The URL can be used to link to this page

Home My WebLink About1031 PALMETTO WAY - Building PermitsCITY OF COSTA MESA g5tpM 4q . BUILDING DIVISION F77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us '— FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BC10-00540 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: SFD-NEW DATE ISSUED: 01/04/2011 ISSUED BY: RMD JOB ADDRESS: 1031 PALMETTO WY CM APN: TPNO08031 Zoning:, Vicinity: Const Type: V -B SQ. FT: 2894 Suite/Unit: Primary Occ: Valuation: $238,300.00 SCOPE OF WORK: PHASE 2: PLAN 2 TYPE 2AR - CONSTRUCTION OF A 2,383 SF 2 -STORY SFD WITH A 56 SF PORCH AND A 455 SF ATTACHED GARAGE WITH 1 FAU < 100 K BTU, 1 REFRIG SYST < 100 K BTU WITH NEW DUCTING, 1 FIRE PLACE, 3 VENT FANS, 1 HOOD W/MECH DUCTING, EL FOR RES A/C PKG, ELECTRICAL FOR A NEW 2,383 SF SFD, 2 LIGHT FIXTS, 4 OUTLETS AND 1 SWITCH FOR GARAGE, 2 BATH TUBS, 1 DISHWASHER, GAS OUTLETS (1-4), 1 GAS SERVICE, 1 LANDSCAPE IRRIGATION, 1 LAUNDRY/TUB WASHER, 2 SHOWERS, 1 KITCHEN SINK, 5 WAHS BASINS, 3 WATER CLOSETS, 1 WATER HEATER, 1 WATER SERVICE. FIRST FLOOR: 1,072 SF, SECOND FLOOR: 1,311 SF REF: PA -05-29, T61917 4 BEDROOM/3 BATHROOM SFD. OWNER: OXBOW 101 LLC Phone: 949-179-4975 APPLICANT: EMERSHAW, KIRSTIN Phone: 949.873-2718 CONTRACTOR: T R CO Phone: 949-719-4975 Cell: ARCHITECT: ENGINEER: HUAN NGUYEN COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTAL FEES: `Refer to fee receipts for all fees paid for project Address: 160 NEWPORT CENTER DR City/State/Zip: NEWPORT BEACH, CA Address: City/State/zZip: License No. 832198 Address: 160 NEWPORT CENTER DRIVEUnit: City/State: NEWPORT BEACH, CA License No. License No.C64238 $287.98 $1,772.15 $228.68 $110.05 $220.85 $23.83 $0.00 $10.00 $2,653.54 Unit: STE 240 Unit: STE 240 ZipCode 92660 PHONE: PHONE: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday -7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day 40TICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and relate( 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. CODE#. INSPECTION TYPE DATE IImRALS CODE# INSPECTION TYPE DATE INnnALS ✓ 1616 Fixed System Final Fire Prevention 206 Final Mechanical P3- f 1 -J1 _E f bqL-0— 1266 Pool Spa Final 206 Final Plumbing P; --II -/I E/ yaa., 200 Final Re -Roof 210 Final Electrical ✓ -II '/I E/tb4lt� 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site �, o 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: WI 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. ❑ 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 permit is issued. My workers' compensation Insurance carrier and policy number are:y C`amer: tn Sv Tar. �e �v r`ck (This section need mol be mmple(etl (he permR is valued atone hundred dollars (5100) or less) Percy -Number: 1-1 2 (o li 1'1 — O ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of they Labor Code, I shall forthwith comply with these provisions. 'Appheant's. signature r -Date I -3 l� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), 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 Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lt icrty, 8 3 Z g Clas l� �✓ l l n Il Contractor's Signature Date 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). Lender's Name: Lender's Address: Signature OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the fallowing reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 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 3057-46(3107) 49 Owner ID verified by driver's license. ❑ Yes ❑ 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) feel 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? ❑ Yes ❑ 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 Califomia 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 ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ 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? ❑ 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? ❑ Yes ❑ No 