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HomeMy WebLinkAbout1904 ORANGE AVE - Building Permits N JI .. CITY OF COSTA MESA >r iitrt.x. BUILDING DIVISION t°a . 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us . ' o. "���+� FOR INSPECTIONS CALL:(714)754-5626 % PERMIT NUMBER: M08-00165 PERMIT TYPE MECH STATUS: ISSUED APN: 42627102 DATE ISSUED: 12/2212008 . ISSUED BY: RMD JOB ADDRESS: 1904 ORANGE AV CM Suite/Unit: Vicinity: - -. SQ. FT: 0 SCOPE OF WORK: MECHANICAL PERMIT-TO CHANGE OUT WALL HEATER < 100 K BTU FOR A SFD. OWNER: RUTLEDGE, MARGARET M W Address: 1906 ORANGE AVE Unit: ' PHONE: 949-646-5687 - City/State/Zip: COSTA MESA,CA APPLICANT: RUTLEDGE,JAMES E&MARGARET M W - _ Address: 1906 ORANGE AVE, Unit: PHONE: 949-646.5687 - - — City/State/zZip: COSTA MESA,CA CONTRACTOR: OWNER-BUILDER License No. 000000 Address: Unit: - PHONE: ' City/State: ZipCode: CELL: MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.30 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1,12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. ;QOt )NSPEC11014 TRE IIL INi11IAL$ CODES INSPECI10N WEE PAW (p• (IN��,A�. 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1. -a.6-©8 1J1`( 1286 Pool Spa Final 208 Final Plumbing 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 • •WORKERS.COMPSNSATION DECLARATION: Owner ID verified by driv ense. es ❑No I hereby affirm under penalty of perjury one of the following declarations: Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' ---Verification of Ownership by(type of document.i.e.-property tax bill or dd): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be oampleled IIthe pend is valued at one hundred dollars(5too)orless.) 2,Art 2.Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I.certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in eny manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the La or Code, I shall forthwith comply with these provisions. Applicants Signature Dale V Y tare arra Q 1 i. -A i 21 Z los Division of Industrial Safety Permit Number: V l ppliwnfs Signature l"�� Date r HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No 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 (Section 65850.2 of the California Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No 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 8. (If Yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). - completion, the owner-builder will have the burden of proving that he or she 'CERTIFICATE OF COMPLIANCE: I certify that-underpenalty-of perjury the did not build or improve for purpose of sale.). . • • ,information given above is correct. I agree to comply with all state laws and y��,,/ I. as owner of the property, am'EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. 'IJCENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature ' Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building out.t.JVibey this permituntil al ins ection. t,Z/ � . IAI I 212-2 L/Vn e 27 O8 t ar Q o m B.AA ek /a$ Signatu a of Legal Owner(s) Date ` Signature Date 3057.46(3/07) • - -- _ —. And/or Authonzed Applicant Date - &at of &4ta Nen $aciea4 t4,4'oa A,CIA E OWNER-BUILDER t� VERIFICATION p cAddress: f 0 -1 OYQY1c\e, Ave. Permit#: A city or county,which is required to give notice pursuant to Section 19830,shall attach to such notice, and,as a condition precedent to issuing a building permit, require the completion and require the return of, an owner- builder verification. Attention Property Owner: An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the ma' r labor and materials for construction of the proposed property improvement. ❑ Yes No i 2. ave not) feta' t signed an application for a building permit for the proposed work. c 3. I have contracted with the following person(firm) to provide the proposed construction: