HomeMy WebLinkAbout1968 CHURCH ST - Building Permits I $
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4111
i ' ^ CITY OF COSTA MESA
4$ •` BUILDING DIVISION
FA' •Ctl77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
.4.�f f FOR INSPECTIONS CALL:(714)754-5626
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PERMIT NUMBER B07-01027
PERMIT TYPE BROOF2 STATUS: ISSUED
j DATE ISSUED: 11/16/2007
_ . ISSUED BY: RMD
JOB ADDRESS: 1968 CHURCH ST CM. , Suite/Unit:.::
Vicinity: HOUSE AND GARAGE ROOF '
Squares: 1600 - -
Valuation: '$4,500.00
SCOPE OF WORK: TEAR OFF'(E)ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT ON A 4:12 OR GREATER PITCHED ROOF,
REROOF WITH 30 YEAR COMP SHINGLES ON A•DETACHED HOUSE AND GARAGE,APPROX.1600 SF.REPAIR AND
REPLACE SHEATHING AS NEEDED.:REROOF OF HOUSE AND GARAGE TO BE DONE CONCURRENTLY. '. _
OWNER: GORDON, SUSAN 0 NEILL; " , • Address: 1968 CHRUCH ST _ - • _ • Unit:
PHONE: 310475-2802 - _,:' City/State/Zip: COSTA MESA,CA ' ' •-
APPLICANT: BOLTON,CARL *: , . -. Address: 10657 STANFORD AVE • : Unit: :
PHONE: 714-636-5679. . City/State/Zip: GARDEN GROVE,CA •
CONTRACTOR: MR ROOFING SERVICES ' ' License No. 765080
Address: 10657 STANFORD AVUnit: _ PHONE: , , 714-636-5679
City/State/Zip: GARDEN GROVE,CA 92840 - CELL:
ARCHITECT: - - License No. _ j f - : PHONE:'.
ENGINEER: ' License No. - PHONE:
•
FEE SUMMARY •
•
-.
Reroof Plan Check:
Reroof Permit Fee: $111.25 . r. ft
Reinspection Fee: $0.00-.._ - : . .
TOTAL FEES $111.25 ' - ..
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE I. INSPECTION TYPE DATE INTTAL$ CODES INSPECTION TYPE DATE, INTnIALS
1616 Fixed System Final Fire Prevention 4 206 Final Mechanical
1266 Pool Spa Final - ,J 208 Final Plumbing
200 Final Re-Roof //--V-7 41 210 Final Electrical
201 Final Block/Retaining Wail /,/ 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
I . "I
I e
WORKERS'COMPENSATION DECLARATION: S Owner ID verified by driver. ❑Yes ❑No I •
1
I hereby affirm under penally of perjury one of the following declarations: Driver's License No. Expires: I
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property taz bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the I
performance of the work for which this permit is issued. I
❑ I have and will maintain workers'compensation insurance,as required by I
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 ❑ I hereby certify that no excavation five(5)or more feel 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,or demolition
[Carner�. /�fCKo. or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(Thissecron need not be completed the penal is valued at one hundred dollars($100)wless.)
2,Art 2,Sec.341,Title 8,California Administrative Code).
r
PolicyNumber: 0 002 39 9 2 0 D 5
❑ 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
beci'ect to the workers'compensation provisions of Section 3700 of
the s�MIfI fyp17 with comply with these provisions.
�/ Applicant's Signature Date
/n /��b/v y Division of Industrial Safety Permit Number:
`Applicant's signature bate _� 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 ❑ 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). I
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. /! a registration form for acutely hazardous materials? ❑Yes 1 ❑No
Li
c.,#- '7- ..5-92,5 Class —' L 3� (Section 25533 of the California Health and Safety Code, with some
i
exceptions, requires registration with the Costa Mesa Fire Department by
a.. / /,.(72t each business which at any one time has on hand a quantity of acutely
ContraUor's Signature -Dat 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). 1
❑ 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
,.7;-q ,c.'4.414.an RMPP is presently required, has Section 25534 of the California
"t :: , v .'Health and Safety Code been fully complied with? ❑Yes' 0 No
OWNER-BUILDER DECLARATIONS: ,t.'�,.
I hereby affirm that under penalty.of perjury that-1,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 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65650.2 of the California 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 feet from the outer boundaries of a school? ❑Yes, ❑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). 1
❑ 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? ❑Yes ❑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 forI
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
city ordinances regarding Hazardous Materials and Emissions.
❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH I
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 Ucense 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 authorise representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection pur sea I agree not to occupy or allow occupancy of any building
authorized "nit nit 1 inspection. /
/Signn/atpure/of Legal�lOOwner(s) to
Signature Date r[�dts 4 6 n L iOA. /7/7;a6_
3057<6(3b7) `-And/or.Authorized Applicant_ _ I Date__]
•
PROJECT ADDRESS: 1968 CHURCH ST • UNIT: 0 CITY OF COSTA MESA - BUILDING PERMIT - • PERM NO: E 044757 ..
OWNER'S NAME: .29 E FILARDI - •
• •
ADDRESS: SME . • PERMIT NO: E 044757 PLAN CHECK NO: N • GOVT: N SUPP : N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
• , .
• ARCH/ENGINEER: •
REO.NO.: JOB DESCRIPTION , : GARAGE SUBPANEL ' SQ FT:- •
ADDRESS: - UNIT: - • - -
• CLAIM •VALUE: CALC-VALUE: GROUP OCC : . . / •
PERMITTEE: JOE FILARDI ( 714 ) 548-5648 -
ADDRESS: 1968 CHURCH ST - COMMENTS : '
C .M. CA 92626 *�P+ *aP�rat**er* ******xitaE�d**�E***�P***********�E*er******eye**aEed**�a***�t+ r iter******nx*tr**.1t
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU I- R EMEN T S f
7000)of Division 3 of the Business and Professions Code,and my license is in fug force and effect. S E T. B A C K S -
CITY UC.: STATE UC.: CLASS: ' •
Date: Signature' • •
- MAIN BUILDING ---- - ACCESSORY BUILDING' -
WORKERS'COMPENSATION DECLARATION: self-insureIhereby affirm that Ihave acertifiateofconsent to '
or a certificate of Workers' FRNT: FT TN REAR: FT IN FRNT: FT IN REAR: FT IN'
•
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: • FT IN RGHT: FT IN LEFT: FT IN RGHT: FT I.N'
r POLICY NO.: EXP.DATE: - ,
COMPANY: PARKING REQUIRED :. PARKING PROVIDED : PARCEL: 42626405 ZONE:
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> - -
Date: Applicant: ***********..********************************************************************
EAENPf1ON FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit Is for one hundred(5100)or less). _ D ; E V EL O', P M E N T SERVICES REQUIREMENT S ,
I certify that in the performance of the work for which this permit is issued,I shall not employ ny p s in any manner so as to become •
subject to the Workers'Compensation LawsCalifornia. ON ING APPROVED BY +_ •
,DATE:
S9a /
Date: II h ISignature: //_2
NOTICE:If.atter making this declaratioh•you should bacon( subject the'Warkers'Compensation provisions of the Labor t tt W I LD I NG-APPROVED BY : _ DATE _
Code,you must forthwith comply with such provisions or t permit shall be deemed revoked. - .
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY : L ( —'L-'"' a
which this permit is issued(Section 3097,Civ.C). ********************** • `, . - ********** it** **44:1(**
' LENDER: ***********-*****************-***************************************************
ADDRESS: - LEGALIZATION: A1 . . FIE E' -..Sr- U 'M M 'A R Y . - - 'SIR1,7,CTURAL SEGMENT':N " .
•
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES •GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to consirucgalter,improve,demolish,or PERMIT . 11,00 -
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed . ;50t l SHIP/NON-=RES'
pursuant to the provisions of the Contractors'State License Law(Chapter,9(commencing with Section 7000)of Division 3 of the Business PLAN • •
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by . `11 '
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE- FEE 15 . 0 0 __ , •
• I as owner of the property or my employees with wages 'as their sole compensation, will do the'work, and the • BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID '.-; ' . DUE
.® structure is not intended or offered for sale(Section 7044,Business and Professional Code: -The Contractors'State License Law TOTALS----> 11 . 00 15 . 00 0 . 00 ' . 26 . 00 : 26 . 00 ,%. . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ' - .+-�- ••
his or her own employees.provided that such Improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 26 .00 OVER/SHORT:' �' -' . 00
.improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve '
•
or the purpose of sale). : BLDG PMT PLUMBLNG ELECTRIC- MECHANIC FIRE SMIP/TOT • 'GRADING"PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business • ?6 .'O O - •
a3
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • •
and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware - ***************************'*****************************************lt**********
that proof of their Worker's Campensation'insurance should be provided to me. IND IV IDUAL F E E B R E A K D O W N '
❑ I am exempt under Section: B.&P.C. r
for this reason: �� i. �lr) TYPE QTY DESCR IP T I- 0 N ' UNIT COST ,TOTAL COST .
