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Home My WebLink About1614 BAKER ST - Building Permits 0 161#.1.6 S li - CITY OF COSTA MESA o`mweBUILDING DIVISION 1 0•11111 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us u, FOR INSPECTIONS CALL:(714)754-5626 ''°TMS^°"" PERMIT NUMBER: BC11-00368 PERMIT TYPE: B_COMBO STATUS: ISSUED i3 il 0007/p Sub Type: RES_ALT DATE ISSUED: J07/25//2011 ISSUED BY: �o VV JOB ADDRESS: 1614 BAKER ST CM Suite/Unit: • APN: 13919230 Zoning:R1, , Vicinity: Primary Occ: Const Type: V-B SQ. FT: 0 Valuation: $5,950.00 SCOPE OF WORK: HOUSING REHAB PROJECT. CONSTRUCTM 3- 10'X 12'ALUMAWOOD SOLID ROOF PATIO COVERS. ICC/ESR 2676. REPLACE WATER HEATER WITH NEW 40 GALLON WATER HEATER, REPLACE GAS PIPING TO FURNACE. BRING ELECTRICAL WORK IN THE GARAGE UP TO CODE. MISC CONDUIT,ADD 4 OUTLETS AND 1 LIGHT FIXTURE. DEMO EXISTING ENCLOSED PATIO ROOM. - OWNER: MALIKIAN,BERGE Address: 1614 W BAKER ST Unit: Phone: 714-545-7295 City/State/Zip: COSTA MESA,CA • APPLICANT: HOPPER,TOM Address: 915 LAKE STREET Unit: : Phone: 714-960-7052 City/State/zZip: HUNTINGTON BEACH,CA . CONTRACTOR: J K CONSTRUCTION License No. 450297 . Phone: 714-404-9846 CELL Address: 915 LAKE STUnit: Cell: 714-960-7052 City/State: HUNTINGTON BEACH,CA ZipCode 92648 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $81.41 tBulldiing Fees: $125.25—f 1 /�. Electrical.Eees;� X47":20" 7 o -p( vMechanicaFFeesj 1.L$3330—� r7/ ��r� �Iu�g Eges:-fi L$33:30—� 2 / SMTP Residential: $0.60 • SMIP Commercial: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES: $318.41 *Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010- PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day,Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE INTITIAL$ CODES INSPECTION TYPE DATE INPTIAL$ 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ _ 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 2o1 Final Block/Retaining Wall _ • 212 Final Fire Prevention 2d2 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign _ 222 Final Site //�� rAT� r� 204 Final Demolition 250 Final Building/Occupancy FT/!•. '1/ Q_ M _ WORKERS'COMPeNSATIObLDECLARATION: . - Owner ID verified by driver s license. ❑Yes ❑No I hereby affirm under penalty ofperjury 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 rkers' mpensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: v�� person is required to no il will be made in connection with work zed {-- by this permit.and that no building structure,scaffdding,falsework,or demolition Carrier: 1 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need rd r� teet the perm i3 valued atgtq id dwars(sra0)abssJ 2 Art2 Sec.341 Title B,Califomia Administrative Code). PolicyNumber: ( (b� 6 C(/ 5/ ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in th- •'rfo mance of e work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not e ••oy any •erson in . y manner so as to become subject such person has a permit to do such work from the division. to t - workers't• pensati• laws of alifomia, and agree that if I should . becom: subjec o the wo ers'co •e •ation provisions of Se ion 3700 .f he Lab. Cod ,I shall fo 'with c."p • 'th these provision Applicant's Signature Date Al] Division of Industrial Safety Permit Number: i ape!at r Signature Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: • ••NING FAIL •E TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and UNLA -• 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? ❑Yes ❑ 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 Prole;isions Code, and 2. Does or will the applicant or present or future building occupant need to file my license's in full lorffec 1.///. a registration form for acutely hazardous materials? ❑Yes 0 No SClass# (Section 25533 of the California Health and Safety Code, with some /7 exceptions, requires registration with the Costa Mesa Fire Department by �'/ �/j (�/l 1 each business which at any one time has on hand a quantity of acutely . ;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 CO. : RUCTION LENDING AGENCY: temperature and pressure). S 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 0 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: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? 0 Yes ❑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 the Contractors (Section 65850.2 of the Californian Government Code requires that the requested ed License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications fa non-residential building permits). 