HomeMy WebLinkAbout328 19TH ST - Building Permits.,.,
I •�
Pfl0.1ECT p00flE55: 3 Z S E 19 TH ST
rowara:s,r�nME: WAITE, DAVID H
ADOHE55: 3 Z B E 1 9 TH ST
COSTA MESA,CA
714) 692-5566
ANCNIENGINEEB: •
RUOflESS:
UNIT:
92627
flEG.NO.:
UNIT:
PENMITTEE: DAVID WAITE ( 719 ) 642-5566
aooxess: 328 E.19TH ST
C,M. CA 92627
LICENSED CONTPACTOfl UECLAflFTION: I �ere�y allirm t�al I am licensed unAer provisions ol C�aD�e� 9(�ommencing with Section
7000� ol �ivision 3 0� �he Business ana Prolessions Cotle. and my license is in lull lorce antl eilect.
CITY LIC.: $TPTE LIC.: CLASS:
�ate: Signai��¢:
WOHNENS' COMPENSA710N OECLAOATION: I hereGy affirm iha� 1 have a cenifica�e o� consent ro self-insure ar a certilrcate ot Workers'
CompenSalion Insurance. or a[etlilietl coOY ��e�eol (Sectian 3800, LaU. C�-
POLILY NO.: E%P. OPTE:
LOMPANY:
� Certilied copy is hereby fumis�ed. ❑ CertiliNd copy is liletl vnth Ihe city Building �ivision. �
Oale: Appliceni:
E%EMPTION FNOM WOBNEP$' COMPENSATION OECUBATION: (This 5ec' n neetl nai be compleied il I Oer il is lor one hundred (5100) or less�.
I certity �h in the pedormance al the work for whicA Ihis pe it i ed, I shall n mploy ai � pers n in any manner so as �o become
Ihe Workers' Comp nsa�ion Laws ol CalilOmia.
�
ate: �` Signa�pre:
OTICE: II. alier makinq I�is Ee[laration, you 5qaultl Decame � Ie�� �o t�e Woder Com n rovisions al ihe LaEor
CaOe. you musl farlhwi�� comply with suc� pmvisions or I�is permi� shall De tle¢ eG revoke0.
CONSTHUCTION LENOING RGENCY: 1 here�y allirm ihat there is a consimction len ng agency lor t�e peAormance ol t�e work lor
whicn Ihis oermitis issuea (Sedion 3097. Civ. CI.
LENOEP:
nooaEss:
OWNEfi BUILOEB OECIABptION: I here�y atiirm �hat I am exempl imm ihe Contractors' Stale License Law far t�e followinA �eason
(Section 7031.5 Business and Pralessional Cqtle: Any ciry ol taunty whitn requires a permit to consVucL alter, impmve, Uemolisn, or
repair any 9rucWre. pnor to its issuance. also reQuires I�e applicani tor such Dermit io lile a 5igne0 Slatement thaf hplshe B licens¢J
pursuant w t�e pm�slons ot t�e Contracmrs' State Litense Law (ChaD�er 9(wmmencinA ��� �tion 7000) of Oivision 3 of t�e Business
an0 Pmfessions Coae) or t�at �e/sne is eRempt t�ery��am ana ihe 6asis lor ihe allepeE exemD�ion. My violation of Section 703t.5 by
any applicanl lor a permii SUGjeciS ��e apPlicani lo a civil penal�y o� noi more Ihan �ive �unUretl dollarz (SSOU).
I, as owner ol the pm0eny or my employees with wages as iheir sole compensation, will Oo Ne work, an0 ihe
❑ slmcWre is not imenGeA or ot�eretl �or sale (Section 70d4, Busness an0 Professional Cade: The Contractors' Siate License Law
tloes no� apPty Io an owne� oi a propetly who builtls or impmves Ihereon, antl w�o does such woB himsell/�¢rsel� or IhmugA
Ilis or Aer own employees. D�avidetl ihal suph imOrovemenis are not intentletl or ollereA lol sale. If, however t�e �uilding ar
impwvemenl is 5oi0 wil�in one year ol completion, Ihe owner vnll have Ihe Uuraen ol pmWng �e/she tlid nol bui10 ar impmve
. lor ihe purvose of salel.
