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HomeMy WebLinkAbout1642 BAKER ST - Building Permits CITY OF COSTA MESA BUILDING DIVISION>`9 �,d�A1! 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us'. v.fl. FOR INSPECTIONS CALL: (714)754-5626 • PERMIT NUMBER: P1Q-00061 PERMIT TYPE PLUM STATUS: ISSUED APN: 13918413 DATE ISSUED: 05104/2010 - ISSUED BY: CAC JOB ADDRESS: 1642 BAKER ST CM Suite/Unit: ' Vicinity: . � - _ , . SCOPE OF WORK: REPLACE SECTION OD'DAMAGED SEWER LINE.AT THE DINNING ROOM FLOOR OWNER: HAACK,CLARISSE Address: 1642 W BAKER ST , . PHONE: - _ .. City/State/Zip: COSTA MESA,CA APPLICANT: BOB BRYANT - - Address: 1525 MAC ARTHUR BL. : PHONE: 714-6411545 , - , • City/State/zZip: •COSTA MESA,CA CONTRACTOR: C AND R DRAINS INC . License No. 531746 * I1-000x:1 Address: 1525 MAC ARTHUR BL. • - PHONE: 714641-1545 City/State: COSTA MESA,CA - ZipCode: 92626- " - , CELL: ARCHITECT: License No. ,_ PHONE: ENGINEER: License No. PHONE: .PLUMBING PERMIT-FEE SUMMARY • •PLAN CHECK FEE: $0:00 PERMIT FEE: . $48.15 , TOTAL FEES: - , $48.15 fs_r:rzQt:r. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODEC INSPECTION TYPE lag IN1111AL$ CODES INSPECTION TYPE DMT INTIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical G- + e / 1266 Pool Spa Final 208 Final Plumbing 57- le ,try nN t,kg 200 Final Re-Roof 210 Final Electrical • 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site .(.-..!:;"1, 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. OFt I 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a p person is required to descend,will be made in connection with work authorized y MAP )4.; by this permit,and that no building structure,scaffolding,falsework,or demolition •seaidn m-. ..t be competed dine permit valued al one hundred dollars(sroo)or less) 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). P.Iicy N •er: /I r. i . I ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to . workers'compensation -rovisions of Sec ion 700 of the Labor Co. I i . • y wile re .rovisions Applicant's Signature Date Co": Division of Industrial Safety Permit Number: - .gn-'ure - CM' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and eff-et. f'�) a registration form for acutely hazardous materials? ❑Yes ❑No S ' `6Ydss# _ (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 T lP "'r, r re pat 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No 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 8. (If"yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and El I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. • LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with a contractor(s)license pursuant to the Contractors License Laws.). CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Date Da 1//Af) 3057-46(3/07) 1 And/or: p leant to `�, t �-'- --- I _ _ ��nt to fill in all spaces except those:iatthih to _ . �� sign all appropriate tlaclarationi. CITY OF COSTA MESA r g I NO. TRACT NO LOT NO. BLDG.NO. - - CONSTRUCTION PERMIT ' . , . ' f PZ 21.'741. 3115 J 23 • J '/ 7�• y� S T- 93014 , 2/13/86 " cja �t. /'oi 4) Project Address � , Pcf TYPE OF CONSTRUCTION. -U NEW 14 ADD IJ ALTERATION U REPAIR ' '/ ^ Applicant's Mailingf{f�zdldress �2 S �� Qe ❑ CONVERSION ❑ DE OLISH 0TH R I' - • A.P.