HomeMy WebLinkAbout645 17TH ST - Building PermitsOWNER g�IA] & YOUNG INC. DATE 5/11/81
JOB ADDRESS 645 W. 7th Street BUILDING PERMIT N0. 5
G"'ORAL CONTRACTOR Owner- uL r DESCRIPTION o( WORK Leg 1ze NOn-e eC, Gmitti 51gn
A. .o. 424-301-01L0T 7RAC7 FIRE ZONE VALUE S' 100.00
INSPEC71oN5 57 not�re Oat. TVPE GROUP ZONE MG
c�s` ' SUBCONTRACTOR Dete Num6er Si naturs
w�rer+ Plumbin
ROUGM PLUMBING
PnOP. 5�+'R. LINE r� HOUSE CON.
SPRINKLING SYSTEM
mISCELL�NE0U5
ROUGM NE�TING �ND �IR CONOIT�ONING
TEMPOR�RV SERVICE OP POIE
UNOERGROUN� � POWEN �
�AOUGM WIRING Hea�in ond Vant.
XTRENCHES (J FORMS STEEL REINF.
roFL00R SYSTEM
- r]BOH� BEa�t STEEL AEIHfORCE
�SNEPTM�NG
FRqME ANO FLASHING
� �IpTNING_IN G OUT
�P iR. BROWN CO�T
a51...,.TURAL, FIN4L
HEITING, VENT., REiRIG. I.NO ����. FIM�L
PLUMBING. FIN�L AHD G�5 TEST
ELECTRIC, FIN1�
BUILDiNG. FIN4L ✓�• �LI'%� �
OWNER gr,�N & YOiNG INC.
JOB ADDRESS 645 W. 17th St]
G' `RAL CONTRACTOR pvmer—k
A. .o. 424-301—01LOT
INSPECTIONS
SOIL
c�s
W �TER
AOUGN PLUM9ING
PROG. $WR. LINE n HOUSE CON.
SPRINKLING SVSTEM
MISCELL4NEOU5
ROUGN ME�i1NG RNO �IR CON�ITIONING
TEMP00.AqY SERVICE OR POLE
UN�EAGNOUNp � POWER �
AOUGH WIRING
THENCHES I I FORMS $TEEL NEINF.
� FLOOP SVSTEM
N BONO BEnM [-] $i
� SMERiMING
� �R�ME AND FL<SNING
I.ATHING — IN ��
.� P iP. BROwN CO•
N 51..,,GTUR�L, FiNnL
C NE�TING. vENT., qEPi
ns
� PLUMBING, FINAL RND GAS T
a ELECiRIC. F�N�L
F
DATE
BUILDING
SUBCONTRACTOR
(714) 754-5273 � Fax (714) 754-4856 • wvrw.ci.costa-mesa.ca�uU1LDING PERMIT » FAIR DRIVE, COSTA MESA, GA 92626
Job ndaress: 645 W 17TH ST
Suite:
Vicinity: ROOF
Parcel Number: 42430101
Zoning:
ApplicanC ERIC PETERSON
Adtlress: 1653 SUPERIOR AVE
,. " ' . Phone: (949)642-7222
COSTA MESA; CA '-, 2ip: 92627
owner: STABLER, MARIE A TF2
Address .%CLARK, VALARIE
� BALBOA, CA � •- . Phone:
1740 E OCEAN BLVD " ' Zip: 92661
Contractor: LEE ROOF.ING OF COSTA MESA
Adtlress: i653 SUPERIOR AVE
COSTA,MESA, CA
Zip: 92627
Arch :
Address:
Zip:
Phone: (949)642-7222
License: 349686
Eng:
� � � - Address:
Phone:
License:
Si
REMOVE EXISTING ROOF. INSTALI 1 BASE, 2 FLY, 72# CAP
ATTACHED GARAGE. �" "
Plan Check: $0.00
PErmit: $139.25
SMIP Res: $0.66
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $139.93
Status: ISSUED
Applied: 07/14/2003
Issued: 07/t4/2003
Phone:
License:
30 YEAR; COMPOSITION SHINGLES. 36 SQUARES INCLUDES
FEESUMMARY
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0- 0 Rear 0- 0�'
ACCESSORY Front � 0- 0 Rear 0- 0
PARKING Existinq: o Required: , o
Calc Valuation: Ss,eoo.00
Claim Valuation: S6,eoo.00
Left 0- 0 Righl 0- 0
Left 0- 0 RigAt 0- 0
Pr000sed: 0
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ortl. No. 92-28, § 1, 1241-92)
EXPIRATION: 7his permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period ot 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 Inspectlona and Iinel approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
taaere �rvw�
WORKERS' COMPENSATION DECLARATION: / �
I hereby aHirtn untler penalry of parjury one oi ihe tollowing declarations:
❑ I have end will maintain a certificate ot consent ta self-Insure for workers' compensetion, es provitled for by section 3700 of iha Lebor Code, for ihe perfortnence of the
work tor which Ihis permit is issued.
