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HomeMy WebLinkAbout1778 NEW HAMPSHIRE DR - Building Permits _to`"' CITY OF COSTA MESA 1st P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 cnsmsan , • •T DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION NOTICE OF PERMIT EXPIRATION March 11, 2005 Hilario Burciaga 1778 New Hampshire Dr Costa Mesa, CA 92626-2032 PERMIT NUMBER (S): P03-00687 FOR: Water Heater PROJECT ADDRESS: 1778 New Hampshire Dr., Costa Mesa This is to advise you that the above permits are about to expire. Per Ed Petros, Chief of Inspections, you have 10 days in which to complete the job and have an approved final inspection. If you do not complete work and have an approved final inspection, your permits will expire on March 25, 2005. Additional fees will be required to finalize expired permits. If 1 you have completed the job without a final inspection, you may be in violation of the building code. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will assist you. We appreciate your working with us to resolve this matter. Sincerely, /, Ma ane Weidenkeller Office Specialist II Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TOD(714)754-5244 • www.ci.costa-mesa.ca.us w9 CITY OF COSTA MESA . BUILDING DIVISION F i •„-T DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT 6/03-00687 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT _ - Job Address: 1778 NEW HAMPSHIRE DR ' Status: ISSUED Suite No Applied: 10/16/2003 Issued: 10/16/2003 Vicinity: • Parcel Nunmber: 13957224 /. - ISSUED BY: Applicant: KEVIN SZABO • Address: 2737 S CRODDY _ STE D .- • Phone: (714)241-1414 " N SANTA ANA,CA , Zip: 92704 - N • - A Owner: BURCIAGA, HILARIO Address SALVADOR .� ' COSTA MESA,CA Phone: �� 1778 NEW HAMPSHIRE DR Zip: 92626 - - , Contractor: COAST ROOTER PLUMBING HEATING &AIR CONDITIONING Address: 2737 S CRODDY . - ' STE D Phone: (714)241-1414 , SANTA ANA,CA Zip: 92704 - , License: 529127 Arch / Eng : . . , - - - Address: - '- - " - , Phone: , Zip: ' --- License: - - - - ' . SCOPE OF PERMIT . , CIO OF WATER HEATER. ' )/ FEE:SUMMARY , ' �, AMT QTY AMT ..,QTY �';= 'AMT QTY ISSUE FEE . • $23.50 Laundry Tub/Washer $0.00 -0 _ Sump Pump $0.00 0 Backflow irrigation $0.00 0 - - Landscape Irrigation - $0.00 0 -• . Swimming Pool . ' $0.00 0 i' Backflow Preventer $0.00 '0 P-Trap , $0.00 0 Trap Primer' , -$0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 ' ' Vacuum Brkr 13kflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 , - Receptors $0.00 0 Vacuum,Brkr Bkflow(5+) $0.00 0 Dental Units `v $0.00 0 Septic Tank $0.00 0' ' . Wash Basin - . j $0.00 0 Dishwasher ' $0.00 0 Sewer Cap for Demo $0.00 0 . Wash Basin Set/ $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 -0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 - Sink,commercial $0.00 0 _ Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor ' $0.00 0 Water Service $0.00 0 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: 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. 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. FOR INSPECTIONS CALL: (714)754-5626 2446-46(8/00) DECLARATIONS ( WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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. 