HomeMy WebLinkAbout993 OAK ST - Building PermitsCITY OF COSTA MESA
BI/ILDIN�'i DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-.1856 • www.ci.costa-mesa.ca.us ��
FOR INSPECTIONS CALL: (714) 754•5626 . �
PERMIT NUMBER: BC08-0�212
PERMITTYPE: B COMBO STATUS: �lPPL-f�D' ��SUEb
Sub Type: RES_ALT DATE ISSUED; 06/27/2008
� - " ISSUED BY:
_
JOB ADDRESS: 993 OAK ST CM "SUlte/Unit ��:'-, �
APN: 42247102 �,�.Zoning. .. .,
_ � � , :.:.�.�, . . . .
Vicinity: INTERIOR OF HOME �- �� Primary Occ:� R-�3 �
Const Type: V-B SQ. FT: '' 682 �.Valuation`. $48,065.92
SCOPE OF WORK: ADD 488 SF.70 A SFD`NEW FAMILY ROOM & EXPAND EXISTING CIVING ROOM & KITCHEN INTO NEW
FAMILY ROOM AREA. 1 196�PATIO LAUNDRY TUB/WASHER, 1�KITCHEN SINK, 1 FACTORY. FIREPLACE, 1 NEW KITCHEN ..
.. . .. _ . .. .. .
HOOD, 1 SVC PANEL TO 200 AMPS, �18 LIGHT FIXTS, 15 OUTLETS 8 6 SWITCHES . . �
SEE BC08-00214 FOR GREEN APPLICATION/CONSTRUCTION,OF WINDOWS & APPLIANCES `
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OWNER: KOGLER, KARL R ���AddreSs: 993 OAK ST ; ��''+ Unit: � ���
Phone: 949-637-4484 ' -�� �City/Slate/Zip: COSTA MESA, CA _ ' � .- ,� ,� � �
.. , i . � � , �i'.t. � �
APPLICANT: KOGLER, KARL R � _ , , - �� `- Address: ' 993 OAK ST - ' , - � , •�Unit: :
Phone: 949-631-4484 - -. City/Slate/zZip: � COSTA MESA, CA . � �
CONTRAC70R: OWNER-BUILDER - ., LicenseNo..�, 000000��� � �
Phone: :_. -. : .. Address Unit:.�. � � :` J� ' . ;`: ' �:.
CeIL• s City/State '" � ,ZipCode . �
�:� �. ..i , . .
�,.,� ;�� . ..-; ; , ,:._: �. --� �7�. . �
. . .. . -, . . .
ARCHITECT: � - � . License No. - � -`PHONE: ��
ENGINEER: DONALD INMAN ��'� "" - � License No.11888 '�-PHONE:714-521-0554
COMBINTATION PERMIT FEE SUMMARY.`:
<. • .
Building Plan Check: �' �' '� �' , "� $412.20� - � ` .` ��..�.`� . � � . ... .•` �
Building Fees: $634.15. �,�
Electrical Fees: _ . ' $96,90 ` .
Mechanical Fees: ` $44.80;__; ,
Plumbing Fees: `�, � $43.10 "'- �; . , , - - �
SMIP Residential: "-�-': $4.81-„ . � - '- - . � - ' . �
SMIP Commercial: $0.00 ` ' „
TOTAL FEES: $1,235.96
"Rater to fee raceipts tor all fees paltl for project
.,,•,, a �y
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California.statutes and related
regulalions. (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 (or the work authonzed under this permit to be considered legal, such work must wmply 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 o( this permil.
CODEt, INSPEC710NTYVE DRT INTRIALS C�DEt �NSPEG710NTYPE . ORTE N RLS
1fi16 Fized System Final Fire Prevention 206 Final Mechanical y),�"1�'''LI_ V,�Y,J
1286 Pool Spa Final 20B Final Plumbing� ��
200 Final Re-Roo/ 210 Final Electrical �Z��Q
201 Final Block/Retainin9 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 Builtling/Occupancy ��
WORKERS' COMPENSATION DECLARAnON: , , .
