HomeMy WebLinkAbout1128 MISSION DR - Building Permitsi
PROJECT ADDRESS: 1128 MISS ION DR UNIT:
. VER•S NAME: WHITE ROBERT W
ADDRESS: 1128 14ISSION DR
COSTA MESA,CA 92626
AflLHIENGINEER: 979-7781 REG.NO.:
ADDRESS: UNIT:
PERMITTEE: ROBERT AND PAT WHITE (714)979-7781
ADDRESS: 1128 MISSION DRIVE
COSTA MESA CA 92626
LICENSED CONTRACTOR DECLARATION: Ihereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and P'at
essions Code, and my license is in full force and effect,
CITY LIC.: STATE LIC.: CLASS:
Date: Signature:
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers'
Compensation Insurance. or a certified copy thereof (Section 3000. Lab. Q.
POLICY NO.: EXP. DATE:
COMPANY:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
'ale: Applicant:
.EMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need nor be completed if the perml is for one hundred (3100) or less),
I certify [hat 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.
Date: Signature:
NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code. you must forthwith 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, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the ConlraCtore' 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 lot such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he/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 (5500).
I, as owner of the properly or my ar loyees with wages as their sole compensation, will do the work, and the
El structure is not intended or offered for sale (Section 7044. Business and Professional Cade: The Contractors' State License Law
does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/hersell or through
his or her own employees. provided that such improvements are not intended or offered lot sale. If, however the building or
improvement is sold within ane year of completion, the owner will have the burden of proving he/she did not build or improve
lot 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 Cade: The ContractorsStale License Law does not apply to an owner of Fieldry who builds or improves thereon
and who contracts for such projects with a contractions) license pursuant to the Conlraclors' State License Law(. I am aware
that proof of their Worker's Compensation insurance should be provided to me.
am exempt under Section: BP 70 4 4 B. 8 P. C.
or this reason: ALL WORK BY OWNER
Owner: �]�eCT�``11V 1'C[CrrG W�ll�
I do hereby deadly that I am aware of and understand the requirements at California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building oocupn a will not (circle one) need to comply with said state codes and the requirements for a
permit for construction or modification from the nn Ouahty Management District. Residential construction applications are exempt from
these provisions. �`
.,_._. __� I ... Applicant: P6 ` (• I�L�gy�� 1
I hereby certdy 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 slate laws relating to building construction and author¢erepresentatives of this oily to enter upon the above mentioned
properly far
inspection purposes. A
.._. 10-3-91 ? Signature: bA f 9 1 Cie
Driver's License or Social Security 4:
1641,46 yJmte—Budding: Green—Code Enforcement: Canary—ApPltwnt: Pink—Revenue: Goldenrod—Assessor
CITY OF
COSTA MESA —
BUILDING PERMIT
ACCESSORY BUILDING---------
PERM NO: B 05425
PERMIT NO: B 054258
PLAN CHECK NO: N
GOVT:
N SUPP: N
CONSTRUCTION TYPE: V—N
PERMIT
TYPE: STR
FT
PURPOSE: ALT
JOB DESCRIPTION ; T/OFF REROOF W/CLASS
A WOOD SHINGLES
SQ FT:
3,000
CLAIM VALUE: 3,000.00
CALL—VALUE:
3,000.00
GROUP OCC:
R-3 /
COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME
�*BeBI•kBE•ikBHBt***BP9HBrBfifBFkBekk*iEifiElf Bfitr�r+r+H�E�r�r�F�r***�r�E�P�r+FitRr�P�*��PiEar+rSE�E�E�***;e**�r�r�F��E*���E*SLOE
Z O N I N G S E .T R E B Q A U C I K R S E M E N T S
------------ MAIN BUILDING
----------
---------
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
PARKING REQ• PROV:
PARCEL:
14156233
ZNE:
REF NO:
PLANNING N TES>
REVENUE DIVISION TOTALS-->
COLLECTED:
54.50 OVER/SHORT:
•00
>
PLUMBING ELECTRIC
MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
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iE•********9E BE iP iE iE *iE BF*if**iE 9E 9E 9EBt 9E*BE
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 NT -S
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I N D I V
I D U A'L F E E
B R E A K D O W N
ZONING APPROVED BY
11
DATE:
TYPE QTY
D E S C R
BUILDING APPROVED BY :
UNIT COST
TOTAL COST
SFR 3000
DATE:
APPLICATION ISSUED BY: )Y DATE•
9F iF M Bf iE iP aPiP BtiEit BtiH BE iEiE iFBt ifk**it*it**k**k*BtiE klF BEkM Bt*iHiEit kiE 9t BP*RP iHk**9E dF*iE***dP iE *BP NE BF*******Bl BE
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 54.00 50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—>
PERMIT
ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
54.50
0.00 0.00
54.50 54.50
.00
REVENUE DIVISION TOTALS-->
COLLECTED:
54.50 OVER/SHORT:
•00
BLDG PMT
PLUMBING ELECTRIC
MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
54.00
•50
k iPk MBf RF*kkiFkMkiE BE ikk Bf if BEk Bt Bt***iE
itit********k*iH 9E kitiE*iH
iFMkif 9t Bt iF It*at Bt BFk BtitiP iE *JeiEit at Rt BF *iFiE *BE iP Bt Bt jE
I N D I V
I D U A'L F E E
B R E A K D O W N
11
TYPE QTY
D E S C R
I P T I O.•N
UNIT COST
TOTAL COST
SFR 3000
REROOF BY
VALUE RESIDENTIAL
NOZONE 1.00
3,000.•00
-END OF FEES
CONSTRUCTION AND PLANNING
POOL & S' _ `
f
"�"
APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
l
Dat
tnsp ctor
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd._ -
53. Steel Reinforcement -
--.3 JE Ce :I -al Conduit_L)"ljlity-Undrgrnd.
