HomeMy WebLinkAbout1731 NEW HAMPSHIRE DR - Building Permits C
C.
PROJECT ADDRESS: 1731 NEW HAMPSHIRE DR UNIT: CITY OF COSTA MESA BUILDING PERMIT PERM NO: P 052281 .
OWNER'S NAME: ROEDER MARK A •
ADDRESS: YARNALL KATHRYN A PERMITNO: P 052281 PLAN CHECK NO: N GOVT: N SUP?: N
1731 NEW HAMPSHIRE DR
COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU • PURPOSE: OTH
241-8880 .
ARCH/ENGINEER: REG;ND.: JOB, DESCRIPTION : CHANGE OUT WATER HEATER SQ ^T: .
•
ADDRESS: • - ' UNIT: •
PERMITTEE:'NOCK PLUMBING CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3. / ' •
( 71'4 ) 895-1246
ADDRESS: •11610 SEABOARD CIR COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME - •
STANTON CA 90680 ***************KK*KK**K***a **.***********K****-*-*K**Kx******K***K*****KK***35****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions'of Chapter 9(commencing with Section Z 0 NING R E Q U I R E M E N ,T S .
70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: 0503866 STATE LIC.: 511971 CLASS: C 36' '
•
Date —��' ( / Signature- _ _ _ _ MAIN BUILDING ACCESSORY BUILDING
�� � � FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: ; FT IN=
`WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certlllcate o onsenl to self-insure ora certificate of Workers'
Compensationivpu.rayryC,o, cuLeQcopy thereof(Section 3800.Lab W. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: : FT IN
POLICY NO.: IIb /7�L`JV EXP.DATE: V3/01/92
COMPANY: STATE PARKING REQ: PROV: PARCEL: 13961207 ZNE: REF NO:
❑ Candied copy is hereby furnished. Certified copy Is file ith the city Build g Division. PLANNING NOTES> .
a� -/0 /A Applicant: Be****K**************N.***3i'**********-*******************M*****K*%******************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be co feted if the permit is for one hundred 15100)or less). D E V E L O P M E N T SERVICES R EQUIR EMEN TS
I certify that in the performance of the work for which this permit is issued.1 shall not employ any person in any manner so as to become ,
subject to the Workers'Compensation Laws of California. , ZONING APPROVED, BY . DATE•
Dale: nSignature:should • BUILDING APPROVED BY : • _ DATE:
NOTICE: ,atter making this declaration,you become subject to the Workers'Compensation provisions of the Labor
Cade.you must forthwith comply with such provisions or this permit shall be deemed revoked. • • . •
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• DATE• ( �G•""7/
which this permit is issued(Section 3097.Civ.Cl. ************************** ** * **M' **************************,** ******111000***tt***
LENDER: ************************************ ****************************************
ADDRESS: •
LEGALIZATION:N F E E S U M M A R -Y. ' STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC • FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2,00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed ' . 25%- SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business P LAN '
•
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5•by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($5001. - ISSUE FEE 3. 00 '':
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
•
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 2 . 00 3 , U 0 0 . 00 5 , 00 5 . 00 , U U
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 employees.provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED: 5 .00 OVER/SHORT• 00
• improvementis
of sale(-ie sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpoBLDG PMT PLUMBING ELECTRIC MECHANIC • FIRE SMIP/TOT GRADING PLAN—�
HECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 ' O O •
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware ***********************************-***************************************'Y****.