�I have and will meintain workars' compensatlon Insurance, es requiretl by section 3700 0l Ihe labor Cotle, lor ihe peAortnance ot the work for which this permit is issuetl.
My workers' c mpen ation I�cv��.—�nce wrne^r ap1d Oollcy number a�e: ^�
Cerrier: Cj�-P� 6�V �l� PoliCy Number: 2(7� Si ��� l
(Thls section need not be complefed i! fhe permif is ve d et one hundred dollars ($100) or less.)
❑ I certity thet in Ihe peAortnance ol d� for which this pertnit is issued, I s�ell not empioy any person in eny manner so as lo become subject to the workers'
compenselion lews of California, nC egree t�ia f I shoultl become subject to the workers' compensetion provisions of Secllon 3700 oi tha Lebor Code, I shall torthwlth
comply with these provisio �
Applicant Slgnelure: �� —'�— Date: %// % /O �
WNRNINO: FFIl.URE TO SECURE WORKERS' COM EN� ATION COVERA IS UNLFWFUL AND SHAIL SUBJECT AN EMPLOVER TO CRIMI PENALTI 5 AND CNIL FlNES UP TO ONE HUNDRED
THWSAND DOLURE (E100,OOO�.IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMNGES AS PROVIOED FOR IN SECiION 37060F THE LABOP CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aMirm ihat I am
torce and eMeci. Lic. N
ContrectoYs Signeture:
Chapier 9(commencinq with Sectlon 7000) of Division 3 of �he Business and Professions Cotle, antl my licensa is in full
Class N
3-�-� __ Date: 7 (u O �l
CONSTRUCTON LENDING AGENCY:
❑ I hereby eHirm thet there is a wnstruction lending egency lor the Oerformance ot Ihe work for which �his permit is issuetl. (Sec. 3097, CiWI Cotle).
Lentlers Neme: Lentlers Addre55:
, Signeture: Date:
OWNEH-BUILDER DECLARA710N5:
I hereby aMirm that under penalry ot perjury Ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which reQuires e permit to consiruct, alter, impmve, demolish, or repair any atrucNre, prior to its issuance, also requires the applicant for such permit
to tile e signetl stetement ihat he or she is Ilcensed Oursuant to Ihe provisions of Ihe Comrectors License Law (Chapter 9(commendng with Sectlon 7000) ot Division 3 of ihe
Business and Pmfessians Cada) or Ihat he or she is exempt Iherefmm and �he basis for Ihe elleged esemptian. Any viWation oi Sectlon 7031.5 by any epplicam far e pertnit
subjecls ihe epplicant to a civil penalry of not more Ihen five hwAretl tlollars ($500).):
❑ I, es owner ot the properry, or my employees wit� wages es their sole compensation, WILL DO THE WORK, and the siructure Is not Intentle0 or otfered tor sele (Sac.
7044, Business and Professions Cotle: The Con�rectors License Law tices not epply to en owner ot property who builtls or improves t�ereon, and who does such work
�imself or herseli or �hroug� his or her own employees, provided that such improvements ere not In�endetl or oHereO tor sale. II, however, the building or improvement is
sold wi�hin one year of completioq Ihe owner-builtler will heveYhe burden of proving thet he or she did not build or improve for purpose ol sele.). �
❑ I, as owner oi �he Oroperty, em E%CLUSIVEIY CONTRACTING WI7H LICENSED CONTRACTORS to construct the prolett (Soc. 704a, Business and Professions
Cotle: The wntractors License Law Aoes not apply to en owner of Dmperry who bulltls or Improves thereon, and who contracts lor such project wit� a conirector(s)
license pureuant to ihe Cantractors License Lews.).