8. (If "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state (hat the information given is correct. I agree to comply with all slate 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. Signature of Legal Ow arts) Date pi I L,4 i At a5N Authonzed Applicant olt i NEWPORT -MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AS 1600 AND AS 181 To: (City of Costa Mesa ( ) City of Newport Beach ( ) County of Orange Applicant: Address Telephone Number: Tract/Parcel and Lot Number(s): Location of Project: I b Number of Square Feet of: tZ4z-S Residential Space ma ft W Iry aril r>� It 0A &Y PWA t -fh i 5 Af /:X� /'5 Pfatn 2 �Wh i h Nw,S Commercial andf Industrial Space :<-" "' �'x $.30 N2 7002 1(�03 District Receipt No. r3 t,10 - xSNO Plan Check No. Total 'u0 i - L2 Total DCommercial/Industrial Project is: (Check One) D 1 2011 Motel JAN 1 Warehouse Preschool R & D Bank Auto Repair Movie Theater Neighborhood ShopsCCTY Or COSTA Id1ESA Hospital Mini -storage Racquet/Health Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park - Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Permits for this square footage in this proposed developme may now be issued by your jurisdiction. Checks are to be made payable to Newport -Mesa Unified School District. By: AWwrized RAkeserWr4el The above representation as to square footage is true. Applicant agrees that if it is tater determined that such representations are not true, then this certificate shall automatically terminate and the appropriate City/County shall be notified. Dater_ A_1d1\ l L) r1e cTb w SHEET: 11111FIRMP41w "='"' • GOLTVIS��fl��B�V@L�� JOB NO.: 61944 M mnsidnnggrmup,mr. DATE: 03/08/11 "EA: MISSING ANCHOR BOLT - CLIENT: TRCO Development ''.SIMPSON'TITEN HD ASTM (F568M)THREADED SIMPSON STRONG l L) r1e cTb w - _.. REPLACEMENT ANCHORS FOR "EA: MISSING ANCHOR BOLT - ''.SIMPSON'TITEN HD ASTM (F568M)THREADED SIMPSON STRONG ,SCREW ANCHORS ROD INHILTI-RE 500SD . BOLT 1 -POUR OR 1 -POUR OR 2 -POUR WI DOWEL 1 -POUR OR 2 -POUR W/O DOWEL 2 -POUR W/O DOWEL -(ICC ESR#2713) (ICC ESR#2322) (ICC ESR #1771) .WALL TYPE - QUANTITY BSIZE Le. 'QUANTITY &SIZE Le QUANTITYBSIZE Le 2X4 SILL 2 3/8"� 3 1/4" 2 3/8"m 3 1/4" N.A. N.A. EXT. 3X4 SILL (3).3/8"m 3 1/4" (3) 3/8"m 3 1/4" N.A. -.- N.A. 2X6 SILL 2 1/2"� 4" 1 5/8"m 5 1/4" N.A. N.A. 3X6 SILL N.A. N.A. 1 518"m 51/4" N.A. N.A. INT. 2X83XSILL 2 1/2"m 4" 1 518"m 51/4" (2 1/2"m 41/2" EQ. EQ. 1. POST -INSTALLED ANCHOR 2 PER TABLE. SPACING BETWEEN 1 1 ANCHORS AND MIN. DISTANCE I °`� J FROM EXISTING A.B. TO BE 3 112" a IS REQ'D. 31/2°, 2X6 WALL FOR 2 y FOR TITEN HD AND HILTI 500 SD, ANCHOR INSTALLATION) � AND 4" FOR STRONG BOLT. MET CONTACT GOUVIS 2. PLATE WASHER PER FOUNDATION ENGINEERING FOR SPECIFIC FIX MISSING NOTES ON SNI SHEETS. D5103N1 ' --'� u�ir', NOTES: a. - - IF DOWEL IS NOT INSTALLED EMBEDMENT Le IS INTO THE 2", 2X4 WALL �% 01'E'SStO� . 423 Ex — 3M �r C 9\F' DF °`� 3PEClA INSPECTION a IS REQ'D. 31/2°, 2X6 WALL FOR ANCHOR INSTALLATION) - IF MIN. SPACING CAN NOT BE MET CONTACT GOUVIS ENGINEERING FOR SPECIFIC FIX MISSING OR MISPLACED A.B. D5103N1 INSTALLATION CERTIFICATE i CF -6R -ENV -01 Envelope — insulation; Roofin • Fenestration Thickness (inches): Thermal Resistance (R- ❑ §150(d): Minimum R-13 insulation in raised wood -frame floor or equivalent U -factor. (Page 1 o(3) Site Address: Lot 17 Enforcement Agency: I Material: Brand Name: Permit Number: tfmore than one person no responsnutity for installation of the items on mu certifimte eacH peraon s tt prepare ones sJgn a eterHficale applicable to the portion of construction jar which they am responsible; alternatively, the person with c ref sponsibiliryfor construction shall prepare and ngn this cer[hcare for the entire construcnom All applicable Mandatory Measures with chirck1boxes require to be checked to ensure Description of Insulation 1. RAISED FLOOR Material: Brand Name: i a Thickness (inches): Thermal Resistance (R- ❑ §150(d): Minimum R-13 insulation in raised wood -frame floor or equivalent U -factor. e): 2. SLAB FLOORIPERIMETER Material: Brand Name: Thickness (inches): Thermal Resismncc (R -Wal Perimeter Insulation Depth (inches): ❑ §150(1): Water absorption rate for the insulation material alone without facings is no greate than 0.3%; water vapor permeance rate is no greater than 2.0 perm/inch and shall be protected from physical damage and UV lig h d terioration. 