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HomeMy WebLinkAbout1798 ORIOLE DR - Building Permits (� M CITY OF COSTA MESA 41110 F`u' •I BUILDING DIVISION P�� �* DEVELOPMENT SERVICES DEPARTMENT So4,0 at PERMIT PERMIT NUMBER . wrap P99-00057 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 • PLUMBING PERMIT • Job Address: 1798 ORIOLE DR Status: ISSUED Suite No Applied: 02/03/1999 Issued: 02/03/1999 Vicinity: Parcel Nunmber: 13962227 Applicant: RON NOCK Address: 11612 KNOTT ST . Phone: 714 895-1246 GARDEN GROVE,CA Zip: 92841 Owner: BIRNBAUM, WILLIAM S - Address 1798 ORIOLE DR . Phone: . ' COSTA MESA,CA Zip: 92626 . Contractor: ' NOCK PLUMBING - Address: 11612-KNOTT ST ' - - , Phone: 714 895-1246 GARDEN GROVE ,CA Zip: 92841 • License: 707775 Arch/Eng: ' Address: Phone: Zip: License: SCOPE OF PERMIT ' REPLACE WATER HEATER FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 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 Backflow Preventer $0.00 0 P-Trap . $0.00 0 Trap Primer k $0.00" 0 Bathtub . -$0.00 0 Pressure Regulator $0.00 0 Urinal . $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 .Vacuum Brkr Bkflow(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 $0.00 ' 0 • Septic Tank . $0.00 0 - Wash Basin $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 $11.00 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 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $33.00 COMMENTS/SPECIAL CONDITIONS p......) tilA OD PA' EXPIRATION: This permit shall automatically expire and become void it 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 DECLARATIONS ( ) C' cµ WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insuran carrier and olicy number are: ^,/ q �O� Cartier: eG G O I Policy Number: LEAJ —`t'7 (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these provisions. (� c ppn Applicant Signature: Vas Date: -- T WARNING:FAILURE TO SECURE WORK RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP 0 ONE HUNDRED THOUSAND DOLLARE(5100,0130),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Cha (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# 7n 7 7 7 5 Class# !" � Contractor's Signature: �T -��� Date: 2.—,c_ ez CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). 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 en owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by 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,fatsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑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? 0 Yes 0 No (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 hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 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? 0 Yes &No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 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 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: _ Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. /1 V i->n Sigr�4we Of teaeF�. qs) , ! Daft And/Or Authorized Applicant !e,, Date • CDDLL INSPECTION TYPF DATE 41,1716-5 CODE/ INSPECTION TYPE DATE MALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical /7.n 1266 Pool Spa Final 208 Final Plumbing Y-2'4-ay Icy 0f2) 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 2446-46 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. � PERMIT NO. TRACT/ _ NO.pp LOyy�°y UNIT NO. CITY OF COSTA MESA O STR CTI PE M E,3$6 $o O + A P # TI . i 39 a s -a 7 Zone }Project Address ! J L O -�no Pt S C( ' Imo' __// S Main Building: Accessory Building: • ApplicanYS MBi ling Address S W TYPE OF CONSTRUCTION U NEW ADD L`1 ALTERATION U REPAIR E • IZ Owner's Name `,, v VVI Yll__.R(('SON S't9 1321 ❑ CONVERSION ❑ DEMOLISH `� OTHE- ' �s 7....e_---• T Front O �� Lll(�.I_ (i Phone p - - '• 1. I B Rear N Lir/ /© D- CRIPTION OF WOR K/ EOF :LDC. 