HomeMy WebLinkAbout413 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.c�.costa-mesa.�ILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
,lob Address: 413 E 19TH ST
Suitg:
Vicinity: HOUSE 8 ATTACHED GARAGE
Parcel Number: 1 i 734152
Applicant: FAUBERT, BRAD
Address: 8902 SAI�PORT DR
HUNTINGTON BEACH, CA
Owner: COVAULT, CAROIINE K TR
AddreBs 473 E 19TH ST
Zoning:
Phone: (800) 854-0017
Zip: 92646-2664
Phone:
COSTA MESA, CA 2ip: 92627
Contractor: STAR COURSE ROOFING CO.
Address: 8902 SAILPORT DR
Arch :
Address:
HUNTINGTON BEACH, CA
Zip: 92646-2664
Phone:
Phone: (800) 854-0011
License: 532778
Eng:
Address:
Status: ISSUED
Applied: 12/042000
Issued: 12/04/2000
1�
Phone:
2ip: License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (30 SQ). TEAR OFF EXISTING & RESHEATH
WITH 7/16" OSB. INSTqLL 1 LAYER OF 15# FEL7 UNDERLAYMENT & REROOF WITH 30 YEAR COMPOSI710N SHINGLES.
Plan Check: $0.00
Permit: $12525
SMIP Res: $0.56
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.81
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0. 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Righl 0- 0
55,600.00
ss,soo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRA710N: This permit shall automatically expire and become void if vrork is not commenced wilhin 1 BO days, or If work is suspended or abandoned
for a pedod of 7B0 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all
requlred Inepeetlona and final approvel must be obtained. Failure to obtaln Inspections and tinal approval will result in ihe expiretlon of this permit.
FOR INSPECTIONS CALL: (714) 7545626
?4i646 (B�W)
WORKERS'COMPENSAnON DECLARATON:
I hereby eflirtn untler penalry ot perjury one of the lollowing declaratlons:
❑ 1 heve antl will maintein a certiflcate of consent to selbinsure tor warkers' compensatlon. es D��tletl tor by sectlon 3700 of ihe Lebor COGe, tor the peAortnence of Ihe
�work tor whith Ni5 pertnit is issuetl.
� }j�eva entl wlll meintain workers' compensa�On Inwrence, es required by section 3700 of Ne L9bor Catle, tor Ihe peAortnence of Ne work for which Nis pertnit Is iswed.
'TfJly workers' compen�on �nsurence certier and pdky numbar ere: �F,3 � g/�, _G�
Cam'er: g��%S jTi�. P _ PdicyNumber:
❑ I certify ihat in Ihe peAoi
wmpensetlon laws
comPly with ih�"vis
AppllcenPSigne
WAFiNINO:.FAIL E- OSEC
THOUSAND LAR , �.
LICENSEDCONTRACTORS
I hereby eflirtn thet I.em licen:
lorce entl etteCt. lia k�
��which this permil Is Issuad, I s�all not employ any parson in eny manner so es to becoma suDject to tha workera'
that II I ahould 6ecome sub�ect to the workers' compensation provlsions of Sectlon 3700 of Ihe Labor Code, I shell IonMAth
/// /
� Date: /� Z�- — �-'C�
WOiiKERS' COMPENSATION COVERAGE IS UNUWFUL PND SFIALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND dVll FlNES UP TOONE HUNDRED
IN ADDITION TO THE COST OF COMPENSATION, DANAGES AS PROVIDED FOii IN SECiION 3�08OF THE UBOR CODE, IMEREST, AND ATTORNEI^S FEE9.
9(commencing with Seclion 7000) af Division 3 of Ihe.Buslness antl Prateuions Code, end my Iicense Is in full
❑ 1 �ereby aXirtn that t�ere is e construction lending egenq lor ihe pertortnence ol Ne work br w�ich thb pertnll is Issuetl. (Sec. 3097, Civil Code).
