HomeMy WebLinkAbout1359 BAKER ST - Building Permits 4
CITY OF COSTA MESA
BUILDING DIVISION
Fn its
DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
PERMIT B05-00555
Sbesropearsole
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.r� LDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1359 BAKER ST Status: ISSUED
Suite: Applied: 04/06/2005
Vicinity: 3-UNIT APT COMPLEX WITH DETACHED GARAGE Issued: 04/06/2005
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number: 14119111 Zoning: R3
4
Applicant GUITIERREZ, ALFREDO ISSUED BY: %�i
Address: 8902 SAILPORT DR Sr yr
•
• " Phone: (800)954-0011
HUNTINGTON BEACH:CA Zip: 92646-2664
Owner KANEKO, KEVIN C TR'
Address %CFG INVESTMENTS INC
FOUNTAIN VALLEY,CA - ' Phone: -
17220 NEWHOPE#224 Zip: 92708-4288
Contractor: STAR-COURSE ROOFING COMPANY
Address: 8902 SAILPORT DR "
Phone: (800)954-0011
HUNTINGTON BEACH,CA
Zip: 92646-2664 ?License: 532778 ;
Arch : • _ Eng:
Address: - Address:
Phone: Phone:
Zip: License: - License:
SCOPE OF PERMIT
REROOF 3-UNIT APT COMPLEX AND DETACHED GARAGES:REROOF OVER 1_LAYER OF EXISTING COMP, FELT PER MFGR'S SPECS,
APPLY"30-YEAR COMP SHINGLES."26 SQUARES - - - '
GARAGE(FLAT ROOF):T/0 AND INSTALL NEW HOT-MOP B.U.R.SYSTEM.5 SQUARES
- FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $5,640.00
Permit: $125.25 Claim Valuation: $5,640.00
SMIP Res: $0.56 •
SMIP Corn: $0.00
Other: $0.00 .'
Inspection: $0.00
Total: $125.81 , •
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right "0-0
ACCESSORY Front '0.0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0: '
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
I•
DECLARAT?ONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
E l I have end will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is Issued.
WI have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
M workers'compe satlo. Insurance ;.r er and poi number are:
0. 4 . POrc;yjynbtf: l ? ro/p 6-- too S
this section need not be comply edit the permit is valued at one hundred dollars($I00)or less.)
O 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 Code,I shall forthwith
tt''..��comply�'`p�with these provisions.
Appycanrolgnature: ./�:� valPP="— 0 S'—0 6—o
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COV E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(SWOO,OCO).IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am titan ed under p o ons of Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect In , 3Z� _ C 3 9
m"a res. `��7V ltdr tcxar—
, d —O . —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,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 toe civil penally 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 end 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 ono 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 property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 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 driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,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,falsework,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 lime 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? 0 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.
...f....R...P presently q..
4 If an RMPP is presently required,has Section 25534 of the California Health and 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 aEermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district Or agency? LJ Yes LJ No
(Section 85850.2 of the California 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? ❑Yes 0 No
(II"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 COMPUANCE 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 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.