Name &IA rJ tire, I'nLu vt iAn 1 `t H eok' n c n Address 16 5e) )-.o-riMI pSUyl 1-t tC City Q rat,5 {`OYe Phone 611 ` —(o)/, Contractor's Lic. No. 7Y1 15 H 4. I plan to provide portions of the work,but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone( ) - Contractor's Lic. No. _ 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work 1042-46 (Rev.11M4) - . I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my personal knowledge, in compliance with this State law. Signed: LM ot/r 9 ank �P DELLA Date: t 2I a aloe Name: Iv1QYtQare* '� uT e. 1 C (Printed or Typed) C.D.L. # For more information call City of Costa Mesa Building Division at(714) 754-5273. • 1042.46 (nw.11/04) AGGRESS oc SIRLOINS: 1904 ORANGE AV WIT: CITY OF COSTA MESA - BUILDING PERMIT OWNER'S NAME IFgreet JIM RUTLEDGE PERM NO: P 08452` AWNES& 1904 ORANGE AV C.M. CA 92626 PERMIT NO: P 084525 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MMINIS ADDRESS: CONSTRUCTION TYPE; V-N PERMIT TYPE: PLU PURPOSE: 0TH ARCHITECT OR ENGINEER: UC.NG: JOB DESCRIPTION WATER REPIPE SQ FT : ARCH.OR ENG'S ADDRESS: WIT: . CLAIM VALUE : CALC-VALUE: GROUP OCC: R-3 / CONTRACTORSNAME MASTERSERV INC . ( 818 ) 957-8985 caNIMCTOwsMMIDA 3502 VERDUGO RD COMMENTS: NO OTHER WORK AUTHORIZED. ADDRESS: GL CA uCND.: 580017 ******RE*;(-**** ;est;r;t; *; **; ******1r;r; ;Eh*;i*; ;cx-; *x*Rc- -; ********;(-;t-****;t**************** 91208 GMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby&nim under penalty of perjury that I em licensed under provisions d Cheviot g SETBACKS (comm, .. •with Section 7000)d Division 3 of the Business and Professions Code,andel my license license is n roll force and effect. IC.CLASS: UC. C/�, Y�,J"J°�,Xi- -a+„&Y C 36 //�w/J m'f P: MAIN BUILDING ACCESSORY BUILDING _/ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN contractor, LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN • - BUILDER DECLARATION:I hereby affirm under Randy of perjury that I em exempt from Contractors License Law for the ti ,L.Si•meson(Seda n 7031.5&nines end Pmreedona Code:Ant'thee"a oamry wAidi i perms to O envtn.cher,impro e. ' i. `:mduh,arepa&otry etnnure.pwW a bususne,dxereharter for with wth edg7000) nNNatMaahe PARKING REQ PROV: PARCEL: 42627102 ZNE: REF NO: ieZ"°licensed pursuant to the provisions of the Contractors License Law(Chapter 9(oanmeedng with Sedan 7000)of Division S of the PLANNING NOTES> C. 'dueness and ProfessionstfCode]or that he or she p and t a civil a end the beau for the alleged e dollen Awry 01). d Section > 7031.5 by arty epPisar&laapermlt subjects the eppt&aat los civil peraMdrW more than five hundred dmm.fSSODU. *****************************if***iE*1EfE*********thin**if********iE*ii*dE**fc**ie******icii* ❑ I,n owner of the progeny or my rnpnyess wih wages n the&sole compensation.will do the wak,and the ennuis u not branded oroffered for sele(Secen7Dw,Business and Professions Code:TheContrm«sLicense Law don norentyt0 an Ownrd property DEVELOPMENT SERVICES REQUIREMENTS who builds or in prove!thereon.and 1.63 does such work himself or Navel or through his a her awn employees,provided IMI such improvements atnot t i nended a offered for sale.I.Mwevet,the building or anon:moment is sold within cns year of completion.the 'b4..- owner.bnner wee have the burden or proving hes she did not build or improve la the Pnpeed ads). ZONING APPROVED BY DATE: ❑ I.ee owner of the property.ant eaduSety contracting with licensed contractors to construct Me prgea(Section 7044,Business and BUILDING APPROVED BY DATE: _ Professions nor a Cade:The Contradors License Law does nop*to en ownepropertywhe propy adds a Improves thereon Ceon and who ' monads Wmidivi projects with a raaa(s)(tensed pursuant to the Contractors License Law). ❑ lam exempt under Section: B.a P.C..Wthis resew APPLICATION ISSUED BY: DATE: Q] Dare: Chow: ***************************A************ A-* 7�1i7F3F A`y� �F**if-*sE*iE**ii �P�iF - edt' Idohereby camlythat leonaware ounderstand u miaHethandSafetyCodeSectian505,Peenend LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N 25534,and Net I or any future building occupant_ai anatwill/wR nal(circle one)need to campy will said state codes end the requirements bpermsa pms faaaatructiona modification fromlM Mpmwa°lurid.Resider&ial matrWim appfetnro en exempt born thew BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING pr°®" PERMIT 8 . 