# ' _(I�r•!' I Zone R I Owner's Name • ( /f/(� 1:5 5 0 p Pho4go •- 299 D. SCR •TION OF WORK _ .t - • rr a� '{Ca 7� ,az / 4 - ifA�r' S Main Building:, Accessory Building: O Address /le 12 //F Sf} , TYPE OF PERMIT p GRADING r�U FOUNDATION �' $ •UCTU RAL 4) ' * T Front N Arch/Eng.-_L-1_,C O tar ' O TENANT LLg.ELECTRICAL L_r1�¢LUMBING ❑ MECHANICAL • B � i N Rear Address - _ - ❑ 'OTHER A - Contractor's Name Lf7VAU54' I? tAt 4/Phone e0W-2600 PROJECT DESCRIPTION SQ. FT. -3Z-9 OCCUPANCY C Right '-����� ill _ t. G X12 ^ I �,F' CON STRUCTION TYPE ' VALUATION *WO $ Left "f• 3 � Qp - R Address(mailing) aid( p I%W L/_ r9.I/�¢/,E'/M en E ts� !/L°�G�r ZONE GRADING CU.YDS. 'ACRES Ping. Ref.# Park.Fees $; Q N City License No. U LICENSED CONTRACTOR DECLARATION Remarks: , Parking Req./Provided M I hereby affirm that I am licensed under provisions of Charter 9 (commencing ��//.� \_\\\f with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: 4)/x a7��t p't'7, G��' (''e'.r'rria-I) E my license is in f= force and effect. - ' �'�""`^ \ License Class icon, , PLUMBING FEES Planning Notes: • M 'P Date r - Signature i �r fr v E WORKERS'COMPENSATION DEC LA RA ON Bar Sink Showers N I hereby affirm that I have a certificate of consent to self-insure ora certificate gackf low Preventer Service Sink S I of Workers' Compensation Insurance, or a certified copy thereof (Section yv) 3800, Lab. �1 D 7/c.i •-r i Backflow Irrigation Sewer Cap - " ELECTRICAL : FEES • 'Policy No. Company _ II i ,, CertRled copy is hereby furnished. �i Bathtubs Sewer Connection Automatic Washer Transformer 0 15.50-KW Certified copy is filed with the cit •� n• • inion. ..../ -1 -� ,❑ 50+KW Date_- /2-Vel App Iican.. ai/✓i- . .- amu. St Clarifiers Solar Collectors • Construction Pole Sub. ' EXEMPTION FROM WORKERS'CO'- SATION DECLARATION - Diahwasher Solar Piping Cookin Unit Meter ❑u to 100 amps (This section need not be completed if t-e permit is for one hundred($100) or 9 P • • less). DrinkingFountains ' I certify that in the performance of the work fpr,whlch this permit is Issued, I ' Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Floor Drains' Swimming Pool w/Spa, Dryers ❑Gas' ❑Electric Sub Panel ' Date Signature ' - - - NOTICE:If,'after making this declaration,you should become subject to the • Floor Sinks . Urinal , Fan Motors 00-1 HP 01%-8 i Workers' Compensation provisions of the Labor Code, you must forthwith - -- - ' - - - - - - - - - - -• - comply with such provisions- or this permit shall be'deemed revoked. Gas Service -Outlets • Water Closet F.A.U. • Inc.Solar ❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY: �q 1 hereby affirm that there Is a construction lending agency for the performance , Interceptors .. _- Water Heater. ' 2. Fixtures Microwave 097t/ of the work for which this permit is issued (Section' 37_ Civ. C.)i - '- Lender's Name 'P Kitchen Sink - ' Water Service - ' �p�`' Device Boxes Pole Light Lender's Address - ' OWNER BUILDERDECLARATION Lavatories - f - I hereby affirm that I am exempt from the Chntractor's License Law for the - - /m `- "'Y""' �2z Outlets • Range I I 1 o0 following reazoii (Section 7031.5 Business antl.Professional'Cotle: Any city or P-Trap - /� I .e '6, / �/�' , L OD / Switches Sign i 2Q 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 Roof'Drains . ' - - Garbage Disposal ' Standing Sections • to file a signed statement that he/she