SI natur Of Le9al ne(s) Date
A/`A- O v//GY/'G1 97.5'-O 6-c S
And/PP utho>ri 'Applicant Date
CODE I INSPECTION TYPE RAIL INDTIALS LO2E1 INSPECTION TYPE RAIL INIIBALU
1816 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final ( /,,///� 208 Final Plumbing
200 Final Re-Roof 2 —I-®7 J 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
•
PROJECT ADDRESS: 1359 BAKER ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 053505
OWNER'S •
ADDRESS:S: ESTATE PLANNING
INVESTMENTS THREE HUNDRED PERMIT NO: B 053505 PLAN CHECK NO: N GOVT; N SUPP; N
4 %C F G INVESTMENTS INC
17220 NEWHOPE ST #224 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
,-ARCH/ENGINEER: FOUNTAIN VALLEY, CA 92708 REG.NO.:
`a
ADDRESS: UNIT: JOB DESCRIPTION : REROOF 3600SF APART E. GARAGE SQ FT: 4 , 500
PERMITTEE CLAIM VALUE: 4 , 500 . 00 CALC-VALUE: 4, 500, 00 GROUP OCC: R-1 /M-1 ,
ADDRESS: CAL-CUSTOM ROOFING ( 714 ) 974-3542
1442 E. LINCOLN 372 COMMENTS: REROOF APATR W/COMP SHING GARAGE W/HOT n
OP ANC1 CA..9265 +E**FF�E*+E*�r*+e***** **** F+t�6**** FTE*�E�E*+�S>E�r** **3E***aE�E�:*�t** x+r�tas+E�¢**yi*D -{exa' 4�( �u
LICENSED CONTRACTOR the
DE iARA ION: I hereby affirm that am licensed under provisions ofof hooter 9(commencing with Section ZONING RE Q U I R E M E N T S��•�[E 1 ��
7000)of Division 3 0l the Business and Professions Code.and my licens in lull lore nd effect / S E T B A C K S S ` kC
CITY LIC.: STATE LIC.: LASS:
046871 5425 _ •
Date,_9. 1'-9 S4nignature:- 0 - MAIN BUILDING ACCESSORY .,E e�TS`'G
WORKERS'COMPENSATION DEC LARATIO . I herebyauirm at have a certificate of conse sell-insure or a cenificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Sect 3800.Lab.CI. LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: 1256413-91 EXP.DATE: 07/10/92
COMPANY; STATE /PARKING REQ; PROV: PARCEL; 42405302 ZNE: REF NO:
k EDCenilied copy is hereby furnished. Q' Ce d copy is file. ori h y Building Divisi.'. PLANNING NOT.E.S>
Dale:-a "Jai J / APpbwn *******************N*********************MM******M************1F*****-*k*********
EXEMPTION FROM WORKERS'COMPENSATION OECtARAT r (This s- need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N .T S
I cenily that in the performance of the work for which t rum ' ssued,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: . -
Dale: Signature:
NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; DATE: ..,
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
—
CONSTRUCTION LENDING AGENCY: I hereby affirm That(here is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE• `J( .
wnicn lois Permit is issued(Section 3097,Civ.C). .*********.*************' • • • . • • . ..•it fri -* *******r.*************�� +� . x 1 *
LENDER: **************************************************si-****************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 72 . 00 5 0
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation. wilt do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID •
DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Cade: The Contractors'State License Law TOTALS----> 72 , 50 0. 00 0 . 00 72 , 50 72 . 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• 72. 50 OVER/SHORT• ,00
for me propose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE Si` IIP/TOT GRADING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 72 . 00 . 50
❑ 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 acontracter(s)license pursuant to theContractors'State License Law).I am aware *,*,#*********************************16*******************************'***********.
that proof of their Worker's Compensation insurance should be provided to me.
❑ f am exempt under Section: B.a P.C. INDIVIDUAL F E E BREAKDOWN
for this reason' TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: Owner:
I do hereby cenily that l am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505.25533.and SFR 4500 REROOF BY VALUE RESIDENTIAL. NOZONE 1 . 00 4 , 500, 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES •
permit lot construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Ap icant: / -
t hereby certify that I have read this applicatio nd state that the above inh• ation is correct I agree to comply 'Ib all city and county,/
ordinances and state laws relating to building c nstruction and hereby aur' 'present. of this dry to enter tithe above-mentioned •
property ler inspection purposes.
