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HomeMy WebLinkAbout1800 ORIOLE DR - Building Permits p , CITY OF COSTA MESA BUILDING DIVISION . DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F r t PERMIT ik beThamm�mo 05-00414 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.caa..us UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1800 ORIOLE DR Status: ISSUED Suite: Applied: 03/14/2005 Vicinity: ROOF Issued: 03/14/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number 13962228 Zoning: R1 Applicant: JERRY BLANKS ISSUED BY: to Address: 17501 NORWOOD PARK PL . Phone: '(714)573-0155 - TUSTIN,CA - Zip: 92780 . Owner: GONYA, BETTE J TR / Address 1800 ORIOLE DR Phone: - - - ., , COSTA MESA,CA. Zip: 92626 Contractor: '•PREMIER ROOFING AND BUILDING CO INC - 'Address: 17501 NORWOOD PARK PL . , , , Phone: (714)573-0155 - TUSTIN,CA Zip: 92780 -.License: 634404 Arch : - Eng: ' Address: - Address: Phone: • Phone: Zip: License: License: SCOPE OF PERMIT ., TEAR OFF EXISTING ROOF. INSTALL 1/2"CDX,30#FELT,50 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS NEEDED.2,800 S.F.INCLUDES ATTACHED GARAGE. - FEE SUMMARY - Plan Check: $0.00 _-_ - ._ Calc Valuation: $9,238.00 ' Permit: $181.25 Claim Valuation: $9,238.00 SMIP Res: $0.92 SMIP Corn: $0.00 Other: $0.00 . Inspection: $0.00 - , - . . • Total: $182.17 PLANNING &ZONING SETBACKS x MAIN STRUCTURE Front 0-0 . Rear 0-0 Left 0-0 Right 0-0' , ACCESSORY Front . 0-0 - Rear 0-0 Left 0-0 . Right 0-0 " PARKING Existing: 0 _ Required: 0 Proposed: 0+• . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(8/00) DECLARATIONS f (n 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. Oave 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. ppworkerss''/ccom ensetio/p_insurance carrier and policy number ere: (� n •Garner:s'i 5/ L I �'wJ �ojo/.Number '/ /�0>// 0200* T/sTeecfion need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the perfo -nce of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C:ifomia,and a•r:e that If l;y ould become subject to the workers'compensation provisions of Section 3700 the Labor Code,I shall forthwith comply with these provi-.ons. ,tfii•ari , ,.IgnatS :-°• i�r� -/ Date: WARN FAICURET ECU': WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENA ES AND CIVIL FINES UP TO ONE HUNDRED SAND DOLLARE(5100.• e,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 27060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I here -affirm'tttattarn1lcensyd.a'or envisions•f Chapter 9(commencing with Section 7000)of Division 3 usiness a d P,rgfe ions Code,and my license is in full f r d Lict-N---WS' C? .e : Class p'• *t. - �i3 . Co n tua e:" "•. I [i' t.. Uata: Q CONSTRUCTION LENDING . ENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's 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 end 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(5500).): ❑ 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 end 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 properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. . Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high,(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B.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? