HomeMy WebLinkAbout1367 BAKER ST - Building Permits 'liLSI' CITY OF COSTA MESA
BUILDING bIVISION
} DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER
�` 'y PERMIT
/0e�•oanm� B05-01793
(714)754-5273 • Fax(714)754.4856 • www.cl.costa-mesa.cNILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1367 BAKER ST Status: ISSUED
Suite: Applied: 10/06/2005
Vicinity: ROOF Issued: 10/06/2005
Primary Occ: Type of Construction: V-N
Parcel Number: 14119109 Zoning: R3
Applicant: BLANKS, JERRY
Address: 17501 NORWAOOD PARK PLACE Jl 1 111
Phone: "714-573-0155 ISSUED BY: VC
TUSTIN,CA - - Zip: 92780
Owner EDLER, PAUL %CGF INVESTMENTS INC
Address SUITE 224 FOUNTAIN VALLEY,CA Phone: -
•
17220 NEWHOPE STREET - Zip: 92708-4288
Contractor: PREMIER ROOFING AND BUILDING CO INC
Address: 17501 NORWOOD PARK PL
Phone: 714-573-0155
TUSTIN,CA'
Zip: - 92780 .License: 634404
Arnh : Eng:
Address:. . . . Address:
Phone: -- Phone:
License: - License:
SCOPE OF PERMIT
T/0 EXISTING ROOF ON 2:12 PITCH,INSTALL 2 30#FELT AND 30 YEAR COMP SHINGLES ON FLAT ROOF AND INSTALL 1 BASE,2 PLY AND
, ROCK W/HOT"ASPHALT ON APARTMENT COMPLEX,2900 SF.
" FEE SUMMARY "
Plan Check: $0.00 - - Calc Valuation: $9,100.00
Permit: $181.25 Claim Valuation: $9,100.00
SMIP Res: $0.91
SMIP Com: $0.00
Other. . $0.00
Inspection: $0.00
•
• Total: $182.16 •
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
244848(WOO)
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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
lo for which this permit Is Issued.
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' mpansttlon I rance ca �er and policy number are:-
Carrier;, . *_�/i�l 1-y,4_j,,, PBRCy'Namber1...�'v)L.�o2%
`'a0cti need not be completod if the permit is valued at one hundred dollars ($100) or less.)
❑ I certify that in the perto�rrlonce 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 fl,alifornia, and agree that If hould become subject to the workers' compensatlon provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these pr Islons.
MGEe: _ %/�
RO S
S C RE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYIERiTOCRi INAL E ES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE 1$1 I. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under rovi io s of Chapter 9 (commencing with Section 7000) of Division 3 of the Business end_P55o ions Code, and my license is in full
fo,�aaamhenea CIJc. p
�C�n�t�reold-Sigpefure: '444======
0 te:�—
CONSTRUCTION LENDING AGENCY:
❑ 1 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: 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 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).):
❑ 1, as Owner of the property, or my employees with wages as their sale 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 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 contractors)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature:. Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No, Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or dead):
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 B, 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? ❑ Yes ❑ 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 reposed 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 standar 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 ❑ No
(Section 25533 of the California Health and Safety Code, with some excaptions, requires registration with the Costa Mese 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).
...__............ r willt............plic..._........................................... builds _............. antn_...................—._._........._._...........__..._............................v.p..............._.._.............._....._._..._..........__.........___..
3 Does or will the appplicant or present or future building occupant need to prepare en RMPP (Risk Management end Prevention Program for acutely hazardous materials)?
❑ Yes ❑ fJo
(Section 25534 of the California Health and Safety Code provides that the Costa Mese 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.
..........._.....................__._........tlyre_...._...........................___.__............he California
.__...... Safety
.............._..._ullyc............................._.....[ ....._-�....................__..........._.._...._.....—.
4 If an RMPP .. presently required. hes Section 25534 of the CelHealth end Safety Code been fully complied with? ❑ Vss ❑ No
5 Does or will the applicant or present or future building occupant require for the work which Is the subject ofplication app�ermit for such construction or motllfication
from the South Coes) Air Duality Management District or from any other air pollution control district or agency?? Byes L] No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building Permits).
.................................................................................................................................................................................................................................u...........e......................................... ._......................................................................................
