The URL can be used to link to this page

Home My WebLink About956 17TH ST - Building Permits�: r r... , �,.•�.�' . `'�.� i.ca#a*s"�«�'�ufe%t�'u�:. . . ' . . ' . . .� ` ..��*"j�'4;;'ti��l.��'-�;K . ' - . us':e" � @ (714) 754-5273 • Fex (714) 7543856 • www.ci.costa-mesa.81HLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Addryss: 956 W 17TH ST Suite: A Vicinity: UNITS A AND B Primary Occ: R Parce� Number: 42437107 npp�icant: THOMAS LIEBHERR Address: 17066 PALMDALE ST HUNINGTON BEACH, CA Owner: SALCIDO, DAVID L Address 954 W 777H COSTA MESA, CA Contrecror: PRIMO ROOFING CO Address: 17066 PALMDAIE ST HUNINGTON BEACH, CA Zp: 94627 Arch : Address: Phone: Y'�' License: Type of Construction: V-N Zoning: Phone: 714-841-4456 Zip: 94627 Phone: Zip: 92627 Phone: 714-841-4456 License: 331720 Eng: Address: Status: ISSUED Applied: OS/29/2007 Issued: 05/29I2007 Phone: License: SCOPE OF PERMIT TEAR OFF pXISTING ROOF. INSTALL 20 YEAR COMPOSITION SHINGLES, GAF "SENTINEL", 1 LAYER 30# FELTAND REPAIR/REPLACE SHEATHING AS NEEDED. 1839 S.F. FOR UNITS A AND B. - FEE SUMMARY Plan Check: $0.00 � Calc Valuation sa 55i o0 Permit 5111.25 SMIP Res: �0.50 SMIP Com: $0.00 Other: S0.00 I nspection: 50.00 Total: $111.75 PLANNING & ZONING SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Froni -. 0- 0 PARKING Exlstina: , o Claim Valuation: sa,55i.00 Rear. 0. 0 Left 0• 0 � ,.Righ� 0- 0 Rear 0-0 Left 0-0 Right 0-0 Reauired: 0 . Pr000sed: 0 '�, NOTICE: The work authorized by this permtl shall comply with all applicable handicap access requirements under California statutes and related j regulations. (Ortl. No. 92•28, § 1, 12-21-92) ' EXPIRATION: This parmit shall automatically expire and become void if work is not commenced wlthin 180 deys, or If work Is suspended or abandoned tor a pedod ol 190 days. � ' INSPECTIONS: In order for the work authorizatl under thls permit to be considered legal, such work must comply with all applicable codes, end all requlred InepeCtlona and finel approval must be obtained. Failure to obtein Inspectlons and flnal approval will result in the ezpiretion of this pertnit. FOR INSPECTIONS CALL: (714) 754-5828 z+aa+e ta'w) WORKERS'COMPENSAnON DECLARAnON: � I hereby eXirtn under peneliy of per�ury one o1 iha fWlowing dedaretions: ❑ I have end will meinteln e ceNficete ot consem ta selt-Insure for workers' campensetlon, es provided tor by sectlon 3700 of Ihe Lebor COEe, for Ihe peAormance at the work far whiCh this pertnit is IssueC. '�,�, _I,�ave and will mainWln workers' compensetion insurarxe, az requlred by section 3700 of ihe Lebor Coda, for the paAormance ol t�e work tw which ihis pertnit is issuetl. My workere' compensallon Insurence carder and policy number ere: �7 Q �— ��OS / S��i �dl''�06 .CBfiiBr:-: �-T�_�l//N� P�o�(cy.Numher._ �1ls.seeNon�need nof be canpleted!! fhe permit fs velued et ane huntlred tlallers ($f 00) or Iess.J , ❑ I cerlity Ihet In the performance ot Ihe work for which t�Is pertnit Is Issued, I shell not omploy eny person in any menner ao es to become sub�ect �o �he workers' compensatlon lews ot Celifomie, end egree t�ay it I s�w4 m ub�ect to the workers' compensatlon prodslans of SeclJon 3700 pf Ihe Lebor Cade, I shell lonhwlth comD�y wlih Ihe /� ��Apprteen(-S'lg' naiu,_�: ��,� �'�/a./!C1 � Oat[ a: T�/a7,�d 7 WARNINO:FAILURETOSECORE'N/ORKER6'GYkAP TIONCOVERAGEISUNLAWFULANDSHQLSUBIECTANEMPLOVERTOCRIMIP— W.PENALTESANDCNILFlNESUPTOONEHUNDRED THIXISAND DOLLARE (SI00,000), IN ADORION TO