HomeMy WebLinkAbout2908 BAKER ST - Building Permits sr vet
CITY OF COSTA MESA M
�i
y momBUILDING DIVISION
t' ---n;'4 ' DEVELOPMENT SERVICES DEPARTMENT /(C7-re •
se. PERMIT , /PERMIT NUMBER
c
P98-00614
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 2908 BAKER ST • - Status: ISSUED
Suite No Applied: 08/04(1998
Issued: 08/04/1998
Vicinity:
Parcel Nunmber: 13926118 -
Applicant NOCK, RON - - _
Address:
_-------;---yr
�� ;(Phone: _,
-
x- �� Zip
Owner SHAHAN;KAREN�M� - �� < L f ���� C�
uT A :' -y--- - -�V �-\:-...--,;(-14';‘,�,'N,�`.
Address/70908/BAKER ST" / -- ` =� i y�
/2, /( n //=�j Phone: �:\ �"- (/�� •� •
!I' `COSTA MESA,CA% Zip: 92626 ����v./N v
Contfactor: NOCK'PLUMBING �`
)u ilii'
/( Address:-j11612'KNOTT ST I IC----
C'I LLL.
/./,'/ «��'-//( Phone,7 895-1246 -�
/,'(f /(7 / /GARDEN GROVE,CA_,.,‘ -,,i.----
�-.Zip: 92841�. �...a.
//,l�� L / ���g/,i , , /.1 %`. ° -License`707775 . c- -s_, ,s.�- /
I �,�Archl Eng /i ( it _� / '1 - 11
\\ I ''�/ .\ �> /
is
,,' Address:!'1,
I p r Phone, i•�r�
� i % _J 111 ivy ' S -, l,, / , ( /� yy
, `"1 I',t., I, =- - License = - - _ •
I ' ver. - -
L 4< SCOPE OF•PERMMMMIT j/ . _•
} 1 - 1 VINST W.H. /7 ,
,\ FEE SUMMARY- j \i� '
1 ‘ A \VAAMT QTY -"AMT--OTY i/ , ., . ) /AMT QTY
ISSUE PEE \\\� $22.00 Laundry Tub/Washer $0.00 0 Sump Pump / ' / ,$0.00 0
Backflow irrigation_,� $0.00\ 0 '1 Landscape Irrigation \ $0.00 0 Swimming Pool � I 1',so.® 0
Backflow Preventer v $0.00y 0 P-Trap (a;,,� $0;00 0 Trap Primer ,, ,$0.00 0
Bathtub \' ti ? $0.00 /0 ` Pressure&Regulator �,; * $0.00} 0 Urinal' ` ' II $0.00 0
Clarifier Systeme / ' $0.00 .0 ,- Process Piping(per 10 ft)' y$0.00,, 0 ;-Vacuum Brkr Bkflow(14) .� $0.00 0
Connect(Ice,Soda c) $0.00 0� Receptors, ' /� ,y" $0.00.,A 0 j Vacuum Brkr Bkf1ow(5.)' $0.00 0
Dental Units N ;$0.00 ,, 0 .,v� .Septic Tanks ,-,, $0.00 ,0 ' Wash Basin 7 $0.00 0
Dishwasher vv,. Z" $0.00" 0 Sewer Ca for Demo„ /_`
/�_ �- p � $0.00� ".0 .Wash Basin Set i� $0.00 0
Drain,Floor A I $0.00'i/0")......„,�Sewer_Connect _ $0.00 - 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 \\ 0 '/ - Sewer Private Line - $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof `$0.00. 0,1.-. �/ ^Shower $0.00 - 0 =Water Heater/vent $11.00 1
Drinking Fountain $0.00 *0 7`, 'Sink,bar, 's / $0.00 0 - Water Piping(Inst or Rep.) $0.00 0
1 Expansion Tank $0.00\` 0 '�.Sink,commercial $0.00- 0- ' Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 '0. - Sink, Floor -/ ,.\,; $0.00 0 ' Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen , .$0.00 .0- -" Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 - Sink,service/mope $0.00 0 _ OTHER $0.00
Gas Repipe $0.00 0 Spa(private) - $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $33.00
COMMENTS/SPECIAL CONDITIONS
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 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.
FOR INSPECTIONS CALL: (714)754-5628
w
DECLARATIONS C
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
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 ofaTthee�woorkk for which this peril is issued.