75 Dale: Apptnanl: 258 on SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby am under penally of perjury one of the fallowing declarations: PLAN ❑ Ihave and dimaintain aetfraaotconsent IDeetfimure for workers'compensation,asprovdm edforbySeon3700oftheLabor ISSUE FEE 2200 Code,for the performance ot bia eworkforwhthispemIssued. BUILDING-DIV-> PERMIT ISSUEbiePLAN-CHECK TOTAL PAID DUE ❑ bave end wmaintain t „wakaa is issued.MP as required l Code,kwthe p.damenceofthe TOTALS----> 8 . 75 22 . 00 poky number ere: 0 . 00 30. 75 30 . 75 . 00 ..--- Carrier: y workers'compensation insurance r^r_'T nrn7 ti--->i-,T r EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 30 . 75 OVER/SHORT: . 00 Polry r .e;.,`-e. Numbe -(I 7702 07/07/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (7hu.--'. need not be completed N the permit 6 for one boded d'Mn1J1001 or less.) 30 . 75 J ay that in the peformeea d the work for which this permit i ne issued,I shall not employ any person in any mao as to subject to the workers'compensation laws o California.end ag Nal R I shoed subject to the ms'cessationprovions d Sed$ 700 d the Labor Code,I rysw 7-- 9 / Predicant • y(%yejINDIVIDUALer Failure fosscun s/Nan'conparwtlon coverage Is unlearnt'',and tlWl subject an amployarfoalMrW parWtlee ***********if*****fi*****************iE***************************fi*************** and TYPE QTY D E S C R I P T -I F E E BREAKDOWN O. N UNIT COST TOTAL COST c/dl fines rpt to one hundred thousand dollars(a100,000),In addition to the cost of conpensatron damage.as provided for In Section 3706 of the Labor Coda,Interest,and attorney's fees. ' CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a cannnnWfor nn lending agencythe PLU 1 WATER RE-PIPE 8 . 75 8 . 75 perlammKeothe work for which this permit isiw sued(Sion3097,Civ.C). END OF FEES LENDER'S NAME: LENDER'S ADDRESS: 7 I certify that I have read this application and stele that the above information is coned.I agree to comply with dl dry and caunry ordinances i r Th and state laws relating to building construction and hereby authorize representatives of this ay Io enter upon the above-mentioned property / -/-.., ) for inspection _purposes. 1 h T . -AS OLSON _' •• 09-03-1997/11:58 (1;/539.75 I!� R Q c� rl6�r.��,,•d_e� Ly ,' Dale: / �i� / PERMIT?1084525 Sig •ureof fee p•7: t/Co.r.•or (5151-46 WP) WhbeBuild •&Safety:Green-FW Ca ary-Appicant:Pink-Revenue:Goldenrod-Assessor a CONSTRUCTION AND PLANNING POC SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary 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.- 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings • _ 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 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 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 Wiring0 •• 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 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: rp,e t 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy • 37. Final Factory Fireplace -7 4 _ 38. Final Plumbing Qll _C L� 39. Water Service-Final L 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low 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 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - CITY.O+^F COS-A-MES,IA CONSTRUCTTION PERMIT