HomeMy WebLinkAbout2096 MARIAN WAY - Building Permits�
�
CITY OF COSTA MESA
��o�""'ES9 • BUILDING DIVISION ' '
i� � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • �wvw.ci.costa-mesa.ca.us
: �'
�. ` FOR INSPECTIONS CALL: (714) 754-5626
°�-��_"° PERMIT NUMBER: 610-00313
PERMIT TYPE B_ROOF2
APN: 42620225
JOB ADDRESS: 2096 MARIAN WY CM
Vicinity: HOUSE AND GARAGE ROOF
Squares: 2800
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
� Valuation:
ISSUED
10/27/2010
RMD
$6,000.00
SCOPE OF WORK: TEAR OFF EXISITING ROOF MATERIALS, INSTALL 1 LAYER OF 30# FELT ON A 5:12 PITCHED ROOF AND
REROOF WITH 30 YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE, APPROX 28 SQUARES. REPAIR
AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED JOB CARD AND CITY PERMIT.
OWNER: WEAVER, WALTRAUD TR
PHONE: 949-642-7030
APPLICANT: �i n.�.a,0 � �N � I��/�I Y)'1
PHONE: � �,', 9 33— ��Si07J
(0
CONTRACTOR: OWNER-BUILDER
Address: Unit:
Ciry/State/Zip:
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $125.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
Address: 2096 MARIAN WY
Ciry/State/Zip: COSTA MESA, CA
Address: 2096 MARIAN WY
City/State/Zip: CQSTA MESA, CA
License No.
License No.
19:P7:1�1
License No. 000000
CELL:
PHONE:
PHONE:
Unit:
Unit: :
4L FEES $126.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3H8/2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibilied all hours - Sundays and the following Federal holitlays
New Years Day, Memorial Day, Independence Day, Labor DaV, Thanksqivinq Dav antl Christmas Dav
6
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia sWWtes 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�. INSPEGiIONiYPE DRTE IN101RL5 COOEO INSPECTIONTYPE OATE INiI71AL5
1616 Pixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Finairte-rtoor �XIi-'�d''O�M 2to FinalElectrical
207 Final Blak/Retaining Wall 212 Final Fire PreveNion
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign, 222 Final Site
204 � Final Demol�on . 250 Final Buiiding/OcCupancy
WORKERS' COMPENSATION DECLARA710N�
I hereby aKrm under penairy of perjury one of the (oliowing dedaretions:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as provided for by section 3700 0! the Labor Code, for the
peRormance of the work for which�this permit is issued. .
❑ I have and will maintain workers' compensation insurance, as required by
sectbn 3700 0l the Labor Code, for the performance of the work for which this
permit is issued. My vrorkers' wmpensa�ion Insurance carrier and policy
number are:
Carrier.
(This secfon neetl rrof Op �mpleted Alne pe�mrt is valued at one nuntlretl tlMars (5/00) a less )
Policy Num6er:
r- �
�I certify that in the performance o! the work for which this permit is
ed, I shall not employ any person in any manner so as to become subjact
to the workers' com ensation lavrs of California, antl agree thal if I should
become subject to hg rkers' compensation provisions o( Section 37/00 of
�h��G��Q `� _�� fn hwit r.nnnlv with these Drovisi0ns, �
/d U O
,�
Ap I�N's:wgrwwre� D ro
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVI� 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 CO�E, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CON7RACTORS DECLARATION:
I hereby aKrm lhat I am licensed under pmvisions o( Chapter 9(commencing
with Section 7000) o( Division 3 of lhe Business and Pro(essions Code, and
my license is in full torce and eftect.
Lic. # _ Class #
Sigrewre
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn that [here is a construction lending agency for the
peAortnance of [he vqrk for which [his pertnil is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Adtlress:
Signawre Date
OW NER-BUILDER DECLARATIONS:
I hereby aKrm that untler penalty of perjury Ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the (ollowing reason (Sec. 703t5,
Business and Pmfessions Code: Any city or county which requires a permit to
construct, alter, improve, tlemolish, or repair any slrucWre, pnor to its
issuance, also requires the applicant (or such permit to file a signed statement
thal he or she is licensed pursuaN to the provisions of the Contractors
License Law (Chapter g(commencing with Section 7000) of Division 3 ot the
Busine55 and Professions Code) or that he or she is exempt therelrom antl
the basis for the alleyetl exemption. My violation of Section 7031.5 by any
applica t for a permit subjects �he applican� to a civil penalty of not more than
fve ndred dollars (5500).):
I, as owner of the property, or my employees with wages as Iheir sole
co ensation, WILL DO THE WORK, and Ihe swcture is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not iNentled or offered for
sale. If, however, thp building or improvement is sold within one year of
completion, the ovmer-builder will have lhe burden o( proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Pro(essions Code: The contractors License Law dces not apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contreCtw(s) license pursuant to Ihe ContraGtors License Laws.).