Date: P .-X`� (Owner- i/all ELE 1' MISC APPARATUS NOT LISTED REQ PERMIT 11 . 00 11 . 00
I do hereby certify that I am aware of acid understand the requirements of Califo Health and Safety Code Sections 25505,25533,and • . END OF FEES
25534 and that I or any future building occupant wilUwill not(circle one)need to mply with said state codes and the requirements for a _ .. .. .
permit for construction or modification from theN�ua4ry Management District.Residential construction applications ale exempt from • . . t..tilt ,
these provisions. It '
Date:' Applicant: • e
I hereby certify that I have read this application and state that the information is correct.I gree to mply with all city and county •
• ordinances and state laws relating to building construction and here .lives of /s city t.- . upon the above-mentioned , '
•Property for inspection purpou5. i •
� ! .� / .
' Date: II— Signature: ' ' // - .
Drivers License or Social Security N: •
4• - �r —
1641-46 • White—Bulldino:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor �. ;•- -- -. • . E: i',11111): .T Iti-j Un::46
CONSTFtUCTION AND PLANNING - . - Pt...l & SPA - - - .
APPROVALS . Permit Date Inspector APPROVALS Permit #
• Date Inspector
` •
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location .1
2. Soil Pipe-Undrgrnd. " - 53. Steel Reinforcement " ' j
-'33.. Electrical Conduit Utility-Undrgrnd. • 54. Forms "
4. Electrical Conduit-Unargrnd. _ 55. Electrical Bonding ,- •
r 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 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 I
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap - 63. Heater & Vent-Final
. j
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 &Aii Conditioning - ' • - .- ' FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . r . 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 0 Oil
25. Roof,Sheathing • 74. Overhead Hydro
26,T-Bar Ceiling (Structural) & Monocoat J 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: - V '
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
1
41. Solar Domestic-Final • . ' , . •
42. Backflow Preventer . .
43. Backflow Irrigation - -
_44.. Landscape Irrigation System . - '
45. Sound •Attenuation E X P I.R E D
46: Handicap Regulations - -
Inwn,pI t InsP -tions
47.- FINAL STRUCTURE & BUILDING-- -• - Vote Y�/ Sig _
48.FINAL PLANNING Il
49: Electric Release to Edison
50. Gas Release to Southern California Gas Co ' "-- ._ - •
51. CERTIFICATE OF OCCUPANCY
No. Date i
PROJECT ADDRESS: 1968 CHURCH ST UNIT: 0 CITY OF COSTA MESA' — ;BUILDING PERMIT PERM NO: E 044756
OWNER'S NAME: JOE FILARDI - - -
ADDRESS: SAME PERMIT' NO:- E 044756 PLAN CHECK NO: N GOVT: N SUPP : N
CONSTRUCTION 'CYPE: PERMIT TYPE: EL; PURPOSE: O'I'H
•
1
ARCH/ENGINEER: = RED.ND.i •
JOB DESCRIPTION : UPGRADE METER SQ FT:. I `
A • - ADDRESS: UNIT:
PERMITTEE: CLAIM VALUE,: • _ CALC-VALUE: , " ,GROUP OCC: /. )
ADDRESS: JOE FILARDI r ( 714 ) 548-5648 .
' 1968 CHURCH ST COMMENTS: •
•
C.M. CA 92626 *+c*IE*Nva*****SEN***�r***->E** ** iE******x�rN•i��a�r�a*N•***>t*N-x�a*** •*�k******* ******1***N*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZO NING R E Q U I R E M E N T S.
7000;of Division 3 of the'Business and Professions Code,and my license sin full force and effect. • S E T B A C K S • •
CITY UC.: STATE LIC.: CLASS: .
Date: ' Signature: = MAIN BUILDING ACCESSORY BUILDING -.-------- ,
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT . IN
Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: ' FT IN LEFT: FT IN RGHT: FT : IN t
' POLICY NO.: ' , EXP.DATE:
COMPANY: PARKING REQUIRED : PARKING PROVIDED: PARCEL : 42626405 ZONE:
0 Certified copy is hereby famished.. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> '
_ >. . • .
Date: Applicant: *******************************1E****************Yr**** ****jF********************.