I hereby aKrtn under penalty of perjury tlne of the following tleclarations:
❑ I have and will maintain a certificate of consent to se141nsure (or workers'
wmpensation, as pmvided for by sect�on 3700 of the Labor Cotle, for the
peAormance of the work for which this permit is issuetl.
� I have and will maintain workers' cOmpensation insu2nce, as requiretl�by
seclion 3700 0! the Labor Code, for the pertormance of [he vrork for which this
pertnit is issuetl. My workers' compensation Insurance carrier antl policy
number are:
Carrier:
(IDis sec(bn neetl ipf �a cnmpleled d Ihe pem1R is valuetl at one hundred dollars (Ef00) orless )
Policy Number:
❑ I certify that in Ihe pedormance of [he vrork for which this pertnit is
issued, I shall not employ any person in any manner so as [o become subject
to the workers' compensation laws of Califomia, and agree that it I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, I shall (orthwith comply wRh these provisions.
AOPliranfs SignaWre
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF TME LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm lhat I am licensed under pmvisions o( Chapter 9(commencing
with Section 7000) of Division 3 of the 6usiness and Professions Code, and
my license is in full force and effect.
Lic. # _ Class #
CanVador's SignaWre
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby aHUm that there is a ponstruction lending agency (w the
per(wmance of the v.ork fa which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lander's Name:
Lender's Adtlress:
SigndWre Ddle
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of pepury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit to
constmct, alter, improve, demolish, of repair any stmcture, prior to its
issuance, also requires the applicant for such permit to file a signetl statemenl
that he or she is licensed pursuant to the pmvisions o( the Contraclors
License Law (Chapter 9(wmmencing vAth Section 7000) of Division 3 of Ihe
Business antl Professions Cotle) or thal he or she is exemp[ therefrom antl
the basis (or lhe alleged exemption. Any �iolation of Section 7031.5 by any
applicant for a permit subjecis Ihe applicent to a civil penalty of not more than
five hundred Oollars ($500).):
�❑.-- I} as owner of the propeRy, or my employees with wages as Iheir sole
compensa[ion, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contrectors
License Law tloes not apply to an ovmer of property who builds or improves
ihereon, and who does such work himsel� or herself or lhrough his or her own
employees, provided that such improvements are not intended or oftered for
sale. It, however, the building or impro�ement is sold vrithin one year of
completion, the owner-builder will have the burden of proving that he or she
�tlid not builC or improve for purpose of sale.). . .
�' I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct lhe projecl (Sec. 7044, Business and
Pro(essbns Code: The cont2ctors Licen5e Law dces not apply to an owner o(
property who builds or improves thereon, and who con[2cts for such project with
a coM2cla(s) license pursuant to ihe Contraciws license Wws.). -
❑ I am exempt under sec.
Business and Professions Code for this reason:
_Owner ID veri(ed by dnvt. „ ncense. ❑ Ves ❑ No
�Driver's License No. Expires:
Veri�cation of Ovmership by (type of document, i.e. - properry tax bill or deedj:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: .'
❑ I he2by certdy Ihat no excavation frve (5) or more feet in depth into wfiich a
person is requiretl to tlescend, will be made in connec[bn with wnrk authonzetl
by lhis permit, and Ihat no building s[ructure, sca(fdtling, falSewvlk, a demolition
or dismanlling lhereof, will be more than lhiey-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, T�le 8, Califomia Adminis�2live Code).
❑ As ovmervbuilder, I will not employ anyone to do vrork which woultl
require a permit from the Division of Industrial Safety, as notetl above, unless
such person has a permit to do such vrork (rom the division.
Ap0licanfs Signature
Division o( Industnal Satety Pertnit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or (uWre builtling occupant need to fle antl
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Ves ❑ No
(Section 25505 of the Califomia Health and Safery Code requires, wilh some
excep[ions, that a Business Plan be fled wilh the Cos[a Mesa Fire
Departmenl by every business which has at any one time during a reported
year a quantiry of hazardous matenals 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 temperature and pressure).