Is licensed pursuant to the provisions of - , - - - ' the Contractor's License Law(Chapter 9(commencing with Section 7000)ofGenerator ❑0.5 KW❑5-15 KW •Trash Compactor Division 3 of the Business and Professions Code) or that he/she is exempt - ' ' - P , 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 Reins coon Fee1 3 nenalty of not more than five hundred dollars($500). Pe $25 Issue Fee', $ ., - ' 1 1, as'owner of the,property or my employees with wages as their sole MECHANICAL • Reinspection Fee $25 Issue Fee- + . $ 3 ,mpensation, will do the work,and the structure is not intended or offered uI, FEES i. • or sale (Section 7044, Business and'Professional Code: The Contractor's - - '.. . PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler _ • Hood or Type I 0 •' w y T. a thereon, and who does such work himself/herself or through his or her own -y: Zoning Approved By .� ' Date 'I -8 employees, provided that such Improvements are not intended or offered for Canopy Type II 0 _ sale, If, however,the building or Improvement is sold within one year of com- Duct-Under Ground • -, Application Approved By - .:%�r'r=r Date elation,the owner will'have the burden of proving he/she did not build or im- — - i� l rove for the purpose of sale). -- - Duct-Structural ■Refrigeration System • Application Issued By �� Dat • oI, as owner of the property,am exclusively contracting with-licensed con- ❑0.100,000 B 100,000 BTU • tractors to construct the project (Section 7044,Business and Professions Code: • a - ( - SUIY](JI(�RV OF FEES The Contractor's License Law does not apply to an owner of property who- - a 6flt - [' builds or Improves thereon,-and who contracts for such projects with a con- ,E ■ ' Sys • -epair/Alteration - •.BUILDING PERMIT $ •SO SMIP- $ i:..)�- tractor(s) license pursuant to the Contractors License Law). - PLAN CHECK $ 28• J PERMIT ❑'lam exempt under Section B.& P.C.for this reason =• �' • r PLUMBING $ 7, CO ISSUANCE $ • Date - - Owner ' Heating System&Duct•- PLAN CHECK $ / ENERGY P.C. $ - I hereby • that I have read this application and state that the above ❑0-100,000 BT re 100,0008 GRADING $ 'Marna '•n is c.rrect.-I agree to comply with all city and county ordinances - ELECTRICAL $ and sta e laws r lab)g to onstructlo ,and-hereby authorize repre- PLAN •CHECK $ • R© MICROFILM $ sentptl -s •f is y n • .•ova-mentioned property for insptt . ,os. i,:. �� - • 87. 33 Signatu •Vi_ ,//},/ 1'._-� r�' DatZ.-��' MECHANICAL $ TOTAL FEE $ 1` Drivers' cense •r •S Reinspection Fee '$25 Issue Fee $ 3 / u.,CK $ • ala CMF 0865.6 rev. /83 ' White-Building;Canary-Applicant;Pink'Accounting;Goldenrod -Assessor `a+,, 14. CONSTRUCTION AND PLANNING POOL& S. APPROVALS Permit# Date ' Inspector APPROVALS Permit# , Date Inspector ' 1: Temporary Electrical Service or Pole. ' 52. 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. . , 8.' Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe--Undrgrnd.' .' ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - •- 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap63. Heater & Vent-Final 13. Roof Drains s 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 20. Rough Factory Fireplace APPROVALS Permit# "2i. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas O0il . _ 23. Gas Pipe-Rough& Test 72. Underground Flush 1 '24.