HomeMy WebLinkAbout1590 BAKER ST - Building Permits CITY OF COSTA MESA
4 9 BUILDING DIVISION
a>h—,• 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.aov
4. FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER: B13-00011
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 13919224 DATE ISSUED: 01/28/2013
ISSUED BY: RMD
JOB ADDRESS: 1590 BAKER STCM<" '`" , , , . Suite/Unit:
Vicinity: HOUSE AND GARGE
Squares: 2700 ' ' \ - Valuation: ', - $9,000.00
-.22 \ � "
SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT.ON"A 4:12 PITCHED ROOF AND
REROOF WITH GAF TIMBERLINE SHINGLES ON AN ATTACHED HOUSE AND GARAGE,APPROX 27 SQUARES:
REPAIR AND REPLACE SHEATHING AS NEEDED.COOL ROOF NOT REQUIRED.
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'a_lar_ms by the'City Inspector. See Attachment w/Inspection Card
OWNER: RAMIREZ TINA LAND BRAVO SHELLY L - 'Address: - 1590 BAKER ST-, Unit:
PHONE: I / City/State/Zip: COSTA MESA,CA-
.
APPLICANT: ELIASON,STEVE Address: - - Unit: :
PHONE: 714-745-5178 / , " , "' City/State/Zip:- -. •,\ -: ,
CONTRACTOR: SANTIAGO ROOFING License No. 576276
Address: 2500 E IMPERIAL HWYUnIt: - - — 20136_1." ,.-. ' PHONE: ' 714-529-0440
City/State/Zip: BREA,CA �.t , . . 92821 - - -/ , CELL:
'
ARCHITECT: License No. ' PHONE:
ENGINEER: License,No. - , PHONE:
‘,
FEE SUMMARY �� >�//2"),-
�:�,
Reroof Plan Check: $0.00 <./' ~ ', I/
Reroof Permit Fee:
Reinspection Fee: $0.00 _t : - . , . , `_
Bldg Std Admin Fund $1.00 _ ,
TOTAL FEES $168.25
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
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE r, INSPECTION TYPE egg INTmALS CODE INSPECTION TYPE pA�FT INTmALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final � * 208 Final Plumbing
200 Final Re-Roof r — / 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
WORKERS'COMPENSATION DECLARATIL Owner ID verified by o,,.,,r's license. 0 Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the •
performance of the work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance, as required by
section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 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
Carrier:
/N 406/1' C_ ✓t .CJY by this permit,and that no building structure,scaffolding,falsework,or demolition
or dismantlingthereof,will be more than thirty-six(36)feet high.(Chap.3.2,G
(This section not be conmiered it the permit is valued of one hundred ckaers(31001orlesaJ rly- 5 Grp
�/� /^,, / 2,M 2,Sec.341,Title 8,Califomia Administrative Code).
L
Policy Number: YGj ^ 19`t % *4'
44 0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless
issued, 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 subject tot workers' compensation provisions of Section 3700 of
Applicant's Signature Date
-".?a ode,I 4. hwith comply with these provisiopps.
'. `I A AV/ / /2-rt Division of Industrial Safety Permit Number:
Apr - , re 4/ D e HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
W.-ZING: 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 Califomia Health and Safety Code requires,with same
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions,that a Business Plan be filed with the Costa Mesa Fire Department
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: volume of 55 gallons, or 200 cubic feet of compressed gas at standard
I hereby affirm that I am licensed under provisions of Chapter 9(commencing 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. �?7 Cy a registration form for acutely hazardous materials? ❑Yes 0 No
Lib.# b�?b Class# C- 3 ! (Section 25533 of the California Health and Safety Code, with some
yteasaahr exceptions,requires registration with the Costa Mesa Fire Department by each
/ a/�1� 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,ora volume of 55
gallons, or 200 cubic feet of compressed gas at standard temperature and
UCTION LENDING AGENCY: pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building 'recreant 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
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:My 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? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of me Contractors License (Section 65850.2 of the Califomia Government Code requires that the requested
Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business information be fumished on applications for non-residential building permits).