Lentlera Name: Lendefs Atltlress:
Slgnature:
Dele:
OWNER-BUILDER DECLARATIONS:�
�.,i i� �
I hereby effirm t�el untler penalry of per�ury,thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the lollawing reasan (Sec. 7031.5, Business enA Protesslon,
Code: Any clry or counry which repuires e permi4to�construct, eller, Impmve, aemolish, or repalr any siructure, pdor to Its lasuence, elso requires the eOP�icent br such pertnl
to tile e signetl sletement thet he or she is Ilcensed pursuent to �he prodsions af Ihe Conirectore Llcense law (Chepter 8(commencing with Sectlon 7000) ol Divlslon 3 0l t�[
Business and Prolessions Code) or thet he or ahe Is ezempt therelrom and Ihe basis tor Ihe alleged ezemption. Any violatlon at Saction 7031.5 Dy eny epplicant ior e portnl
subjects the epplicam ro a civil penally ot not mare Ihen`fWe �undred dollers ($500).):
❑ I, es owner af Iha proparty, or my employees with waBes es their sole compensaUon, WILL DO THE WORK, an0 ihe siructure Is not Intended or oHered for sale (Sec.
7044, Business antl Pmfessions CoUe: The Coutrectors License Lew tloes not apDly Io an owner ol property w�o builtls or Improves thereon, end who tloes such work
himself or harsetl or ihrough his or her own employees, provided that such impmvements ere not Intended or ofleretl tor sale. tl, however, the building or Improvement Is
soltl within one year ot wmD�etion, �he owner-builder will have ihe Durtlen ot proving thal he or she did not build or improve for purpose of sale.).
❑ I, es owner o1 Ue properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 70aa, Business antl Professions
Coda: 7Te contractars License Lew daes not apDN �a en owner oi property who bullds or Improves Ihereon, end who contracts br such pro�ect wlth e mmrectw(s)
Iicense pursuant ta the Coniractors License Lews J.
❑ I em exempt under sec. Business antl Prolessions Code tor t�is reeson:
Signaturo: Date:
Ownor ID veritied by drivets llcense. ❑ Ves ❑ No Drivers License No.
Vedficetlon oi OwnersNp by (type of dacumem, i.e. - properry taa blll or deed):
Expires:
OIVISION OF INDUS7RIAL SAPETV PERMR CERTIFICATION:
❑ I herehy cenify that na excavetion five (5) ar more feet In depih Into whic� a person Is requiretl Io tlescend, wlll be mede In connection with work authorizetl by t�is
pormil, and that no building siructure, swHolOing, felsework, or tlemolltion or tlismentling thereot, will be mOre Ihen thlrty-slx (36) feet hiph. (C�ep. 32, Grp 2, Ah 2, Sec.
341, Title 8, Celitomia Administretive CaCe).
� As owner-builder, I will not employ anyone to tlo work which would require e permit fmm Iha Dlvision o� Indusldal Safery, es notetl above, unless such person has e
parmit to tlo sucn work from the tlivision.
Signature: Date:
Divislon of Indusirial Safery Pertnit Number:
CERTIFlCATE OF COMPLJANCE AND AIfiT10RVATON OF EMRY: I certity under penalry of perjury ihat I hava read this epplication and state Ihet ihe Iniormetion given is
correct. I agree to comply wlih all state laws end ciry ordinances relating ro building constructlon, antl authodza representatives of the Glry of Coste Mesa to anter upon Ihe
ebove-tlescdbed property tor inspectio . e ot to acupy or allow occupancy of eny building euthorized by this permit until finel inspection.
COOE 1. C�d��ONTYVE
7816 Fixetl System Final Fire Prevention
7266 Pool Spa Final
200 Finel Re-Roof
201 Flnel Block/Retainfng Wall
202 Flnal Facrory Fire Place
203 Flnel Sipn
204 Final Demolition
�g �
COOE� INSYEGTONME
206 Final Mechanical
208 Final Plumbing
270 Finel Eledrical
212 Flnal Fire Preventlon
220 Flnal Plenning Approval
222 Final Site
250 Finel BulldinglOccupancy
Date /
/'7_�-7- ' Y/C/
/ Oaln �
PAff. �LB
1�
(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa��DING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
dobAddress: 413 E 19TH ST
Suite:
Vicinity:
Parcel Number: 11734152
Appliwnt: WARD, LIND
Address:
Owner: WARD, SAMUEL 8 LIND
Address 473 E 19TH ST
Contrector.