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic Leet 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? 0 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? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes*,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If 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. ignature ,eat A, er s) / /,' L//0 D � Or Authorized Applicantf,i / Date:._ a At lropE I IB$CE4llgBIl ^-mow Pali . - INTITIALS SODS I INSPECTION TYPE PAIS rianALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 7 -u'o erC &4-01- 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 PROJECT ADDRESS: 1800 ORIOLE DR . - - . ' UNIT: - • - - ' • CITY OF COSTA- MESA - BUILDING -PERMIT' - -'PERM NO: B 045.1-_95 '' _ OWNER'S NAME: DONALD GONYA - • - - • "- - ' - : . , • • ADDRESS: 1800 ORIOLE DR ' ' ' - - - PERMIT, NO: B ' '045195" - • `PLAN CHECK NO: N GOVT : td SCID f' : N . COSTA. MESA• !" . CA "92626 CONSTRUCTION TYPE: 5-NiPERMIT• TYPE: . STR ' : PURPOSE : • ALT , , _ ( -714 ) 55'7-'8'744 .. . - ARCHJExGINEEfl: . .' REG.NO.: ,JOB DESCRIPTION ' . INSTALL VINYL SIDING ( ICBG# .3663 ) . . SQ El.:- 5 , 820' ADDRESS: .- : • i UNIT: ' n , ' CLAIM VALUE: 5 ,.820 . 00 CALL VALUE-: 5, 820 , 00 GROUP. OCC: .R-3-' 'r' .PERMITTEE: AMERICAN REMODELING . ' ' • ( 77.4.);837-010.1 ' • • - - ' ADDRESS 620 N ECK110FF I . ---- COMMENTS: . - - ORANGE CA 92668 ######9L########**###*################ie#######*###**#ar#####* *#######*#######hr LICENSED CONTRACTOR DECLARATION: hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I -N •G R E- Q II I R E' M •.E N" T S •• 7000)of Divisi n pf he Business and Profe�slp oriE 4nd my license is in full force and effIF . ect. i SE TE A C K S ' 1 , . - CITY LIC.:° Z,(^. STATE LIC.:‘"/j v 4 CLASS: t , 7 MAIN BUILDING 'ACCESSOR.Y ' BUILDING. Date: •1/ -3o '�$' -Signature. ecctb, r `FRNT: ' ' FT 1N REAR: ', FT IN- FRNTi' - FT IN REAR: : FT • : IN . . WORKERS'COMPENSATION DECLARATION: Ihereby affirmthat Ihveacertificateofconsent toself-insure or a certificate of Workers' ' .LEFT: FT ':IN RGH'T: FI' • IN LEFT: AFT IN RGHT: ' f F'T ' ' IM . Compensation ilF)]rom fry 5ert)reg 3o$y thereof(Section 3800,Lah.1C)1 /01 /90 -- + _ • , •MAY ND.:NAT' L UNION EXP.DATE: PARKING , PARKING REO: PROV- : PARCEL : 13962228 ZNE: R1REF N O:' " 14;15,'rANY: LJ : ' PLANNING ' NOTES> APPROVAL TO INSTALL :VINYL SIDING. ON EXISTING ' HOUSE r '-,certified copyis hereby furnished. Certified copy is filed with the city Building Division. , > • - , { ' Date: ( ,3O - sr-51 Applicant' ! � / ' y #9 ############## f##3 ######## ##############%###############i #####i ## *W***44( -## � � O D • EVELOPMENT S EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This session need not be completed it the permit is for one hundred($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 ZONING: APPROVED BY' DATE: subject to the Workers'Compensation Laws of California. __ _ • __ -- + - --- i _ -Date: -Signature: BUILDING APPROVED BY. - DATE': _ NOTICE;If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor --- - • •Code,you must forthwith comply with such provisions or this permit shall be deemed revoked., APPLICATION ISSUED - BY: A' x //� n �/ t _ /�l_ i CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for ...may • DATE: -6"IJ4;?,' `X YF , which this permit is issued(Section 3097,Civ.C). i(-################aE####IFTr- lF !,'. �^ • ########## # 9E.