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HomeMy WebLinkAbout1868 NEW JERSEY ST - Building Permits - "a:,-., CITY OF COSTA MESA >y.r �� BUILDING DIVISION F I •^"-^ei ' DEVELOPMENT SERVICES DEPARTMENT PERMIT PE IT� NUMBER � B98-01846 [// (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT • Job Address: 1868 NEW JERSEY ST Status: ISSUED Suite: Applied: 10/12/1998 Vicinity: Issued: 10/12/1998 Parcel Nunmber: 13910318 Zoning: Applicant: LUKE, GARY Address: Phone: - Zip: Owner: ROBBINS; LARRY R Address ROBBINS,JOANNEC - COSTA MESA,CA Phone: 549-3664 , - ' 1868 NEW JERSEY ST - Zip: 92626 Contractor:: LUKE ROOFING - Address: 00448 S MONTGOMERY .t., • � Phone: 633-8798 �c • " ' -ORANGE.CA Zip: 92667 • . License: 672569 Arch/Eng: • s ' ' Address: "' - , !�`, - . Phone: - : / , Zip: License: - l SCOPE OF PERMIT ' .REROOF OVER EXIST. 1 LAYER WOOD SHINGLES WITH 1 LAYER OF SAME • - FEE SUMMARY ;.f j Plan Check: $0.00 " — 1 , , Calc Valuation: - $4,soo:oo ` Permit: $99.75 / / Claim Valuation: ,: $4,500.00 SMIP Res: $0.50 :' r SMIP Corn: $0.00L.- / ' ` Other:". $0.00 - _. Inspection:, $0'.00 . • Total: $100.25 , , PLANNING &ZONING ' SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right .0-0 - • ACCESSORY Front 0-0 ' Rear 0-0 Left . 0-0 Right . 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 ' NOTES: EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. I 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. IFOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'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: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)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 workers' compensation laws of California,and a rethe 'f I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: // Date: .,./C 'i2 .- Yj- WARNING:FAILURE TO SECURE WORKERS` NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION THE CLtST 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 o apter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.ft Class e C '.�S Contractor's Signature: z Date: /G—/ 2 - er../ i / 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: Lenders 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.). ❑ I, as 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: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax 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,or demolition or 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. Signature: Date: 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 0 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 Califomia 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? 0 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 appermit 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 Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If aermit 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? 0 Yes 0 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: Date: 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 roe not to occupy or allow occupancy of any building authorized by this permit until final inspection. e er(s) Date CI-- And/Or Authorized Applicant Date DOM 6 INSPEDTIONTYPE D&M =AIS CODE! INSPECTION TYPE DAM DNTmASa 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ? /0 2081Final Plumbing 200 Final Re-Roof �d 9G�� 210 Final Electrical 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 Building/Occupancy 2446-46 - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CIT A MESA777.19.-0.)--• •- CONST• CTION'P RMIT PER MI • �TjNO. 'TRACT NO. LOT NO. UNIT NO. I Project Address /7G d- �O.0-� • : •• r aV 5 ; . '8177 6/24/86 , ! 1,5`50 ' TL Applicant's Mailing Address / s�. ./ddi t' ry , TYPE OF CONSTRUCTION. ❑ NEW U.ADD ❑ ALTERATION H REPAIR r - Owner's Name NUS p.M RS ,0934,CS . PSone7j^S/_'�'-� ❑;CONVERSION ❑'DEMOLISH ❑ OTHER _ i " ; ;1 ,,f1'' 11'' DESCRIPTION OF WORK/USE OF BLDG. � - �/f,� � A.P. _ - Zone • Address !���''zyp,/d 5@N-,SeF' I • !• r�l til ..- S Main Building: . Accessory Building: I Arch/Eng. License-No. 'J/D,P33• T•YPE OF PERMIT tJ GRADING ❑ FOUNDATION ❑ STRUCTURAL ,T Front ! • p ' Address ' ❑ TENANT ❑ ELECTRICAL X PLUMBING ❑ MECHANICAL ',B - N //,, • �" • ❑ OTHER - .A Rear • I - Contractor's Name leges /e, keetnener_�7 C` Phone CR2-JG.7/ - - — - -- - - ' - — ' , - �j! PROJECT DESCRIPTION SQ.�FT. OCCUPANCY C Right Address(mailing) r-_�462 4:46/7.0e- Gia-AeN •63COV 2 K Left I • G CONSTRUCTION TYPE VALUATION$ $ - R City License No. : ZONE • GRADING CU.YDS. ACRES pl ng. Ref.# , Parking Req./Provided ' E LICENSED CONTRACTOR DECLARATION ' ' •.- O I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: � 1 /n/ • Planning Notes: l ! ' I { ! • ; M ^ with section 7000)' of Division 3 of the Business and Professions Code, and sf' 7 T 1 `my license is in full forceand effect. , I I I • - . . I ' A License Class C- SKr License lyo. ' c _! i f • S, .1 Date L/f�/�4p Signature z.r t -? * . ' PLUMBING ' , FEES. - ; I rl '� WORK RS' (.COMPENSATION DEC ARATION - •- - l I I _ I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink, Showers - ELECTRICAL > - FEES of Workers' Compensation Insurance, pr a certified copy thereof (Section Backflow Preventer • Service Sink - '^ I f `l� 3800, Lab. C. �� yze1 •• Automatic Washer Transformer .❑ 15 50 KW ;1 Policy\No.�P4Q 'C Company .S• / `' . , Backflow Irrigation ' Sewer Ca _ - - • ^ I •.❑ 50+ KW; . tI r ❑ Cor yyI trigay furnish e•. �# - ,kaE!/VC/ sem-- Construction Pole Sub.. ; Cer as a-r1yy {jIc4LLvlth the cit• 1� 'ZNIo Bathtubs �D Sewer Connection ' a_rQV Cooking Unit Meter ❑up to 100 amps -' ' EXEM-TIO ROM WORKERS'COMP NSATION DECLARATION.' Clarifiers Solar Collectors . Dishwasher ✓. _ Meter Clover 100 amps ; 1 (This section need not be-completed if the permit is for one hundred ($100) or - - . . - less) - , Dishwasher . Solar Piping Dryers ❑Gas .❑Electric Sub Panel. - I I certify that in the performance of the-work for which this p mit is issued, I - ' - shall'not employ any person'in any manner so a .