'Address• .f 0 Y(6�C'i e P ■. i.. .. �u a — i••. - •• — N Arch/Eng. License No. YPE OF PERMIT U GRADING U FOUNDATION - STRUCTURAL K Right G Address, -a� M` 0TENANT Wt ELECTRICAL ,❑ PLUMBING ❑ MECHANICAL - $ • R (n�., 3 ` �LJ..GSF1Eit� e�t_•r^ f1res.."f f -To �1i �1Qt� {rYA�Il4 Ping. Ref.# . Parking Req./Provided E [Addonre Address maf's Name f�✓C.0 Phone ✓ I _ M ���/// r PROJECT DESCRIPTION SQ. FT. •• '' OCCUPANCY•�sft-,3 PlanningNotes: /nf /,e ^ ' .,.., Address(mailing) CONSTRUCTION TYPE .r N VALUATION $ ^49� � Y l�/s�(J 1. City License No. T ZONE GRADING CU.YDS. ACRES $, LICENSED CONTRACTOR DECLARATION I he - m that I am licensed un• . •visions of Charter 9 (commencing Remarks}1 rie - - with section 7r•: • Di visi•• • theBusiness and Professions Code, and IY•�� za"�-IOV _ my license is in full to - . ELECTRICAL FEES License Clas -use No. ` 0. Signature - PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW • ••••nRKERS'COMPENSATION DECLARATION DOOStrudtiop POIe Sub. 0 50+ KW ":eby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink • Showers • •"norkers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter pup to 100 amps ...;tio, Lab. C.) ' - .- Backflow Preventer Service Sink - • - - - Policy No. Company • Backflow Irrigation Sewer Cap • _• Dishwasher Meter Dover 100 amps • A Certified copy is hereby furnished. • - Dryers ❑Gas ❑Electric Sub Panel ' Certified copy is filed with the city Building Division. Bathtubs • Sewer Connection Date Applicant Fan Motors ❑0.1 HP ❑1%-8 \ •Clarifiers Solar Collectors .�f EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - (This section need not be completed if the permit is for one hundred ($100) or F.A.U. Inc Solar❑9-15 HP al 6-15C less). • Dishwasher Solar Piping I certify that in the performance of the work for which this permit is issued, Fixtures Microwave shall not employ any person in any manger so as to becorr�_subject to the Drinking Fountains Solar Tank Workers' o p nsation Laws of Califory��j'YL_L - •`-`^—/L/� Device Boxes Pole Light ' Date Signature Floor Drains Imming Pool w/Spa NOTICE If,a er eking this declaration, yy�should become subject to the - • Workers' Co pensation provisions of the or Code, you must forthwith Floor Sinks Urinal • Outlets • Range- • comply with such provisions or this permit shall be deemed revoked. - -- -a ,- CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches 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 ❑0-5 KW 05-15 KW Trash Compactor aOWNER BUILDER DECLARATION - — I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash �•rLt/r f r'C�/b(�/p on 4121- 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 I ✓ � % Q 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 / r .k,, ,Contractor's License Law(Chapter 9(commencing with Section 7000) of C� �i toys) -•;:7{;non 3 of the Business and Professions Code) or that he/she is exemptReinspection Fee $15 Issu SAE .q "jj';:'.from and the basis for the alleged exemption. Any violation of Section tj — ;:J1.5 by any applicant for a permit subjects the applicant to a civil 'Penalty of not more than five hundred dollars($500). • _ $ 3 DEVELOPMENT SERVICES REQUIREMENTS: _6 .r:,:,••••, �� Reinspection Fee I $15 Issue Fee ZoningApproved 'co I, as owner of the property or my etr uct ur ez with wages as their sole P¢ pp By '� - Date for sale (Section will tlo the work, and the structure is not intended or Contractor's - ���,e for sale (Section 7044, Business and Professional Code; The Contractor's MECHANICAL FEES Building Approved By ��-�'�%/// ' Dat,�A... �• License Law does not apply to an owner of a property who builds or improves ��d/✓/.r�i// thereon, and who does such work himself/herself or through his or her own Hood Or. Type I ❑ • Application Issued By �_ _ �_�i_� _ _;�- a_.t 7+����L. 