Date: Signature:
�,-c1-, 01 00095348-00095349'• TOT ;Cs Ell
Driver's License or Social Security a: 7G., DATE: 08/22/91 TINE: 10:S6
1641.46 Wiule—Building:Green—Code Enlorcemel Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
COiTRUG�'ION AND PLANNING POOL ,PA
. . APPROVALS Permit # C4 Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole ui 52. Pool & Equipment Locationtoe
•
2. Soil Pipe-Undrgrnd. ti - 53. Steel Reinforcement ir
s
3. Electrical Conduit Utility-Ungtornd. a- 54. Forms rfr
4. Electrical Conduit-Undrgrnd."-- 55. Electrical Bonding
5. Steel Reinforcement _ 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings l's
) 58. Electrical Conduit-Undrgrnd. - 7
8. Foundation /�� 59. Gas Pipe, 0 Undrgrnd.,Test /Y;y)
9. Water Pipe-Undrgrnd. 41Pf7 ` 60. Backwash Lines, P-Trap, 0 Undrgrnd. i /!�
i ,f
10. Structural Floor Systems r '7 61. APPROVAL TO DECK L/ rrr
11. Property Sewer Line & Hotise Connection V 62. Backwash & Receptor-Final �'�
12. Sewer Cap e
A /, 63. Heater & Vent-Final
13. Roof Drains i?- / ` 6 64. Plumbing System - Final i
del
14. Rough Plumbing t/' - 65- Electrical-Final 47 I
15. Rough Electrical-Conduit 1 66- Solar System-Final /
...1/.
R ,7
16. Rough Electric Wiring i% 67. Fencing & Access Approval t
17. Rough Wiring Sign �I(C 68. APPROVED FOR PLASTERING alkc
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 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
r
38. Final Plumbing
39. Water Service-Final -
40. Gas Service-Final
41. Solar Domestic-Final '
42. Backflow Preventer r- 1
43. Backflow Irrigation rG
44. Landscape Irrigation SycterR-
45. Sound Attenuation :t ``
46. Handicap Regulations, , ///
47. FINAL STRUCTURE & BUILDING '� �L(�/�. ,����o ,[�' ._ ,�G
48. FINAL PLANNING - u `-
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co _
51. CERTIFICATE OF OCCUPANCY
No. Date
__ -- _ _ _ •_ _ -. __ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 1165' 8/11 /86 ,7600 TL
CITY OF COSTA MESA CQNJSTR UCTION PERMIT • PER/,l �NNOyp.!/i TRACT NO. LOT NO. UNIT NO. I
Project Address / 9 > G>K�<�T 3 • ! 7
, Applicant's Mailing Address - t5#1'lE " TYPE OF CONSTRUCTION ❑ NEW ❑ ADD, U ALTERATION L!t REPAIR '
�'.E je TOU�.a/i Gam?/ fan ❑ CONVERSION ❑ DEMOLISH ❑ OTHER I •q,p•# —
Owner's Names lr�•?Wtl^—+-N �U�7 P,hIoneW Y DESCRIPTION OF WORK/USE OF BLDG. - •'
Address 176 o .Gphor moi¢ • FV•• II��II S Main Building: Accessory Building: Z
• Arch/Eng. - • License No. - TYPE OF PERMIT 0 GRADING LJ FOUNDATION 0 STRUCTURAL T Front - 0
Address •
(�.t n CA-ti
❑ TENANT 0 ELECTRICAL LM PLUMBING 0 MECHANICAL + A Rear - N
• Contractor's Name rll�lU lP IhL�1+v) + Phone kW-Ma 0 OTHER - _ _ - - -
/� vyyy��,�,1/�pp��.. PIN
1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(Mailing) !Let t�I R• 1' (nr v iE ' -PINCF,utIPK G
/ 0� •
) CON STRUCTION TYPE VALUATION$ _ S Left
City License Na. (n ZONE GRADING CU.YDS- ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: - • ' - M
with section 7000) of Division 3 of the Business and Professions Code, and -
• my license is in full fore effect. n - _ T
License Class �'2.7(O Li se No. 4'�7//7 • S'
Date ��- �.� Signature ./ PLUMBING FEES - , • I `
• WORKERS' COMPENSATION DECLARATION Bar Sink Showers • - il
hereby affirm that I have a certificate of consent to self-Insure or a certificate . ELECTRICAL' .FEES
if Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
Automatic Washer Transformer 0 15-50 KW •
3800,is Lab. C.) 8(0 wry)/S6IDA) Ir1,.,�nICfi{) 0 50+'KW
Polic No. Compan //f ���1�t,Tll1 Backflow Irrigation - +
e v g Sewer Cap _ Construction Pole Suh. - ,
(�, HI
Certified copy is hereby furnished.
