HomeMy WebLinkAbout919 OAK ST - Building Permits'PHQIECT pUONESS: 9 1<j OAK ST . uxiT:
OWNEf�NRME: GUY PAGE
' aonxEss: g 1 9 OAK ST �
� •' COSTA MESA
: � CA 92627 '
(714)838-4933
�N(INIENGINEEP: �� " HEO.NO.:
• j ROUPESS: � � UNR: �
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„ �PEHMITTEE: M D CONSTRUCTION (714)838-9933
nooxess: 1707 P:O, bOX
�' SANTA ANA CA 92702
110ENSFD CONTMCfOB OECUMTION: I Aerehy affirm that I am licensetl unUer proNsions ol C�apter 9(commencinA'�'i�h Section
7000) oi Division 3 af t�e Business antl Protessions Code, an0 my license is in full force anG ellec
ciTruc.:042514 sTa�uc.:369470 cus: -29
Oate: �o — 7 �- � � Signature:
�
WOBNEpS'COMPENSATIONOECUMTION: IherebyaKrmihatlhave eNlicateolconse uoSNbinsumoracMiilcateoiWod¢rs'
Comcensation Insuranc g[ cp�rf�j eQ wDY �hereof (Sec[ion 3800, LaD. .
POLICY NO.: NWC� b� 7`� J E%P. DRlE: 1 I 1 S I J
coMraxr: GOLDEN EAGLE ' �
❑ CenifieE copy is hereby tumis�eG. L� Cetlified copy is fileE vnN the /c'�ry/�puilUinO Oinsip/n �
Date: G � 7-- � r% Appliwn� � ��✓� �� �N "%� �v, �
IXEMPfION FHOM VlOHNEHS' COMPENSPTION OEClAN1TI0N_� (tlws section nee0 not— be complete0 A ihe permii is for one huMreA (5100) or less�.
I cerliry that in the De�ormance of ihe work for whicA this permit is iuue0, I s�all not emD�oy any Derson in any manner w as ro bewme
SUDIe�� �0 the Workers' Campen5ati0n Laws of Califomla.::"
�ate: � ' SiAnature:�
NOTICE: I�, atter makinA this Oeclaration, yau shoultl-become subject ro IAe Workers' ComOensation Dravisions of the LaDor
CaAe, you must fartAwith comD�Y ��h such Drovisions�or ihis permil shall �e tleeme0 revokeU.
CONSTBUCTION LENOING 1GENCY: I hereby attirm thal there is a consiruction IenOinA aAe��Y �or the pedormance oi the woB tor
wAich this permit is issueA (Section 3W7, Civ. C). '" .
�ENDEP:
aooeess: . .
OWNEB BUILOEB UECLAMTION: I heieby affrm ihat I am axempt from the Contractors' State License Law tor t�e followinp reason
(Section 7031.5 Business antl Pmfessional CoOe: Any city oi counry whicA reQuires a permit to constmct, atter, improve, damolish, or
repair any simcNre, prior to 8s issuance, also requires the applicant for such permit ro file a signea statement that he/she is IicenseA
pursuant ro the pmvisions oi the Coniractors' State License Law (ChaD�er 9(commencing with Section 7000) oi Division 3 0l t�e Business
an0 Professions CoOe) or that he/she is exempt IAereirom an0 Ihe basis for Ihe allepeG axamption. Hny vlolatian of Sec[ion 7031.5 hy
any applicant for a permit suble�s the aDPlicant ta a civil penalry of not more ihan tive hunOred tlollars (5500). ,
� I, as owner of Ihe prdperry or my employees wit� wages as iheir sole compensation, will tla Ihe work, ana the
❑ stmctua is not intentleA ar oflere0 for sale (Section 70C4, Business an0 Protewional CaOe: ihe Coniractors' Stata Licenu Law
Uoes not apDly to an awner of a D�oDertY who 6uiltls or improves t�ereon, antl who tloes such woM �imsalf/harself ar throuq�
�is ar her own employees, OrovideOlhat such improvements are not intanEeE or offeretl lor sale. II, however Ihe builtlinp or
improvement is solU within ane year oi completion, [he owner will Aave tAe EurUen oi Dmvinp he/she tliA not 6uiltl ar improve
lor the puryose ai sale�. .
,
I, as owner af Ihe prope�ty, am exclusively controctinA with licensed coniractors ta consimc[ Ihe prajep (Section 7044. Business
❑ and Pmfessions CoAe: The Contractors' State License Law Oces not appty to an awner ot DroOerty who CmIOs ar improves Ihereon
an0 who caniracts far such proletls cith a contactor�s) license pursuant to tAe Controctors' State License Law�. I am aware
thaLpraof oi their Workei s CompensYeion insurance should be provided ro me.
� I am exem0� untler Section: B. 8 P. C.
for Nis reawn:
Date: • Qwner:
I Do AereDy certity that I am aware af anC unEerstand Ne requirtments oi Calitamia Healt� antl Salery COEe Sectians 25505, 25533, anE
25534 antl ihat I or any W[ure builEing occupolll WlNwill no[ (circle one) neeU to ComDM ��� sai0 state cotles antl the ropuiremenl5 tar a
permit for construction ar moAification irom IDe tir Qualiry Management Oisinct. Hesitleniial consimction aD0lications are exem0� ��om
inese provisians. �
Date: • Applicant:
I h¢reby t¢Riry t�at I have rea0lhi5 application anA State tha[ Ihe a�ove in/ormati0n is cortect. I apree Io ComDly with all tiry anA
or0inance5 and state Wxs relatinq to �uildinq constructlon and hereby authoiae representatives oi this ciry to en�er pon t aEove�me
proDeM/��o� inspection purp�ou�sf.
