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE 1. INSPECTION TYPE P9ff. RMM9L9 CODE( INSPECTIONTYPE 2AR 1117711M. 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 241&46 -\ I PROJE&/;'TRESS: 126 E 1:9TH ST i OWN. aE: CAREYWARD RESS: SAME `t 714)6.31-2242 ARCNJENGINEER: . ADDRESS: - - UNIT: - PERMITTEE: CAREY WARD ( 71.4) 5.31 -224 2 ' .ADDRESS:," 126' E 1.9TH ST ' CM CA 92627 UCENSEO CONTRACTOR 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. ' CITY UC.: STATE UC.: CLASS: Date: Signature: •1NKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' npensation Insurance, or a certified copy thereof (Section 3800, Lab. C). 4LICY NO.: ' EAP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. i Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This 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 sued. I shall not employ y person In any manner so as to become subject to the Workers' Compensation Laws of California. Date: 2" 6._¢O Signature: NOTICE: It, after malong this declaration, you should become subj0 the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this per shall be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ADDRESS: " . r OWNER BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Cohtractois"State License Law for the fallowing reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to conslmm, 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/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 70D0) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I, as owner of the property or my empployees with wages as their sole compcn90tioh, will do the work, and the J structure is not intended or offered for sale (Section 7064, Business and Professional Code: The Contractors' State License Law does not apply to an owner of 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 boding or '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). I, as owner of the propedy am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law dos 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' Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. I am exempt under Section: 7 0 4 4 B. S P. C. orthisreason: OWNER DOING;OWN WOW 2-�-c7O Date: Owner I do hereby certity that I am aware of and understand the requirements of C;,tom .Health fety Code Sections 25505. 25533, and 25534 and that 1 or any future building occupant wilgwill not (circle one) need to comply with said state codes and the requirements for a pemdt for construction or modification from the Air Dually Management District. Residential construction applications are exempt from thew provisions. 1 Date: Applicant: 1 hereby cedity that I have read this application and state that the above information is correct. I a e to tangly with all city and county ordinances and state laws relating to building construction and hiauthom representatives of tN � to enter upon the above-memioned property for inspection purposes. , CVJ ' Date. 2— — Signature: ' Driver's License or Social Security #: 164148 While—Building; Gieen—Cade Enforcement; Caner,—Applicant; Pink—Revenue; Goldenrod—Asaeseor^ CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 045977 PLAN CHECK NO:a N CONSTRUCTION TYPE: '' PERMIT TYPE: !3TR'', PERM NO: GOVT: H 045977 N SUPP: N ;PURPOSE: OTH JOB'DESCRIPTION CHANGEOUT 7 WINDOWS SQ FT: 1,5190 CLAIM (VALUE: 1.,590.00. CALC-VALUE: 1,590„00 GROUP'OCC: R'-3 COMMENTS: CHANGEOUT 7 WINDOWS (E) OPENINGS Z O N I N G R E Q U I R E M E N T S S E T B A C. K.S "------------ MAIN BUILDING---------- FRNT: FT IN REAR: FT IN LEFT: FT IN,RGHT: FT IN --------- ACCESSORY BUILDING'-- ------' FRNT: FT IN REAR: FT IN LEFT: FT; IN RGHT: FT IN PARKING REQ: PROV: PARCEL:'4262630'1 zNE: REF NO: PLANNING N0TES> D EV E L O P M E N T' SERV ICES R E Q U I R E M E .N' T: S ZONING APPROVED