-Roof Framing73. Undergrnd.StorageTank0Gas ❑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 Iy 29. Insulation i 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT • 31. PlasteriBrown Coat - 79. FINAL INSPECTION ti 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED `n 33. Final Electric 311-5),g6 fee-) Notes: 3/C/g �•A1E A rc i', V(„/ 34. Final Heating & Air Conditioning N4 c C'AeCa0 35. Final Gas Pipe-Test Jj JO-6 (-EO ,3t 3/S4 NO 044(1- fro / i3Ons 4 36. Hood or Canopy Ec-ter o2 (bile- vc i i 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, J � / 47. FINAL STRUCTURE & BUILDING c'iy� V6 48, Special Requirements Completed JJ V 49. Electric Release to Edison . - . , f 50. Gas Release to Southern California Gas Co . - - N. 51. CERTIFICATE OF OCCUPANCY . I ,` . No. Date A PROJECT ADDRESS: 1642 BAKER ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 063961 OWNER'S NAME: HILDEBRANDT SUSAN ANNN ADDRESS: P 0 BOX 7001 PERMIT NO: B 063961 PLAN CHECK NO: N GOVT; N SUPP: N HUNTINGTON BEACH, CA 92646 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT NI 434-7349 AflCMIEN EREG.NO.: JOB DESCRIPTION : T/OFF SHEATH REROOF W/COMP SHINGLES SQ FT: 3, 000 ADDRESS: UNIT: CLAIM VALUE: 3, 000 . 00 CALC-VALUE: 3, 000 .00 GROUP OCC: R-3 /M-1 PERMITTEE: THUNDER ROOFING ( 714 ) 646-4122 ADDRESS: 854 W. 19TH STREET COMMENTS; REROOF 2600SF RESDIENCE S GARAGE W/COMP SHINGLES COSTA MESA CAIE 92627 ************** ************* *********+E**+F*+F***** ******** F ' < : • LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON I NG REQUIREMENTS � U ETf=CTOR 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. • S E TB ACK S CITY UC: 05 A STATELIC.:63814, ILA r? REQUIRED , Date:'< 0 /4 93 Signature: I ( - - MAIN BUILDING ACCESSORY BUILDING WORKERS'COBIPENSATION DECLARATION: I hereby a���III' that I have a certificate of consent to sell-insure orate ificate of Workers' FRNT: FT IN REAR : FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof l .on 3800.Lab.C). - LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: / COMPANY: C PARKING REQ: PROV: PARCEL: 13918413 ZNE: REF NO: 0 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> Date: Applicant: ******fe************************************************************************ • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TT$ completed treed not be npleted it the pemfl'is for one hundred ISM)or . 1. DEVELOPMENT S ER V ICES R EQU I R E M E N it S I certify that in the performance of the work for which this permit'•issued,l stall not employ any perso n any manner so as to beco e subject I the Workers'Compe ation Laws of California. ZONING APPROVED- BY : DATE: J _ Date' �j� Signature: 7 ° - I NOTICE IL site maks this declaration.you should bee, subject to me W Co anon provisions of the Labor BUILDING APPROVED BY DATE: -. Code.you must forthwith comply with such proviiov• rt this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm t • ere is a construction lending agency for the performance of the work 1.r • • e ICAT I ON ISSUED BY: �- DATE: obil* ** .14.*I y( ORI * *. which this permit is issued(Section 3097.Civ.C). ************* *********ar*************** **** ******************** .*.