2. Does or will the applicant or presen� or fuNre builtling occupant need to file
a regis[ration form for acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of the Califomia Health antl Safery Cotle, with some
ezceptions, requires regisiretion vrith the Costa Mesa Fire Department by
each business which a� any one time has on hand a quantity o( acutely
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
lemperature and pressure).
3. Does or will lhe applicant or present or future building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program (or acutely
hazardous matenals)? ❑ Ves ❑ No
(Section 25534 of the Califomia Health and Safery Code provides lhat the
Costa Mesa Fire Department may require the preparation, certification antl
fling wi[h the Fire Department of an RMPP by Dusinesses which are required
to register acutely hazartlous matenals wi[h the Fire DepaM1ment.
4. If an RMPP is presently required, has Seclion 25534 0( lhe Califomia
Health and Sa(ety Code been fully complied with? ❑ Ye5 ❑ No
5. Does or will the applican[ or present or (uture building occupanl require tor
the work which is lhe SubjeCt of [his applicalion a permil (of SUch conSlfuClion
or modification from the South Coast Air Quality Management Dis[rict or (rom
any other air pollWion control disMct or agency? ❑ Ves ❑ No
(Section 658502 of lhe Califomia Govemment Code requires that Ihe requested
in(ortnalan be fumishetl on applicatbns fv rqn-residential bUiltling permi�s).
6. Will any paN of the faciliry to be constructetl untler this pertnit be wilhin
1000 feet from the outer boundanes of a school? ❑ Yes ❑ No
Qf'yes", ihe (acility must meet the requirement of Seclions 25534 antl 42303
o( the Califomia Health.and Safery Code).
7. If a pertnit from the South Coast Air �ualiry Management District or other
air polWtion conlrol disUicl or agency is required for [he vrork which is lhe
subject of this application, have all of the disclosures prescribed by California
Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If yes", attach certificatebf compliance from Ihe appropriate air�pollution
control oKcer). _- . ' . . �
CERTIFICATEAF COMPLIANCE:�I'certify,ihat under penalty of perjury ihe
information given above is covecL I agree to comply with zll state.laws and
ciry ordinances regarding Hazaidous Materials an0 Emissions. '�� '
CERTIFICATE .OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty o( perjury that I have read this application and state Ihat
lhe information given is cortecl I agree to comply wit� all state laws and city
ordinances relating to building cons[ruc[ion, and authonze represen[atives o(
the City of Costa Mesa to enter upon the abovetfescribed property tor
inspection purposes. I agree nol to occupy or allow dccupancy of any builtling
authorized by this pertnit until fnal inspection. . �
�A /��� I��� �Q �2� f O� SignaWreofLegalOwner(s) a�e
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Slgnalure�• Da�e� �I,� . „�I/' � /' �� �
3051�d6(3/0�) „ � ��r�.VCJim _l.L
An0/or ut�onzeEA001iwm `Oale _�
CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsta-mesa.ca.us
FOR INSPECTIONS CALL: (714) 7543826 �
PERMIT NUMBER: BC08-Q0214
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: GRN1_RES DATE ISSUED: 06/27/2008
'„° ISSUED BY:
�oe,4DDReSS: 993 OAK ST CM � � f�Suite/Umt `=�
APN: 42247102 f , Zoning - =
Vicinity: " � `� Primary Occ. R3
ConstType: V-B "�-, SQ.FT:. 0 Valustion: $10,000.00
SCOPE OF WORK: PROPOSED GREEN CONSTRUCTION APPLICATION TO INCLUDE:'.- `
C/O (4) EXISTING WINDOWS TO DUALPANEL ENERGY STAR RATED WINDOWS, REPLACE (1) 6' SLIDER GLASS DOOR,
REMOVE OLD DRYWAL THROUGNOUT HOUSE & INSULATE W ITH R-30 INSULATION; ADD (2)'SKYLIGHTS AT ENTRY.