Oa�e:�/ �' 7�� ( v
Applicant; Pink—Revenue; GolEanroA—Aesaeaor
CITY OF COSTA MESA - HUILDING PERMIT PERM,NO: B 047662
PERMIT NO: B 047662 PLAN CHECK NO: 04356-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE; S-N PERMIT TYPE; STR PURPOSE: OTH
JOB DESCRIPTION : 140LF OF CMU WALL @ 6' HIGH SQ FT: 190
CLAIM VALUE: CALC-VALUE; 2,800.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR(S) AEQUIRED IN HOME. �� '
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2 O N I N G R E Q U I•R E M E N T S :'�
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY'BUILDING ---------
FRNT: 10 FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT 6 IN RGAT': FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42249421 ZNE: R1 REF NO:
PLANNING NOTE5> 140 LF BLOCK WALL NOT TO ENCROACH INTO THE FRONT 10 FT OF
> SETBACH. ' i
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D E V E L O P M nE N T S E R V I C E S R E Q U I.R E M E N'T:S
ZONING APPROVED BY • a C �%� ;DATE:, -lo�/� ��
BUILDING APPROVED BY ; _ _ _ _w DATE: _(i (%�f/b' __
APPLICATION ISSUED HY: • / ' DATE;
**�r�*��r**��r**�*�r*�e+r�r�r�r ***+t***�r*�r ��
itiFitiEiEikiEiEiFiEitiEiEiEiEjEililiEililililiEiEiliEiEitkillEkifiEiliEiEiFifiE itiEikiFjfiEiFifiEiEiEiEiFitifiEikififi!'lfifiEiFiFiEitif�]@iEiPiE1E�EiE1E
LEGALIZATION:N F E E S U_ M M,�A R-Y �� � STRUCTURAL•��SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC �"FIRE SMIP/RE51' GRADING
PERMIT 54 . 00 % -' S0 �',�
�;, ; �-% I f SMIP /NON=RES
PLAN 35.10 �� , },� .. �
ISSUE FEE � . � - , , � • �
BUILDING-DIV-> PERMIT • ISSUE PLAN-CHECK �- TOTAL�' PAID DUE
TOTALS----> 54.50 0.00 ",35!'10 ,�'�!, 89�.60,1 89,60 .00
i' �:• , j "` ".i� -' '� � : - � �
REVENUE DIVISION TOTALS--> COLLECTED;, %`'�89,60 OVER/SHORT: 00 �
HLDG PMT PLUMBING ELECTRIC MECHANIC FIR�E ,SMIP/TOT GRADING PLAN-CHECK
54.00 ,' ,�" F" '. ". SO 35.10
� i
if iE it ik iElF ik i! iF jE iE it if dE if it it iE iF iE it �E jE ik iP if iklf iE iE iElE if iE if if if i! iE iE iE iE iE it�if� it iE iE�M it �E iE 1E it iE iE it it iE iE it it dE f! iklE if it it ik if ik it iE if iE 1t iE i!
I N D I V I D U A L, �,F E E �^B : R E A- R' b O W N �
i , ' � � �,
TYPE QTY D E S C R I P T I O N'- •;,�, UNIT COST TOTAL COST
� � � .
SFR 140 RES-CONCRETE BLOCK WALL �',,f /,� F.T. �;'�1,20, 00 2, 800.00
END ,OF,� FEES <, � ;' /� , r } �
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CiUNSTRUCTION AND PLANNING � � _ . POOL & SPA .
APPRUVNC�`� Permit# � _Date Inspector qppROVALS Permit# Date Inspector
1. Temporary. Electrical Service or Pole -, '�� - - �52. Pool & Equipment Location
t'