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. K My workers'compensation Insurance carrier and policy number are: 5 I /- Carrier: L�1 '�T? i/J1( 1) Policy Number: a I (02-3j) -o3 (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) O I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C lif ia,and agree - I sho d become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provis 5. Applicant Signature: Date: IC ' ("7—0.-3 WARNING:FAILURE TO SECURE WO ERS PENSATIS' COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DCLLARE($tw,000),IN DITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am Iicensgtu��provisions of Chapter 9(commencing wit Section 7000)of Division 3 of the Business z nd Professions Code,and my license is in full force and effect.Lic.x J Class x est,.4-h C Contractors Signature: Date: /0- /7—p3 _ CONSTRUCTION LENDING AGENCY: O 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). Lenders 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.). • O 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 drivers license. ❑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 e 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? 0 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 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mese 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 1 (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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li Yes D No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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? 0 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: Date: CERTIFICATE OF COMPUANCE 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 pu •oses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. a aura• egal Owner(s) Date lax.. 4A .ai 10 '17.0 ".. •N: d/Or • thorized Applicant Da I CODE I • ' er•' I' PAIL INTRULS CODED INSPECTIONTYPE PATE MAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing ' -2-2'O5 200 Final Re-Roof 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 ADDRESS OF BUILDING: 1778 NEW HAMPSHIRE DR UM: CITY OF COSTA MESA — BUILDING PERMIT """'"'"' SALVADOR BURCIAGO FLOOD: AE-37 PERM NO: B- 084905 ADDRESS: 1778 NEW HAMPSHIRE DR BURCIAGA, MIRNA AIDA PERMIT NO: B 084905 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MAILING ADDRESS: COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENCd1EER: UC.ND' JOB DESCRIPTION : T/O ROOF INSTALL COMP SHINGLES SQ FT: 4 , 000 ARCH.OR ENG.'S ADDRESS: MT: CLAIM VALUE: 4, 000 , 00 CALC—VALUE; 4 ,000 . 00 GROUP GCC: R-3 / CONTRACTORSNANE: ALPHA CONSTRUCTION ( 714 ) 537-5006 CQGRACTORSNYUIC 13461 SHAPELL ST COMMENTS: SMOKE DETECTORS ARE REQUIRED ADDRESS: GARDEN GROVE CA uc.NO.: 694277 +E*********yEtt*******jt****yk***********yta *****at*at*+t*************** tit*;t;tat;t*-x*** '*it*, 92644 UM' ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby attire under penally of perjury that I errs bossed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in fun force and effect CRY LIC.NO.: LIC.CLASS: UC. O.: H 694277 EXP: MAIN BUILDING ACCESSORY BUILDING ,_ thee: Contractor Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN • Ce �i ' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury t am!Sion the Card ale the 'elowlag reason(Section 7031.5 Business end Professions Code:Any city or county which uires a panne to conseu d,alter, prove, tmol''eh,or rept*any structure,prim to its issuance,oto requires the applicant for such a to file a signed statement that or she PARKING REQ PROV: PARCEL: 13957224 ZNE: REF NO: licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING NOTES>' Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Amy violation of Section ..,." 