THE WST OF OOMPENSATION, DAMAGES /S PROVIDED FOR IN SECTIIXJ 3708 OF THE LABOR ODDE, IMEREST, AND ATfORNEY$ FEE9. LICENSED CONTRACTORS DECLARATION: I hereby eMirtn t�et I flm IlceyjeG�nEer p�y,�lons at Chapter 9(cammendng with Sectlon 7000) of DMsion 3 ot t�e Business end Prot�ns Code, and my Iicense is in full LONSTRUCTION LENDING AGENCY: ❑ I hereby eflirtn that t�ere Is e construction lending egenty tor the peAortnanca al the waB for which ihis pertnit Is Issued. (Sec. 3W7, Civil Coda). Lendels Neme: Lentler's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHlrm t�a� under penelry ot per�ury Ihet I am EICEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Prolessions Cotle: Any ciry or county which requires e pertnit b wnstruct, alter, improve, tlemollsh, or repeir eny siructure, prlor to Its issuence, elso requires the eppllcant for such pertnit to Nle e sipnetl stetement thet he or she Is Iicensetl pursuent to Ihe pravisions oi the Contrecbrs llcense lew (Chepler 9(commencing wlih Sectlon 7000) al Didslon 3 of Ihe Business end Professions Codej or t�et he or sha is exempt therafrom end tha besis for the elleBed esemptlon. Any violetion of Section 7031.5 by eny appllcant for e pertnit subjecls the eppllcent to e clvll penely oi not more than tive huntlred tlollera ($500).): ❑ I, as owner o1 Ihe property, or my employees with wages es their sole compensatlon, WILL 00 THE WORK, antl Ihe sVucture Is not Intanded or oHereC lor sale (Sec. 7044, Business and Profeuions Code: The Contractors License Law does not apply to en owner of properry who builds or improves Ihereon, anA who Coes such work himselt or hersetl or through his or her own employees, provided ihal such improvements ere noi Intended or oHered tor sele. If, however, the building or improvement Is sold within one year o1 completion, the owner-builder will have the burden of proving that �a or she di0 not builtl or improve for purpose of sale.). ' ❑ I, es owner oi tha praperry, am EXCLUSIVELY CONTRALTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cotle: The comrectors Llcense Lew does not appty to an ownar ol property who bulitls or Improves thereon, end who contracts for such projed wlth e conirector(s) license pursuent to the Coniredors License Laws.). ❑ I em esempt under sec. Business end Professions Cotle lor this reeson: Signeture: Date: Owner ID verilled Dy drivefs Iicense. ❑ Yes ❑ No Drivefs LJcense No. Veriflcetlon o1 Owners�lp by (type ol document, i.e. - properry tex 6ill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Explres: ❑ I hereby cenliy tnat no excavetlon frve (5) or more teet in depth inta whlch a person Is requlred to descend, wlll be mede in wnnection with work euthodzed by this permh, and Ihat no building strudure, scettdding, talsework, or tlemditlon or dismamling thereof, will be ^�ore Ihen thirry-six (36) feet high. (Chflp. 32, Gry 2, Atl 2, Sec. 341, Title 8, Calllamie Adminlslretive Cotle). ❑ As owner-bulider, I will not employ enyone to da work which would requlre e pertnit from Ihe Dlvision ol Industriel Sefery, es nated ehove. unless such person hes e permit to do such work Irom Ne division. Signeture: Date: Dlvislon of Industrial Salery Pertnit Numbar: ICERTIFlCATE OF COMPLIANCE AND AUfHORQATION OF EMRY: I certity under penelry ol perjury that I have read thls application and state Ihat ihe infortnetlon given is I wrtect I egree to comply wlth all stete laws flntl dry ordinences relating to bulidfng