and Professions Code)or that he or she is exempt therefrom and the basis for 6. Will any part of the facility to be constructed under this permit be within
the alleged exemption.My violation of Section 7031.5 by any applicant for a 1000 feet from the outer boundaries of a school? 0 Yes 0 No
permit subjects the applicant to a civil penalty of not more than five hundred (If"yes",the facility must meet the requirement of Sections 25534 and 42303
dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property,or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
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
property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
El I. as owner of the
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
the City of Costa Mesa to enter upon the above-described property for
Business and Professions Code for this reason: inspection purposes.I agree.not to occupy or allow occupancy of any building
authorized by this permit til finalalinspection.
' ;gna;reo00egs) ` pat /13
signature Date - .or Au( •rized Apptcanl .Date
305746(3/07) -
WNER LeNORMAND, Lloyd • DATE . 9/18/72 •
.
\JOB ADDRESS 1590 Baker St. BUILDING PERMIT NO. 35408
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Legalize Stge. Rm.
'y APNo.139-192-24 LOT TRACT FIRE ZONE . VALUE $ 50.00
INSPECTIONS Signature Date GROUP J TYPE V ZONE R-1
p salt PERMITS ISSUED
1t' GAs SUBCONTRACTOR Date Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM
ID BEAM ❑ STEEL REINFORCE n
4ATHING
FRAME AND FLASHING
LATHING — IN fI OUT n
PLASTER, BROWN COAT
STRUCTURAL,ING, FINAL E,Je`trpJ'����fo�') / l7 . n �
HEATING, VENT., REFRIG. AND A.Cr.-,FINAL /Tv� 4wr it/M 00
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL / n•7
BUILDING, FINAL / 9-/9a•z.._.
OWNER COMESA, INC. • DATE " 5-1tt-59
JOB ADDRESS 1590 Baker St. BUILDING PERMIT NO. 9317
GENERAL CONTRACTOR Dike & Colegrove, Inc. VALUE $14, 387.00
No. LOT 82 TRACT 28222 FIRE ZONE DESCRIPTION OF WORK Res. w/att .Gar..
....dPECTIONS 6,2�''i DATE I GROUP TYPE ZONE A 1
Underground Soil /ji}j5 U.G. WaterN}}$ I-3 't SUBCONTRACTOR PERMITS ISSUED
Underground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating 445 722- 2 t 77e 27 - G--2-3-5. " 4, 7
Rough Plumbing ,41/5 -- -o ri J sJ&-c-c._-) 67-42--5-7 2INC.
Miscellaneous
Prop. Swr.LLine Houg�'ICon. St. Swr. IE(t,-e( (J-k,',,k, $25:-...4 7( if I re-; t p
(
Sprinkling System `�� nif I-
Heating, Final k li 14a$M7 re
Plumbing Fixtures lirti aaa . ._ - - i
Final Gas Test !I.-X6. A /i✓ 0-' *o ' .,./..44.,
Construction Pole -
Underground Power - ." -
Rough Wiring. {'/.1/,1 7,AI S/_ f 42T`J/-e.v- ;;;e .(u _- 7- /-5-7 95-57ii.
Trenches Forms I/ Steel 379—
VW-,
Floor Syste
Steel Reinforce Chimney Re-Rod
id Beam
athing
r rame and Flashing I/09ly 1-23-if
Lathing, In Out /1,91#)1- et-/--f9
Plaster, brown coat /01o1 f"3/- K'9
Plumbing Fixtures, Final 1 /�J sf.