My workers'cpncpeo tjon Ipsurancq certi tl poliyy number are: V79'911'/ / '3 YO
Carrier. ( � l)ld/ .�f 1/.`rY/I Policy Number.
(This section need not be completed I1 the pormit i alued et one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor e,I shall forthwith
comply with these provisions. [J_
Applicant Signature: Date: —/
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(S100.000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisi ns,P,f §P{e (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
force and effect.Lic.M -7 / ) ( Class a �/
Contractors Signature: \ Date: U T — L O
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,CMI Code).
Lender's Name: Lenders Address:
Signature: • Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or 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
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that hear she Is exempt 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 penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves 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 sale.If,however,the building or Improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business end Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. _ Expires:
Verification of Ownership by(type of document,i.e.-properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,lalsework,or demolition 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).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No .
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(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 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 temperature and,pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(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.
4 If an RMPP is presently required,has Section 25534 of the California Health end Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes ❑No
(Section 65850.2 of the Cafifomia Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penally of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of 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.
SitirLure Of Legal Ow ' D e Q
• A .;.r Authorized Applicant Date
GOOE�. DIDEECEIONTYPE DATE INIIDALS LgQFl INSPECTIeN TYPE DAM MAID
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical J_ ���� ��/yy����
1266 Pool Spa Final 208 Final Plumbing '4' 2-ni ITT /WAS
200 Final Re-Roof _ 210 Final Electrical _ �f
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place _ 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition _ 250 Final Building/Occupancy
2446-46
,4--0,--„--U,!7-4, CITY OF COSTA MESA
4
WBUILDING DIVISION
> ,.""11" I DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
t.4. art!a� PERMIT 06-01892
(714)754-5273art • Fax(714)754-4856 • www.ci.costa-mesa.c$4/ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2908 BAKER ST Status: ISSUED
Suite: NI . 2 Applied: 11/09/2006
Vicinit : ROOF - °''
y r � Issued: 11/09/2006
Primary Occ: R-3 Dwellings/Cong i3-s<1 i ,. 'al ype •ohl on cti . V-N
Parcel Number 13926118 Zoning: R1
Applicant: SHAHAN, KAREN
Address: 2908 BAKER ST / a
Phone: 714-557-4573 ISSUED BY: ..:�,-``
COSTA MESA,CA - Zip: 92626
Owner SHAHAN, KAREN-M '� _
Address 2908 BAKER >�
.ST !��- i
% -,y v -�� Phone:
COSTA MESA,CA\ j y, ' - .--Zip: 9262
/ <V7- (N
Contractor: OWNER-BUILDER - �yv«"
Address /. / \ 7/•:,,'''-, �� '�.<.g.,, -
' ' Zip: N` /4' License: 000000 '
// /-
/Aich :/ ' ' /i,1,7 Eng:
:Address:- _ / X27`!' • - Address:
' Phones _ Phone:
Zip: -License:y License:
SCOPE OF PERMIT ' ' ' - '
`'TEAR OFF EXISTING ROOF.INSTALL 1 LAYER 30#FELT, DECRA STEEL, ICBG#3409, 1.5 LBS PER S.F.3200 S.F. INCLUDES ATTACHED
GARAGE. \.„•'''',•)
% -7, • .-1 7 /r - -. •FEE SUMMARY
' Plan Check: " $0.00 ...,,-...,,-,il. . Vii.'/_i� _ .-- . •' , -- . - Calc Valuation: $17,839.00`
Permit: $293.25 Claim Valuation: $17,839.00
SMIP'Res:" $1.78
SMIP Com: $0.00 �� ��:T `c ,
i Other:,. $0.00 - ; .
Inspection: ; $0.00
t
� Total: ..' $295.03 - _
. - .
t ,,,,PLANNING & ZONING
SETBACKS ? _,‘;•;f-t;' ,-
MAIN STRUCTURE Front` 2ar
0-.0 Re ,'10-0 r Left 0-0 . . " Right 0-0
ACCESSORY\ Front' 0='0",-.' Rear- 0-0"�-' Left ' 0-0 Right, 0-0
PARKING\ -,:;\v Existing,//0� .Required: , 0- _ - Proposed: 0 - -
,/ — -
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: 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. y ,
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.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'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 permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed ll the permit is valued at one hundred dollars($100)or less.) . .
