HomeMy WebLinkAbout2900 BAKER ST - Building Permits wCITY OF COSTA MESA
04111 MFS BUILDING DIVISION
4 A
F1 't S 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov
�. �til I 1 FOR INSPECTIONS CALL:(714)754-5626
9%gnn„pro If .
PERMIT NUMBER: BC12-00353 y
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES_ALT DATE ISSUED: 06/11/2012
ISSUED BY: KJB
•
JOB ADDRESS: 2900 BAKER ST CM • Suite/Unit:
APN: 13926116 Zoni ng:R 1, -
Vicinity: Primary Occ: ,
Const Type:V-B SQ. FT: 0 Valuation: $8,000.00 ; •
SCOPE OF WORK:REVISION'TO PERMIT ON 07/30/12 TO INCLUDE THE UPGRADE SERVICE TO 200A AND A NEW SUB PANEL
TO100A. -
NON-STRUCTURAL RELOCATION OF LAUNDRY ROOM TO EXISTING BEDROOM FOR FUTURE KITCHEN EXPANSION.
KITCHEN EXPANSION ISNOT INCORPORATED IN THIS PERMIT.ELECTRICAL TOaINCLUDE 4 LIGHT FIXTURES,4 OUTLETS, 1
SWITCH, PLUMBING TO INCLUDE: 1 LAUNDRY/TUB WASHER, 1 SERVICE SINK, 1 SEWER CONNECTION - PRIVATE
LINE, 1 GAS OUTLET.
OWNER: KNIGHT, LAURA . - • Address: 2900 BAKER ST Unit:
Phone: City/State/Zip: COSTA MESA,CA •
APPLICANT: FARTHING, SCOTT Address: 904 DOGWOODUnit:: , , -
Phone: 949-500-2870 City/State/Zip: COSTA MESA,CA .1 .
•
CONTRACTOR: FARTHING DEVELOPMENT INC License No:560875 • - •
Phone: 949-500-2870 Address:904 DOGWOOD Unit:
Cell: City/State: COSTA MESA,CAZipCode92627
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
COMBINATION PERMIT FEE SUMMARY • d° '. k
Building Plan Check: $0.00 C r
Building Fees: $153.25 h '�„-
Electrical Fees: $94.40 9g�`�'`
Mechanical Fees: $0.00 ��, fp
Plumbing Fees: $73.90 •
SMIP Residential: $0.80 s1PrS
e.
SMIP Commercial: $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES: $323.35
•Refer to fee receipts for all fees paid for project
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays:
New Years Day,Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day
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.
CODE/ INSPECTION TYPE PAIS INTMALS CODE# INSPECTION TYPE DAM )N1171515
1616 Fixed System Final Fire Prevention 206 Final Mechanical m(�
1266 Pool Spa Final 208 Final Plumbing TO I De C
200 Final Re-Roof 210 Final Electrical i0 A. 'L ���
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site `J
204 Final Demolition • ..
.. 250 Final Building/Occupancy L- #17D
.
a .„,
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 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.
❑ 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 is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier: or dismantling thereof,will be more than thirty-six(36)feel high.(Chap.3.2,Grp
(This sewn need not be completed dthe pernma valued et one hundred dollars(S/GO)orless) 2 Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number:
0 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 the wo . rs' compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I shy.•'twith co •p with these provisions.
//� Division of Industrial Safety Permit Number:
Annus Signatur; Date
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? 0 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 effect. ,2 a registration form for acutely hazardous materials? ❑Yes 0 No
Lic.(# QA. ' "'I v� Class? 6 (Section 25533 of the California Health and Safety Code. with some
/� a exceptions, requires registration with the Costa Mesa Fire Department by
77I
o,l/p2 each business which at any one time has on hand a quantity of acutely
Contractors Si.-.tura pate: "^ 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,CMI Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 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 0 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 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia 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? 0 Yes 0 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(8500).): 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 0 No
thereon,and who does such work himself or herself or through his or her own
8. (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
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
property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
❑. I, as owner of the
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 CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license,pursuant to the Contractors License Laws.). 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 M La er(s 7f Date
Signature Date //360a
3057-06(3107) r Authorized Ap nt
c(.