6 Will any pan of the facility to be constructetl untler this permit be within 1000 feet Tram the outer boundaries of a school? ❑Ves 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 press ed by California
a Heal or other err pollution i n 4 district or add? is required for the work which is the subject of this
application, have all of the disclosures prescribed by Calllomle Health and Safety Code Section 42303 been made? ❑Ves ❑ Na
6 (Ii yes', erech certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I conity 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 tocomply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Masa to enter upon the
above-describe roperty for inspection p sea. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection.
at eget Owner(s)
�rAndlOn�ADtROriY$d Applicant:"
INSPECTIONTYPCODE I INSPECTION TYPE PA7E INTtnALS
166 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing . ,.
200 Final Re-Roof �� "�� 210 Final Electrical
201 Final BIocWRetalning 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 '
1"'WMINIMOFBMLOWO: 1367 BAKER ST UNIT: CITY OE' COSTA MESA — BUILDING PERMIT
OINNER'S ME IF iatty N: EDLER, PAUL d iPERM NO: B 080582
ADDRESS: %CGF INVESTMENTS INC
17220 NEWHOPE ST #224 PERMIT NO: B 080582 PLAN CHECK NO: N GOVT: N SUPP: N
FOUNTAIN VALLEY,CA 92708
APPL. MA11pq AODRE55: CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTII
ARCHITECT OR ENGINEER: UC. NO.:
ARCK OR ENG.'S ADDRESS: UM:
cNmActwit RtuE: PREMIER ROOFING (909)674-7052
CGNTRACTGR,sm u,, 13:154 BROKEN BIT CI
ADGREss: CORONA CA mm: 634404
91719 UNIT.
LICENSED CONTfl 5 DECLARATION: I hereby aI'vm undo penetly d 'ury Iha I em licenand under provbi«s d Cheplr 9
(commerrarp Mil tern 0001 d Divbon 3 d the Buapett and PM a acrd mY a in hA lens end effect.
u. No: 6 �^uc. cuss: C— 3 9 L o.: Ey�•21�g�0 3/ 9 7
me: ) Con Cl,
OWN BUILDEfl DECLARATION: I M affirm under penehy d perjury iha I ern semq Irons the Conireaors License Lew 1« the
' a - reason (SBctMM ]031 5 Bsnss errd Praessona Code: Arty cAy « oaumY which rpuirse a permh to ponatrun, ell«, improve,
omdvh, «repel any siruaee, prbr w da bauance. eLyo rsquiree 1M apgimnl l« such pmdl to fde a tipped esemanl tls M «and
licensed pursued to the odirl lam d the r A. i s, License Lew jCMprer S t. for rdne vend Seton n. M r Orvion 3 e the
Business;bend Professions ca Mor 1ha M or aha pi exempl thereh«n and the baro i« the abpnd dremq"m. Any violation a Sad'on
7031.5 by any applicant f« a permA Wbpcts the Mploana to a evil posy d mol more Than Ms hundred da0wc (scoop.
❑ I, as owner of the propemy or my empbyaet vend ways as their tole compenshon, will do for work, and the stnraurs to not mended
or offered! for sale (Section 7016, Busbros and Professions Coda: no C«dradors License few does rot appyto an ownerd property
who Wilds «kn cons flerear, ea orso does such Werk limself or herself «Mrough his or their own employees, provided heel Wal
prw«nada are not intended or island for sale, ff, however. IM Wilding or knpraremeM is sold whhn ono Yee of completion. Me
owner -builder will have IM burden of proving he or she did nor build or improve /or the purpoea of sale).
❑ I, ss owner, of IM propemy, son sort vrvay conlrsdin whh licensed conbed«e to construct this projed (Section ]W 6.I a'urss end
Prdessons Code: The Cantrsctars License Law does rhe a" w an owner of IMoParrY wM Milds or Improves thereon and who,
convects 1« such projects vab a rent oolor(s) licensed Moment to the Contractors License Law).
❑ 1 am eaempl under Section: B. & P.C.. ler this reason:
Dee: Ownx
I do hereby corny that 1 ern aware d errd underalwll Me mrluirtmenn d neM«de NUM end word
d Code sed'nn a nos, ernma and
255inc end that a orn futurs Wildhp . the
will / veil era (circle «s) need to oompy vend sea sae codes era the amptfimanb ler
apermhl«oonsimcran«madifiauionhom etre Ab sty ane0emenl District. Fleekantiel construction eppli�bnsenesmgtmmlheee
prodsone.
Dae: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby affirm under penally of pepuy one d the bllownp declensions:
❑ Iheve eawiimeimenacenird fonseaaaffinsurs t«wuMes compenselion,s provlded r«ler Sedwn 3]OlatM labrr
Code, l« the pedormanco d the
woA I« which this peck is issued.