* LENDER: *********************************************************************,********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the ollowing r.son BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESP GRADING (Section 7031.5 Business and Professional Code: Any city of county which requites a permit to construct,alter,improt• de • sh,or PERMIT 54 . 00 5 0'., repair any structure.prior to its issuance,also requires the applicant for such permit to tile a signed statement that he/s • is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(35001. ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation. wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 does not apply to an owner of a properly 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.IL however the building or improvement is sold within one year of completion,the owner wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED • 54 . 50 OVER/SHORT; 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING' PLAN-CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 . 50 .A ❑ and Professions Code: The Contractors'State License Law does not appy to an owner of properly who builds or improves thereon • I and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *****************.************.**.*****.*******.*******.*****.***************,********* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ^ o I am exempt under Section: B.8 P.C. tri for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: 0neo SFR 3000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 3, 000 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505.25533.and END OF FEES �• 25534 and that I or arty future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from theAirOualrty Management District.Residential construction applications are exempt from 41 these provisions. .r Date: Applicant: tr-- 1 hereby evilly that I have read this application and state that the above information is correct.I agree to comply with as city an• •unty ordinances and state laws relating to building construction and hereby autr or'ue representatives of this ci to enter upon the above. . honed 'I. property r inspecti n purposes ""---3. Date: - S hare: -n---9---7' / ' e 4,-4 _ ' DriversLic se or Social Security.: 01 00145864-00146865 TOT 54.50 1641-46 wane-Building:Green-Code Enlorcem I:Canary-Applicant Pink-Revenue:Goldenrod-Assessor DATE: 09/14/93 TIME: 10:51 i f POOL & SPr- CONSTRUCTION AND PLANNING APPROVALS Permit # • Date Inspector APPROVALS Permit ;P Date Inspector 1. Temporary Electrical Service or pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit UUlity•Undrgrnd. 54. Forms I 4. E:actr,al Conduit-Undrgrnd. 55. Electrical Bonding ___, 5. Steal Reinforcement 56. Rough Plumbing & Pressure Test 1 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER•GUNITE ' 7 Footings 58. Electrical Conduit-Undrgrnd. _ -1' 8. Foundation '- 59. Gas Pipe, 0 Undrgrnd.,Test --~ 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P Trap, Unit/q d. 10. Structural Floor System I 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection62. Backwash & Receptor-Final ' 12. Sewer Cap ~ 63. Heater& Vent-Final I I 13. Ruof Drains 64. Plumbing System •• Final f 1:. - - -+ 14. Rough Plumbing 1 65. Electrical-Final 15 Ro,:7h Electrical-Conduit 66. Solar System-Final • l 16. Rough Electric Wiring 67. Fencing & Access Approval I 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ___1 