Address:
Zip:
Arch :
Address:
COSTA MESA, CA
Phone:
Zoning:
Phone: 949-5483756
Zip:
Phone:
Zip: 92627
Phone:
License:
Eng:
Address:
Status: ISSUED
Applied: 12I052000
Issued: 12IOSI2000
ISSUED 8Y:
Phone:
Zip: License: License:
SCOPE OF PERMIT
STUCCO OVER SIDING ON ATTACHED GARAGE.
Plan Check: $15.28
Permit: $23.50
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $39.28
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Ezistin : 0
NOTES:
Rear 0- 0
Rear 0-0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Righ� 0-0
Right 0-0
ssoo.00
ssoo.ao
NOTICE: The work authorized by Ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire end become void if vrork is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized untler this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepectiona and final approvel must be obtained. Fallure to obtain inspections and final approval will result in the expiration of this parmit.
FOR INSPECTIONS CALL: (714) 7545626
zaaae (srool
WORKERS'COMPENSATONDECLARAnON: �
I herehy aftirm under penalry ot perjury one of the following decleretions:
❑ I �eve entl will meintein e cenificete ot consent to self-Insure lor warkers' compensation, es provided lor Dy sectian 3700 of the Lahor Cotle, lar the peAartnance o1 the
work tor whlch t�ls permit is IssueG.
❑ I heve end will mainiain vrorkers compensetlon Insu�ance, BS requlretl hy section 3700 01 Ne LaDor Catle, br Ihe peAortnance Ot ihe work fa wlJch this pemJt ls iswed.
My workars' compensatlon Insurence carder ena poliry number are:
Cartier: Policy Number:
(7his sectlon neetl not be completed i! the pemnf is velued et one hundred dollars (S f00) or IessJ
❑ I certity that in the peAormance ol [he work tor whlch this pertnit is issuetl, I shell not employ eny person in eny menner so es to become subject to 1he workers'
compensation laws oi Calitomia, end egree Ihet If I shoultl become sub�ect to Ihe workers' compensetlon proNsions of Sectlon 3700 at the Labor Code, I shall fort�wlN
compty with these P�Ions.
Applicen� Signeture: Date:
WARNING: FFILURE TO SEWRE WORKERS COMPENSATION COVEMOE IS UNLhWFUL AND SMALL SUBJECT Ml EMPLOYER TO CRIMINAL PENN.TIES AND CML FlNES UP TO ONE MUNDRED
T10US4ND DOILARE (5100.000� W ADDRIOM TO T/IE WSi OF CMIPENSATION, DAfAAGES 0.S PROVIUEO FOR IN SECiION T10B OF TNE UBOR OODE. INiEREST, M10 ATTORNEI"S FEES.
LICENSED CONTAACTORS DECLARATION:
I hereby aflirtn that I em Ilcensetl under provlsions ot Chapter 8(commendng wl�h Sedlon 7000) o� DMsion 3 ot the Business antl Professlons Code, entl my Iicense is In tull
brce enC eHect. Lic. a Class p
Contrectofs SlgnaNre: Date:
CONSTRUC710N LENDING AGENCY: �
��� ❑ I hereby ettirtn that t�ere is e construction lending egenry for tha peAormance ot tha woB far which this pertnit is issued. (Sec. 3097. Chnl Cade).
Lentlefs Namo: Lendefs Address:
SigneWre: Da�e:
OWNER-BUILDER DECLARATONS:
�i� �
I hereby efllrtn t�et under penalry of perjury Ihet I em E%EMPT FROM TME CONTRAc7oRS LICENSE LAW for t�e lollowing rea5on (Sec. 7037.5, Business end Professions
Codo: Any Gry or counry which requires e permil to construct, elter, improve, demWish, or repair eny swcturo, pdor to Its Issuence, elso requires the applicant tor 5uch pertnit
to lile e 518netl sfetement thet he w she is Iicensetl pursuant to Ihe proNsions ol ihe Contractws LJcense lew (C�apter 9(commenGng with Secllm 7000) of DMslrn 3 of tne
Business end Protessions Code) or't�at he ar she is exempt therelrom antl t�e besis tor the elleped exemption. Any violatlon ol Section 7031.5 Dy any epplicent fa a pertnit
sub' c e epplicent to e dvll penelry of not'more itlen five huntlretl tlWlers (5500).):
I, es owner ot the property, or my employees with wages es thelr sole compensatlon, WILL DO THE WORK, en01�e stmcwre is not Inientled or oHered lar Sele (Sec.
