HomeMy WebLinkAbout1319 BAKER ST - Building Permits fay CITY OF COSTA MESA11111
51"MFsy BUILDING DIVISION
`a ,l 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.gov
0.411 FOR INSPECTIONS CALL:(714)754-5626• a
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PERMIT NUMBER: B12-00124
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PERMIT TYPE B_ROOF2 STATUS: ISSUED
Aa. N: 14119121 DATE ISSUED: 06/05/2012
• ISSUED BY: KJB
JOB ADDRESS: 1319 BAKER ST CM Suite/Unit: . •
Vicinity: -
Squares: 2600 Valuation: $7,500.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF.REPAIR/REPLACE SHEATHING AS NEEDED. ROOF PITCH IS 3:12.COVER WITH 30
tiEAR COMP SHINGLES.DOES NOT INCLUDE DETACHED GARAGE.
NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for
verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card
I
OWNER: HUGHES,MICHAEL PAUL TR C/O CFG INVESTMENTS INC Address: 17220 NEWHOPE
ST Unit:
PHONE: 714.557.1430 City/State/Zip: FOUNTAIN VALLEY,CA
Ci
APPLICANT: PRICE,BOB Address: Unit: :
PHONE: 714-573-0155 City/State/Zip:
CF , 1
ONTRACTOR: PREMIER ROOFING AND BUILDING CO INC License No. 634404
Address: 17501 NORWOOD PARK PLUnit: PHONE: 714-573-0155
City/State/Zip: TUSTIN,CA 92780 CELL:
ARCHITECT: License No. • PHONE:
VEN:.
GINEER: License No. PHONE:
Pr
FEE SUMMARY
FSeroof Plan Check: $0.00
Seroof Permit Fee: $153.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
r.
TOTAL FEES $154.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays
New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day
14.0
{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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
sciquired inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
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CODE INSPFCnON TYPE QAIL IN1mAL5 CODE I INSPECTION TYPE QAIE minas
Sp6 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
Q00 Final Re-Roof �Y 210 Final Electrical
201 Final Block/Retaining Wall �� 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
403 Final Sign 222 Final Site
it
204 Final Demolition 250 Final Building/Occupancy
IT •
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers icense. ❑Yes ❑ No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑❑�(q�IkI hhaawe and will maintain a certificate of consent to self-Insure for workers'
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
cv tion, provided for by section 3700 of the Labor Code, for the
rf ance of the work for which this permit is issued.
I have and will maintain workers'compensation insurance,as required by
s tion 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffolding,falsework,a demolition
Carrier: or dismantling thereat will be more than thirty-six
(36)feet high.(Chap.3.2,Grp
(Thsseaun need not becomnpletedd the permit is valved et one hundred dollars w
rs($100) less.) 2.Art 2, TitleSec.341, ue 8,California Administrative Code). g
Policy Number: Cec1H4`o`(7(�
❑ As owner-builder, I will not employ anyone to do works which would
O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subjec rkers' compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor C rthwith tom with these pro islons
�� Division of Industrial Safely Permit Number:
A iwrlls Signature Da1B HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa ,Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds. or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license/ is in full force and effect. "2 a registration form for acutely hazardous materials? ❑Yes 0 No
Lic.# w �� ��Class# C J _ exceptions,
25533 the California Healths and MeCode, with somet b
eachpbusin srequires registration with the Costa Mesa Fire Department y
V each business which at any one time has on hand a quantity of acutely
c°ntrac)I Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
Signature Date
- - to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fa non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feel from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044.Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
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 8. (If"yes",attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the properly, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signal gl'[�aJA�uner(s� ♦
Signature Date C/}/ /t%"
]05]-46(y0]) And/or Author ed Applicant Date
- /3 / ! A_ .ge ,s / Applicant to fill in all spaces except those within heavy border Ilnes and sign all appropriate declarations.