-u Certiped cgpy Is filed with the city Bulltlin ivi��ot�}L. Bathtubs Sewer Connection _ 'Cooking Unit- .Meter l❑up to,100 amps , • ' •
V Date t] !y ]n P Applicant 0 L ,
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - Solar Collectors - Dishwasher .'Meter Dover 100 amps, ,
(This section need not be completed if the permit is for one hundred ($100)or - - -
i
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel, ' _
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 Drinking Fountains Solar Tank Fan Motors 00-1 HP 0134-8
Workers' Compensation Laws of California.
Date Signature _ - Floor Drains Swimming Pool w/Spa - F.A.U. •
Inc.Solar ❑9-15 HP ❑16.15+
NOTICE:If,after making this'declaration, you should become subject to the -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal , Fixtures i
, comply with such provisions or this permit shall be deemed revoked. - Microwave
CONSTRUCTION LENDING,AGENCY Gas Service Outlets Water Closet iv Device Boxes Pole Light -
+ I hereby affirm that there Is a construction lending agency for the performance /' 9 '
of the work -for which this permit is issued (Section 3097-Civ. C.) Interee [Ors Water Heater [
Lender's Name - ' s p Outlets Range
•
Lender's Address _— _-- -- - - Kitchen Sink • Water Service - - - - Switches Sign - +
OWNER BUILDER DECLARATION -
• I hereby affirm that I am exempt from the Contractor's License'Law for the s- Lavatories - Auto-Wash • Garbage Disposal Standing SectionsI
following reason (Section 7031.5 Business and Professional Code: Any city or - -
county which requires a permit to construct,alter,improve,demolish or repair r' P—Trap LaundryTrays + +
• Y Generator ❑0-5 KW ❑5-15 KW Trash Com actor
any structure, prior to Its issuance, also requires the applicant for such permit - P ( L.
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains '
the Contractor's License Law(Chapter 9 (commencing with Section 7000)of - i.
• Division 3 of the Business and'Professions code) or that he/she is exempt ^p1 • - -
erefrom'and the basis for the alleged exemption. Any violation of Section / A[(I .W ��rr a'W - i '
31.5 by any applicant for a permit subjects the applicant to a civil I�LC7 - �� ,
' aridity of not more than five hundred dollars($500). • +
' 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee ' $15 Issue Fee $ 3 - -
compensation, will do the work, and the structure is not intended or offered - . Reinspection Fee 1 $15 Issue Fee - -$ 3 '
- for sale (Section 7044, Business and Professional Code: The Contractor's •
MECHANICAL FEES
License Law 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 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for Boiler Hood ar Type I ❑ ,
sale. If, however, the building or improvement is sold within one year of con- Canopy Type II 0 Zoning Approved By Date
prove the owner se o have the burden of proving he/she did not build or im- Duct-Under Ground - Building Approved By . Date _
rove for the purpose Of sale).C I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ' Dat
, tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating • 06100,000 BTU 0100,000 BTU - SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple.❑ _ System Repair/Alteration BUILDING PERMIT $ • , SMTP . $ ' •
proof of their Worker's Compensation insurance should be provided to me:. _ PLAN CHECK $ PERMIT
•
• '❑ I am exempt under Section B. & P.C.for this reason - Firepl/Fact.Bit. ICeD# Fire Dampers - T �ry7J� -ISSUANCE - $ 'u
_ PLUMBING •• $ �f-°+L� _ -
Date Owner • Heating System&Ducting Registers : PLAN CHECK 25% $ ' - ENERGY P.C: $ - -
I hereby certify that I have read this application and state that the above 06100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ - -.Information is correct. I agree to comply with all city and county ordinances - _ . ,
and state laws relating to building construction, and hereby authorize repre- - ' - PLAN CHECK 50% $ MICROFILM $
sentatives of this city o enter upon DI: ,above-mentioned property for - - -" n s,n��f�
inspection purposes. � . / ,,pp QQ/_ •
MECHANICAL $ •
— TOTAL FEE $ -.116.0
Signature 41 /A DasnU ���<n/�/ I
Drivers' License or SS* � Reinspection Fee 1 $15 •, Issue Fee $ 3 PLAN CHECK '25%• $
111 I
CMF 0865-46,rev- 10/84 White - Building: Canary -Applicant; Pink -Accounting;Goldenrod -Assessor