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 ❑ 'ARV OF ,EES / plelien, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground prove for the purpose of sale). fppL aBUILDING PERMIT $ 30• dr) S P $ •!r/ ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration SystemPLAN 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 000 _00 BTU ❑100,000 BTU PLUMBING $ • ISSUANCE ,� ,-. builds or improves thereon. and who contracts for such oroiects with a con- ENERGY P.C. $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ stem Repair/Alteration - PLAN CHECK ' 25% $ proof of their Worker's Compensatio surance should be provided to me.' ELECTRICAL $ 37 . �� GRADING • $ I am exempt under Section 76 B. P.C.for this reason • Firepl/Fact.Blt. ICBG# / Fire Dampers • f PLAN CHECK 50% $ MICROFILM $ /� 1�''� Date �— owner this• yX�e� •, Heating System&Ducting Registers MECHANICAL $ TOTAL FEE $ (O /, I hereby ertif t at I have read chid• plication and state that the above • 00-100,000 BTU 0100,000 BTL— - PLAN CHECK 25% $ informati n is correct. I agree to comply ith all city and county ordinances _ and state laws relating to building construction,and hereby authorize rept¢ - •� sentatives of this city to enter u•• - the above-mentioned 'property for ' ' Inspection •y'•uses. / __ . Lf Signature _ ._. Date — �7p C Reinspection Fee i$15 • Issue Fee $ 3 .'Sp t Drivers' License or i # 1 TOT f'C CI 04634079-00034 3a^ yr} �, 0865-46,rev.5/88 White - Building; Canary -Applicant; Pink —Accounting; Goldenrod - Assessor DATE! 05/30/89 TIME: 13:34 - •CONSTRUCTION AND PLANNING PO :SPA Date Inspector Date Inspector APPROVALS . 1Sermit# APPROVALS Permit# • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. , 53. SteelReinforcement. • - - y • 3. Electrical Conduif Utility-Undrgrnd. 54. Forms - - 4:-Electrical Conduit-Undrgrnd. t . 55. Electrical Bonding - •5.--Steel"Reinforcenent - I; 56. Rough Plumbing & Pressure Test . CElectrical UFER•Grnd. • 1 - 57. APPROVAL TO COVER-GUNITE ] 'I _ • 7;Footings t, i it 58. Electrical Conduit-Undrgrnd. .:,•,i 8c t Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test ' 9. Water Pipe-Undrgrnd. - {I 60. Backwash Lines, P-Trap, 0 Undrgrnd.' y i . •_ t - 10. Structural Floor System . \ r 61. -APPROVAL TO DECK • 11. Property Sewer Line & House Connection i • 62: Backwash'& Receptor-Final - - 12. Sewer Cap ' • / 63. Heater & Vent-Final 13. Roof Drains a i • - ; 64. Plumbing System - Final 14. Rough Plumbing - - 65. Electrical-Final . 15. Rough Electrical-Conduit. - - 66. Solar System-Final f16. Rough Electric Wiring - • • 67. Fencing & Access Approval -, _ '17. Rough Wiring Sign . ' - - • 68. APPROVED FOR PLASTERING ' it 18. Rough Electrical,-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - -19'. Rough Pleating& Air Conditioning FIRE DEPT. REQUIREMENT. ' _ 26 Rough Factory;Fireplace -r, APPROVALS Permit# ' 11.. Ducts, inhStruct ire �4 70. Underground Hydro - - 22. Ducts,tVentilaiin'g •`r •. _ ,71,. Product Piping 0Gas DOH •• 23. Gas PipetRough_& Test i, ,72. Underground Flush - / 24. Roof Framing---- / 73. Undergrnd.Storage Tank O Gas ❑Oil 1 25. Roof Sheathing? ' 74. Overhead Hydro 26. T-Bar(Ceiling (Structural) & Monocoat 75. Dry Chemical • - 27.,Frame�and Flail-ling 76. Dry Standpipe 28.- Lathing,&'Siding . 77. FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREY. FINAL ' 30. Drywall,Nailing, li - - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat _;Y -79. FINAL INSPECTION ' . . 