3. EXTERIOR WALL a. Insulation Type (e.x. Batt, Loose Fill, Spray Foam) Batts a. Thermal Resistance (- alue): 13 b, . Insulation Type (e.x. Batt, Loose Fill, Spray Foam) b. Thermal Resistance g. -N alue): Brand: CertainTeed Spray/Loose fill) Installed Actual Thickness SpraylLoose fill) (inches): 3.5" Contractor's min installe - % eighUft2 _lb Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Val ❑ §150(c): Minimum R-13 insulation in wood -frame wall or equivalent U -factor. le Exterior Foam Sheathing (rigid Insulation) Material: Brand Name: Thickness (inches) : - Thermal Resistance (R- ale) 4. FOUNDATION WALL Materia(: Brand Name: Thickness (inches): Thermal Resistance (R- e): 5. CEILING Batt or Blanket Type: Batts Brand Name: CercairTead Loose Fill Type: Blown lnsulsa a Thermal Resistance (R- e): 30 I Spray Foam Type: Brand Name: certai Installed Actual Thickness(inches): Hatt 10„/Blow 11.75"Contractor'Smin installed Te d eighUfta •462 lb Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Val e) 30 ❑ § 150(a): Minimmn R49 insulation in wood -frame ceiling or equivalent U -factor. 6. ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER Material: Brand Name: Material: Brand Name: Thickness (inches): Thermal Resistance (R -V ): il ❑ § 118(a): Insulation installed meets Standards for Insulating Material. O § 150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16 2008 Residential Compliance Forms I i August 2009 I -d SbE9689916 %H3 13Ca3SH'1 dH Wd9S:f 0102 06 daS INSTALLATIOr Quialitt, Insulatto. ' Site Address: Overview —In order fe with no gam or voids. Lot 17 3van in r uananon to worK con raised floor ban and blown in be Agency: no gaps orvoids. OR Insulation Stage Checklist ✓ FLOOR INSULATION ❑ ® ❑ ❑ All floor joist cavity insulation sistalled to urnfomrly fit the cavity side-to-sidean end-to-end. (NA if floors slab Yes No NA on grade). ❑ 5 Yes ❑ No ❑ NA Insulation in full contact with the subfloor, NO gaps. (NA if floors are slab an g e). M Yes ❑ No ❑ NA Insulation in contact with air barrier on all five sides. (ends, sides, back). NA f fl ars ere slab on grade. Is Yes ❑ No ❑ NA Hens cm to fn around wiring and plumbing, of split (delaminmed). (NA if loo a 11, SPF, or slab oa grade). EI Yes ❑ No ❑ NA Ban insulation has continuous support. (NA if loose fill, SPF, or slab on grade). ❑ ❑ ❑ ® SPF (Spray Polyurethane Foam Medium Density) insulation the average thic a is equal ro orgtealer Man that Yes No NA listed on the CF -IR and the minimum thickness &hall be no more Men 'h inch ss as the requited thickrass for ❑ BATFS, voidsrdepressions less than 3/4" allowed as long as the arca is not gn ate(than l0%ofthe surface area Me R -value. , A for other forms of insulation . No ® Yes ❑ No Insulation R -value same or greater than listed on the CF -I R. 13®s ® ❑ ❑ Ye No Yes No NA SPF insulation properly adhered to avoid gaps and provide an air seal (NA for th r Corms of insulation). ® ❑ ❑ For SPF list the recruited flour cavity R -value from CFAR, R- j Yes Nc NA List tested average depth of insulation (inches) _ X 5.8 (R-value/iach for a density SPF) Any gaps between studs or insulation larger than 1/8" must be filled with Insul ati �a I or foam. (R -value). This is the iosta]led R -value and must be equal to or greater than Ii [ on CF -IR (I'IA for other Comts of Insulation). ❑ ✓ WALL INSULATION ® ❑ ❑ Standard depth cavities insulation fills cavity and touches air barrier on all six 3ides. (NA if SPF used and meets