constructlon, end euthotlze representatives ot the Ciry o1 Costa Mesa to enter upon t�e ebove-described praperry lor inspection purposes. I egree not to occupy or allow occupency of eny building aulhorized by this pertnit until finel inspectlon. cooe �, msvetTroxtrve 1816 Fi:ed System Final Fire Prevention 1286 200 201 202 203 Pool SOe Flnel Flnel RaRool Finel Block/Retelnlnp Well Finel Fectory Fire Place Flnel Slgn 206 Flnal Demdltlan i i Date CO�E I INSYECTION TYPE ZOB Finel Mechenicel 208 Final Plumbing 210 Finel Elettricel 212 Finel Fire Prevention 220 Final Planning Approval - 222 Finel Site . 250 Finel Bulidinp/Occupanry � � It�� ,.. . ; Job Address: 956 W 17TH ST � Suite: C Vicinity: DUPLEX BLDG WITH UNITS C AND D Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construclion: V-N Parcel Number: 42437107 Zoning: App�icant: LIEBHERR, TOM Address: 17066 PALMDALE ST _,.._ .Phone:_ 714-841-4456 HUNWGTONBEACH,CA:.„--'';��i�,c='-`_' �'=Zip:�-94627�-.__, ISSUEDBY: .,� �".rf%�- :,r-- - -• Owner SALCIDO,.DAV.ID�L � 'j � y � ��"� Slatus: ISSUED Applied: 03/22/2007 Issued: 03/22/2007 Address 954 W 17TH,�,r ,'i„ "' 1 '- 4 ` �'��`` �c�..A i � � 11 � r S�; �,� %. _�� V S ' Phone �� J � :�^� �-; �,� 1 COSTA MESA, CA � "'"' __� �Zip 92627_ , �`' � �� = `� � r �. � � . .% ' _ - . �� .: A � - %., i � ' 1 .,' ` � -. . � .. t � > A Contractor :�PRIMOROOFINGCO`.;�c —�� '' ` � ' � Address �'17066 PALMDALE.ST �, �' � � ' `� i ' � i � �� r � ' u'r�� .� / - �:i�� Phone: 714-84�-4456 A�.� ��.�� .AV�`>> �. �� ' ��HUNINGTON BEACH, CA .�� 1 �` � '�L��. --j Zip: 94627, � ��s � License: 331120 �� e��, L ��`, � . . ,� (i/,-f'�' �' �i�.AA� \ l`, - Arch s Eng: `� . 'Address: �' � Zip � �f%�� t �, Address: � �.��I - Phone: :��: ,. ,_' ,. -Licensa� �� { � � � � 'i - � � . , . � �� ..,. _ „__ — .., - ' � .. �: � � � �Z �� ' " � � SCOPE OF PERMIT � �_ � �� REROOF DUPLEX BLDG WITH UNITS C,& D: T/O EXISTING COMP ROOF, REPAIR/REPLACED SHTG AS NI "GAF SENTINEL COMP SHINGLES.','-14 SQUARES PITCH 3:12 � \ j ' V . Plan Check: $0.00 Permit:` $97.25 SMIP Res ` $0.50 SMIP Com`, $0.00 ` Other: $0.00 Inspection: �,: $0.00 �,`, � 'Phone: ,.�; License: ��,.' � r_ �Yw��1 / •�=;sFEE�SUMMARYT�� r��' ,: _. _. �L'r,� :r. .�,.�,,�, ,�;.,(:. ': ;.�`CalcValuation: ` - ` ; :,, Claim Valuation: 4. 1 LAYER 30# FELT,.APFLY i , � � � ' � , $3,070.00 � � � $3,070.00: ., , ,',� �,�, ,1 ` !1,' � �, _ � __�___ ` +`. ._ " : r . _. �' ,— %': �' ., _ � . , ,, �, _ f , ' , �-t . TotaL• $97.75 t.� ` � `- ; v ! :. � t: �� FL"ANNING&ZONING � �-� ,��;-< � � SETBACKS � i, � p� - � , � i ,, MAIN STRUCTURE .Front 0-0 RearT 0 0 � �' Lefl- 0 0 r' r TRight„1, 0 0 � , . ✓-' .� i t, � . �- .., � r � u�� t � � i �A -, l�`��' . c - . �'.�� '// ACCESSORY. Front 0 0� ; Rear� 0-0��r` ' Left,. 0-0 � Right%/ 0-0% �� '` r% � � </� � � . � �_� r- ,�` a o ; � �' - 2 .. r/ i /:��; i . - i ! PARKING ti�Ezistina �'0� �.Raduired � -'0 - t�� P.ronosed: 0_ r,. � � '`� � �/ `� � � i'� , _�� i � /.�.ij � � '. f ::�. �� `�� ` "�' �tiV''� `�' '`"� ��,�� S` � �r �;,,/, �, .-, . r-' - r _ i w �. ��i' i "i, ./„ % t ] � r i '„ '>' � " .�, .� . .. :i j,.