that proof of their Worker's Compensation insurance should be provided to me. IND• I' V I D U A 'L ,F E E B R E A K D O W N ,
•
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date' 'Owner: PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and :END OF FEES
25534 and that I or any future building occupant will/will not(circle one(need to comply with said state codes and the requirements for a r
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
t
Date: Applicant: t
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county U I5100&9627—OOOE9h27 "{-4�.1—{-
ordinances and slate laws relating to buitding construction and hereby aNmrize representatives d this city to enter upon the ahoy/entioned - ' U+�
property lot inspection purpnses•. • DATE: D6/14/91 TINE: 12:00
i _Date? 6"- /�-- gL . wA
/ Signature: ' /. .{ I ' t _ - /
' Driver's License or Social Security
Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • r
CONSTRUCTION AND PLANNING POOL& SPA
Date Inspector Date Inspector
APPROVALS Permit# * ' APPROVALS Permit # _
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. r 53. Steel Reinforcement .�
3. •Electrical Conduit Utility-Undigrnd.- ' . 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 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 'T 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 i 65. Electrical-Final ,
15. Rough Electrical-Conduit " �!- 66. Solar System-Final '- 1
16. Rough Electric Wiring ri 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#
21. Ducts, in Structure' . . - 70. Underground Hydro •
22. Ducts, Ventilating { - - - 71. Product'Piping OGas ❑Oil
23. Gas Pipe:Rough & Test 72. Underground Flush
24. Roof Framing - - - ; 73. Undergrnd.Storage Tank 0 Gas OOil •
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 - •- i ! 78. FIRE PREV. FINAL
-30. Drywall.Nailing . - ; . 1- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat" 79. FINAL INSPECTION -
32. Electrical Power Meter-Final ' .,--) .80. FOOD CERTIFICATE ISSUED
I
33..f inal Electric : %• Notes: 4, . - e . - . , ,
34. Final Heating & Air.Conditioning "_:�• \. .. .
35. Final Gas Pipe-Test - I
36. Hood or Canopy ,
37. Final Factory Fireplace ,
38. Final Plumbing - _ GgZq'Q(, tin -
39. Water Service-Final.
F •
-
40. Gas Service-Final •
41. Solar Domestic-Final -
42. Backflow Preventer. '
4
_43. Backflow Irrigation -
44. Landscape Irrigation System . . .
-45. Sound Attenuation ' .
46. Handicap Regulations . - -
47. FINAL STRUCTURE & BUILDING - ''
i •
48. FINAL PLANNING - 3,.
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co l I -"I .
51. CERTIFICATE OF OCCUPANCY •
No. Date ,
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
- PERM O TRACT NO. LOT NO. UNIT NO.
• clTv oF;coSTa ME/S�A2 CONSTRU{� ION PERMIT �� 33 (J 7 Q •
Project Address /a.// Ale/ 7 J rr 11 �(/
Applicant's Mailing Attffdreesss MT
r� II/I fA' TYPE OF CONSTRUCTION .❑ NEW LJ ADD LJ'ALTERATION KJ REPAIR , • 1y4 ,PA T -t+T,r UC!•C T err...,
Owner's Name ' 41/1 f I / PhoneC�7 �!1_,1.D(/ ❑ CONVERSION' CI DEMOLISH ❑ OTHER _ - UUUUU*U7-}J]. ..-•.JJV • 3sQfl
(U A.P. -. trine-'f
DESCRIPTION OF WORK/USE OF BLDG. n...=..-. f. - •�u-.:a•• vim
Address • S Main Building: + �knns> .-q N
• E RECEI�' 2
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front t'lTY OF•c.ngmd:tccetA, t 49
• Address ;❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL • B Rear Fl)R' DEFOeIT CML'? N
Contractor's Name • I �� �" Phone p�/�g II/ OTHER C 0.�..`.. '• sa b Is
�J.h!- /�^ I/� C Right +tt"-�nktato- tvHtSVMgt .N, K
Address(mailing) 3(3 / � . p �1 // //� PROJECT DESCRIPTION, SQ. FT. oCC UPANCY K
?n / CONSTRUCTION TYPE VALUATION s Left t G
City License No. ,073. ZONE • GRADING CU.YDS. ACRES E
Ping. Ref.# Parking Req./Provided E
• LICENSED CONTRACTOR DECLARATION _ 0
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 tom- a d effect. •/� . /Sat - S
License Class _ - icense No. {/'(T�)!(1 11 •
Date i Signature iso _ PLUMBING I FEES
WORKERS'COMPENSATION D CLARATION Bar Sink . •
ELECTRICAL • _ 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 Backflow Preventer 'Service Sink "
Automatic Washer - Transformer ❑ 15-50 KW
1 3800, Lab. C.)
