HomeMy WebLinkAbout1098 MISSION DR - Building Permits?' 'e CITY OF COSTA MESA s - f
BUILDING DIVISION
F77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: BC09-00431
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES_ALT DATE ISSUED: 03/12/2010
ISSUED BY: RMD
JOB ADDRESS:198 MISSION DR CM # Suite/Unit:
APN: 14156240 ' Zoning:
Vicinity: PrimaryOcc:
Const Type: V -B SQ. FT: 743 - Valuation: $47,158.96
SCOPE OF WORK: 435 SF ADDITION AND ANEW 308 SF LATTICE PATIO COVER TO SINGLE -STORY SFD. CONVERSION OF
AN EXISTING BEDROOM TO A WALK -IN -CLOSET FOR THE MASTER SUITE, ADD A NEW MASTER BEDROOM/BATH. AN
EXISTING BEDROOM WILL BE EXPANDED WITH THIS ADDITION. 1 ALTER/REPAIR COOLING/HEAT SYST, 1 VENT FAN, 12
LIGHT FIXTS, --
14 OUTLETS, 12 SWITCHES, 1 BATH TUB, 1 WAHS BASIN, 1 WATER. CLOSET. -
EXISTING 3 BEDROOM; 2 BATH DWELLING -WILL BECOME A 3 BEDROOM, 3 BATH SFD
OWNER: PEPIC, NURDIN AND DOKOVIC„EMINA Address: 1098 MISSION DR' Unit:
Phone: 714-422-6770 - City/State/Zip: COSTA MESA, CA
APPLICANT: DOKOVIC; EMINA
Phone: 714-422-6770
CONTRACTOR: OWNER -BUILDER
Phone:
Cell:
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY -
Address: ----
City/Stale/zZip:
Address: Unit:
City/Slate:
License No.
License No.
Building Plan Check:
$405.63
Building Fees:
$624.05,
Electrical Fees:
$65.30 -
Mechanical Fees:
- $44.45 .
Plumbing Fees:
$52.90 :.
SMIP Residential:
$4.72”
SMIP Commercial:
$0.00 -
Bldg Std Admin Fund
$2.00
TOTAL FEES:
$1,199.05
License No. 000000
Unit: :
ZipCode
PHONE:
PHONE:
"Refer to fee receipts for all fees paid for project
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/1812010 - PER CMMC Sec. 13-279
Monday thru Friday -7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays:
New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE S. INSPECTION TYPE DATE INTITIALS CODE INSPECTION TYPE DATE INTITIAL6 (fII
1616 Fixed System Final Fire Prevention 206 Final Mechanical —10 - t(7 m P o -k -
1266 Pool Spa Final 208 Final Plumbing X )I -to -/0 M0 i
200 Final Re -Roof 210 Final Electrical Ilr 02 '10 aA CA—,
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final BuildinglOccupancy I I Z- IV Cs
WQRKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(This section need not be completed if the permit is valued atone hundred dollars ($I W) or less.)
Policy Number:
10lf-certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, I shall f " with
hccomply7with these provisions.
( 11_4 ahLs re /Date
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 THE LABOR CODE. INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that 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 effect.
Lic. # Class #
Contractor's Signature Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Signature
Date
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason- (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
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
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure 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 intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
1&es'owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (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 contracts for such project with
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
3057-46 (JIO])
Owner ID verified by driso
ver's license ❑ Yes ❑ No % 4
a
Orfver's-Clcense No. ! E� zpir
Verification of Ownership by (type of document, i.e. - property lax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, a demolition
a dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
Apah,:anl's Signature
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
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
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 present or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department 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 standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
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.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Govemment Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If "yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signature
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correct. I agree to 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-described property for
inspection purposes. I agree -not to occupy.or allow occupancy of any building
authorized by this permit until final inspection.
��P ,�• zjiD
Signaf0 begaLOwDer(s) _ _ Dais -
And'.,
Authorize. AGpt.cant Date
City of Costa 914esa Buifding Division
Costa Mesa 77 Fair Drive, Costa Mesa, CA 92626
714-754-5273 / Fax 714-754-4856
OWNER BUILDER VERIFICATION
Permit # " - QUg3c
Disclosures & Forms for Owner- Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submittd incur name listing yQu,rself as the builder of the
property improvements specified at �Q �1 IyY
We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you
aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of
each provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting
authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
C-!1
��. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner -
Builder' building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. 1, as an Owner -Builder, may be held liable and subject to serious financial risk for any
injuries sustained by an unlicensed person and his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder
and am aware of the limits of my insurance coverage for injuries to workers on my property.