Yes No NA the required R -value). M ❑ ❑ All double walls and bump -outs, the insulation fills the cavity or additional air hairier installed so that the Yes No NA insulation fills the cavity. Insulation touches all six sides. (NA if SPF used und mets the required R -value). ® ❑ Behind tub/shower, walls under stairs, and fireplace, insulation touches air bar ' rion five sides, Not required to Yes No fill the space. Cavity required to be air tight C' ❑ ❑ RAM. note single void/depression deeper than %" in ANY stud bay. (NA 1 to se fill or SPF) Yes No NA M ❑ ❑ BATFS, voidsrdepressions less than 3/4" allowed as long as the arca is not gn ate(than l0%ofthe surface area Yes No NA for each stud bay. (NA if loose fill or SPF). ❑ 13®s Fill depth if butts SPF). Ye No NA Loose no gaps or voids of any allowed. (NA or ❑ ❑ 10 SPF insulation properly adhered to avoid gaps and provide in air seal (NA forof er turrets of insulation). Yes No NA ®s 13 Any gaps between studs or insulation larger than 1/8" must be filled with Insul ati �a I or foam. Ye ® ❑ All Rim -joists to the outside insulated. Yes No �1 ❑ Special attention must be paid to co tier channels, well ¢te sect oa and behi d blshower e¢closurts Yes No insulated to proper R -Value. ® Yes ❑ No ❑ NA All skylight shafts and attic lateewalls insulated with minimum R-19. es No NA Insulation in tall contact with dn•wall or waif finishes of skylight shafts and 'c i awaits. z - d Regutrvrion Nwnber: Registration Daialnose: HERS Provider: 2008 Residenrial Compliance Forms March 1010 I I SbESGBSSf6 XHd 13C?J3Sd1 dH Wd9Stl 0102 06 JOS INSTALLATION CERTIFICATE CF -6R -ENV -22 -HERS ualib' Insulation Installation I - Insnledon Ste. a Checklist (Page 2 of 3 Site Addreu: Lot 17 Eaforcemtut Agency: Y Permit Number. El ElYes Wall insulation same or better than what is listed on the CF -1R, E3 0 Y No if ionse fill or SPF). Yes No ❑ ❑ 0 SPF list the required wall cavity R -value from CF -IR, R._. List t t d average depth of Yes No NA insulation (inch) _ X 5.8 (R-value/inch for medium density SPF) _, Yes l(R-value) This is the Np for each stud bay. (NA if loose fill or SPF). installed R -value and must be equal to or greater than listed on CF -1 R for other forms of NO gaps or voids allowed for loose fill and SPF. (NA if batts). insulation No 0 ❑ 0 SPF (Spray Polyurethane Foam Medium Density) insulation the average thickne 0 Yes is equal n or greaau than that Yes No NA listed on the CF -I R and the minimum thickness shell be no more than Y, inch as than the requited thickness for Insulation in full contact with the ceiling, NO gaps. the 11 -value. A for other forms of insulation ®s ✓ CEILING INSULATION E3 0 BATTS there must not be a single gap/void/depression deeper than'/.". (NA if ionse fill or SPF). Yes No ® ❑ BAITS voids/depressions less than 314" allowed as long asthe area is not gi aat r than 10% of the surface wren Yes No for each stud bay. (NA if loose fill or SPF). ®s E3 NO gaps or voids allowed for loose fill and SPF. (NA if batts). No NA 0 Yes 0 No All ceiling insulation installed to uniformly fit the cavity side-to-side and en -t nd. 0 Yes ❑ No Insulation in full contact with the ceiling, NO gaps. ®s No Insulation in contact with air barrier on all five sides.Ye j 0 0 Batts cut to tit around wiringmme A for and plumbing, Int delamg' or Will ( CN fill or SPF )- Yes No NA M ❑ ❑ Batts taller than the trusses must expand so that they touch each other over I ic saes. (NA for loose fill or Yes No NA SPF). ❑ ❑ ❑ Yes No NA SPF insulation properly adhered to avoid gaps and provide an au seal (NA f ir ther forms of insulation) ❑ ❑ M Ireulation fully fills cavity below any plywood platform or eat -walk. If SPF syH then minimum Yes No NA 3 inches. A if no platforms or cm -walks) I( ® 0 Yes No Attic access gasketed 3 ❑ Attic access insulated with rigid foam or ban insulation using adhesive or tot ical fastener. Yes No R -value same as ceiling