PLUMB. -(1)TqNKIESS WATER,HEATER & NEW ENRGY EFFICIENT DISHWASHER. .'
MECH. - REMOVE WP.LC�FURNACE.AND'REPLACE WITH ENERGY EFFCIENT FAU. - �� �. � -
�. .._ , ,: . ,:—... ... . . :_ .
NO ELECT. AUTHORIZED BY THIS:PERMIT.-SEE - � � `�' ' � `:. "'� : -Y, i ,! �
REF: BC08-00212 FOR�486 SQ FT�:ADDITION TO HOME BEING CONSTRUCTED AT SAME�TIME OF ABOVE WORK �-
�.. ,
, . . � . � .. ,_ ... ...... ... . .... � . . ..,
OWNER: KOGLER, KARL�R • � - Address: 9930AK ST - - . . � �-'' Unit:
Phone: ,,a ' � �� � City/State/Zip: COSTA MESA, CA - � , "
APALICANi: KOGLER,KARL�R � -Address:,��9930AKST , :� , '�;�Unit: :. '
Phone: 989 631-0484� � ��. City/State/zZip: COSTA MESA, CA �� �
.,� �. -_ - . � ,
CONTRAC70R: � . Cicense No. , , - , . . .
Phone: ` ��..�.��� �.. , - ;_ ' ' Address:�;' Unit: . ..- ��,-. : ' �'- . .
Cell: � � Ciry/State: - .�� ZipCode
ARCHITECT: . � � ; License No. �. . - "' PHONE: �
ENGINEER: " � � License No. ' - � PHONE:
. . -� „�ir�,
COMBINTATION PERMIT FEE SUMMARY ,
; ,
Building Plan Check: : -"•,.$,117.81 � � : - - -
Building Fees: $18125 . . ' " -- �
Electrical Fees: $0.00 -�� � . . . .. . � -
Mechanical Fees: $38.50
Plumbing Fees: $43.10
SMIP Residential: $1.00
SMIP Commercial: $0.00
TOTAL FEES: $381.66
••Refer to fee receipts for all tees paid for project �
_ . , <` �ti, .:;:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia sfatutes and related
regulations. (Ortl. 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 authonzed under this permit to be considered legal, such work must wmply with all applicable codes,� and all
required inspections and final approval must be oblained. Failure to obtain inspections and final approval will result in the expirelion of this permit. �
CODE . INSPECTIONTYYE
1618 Fixed Syr,tem Final Fire PreveNion
t266 Pool Spa Final -
200 Final Re-Roof
201 Final BIo�WRetaining Wall
202 Final Fac(ory Fire Place
203
204
Final Sign
Final Demolition
O�TE INTRIRLS
GODEt �Nsvecnoxrwe
206 Final Mechanical
20B Final Plumbin9
210 Final Electriwl �
212 Final Fire Prevenlion �
220 Final Planning Approval
222 Fina15ite
250 final Building/Occupancy
.Z% i�
>: 1 �
WORKERS' COMPENSATION DECLARATION:
I hereby aKrtn under penalry M perjury one of the (ollowing tleclaretions:
❑ I have and will maintain a ceAifiwte of consent to self-Insure (or vroAcers'
wmpensation, as provided for by section 3700 of the Labor Code, for the
peAormance ol the work for vfiich this permit Is issuetl. -
❑ I have and will maintain workers' compensation insurence, as requiretl�by
secl'an 3700 01 the Labor Cotle, for the peRortnance of [he work (or which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier.
(T�is seCiwr neeE nof be mmp'efetl Ffhe permAis valuetl al one huiMmd �Ilars (Ei00) w less.)
Policy Number:
❑ I certify ihat in the peAormance of [he vrork tor which this permit is
issued, I shall not employ any person in any manner so as to bewme subject
to the workers' compensation laws of Califomia, and agree lhal if I should
become subject b the vrorkers' compensation provisions of Section 3700 of
the Labor Cotle, I shall (orthwith comply with these provisions.
Applipnl'S SignaWre
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm lhat I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and eflecl.