#' i AOURESS: - - • - . - ' -- '- -- LEGALIZATION:N .,- . . .. . - F -E E S Cl. • M A R Y STRUCTURAL. SEGMENTnY.. ., •• OWNER BUILDER DECLARATION: I hereby affirm that l am-exempt from(the Contractors'State License Law for.the following reason 'BLDG PMT - PLUMBING: ELECTRIC '•MECHANIC FIRE SMIP/RES GRADING t PERMIT 81. . 0050 (Section 7031:5 Business and Professional Code:'Any city of county which requires a permit to cokens t,.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/she is licensed ' ' - ,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 -PLAN _ I I •and Professions Code)or that he/she is-exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031:5 by ISS UE FEF. -- any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred'dollars($500). - ' ' BUILDING-DIV-> PERMIT' " ISSUE - PLAN-CHECK TOTAL • PAID ' DUE ' I, as owner'of the properly or my employees with wages as their sole compensation, will db the work„and the TOTALS---- 81- 50 : 0 . 0O 0, 00 81 . 50 81 . 50 ' . 00 .❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code:-The Contractors'State 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 employees, provided that such improvements are not intended or offered for sale.If,however the building of .REVENUE- DIVISION TOTALS--> COLLECTED: 81 . 5 0 OVER/SHORT: 00 'improvement is.sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE -SMTP/TOT GRADING' PLAN-CHECK . � for the purpose of sale). '• ' 81 . 00 - - 5 0 I.as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 7044,Business - -' 1 -•,-, I. and Professions Code: TheContractors'State License Law does not apply to an owner of property who builds or improves thereon .y1..x.####'#.x.###)EiE#3f#3E9E#iE.fEi6#it.)f.k.jf'##.N..M.ihN.#iE#.If*k**..x.ih#.lE###*iA.lf#y.#ic.#.N.****##iE####.#.1E.K.#,>E,.N.#i:.ih#,p. and who contracts for such projects with a contractor(s)license pursuant to the Contractors'.State License Law),:I am aware that proof of their Worker's Compensation-insurance should be provided'to me. . „ I N D 1 ' V 1 D U A' L ' F E E BREAKDO W N • ❑ iamexempt under Section: q B:SP.c. • ' 'TYPE - QTY D E S C R I P T I . O N ' - ' UNIT COST TOTAL COST for this reason: - Date: - Owner: - SFR 5820 ,. ALTER BY VALUE, RESIDENTIAL' NOZONE ' . 1 .00 • '5, 820 , 00 • I do hereby certifythat I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF .FEES , . ', i 25534 and that I or any future building occupant wiltwill not(circle one)need to comply with said state codes and the requirements for a : . • I ' permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from , . these provisions. I • . I I . 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 r • - ordinances and state laws relating to building construction and hereby authorize representatives of this ofy to en-r upon the above-mentioned-. - • - • property for inspection purposes. / j - _• • , Date: `/- 3O ,S' Signature: _l _i� Drivers License or Social Security a: - 71411 . : 01 E:- 11/30/89 �r3659 TOT T ' 91.SQ 1DATE:- 11/3D/89 :T . 13:., i -\ 164146 White=Buildino;Green-Code Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor � CONSTRUCTION AND PLANNING �' PO' SPA • - APPROVALS . Permit Date Inspector APPROVALS Permit # Date Inspecto r • ' 'J. 