2. Soil Pipe-Undrgmd. , � - 5 53. Steel Reinforcement
�3. Electrical ConduibUtility-Undrgrnd. -• 54. Forms -
• 4. Electrical Conduit-Undrgrnd. . 55. Elect�ical Bonding � �
� 5. Steel Reinforcement' �� . 56. Rough Plumbing & Pressure Test ' .-
6.- Electrical UFER Grnd. -- 57. APPROVAL TO COVER-GUNITE .,
� 7. Footings � - 58. Electrical Condui[-Undrgmd. � � _
8. Foundation. - � 59. Gas Pipe, O� llndrgrnd.�, Test � �
9. Water Pipe�Undrgrnd. �' � 60. Backwash Lines, P-Trap, O Undrgmd. '
10. Structural Floor System '• �- 61. APPROVAL TO DECK ` .
11. Property 5ewer Line � House Connection 62. Backwash & Receptor•Final �
72. Sewer Cap . . � . 63. Heater & Vent-Final ' � .
73. Roof Drains - 64. Plumbing System � FinaF � _
14. Rough Plumbing � � 65. Electrical-FinaP - - . . -
75. Rough ElBctriwl�Conduit ' ' 66. Solar System-F.inal - � �
16. Rough EI¢ctric Wiring ' 67. Fenoing & Access Approval �
77. Rough Wi�ing $ign . 68. APPROVED FOR PLASTERING '-
18. Rough Electrica6T Bar Ceiling ^ 69. POOL/SPA SYSTEMS�FINAL � �
19. Rough Heating & Air Conditioning � . . , FIRE DEPT. REQUIREMENT
20. Rough Factor�y Fireplace � � � _ � APPROVALS ."Permit #
21.Dutts,in'Structure ` - �- `, 70. UndergrouridHydro
22. Ducts, Ventilating' ,. - , . -71. Product Piping O�Gas ❑Oil
23. Gas Pipe-Rough & Test �_ . " ' � 72, Underground Flush�
24. Roof Fram�ng � - �� _ .73:;Undergrnd.StorageTank-OGas ❑Oil
25: Roof Sheething , � _ 74. Overhead Hydro � �
26: T-Bar Ceiling IStructurall & Monocoat = �� . ;. - - � .� 75rDry Chemical '
27. Frame and Flashing - - - - 76. Dry Stand'pipe �- � .
-28. Lathing & Siding ' ° � ' � ' - � � 77. , FIXED SYSTEM F,INAL �
29. Insulation " - � -.��,� , 78�.�FIREPREV.FINAL '
�30. Drywall Nailing - � . , , , t '' � � � HEALTH'DEPL. REQUIREMENT
'31. Plaster Brown Coat ' ' - .r+• 79. FINAL IN$PECTION � _ '
;32. Electriwl Power MeterFinal' �,� `� �" 80: FOOD CERTIFICATE ISSUED '
:'33.•.Final Eleciric � .; ,. ^ • Notes: � Q ":
34. Final Heating & Air Conditioning ' - _ , � ' , � � Y _ � e�
35.. Final Gas Pipe-Test � �� 6 _/ �
36. Hood or Canopy � ' � ;� / �� � '
��37.�•Final Factory Fireplace�� • . <• �' �
' ! f i �i � �trA1
38. Final,Plumbing , " `�' ^
r f/�
'"39. Water Service-Final .- �� r , � -
40. Gaz Service-Final " • - - ' ' ��� L- =� �
/ �
41. Solar pomesticFinal � . . �`�� ^ _
0 6i
42. Backflow Preventer � ' - _ � - -' �'
. �Y `:l,
43. Backflowlrrigation � �. - � - �� f y
- -�
- 44. Landscape Iriigation System' � _ � � �
+. : • - � .. ' �� � -
45. Sound Attenuation- . . '�! . . . �. � - �. . .-.
46. •Handicap Regulations � '. � ' �,. •
47. FINAL S7RUCTURE & BUILDING ZL '� • � -
48.-FINALP4ANNING � _ � `, �•; ,^. - ; : :
49. ,Electric Reiease to Edison . ,' �; � ' ��, . , .
50. Gas Release to Southem Cafifornia Gas Co ' - -,' -' '
51. CERTIFICATE OF OCCUPANCY �
No Date
,
�
� TYPIC�AL 6�� CONCF�ETE BLOCK FENCE �
. . _ �. _ .. .. . - _. . ., r: c:--.. '
t Y ( .1 � _.T'.,-a � � � . .
�
CemeotCoPinqOPtaaaly, „.�.:. v� - : r_� � �,, -� _. - -_. �.. GENERAL- fVOTES
CMnnelBbtk With t3/8� ' - �
HoriioeUl Top ol all .' ?'.S` .' � _ .� � •' _ � '
Fenas
.. , , ! � MORTAR; One Parf Pbslic Cemenl, and
` � �� •' - -� -' • . GROUT; TA�te Parls Sand
ForFenees5'orlasf � �''�•��,�+.. ;_.. . One Port Cemenf Thee ond
Ven. Ban 3/B"�+e �' •0" O.C. o. , _,, . ' One Hal( Ports �ond
� .�,....,._._._..... � C P G'
for Fenee� Hgher Tlun 5; - �
Ven. Ban 3/8"� �t 72"-O.C:
Fill Celh Solid W��h Grout
WAere Steel Ottun � �
Reinloreinq S�ee� Shall
Conlorm to Sae.A�15-39
A.S.T.M.
All Steel lo be Lappd
2�" o� 10 i�.011� �
. � NATURALGRADE-7_
��
n
Tw0 y/B"O BAqS . s �
CONTINWUETOV ��,
d BOTTOM
�
HOTiSTEEI MUSY BE TIED IN �
VIACE 11T iIME PF �pENCM
�NSVEC110N. �� -
-KIOTF; ' I ,� �
SEE CMARi �
BELOW � �
.. -.�.��....�n..��.pncc��nc�vn� 'a1 I
F=\�e'~aWIDT�H�� y:. .�. . . . . . . i-.
� � •-%- � �-�`iHICNNESS =
ti�l�.� .;:(� OEPTH .OF EARTHTOOTH
_7�,.,� ��,SQACING OF OARTHTOOTH
pitl .t'?Q .�'il4 J� , r
�1 _Cit.X3,of .:Cos�t�a' Mesa, �
i Ht �1tA�J� �O xG��s.a3W
��---Bu�ld��n�g�-�-D�epa rtme nt
. I�P:'r.rn Nnv. PC
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TO �6� 0 C �tAx
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i.. •
r, ,� .
Z�� �
ING REUU�REMENTS CHART
.