•
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be complete if the permit is far one hundred($100)or less). DEVELOPMENT; S.' E R V I C E S REQUIREMENTS ,
I certify that in the performance of the work for which this permit I 'sued,I shall no 1 plo person in any manner so as to become
subject to theorkers'Compen tion Laws a California.
/y4 ZONING APPROVED BY 'DATE:
Date: /1 — 1 v 'Signature: - WM r/ - - —
NOTICE:If,after making this declaration,you should bee e subject to the Workers'Compensation provisions of the Labor BUILDING AP PROVED BY : �- • •DATE :',
Code,you must forthwith comply with such provisions this permit shall be deemed revoked.: - 1 •j p
•
CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for APPLICATION ISSUED ' BY: . ... DATE: ` '_ 1
which this permit is issued(Section 3097,Civ.C). ******************************************************* *.*.**.*.#**** * FN*
UNDER: *********************************Jf*********************************************
ADDRESS: . , LEGALIZATION: N - F E E S U' M M A R Y - STRUCTURAL SEGMENTA N
OWNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors'State License Law for thefollowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT , 1 8 . 50
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed • S O% SMIP/,NON-RES '
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing wfth Section 7000)of Division 3 of the Business - _ I I •
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ', 'PLAN ' ' •
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). .ISSUE FEE ' • - 15 . 00
.I, as owner of the property or"my employees with wages as their sole,compensation, will do the work„and the q BUILDING-DIV- > PERMIT "ISSUE. . PLAN-CHECK TOTAL PAID .DUE
tJ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors State License Law ' TOTALS--———> ' 18 . 50 15 . 00 - 0 . 00 33 . 50 ' • 33 . 50 i . 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through • •
•
-his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or r TOTALS—._ r
improvement is sold within one year of completion,the owner will'have the burden of proving he/she did not build or improve 'REVENUE DIVISION TOTALS > COLLECTED : 3 3 . 5 0 OC ER/SHORT:. . 00
' for the purpose of sale).. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 'SMIP/TOT GRADING PLAN—CHECK
1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 33 •-5 0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon '
and who contracts for suchprojects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware ***************************************)E******************.**********.N.***.N.****** '
that proof of their Worker's Compensation insurance should be provided to me. • 1 INDIVIDUAL F E E B R E A. K D O W N
❑ I am exempt under Section: B.8 P.C. 1 1 O '
•
for this reason: J//E/,IL,✓All TYPE QTY •
D E S C •R I P T I O N UNIT: COST, TOTAL COST
Date: ')— I — I Ower: I ELE 1 SERVICES BELOW 600 V & BELOW 200 AMP 18 . 50• ' 18 . 50
I do hereby certify that I am aware of and understand the requirements of Califs a Health and Safety Cade Sections 25505 25533,and ENDO F FEES '
25534 and that I or any future building occupant will/will not(circle one)need to mply with said state codes and the requirements for a. ,
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from • ' •
these provisions. .
'
Date: Applicant:
I hereby certify that I have read this application and state that tit a information is corre t.I ag -to comply with all city and county t
ordinances and state laws relating to building construction and he by utho'.' . - -ntat ••ol� t to enter upon the above-mentioned .
property for inspection purpose;. , / .
•
Date: II - I _ Cl1 (Signature: , L • • t _ _ _, _
Diver's License or Social Security N: •
f;' '.,,,:.4,--.,-,-,,,: �'•: �° "-'
itEe 1 !J.: 9 tirir': 7:—,5
1641-48 White-Builds Green-Code Enforcement;Canary-Applicant: • . . .
White-Building: Pink-Revenue;Goldenrod-Assessor
.
• CONSTRUCTION AND PLANNING - - POOL & SPA I
APPROVALS Permit# Date Inspector APPROVALS Permit # •-• Date 'Inspector
1. Temporary'Electrical Service or Pole - ' . 52. Pool & Equipment Location
s I
2._Soil-Pipe-Undrgrnd. . - ' 53. Steel Reinforcement .