}11_11,r:ertify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of C litemia,and agree tha I ouid become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these p s. I� Mao
Signature:. �s1"i Date: ) I
IWAfiNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EtTD'CRIMINAL PENALTIES AND CML RNES UP TO ONE HUNDRED
THOUSAND DOLLARS($100,000),IN ADOPTION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECtON 3rd%OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
force and effect.Llc.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or 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
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors 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 the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,end who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
4—I,-as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
)4 Cede:'The contractors License Law does not apply to an owner of properly who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ Ilam exe nder s . Business and Professions Code for this reason: /1 ban
Signature:, Al Y*'Date:
mer ID verified by driver's license. �Ves 0 No Driver's License No.
Verification of Ownership by(type of doc m t,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,faisework,or demolition 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).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire 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 500 pounds,or avolume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(Section 25533 of the California Health end 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 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the Calitomia 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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication aPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LD No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(if yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (if"yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all ate s and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-descrlb operty ford`' c to rposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Gurl�/ — IID` /U06
Signa Of Legal Owner(s)__,_;;,,j' Date
And/Or Authorized Applicant Date
CODE L INSPECTION TYPE ' PAIS intra CODE I If/SPEC110N TYPE PAIL IDLs
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof / 6r 210 Final Electrical •
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition — - 250 Final Building/Occupancy
•
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA-MESA - P MIT NO. - TRACT NO. LOT NO. ' BLDG.NO.- - - - - - - - • -
• '! CONSTRUCTION PERMIT /35Z 83 '' . ' 1216 Ip/0 /�1P• •
6.00 , TI
Project AddressoQ9Q9- /3, j� ar.lh., TYPE OF CONSTRUCTION �` ` _ - -
•
Owner-f/ ,-cet,„.,,,__;- -- - - -• Phone •- - -O NEW ❑ ADD 0 ALTERATION' - " . - . . -' • . ` ' -'
' Addres • C0 • _ _ 0 REPAIR O:CONVERSION ODEMOLISH
� /ti' - ✓2� , . . . - ,
- , " ZONING REGULATIONS - . ,
. Arch/Eng. - - - -.License No. - EI OTHER _ • _ - __ _ -_ - -
Address - (/1 -- - _ - -.DESCRIPTION OF WORK - _ - • _ _.-
/� .` 'ZONE - PL'NG. REF.-9F•
1 Contractor-`�L •�-G1GIa--Phonrcr Y'7�G TVPE.OF PERMIT _ _ ._ - - - BUILDING-- �rrpp gg�LIII p,t NG - - .
SETBACK C/L ST PROPERTY UNE
Address ���' r,-_ /irs /O�/�y� . - ❑GRADING -0-FOUND& ION -El STRUCTURAL- SIDE:YARD -- --- - -- a - -
LICENSED CONTRACTOR DECLARA N.... / /? 4-
V LE
T lam. FI/t-� ❑ TENANT ❑ ELECTRICAL' LUMBING ❑MECHANICAV. RIGHT YARD. - -- -' - - - - - -
I hereby affirm trait I am licensed0)-. Antler rovis Ions of Charter 9 (corn- - .. . - . RIGHT :
Profeng.,with- section 7000)-of ;Division_3 of the Business and. . .�.OTHER• _� . - _ - •
Professions Code, tl license is In full force and f t. REAR YARD (TO P/L) _ .. "!
�rtt!v �'(_ ': PROJECT.DESCRIPTION• •
License Class ' - a -`--• en �'� - PKG.-SPACE REO.-_ - -- - PROVIDED. - • •
Date-24/A•2 -1+ • Signature-^- _mo i/ - . SQ.-FT! , . _ - _ -_ __ _
STREET WIDTH -` , PARK FEE'$' -
,WORKERS'COMPENSATION DEC LA RHT.I on • '' VA .. .. _=CONSTRUCT N TYPE ZONING APPROVEDBy " '- -I DATE
,I hereby affirm that I have a certificate of consent to selftnsure ora VALUATION- q ZO E - '
certificate ofoWorkers' Compensation Insur nce, or-.d C¢rtifietl Copy \ _
•
thereof(Sectifji�n/,8 0,-Lab. Cd- j , /4 T GRADING CU YDS. - qc 5 { - 'SPECIAL CONDITIONS- ,
Policy No.^Y -y�i//-Company'Le" '>rlevt-ar" _ -- -- - /'_. • \ - - - { _ _ - -
i C led copy isshereby furnished. _•- _ REMARKS: i _- - _ - - _ _ _ - _ -. -_ , •
s., :F .:.
ertifled copy is filed with the city Bathing Division. r,sti .I , •
XEMPTION FROM WORKERS' COMPENSATION-DECLARATION - - - • - - -- - - - -- J La
(This section need not be completed if the permit is for hundred • -- `ryts \ft
($100) or less): .. - -one _ - - - '. .__ - �_.