•.ec• subject to the Drinking Fountains 1 ' Solar Tank Fan a Motors❑0.1.HP ❑1%-8 Workers' Compensation Laws of Califor J. -L , t - - - - Date _ _ - \ Floor Drains , ' • Swimming Pool w/Spa p,A.U,' - Inc.Sola? ❑9-15•HP'❑16-15+^ ' �.. -NOTIC . If,•af •r. a ing this declara io , you should become su•1-ctcto the.. ! ._ - . - _ . - - . - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - . Urinal i ' Fixtures l I comply with ,such' provisions or this permit shall be deemed revoked. Microwave • CONSTRUCTION LENDING AGENCY I Gas Service Outlets T `' Water Closet V bp: Device Boxes Pole Light I • hereby afferr thatithere is a construction lending agency for the performance - - - A. r g , ' Of the work. for'which this permit is Issued (Section 3097:4Civ. C.) ' -,•, Interceptors Water Heater Outlets Lender's (Name •-"^ ,•1 Range 1, y .Lender's.Address - ' ' '' - Kitchen Sink '_ • Water Service - r.. :- - - - -•?. . OWNER BUILDER DECLARATION Switches-' Sign , • I hereby affirm that I am exempt from the Contractor's License:Caw for the /- Lavatories U-/j' Auto-Wash ' A�-Dr Garbage Disposal Standing Sections • •- following reason (Section 7031.5 Business and Professional Code: Any city or l 1 - county which requires a permit to construct;alter,improve,demolish or repair P-Trap i I • Laundry Trays Generator)❑0-5 KW ❑5-15 KW. any a s structure„prior r to its issuance, also requires the applicant uch permit - Trash Compactor �• , to file a signed statement that he/she is licensed pursuant to the provisions of ? - the Contractor's License Law(Chapter 9(commencing with Sec ion: 000) of Roof Drains • _n I . C i • -.Division 3 of-the Business and Profed exe•Code) orth zt he/she is exempt- - •- - - - -- - - -- - - -- -- - - •7031.rom and Service ; .for a permit subjects the applicant to a civil / /4iT�-e/ "yeN .•,,E•' (f3p1.4,-, • ) - , /IUl— -penalty of of not more than five hundred dollars ($500). I / J S " ' I • UI, as owner of the 'property or my employees with wages as their sole Reinspection Fee $15 - . Issue Fee 1 • $ ' compensation, will do.the work,and the structure is not intended or offered 1 - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Businessland Professional Code:•The Contractor's MECHANICAL FEES' - - License Law does notapply to an owner of a property who builds or improves • - ' thereon, and who does such work himself/herself or through his or her own _ DEVELOPMENT SERVICES REQUIREMENTS ' ' employees, provided that such improvements are not intended or offered for Boiler (Hood or Type I '❑ I _ sale, If, however,'the but ding or improvement is sold within one year"of cam- -• - -- Canopy Type I ❑ , l Zoning Approved By Date - prove , the owner will have the burden of proving he/she did not build or im- Duct- Under Ground ' I I Building Approved:By /� '- Date • I prove for the purpose of sale); I�,d11Y) yy ❑'I, as owner of the property, am exclusively contracting.with licensed con- ' Duct-Structural ' Refrigeration System -Application Issued By ` ' Date oZy' O� tractors to construct the project (Section 7044,Business and Professions Code: ' The Contractor's License Law,does-not apply to an owner of property who Duct-Ventilating . I , ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES '- I - - v builds or improves-thereon, and who contracts for such projects with a con- - - - _ - _ _ tractor(s).license pursuant'to'the Contractor's License Law). I am aware that Exhaust System ❑ 'Multiple❑ System Repair/Alteration BUILDING PERMIT- •$ ' SMIP '$ proof of,their Worker's Compensation insurance should be provided to me. - - PLAN CHECK ' - 1$ - PERMIT, ' ❑.1 ani exempt under Section - - e.& P.C. •for this reason' Firepl/Fact.Blt.ICBO# ,Fire Dampers ! •' ISSUANCE i$ .- - - _ PLUMBING • $- _ ^`�O Date towner Heating System& Ducting • - ' Registers - - PLAN CHECK •25% •$' ' cp c ;: ENERGY P.0 �$_ I hereby certify.rthat I have-read this application and state that the above ❑0.100,000 BTU ❑100,000 BTL III�'+II1- ELECTRICAL - '.GRADING $ ' -' ' information is correct. I agree to comply with all'city and county riz repro' I I ) '$' • and state laws relating to building construction,and hereby authorize repro _ ? - MICROFILM •$- - sentatives of this, city to. enter upon the above-mentioned property for-_ I •' - . , PLAN CHECK-• 50% .S. ••• _ _ l Inspectio -P es. �j/�� _ Date G/•�y`�� MECHANICAL - $ - TOTAL FEE_ $, _IS- S • Signature �� • :Drivers' License • - Reinspection Fee • • •$15, Issue Fee $ 3 PLAN CHECK 25% '$- , CMF 0865-46,rev.-10/84- White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • . f . y 1i 4 CONSTRUCTION AND'PLANNING POOL&SPA o Date Inspector , Date • Inspector ,APPROVALS Permit# - APPROVALS Permit# as 1•. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd: ,. . 4-24•:,1,. LU) 1 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms y 4. Electrical Conduit-Undrgrnd. 55.' Electrical Bonding y 5.,Steel•Rein'forcement• 56. Rough Plumbing & Pressure Test d 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 1• 58. Electrical Conduit-Undrgrnd. ' m 8. Foundation• 59. Gas Pipe, 0 Undrgrnd.,Test 9, Water Pipe-Undrgrnd. 4-2.41-4, GL:) - 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• • 12. Sewer Cap 63. Heater & Vent-Final 13.-Roof Drains' 64. Plumbing System - Final , • 14.-Rough Plumbing - 7/43/9 LEO 65. Electrical-Final i 15. Rough Electrical-Conduit - 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 4 , 69. POOL/SPA 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, Ventilating _ 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank U Gas 0 Oil 25. Roof Sheathing ' - 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27.-Frameand Flashings 76. Dry Standpipe 28. Lathing & Siding • 77. FIXED SYSTEM FINAL l 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing . - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 1 79. FINAL INSPECTION • • 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED ,%• 33. Final Electric - Notes: / 34. Final Heating & Air Conditioning . : • • 35. Final Gas Pipe-Test • 36. Hood or Canopy . 