PERMI O. TRACT NO. LOT NO. UNIT NO. 1647 3/24/86 501:. IL P of ject Address IgG) Y /4'44: o 4140 V c3/7a Applicant's Mailing Address /53a /41 4,-A�CA�-/)//i q TYPE OF CONSTRUCTION ❑ NEW U ADD LI ALTERATION U REPAI R ��/l SOC%// Phon&/6 6'�/O ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A•P•# . Zone Owner's Name DESCRIPTION OF WORK/USE OF BLDG. Address 54 'fl O • r S Main Building: Accessory Building: Arch/Eng. License No. __ TYPE OF PERMIT ❑ GRADING r .FOUNDATION ❑ STRUCTURAL E Front 0 ..,�� Address [[ // ❑ TENANT El ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam7IE' 6c/ ?1J,-< jyxli= PhoneO22 39170 ❑ OTHER C Righi N t g/ + I �/ �I nom/ 1 . PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G Address Imailin 1 9-x5- /s- ,U s ,<c �J . CONSTRUCTION TYPE VALUATION $ 1 City License No. _ J X 30 - ZONE • _ GRADING CU.YDS. .ACRES 'Ping. Ref.# Parking Req./Provided E' CY) LICENSED CONTRACTOR DECLARATION • - ' Q- ' thereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: • ._ • M with section 7000) of Division 3 of the Business and Professions Code, and - 7�(�Iy n�) 1 t Q my license is in full force and effect. ,�-, RFC FI V EO MAR 2 !Ii 1986 - T License Cl9 s 47 - icense N / • $ Date":3 -3t"k /. . Signature/i_ ad AS -/G`-71:4FJ PLUMBING FEES • tap WORKERS'COMPENSATION DECLARATION / A ereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL : FEES Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - Automatic Washer Transformer-0 15-50 KW • .00, Lab. C.) /�,/ iPolicy No. Q76`�4 Company -A'- _! 4-'& Backflow Irrigation Sewer Cap Construction Pole-Sub. • ❑ 50+ KW Certified copy is hereby furnished. ! • Certified copy is filed with the city Buildin Division Bathtubs Sewer Connection Cooking Unit • Meter Duo to 100'amps Date3-3-=5 Applicant THE F,ARIS PLW3INGt INC. Clarifiers • Solar Collectors Dishwasher Meter Dover 100 amps EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - P (This section need not be completed if the permit is for one hundred($100) or-' Dishwasher less). Solar Piping Dryers ❑Gas 0Electric Sub Panel • I certify'that in the performance of the work for which this permit is issued, I - - t shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - 'Fan Motors• ❑0-1 HP ❑1'h-8 Workers' Compensation Laws of California. . Date Signature Floor Drains ' Swimming Pool w/Spa . F.A:U. Ina Solar ❑9-15 HP 016-15+ , NOTICE: If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith i Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave - , CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet; - r� 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.) Interceptors -• Water Heater Q Outlets Range Lender's Name' ; . Lender's Address Kitchen Sink Water Service - ? Switches Sign OWNER BUILDER DECLARATION - I _ • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories ' Auto-Wash . r 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-Trap Laundry Trays - •,Generator ❑0-5 KW ❑5-15 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 '/ • 'vision 3 of the Business and Professions Code).or, that he/she is exempt - refrom and the basis for the alleged exemption. Any.violation of Section 31.5 by anyapplicant for a permit subjects the applicant to a civil „e natty of not m_ore than five hundred dollars($500). , , LI 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 Reinspection Fee I $15 'Issue Fee $ 3 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 thereon, and who does such work himself/herself or through his or her own - Hood or Type 0 - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler sale- If, however, the building or Improvement is sold within one year of com- Canopy . Type II 0 Zoning Approved By ^ Date pen, the owner,will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By / _\ _Dat prove for the purpose of sale). V�J ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat • 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 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 that0 _ BUILDING PERMIT $ SMIP $ ofExhaust System 0 MultipleSystem Repair/Alteratioh - proof their worker's Compensation insurance should.