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 UFERGrnd. - 57.-APPROVAL TO COVER-GUNITE -7. Footings :22_r - 58. Electrical Conduit-Undrgrnd. . . 8. Foundation ' 59. Gas Pipe, 0 Undrgrnd., Test • 9. Wjpc,Pipe-Undrgrnd.. 1 - 60: Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Sttuctural Floor System r 61. APPROVAL TO DECK 11. Pro;erty Sewer Line & House:Connection I 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 j • 66.'Solar System-Final 16. Rough Electric Wiring _ 67. Fencing & Access Approval - _ I 17. Rough Wiring Sign - 68. APPROVED.FOR PLASTERING 18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL • ' ' "19. Rough Heating'8/ Air`Conditioning _ ,,•, -, . t:, , - ,.r • FIRE DEPT,.REQUIREMENT • 20. Rough Factory Fireplace - • t - APPROVALS Permit # • - -~ 21: Ducts,in Structure - " - f 70,:Underground Hydro 22, Ducts, Ventilating . , - - 71. Product:Piping 0-Gas 0 Oil 23. Gas Pipe-Rdugh & Test _ - • ' , ' 72. Underground Flush:- 24., Roof Framing P 73. Undergrnd.Storage,Tank 0 Gas 0 Oil J 25. Roof Sheathing _ - 74. Overhead Hydro 26: T-Bar Ceiling (Structural) & Monocoat 75.-Dry Chemical - •- 27. Frame and Flashing - - -r 76. Dry Standpipe'- � - - T•t 28. Lathing & Siding • 77- FIXED SYSTEM FINAL . - - 29. Insulation - '� . ; 78. FIRE PREV. FINAL r - 30. Drywall Nailing ' -. , .,., - {HEALTH DEPT.REQUIREMENT - - 31. Plaster.Brown Coat _ - i t 79. FINAL INSPECTION • 32: Electrical Power Meter:Final �,•, , 80. FOOD CERTIFICATE ISSUED 33. Final Electric , - I - Notes: 34. Final Heating & Air Conditioning - -r 35. Final Gas Pipe-Test - • >• - ' , •- - - - +r� - 36. Hood or Canopy • - . -ik r:r �. � 37. Final Factory Fireplace - • _ _ _ 38. Final Plumbing ' t+; ;: - 39. Water Service-Final - I. - • i , • 40. Gas Service-Final ' - • • - ` - ' 41. Solar Domestic-Final . , - - - - - s. , 42. Backflow Preventer II- . 43. Backflow Irrigation . - " , + - 44. Landscape Irrigation System': ; _ , ' e, ' - : _ .• ,••c 45. Sound .Attenuation - - . - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /ffr .- -- , 48. FINAL PLANNING - i, n ' • 49. Electric Release to Edison t i 7- 1 . - - �- 50. Gas Release to Southern California Gas Co ' ." - 51. CERTIFICATE OF OCCUPANCY I • - ' No. Date C. ---_ _ _ Applicant to fill_i_n_all spaces except those within heavy border lines and sign all appropriate declarations. . _ _ _ __ CITY OF'COSTA MESA CONST UCT19N'PERMIT P�/'{$MIT ND..t' (� :TRACT/ -7NrO. LOT O. UNIT NO. 42 2 0�0 X86 28.5 TL Project Address /oto • .ry.; . a-, `�-� LJ ��`� �p/V v ^� I • Applicant's Mailing Ad ss I TYPE OF CONSTRUCTION L i NEW ADD Li ALTERATION REPAIR r ' ' / ` El CONVERSION ❑ DEMOLISH ❑ OTHER Cy /' /Q Owner's Name ho't e� Phone l+c+'_`7 T"�,'i% - ..v _. . A.P.-# �3 < — 6 gi 2 — 2 Fs.. - Zone K j . ` DE$ RIPT ION OF OAK U$E OF BLDG. /Sc' `/1h7>/f C-V�tt > Address • 2(9-0d Or/c)/6 .U� j� j.4/ S Main Building: ; - • 'Accessory Building: • Arch/Eng • License No. ,r226;0" TYPE OF PERMIT C7 GRADING El FOUNDATION LI STRUCTURAL T Front' I !p • Address I I B t I �, ,(/ ,/ i ❑ TENANT'❑ ELpE�TRI��AL• ❑ PLUMBING ❑ MECHANICALN LiI/CC �f�/"'p 603 f) .OTHER. /106f//c A Rear • Contractor's Name Phone �' ( - ' , - - I { Address(mailing) 9,--7; .4.