•
Policy No.14/43 t/-Es Company ( _, / Backflow Irrigation , Sewer Cap. •
Construction Pole Sub. ❑ 50+ KW -
Certified copy is hereby furnished.
ert' 1 fi a with the city Bul I Diyisn //A / Bathtubs Sewer Connection CookingUnit • Meter' ❑u to 100'am s ,
ate � � � Applicant ���-L % • P P
EXEMPT ON F OM 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 V
•
less). r Dishwasher A- 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 TankFan
Workers' compensation Laws of California. - - ✓ "( Motors Do-i HP ❑1R-8'
• Date Signature Floor Drains Sw• imming Pool w/Spa I F.Q.U. Inc.Solar❑9-15 HP 016-15+
- NOTICE: If,after making this declaration, you should become subject to the ,p�� -
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal -Vtl , Fixtures y Microwave -
comply with such provisions or this permit shall be deemed revoked. 6Y/
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet p Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for.the performance g
of the work for which this permit is issued (Section 3097•/Civ. C.) Interce tors Water Heater • (I •
, -
Lender's Name p ( '� Outlets Range
Lender's Address ).' Kitchen_Sink Water Service - Switches- - Sign r - . '
OWNER BUILDER DECLARATION :
I hereby affirthat I am exempt fromthe Contractor's License Law for the Lavatories Auto-Wash '
m 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:4Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit _
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
Division`3 of the Business and Professions Code) or that he/she is exempt - - , ,
• therefrom and the basis.for the alleged exemption. Any violation of Section • - .
7031.5,by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500). •❑ 1, 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 - Reinspection Fee ( $15. Issue Fee $ 3
for sale (Section. 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES - -Ifenagr
' License Law does not apply to an owner of a property who builds or improves - DEVELOPMENT SERVICES REQUIREMENTS:
Hood or
thereon, and who does such work himself/herself or through his or her own '
•
employees, provided that such improvements are not intended or offered for BoilerType I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground 'Building Approved By Date •
prove for the purpose of sale). _ •
El I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By bDat' ne•
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 ❑o-100,000 BTU 0100,000 BTU 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). I am aware that - BUILDING PERMIT_ $ • SMIP _ $
of Exhaust System 0 'Multiple 0 System Repair/Alteration
proof their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT +
❑ lam exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING • $ ' 5- OL! ISSUANCE $
Date - ' Owner - Heating System&Ducting Registers PLAN CHECK 25% $ - ENERGY P.C. $
I hereby certify that I have read this application and state that the above' ❑0-100,000 BTU ❑100,000BT ELECTRICAL $ 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 Ont- upon the above-mentioned property for
•
•
\Inspection pure a �/ �/ // //5pG MECHANICAL $ TOTAL EEE $ + i
J • Signature /`L./ • Dmv 3
�7rivers'"License or SS# _��'
Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND,PLANNING " POOL&SPA
APPROVALS Permit-�/# Date Inspector APPROVALS Permit Date,- Inspector
1.) Temporary Electrical.Service or Pole 52. Pool & Equipment Location �,
� ' r
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,• ,(
3. Electrical Conduit Utilit' -Undrgrnd. 54. Forms r - 's R:
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
i
5. Steel Reinforcement - .56. Rough Plumbing.& Pressure Test
6. Electrical UFER Grnd.l 57. APPROVAL TO COVER-GUNITE ' , ; ,
7. Footings �.,1 58. Electrical Conduit-Undrgrnd. , ; t='_ •
Li
8. Foundatio 59.-Gas Pipe,•❑ Undrgrnd.,Test •
9. Water Pipe Undrgrnd. 60. Backwash Liries, P-Trap, 0 Undrgrnd. C
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 65. Electrical-Final - . • '
15. Rough Electrical-Conduit - - 66. Solar System-Final I
16. Rough Electric Wiring -- 67. Fencing & Access-Approval - - --
17. Rough Wiring Sign - r 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling /2 69. FOOL/SPA SYSTEMS FINAL -
19. Rough Heating & Air Conditioning JF'• ; / . 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. Undergrouhd 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 & Siding77. 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 �,y;
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 - / (�W '
39. Water Service-Final VII/
40. Gas Service-Final - . -
41. Solar Domestic-Final . •
42. Backflow Preventer -
43. Backflow Irrigation - - n
44. Landscape Irrigation System - 4 -
45. Sound Attenuation - •
46. Handicap Regulations • - - - ,
47. FINAL STRUCTURE &-BUILDING - - -
48. Special Requirements Completed
49. Electric Release to Edison - - •
y
50. Gas Release to-Southern California Gas Co • _ • - - - . A"
LDate51. CERTIFICATE OF OCCUPANCY - _ - -
No.