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 feet 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 0 No thereon,and who does such work himself or herself or through his or her own 8 (If yes'.attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for • control officer). sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she 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 property, 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 ❑ 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 agr•' not to occupy or allow occupancy of any building authorized by this permi •ntil fin./'nspection. Signatu : ' . 4.!. 's, Dat y / , iSignature Dale - 3057-46 1 -/ JO6z61JIW 1 And/or Authorized Applicant CCC to 1 • CITY OF COSTA MESA Oslfl A'F BUILDING DIVISION i. ,. e 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us F1 I FOR INSPECTIONS CALL: (714)754-5626 4Cleft;rn" PERMIT NUMBER: B11-00219 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13919230 DATE ISSUED: 07/25/2011 ISSUED BY: KJB JOB ADDRESS: 1614 BAKER ST CM Suite/Unit: Vicinity: RESIDENCE AND ATTACHED GARAGE Squares: 0 Valuation: $7,750.00 SCOPE OF WORK: HOUSING REHAB PROJECT.TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATHING AS NECESSARY.COVER WITH CLASS A-30 YEAR COMP SHINGLES.ROOF PITCH IS 4:12. REPLACE DAMAGED FASCIA. 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 OWNER: MALIKIAN,BERGE Address: 1614 W BAKER ST Unit: PHONE: 714-545-7295 City/State/Zip: COSTA MESA,CA APPLICANT: HOPPER,TOM Address: 915 LAKE STREET Unit: : PHONE: 714-960-7052 City/State/Zip: HUNTINGTON BEACH,CA CONTRACTOR: J K CONSTRUCTION License No. 450297 Address: 915 LAKE STUnit: PHONE: 714-404-9846 CELL City/State/Zip: HUNTINGTON BEACH,CA 92648 CELL: 714-960-7052 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY J2eroof Plan Check: . $0.00 Reroof Permit Fee: . $153.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 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 • 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 required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE INTITIALS CODES INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 8-I a- 11 DG by d) 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 DECLARATION: Owner ID verified by driver.ircense. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O 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. O 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 worker compensation Insuranc97 carrier and policy 0 I hereby certify that nce d,will be five nfeet in depth into oa number are: .1L/Z_ U^/ person is required to descend,will be made in connection with work authorized (/ice by this permit,and that no building structure,scaffolding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm (This section need not be fDmpl tithe perme is Valued al one hundred doners(5100)or lesSJ 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ( R". 6 SC 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of t•- ork for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued.I shall not employ an person in . • anner so as to become subject such person has a permit to do such work from the division. to the workers' compensate'n laws o - ornia, and agree that if I should •-come - bject to the wo rs'Co •- sation provisions of Section 3700 of Applicant's Signature Date t - Labor C.de,I shall it 'th co.,.p. r these provisions. ///�L 7 /..— /� Division of Industrial Safety Permit Number: is ignawre' Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: -' ING: F•r TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and UNLAWFI 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 Pro slops Code, and 2. Does or will the applicant or present or future building occupant need to file se s i fe•I force a d effect. a registration form for acutely hazardous materials? 0 Yes ❑ No, "/) Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by Titsrfi these ' . 7 ��4 � each business which at any one time has on hand a quantity of acutely '.�gnature ' - a e 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 CO RUCTION LENDING AGENCY: temperature and pressure). Si 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 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: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? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for 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 feet 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 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 ❑ I. as owner of the property. 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 Dale 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 ❑ 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 t• er cupy or a •w occupancy of any building onze• • is permit until cis, spectio• Signatur' of - er(s) Dat Signature • Dare 3057-46(3/07) And/or Aut ICApplicant Date - - - _ _ r _ - -_ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • _ ape .e/05 86 _ . _ 7.Q- �` r• _ PERM T NO. TRACT NO. LOT NO. UNIT NO. CITY OF,COSTA/N/ESA CONSTRUCTION PERMIT oZ �g�,7 • • 1 /Project Address 0/y /..