---. . /'.. PROJECT DESCRIPTION SQ. FT D2 OCCUPANCY C Right N J g / ' 1 g ��0 ecLL CONSTRUCTION'TYPE I VALUATION $ X200. 'S Left • -. • • I R • City'License No, T ZONE GRADING CU.YDS.. ACRES • LICENSED CONTRACTOR DECLARATION • Ping. Ref.# ' Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' , ' Planning Notes: ' I I M with section 7000) of Division 3 of the Business and Professions Code,and ' I my license is in f forces and effect. , i ; . .- - • , _ , T License Class { % - fen No. `7/�2G yd/ - ' • _ S i nate-/'�-� Signature' ,PLUMBING - FEES - 1 - - ' , - • -, WORKERS'COMPENSATION DECLARATION '� - ELECTRICAL - FEES hereby affirm that I have a certificate of cons tit to self-insure or a certificate Bar Sink .. • Showers, I __ • - • , Workers' Compensation Insurance, or a'certified copy,thereof (Section gaCkflOw Preventer Service Sink • • ` • • X800, Las, c.) i - Automatic Washer I _ Transformer_❑ 15-50 KW • Policy No: 4�� • Company •c - '�/ Backflow Irrigation p i - Construction Pole Sub- / 9 : Sewer.Ca - 0 50+ KW L Certified copy is hereby furnished. E ' - - - - - • '• Certified copy is filed with the city Building ! - . Bathtubs Sewer Connection - Cooking Unit { - • Meter ❑up to 100 amps I. Date ,4a7"C-/C: - Applicant - F EXEMPTION FROM WORKERS'COMPENSA ON DECLARATION Clarifiers 1 Solar Collectors. , ,_ - I Dishwasher - - Meter Dover 100 amps 1 �. (This section need not be completed if the permit is for one hundred ($100) or - ' less).' Dishwasher ' - f Solar Piping • ' . . • ' - , - ' Dryers"❑Gas ❑Electric : Sub Panel ' 1 " - I I certify that in the performance of the work'for which'this permit is issued I " • ' + • ` , shall'not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank J Fan ' Motors❑0-1 HP O 1 A-B Workers' Compensation Laws of California. _ - . Date; Signature - Floor'Drains . ' ' - 'SwimmingPool'w/S a NOTICE: If,after making-this declaration, you should-become subject to the - - - p _. F.A,U.- _ _ Inc.Solar ❑9-15 HP ❑16-15+ Workers' Compensation provisions'of the Labor Code, you must forthwith Floor Sinks ' Urinal I t - , comply with such, provisions or this permit shall be deemed revoked. I • Fixtures I Microwave CONSTRUCTION LENDINGS AGENCY j • Gas Service Outlets ; 'Water Closet • • I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light of the work 'for=,which this permit is issued (Section 3097 Civ. C.) I . ' G; , Interceptors . - ' Water Heater Range Lentler's Name -- �-�/sr��- I Outlets I ' Lender's-Address_ f �•y/NC ' .- - Kitchen Sink- - WaterService•-- - - -- - - - - - -- -- - - OWNER BUILDERDECLARATION( 1 - - $witches' Sign' • I hereby affirm thatfi am exempt from the Contractor's License,Law for the ' Lavatories i Auto-Wash - • Garbage Disposal ' • following reason (Section 7031.5 Business and Professional CodeAny citylor - - 9 P Standing Sections � county which requires'a permit to construct,alter,improve,demolish or repair P—Trap ; Laundry Trays Generator ❑0-5 KW'❑5-15 KW , ,. any structure,prior to•Its issuance; also•requires the applicant for such permit Trash Compactor , to file a signed statement that he/she is licensed pursuant to the provisions of ROOF Drains ' , t - the Contractor's License Law (Chapter 9(commencing with Section 7000) of I •I t • •livision 3 of the-Business and Professions'Code) or that'he/she is-exempt 1 ' " ' - ' - . - erefrom and the basis:for the alleged,exemption. Any violation of Section - 1 • ' J31,5-by any applicant for a permit subjects the applicant to a civil - I • • _ ' LJenalty-of not more than five huntlred dollars($500). , . . - , , l • I; as owner of .the-property or my employees with wages as their sole Reinspection Fee ` $15 Ii Fee I $.3 I compensation,iwill do-the work, and the structure is not intended or offered - - Reinspection-Fee ' I' $15 Issue Fee $ 3 • I 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 mproves - ` - . 1 , thereon, and who does such work himself/herself or through his or her own . - DEVELOPMENT SERVICES REQUIREMENTS: • - employees, provided that such Improvements are not intended or offered for Boiler - . Hood or ' Type I ❑ • • s.sale. If, however;the building or improvement is sold within one year of com- - , Canopy Type II 0 l Z°mng APProved By - ' I Date - „pletion,-the-owner will have the burden of proving he/she did not build or im- Duct- Under Ground , - , ✓ - 1 yyy ' -prove for the purpose of sale). I , - - Building Approved BY Date /p/'. • 0 I, as owner of.the property, am exclusively contracting with licensed con- ' Duct-Structural , I Refrigeration System , - i -Application Issued By ' • Date��/�/c ffv_ , tractors to construct the project (Section 7044,Business and Professions Code: - !(( • The Contractor's-License Law does not apply-to an owner of property who Duct-Ventilating i - ❑4100,000 BTU 0100,000 BTU - _ - - SUMMARY OF FEES 1 - builtls.or,improves thereon,and-who contracts for such projects with a con- - - - - • . • tractor(s) iicense'pursuant'to the Contractor's License Law). I am.aware that- ' Exhausts stem ❑ "Multi le❑ - System Re air BUILDING PERMIT �$ ' 28.cc SMIP •- $'- ©.. -0 Proof of their Worker's Compensation•insurance should be provided to me:. V- PP /Alteration I - - • - PLAN-CHECK $ PERMIT- ' ` ❑,I am exempt untler'Section - ' '' B. & P.C.-for this reason ! Firepl/Fact.,Blt.,,IC60# _ Fire Dampers - PLUMBING $- I - ISSUANCE $ ' Date. - - Owner - I • Heating System& Ducting _ Registers _ I i _• PLAN CHECK 25%' $ . '. ENERGY. C. $- • ' I hereby certify that,] have read this application and state that the above ❑4100,000 BTU 0100,000 CT - GRADING • '$ ' • , , information Is correct.'I ag ee to, comply with all city and county ordinances' - - ' ' ELECTRICAL $ , '. and state laws relating;t ig construction, and hereby authorize repre- , ,- , - - - - -MICROFILM $ ' • ' sentatives of this cit e upon•the above-mentioned- property for - - • _ -_ PLAN CHECK -503 $ -_ - _ •n_D inspection purposes /ys/fyd�/rs w/� - J •- •' •r MECHANICAL $ ' TOTAL FEE $' 49•. SEs ' Signature : 55 / Date . , _ . . - Drivers' License - SS ' . - Reinspection Fee $15• Issue Fee - • $ 3- PLAN•CHECK 25% $ , • CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNINGL POO &SPA r, Date • Inspector` sDate Inspector' APPROVALS Permit# - - APPROVALS Permit# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location l 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, D 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 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 ' i FIRE DEPT. REQUIREMENT - 1 . 20. Rough Factory Fireplace APPROVALS Permit# _ • 21. Ducts, in Structure .