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred doper 155000. >., El las owner tithe propertym my employees orae wages astheeode compensation,willWMe worts.end the structure lend intended ******************************************************************************* or offered for sale(Section 7044.Business and Professions Code:The Cantradoe License Law does not appyto an owner of popery D E V E2L' O P M E N T SERVICES R E Q U I R E M E N LT S who bolds or improves thereon,end who does such work hint,or herself or through his or het own employees,provided that such - .. improvements ere not intended or offered for sale.R,however,the building or mpovmn e'u sold within one year d mmulecion,the - i ownereueder will have the burden of proving he or she did not build or improve for the parPose of sale), ZONING APPROVED BY : DATE: _ '� o I,as owner of the papery.am exclusively contracting with licensed cone/stars to construd project(Section 7044,Business and / Profession Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon and who BUILDING APPROVED BY : / DATE: ; '1 . .. contracts for suds projects with a contractor(s)licensed pursuant to the Contractors License Law). ( ✓ r / (' , ❑ lamexemprunder se len: B.SPc., o this reason: APPLICATION ISSUED BY: 0 ?Of DATE: 7 Date: Owner. ********************************* - ** *** -******************* - w,x -r ,y ** Idohereby ceriytatItnaware ot and understand the requirements ofCalionia Health and Safely Code Sections25505,Pagel.and LEGALIZATION';N F E E S U M M A R Y STRUCTLA SEGMENT;Y 25534,and that I or any future building occupant will/will not(circle one)need to comply wish said requirements le ate codes and the requirements '� =f a permit for pmntructionor modirmionfrom the AiWaanagenenl Didrid.Reaieemid condnwbnwlAaatimn are exemplfmm Mese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADING provisions. PERMIT 87 . 25 . 50 : Date: ApplicantSM I P/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury we of the following declarations: PLAN ' ❑ I have and willmainreis a certificate of consent to sett-insure for workers'compensation,a provided for by Section 3700 of the Labor ISSUE FEE Code.fotheperformanceoftheworkfowhichtispermitisissued. gUttihtN(3-DIV-s PERMITuISSUE PLAN—CHECK TOTAL PAID DUE ❑ Ihave and wil maintain worker:compensatun insurance.esrequired by Section 3700 of the Labor Code,lerm r the of the 'tj�'t U Ah§----y / : fIg V s oo MO 87. 75 87 , 75 . 00 work for which the perms is issued.My workers'compensation insurance carrier and poesy number are: Carrier:Policy Number R VkMtILnGPATPLOIYITT II15ELECTRIE°kkEfaii9 t FIR§7' 7AIPCYFRS8RRLtNG PLAN—CR CK (This section need nor be completed I the penal is for one hundred dollars/5500/or less.) 87. 25 . 