BY, DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY.:, a� LEGALIZATION:N” F E E S U BLDG PMT 'PLUMBING ELECTRIC PERMIT 37.00 DATE:, OZ'O5 A R Y' STRUCTURAL SEGMENT:Y ANIC FIRE SMIP/RES-JGRADING 50,-aJy d SMIPINON TES( PLAN jj 'ISSUE FEE BUILDING-DI•V-> PERMIT ISSUE PLAN-CHFCK TOTAI, PAID fl ^'i DUE TOTALS 37.150 0.0.0 0,00 37.50 37.50 :lNi � .00 ' s• REVENUE DIVISION TOTALS--> COLLECTED: 37.50 OVER/SHORT: I ( 00 BI,DG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/T0T GRADING PLAN CHECK, • 37.00 .50 I N D I V I D U Ar L F E E B R E A. K ,D O W N TYPE QTY' D E S_C R,I_:P T I,O N UNIT COST /TS/OTAL COST v 1 SFR 1590 ALTER BY VALUE RESIDENTIAL NOZONF. 1,00 f1'-,590.00 'END OF FEES r I 01:00053517-00053518 TOT ) 37,50; DATE: 02/06/90. TIME: 13:23 CONSTRUCTION AND PLANN...s A�ROVALS -Permit# Date Inspector )OL & SPA APPROVALS Permit# 152. Date Inspector '..Temporary Electrical Service or.Pole - 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. - B. Foundation 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe-Undrgrnd. - . - 60. Backwash Lines, P -Trap, O Undigrnd. 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 APPROVALS;. Permit # - 20.- Rough Factory Fireplace _ 21: Ducts, in.Structuire' 70. Underground Hydro 22, Ducts, Ventilating,, _ _ .• _ 77, Product Piping❑Gas OOiI 23. Gas Pipe -Rough & Test C' , r -72. Underground Flush ` - 24. 'Roof Fiaming 73._Undergrnii.Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro- . 26. T -Bar Ceiling (Structural) & Moriocoat - 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 1 ..HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat :. I �, '79_ FINAL INSPECTION 32: Electrical Power Meter -Final < IK 180:. -FOOD CERTIFICATE ISSUED. 33.'.Final Electric _ _ _ ••>'�� - Notes: _ '34. Final Heating & Air Conditioning r�„ v 35.' Final Gas Pipe -Test ( - 36. Hood or Canopy. - 37. Final Factory Fireplace ^• e ._38. Final Plumbing ` ' 39. Water Service -Final _• , .40. Gas Service -Final j - ..41. Solar Domestic -Final'"- - %J r 42. Backflow Preventer 7._' • ,- 43. Backflow Irrigation - 44. Landscape Iriigatidn System - 45a 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 51. CERTIFICATE OF OCCUPANCY No. Date V"/ •! - I / Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT pPRnnIT Nn TRACT ND- LDT NO. IINrt Nn Pr,oJe`t Address /�� 6 • f S) •• - Applicarit's Mailing Address 7 ZG 1 g GlM Owner's Name lCill Phone I-2.2 Z Address )-a-A, Arch/Eng. License No. Address Contractor's Phone Address (mailing)ling) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class License No. Dale Signature "RKERS' COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -Insure or a certificate .,r Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company 8 Certified copy is hereby furnished. Certified copy is filed with the,city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred $100) or Iescs). ertify that in the performance of the work for which this permitAs issued I Shall not employ any person In any man so a5 t ¢ me Work, S')Cf�y^p ns Lav/s of Callforn _jIs ject to the Dale (T r fill re NOTICE: If, after making this declaration, you o Id become subject to the Workers' Compensation provisions of the " ode, you must forthwith comply with such provisions or this perm) shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance o, the work for which this permit is Issued (Section 3097 Clv. