HomeMy WebLinkAbout1323 BAKER ST - Building Permits CITY OF COSTA MESA y... •�� :•".: • .;
os`�s. BUILDING DIVISION • --- -- -- - ---
F; �3 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
�`r#� FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: B11-00211
PERMIT TYPE B_ROOF2 STATUS: ISSUED •
APN: 14119120 DATE ISSUED: 07/18/2011
ISSUED BY: CAC
JOB ADDRESS:El323 BAKER ST CM , Suite/Unit: • •
•
Vicinity:
Squares: 0 • Valuation: $2,468.00
SCOPE OF WORK: REAR UNIT.INSTALL 1 LAYER OF 30 COMP.SHINGLES OVER EXISTING 1 LAYER OF COMP.- . - •• •-- -- - -•
NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for
verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card
OWNER: GOKA, GEORGE HATSUICHI TR Address: 19251 BROOKHURST ST#121 Unit:
PHONE: City/State/Zip: HUNTINGTON BEACH,CA
APPLICANT: LINDA DIAZ Address: 1653 SUPERIOR AVE >• Unit:3:21 1
PHONE: 949-642-7222 City/State/Zip: COSTA MESA,CA
CONTRACTOR: LEE ROOFING OF COSTA MESA License No. 349686
Address: 1653 SUPERIOR AVEUnit: PHONE: 949-642-7222
City/State/Zip: COSTA MESA,CA 92627 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE: •
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $83.25
Reinspection Fee: $0.00 -"`tion Card •
Bldg Std Admin Fund $1.00
TOTAL FEES $84.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 , 1 {I,1,: 1....:
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm.Prohibitied 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 r. INSPECTION TYPE DATE INTIALS CODES INSPEC110NTYPE DATE IN1111ALS.
1616 Fixed System Final Fire Prevention 206 Final Mechanical ' •
da
1266 Pool Spa Final _ _ 208 Final Plumbing
200 Final Re-Roof • 4b• ler U C 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval `I
203 Final Sign 222 Final Site - •11.Y.Caai P htiC3/5i
204 Final Demolition' • _ 250 Final Building/Occupancy --------- ----�
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drives _.Icense. 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 ❑ I hereby certify that no excavation five(5)or more feet m depth into which a
number are: person is required to descend,will be made in connection with work authorized
NLs w by this permit,and that no building structure,scaffolding, or falsevsork, demolition
Carrier: R or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
fibs seem need not lcelgmpfeted ul perms:
J Z isvalued a at one
huundreddaters(Sfod)or less) 2,Aril Sec.341 Title B.Califomia Administrative Code).
Policy Number. `-'I l/;)`(/ l�I dv 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,1 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 Date
the Labor Code,I all forthwil comply with these provisions.
Celi ' ' I Division of Industrial Safely Permit Number:
innt's gnawrc 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? ❑Yes 0 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 forceandeffect. � a registration form for acutely hazardous materials? ❑Yes ❑No
H
Lic.# "3`-1"1 Cl Lp w2 Class# 6/ (Section 25533 of the California Health and Safety Code, with some
G� I ( 1 exceptions, requires registration with the Costa Mesa Fire Department by
1 each business which at any one time has on hand a quantity of acutely
tra tor's S. tura Dale 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 Califomia 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? 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 ❑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 (Section 65850.2 of the Califomia Government Code requires that the requested
information
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the be furnished on applications for non-residential building 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 California
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 8. (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for control officer).
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 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
❑ 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 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'relatingto 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.