50 inI certify that in the performance of the work for which this perm)is issued,I shall not employ any pence in any manner so as to become subled to the workers'compensation laws of C agree Mat if I should become subject to the workers' ******************************************************************************* pereelion provisions of Section 3700 of the Labor Code,I ate: .44 Applicant Math pry with those provisions.:iw• a:F•rwro secure won«.'aorerar..Uoncovg.Ison a ,h.n tanoyes to Kxw. • • and TYPE QTY INDIVIDUAL DESCRIPTION •F E E BREAKDOWN UNIT COSTTOTAL COST acdi fines rpt a one hundred thousand dollars($504000),In*citation to de cost otG$anpansatlorA damages as pro j •ler In Section 3705 of MS Labor COW,Interest,and aftorney'•Iesa SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 000 . 00 • CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that then is a construction lending agency for the END OF FEES performance of the work for which this panel'n issued(Section 3097.Cie C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have mad this application end dale that the above information is correct.I agree to comply with all city and county ordinances and slate laws relating to building consuedion and hereby authorize representatives of this drys enter upon the above-mentioned property for inspection purposes. SUNG HONG 29-26-1997/04:28 Pa/$s?I.73 Print Name ' _ RCPT#:01«t1E724 i !/fir _ /at.:� PEC{(9I'T:©8490 •Sig,..of e -p..S. 'meads /' / (5151-46.WP) White-Building&Soley:Green-Flo;C - t;Pink-Revenue;Goldenrod-Assessor / CONSTRUCTION AND PLANNING PO :SPA APPROVALS Permit # .Date Inspector - APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equiprhent Location . 2. Soli. Pipe•Undrgrnd. '53.. Steel Reinforcement ; ' ' . • - - 43. Electrical Conduit:Utility-Undrgrnd. -54. Forms - =4: Electrical Conduit-Orargrnd. - • 55. Electrical Bonding .:S:jSteel Reinforcement"- 56. Rough Plumbing & Pressure Test 6. Electrical UFER.G"rn8. - 57. APPROVAL TO COVER-GUNITE ' ,t 47?Footings '--' j 58. Electrical_Conduit-Undrgrnd. r 8.•Foundation - '59. Gas Pipe, 0 Undrgrnd„Test -:9...Water Pipe-Undrgrnd. - - . . 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' 10. Structural Floor System61,. APPROVAL TO DECK .11: Property Sewer Line & Housetonnection _ 62. Backwash &::Receptor-Final ' 12. Sewer Cap _ 63. Heater & Vent-Final i ' - 1,3. Roof Drains - - 64. Plumbing System - Final .14. Rough Plumbing, -, 65. Electrical-Final ' 15. Rough Electrical-Conduit • . - 66. Solar System-Final - ' . 16. Rough Electric Wirirl4! - ;67.. Fencing & Access Approval I 17. Rough Wiring Sign r• 68. APPROVED FOR PLASTERING: 18. Rough Electrical-FT Bar Ceiling I . . .-' • ;- 69. POOL/SPA SYSTEMS FINAL ' ' ' '19. Rough Heating & A - - - ir Conditioning - - ' ' - ` - FIRE DEPT:REQUIREMENT - • - - 20, FtougFi FactoryXFireplace _° '" �. i. _ :gPPROVFP4yS ....-;;Pee.;lt # 21. Ducts;in Structure= e •• _ : ` r3 .-I i ?70. Underriourid Hydro .'t 22. Ducts, Ventilating,: - i •7 t ., =e 71. Product•Piping El4as C oil 1 _ 23. Gas Pipe-Rough & Tast =5 I, •^ S - + 72. Undergrouhd Flush c •t. " " 24. Roof Frart)ing•' - I "t a " l �'� n y 7J:; Undergrrid.StoraS,'igTenkp❑Gas ❑Oil 25. Rooi,Sheathing R. : .t, l0/'`, f�_ 74:'•Overhead Hydro:? tt 26. Ta'-Bar'Ceiling (Struetpral) & Modogoat , - 7 -" "_;f. 75; Ory Chemical _;..:; J y ,": 27. Frame and.Flashing i - .7‘...s.: i •-• ^'± 76. Dry Starfgpipe .-.7-; . a - 28. Lathing St-Siding .. ' I i " 77{3 FIXED SS'STEMiFINAL , T r - •.