I certify that n the performance of the work for which this permit Is q
Issued,-I-shall not employ'any person in any manner so as to become -PLUMBING' _ LA ECK' - - - • `Qs/ RICAL - `-- -- PLAN' CHECK- - - - '
subject to the Workers'Compensation Laws of California.-- •t - "j LLLING... - .,SGA RAGL _ _ I
f - _ - -BATHTUBS• -- - WERS - -- (,�( SO FT Sri FT
Date - Signature p - - '-
'NOTICE: If after making this declaration, you should become subject TOILE ' . . ..,URI ALS - - -,...t1:--7i GENERATOR - 01 KW ' -- 110 KW -- 1
to the Workers' Compensation provisions of the Labor Code,you must �'_ 'TRANSFORMER .'
forthwith comply with such provisions or this permit shall be deemed LAVA ••IES DOUBLE LAYS ^* - r,V ,APPLIANCE - 10-50 KW=50+ KW
}eyoketl. _ { ' 'T IT.'SI -
-- • - DISHWASHERS - f
CONSTRUCTION LENDING AGENCY • �h i - •- - -MOTORS- - 0-1 HP_I'-10 HP - --- - - - --
I hereby affirm that there is a construction lending agency for the pe SERVIC= - . SUMPS --- -- - ;(INC.SOLAR).- .10-50 HP 50.+ HP' -
formance of the work for which this permit is issued (Section 30 f_ - -
Civ-CJ.- --- ---- ,- .- - -- --- - - - - - - - FLOOR' ' KS,- FLOOR DRAINS 'FIXTURES - OUTLETS SWITCHES --•- - ' _.-- y
Lender's Name
-' -. -( ' .
- - -- ' '""'"'- - - 7 -DRINKIN FOUNTAINS--'-" --- -' -'-•" - • "GAS TUBE SIGNS
Lenders Address - - "' ' —_ '- -
OWNER-BUILDER-DECLARATION - - -- i- `''" - - '" s {= -' • - - -------- --- - - -I
I hereby affirm that I am exempt from the Contractor's License La for -INT 13CEP •RS --CLARIFIERS----'- .
the following-reason-(Section 7031.5 Business-and-Professions COde:. - -SW MING POOL- •--P TRAP - - -- -t - - - - _Lurvs 1•HUc l iury - - _ - -
Any city or county which requires a permit to construct, al er, {POLESMETERED-- SUB •
improve,demolish or-repair any-structure, prior to its-issuance,also re- TER SERV ICE - -• ALTERATION-- -1-
quires the apt licant for such permit to file a signed statement that e
is licensed-pursuant(csuant to the provisions of-the Contractor's-License GAS: - - OUTLETS'- 4 ' --- ' - - - 'SERV ICE - - - - AMP - - - --
(Chapter, n (commencing with Section 7000) of Division 3 of the - - - - - 1
�ss ess-antl Pllegedions mptio-,R that he-is exe mptSection 7031.5 the- -\WATER HEATERS- BTU'OUTPUT- -- 00 ' - -
basis for the -foxed exemption. Any violation of Section by _ •
any-applicant-for-a permit subjects-the applicant to-a-civil penalty- - SE�iV ER-LONft IONS - - - - -- -.- - '' -• - -- - - -- - - - --- - - - -
nf not more than five hundred dollars ($500). _ - _ -
', as-owner of the property, or my employees withwagesas their -SOLAR TANK -- ' 'COLLECTORS --- .A - -- -- ------ - -- - - -- - - _
compensation, will do the work, and the structure is not intended ' -' ' -
.iffered for-sale. (Section 7044, Business-and'Professions Code: The- SOLAR PIPING SYS. - -'-- -. - - - '( ISSUE FEE -- - - -- - - - -