Slgnatur-of regal Owners) - ^Vr \'Date
Signature Date �. ?, I
3057-46 q/071 A .tor • tharized A..licant Date
AooRtssaeuLaND: 1323 BAKER ST Wit CITY OF COSTA MESA BUILDING PERMIT
OWNERS IUMEIF INC/M4: GOKA, GEORGE HATSUICHI TR PERM NO: B 082927
Al► ADDRESS: 19251 BROOKHURST ST #121
r� HUNTINGTON BEACH,CA 92646 PERMIT NO: B 082927 PLAN CHECK NO: N GOVT: N SUPP: N
APPL,MAILING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
ARCHITECT OR BONUS: LIC.NO.: JOB DESCRIPTION : REMOVE ROCK & REMOVE W/SAME ?)149-- SQ FT: 1 , 370
ARCH.OR ENG.'S ADDRESS: BMT:
CLAIM VALUE: 1 , 370 . 00 CALC-VALUE: 1, 370 .00 GROUP OCC: U-1 /
c01RRACTORSNAME BEST ROOFING ( 714 ) 650-1366
cOMIRACTORS MAILING 236 VICTORIA ST COMMENTS : GARAGE
ADDRESS: COSTA MESA CA UC.NO.: 603323 ********4**********************************************************************
92626 BN: ZONING REQUIREMENTS
I SETBACKS
LCENSED CONTRACTORS DECLARATION:I hereby tem under penally d perjury that I am licensed under provisions d Chapter 9
Ixsnmendng with Section 7000)d Divaun 3 d the Business and Professions Code,and my license is in full force and idled.
LIC.NO.: 051718 LIC,cLASS: C-39 uC,NO.: . # 33 EXP: 09 /97 MAIN BUILDING — ACCESSORY BUILDING
'Dale: cel sr' ?7 Concede - ?' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
` LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
0 R BUILDER DECLARATION:I hereby affirm under penalty of -rjury that I son pt from IM Comrade's License Lew la the
ollowi g reason(Section Torts Business and Professions Code:Any civ or county whit requires a permit to cansbuct.alter,improve, PARKING REQ: P RO V: PARCEL: 14119120 Z N E: REF NO:
demolish,or repair any structure,prior to its issuance,also requires the applicant for such penin to file a signed statement Bat he or she PLANNING NOTES> '
a licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)d Divaion 3 d the 1 .
Business and Professions Code)or that he or she S exempt therefrom and the basis for the alleged exemption.My violation of Seders : '>. '^
7031.5 by any applicant for a permit subjects the applicant toe dvn penalty of not more than five hundred dollars($5001). ********************************************************************' **********
❑ I,as owner of the property or my employees*fib wages as their sae compensation,will do the work.and the stniciure is not intended D EV E•7L O P M E N T S E R V I C E SR E Q U I R E M E NST S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly �^
who builds or improves thereon.and who does such work himself or herself or through hissuch a her own employees,provided that ':-. 4/
improvements are naemended ended or offered ler saew
.f,bouncer,the building or inprement is sol within one yew of completion.the ZONING APPROVED BY DATE:
awing will have the burden of wing he or she did not drill or improve for the purpose d sale). p
❑ I.as owner of the properly.am exdudvely caniredmg with licensed contractors to construct the project(Seaton 7044,Business and BUILDING APPROVED BY : DATE: /_
Professions Code:The Contractors License Law does nor apply to an owner d property who builds or improves thereon and who
contracts for such projects with a contractors)licensed pursuant to the Contractors License Law). 'A ****
��
El Na I am exempt under Section: B.&P.C.,for reason: APPLICATION ISSUED BY: DATE: 'iP#
*********************4********************* ***********************at **
Dole' Owner LEGALIZATION:N , F E E SUMMARY STRUCTURAL S GMENT:Y
I do hereby certify that I ant aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and
25534,and that I«any future building occupant will/wit not(circle am)need to comply with said date codes end the requirements for
a pwmltfor construction or modification from the Air Quaky ManagementDMrid.RmkdtialmnstnMion appkmiaw ereexampth«n those BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 45 . 75 . 50
Date: Applicant S M I P/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affil under penalty of perjury sad the following declarations: ISSUE FEE
❑ I ham and wil rnaimain a certificate a consent to sell-insure frx worker'compensation.es provided tor by Sedion 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Coda tor the performance mthe work for which this permit aissued. TOTALS----> 46 . 25 0 . 00 0 . 00 46 . 25 46 . 25 . 00
' ❑ I have and wit maintain workers'compensation insurance.as required by Section 3700 of the Labor Code,for the performance of the
work for with this penin is issued.My waken'compensation insurance carnia and policy number are:
Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 46 . 25 OVER/SHORT: . 00
Policy Number: • BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need via be competed ANe penni is for one hundred dollars/$100)or less.) 45 . 75 . 50
nI certify that in the performance d the work for which this permit a issued,I shall not employ any person in any manner so as to
subject to the workers'compensation laws of California,and eons that if I should become subject to the workers' *******************************************************************************
pensatbn awisar`/5 dld./Section 3700 d the labor Code.I shall t sang those provisions.
ji
INDIVIDUAL F E E BREAKDOWN
cr/c r Applicant:
Mg:Failure to secure workers'compensation coverage Is rn are l subject an employer tocriminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(S104000A In add/Von to the t of compensation,damages as provided for In
Section 3706 of to Labor Code,Interest,andettomeye lees. SFR 1370 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 370 .00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there i a construction lending agency for the END OF FEES
performance of the worts for which this permit S issued(Section 3097,Cy.C).