❑ 1 am exempt unqyr sec.
Business and Professions Code for Mis reason:
/�^., I'.� }I� - 0�2-% /O
-W ✓�-�' - --
�[S�qnalute ' 1.��
905]�A6(0I0]�
Ovmer ID verified by tlriver�se. es ❑ No
Driver's-L'Cense.No.� �xpires_:�
Verification of Oviriership by (type of document, i.e. - property 1ax 6ill ot tleed�:
DIVISION OF INDUSTRIAL SAFE7V PERMIT CERTIFICA710N:
❑ I hereby certi(y tha[ no excavation (rve (5) or more feet in depth into wfiich a
person is required to descend, will be made in connection wiih �w,lc autMAzed
by this permit, and Ihat no builtling strucWre, sca(tddinq, (alsework, a tlemolition
or tlismantling �hereo(, will be more than Ihirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Ttle 8, Cali(omia Adminisf2tive Code).
❑ As owner-6uilder, I will not employ anyone to do work which woultl
require a permit lrom the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work trom �he division.
Applicanl's SignaWre
Division ol Induslrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant neetl to fle and
cehify a Business Plan for emergenty response �o release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health antl Safety Code requires, with some
exceptions, lhat a Business Plan be (led with the Costa Mesa Fire
Departmenl by every business which has at any one time during a reported
year a quantiry of hazardous materials equal ro or greater than a weight o!
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standartl temperaWre and pressure�.
2. Does or will lhe applicant or preseM or future building occupant need to file
a registration lorm tor acufely hazardous marerials? ❑ Yes ❑ No
(Section 25533 of [he California Health and Safety Cotle, wiN some
exceptions, requires registration wi[h the Costa Mesa Fire DepartmeM by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds. or a
volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard
temperaNre and pressure).
3. Does or will the applicant or present or (uture building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials�? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Sately Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
filiog vrith the Fire DepaAmenl of an RMPP by businesses which are required
to regis�er aculely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of Ihe California
Health antl Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will lhe applicant or present or future builtling occupant require (or
the wOrk which i5 [he subject of IhiS applicaiion a pefmll fof SUCh COnSINCtion
or modifcation from the South Coast Air �ualiry Management Dislrict or from
any olher air polNtion control disMct or agency7 ❑ Yes ❑ No
(Seclan 658502 Of �he Cali(omia Govemment Code requires that the requestetl
information be (urnishetl on applica�ions fu non-re5idential building pertnits).
6. Will any paA o( �he facility to be construcled under Ihis permit be vri�hin
1000 feet from [he outer boundaries o( a school? ❑ Yes ❑ No
(If "yes", the facility must meet Ihe requirement of Seclions 25534 and 42303
of the Califomia Health and Safery Code).
7. 1! a permit lrom the South Coasl Air Quality Management District or other
air pollution conlrol disMct or agency is requiretl (or the v.ork which is the
subject of this application, have all of the disclosures prescnbed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certificate of compliance from Ihe appropriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correcl. I agree to comply with all state laws and
ciry ordinances regarding Hazardous Materials and Emissions.