CONSTRUCTION AND PLANNING! L.-
POOL &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 i
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
ru
Ll
7. Footings 58. Electrical Conduit-Undrgrnd. -•
8. Foundation59. 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 64. Plumbing System - Final .
14. Rough Plumbing 65. Electrical-Final 00
•
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 ❑Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
•
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
•
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall NailingHEALTH 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 / c-j;-y' (,iO .
36. Hood or Canopy
37. Final Factory Fireplace - -• •
38. Final Plumbing 013--64 LS) -
39. Water Service-Final •
40. Gas Service-Final
41. Solar Domestic-Final ,
' 42. Backflow Preventer
-43. Backflow Irrigation .
44. Landscape Irrigation System a
-45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING . - •
48. Special Requirements Completed - ,
49. Electric Release to Edison 1
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No.__ Date
I
1
8981 FEE ECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT q'T( q Lj
P.O.BOX 317 COSTA MESA, CALIFORNIA J I
• TINA C_ DEPT.
fOR APPL/CANT TO HU /N COMPLETELY APP,LICNTIQNjTEdWSkERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 1359 A, B, C Baker St. '
COSTA MESA, CALIFORNIA fOR Off/CE USE ONLY
OWNER Kendon Homes, Inc. f� I RECEIPT NO. I PERMyT yo/
AMAIL
DDRESS 1555 Placentia, Newport Beach gELEIVED BY I DA E RECEIVED ATEE ISSOED
CITY • MI 6-3227 TEL
BUILDING
NO. ADDRESS
ARCHITECT same LIG. COSTA MESA, CALIFORNIA
OR ENGINEER NO.
FIRE
7,1---
ADDRESS j(� Const.
ZONE tY����///JJJ ��P ��
CHtdTfSACTCIYll CO. LIC. 61195 APPROVED
DATE 1,1
ADDRESS RPTRA L ZONING
LEGAL cel BLR 1vA,A� ZONE ry1 NO..OF USE OF NEW Ay��
DESCRIPTION NO. I BLOCK TRACT IYPCANS I BUILDING Y` ,9' a /'
A.P.NO. BYAPPROVED/1144432/I ` i1._.(((llS—
DATE
SIZENO.OF SLOGS. YARDEVES
OF LOT 50 x 130 I NOW ON LOT 0 REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT .�-6 FT. IN.
CENTER ENTER OF LF FROMREET 63,_2R' REAR YARDS R.SIDE 'FT. IN.
C
SIDE YARD (LEFT 5 RIGHT L.SIDE S FT. IN.
DESCRIPTION OF WORK �T
REAR may.SFr. IN.
NEW I % II ALTERATION I II ADDITION I
REPAIR I D MOVING I II DEMOLISH _I
BUILDING 2710 ROOMS 12 •
SIZE STORIES 2
EXTERIOR WALL I ROOF hot •
—mop
$LUCCO COVERING hot—mop
USE OF BUILDING AND WORK TO BE PERFORMED
Trip)ex residence and garage
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDIN • STRUCTION. -
SIGNA / VALUATION PERMIT FEE $ 43.00
PERMI 4 And_ a 4 -I` L^ n�
/ $ 23,060.00 PLAN CHECK $ /1.50
AUTH•�D AGENT TOTAL FEE $ 64.50