LENDER'S NAME:
LENDER'S ADDRESS: '
certify that I have read this application and date that the above information a correct.I agree to comply with all sty end county ordinances
and state laws relating to building construction and hereby authorize representatives of the city to enter upon the above'nemuned property
tor inspection purposes. JIM GOULD 05-l5-1'937/64:25 )'%/$4E.25
�Arw PdnlName Date mr
� �� PEk17ZT�.-)082327 '
\v
....
Sig .uredOwxeNApenVAPpkpan r ,
mem-Appkunt:Pink-Revenue:Goldenrod-Assessor /
N+�.�'SG •
POOL & SPA
CONSTRUCTION AND PLA •
Date Inspector Date Inspector
APPROVALS Permit# - APPROVALS Permit #.
1. Temporary Electrical Service or Pdle. 52. Pool & Equipment Locatiorr-
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, Q 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 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 C 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 9 / q7 Q C4.261-• 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
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: -
34. Final Heating& Air Conditioning - -
35. Final Gas Pipe-Test - - -
36. Hood or Canopy
37. Final Factory Fireplace • ' -
•
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backf low Preventer • -
43. Backflow Irrigation
44. Landscape Irrigation System .
-
45. Sound Attenuation -
.46. Handicap Regulations
•
47. FINAL STRUCTURE & BUILDING clq'..C,76
48. FINAL PLANNING C G
49, Electric Release to Edison
50. Gas Release to Southern California Gas Co --- -
51. CERTIFICATE OF OCCUPANCY
No Date
,t
PROJECTADDRESS: 1323 BAKER ST UNIT: •
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05360E
OWWNER'S'SNAME: GOKA, GEORGE HATSUICHI
ADDREss: GOKA, LINDA LOUISE PERMIT NO: B 053605 PLAN CHECK NO; N GOVT: N SUPP: N
1873 RHODES DR
COSTA MESA CA 92626 CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: 714 549-4844 REG.NO.:
ADDRESS UNIT: JOB DESCRIPTION : T/OFF RESHT. REROOF W/COMP SQ FT; 2, 400
•
PERMITTEE: CLAIM VALUE: 2, 400 , 00 CALC-VALUE: 2, 400 , 00 GROUP OCC: R-1 /
ADDRESS:• ALL CITIES ROOFING ( 714 ) 537-1050
8321 GARDEN GROVE BL ********#*• *+MRiot***;o******4RA***REQUIRED****IN ******4**###**#*****###*#** #+E�6k* *K*****
G GCA 92E04 •
LICENSED CONTRACTOR the
OFCLAss and: hereby affirm that I am licensed under provisionsorcead of cooter 9(commencing with Section ZONING REQUIREMENTS
70001 of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS
CITY LIC.: STATE LIC.: CLASS:
51 2 547662 C39
/ Date: GP10 }/ Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby alfirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICYND.: 1247202-91 EXP.DATE: 04/11 /92
COMPANY: STATE PARKING REQ• PROV; PARCEL; 14119120 ZNE: REF NO;
' '7 Cemfied copy is hereby furnished. d Certified copy is filed with the city Building Divisio . PLANNING NOTES>
K/p , > 'in,.
de Date: tp/17/9! Applicant: ..�r.t / " ********fE**##iF#**#**#*1e*##IE*iE#***##**##*#**####*###*K•*#;r#*#***#*##**,ii-**K#*#*K**
EXEMPTIO FROM WORKERS COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred l$t®l or less( D E V k'%L OPMENT S E R V I C E REQUIREMM C'N;:!a S
I certify tat 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. ZONING APPROVED BY DATE
^
Date: Signature: -` •
NOTICE:IL alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - DATE:/ 1 �f
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. Q
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; /Y( •; DATE•r rl ,���/.
