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HomeMy WebLinkAbout1395 BAKER ST - Building Permits ,� CITY OF COSTA MESA • BUILDING DIVISION Y�rf �i$ DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER Pia fi .� r.ill fib' ip .1411 ilC�tia ®® PERMIT ""Mmo-.mwo'd° 603-00799 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1395 BAKER ST Status: ISSUED Suite: Applied: 05/12/2003 Vicinity: APT BLDG Issued: 05/12/2003 Parcel Number: 14119102 Zoning: R3 R3 Applicant: BLANKS, JERRY ISSUED BY: -refinli AIL Address: 17501 NORWOOD PARK PL Phone: (714)573-0155 TUSTIN,CA Zip: 92780 Owner: GULLO, CARMEN F TR Address %C F G INVESTMENTS INC FOUNTAIN VALLEY,CA Phone: 17220 NEWHOPE ST#224 - Zip: 92708 Contractor: PREMIER ROOFING AND BUILDING CO INC Address: 17501 NORWOOD PARK PL Phone: (714)573-0155 TUSTIN,CA Zip: 92780 , License: 634404 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF APT BLDG:TIO EXISTING ROOF.PITCHED ROOF:REPAIR/REPLACE SHTG AS NEEDED,2 LAYERS 15#FELT,APPLY"30-YEAR COMP SHINGLES:FLAT ROOF:INSTALL 1 BASE,2 PLY&#5 GRANITE WITH HOT ASPHALT.PITCHED ROOF:27 SQUARES,FLAT ROOF:4 SQUARES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 55,200.00 Permit: $125.25 Claim Valuation: 55,200.00 SMIP Res: $0.52 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.77 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 2448-46(ero0) 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'crnisensation insurance caller nd policy number are: c ��-11 Carrier: -c5/ f//r; ff.-" Policy Number: /4 �a 15 9 ` o� (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the porter .nce of the work for which t• :mat is issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of C�'domia :r•//a. ee t ..If ,fid become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these p •p.. _ •. / Applicant Signature: blit �rc� Date: NAL a9 O 3 ter- WARNING:FAILURE TO S- RKERO C S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TRIMI PENAL ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($1...000),IN ADDr10N TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license.u .or•revision'of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Pr essiops Cade,and my license Is in full force end effect. (Jo • i Class$ / 7/t�J Contractors Signature: • �A� Date: ) T /..2�j2 3 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). Lenders 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).): ❑ 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.IL 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 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.-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(38)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 filo 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). __. .._. r�...___ _...._..` 2 Does or will the applicant or presentt 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 Flre Department. 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 presentcant.__r.. fut ._._ on_. 5 Does willo thetiAirt or aor emen building occupant at requirer for too work which Is the subjectage c this application a0Permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 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? 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 AirOualiy Management District or other air pollution control district or agency is required for the work which is the subject of this application,have at 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 penally 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 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 pu•es.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. / l��ur�aT' e.: n,ner(s) !