Electric Fixtures, Final ,/J�// y��
Building, Final "(/'U 1r I2 '_
OCCUPANCY
Form 210-3M-4. _ _'
59 - - - - ._ - - 9317
OWNER DUKE,R. DATE 8-25-60
JOB ADDRESS 1590 Baker St. BUILDING PERMIT N0127149
GENERAL CONTRACTOR Blue Haven Pools VALUE $2,600.00
'^ No. LOT 82 TRAC'2822 FIRE ZONE DESCRIPTION OF WORK Pvt. Swim Pool
PECTIONS DATE i GROUP TYPE ZONER1
underground Soil h U.G. Wateri SUBCONTRACTOR PERMITS ISSUED
Underground Gas DATE NUMBER '
Overhead Water and Gas
Rough Heating
Rough Plumbing
• Miscellaneous iji11q-�3;G,q . o ,,L �/ t- 17,040 ,Pfd,ibe)
Prop. Swr. Line H se C St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power N1
Rough Wiring 'f'M 21-G4. 0 /.53 7.f-
Trenches Forms St el rJr1 /3-6n
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
athing
me and Flashing
Lathing, In Out
Plaster, brown coat
Plumbing Fixtures, Final • ,7-11 /i' ci-6n
Electric Fixtures, Final Q-111 /e -t.-Fir,
Building, Final JC
OCCUPANCY TV-if (v
Form 410-5M-11-59 5.11 P 12749
_ L 931 '7 r. RI-
LLtVLD
ar"'' MAY IB1959
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 917 COSTA MESA. CALIFORNIA FINANCE DEPT.
cm OE COSTA MESA I
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 1590 Baker St.
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
Giantess., I RECEIPT NO. I tSERMIT 3 / O.
OWNER ('ipII19$8, Inc.
MAIL ADDRESS 419 E. 17111 St. RE EIVEp BY DAT RECEIVED DATE ISSUED
_YV// , /3-59 SW-
CITY
/V—S
CITY Costa Mesa TNo:LIB1159 BRING
A KESS
ARCHITECT
OR ENGINEE Carlson 1ebrook NO. COSTA MESA, CALIFORNIA
MADDREES,�Sk7�pp��Garden Grove ZONE FIRE 3
CONTI7nAW8R& Colegro Ve, Inc LIC.NTOE. 167293 APPROVED J/
BY i.
1 DATE7l'/ -
ADDRESS 419 E. 17th St. . Costa Mesa ZONING / .
LEGAL I LOT g2 I 12822 ZO�F�1 NO.OF USE OF NEW
DESCRIPTION NO. 44 BLOCK TRACT / �f{I� PLANS a- I BUILDING
it/3-s-
.
1, APPRO /L���� 1/ DATE ? 'I /S'I 9
SIZE 6O x 113NO.OF SLOGS. YARDS EVES
OF LOT I NOW ON LOT none REQUIRED ALLOWED
USE OF none (CENTER LINE ST.)
EXISTING BLDG. _—.. FRONT
FT. IN.
•
SETBACK LINE FROM 55' REAR YARD 29'
CENTER OF STREET R.SIDE ./ FT. IN.
SIDE YARD I LEFT 5! I RIGHT 51 L.SIDE 5 FT. - IN.
DESCRIPTION OF WORK
FT. IN.
X
REAR /J
NEW I X I ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
S =IE DING NO.OF ROOMS 6 STORIES 1
EXTERIOR WALL ROOF .
COVERING Stu• 0 COVERING Shingle
USE OF BUILDING AND •ORK TO BE PERFORMED
Single family dw ling with
attached double g: ::e
Plan 130A
I HEREBY ACKNOWLEDGE THAM I HAVE R 'D THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT'A 0 AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE L WS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. /� VALUATION
,SIGNATURE O � /�//r PERMIT FEE s 34.00
PERMITTEE 11 Y^ •
17.00
$ l•�,. PLAN CHECK $
AUTHORIZED AGENT Dike & Colegrove, Inc. "�3 • 511". TOTAL FEE $
•
• „, 0 -,r 1274 la VED
COSTA MESA BUILDING-SAFETY DEPARTMENT !�
P. 0. BOX 317 COSTA MESA, CALIFORNIA �yN�AFNCE DEPT.
ESA
For Applicant to Fill In Completely APPLICAT�N PC R�PERMIA T�
TYPE PRINT
BUILDING
BUILDING/S7 D d...,,,4„,
ADDRESS -�/
/^C/OSTA MESA.nCALIFORNIA For Office Use Only
//✓ I RECEIPT NO. I '07 NO.'