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I /iereby affirm that I am exempt from the Contractor's License Law for the /Showing reason (Section 7031.5 Business and Professional 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/She IS licensed pursuant to the provisions of he Contractor's License Law (Chapter 9 (commencing with Section 7000) of )vision 3 of the Business and Professions Code) or that he/She is exempt merefrom•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 ,Ratty of not more than five hundred dollars ($500). I, as owner of the property Or my employees with wages as their sole co pensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and he tloes such work himSelf/herself or through his or her Own employees, provided that such improvements are not Intended or offered for Sale. If, however, the building or Improvement is Sold within one year of com- pletion, the owner will havo the burden of proving he/she did not build or im- r Ie for the purpose Of sale). as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such oroiects with a con- tractors) license pursuant to me Contractor's License Law). I am aware that proof Of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. . C. for this reason Date // Z4 Owner information certify that I have road. this ap tion and stale that the.above Information Is correct. 1 agree to comply w hall city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives Of this city to enter upon the above-mentioned prop inspection purposes. Signature Date /i Drivers' License or SS W - ' 33co 2(0 . o&o a TYPE OF CONSTRUCTION U NEW_1J ADD U ALTERATION 77 REPAIR ❑ CONVERSION ❑ DEMOLISH OTHER 4-XCe&I(!w DESCRIPTION OF WORK/USE OF BLDG. 11)ILI2eL�l TYPE OF PERMIT LJ GRADING U FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER '1 PROJECT DESCRIPTION SO. FT. 1 ' OCCUPA �ry C O N ST RUCTI ON TYPE VALUATION$_7_/.�f„d ZONE GRADINGCU.YDS. ACRES— Remarks: It75Ta/l ?1i)/JQ/2 Ar/r 0:&n 1,J7A/1'Jl)Ysil 11 Bar Sink Showers Backflow Preventer Service Sink _ Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher Solar Piping Drinking Fountains Solar Tank Floor Drains Swimming Pool w/Spa r - Floor Sinks Urinal Gas Service Outlets Water Closet Interceptors Water Heater Kitchen Sink Water Service Lavatories $Auto -Wash Roof Drains A.P. # 41aLO' S Main Building: E T Front ARear C Right S . lief Ping. Ref. # Planning Notes: FEES Automatic Washer Construction Pale Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Zone Parking Req ELECTRICAL Transformer ❑ 15.50 KW ❑ 50+KW Meter ❑up to 100amps Meter ❑over 100 amps Fan F.A.U. .'I Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW ❑5-15 KW I I Reinspection Fee I $15 1 I Issue Fee . I -S 3,1 I Boiler . Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBG dA Heating System & Ducting ❑ 0-160,000 BTU ❑ 100,000 Reinspection Fee I $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type ❑ Canopy Type II ❑ Refrigeration System 00.100,00013TU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee I $ 3 Sub Panel Motors ❑0.1 HP ❑1.% - B Inc.Solar ❑9.15 HP 1116-15+ Microwave Pole Light ~r Range Sign Standing Sections Trash Compactor FEES N G R E O M T S. Reinspection Fee 1 $15 1 1 Issue Fee ' $ 3 DEVELOPMENT SERVICES RECUIREMEIT �/� / Zoning Approved By `�"'r"-' -Data—/- Building Approved By - /t Date— SUMMARY ate _ _ PLAN CHECK 25% $ 01 00020620-00020622 TOT 5ATE1 11/29/88 TII 09:27 SUMM RY ONFEES D_ BUILDING PERMIT $ 1 S _ SMIP $ PLAN CHECK $_%S -PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ 01 00020620-00020622 TOT 5ATE1 11/29/88 TII 09:27 �- CONSTRUCTION AND PLANNING 'APPROVALS Permit # 1. hemporary Electrical Service or Pole Date Inspector - r -P. ,., & SPA APPROVALS Permit # 52. Pool & Equipment Location Date Inspector 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test t 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. , 10. Structural Floor System 61. APPROVA12TO 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. POO USPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0Gas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 25. Roof Sheathing 74. Overhead Hydro ' 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and rl rtffq` 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation B 6$ 78. FIRE PREY. FINAL 30. Drywall Nailing gg 44 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: e 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test - 36. Hood or Canopy 7R/020 37. Final Factory Fireplace w 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 48. Special Requirements Completed 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co 1 i 51. CERTIFICATE OF OCCUPANCY No Date r/ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY Op.