SignaWre Uale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this applica[ion antl state that
the information given is correct. I agree to comply with all sta�e lavrs and ci[y
ordinances relating to building con5truction, and authorize representatives of
[he Ciry of Costa Mesa to enter upon the above-described property for
inspection purposes. I e not to occupy or allow occupancy�f an building
�auth��z by �his �ermi i+final inspection. � / � �
�cgc_. wmer�s� / Date�
�7
And/o� AulhotliedApp11fa0� r031e
i
t�
Certificate uf
General Infurmation
Site AAdress: %��
Building 7"yp�((�'Single Family ❑ Mulii Family
Residential
J
Agencl•:
Cimle the Froni Urientation:
Yroiec� Type: ❑ Alteraiion
� CF-IR-ALT
(Pa e ] of 5)
Climate Zone f1 _ � N of Storirs
I Unte: /�/��//�
, or degrees i� �
�pe � Fenestration lioof O HVAC
1VOTE: Thia' Jorm i.e un� tn bc u�- nr NeWh� C�nstrnetcA-l1��ifdingsnrAdditinn �-- i
lnsulntinn Value.v For Opaque Sw;(nces (Jor Furring usr U>c Moxs and Furring Sirips Cons�ruc�ion mGle belowJ �
Assemhlp Alterotion
O Opening of frnmed ca��q' nlone- A6eraiinns Ihni involne Ihe opening oJlhefr'amed caviq� o(n woll, ceiling, or,/loa• mus! insml/ the
mandaiori� mininnrrn insulnlion value per §1 SG fa� ihe a/iered a.u•emGl��. Fill in C'olvmns A-C and emer mandaion� insulatiai valuc in Colvmn H.
❑ Replucemen� of entire assembl��-Replucemen� oJarr ervire wall, cei(ing, a�Jlow� assembl�� requires Ihe insiallaiion o(Componeni
Ynrkuoa- D insulntion valu2s inTabl[ 151-C. Fill in G'olumns' A-J.
Surt'ace Details Fo� t�re rurred
7'ag/ I Assembiy Name
ID' orTvoe�
Noie: For
:��d of M-�ass Wa—lls see �Ru
U 1 L ' 1
U- q I]A4 Tabse I Caviry
cmr Number R-value
see Poge JA4-3 and bguauai 4-l.
n Table beloH•.
H. . .�, .
s From JA4 Table
�ontinuous JA4
lnsulation Assembly
R-Value� Cell Value�
vto�in�Jun�ed wa(fs ust Ihe
Fur'rinR Cons�n�ctian iable belou•.
L For Tng/!D indicaie the idenri(canon name thar marches the bvilding platts.
1. lndica�e ihe Assembfr Name ar Npe: Roo(/Ceiling, Walls, Floors. Slabs. Crawl Space, Doors and etc...lndicate the Frame rype and Size: For
Wood, Meml. Meial Buildings, Mass, enier 2s4. ?zG, m� eic... see JA4 {or other possible framc rype assen;blies.
3. E�ver iHe rhictrness for mars in inches or Spacing Gerween {raming members emer; 1 G"or 24 "OC; or O�her jor a!1 o�her assembfy dexeripfion
such as Cancre�e Sandwich Panel, Spandrel Panel, Logs, Straw Ba(e Panel and etc....
4. Bused on 16e Climare Zone; emer the S�andm�d U faaor fi�om Table 131-B, C ar D fw� euch d�erenl assembl�+Namc a� rype.
5. Enter �he TaLle rmmber �hai closefp rea�emGles die proposed asa�ernbli�.
G. Lnmr' Il�e R-i�aluc drn! is beiieg ins�talled br �he mall carim or Lelweeir Ilre f'an+i+eg; o!lrei�vise, exler "0 "'.
7. En�er lhc Con�inuou.v Jns�daiion R-nalve,%r' !he proposed assembl��; o�her-wisc, eiiier "0".
b'. Ln�er' Oie rnw m�d column of �hr U-facior valuc 6ased on Co(umu F Tuble Numher and emer �he Assem6l�� U-(ucior in Column J
). Thc Pro/msed Ase�emLln U-(ocior, Calu�nn J, musr 6e equal m or (ess than �he Smndnrd U-fucior in Cofunm E m comp/i�.
lfegia�traiiai NumLer: Regis�raiinn Uaie/Timc: HE2S Prnvider:
2pOb' Residential Compliunce Forms flugu.si 2009
or
Residential Alterations
Prnicc� Namc: .
Climate Zonc N
3 of
N of SCories , I
ROOP'ING PRODUCTS (COOL ROOFS) §15�(p12
When Nie nreu ajrxterior rnnjsurjace ro be'replaced ezreeds more tGars 50% oj(l�e erisiing roojaren, nr mom thu++ 1,000 j!, �ul�ichever is
lesa�, U�e ne�n roofi�tg areo musl wee(!/:c rnofing producl "Cool Roof're�uirements nj§l52(bJIHi, 152(bJlHii, or IS2(b)IHiii.
Check opp(icable ahernntive oi� ucep�iwr be(o�r iJlhe rooJa6eralion is esemp� fi�om �he roofing produc� "Cool Xoof : requirements. No�e; /Jony
one of ihe aherno�ives m� etcep�im� 6elow is checked, the Aged Solm� ReJ7eclance aid Thermal EmillAnce requiremen�s for roofing produc�s in
§I l8(iJ are no� applicable. Do nn{flI �abfe below.