• •• It T ` 78; FIRE PREY. FINAL > - '' 29. Insulation - _ •• _. ' 30. Drywall Nailing ,. ! It- ,S 1-IEALTM'DEPT.'FiEQDIR:EMENT 7. 31. Plaster Brown/Coat .:--r 4 f i! ' •79.I FINAL IYVSPECTION I_ _ 32. Electrical:Powei Meter-Figal * -t (f ''Kai Q7FOOD CERTIFICATE I S4hlED� -_33. FinaI,Eleciric _ _ 1 tv Noies: rri 4 - 0 0 +. � in-. , i 34. Fine:ideating& AirConditionin`g " - ,. M,' ._ to .•'7 i:, r, I - I it . 3 .. -,-1.: '9 35. Final Gas;Pipe:7est - i } ,_ _ . _36. Hood-or Canopy ` - - - . - - i , le t' 37. Final:Factory Fireplace' -- , - _ r I - Ir . J38. Final'Plurtibing - 1 - - 39. WateiSer4ice-Final • _ J 40. Gas Service-Final ',: ' "1 I 'r • _ - 'n t _ i 4, - - r -C 41. Solar Oomestia-Final' - •• I !t ;:- :, t 42. Backflow Preventer is i, - '! .ti •-J 43. Backflow Irrigation i > ' ' s „ , i i - - 44. Landsca0.5 Irrigation,System .r r -. w ` Ti C: - 1 ._2 .ii = 45. Sound Attenuation 1t. 46. Handicap Regulations _ 47. FINAL STRUCTURE & BUILDING •• �01. 7 (I 7 T . t. 481. FINAL PLANNING • 1 •I • 1 i 49'. Electric Release to Edison ' e • :1 r • 50. Gas Release to Southern California Gas Co ' - ,+ - ,� i ! ^ • . . - .i Si. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA REQUEST FOR OCCUPANCY�7 TRACT NO. eg- 91`Y//��` DATE %-` 4 —70 LOT NO. CQ/ ADDRESS 7 ) 78. � - $ 2) e DA cocz- The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. 9 . BY t At2L C ��� arc?BY ' ' .� C O" Deve_oper an. or : . horized representat. e J������L� U -/ Lender ., 'O • Applicant to fill in all spaces except those within heavy border lines and.sign all appropriate declarations. . _ - _ _ - �.no TL - CITY OF COSTA ME•'SsA CO/�/ISTR,U/CTION PERMIT - PERMIT NO. TRACT NO. - LOT NO. UNIT NO. _ • 5O9G• I-/O7, . V • Project Address /7 New HQ(Vl.( `r e p/'9a6 �l �l - ` r _ ` . ..AsppQ" TYPE OF CONSTRUCTION•• -J NEW 0 ADD U ALTERATION' U REPAIR • Applicant's MailingAddressss 4Q4t. (1 1LLGi_Cl • - O, Owner's Name • s'('Ir�!� - Phone ❑ CONVERSION ❑ DEMOLISH El OTHER • A.P. # I Zone r/t�_� _� -� DESCRIPTION OF WORK/USE OF•BLDG. Address wL'N'1'`< ' ' S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADIN FOUNDATION ❑ STRUCTURAL T Front _ • p Address - ••❑ TENANT ❑ ELECTRICAL 'PLUMBING ❑ MECHANICAL B Rear - • N • 1'YI -k PI ' Contractor's Name r r fA/i1'L��A! 'Phone Q -i-9c V�, El ' • C Right - _ - N 6 I ,.�_ // �•�� �f PROJECT DESCRIPTION SO: FT. OCCUPANCY G Address(mailing) yZ"I`r SIX/PP /.f/�r� )-Nil-f AC,en• �a7'� K-' • .J� � 3J CONSTRUCTION• TYPE VALUATION - S Left R City License No: - ZONE _ GRADING CU.YDS. ACRES ' O LICENSED CONTRACTOR DECLARATION - - - Ping. Ref.# Parking Req./Provided E I-hereby affirm that I am-licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M Q q� with section 7000) of Division 3 of the Business and Professions Code, and T I my license is in II49rce and effect. [ q[--S s License CI ss 5(c' —LiC se No..41r _su/ \! "ate •'-cL,. Signaturel./-r e l� PLUMBING FEES 1 a /ORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate • of Workers' Co ensation Insurance, or_a certit_i copy. hereof (Section Backflow Preventer Service Sink rrr���]]]DDD Automatic Washer Transformer D 15-50 KW - 3600, Lab. CJ CSa l q 10 I - P icy No. l_I Company a Backflow Irrigation Sewer Ca0 50+ KW P Construction Pole Sub. 'Certified copy is hereby furnished. - Certi ie co& flied with the city By1ry'L'tl,Ing r41Ivi�ypn. Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps ate � - APPlicant •• 'l�A- Is. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION' Clarifiers • Solar Collectors Dishwasher ' Meter Dover 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 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 sto b me s lett to the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1'f.-8 Workers' Corppe n Laws of California. /'y/ / Date 1- >" S ry�Signature � �� ./ . 4c:!// • Floor Drains • Swimming Pool w/Spa , F.A.U. Inc.Solar ❑9-15 HP 016-15+ 'NOTICE: If,after making this declaration,you should become 333000Ylect to the ' Workers' Compensation- provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures - '- - • '- - comply with such provisions or this permit shall be deemed revoked. 'Microwave CONSTRUCTION LENDING AGENCY • Gas •Service Outlets Water Closet • Device Boxes ' I hereby affirm that there is a construction lending agency for the performance - • POIe•Light i of the work for which this permit is issued (Section 3097 Civ. C.) r , Lender'st Name /f�/� Interceptors �_ Water Heater O-•�v Outlets Range Lender's Address ' /( 1/ Kitchen Sink - Water Service _ ' r, Switches Sign ' - OWNER BUILDER DE ARATION - ' 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 P-Trdp - I Laundry Trays- , - Generator DO-5 KW D5-15 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 9 (commencing with Section 7000) of- - I 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 ; CONSTRUCTION AND PLANNING -• ctr t.../L& SPA _ • -Date Inspector - Date Inspectnr I-- :APPROVALS Permit# - . - APPROVALS Permit# - ' 1. Temporary Electrical Service or Pole52. Pool & Equipment-Location' ' :-2. Soil Pipe-Undrgrnd. !, "} 53. Steel Reinforcement ' . - ` i _. 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,4. Electrical Conduif-Undrgrnd. - - - 55. Electrical Bonding T . + ' 5. Steel Reinforcement . T� 56. Rough: Plumbing & Pressure Test -6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE - - 1. ' I.7. Footings ' g - •� - ; ' -58. Electrical Conduit-Undrgrnd: 8.. Foundation - 59: Gas Pipe, 0 Undrgrnd:.,Test •9. Water Pipe-Undrgrnd: 2,' - ' 60; Backwash Lines, P-Trap, ❑Undrgrnd. 10.•Structural Floor System • - _ ; i; 61. APPROVAL TO DECK - 11. Property Sewer Line& House Connection - • , 62. Backwash &.Receptor-Final •- .1-2'Sewer Cap • %' 63. Heater & Vent-Final - • • 13. Roof Drains - 64. Plumbing System'- Final _ 14. Rough Plumbing Ji • 65. Electrical-Final - - 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 69. POOL/SPA SYSTEMS FINAL , I 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 ❑Gas- 0 Oil • 23. Gas Pipe-Rough& Test 72.`Uhderground 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 PREY. 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 - Notes: 34. Final Heating & Air Conditioning . 35. Final Gas Pipe-Test - 36. Hood or Canopy - - - 37. Final Factory Fireplace - " 38. Final Plumbing //q/55- /.4E? - . • 39. Water Service:Final - . 40. Gas Service-Final • . • - . 41. Solar Domestic-Final _ • - . . - 42. Badkflow Preventer - - • ' 43. Backflow Irrigation - - is• a • 44. Landscape Irrigation System - • . ; ) , ' 45. Sound Attenuation , . - 46. Handicap Regulations . ' , ; ' r- - 47. FINAL STRUCTURE & BUILDING r ' ' - I. 48. Special Requirements Completed• r I - •. , ' I - ' 49. Electric Release to Edison , : ' 1 - - -- - ; - - " - - - - '" i ' ",50. Gas Release to Southern California Gas Co - 4 I ' "+ 51. CERTIFICATE OF OCCUPANCY. _ .