^��z�1ate And/Or Authorized Applicant Date 1 cO tiO INSPECTION TYPE gall gilmaka CODE,' INSPECTION ME pall UfTIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof c. It c ) 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 P • • Applicant to.fill in all spaces except those within heavy border lines and sign all appropriate declaration's. , - . -- CITY OF COSTA MESACONSTRUCTIQQN PERMIT PERMIT NO �j- tri RACT NO. LOT NO. UNIT NO. , � � `Q`� II,CTIoAtN /� J/7otr • 5656 6/27/85 'c5e"53 TL . Project Address r - - - ., ` TYPE OF CONSTRUCT ON U NEW •U ADD U ALTERATION ❑-REPAIR - . Applicant's Mailing Address ' ' L • • Owners Name r`F.G �NUES7MLNT-.a phone ❑ CONVERSION DEMOLISH 00TH R _ A-P-# • : Zone _ ESCRIPTION O��EEppK/US OF BLDG. • -z•z ' Main Building: Accessory Building: Address �(,t!(M/VC u` /4G�(e �-//.l W/TM ry f �ef(.�_ CN- _D_` E - • _ Z Arch/Eng. License NO. -_ - TYPE OF PERMIT U GRADING ❑ FOUNDATION ❑ STRUCTURAL Iv,�N' T Front 0 Address �-•� . _ • ❑ TENANT 0 ELECTRICAL ❑ PLUMBING 0 MECHANICAL B Rear ' - N ( Contractor•5 Name �I VFO DO d CO �{ E3 -El - A N Phone 'yC Right • Address(mailing) Q'�DO Cpl-, o,es'h4 Avg A./g Toe? DESCRIPTION SQ. FT. OCCUPAN V K. G • / CONSTRUCTION TYPE VALUATION$ / S Left R: City License No. 1 ZONE GRADING CU.YDS. A •ESt• E' ((( LICENSED CONTRACTOR DECLARATION �r Ping. Ref.# I • Par king,Req./Provided I hereby;affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �,g14-4/r CoA_ 1oAe.Trew ee g • ' = M • with section 7000) of Division 3 of the Business and Professions Code, and Plannin Notes: my license is in full Drce and effect. , T License Class /Y' / Li se Nq. S Nil Dates J''1-25 Signature, }1�%J1+s.. , , ' , PLUMBING FEES WORKERS' COMPENSATION DEQLARATION Bar Sink Showers ELECTRICAL ' FEES I hereby affirm that I have a certlf to of consent to self-insure or a certificate - -_ . �\ 71.Workers' .Compensation Insurance, or-a certified copy thereof (Section •Backflovv Preventer ' ' " Service Sink - -- _ - , • Automatic Washer ,Transformer ❑ 15.50 KV7/ • 3800, Lab. C.) 1 Policy No. 19.1-: Company•S7RF, FvI)0 Backflow Irrigation Sewer Cip i Construction Pole Sub. • ❑ 50+.KW ertified copy is hereby furnished. • I • 1 Certified�cospy is f lth the city B ildi Dlvlslo I Bathtubs • Sewer Connection C• ooking Unit Meter ❑up td 100 amps 1 D e 1�� Applicant EXEMDYion FROM-WORKERS'CO PENSATION DECLARATION Clarifiers • - - Solar Collectors • . _ - -_ Dishwasher Meter Dover 100 amps; _ •_ - (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher • I Solar Piping - ,Dryers ❑Gas ❑Electric •Sub Panel 1 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 TankFan, Motors❑0-1 HP ❑1 h'-8 Workers',Compensations Laws of California. - Date Signature ' Floor Drains. ' Swimming Pool w/Spa' F.A.U. Inc.Solar 09-15 HP 016-15+ '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 • '- - • • - - • - .. - '. comply with such ,previsions or this permit,shall be deemed revoked. i MiCfOWave CONSTRUCTION'LENDING AGENCY- •a' - , Gas Service ' Outlets .. 'Water Closet - ' Device Boxes ! I hereby affirm that there Is a construction lending agency for,the'performance - - POIe Light , of the work for -which this permit-is issued.,,(Section 3097 Civ. C.) Interceptors Water Heater • - Outlets . Range Lender's Name- - - - ' •• _ - • Lender's Address - - , - . ' Kitchen Sink 'Water Service . - Switches Sign i - • OWNER BUILDER DECLARATION ' - - • • I hereby affirm that I am exempt from the Contractor's License Law for'the Lavatories Auto-Wash ' • • following reason (Section 7031.5.Business and Professional Code: Any city or - Garbage'DiSpOsal :Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap. • - Laundry TraysGenerator 00-5 KW❑5-15 KW , any structure, prior to its issuance, also