54. Forms
::4t._babtrical Condult%Uddrgrnd.
55. Electrical Bonding
r5 -'.St ee I ReinforceT6tj
56. Rough Plumbing & Pressure Tes't=�-
=
�ElectricalUFERGIaid.
57. APPROVAL TO COVER -GUI.
r
,
7i •Footings {
58. Electrical Conduit-Undrgrnd.
o
C✓ .`Foundation
59. Gas Pipe, O Undrgrnd., Test J
9. Water Pipe-Undigmd.
60. Backwash Lines, P -Trap, 0 Undrgrnd.
10. Structural Floor.- System
61. APPROVAL TO DECK
11. Property Sewer Line'& House Connection
62. Backwash & Receptor -Final
r' d
12. Sewer Cap v
63. Heater & Vent -Final
13. Roof Drains 'c
64. Plumbing System - Final
14. Rough Plumbir d rD
65. Electrical -Final
15. Rough ElectricZ-Conduit
66. Solar System -Final
16. Rough Electri QWiring
67. Fencing & Access Approval
17. Rough Wiring S,jgn
68. APPROVED FOR PLASTERING
18. Rough Electrical' -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
:APPROVAL
20.1*RouSgh FS`ctdi
0'*
C. =2=� 1 �lr' J: *
Y
r• -i O'.x 'X
' .^N -'- •^• 1 a:
21. Duffs, inSetructu�.x
�.y
J0.
4s
x S
,-x x
Uadergroupd;Hytiro t
22. Du%,, Vsntiating
';7 1. ProducgrDOil
'n
st
23L(aPipe�oCjI
T
a
-Cl
2. Under ro Ind Flu�'
as
rn
•S 0.
.-i�gCTG-as
o
24., -Rod Framing ';E"*' - - ^ »
•�+ ? _
a .A
,73JUndergmPStoragejank OGas ❑ 08
,
25. Roof Sheathing 7E`r'.,
�0 �%
�/4 Overhead Aydro`1 '� x
•r°'�V� v
26 T -Bar Ceiling (Stanotural) &-talonocoat
J z
: u:
s
.�a
r•r• t i
27 ;'Fra a and Flash' ' 'x
j79«
a
of .,, x
-� n OX x 5 11 aC
76' Dry Stanrii�e
., Ou. i
:! z
i1x X
O
-28.`Lathing $` Siding^ r, �a r ,F
'X..
•• r +
77,E FIXED SY^TEM,,RINAL*
I
x29. Insulation i[re ,� •• ••
` dt !
j {
78.j FIRE PREY. FIOAL i •> �.
�
..30. Drywall[NaiHng tip
_ 1
I r
c HEALTH.,DEPT),REQUIREMENT
r
',31. Plaster 0rowa.Coat
-�"
9' FINAL IN P.ECTI(N _ s
t
,�
i
`,. (i vv 1 1
32 Electrical Po' M_eteLsFinal I
•.
+ N
.r.
,TTS j.,
,,80:,FOOD CERTIFICATE ISSUED -
533 SFinaZ Electri
"Notes:
r S''-
-Finaf Hefting-& Air,Conditioni )g�
(
•
„� r r_,
n34
`35 •�
x
I r
L
S r
GaVPipe-Te-y >: 1
{i
c
�Fina1
v y
I
Y .t:
J O r. tr
ri36 THood or?Canopy•y v rj r --.