32. Electf cal Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final'Eleciric Notes: - .34. Final Heating & Air Conditioning I - - - 35. Final Gas Pipe-Test . ' • 36. Hood or Canopy ' . * 37. Final Factory Fireplace • - 38. Final Plumbing • . • ' • 39. Water Service-Final - • r / b' 40. Gas Service-Final • • ,1>IV? • 41. Solar Domestic-Final. 42. Backflow Preventer • ....1 • ' !Are'r C 1 i- 43. Backflow Irrigation t • _ • ''hi -1 I' ,. jn N., ;j , 44. Landscape Irrigation System - - .J� _ ,,,, i• i • 45. Sound Attenuation: = E X:P 1 R E P.,. {n.: - : : .,,.t 10(15 46. Handicap Regulations ;,iii 47. FINAL STRUCTURE 84 • - . DaYe -`s 51t$ - �,-• - '/� . 48. Special Requirements Completed - 'a, 49. Electric Release to Edison - I .- t (J, .. rt . 50. Gas Releasqg to Southern California Gas Co , , 'f+�! �• 51. CERTIFICATE OF OCCUPANCY1 "r ;,;;/ (^ ),' No: Date • F7:7:','", 15'4.I t s.'. 1 1 vv1 'W!' 14- „ :,,,,,_„,,,,• ., '':7''.''' 1'1ec0.,0M p ♦rv,„G •N ;AWL! PM I ` L i. 1. L_(e.xc I.-X00.4 417 - I. �L I 1,1-1x1-U=• . �i YI `Y ] CAR LLR11.f y Y ♦\ 7r BCOROON !10 ix 2 L`PUON } ' -- L' I K1R 50r1L -� 1 • 1 — cet-XOK TO PROCEED LE)• / SUBJECT TO MEASURL G EXEMPTION. . _ ._ _-._._-_,- _ __ _ ... r DATE 6. 119-M_ INITIALS of �'�v�� I • APPROVED I _ j5°L / �'CI f•F O A ESM A 2 1- .VV^ 1 ` `� •Nao t PUNNING DEPT. ”«' / , SUBJECT TO BLDG. DEPT. SEM ' ' �+ IlY `-(A.-&(--' DATE-44).- ,/-2 DISECTOS OP MIANNINO . V C(, -L 0 • 1:5ODV' • 1 Area ±'.fig "^_ 1 N ,J ADDITIONS, DELETIONNS,, OR CORRECTIONS SHALL - rr BE APPROVED BY THE PLANNING DEPARTMENT kJaiLse. 4l f-- _. .. . .._...______..__._.__.. __ _ _ . __._ _.,, 1 • CITY OF COSTA MESA BUILDING DIVISION OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and,as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete a,d aturn 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 major labor and materials for construction of the pro- posed roperty improvement. ❑ Yes 0 No 2. I (t have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person(firm)to provide the proposed construction: Name C ( e v c —� Address Oct to S-4-re 2.-v-V f City i rJ/ n P_ Phone (•2(t) 7 g6 0 7 Contractor's Lic. No. 4. I plan to provide portions of the work,but 1 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 pro- vide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my per- sonal knowledn compliance with • State'aw. Signed: �, w'- -�- Date: 946/7 rY U Name: A �lvw14 v1 vt q ,/ So v1 I (Printed or Typed) C.D.L. # or S.S. M ` 754-5273 104246 CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. p>0."—eDATE Za recited, 7a LOT NO. .�r.? ADDRESS /798 o9 eOCE' ,0.e 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 (was or ‘;:1,0 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 LL% D y ' Purchaser BY `���4 AL-CO// L°/:The •� RECEIVED Developer and/or authorized CITY OF COSTA MESA representative PLANNING DEPT. / MAR 2 :3 97? By/A7, , „ FM Lender 7I61 r ILJJIliI:JL;k,IS;4i3i6 4 1111111 / , ADDRESSOPDUILMO: 1798 ORIOLE DR WIT: CITY OF COSTA MESA — BUILDING PERMIT ovmExseumw mm: BIRNBAUM, WILLIAM S PERM NO: B 018906 .ems& 1798 ORIOLE DR — COSTA MESA,CA 92626 PERMIT NO: B 078906 PLAN CHECK NO: N GOVT: N SUPP: N • AP PL AUJUNG ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR BaDIEER: LW No.: JOB DESCRIPTION : T/OFF & REROOF W/WODD SHAKE SQ FT: 13, 500 ARCH OR BIOS ADDRESS: WIT: CLAIM VALUE: 13, 500 . 00 CALC—VALUE: 13, 500 . 