�� , � ,, �, __ _ .; „� _ �� - _, _,`,-_»-_-,;:-~-,-%%'-'" '( ,: f ` NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia 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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 z�wo-<o taw7 WORKERS'COMPENSAnON DECLApAnON: _ I hereby aHirm under penalty oi perjury one of Ihe following tleclarations: ❑ I have antl will maintain e certiticate of consent to self-Insure for workers' compensation, as providad for by section 3700 of ihe Lebor Cotle, tor the peAormance of ihe work for whiCh ihi5 partnit is i55ued. I have and will maintain workers' wmpensation insurance, as requiretl by sectlon 3700 oi Ne Lebor Code, for the pertortnance of the work for which �hls pertnit is issued. My workers' compensatlon Insurance carrier and policy number ere: Cartier. �- , �_�% ��%/�/�� Policy Number: ��5 7G ^ ��lo (Thls secfion need nof be comp/efed i( (he permit is velued af one hundred dollars ($f 00) or less.) ❑ I certify ihat in ihe peAormance of ihe work for which ihis pertnit is issuetl, I shell not employ eny person in eny manner so es to become subject to the workers' compensation laws of Celifomie, end agree that ii l should be�Ject to the workere' compansation pmvislons of Sactlon 3700 of the Lebor Code� I shall forthwith comply with th „L„,�/ � ��? ApplicentSignature:��JZ//"G/��/fQ Date:=�V//J�i� /� % 0 WARNING: FAILURE TO SECURE WORKER$' COMPEI SATION COVERApE IS UNLAWFUL AN� SHALL SUBJECT AN EMPLOVER TO CRIMI WJ. PENALTIES AND pVIL FINES UP TO ONE HUNDRED TTIOUSAND DOLLARE ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDEO FOR IN SECTION 3108OF THE IABOR COOE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am Iicensed under provisic force and eHect.�Lia #s_-'/ �J� Coniracror's SignaWre. of Chapter 9(commenr.ing with Section 7000) of Division 3 of the B Class a Code, and my license is in full CONSTFiUCTiON LENOING AGENCV: ❑ I hereby aHirrn that Ihere is e construdion lending agency for the peAormance of Ihe work for which this pertnit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lenders AAdress: SignaWre: Data: OWNER-BUILDER DECLARA710NS: � I hereby ettirm that under panelry of perjury ihat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reeson (Sec. 7031.5, Business and Professians CoOe: Any ciry or counry which reQuires a permrt to constmct, eller, improve, demolish, or repair eny stmcWre, prior to Its luuance, also requires the applican� for such pertnit ro file a siqned statement thet he or sha Is licensed pursuent ro the provisians ot the Contrectors License Law (Chepter 9(commencing with Sectlon 7000) of Division 3 of ihe Business antl Professions Cotle) or that he or she is exempt Iherefrom antl ihe basis for Ihe allegetl exemption. Any violetion of Section 7031.5 by eny applicant for e pertnit subjects the applicant to e civil penelry of not more ihan five hundred dollare ($500).): ' ❑ I, es owner oF the property, or my employees wlih weges es Iheir sole compensation, WILL DO THE WORK, and Ihe struqure is not intended or otteretl for sale (Sec. 7044, Business and Pmfessions Cotle: The Contradors License Law does not apply to an owner of properry who builds or improves �hereon, and who tloes such work himself or herself or ihrough his or her own employees, provitled ihat such improvemenis ere not intended or offered tor sale. If, howevar, ihe building or improvement is sold within one year of completion, ihe owner-builder will have ihe burden oi proving that �e or she did not build or improve for purpose ot sale.). • ❑ I, es ownar of ihe property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prqect (Sec. 7044, Business antl Proteuions Code: The contractors License Law tlaes no� epply to en owner of property who bullds or Improves thareon, antl who coniracts far such projact wlth