37. Final Factory Fireplace , 38. Final Plumbing • 0-to-It ( # 39. Water Service-Final . 40. Gas Service-Final - 41. Solar Domestic-Final . 42. Backflow Preventer 43. Backflow Irrigation ' . 1 - 44. .Landscape Irrigation System • . 45. Sound Attenuation .. :.46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed • 49. Electric Release to Edison 50. Gas Release to'Southern California Gas Co - . . 51. CERTIFICATE OF OCCUPANCY . No. • • Date _ . t Applicant to fill in all spacesexcept those within heavy border lines and sign all appropriate tlecla folie ns.- - _ - - `� OF - - B MIT NO. TRACT •NO. LOT N0. UNIT Nor: _ _ _ • 4768 I .E/0 /3• '; r r-: i_t - . T . `t,-I • `Adrss " MESA • CONSTRUCTION PERMIT -EMIT 23 6'% 3640 ,e,p5I - ' • • [[a�pppp N PrG, Address �OVQV •Q.\N1J ,QrC�jQ� �\ pp 1�� - I Applicant's Mailing Address 'a`.35 ' o,c., -cb C.vv.,. . . TYPE OF CONSTRUCTION H NEW KADD H ALTERATION LJ REPAI R Owner's Name e� 01 CONVERSION ❑ DEMOLISH ID OTHER + G1 p P�CC1 `r\b$�\N4SPhona �. O .- A.P.AP # .13 "f fl�' V - Zone. /��. - DESCRIPTION OF WORK/USE OF BL G. AC7n 'Q•oROC"t`f\ Address ��wv�•c'��5 IRCD\-CC-a\ - - .Q.y�^ v,r- �� tj •QiNe..��cy '�\G�.<•�+St•O Q^ .e S Main Building:, r2�, Accessory Building:' ,, Z Arch/Eng.C+`.D4\. �`I\Oxt`t e't License No. N*� TYPE OF PERMIT LI GRADING' 1.'J FO_llf LATION 1CMSTRUCTURAL' - _ T Front , s)/G14; r = O. Address (QaZS \�v�4l�• \�c�• d'Ce..cv e. - ❑ TENANT _❑ ELECTRICAL ❑ PLUMBING '❑ MECHANICAL . B Rear n - I , - - N Contractors Name ��¢,C0`� aN �7DcIPhyon0\� oZEa • .qOTHERI - ...5A ? . I Address(mailing)f7.0 S Q.. 6-Set LbS"tcCC ' ' GS PROJECT DESCRIPTION SQ. FT: ��: OCCUPANCY --* C Right e��• -• • N r_O�� , , CON ST RUCTION,TY OOO �� �(q LUATION$ "a��,bOp� $ Left %' s , - • R' City License No, lLJ , - w'• - ZONE GRADING CU'VDS, ACRES ' Ping. Ref.# , Parking fleq./Provided t E LICENSED CONTRACTOR DECLARATION • ' • -- - - I -+ I hereby affirm that I am licensed under provisions of Charter 9'(commencing ' Remarks: ' ' ' - Planning Notes: I _, M • with section 7000) of Division 3 of the Business and Professions Code, and ' ' _- ` • ' ' T • my license is in full rce and effect. , I P /�` •, 5 ' '�4_ • I ( - $ Licenser Ls- .mor I Li.a se No.-_,.. L • } Date " - - Signature" • t1 �T�- PLUMBING"; i ,FEES I WOR KE-S' OMPENSATION DECLA'ATION • ' - I Bar Sink I ' Showers 1 2 ELECTRICAL i FEES 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 - - - - -- :- -- - - — - - --- - -z--- -- r • . 3800, Lab. CJ v •yk I te., Backflow Preventer Serv.ce.S in ,�. )_11, t,q , M1__ Automatic Washer Transformer 0 15"50,KW. Policy No. - Company f 1" - 1..~ Backflow Irri ation a - - 1 '� 0 50+.KIN 9 $ewer.Cap ,-Lc-c".*-- ---t. f, Construction Pole Sub. - I ElCertified copy is hereby furnished. ,,-f , I - „ - - - Certified copy is filed with the city Building Division. • �� Bathtubs Sewe6Cohnection -•:- �• ' {�•% Cooking Unit I Meter ❑up to 10damps Date Applicant +- - - i - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - . Clarifiers "_ -_ - , , Solar� .7Collectors ', 'I ... -- Dishwasher- - ' . . - - - Meter-.Dover 100 amps-- '- -- --- - (This section need not be completed it the.permit is for one hundred ($100) or-� less). , ,. .. } r Dishwasher I Solar Piping it i r` �.a .r Dryers ❑Gas DElectric Sub Panel ."7••-:' I I certify that in the performance of the work for which this permit is issued•It - - _ shall not employ any person in any manner so'a5 to become subject to the. Drinking Fountains Solafl;Tank '.. -'7-,1,17' •', �.J - Fan Worker g nsation Laws of Cal' pI , y\ _ - •' Motors 00-1 HP 01'/z-.8 • • . Date Signature Floor Drains Swimming Pool w/Spa' F.A.U. ! Inc.Solar 09"15 HP 016"15+ • 'NOTICE: f,atter making this declaration, ou should become subject to th _ - __ _ _ _ __ Workers: Compensation provisions of the -Labor Code, you must'forthwith' . - Floor Sinks; - • • Urinal • • - Fixtures Microwave I I comply with suchh-provisions or;this permit' shall be deemed revoked. - -' •. - • CONSTRUCTION LENDING AGENCY ' ' - .- l .. - - - _ Gas Service t,Outlets' 'Water Closet t� Device Boxes .- - -t••'`� '� - Pole Light I ( 1 hereby affirm that there is a construction lending agency•for the performance , - Ili _� i' • of the ;work for which' this permit •is issued=(Section 3097 Civ, 'C,) I Interceptors ') '' : -Water Heater - - .', Outlets-" -tom' J i Range ' Lender's Name" - _+ %"' ,- Lender's Address NV O�'Q. ' Y X. . Kitchen Sink Water Service, r ; �' • Switches 11'''''•" ✓^ � ' OWNER BUILDER DECLARATION • s • .1• \� /" Sign I hereby affirm that I am exempt from the Contractor's License Law for the + Lavatories- i .• Auto-Wash r - , r 7 Garbage Disposal�r --) - .] ;$tandingjSections ' ' • following reason (Section 7031,5'Business and Professional Code: Any city or - -- - + - ' county which requires a permit to construct,alter,improve,demolish or repair, - P-Trap _ ' ( ' '' .LaundryTrays - i ;Trash Compactor Y i Generatorf❑`0-5 _' 05-15 KW •'any structure, prior to its issuance, also requireslthe applicant for such permit ' - - ;_I �. r- P to file a signed statement that he/she is licensed pursuant to-the provisions of ' Roof Drains ' 1 - 'v ' 'J ,,, - 1 ...the Contractor's License Law (Chapter 9 (commencing with Section is exempt of ' - -- - - "•F'`6� '} ��I�� 4 I ( Division 3 of the Business and Professions Code).or that he/she is exe , therefrom and the basis for the alleged exemption. Any violation of Section -; - ' 'c 1 C.. . 1 - I `a, -- J I, el, ,/.7 ' 7031.5 by any applicant for a permit subjects•the-applicant to a civil ' - • • - ' • - . " _ - - , I penalty of not more than five hundred dollars ($500 . ( ' , II - 'i. r '• . i -:;:ii-,o , ❑ I; as owner of the property:of my-employees with wages as their sole I Reinspe MIOn.Fee I V $15 ' i Issue Fee' 1 $ `3 ` ' ; - compensation, will do the work,and the-structure is not intended or offered - I Reinspection Fee t 41 $15 -Issue Fee $ 3 License Law does 7044, Business and Professional Code: The Contractor's - - I , 'MECHANICAL FEES -- -- - - •-employees,nsLaprovided not apply to an owner-of'a property who builds or improves . - - I - _______ for sale (Section thereon, and who does such work himself/herself or-through his or.her own • - - _ - - I _ DEVELOPMENT SERVICES REQUITE S. /�/�i who, that such improvements are not'intended or offered for Boiler - .