0 IN . One Pa►1 Cement, TAree
� Parfs Sond
��-CONC�ETE: Weil Mised 1:2-1/2:3-I/2
MaM. of 7-I/2 Gai;ons of
Wa1er Per Sock nf .CemeM
GROUT MAV BE POUqEO FROM THE TOP
OF TME FENCE IN CELlS WHEHE STEEL
OCCUNS.
CELLS AND AREASOF MORIZONTAL NEIN�
fORCEMENT SNALL BE C�EAR, CLEAN d
FREE Of All MORTAR DEBRIS, ETC:
DE �TN (ii E 4RTNiCOTM
�/� iME MEIGTM Of �ENCE
BECOW BOTTOM OF iOGT�NG
SCALE: I/2�� = I'
10" 10" . . . g ' .
24° 20" 15" . . .
12� 14� 16�
lifornia
t2"
e�
I�y
16�
b
(,� �T, ����� OR!tECTIONS SHALL
p\v , ADDITIOP:" D-1.:.,'%:.�, 0't C
�� BE AP;'RIiVEU v'i 1tiE rl'.ANi;I��G CcPART19ENi
� �
i\ APPROVED
City of Costa Mesa Building Dept.
� BY �Q%%/'/ DATE �19_�J
�THcSE PtANS MUST BE ON J09 AT ALL TIMES MAKE
I NO C1,'ANGES WITNOUT PRIOR APPROVkL OF DEP7.
T41E I' iUANCf O(i GRANTING OF A PERMIT OR APPROVAL OF
I p�nNS JU SPECiFICAI NS SF7ALL NOT BE CONSTRUED �(O 6E A
PEIL'.:IT °OH, OR AN N Pf70VAL OF, ANY VIOLATI014 GF pNV OF
l'i1E PR( VISIONS OF TH S CODE. NO PERMIT PRESUMING TO GNE
pUfHD iV TG VIOLAT ^ " " Nc � F T
CODE S IALL BE VALIU %CFPT IN SO FAR AS THE W OR USE
Wli1CH I AUTHOf71ZES I' LAWFUL.
THE ISSUANC[ O A PERMIT BASED UPON P ANS AND
� SPECIFI .A�101J5 SHALI NCT FREVEhT THE BUIIDIN CFRCIAL
ROUTN@FfAFTERHE UIRI �� ���- OF RRO
� p�nNS �ND 5. :CIPI ATIONS UR�PRO. PR VE ING
U D;K/' OPEFATIONS Bel CARFlED ON THEt _UM ER V H[N
" VIOL TION OF THIS; OL'E UR OF ANV OTNER RDI ANC OP
�E'N�. . .. `.
�
�
�pl�qq
�.rr � ,7�.
CRY OP COSTA MESA
►LANMINC3 DEPT.
�w�cr ro Koo. osr. eea
,r�DAw %� • �• [.7
�a a eusis» _ .
e�G •F� 6 '/�`�ra �.«�� �-Q
�U- � c�'"S_.� s�� -
� tso i- �m �,-*t�AG � �,.J►-o
---��- �fl' �c s��...�,s�,�
Permit.. #� Y7GC� 2
THIS NUMBER MUST ACCOMPqNY
ALL INSPECTION REQUESTS
���10lK�
"�%�
:9,
qR I SPECTION��
CALL .
54-5626
,. , or,�
` 54-5627
M��/1tf � � i '
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' l �f�- • J� � �- c'"'`.P� ,t���,,'�'"'� ,n`.C� ��.6/i
_ '� � _ - ,�• S/R[fY � �
. � .. . � �� ��/�^� � �j , �
:ii Ol�A MESA
11AN DBT.
�1R.T TO blDO. DlR. R[O
�
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PARTY WALL
�� r
AGREEMENT
78IS q(3t�TP, made and entered into this 1 day of
~ � and betveen ��c ]/ �T
���1 �, �7-_ �r
heteinaftec referred to as 'I.i�I�ID ofd�ffi2", and ����Q�je,l^�'' S
hereinafte[ referred to as •AA7ACHTP PROPFRTY aNE�R'.
It is hereby agreed that a party vall vill be constructed on the
property line betveen
�
r
(Address of Adjoining
�e
in the Citp of Costa Me.sa, Cwmty of Ocange, State of California, as per
map tecorded in Hook . Page of Miscellaneous Maps, in the office
C� .~..�:Q �..^."RYs Aa+yr�rr7�� �f 9d'_fl �Il^..�'.]�� '�'4�g ��rty :.;�77 e{�a71 hc %Lte�if�T_c+�l �-n
eRCL'OdC}1
IN WI$�SS Fffi�d200F. the parties have entered into this Agreement the
day and year first above vcitten.
:,u �..,'�:7
l3u-/ �f �G(-
Name 7yped or Printed
�-�1 1 cl �� 1(_ 5 T
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�+oGlicant to fill in all ipaces except those within heavY bortler lines antl sign all appropria[e Eeclarations.
� PERMIT NO. � �TRACT NO. LOT NO� �UNIT NO. ' . ' i ` � - �r - -•r � - - �
SA C � StTRUCS7T10N�P� MIT � �8�3 Z ' � � + • � � , . a
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� , . . ' �283 E/24/^c7 ' 7a.:rr
ngAddress ����� � __ , �� TYPEOFCONSTRUCTION � NEW 'AOD ALTEftATION REPAIR
L� '.'( �+O CONVERSION ❑ �EMOLISH � OTHER t Zone
� ��i�'� !� i�UC"l� ' ' Phone '3�:�'��'�/ � _ .. , . A.P. �k � . , .