R -value listed on CF -IR 0 ❑ Recessed light fixtures covered full depth with insulation. If SPF used then othl forms of insulation used to Yes No coveror enclosed in a box fabricated from Fi-inch plywood, lS ge. sheet m 1, /4 -inch hard board ardrf wall 0s Roof insulation same or better than what is listed on the CF -IR Ye Ye No 0 ❑ ❑ Loose Fill Insulation at proper depth — insulation rulers visible and indicatin p open depth and R -value for Yes No NA blown in insulation. A for batts or SPF). ❑ ❑ 0 Loose Fill Insulation uniformly covers the entire ceiling (or rood area from . side of all exterior walls. (NA Yes No NA for bans or SPF). Loose -fill insulation meets or wtcceds manufacturers minimum weight and t i iicicness requirements forthe target 0 ❑ 13 R -value. Target R -value. Manufacturer's minimum required weight for the gt R -value (pounds-per-squ Yes No NA foot). Manufacturers minimum required thickness at time of installation. M u acturers minimum required settled thickness. Note: To receive compliance credit the HERS ratershall ri that the manufacturers minimum weight and thickness has been achieved for the target R -value. (I'1 f r Batts or SPF). Registration Nrmrber: Registration Date?lme: JIERSProvtder.- 1008 Residential Compliance Farms i March 1010 E -d SirES689916 XH3 13J7d3SHl dH Wd9SrI OIOZ OE daS INSTALLATION CERTIFICATE ❑ CF -6R -ENV -22 -HERS Insulation Installation II - Insulation Stu a Checklist (PaSte 3 of 3 Pu Site Addresr: Lot 17 Enforcement Agency: NA ! I Permit Number. ® ❑ ❑ SPF list the required ceiling cavity R -value from CF -I R, R- . List lesvcrage depth of insulation_ than Yes No NA in X 5.811= R this is the installed R.value and must 1; equal to or gm tet{ listed on CF -1R (NA for CSLBLicense 449739 other forms of insulation Posi' n With Company(Title) ❑ ❑ ® SPF insulation must be covered with other fors of insulation or enclosed in x fahriceted fmm'h inch Yes No NA plywood. I8 gauge metal, 'G inch fiord board or drywall. The exterior ofthe may then he htsulated with SPF. ❑ ❑ m SPF insulation the average thickness is equal to or greeter than than listed on aCF- IR and the minimum Yes No NA thickness shall be no more than ''A inch less than the required thickness for theRF value. (NA for other fortes of insulation ✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES no conditionedice ver ra e 13 ❑ ❑ Insulation installed at joists against the air barrier in the garage to house trnn i6 A1-1. n. All wall insulation Yes No NA requirements above must be met (NA if conditioned space over garage). I ✓ GARAGE ROOF/CEILING INSULATION FOR TWO STORIES conditioned s e ver garage) ®❑ ❑ If insulation is to be installed at subfloorthen the insulation mast also be ins II atjoists againn the air barrier Yes No NA in the garage to house transition. All ceiling and wall insulation requirement clef ave must be met. (NA if no conditioned space over garage). 13 1 ❑ 1 ❑ 1 If insulation is to be installed at ceiling of garage then the joists to the outsl m t be insuleied and all the Yes No NA insulation requirements listed above must be met. (NA if no conditioned s e er ua e). DECLARATION STATEMENT • I certify underpenelty of perjury, under the laws of the State of California, the information pmvit • 1 have read the High Quality Insulation Installation Procedures (Residential Appendix, RA3.5), u understand that there are additional requirements than must be met then those listed on this C F-61 • AI] rows in this document have been checked and all answers arc yes or NA • 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility representative of the person responsible for construction (responsible person). • I certify that the installed features, materials, components, or manufactured devices identified on confoms to all applicable codes and regulations, and the installation is consistent with the plans i enforcement agency. • 1 understand that a 