- I Hood or- Type I ❑ t- r-' it I • 1 J_ sale. If, however, the building or improvement is sold within one year of com- ' Canopy Type II 0 ' ' "J ZOning.A• pproved •By a Date pletion, the owner will have the burden of proving he/she did not build or im- , Duct- Under Ground ' I - + •- Building Approved By- 'y` �V B ) Date prove for the purpose of sale). - _ x \� -.3147/e6. ❑ I, as owner of the property, am exclusively contracting with licensed con- ' Duct-Structural . - Refrigeration System - ' t., Application Issued By-r - = \\// Date tractors to construct the project (Section 7044,Business and Professions Code: • ' - --- - - - I e _ _The.Contractor's,License Law does not apply to an owner of property who . . Duct-Ventilating - - ❑0-100,000 BTU ❑100,000 BTU -I - i "/' 1 p' 1. t-`A:SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- x l, JJ Q tractor(s) license pursuant'to the Contractor's License Law). I am aware that I '. ' BUILDING PERMIT'. $ ' /6`Tr St' SMIP ' $ !16Q proof of their Worker's Compensation insurance should be Exhaust System 0 Multiple 0 System Repair/Alteration provided to me. ..?PLAN CHECK) rT $ /06.92- PERMIT ' 0 I am'exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers )t • C p. $ - I'-,( ISSUANCE $ - PLUMBING .-� Date Owner, I Heating System& Ducting Registers - . 'PLAN CHECK:.•25%' $ ENERGY P.C. $ 1"hereby certify that I-have read this application and state that the above' 00-100,000 BTU 0100,000BTL '�.�{ - ,s '/ GRADING I $ ' information is correct. I agree to comply with all city and,county ordinances ' \ ELECTRICAL $ 1 . I and state laws relating to building construction,and-hereby authorize repre- • I" s'' - ' `iT f- ' - MICROFILM l $ ' r PLAN CHECK'- 50% $ sentatives of this' city to enter upon the above-mentioned property for -, _ y inspection poses. i i I ,Y MECHANICAL !\� $ - •' TOTAL FEE $ ��J' 10 Signature��Date alk .\ o - v- I V Signature 9f �„ ' Reinspection Fee • $15 : Issue Fee $ 3 PLAN CHECK 25%. $ '1865"46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING i POOL &SPA Date Inspector APPROVALS Permit# Date Inspector. ,. PROVALS Permit# 1 .JTemporary Electrical Service or Pole - - - - 52. Pool & Equipment Location r ' .2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - - 3: Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement- - 56. Rough Plumbing &Pressure Test • 6. Electrical UF ER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings 7 .i .L ,, 1 VV/ • ' 58. Electrical Conduit-Undrgrnd. . 8. Foundation {'J/ '/ 59. Gas Pipe, 0 Undrgrnd.,Test . . 9. Water Pipe-Undrgrnd. - . b.2.[ Lf.1P 60. Backwash Lines, P-Trap, D Undrgrnd. - 10. Structural Floor System 61. APPROVAL TO DECK r 11. Property Sewer-Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final - 14. Rough Plumbing' 7,04.. Lea .- ` 65. Electrical-Final 15. Rough Electrical-Conduit - - , 66. Solar System-Final - - 1.6. Rough Electric Wiring 67. Fencing & Access Approval 17.:Rough Wiring Sign . I 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19•. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT 20!' Rough Factory Fireplace - - APPROVALS Permit# ' 21. Ducts, in Structure .1/4' 70. Underground Hydro 22. Ducts, Ventilating 1•" - 1 ' 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test ; . 72. Underground Flush . 24. Roof Framing tU 73. Undergrnd.Storage Tank 10 Gas 0 Oil . 25. Roof Sheathing /Dad krr `1�[iriji, 74. Overhead Hydro . ) 26. T-Bar Ceiling (Structural) & Mon it • /�/ �, J-Cj 75. Dry Chemical 27. Frame and'Flashing ` 7 2.04. (L / 76. Dry Standpipe • �1 - - ,p � , • "d 28. Lathing & Siding era 't 77. FIXED SYSTEM FINAL 29. Insulation ill, •• Of ��� 78. FIRE PREV. FINAL (I 30. Drywall Nailing , fW HEALTH DEPT. REQUIREMENT• 31. Plaster Brown Coat. - b 4 79. FINAL INSPECTION 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: /zj/c o o S (� Qk. Pia-- . - 34. Final Heating & Air Conditioning 7/1.-c, J-.Uii A[� v � %c _e� r ice. i`v�/ 35. Final Gas Pipe-Test ' L,A i c '% $*a-.0 4,., Argot't' k9- 36. Hood or Canopy 60/KC 37. Final Factory Fireplace • . ne . ' [,��P_ .�0e.-A-r £LM 38. Final Plumbing - [/_$ r "et ti.) . artaat) 39. Water Service-Final it? C6€e s ton n gccj0� (�,- 40. Gas Service-Final & �/4Gorrn v FE41. Solar Domestic-Final 42. Backf low Prever ter L5i�JLe,)LG - /'o�o+" .�/n .e9r 43. Backflow Irrigation - 44. Landscape Irrigation System . 45. Sound Attenuation . 46. Handicap Regulations , ' 47. FINAL STRUCTURE & BUILDING /DA rg 48. Special Requirements Completed 49. Electric Release to Edison - - - ) 50. Gas•Release to Southern California Gas Co ...• 51. CERTIFICATE OF OCCUPANCY - - . No. - Date " - Ca BNI FORM DIA FORM 1486 ' • • INSULATION „ CE..RT.I.F'ICATION Job #450 This is to certify, that, in conformance with the current energy regulations (California Administrative Code, ' Title 25, State of California*) and approved plans, insulation has been installed in the building located at: • Costa Mesa - Orange • . city County - ' • 1868' New Jersey-St. . . _ •_ Street No. (If Available) Street - Lot Number Tract No. DESCRIPTION OF INSTALLATION ROOFS • Type of Material Manufacturer Thickness _ R Value" - EXTERIOR WALLS Type of Material • . fiberglass Manufacturer Manville - • • Thickness 31" R Value" R-11 • (Or Trade Name) CEILINGS Z BATTS: .. - T e of Material fiber lass " Manufacturer ' Manville - J "Type q Thickness 6". R Value" R'19 —a (Or Trade Name) - W. W Sq. Ft.Covered 470 Sq.ft. • p BLOWN: Z Type of Material . Manufacturer • Thickness - No. Bags Vs (Or Trade Name) - ' Z Wt./Bag Sq. Ft.Covered R Value" % - • I- • N FLOORS - a Type of Material •� Manufacturer - Thickness ' R Value" - IX (OrTrade Name) _ O SLAB ON GRADE . . 1 Type of Material Manufacturer ' Thickness R Value" (Or Trade Name) ." 