D3 — So
0111 �. .
CITY OF COSTA MESA
`o "MF' BUILDING DIVISION
4,4IIIW•
fQ-',, ,n-Ra j1, 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov
v FOR INSPECTIONS CALL: (714)754-5626
'i PERMIT NUMBER: BC12-00353
r •
PERMIT TYPE: . B_COMBO STATUS: - ISSUED '
Sub Type: RES_ALT DATE ISSUED: 06/11/2012
ISSUED BY: KJB
JOB ADDRESS: 2900 BAKER ST CM - Suite/Unit:
APN: ' 13926116 Zoning:R1, ,.
iOr-
Vicinity: • Primary Occ:
•
Const Type:V-B SQ. FT: 0 Valuation: $8,000.00
- •c
SCOPE OF WORK:NON-STRUCTURAL RELOCATION OF LAUNDRY ROOM TO EXISTING BEDROOM FOR FUTURE KITCHEN
EXPANSION. KITCHEN EXPANSION IS NOT INCORPORATED IN THIS PERMIT. ELECTRICAL TO INCLUDE 4 LIGHT FIXTURES,
OUTLETS, 1 SWITCH, PLUMBING TO INCLUDE: 1 LAUNDRY)TUB WASHER, 1 SEP/vitt SINK, 1 SEWER CONNECTION-
PRIVATE /
LINE, 1 GAS OUTLET. /
pa.
OWNER: KNIGHT,LAURA Address: 2900 BAKER ST Unit:
Phone: , ' City/State/Zip: COSTA MESA A
APPLICANT: FARTHING, SCOTT Address: 904 DOG OODUnit:: .
Phone: 949-500-2870 City/State/Zip: COSTA/MESA,CA .. . ..
CONTRACTOR: FARTHING DEVELOPMENT INC License No:560875 - ..
Phone: 949-500-2870 Address:904 •OGWOOD Unit:
Cell: - City/State: 'OSTA MESA,CAZipCode92627
aGid
ARCHITECT: Lice e No. PHONE:
PHONE: \\
ENGINEER: Lic.nse No.
Y\\'
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $1.00 •
f
Boilding Fees: $ .3.25
Electrical Fees: '.33.40
Mechanical Fees: $0.00 •
PIi mbing Fees: $73.90
SMIP Residential: $0.80
SMIP Commercial: $0.00
pldg Std Admin Fund $1.00
TOTAL FEES: $262.35
•
"Refer to fee receipts for all fees paid for pro".ct
HOURS FOR CONS 'RUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMCa Sec. 13-279
i Monday thru Friday•7:00 am thru 7:08 •m. Saturdays-9:oo am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays:
New Years Day,M- orial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day
at!.
BI:
Ce
!}NOTICE: The work author' ed by this permit shall comply with all applicable handicap access requirements under California statutes and related
sregulations. (Ord.No.92- :,§ 1. 12-21-92)
EXPIRATION: PERMIT XPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
{'INSPECTIONS: In or•er, for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
S bquired inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
ii14
gal, 185PEC110N TYPE PAM 1,41711815 COM/ 816PEC8C,4 TYPE 0m L8ma
E1p}16 Fixed System Final Fire Prevention 206 Final Mechanical
:kIS466 - Pool Spa Final 208 Final Plumbing
•
"1x00 Final Re-Roof 210 Final Electrical
Sw
G101 Final Block/Retaining Wall 212 Final Fire Prevention
Ct.:
jire2 Final Factory Fire Place 220 Final Planning Approval
1203 Final Sign 222 Final Site
1204 Final Demolition - 250 Final Building/Occupancy
i
. • a • • ...
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's 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.