requires the applicant for such permit - - Trash Compactor 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 - - ' - - - • • Division 3 of the Business and Professions Code) or that he/she.is exempt - - - - - - - _ , -,.herefrom•and the basis for,the alleged exemption. Any violation of Section - 1 � - e i. -n ' I ' "031 5 by any applicant for a permit. subjects the applicant-to a civil - ' - • - • '"::::-;11.031.5 f'enalty of not more than five hundred dollars($500). - - 'r• ., ❑ I, as. owner of the property or my'employees with wages as their sole . Reitrispection Fee ' I ' $15 Issue Fee . V $•3 • compensatIon, will do the work,and the•structure is not intended or offered , - •_ . Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's •- _ i 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 or Type I 0 , sale. If, however, the building or Improvement is sold within one year of corn- Canopy Type II 0 l Zoning Approved By Date _ pletion, the owner will'have the burden of proving he/she did not build or,im- ' Duct-Under Ground • - -Building Approved By �-�--_-, Date ' prove for the purpose of sale). - ❑ I,as owner of the property,am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System • Application Issued-By - 1SC'� - Date{ a) n tractors to construct the project (Section 7044,Business and Professions Code: , - ' The Contractor's•License Law does not apply to an owner of property whoy, Duct-Ventilating •• _ . ❑0-100,000 BTU ❑100,000 BTU _ l SUMMARY F 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 $ VTT ' SMIP $ = 5-0proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ //. 4/ - PERMIT ❑ I am exeni pt under Section - - ! B. & P.C.for this reason 1 Firepl/Fact.BIL ICBG# I Fire Dampers , PLUMBING $ - 'ISSUANCE $ • 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 ' - . 00100,000 BTU 0100,000BTL ELECTRICAL $ 1 GRADING $ • ' Information is correct. I agree to comply with all city and county ordinances . - i -- r ' and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50°.6 $ MICROFILM ' $ sentatives of this,city t er o he above-mentioned 'property fol..' • I 1 I 1 inspection purposes 4®�D he / u'se's �. - - MECHANICAL ' $ _ ' - TOTAL FEE $ �p3� ' Signature � .•r/iw�` Date(. -�a K ' $ 1 Drivers' License or SS .� Reinspection Fee $15 : Issue Fee I $ 3 PLAN CHECK 25% . • - CMF 0865-46,rev.10/84 , White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor A . .. .... . .. _ • • ^CON -STRUCTION'ANDPLANNING• - `, POOL. . A - Date ' Inspector Date Inspector APPROVALS Permit# c - APPROVALS . •Permit# . 1. Temporary Electrical Service or Pole' - . . 52. Pool & Equipment Location .2. 'Soil Pipe-Undrgrnd. r - _ - -' ' I 53. Steel Reinforcement It •• 3. ElectriFal Conduit:+Utility-Undrgrntl. i•- / 1 54. Forms - . _ `- 4.•Electr;cal ConduitUndrgrnd.• _� r -55. Electrical Bonding 5/Steel Seinforcerbent 56. Rough Plumbing & Pressure Test -6:f Electrical UFER•6rrid. -• . ,- 57. APPROVAL TO COVER-GUNITE _1 7. Footi,rr s 1. - er, 58. Electrical Conduit-Undrgrnd. - , ;B7:Founi6ation ' '. • 4 • 59. Gas Pipe, 0 Undrgrnd.,Test 9.�Water Pipe-Undrgrntj. j .) 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10!structnral Floor System ,: . , { 61. APPROVAL TO DECK - ., 11. Property Sewer Lingi& House Corfnection ,.i - 62. Backwash & Receptor-Final ' 12. Sewer Cap . 