' p O�9KS� - � � � (DESCRIPTIONOFWORK%USEOF�BLDG. � � ��- - �� � � � - .
AddreSs �� /' C��F� �z5� ' ' ' . i • S Main Building: � F�ccessory Building: �
( � �4♦' �� TYPE OF PERMIT ' GRADING ❑ FOUNDATION ❑ ST,RUCTURAL E Front ' � � Z
Arcfi/En9. ' ' License No. � - �( T - � O
Addre55 � � ' �!��'' � r `�� TENANT Igl ELECTRICAL ❑ PLUMBING O MECHANICAL . g ' . , � ' N
/ � , Rear � , � � .
Cont�dCtO��sNam � ' � Phonetl� � ❑ OTHER � � ' 1 � . ! A . . _ _ " _`"'_ _ _ _ _ �
't, , 1� PROJECT DESCRIPTION SQ. FT. � ' OCCUPANGV
,C RighD� , , - G�
Address (mailing) 1 • . . -. .•• . � ' ' ' � K Left � � ' ' � 4
- - �' '��.�, • . ' � . 'a' � CONSTRUCTIONTV.PE � VALUATION,$ g j �
CityjLicenSeNo. � ' � ' �� �t?�� �� � rh ZONE GRAOINGCV.Y�S. ACRES ' - � R
LICENSED CONTRACTOR DECLARATION � � � ,(r,I : � � � � Ping. Ref. # , Parking Req./Provided E
-.. : Q
1 bereby aftirrti that I am licensed untler provisioni of Charter 9(commencing Remarks: � ' ' . � ' I � i . Pldn0i0g NOt¢5: - ' �� M
wltn sectlon ]000J ot �ivision 3 of the Business antl Professions',Cotle�and • ' ' - -
my-license is ln full fdree antl�etiect. • � ' �.Y ' ' ' �. -' ' � ' , . • ' - , ' 7
� � ¢-�, � ' > �*,S, ;. � �i j ( i • � s
License Class � =' ' License �No. � � ' � .
Date ' f{�Signafure � �' ' �� � ".� � � �. ' � -� PLUMBING �� � ' "FEES' � � • - � �
WORKERS'COMPENSATION DECLARATION � � ' � _ � . �
�� � ��>` , BarSink' '" �' � ' � Showers. � r' '� - � ' � • ELECTRICAL - -- FEES
1 hereby affirm tnat I,have aycertificate of consent to self-insure or a certilicate :� -
ot Workers' Compen5ation,l'nsurance, or a certifietl copy thereof (Section-' r ' � ' , ' � � . ' � : T � ,� . �
3800, Lab. C.) ' 7i �:i.f , rr Backflow Prevenier . Service Sink . ��� � ,(. ° qutomatic Washer � Transformer� 0 15-50 KW _
voiicy rvo. �� µ ^� Company ' � , �.) ' Backflow Irr�gation � � Sewer Ca - ' � � � � A ' ..� 50+ KW' � ;7, �
r - x „ . , - _P . . Constiuction'PoleSub � r . , y � :
❑ Certifietl copy is hCreby tumishetl. . {,, - _ � . .. . „ - � �
� CertitieC cooY is filetl wim,me city euiltling Division. �' . Bathtubs _ � � Sewer. Connection 61 , �� Cooking Unit � Meter ❑up to 100 amps �-
Oate • "��' 'Applicant ^'�`° - , . �
EXEMPTION F0.0M.WORKERS' GOMPENSATION OECLARATION c �� Cl9�ifi¢�5 -'-' � � Sola� Co1lBctoiS �,� � . Dishwdshe� � M2t2[ ❑over 100 Bmps
. (This section neetlmot be completetl if tne permit is for one huntlretl,($100) or�. �, - � ' ' ' �
. less). � - � � •, � : � n, y Dishwasher-' . - Solar'Pipin9 �• Dryers �Gas ❑Electnc � Sub Panel � ' ' ' 4 � � �'
� 1 certify that in the: performance of the work tor which this perm�t is issuetl„Ip � - �. . . � y - � � � �
shalt'not employ any pe�son in any manner so as o be[ome sutiject to tne � r DFinking;Fountains . �$olar Tank �- � Fan ' Moto'rs OO-7 HP O1 %- 8
Workej s• o nsa ioq Caws�ot Calify my'�� • ' .