OWNER 1///� y¢ "v�� 1 ,✓��%//)
MAIL Reul p /)I �RS �OIk_1J ".e6
MADRES rJN/•7G^/,7
Ata-4---70-.• BUILD( /�9 b "'w/"-
CITYADDRESS !ll���..«///•••�
ARCHITE«�� A TE COSTA Ail LIFORN
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CONTRACTOR SD / -��
APPROVED �V 1 . DATE .0 2/ /D
Lu s•I..i�Iu �:� V O (J
ADDRES/Z i- i 27 7• NING •
I ZONE NO.PLANS f BUI OP NBW��!
CITY JL�(/W--�5"" TELI�/,1i°IINO.O ?i•BUSIII %G /A 7.
LIC.TE NO. l5�y J NO. ` S6 OSr LEGAL / _ �/_ In� Q7�4"
DESCRIPTIO
/� .,P.•J
SIZE / NO. OP SLOGS.
OP LOT (pC "NO.. oN LorA.P.NO.
USE OPYARDS EVES
EXISTING BLDG Ur APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARDFRONT Y ST.
.a P �` IN.
SIDE YARD I LEFT I RIGHT R.SIDE . 'T.i IN.
DESCRIPTION OF WORK
L.SIDE /DFT. IN.
NEW I ALTERATION I II ADDITION I REAR
II II MOVING APPROVE10/„../.0, �j `IN. .T
REPAIR I I DEMOLISH I BY ��/ D/ DATE C7 ��li�//
BUILDING �/ NO. OF `3 •22'7
SIZE '/� /� 3 V ROOMS ,STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO ORMED
>_ IrO Q
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CO ECT AND TO COM•
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY OROINANCES A D STATE LA ULATING
Bu1LDlN0 -- - •• /N. /n/ VALUAT ON vo
SIGNATURE OF / - -Y w PERMIT FEE 5/6 t'�-•
PERMITTEP ...
444"'VVV���---YYY/// / ,aQD uy o
• / / / I $ /r Ove PLAN CHECK S57
{�'` _
AUTHORIZED AGE is Y� r.f 0
'" OTAL FEE • h.
35408 SEP 18.72_PAID 612 v** **5.00
MSA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA PP IC ION FOR BUILDING PERMIT
For Applicant to Fill in Completely
BUILDING //�� R CEI ED pDA ERE EIVED rzpryl ISSUE
ADDRESS /-rl1O []lite,' Sr 4 ]�— /�•S/� RL///JMMM///E/I' (�(
OWNER `L/LCYCJ 2G �004114/i A.P. NO. I.J ) - I CIc).-a /'s' ER I r•.40l
MAILUILDING /^ ��
ADDRESSpp ina &ste/- Srr ADDRESS /J92 I(g ex 0-U CITY L.OS1147 /pea, NO. S%f U7 TRACT OZ. I LOT 6 x BLOCK
Z 4 0 ca CONSTRUCTION NEW ADD I ALTER`REPAIR I MOVING nen/top ISH
F- LENDER
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aca
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JN (�/J J ,/ /� OWNERA/9/2 CO J ADDRESS (7t ^fir /'jam.{ �9 �. z�zs ��tsV�A,LtU (�/ �/�yj0] ARCHITECT TEL. USEJ101weer/ge,,yeefevel
INct tL!
Q OR ENGINEER NO
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Z Q
W ADDRESS
ZONE TYPE GROUP
Q
0.W APPROVED
J Z CONTRACTOR �a/-n om '
BY DATE
CO Z
:ix ADDRESS If�%iTc FEW/\ Hll'k'/i' ri 12i� 1jiui
W W ZONE 1`^ NO.OF USE OF NEW lit/(�f/
0r CITYTENO. 1\I PLANS ,2 BUILDIN -/n h r
Z_ H
W0 STATE CITY YARDS APPROVED YARDS APPROVW
to DC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D SIZE NO.OF BLDGS. (FROM C/L STREET) ,(
OF LOT I NOW ON LOT / FRONT FT. FT.