1 PERS rater will be checking the installation and that if such checking identifie corrective action at my mpense, If the installation is pan of asample group far HERS verificatio the requirements of such quality assurance checking, additional checking/testing and repair of oth sample group will be required stray expense. I understand that the HERS provider, and Energy also be performing checks of the installation an jobs not tested by the HERS rater. • I reviewed a copy of the Certificate of Compliance (CF -IR) form approved by the enforcement al requirements for the installation. I certify Thatthe requirements detailed on the CF -IR that apply • I will ensure that a completed, signed copy of Ibis Installation Carlificate shall be posted, or permit(s) Issued for the building, and made available to the enforcement agency for all appli that a signed copy of this Installation Certificate is required to be included with the docume building owner at occupancy. I will ensure that all Installation Certificates will come from a M multiple orientation alternatives and on October 1, 2010, for all low-rise residential buildings. i form is true and correct. these procedures, and or an authorized (the installation) ins approved by the cts, I not requited to take the installation fails to meet allations in the HERS fission represmtativrs will that identifies the specific installation have been met. available with the building inspections. I understand IT the builder provides to the rovider data registry for CompanyName; (Installing Subcontractoror General Contractorar Builder/Owner) Walldesign Inc. Responsible Person's Nome: Responsible Pers o' rgnature Pletcher Fasick CSLBLicense 449739 Date Signed:6. 7.11 Posi' n With Company(Title) roject Admin. RegWratlon Ntonber: Registration Date/fimr: 2008Residenital Compliance Forms b'd SbE9689916 XH3 1317?J3SH-I dH Provider: March Iolo Wd9S:T OT02 OE daS ROBIN B. HAMERS & ASSOC., INC. CIVIL ENGINEERS • PLANNERS • SURVEYORS ... since 1981 June 3, 2011 City of Costa Mesa Building Dept. 77 Fair Drive Costa Mesa, CA 92626 Attention: Grading Inspector Subject: Civil Engineer's Final Grading Certification Reference Project Address: 1031 Palmetto Way Lot 17, Amended Tract No. 16917 234 E. 17TH ST., SUITE 205 COSTA MESA, CA 92627 Phone 949/548-1192 Fax 949/548-6516 I hereby approve the final grading for the referenced project in accordance with my responsibilities under the Orange County Grading and Excavation Code. Final grading and drainage of the lot has been completed substantially in conformance with the approved Grading Plan as determined on May 31, 2011. Sincerely, FV in B. HamersRegistered (to Civil Engineer RCE 31720 .I� NEWPORT -MESA UNIFIED SCd 001_ DISTRICT N® 6994 CERTIFICATE OF COMPLIANCE OF OfVK NT FEES PURSUANT TO AB o tio�� lot I my To: City of Costa Mesa & �P� 0 4 rDi�stricctt Receipt No. ( ) City of Newport Beach ��`\` \ P D� 5`�� ( ) CountyofOrange C� (fir GC0JN1t1 v' Ian he No. Applicant: OX DOL.J O i �LL� r t l Address: WO `v+tWPV� C-r,:1PX bY\J� iia �b, [1e.we&A_-t ar ,Ca 12,(olon Telephone Number: �yr� ' l Ck - Liek-15 Tract/Parcel and Lot Number(s): Location of Project: Number of Square Feet of: 1031 Residential Space Commercial and Industrial Space CommercialAndustrial Project is: (Check One) aj'DJ-0x $1.84 x $ .30 M Int Total 3.g (h3. (PD Total Warehouse Motel Preschool R & D Bank Auto Repair Movie Theater Neighborhood Shops Hospital Mini -storage Racquet/Health Large Office Heavy Industrial Hotel Office Bldg. _ Regional Shops Medical Office Restaurant Light Industrial Office Park Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Pernik for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport -Mesa Unified School District. By: The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true, then this certificate shall automatically terrninate and the appropriate City/County shall be nolilhed. Date: ILA AppGunl