❑ Cool Roofs Noi Required in Climate Zones I-12, 14, and 16 with a Low� Sloped. Less or 2:12 pitch.
�Cool Roo(s Not Required in Clima�e Zones I through J and 16 with a Steep-Sloped Roofs (pitch greater than 2:12) and product unit weight less
�Alternotives to §152(b)1Hi and §152(b)Hii, Steep-slope ruof (pitch > 2:72J
❑ Insulation witli a thermal resisinnce of at leas� 0.85 hr� °FBtu or at least a 3/4 inch airvspace is added to [he roof deck
over an attic; or
❑ Existing ducts in Ihe ettic are insulated and sealed according to §I51(�10; or
❑ In climate zones 10, 12 and 13, with I ft'-of Gee ventilation area of anic ventilntion for every I50 fl' of attic iloor aren, and
whe`e et least 30 percenl of the free ventilation area is within 2 feet vertical distance otthe roof ridge; or
O Building has at least R-30 ceiling insulation; or
O Buildmg has radiant barrier in the attic meeting the requiremenu of §151(�2; or
❑ Building has no ducts in the auir, or
� ln climate zones 10, ] 1, 13 and 14, R3 or geater roof deck insulation above vented attic.
Exception to §152(b)1Hiii, Low-slope roof (pitdr g 1:12)
❑ Building has no ducts in the attic.
❑ RooSng area covemd by building integrated; photovoltaic panels and solarthermal panels are exempt from the below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof inembrane with at least 25 Ib/ft is exemot from the below Cool Roof criieria.
te If no CRRC-1 iabel is
Check the aoplicable 6oa
Product ID Numbcr�
cannot be used, use the PerPormance Approach to
Roof Slope I Product Weight I Product I Aged 5olt+r I Thermal
2:12 > 2:12 < Slb/ft� > 516/ft� Tvoe' Reflectance� ° Emittanc�
❑4
�4
O"
❑°
O°
Tlte CRRC Produc( ID Number can Le oGmined from dic Cua/ RaafAoling CaunciYs RorcdYroduc� Direc�orp a! ww�v.molrnoCs.ore/nroducls/seorch.nlm
Lidicarc tl�e iype oJprnducl is Geing u.re� for !he rooJrop, i.e. single-pl�� roof, asphofi roof, mmal rooJ, c�c.
IJi6c Agtd RePeciance is no� ovailaLle ln.�he Cool 1tooJRaiing Cmmeil's Raied Produc/ Diretmq� llimr u.re �he Ini�ial NeJlecionce va/uc fi�om �he same
direcmr�� �i�d use �he equo�imi (D.1+p.7(�lini��ul— 0.2) lo obmin n calcula�ed aged vuh�e. Wlrere p ii ihe lnilia( Sofm' Reflectmme.
Check ba,� ffhc �ged Re/lrcmnce is n calndaied raluc using Ide ey�m�ian aLove.
Ca1c�Jme Ihc 58/ vaLic In� using dm S/U� Wa'ksheer nl lutn:�����������.enerm�.ca.env//illcl4/ond enrer /hc remdring vnlur in Ihe SR/ CoLnnn aGo�e andauach uct
lhc SRI- lyarkshcar m U�c Cf-Ilt.
� apply l.iquid Pield Applied Cuu�ings, the coating must bc applied across the entire rouf surfuce and meet the dry mil lhickness or coverage
canmendcd by lhe coatings martutacturer and meet minimum perCormance requirements listed in § I I8(i)4. Selecl the applicable coating�.