a comrector(s) licensa pursuant to ihe Contractors License Laws.). � I em exemp� untler sec. Business and Protassions Cotle for Ihis reason: Signature: Date: Owner ID verified by dnveYs license. ❑ Ves ❑ No Drivers License No. Expires: Venfication of Ownerehip by (type of document, i.e. - property Iex bill or deed): _ DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity Ihet no excave�ion five (5) or more feet in depth into which a person Is required to descend, will be matle in connectian with work euthonzed by Ihis permit, end that no building siructure, scattoltling, falsework, or demolition or dismantling thereof, will be more than ihirry-siz (36) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, Ttla 8, Celitornia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require e permit irom Ihe Division of Industnel Setery, as notetl above, unless such person hes e pertnit to tlo such work trom the division. Signature: Date: Division ot Indusinal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRV: I ceniy under penalry of peryury that I hava read ihis application and state that ihe iniormation given is correct I agree to wmply with all stete laws and ciry ordinances relating to building construction, end authodze representatives of the Ciry of Coste Mesa ro enter upon the ebove-described property tor inspection purposes. I egree not to occupy or allow occupancy of any building authonzed by this permit until finel inspection. GOUE1, INSPECTONTYPE 761fi Fixetl Sys�em Final Fire Preven�ion 1266 200 201 202 Pool Spa Final Final Re-Rooi Finel BIocWRetalning Well Final Factory Fire Place 203 Finel Sign 204 Final Demolition PAIE I�� ' r /�� COpEt INSGECTIONTYPE 206 Final Mec�aniCal 20B Final Plumbing 210 . Pinel Eledrical 212 Finel Flre PreventlOn 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAg 1[�L9 PHOJECT AQOPE55: 9 S 6 r 1 7: y ST OWNEH'SNpME:LORt.=�A SAT�CIDO nooeess: g, 4 k 17 i fi . C:N CA 92627 548-0358 APCM/ENGINEEfl: RDDflE$$: flEC.NO.: UNIT: UNIT: PEflMITTEE:LOREITA SALCIDO (71?)548-0.358 aoueess: 9j4 h' 17TH ST CM CA 92627 LICENSEU CONTPALTOfl UECIABATION: I �ereGy a�firm Ihal I am Iicense0 untler pmvisions oi C�apler 9(commencing wii� Sec�ion 7000) of Orvision 3 oI I�e Business antl Pmtessions Cotle. and my license is in Iuil �orce ana elleci. CITY LIC.: STATE LIC.: ClA$5: Oale: Signature: WOflNEflS' COMVENSATION DECLANpTION: I hereby alfirm Inat I have a teniiitale oI cOnSen� �O Sell-in5ure or a Cenilicaie of Workers' Comoensaiion Insurance, ar a cendied copY �hereol (Seciion 7800. La�. C). POLICY NO.: E%P. UATE: COMPANY: ❑ Cerlilie4 w0Y is hereby Wmis�e0. ❑ Certifietl coOY is �iled wilh I�e ciiy BuilAing �ivision. �ale: Apo�icanF. E%EMPfION FPOM WOPNEIIS'COMPENSRTION OECLAHATIUN: (inis section nee0 no� be completeE il ��e permit is lar one hunareA (5700� or leu�. I cenily Inat in ine Dedormance ol the work for which Ihis permit is issuetl, I shall n t employ any veaon in any manner so as lo Oecome /SUble�� o the WOfk¢f5' COmpensation LdwS 0� Cdli�Olnia.�-� r( /_' �% oa�e� —�� L—C%i �'�ITG% � SignawrP/ / 7�'�/O / �C�G�O�ci�w7 NOTILE: I)!aller making �his Ueclaralion, you s�o berome suEjetl t0 the Workers' ComOensa�ion Dmvisions oi t�e La�or CoOe. y0d OIV51 IOtlMvii� LOrtlply wIU SUth pfON51ap5 Of IhiS OQ�mii S�dll 6C UEERIEO fCVOkCO. CORSTflUCTION LENOING RGENCY: I hereby allirm I�a� there is a conslmciion lending agency lor ��e Detlormance af the work lor which ihis pe�mil is �ssuea �Sectmn 3097. Civ. C�. LENOEfl: AOOflESS: OWNEP BUILDEfl DECLABATION: I here�y aHirm Ihai I am exempl �rom �he Contractors' State License Law lor me lollowing reason .