2 -' • - .63.. Heater & Vent-Final - 13. Roof Drains -- 64. Plumbing System - Final `A 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'E(ectrical-T Bar.Ceilinq 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 ' 1 • - ' ' 72. Underground Flush 24. Roof Frarping- .: 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Shebthing 'r - 74. Overhead Hydro 26. T-Bar-eiling (Structural) &-Monocoat - - 75. Dry Chemical _ ' 27. FrameArid Flashing 1:' - - 76. Dry Standpipe •- _ G,- 28. Lathin9;$i Siding 2r 77. FIXED SYSTEM FINAL 29. Insulajio i - - .,• 78. FIRE PREV. FINAL 30. Drywell•Nailing - ,j HEALTH DEPT. REQUIREMENT 31. Plast&r.Brown Coat 79. FINAL INSPECTION 32. Electr • ical Power Meter-Final, 80. FOOD CERTIFICATE ISSU%0 - • 33. Final Eleritric �' Notes: a /��' �()ys.(7 34. Final Heating & Air Conditioning ,j/ / til 41 PI f9-p--- &'1n4'z' ( 35. Final Gas Pipe-Test p 7/41 -0tdit--f A 36. Hood or Canopy - _ In * ' "' �r_� `t 37. Final Factory Fireplace' 38. Final Plumbing -. . 39. Water ServicetFinal , 40. Gas Service-Final ' 41. Solar Domestic-Final - ' 42. Backflow Preventer - 43. Backflow'Irrigation - - - • - - - 44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations . . ,p/J ,///J - 47. FINAL STRUCTURE & BUILDING 7/1S/S0S�(j�}•�(�% • - - 48. Special Requirements Completed' 49. Electric Release to Edison - - • • • - 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY . . - _ - - ' No. - Date . _ Applicant to fill in all spaces except those within heavy border lines andsign all appropriate declarations. 721 7 2/07/B5 - . , CITY OF CC •A MESA CONSTRUCTION• LPERMIT PER/MIT NCO/,, /�J TRACT NO. LOT NO. UNIT NO, Joe VG �> ProjectA dress /,3�5" `j k) ' azi ���/L. Iv' l `� / 5 rr II I \ Applicant's Maillii/no Address 7y 7 •eSc V1e/4N Z•'y.��/i N • TYPE OF CONSTRUCTION Li NEW u ADD 'ALT ATIO REPAIR t Owner's Name /� - •�/ SS/�2 Phone'Ste!N 7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER CCs, - A.P.# Zone - �/J(� /r tee, .S"y� S/�Ol DE CRIPTION OF WORK/ SE OF BUG '.II�/L < </U'e 'e Address o/ '231 „Ala - CO.NiY /77FS/� „ y - ,,7-. �Lt Aer , -nrir S Main Building: Accessory Building: I Arch/Eng. - License No. - TYPE OF PERMIT U GRADING U FOUNDATION III STRUCTURAL Ml E Front Q Address �� ,,,,. / ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N en'Z C/ NC Phone 1.5430a/ ❑ 'OTHER �A!?� -5/,‘,77/1/C C Right _ N Contractor's Name ,_,c. - - - Address(mai lingilia .E Vet cZv7.r-LV T-$//N PROJECT DESCRIPTION SQ. FT. OCCUPANCY K 315-a1 CON ST RUCTION TYPE VALUATION$ 'S IC7Cw $ Left - R City License No. ZONE GRADING CU.YDS. ACRES/ . ' I� ^ LICENSED CONTRACTOR DECLARATION I - Ping. Ref.# Parking Req./Provided E 0 , / 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • Planning Notes: M 65 with section 7000) of Division 3 of the Business and Professions Code,and T my license is in full force a•. effect. /6-73 br S License Class - - _i tens , I Date •4-6�,1 Signature �� PLUMBING FEES • t� WORKERS'COMPENSATION DE •• -ATION - Bar Sink Showers 1 _ I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES • ' f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - 800,-Lab. C-) '- Automatic Washer Transformer ❑ 15-50 KW _ -- Policy No. 4,5—.3 WI/"[ Company S7✓.A-Tl ADA-,D Backflow Irrigation Sewer'Cop. Construction Pole Sub. 0 50•TIK„W CCxxTT((fled copy is hereby furnished. - - Certifi d co y iuiled with the city B wisio Bathtubs Sewer'Connection Cooking Unit Meter ❑up to 100 amps J Detest- • _ S an EXEMPTION cFROM WORKERS'C P SATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps , (This section need not be completed if the permit is for one hundred($100)or • - - • less). Dishwasher Solar•Piping Dryers ❑Gds ❑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 SolsreTank FanMotors❑0.1 HP ❑1 h 8 ' Workers' Compensation Laws of California. Date Signature - - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ '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 - • comply with such provisions or this permit,shall be deemed revoked, Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service :Outlets - Water Closet J_ Device Boxes Pole Light - I hereby affirm that there is a construction lending agency for the performance 9 _i of the work for which this perm) i issued (Section 3097 Civ. C.)