�, as owner of �he pmpetly, am excWsively comrac�ing wil� licensed coNractors m constmc� I�e pmlecl (Seci' 70aa. Business
❑ and Pmlessions Cotle: T�e Coniracmrs' Slate license Law tloes not appty lo an mvner ol pmperiy wtw hm10 r mproves rtiereon
an0 who canlrati5 br 5uth O�alecis wilA a ppnVaCtor�S) litense pursuanl Ia Ihe Contrattof5' Slate LiC se awl. I am aware
I�at 0��� a� their Worker's Compensation ipsurance slloul� 6e pmvitled to me
� i am e�emo� unaer Senion: B P% O 4 4 B. 8 P. C. ' n� n^
mrmisreason: OWNER—BUTLDER // // ,
��ereby Cetlity thal I am awate 01 and underslantl �he reQuirement5 0l
2553d ana lnat I or any future buil0ing acupan� vrill/�II nol (circle anel n
permil br con5iruction or mo0ilication imm 1�¢ Fir ualiry Manapemen�
��ese provisions.
Oaie.
I nere
Fpplicanl: _
Ihai I have reaa ��i5 ap0liwlion anU S�ale lha� Ihe
state laws reialing lo buil0ing conslmction antl heret
'�OPCIiOn pulpOSci , A
o� sociai Securny •:
�64t-A6 �4'nM1e—ButlOmg: Green—Co�e Enlo¢emenl: Canary—ApplicanC
0 Salety Co� ctions 25505, 25593. an0
aiA state c es ana ihe reQuirements for a
cOn5imcl' n aDVli�'ations are exempt fmm
—.
camply wilh ailcily anE county
Ii�i ciry terupon�heahove�memioned
mue: GOWenrotl—Assesmr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06568
PERMIT NO: B 065689 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : RE—ROOFING OVER EXISTING COMP W/COMP SQ FT: 3,000
CLAIM VALUE: 3,000.00 CALC—VALUE: 3,000.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS ARE REQUIRED AS PER 1991 U.H.C.
***�e*�r�r***�r�r�ri�x�**�e�rxr*+r�r*�r+t*+t**+r**�r+rit�r�ti�*�r*+t+t+rit�*�***x�x�*****ir*�rir********x-ir�t**+�*
Z O N I N G R E Q 0 I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSOAY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 42629113 ZNE: REF NO;
PLANNING NOTES> �
i
+r�**�r�r��x�*�*****�r*�*�*+���r**�**�x�*x**��r*��r■�*******x��*��**x�*+�*+�x+�*��**•+�*��r����**
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N';T S
ZONING APPROVED BY DATE: �
BUILDING APPROVED BY : DATE: ,;
APPLICATION ISSOED BY: DATE: .
ifiFlF�fififilifiFifiEififiEiEiflfiElEiF3EiE 1E1EIfiElflFiFiEiFif 1E9f
ifiEiEitiFlfifiliEiEifiEiElflFiF1F1F1fiEiEiEitiElFfliFiEiEiEiEfflE9EitiEifkillfiEiE7EiEiFiEiF1E�EMifaEifiFiFifiFiEiEifiEiEiEiEiE�FiEifiF IEif1FiE1EiE9F1Eif
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT S�bQ�OE ��'�'E� � Vi' � ' SMIP/NON—RES
PLAN R�\Fnif �(�
BUILDINGEDIV—> 'FERPIiT��i3SflE PLj�N—CHECK TOTAL �� pAID DUE
TOTALS----> 54.50 0,00 0,00 54,50 54.50 ,00
REVENUE—aT��7SION TOTALS--> COLLECTED; 54.50 OVER/SHORT; 00
iE**iE*4 1E �O�OS�7f1�l���
I N D I V I D
TYPE QTY 7J�4 E�S C R I P
S fi�.4
SFR 3000 RERZiJE' HY VAL
or
754-5627
;C MECHANIC FIRE SMIP�TO�T GRADING PLAN—CHECK
it iE iE 3f iE it iE %iF it if iF if iE if iF if iE 1E iE it iF if if 1E�if iE iE iE iE if iE if IF if iF if iE iF IE iF iF iE iE iE if fE i!
A L F E E B R E A K D O W N
I O N UNIT COST TOTAL COST
RESIDENTIAL NOZONE t 1.00 3,000.00
END OF FEES
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J1 �QIS3C,4'—DQ153b49 Y'CiT
"vAT�E.'t' O1l13i94 iIl1E: 16:06
�f! . S�
� . CONSTRUCTION AND PLANNING
i � APPROVALS Permit .# �
�-c� -
� i. Tempo�ary Electtical Service or Pole
2. $od pipe�Undrgrnd. �
.1 E'=cwcal ConUiit JJt:hty�Und�grr.C.
� �i. Nectrical Conduit�Undrgrrd.