'
Ca OF COSTA Mjefrit NS RUCTION PERMIT - PE IT ty11,�� n TRACT NO. LOT NO. UNIT NO.
eftProject Address V.... . ale-
a /p ,, • '� /fie- r LU[ vll Y
Applicant's Mailin Address _T_s ! .0 ( - 1111.."4.. TYPE OF CONSTRUCTION NEW ❑ ADD LT/�AT ^N `,�'l lam,
Aga ••-fit/ ❑ CONVERSION ❑ DEMOLISH ❑ OT-ER ( / A.P.# Zone
Owrier's Name�Ja/ r /C.:/a -wry/���Sl • Phon �/4 D�$CRIP N�OF�OFj 1�lj1$E f�F B G. •• ��� 2e
Address /7.20 / lac/7-ore— 20 jr ,nN {/" 3-Ay C./�' {e(f-(/— /7�[❑� y,c- �( S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT U GRADING FOUNDATION STRUCTURAL T Front • O
Address _ CI TENANT LEC�g ICAL PLUMBING 0 MECHANICAL B Rear N
(,7 U _ Z ❑ OTHER /-170r; _ A I
Contractor's Nam ,/ _ _Phon PROJECT DESCR PTION SQ. FT. '/ 0C..) OCCUPA -170 C Right G
Address lmailin91�7�/^�al= 'L�NCC'L/ t l�2 N�� CONSTRUCTION TYPE VALUATION$ TOO g Left R
City License No. 4 7/ ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION Q
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 T
my license is in full force and effect. S
Ucenfs�Class cense
Date.- /�g f Signature, ('K L i PLUMBING FEES .
t� WORKERS'COMPENSATION DEC aRATION Bar Sink Showers ELECTRICAL FEES '
V` I hereby affirm that I have a certificate of consent to self-Insure or a certificate
j' Y Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
000, L b. ) Automatic Washer Transformer 0 15.50 KW
t Policy _ I6 Company I3c1n e- I " ( 7' Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
❑•Certified copy Is hereby furnished. O
l
r led copy Is filed with the city a ding isio � Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps
Date_B+� // (GC/ Applicant y
EXEM PTIQN FROM WORKERS'CO ENSATION EC LARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if he permit Is for one hundred ($100)or .
less). Dishwasher Solar Piping • Dryers OGas ❑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 Do-i HP 01%-B
_
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 Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes '
I hereby affirm that there Is a construction lending agency for the performance Pole Light
of the work for Cyhlch this permit Is Issued (Section 3097 Civ. C.)
Lender's Name r Interceptors Water Heater Outlets Range
, Lender's Address -s !',/ jC - Kitchen Sink Water Service
OWNER BUILDER,DECLARATION Switches Sign
I hereby affirm that,l am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 005 KW 05-15 KW Trash Compactor
any structure, prior to Its issuance, also requires the applicant for such permit P
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
Therefrom and the basis for the alleged exemption. Any violation of Section
131,5 by any applicant for a permit subjects the applicant to a civil
-rutty 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 I $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $15 Issue Fee $ 3
for sale (Secion 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 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
;Action, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved BYDate
prove for the purpose of sale).
0 I as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By —Date /?
tractors to construct the projectSection 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct- Ventilating 00100,000 BTU ❑100,000 BTU SUMM RV F FEES . '
builds or improves thereon,and who contracts for such projects with a con- y�
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ '�•� SMIP $ ,s--V
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.Blt. ICBG# 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 0100,000 BTL. ELECTRICAL $ GRADING $
information is correct. I a•ree to comply with all city and county ordinances
and state laws red-'no/ con ructio , and hereby authorize repre- PLAN CHECK 50% $MECHANICAL $ MICROFILM $ /] S
sentatives of t 7 city enter p• the .•ave-mentioned property for lR. �
inspection our• es. TOTAL FEE $
Signature -or _ii _ / r Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' Licer se or ss$
I
CMF 0885-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting;Goldenrod - Assessor
0110026557-002655B TOT 19.56
noir, 119/17/40 TTdCe 11.2t
CONSTRUCTION AND PLANNING POOL &SPA '
APPROVALS :Permit-4 APPROVALS Inspector APPROVALS Permit# Date Inspector
1:Temporary Electrical.Sdivice or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement . 56. Rough Plumbing& Pressure Test
r
6. Electrical UFER Grrid..' 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation -- 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 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# 1 ' '
21. Ducts, in Structure 70. Underground Hydro ' .,0
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 •;.k '
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 r '•
33. Final Electric Notes: ,•_
34. Final Heating& Air Conditioning r•
35. Final Gas Pipe-Test -
36:,Hood or Canopy
l
37. Final Factory Fireplace ir I-• / r•
•
38. Final Plumbing �4 j: �r .' i
--39. Water Service-Final .„_
.