Alumiitum-Pigmented Asphall Roof Coating �LJ Cemenl-Based Roof Coating
Regia7rulian N�imber: Regis�ro�ion Daie/fime:
2008 Residen�ia! Compliunce Fornes �
O[her
FIERS Provider:
Augus�2009
1'rescriptive CertiScate of Com��nce: Aesidential "� Cr-] R-ALT
ResideiztLrd Alterrztians (Pa�e. � 01'S)
Pruject IJrmo-.: I Climnir "Lmic ii I� of S[uriea
H�I:S VLP�IrI CATI ON SUM�IAP�)' Thr enla�cc,nem agrncr shoufd pm� syec�ol �memion m �hc HG/fS /�leosures xpeciJied ur �hia
checkhs� Lelon• d cwnyleied�mdsigned CF-41( Fa�m,for cdl �he +nena�w�es s7�ecijied shnll bc suLmiued �n liu� Guilding ina�pecior Leforc_Jinal
DuCt SL'nline� & 7�t'Stiud HElfSnerilccuionisreqzrirct(1ord�iamensure. �
❑ i'LS D NO vCS: lli Climoic Zunes 7 nud 9-I G, if more thui� 4U hneor feel of ncw or replucen�ent duciti art in5�tilled in unconditioned
spxce, �he ducts ure io �e sealed per �1i2(b)IUii and tlte uewly iustulled ducts are tu be �insut.ue0 pei j�151(f110.
❑ LXCL�PT10�: Lxis[ing duci systems qmt m�e extended: which are cuustrucced, inxulaied ur se�ded wit6 :�s6esms.
❑ �'�S ❑ NO YES: ]n Climate "Lones 2 and y-]G, i1'the existiuE space-conditioniug sysiem (HVAC equipmem and duciinal is replaced, the
ducts are to 6c sealed per (152(b)1 Di. .
� 1'�S ❑ NO Y�S: L� Clima�e Zones � und 4JG, if [he exisiing HVAC equipmeni is repluced (including th= replacemeni o1 the nii handler,
outdoor ca�densing unii of n splii system, cooling or heating coil, or tbe f'urnnce lieai exchanger) [he ducts nre to be
sealedpei §]52(bpE. �
❑�XC�PTIOn: Duct systems tLnt arc dncumented w Imve been previnusly sealed confirmetl thruugL HC72S
� verificetiou in nccm'dnnce with procedures in the Reference Residential Appendiz RA3.
❑ r.aC�PT10�: lluct systems with less thxn 4U lineur ieet iu unconditiuned space. �... .
constructed.insWated orsealed
R�frigerant Charee - Split S)'stem HERS verification ia'required,Jor �his measure. .
❑ 1'ES ❑ NO YES: In Climate Zones 2 and S-I5, when the eristing HVAC equipment is replaced (includin� [he replacemeni of the air
handler, outdoor condensino unit of a splii system A/C or heat pump, cooling or heating coil, or the fumace heat
Central Fan Integrated (CFI) Ve�
The ve�ulation renuirements of 6150f o) do
meemrcment shall be
System and Fan V✓att Draw
tn existine residentiel homes.
Ducted Split Systems - Air Conditioners and Aeat Pumps: Airfloh� HERS ve,�iiica�iw, is reguired Jor rhis meosivc.
❑ Y�S � NO 1'E5: In Climate Zones 10 through 15. when [he ezisiing space-conditioning system (HVAC equipment and ducting) is
reolaced. the airflow• and ian watt draw shall be verified ner § 152(b) l Ci to meet the reauirements of 6151(f17B,
Deciaration
of Comnliance documentetion is accurate and comolete.
/J I Cienature:
Hddress:
Late:
/o Z7
1f Applicable O CEA or
(Certification A):
'�i y'Z- 7�
Responsiblc liuildine Desi�ner's Ueclaratiur Statement � � T-
e I am eligible under Division i of tlic Culifomiu Business end Professions Codc lu accepi respuusibility I'or the buildiug desi@n identiGeA on
this CeniSca�e of Compliancc.
• 1 cenify thai thc energY fwiures and per(ormancc speci6cntion:. foi the building desigu identiimd on this Certifieate of Cumpliance cunform
�o the requirements ofTitic 2q, 1'ans I.md 6 of tl�e Culilbmia Codr of Kegulatiuns.
• The building desipn feowrati identiGed on �his CertiLentc nf Campliunee nre cons�stem wilh �he in(ormntiun pruvided «� ducumeiu tbi::
building Aesi�n on th: othu- upplicnble compliunec Ibnns, worlsheets, culcula�ions, plam mid speciLe�uiom: submilted w tbe eniorcemeni
Name
Company:
Adoress:
Si�naturc:
Phmie:
TOI'lI.AS1.51lOiLC OI' f�1IC51101t:. 1'C�fl!llftl� ihc Encror Sttmdm•rl.��, ca7lttcl fheL'nel'el' HoLlinr at: 1-811l1-7i2-i3blf.