4 • Z_ Width of Insulation Inches 0 • FOUNDATION WALLS (if required) Type of Material Manufacturer Thickness R Value" (Or Trade Name) • - - REMARKS (if desired), R-11 Kraft Type Insulation to skylite shaft. General Contractornt� (Builder) 0'' Eccci, ,k, c:-.)..... License Number' 'ate\3g By�Ct�����xs,...n �.O:0Title Date 9:, 'N,\,%L • Sub-Contractor(Insulation Applicator) Energy Control Insulation. License Number 404822 • '. (Insulation, Masonry, Etc.) (State"SAME"If same as General Contractor) . By Michael E.Sullivan • Tine President • Date July 30, 1986 ('California Administrative Code, Energy Insulation Standards, declares: EXCERPT from Sec. 19875 of the Health and Safety Code of the State "Compliance. Upon completion of the installation of insulation. a card of California: certifying that the insulation has been installed in conformance with the requirements of these regulations shall be completed and executed by "No certificate of occupancy or similar certification that a newly con- the insulation applicator and by the builder. This insulation compliance structed hotel, motel, apartment house, home or other residential card shall be posted at a conspicuous location within the'dwelling.") dwelling is habitable shall be issued by such a building department unless the structure at least satisfies the minimum energy insulation ("R Value is the measure of the resistance of a material or building standards established pursuant to this chapter: component to the passage of heat. The resistance value (R) of mass-type " insulations shall not include any value for reflective facing.) - FORM 116 —PUBLISHED BY• ED*APT*az,kc. 3055 OVERLAND AVENUE,LOS ANGELES,CALIFORNIA 90034—(21318709871 ®1982 - • Form 1486— © BUILDING INDUSTRY ASSOCIATION OF SOUTHERN CALIFORNIA,INC.,1571 Beverly Blvd.,Los Angeles,Calif.90026—(213)625-5771' ,«, +, .. y i.ciK440“02,,a.t• u.dk t"z: o i� , t .-R^`>2rzA£- f ( fit 4:,,,.:-..:,;;;',.::' " s, ?F.G1.•r,. xw. r"�' �. ntoa ,fir�. .� Y - W � +' !�`�a! ,. . :r40 �t �`^n a�- xi ', ea .it4:1Satt A ..ow, �. '�. .� �" t'- ai�= } x .. 4,N or . t - v LYpLqAp - Q ` ^Al SA YYp' y, v Y 1 ^r,,z. a .'' z ;113FR§if iia *�i.".ewm: 1 It i-rt. Lr ei-cA .4-:L ,t } J .. '` City Of Costa Mesa 10/20/36 Dept. of Euildinua Safety 77 Fair Drive Costa Mesa, Calif, RE: 1868 Now Jersey Costa Mesa, Ca. Building Permit # B 23696 Dear Sir, Per your request of drainage verification on above subject property, this is to confirm to you that said property does have sufficient drainage to the street from all yard areas as well as new concrete flat:lork areas. Sincerly, Richard L. Overby NOTE NEW PHONE NUMBER 714-557-1726 2735 DeSoto Avenue, Costa Mesa, Ca 92626 [714) 642-3742 Lic# 291382 • .I �•" Applicant to fill in all spaces except those within heavy border lines andsign all appropriate declarations. ` PER NO TRACT NO. LOT NO. UNIT NO. _ I CITY OF COSTA MESA C(/j��NSTRUCTION PERMIT I { + .9991 7/23/86 14.70 . Tl. • Project Address / $I� +pVLw iJ c v ,.-Y /� L— ��5 J ��//' , , 1 + 1•. .,. Applicant's Mailin A r ss S !l7 S.'ea�`.t� Sam 4 4N., TYPE OF CONSTRUCTION ❑ NEW 1.9 ADD, L_I ALTERATION U REPAIR - - I i I 75is '�'^•� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' Owner's Name -ten J + I�`g N , Phone I DESCRIPTION OF WORK/USE OF BLDG. , Address <-`^^' ��"+!- l I S Main Building: I ,Accessory Building: , Arch/Eng. License No. TYPE OF PERMIT LI GRADING, ❑'FOUNDATION ❑ STRUCTURAL ; T Front ' i • I I ,O Address '•(( ❑ TENANT Ve LECTRICAL '❑ PLUMBING ❑ MECHANICAL B Rear N C• ontractor's Name P'Ou.• ' ' (c . Phone`f2." Ob ❑ OTHER ' ' A _ _ _ ...p 1 • j /• PROJECT DESCRIPTION; SQ. FT. ' OCCUPANCY C Right ; - .G ' Address(mailing) >t s•7 S. L>1? 0 CA- - 1 K ' _ - - ,,,[ II CONST RUCTION TYPE • VALUATION$ $ Left City License No. JL�Z( gidb { - R • 'ZONE GRADING CU.YDS,' - ACRES ' Pln Ref. # i ParkingR _ E LICENSED CONTRACTOR DECLARATION I ' n .. -, 9 eq./Provided 1 Q I hereby affirm that,' am licensed tinder provisions)of Charter 9 (commencing Remarks: !.� l :Planning Notes: i M ' with section 7000) of Division 3 of the Business and Professions Code, and Z 3t" 7 6y • - ' • my license is in full force and effect: ` 7 5r - - - T • Licens- lass - _ b i ' & 6 7 - , , _ - _ • Date 2 • Signature ��i�G%I�/l • PLUMBING ,FEES ' ! WORKERS'COMPENSATION D'% F" ' r • I ' - _ Bar Sink' :Showers I ' • I ' r FEES I hereby affirm that I have a cert fate of consent to self-insure ora certificate - - + ELECTRICAL• t i of Workers' Compensation Insurance, or a certified copy thereof (Section i. Backflow Preventer - 'Service Sink. ' .0 - V . Transformer°❑'-15-50 KW 3800, Lab. C.) .. - - Automatic Washer: -" - Policy No. I Company Backflow Irrigation Sewer Cap ' = Construction Pole Sub. ❑ 50+ KW q El Certified copy is hereby furnished. - - • . _ r L - - •Certified copy is filed with the city Building Division, Bathtubs • � Sewer Connection Cooking,Unit' Meter ❑up to 100 amps ' Date Applicant - ' - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers, Solar Collectors - • I , Dishwasher ' ' 'Meter ❑Over-.100 amps, ' (This section need not be completed.if the permit is for one hundred($100) or - less). . - Dishwasher ' - Solar Piping , : - ' Dryers ❑Gas ❑Electric' 'Sub'Panel I . . I certify that in the performance of the work for whi h thI perm it is issued; • - I shoo not employ a person in any mane as o - ome subject to the Drinking Fountains • Solar Tank Fan ` Workers' e5Y//o//fihygB/�stiory;l.aws of CalifoW/ry/f/�' - - sZ - Motors❑O HP 011/2-8. 