- - - - - - - J --
CITY OF COSTA MESA REQUEST FOR OCCUPANCY ^�
TRACT NO. 49C DATE „ s- / I
LOT NO. w'// , / /�
ADDRESS / 731 /refry NeR r iie � (^/4//
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.
BY
Developer and Z as orized
representati -
`V/ Le
- Applicant to till in all spaces except those within heavy border lines and sign all appropriate declarations. • ,
P RMIT O. TRACT NO. LOT NO. UNIT NO.
CITY of COSTA MESA CONSTR,ICTIO PERMITjO —Z A.P.# son
e
Prr i ct Address `g'�II/ Y ]� � / .17 ^_ S Main Building: 'Accessory Building: 1
i TYPE OF CONSTRUCTION ❑ NEW' U ADD �1LTE RATION H REPAIR E - - z
Al�cant•s Mallin �Adytlyrsers!s
\ [N Jlr/ Phone CI CONVERSION III DEMOLISH ❑ t�' • _ Front •
-
D
OvarK a e�yy��• ayl �d D CRI•TI•N OF WORK US• O' B DG.re 'ei A &5 lat. •ear N
Address• CY/ //C.a I • Q1t..° •• i • s Os 'as_r 0 S t.7 — . _ IL —
Arch/tang. License No. TYPE OF PE- .•r - \' � � 51 FOUNDATION STRUCTURAL C Right G
•
1
Address r '•3 ❑ TENANT ❑ ELECTR CAL _IIIA PLUMBING ❑ MECHANICAL , S Left _ R
Contractor's Name A -I� lI .. n ❑ 'OTHER 3 ping. Ref.# Parking Req./Provided Q
//.�.r�IIy PROJECT DESCRIPTION SQ. FT. T OCCUPA �J ]�'� PlanningNotes:
/ Address(mailing) CL/ ✓ a ,• �- J CONSTRUCTION TVPE'�•N VALUATION$ Si✓ am-"•-�'�. M
City License No. , ZONE GRADING CU.YDS. ACRES S.
LICENSED CONTRACTOR DE RATION /� TTT111 s _
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:* `_. L '/ #' 'q s ri
with section 7000) of •ivis •n 3 of the Business and Profess)'onsCode, and �^1 P I//)j/C/AJ�r�— rrr"'lll 7^ *p ELECTRICAL / FEES
my license is in full f• - . 'ffect. i.y1L/' /g) /Q C-s- �• I�• /` ���, /f) ��^•<a2/
'f/0- .� .