• Interceptors Water Heater - - - Outlets Lender's Name q /CRange - r , , Lender's Address /sL Kitchen Sink Water Service •".. Switches - Sign r OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash Garbage Disposal 'f .I following reason (Section 7031.5 Business and Professional Code: Any city or - 9 P ;Standing Sections county which requires a permit to construct,alter,improve,demolish or,repair P-Trap LaundryTrays ' Y Generator ❑0.5 KW❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permitP 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 - - - Division 3 of the Business and Professions Code) or that he/She is exempt ` _ :1 l�' - 'serefrom and the basis for the alleged exemption. Any violation of Section , - 1' )31.5 by any applicant for a permit subjects the applicant to a civil anally of not more than five hundred dollars(5500). - $ 3 , • s '. 11/ 1, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, will do the work,and the structure Is not intended or offered -- - - .' Reinspection Fee I $15 Issue Fee i i II ,I $ 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, andwho does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: •• ;. II; , employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. if, however, the building or improvement IS sold within one year of com- Canopy . Type II ❑ Zoning Approved By ' Date 1 pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground - Building Approved By I'DatO ' shrove for ownerthe•po the of sale). • ,v -�� ra I, as of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By r 'Dat:' tractors to construct the project (Section 7044,Business and Professions Code: 1 The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU 0100,000 BTU SUMMARY OF FEES - " builds or improves:thereon, and who contracts for such projects with a con- - p s tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ 3@ no SMIP ' $1 • SC) Exhaust System 0 Multiple ❑• System Repair/Alteration ii ! proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT r` f al am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ .ISSUANCE 1 . $} '� Date owner Heating System& Ducting Registers - PLAN CHECK 25% $ ENERGY P.0 f $ _ — I hereby certify that .1 have read this.application and state that the above - 00-100,000 BTU 0100,000 BT . information is correct. I agree to comply with all city and county ordinances GRADING '' $ELECTRICAL $ •s' 4 i and state laws relating to ••ildin• construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM f' Sr' 'f ' sentatives of this c' y - • ent-,/ •on the above-mentioned property for ' q' inspection pui-' e. / - e- etc— - MECHANICAL $ TOTAL FEE $' •,--•v•1+o Signature •,...a• Date r J ' Drivers' L -nse or SS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ •CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor .. . .. _ . ..a -V - - • CONSTRUCTION AND PLANNING • P00. 3PA //APPROVALS Permit Date ' Inspector - APPROVALS Permit# , Date Inspector ,T. Temporary Electrical Service or Pole 52. Pool & Equipment Location • , 42. Soil Pipe-Undrgrnd.• 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms r'4:'Electr,ical Conduit-Undrgrnd. 55. Electrical Bonding -5. Steel Reinforcement- - 56. Rough Plumbing & Pressure Test •• 6. Electrical UF Grnd. - 57. APPROVAL TO COVER-GUNITE • !.7. Footings - - ,�r- 58. Electrical Conduit-Undrgrnd, , 8. Foundation - 59. Gas Pipe, ❑ 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 " 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 ❑Gas ❑Oil - 23. Gas Pipe-Rough&Test . 