4 Otf — Date Cr e pap•Signature • Floor Drains Swimming Pool w/Spa - ' - F.A.U. ' _ •Inc.Solar ❑q-15 HP 01&15+.NOT( 1 after maWnq.rovi provisions.of n,.y should become subject to the - •- _ . Workers' Compensation provisions.of the Labor Code, you must forthwith Floor Sinks Urinal // Fixtures ' Microwave a; �17� comply with such -provisions or this permit shall be deemed revoked. - t .?1 CONSTRUCTION LENDING AGENCY I Gas Service Outlets Water Closet I hereby affirm that there is a construction lending agency for the performance ... ' • 'Device Boxes , Pble Light I I . , of the work for which this permit lis issued (Section 3097 Civ. C.) Interceptors Water HeaterOutlets Lender's Name • /O Range , lac Lenders Address.. ^Kitchen Sink - — 'Water Service - • - - - Switches OWNER BUILDER DECLARATION - 8Sign 'I s I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-WashGarbo a Dis osal following reason (Section,7031.5 Business and Professional Code: Any city or - g P Standing Sections• , county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays • Generator 00-5'KW ❑5-15 KW Trash Compactor any structure, prior to its issuance,.also requires the applicant for such permit P , • to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ' • the Contractor's License Law(Chapter 9ions Co racing with Section 7000)of ' ' ' Division 3'of the-Business'and Professions Code)-or that-he/she is-exempt - - -- - - - • - -- - • - - --" - - - - "' • -- 7031.rom and the basis for the alleged exemption. Any violation of Section • , 7031.5 by any applicant for a permit ss($5 subjects'the applicant to a civil - • penalty of not more than five hundred dollars($500), ' J I, as owner of the property or my.employees with wages as their sole Reinspection'Fee $15 ' - Issue Fee , I $ 3 .. compensation, will do the work,and the structure is not intended or offered _ - Reinspection Fee I $15• Issue Fee , $ 3 . for sale'(Section-7044, Business and Professional Code: The Contractor'sMECHANICAL ' FEES License Law does•not apply to an owner of a property who builds or improves . - .thereon, and who does such work himself/herself or through his or her own - - DEVELOPMENT SERVICES REQUIREMENTS: . employees, provided that such improvements are not intended or offered for Boiler - ' Hood or ;Type I ❑ _ - ; 1 sale. If, however, the building.or improvement is sold within one year of corn- Canopy ,Type II 0 Zoning Approved By Date .prove , th owner willrhavele the burden of proving.he/she did not build or im- Duct- Under Ground Building Approved By e - Date ' ��- a prove for to own pose of sale). ' " iL-66) �-- `` • Ll'I as.owner of the property, am exclusively contracting with licensed con- Duct-Structural • Refrigeration System Application Issued By - . ' - Data 'tractors to constructithe project (Section 7044,Business and Professions Code: - -: I • The Contractor's License Law does not apply to an-owner of.property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES - - builds or improves thereon,and who contracts-for such projects with a con- - - - _ r. tractor(s) license pursuant to t he•Contractor's License Law). I am aware that- Exhaust System ❑, Multiple 0 System Repair/Alteration BUILDING PERMIT_ $ - -SMIP, _ $ _ ' proof off their Worker's Compensation insurance should be provided to me. PLAN CHECK $e_ PERMIT _ 0 I am exempt under Section B.& P.C.'for this reason Firepl/Fact.Bit. (CBO# ' I - , I -ISSUANCE % $ t ..• PLUMBING , 1 ^'$ I 'Date " I Owner - Heating System& Dotting e PLAN CHECK 126%' $ ' • ENERGY P.C.• $ .' hereby certify that 5'haJe read this application and state that the above ❑0.100,000 BTU 0100,000Bt - , ELECTRICAL _ e' GRADING . , $ . -information is correct. agree to comply with all city and county ordinances ' n - .and state laws rel. o P. construction,and hereby authorize.repro-, - - �V MICROFILM $ - • sentatives 'of i• 9/ upon the above-mentioned pro erty or _ - , PLAN CHECK 50% $ _ -'/ 'inspection P - y� � / �. - MECHANICAL ' , $ �4/10 'Signature �d��//Gei. • Date 7. 3 �' • TOTAL FEE $ Drivers' Li =rase or S# CMF 0865-46,rev. 10/84 White.- Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 1` L CONSTRUCTION AND PLANNING POOL & SPA - o Date- Inspector - • Date- Inspector APPROVALS Permit# APPROVALS Permit# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd.i' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. -54. Forms - y 4. Electrical Conduit-Undrgrnd.9 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test iti 6. Electrical UFER Grnd. . 57. APPROVAL TOCCOVER-GUNITE _ 7. Footings .• 58. Electrical Conduit-Undrgrnd. ill 8. Foundation . . • 59. Gas Pipe, O Undrgrnd.,Test - 9. Water Pipe-Undrgrnd. . 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 12. Sewer Cap • 1 63. Heater & Vent-Final 13. Roof brains 64. Plumbing System - Final -, 14. Rough Plumbing • • 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar.System-Final - 16. Rough Electric Wiring : • 7.7,4 8-6 e 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 • 20. Rough Factory Fireplace APPROVALS Permit#_ - _ I 21. Ducts, in Structure 70. Underground Hydro - . - . . 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof. Framing • - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 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. Insulation78. FIRE PREV. FINAL 30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION , i 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric /0,3_r`,t'J0-- Notes: • :r 34. Final Heating & Air Conditioning �l - 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace • • 38. Final Plumbing - 39. Water Service-Final 40. Gas Service-Final • • 411 Solar Domestic-Final • ' 42. Backflow Preventer - - , 43. Backflow Irrigation , 44. Landscape Irrigation System . ' 45. Sound Attenuation. - - , '46. Handicap Regulations - - • 47. FINAL STRUCTURE & BUI LDI NG , 48. Special Requirements Completed - • . - 49. Electric Release to Edisoh ' y 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY - - . No. Date . • • _ _ _ _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PTY Address ._ - _ _ _ ... . _ ' — PERM! •O. TRACT NO. ' ;LOT NO. UNIT NO.: - • •' CITY OF COSTA mEs CONST UCTION PERMIT oZ (o3q i 9931 7/22/86 + 8.00 TL 'I • TYPE OF CONSTRUCTION ❑ NEW L I ADD ALTERATION ' Applicant's Mailing A r ! /7/7 eft< Jetf9//fa77 / LI REPAIR; ` ' _ /¢�1� y e/' ❑ CONVERSION` ❑ DEMOLISH ❑ OTHER A,P,# I Zone • Owner's Name' 1/Cte 022(4.9R ' Phone ^ / . - . - . , - . . - - .._ , i -. -. - CC� -- -- DESCRIPTION OF WORK/USE OF BLDG.' • Address .Y^7%�� • • ; S Main Building: ! 