•'40. Gas Service-Final :. t ' .•
i 'i .6
-41. Solar Domestic-Final
, in I .
'• '� ,r
i
'
' 42. Backflow Preventer 4
• V,
, 43. Backflow Irrigation � L
44. Landscape Irrigation System „.. . •r - '. '
45. Sound Attenuation '
I
46. Handicap Regulations ..• r-;
47: FINAL STRUCTURE & BUILDING 3-22-10)
Igg, - ', 1, •:'! �
48,Special Requirements Completed l • '
49. Electric Release to Edison • y.
50. Gas Release to Southern California Gas Co •- 11.
51. CERTIFICATE OF OCCUPANCY • 4 1
No. Date '
VS
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA -I- PERMIT NO. TRACT NO. LOT NO. BLDG.NO. - -
CONSTRUCTI(TICf'P) EMIT �- — ��� 9L 2D' 12/,9/33 2,.,,,g it
I
f
Project Address • q` s --(Q�- 'lib.
TYPE OF CONSTRUCTION LI NEW H ADD LJ ALTERATION U REPAIR ' . - �•
Applicant's Mailing Address 'Vick kept-N\7� I' \ ,•ll ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 66���.� A'.p.# - .Zone - '
CA .Sn-nls 'le'll_ )^ DESCRIPTION OF WORK't�STAL,( 1JCU.A) Sf\LtaCT\L tot
Owner's Name ("‘CV
p o e to t S .�` - . . S Main Building: • Accessory Building: Z
AddressT,C)90 111�lb1o\v Qc . ALM.citi1A0
TYPE OF PERMIT GRADING FOUNDATION ❑),STRUCTURAL E Front N
•
Arch/Eng. License No. ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear - -
•Address 0 OTHER . _ - A - N
C Right G
Contractor's Name Li O c-.'k'gQ�( r1 Roci�{• CI-1 Phone�Z rn PROJECT DESCRIPTION SO. FT. C\Cl •OCCUPANCY '
•
Address(mailing) -14 1 T^��Cln. Q�4A Z1�, ' t'-`IN: G a I CONSTRUCTION TYPE - VALUATION$ I.�O•(tilt) g Left E
City License No. <�O ! t/ ZONE GRADING CU.YDS. ACRES P1ng. Ref.# Park.Fees $ O
. - U
LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided . I
I hereby affirm that I am licensed under provisions of Charter 9(commencing - R
with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E
ce
my license is In full forand effect. .
License Class' (✓ 3"1 - LltensrWa•�rzszJ - PLUMBING FEES Planning Notes: M
Date I ›.-(n"t.3 Signature i .Fn.z�..! C�i !` - N
WORKERS'COMPENSATION DECLARATION Bar Sink • I Showers
'herebyaffirm that I have a certificate of consent to self-Insure or a certificate T
-Service Sink S
f Workers' Compensation Insurance,'or a cert_ tl c py t e of (Section'- • Backflow Preventer. ._ _. - - - -
_.800, Lab. jjCc) ) e. ' Backflow Irrigation Sewer Cap , ELECTRICAL i FEES
Policy No.6,Ac-7G 7.-/CTS Company - -
Certified copy is hereby furnished. t . Bathtubs Sewer Connection 1 Automatic Washer Transformer 0 15-50 KW •
•
Cert`fiey_copy Is filed with the city Idin: Divi ' - 0 50+ KW
Date id- `1-15) Applicant r _QS., A.%-d _♦ Clarifiers . Solar Collectors ' ' Construction Pole Sub. • •- _ -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - - - - - -
(This section need not be completed If the permit Is for one hundred($100)or • Dishwasher Solar Piping - Cooking Unit ' Meter ❑up to 100 amps
less). ` DrinkingFountains
I certify'that in the performance of the work for which this permit is issued,I Solar Tank _ Dishwasher Meter Dover 100 amps
shall not employ any person In any manner so as to become subject to te .