Lic. # Class #
Conlra[tor's SignaWre Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affvm tha[ ihere is a construction lending agency fa [he
perfortnance M the work far wfiich this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Signawre Da�e
OWNER-BUILDER DECLARATIONS:
I hereby affrtn ihat under penalry of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or lhe (ollowing reason (Sec. 7031.5,
Business and Professions Code: Any ci[y or county which requires a permi[ to
construct, alter, improve, demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for such permil lo file a signetl statement
thal he or she is licensed pursuaN to the provisions of the Contractors
License Law (Chapter 9(commencinq with Section 7000) of Division 3 0( the
Business and Professions Code) or Iha[ he or she is ezempt therefmm antl
the basis for the alleged exemption. Any violation of Section 7037.5 by any
applicant for a permit subjects the applicant to a civil penalty ot not more than
five hundred dollars ($500).):
�❑ .I�as owner of the pmperty, or my employees with vrages as their sole
��-compensation, WILL DO THE WORK, and the structure is not intended or
oKered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of propeAy who builtls or improves
thereon, and who does such vrork himself or herself or lhrough his or her own
employees, provided ihat such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builtler will have the buMen of proving thal he�or she
did not build or improve for purpose o( szle.). .
❑ I, as ovmer o( lhe property, am EXCLUSIVELY CONTRACTING� WITH
LICENSED CON7RAC70RS to consiruct the pmjecl (Sec. 7044, Business and
Professbns Code: The contractors License Law dces not appty to an ovmer of
propeAy who builOs or improves thereon, and who contracls for such project with
a cantracta(s) license pursuant to ihe Contractors License Laws.).
❑ 1 am exempt under sec.
Business and Professions Code for this reason:
I V�t C�J�.I�LYZY � 2
�-SlgnaWre . Oal a
l05]�46�3I0])
Owner ID verifieA by tlme� ., ncense. ❑ Yes ❑ No
Driver's License No. Expires: �
Verification of Ownership by (rype of document, i.e. - property lax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �
❑ I hereby certify that no excavalion (rve (5) or more (eet in tlepl� into vfiich a
person is requiretl to descend, will be made in conneclbn with wvrk authorizetl
by this permit, antl lhat no building struc[ure, scaHdding, Falsev.ork, or demolition
or tlismantling thereof, vrill be more Ihan lhirty-six (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Califomia Atlministra�ive Cqde).
❑ As owner-builder, I will not employ anyone to tlo work which would
require a pertnil (rom the Division of Indus[nal Safety, as no[ed above, unless
such person has a permit to do such vrork from the division.
Apvliranl's 9gnaWre
Division of Industrial Safety Permit Number _
HAZARDOUS MATERIALS �4ND EMISSIONS CER7IFICATION:
1. Will [he applican[ or present or future building occupaM need to fle antl
certify a Business Plan for emergency response [o release or t�reatenetl
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the California Heal[h and Safety Code requires, with some
ezceptions, that a Business Plan be fled with [he Costa Mesa Fire
Department by every business which has al any one [ime tluring a reported
year a quantiry of hazardous materials equal to or greater than a weight of
500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will Ihe applicant or present or fuNre building occupant need b fle
a registretion form for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Cotle, with some
exceptions, requires regisiration with ihe Costa Mesa Fire Department by
each business which at any one lime has on hand a quantiry of acutely
hazardous materials equal ro or greater ihan a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic fee[ of compressed gas at standard
temperature antl pressure�.
3. Does or will Ihe applicant or present or (ulure building occupant need to
prepare an RMPP (Risk Management antl PreveMion Program for acutely
hazar0ous materials)? ❑ Yes ❑ No
(Section 25534 of [he Califomia Heal[h antl Safety Code provides Ihat the
Cos[a Mesa Fire Departmenl may require [he preparation, ceAifca[ion and
filing wilh the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Departmenl.