'Accessory, Z ' Arch/Eng., / License No. TYPE OF PERMIT -❑ GRADING U'FOUNDATIO�N 0 STRUCTURAL T Front , I t ' 0 Address - S •i ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING CJ MECHANICAL B I , N Rear Contractor's Name : WA(Ira ' /��' -S Phone 65a-2-sir, '❑ OTHER . . / A _ l ' ' I � PROJECT DESCRIPTION• SQ. FT. oCC OCCUPANCY• -C Right N' Address(mailing) l�7 �'): F� L.L-(/1 S Left I I R ''COfV STRV CTION TYPE !VALUATION $ ._ City License No. • ZONE 'GRADING CU.YDS. ACRES I Ping. Ref. # ,Parking Req./Provided -I E LICENSED CONTRA TOR DECLARATION! - ' - • - -. . < Q •I hereby affirm that I am'licensed under'provisionsof Charter 9 (commencing Remarks: qq1 •� c, , , • I Planning Notes:' M • with section 7000) of Division 3 of the Business and Professions Code,and L� 2 .�-5�'7 ' - my license'is in full t• ce and effect. I I , . l SI License ..s '-a ' License No.2�x� D - . _ _ Oa Signature n . L-' _ — • - : , _ PLUMBING " - i FEES Date , , - I - - .� WORK -S'Ce MPENSATION DECLARATION Bar Sink • ,Showers • - .- - I hereby affirm that I have a certificate of consent to self-insure or a certificate . - - I- , ' • - 1 - i _ • ELECTRICAL' _ I . - FEES * - of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Prev¢nter Service Sink • r - :- I s 'i 3800; Lab: C.) Automatic Washer Transformer'❑�15-50 KW Policy No. Company • eackf low,l rti anon - El Certified copy is hereby furnished. g - Sewer Capr - I , I '❑ 50+KW t - Construction Pole Sub. Certified copy is filed with the city Building Division. Bathtubs 'Sewer Connection : I - r Cooking.Unit• - Meter ❑up to 100'amps - Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers = - ;Solar Collectors ' Dishwasher ' _ Meter ❑over-.100• amps y I - (This section need not be completed if the permit is for one hundred ($100) or - , - - . - . less). : Dishwasher: - I - .Solar Piping - Dryers ❑Gas ❑Electric; 'Sub-Panel' . , 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 Drinking Fountains Solar Tank 1 - _ Fan Motors 00-1-MP ❑1'h-8 J. Worker e n Laws of Califon 1 _ - - Date '1 Signatures/xw��� Floor Drains' SwimmingPool w/Spa ' - i Inc.Solar r P F.A.U. -' ❑9-15 HP ❑16X151 .NOTIC if at r making,this declaration,.you should.;eyome.subject to the - - - - - - - - - _ Workers' Compensation provisions of the Labor Code; you must forthwith Floor Sinks Urinal / Fixt ureS • 1 comply with such provisions or this;permit shall be deemed revoked. I I , Microwave , ` CONSTRUCTION LENDING AGENCY s - ' Gas Service Outlets Water Closet Device Boxes • I hereby work that there Isa is permit lendingagencyc for the 97rfCiv. C,) - • -- r Pole , of the work for which this permit is issued' (Section 3097 Civ. C'.) ' 'r, ' Interceptors Water Heater Outlets Range ' ' ' Lender's Name - - _ Lender.•s Address ' 1, _ Kitchen Sink . 'Water Service -, -- - 1 , -- Switches —' ' Sign . - ' -- • - • OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories ,Auto-Wash _ , Garbage Disposal • Standing Sections ' - • , following reason (Section 7031.5 Business and Professional Code: Any city or - • county which requires a permit to construct,alter,improve,demolish or repair R5Trap I Laundry Trays •'." Generator ❑0-5 KW ❑5-15 KW any structure, prior to Its issuance, also requires the applicant ch permit Trash Compactor I to file a s ctor'statement that he/she is-licensed(co sed pursuant to the provisions of s ; s i , • ! _ • , • the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Roof Drains .� -Division 3 of the Business and-Professions•Coie)•or that he/she is exempt- - -- - - - - • -. •• - •-- - - - ' 7031,rom,antl 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). II • ' ' i I , ; • 0 I • ,as owner of the property or my employees with wages as their sole Reinspection -Fee . I' $15 Issue Fee, $ .3 ' compensation, will do the work, and the structure is not intended or offered 11 ` Reinspection Fee -I $15• Issue Fee ' ! , for sale (Section 7044, 'Business and Professional Code: The Contractor's MECHANICAL ( FEES - -' , License:Law does not apply to an owner of a property who builds or improves ___ _ - I _ • .thereon, and who does such work.uimself/herself or through his or her own - - — DEVELOPMENT SERVICES REQUIREMENTS: . - I employees, provided that such improvements'are not intended or offered for Boiler Hood or 'Type I ❑ sale. If; however, the building-or improvement is sold within-one year of com- - Canopy Type II ❑ • Zoning Approved By , Date • ` -prove for owner,se o have the burden of proving he/she did nghbuiltl or im- Duct-Under Ground Building Approved By • Date I - prove for the purpse of sale). - -4 El:1, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System; Application Issued By - Dat— .tractors to constructithe project(Section 7044,Business'and Professions Code: - The Contractor's License Law does not apply to an owner of property who /• Duct-Ventilating . ' 00.100,000 BTU 0,100,000 BTU 2. Ca SUMMARY OF FEES - •- - . builds or improves thereon,-and.who contracts-for such projects with a con- ! - - 'tractor(s) license pursuant to the Contractor's License Law)! lam aware-that Exhaust System ❑ -Multiple 0 - System Repair/Alteration I BUILDING PERMIT $ SMTP- I $ '- proof of their Worker.'s Compensation insurance should..be provided'to me. I - - a ' <• - r - -- _ — I• PLAN CHECK -. $ _ •_ PERMIT ' - I :❑ I am exempt under Section' B.& P.C.for this reason Firepl/Fact.BIt.,ICBO# Fire Dampers PLUMBING $ _ 1 ISSUANCE $ C Date - - Owner I - - ' - - Heating System& Ducting ,Registers - - -ENERGY P.C. $ - - - Z PLAN CHECK 25% $ - i hereby certify that I have read this application and state that aboie 00-100,000 BTU ❑100,00013T_ • , ' . : ELECTRICAL $ ' ' 1 GRADING ' $ information is correct,-I agree to comply with all city and county ordinances ' - and state laws relating-to building construction,and hereby authorize repre-'. - PLAN CHECK 50% $ - MICROFILM' $ - 'sentatives of this city to enter upon'the above-mentioned pr perty f ., I - • . inspection •u •ores.' - - MECHANICAL _$ TOTAL FEE $ . 4 0, - Signature . Date • • Drivers' License or SS# .; $1 - Reinspection Fee . 