00 GROUP OCC: R-3 /0-1 CONTf1ACTOR'SNAME: BURR ROOFING ( 714 ) 548-2965 CaNTRACTOWS MAILING 711 WEELO DR COMMENTS : X ADDRESS: COSTA MESA CA uCNO.: 635586 *+ +t*****4****it*atRtaT*aF*itit****** **at**x*itdt*itiE*****ftxdE****aE*xfeat****x*et********se [atiE* 92627 DNT, Z ON ING REQUIR EMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under povidone of Chapter 9 SETBACKS (commendrg with Section 7000)of Division 3 of the Business and Professions Code.and my license bin full face end Bled. ' MC.NO.: 0 1 1621 uc.cLAss: C 39 uc.NO.: 35586 EXP: 09 /96 MAIN BUILDING ACCESSORY BUILDING / ^� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN oma: 'Sr-S 5 h Contractor: Id -,� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN ER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contradore License Law for the Ilowina reason(Section 7Oal.5 Busnasa and Professions code:Any Nvaagnty witch requireeapermit mmnstrud.oda,improv. PARKING RE PROV: PARCEL: 13962227 ZNE: REF NO: demd'uh,or rape's any structure,prior b its issuance,also requires the applicant for such peak to file a signed statement that he or she PLANNING I NG N T E$'>' is licensed pursuant to the provisions (commencing of the Contractors License Law[Chapter 9(commencing with Section d ion 7000) &vision 3 the I> — Business end Professions Code]or that he or she is exempt therefran and the basis for the alleged exemption.Any violation of Sedan 7031.5 by any applicant for a permit subjects the applicant to a civil penalty or td more than Ere hundred dolbrs 1$5001). *******************************************************************.*`*********** ❑ I,as owner or the progeny or my employees with wages as their sole compensation.will do the work,and the structure is not intended DEVELOPMENT SERVICES R E Q U I R E M E NJjT S • or offered for sale(Section 7044.Business and Professions Code:The Contradors License Law does not apply to an owner of property v /�. who builds or improve thereon, Nada who does such work Nmsor herself or through his or her own employees.provided that such improvements ere not intended or offered for sale,if,however, he building or inproveenent is sold within one year of completion,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she da not build or improve for the purpose of sale). ❑ I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Sedisn 7(144.Business and , LicenseProfessions Code:The Contractors Law does not apply to en owner of property who builds or improves thereon and who BUILDING APPROVED B Y : DATE: contracts for such projects with a antractor(s)licensed pursuant to the Contractors License Law). y' ❑ lamexempt under Section: B.SP.C.,brthis reason: APPLICATION ISSUED BY: `HFA DATE: *************************************** ************************ ** Dae; Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL S GM T:Y I do hereby certify that lam aware of and understand the requirements of Calfomia Heath and Safety Code Sections 25505,25533,and 25534,and thml or anyfmure building occupant will/will no(orcb one)need to comply with said stele codes ardlhe requirements tor BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for construction or modification from the Ar DualityManagement District.Residential constructer, papplications ere exempt from these provisions. PERMIT 212 . 25 1 . 35 Date: SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE ❑ Ihave and MPmaintain acenffate oconsent tosedinsure for workers'compensaion,es provided foediat byS3703 othe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,r«the performancedtnewokf«wNnmiapemhis issued. TOTALS----> 213 . 60 0 . 00 0 . 00 213 . 60 213 . 60 I have andvie maintain workers'compensation insurance,an required by on 3700 W the Labor Code.forthe e performance d the• 0 0 work for eftidi this permit is sued.My workers' i and policy number are: Cartier: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 213 . 