❑ I am exempt under sec. Business entl Pmtessions Code for Ihis reason:
Signature: Date:
Owner ID verified by tlnvers licen58. 0 Ye9 ❑ No Dnvers License No. E:pire5:
Verilication ot Ownership by (type of documen6 i.e. � property cex bill or tleatl):
DIVISION OF INDUSTqIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby certify i�et no ezwvation five (5) or more feet In depth Into which e person is required to descend, will be matle in connection with work authonzed by this
permit, antl that no builtling stmcture, scalloltling, falsework, or demolition or dismantling thereot, will be more than thirty-six (36) leat high. (Chap. 32. Grp 2, Art 2, Sec.
341, Title B, Calitornia Administretive Code).
❑ As owner-builder, I will not employ anyone to do work which would require e parmit trom the Division af Indusirial Sefety, es noted ebove, unless such person has e
permit to tlo such work irom the division.
Signature: Date:
Division of Indusirial Sefery Pertnit Num6er:
CERTIFlCATE OF CAMPLU�NCE AND AUfHORIZATION OF ENiAY: I certify untler penalty of perjury ihat I have read this epp�ication antl staie that the information given Is
correct. I agree to compty with all state laws flnO Uty orAinances relating to builtling consWction, and euthonze representetives of ihe qry ot Costa Mesa to enter upon Ihe
ebove-descnbed property tor in ion puryoses. I egree not to occupy or allow occupency of eny builtling authorized by this permit until finel inspection.
CODE �. INSPECTIONTYPE
1616 Fixed System Final Fire Preventlon
1266
200
Pool Spe Finel
Finel Re-Roof
201 Finel BIocWRetaining Wall
202 Finel Factory Fire Place
203 Final Sign
204 Final Demolition
Gdg It�6fl
... .,�; �
� i i/ o -S ---
Date
COOE 1 INSPECTION TYVE
206 Final Mechanical
208 Final Plumbing
210 Final ElecMcal
212 Final Pire Preventlon
220 Final Planning ApDroval
222 Final Site
250 FinalBuilding/Occupan�y
BdIE 1[�L$
x;
AOP��cdnt to flll Ip all SP:.�lS!%CCp! �hOSB
hcavy borGer Ilnes antl sign all a0�roprlale Eaclaratlon5.
'ITY OF cOSTa MESA CONSTRUCTION PERMIT �` ""' "" � n��� �JO. LOT NO. UNIT N6.
"" 645 W.. 17th St. , � �� b� .
. ProjecCAddress
AppliGant'SMailingAddr255 �iFi CNII/IIBI'CIO�� C_M. 97627 � TVPEOFCONSTRUCTION� rlew � noo ALTERATION REPAIR
'QWner'S Name Rl incL3_Y�� nn On_ Phone ��?3' � CONVERSION ❑ DEMOLISH ❑ OTHER
Atldress �L��{J j7th S_T�('nc�p mam� (`A 9iFii7 � DESCRIPTIONOFWORK%USEOFBLDG.
Arch/Eng. - Licenu No. � � TVPE OF PERMIT ' GrtADwG - FOurvoATiON. S7RVCruaAL
Addf2S5 � � ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
' Contractor'sName - C/'onk BrOS Rfg Co 'vno�e SUS-SS69 . �'OTHER - �
Address (mailing) - 17fi CORmIe!'!` lQl WQY Costa Mesa. CA PROJECT DESCRIPTION 50. FT.� SS,w� oCCUCArvCv_
CityLiCenSeNo, i�s�i93 ' CONSTRVCTIONTVPE-CORIOIEI'C/Q� VALUATION$ 4,967
ZONE GRADING CU. VDS. ACRES_
� LICENSED CONTRACTOR DECLARATION "
I hereby afOrm that t-am Iicensetl untler provislons ot Charter 9(commencing Remarks: � �
wlth Sectlon ]000) o( DlviSion 3 ot tne Busln<55 dntl Professians Code, dntl
my Iicense is in fu11 forte antl etfecL . . , - "- -
License �Ips _Lic s o. ?7
Date� Si9nature ' ' � PLUMBING
WORKERS'COMPENSATION E LARATION �' BarSink ' . Show2�5
I M1e�eby affl�rti that I hav¢ a[e cate ot consent to 581f-IOSu�e o� a ceitl/1CAte
, ' Wo�kers' COTpansation Insu�ante, o� d certltietl copy tnereof (Section � gackflowPreventer S¢fviC¢Sink •-
)0, Lab. C.) '
Ilry NO. ZS274 - � Compdny Zenith Backflowlrrigation SewerCa � •
P
�[] Certittetl copy is hereby furnisherl. � � .