& P.C.providedthis tome. PLAN CHECK $ ` PERMIT ❑ am exempt untler Section B.& . .for this reason Firepl/Fact.Blt. ICBG# • Fire Dampers • _ PLUMBING $ , - ISSUANCE ' $ Date Owner Heating,System& Ducting • RegistersPLAN CHECK 25% $ ELECTRICAL $ GRADING $ENERGY P.C. $ • tI hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL • • -information is correct. 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 t is city.to enter up the above-mentioned property for / inspection ppr ses, �7 / /�pr� / MECHANICAL $ TOTAL FEE $ h Signature/1 d).1.Cd` (ttt'!U Date 3-3 -Fb - - Drivers' License or SS e Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • - • \ ` \ • • 11'1-4}CONSTRUCTION AND PLANNING POi :SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 41 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' (2. -Soil Pipe-Undrgrnd. 53. Steel Reinforcement I. 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55: Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure,Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings 58. Electrical Conduif-Undrgrnd. 8: Foundation 59. Gas Pipe, 0 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 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing65. 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 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: y-8-$G L 120 [,CQ 34. Final Heating& Air Conditioning • 35. Final Gas Pipe-Test .SC • 36. Hood or Canopy '/ 37. Final Factory Fireplace 38. Final Plumbing - - 5/�/7f�t1 1117 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final , 42. Backflow Preventer '- -� 43. Backflow Irrigation 44. Landscape Irrigation System Le( • 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 ' __pp<�V WIN Zit DATE 7 11 U7 tJOB ADDRESS 1904 Orange Ave. BUILDING PERMIT NO. 24162 GENERAL CONTRACTOR R.W. Wilson DESCRIPTION OF WORK Add Screened Pat.to Res. AP No. 118-091-8 LOT TRACT FIRE ZONE VALUE $ 700.00 INSPECTIONS I Signature Date GROUP J TYPE N ZONE al PERMITS ISSUED SUBCONTRACTOR G,._ I Date I Number I Signature Water Plumbing Rough Plumbing _ Prop. Swr. Line 0 House Con. 0 Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power 0 Rough Wiring Heating and Vent. Trenches 0 Forms 0 Steel Rein!. 0 Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing— In 0 Out 0 Plaster, Brown Coat Structural, Final Electric H' .ig, Vent., Refrig. and A.C., Final P. .ing, Final and Gas Test 0 Electric, Final Building, Final r . -- GJ/G S WIT OF USIAA MESA 24162 COSTA MESA BUILDING-SAFETY DEPARTMENT MAY 17 1965 ' P.O.BOX 317 COSTA MESA,CALIFORNIA p� For Applicant to Fill In Completely APPLIVaii LIT TYPE OR PRINT BUILDING BUILDING /`� A I/ For Office Use Only ADDRESS Rio /(/ l✓I r^ y e_• RECEIPT NO. PEry.1 j t1 COSTA MESA, CALIFORNIA /J'/y{ \/ l/D yy REC Y O C E j I8B D OWNER / Gni serial i .h f �S /? 6� ADDRESS r,l� ADDREISS fret �l ACCS- Alit , CITY X.. VP-., -7z09 FIRE IL GROUP Z ' /�!f_ -��1'-�•"•3 TEL ZONE ril �E / APPROVED - / /'�lj_ARCHITECT bTEL. - BY DATE / YI_So MGINEER NQ. ONING ��_ AL..RESS �_ ///��� ZONE I NO.OP USE OF NEW -. 'r .-1:9- CONTRACTOR II, �1 /5 /1 Al PLANS -1/SII BUILDINGngC��,"/ •4/ CONTRACTOR Y/�,]// At ///��� cC � / / LEGAL �A _•._.(24 l 73 ADDRESS /// 1,,c (-7.4 'a fill, T/ I DESCRIPTION / g ''.. 