7044, Business antl Prolessions Code: The Canirectors lJcense Lew tloes not epDN �o en owner of properry who builds ar Improves Ihereon, anO who does such work
himselt or herself or Ihrouph �Is or her own employees, provitletl that such improvements ere not Intended or oXered tor sele. II, however, ihe building or Improvement Is
sold within one year of completlon, t�a owner-6uilder will have ihe burtlen at provin91he1 he or she AiA not build or Improve lar purpose of sele.).
❑ I, as owner ol the pro0erry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conStruCt ihe pro�ect (Sec. 7044, Businee9 erW Profe551on9
Code: The contwCtor9 Llcense Lew does noi flpply lo Bn owner of property who bullds or Imprmes Ineraon, end wno conlretts br 5uch projeCt wilh e conirector(s)
Iicense pureuant to the Contrectors License Laws.).
fem e em t sac. Business en0 Proteuions Cada tor t�ls reason:
Signature� �— Date:
'Ownei ID,veriti by Grivers license. ❑ Ves ❑ No DrNefs License No. Expires:
by (type af document, i.e. - property lax �ill ar tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATION:
❑ I hereby cehify t�at no evwvation five (5) or more teet in depih into which e person is raquired lo descend will be meda In cannedion vrith work euthonzeA by this
permit, entl ihat no DuilCing sWdure, scaHWding, telsework, or demolition or dismantling Iheraof, wlll be more t�an t�ltly-sla (36) teet high. (Chap. 32, Gry 2, Atl 2, Sec.
341, Tltle 8, Califomla AAministretive Cotle).
0 As owner-builder, I will not employ enyone to do work whlch would require e permit tmm the Division of Industnal Safery, es notetl aDove, unless such person hes e
permlt to do suc� work irom Ihe tlivision.
Signatura: Date:
Division oi Indus�rial Safety Permil Number:
CERTIFlCATE OF COMPLJANCE AND AIfTTiORVJ1TON OF ENfRV: I cenity under penelry ol perjury that I heva read this epplication antl state that ihe information given is
correct. I egree lo comp /�v th ell state laws and ciry ordinances relating to bulltling construction, and euthorize representetives ol the Ciry ot Costa Mesa to enter upon the
ebove- s ribed prope r'nspection purposes. I egree nm to occupy or allow occupancy oi eny builCing authorize0 by this permit until finel inspaciian.
l SlgnaNre OI Lagal Owner(s) � /���/D�
MU/Or Authortzotl ApPlicent � DU U
COOE t. INSVECfIONTYVE
1676 Fi:etl Sysiem Finel Flre Prevemion
1266 Pool Spe Final
I 200 Final Re-Rool
207 Final BIocWRetelninp Well
202 Final Factory Flre Place
203 Final Slgn
204 Finel Demolition
Qdg II�dLs
COOE� INSPEC710NT'VE
206 Final Mechenical
20B Flnal Plumbing
210 Flnel Elecirical
212 Flnel Fire Prevention
220 Final Planning Approvel
222 Final Site
250 Final Building�Occupenq
Peff. 1NI�Ali
vxaecT nooness: q� 3 � 19 T'H 'S T
OWNEfl'SNAME: �•OVATILT CAROLItiE K :R
aooness: � 1 3 E 1 JTH ST
COSTA N.ESA,CA 92627
i
ANCM/ENGINEEfl: S 4 S— S 4 I,� flEG,NO.:
ADUNESS:
uxir:
UNIi:
PEBMITTEE: LEE ROOr TNG OF CUS'CA MESA ( 714 ) 047.-7223
aooness: i653 SUPERIOR
CM CA 92627
LICENSED CONTBAC70B OECN8p7lON: I here0y afiirm that I am IicenseA unaer piavisions ol CAapter 9(commencinA ��� Section
7000� al Uvision 3 0l I�e Busines5 ana Prblessions CoOe, an0 my license is in lulllo¢e anA elfect.