5- , ,- Issue Fee $ 3PLAN CHECK 25%- $ - CO - • CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor L.- -•.4-•i CONSTRUCTION AND PLANNING POOL &SPA. , APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector act .. 1. Temporary Electrical'Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd: • 53. Steel Reinforcement` 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • ' Q 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • ' to 5.'Steel Reinforcement 56. Rough Plumbing'& Pressure Test ^ 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System S 61. APPROVAL TO DECK 11. Property Sewer Line.& House Connection - 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Signs 68. APPROVED FOR PLASTERING . . .• 18. 'Rough Electrical-T Bar Ceiling . 69. POOL/SPA 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, Ventilating 1 - q;Yis6 (*3 71. Product Piping 0 Gas OOil 23. Gas Pipe-Rough & Test; - • 72. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil •• • 25. Roof Sheathing • 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 PREY. 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: 34. Final Heating & Air Conditioning . t1_cr.44 (,esl - 35. Final Gas Pipe-Te'st l 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 "43. Backflow Irrigation - . - 44. Landscape Irrigation System - 45. Sound Attenuation • 46. Handicap Regulations ' • • 47. FINAL STRUCTURE & BUILDING . . - • 48..Special Requifements Completed . • r 49. Electric Release to Edison' 50. Gas Release to Southern California Gas Co ; '51. CERTIFICATEOFOCCUPANCY _ No._- ' Date 12483 FEE JULE�CIFIVED Cf; TA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely APPLICATION FOAITVE I£OSTA MESA TYPE OR PRINT BUILDING, ADDRESSAD1868 New Jersey St. COSTA MESA. CALIFORNIA For Office Use Only P I RECEIPT NO. reetp Q�{ OWNER New York�+ Properties, Inc. - - .J ADDRESSMAIL E. S B RECEI BY DATE RECEPI DOI ,AILS [arum11 419 17th t 7�6 :ira I U TEL. BUILDING CITY Costa Mesa NO. TEL.,. l 59_ ADDRESS ARCHITECT • Carlson & TEL. COSTA MESA. CALIFORNIA OR ENGINEER Middlebrook • - NO' - (, FIRE /� r� ADDRESS Garden `rove ZONE TYPE (/ GROUP G CONTRACTOR Dike & Col enrove, Inc. APBY DATE ADDRESS 419 E. 17th St. • ZONING he y'D ZONE NO.OF / USE OF NEVf�/ / CITY • Costa Mesa �I PLANE �Ir BUILDING �. LIC.NO. '16729'3 NO. Li . 8-1159 LEGALSTATE TEL. I/ DESCRIPTION Lot 88, Tr. 3648 SIZE OF LOT 60 x 100 I NO. OF 9LOGB.nNow ON Lot one A.P.NO. 0.-‘..-r ---""--- USE OF YARDS EVES EXISTING BLDG. none , APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.)5 CENTER OF STREET 521 REAR YARD 25 I FRONT FT. IN. SIDE YARD I LEFT 51 I RIGHT 51 L` R.31DE / FT. IN. DESCRIPTION OF WORK L.SIDE �/T. IN. X IIALTERATIONI II ADDITION I .5 NEW REAR � FT. IN. REPAIR I II MOVING I I DEMOLISH I APBYPROVED °A."19 L/1 D�/1 ?`10 O BUILDING NO. OF SIZE 1/50 sq.ft.ROOMS 6 STORIES EXTERIOR WALL I ROOF COVERING F711r•rn COVERING Cmmn, & Rnrk USE OF BUILDING AND WORK TO BE PERFORMED • Single family residence with attached garage. Plan 40AR - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE ANO STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COM- PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY TION.ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION L VALUATION PERMITTEE OF - — n PERMIT FEE s 35. N il $ 15,045. PLAN CHECK 5 17.50 4' AUTHORIZED AGENT Dike & e•rove 52 50 0 ..�... . ,. ... . -. - . TOTAL FEE . .. z� FEE RECEIVED • CO217 STA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX all COSTA MESA. CALIFORNIA ' OCT 281960 NANCE For Applicant to Fill In Completely APPLICATI(�FIO�Np�.PpI�ppIUDH�TEPT. . TYPE OR PRINT 'tiIT "lY7WJIri MESA BUILDING ADDBUILRESS DING kgW/Uriti ^)-RnEY Sr COSTA MESA. CALIFORNIA / For Office Use Only Pin- /�,,,,Cis/�,., I RECEIPT NO. Ip (�repT.ND. OWNER //i!/./- I....c ll afee_/_f'e - R.•.),A-0.1. f'T MAIL r RECEIV D BY OAT RECEIV D DA E$ISSUED ADDRESS Nn T CITYCCtiOrn///ES// NO.L. EBUILDING ADDRESS ARCHITECT TEL. OR ENGINEER- NO. COSTA MESA, CALIFORNIA ADDRESS FIRE ZONE // /r �9 �� p /, • �'^/ APPROVED TYPE (/ ,GROUP YI CONTRACTOR' CC We'. LQ(q/C/4'TI 40 re BY - DATE ADDRESS/225"n Cnc! /Y b&car-84.4 ZONING nTIn Ill ) �j r Z f / NO. S - / USEIDI NEV a . DITYG/T/<G;,D///F/� GV�L _/TC �/L (��o �� �I I P/LANB (/o BUILDING LIC.NO. AI}'( L- ] tz NOVC�/ w 6 EGAL DESCRIPTION I (0 1 p j V (p SIZE I NO. OP BLOTB. LJ OF LOT Now ON Loi A.P.NO. � USE OF YARDS EVES EXISTING,BLDG. - APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.) CENTER OF STREET ' REAR YARD FRONT F_—T.—� IN. SIDE YARD I LEFT I RIGHT R.SIDE - FT. �' IN. DESCRIPTION OF WORK —. ' L.SIDE FIN. NEW I)eIIALTERATION I II ADDITION I REAR Ft - 6 IN. REPAIR I (MOVING I DEMOLISH APPROVED W y /(1 n (r) : /4) BUILDING . - NO. OF O 17 SIZE ROOMS STORIES EXTERIOR WALL I ROOF COVERING ,,/ COVERING USE OF gar kai LAND WORK TSO BE&FORMED xgxY6 - /[,,,ck� BE_ lam/ /f 1 I HEREBY ACKNOWLEDGE THAT I- HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNTSHOWN UNDERVALUATIONIS FOR THE PURPOSE OF, ESTABLISHING A PERMIT FEE ONLY. PLY WITHALLCITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRU ION. .. VALUATION SIGNATURE OF �/ ^ � t/ZA/. - cay PERMIT FEE $ TM/b N PERMITTEE R $ PLAN CHECK S 11; AUTHORIZED AGENT ¢ a I TOTAL FEE $ LL n• v OWNER ton 4COLE511017 ...>. AUG 1 0 1961 x"(/ DATE 10-2860 JOB ADDRESS 1868 New Jersey St. , BUILDING PERMIT NO.13217 GENERAL CONTRACTOR C.W. White VALUE $ 360.00 AP. No. LOT 88 TRACT36.18 FIRE ZONE DESCRIPTION OF WORKRet.W211 INSPECTIONS DATE I GROUP J TYPE III ZONE R1 Underground Soil U.G. Water PERMITS ISSUED Underground Gas SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous _ Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring Trenchesr(13'W-Forms Steel,f(PY1f— !hi-•G 0 Floor System Steel Reinforce Chimney Re-Rod Bond Beam c, Sheathing Frame and Flashing p Lathing, In Out Plaster, brown coat p Plumbing Fixtures, Final P ,1 Electric Fixtures, Final —�— • 7"---?- 1>, Building, Final 1 al'n / •P1 OCCUPANCY Form 210-5M-11-59 5-B P 13217