Ihavesea veil mermenwor ionmmpesn Isuronse,srequiredby Section 3]OGaMe Lebon Code. brthe perMmensathe
work f« whits Mrs pertnh b beued. MY workers' core satin insuranro cemar and pdicy number are:
Carder: STATE FUND EXPIRES
Pdk:y Number. — 10/28/97
(This section need nd be conrp/ersd %the pelmrt is for. hundred do,'Wa 151001 «less.)
❑ I eeary, Mel in the Md«mence of the work for which thb permh employ any penton n any manrw so s to
become Wbjea ly the w«kers:oanpenmton bee d C _ w�e��a d I shook bexwne subpot to the MMaa'
am p: Fallurs ro axon woaei rol "Ims on naDOCI a Is unillon end cosi f Mrs on atim, x to gamedrovided and
roc W ro ons hundred rhouuM do/bn ($100,000A M atld/tlon w Me ever of rompefwobrs demeps sa fvnvldW An, In
xtlan 3106 of Ne Labor Code, Indent and eflomoy's lase.
CONSTRUCTION LENDING AGENCY: I hereby alfis under penally of perryry the there is a omamction brain agency, for the
Performance of the Mork ler which this penny is based (Section 30p7, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
1 rohdy the I hover reed the ayplicaion and awe the Me cove inl«metion is coned. I spree to e«nply with all cty and cosy ordvxnoee
end We W. «Win to Wildin cropruaian are hereby i mhora. repeaeniwrvs of this cty, 1. enter upon IM above manlorred property
for inspection purpeaes. BOB PRICE
Pdm Nem '//
Door
5,neture d ZyycerlAnTMsoftrIrsoIor
(5151d6.Wp) Whhe-BuiMip A SaWy: GcsmAM.,*pCmmy-AppIcmt: Pink -Revenue: Gddenrod-A�»s«
JOB DESCRIPTION : T/OFF 6 REROOF W/BUR SQ FT: 500
CLAIM VALUE: 500.00 CALC—VALUE: 500.00 GROUP OCC: U-1 /
COMMENTS: ONLY THE GARAGE AREA
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN
BUILDING
----------
---------
ACCESSORY
BUILDING---------
FRNT: FT IN
REAR:
FT IN
FRNT:
FT IN
REAR: FT IN
LEFT: FT IN
RGHT:
FT IN
LEFT:
FT IN
RIGHT: FT IN
PARKING REQ:
PROV:
PARCEL:
14119109
ZNE:
REF NO:,
PLANNING NOTES>
D E V E L O
P M E N
T S E R V I
C E S R
E Q U I R
E M E NIT S
ZONING APPROVED BY
DATE:
BUILDING APPROVED BY :
APPLICATION ISISUED BY
#####################
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE
:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 21.0050
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 21,50 0,00 0.00 21.50 21.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 21.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
21.00 .50
###############################################################################
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 500.00
END OF FEES
96
01 00219793-00219794 TOT 21.50
DATE: 11/25/95 TIME: 10:44
CONSTRUCTION AND PLANNING
APPROVALS Permit # f . Date
Inspector
POC SPA -
APPROVALS • Permit #
Date
Inspector
Electrical Service or Pole
�SoilPipe-Undrgrnd.
52. Pool & Equipment Location '
.
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.
B. Foundation
59, Gas Pipe, O 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
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas O Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24, Roof Framing
73. Undergrnd. Storage Tank OGas OOil
25. Roof Sheathing "j,�-
�6
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 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. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
-
50. Gas Release to Southern California Gas CD
51. CERTIFICATE OF OCCUPANCY
No Date
CITY OF COSTA MESA CONST UCTION P
Project Address /
Applicant's Mailing Address
Owner's No a
Address.
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _
IT PERnn^gnIT NO. TRACT NO. LOT NO: UNIT NO.
1 / I I' -ate'. i - -
Arch/678-- 7 �L�IeMse No.
Address
Contractor's Nam Phone
r=2a�14
ODIN Address (mailing) G 7r
V City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full ce and of c ,
Licensg Class f r License No -
Date I' 9 Signature wl
WORKERS' COMPENSATION D ARATION ,
hereby affirm that I have a car icate of consent to self -insure or a certificate
f Workers' Compensation Insurance, or_a certified. opY they of (Section
6800, Lab. C.)
Policy No. C><fhBSCI✓H l /"--7 Company
-�-I� C�[bfietl copy is hereby turn ishetl. -
Ud1Certifled,2py is filed with the city it ing Dlvislo
Date?=.� Applicant
EXEMPTION FROM WORKERS' CO ENSATION DEC LA RATI
(This section nee tl not be completetl the permit is for one hundred ($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.,
.