(Section 7031.5 Business anA Pml¢ssianal Gotle: Any cily oi county w�ich repuires a Oermii lo consiruc6 aller, improve, tlemolish, or ' repair any 51mc�ure. D�ior to its is5uance, ai5o repuires the applicanl far such permil ta lile a SigneG Slalemeni Ihai hNSAe is licensetl pursuanitothe pmvisions ollhe Conlractors' State License LawlChapter9lcommenting witn Section 7000�o10ivision 3 alihe Business and Pmlessions CoOe) or that he/s�e is exempl I�e�elwm ana Ihe Gasis �or I�e alleAea exemplion. My violation of Section 7031.5 Oy any applicani lor a p¢rmii subi¢cii �he aOPlitani to a civil p¢naliy 01 nol mort tlun tive �unOreA O011ars (5500). I. as owner ol the pmpeny or my emyloyees with wages as tAeir sole comoensation, vrill tlo ihe wark, antl lhe ❑ s�mcWre is noi fntentlea ar ot�erea br sale (Sec�ion 7044, Busness anE Pmfessianal Cotle: T�e Caniractors' Siate License Law tloes not apDly to an owner of a pm0erly who builtls or improve5lhere0n, an0 w�o Oaes SucA wark �imseli/hersell or ��wugh �is ar �er mvn employees. OwviGed Ihat 5uch im0�avemeni5 are not intenae� ar oHered lor sale. Ii, howev¢r Ihe builainp or impmvemem is solU wiihin ane year o� tompletian, Ine owner vnll nave Ine CurCen o� O�ovinA he/she Ui0 no� build or improve lor Ihe Ourpose of sale�. I, as owner ol t�e propeny, am eeclusively comractinp wi�� licensea coniracmrs m constmct I�e pmject (Sec�ion 7044, Business ❑ antl Pmfe55ion5 CAtle: The CqnVactors' S�ale license Law aces n01 appy to an owner ol pmpeM �o hmIUS Or imD�'� ��efeon an0 who conVatiS lOr Such prolects wiih a tOntractor�s) litenie purSUanilo I�e ConiraClOrs' $tate LicenSe Law�.l am aware Ihat pmol ol their Worker'S Compensalian insurance shoultl �e pmvitletl Io me. I am eaempl un0er Sec�ion:B P'� Q�(� B. 8 P. C. mr mis reason1: pj�L WORR BY OWNER (( //JJ � �/��) � Oale: ��d / 7 � Owne` ��e X� f'[�� ) I tlo here�y certify al I am aware oi ana untlers�antl Ne requirements ol Calibmia,Heall� anU Salery Cotle Sec�ians 25505, 25533, antl 25534 antl ihat I or any iwure Ouilning occupam wiil/wiil not (circle one) nee0 to camply with saiA state ca0es anA the requiremenis for a permii for con9mction ar mo4ilicaiion irom �he Nir Ouab�y Managemenl Districl. Residential consimclion applicaiions are exempt �mm these pmvisions. Oa1e: Applicant: I here0y ceriity Ihal I have rea0 i�i5 aDPlicaiion ana slate I�al �he aEove inbrmalion is correcl. I orCinance5 an0 s�ale lav�s relating lo builtlmg consimction anA hereby aWhorize represen�alives ot I' piopetly Iorinspeciion purposes. Oaie: � SignaWr . L � C ori�er's �icense or 5oua� Secud�y �: USgRNp� �o comply wil� all city and county io emer upon ine aUove-memioned � ibat-e6 M�h�te—BuilOing: Green—Cotle Enb¢ement; Canary—Appl¢anC Pink—Revenue; GOltlenro0—Assessor C_=Y Oc COjTA M=5A — 3iiI�D�:dG P=R!iIY PERN NO: P 062�07 P�R�:=: 'v0: ? 062107 PLAN CriECK NO: N GGVT: :v SU�P; N CO�S:kJC�:GN TYPE: V—N PERMIT iYFE: P�u PL'RP�SE: OTA JUB :lESCRZPTION ; WATEREEATER RcPLACEN,ENT SQ FT: C�AI,: VAiliE: CAi,C—VA�UE: GROiJP OCC; R-3 / CO�I�:ENTS: WATERHEA?ER RE?LACENiENT �**��**�****�*�**#��**��t�*x-tt�t*�xxa��x�**>****x��t-�*��t#�#�ct#��*��at��**�*�x-*�x ��t Z O N I N GS ERTE�Q�UCZ�RSE M E N T S ------------ MAIv BUILD=NG ---------- --------- ACCESSORY BuILDING FRNT; FT IN REAR: FT IN FRNT; _FT :N REAR: rT IN LEFT: FT IN RGHT: FT Z:J LEFT: FT IN RGHT: FT IN PARKING REp• PROV: PARCEi: 00000000 ZNE: REF NO: PLANNING Ni3TES> i Y�*�t**�*��t�c*�*#�t*�*#*�t�t**?t+�****�t�*�*�t�t:�****#�#�t�#�##x��#*�#�****x*�*?