4. If an RMPP is presently reQuired, has Section 25534 of the Califomia
Health antl Safe�y Code been (ully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future builtling occupanl require for
lhe vrork which is lhe subject of [his application a permit (or such conslruc[ion
or motliLcation from Ihe South Coast Air Quality Management Districl or trom
any other air pollution control disMct or agency? ❑ Yes ❑ No
(Seclron 658502 of the Cal'rfomia Govemmen[ Code requires Ihat the requesled
infortnation be fumished on applications fa non-resitlential building permits).
6. Will any part o( the facility to be constructed under ihis permit be within
1000 (eet fmm lhe outer boundaries of a school? ❑ Ves ❑ No
(If'yes", the faciliry must meet the requirement o( Sections 25534 and 42303
of Ihe Califomia Health and Safery Code).
7. If a permit from the South Coast Air �ualiry Management DisMcl or o[her
air pollution contml district or agency is required for [he woik which is Ihe
subject of this applicatioq have all of the disclosures prescribed by Califomia
Health and Satety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'ves", anach certificate of compliance from the appropriate air pollution
control oKcer). � � �- � .. ,
CERTIFICATE OF COMPLIANCE:� I certify that untler �peoalty of perjury the
information given above is correcL I agree to. comply with all state.laws and
ciry ordinances regarding Hazardous Materials and Emissions. � �" ��
Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:' I
certi(y under penalty of perjury Ihat I have reatl l�is application and state Ihal
the information given is wrrect. I agree lo comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-0escnbed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this pertnil until fnal inspection. � �
SignaWreo egalOwner�s) pale
�L. ��� lti � Z �� a�
�MNwAuNmzeEA001iw Date �
, , s,,
OWNER .�,$i. ALBERT S. AND B NCHF / DATE �n_�R_KK
JOBADDRESS 993 Oak St• BUILDINGPERMITNO. 2n18
GENERALCONTHACTOR
VALUE
LOT %(j BLOCK TRACT �'7lQ Detached ��pe
GROUP J TYPE V ZONE RIi FIRE DISTRICT . f(�nq0
� PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER
Footing Trench
Foundation Forms and Grade to
Rough Framing
Plumbinq. Rough to Slab
y ��
Heating, Final
^eewer, House Sewer, St.
Seotic Tank or CesSDool
Lathing, In Out� �� � !z �.Z'
Plasterin9 � �2^2d
Plumhing, Final Gas Test .
Wiring,Final /�,-7�Y-yy , ��.
Occupancy ��� ��6 —
Form'L10 G-H 15C01-55
�osta Mesa Bnilding Department �
' 111 EAST 20th &TREET f� ,
COSTA MESA. CALIFORNIA �r �
FOR APPLICANT TO FILL IN�
Bu(Iding
Address
Costa Mesa, California
Mail
Address
or
I I Lot
:ion No.
Metes and B�
ot %� X
Setback Line fra
Center of Street
DESI
New I 1
Size
No. of Bldgs.
% Naw on Lot �
No.of � No.o�
r Families Roort
, Rear Vard
Side Vard 3 �
ON OF WORH
ition I I Addition
9 I I Demolish
No. of
Rooms � Stories
I Roof
APPLICATION FOR PERMIT"
� BUiLDING '�
FOR OFFICE USE ONLY •
Receipt No. Permit No.
�0.. / �
�%Rp/c�G ved bY /6DZ� SS Id a zJf%S S
Y�(
s��ia��9
Address ' � � --- �--� �
Costa Mesa, California
K u' I Plans I 1
Approved ..__�'>-
-- - Forms, Materlal:
Under-Pinning
Frame: Flre Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply LaYh. Int.
with all City Ordinances and State Lxws regulating
building construction. / / Lath. Ext.
Signatureof /� y��s�
Permtttee [� lL1f �� Plaster, Int.
Authorizetl Agt. plaster, Ext
Valuatlon Permk Fee $ p� �6 Masonry Reinforce
Plan Check $ Bond Beam
$ � b. tf n— Towi �
Fee $ , i 8 � FINAL �
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ORANGE COUNTY BUILDING DEPARTMENT . APPLICATION FOR PERMIT .