❑ I have and will maintain workers'compensation insurance,as required by
section 3700 of the Labor Code,for the performance f work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation 1 ra a carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are:, person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier or dismantling thereof,will be more than thirty-sox(36)feet high.(Chap.3.2.Grp
sereon need m be completed d She pemms v ued et hundred dollars(S100)or less) 2 Art Sec.341,Title 8.California Administrative Code).
licy Number:
❑ 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
d, 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 the workers'compensation provisions of Section 3700 of
Applicant s Signature Data
the Labor shall f h comply with these provisions. r
2 .--Division of Industrial Safety Permit Number:
Apple ignature Date 1 \ 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 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia 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 effect. a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# 5epg7Class# (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
I each business which at any one time has on hand a quantity of acutely
Contractor's Signature Date 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
Lenders Name: hazardous materials)? 0 Yes 0 No
Lenders Address: (Section 25534 of the California Health and Safety Code provides that the
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 Califomia
OWNER-BUILDER DECLARATIONS: • Health and Safety Code been fully complied with? 0 Yes 0 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 0 No
issuance,also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors (Sectionrml 65850.2 be furnished the California Government not Code requiresbuilding thnt thee requested
License Law(Chapter 9 (commencing with Section 7000)of Division 3 of the information on applications for non-residential permits).
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 Califomia
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 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. (lf?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 alt state laws and
property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
rope
❑ I, as owner of the
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 CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I 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. I. D
CP - I� r
signature Data ��� ✓ i
castes fetor) _
Mellor Autrwnted Appleton Date
•
ADDRESS OF BUILDING: 2900 BAKER ST DMT' CITY OF COSTA MESA — BUILDING PERMIT
OWNERSNANweamN: ROAK, VERNON J 'PERM NO: B 080249
ADORES'' 2900 BAKER ST
1/` COSTA MESA CA 92626 PERMIT NO: B 080249 PLAN .CHECK NO: N GOVT: N SUPP: N
( 714 ) 842-3E.22
MIK.WARM ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCHRECT OR E1GNEEN: UC.NO.: JOB DESCRIPTION : T/OFF EXIST ROCK/APPLY NEW 4OYR"ELK"COMP SQ FT: 6, 000
MCN.OR ENG'S ADDRESS: WIT:
CLAIM VALUE: 6, 000 . 00 CALC—VALUE: 6, 000 . 00 GROUP OCC : R-3 /U-1
commEffsm0EACTION FIRST ROOF CARE ( 714 )841-7663
caNmACTOWSMMUN013352 GOTHARD ST COMMENTS: NEW COMPO ROOFING AFTER REMOVING EXISTING ROCK
ADDRESS:HUNTINGTON BEACH CA uc.ND.: 502900 ***********************+E**x'* ' '******* '********************** -+E '*+E******iErt**iEitsE*
92648 WMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby dram under penaly of perjury that I am licensed under provisions d Chapter 9 SETBACKS
(commenting with section 7000)of Division 3 d the Business and Professions Code,and my license is in full force and effect.
CITYUC.NO.:0643O2 ucCLASs: C-39 uc.No.: 502900yyEXP: 05/97 MAIN BUILDING ACCESSORY BUILDING
Date: lb"�J1'16 comae« ( IDAI YI�Y( Z�K... ✓. S FRNT: F1' IN REAR: FT IN FRNT: FT IN REAR : FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I em exempt from the Contradors License Law for the
following reason(Sadion7031.5&dnees and Professions Code:Any city or county Math requires a permit todxamrd,eler.improve, PARKING REQ: PROV: PARCEL : 13926116 ZNE: REF NO:
demolish,or
pursuatny toaeproviprimbies Contaatmoicenuance,also ires theeLaw applicant for
such permit tafihSell 7000ned )a 3nt that he dtse PLANNING NOTES>
isliinesed Pueet i the oiej or that
d ee she sump.