3. Lifttrical Conduit Utility-Undrgrnd. 54. Forms ,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •
• 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test '
,46. Electrical UFER Grnd.- . • • 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 ' ' •
1 61.'APPROVAL TO DECK
11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final •
12. Sewer Cap 63.. Heater & Vent-Final I
- I
13. Roof Drains , . 64. Plumbing System - Final - .
14. Rough Plumbing 65. Electrical-Final - •
15. Rough Electrical-Conduit 66. Solar System-Final - - -
• 16. Rough Electric Wiring - 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL -
19..Rough Heating & Air Conditioning , . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace _ • APPROVALS . Permit#
21.(Ducts, in Structure - - - `70. Underground Hydro '
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil -
23.iGas Pipe-Rough & Test • • ' i " - 72. Underground FIOsh j
24. Roof Framing - . 73. Undergrnd.Storage Tank 0 Gas ❑Oil
25. Roof Sheathing - - r 74. Overhead Hydro -
26.1T-Bar Ceiling (Structural) & Monpcoat . - 1 . . 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 • - • • r - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - _ -^ - 79. FINAL INSPECTION
32. Electrical Power Meter-Final /f 4 80: FOOD CERTIFICATE ISSUED
33. Final Electric - - Notes:
:..34. Final Heating& Air Conditioning - - ..
35: Final Gas Pipe-Test •
•
36.1 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 i
45. Sound Attenuation .
46. Handicap Regulations - - ,
-.477F!NAL STRUCTURE & BUILDING -
48_FINAL PLANNING - T
.49. Electric Release to Edison
-
50. Gas Release to Southern California Gas Co - -
51. CERTIFICATE OF OCCUPANCY
No. Date •
n
.. .- —1 •
•
COUNTYBUILDING DEPT.. 3 3Q '
' 630 No.Broadway Permit No /
a Santa Ana,California • • Application for Building Permit , - -
` Phone:KI 2-6211 AND FOR A •
Certificate of Use and Occupancy•
Date ... ./ 9- 57
1. OWNER'S NAME F. H• Paulsen PHONEBeanon---6?491
MAILING ADDRESS-----.-258--Sante.--Isabel' CITY-.-Costa... mesa.
Name _Omer Name Owner
(Architect or Engineer) (Contractor)
Address Address
City City
State State
Lic. No Phone Lic. No Phone
PROPOSED USE- Dwelling •
•
2. JOB LOCATION 1966 Churchh--Stree-t- Costa--Mesa
(House No.) (Name of Street) . (Town or School District)
•
3. LEGAL DESCRIPTION: Lot Block Tract
(Metes and Bounds DescriptionUse reverse side of form)
4. CORNER LOT ( ) INTERIOR LOT ( ) THROUGH LOT ( X ) SLOPE OF LOT ( )
5. SIZE OF BLDG.:--.30_.8---41 ....--..AREA:--...9.Q0SIZE OF LOT-46 a 275 AREA- 12650
6. HEIGHT OF BLDG.:--.12 t CEILING HEIGHT- 8'4" NO. OF STORIES 1
7. NO. FAMILIES 1 Size of Smallest Bedroom- 10__..x 11 Size of Kitchen 10 a 10
8. EXTERIOR WALL CONSTRUCTION• StrJ Q.CO INTERIOR WALL COVERING Plaster
(Frame, Stucco, Etc.) (Plaster-Drywall, Etc.)
9. SETBACKS: Front Yard From Center Line of Street 5.0'
Nearest Side Yard----5 I On Rear Yard 71' Distance in Feet Between Bldgs. on Same Lot24'0"
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width 1!2" Depth in Ground 11 Width of Wall 6"
Accessory
Bldgs. and
Similar (b) Size of Studs- 2 a 4 Spacing 16 "CC Material of Floor Oak
Structures:
(e) Size of Floor Joists: .2--.5...6 Spacing .16 "CC
(d) Size of Rafters- 2 ]r 4 Spacing 24 "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $- 40---- d-
R
7 d
G
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND-THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed t •�Ufr
Plans Filed- / 0 — (Owner)
By•
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
FEES: ry/i �s� CHECKING BY
Bldg. Pcrmit - $-f(� e v GROUP.. .-.�. APPLICATIOIVe.6r. HEALTH
Plan Check - $ 1„-02) TYPE--. FIRE
ZONING �� -- MARSHAL
Total - - - $..0-?...6.11.19 DIST. ,+ PLANS AND
Receipt No. IPI.O-G MAPii? SPEC'S 4-t STATE,
Paid to - - e�+etAl_--_--- SHEET NO... CORRECTIONS ENGINEER
Date 7--'/9_--_t--- VERIFIED 11
11 CAL
PERMIT •
"'fieri E CzUN :U L•1I • .
�l`( -�1 = - -. •
f Pct6G
DATE II /
•
SM-3.51 ,ter — -D Pt E”,tTV• _
e.--fit.
rf
i , r . .