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 2C. Rc�tt,h Factory F4ep'ace APPROVALS Permit ;t' 21. Ducts, in Structure 70. Underground hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test72. Underground Flush 24. Roof Framing 173. Undergrnd.Storage Tank 0 Gas 0 ' ?At;25. Roof Sheathing 74. Overhead Hydro I 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemlcul i 27. Frame and Flashing 76. Dry Standpipe 1- ~II 28. Lathing& S ding 77. FIXED SYSTEM FINAL I I 29. Insulation i i , 78. FIRE PREY. FINAL I ' 30. Drywall Nailing . HEALTH DEPT. REOUIRci�SENT I 31. Raster Brown Coat 79. FINAL INSPECTION 3. Electrical Power Meter Final I80. FOOD CERTIFICATE ISSUED - -.1 _ 1 _____i 33. Final Electric Notes: 34. F.ne! Hcating & Air Condtioning i 35. Final Gas Pipe-Test } i -~ i 36. Hood or Canopy 37. Final Factory Fireplace I ; ;i - I 38. Final Plumbing I I 't i 39. Water Service-Final 7 40. Gas Service-Final i 11I 1 41. Solar Domestic-Final 42. Backflow Prevanter I i 43. Backf low Irrigation -II _J 44. Landscape Irrigation.System 45. Sound Attenuation - -o-. -1 46. Handicap Regulations' r; - _--_ 4 47. FINAL STRUCTURE?&t-UILDING I�LYct7- 4- 4S L 5-4,...,4.._ l�+r[ 0.4_,....64.4.---- 48. FINAL PLANNING. ' �f I ._ I ' to 49. Electric Release to sct'r• 50. Gas Release to Soutttern• rCalfornia Gas Co 51. CERTIFICATE OF OCCUPANCY No. tiOate OWNER BARRICK, D. F. DATE 11-15-62 JOB ADDRESS 1642 Baker St. BUILDING PERMIT NO. 18221 GENERAL CONTRACTOR Owner-Bldr. VALUE $ $0.00Atkin. AP No139-154-13 LOT TRACT FIRE ZONE DESCRIPTION OF WORK to Res. INSPECTIONS Signature DATE GROUP j TYPE V ZONE R-1 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line ❑ House Con. 0 St.Swr. 0 Sprinkling System Construction Pole Underground 0 Power ❑ Rough Wiring - Trenches 0 Forms ❑ Steel Iteinf. 0 Priv(_/ Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing R Lathing — In ❑ Out ❑ _ Plaster, brown coat Refrig. ❑ Air Cond. ❑ _ Final_ Heating, Final • Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final Q pit9- I I-14o OCCUPANCY FORM BU4-5M - 7.61 l a. .).7 -OWNER s Mesa Verde Estates DATE 12_11_58 JOB ADDRESS 1642 Baker Street BUILDING PERMIT NO. 8358 GENERAL CONTRACTOR L. G. Robinson VALUE $ 15,495.°0 AP. No. LOT 123 TRAC11115 FIRE ZONE DESCRIPTION OF WORK Res. & Att-. Gnr. GROUP I&J TYPE V ZONE Al PLAN NO. INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches (/Forms //Steel IC /_z,/-c t Floor System 1 Steel Reinforce Chimney Re-Rod Bond Beam f=/t4 $ -2-1%77 Frame and Flashing .1. --f Lathing, In Out /C ,ter i Plaster, brown coat y...-¢. C-15? -14- Underground soil/y/fc W/G Pipe Test/liic i_2./-s-0 / "Top Out /Ati S 0/.0,,,:i-Aa,,4 �4fl1/4-('y is..." n �i iitdt? ff/D Sq ,z O 9 Furnace /2445 e-26-A-1, /" . , ' Z.. rt.-, ?-13'77 J 76 .2/0 Gas Vents \ i Rough Plumbing m...0. S 3-XG-,Sy itLci at m i c. 13-at-sy- /6 Yi , F�y ' a Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. tpj`V ' 'Sprinkling System I�\ Heating Final ZS 1.:241S; S� U Plumbing Fixtures, Final ZSS' 6-2G 3; - Final Gas Test/a— 44'-S -2/i-SJ3 �\fly •Construction Pole mit l� Underground Power Rough Wiring /i1-Y. ( 2 ' 50 31/2-7/ .egele:t-, 3•.23- .f% PS,L75 / Fixtures, Final / q 4,,ye, ...00CUPANCY /*s G `ST' - Form 219-5M-1-57 535 JAN 1959 �� C TA MESA BUILDING DEPARTMENT I..,JAN DEPT.I1, `•. ,n""•A 'CCP P.O.BOX 31T L . I -. . . .'