Date �� �� �^� Signatwe/ ' �_(� ' - �� f � � n Floor Drains ' Swimming Pool w/Spa ' = F A'.U. �' ' ' ' ' ' ' � Inc. Solar 09-15 HP �16-15+� -
NOTICE: If, atter making thi5;deciaration, you should become subjecf to the — �
Workers' Compensation provisions of the Labor Cotle, you must forthwith� � FIOO�Sinks ' • `U�iOdl � Fiztu/¢5 � �
comply with. such p�ovisions or, this permit shall ;be tleemetl rewketl. ' � ' Microw3v¢ �
CONSTRUCTION LENDING AGENCV ` ' ' t ; • � � . ' 1 F • , � •
Gas Service � Outlets � 4 Water Closet �� Device Boxes Pole Li hr '
I hereby aftirm that there is a wnstruction lentling agency for the performance 'i + � ' 9 �
of th¢ wark tor which this permit. i5 issued (Section 3097 Civ. C.) Int¢�C2pt0�5 � � Water Heater � � Outiets ' � Range � �
LenCer's Name (� , � �
-Lentler'sAtlaress � _ KitchenSink _ _ Wa[erService ' _ . Switches.'.. . ,_. .. _ _ - -Sign. ---� - - - �- � �-� �
OWNER9UIL�ER,DECLARATION � i - ' � �
I hereby affirm that I am ezempt from the Contractor's License �aw for the Lavatories � Auto-WaSh � �
�0, Garhage Disposal Standing Sections
following reason (Section 7031.5 eusiness antl Protessional Cotle: Any citybr _ I � uJ
county which requires a permit to construct; alter, improve, tlemolish or repair , P-Trap : � Laundry TraYs � ' Generatorf�0-5 KW 05-�15 KW ' - �
any 4tructu�e, prior to its issuance, also requires the applicant tor such permit ' ��j� k TrdSh COmpact0�
to tile a signetl statement that he/she is licensetl pursuant to the provisions ot - ROOi D�dinS � , � � �
ihe Contractor's License Law (Chapter 9 (commencing with Section ]000) of �';,� • , � !� , �
� -Division.3 mf the-Business antl .Professions �Code)� or that he/she is ezempt � _
�, therefrom antl'the basis for the alle9etl exemption. Any violation ot Section ! k_ � . i' + � ' - ' . j �
7031.5 by any applicant for a permit 5ubject5 the applicant to;a civil � �
� ; pen�tty of not more than five huntlretl tlollars ($500). �� � • ' � � � � � � , � _ ' -
!' lid�l, as owne� ot the prope�Ty ^• ^� �^"^^'^�" 5 with wa9es ia5 their sole Reinspectiod Fee $15 �� � ISSUe Pee � $� 3� � �
compensation,.wili tlo the work, antl the structure is not intendetl or offeretl ' - Reinspection Fee $15 155ue Fee ' - "$ 3
for'sale �Section-7o44, Business antl 8rofessional coae: The'.Contractor's � , • MECHANICAL, � FEES � '
�' License Law tloes noYappty to an owner ot a�property who builtls or improves - -� -
. thereon, antl who tlaes such'work nimselt/herseli or throu9h his or ner own � - � � -' DEVELOPMENT SERVICES REQUIREMENTS: � ' '' . ' �
employees, provitletl tM1at such improvements a�e not intentletl or offeretl for Boile� ' - .HoOd O� Typ21 ❑ � . . ' '
sale. Ih, however�the builtling or improvement is soltl within one year of com- " ' Canopy Type II ❑' Zaning Approved By ' Date �
�� pletion,�tM1e.owner wilYhave the burtlen of proving M1e/she tlid not buiitl or im- DuCt - Uf1dE� Ground � � ' � i ' �
.prove for the purpo'se of sale). ' � �' , � �- � � Building Approved By . Date��
�' 0 I, as owner of the roperC am exclusivety tontractin with licensetl.con- . DUct -Stfuctural � � Refri elation S�5tem ' '' A lication luued B DaT ��� ���/ �
P Y. 9� � 9 Y i . PP Y ��J_ �
Yrattorsto construct the project (Sectian 7044, Busines5 antl Protessions Cotle: �' ' ' � _
The �Contractor's'License Law tloes not apply to an owner ot property�who Duct Ventilating '� �0-1�00,000 BTU ❑t00j000 BTU � �-, � • -. SUMMARV OF FEES �
builtls�or�improves thereon, antl who contracts for suth projects with a mn- ' -� �-� - � . �
tr5ctor�s)�iicen'se pursuant�to.the Contractor's License Law). 1-am aware tnat - � ' � - "' BUILDING PERMIT' '$ � SMIP . � �� ,$ � '
root of'their, Worker's Gompensation, insurance� shoultl be Exhaust System ��,Multiple ❑ , System Repair/Alteretion �
p , _ provitletl ta me. _ - ' PLAN,CHECK ' �$ , � � �"PERMIT
❑�I am ezempt untler Section � ' � e. & P. C: for this reason� � Firepi/Fact. Blt. ICBO # ; Fire Dampers . - . " � ' � ' �. ' - ' ' ISSUANCE - ,$ � y
Date � ' • Owner ' - , Heating System & Ducting � 1 . Registers�. � PLUMBING : ; ' �$: � -
� ' . - : . �' � � . . . .• . - � PLAN CHECK • �25/ $� .�. � � � ENERGV P C. '$ , �
i hereby certify_thati nave reatl tnis appiication and state that the atiove- ' OO-100,000BTU �100,000BT ' ' ELECTRICAL ''$ 12.�(7 .GRADING �$ � �
iniormation is correct. 1 agree to comply with all �city antl county ortlinances' = � • - -. � �
antl�state laws relating to builtlinq construction, antl hereby authorize�rep�e- � � �� - ' + " ' � � � MICROFILM � '$� �
sentatrves'of�this aty to enter upon, the�ayove-menbonetl pp perty�,for � � ' � - , � 1 � ? _ PLANCHECK' S0/ $- - , _ '
� MECHANICAL $ � 2'.%!i_
' inspection p La o-s' s -' - `�`� � / � '' ' ' � �' � � '
. Signature��,��(.� Da�t�" 'z '�. � ` � ' . . TOTALFEE $ _�
�Drivers �License or F � ' �� � � � ' - Reiospectidn,Fee � �� ' $15' �. . � Iwue Fee �'q '$� 3 ' � P.LAN CHECK 25°/ �$ , � '
1
`-0865-46, rev. 10/84" White --Building( Cinary` ��qpplicant; Pink�- Accounting; Goldenrotl - Assessor � � � �� - � � " ' - � � - �� � � � � �� � ^ � � � � - � � � �� � -
CONSTRUCTION AND PLANNING� .