R r,
i
Y•�
237.1-Fini1l Faetory Firg`ptaif,
�
Ix
:r I. •u
.,
I
a
:t: w N
x
38. Fina} Plumbing �•r ••
' ��
I
Ix ».
-` S r, •� -•
-..
C39. Water S6Pvice-,Final* -
't
t a
a v!r! a. x O
X
I
i
t z : 5
'dd0. Gas Service-F�nal
1
x .r
- ,•.
•^i-+
?"41. Solar Domestic-FinAI.S ii ••
.K ''r I
I
+
N
42: $ackflow Preventers '
h ,.
o: •� . ., �-
N
I
,
43. Backflow Ir rigation* • xs
»'
* »
ru '1- 0
44. Landscape I%pati n SystemJJ!v.,
•r
C
tr
E45..Sound Atterivatiom
s_ ez
= ;�:. *
-
--+ -. urs W a
•� rr x
71
rr, ,.r. v
T c w •r »
1 J ,1
s46:
F !r7
••�F
/ 1 r 1
••'�
Handicaq,Regplatio�js _ _
J
�
,;G ,-p
47.�FINAL RE STRWCTU& BUJLDING
^h +
JC' X
x
L (
�r
-
48.'FINAL PLANNING, ; IT
::49. -Electric Release to Edison
a.
I
t
m .r
50.;Gas Rebase to South ern California Gas Do
-, I
f'
r, _.
51. CERTIFICATE OF:OCCUPANCY
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER -BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, 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. 1 personally plan to provide the major labor and materials for construction of the pro-
posed property improvement. 9 Yes ❑ No
2. 1 (have/have not) �pt I signed an application for a building permit for the
proposed work.
3. 1 have contracted with the following person (firm) to provide the proposed construction:
Name _
Address
Phone (
City
Contractor's Lic. No.
4. 1 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 (
City
Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to pro-
vide 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 per-
sonal knowledg 'i compliance with this State law.
Signed: to t C- r T -'II `t )� t o Date: 1 I '3 R
Name: PQ� r i o � Q 1, )Y)) I �_
(Printed or Typed)
C.D.L. a or S.S. #
754-5273
1042 ae
I 15. 44
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING
ADDRESS 1128 Mission Drive
COSTA MESA. CALIFORNIA
Lot 33, Tract A,, �lX3 L E SE E D1961'
FINANCE DEPT.
CIFY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO. PERMIT NO.
OWNER
rl- I-) "R A
MAIL
RECEZ BY OA R�jO�Ij'EO/ DATE IBSUEDI.
ADDRESS t
f l.' �/ `Y�y 1`FO C +nc
TEL.
del Mar Calif.NO. 220
BUILDING
CITYCO ona
ADDRESS
ARCHITECTTEO.L.
COSTA MESA. CALIFORNIA
OR ENGINEERN
p
3800 E. Coast Hiahwa
FIRE
ADDRESS
ZONE TYPE GROUP
CONTRACTOR MaCCo Corporation
APPROVED
BY DATE
ADDRESS 3800 E Coast Hi hwav
ZONING
11,,..ii
CITY yry
ZONE I
-_ 1
NO. OF
USE OF NE
OUILDING
STA
8808
LEGAL --.
LIC.TNo. -SB -1 ND.GR 3L220
DESCRIPTION T- -- U lF Or
SIZE
6204
NO. OF BLOCS.
I
OF LOT S F
NOW ON LOT none
A. P. NO.
USE OF
YARDS EVES
EXIHTING BLDG.
APPROVED ALLOWED
SETBACK LINE FROM
IR N LIN
CENTER OF STREET I 11 REAR YARD 1 11
FRONT '7 FT. IN.
T
I 61 I 61 - -
SIDE YARD LEFT RIGHT
R. SIDE FT. IN.
DESCRIPTION OF WORK
--
L. SIDE FT. IN.
IXX (ALTERATION I (
3
NEW ADDITION
REAR z` FT. S IN.
REPAIR I II MOVING I I DEMOLISH I
APPROVED DATE �j/6�
4
BUILDING NO OF
1611
SIZE 01X ROOMS 7 STORIES 1
StllCC�ROOF
EXTERIOR WALL OF
COVERING COMP.
USE OF BUILDING AND WORK TO BE PERFORMED
Garage 476 S F
area
w/attached garage
Covered Porch etc. 3
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO EOM.
PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
VALUATION
BUILDING CONSTRUCTION.
SIGNATURE OFDel Development Co
PERMIT FEE S
PERM ITTE
By
$16,G84.00
PLAN CHECK S
AUTHORIZED A Ao
TOTAL FEE s4.00