USE OF
EXISTING BLDG. C-0,e4l r- A SIDE FT..
I-` SIZE OF 6z 4'. r M sfNO.OF
Z NEW BLDG. /3 ,(J' A?) ROOMS / STORIES L.SIDE FT. FT.
Q EXTERIOR WALL . ROOF
V COVERING i/.Cie COVERING REAR FT. FT. ).
1 USE OF BUILDING ND WORK TO BE PERFORMED DISTANCE ET. BET.MAIN&
a-
a I ni TE-(ei 0/c At_/p-a.-ArJnM Oru l.Y MAIN BLDGS. ACCESS. BLDGS.
Q `t ' - _ _ VAR.# DATE
O ,S' C (� .eAA LSIr E,X ST1 rJG C.U.P.# APPROVED
I-fq Itv7P it) Sl llRA G- L enfrvi. APPROVED VY/�� DATE /� 0/7L
Z
0
oI.hereby acknowledge that I have read this application and state
O that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ VI
r any person in violation of the workman's compensation laws of
17 the State of California. m
Z .skiA. U
I hereby certify that I am properly licensed as a contractor under SO. FT. O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR x>
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Na
am exempt from the provisions of the State of California Business VALUATION
and Professions Code, Division 3,Chapter 9, �i .✓) m
PERMIT FEE $ e,i 0-6 N
co
Signature of �j� //n m
Authors a •
�� /01.90.14...).7
.�//«�1'J1 d�C L� $ 04
Q �� PLAN CHECK $ E
\\\ —� o
Authorized Ag nt 5- LL
,, TOTAL FEE $
Applicant to fill in all spaces except those within heavy border lines and sign ail appropriate declarations.
CITY OF COSTA MESA/� COTN'�STjRU-ACTION PERMIT - r itsMIT itsct Q� TRACT O. LOT NO. UNIT NO; Zone
•
Project M�dress I c`)n fnlA-D''CQQQ�/�,/I`�l�T ` S Main Building: Accessory Building:
Applicant's Mailing Address IS'1�-Q�, a I�/Oi40e. �l pp O� TYPE OF CONSTRUCTION 11)2 NEW H ADD H ALTERATION U REPAIR-
OwNer'sName�7CitERA .D 4 R,14CI.A A Uviol Phone4�'8707 ❑ CONVERSION ❑ DEMOLISH ❑ ORIER a
Sq 7204KKEST ASIA M ESA DESCRIPTION 5 WO�(U,SE OF BLDG. t"LjTTINCi ON FF ME+1'C�
Address (.,Y
A IN
Arch/Eng. License No. TYPE OF OF PE GRADING. ❑ FOUNDATION ❑ STRUCTURAL
Address �❑pl TENANT ❑ ELECTRICAL CI PLUMBING 111 MECHANICAL
Contractor's Name 0///)^' Phone • I Ping. Ref.* Parking Req./Provided
y-VOTH ER
PROJECT DESCRIPTION SQ. FT. Hef, OCCUPANCYan"C..SPlanning Notes:
a
Address(mailing) - /�CONSTRUCTION TYPE VALUATION$ r ee
City License No. ZONE GRADING Cu.YDS. ACRES '
LICENSED CONTRACTOR DECLARATION -
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:
with section 7000) of Division 3 of the Business and Professions Code,and
my license is In full force and effect.
License Class - License No.
Date Signature PLUMBING FEES Automatic Washer Transformer ■ t
WORKERS'COMPENSATION DECLARATION ■ s
I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink $how¢fs
of Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink - king Unit ' Meter ■ ss
3800, Lab. C.) - - - Dishwasher•• Dover• • el
. Thlicy No. Companyamps
Backflow Irrigation Sewer Cap
Certified copy is hereby furnished. • ■ ■
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection
Electric Sub Panel ,
Date Applicant - Fan Motors ■a • ■
. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • _
(This section need not be completed if the permit is for one hundred ($100) or - Inc:S• • '❑9-15 HP ❑16-15+
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is issued, I �' rowave
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar T k
Workers' Compensation Laws of California.