Licen - Cl. s Licen-e No. � � y ( 6 l Y I� iI
Date � _ �� PLUMBING FEES . Automatic Washer Transformer ❑ 15-50 KW '
3a. Signature •Iii
4 CtIN, WORKERS' COM'ENSATION DEC A-A • Construction Pole Sub. 0 50+KW
I hereby affirm that I have a certificate of consent to ajr-insure or a certificate Bar Sink Showers •
of Workers' Compensation Insurance, or a certifies copy they of (Section Cooking Unit Meter ❑up to 100 amps
3800, Lab. /n Backflow Preventer Service Sink bt�a Y �/ Dishwasher Meter ❑over 100 amps
3800y No. CoCmpany' s' Backflow Irrigation Sewer Cap �,
\yl Certified copy is hereby .fumished. ff Dryers E]Gas DElectric Sub Panel
¶-Cer a its d with the city Bul •,Vrl• Bathtubs Sewer Connection
Date � ( Y Applicant •
1\ _`, Clarifiers Solar Collectors Fan Motors El 0-1 HP 01%-8 •
V EXEMPTION FROM ORKERS'COMP SAT • DECLyprts TION
(This section need not be completed if the permit is for on ndred ($100) or Dishwasher F.A.U. Inc.Solar 09-15 HP 016-15+-
less). Solar Piping
I certify that in the performance of the work for which this permit is Issued,I Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Microwave
Workers' compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa - Device Boxes Pole Light
NOT If,after making this declaration, you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal . +-
comply with such provisions or this permit shall be deemed revoked. Switches iat •'
CONSTRUCTION LENDING AGENCY, Gas Service . Outlets Water Closet .Sign •
I hereby affirm that there is a construction lending agency for the performance
of the .work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections
Lender's Name - Interceptors Water Heater
Lender's Address Kitchen Sink ' Water Service _ Generator 00-5 KW 05-15 KW !Trash Compactor
OWNER BUILDER DECLARATION - •.-
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash,
-
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 Laundry Trays '
any structure, prior to its issuance, also requires the applicant for such permit _ .'
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
Division 3 of the Business and Professions Code) or that he/she is exempt . Reinspection Fee ! $15 Issue Fee $ 3
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 -
I
enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS:' At
'LJ I, as owner of the property-or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By " Date
compensation, will do the work,and the structure is not intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
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 Application Issued By v Dat+ J
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑. SU MARY F ES
• pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground 3. 00 SMIP $
' prove for the purpose of sale). BUILDING PERMIT $
❑ 1,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
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 ❑0-100,000 BTU 0100,000 BTU -. ,1' PLUMBING $ -- ISSUANCE : $
builds or improves thereon, and who contracts for such oroiects with a con-
tractors license pursuant to e Contractor's License Law). I am aware-that Exhaust System 0 Multiple 0 14SYstem Repair/Alteration of' m
their Worker's Compensation insurance should be provided to me.• ,e PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ IN
❑ •\N.,,,,...
I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers EXPIRED R FI (i, ":.
PLAN CHECK 50% $ c�
Date Owner Heating System& Ducting Registers Incomplete Inspec tons MECHANICAL $ '��� TOTAL �$ A 3 r•Sa
I hereby certify that I have read this application and state that the above ❑0.100,000 BTU ❑100,000 BTI. r.., PLAN CHECK 25% $ 9 `
information is correct. I agree to comply with all city and county ordinances L1 "
and state laws relating to building construction, and hereby authorize repre-
sentatives
Date __ J'� - - ='�•�"
sentatives of this city o It r up n the above-mentioned operty.lfgr /
inspection purposes. (p,+s/ sr���/(,/1�LL -'
Signature (__ (� 1 t— - f
Drivers' License or 5 # Reinspection Fee $15 Issue Fee $ 3 2Iz l I •
f Of COSI N hit,^
CI"IY
' 0865-46,rev.5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor ,
CONSTRUCTION AND PLANNING • POOL &SPA
APP VAL Permit# Date Inspector APPROVALS Permit # Date Inspector