Data Signature
'NOTICE: If, after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be 'deemed revoked.
CONSTRUCTION LENDING AGENCY'
1 hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.)
Lender's Name
Lender's Address
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the
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
enalty of not more than five hundred dollars ($500).
1, 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 (Section 7044, Business and Professional Code: The Contractor's
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
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement Is sold within one year of com-
pletion, the owner will have the burden of proving he/she did not build or im-
prove for the purpose of sale). ,
❑ I, as owner of the property, am exclusively contracting with licensed con-
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
builds or -improves thereon, and _who contracts for such projects with a con-
tractor(s) license pursuant to -the Contractor's License Law). Iam aware that
proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. & P. C. for this reason
Date Owner
I hereby certify that I have read this application and stale that the above
information is correct. I agree to comply with all City and county ordinances
and state laws asting to building constretion d hereby authorize repre-
sentatives of jthiy city, to enter uppn J o e -mentioned property for
53.11 (/09/55 rr
TYPE OF CONSTRUCTION . LJ NEW LJ ADD LJ ALTERATION L-1 REPAIR
-❑ CONVERSION. ❑ DEMOLISH :E1 OTHER
. DESCRIPTION OF WORK/USE OF BLDG.
'
'
SUMMARY OF FEES
A.P.# '_ Zone
- -
S
-
Main Building: Accessory Building:
SMIP
$
TYPE OF PEflM1T GRADING- 'FOUNDATION ❑STRVCTU RAL
❑ TENANT ❑ELECTRICAL '❑ PLUMBING ❑ MECHANICAL
.❑ OTHER' -
T
Front
PERMIT
' I
O
B
A
Rear -
- S -CO ISSUANCE
N
I
PROJECT DESCRIPTION SO. FT. OCCUPANCY'
CONSTRUCTION TYPE VALUATION$
ZONE GRADING CU.YDS. ACRES -
C
Right
ENERGY P.C.
$ '
N
S
Left
- GRADING
G
R
Ping. Ref. # Parking Req./Provided
50%
E
Remarks: - _
Planning Notes:
i
-
M'
I TOTAL FEE
$
PLAN CHECK
25%,$
T,
S
. PLUMBING
FEES
i
Bar Sink i Showers
_ ELECTRICAL
FEES
Backflow Preventer- - Service Sink -'
Automatic Washer
Construction Pole Sub.
Transformer ❑ 15-50 KW
50+ KW
,
1 1
Backflow Irrigation Sewer Ca P
Bathtubs Sewer Connection
Cooking Unit -
,Meter ❑up to 100amps
J ,
Clarifiers _ _ _ Solar Collectors _
_
Dishwasher _ _
^
_ Meter❑over 100 amps'
Dishwasher Solar Piping'
Dryers ❑Gas ❑Electric
Sub Panel
Drinking Fountairis Solar Tank i
Fan
Motors ❑ 0-1 HP ❑ 1 % - 8
1 i
Floor Drains. Swimming Pool w/Spa
F.A.U.
Inc Solar E19-1 9-15 Hf❑i6-15
!
Floor Sinks - -• Urinal -- '-
Fixtures
- ---
.Microwave
P Gas Service. 3 -outlets - .Water Closet
2
Device Boxes
.Pole Light
: !
Interceptors, Water Heater
Outlets
Range
Kitchen Sink - Water Service
Switches
3190 -
Lavatories Auto -Wash - -
_
Garbage Disposal
;Standing Sections
'rap' -Laundry Trays
_
Generator ❑0.5 KW❑5-15 KW
Trash Compactor
'
Roof Drains-' -
Reinspection Fee $15
i
Duct - Under Ground
Duct -Structural i
Duct - Ventilating_ - -
Exhaust System ❑ Multiple ❑
Firepl/Fact. Bit. ICBG# -
Heating System & Ducting
❑ 0- 100,000 BTU ❑ 100,000 BT
insPecuon pyipyjes. / / //' ' JC.
! i
Signature,'�-—/'Y��`�� Date Reinspection Fee $15
Drivers' �+e SS %f �� /�/
CMF 0865-46, rev. 30/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor
Issue Fee $ 3
Hood or Type I ❑
Canopy Type If ❑
r
Refrigeration System
❑o-100,()00 BTU 0100,000 m
System Repair/Alteration
Fire Dampers
Issue Fee
$ 3
Reinspection Fee $15 Issue Fee
DEVELOPMENT SERVICES REGUIREMENTS:1
Zoning Approved By
Building Approved By
Application Issued By!