��t��rr?�*�r** D E V fi L O P M E N T S E R V I C c S'.� R E Q U I R E M E N T S ZONING At�PROVED BY ` DATE: 3UZiDI�G APPRGVED BY : AP?i,;CAiIOIv ISSUED 9Y;____,�w�,�� iE?f 3f if 1E 3E if Y if ?E 3F')E i!� iE iE iC #')F iE i� iE'N' �e - � iF iE E�E iE±E iE iE?E iF iE 3E iF # i° ## IE iE #�lE # jF iE if jE iE?f !f je if iE if if iE iE � LF.GALT_ZA1ION;N Y t E S B�DG PMY P�UMHT_NG ELECTRI P�3,Mii 725$ I DATE: DATE: O�/ O�oJ� errzr. itittt . i!#ifiFiEiEiE�1E?E?E x x ifit i' iF ## ###!E iF 3E �E �If !E if ##�if iE ie?E iE if if iE iF jf 3E ?E if ###?f � if iF iF! M M A R Y STRUCTURAL SEGMENT:N MECHANiC �IRE SMIP/RES GRADING SMIP/NON—RES PLAN 1$bV: :`t 20.�0 BiJiLD�NG—DIV—> PERY�T ISSuE Pi,A —CHECR TOTAL PAIU D'JE TGYAL•5----> 7.00 20.00 0.00 27.00 27.00 .00 R£VENGE L1VT_SlON TOTA�S--> COi,LECTED: 27.00 OVER/SHORT• 00 BLDG PMT Pi;iMHING ELECTP.IC MECHAN_� PZRE SMiP/TUT GRAUIMG PLAN—CHECR 2%.00 ?f if if iF if ?f 3E �f if 3E 3f iE jf if iE if jE 3E 3f !E if iE i'r # 3'r i4 iE if iE iElF iE 3e � 3E if �If ie * if 3E?f �E iE iE ## ## if iE iE # if # 1E iElE 9E !i� iE �E iE if iE i!�!E �E } iF # iElElE iE ik iE iF if I N U I V I D U A L : c E B R E A iC D O W N TYPE QTY D E S C R Z P T I u N UNIT CUS3 TOTAi COST PiJ 1 WATER HEATER AND/OR VENT 7,00 7.00 END OF FEES 01 00138539-00138839 T O T 27,00 DATE: 05/10/93 iIHE: 13:51 � i CONSTRUCTION AND PLANN�NG APFROVALS Permit,�-r t 1. Tempofary Electncal Secvice or Pote 2. Soil Pipe-Undrgrnd. 3. ElectriCal Conduit UtditY•Undrgrnd. 4. Electricai CondwbUntlrgrnd. 5. Steel ftei�forcement 6. Elect��cal UFEfi Gmd 7. Footings 8. Found2tion 9. Water pipe�Undrgmd. 70. Structurai Floor System 11. PropertY Sewer Line & Nouse Connection 72. Sewer Cap 13. Roof Orains 14, Rough Plumb�ng 15. Rough Elec[rical•Condwt i6. Rough EleciricN'iring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceil�ng 19. Rouqh Heating & Air Cor.ditioning 20. Rough Faeto�y F�repiace 21. Ducis,�� Structure 22. DuRs, Veni�lanrtg 23. Gas Pipe-Rough & 7es[ 24. Roof Framing 75. Roof Sheathing 26. T�Bar Celling IStr��r.turail & i�Forocoat 27. Prame 8nd Flashing 28. L2ihing & Sid�ng 29. Insulallon 30. D�ywall Nailmg 37. Piaster 8�o�vn Cca! _ 32. ElectnGal Power :.'.e:er F�na. __ 33. Fir.;,l Electnc 34. Finai Heaung ffi Av Conditioning 35. Final Gas Rpe�Test 36. Hoo� ar Canopy � 37. Fina� Factory Fvepiace 38. Final Pfumbing 39. 4'Vater Service�Final 40. Gas Service-Final 41. Sotar pomesucFiral 42. Backflow Preventer 43. Backfiow Irrigation 44. landscape Irripation Systern � 45. Sound Attenuation 46. Ha��dicaP Regulations 47. FINALSTRUCTURE&BUILDWG 48. FINAL PLANNING 49. Etectric Release to Edison 50. Gas Release to Southem California Gas 51. CERTIFICATE OF OCCUPANCY !o. - Date Date Inspector � i POOL SPA - I APPROVALS Permit * Date (nspector 52. Pool � Eqn�pment Locatian 53. Steel Reinforcement ^-� 54, Forms 55. Electrical Bonding � 5fi. Rough P4um6ing & Pressure Tesc '� 57. APPROVAL TO CO��ER GUN!TE ; 58. Electrical Conduit�Undig•na. _ I � 59. Gas Pipe, � Urd�qmd., Test I , 60. Back4vash �ines, P�Tra0. C! Undrisrnd, � -- � _i 61. APPROVAL TO DECK _ � j 62. B&ekr.ash & Reeap'c� F�nz� • I 63. Heaur & VenbFinal � G4. Piumbing SYstem � Flnal � ' 65. Electrical�Pinai ' 66. Solar SYstom-F�nal ' - - --'. 