Li.thee frow
1O3l.5m and Professions Coder n that he or she is exempt therefrom and the basis for the allegedhu exemption.My violation d Section >
7031.5 by any appliram fora permit subjects the applicant to a dud Penalty d not more then roe hundred doAen rSSODD. 1f 1E 1E#')E#)E')F if�E 1E bE 1E'N'dE 1E 1E if 1E'1E if 1E'IF 1F df'1E 163E 1E 1E'lE'N iF 1(-iE 1E 1f*****1E lE****iE 1E lE-)E 3E IE'1f iE 1f 1E 1f df iE bE 3E 3E lF 3E**-*IE lF�h'*******
❑ I,a owner of the property or my employees with wages as the eole oximecisation,ml do the work.and the structute is not intended DEVELOPMENT SERVICES R E Qy'y U I R E M E N T S
or offered for sale(oryticn 7044,Business and Professions Code: Contractornoter
The Contractors License Law does napply to an ownera property M
who buids or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such
inureowne""t aim hravalmtendehe ddn Bredf li"saling l«'ahahowdeeer.t ebbubd"ddingorrisove rproreor mmeniisee within. W" ZONING APPROVED BY DATE;-
❑ I,as owner of the property.are esdudvely conlrwiso with licensed contractors to construct the project(Swan 7044,Business and
contracts
Professsios Code:hprcjeGaatewitamdtenseactorLaoense pursuanttdoes not apply o the owner
r of mLron.'ody vseo or buiklsimproves thereon and who BUILDING APPROVED BY : `J DATE:
O folamexempt under Section: B.AP.C.,(or this reason: APPLICATION ISSUED BY: DATE: 0' .3
1 ***** * ******************* **
Date LEGALIZATION:N F E E S U M M A Y STRUCTURAL SEGMENT:Y
I do hereby certify Out I em aware of and understand the requirements of California Health and Salary Code Sections 25505.25533.and
e2 perm'Eaconstuathat I°`tadmhMum
°modi5frattiionhng n ffromoccupant iwDualityylfi not(aaagee Manle agementDistrict.) dF Residential occoplY coomtmclid onsppok :ascodes ereexem$from Mets se BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 112 . 25 • , 60
Date: Applican: SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby elfoder penally d paddy one d the following declarations: PLAN -
in
❑ I have and will maintains,maintainmaintains,ccandies!.dconsent nsent toeellimon pen ,as w
for workers' provided for by d n 3700 the Labor IUILE FEE
w
Code,for the performance dthe work tor whwmisppm*isissued.
BUILDING—DIV—> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE
❑ Ihemand vilmaMlo
anw rkers'comperuenvmurance,mnw., d
quiredbyS3700dalaborCods,kathewd
performance TOTALS— > 112 , 85 0 , 00 0 , 00 112 , 85 112 . 85 00
work for which rho permi is issue.My workers'comps aation Insurance center and policy number are:
Coni..: NAT ' L UNION FIR EXPIRES REVENUE DIVISION TOTALS--> COLLECTED ; 112 , 85 OVER/SHORT; . 00
Policy Number. D0007A41 09 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed i the pant is for one hundred do0en 19MOWJ or Awa.) 112 . 25 . 60
•
❑ I certify that in the performance of the work for which this pemd is issued,I deg not employ any person In any manner so as to
became subject to the workers'compensation Jaen d Cdibmia,end agree Mal i I Mould became anted to the wham' *3E****1Eit1E1k*iFlf****iEiElEiE1E1E1E1E1EfFlEfEif****1f 1EilfEiE****fEfEiE****1E111F1E11)E1Elf1E1EiE1E1flE1Eif1ElE*****lE*****
compensation provisions el Section 3700 of the Labor Cods.I shall f.o,rt�bwih comply wall those provisions.
Date: (0—3 -11 Appfican: 1" -i013 $;✓G4Sf C64. c';j. INDIVIDUAL F E E BREAKDOWN
Warning:Failure to secure workers'compensation coverage launlawM,and shall subject an employer to criminalpamldea end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
doll fines rpt to one hundred thousand dollars($100,00c),As addition fo the coat of c mper:a on damages as provided for In
s«don37gsoymeLabor Code,lnbtattorneys f SFR 6000 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 6, 000 , 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty d perjury that then is a commotion lending agency for the END OF FEES
performanw as the work for which the parmi a issued(Seaton 3057,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I candy that I have read this application and date that the above information is coned.I agree to comply with all City and wooly ordinances
and state laws relating to building construction and hereby authorize representatives of this an,to over upon the above-menlioned properly
for inspection purposes.