a.• 1. Ter. orary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. • - 53. Steel Reinforcement
3. ,Electrical Conduit Utility-Undrgrnd. • - 54. Forms
,
4. ;Electrical Conduit-Undrgrnd. r' �j 55. Electrical Bonding •
5. Steel Reinforcement? ,j... 56. Rough Plumbing & Pressure Test - .}i,
' 6. .Electrical UFER Grnd.'` 57. APPROVAL TO COVER-GUNITE "•'
7. Footings - - Conduit-Undrgrnd.58. Electrical Cduit-Undd,
8. _Foundation �.� - 59. Gas Pipe, 0 Undrgrnd.,Test ....,
9. Water Pipe-Undrgrnd. i - ;;,r. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
,
10. Structural Floor System F 61. APPROVAL TO DECK
11. Property Sewer.Line & House Connection / ' 62. Backwash & Receptor-Final
12. Sewer Cap •�- - r! 63. Heater & Vent-Final
J . •
13. Roof Drains - 64. Plumbing System - Final t'
14. Rough PlumUing 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 tic 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Condning FIRE DEPT.,REQUIREMENT
20. Rough Factory Fireplace �tJ; ,., APPROVALS Permit#
21. Ducts, in,Structure U�•' •70. Underground Hydro-
' 22. Ducts, Ventilating 11 •r it 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Teat / A 72. Underground Flush
24. Roof Framing . •
F 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25.,Roof Sheathing `
..ii, f^ 74. Overhead Hydro
1 i
26. T-Bar'Ceiling (Structural) &%Monocoat 75. Dry Chemical - '
27.•Frame and Flashing . 76. Dry Standpipe
28. Lathing &Siding ,� E.{ 77. FIXED SYSTEM FINAL ,
29. Insulation �"+.J 78. FIRE PREV. FINAL - i..,
30. Dryvaall:Nailing ;,', . a7 HEALTH`DEPT. REQUIREMENT ..i • •
31. Plaster Blrown Coati .;;;;.,:.;0"; 79. FINAL INSPECTION ,
i
32. Electrical Power.Meter-Final-c / 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 •
39. Water Service-Final
40. Gas Service-Finalrfe
41. Solar Domestic-Final il
ie _
42. Backf low Preventer •
7p 7,, + `LJ `
43. Backflow Irrigation 1� U-- • rn
44. •Landscape Irrigation System E X N 1 K E D/-!i ,
artifinsp
45. Sound Attenuation ,[{/.� 'r
46. Handicap Regulations 110-8 _2i7(=[ big
47. FINAL STRUCTURE & BUILDING .
{I UUUIII \t _ ._
"48. Special Requirements Completed 3 •}
49. Electric Release to Edison f
r/ e'
50. Gas Release to Southern California Gas Co /2 N. {+%
51. CERTIFICATE OF OCCUPANCY - r" • ,9 a
No. Date Vii
' PROJECT ADDRESS: C-} U ,NIT:
OWNER'S NAME: ^73-i"'NEW HAMt?SAI E DR •
CITY OF COSTA MESA •" BUILDING PERMIT PERM NO; P 051695
ADDRESS: ROEDER MARK A •
• '
, • YARNALJ,r KATHRYN A PERMIT NO; P 051699 PLAN CHECK NO: • N GOVT: N SUPP: N
1731 NEW HAMPSHIRE DR
COSTA MESA,CA 92626 CONSTRUCTION TYPE; V-N PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER: 'nt'41-8880 REG.NO.: '
ADDRESS: - UNIT: JOB DESCRIPTION : CHANGE OUT WATER HEATER SO FT: • ,
PERMITTEE:
CLAIM VALUE:' • CALL-VALUE: GROUP OCC: R-3 / ' "
ADDRESS: NOCK PLUMBING ( 714 ) 895-1246 ' •
11610 SEABOARD CTR . COMMENTS: SMOKE DETECTOR REQUIRED
'rE
STANTON CA 90680 *4 **>i� *k**** ** *44*•******.*.. . *******934 *** *********** *** *** *44**** *** **
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section
Z ONING R E Q U .t R E M E N T S
7000)of Division 3 of the Business and Professions Cade,and my license is in full force and effect. $ E T B A C, K $
CITY LIC.: STATE LIC.: CLASS:
050386 51197 �//� C-36
date: l et' le -- R1 `Signature: �J Yk.A..b;4i i-4 MAIN BUILDING --- ACCESSORY BUILDING
COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or ace ticate of Workers' - F'RNT: FT IN REAR: FT • IN ERNT: FT IN REAR: " FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). • LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ' IN
POLICY NO.: 116799290 EXP.DATE: 03/01 /92 • i '
•
COMPANY: STATE PARKING REQ:,, PROV: PARCEL: 13961207 ZNE: REF NO: •
❑ Certified copy is hereby furnished. Certified copy is filed with the city Building Division NOES>PLANNING
(� A >
Date 4 t� - 1 � Applicant: ��•-i.ti•Yi �l•� / •
##IEY.*M.**%*-8-X*9E#3F X-3.(• Ite* M-*•*k8%:N9i%3FFF')F*) At*krYIE14)(•**iiE#ie***1%*klE)c3!-1(.*** f**NM-9.5* -****•8:.*- i.1f•ki •
( � ( ppermitDE. VEL SERVICES ' REQUIREMENTS
‘'EXEMPTION thata FgOh Werforma' ofthe COMPENSATIONoDECLARATION:this
(This issued,sue I s shall ref completed ifyponn for one as to become
7
certify m the performance of the work for which This permit is not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California.