lfegisu�aunu h�um6er Ife�i.cu�nuon Lme?�mc
200f: 1(c:+¢leniial Complionce Fnrms
/iL1;5 !'rm•iacr:
�i zrgu.r+ :.� 00J
AOOPESSOFBNIWC: ZOiV MARIAN WY
oxNexsruweiraaw++: WEAVER, WALTRAUD TR
wor�u: 2096 MARIAN WY
CO5TA MESA,CA 92627
328-9925
�vr�. �uuxo �nowEss
µ�XREGT Ofl FNtalFFA:
J1CX, OA E/q'SIDURE54:
c«nx�crarsruwe: DZ PLUMHING
cwm�croxs�uta+o 19755 LORENCITA DR
��, COVINA 91�zq
UGENSED COMNCCTOPS DECLAPRTION: I �ereby ellvm unde� penely d
(mmma�M rM SecUon ]OW) d Oiviaion a d tM &d�wsa ard Pminaiona �
y�.�c.No.: 066643 uc.cuss: C 36 uc.No.:
� �
UMT:
uc. No.:
UNT:
(618)331-6700
CA „�,�; 391743
uKr:
,n�rv �nd i� ik.�..a ��aa wo.+vo� m cnaNa, a
de, utl mY 4oen+e u in Iu0lace ud afled.
39�� EXP: O1/97
comreaor.
9 BUILD P DEC q�TION: I hereby alfirm uMer penely d r'puy al I u Imm �M Conlretlon Liorue Lew la iM
9 �e%+� (�� ]�1.5 &niae� end Pm/eevma Cade: M c1Y wnlY i ui�ep e permn to cawlrun. eliw. imqwe.
in, a repn'r arry aliuctura. q'w io m osuerca. ebo nawm t xau Ip �u i u to fJe a egned vimamm Nm M o�M
eeE W�eM to IM prvriti0na d IM Canlradare licenfe law �Cheplx 9(canmmvip xilh Setlion )000) d Dv6ion 3 d �M
o erd Prdmona GoCe� n Ihel M a sM ia axemq Iherelmm erd IM bun Iw Na elleped evemption. My vqbtbn d Senion
Ey eny epplirani la e permn eubjep� ihe apqi�ni io e wil peneM1y d ml mae then frve huMred dMva �5500��.
�, o�,�.. d in� wownv � mv.mdw� wcn waa« � mai.oro oomw��a�, w�n eo m, won�. �e in, ewnure e �a �mmaae
V OIIOflE b eN! (JK�IqI ]M�. tlUfV1649 Blq YfOfOOAMf 1i00C: 1 M liqWfBGM LKtlpB IdW WCt 1q1 NM/IOM OMTMq plOpOfly
W�10 b11�9 q Tp1DM! 1�1BIB011. Blld WIIO EUGB BVC�1 MClk hYllttll IX �1lIfB+C! QVQIQ� h6IX IIN OWT MfidO�!!t. G�w�'� 1�1l1 YC�1
'unW�mmlf ere nd irueMed n dfxed la seb. M. Iwwevar. the Wiki!ro a'vnD�'amem u eatl xilhin ma Ymr ol mmWnion. iM
ownr-0uiHer r�iil heve Iha Wrden d pmriip M1e or ehe did ml Duild «impo.a la iM puryoee d Wa�.
� I. d owmr d Ihe popeM. � extluviveFy oonlrecliq xiln Iqenesd conVeMon lo conWua IM prqap (SediM 1060. Bwi�e erd
PMambn Gods: TF.e GOMm�1m liee�ae Ww doa ml eDdY w an ownee d pqMy vRa build� « impovm thxao� eM Mn
wnvern for wtli popes w�h e owurmw(e) Iicen�eE pwsuani Io IM Cwretlae lioe�ee law).
� I un a�emq uider Sscinn: B. 8 P.G.. br Nb reeson:
o�.: o �:
1 dn hereEy cenily thm 1 em awve d mA urbeniard 1M �apui�amm4e d CelAwmalbMh eM $afery Coda Saqiom 25�05.25,U. mA
255J1. ud Nat I a ury Mun WJEvq ampeni wAI / wll mt (�b one) nsaE W canply wIh �eiA uete aodee enE iM isp�iremmp br
eG^rmllaeanhuetimnmodifmionhantheA �empen+^�Dipr"vf.ReddarnwlmrmeutlioneOP�ovenezemqhwnOme
ome: �vd�:
WORKEN'S COYPENS�TION DECLAR�TON: I hereby elfum wdar penNyd prjW one W Ne blbr.'uq EeWretiam:
� I hera e�d Mil meinlein e cenilwe W mneem io esX�ineure M xorkers' canpenW ion, m pwNM lar by Seeim �]00 d tha IaOor
COM, la tM pMormeriee d tM wak ta wlieh ihn peemA is Inued.