72. Underground Flush • 24. Roof Framing ' 73. Undergrnd.Storage Tank 0 Gas LI Oil 25. Roof Sheathing .... 05- �,I74. 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 -V/5145'fril h ohen-A,.�.- eyrie 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 3.jSe el C!, • •,..-.7- 4� _ ' _ _ , 48. Special Requirements Completed ' ' 11� ' _-_ = T : _ • 49. Electric Release to Edison • - - _ Le ' ♦ , 50. Gas Release to Southern California Gas Co / / 51. CERTIFICATE OF OCCUPANCY . No. Date 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 3269 6/29/84 8.01; Ti • CITY OF COSTA MESA CONSTRUCTION PERMIT T PERMIT NO. TRACT NO. LOT NO. UNIT NO. Project Address /..S.QS RR+O'K�C —/L392-D _ , - Q �c Celerna-Ano p c. TYPE OF CONSTRUCTION U NEW' LI ADD LI ALTERATION IJ REPAIR - • f Applicants Mailing Address ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# - . - ,, Zone Owner's Name -- - - _ Phone DESCRIPTION OF WORK/USE OF BLDG. • ' ' Address - t � - • S Main Building: . Accessory Building: ' Arch/Eng. - .__License No. TYPE OF PERMIT���v�/77�lpppI ❑ GRADING ❑ FOUNDATION L I STRUCTURAL T Front -• - - . - O Address ' I - ❑ TENANT N ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear : . - ' N ,A 979-.D31 ❑ -OTHER Contractor's Name 7�l�hot.°tii ii.t — Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G Address(mailing) `A'l�'_C Cas-)%4•�O Co/(._ K Left CON STRUCTION TYPE VALUATION$ S R City License No.� ZONE GRADING CU.YDS. ACRES ' Ping. Ref.# Par king,fleq./Provided E LICENSED CONTRACTOR DECLARATION - Q I hereby affirm that I.am licensedunder provisions of Charter 9(commencing Remarks: Planning Notes: - • M with section 7000) of Division 3 of the Business and Professions Code, and - T my license is in fy}IL�ll,force and effect. • , �� `� I ' •- S License Class l'S— —in License No. - Date '10--305-950= Signator �'' ' PLUMBING FEES , WORKERS'COMPENSATION D CLA RATIgf] / Bar Sink ShowersELECTRICAL FEES I hereby affirm that I have a certificate of consent l f-Insure or a certificate ' of Workers' Compensation Insurance, or a certified copy thereof (Section - Backflow Preventer Service Sink . J Automatic Washer - - - Transformer ❑ 15-50 KW-- . • 3800, Lab.&6_3 q 3 ' t��.{/� - �� Policy No ��/c� _ Company Backflow irrigation Sewer Cap0 50+ KW Construction Pole Sub. Certified copy Is hereby furnished. e55tifietl opyJ pled with the ci ` g . inion Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps I Date [e— Applican `f 6.4.•✓� - EXEMPTION FROM WORKERS'COMPENSATI: • CONSTRUCTION AND PLANNING 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 SrSieel Reinforcement , _ 56. Rough Plumbing & Pressure Test ' 6.1i Electrical UFER Grnd. e- . 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. ,` 8. Foundation, c ; .- 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. '. - 60. Backwash Lines,P-Trap, 0 Undrgrnd: 10. Sductural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final 12. Sewer CapJ.- ' • 63. Heater & Vent-Final 13. Roof Drains la, • ' - 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 17-1 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 ❑Oil - '-25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat , , 75. ,Dry Chemical,_. -- 27. Frame and Flashing • - •. <-- 4t1".- 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL. 29. Insulation 4 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 • !/.0Q. AcV Notes: • • 34. Final Heating &Air Conditioning 35. Final Gas Pipe-Test , 36. Hood or Canopy • ' 37. Final Factory Fireplace 38. Final Plumbing _ -_ -� ^w _ ._ _ _ _ 39. Water Service-Final - - -- "-- ---^£j - - - ,_� :x-• 40. Gas Service-Final 41. Solar Domestic-Final • 42. Backflow Preventer • :- :7.,c- ,4 _ _. _ . 43.