109/''''' or 0- J CITY •'L'Y`w NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE / /r;/ NO /�Oa° 90' TO SIDE @ REAR P.L. LIG.NO. ) J {� Oe V EAVES OF LOT (7 1 7SIZE 'c q/3 ,31 NNOW ONLOTS. / ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF `^ //. /',�,} - ACCESSORY BUILDING EXISTING BLDG. ! �/ 17'`�� Mint ' SETBACK LINE FROM -��" CENTER OF STREET cn t REAR YARD ({J 6' R.SIDE 5FT. SIDE YARD LEFT a-n I I RIGHT ,C ' �' ---- - DESCRIPTION OF WORK L.siDE 91:7)FtFr. REAR 6, [ALTERATION DEMOLADDITISH HH ' BET.ON DISTANCE BET. MAIN S@ REPAIR MOVING MAIN SLOGS. ACC LDGB. DATE BZIELDI / 20ROOMS 0 STORIES r APPROVED / EXTERIOR WALI.yq !L ROOF AlAPFAQVE• —f 7 `/ S'^ COVERING Mpva` , COVERING 'T�it-i'` BY(/," 'f I I DATE IO USE OF BUILDING AND WORK TO BE PERFORMED 62/6,/7 fa34 CI r.-1/g NE -11A au t 9.4 N SO.FT. B I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE Y AND STATE THAT THE A-' - B CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY • • NANO.. AND STATE LAWS REGULATING VALUATION .� - BUILDING CONSTR 10 a/ PERMIT FEE $ A S SIGNATURE O' „, B PERM ITTEF i $ E AUTHORIZED .ENT 0 �`'d e i TOTAL FEE $ y -OWNER HEINKEL, GEORGE DATE 2-20-59 JOB ADDRESS 19014 Orange BUILDING PERMIT NO. 8700 GENERAL CONTRACTOR 0anrgp Cnneit.. VALUE $. 9,077.00 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Res. w att/gar. GROUP I & J TYPE - ZONE R1 PLAN NO. 8700 ' ''ECTIONS DATE SUBCONTRACTOR PERMITS ISSUED /S, DATE NUMBER Trench Formes Steel / Floor System Steel Reinforce himney Re-Rod , J- 6/ Frame and Plashing vg 3 t31 • Lathing, In Out 4 Q --A7,4,-4Y Plaster, brown coat _lb Underground soi144.-/-5. W/G Pipe tL M1 lj-fl Top Out n_-2.5---.ST " Oi - Furnace IV ?-11-9'y ec/11�./ .e-��� C21V1-,s- 7 / '— Gas Vents Rough Plumbing ,I, ty x.11-hf ,.c /)/ Frit. .->0�$tr7 / /Z67-Cesspool Septic TankroProf• Swr. Litre_ Hotrse'Gon. S�C::LSwr. q-t r'-Y% 6ri-(r.-,, `I - 1-S"Y/ I /SIOI qi:P Sprinkling System I Heating Final /J/f/5' r/d, -3-9 Plumbing Fixtures, Final Mit-4e-'e-s-9 Fir,'.Gas Test /•-- Abe c'-✓c-S9 Cs:l...uction Pole I Unucrground Power �pJ IP Rough Wiring ..�{-+�^1• I /', ) C — _$—.5-5iy / $3s-1- I pV Fixtures, Final Tal U -I 'y t v\11 --OCCUPANCY S Y—/b -S51 I I i Form 210-5M-1-57 i 8700 87 00 J 't RECEIVED l -s5 Qu- COSTA MESA BUILDING DEPARTMENT FINANCE DEPT. P.O. BOX 317 COSTA MESA. CALIFORNIA CITY Of COSTA MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT UING BUILDING AB LDI /ff6f� Ott_7ntX�� /v �.-C! 114 . COSTA MESA`� ` CALIFORNIA FOR OFFICE USE ONLY /J AF� A� / RECEIPT NO. P RMM IIT NO. OWNER© eeb. �a1/, KG(� / O0 MAIL G�(�- J� /�{//� RECEIVED BY DATE RECEIVED! DAA 155 O1 ADDRESS "'S.-7 COyf W4S �_C. / 1 -----)-----74"" sy, -7/71 / Z/ O �/ CITv00SrYT 04 1--S 4 TEL ADDRESSG /9G ! l'n ci//YL ARCHITECT (� ` LIC. COSTA MESA, CALIFORNIA OR NEERJ f�.p IfNC�� NO. ADDRESS31.737 f ` `en ONE J y ./ ZONE PLAN$ 2 TYPE / GROUP/� / 4 qI- - C. j Z.-ANC 1 CONTRACTOR1 fE NO. yi._s . /al // p---/VVC� Vg ` IED /,�_ 4 APPROVED z7_0 ' ADDRESS AOrt�. / g 1 w- 2.6 BY t !` DATE / LEGAL Lor / -7g Il CORRECTIONS DESCRIPTION NO. / -7 g/y's BLOCK ]('� R C pp��pp A.P. NO. I / a' — O!/I — O fl 11 If .i., �� tlJ SIZE / a�T .3/X / 3�/ NO.O F B LOGS. (j'�j�+ L1 Z OF LOT ��p(( v NOW ON LOi USE OF CITY Or ' )o I A I‘iCSA EXISTING BLDG. roti-L GI 111\. ;Ir; DEPT. SETBACK LINE FROM �7 // SUBJECT- TO -DG. DEPT. REG. CENTER or STREET /�B��r p�j/��/jEAR YARD/ (`J // , SIDE YARD -7g (.--RIGHT RIGHT f y f +f LEFT /9 IaeaY g 2-J7 DESCRIPTION OF WORK DATE; PLAN TtCH. 'h NEW ALTERATION ADDITION REPAIR MOVINGMS IFI DEMOLISH SIZE JJ BUILDING 6x 3> 6 NROOSTORIES /CE%OTVRRIONRG WACLV'Itl` NrROOF COVERING 11 - - USE OF NEWBUILDING J }- ).:1 `C,J Si TI 1 V #6 ITL_ �� !/ h j Y j7', I HEREBY ACKNOWLEDGE THAT HAVE REA THIS APPLICATION AND The£wU11{ YIIU�VII UIIU Yd%Udt. is for till STATE THAT THE ABOVE IS CORRECT ANDA EE T COMPLY WITH ALL T � CITY ORDINANCES AND ST S REGUIN ILDING CONSTRUC. nitre`alf /W establislrin a permit fee only. TION. VALUATION �M� PERMIT FEE S 1? d0 SIGNATURE OF C PERMITTEE 0-0 9 o ���''TTT 7 — PLAN CHECK $ /a . 93 2 AUTHORIZED AGENT TOTAL FEE $ 3 6 . U ✓ y0M%