1 1 $3
SUMMARY OF FEES
BUILDING PERMIT
$
SMIP
$
PLAN CHECK
$
PERMIT
' I
PLUMBING
$
- S -CO ISSUANCE
$
PLAN CHECK
25%
$
ENERGY P.C.
$ '
ELECTRICAL
$
- GRADING
$
PLAN CHECK
50%
$
MICROFILM
$ -
MECHANICAL
$
I TOTAL FEE
$
PLAN CHECK
25%,$
CONSTRUCTION AND PLANNINGPOOH
APPROVALS Permit # Date
%4#-_�
Inspector
a SPA
APPROVALS Permit #
Date
Inspecror
1. Temporary Electrical Service or Pole.
52. Pool &-Equipment Location
2. Soil Pipe-Undrgrnd.
;
53. Steel Reinforcement
3�Electrical Conduit Utility-Undrgrnd.
54: Forms
4e Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5 Steel Reinforcement �' r
56. Rough Plumbing & Pressure Test
w I
6� 'Electrical LIFER Grnd.
•`
57. APPROVAL TO COVER-GUNITE
7."Footings
58. Electrical Conduit-Undrgrnd.
B. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9, Water Pipe-Undrgrnd.
60:- Backwash Lines, P -Trap, 0 Undrgrnd.
10 Structural Floor System
61. APPROVAL TO DECK''
11. 'Property Sewer Line & House Connection
62. Backwash & Receptor -Final
i
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
APPROVALS Permit #
20. Rough Factory Fireplace
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 c
24. Roof Framing
73. Undergrnd. Storage Tank 0 Gas 11 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: 11,118 /•[d MeW IOU. 2.P,4i (.EO
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
LiQ
36. Hood or Canopy
37. Final Factory Fireplace
-
38. Final Plumbing
39. Water Service:Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
_
48. Special Requirements Completed
'
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date• `-
l
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
MR APPLICANT TO FILL IN COMPLETELY
TYPE OR PRINT
ADD BUILESNs 67 A B C Baker St.
COSTA MESA. CALIFORNIA
ti EE �E
LONC MESA
APPLICATION FOR PERMIT
BUILDING
folk OffICE USE ONLY
v
OWNER Kendon Homes Inc
I
RECEIPT NO. IT NO
RECEIVED BV
DATE RECEIVED DATEISSUED
AMAIL DDRE551 Placentia Nei ort Beach
fq V
n
MI 6-3227 TIN_
CITY NO.
ADDRESS��
ARCHITECT Same NO.. O
OR ENGINEER N
COSTA MESA. CALIFORNIA
YIx �'OU
ADDRESS Same
FIRE
ZONE
7(
C6ThR'Af,'TdTill Const. CO. LIC. No. 61195
Nil
ABYPROVE
DATE / O
ADDRESS - same
ZONING
LEGAL
T�..
I LPard'el "1
I 1L I '
ZONE
NO. OF
I U6E OF NEW /
DESCRIPTION
NO.
I BLOCK
TRACT
PLgN3
BUILDING
A. P. NO.
BYPROVED/�/'
YARDS
I n- DATE
11/�/
SIZE 50 X 130
NO.w
OF BLDG6. O
OF LOT
No ON LOT
REQUIRED
ALLOWED
USE OF
(CENTER LINE ST.)
EXISTING BLDG.
FRONT
FT. IN.
SETBACK LINE FROM C
50
CENTER OF STREET REAR YARD per/
R. SIDE
'LJ FT. IN.
SIDE YARD I LEFT 16
RIGHT B
L. SIDE
SFT. IN.
DESCRIPTION OF WORK
REAR
IN.
NEW I G II
ALTERATION
I ADDITION
REPAIR II
MOVING I
I DEMOLISH I
4
DING
2
SIZEI2710 ROOMS 12 STORIES
EXTERIOR WALL
ROOF
COVERING Stl1CCO
COVERING hot -mo
USE OF BUILDING AND WORK TO BE PERFORMED
Triplex residence and e
1HEREBY ACKNOWLEDGE THAT 1 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 CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CO TRULTION.
VALUATION
I
SIGNATUR
PERMIT FEE $ 43.00
PERM=
$ 23,C.Co
6o
OV
PLAN CHECK S 21 _50
TOTAL FEE S 64.50
AUTHORIZED AGENT