cirrirc.: Oq2875 p� 5� TAiELICr: 496."_%/ ncuss+r 39 /
Dale: _O-2G_/ Signaiure`�{.�4^•�_.a~ _ — —`—
WOflKENS' COMPENSa7laN OEtlA8R7loN: I nereoy allirm inat I nave a cenilicale ol consent to self-insure ar a cenificate of Wofktti
Compensatqn Insurance. or a cendietl copy t�ereol (Seciion 3800. LaU. C1.
POLICYNO.: QOO6%'i.L9�7 E%P.UATE: OEI3OI9Z
COMPANY: �JJ^t(�G CQ,
� CenilieU [opY is IrertEy Iumi5he0. ��" � IileA wii� e city uilEi q DiviSion.
Da�e ��'1.0�9� MPliun�: �
EXEMVf10NFNOMWOflREBS'COMPENSIITIONOECIAPNT10N: (i�i5se[tionneedimtGlcom01ele0il��epermitiSiMonehunOre0�5100�Or1e55�.
1 cetliiy Ihdi in I�! p¢tlOrrtWnR 0� I�e x9rit �Or w�iCh i�is plrmii i5 i55ueG, I 5hall noi Bmploy any perSOn in any mann¢r W as t0 GECOmB
suDl�� �e ��e Ylarkers Compensaiion LawS ol Calilomia.
Oaie: Signatwe:
NOTILE: II. alter making t�is declaratipq you shoulG Eecome su�lec� to ihe Workers' ComDensa�ion pwvisions of lhe La6or
CaGe. you must fanMnt� campN w+t� sucn pmvisions or tAis permt sAall De AeemeO revoketl.
CONSTNUC710N LENUING RGENCY: I hereby aflirm Ihal ��ere i5 a consiruction IendinA agency for �he Oe�o�mance o� I�e work lor
wnich Ihis peimi� is issuetl (Set�iOn 3W7, Gv. C).
LENOEfl:
RODflESS:
OWNEfl BUILOEB DECUIUTION: I nere�q allirm I�at I am eKempi Iwm Ne Comraclors' Sta�e License Law �or t0e �otlowinA reason
(Section 7031.5 Buvness arM Pmiessional Gppe: pny city of counry w�ic� repuirts a Oe�mit lo construct, alter, impmve, demofn4 or
ROair any sVutNte. prior lo i6 issuance. als0 reQuires t�e aOWKEn1 tar such ce�mi� to hle a signeC statement tAat he/5he 51iceRutl
pursuam to t�e pmvisions ol the Coniractors� State License Law (Chapter 9 gommvndnA'MN Section 7000) of Divition 3 of l�e Business
anC Pmles4ons CoOe) arihdt �e/s�e 6 evempitherelmm anU t�e Da9s forthe allegetl exemption. Any violation af Section 7031.5 by
any applitant tar a oermil subiecis the appiiCant to a civil penally of noi more tnan five nunereG eollars (55110�.
I, as awnet of ihe Orope�y or rty empbyea wilh wdqes as tlieir Wle compensation, vnll tlo ihe woM, antl t�e
❑ simcture is no� intentle0 ar offere0 ior sale (Seclion 70a4, Buvness antl Professional Coae: The Contracmrs' State License law
aces rroi aoDN ta an owner of a D�operry w�o 6uilOs or imo�wes ihereon, an� who tloes such work himsell/Aersell ar IAroupn
Ns or ner oxn emDbYe�. u�wi0etl tlu� such imDmvemems are not inrenaeA or offere0 lor sale. If, Iwwever tAe buildinq or
improvemem is mIE witNn one year oi wmpleGw, ��e owner vnll have t�e EurOen ol pmving �e/s�e tli0 no� 6uBd or im0�%'e
� for tne purpose of 5ale�.