2. 1 understand building permits are not required to be signed by property owners unless they are
responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.
I understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that
I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his
or her name instead of my own.
I understand Contractors are required by law to be licensed and bonded in California and to list their
license numbers on permits and contracts.
c 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors,
and -tie total value of my construction is at least five hundred dollars ($500), including labor and materials, I may
be considered an "employer" under state and federal law.
.06. 1 understand if I am considered an "employer" under state and federal law, I must register with the state
and- federal government, withhold payroll taxes, provide workers' compensation disability insurance, and
contribute to unemployment compensation for each "employee." I also understand my failure to abide by these
laws may subject me to serious financial risk.
-I understand under California Contractors' State License Law, an Owner -Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed
by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of
the work is performed under contract with a licensed general building Contractor.
3148-30 CALBO Jan 1, 2009 013 Packet template 1 of 2
448 _I_understand as an Owner -Builder if 1 sell the property for which this permit is issued, I may be held liable
for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent
construction defects in the workmanship or materials.
I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cs[b.ca.gov for more information
about licensed contractors.
Q. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following address:
�11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern Owner -Builders as well as employers.
&&2. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
information I have provided on this form. Licensed contractors are regulated by laws designed to protect the
public. If you contract with someone who does not have a license, the Contractors' State License Board may be
unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against
unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed
Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible
for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner
and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's
driver's license, form notarization, or other verification acceptable to the agency is required to be
presented when the permit is issued the pro
y owner's signature. /
Sig naturezgLproperty:owne Date:
Note: The following Authorization Form is required to be completed by the property owner only when
designating an agent of the property owner to apply for a construction permit for the Owner -Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I
hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents
necessary to obtain an Owner -Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form
notarization, or other verification acceptable to the agency is required to be presented when the permit is issued
to verify the property owner's signature.
Property Owner's Signature:
Date:
3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2
/
PROJECT ADDRESS: 1098 M ISS ION DR
AD UNIT:
OWNER'S NAME: CARLSON, CARL S TR
ADDRESS: 1862 PAROS CIR
COSTA MESA,CA 92626
ARCH/ENGINEER: 546-5633 REG.NO.:
ADDRESS: UNIT:
PERMITTEE: ROSS E BARROWS INC, (714)557-7440
ADDRESS: 260 E, ALTON AV ---
SAN A A A CA. 92 07
LICENSED CONTRACTOR DECLA ATO hereby affirm than am licensed under provisions of cooter 9 (commencing with Section
7000) of Donsion 3 of the Business and Professions Code, and my license is in full force and effect.
CITY LIC.: STATE LIC.: CLAS:
002092q4 327802 - C-3 XP; 11/99
Date: —.(_ I Signature: p _
WOflXER MPEN TION CLAflATION: I hereby allir hat h ve adificale of consent to self -insure or a certificate of Workers'
Comped anon Insurance. or a certified copy thereof (Section 3800, Lab. C).
POLICYNO.: 606531-94 EXP. DATE: 07/01/95
COMPANY: STATE FUND
El Confined Copy is hereby furnished. Certified copy is filed with the city Building Division.
ate: Applicant:/���fv �'Latit
EXEMPTI FROMWOB EBS'CD PENSATION DECLARATION: (This section needn�completed it the permit is for one hundred($lDO) or less).
I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become
subject to the WorkersCompensation Laws of California.