ZONING APPROVED BY .
DATE:
Date: Signature: - ' i - • __—
NOTICE:
NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : • DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. -____,..-
CONSTRUCTION
��
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: --.- • . DATE: ‘.,---2--9-E.2,/
which this permit is issued(Section 3097,Civ.C). .7(.}•.-***#31.lE.**** i.)P3P#****3f%c:%*3t•** £ , x " 1,-)e-M***** (3i -7E#3r*
**
i( 4*
LENDER:
ADDRESS: 3 ********#***#************#*********.x.*#ii" . . y"' ***}:*******%****%****%***r:3?3:#***
LEGALIZATION:N F E E S ..0 N- M A R Y STRUCTURAL SEGMENT: N
A. •
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason - BLDG PMT PLUMBING EL ECTR ICA MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 2 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 2 S t • SM IP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3,00
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV—> PERMIT ISSUE PLAN--CHECK TOTAL .PAID ' DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 2 . 00 3 . 00 r: .0 ..0,0 • 5. 00 5 . 00 , 00
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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• ✓
5, 00 OVER/SHORT;
for the purpose of sale) BLDG PMT PLUMBING. ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-eHT-CK
I.as owner et the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 • 00' _ -
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon •, 4. )
and who contracts for such projects with a contractor(s)license pursuant to the ContractorsState License Law).l am aware g(****#**#)E*****le#**#*#****#*#*****#1f**3r'3!lE*******+4*k#3E****3i#*#3(3F**iE******3('*4:..%.*x.y.
that proof of their Worker's Compensation insurance should be provided to me. IND T V I D U A -L 'r` F' E E B R E A K D O W N
❑ I am exempt under Section: B.8 P.C. • ,
for this reason: TYPE QTY D tE S C R, I P T I O Nt UNIT COST TOTAL COST
•
Date: Owner:
I do hereby certify that I am aware 01 and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLO I WATER HEATER AND/OR VENT 2 . 00 '2 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF :EES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from .
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county 01 00056124-0P8.86129 -a- p''d `"
ordinances and state laws relating to building construction and hereby a horiae representatives of this city to enter up the above-mentioned {; p. ,-
property ler inspection purposes / ) _ l+ 1.17=`_. `
t/
,r♦`[J!/r RT_. 04/38/9 1 TIME
(4 ( V
Driver's License or Social Security C:
Applicant:Pink-Revenue:Goldenrod-Assessor
•
CONSTRUCTION AND PLANNING - POOL& SPA
APPROVALS Permit# - Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service orPole l 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ''' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5r. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 f -7- 64. Plumbing'System • Final