. _..1 COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ABUILDING DDRESS 1642 Baker St. BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. 8358 OWNER Mesa Verde Estates v MAIL RECEIVED BY i DAT ECEIVED DATE ISSUED ADDRESS 1701 Gi sl sr St- -V-- 42— 6 S 0 DEC 31 1958 TEL. r� BUILDING CITY Costa Mesa Nom, 5-1751 ADDRESS ARCHITECT OR ENGINEER J. R. Shelley LIC NO.. C-2170 COSTA MESA. CALIFORNIA FIRE ADDRESS Long Beach Ge 9-0908 ZONE CITY LIC. ZONEPLOAN6 TYPE GROUP A r CONTRACTOR L. G. Robinson NO. 11230 C "1 n r �,/ 'i `. 5 ADDRESS 1701 Gisler NO. Xi -1751 BBYPROVED DATE / `EGA` LOT CORRECTIONS 1 DESCRIPTION NO. 123 BLOCK TRACT"3333 A.P.NO. y ZE NOWW F LOOT OIF LOT 70 X 100 NOF BLT none USE OF • EXISTING BLDG. ^�ICr- SETBACK LINE FROM ^�Y_J CENTER OF STREET 501plus REAR YARD waenlus — SIDE YARD RIGHT51p1US LEFT 5I plus DESCRIPTION OF WORK NEW X ALTERATION ADDITION REPAIR MOVING DEMOLISH �c'al bin I. SIZE BUILDING 1c60 S.Ft. ROOF STORIES 6 1 ROOMS EXTERIOR WALL ROOF ,.1'k COVERING Stucco COVERING Asphal t & Roc USE OF NEW BUILDING Residence & Attached Garage I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AG COMPLY WITH ALL CITY ORDINANCES ASD nit S ROBIN ILDING CONSTRUC• TION. L• �M yq�UATION �''` �j-p SIGNATURE OF ami SOUTH MADRE ST. ) / PERMIT FEE S 3 ) ' PERMITTEE PASADENA. CALIFORNIA 57,57fl,0 i. L� PLAN CHECK S 17• 5� / - $ /s y9s / TOTAL FEES .S e�.. 6 "°'�` AUTHORIZED,A N rl;T J- / q ll t,--a"- / 18227 FEE NRECEIVED COAA MESA BUILDING-SAFETY DEPARTMENT V I S P. O. BOX 317 COSTA MESA. CALIFORNIA I 9NANCE DEPT. For Applicant to Fill In Completely CITY OF C01 MESA PPP Y APPLICATION FOR PER TYPE OR PRINT BUILDING / �J /_ BUILDING ADDRESS �G /' � /3G. k EU' .1 r COSTA MESA. CALIFORNIAIFor Office Use Only OWNER 2 //F.. 3Q). rG lc �^. I RECEIPT NO.j + PE�8�J%IIaQ�/�7 ADDRESS /.(O / .C..�U jrf,^^ G/1 f ,(�/�9 RECE BY I DATE/ 145:4,'( DATA 1B/LJJ(J_�r. • �' •�• ./17 S 2 NO.J!I / �L�I ADDRESS (/ 1/ CITY C f /[ti OR ENGINEERNE TEL. COSTA MESA. CALIFORNIA _ 'I. AOR NO. . . ADDRESS FIRE ZONE , ZONE . SV TYPE GROUP / CONTRACTOR'JAS/'Z4I✓Ee So/1.-.0EAPPROVED t DATE////J -� z ADDRESS 45 Age v ZONING NEWT " ,}n ?/ ZO I NO. S l I USEIOP NEw�I �.'N-/� ,y CITY PLANS 4 USOP V jl[[NN�`�//I,MI[./LL.� STATE TEL. LEGAL U ., IR .Y r L k "CIC7NO. /; ( l NO. DESCRIPTION 739 � r / l , ;l / SIZE 6y. 1I y / J,•, ,i I NOWHo OONP BLOTB 1 3 t 1 OF LOT ff( • /� A.P.NO. 9 ^/B // 3 USE OF 4' EXISTING BLDG? /NGLE- AHR- Y Cp ES. YARDSEV 6 APPROVED ALLOWED SETBACK LINE FROM )) (CENTER UNE ST.) CENTER OF STREET ��0 REAR YARD ,.„[s FRONT {�O FT. IN. SIDE YARDI LEFT SXI RIGHT L /� R.SIDE 2 FT. IN. DESCRIPTION OF WORK . L.SIDE . 1' AJ -F-E-1 _0-4 IN. NEW I I ALTERATION I ADDITION Gt- �/ (]-- 7 IN REAR �C'CC rr 1T�' 11 REPAIR I II MOVING I I DEMOLISH A PROVED f L/lam l � I_i Jt _/ SIZE DING ^ ^ `3 NO. OF 11 / LT �.0 l NOOF STORIE6 EXTERIOR WALL ROOF / i COVERING COVERING It) e /iP USE OF BUILDING AND WORK TO BE PERFO D red Tio coseeo�/_, ah/7 I- —ej. de,,i, '�° �"AJ4 nT r . / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE O COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES ANDe%eTATE LAWS EATING BUILDING CONBTRUj�ION %. VALUATION — SIGNATURE OF �(J(//rJ/�t //l///// PERMIT FEE S 'UC7 H PERMITTEE /� // m $ KO to �) PLAN CHECK $ hk AUTHORIZED AGENT - �J m 0 TOTAL FEE $ -/i(J K