$01. 7a 4' • ef. ea/ref ("4,$ .Co • - ' Applicant's Mailing Address G�l/� 7� •�/S��I(s �} TYPE OF CONSTRUCTION NEW U ADD Li ALTERATION ❑ REPAIR ' 'Owner's Name• O PAQE �n'/jr/1/ta-10 Phooe Se/c•12,6 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P.# Zone DESCRIPTION OF WORK/USE OF BLDG. • Address /4/el LfI a A KI/` S Main Building: • Accessory Building:, LI• Z Arch/Eng. License No. - TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL • T Front -O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ' - N ('') r1 ,, ❑ OTHER - a . _ _ - . _ . _ _ A Rear . Contractor's Name r — C,41;443D-, Phone -• - - - - I '7' PROJECT DESCRIPTION SQ. T. OCCUPANCY C Right N Address(mailing) / 1 K G CONSTRUCTION TYPE-_ • ,VALUATION$ S Left City License No. R LICENSED CONTRACTOR DECLARATION ZONE GRADING CU.VDS. ACRES Ping. Ref.# Parking Req./Provided E O I hereby affirm that I am licensed un ter'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. - • ' License Class License No. - S Date - Signature PLUMBING FEES - - - • WORKERS'COMPENSATION DECLARATION Bar Sink • Showers ' I hereby affirm that I have a certificate of consent to self-insure or a certificate - ELECTRICAL .. FEES • of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow'Preventer' • Service Sink ' Automatic Washer, Transformer ❑ 15-50 KW 3800, Lab. C.) _ '• ! Policy No. Company Backflow Irrigation Sewer Ca d 0 50+1KW P - Construction.Pole Sub.' • ' 8 Certified copy is hereby furnished. - Certified copy is filed with the city Building Division. Bathtubs Sewer Connection _ - Cooking Unit - Meter Dup to 100 amps • Date • Applicant - - - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors.- Dishwasher - - - Meter Dover 100 amps (This section need not be completed if the permit is for one hundred($100) or - less). Dishwasher Solar Piping -. Dryers ❑Gas ❑Electric Sub Panel - I certify that in the performance of the work for which this permit Is Issued, I - - - shall not employ any person in any manner.so as to become subject to the Drinking Fountains t Solar Tank Fan Motors❑O-1 HP 01A-B - Workers' Com pensat Laws of Califo • Date g [..-' _Signature .��L7 p /4a�a� Floor Drains Swimming Pool w/Spa i • Inc.Solar ❑9.15 HP_016-15+" _ • • NOTICE: 11,-after making this declaration,-you s could becomeS1J'117at-t-sd the - - - - - -• Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' • comply with such provisions or this permit shall be deemed revoked. Urinal Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet ,hereby affirm that there is a construction lending agency for.the performance , Device Boxes Pole Light of the work ,fowhich this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets ' Range ' Lender's Name �CDOa Lender's Address ' • -- - - • Kitchen Sink - Water Service - ' - Switches - • OWNER BUILDER DECLARATION Sign • I hereby affirm that I 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 ❑0-5 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 1 - 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 7031.5 by any applicant for a permit subjects the applicant to a civil - e ty of not more than five hundred dollars($500). 3 , I, as owner of the property Reinspection Fee ` $15 - Issue Fee $ - will do the work,and the structure is not intended or offered Reinspection Fee - .$15 Issue Fee $ 3 r sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I 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. It, however, the building or improvement is sold within one year of corn- • Canopy Type II ❑ Zoning Approved By Date prove 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 sale). In" ❑ 1,-as owner of the property, am exclusively contracting with licensed-con- Duct-Structural I Refrigeration System - Application Issued By Date tW rY . • tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who . Duct-Ventilating O-100,000 BTU ❑100,000 BTU 4; .Ob SUMMARY OF FEES - builds or improves thereon, and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be Exhaust System 0 Multiple 0 System Repair/Alteration p provided me. PLAN-CHECK $ - PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE' $ Dates( — owne Heating System& Ducting Registers PLAN CHECK 25% $ _ ENERGY P.C. $ • I hereby certify that I have read this application and,state that the above 00.100,000 BTU 0100,000 BTL GRADING . - $ ' - information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ , and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50%- $ - MICROFILM $ sentatives of this city to enter upon the abve-mentioned property fo inspection pu/lCu^or^esp. L / (� - MECHANICAL $ fl• 0 v TOTAL FEE $ I• DC1 • Signature /..1 'etc laeukion Fee $15 Issue Fee IFPLAN CHECK 25% $a CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink-Accounting; Goldenrod - Assessor . , CONSTRUCTION AND PLANK. J ' OOL&SPA APPROVALS Permit# 1 Date Inspector - APPROVALS Permit# Date Inspector - 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement. 