Contractor's License Law does not apply to an owner of a property APPLICATION&PPROV ED BV - - DATE--4
who builds or-Improves thereon, and who does such work'hlmself or - ISSUE FEE -' '"-- - - ' -" - -.'�i �(7
through his own employees, provided that such improvements are not ' " '
intended or offered for sale. If,'however;the building'or Improvement -"MECHANICAL- " '-- P -"'•-'- - - --- - - - - -
PLAN CHECK I SUMMARY OF FEES . '',I T
Is sold within one year of completion, the owner will have the burden - {
of-proving he did not'build or-improve for the purpose of"sale): - :_
-- - - - F-100,000-BTU- - - - BUILDING - --- - ----- - - --- -
❑ I,..as..owner of the_property,_am,exclusively contracting.with HATING SYSTEM _ �. PERMIT $
licensed contractors to construct the project (Section 7044. Business - AND DVCTING' _ - - -,
I 100,000'+BTU I ,PLAN CHECK $ PERMIT
and Professions. pert Tho ractori License hereonLaw.does not apply.to G •- ISSUANCE-` $
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100.000 BTU - PLUMBING $ r -
tracts.fro projects with a.contra<tor(s),Iicesnetl pursuant to SYSTEM - - - .--_. -._ _.. _ _ GRADING _$
the Contractor's License Law). 100,000'+BTU PLAN CHECK $ - r. • 'I
•
❑ I am-exempt under Section - -- -- _-B:& P:C.-for this- - - -- - - -- -- - $
BOILERS BTU 'ELECTRICALS $ z
reason _ _ _ - r' 'MICROFILM_E
SYSTEM REPAIR,ALTERATION - - - PLAN CHECK -$
Date Owner _ ' •TOTAL'FEE$ '
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - :M ECHANICHL $ -
PLAN CHECK--$ (LESS AD-
information is-correct. I'agree to comply with all city and county -- VANCE PC -$-
•
representatives.
sta a laws rel ing to construction,and hereby authorize p -
representatives o th s c y to ent r upon e' above mentioned - -- egt
ro ext /1for ecti( r oses. 7O 's/f� s ./--" -� / ��
Signature\_ � • �/�- `moi"
Date'1/ _ . _� ,r FINAL FEE $ 1D
Drivers¢License dr SS 9/ . " - - . ISSUE FEE - - - //-)L/�-'y-/"/�1J _ _ - •
CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
1 CONSTRUCTION AND PLANNING POOL&SPA - -
Datil Inspector - , Date Inspector
APPROVALS Permit# APPROVALS Permit#
1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location._ '
2. Soil Pipe-Undrgrn ._ . - - 44. Steel Reinforcement - -_
3. Electrical ConduitUtility-Undrgrn - 45. ' Forms - - . - -
•
4. Electrical Conduit-Undrgrn - . - . . 46. Electrical Bonding - - -
5. Steel Reinforce _ _ - _ 47. Rough Plumbing& Pressure Test -
6. Electrical UFER Grn - . . 48. APPRO.VALTO COVER-GUNITE
7. Footings _ . _ _ 49. Electrical Conduit-Undrgrn •• . - -
8. -Foundation. .. . _ - . _ _ . . 50..• Gas Pipe, 9 Undrqitn, Test ' '
n
9. -Water Pipe-Undrgrn . __ . .._ . _ - 51. Backwash Lines. P-Trap. ❑Undrgrn ' - . - •
• 10. Structural Floor System .. _ 52. APPROVAL TO DECK - • -•- -'