' ' 636 North Broadway ' ' ' Qeo
�- SANTA ANA, CALIFORNIA _..�,P.V- , �,D_ .N �_--__ ,
FOR APPLICANT TO FILL IN i FOR OFFICE USE_ONLY__ __
f RECEIPT NO:� PEftMIT NO.
BUIL�ING �� //,/) '7
ADDRE55 993 Oak Street � I �' i 6/��',;_ .�1��,� �.
SCHOOL DIST. /� ♦ RECEIVEO BY'.- DATE OF APPL. OATEISSVED
OR TOWN y08 Ya Meea j1 �
NEAREST \ F � � � o�� 3.-,�� l'�ir�J�S'�
CRO55 ST. F� /` � �
BUILDING j Cf �� /' /�� /SL. � �
OWNER SMAVNEE HOMES� IN� ADDRE55 i/ ��� /—� _
MAIL SCHOOL DISTJ ��{)�.1 L �
ADDRE55 9R63 WILSMIRE BLVD♦ OR TOWN j eee ,�/'✓ ��/ •
TEL. NEAREST I �� ,/J .. n 1
QTY NO. CRO55 ST, • (,(i��-�--
ARCHITECT�,pR TEL. ZONEI NO' OF TYP��-^ I GROLIP�,_
ENGINEER l.A1N S� MCKERRACHER NO. SY• 6489� I/ I�pLANS _I µ��I ^ i ,f�J '
� .��.
ADDRE55 Z��O E, WALNUT ST. PASAOENA �SETBAGKLINEFR CENTER OF ST. �
TEL. 1. �/
REAR.VAftD � �.�.-'"SIDEYARD •�. 5 .".Ii.
CONTRAGTOR NFVPART VI CT� CO.NO. CR. �`� �qYPftOVED I r DAT�� // �/ ,
nooaEss 9363 w,�sH�aE BLtlD.� BEV.HIlL3 I � .
( if � CORRECTIONS ;
LEGAL I LOT NO. 7p BLOCK ��_�_2_
DESCRIPTION � , �I � �
IATTACH METES & BOUNDS) _ __ —
TRACT - — � - I� _—
/ NO. OF BLDGS. � 1� �
SIZE OF LOT p X � O I NOW ON LOT O i 1
USE OF NO. OF NO. OF '��� -
E%ISTING BLDG. I FewluEs I ROOMS I___ __ __, -.-- _-.- -
DESCRIPTION OF: WORK '
_ ' . . ._...... :. —. �_ . . __o.
NEW I I ALTERATION I I ADDITION I A
�
REPAIR I I MOVING I I OEMOLISH I �� y
BUILOING 1' NO. OF r'
SIZE o�Oi4 SO• F�O�MS 5 STORIES�
WALL ROOF COMPO
COVERINGSTUCCO I COVERING SHINOLE9
use ov r��g�DENCE
eui�oiNc ��tt Cqr�prt
t
�
APPROVALS
FOUNDATION: LOCATION NSPECTOR OATE
I HEREBY ACKNOWLE`JGE THAT 1 HAVE READ THIS FORMS, MATERIALS, /
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNOER�PINNING '��•i�
ANO AGREE TO COMPLY WITH AlL COUNTY ORDINANCES FRAME: FIRE STOPS, ' �/ ��}
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. BRACING. BOLTS /�� /� 'j7-�•�
' .IATH. INT. ,// ,7 _ � _ j�Zr'[
SIGNATUREOF ���Y� ig J `
PERMITTEF /�
NEyPORT V13TA _CO• LATH. E%T,
AUTHOHIZED AGT. � �-�� /��/lD✓ �, � -PLASTER. �NT.
� 1, PLASTER, E%L
$ y�3Q�yy P. C. S�1 — MASONRV REINFORCED
f
FEE s,i/i - BOND BEAM
VALUATION / - ��t
-.. .. -^ FEE 0 � FINAL �//�iJf \1 �I L �� Y