� APPROVALS Permit #
1. Temporary Electrical Service or Pole �
2. Soil Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgrnd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement �
� 6• Electrical UFER Grnd. � "
7. Footings
� 8. Foundation -
9. Water Pipe-Undrgrnd. � �� ' _
10. Structural Floor System ' �
' i l. Property Sewer Line & House Connection
12. Sewer Cap .
13. Roof Drains . ,
14. Rough Plumbing � '
15. �Rough Electrical-Conduit ,
16. Raugh Electric Wiring� ' �
17.'Rough Wiring Sign-` -
' 18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20.� Rough Factory Fireplace
21.. Ducts, in Structure ,
22. Ducts, Ventilating - � �
23. Gas Pipe-Rough & Test , � . �
24. Roof Framing � �
25. Roof Sheathing � �
26. T-Bar Ceiling (Structurel) �& Monocoat
27. Frame and Flashing � ' '
28. Lathing & Siding
29. Insulation ' , �
30.'Drywall Nailing ' �
31. Plaster Brown Coat '
� 32. Electrical Power Meter-Final
33. Final Electric ��
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 '
41. Solar pomestic-Final '
42. Backflow Preventer '
43. Backflow Ir�igation .
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Compieted
� 49. Electric Release to Edison . .
50. Gas'Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date �
�,
� "- , . - - . ^ �, �� : POOL & SPA � . -
Date, ` �Inspector � � P' . # ' '�� Date - Inspector I
�
APPROVALS ermrt .
i
52. Pool & Equipment Location � , '
, �53. Steel Reinforcement , ' • ,
� '54. Forms : � ' � �
55. Electrical Bonding
56. Rough Plumbing & Pressure Test �
. 57. APPROVAL TO COVER,-GUNITE �
� 58. Electrical Conduit-Undrgmd'. �
- 59.- Gas�Pipe,'O Undrgmd., Test �
� 60. Backwash� Lines, P-Trap, � Undrgrnd.
61. .4PPROVAL TO DECK '
62. Backwash & Receptor-Final '
' 63. Heater & Vent-Final � � '
�
64. Plumbing System - Final .
65. Electrical-Final' �
66. Solar System-Final _
' �67. Fencing & Access Approval � �
� � 68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
� FIREDEPT.REQUIREMENT
'APPROVALS Permit #
. 70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Underground Flush � • '
' 73. Undergcnd. Storage Tank � Gas ❑ Oil
74. Overhead Hydro �
, 75. Dry Chemical
i , 76. Dry Standpipe' �
77. �FIXED SYSTEM FINAL . �
78. FIRE PREV. FINAL
. HEALTH DEPT. REQUIREMENT
79._FINAL INSPECTION - I '� ,
� �80. FOODCERTIFICATEISSUED
Notes: ' • _
� , - _ .�F p o.,,__T,,.,...,,
- I -9n l e �-F M !�
�_ I EXPIRED �
9
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CITY OF COSTA MESA
BUILDING DIVISION
OWNER•BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 79830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require
the return of, an owner-builder verification. -
Attention Property Owner:
An 'owner�builder' building permit has been applied for in Your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be
issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvement. � Yes ❑ No
2. ��I (have/have-*N[) signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
Phone (
Contractor's Lic. No
City
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone (
Contractor's Lic.
City
5 I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
Name Address Phone � Type of Work
I herebY affirm that I have received a copy of the information set forth in Section 19830 of the
State of California Health and Safety Code and have completed the above information to the best of my
personal knowledge, in compliance with this State law.
Signed: � �� �"'ro`'— Date: � – z � _ �7
Name: ���K ��l/�'N�,S
(Printed or Typed)
C.D.L. #or S.S. # � ��
CMF 3042-46 7545273
. �1PR 1 8 1960
, F.. F. SR. DATE
JOB ADDRESS 919 03k St. BUILDING PERMIT NO. 10�1%2
GENERAL CONTRACTOR Owner-Duilder VALUE § 1,200.0�
AP. No. 115-513-21 LOT 1�9 TRACT 1%12 FIRE ZONE DESCRIPTION OF WORK Reoair Res.
INSPECTIONS I DATE I GROUP I TYPE V ZONE R 1
SUBCONTRACTOR
Form 410-3M--4�59
� °`�`�2 ��� RECEIV��
COSTA MESA BUILDING-SAFETY DEPARTMENT -C J(�'—'� ��/
P.O. BOX 31] COSTA MESA. GALIFORNIA FINANCE DEPT�
�u'°�a�' �ir� nF Cnc�ra M�SA
FOR APPI/CANT TO F/[L /N COMPLfTELY a.PP�iewriorv FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING / Q q_�/ j ' ,
ADDRESS /T Ly.
COSTA MESA. CALIFORNIA fOR OfF/CE USE ON[Y
' �� I ftECE1PT NO. �_ pER IT�LO.