- _ -. -. .. .. ',•. 1^ No. Daie - _L , - OWNER APOLLO DEVELOPMENT DATE 1-22-70 JOB ADDRESS 1778 New HampshitsDrive BUILDING PERMIT NO. 31288 GENERAL CONTRACTOR Same DESCRIPTION of WORK Residence W/Attached Garage P - LOT 6 TRACT 6694 FIRE ZONE VALUE $26.638.00 I. . TIONS Signature Date GROUP T g .T TYPE V ZONE R-1 GASSOIL 1--3e-?..) SUBCONTRACTOR PERMITS ISSUED / a Lt — '/-/9Ze Date Number ' Signature WATER u6--7 i y/7c) /4- PI_. bin• ROUGH PLUMBING L ( pr //F� Zf;� / ate_ A - :7p PROP. SWR. LINE r HOUSE CON. r - _2v 01 �/&w,1•__ f L i� 9' . _ SPRINKLING SYSTEM � rf1 .7;;01. -If-, /i• 0 g-3 o MISCELLANEOUS �/ " (/�] ROUGH HEATING ANO AIR CONDITIONING /� Y"- 77 7C) TEMPORARY SERVICE OR POLE q��_�vT UNDERGROUND en POWER ❑ 'v` 1.G,7U ROUGH WIRING��yi . -7Q ' Heatin• a d Ve t TRENCHES l� FORMS STEEL REINF. 0 S�y�/p,/ - ,. j '' A� .3A'070 or -.."--- FLOOR ice FLOOR SYSTEM err ada''cL . /�L-g-7,p �S�7- BOND BEAM fI STEEL REINFORCE n / 0O// SHEATHING ; i 3-17-7.0 FRAME AND FLASHING74 . an . Y_r/r-JC LATHING — IN OUT 24 . .41I1. to y/3°" PLASTER, BROWN COAT X. 'a 4--,.t8' 5" URAL, FINAL / /� - ric HI S. VENT., REFRIG. AND A.C., FI AL F' 41 e I, •`, / • A. - - / / r a PLUMBING, FINAL AND GAS TEST �y I (/ ,7p a - a/' .//10 lr ELECTRIC, FINAL Y(L 6�4/TC BUILDING, FINAL I,�I ��� Jw; L ]C)p�M�: 00 729* ***141.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely REC 7�r7�/BY DATES EIVED DATE ISSUED BUILDING '7 �n �f jj� /r/7-/O 'J 'J ADDRESS / / �'(C.U7�!,%if �(�' fA-� /-�v-/0 PERM( OWNER Apollo Development Cor . �' A.P. NO. JAI GBS MAIL BUILDING .�, K'�iD/l�-C ADDRESS 1104 E. 17th Street ADDRESS17���j(,L(J� / i/ �• ZLuui / a U CITY Santa Ana No�'S47-9673 TRACT 6694 I LOT 6 BLOCK 2 <CONT LENDER U. S. National Bank NEW ADD ALTER REPAIR (MOVING DEMOLISH a m Main Office R • J UD BRANCH J91 OWNER Apollo Development Corp. m J ADDRESS 190 S. Broadway, San Diego - VALUE •m ARCHITECTTEL. USE Dwe1 1 i_n2 $ 15.700 J N OR ENGINEER Kermit Dorius NO. 675-1164 U E 2 tJ 2 ADDRESS 3111 2nd Ave. , Corona Del Mar ZONE TYPE GROUP / 6. 1+ APPROVED J O CONTRACTOR Apollo Development Corp. BY DATE • -J 120 :I¢ ADDRESS 1104 E. 17th Street w W TEL. ZOP/�1 NO.OF USE OF NEY�(//oL / ZF CITY Santa Ana' NO. 547-9673 V"�/ PLANS BUILDING (�(� r w-O STATE CITY YARDS APPROVED YARDS APPOR VED CO 2 LIC. NO. 252549 LIC.NO. 1690 MAIN BUILDING ACCESSORY BUILDING 7 OA (FROM C/L STREET) SIZE NO.OF BLOCS. OF LOT 50 x 110 NOW ON LOT -- FRONT 3 FT. FT. USEOF -.-.. _ EXISTING BLDG. OFT. - FT. H . NO.OF Z NEW BLOFDG. 1782 S.F. ROOMS 8 STORIES 1 L.SIDE / 0 FT. FT. Q EXTERIOR WALL Y r ROOF V_ COVERING •1t�an9 COVERING ' Shingle REAR / b FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED n' DISTANCE BET. BET.MAIN& CL MAIN BLOCS. ACCESS. BLDGS. 0 Q Construct new dwelling with VA U.P # .D S-(;(St APPROVED '- 7v-& 6 C/ 0 1- attached garage. APPROVED IV(„19''A CO BY UM' DATE 4).--7/Q by 2 O U I hereby acknowledge that I have read this application and state HOLD FOR SPECIAL REQUIREMENTc- ✓ that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ H any person in violation of the workman's compensation laws of the State of California. / m Z /! 