1 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding . 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test v 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. a 8. Foundation - - 59. 'Gas Pipe, 0 Undrgrnd., Test ' • 4 I 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O.Undrgrnd. - 10. Structural Floor System • 61. ,APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • 14. Rough Plumbing - - • 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring - 67. Fencing & Access Approval . • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • 20. Rough Factory FireplaceAPPROVALS 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 Framing73. Undergrnd.Storage Tank OGas 0 Oil • 25. Roof Sheathing • 74. Overhead Hydro 26. T-Bar•Ceiling (Structural) & Monocoat ' - 75. Dry Chemical 27. Frame and Flashing _ 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 4.1-'(47(. LSO 35. Final Gas Pipe-Test • 36:-Hood or Canopy ' 37. Final Factory Fireplace - - %38. Final Plumbing - - • 39: Water Service-Final 40. Gas Service-Final i M . 41. Solar Domestic-Final 42. Backflow Preventer -:43. Backflow Irrigation 44. Landscape Irrigation System 9..45. Sound Attenuation ' 46. Handicap Regulations 47. FINAU 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 ., - ' OWNER COMESA;:i ING.INC' DATE 6-3-59 JOB ADDRESS 16114 Baker St' BUILDING PERMIT NO. 9500 Dike & Colegrove 1b552.30 � GENERAL CONTRACTOR VALUE $ «-`ajslo. LOT 88 TRACT 2822 FIRE ZONE DESCRIPTION OF WORK 9.SJjatt.Uar. ` It`Fi PECTIONS 6.,,.4,--4.Q DATE I GROUP I & J TYPE V ZONE R1 Underground Soil Nu< U.G. Water$4-1, G-9 54 SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gas Rough Heating bla 7-y%•y'fiil��r'., I , ; J On f05f,,0 r Rough Plumbing U -Si'. 7-#0-S ,4_ I. �, O- -5/ 7(20;), 7 Miscellaneous Prop. SwrCLinr Houtd`on. St. Swr. 7,/,_34--). '.-t<-.-.c • 7/,''.�/ S 9 /�.—c n W/7-+) Sprinkling System / Heating, Final • /!f%-S f-/7-S9 :ter -44 Plumbing Fixtures Ale '-/7-31 + Final Gas Test Jr' />44S y-17--C 9, Construction Pole / Underground Power Rough Wiring, Iiltl. bilin 3e, �an.✓ Y GIJ_, e,e-,er y 9- i-,S7 9,5771 TrenchesIrp-Forms er Steel - 4.17 /..{9 Floor System Steel Reinforce Chimney Re-Rod Id Beam lathing l:M'IJ- t f1"' Frame and Flashing / /j':1. 7-2-7 ->/ Lathing, In Out ./(102,1- f1''-2L •Cf-T' Plaster, brown coat -j(}f d- 4-I-f Plumbing Fixtures, Final /7_5, Electric Fixtures, Final �� /7 re Building, Final /, ( OCCUPANCY I Form 210-3M-4-59 • • 9500 -.L SR L.LII.:. JJ :.I cog- JUN 3 1969 COSTA MESA BUILDING-SAFETY DEPARTMENT I"Ilt15iCE DEPT. P.O.BOX 317 COSTA MESA, CALIFORNIA C11C,'+r ; n In r Mice:. FOR APPLICANT TO Flit IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING361L. Baker St. ADDRESS COSTA MESA, CALIFORNIA FOR OFFICE. USE ONLY RECEIPT NO. I PERMIT NO. OWNER Comesa, Inc. MAIL RECEIVED DATERECEIVED DATE U ADDRESS L19 E. 17th St. B- _� s/ 6J--_5 / CITY Costa Mesa TEL181159 BUILDING ADDRESS ARCHITECT Carlson & LIC. COSTA MESA, CALIFORNIA OR ENGINEER Middlebrook NO. ADDRESS Garden Grove FIRE ZONE +Y1+ U'/ Tripe V Group f'o,-- CONTRACTOR& Colegrove, Inc.L STATE IC. TEO. 167293 AAPPROVED DATE ADDRESS 4119 E. 17th St., Costa Mesa ZONING LEGAL LOT 2822 ZONE /q NO.OF USE OF NEW DESCRIPTION I NO. gg BLOCK TRACT I / PLANS I BUILDING JJ /(, APPROVED // J /� A.P.NO. BY f'" DATE (o/ J 7 SIZE NO,OF SLOGS. OF LOT 60 X 104 NOW ON LOT none YARDS REQUIRED ALLOWED USE OF (CENTER LINE EXISTING BLDG. none FRONT FT. IN. SETBACK LINE FROM CENTER of STREET 69 REAR YARD 261 R.SIDE S FT. IN. SIDE YARD I LEFT 51 I RIGHT 5' L.SIDE JFT. IN. DESCRIPTION OF WORK • REAR �-D P Fr IN. . NEW I % II ALTERATION I II ADDITION REPAIR I II MOVING 1 II DEMOLISH BUINO.OF SIZE1L50GING ROOMS 6 STORIES 1 • EXTERIOR WALL ROOF • COVERING Stucco COVERING Shingle USE OF BUILDING AND WORK TO BE PERFORMED Single family residence with attached double gairage Plan 1J1ag 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 COM- PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTIION..� rvJ�.j VALUATION SIGNATURE PERMITTEE OF- d�V PERMIT FEE $34 00 �//J/ $ PLAN CHECK $17.00 14,552 Dike AGENT ^ ' e & Colegrove, Inc. TOTAL FEE $51.00