60 OVER/SHORT: 00 Policy Number 1016530-96 07/01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC . FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed V the pend is for one hundred dollars 1$1001 or less.) 212 . 25 1 . 35 ❑ I certify that in the performance of the work for which this permit is issued,I shat)not employ any penton in am manner es as to bacons cabled s'to the workercompensation lawn of California, and dal h I M cosaw.beme mto the workers' ******************************************************************************* panacea provisionsSeedion 3700 ol the Law Code,I e comps sun" INDIVIDUAL FEE BREAKDOWN ate: /) ^ 6—7 G applicant Failure to secure workers'compensation coverage Is unlaw/uh and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST times p to one hundred thousand dollars(5100,000A In addition to die cost of compensation,damages as provided tor In Secdon37t.�sofineLaborCode,Inwest,andartorneyaf»e. SFR 13500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 13 , 500 , 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the . END OF FEES performance of the work for which this permit is issued(Section 3097,Civ.C). • LENDER'S NAME: ' LENDER'S ADDRESS: I certify that I have read the application and date that the above information is coma.I agree tocomply with at city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentiaad property ' for inspedmnpurpases. STEVE BURRp , /St Pnnt Name y/�9 Dae: `� L rii t - - _ ., Signature ofOmer/AgentiApplcen0110 (5151-46.WP) White-Building&Safety:Green-Flo:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor �' F '& SPA - CONSTRUCTION AND PLANNING . • AtPPROVALS Permit# _i Date Inspector APPROVALS Permit# f �) - Date Inspector . 1'. Temporary Electrical Service or-LP-Ole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. Ia 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrhd.' • . - 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 -'ilk 59. Gas Pipe, Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. I _ 10. Structural Floor System - - 61. APPROVAL TO DECK ;_✓ 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final: 12. Sewer Cap 'J I 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System - Final „ 14. Rough Plumbing 65. Electrical-Final I 15. Rough Electrical-Conduit 66. Solar System-Final " 16. Rough Electric Wiring 67. Fencing & Access Approval , 17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling . - - 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 O Oil 23. Gas Pipe-Rough &Test - - _ 72. Underground Flush 24. Roof Framing - • - - 73. Undergrnd.Storage Tank 0 Gas OOil 25. Roof Sheathing - f--7-46 446-- 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat . •, 75. Dry Chemical • 27. Frame and flashing -76.' Dry Standpipe 28. Lathing & Siding . L= •- 77. FIXED SYSTEM FINAL 29. Insulation •' r 78. FIRE PREY. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' - 79. FINAL INSPECTION 32. Electrical Power Meter-Final80. 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-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 (-12/=Gj�j a(Nik: 48..FINAL PLANNING- 49. Electric Release to Edison . ? . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF:000UPANCY --6 , . 'No Date • 3 .l1'2�'33605SEP 14-7i.- QO 359* 7.01 .00 PAID COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . ' ' - APPLICATION FOR BUILDING PERMIT 7. . For Applicant to Fill in Completely f/ ry �` Q ,( ��/s � - RECEIVED BY DATEBECEEIVED EISSUED BUILDING ' 1 / / d O/LC-0Y i abecVx• L�/r V-67-7/ /— / ' 14 1971 ADDRESS /�J ///� Jo y��y}��.���C OWNER . / 81.. f_o_od IA (_An XTs A.P. NO. / �J /J ///7� �PEq /�/V� 6' Ja z MAIL ' /• V `IVII BADIDRIESS < / ,(J ( 04.u -cwltav ADDRESS (o ,� O W W 00/7TEL, (a/3I . ' • TRACT �9 LOT_577 BLOCK HZ 'CITY i� NO. F>ZS- TWI / Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOLLSH O-V) LENDER ' 80 Mr/ !