OWNER � � �
MAIL �1 (,/�,(/q RECEIVEO�Y DATE RECEIV�D jI DATE ISSUE�
ADDRESS ..0 �� �f�.LI�� ' I V i' I I O S'�J �1 I��' 5�-.
CITY i' 1(i TNO E(�•�G ADD ESNS I� �/�i
ARCHITEQ �„�_ ��c. COSTA MESA, CALIFORNIA
OR ENGINEER NO.
.�- FIRE ' /1 (//�
ADpRE55 ZONE TYPE V GROUP �Y�
STATE APPROVED
CONTRACTOR ,� "I� G NO. — BY DATE Q� '
wooaess �" • ZONING
�j � ZONE ���///jjj NO. OF USE OF NEV
LEGAL I LOT � - I � /� � /�
oesceiPnoH NO. BLOCK � RA T / I"�AN9 � 6uIlO1NG /1/A�j��
v I ix
/ S_ � �•� � APPROVE
A.P. NO. ( BY ( � DATE D�' S
SIZE � ���. ( rvo. oF e�pcs. ypRDS 1
OF LOT rvow oH�oi REpU1RE� ALLOWED
USE OF - ICENTER LINE ST.)
EXISTING BLDG. FRONT FT. IN.
SETBFCK LINE FPOM
cerviea oF sreeei REAR YARD R. SIDE FT. IN.
/y� � r
51 E'YARD I LEFT �� ftIGHT /��_ L. SIDE IN.
DESCRIPTION OF WORK /i, /Z_
REAR
� S ZI�LDING %� O� � ROOMS��`�/�STORIES
���
EXTERIOR WALV ,. -� I ROOF M.. .. n
IIJI
�/� /2 � !k �=
i �.,
1 HEREBY ACKNOWLEOGE THAT 1 HTVE READ THIS qPP4CpT10N
AND STATE TXAT THE ABOVE IS CORRECT PND AGREE TO COM- THE AMOUNT SHOWN IIN�EN VALUATION IS FOR THE
PLY WITX r�LL QT OINqNCES TNU STj TE LAWS qEGULATING PUFPOSE OF ESTA6LISHING A PERMIT FEE ONLY.
BUILOING CONST C ION.
� - ^ /����V� � VALUATION
SIGNATURE OF �A � - � ,�/ �9, � PERMIT FpE $ �j�'
PEftMITTEE (� $ ✓)7 �./O�� _—
p /S(
''�� ��� PLAN CHECK $
AUTHORIZED AGENT - TOTAL FEE $ /�
ORANGE COUNTY BUILDING DEPARTMENT
�._ 636 North Broadway � � ' ,
SAyTA ANA, CALIFORNIA
FOR APPLICANT TO FILL IN
nooae's"s 919 Oa.k StrPPt
scHoo� oisr. 1.f..
OR�TOWN �COBYiA t•tCS'$ '
NEAREST
=Ross ST. President Place
OWNER Oneida R�mf1$ li1C�
ADDRE55 9363 �911shire Blvd �
TEL.
��T�' BFVPrlv H911 s "4;H ri4;iF,l
ARCHITECT R LIC.
ENGINEER Lqajn Rn PRnRarranha.r
AODRE552110 E�W alnut#PasAdnea
CONTRACTORNP.Wl�OS'ti Vj-8tA NO. 1�'rj�y��
ADDRE55
DESCRIPTION I NO. � QQ BLOGK I TRACT����
USE OF I NO. OF I NO. OF
crnvm: ncnn rn
fREET .rlii �Y. � SIDE YA
DESCRIPTION OF WORK
E%TERIOR WAL{.,+uCCO I CO�VEI
COVENING 7��
USE OF NEW
euaowc RoalAanno��tt
APPLICATION FOR PERMIT �
'-- . Y V ' � D� �C�-� - . .
POR-OFFICE USE ONLY -
� , RECEIPT NO. PERMIT.NO.
�333 �O/� s,
RECEIVED BY DATE REC'D. DATE ISSliEO
a(��� %—!�—j 3 �'J-3`�,�3
BUILDING n /T n, Q�
ADORESS `� � �T-•
SCHOOL DIST. ^ �� � i
OR TOWN � ��� ��/C.r
NEAREST ' j%�
rRo55 ST.�qOn/ •d�.4� "•
ZONE NO.OF TYPE � GROUP
1I PLANS I I '
BVPROVEDi (1 � � DATE7'I'�3
S..v
CORRECTIONS
0
I HEREBV ACKNOWLEDGE THAT 1 HAVE READ THIS Ff
APPLIGATION AND STATE THAT THE ABOVE IS COflREGT UI
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME
BI
AN� STATE LAWS REGULATING BUILDING CONSTRUCTION.
LATH.
SIGNATURE OF y`TeV ort Vi `d CO _ LATH,
PERMITTE
PLASTI
AUTHORIZEO AG . �
PLASTI
PERMIT FEE S� MASOD
VALUATION S 5902 00 '.3
es
SM
-� PL�N CHECK $
BONO
F�EA` � � FINAL
O
A
�
.. � . . . Z
D
� ._. ... � . � . . � . . , r
,.. -4.� ..�,... . -..l �.. ..,� .,..�.,:, .
APPROVALS
ION �fI�NSPECTOR DpATE
�LS. I%I�"`J I a-I /�1
.YB� �' � �� �.
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