° S�eei Rcintorcemen[
L._' _.
u. t ect.;cc UF�f; Gmd.
i � Z Pbot�ngs
i
�'- 8. Four.dat�on
' 9. 4vater P.pe-Undrgrnd.
� 10. Structural Floor System
;L �'aper;Y Sev.er �ine & Noure Cqnnection
� 12. Sewer Cap
I13. Foo' D�ains
'�-_-
,4. Reua'" P�umU ng
15. Rough Eleciric.�,!�Conduit
�i6. Rough Electrlc6'��iring
�
17. Poug�!VinngSign
� 19. Rou�h E�ect�ic�i-T Bar Ceil�nq
13 RouyFt 1-!ea•�ng � Alr Cor.ditiuning
2L: flougn Factory Firepl;ce
7.1. Dutts,'�n5!ructuie .
?.2. Du.:x,'�'a^�laLaq
23. Gas PiPe�Rough & 1'es[ .
�
�24. RanF Fram;ng
25. Ro��� Sb_athing � . -
� 7_8- T�;,3r Criling �$IruCiurd�) & R�rO'tCCOat
I � ' • � "
27. Frame ard Flash�hq
� 2S. Lafi n5 & SiCing I
�
79. insu:t'Ic� .
j. 3p. prywa,� NaAing - -
37. Piaster 8ro�.�� Coat ,
V3<'. E c;triG'-' Po�.tier ilrte[ F�ncl
i-
� 33. Fin�,l E�ectric
! 34. F��r`I H• iuny & A r Co���t�ar�^rn
�
� 35; Firial GaS Pipe-Test
� 36.yHowd or Gnopy ...� .
i. .
r-- . -- -
37. � �na; Fccimy Fuep�ace _
�38. Fin�� P�umbing �
_ .----c .-_; ,
39. Wa:cr .`,'rvicc�'Final T-
G0. Gas Sercme�Finai
�'. Smar Oomcsi�c•Ftinel �
� A� -_
� �i2. Bacicfie:: P�evancer �
�h3�Bacbflow Irrigation _
<< Lan�s��-�"���i4atmnSyster^ -
IT_
4j'$o��-d Attenuation �
• 45.. Hantlicap Regulauons
POO. SPA � - -' -- -�
Date lnspector AppROVALS Permft;� Date f+�pector
�;
O
�
52. Pool & Equipment tocadon .�
53. Steel Reinforcement _ �
--1
54. Forms
55. Electrical Honcling � !
56. Rough Plumbing & presswe Test I i
57. AP°ROV<N_ TO COl'ER�GUi;�ZE � _�
1 ��
58. Electrical Condu�t-Undrgrnd. � �� j
--i
59. Gas Pip�, O Untlrgmd., 7est �
60. Backwash 1�nss, P-Trap, -' Und�gmd. ��
� 61. APPROVAL TO DECK -' � T�
_�
62. Bae%a:•�sn & Rec.aptorF:r.a� � - ',
_�
63. Heater & Vent-Pina�
64. Plumbing System - Final -' � I
- , --�
65. Elecvieal-Fiiial � '
�
- -�
66. Solar SYstem�Final � ' ` _ J
67. Fencing & Ar.cest APproval .� . �
68. APPROVED FOR PLASTERING � �
I
_�
69. PpOUSPASVSTEAIS('INAL �
�
FIRE DEPT. RE(1UIHEMENI' i i .
qPPROVAlS Permit#
� 70. L'nde�3ro,.,d H;dro � � '
_ . 71. Product Pir�r��, :�cs�fj'Ol T�_�
72. Undeigrov.vJ Fliich'_ :'" - � '�
. .:�------ ---'
73.� UrrdergrnJ.Storaye i�i*+k ;'Gas � OII � , �
- - --� --i
I 74 , QyVtlrhead Hvclrc i .. .� ; �
- �-�- - --- - - �-
� 75 ��/ Clwrr�.r�' ' . _ � I
_ _. __ 7 ' r��P Pe !_;,.._ ��-,' , _ _ ._
�� s p s' -i
�' � 77. FtXER�'YSTEM i:It�SA�i-i ` ' ` �
-- �- --�:-- . l �-----�
78.. F:RE vRE��. FIN�_ `y � ,
�Tr� � c��i�iEALTK'JFf.�I FEQUiRc�v���!T �, '
`--'T :'-':_' `_ � ------`�--- _..�
79. FINALINS!'ECTIOW . � _
-�----- --�;
30. �FQt�D CER�i�fCATE 'L.�I:ED J'
' ----- - � - �'-'-- - ^
--�'iVafes: T. --- �.. --------- - - I �
-�- -
41. FI.`AL STRUCTURE & BU�LDING `�
kF. FINAL'�-ARNING
SScElectnc A�!ease to Etlison
�50. Gas Release to Southern Cal�forn�d Gas
57. CERTIFICATE OF OCCUPANCY
Date
.^_ - y
- - I
-- . . -- ---- ----- - +
,
� _._________--�_
--- - - ---- -� -'- �
------ -- -- -- --�- - --�-�
.- C9 � �iO vt�JB %'C- �cLcilbG �
-- --} �
__ _-_____.-__._ I . ___
-- ---------I-- - --�
1-- --1
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;
C�STA MESA BUILDING DEPARTMENT
P.O. BO% 31�
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
OWNER Vi1
MAIL
A�ORE55
CITV
ARCH�TECT
OR' NEER
COSTA MESA. CALIFORNIA
.. '✓/ .