�4.�1 Certirte c Is tilea witn tne <ity 8 Ilainq DI zion. Bathtubs Sewer Connection �
odea >1���� Aoor�a�c �ronk �ros.. Roofinq Co. ,
' EXEMPTION FROM WORKERS' COMiEN5AT10N DECLARATION Clarifief5 � Solar Coll¢cto�i
(Thls sectlon neetl not tie completetl if the permit is for one huntlretl (5300) or �
less) . Dishwasher Solar Pipin9 ,
I certHy that In th¢ perfo�mance ot tbe work for whlch t�IS Oe�m�tis Issuetl I -
shall ot emo��person. in any manner so az [o betoma subject to t�e Drinking FOun[ains � Solat Tank �
Work! Laws Of CaliforNd. ' '
� Date Signatufe � FloorDraim � � Swimming Pool w/Spa
'NOTICE: If, a(ter making this tleclaration, you shoultl become subject to Ihe '
WolkCfs' CompenSdtiOn- provision5 0( tlle 12�of COtlO, y0u musL toftbwith FIOOf $iflki - - U�indl "
'comO�Y��+��h such proWzionS or thi5 Oe�mit s�all DG tl¢¢metl �evoketl.
/ �CONSTRVCTION LENDING AGEPoCV - - � ��� " ' G25Service Outlets: ` WatCfCloSet � �
I hareby afflrm thatthere is a construction Ientling agency for the Oertormance ` V
'�of �the �work for which this� permi[ is issuetl (Saction 3097 Civ. CJ . .. • .
.I..entlai's Name� - � Int2rc¢ptor5 Water�Heater�
Lentler's Atltlress• � � � � � � � � � ' ' Kitchen Sink . ., , . . � ' Water'Service ' �
OWfJEf3 BUILDEH DECLARATION-� � � ' _ .
I herCby alflrm that I dm exempt trom the ConVacto�'S-Lic¢nse Law fo� tne Cavatories • �- �- Auto-WasF ' �
to its issuznce also reauires the
{ Divislon .3 of� che Bu
' therefrom antl tne bz
'031.5 by any-appl
nalty of not mora tl
.� I, a5 owner o( [h
Eompensatlon' will tic
for sale (Sac(ion 70�
License Law tloes not
ourpose
ne•anegea exempuon. qny vioiauon or aecuon i_
r„a permlt`sub7ects� tM1e -ap011cant ,to' a civll
nuntlretl tlOI1dR (§500). �
rty or'my employees witli wagos as tM1eir-sole
rk, antl.the struc[ure is not intentletl or offeretl
ness antl Pro(essional Cotle:.The Contractor's
� an owner ot a pmperty who builtls or ImprOves
work hiTselt/hers¢If O/ IhrougO hi5 or her Own
� Improvements are not Intentletl or ofteretl tor
or im0�ov¢ment IS SOItl withlll one y¢dr Of Com-
he burtlen ot proving he/She tliU not bulltl or im-
� I am exempt unGer Section
Date Owner _
I hereby certify that I have reatl-tnis
information is correcL I agree to p
antl 5late lawyj elating to buil n9 on
sentatives o! �this tlty to �uoID
se Lawj. 1 aT awa�e that '
oultl be provitletl to me.
B. & P. C. (or tnls reason
�n ana state tnat tne above
city ana <Ounty Ortlinances
dntl M1C/eby aut�o�lEe �ep�e-
we-mentloneU property tor
/
�P ' � � � ' ' Leundry Tr
Drains .