which this permit is issued(Section 3097,Civ.C). . **************4***K***i:**1[#*tt**1FlFiFii .M *##*#*****#*********1f3{*7 *14*ir*f:±ruw{e*
LENDER: #*****#******1E****K*************le******** , ?#*********************e�10***********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTU„L: SEG// MENT:Y
_
r
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason
(Section 7031:5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM'S(P/?SES GRADING
PERMIT 54 . 00
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 50
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/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($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7544.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 property 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.If,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 54 , 50 OVER!SHORT; ,00
• for the purposeot 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 t
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with acontractor(s)license pursuant to the Contractors'Slate License Law).l am aware *.*.**.***********************#***************#******it*#**if#******B{•*#***ii********#
Inas 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.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST”; TOTAL COST
Dale Owner: SFR 2400 REROOF BY VALUE RESIDENTIAL NOZONE • 1 . 00 2, 400 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a
permit for construction or modification from the Air Ouahty Management District.Residential construction applications are exempt from
these provisions. .t
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state taws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
properly for inspection purposes.
Date: /}�/// Signature: 01 00095344-3 295'345 TOT
+ ..
Driver's License or Social Security a: DATE: Oa/[7/91 T j�lI_: :�:, 7-...
1641-46 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor --
J'
:T.
CONSTRUCTION AND PLANNING - POO 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 UF ER 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, O 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 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 /--57-6/ tct, 4/ 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat i� 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 Coat1 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric - Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test • ' -
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final I
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation pea/ ®A--/
46. Handicap Regulations f '���j (o e✓�9`
•
47. FINAL STRUCTURE & BUILDING 1/f0 �
p/ '� `' e'�
48. FINAL PLANNING rr s
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY •
No. Date
I
8990 m EE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT IS/ 4
P.O.BOX 317 COSTA MESA.CALIFORNIA FIWAN t DEPT.
CITY M
FOR APPLICANT TO FILL IN COMPLETELY APPLICATIONCOSTA FOR PERMIT
TYPE OR PRINT BUILDING
ADD ESS 1323' A, B, C Baker St.
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
I RECEIPT NO. 12?9 6
OWNER" KPnd OT! HO7RPR lnr_
MAIL 1555 Placentia, Newport Beach /CEIVED BY /SATE CEI VVEEDD. DATE ISSUED
ADDRESS 1555
��/ - T - I /,C-/3 '��
CITY M1.6-3221 TNO. BUILDING
ADDRESS
ARCHITECT same LIC. COSTA MESA. CALIFORNIA .'
OR ENGINEER NO. // i
ADDRESSAsme Co.- ZONE type v group f(
K. W. Kola Const. CSTATE x»95 APPROVED \ 7
CONTRACTOR LIC.NO. BY DATE
ADDRESS same ZONING �
LEGAL C81 RUII // ZONE l PL NO:
BUEILD NGEW /
DESCRIPTION NO. BLOCK TRACT Y�+ N /
A.P.NO. BYPROVED`/ to
�(�j` DATE -s/�/
SIZE 50 x 130 NO.OF BLOCS. 0 YARDS / EVES,
OF LOT NOW ON LOT REQUIRED ALLOWED - .
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT 6-r-,FT. IN.
SETBACK LINE FROM 631_21t -5
CENTER OF STREET REAR YARD R.SIDE SFT. IN.
SIDE YARD I LEFT 8 I RIGHT 5 L.SIDE S FT. IN.
DESCRIPTION OF WORK
REARFT. IN.
NEW I X II ALTERATION I II ADDITION I . 'I
REPAIR I - II MOVING I II DEMOLISH
SIZIE DING 27 0 NROOMS 12 STORIES 2.
EXTERIOR WAL�{1� ROOF
COVERING SLUG CO ICOVERING hot-mop
USE OF BUILDING AND WORK TO BE PERFORMED
Triplex residence and garage
•
•
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-
PLY WITH A CITY ORDINANCES AND STATE LAWS RE EATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING RUCTION. VALUATION
SIGNATU I PERMIT FEE $ 43.00
PERMITTEE L^
$L
23,0 .00 PLAN CHECK $ 21.50
AUTHOR • AGENT TOTAL FEES 64'50