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 0Gas DOiI • 25: Roof Sheathing . 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe i 28. Lathing & Siding 77. FIXED SYSTEM FINAL . , 29. Insulation ' 78. FIRE PREY. FINAL • 1 30. Drywall Nailing HEALTH DEPT. REQUIREMENT A 31. Plaster Brown Coat 79. FINAL INSPECTION , . 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED I 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 �j7�V "e j_ • 48.'Special Requirements Completed ''774 CC -49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 1 51. CERTIFICATE OF OCCUPANCY '• No. Date . li CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. (g 7SV5P DATE / ci#' /971- LOT NO. ....t"--c5P ADDRESS /Soo o&,OCE OC 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-sh- , (was or a 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. BY7 - Purchaser Cj ` M\Jjb N BY Te �(roc9 RC\1� OF\nCo Vit:°j' Developer and/or authorized \g12 representative g,\�\91�c.\v" L Lender cif" - D SEP 14 71�Mt700 360* *** 1141.C.U !VI .' "•i• . ' • 133606 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 ,rt For Applicant to Fill in Completely 7 Be APPLICATION FOR BUILDING PERMIT • /� /lX/Cc�CJ� RECEIV ...BY CD/AT RECEIVED DATE ISSUED ADDRESS ' /_37/ SEP 14 1971 . ADDRESS D c OWNER / ,Q4- LL%ia Akf n (0,4„ 0 ! A.P.NO. PE 3.433.06 BUILDING /�- -'t- vLrici ' MAIL //�� n ADDRESS �--� L�Y ADDRESSES430 ,..-CD . �. .y\ �U CITY �7 w�. j'-CQQ NO.TE2/aJ TRACT 6�J,S�(� LOT, BLOCK Z Q CONSTRUCTION / NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER r/ O-N l� ,ahG • a 03 n `�/� /n, n J O BRANCH /.(b7 (/I B'lUL�l�!' K tate, JV) OWNER f/ !/l m m ADDRESS �� V LUE�/ `—. • ARCHITECT ' ..--. /%� ,,t TEL.p US ✓` $. /tJ�✓ J < OR ENGINEER 4v./Y• /R w !-4- NO. X70 /SL �J ZQ '/ �/p /� ' c../ 'n —.. FIRE T T�^y WCC ADDRESS STS ,6. ELar,w�-w 4-.“.GC,L[dYs ZONE TYPE GROUP•+ Q tl W ` � / W Z /t-/ APPROVED J O CONTRACTOR/ M �� (9 tryst,^,,i BY DATE a //) m z �A^ � T// J ADDRESS /50/ h ! P 7 W W K� TEL Z E NO.OF USE OF Nl`W, 1 ZFCITY /WA /` 4 No50o-8833 l+ PLANS �,/' BUILDING Ar W- O STATE V CITY F, YARDS APPROVED YARDS APPROVED/ In Ir LIC. NO. /46 12 3 LIC. NO.2Qa 3 MAIN BUILDING ACCESSORY BUILDMMMG D O IXS (FROM C/L TREET) SIZE _brINNOW.00F OF LOTS — yO<C/I,D NBLLOT . / ROM FT. FT. USE OF EXISTING BLDG. R.SIDE 8 FT. FT. H SIZE OF Arc r NO.OF Z NEW BLDG. /a J 0 QROOMS 9 STORIES / L.SIDE 9 .FT. FT. VEXTERIOR WALLL ,,,,�� ROOF (y COVERING ��(,(t1.(,p COVERING REAR ^. _` FT.± FT. J USE OF BUILDING AND WORK TO BE PERFORM` DISTANCE BET. BET.MAIN& aa. MAIN SLOGS. ACCESS. BL OCS. Q �� i / (L` RCUP. E DATE APPROVED HAPPROVED bV / �Ag'/3 _ / / zO. 61441 frn VI hereby acknowledge that I have read this application and state HOI,Q FOR SPFC'IQI. RFQUIREMENTS 7 that the above information is correct and agree to comply with CC , all laws regulating building construction, and I shall not employ F• any person in violation of the workman's compensation laws of CO• the State of California. /16—D v{IT ,Q. Ip 0 Z SO. FT. 1•�r 0 I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER ALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt fr. the provisions• e State of C ' ornia Business C^� ))) and Professio-s s ode, a vision ,C outer 9. VALUATION - / L/' Vm PERMIT FEE $ 7 N J Signature of e-. ) ) n �! 