11. Property Sewer Line & House.Connection.. - - -- - - 53. Backwash& Receptor-Final . '.
12. Street Sewer Connection._ _ . - - - 54. - Heater& Vent-Final -
13. Rough Plumbing __ _. _ _ i 55 Plumhinn System-Final - '
14. Rough Electric-Conduit -- . - 56. - Electrical-Final -
15. Rough Electric-Wiring ' - . '_ - - 57. Solar System-Final .. . :
16. Rough Heating& Air Conditioning- - - . - _ - 58. Fencing &Access Approval
17. Ducts, in Structure ' - -. . . . ti "' 59. APPROVED FOR.PLASTERING . '
18. Ducts, Ventilating- - . - _ _ ._ . _. . - _ _ _
•
19. Gas Pipe-Rough &Test - - 60. POOL/SPA SYSTEMS FINAL , .. . ' ,
20. -Roof-Framing -- - - _ - ' '
' 21. Roof Sheathing - - - - -
22. Frame and Flashing - - . __ . . . NOTES:
23. Insulation - - - _ _ - - t . :r
24. Lathing & Siding . - - r , - - - _ - aI15 gif-- Aft ONE /d -,nir - -- . - -
' 25. Drywall Nailing - . •, , ' .- - _ -- _ .__ __. _ _ ' _ .. _ ,
•
26: Plaster Brown Coat - - . - . - .. - - - - - '
- 27. Electrical Power Meter-Final - - - ---- - - - • • • •
28. FinalhElectric - - -- - -- - . - - ,, , '
' 29. Final Heating & Air Conditioning - - - - . - -- - - v
30. Final Gas Pipe-Test -- - . - . - ' - _,-
31: Final Plumbing - - - _.__ _ .. .-_ - _ •
32: Water Service-Final - - - - ' - _ _. _ . . _. -
- R
33. Gas Service-Final .. . _. .. - --_ _ _ ,-- - - _ - _ _ _ .5 -. - ,• ' ':
• 34. Solar Domestic-Final ' " _ -- - - .
35. Landscape Sp _.rinkling System - - ` . - . .
' 36. Sound Attenuation - - - - - . - •
37. Handicap Regulations - - '
' 38. FINAL STRUCTURE & BUILDING -.f . -
39. Special Requirements Completed - , - . - - - ,
. 40. Electric Release to Edison
41. Gas Release to Southern California Gas Co. - - '
42. CERTIFICATE OF OCCUPANCY -- - -
•
No . Date - --- .. . -
OWNER GALLAGE, A.E. AUG3 0 1881 DATE 9-28-60
JOB ADDRESS 2908 Baker St. BUILDING PERMIT NO. 12912
GENERAL CONTRACTOR Owner-Bldr. VALUE $ 3,000.00
AP.No.113-551-1d LOT TRACT FIRE ZONE DESCRIPTION OF WORK Swim Pool
INSPECTIONS DATE I GROUP TYPE ZONE
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas --- SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating _i._� `�
Rough Plumbing 1 eV-v.-n.)2-4/ - z i-60 se93
Miscellaneous rt.pp •,C ,,Alt " rt-14 Jo-/4/,.
Prop. Swr. Line House on. Et. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test 1
Construction Pole
Underground Power
Rough Wiring 'f l-I al-kc- G/ 4. cvts-c/ J- 2/-60 3 3 7 cP 6.
Trenches Forms Steel T7pt �� /'j-j e
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing
Frame and Flashing
Lathing, In Out
Plaster, brown coat T -
Plumbing Fixtures, Final 0-/{ 71371,
Electric Fixtures, Final 7z3-M 5 - ,1 f--%
Building, Final WM /D ;9-,4
OCCUPANCY
Form 210-5M-11-59 S-B P
•
12912
0 0
-
211- ic?: 11FILE RtGciVcD
ei
COTTA MESA BUILDING-SAFETY DEPARTMENT ..9A- -8 a v
P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
CITY COSTA
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOROF PERMITr.IESA
TYPE OR PRINT BUILDING
BUILDING 2 C1 D c' '.4 g E' (J
ADDRESS / d �a V
COSTA NiSA.awes''' .
^ FOR OFFICE USE ONLY
L. K S' Ni ' IV V V s I . Lv. RECEIPT NO. I '� PER 116,po.
OWNER L� (� Ad r�JIT
MAIL l J 5°. 5 ?��GG Ur I A REC$IVED BY DATEP 7 (ce 5TEO 'EIS-
6 -
ADDRESS /I v RL-iFrt- g+ _//
CITY �/. t TEL.
ND. BUILDING 2 ? D/ itt O- / /"�-
ADDRESS -.4 d.•4 J
ARCHITECT LTO.
OR ENGINEER NO. COSTA MESA. CALIFORNIA
^ l�
FIRE '/
ADDRESS ZONE TYPE GROUP'f �?"