I hew uM xiE mdnlein waken' oompmee�un inwrerce, es raQuiretl by Sec�ion 3100 d the Lebor CoEe. M the pe�armence d iM
work la v.fiiN Nn pemi� u inued. My warken' ��.������ � ��me« u.: EX P I R E S
c�«
Pdiry Number: J 0 4/ 0 7/ 9 6
�xrm, „�e na w�akrsa � rns o�e o ro, a,e nu��ee edws (sral w r....�
V mnYy J� in Ne pMamvica d Ihe wuk lor whch thu pertnG u In�eE, I sAell M emqv/ any panon in ury mannm m m to
wtp'q to ihew�y� ' canpereetio� k�+s M Celtlomu, enE q�rss Net i I becvms wEjW lo iM xdken'
/ mpe�/[} wnaoJW'o(n�s o(�SWun �)00 ot �M Lebor Code. I�hell 1-hwilh oomp�y � .
ele: -I l�I 'I f� _ �VWiceni: ... . — . —
�,�mrv� a.�.m...ne
P.r .. wo.�m.e ro, io
C0�"TRUCiION 4ENDINO AdENCY: I henby �im uMer pe�ly d parpiry ihet ��en ie e mnelrudion landiip epeM.y tar Ns
paAamenm d tM v.vh br which Ihe perml ie caueE (�`eaon 308). Civ. C�.
LENDEfl'S NRNE:
LENUER'S ADDHE54:
i ce�iy ihn � heva road i�ia epqcdion eM pme ihm ihe aEm�e iMmiwbn ia canea, l epree to comWy wuA eA cry erd munry oNinua»
¢� eieta lewe relqvq io WiWiq eameutlion end MraEy eu�Mrixa rcpasenteMa d I�u rnY to anier �pon Ihe ebove�menlbned D�WM
'°""'Ded1O"""'D°'°' SONATHAN MOFFATT
rtlm N/em�. /�\�
�� � I / � Dme: �
—�—S�n r 1 Own r/ p n�t pplicenVCo S6Aor
(S151JB WP) NTue-BuiMip b 5ele�:Oreor�fite:�rlry-Appicanl: Pink-Revenue:OOMonmE-Msseaor
�
CITY OF COSTA MESA — HUILDING PERMIT
,PERM NO: P 07700
PERMIT NO: P 077006 PLAN CHECK NO: N� GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURFOSE: OTH
JOB DESCRIPTION : GAS VALVE ON OWNERS SIDE OF METER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1
COMM£NTS: INSTALLATION OF GAS VALVE FOR EARTHQUAKE SAFETY
�**�*�*��*�*�*+���*****�***+��x**+�***�*��*******+��**�+��****�+��*�*�*+�***����****�*
Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAIN HUILDING ---------- ------- — ACCESSORY BUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARICING REQ: PROV: PARCEL: 42620225 ZNE: REF NO:
PLANNING NOTES>
> -
iE iE iElE 1E 1E iE iE 3E iE iE ff if 1E iE 1E 3E iF ik iE iE iE 1E'1f if 1E �E iE if iE iE aE jE iE iE 3E fE �E 1F 1E iE if jF 1E jE iE �f iE 1E fE iE iE IE iE iE Ik 1E fE 1E if iE �f iE if if �E 1E iE 3f iE iF jE �f �E iE iF �F iE �E
D E V E L O P M E 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 .
BUILDING APPROVED BY :
ICATION I
LEGALIZATION:N F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 7.00
25&
PLAN %
ISSUE FEE 20.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 7.00 20.00 t� 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMBING ELECTRIC MECHANIC
27.00
DATE:
DATE; �
�'iF7F*iEiEkD**1EEiEiE7F��iF � � *iE
STRUCTURAL SEGMENT:N
FIRE SMZP/RES GRADING
SMIP/NON-RES
TOTAL PAID DOE
27.00 27.00 .00
27.00 OV£R/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
IE iE fE �f iE iE IE iF jE �E aE fE iF if if fElE 1E �E iE iE 3E IE 1E i63E iE if iE IElflE iE 1E�1E iE 3E 9E 1E 1F 1k �E iE 1E iF 1E fE IE if iEiF iE iE if 1k IElElE iElE 1ElE �f 1E iE iE iE iF �E 16 �E aF �E if iE �E if !E iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I OiN UNIT COST TOTAL COST
PLU 1 GAS SERVICE - 7,00 7.00
END OF FEES
1 - � /
1 /" _
�.> - - <. -•_,_
CONSTRUCTION AND PLANNWG P��� �A .