67. Fencing & Access Approval . 68. APPROVED FOR PLASTERI\G 69. POOVSPASYST[h1SPINAL ' � � �, FiRE DEPT. REQUIREM[��T � APPROVA�S Permit �-. 70. Undergrourr,' Hy,:ra - ~ 4 ___ _ � 71 . Product Plpina f,� Ga: � Od I � 72. Underground Ft�s'�� ~ 73. Undergmd. Stora9c Tank Gl Gas :J 0�1 � 74. Overheaa Hydro JG. Cry Chem�w� _'- -__-_ _ __ -_' 7G. Dry Standpinr ' 77. FIXED SYSTEtJf FIP;AL 78. FIRE PREV. FINAL ' HEALTH DEP7. REQUIR'c':7E�'T � 79. FINAL iNSPECTIJ?! I i-- - --- ---- - � -- --- - 80. FO00 CER�I IFIG�TE 'SSUED � � -- -- -- -'- - - - , Notes: -_r --t�-�--� 1 r - -� � I - � �' 996b ,;. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA. CALIFORNIA fOR APPUCANT TO f/LL /N COMPLfTELY TYPE OR PRINT BUILDING c ADDRE55 ' I 7 +r ' COSTA MESA. CALIFORNIA OWNER � L (,. / T (�L CR %_ MAIL AODRESS _�� LCf. /`1TI� S% • ■ LEGAL � Ei � � � � �� i.r _ _ � rvo. ov e�ooe. SETBICK LINE RROM / � cEHien ov eiRECT _� � REAR YARD Y r / LEFT J • RIGHT J DESCRIPTION OF WORK � COVERIINGWAL � (JIAiJ ICOV�EI I HEREBY �CNNOWLEDG XAT I AND BTATE THAT THE OVE �8 PLY WITH ALL CITY IN• Bl11LD�N6 CONBTHU N. SIGNATURE OF PERMITTEE .�� R�C�i�l�v ! ��u� z � �sss FINANCE DEPT. CITY OF COSTA N�Egq APPLICATION FOR PERMIT BUILDING fOR OfF/CE USE ONLY I FEGBIM NO. I PENMIT NO. 9�'yloL REC¢IVE BY DAT6 RECEIVED ATE 168UE[ �� 7 �z a-sY� ��C-� BUILDING COSTA MESA. CALIFORNIA FIRE ZONE NO.OP UBE OF NEW M 1 PLANB _ BUILDING YARDS REQUIRED t (CENTER LINH BTJ ea.c II:! � �+ • r / � L THE AMOUNT 9HOWN UNOER VALUATIO 8 FOR TXE PURP08E OP EBTABLIBHINp A pERMIT FEE ONLY. VqLUATION CI�7l�C��QD PERMITFEE $ Y �� / $/ v V U� D O pLAN CHECK $ � y/ 0 ..� ^ d7 y c'/ • G � TOTAL FEE 5.��c- �[ 0 - ' - ��25� �EE REC�VEQ COSTA MESA BUILDING-SAFETY DEPARTMENT �r \\�p, O P.O. BOX 317 COSTA MESA. CALIFORNIA fOR APP[/CANT TO F/[C /N COMP[ETE[Y APPLICATION FINANCE DTPT. QTf��P�6g°FA MESA TYPE OR PRINT BUILDING BUILDING � ) `' AODRE55 y •�• COSTA MESA, ALIFORNIA fOR OfF/CE USE ONIY L, E l-.C. �'T N �� l.. �G �Y I aeceirr r+o. I re MIT NO. ( OWNER �� MAIL "`� �`V �� N S� � RECEIVED BY OATE RECEIVED� ��/I83 E ADDRESS -� - i - 6 � � G � � MLSA. TE�' �` BUILDING CITY �lJS � NO. r/ '� qDDftESS �}{}7�CT LZ4��' %� � � - LIC. Of 'C�HdEER �{c � T• No. COSTA MESA, CALIFORNIA �l YY y ("3 4 Z-G 4.sa V FIRE A��RE C. ZONE TYPE � GROUP'" 6 Q_C o � � I.a S� Go • STATE 1 S� � y I APPROVED v/ /� O CONTRAGTOR LIC.NO. BY OATE �� nooRess3iG) (�' �, SUa..T/{ A.� NING LEGAL I L l b', LUt � I U �[(J O NO. OP U8E OP NEW �� DESCRIMION NO. T IPLAN9 y I BUILDIN6 � 1 3 O APPROVEO _ A.P. NO. BY L DATE SIiE � b� X eO � NO.OR BLO68. � ypRp$ ' OF LOT I Now oN wi REQUIRED ALLOWED ' USE OF Q� �' �~ C S � ��« ICENTEN LINB BT.) EXISTING BIOG. FRONT FT. IN. 6ET9ACK LINE FROM � CENTER OF 9TftEET REAR YAR� R. SIDE FT. IN. � � SIDE VARD ILEFT �J , RIGHT J L.SIDE FT. IN. DESCRIPTION OF WORK REAR Ff. IN. NE` I IIALTERATION I IIADD1710N I REPAIR- I IIMOVING I IIDEMOLISH I BUILDING `/ NO.OF ' SIZE Z� X� y ROOMS STORIES GXTERIOR WALL� I ROOF p � � COVERING COVERING` � M USE OF BUILDING AND WORK TO BE PERFORMEO C�n c �— f'�J �E �OSO'd� •60q � 1 HEPEBY ACNNOWLE TH1T 1 HRVE NEAO THIS APPLICATION pNU STATE TNAT TH[ A OVE IS COPHECT AND AGREE TO CO THE AMOUNT 6MOWN UNOER VAL�TION 19 FOp THE pLY WITH ALL CITY P INANCES O STATE � B ULATI PUNP08E OF EBTABLIBMING A pMIT FEE ONLY. euaoiNo coHsinuC o VALUATION n SIGNATURE OF PERMIT FHE $ �[. � ' PERMIT'fEE $ /O D�D / • � PLAN GHECK $ �� AUTHORIZED AGENT TOTAL FEE S �J