��T t—IM��CON$TRUCTIONPERMIT, . e �m 21 VIV. IIVU. Project 4Ud s CC�� y APWicant's Meing A drptss TYPE OF CONSTRUCTION NEW ADD ALTERATION REvgIR 1:1 CONVERSION 1:1 DEMOLISH El OTHER Owner's utuhone DESCRIPTION OF WORK/USE OF BLDG. Address 12L9e j Arch/Eng. License No. TYPE OF PERMIT LJ GRADING 0 FOUNDATIOM STRUCTURAL Add ❑ TENANT 1:1 ELECTRICAL C1 PLUMBING W MECHANICAL Contractor's Nam 1 i [FU hhoone/; Address (mailing) City License No. b LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Prof s Ions Code, and my license is in tr IDyc and effect. Licen{{{C�{{J333 -L1 J � _ vlTerise s Date 1,�,j,� $ignatur 12�r g 'VORKE S' COMPENSATION DECLARATION )ereby affirm that 1 have a certificate of consent to self -Insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section polis Lab ��1`\�]-�I Qs (e�%5 Policy No.,/s ✓ (v -r Company- I Certified copy is hereby furnished. Cer I iletl with the city t I 4i m Date �y{/��syIW]ed APPlicanh'i�1�� i%Llq•iCLy�n I��_ EX EMPTI N F OR M WORKERS' COMPE NSAT ON DECLARATION (This section need not be completed If the permit IS for one hundred ($100) Or less). certify that In the performance the work fwhich this permit Is , I an so snarl not employ any person in any manner so as to become subjectt to [o the Workers' Compensation LawsCalifornia. Date —Signature NOTICE: It. rifler making this ions f the you , Cod become Subject to the Workers' Compensation provisions et the Labor hall you must forthwith comply with Such LENDING ions or N this permit shall be tleem¢d revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there B a constructionagency for the performance of the woorkk for which this permit iss Issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 crefrom and the basis for the alleged exemption. Any violation pl ]ocuon .031.5 by any applicant for a permit subjects the applicant to a civil malty of not more than five hundred dollars ($500). 1, as Owner of the property or my employees with wages as their solo compensation, will do the work, and the structure is not Intended or offered for Salo (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves tber0en, 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 com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ 1. as owner of the property, am exclusively contracting with licensed can. tractors to construct the Project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon• and who contracts for such projects with a con- tracte,(sl license pursuant to the Contractor's License Law). I am aware that proof o1 their Worker's Compensation Insurance should be provided to me ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner 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 repre- sentatives M this city torlenter uoon the above-mentioned nrooerty. for Drivers' License or SS yP ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES_ Remarks: A.P. # S Main Building: E T Front ARear C Right K Left Ping. Ref. # Planning Notes: Accessory Building: Parking Req./Provided Zone Z O N 1 N G R E Q M T S PLUMBING FEES BUILDING PERMIT Bar Sink Showers $ ELECTRICAL FEES - Backf(ow Preventer Service Sink Automatic WasherTransformer ❑ 15-50 KW Construction Pole Sub. ❑50+KW Backflow Irrigation Sewer Cap S Bathtubs Sewer Connection ENERGY P.C. Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors GRADING Dishwasher Meter El over 100 amps Dishwasher Solar Piping MICROFILM Dryers ❑Gas ClElectric Sub Panel - Drinking Fountains I Solar Tank TOTALFEE Fan Motors 00-1 HP []I% - 8 Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP El 16-15+ Floor Sinks Urinal Fixtures Microwave - Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service - Switches Sign Lavatories Auto -Wash Garbage Disposal Standing Sections . P=Trap Laundry Trays Generator ❑0.5 KW 05-15 KW Trash Compactor Roof Drains Reinspection Fee I $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting RO-100,000 BTU ❑ 100,000 B -P Reinspection Fee I $15 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee S 3 Reinspection Fee $75 Issue Fee IANICAL FEES Hood or Type 1 ❑ DEVELOPMENT SERVICES REQUIREMENTS: Canopy Type II ❑ Zoning Approved By Building Approved By Refrigeration System lqQ-100,000BTU ❑100,000BTU System Repair/Alteration Fire Dampers Registers �— Issue Fee $ 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE S PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ _ MECHANICAL $ TOTALFEE $� PLAN CHECK 25% $ CONSTRUCTION AND PLANNING APPROVALS Per _r Date Inspector POOL &SPA APPROVALS Permit# APPROVALS Date Inspector 1. Temporary Electrical rvice or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. M,, 55. Electrical Bonding a� 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd:; 8. Foundation '�' 59. Gas Pipe, O Undrgrnd., Test, 9. Water Pipe-Undrgrnd:" 60. Backwash Lines, P -Trap, ❑ pildrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK LJ 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final LU 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush I 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas ❑Oil 25. Roof Sheathing . _ - .. 74. Overhead Hydro - % - - 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing-_ 76..Dry-Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION (� 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 'vi 33. Final Electric Notes: 34. Final, Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy _ r 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 48. Special Requirements Completed 49. Electric Release to Edison i% s= 50. Gas Release to Southern California Gas Go " 51. CERTIFICATE OF OCCUPANCY No. Date �- VEE RECE{ l ED 3/ TA MESA BUILDING -SAFETY DEPARTMENT f C P. O. BOX 817 COSTA MEGA. CALIFORNIA FINANCE DEPT, QTY OFC NIESA For Applicant to Fill In Completely APP, ICAT PA P Y APPLICATION FOR PERMIT TYPE OR PRINT BUILDING ?%j BUILDING -/94 _ ADORES$ COSTA MESA. CALIFORNIA For Office Use Only RECEIM NO. PB IT ND. OWNER `� MAILRfiG E Y OA RE i E 'a DATE ISSUED 13- ADDRESS4;A001I I TEL. ' BUILDING CITY NO / ADDRESS W COSTA MESA. CALIFORNIA ARCK_ -CT TEL. OR ENGINEER NO. FIRE ADDRESS _ ZONE TYPE G UPag CONTRACTOR G l ABPPROVED GATE 6'0 Z NING ADDRESS CITY ZONE �7 1 IIT( 1. HO. OF U8E OF NEW /71 PLANS eTl1�i.1LDiN0 STATE TEL. LIC. NO. NO. DE&cRIPnG C! ! an! Lp SIZE OF LOT I NO. OF SLOSH. NOW ON LOT I A, P, NO. J / USE OF` YARDS EVES EXISTING BLD APPROVED ALLOWED BETRACK UNE FROM (CENTER LINE ST.) CENTER OP STREET REAR YARD �q FRONT ,.0 IFT. IN, BIDE YARD.1 LEFT RIGHT R. SIDE FT. IN. DESCRIPTION OF WORK L. SIDE i FT. IN. NEW I II ALTERATION I II ADDITION I REAW�q REPAIR I II MOVING I II DEMOLISH I T� 1ryIN q= 9 PROV V f �h 4, •� f' DA T CT BUILDING / y NO. OF BUILDING A »t V. u ` SIZE ROOMS Y STORIES _ EXTERIOR WALL I ROOF i COVERING COVERING �`� ,y USE OF VDI AND ORK TO BEP OR�IED 1 L A F l- A.3. NO._ ` APPROVED 1 HEREBY ACKNOWLRDG8 THAT 1 HAA READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION 18 FOR TNS AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COM- PURPOSE OF. ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY ORDINANCE& AND STATE LAWS REGULATING BUILDING CON U ON. VALUATION SIGNATURE OP / PERMIT FEE $ PLAN CHECK S (! PERMITTE $o.