APPROVALS Permit #. - Date Inspector qppROVALS Permit �`r Date Inspector
1. Temporary E(ectrical Service or Pole 52. Pool & Equipmenc Location. .
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � -
3. Electrical Conduit Utility-Undr9rnd. 54. Forms - � �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �
5. Steel Reintarcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings 58. EleMrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, L7 Undrgrnd.. Test
9. Water Pipe-Undrgmd. ��� 60. Backwash Lines, P-Trap, O Und�gind.
70. Structural Floor Svstem ' 67. APPROVAL TO DECK ��
11. Property Sewer Line & Hause Connection 62. Backwash & Receptor-Final -.
72.SewerCap ;..� 63. Heater&Vent-Fin�i ?_,�.� "-
73. Roof Orains 64. Plumbing System � Final •''
14. Rough Plumbing 65. Electrica6Fi�a1
15. Rough E�ectrical•Conduit 66. Solar System-Final �
76. Rough Electric Wiring 67. Fencing & Access Approval �
17: Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOUSPA 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,Ventilaiing 77.ProdUctPip'+ngl7Gas ❑Oi�
23. Gas Pipe�Rough &'iesc 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas '-�l' Oil
25. Roof Sheathing 74, Overhead HYdro
26. T-Bar Ceiiing tStructuraq & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe �
28. Lathing & Sidin9 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. F�NAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECT10�
32. Electrical Pow2r Mexer�Pinal 80. POOD CERTIFICATE ISSUED
33. Final Electric . Notes: .h_/z �-li�� �`�� _
`-h f [
34. Final Heating & Air Conditioning
35. final Gas Pipe-Test
36. Hood or Canopy •
37. Final Factory Fireplace
38. Final Plumbing .�,-I z �
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestioFinal
42. Backflow Preventer
43. Backflow irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUC7URE & BUILDING .
48. FINAL PLANNING .�
49. Etectric Release to Edison ��
50. Gas Release co Southem California Gas Co
51. CEftTIFICATE OP OCCUPANCY
No. Date
. - - � �442 ,
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 817 C06TA MEBA, CALIFORNIA
For Applieanf io Fill In Complefely
TYPE OR PRINT
BIJILDING
ADDRE56 zo96 taarian wa
C057A MESA. CALIFORNIA
�
USE OF
EXISTING BLDG
BETBACK LINE FROM
SIZE y�rv� �
EXTERIOR WAI
COVERING
USE O�IIJLD
1 HEeEBY ACKNO�
AND BTATE THAT
PLY WITH ALL CI
BUILDINO CONB
SIG[3ATURE O
PERMITTE
AUTHORIZED AG
NO. OF
OF WORK
O�
iHAT 1 XAVE PEAD THIB APPLiGT10N
)VE I6 CORRECT AND AGREE TO COM-
IANCEB AN� �TAT¢ LAW6 REGULATNG
FEE RECEIVED
��� 3 1962
tINANCcE� 7DEPpT��.�{�I"�
ABbLYCA.�1�V' FOR"PERM IT
BUILDING
For Office Use Only
RECEIPT NO. PEpM
RECEIVFD BY I OI.TF qECEIV-ED. I� �AT=
i�� � i v zi 7
BUIL�ING �����
ADDRESS A AJ iv /
COSTA MESA, CALIFORNIA
ZONE
P
LEGAL
ZONING
NO. OF USE OF NEW
PLANB 2 OOILDMGr
ICHNTER LINE.6T� yfs
FRONT 7 ��
R. SIDE /O
�. s�oe ��
REAR /Q
APPROVED . _ _
m
�
�
�
f�/z � 6 z
y —/U � /
�- yy/�.
TXE AMOUNT 9HOWN UNDER VALIIAT�OMIS FOR THE
PUPPOSE OF EBTABLI9HING A PERMIT FEE ONLY.
VA�UATION y,/
S�/%� PERMIT FEE $ �/
"/ ��1� X PLAN CHECK S� l