2 SQ. FT. y�/� '9 I hereby certify that I am properly licensed as a contractor under z �O O the State of California Business and Professions Code, Divisicn 3, THE AMOUNT g4OWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION and Professions Co Division 3,Chapt 9. D a0 PERMIT FEE $ /U D Signature of • Permittee gr u,� D $ �(C/✓/ PLAN CHECK $ 2/7, E 0 Authorized Agent L/ TOTAL FEE $ /V/ J- LL OWNER APOLLO DEVELOPMENT DATE 6-1-70 JOB ADDRESS 1778 New Hampshire Drive BUILDING PERMIT NO. 31907 GENERAL CONTRACTOR Same DESCRIPTION of WORK Tract Retaining Wall - LOT 6 & 7 TRACT 6694 FIRE ZONE VALUE $ 700.00 I .:TIONS Signature Date GROUP J TYPE ITI ZONE R-1 �sG" SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE n HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES FORMS Q'��'/I''��STEEL 'rr �611�Y REINF. ,R f;--3.-fe BOND FLOOR B EA MSYSTEM STEELf1EIN ORCE / G"'`y"+,j`/fl SHEATHING FRAME AND FLASHING LATHING - IN Li OUT n PLASTER, BROWN COAT S 'JRAL, FINAL Electric H J, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL a ACOA/4( ii' 3 . J7 PAIR U JUN -2-70cwsO0 107 el***i*1,7 00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE VED BY DATE RECEIVED DATE/ ISSUED BUILDING / JL We P t �/I'Y� . .l0 -1-70 ADDRESS / 778 Aka) /�/ 1w Jh't2G �9—fy�/—q7Q J/� ` 1 "��— P Met OWNER ! : �OL. lA. t LT s - A.P. NO. N e BUILDING /x ADDRESS l C T ADDRI/EESSSq J/ i770 �etAi ./ I., tl O CITY r—� K = NO.LU tli 7 . Er 't RACY / �LO BLOCK Z _ • NEW ADD ALTER REPAIR MOVING DEMOI ISH —Oici_ N LLEENDERC710N A t')l AVItycS 1• Lp it."--- �J // ,///�/� J O BRANCH l \•I t/FM/ C� T / (� y y,v .SYt^� J N OWNER �``_`-_ • < Ui ADDRESS �.ee.._ piss•03 (��J y ' `7/ //////// /II ����{q�L 700. /{,!/ m Q OR ENGINEER piss NO. {LV 7J/ USLY /`'s-�' WUlti-U$ O// O Q 1 FIRE `T w CC ADDRESS ZONE ��--••�� TYPE�IL GROUP `/ ���/// a W ( ?,A � APPROVED /7,---- DATE / / /� /Zr /r '/7 J O CONTRACTOR �Y1fY �_ r BY /`/P/'/ DATE�C-t``'/�^��- rn/ m Z / .cc ADDRESS 1 W W TEL. ZON/,{� NO.OF USE OF NEW O1- CITY NO. //`l PLANS BUILDING �/(�� Z F r \ Lu O STATE CITY YARDS APPROVED YARDS APPROVED N lr LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZE INO.OF BLOCS. OF LOT NOW ON LOT FRONT FT. FT. USE OF _ EXISTING BLDG. B,SIDE FT. FT. I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. VEXTERIOR WALL ROOF �s� _ COVERING COVERING REAR FT. L/ FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& d MAIN BLDGS. ACCESS. BLOCS. 1 VAR.,$ DATE Q � \ O '� O•]`(t�—r (/� '\ M sI 1r ` C.U.P.# �./'/� APPROVE/DD / T CO LF7'TJ \�- ' 7 APYPRPj/ED ' 17� - DATE 1/Z `�-I —7V 0 U I hereby acknowledge that I have read this application and state ✓ that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of N the State of California. . co lll ? I hereby certify that I am properly licensed as a contractor under SQ. FT. 6 the State of California Business and Professions Cod- • , ' n 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force d effect, •r I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a: am exempt from the provisions of the State of C- rnia Bus' ess VALUATION and Professions - , ' 'slo. ,Chapter 9. N Signature o PERMIT FEE $ O�3 O r-� m Permittee n / /.ik ji $ - /O0 6 PLAN CHECK $ �� E / a Authorized Agentp u_ , • TOTAL FEE $ O A