1� ATE APPROVED
CONTRACTOR w r QLL 1.g
NO. 6„, I BY DATE
ADDRESS ` L.eGE' u-� A ZONING
LEGAL I LOT (Y/ "�7� L �7 ZONE NO.OF USE OF NEV/31 Fcuu_ly Ree
DESCRIPTION NO. V �J BLOCK TRACT Rel
PLANS 2 BUILDING w/( att. ga-age
BYPROVED\J) j � DAT L(:� '� ��
A.P.NO. 7NONF L //�� /I
SIZE
OF LOT 7 /\ D� NOW ON LOT YARDS (E4E5~�
REQUIRED ALLOWED
USE OF (CENTER LINE ST.) SO
EXISTING BLDG. (-1-
' FRONT .a(d FT. IN.
SETBACK LINE FROM 7
CENTER OF STREET � O REAR YARDL " R.SIDE r FT. IN.
SIDE YARD (LEFT 6 I RIGHT' S L.SIDE VFT. IN.
DESCRIPTION OF WORK
�JO REAR )4_ FT. IN.
NEW I \ALTERATION II ADDITION
REPAIR IN II MOVING I VV DEMOLISH I
1 U
BUILDING I y�.1) ROOMS NO.OF 7 STORIES I
•
SIZE I{
EXTERIOR WALL STu G•ICOOOERING 2 0 C `
COVERING
USE OF BUILDING-AND WORK TO BE gE,RFORMED
;In/ 6. .fit 1 - r? S .
IF
1 HEREBY ACKNO GTHAT I HAVE READ THIS APPLICATION
AND STATE cc
ABE OVE CORRECT ANO AGREE TOICCOTIM THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ARDIANAWREGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING COVALUATIONpSIGNATURE PERMIT FEE $ J cJ�"'
PERMITTEE \. / - -
$// vv.*•� PLAN CHECK $ //q
'-
AUTHORIZED AGENT I TOTAL FEE $ �.�
12912 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 2f 96E
41WietPT.
P. O. BOX 317 COSTA MESA. CALIFORNIA
Applicant to Fill In Completely CITY OF COSTA MESA
For
P Y APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING
BUILDING i) ?O y aixt sr
ADDRESS f- !T �j/I��1GIf- ,
/] COSTA MESA. CALIFORNIA For Office Use Only
OWNER //! G,9GGA Pe" I RECEIPT NO. I PERM' NO.
.
/1--
MAIL A/aQ 84KeR s r RECEI p BY/ 17 I•Y �ED I 9 (!
MADRES/S� // d _1�1y/7^/'_'/J �!!y
CITY 00c TA //!0-S4 NO. YS 7� ABDDLRE V'1�/D Q / • /
ARCHITECT TEL. COSTA MESA. CALIFOIIA
OR ENGINEER NO. .ESA
In (//J
VII i
ADDRESS FIRE
�/� �j p ZONE TYPE. J/ GR/O�n/UP/nJJJ /�
CONTRACTOR Ofll'��•C- CJU/GOb APPROVED } •H�DATE 9 -1 (!/D
ADDRESS ` II/•Ly�/MIING
ZONE I NO.OF I USE OF NEW
CITY PLANS BUILDING
STATE TEL. LEGAL :70-1 3J i 3 7
LIQIS
NO.NO. - DESCRIPTION c ( \ ' c /
SIZE /J / NO. OF BLOCS. 1
OFLOT 72X /OZ INOW ON LOT I A.P. NO. /I3- C �/ ` / a)
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK UNE FROM (CENTER LINE ST,) ft/
,/�
CENTER OF STREET REAR YARD FRONT /? FT. .4- (^ ( IN.
SIDE YARD I LEFT I RIGHT R.SIDE 5-FT. IN.
DESCRIPTION OF WORK L.SIDE 7FT. Z34 IN.
NEW I �[
/T II ALTERATION I II ADDITION I REAR SCT. IN.
REPAIR ( I MOVING I 0 DEMOLISH I APPROVED /• V DATE •9- /tiO'o
BUILDING NO. OF
SIZE ROOMS STORIES •
EXTERIOR WALL 1 ROOF
COVERING COVERING
USE O UI DING ANDWORK TO BE PERFORMED
//l1/11/4Cs- Re 0[,
y
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 TO COM.
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING /,
BUILDING CONSTRUCTION.(� VALUATION PERMIT FEE $/[/ IV
SIGNATURE OF/�jjA�3���. /� io4
PERMITTEE ( // ,.( �• �� B_
S V PLAN CHECK $ °w
AUTHORIZED AGENT ../ % i% 4
TOTAL FEE 5 �V 6