Date: Signature:
NOTICE: It. alter making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor
Code. you must lonhwilh comply with such provisions or this 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
which this permit is issued (Section 3097. Cry. C1.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that hi is ticensed
pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing wile Section 717(0) of Division 3 of the Business
and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500).
with w a their compensation,will do the work and the
f n properly r m em ion I s es s ¢ sole
I. as owner o the o ape Y o y oy g
❑ does not a not intendedor ner of a pro r property
(Secbon 70x4. Business and Professional Code: TheContractors'
hi self Seale License law
does not apply to pl owner of a property who builds ve improves thereon, and who does such work eihowe herself or through
his improvement her own employees, provided that Such improvements are not eche burden
de offered lir Sale. le however old building ve
otthe
rpose sold within one year of completion, the owner will have the burden of Droving he/she did not build or improve
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
and Professions Code: The Contractors' Seale License Law does not apply to an owner of property who builds or improves thereon
and who co raises for such projects with a commercials) license pursuant to the Contractors' Stale License Law),I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. 8 P. C.
for this reason:
Date: Near
I do hereby Cenify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant willlwrll not (circle one) need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this or to enter upon the above-mentioned
property for inspection purposes. /
Dale:/— Signature I�[- all
Driver's Li n or Socrd<� ecunty e:
1641 46 White—Building: Green—Code Enforcement; Canary—Applicant: Pink—Revenue: Goldenrod—Assessor
f;
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 06898C
PERMIT NO: B 068980 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION T/OFF SHAKE 5 REROOF W/COMP SHINGLES SQ FT; 5,720
CLAIM VALUE: 5,720,00 CALC-VALUE; 5,720,00 GROUP OCC: R-3 /M-1
COMMENTS; SMOKE DETECTORS ARE RE�UIRED AS PER 91UBC REROOF 2600SF RESID,
Z O N I N GS E R T E B Q A U C I K R S E M E N T S SMOKE DETECTOR
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILR EQUI E-D-
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ; PROV; PARCEL; 14156240 ZNE: REF NO:,
PLANNING NOTES>
T
###############################################################################
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 DATE:
BUILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY; DATE; R
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 81,00 ,57
PLAN SMIP/NON-RES
ISSUE FEE
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 81,57 0,00 0,00 81,57 81,57 ,00
DIVISION TOTALS
--> -->
COLLECTED:
81.57/ V
O ER/SHORT•
00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK
81,00 •57
###############################################################################
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 O N UNIT COST TOTAL COST
SFR 5720 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 5,720,00
END OF FEES
01 00168261-OU168262 T rET 81.57
DATE: 09/22/94 TIME: 14:52
CONSTRUCTION AND PLANNING
APPROVALS Permit #_757
r, Date
Inspector
POOL &
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Servic Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. y
ly
53. Steel Reinforcement
• ?
3. Electrical Conduit Utility-Unb grnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, O Undrgrnd.. Test
9. Water Pipe-Undrgrnd,T
60. Backwash Lines, P Trap, O Undrgrnd.
s
10. Structural Floor System .ice
61. APPROVAL TO DECK
11. Property Sewer Line & House2;onnection
62. Backwash & Receptor -Final
�
12. Sewer Cap r�
63. Heater & Vent -Final
13. Roof Drains
n
64. Plumbing System - Final
f
14. Hough Plumbing
l
65. Electrical -Final
15. Rough Electrical -Conduit
h
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
APPROVALS Permit
20. Rough Factory Fireplace
-
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas 1100
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
25. Roof Sheathing JQ
73. Undergrnd. Storage Tank OGas OOil
74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREV. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33, Final Electric
Notes: �0�� 51�� ��`� O✓tVfS(
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 Domestic -Final
42, backflow Preventer
/p _ s O•(� /' G� //,.L �/y� ��,
[ 7� ��c. L �C'•
43. backflow Irrigation
�('�
�v
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE&BUILbING
48. FINAL PLANNING •"
49. Electric Release to Edi�Qn y
50. Gas Release to Southern Callfornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER CHEATHAM II, Burton Lee DATE 3-9-71
JOB ADDRESS 1098 Mission Drive BUILDING PERMIT NO. 3279
A" �. 141-562-40 LOT TRACT FIRE ZONE VALUE
In dETIONS
Si nature I Date
GROUP J TYPE III ZONE '
SOIL
SUBCONTRACTOR
PERMITS ISSUED
GAS
i Date I Number Signature
WATER
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE [:j HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND C] POWER ❑
ROUGH WIRING
Heating and Vent.
TRENCHES FORMS 0 STEEL REINF.
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN M OUT 77
PLASTER, BROWN COAT
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COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
PAID
NAR-9-71cnsAOO 230 d*****5.00
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
PIECE I V D BV I
DATE RECEIVED
3-13-5;-7,)
DATE ISSUED
BUILDING /z
ADDRESS a S `. /
�// n�T /n�
'—
PERMIT NO
OWNER
A.P. NO. '5(0 {' U
I
BUILDING
MAIL C
ADDRESS /
ADDRESS
TEL.