-Backflovy;Irrigation,,-.:y-Ax-ra ti,s.gG-..- -- .- -_.. . -. 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 • � : r : • • 8972 y � �� COSTA MESA BUILDING-SAFETY DEPARTMENT FINA CCOSTAE'DEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF MESA FOR APPLICANT TO fill /N COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 1395 ABC Baker St. COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY OWNER Kendon Homes, Inc RECEIPT NO. I PER MIT NO. ED ADDRESS 1555 Placentia, Newport Beach RECEIVED BY DATE RECEIVED DATE ISSUED .w.1� �frT TM - �P �— P -zs5 4/-i-Ls� •} . 6-322! BUILDING CITY NO ADDRESS ARCHITECT LIC. OR ENGINEER same NO. COSTA MESA, CALIFORNIA. L ADDRESS same FIRE "7 type / / group y'l 7( i p1], Co. ZONE / iT (/ ��� C�NI•(tA70R Const. VSTATE LIC.NO. 61195 APPROVE C- y (� BY DATE / SrY ADDRESS RRme ZONING 1�I I 164.4 ZONE /'T ^ NO.OF . I USE GEW / LEGAL rcel f1 Bll BLOCK TRACT //•O 9.....NO./PLANS^ BUILDINGSEFN ✓✓✓Ql/Y -c A.P.NO. BYAPPROVE D/�j. "J y / I ,,.pDyATE .117-12 `-' OF LOT 50 X 130 I NO.OF BLOCS. 0 YARDS /, /J'. U`�/EVES NOW ON LOT REQUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG, _ FRONT J "FT. IN. SETBACK LINE FROM 1t qq ...-- CENTER CENTER OF STREET 63 -2 REAR YARDy.S R.SIDE 5 FT. IN. SIDE YARD I LEFT 8 I RIGHT 5 L.SIDE 5-7FT. IN. DESCRIPTION OF WORK v REAR .� FT. IN. NEW Ix II ALTERATION I II ADDITION I REPAIR I II MOVING I II DEMOLISH I BUILSIZE ROOMS 'zn0 NO.OF ROOMS 12 STORIES 2 EXTERIOR WALI,LL I ROOF • COVERING stucco COVERING hot-mopped 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 CON. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ITT ORDINANCES AND STATE LAWS REGULATING BUILDING UCTION. VALUATION SIGNATU- •• / to A• PERMIT FEE $ 43.00 PERM ITTEF / $ 23,060.00 PLAN CHECK $ 21.50 AUTHO-1 D AGENT TOTAL FEE $\64.50 . `, w 9527. EE RE EI7 ED COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 317 COSTA MESA, CALIFORNIA FINANCE DEPT. ITN OF COSTA MESA \ FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING �3 93 /3 ' ? Z/I/tA.2 it ADDRESS 7 �7 ! FOR MESA. CALIFORNIA FOR OFFICE USE ONLY RDR - hie) . SUS AiAA/ I RECEIPT NO. I / M1 N0. OWNE �'JJ �7 / / ( Jr ADDRESSSO2327 rtoe(/s� �J r R VED/BY /II (DDATE.RECEIVEDI QAT/ IB(' !7 CITY J )9,-.4e 779 ���J TEL. NO. ADDRESS [ 5-( ph L//(' -/9 !�d/r.C."1✓ /--• • ARCHITECT lri.y aJ Tn yea,' NC.SEI�z COSTA MESA. CALIFORNIA . OR ENGINEER NO. < f ADDRESS �w7��I9Oeu,/� _ FI E op- JDEi"/"� e *A fee /JL/— r(/b CONTRACTOR/ V L✓4y L i"J ,IC.No./f'J$e rSTATE APPROVED ea,tir r_ D ) , • ADDRESS/ Y9 w4sj'. x. ma at eo ZONING LEGAL LOT I I i figi _ ZONE/r I NO.OF I USE OF NEW 2. �J DESCRIPTTIIO/OW�N N�/O. : �/ BLOCK/J TRA 7 \ I/.1it ( PL'AN/S�(/. BUILDING �rT)/�_J"�D��Jf`/� A.P.NOW, /c;. /i 13 0 �,�LE.r BYPROVED//j 7 N r DATE OF LOT���)))YYYYYYI// X [ D I NO.OF NOW ON LOTS ." YARDSREQURED` YJ`• ALLOWED USE OF Apr T.. /��� _ / w p�., (CENTER LINE 6TJ , n/ ' EXISTING BLDG. .Y{A/ 6.01- FRONT �I!// FT. IN. SETBACK LINE FROM '�JJ����/L ((( }^(/ CENTER OF STREET / REAR YARD30 R.SIDE FT. V IN. /V/�/ 11 (0 11 `/y} �Ky/ ' SIDE YARD LEFT / / /) RIGHT y 7j L.SIDE / FT. L� IN. DESCRIPTION OF WORK REAR `30 FT. 74 IN. NEW 1 A...s#.....-ALTERATIONI II ADDITION I REPAIR I II MOVING 1 V DEMOLISH BUILDING ♦/TO p/ NO.OP SIZE ��.J ROOMS STORIES EXTERIOR WALL ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED Sail(AIM ,A/6, _oo L „S£mi: 4 R., 1 HEREBY ACKNOWLEDGE/THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ASO I6 CORRECT AND ES TO C M. BUV WITH ALL CITY ftO pYl♦7llIICEQfND 6T`/�U PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING ON6TRU TON Y(.(/ Yrf� VALUATION I SIGNATURE F /f. lf PERMIT FEE $ . PERMITTEE $ . v/yam `q.{OO \ PLAN CHECK $ . AUTHORIZED AGENT TOTAL FEE $ /8, ,.