DORIS WADA
i(�✓; Print Name DATE:010 10214-00218I117 TO 112.85
Date: 1.0-31 —q-b
w.* h' Signature of OwnadAgenvAppicantvContrador
1 (5151-46.WP) White-Building&Safety;Omen-Re;Canary-Applcant;Pink-Revenue:Goldenrod-Assessor
_P�1
CONSTRUCTION AND PLANNING - & SPA
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 Cap 63. Heater & Vent-Final
13. Roof Drains r - 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#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing I'%4j6.� �G� 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat Z 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. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final _ - 80. FOOD CERTIFICATE ISSUED
33. Final Electric , Notes: tt C {may'
34. Final Heating& Air Conditioning _ (f�/dj1CIA4,e--kAS
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 Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation /
46. Handicap Regulations `/ 4
47. FINAL STRUCTURE & BUILDING ",4 , 41;
48. FINAL PLANNING !!! BB - •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
OWNER ROAK, VERN DATE 11-23-70
1 JOB ADDRESS 2900 Baker St BUILDING PERMIT NO. 32488
A GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Add Family Room to Res.
AP No. 139-261-15 LOT80 TRACT 3529 FIRE ZONE . VALUE $ 5,8214.00
?-INSPECTIONS Signature Date GROUP I TYPE V ZONE 114
"SOIL SUBCONTRACTOR PERMITS ISSUED
1GAS Date
WATER I Number Signature
Plumbing
ROUGH PLUMBING /tA-Ze .5:72/s' _—
PROP. SWR. LINE ❑ HOUSE CON. 0 /
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 9 POWER 9
ROUGH WIRING
/,�� �(r
/� ]D Heating and Vent.
TRENCHES FORMS a STEEL REINF. 9 ]2_,-17?
FLOOR SYSTEM /..7-1-7'0
BOND BEAM n STEEL REINFORCE n �f
SHEATHING /tr`47 t2''O-/O
FRAME AND FLASHING 41, /2-/7-741
LATHING — IN n OUT /1'2Y'r0
PLASTER, BROWN COATfitint-c— dig/7i
STRUCTURAL, FINAL �A E1ec c /�'/6'2O �]y77
HEATING. VENT., REFRIG. AND A.C., FINAL Y' ' /
PLUMBING, FINAL AND GAS TEST n9,4"
73-1,
ELECTRIC, FINAL /�� 3^ R
BUILDING, FINAL (�t ''
gI r�
2I B 117_1.2 FEE n�EC�i\9E�
. .,,9
CDSTA MESA BUILDING-SAFETY DEPARTMENT q-B-t o
P.O.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT.
F COSTA
fOR APPLICANT TO FILL IN COMPLETELY APPLICATION FORPERMITSA
TYPE OR PRINT BUILDING
BUILDING Qg00 `t3AKtQ S-
ADDRESS l
COSTA MESA. CALIFORNIA11FOR OFFICE USE ONLY
OWNER E LK &N I Nu E-S-r. Co RECEIPT NO. 1Pi�iNOz
MAIL w n A RECE}VE�BY DAT RECEIVED DATE ISSUED
ADDRESS Ibsc PL- ocG-w , d L(.� � 7 (-r I y_�/-�pC
{'J� TEL BUILDING - j//'
CITY I�,J . NO. ADDRESS r� t -Q-/ ,
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR ENGINEER NO.
ADDRESS
FIRE _ A d/1
ZONE TYPE GROUP \f^ / yTr.
I• ' STATE APPROVED
CONTRACTOR k".(4/. iv 1-1—LIC.NO. BY DATE
n
ADDRESS ) sG 5 ?LAC I N'TIa9 ry ZONING �+ �/ i,��
LEGAL LOT Q ( - 35 .2 { ZONE NO.OF USE OF NEW Slagle PQL141 Att.DESCRIPTION INO. !J BLOCK (TRACT R-1 (PLAINS 2 ( BUILDING Res. With/ A t.
A.P.NO. NONE APBY.
I 1 ✓i) �JOATE �e5 �N a
•
SIZE ^� 3 X ' D 3 I NOW NO.OF SLOGS.
ON LOT YARDS V a IVES ,_
OF LOTREQUIRED ALLOWED
USE OF (CENTER LINE ST.) ry..Tv
EXISTING SLOG. FRONT y FT. IN.