Fee � $15 , ; . Issue Fee
Boiler'. '
Dutt- Under Giound'
Duct - Structural .
Duct-Ventilating .
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ ai oo,000 eru �� oo,000 eT
Drivers' c te or 55 � - - -I i I Reinspection Fee
CMF 0865- , rev. 30/84 Whl[e - Builtlinq; Canary - Appllcdnt; Plnk - AGGounting; Goltlenrotl - Assessor
EES
��I
���
��
�Hood or Typel ❑ i .
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑100,OOO.BTU
System Repair/Alteration �
Fire Dampers '
Registers � � '
A
I I• � . � I i I �
$15 � Issue Fee , � $ 3
A.P. �p
S Main Bu
E
T Front
8 Rear
A
C Right
K Left
S''
Ping. Ref. #
Automstic Washer
Construction Pole Sub.
Cooking Unit .
Dishwasher '
Dryers ❑Gas OElec�
Fan
F.A.U.
Fixtures - �
Device Boxes ��
Outlets �
Switches
Garbage Disposal
Generator �0-5 KW C
s
1 723 I !�/06/84
Accessory Building: _
36D02 � TL
2one ' ' '
ELECTRICAL �
Transformer- ❑ 15�50 KW �
❑ SO+ KW
Meter ❑up to �100 amps i �
Meter ❑over100amps
Sub Panel . .
Motors0Q1HP07:4-8 �
� IncSolar09-15HP,�7645+,
Microwave
' Si9n '
; Standing Sections
5 KW Trash Compactor '
� Reinspection Fee �$75 ' I luue
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
0
�
Z
O
N
I
N
G
R
E
Q
M
T
S
$�-1 ' .
Building Approved By � Data
, Appliwtion Issued By � Dat
� � SUMMARV OF FEES �
. BUILDING PERMIT �$ • �i S. SZ SMIP � � $ ' • �d �
PLAN CHECK $ PERMIT , �
' PLUMBING � $ �SSUANCE 5
' PIAN CHECK 25% $ � ENERGY P.C. $�
� ELECTRICAL $ GRADING $
� PLAN CHECK 50% .$ ; MICROFILM �$ �'
MECHANICAL $ � TOTALFEE '$ -��•n�—
PL'AN CHECK 25% �$ � � � , '
�
j'CONS'I�RUCTION AND PLANNING
APPROVALS Permit #
1. Temporary ElectricBl Service or Pole
2. Soil Pipe-Undrgrnd. .
3. Electrical�Conduit Utility-Undrgrnd.
4. Electrical Conduit-Undrgrnd. �
5. Steel Reinforcement , - � ,
• 6. Electrical UFER Grnd.
, 7. Footings
8. Foundation i
9. Water Pipe-Undrgrnd. -
10. Structural Floor System ,
71. Property Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains �
74. Rough Plumbing '
15.� Rough Electrical-Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign
18. Rough Electriral-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. DuCts, in Structure
22. Ducts, Ventilating "
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing �
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing ,
28. Lathing & Siding
29. Insulation
30. Drywall Nailing �
31. Plaster Brown Coat
32. �Electrical Power Meter-Final '
33. Final Electric .
34. Final He2ting''& �Air Conditioning� • �
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ,
39. Water Service-Final ,
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer� '
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation •
46. Handicap Regulations '
47. FINALSTRUCTURE&BUILDING f
�
48. Special Requirements Completed!
49. Electric Release to Edison
�50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY -
Date
- Poo�� .-a
Date Inspector qppROVALS Permit#
� �� 52. Pool & Equipment Location
,; , 53. Steel Reinforcement -
- 54. Forms � -
� 55. Electrical Bonding
56. Rough Plumbing & Pressure Tesi
57. APPROVAL TO COVER-GUN6TE
-58. Electrical Conduit-Undrgrnd.
- 59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trep; O Undrgrnd.
. 61. APPROVAL TO DECK -
62. Backwash�& Receptor-Final
63. Heater & Vent-Final .
64: Plumbing System - Final
65. Electrical-Final -
66. Solar SYstem-Final .
� 67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
� � 69. POOL/SPA SYSTEMS FINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
70. Underground Hydro
71. Product Piping O Gas� ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank 0 Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
t. .
�
Date � Inspector
n