0 Permittee -t - $ N PLAN CHECK $ /j /! '�� E / L 0 Authorize• Agent • `/16 57�• TOTAL FEE $ J / // u $OWNER GONYA, :Don DATE 2/15/73 %1'J0B ADDRESS 1800 Oriole Dr. BUILDING PERMIT NO. 36098 ,GENERAL CONTRACTOR House Or Huntington DESCRIPTION of WORK Patio Cover ' P 139-622-28 LOT TRACT FIRE ZONE . VALUE $ 430.00 Ih .;TIONS Signature Date ,GROUP .T TYPE V ZONE SOIL PERMITS ISSUED GAS SUBCONTRACTOR !`1 Dare Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING ^ Heating and Vent. TRENCHES 0 FORMS 0 STEEL REINF. LG✓-� g �_��, -7) FLOOR SYSTEM BOND BEAM C7 STEEL REINFORCE n SHEATHING FRAME AND FLASHING ^ LATHING — IN n OUT l P' ASTER, BROWN COAT CTURAL, FINAL Electric . .1ING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL y BUILDING, FINAL /t/>( 3-7 73 36098 FEB1s ,3FalifnA 577c- *'***•••=5.50 o. • COSTA MESA BUILDING-SAFETY-DEPARTMENT ' , P.O.BOX 1200 -COSTA MESA,CALIFORNIA 92626 TLI TION FOR BUILDING PERMIT • For Applicant to Fill in Completely Mr. Uk ` ` RECE /�/(/1{' DATE/� RECEI�VJED DATE ISSUED^� BUILDING aW ©rio �{/i )e /` r" /g- 3, T-Is .- 7s ADDRESS • ,/�/� 6.... q ..� �7 il'ilhr. Mr- 1 115 A.P.NO. I' I -C•).. •—Ci0 - - PERMFTNOfQn OWNERN�4� ri Z AMAIL DDRESS /gO(7 E7 rein 1C� P� • BUILDING {SOD Ot `OtG ADDRESS/ Q ! Q aU CITY NOTEL (-758,. C''(l - /� I AA_�Q_ 56-7 O�J`J/... TRACT LOT BLOCK Z `etC�ZCL' 1v 1E' "/ O/ / NEW DID "NI TER REPAIR MOVING DEMON LSH • - C CONSTRUCTION vis...--L-._ ON LENDER a_ m J BRANCH /�_� eip Ydda J OA OWNER L%E'J m m ADDRESS /' /U�y /J VALUE i/3j J Q OR ENGINEER NOARCHITECT . USE AT/D (-V/0�/� U Q FIRE w Q ADDRESS ZONE T PE GROUP \ J ZQ CONTRACTOR 11-0 um..., Nigel 14.le' IA APPROVED DATE -75----?-,7 mZ ��• 111'' r J ADDRESS .%s ,t A W W � / ���/ //�•/,-ra��" " ' ��`�,g�.��// ZONElei NO.OF USE OF NEW ll Cr CITY VL/P S�'1Ih'I's�P4.. NO..TEfl/ I <pU PLANS BUILDING '.4.9_11-.4 LU STATE ft CITY YARDS APPROVED YARDS APPROED �< In CC LIC.NO. -2166 /39 LIC.N0,2./0 2.-- MAIN BUILDING ACCESSORY BUILDING D O t (FROM C/L E TIQ SIZE y� NO.OF BLDG& I 5S// OF LOT &r..r 5 9 v vs/ I NOW ON LOT . I FRONT C r Y. XT. USE OF - /{o f 1/ EXISTING BLDG. ASIDE / a FT. b I- SIZE OF ri NO.OF Z NEW BLDG./04 sLROOMS STORIES L.SIDE ��FT. _ Q EXTERIOR WALL •1ROOF �A �t U COVERING } OVERINGCO me REAR /ry. FT. FT. - J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& CL MAIN BLDGS. ACCESS. BLDGS. 1 a VAR.# DATE O =01-•I0 — — `"' '- - C.U.P.# APPROVED V _ — Y APPROVED( / /` y1* _DATE .2-/� 73 0 herebyI acknowledge that] have read this application and state - IN Lin 51 p7C • D that the above information is correct and agree to comply with • XC✓19 all laws regulating building construction, and I shall not employ S CC I- any person in violation of the workman's compensation laws of Nthe State of California. J m Z Da I hereby certify that I am properly licensed as a contractor under SQ . FT. T O V the Stare of California Business andProfessions Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licensess are in full forcea and and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: It CC am exempt from the provisions of.the State of California Business VALUATION - and Professions Code,Division 3 Chapter 9, Cel m PERMIT FEE $ J c' op 7 • ' Signature of m Permittee x $ PLAN CHECK $ E o Authorized Agent u . TOTAL FEE $