14. Rough Plumbing t 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final - ?
16. Rough Electric Wiring r r 67. Fencing & Access Approval
17. Rough Wiring Sign •
68. APPROVED FOR PLASTERING
r 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
r 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 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 PREV. FINAL
30. Drywall Nailing • • HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' ,-/ 79. FINAL INSPECTION
32. Electrical Power Meter-Final ' , 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:SP/4( fit o'pElfcme- ,en-CO2o - GED
34. Final Heating & Air Conditioning // '7/'/2/9Y NO ONE''0eny-L€FTCdpao-
•
35. Final Gas Pipe-Test ' i ci/, _/q/ mI7 - Efn40 .4 Pies^ ?c73
36. Hood or Canopy ./7 Cie Ft L-1,D
37. Final Factory Fireplace -
38. Final Plumbing / .I • 7
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. FINAL PLANNING
49: Electric Release to Edison •
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY -
No. Date
v°R22
? NOV -4-70-eMSA 1013 ***120-00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIV B DATE RECEIVED DATE ISSUED
BUILDING /fe2.2-7
ADDRESS 171'1 New Hampshire Dr.
PERMIT NO.
OWNER Modular Technology, Inc. A.P.NO. nn A I "_
P7
MAIL BUILDING 1731 New Ham shire Dr.
Z ADDRESS 1104 E. 17th St. /— ADDRESS
0. 0 CITY Santa Ana NOL 547-967- TRACT 6695 I LOT? BLOCK
I—Z
Z < CONSTRUCTION NEW ADD TER REPAIR MOVING OFMOLISH
Cu,I- ti
LENDER U. S. National BanX
J D BRANCH Main Office
OWNER Modular Technology, Inc.
m J ADDRESS 190 S. Broadway San Diego
VALUE
-CO ARCHITECT
-i<
OR ENGINEER Kermit Dories TEL'675-1164 USE Residence $ 13,300
U Ne
FIRE
W ADDRESS 3111 2nd Ave. Corona Del Mar ZONE TYPE GROUP p0t/�
0_ 4 J
W Z APPROVED
_1 ° CONTRACTOR Owner BY DATE '
m Z Same 5—y`-
J ccADDRESSill Lu
p��S
0 i Same TEL. ZOf/ l (PNO.OF LANS U OF E 7teiA
Z CITY NO. IF
LLO STATE CITYYARDS APPROVED YARDS APPROVE
In CCLIC. NO. 252549 LIC. NO. MAIN MAIN BUILDING ACCESSORY BUILDING
D O SIZE 'NO.OF BLDGS. (FROM C/L STREET)
OF LOT 51 x 96 NOW ON LOT -- RONT FT. FT.
USE OF
EXISTING BLDG. --
ill
FT. FT.
I— SIZE OF 1440 sf NO.OF 7 1
2NEW BLDG. ROOMS STORIES FT. FT.
U EXTERIOR WALLPer Plans ROOF Wood shin le_ COVERING COVERING g FT FT.
J USE OF BUILDING AND WORK TO BE PERFORMED . BET.MAIN&
0.y / ACCESS. BLDGS. �"DATE
Construct new residence with.'�'�.attache >p�J�—(y APPROVED 57--.:7,647 y
CO garage. RY APPROVED n_ TE /I - 7--70
z g g D "/M A
HOLD FOR SPECIAL P, I�QU..._hl 2vT 5
o sr
V hereby acknowledge that I have read this application and state
D that the above information is correct and agree to comply with
cc all laws regulating building construction, and I shall not employ
r any person in violation of the workman's compensation laws of ) ' J
in the State of California. / / /D "13 CO
7 Y CO
z I hereby certify that I am properly licensed as a contractor under SO. F 0
the State of California Business and Professions Code, Division 3, THE AMOUNT HOWN UNDER VALUATION IS FOR
Chapter 9, and that such ' erases are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0
am exempt from the rovi ons of the State of California Business CC
VALUATION �J
and Professions Cod Di sion 3,C/ ter �I PERMIT FEE $ exec, re
cc
Signature of / y�/�/) l/z� �/ m
Permittee r��.,I/ �t Jam! $07/O (/ PLAN CHECK $ /Q— E
/ � ' p
Authorized Agent
/ 4'26 , u.
TOTAL FEE $