TRACT 2J
LOT Q BLOCK
CITY C NO,
CONSTRUCTION
NEW
ADO
LENDER O
BRANCH
OWNER
ADDRESS
VALUE
ARCHITECT TEL.
USE $
OR ENGINEER NO.
FIRE
ADDRESS
ZONE TYPE GROUP
APPROVED2 q q
^ /
CONTRACTOR
BV ATE3
ADDRESS
ZO E
NO. OF
USE OF NE
TEL
CITY NO.
PLANS
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZENO.
OF BLDGS.
IF ROM C/L STR E ET)
OF LOT
NOW ON LOT
NT FT.
FT.
USE OF
EXISTING BLDG.
SIZE OFNO.OF
r //
NEW BLDG. ROOMS STORIES
L SIDE FT.
FT. ;J
EXTERIOR WALL
ROOF
COVERING
COVERING
REAR FT.
USE OF BUILDING AND WOR TO BE ERF RMED
DISTANCE BET.
BET. MAIN &
MAIN SLOGS.
ACCESS, SLOGS.
VAR, fW
DATE
SI
C.U.P. I
APPROVED
M&d=
— /
DATE
1 hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
1 hereby certify that I am properly licensed as a contractor under
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or 1
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
Professions 9.
VALUATION
and Code. Division 3, Chapter
PERMIT FEE $
�/�
Signature of///) �
Permittee .�//2—t/i(/ ---.+ .
$/�•I ,\
PLAN CHECK $
T
Authorized Age
,
TOTAL FEE $ 1/
.: -� ���5� LGt LG, Trac(Ti20 RECEIVED
�iay>.,9SI,
1.ky
COSTA MESA BUILDING -SAFETY DEPARTMENT NANCE DEPT.
P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely' APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
COSTA MESA. CALIFORNIA ' For Office Use Only
Y
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0
RECEIPT NO. PeRMIT NO.
OWNER
n
MAIL
RECBIyls BY
R CEIVED OAT! I88UlD
ADDRESS
%�
—� - ��,i U 77171
Corona del Mar CaligoL. OR 220
BUILDING
CITY
ADDRESS
ARCHITECT rEL.
Macco COrporation
COSTA MESA. CALIFORNIA
OR ENGINEER NO.OR 34220
800 E. Coast Highway
FIRE
/
r s
ZONE
TYPE (' GROUP
NTRACTOR
APPROVED
BY
DATE
ZONING I
ADDRESS
ZONE 1
NO.
I
OF
UBE OF NM ms'µ
CITY Coronad 1 ar, California
�S
PLANE ?jI
]USING I//)) _
uc 8808 B-1 TNO.OR 22O
L CA
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/B
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No.
DEBCRIPTIoN
`!/��-� ND
I OT
OF LOT 20 ai F NOW ON none
A. P. NO.
USE OF none
YARDS
EVES
EXISTING BLDG
APPROVED
ALLOWED
SETBACK LINE FROM1 � 7 1
hq 1611
(CENTER LINE ST.)
CENTER OP STREET REAR YARD
FRONT
FT. IN.
SIDE YARD ILEFT I
IRIGHT 1
R. SIDE
r/
FT. IN.
DESCRIPTION OF WORK
// �
--
L. SIDE
FT. IN.
NEW I II ALTERATION I
I ADDITION
REAR
JY �J
Z / FT.
MOVING
DEMOLISH
/IN.
APPROVEDDATESILL...S
NO. OF1[SREPA
E fyqof 11 ROOMS 6 STORIES
OR WALL brickROOF
comp.
CO ERIING COVERING
Living
area 1281 S F
USE OF BUILDING AND WORK TO BE PERFORMED
S F
Sinalp, Family Residence
Garage area 445
w/attached garage
Covered
Porch etc. 77 S F
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION 18 FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM -
PURPOSE OF
ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS RBDULATING
VALUATION
BUILDING CONSTRUCTION.
SIGNATURE OFC
_PERMIT FEE SL�
PERMITTEE14
2l;6
S T BOO
_PLAN CHECK S
AUTHORIZED AG 6e
TOTAL FEE
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0