SETBACK LINE FROM 5 0 I
CENTER OF STREET REAR YARD ( R.SIDE 7 FT. IN.
5C/
SIDE YARD LEFT RIGHT O L.SIDE �FT. IN.
DESCRIPTION OF WORK
V REAR FT. IN.
NEW I XI ALTERATION I II ADDITION I - J�
REPAIR I II MOVING I . II DEMOLISH I
BUILDING Ii 0 NO.OF
SIZE 0 ROOMS (jJ STORIES
EXTERIOR WALL( `uCi cROOF t 0 .AD
COVERING COVERING K.
USE OF BUILDING AND WORK TO BE PERFORMED •
' AIWG FAM. 2E5
LTT" , &ee._
I HEREBY ACKNOW •G THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
ANDHE AS(YE IS C•-RE REE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITHITH ALL LLC C Y ORD ANCESS LA / LATINO
` BUILDING CONST UC'I• '. `` VALUATION
SIGNATURE OF / PERMIT FEE $ 37�-
PERMITTEE I A. A2n sill iI//Z.A lab
ac
$II /� I7V PLAN CHECK $ / Jr�-
AUTHORIZED AGENT TOTAL FEE $ Sy��
i *32 88 NW z3-7O� S�00 858* 48.00
,,
-...�� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely REc Iv D 7 DATE RECEIVED
BUILDING J�%. � .C�E�P S'T (/T-,-E ISS ED leg
ADDRESS r( riD 2
I/rR t . 681< A.P.NO. 4n- 5,2 2-/S PERMIT NO.
OWNER At \ 9,50
MAIL aG Y C:� n g/T/�E,( �t ADDRESS �, 4P�4/1
Z ADDRESS q
a U CITY C• 44 4 NOw ,�gLis• / TRACT 'f'O / LOT to BLOCK
Z < CONSTRUCTION Gln A'l' NEW ADD ALTER REPAIR MOVING DEMOI ISH
O N LENDER ��/��/C •
a m //
J r BRANCH •
J(n OWNER este
4,..24 peltett
COerE -I ADDRESS VALUE
-CO ARCHITECT TEL. USE 5
J Q OR ENGINEER G - NO,
5 En FIRE
ZQ ZONE TYPE GROUP
W TC ADDRESS J
0_ Ly APPROVED %�/ ATE/I%D-/rj
D
W Z CONTRACTOR BY d�"
J O •
CO
JCC ADDRESS --
LNO.OF
n F ZONFjt / PLANS ` USE OF •
O= CITY TEL /�(v/ PLANS O'(1 BUILDIN
w-O STATE CITY YARDS APPROVED YARDS APPROVED
in 0= LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
O (FROM C/ T
SIZE NO.OF BLDGS.
OF LOT NOW ON LOT FRONT FT FT.
USE OF �(
EXISTING BLDG. _R SIDE ..a aFT. FT,
2 NEW BLDG. /G A/2,..g ROOMS / S DRIES / L.SIDE j .$FT. FT.
EXTERIOR WA ROOF
U >k
COVERING d COVERING /{L.l • REAR /L7 FT.3 FT.
J USE OF BUILDING AND WORK TO BE P RFORMED DISTANCE BET. BET.MAIN&
a a MAIN BLDGS. ACCESS. BLDGS.
0 r00- '�� C.U.P. DATE
0 ri_a_J_y_�j �-Z C.U.P.qy APPROVED
APPROVED
U.) BY 4/� DATE /1- 9- 7a
2 •
0
I—
C.) I hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of .•
U.)
the State of California. �//h tO
I hereby certify that I am properly licensed as a contractor under 7 SQ. FT. O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5
Chapter 9. and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m
CC
am exempt from the provisions of the State of California Business
and Professions ode,Diiin 3,Chant, 9. VALUATION 52,0(f �. ____.. co
/ Me 1 O a•, PERMIT FEE $
Signature • V /6/D O
m
Permittee 2/i. ithr / /�.�ti. . $ PLAN CHECK $ E�
r O o �/
Authorized Agent , `� 1•Z'y'—" TOTAL FEE $ --,9-1-74-r/