�D AUTHORIZED AGENT /�%'V TOTAL FEE Q I 1 HEREBY ACKNGWLHDOH THAT 1 HAVE AND STATE THAT THS ADDY% IB DORM PLY WITH ALL CITY ORIUMANCEt AND I BUILDING CONETRUCYION./ aIONATUREO / ^) PERMITTH AUTHORIZED/NT WILD FOR SPECIAL I i 2r,855 j .173E PAID MR—5-67cwsA�0.237- VALUATION s f��a PERMIT FEE � • �'� p 'o- COSYA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1208 COSTA MESA, CALIFORNIA 82626 For Applicant to Fill In Completely APPLICATION FOR PERMIT.; - .,..- TYPE OR PRINT BUILDING For, Office Ute Only ` BUILDING / r —ADDRESS p C/ CF /'i ,�, ' �°T O �•- / -� .eL�•.-. • ' NO. [RMIT COSTA MESA. 'CALIFORNIA ,S . V. RECEIPT NO. � R[ IV BY Y , -DAT[R�CtIY[Dr IBeu60 •-- „ - , OWNER -/'�!...6 ,- -`/:11, MAIL OP+ o - ADDRESS ✓%air=''•— INGYY rc//. ((,�...�. [, ` (` / -ADDRESB-�`U.-�Z dl\:EI-'/''./..' ,-L ` V TEL:'.. -_• '��0-��yl •"'� - FIRE -.,i- g�T ZONE 'TYPE'` GROUP _-N0.6�a35 ' HITECT TEL "APPROVED ``/,r ��/ OR ENGINEHR NO. BY ..,DATE / 1 • ..Tc,-,. .•r. I. :, 3• �:; �r ZONING.°7o/. - 'AOORESS .. - •.. .. ` / - T.i1 PUNT BUILDING, CONTRA Rr a �-ia•.Pz � • 1 / /'4G - /Bdb'ry ADDRESS .raj r �^ .1 To �rl �L :.0�. - ...'1i� "r -�-Y\�:i' . A: P. NO:'r,c 6 + CITY NOTE: NO [AV[ OV [RHANG SHALL BE LESS THAN STATE TEL. 80' TO SIDE a REAR P. L. LIC. NO. 812E ,/ //�tN �a b ^ SIC+ NO. OI EEOC[. EAVES ALLOWED ALLOWED (U..B.C.REOUIRBMENT)- OFLOT HOW ON YARDS ROVED USE OP q MAIN BUILDING BUILDING BUILDING ACGEB80RY BUILDING ACCESSOYARDS RY EXISTING BLDG.-�'A.LiL.L.aJL. �t// _ eETBACK LINE FROM ,pq ` r / IV •- - [PROM C/L BTRH[TI /t FRONT FIr' ceNTen OP ETR[ET O/ 6 REAR YARD G //• /1 � Flo // R. BID[ J, FT. FT. 81D[ YARD LEFT RIGHT DESCRIPTION OF WORK L. BID PT. % / Fr. i rt NEW ALTERATI N ADDITI N REAR FT. FT. DISTANCE BR. / BHT. MAIN a ACCESS. SLOGS. REPAIR O IN M LISH MAIN BLD S BUILDING NO.OF VAR.* DATE SIZE ROOMS BT RI C.U.P. APPROVED EXTERIOR WALLROOF APP [D �-- COVERING COVERING BY V DATE — - UBHOFBUILDING AND WORK TOBBPERFORMED t`. : 0' 1 HEREBY ACKNGWLHDOH THAT 1 HAVE AND STATE THAT THS ADDY% IB DORM PLY WITH ALL CITY ORIUMANCEt AND I BUILDING CONETRUCYION./ aIONATUREO / ^) PERMITTH AUTHORIZED/NT WILD FOR SPECIAL I -ION :OM• THE AMOUNT BNOWN UNDER VALUATION IB FOR THE PURPOSE OP E ABLIEHINO A PERMIT PEE ONLY. j .173E rime VALUATION s f��a PERMIT FEE � • �'� p TOTAL FEE Conditions: 1. Gasoline storage not to exceed 10 gallons"and' roust' be `kept`'out'sid'e" the building. 2. Provide'one'S'ib.'dry�-powder fire extenguisher'in 'area used. for :.• repair seryiceY 3. Must meet 'all -r'equire'ments of Uni,fdrm Fire Code, `1961 edition. 4.--.Dedication•'of'al,fland 40;1 from;the-c/1'of--E: 19th Street-to- the treet to -the City.-of!Costa -Mesa -for-street widening purposes!- Ispandrel S�-. -J. 5. Dedication o` 15 at the corner. 6. Line interior of -north ah_a7s_6ufh-garage walls -with type X -Gypsum Board-; provide:_3/.4-hour_f ire_doors'_between sales room and porch or. bedroom; provide light at entry aiid fire protect attic skuftle. :- 7. Tree planting compatible'with:the-area(one'-on E.- 19thStreet---.-- and --two.-on.Church- Street) . ( 8. Post bond, 5the:dinount to be determined �by the Engineering Dept`.,`to- " - ,i cover the'8o§f=of�instaTTat'ion ofsidewalks.on_E. 19th _Street .and_Church:St•.' 9.. -.. That. .all_°il`Iegal_structures be removed, which includes the large` reader board 'Sin, the front of the. property facing E '19th St: '-- - - - "- 10..- That 1%2- half `of"'the-garage"be';kept._usable-for car -parking;' -and that.... a -the-off-street_.parki,ng,-be.underJthe'direction of the Director of Planning. T ' 'il Nth Y. �_ SDZO 1 OA1.:JIC. I 5 , Ij- C. -natrla%a:rc3��x .ukJa_�?_aa� az�1;. -_. _ . . _ '-: = • - —_ � .-_._---- ---�----- -- '. :%O :;I: - .•^r_ t1 q ] l 1: W.'. '!T '!"Ili tlr.'