- J D BRANCH J rn OWNER /t2( _ �` ' //.ri L�Gi�� 03 W . ADDRESS Zed (V/4-Ci X`'(/����/� .. /27 J▪ CO ARCHITECT �'J p//� - Q TEL.p�.r USE Zed1€01t r11 ALU$E ,/�r/0� UN OR ENGINEER/T. i(/V--vUn.l. l -Y.� NO. n le- syfl -- a ' - --' (I 7pr Q _Q FIgE .{.mss,, • WCC ADDRESS as r� , ZONE TYPE �GROUPI GI d W W Z �`/Sf'i APPROVED J O CONTRACTOq / 4(14,--reel. BY DATE a , CO Z 115 cv ,1i :iz , /zc-1Q' J ADDRESS • W W TEL E / NO.OF USE OF NE ' ZF=- CITY NO./j1U-223 ( PtANS'L- BUILDINGogi W-O STATE '/ CITY n p ARDS APPROVED YARDS APPROVED to o LIC.NO. -L 6 T L 3 CLIC.NO.0 o p o MAIN BUILDING ACCESSORY BUILDING SIZE / NO.OF BLDGS. (FROM C/L/STREET) OF LOT-s-7-86'y , O D I NOW ON LOT h FRONT - 4 ti FT. FT. USE OF - L/ EXISTING BLDG. / n R.SIDE - /Q/ FT. FT. Z NIZE OF EW BLDG. a 96 to ROOMS // STORIES 2 _ L.SIDE O FT, FT, COVERING5EWALL I ROOF S / . / r� ] `I' U l LCCCU COVERING t 7A7 C. REAR d�J FT. FT. • J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&, • 0' 0 MAIN BLDGS. ACCESS. BLDGS. %�//qp `//fir/ ( '`L,: VAR.# DATE C O R `��L C.U.P.# APPROVED APPROVED CD _ay DATF Z 0 I hereby acknowledge that I have read this application and state HOLD TOR SPECIAL REOUTREMENTc r . that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. /, m j9 z I hereby certify that I am properly licensed as a contractor under rP SO. FT. Z Io the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER ALUATION IS FOR Chapter 9, and that such licenses ace in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: cc am exempt f • the provision f e State of C.lifornia Business VALUATION /3 r� . y and Profes. Cotla, •. visio 3, enter 9. - PERMIT FEE $ lJ �` N D Signature m /f m Permittee ♦ /-- `• G /� $ q�. PLAN CHECK $ 47r �� E J^ W o Agent Authori -d q g - •.. Ot f TOTAL FEE $ l' 0/ / '�-- City of Costa Mesa • MEASURE "G" EXEMPTION Plan Check # /ADit/a_ Exemption # 89-504 Permit # Case # Address: 179880riole Unit: Applicant: Waymann Carlson FACTS: 0 Residential ❑ Commercial/Industrial ❑ Other ❑ Existing Lot ❑ Not Part of Larger Project Project Description: Legalization of exterior door added to existing residence No. of Dwelling Units One Gross Floor Area NA Square Feet F.A.R. NA Estimated Traffic Generation: NA Avg. Trips/day FINDINGS: The above described project is exempt from compliance with Measure "G" for the following reasons: n 1. Project is a commercial/industrial development which meets all of the following criteria: gross floor area is equal to or less than 10,000 square feet or has an average daily trip generation of less than 130 daily trips, has buildable floor area ratio of less than 0.5, on an existing lot, and is not part of a larger project. n 2. Project is a residential project of four dwellings or less on an existing lot. n 3. Project is residential construction that does not increase the number of permanent housing units on the parcel where the construction takes place, such as remodeling or rebuilding of an existing house. n 4. Project is commercial/industrial construction that does not increase the footprint or square footage or change the use on the parcel where the construction takes place, such as remodel- ing or rebuilding an existing structure. n 5. Project is a public benefit facility, which is defined as public libraries, public administration facilities, public parks, public utilities, and religious facilities. n 6. Project is a facility serving the health and safety of the people, which is defined as hospitals, police, fire and safety facilities, and schools. Exemption ratified by: p Planning Commission Date _ May 22, 1989 ❑ City Council Date • NISEI ' I �y 1648-30 -� 0 �.