, METES AND BOUNDS DESc_1.�PTION: The Northeasterly Elba 05 feet of Lot 191, of
Nempnrt Heights, as per crap thereof roaorded in Book 4, Pa-o 83, Miscel.
Maps, Records of Orange County, RXCRPT the Northrnesterly_30 f.
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COUNTY OF.ORANGE , . t
. „. . , . . . -
• -• BUILDINGDEPT. - - . . ., ... .
Permit No..3 --C-92rr•S ..
S.6an3t6a NAon.a,Bcaroaliclfwoay.a • , .
Application. Far Building Permit •
.,
,...
- • .
Phone:KI 2-6211 - AND FOR A
. ,
. . ' Certificate of Use and Occupancy
... .
Date / I—
_
I. OWNER'S NAME F. H. Paulsen • • nioNlisaaon...67491...
MAILING ADDRESS 258 Santa Isabel Stbeet, . CITY Costa Mesa
Name Owner . Name ' .
ownpr • . .
(Architect or Engineer) (Contractor)
Address Address
•
City ' City •
State Stale .
Lic. No Phone Lic. No Phone
PROPOSED USE:. Garage - • . • • • . ,
' •
• 2. JOB LOCATION 1.9.6&Chun& Street., 000a Mesa,
(House No.) (Name Of Street)• - -• ; ; (Town or School District) .
3. LEGAL DESCRIPTION: Lot Block Tract
(Metes and Bounds Description—Use reverse side of form)
4. CORNER LOT ( ) • INTERIOR'LOT ( ) THROUGH LOT ( X ) SLOPE OF LOT ( )
5. SIZE OF BLDG •18 x 20 AREA- 3609 SIZE OF LOT' 463[275
AREA' 12650
• 6. HEIGHT OF BLDG • 10'
CEILING HEIGHT•9 I
NO. OF STORIES 1
7. NO. FAMILIES Size of Smallest Bedroom. . Size of Kitchen
S. EXTERIOR WALL CONSTRUCTION- Stucco. INTERIOR WALL COVERING !WOO
(Frame, Stucco, Etc.) (Plaster-Drywall, Etc.)
241
9. SETBACKS: Front Yard From Center Line of Street from rear house
2' 1710140'
Nearest Side Yard Rear Yard Distance in Feet Between Bldgs. on Same Lot .
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
,
11. For (a) Footing: Width 14" , Depth in Ground 12" Width of Wall 6"
Accessory
Bldgs. and 2x4 . 16 Cone.
Similar• (b) Size of Studs. Spacing "CC Material of Floor
Structures:
(c) Size of Floor Joists' .
'Spacing .
"CC •
(d) Size of Rafters 2x4 Spacing 24" -cc_
12. VALUATION OFPR le a IF.0.$&D WORK: Including all labor, plumbing,electrical wiring, heating, fire sprinklers, painting and
--a-u
sewage disposal $
n
13. I HEREBY CERTIFY7TIkrTO THE BEST OF MY KNOWLEDGE AND 'BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OP
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed- °TA: rirn..- -----
Plans Filed. q%./ 9 '- S7 (Owner)
By-
(Authorized Agent)
. • .
FOR DEPARTMENTAL USE ONLY
FEES: ..----. 1 ‘ , 2-11c1CING BY
Bldg. Permit • $ q_ 00 GROUP
APPLICATIO/ HEALTH
Plan Check • $ 4120 TYPE ' - ZONING ;.1 FIRE .
Total - - - $ .S.---00 DIST.
Receipt No. MAP .
Ce, Ry PLANS AND MARSHAL
• b./.84.
SPEC'S /it. STATE
Paid to • • .44:4,42....... SHEET NO Sr CORRECTIONS ENGINEER
Date -'19-7.3".1 VE t TED /
CAL
, . . r :•-Dr--
O-t-
.N—O_H r. COUNTY
PERMITISS EtIY - _ INSRiSCTUO:LR
DATE O
ING .
SM-2-51 • • -- ••- • - - -- --- ---.: .. . -. --......,...
C fr".
•
. wk. . ,
METES AND BOUNDS DESL__sPTION: The Northeasterly 4 .05 feet of Lot 191, of -
Newport Heights,. as per map thereof recorded in Book 4, Page 83, Misce1 _
Mans . Records of Orange County, EXCEPT the Northwesterly 305 feet thereof.
•
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