I, as owner ol me properry. am excl�iv¢Iy coniracting wi1� IiunseG comraciors la unstmct the prolect (Seclion 7044, Busine55
❑ aM Rol¢5ypn5 CoE2: The CanVaqors' State license Law Uces not aDP�y �o an awner of Oroperty who builtls or improv¢5Ih¢reon
anG w�o comratls lor suc� projec45 vn1� a comratloqs� ticense pursuanl lo I�e Comrac�ors' State License Law1. I am aware
. Itwl prool o� t�eir Worker'S Compen5a�i0n insurance SAould �e provi0e0 lo me.
� I am exempi wder Setlian: B. 8 P. C.
to� I�is reasan:
Date: Ownec
100 �CmW ceNty Inal I am aware ai antl unaer5lan0 �he repuiremenl5 oi Cali�omia Heal�h an0 $ately Cotle S¢ttions 25505, 25533, antl
2557E an� Inat I or any luture Guilemg occupant willlwill no1 (cirtle one) neee to cam0ly wiln saie state Coaes antl tAe requirements for a
perrtni 10� con5uutli0n Or moDilicaiion irortl I�e Air �uahly Mandp¢m¢nl �iSVict, fl¢siG¢nlial consVuciion aDPlications a�e exemp� Imm
lIICSE pfON5�0�5
Dalel ppplicanl:
1 nere0y cenify tAai 1 nave read ittis aoW���on a iate iAat iAe aAave inlarmation is correc�. I a0�¢e to wmpry vnih all ciry an0 couniy
orGinances an0 sidte laws relatiny to OuilGinp uciian an0 tceretry auttwr¢e represemativ¢s ol INs ciry to enier upon the above�memio�
propetly �or m5pft1i0n pur0oSC5. /J�
Da1e ` � � 9 � Signatur�� _ / �
Oriver's ��mnse a Sociai Security .: � �-� _ �
16nLa6 Wnno—Bmlaing: Green—CoGa Enbrcemom; Canary—Applicanl; Pmk—Rovonua: GolOenroO—Assessor
CZTY OF COS1A N,iSA — HUILDING PERMIT FERi2 NO; B OS3468
PERMZT NO: H 053468 PLAI� CHECK NO: N GOVT: N SUPA: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PUAPOSE: OTH
JOB DESCR•iPTION : RERqOF 300USF RESID 6 GAAAGE YI/COMF SHIN SQ FT; 2,900,
CLAIM VAI.f]E: ?., 900. UO CALC—VALt1E; 2, 900.00 GROUP OCC:: A-3 /M-1
COMMENTS: }C [��i:."1L"J'ti-���1+A�
*�#*����*��r�****��*�r*�*x�*�=�� �**����+�*�r*��*±�*#�***�**�c�*�..
Z O N I N GS E�TEB�AUCIK�SE N, E N T E
�EQUIRE�
------------ N�AIN BUILDING ---------- --------- ACCESSf1:..Y-BLILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; rT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • PROV: PARCEL: 13952415 2NE: REF NO;
�LANNING NGTES>
>
R�7E iE it iF if K ii� 3E 9F ii� if if iE +E 3E iF i4 af ac if iF �f ie i!� iE iF k iF if if aF i4 iF �lE K• if iFiF iF if iF iE ff iE iF i'r ih �lE if R-1Ejf ii� ae jE iE iE iF+f )F iF �E #� # iE iE iP !F if �� 3(� i'r }}'� iE if %�
D E V n L O P M E N T S E R V I C E S R E Q U I i7 'a M E N T S
ZONING APPROVED BY DATE: ,`.
BUILDING APPROVED BY : DATE: �,�
APPLICATION ISSUED BY: DAT�: C���
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LEGALIZATION:1� F E E S U M M A R Y SiRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECT�IC MBCHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 .50:
SMIP/NON—RES
PLAN
�SSUE FLE .