Date Signature Floor Drains S - ming Pool w/Spa DevicePole Light
NOTICE:If,after making this declaration, you should become subject to the • Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet . Switches Sign •
I 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.) Interceptors - Water Heater Garbage Disposal Standing Sections
Lender's Name ■t W ❑5-15 KW Trash Compactor
Lender's Address Kitchen Sink Water Service . Generator
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 -
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Treys
any structure, prior to its issuance, also requires the applicant for such permit '
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Or:ins -
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 Reinspection Fee I $15 Issue Fee • $ 3
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 -
natty of not more than five hundred dollars($500). „ --
$
/ DEVELOPMENT SERVICES REQUIREMENTS:
NI, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 Zoning Approved By Date
sole sale iec, will 0 the work, and the of scion is not intended C or-offeredtracto - y -
for sale (Section 7044, Business and Professional Code: The Contractor's - • MECHANICAL • FEES Building Approved By �v7r 1-flo�1 • Date /�/�/�JJJ///���/(.�
License Law does not apply to an owner of a property who builds or improves �' (�"T�
thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By Dat- 4I [J
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is s thin one year of com- Canopy Type II ❑- - _ SU 1f-OF FEES
prove , the owner will have the burden of proving he/she did not build or im- Duct-Under Ground BUILDING PERMIT w
50
prove for the purpose of sale). $ — SMIP $
❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration tem I
tractors to construct the project (Section 7044,Business and Professions Code: PLAN CHECK $ PERMIT •
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,0 BTU 0100,000 BTUPLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con-
tractor(i) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ Syst Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensati n insurance should be provided to me. -
ELECTRICAL $ •GRADIpy{���
am exempt under Section 7 B.& P.C.for this reason Featin Fact:Blt. ICBO# we Dampers $ I OµIUM
PLAN CHECK 50%
P sta 'k 1 , / Heating System&Ducting Registers
itsPi
DateIlAl �i Owner }}}SSS _ MECHANICAL ' TOTAL FEE $ - A '
I hereby certifys that I have read this application and state that the above ❑Q100,000 BTU 0100,0008T $ 'a �'
information is correct. I agree to comply with all city and county ordinances / PLAN CHECK 25% $ r 4 4 i�'Q 1 ,
and state laws relatingiscity
to be ing construction, and- herebyiauthorize repor
Inspection
of this city Ips upo the above-mentioned pro ort for •
inspection �2 s. 7/ /J�,� yJu�tl ”
Signature �/ r f/.((y-L�l�- Date� �__ �� '
Drivers' License or 55 1� Reinspection Fee/ $15 Issue Fee $ 3
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor Calt V'
-
CONSTRUCTION AND PLANNING POOL& SF..
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1.tremporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement . . ,
3-Electrical Conduit Utility-Undrgrnd. 54. Forms ' ,I
4.1Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6.' Electrical UFER:Grnd. 57. APPROVAL TO COVER-GUNITE _ • '
- 7. Footings 58. Electrical Conduit-Undrgrnd. ,
8. Foundation 59. Gas Pipe, D Undrgrnd.,Test - I
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. RooPprains 64. Plumbing System - Final .
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
'16. Rough Electric Wiring 67. Fencing &Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE-DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71: Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough&Test .72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas D 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 j, HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 1 79. FINAL INSPECTION
32. Electrical Power Meter=Final 80. FOOD CERTIFICATE ISSUED If
'33>-Final ElectricNotes:
34. .Final Heating & Air Conditioning .„....2"--. r
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 1
•
47. FINAL STRUCTURE & BUILDING //Vfr
tar
-
48. Special Requirements Completed
49. Electric Release to Edison - ` •
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY .
No. Date s , - 1