Workers'.Compensation Laws of California. • Floor Drains Swimming Pool vv/Spa Dryers ❑Gas, DElectric I .Sub Panel
Date Signature -
NOTICE:If,•after making this declaration,you should become subject to the Floor Sinks , ' - Urinal _ , Fan - - . - -- Motors.❑0-1-HP ❑.1'/a-B ..
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions_ or 'this permit•shall be deemed revoked:, Gas Service :Outlets ' • -Water Closet ' -
CONSTRUCTION LENDING AGENCY' ' - - - ' - • F.A.U. ,Inc.Solar 09-15 HP 016-15+
I hereby affirm that there is a construction lending agency for the performance Interceptors „ Water Heater - Fixtures .Microwave •
of the work for which this permit is issued.(Section 3097 Civ. C.) . • .
Lender's Name' _ _ ' - Kitchen Sink - ^ ( ._ . ' ,- Water Service ` ' - - Device Boxes ' - Pole'Light
•
Lender's Address 1 - _ '
OWNER BUILDER DECLARATION - - ' I _ - Lavatories c• - Outlets Range '
I hereby affirm that I am exempt from the Contractor's License Law for the ' - , — ,
following reason (Section 7031.5'Business and Professional.Code: Any city or P=Trap, ,_ _ -_ • Switches• .Sign
county which requires a permit-to construct,alter,Improve,demolish or repair ; - , . - '
1
-any structure, prior to Its Issuance, also requires the applicant for such permit ' ' i Roof.Drains . . ' ' Garbage Disposal .Standing Sections
to file a-signed statement that he/she is licensed pursuant to the provisions of _ - ' - .
.the Contractor's License Law(Chapter 9 (commencing with Section 7000)of - - - Generator ❑0.5 KW❑5-15 KW 'Trash Compactor•
'li vision 3 of the.Business and Professions Cotle)+or that he/she is exempt - - • - - - . p
'erefrom and the basis for the alleged exemption. Any violation-of Section ' - . - - .
)31.5 by any applicant for permit-subjects the applicant to a civil Reinspection - I $.3 .
malty of not more than five hundred dollars($500).• pe $25 Issue Fee -
Li I_as owner of the property or my employees with wages as their sole • Reinspection Fee $25
I Issue Fee • . $ 3
compensation, will do the work,and the structure is not intended or offered - - I :MECHANICAL I FEES
for sale'(Secion ;7044, Business and Professional Code: The Contractor's - - PUBLIC SERVICES REOUIREMENTS: '
License Law does not apply to an owner of a property who builds or improves I Boiler Hood or Type I 0 ! '
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 - - Canopy Type II ❑ - Zoning Approved By Date
sate. If, however, the building or improvement is sold within one year of com- : Duct-Under Ground ' Application Approved By Date •
pletion, the owner will have the burden of proving he/she did not build or im •
-
Lirove'forthe purpose of sale). Duct-Structural Refrigeration System Application Issued By ' ' Date
I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU •
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating �,/-�� ,SUMM/�R OEt EES _
The-Contractor's License Law does not apply to an owner-of property who - p /
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ o'- t5 SMTP. $ s5
tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ - PERMIT
❑-I am exempt under Section B.& P.C.for this reason , Firepl/Fact.Bit. ICBG# t PLUMBING $ ISSUANCE $ t
• Date Owner • - Heating System& Ducting 4 PLAN CHECK , $ ENERGY P.C. - $ '
I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BTL GRADING $ ' . '
information Is correct. I-agree to co •ly with all city and county ordinances , . - - - - ELECTRICAL ' $ ' i
and'state laws relating'to builtlin• rust-•coon, and hereby authorize repre- MICROFILM I $
sentatives of Is' I to alit.i ••• • th�Ove-mentioned ,property for' . i 1 PLAN CHECK $ i
inspection p os- . 1 '
Signature L.i- .✓._. Date ' MECHANICAL $ TOTAL FEE i $ '��'��
_/ Orivers' License or SS# _ Reinspection Fee $25' I Issue Fee $ 3 PLAN CHECK $ i •
/' CMF 0865-46 rev. 7/83 ' White'Building;Canary-Applicant;Pink'-Accdunting;Goldenrod-'Assessor' - - -- ' ' -' - -- - --` ' -• • ' ' ' '--' - -
_ CONSTRUCTION AND PLANNING POOL ,PA
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
t13. Electrical Conduit Utility-Undrgrnd. - 54. Forms
-' j4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - • -
4 t 5. Steel Reinforcement - - - 56. Rough Plumbing & Pressure Test •
6., Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings I _ . 58. Electrical Conduit-Undrgrnd.