9UILDING—DIV—> PE�MIT ISSUE PLAN—CHECK TOTP.?. PAID DUE
TOTALS----> 54.50 0,00 0.00 54.50 54.50 _ .00
REVcNUE DIVISION TOTALS--> COLLECTED• 54.50 OVER1SiiORT• � 00
BLDG PMT PLUMBING ELECTRIC MECHANIC rIRa SMIP/TOT GRADING PLAN—CH:CK
54.00 .50
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Z N D I V I D U A L F E E H R E A K D O W N '
TYPE QTY D E$ C R I P T I O N UNZT COST "TOTAL COST
SFR 2900 REROOF HY VALi)E RESIDENTIAL NOZONE 1.00 2,900.00
END OF FEES
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' POOL PA
CON�TRUCTION AND PLANNING
APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector
1. Temporary Eiectrical $ervice'or Pole � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. �`� �.j 53. Steel Reinforcement I
3. Electrical Conduit Utility-Undcgrnd. � ; 54. Forms _
4. Electricai Conduit-Undrgrnd. - � � 55. Electriwl Bonding
5. Steel Reinforcement , � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings �t 58. Electrical Conduit•Undrgrnd. ��
8. Foundation =-� 59. Gas Pipe, O Undrgrnd., Test L'
.�
9. Water Pipe-Undrgrnd. i S+ 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Ftoor System , 61. APPROVAL TO DECK
11. Property Sewer Line & House�Connectio� '`'` 62. Backwash & Receptor-Final i
�
12. Sewer Cap ' � 63. Heater & Vent-Final „
13. Roof Drains � ' ��
� 64. Plumbing System - Finai
14. Rough Plumbing � 65. Etectrical-Final f
15. Rough Electrical-Conduit 66. Solar SYstem-Final �,
16. Rough Electric Wiri�g 67. Fencing & Access Approval
1). Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Stora9eTank OGas ❑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. Plasier Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final i � 80. FOOD CERTIFICATE ISSUED
33. final Electric ' Notes:
34. Final Heating & F,ir Conditioning ;
35. Final Gas Pipe-Test
36. Hood or Canopy .
37. Final Factory Fireplace
38. Final Piumbing � �
39. Water Service-Final �
40. Gas Service�Final �
41. $olar pomestic•Final �
42. Backflow Preventer
43. Backflow Irrigation �
44. �andscape Irripation SVstem
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING S�,R/ ��1J ��_n�� S'���,', p_� s�G'
A/- „Z t�-�F+'!'
48. FINAL PLANNING , � `�
49. Electric Release to Edison
50. Gas flelease to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
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� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUILDING
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CONTRACTOR
ADDRESS
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SIZE
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USE OF
EXISTING BLDG.
SIZE OF
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NO. OF
ROOMS �O STORIE!
ROOF
COVERING S �•
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I hereby acknowletlge ehat I hnve read [his epplication antl state
that che ebove information is correct and agree to comply with
all laws regulatlnB builq�ng cpnscruc[ion, antl I shell not amploy
any Oerson in violation of the workman's compensetion laws oi
tha S[ate of Califom(a.
I hareby certify ihat I 4m properly licensatl as a contrecmr untler
the Stexe of California gusiness entl Professions Cotle, Divisicn 3,
Chaprer 9, antl that such licenses ere In full for antl effxt, or 1
am ezempt fro the pre��sions of the State o( al fornia Business
and Protessions otle, Divhi n 3, Chapter 9.
Signa[ure of
Perml
Authorized A
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APPLICATION FOR BUILDING PERMIT
RECE E V D E R CE�VED D TE ISSUI
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� PERMIT NO
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BVILDING ♦ // � � ' � � � �
ADDRESS i'}
OWNER��J-�
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FIRE
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APPROV �
BV
ZON NO.OF
PLANS �
VARDS APPROVED
MAIN BUIIDING
(FROM C/L STREET)
FRONT ?,s�FT.
R.SIDE `� FT.
�. SIDE -/ FT.
REAR ,.,(/p��j FT.
DISiANCE BET.
MAIN BLDGS.
VAF. �{`+
THE AMOUNT SHOWN U
THE PURPOSE OF ESTABLI
VALUA710N
PERI
$ ��L ZOO PLAI
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VAIUE
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YARDS APP
BET. MAIN &
ACCESS. BLD
DATE
APPROVEO
TOTAL FEE
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VALUATION IS FOR �
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