LIC.
NO.
/ V--
CITV LIC.
NO.
LEGAL LOT �
oesceiPnoN NO. BLOCK
A. P. N O. � O� D
OF LOT � � ��O
USE OF
EXISTING BLDG.
SETBFCK LINE FFOM'
CENTER OF STREET
SIDE YARD RIGHT �y7 /
DESCRIPTION OI
NEW � qLTERATION
REPAIR MOVING
BUILDING�Ojla ROOMS
SIZE .L
EXTERIOR WALL� ROOF
NO.OF BLOGS.
NOW ON LOT
=FT S /
WORK
ADDITION
DEMOLISH
` STORIES
FEE RECEiVED �
�— �9_� jV�l
FINANCE DEPT.
APPL7CYAT10�N�FOR PERMIT
, ., BUILDING
FOR OFFICE USE ONLY
0
2! xto
2 � ��� / � f.
�- �-/.�-e!
'A MESA, CALIFORNIA
pf.
�•
PLANNING DEPT•
o �'G�c>~ /3
i r- �. i r— mc nmuum sn�wn wiuei vamanon is wr tne
I X REBY ACKNOWLE�GE TMAT' H VE REi� TMI$ 4P LICITION LND
STPTE THAT THE RBOVE I$ CORRECT iN0 RGREE TO COMPLV WITN hLL purpose o{ esiablishing a permit fee only.
CITY OPOINFNCE$ AND ST>TE LPWS REGULRTING BUILDING CO UC�
TiON. VALUATION /J
SIGNATURE O PERMIT FEE $ /a �
PERMITTEE �
� / �/6 � PLAN CHECK $ ` y J
$ �O
' �' � �eMr
AUTHORIZED AGENT TOTAL FEE $ '�
. ,,.
CO�STA MESA BUILDING-SAFETY DEPARTMENT
P. O. BO% 917 C08TA MBBA, CALIPOiW1A
For Applieanf to Fill In Complefely
TYPE OR PRINT
eui�.ciN� .� g ��
ADDRE88
COSTA MESA. CALIFORNIA
�i.r�-..�J �.r i.t �ll.`._,.�
�
LINe
�
TEL.
r I ��w°�..a��.
DESCRIPTION OF WORK
BUILDING NO. OF
81ZE ROOMS
EX7ERIOR WAL4 IROOF
COVERING COVERII
U8E OP BUILDING AND WORK TO BE
I1 H6R6BY ACKNOWLHCG6 THAT 1 XAVH RBAD T119 APP4GTION
AND 9TAT8 TXAT TX8 11BOY8 19 WRRBR AND AQR86 TO COM•
PLY WITII ALL GTM ����NC88 AND HTATB {.AWB pHO11LATINO
SUIIdINO CON8IRUCTON.
APPROVED
F�E RECEIVED
(��SEP 8 1960
FINANCE DEPT.
APPLICATION F��PF�A���A ��
BUILDING
For Office Use Only
�RECEIPT NO. P6R IT NO.
ie2.�o 3
r I nwre necerveo I oere issueo
(Z�NING
Irvo. or '�/ I use ov n
runs I amtoiNc
°�Z//4ry�-lZd
/l F.Y e � `l i �
ICENren LINa eLl
THG AMOUNT BXOWN UNOEH VALUAT�ON �8 POR TH8
PURPOBE OP E9TABL18MING A P6RMIT fE6 ONLY.
VALU iION
PERM7T FEE $ ♦ �' N
/� ///Jff///yyy g � L/ � p
$�,(!//,/ PLAN CHECK $ J
r/�/ / .- s-o �
TOTAL FBE i LL