8. 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 ,
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains ' - - 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit -- - , - I - - 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 I ' APPROVALS ' Permit#
21.. Ducts, in Structure, . ' I 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 I 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-Final80. 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 r
41. Solar Domestic-Final . __ --'- - ,
42. Backflow Preventer
43. Backflow Irrigation . . ' . I /
44. ,Landscape Irrigation System
-
45. Sound Attenuation /
46. Handicap Regulations /
47. FINAL STRUCTURE &BUILDING • / '
48. Special Requirements Completed , • / '
49. Electric Release to Edison - - - -- /
I 50. Gas Release to Southern California Gas-Co I -_
51. CERTIFICATE OF OCCUPANCY `I
No. Date - -- • --- - `�
)
8991 G=EE RE EIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT �{ 9 55 --
P.O.BOX 317 COSTA MESA, CALIFORNIA RNAE DEPT.
FOR APPLICANT TO FILL IN COMPLETELY APPLICrAT1ON�TFCSR,HPTRMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 1319 A, B, C Baker St.
COSTA MESA• CALIFORNIA FOR OFFICE USE ONLY
Inc. ECEIPT NO. I FPERMIT NO.
99 /
OWNER KPT1C�Dn HOIIIPS. Jll
MAIL1555 Placentia, Newport Beach ,REECEIVED BY �[DATE PACEDATE ISSUED
ADDRESS T/-/ - A, � / - -- 'AR 13-U 7
CITY WI 6-32277 TEL: BUILDING
N O. " VV
ADDRESS
ARCHITECT same . LIC. I.
COSTA MESA, CALIFORNIA _J
OR ENGINEERNO.
type /7\ � p
JADDRESSsame ZONE
gewilt,J.9,t1 Const. Co. STATE61195
LIB?PR D .1;71‘
BY
77,
ADDRESS same `ZONING •
LEGAL *Peel RVR 1y[]{Iy('L ZONE '} _ NO.OF USE OF NEW {�
DESCRIPTION rvV. BLOCK TRA`r' IR%r I PLAfNSA I BUILDING /`���
APPROVED /�/- , /Dr DATE �-h�/
A.P.NO. 130 BY �j/ 000___
SIZE 50 X I NO.OFO BLOCS. 0 YARDS VES/
OF LOT NOW ON LOT REQUIRED ALLOWED
USE OF (CENTER LINE ST.) � �
EXISTING BLDG. FRONT .S O FT. IN.
SETBACK LINE FROM n
CENTER OF STREET 50 REAR YARD 015 R.SIDE SFT. IN.
SIDE YARD I LEFT 16 I RIGHT 8 L.SIDE 5-FT. IN.
DESCRIPTION OF WORK Cr.EAR o" � IN.
NEW I X II ALTERATION I II ADDITION I
REPAIR I - II MOVING I II DEMOLISH I
S ZIE LDING 2710 ROOMS 12 STORIES 2.
EXTERIOR WALL ROOF a
COVERING stucco COVERING hot-mop
USE OF BUILDING AND WORK TO BE PERFORMED
Triplex residence and garage
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH A TY ORDINANCES AND STATE LAWS REGULATI G PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING C. /UCTION.
SIGNATURE VALUATION
PERMITTEE 23,060.00 E •S �/' /
PERMIT FEE $ 41.00
$ PLAN CHECK $ 21.50
AUTHOR , • AGENT TOTAL FEE $ 64.50