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Home My WebLink About1693 MINORCA PL - Building PermitsCITY OF COSTA MESA BUILDING DIVISION OINNER-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 and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. 1 personally plan to provide the major labor and materials for construction of the proposed property improvemen AYes ❑ No 2. 1 (have/have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name A) Ze!!9t Address City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provideiA the major work: Name } Address City iPhone ( 1 Contractor's Lic. No � 5 I will provide some of the work but I have contracted (hired) the following persons to provide i 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 personal knowledge, in compliance with this State law. Signed: %fir �r�"'�' •C!� Date: 7 Name: DA VI D Lc • 7_21 C-AI06—_ 77 (Printed or Typed) C.D.L. orS.S.# 754-5273 CMF 1042-46 CITY OF COSTA MESA 605jp MASA BUILDING DIVISION w F77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 754-4856 • ww.ci.costa-mesa.ca.us y. FOR INSPECTIONS CALL: (714) 754-5626 '`"°�°'" PERMIT NUMBER: B11-00315 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13932206 DATE ISSUED: 09/21/2011 ISSUED BY: KJB JOB ADDRESS: 1693 MINORCA PL CM Suite/Unit: Vicinity: REAR OF RESIDENCE ONLY Squares: 1300 Valuation: $5,785.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF. COVER WITH 30 LB FELT AND 30 YEAR COMP SHINGLES. 1300 SO FT/REAR OF THE RESIDENCE ONLY, ROOF PITCH IS 5:12 NOTE: RESIDENTIAL RE -ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: DIBBLE, ERIC Address: 1693 MINORCA PL Unit: PHONE: 949-500-5578 City/State/Zip: COSTA MESA, CA APPLICANT: KOZITSKY, TOM Address: 1511 S BAYLESS ST Unit: PHONE: 888.525-5867 City/State/Zip: ANAHEIM, CA CONTRACTOR: ALLTOPS INC Final Site License No. 722766 Address: 1511 S BAYLESS STUnit: PHONE: 888-525-5867 City/State/Zip: ANAHEIM, CA - 92802 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $125.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $126.25 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. Prohibitied all hours - Sundays and the following Federal holidays New Years Day, Memorial Day Independence Day, Labor Day, Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord, No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE %. INSPECTION TYPE DATE INnnALS CODES INSPECTION TYPE ( DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final (�(� {y 208 Final Plumbing 200 Final Re -Roof 1( VjF_4U - 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintaip 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. ❑ 1 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 issuedworkers' compensation Insurance carrier and policy number are: /// 7G�'�7�/�[.. Carrier: meed (This Section need trot/b�e/m/mdeletl AMe perms B va+lu7etl at one hundred OONars is 10) or less.) Policy Number: ,1EfJ_ 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 1pm of California, and agree that if I should become subject to the wai-kege compensation provisions of Section 3700 of the labor , I shall fort hcomplese provisions. App4cadl'S S un, Date 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. 7�7 -) Lic. # / Class # Gon is Sigwtur Date CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for Mich this permit is issued. (Sec. 3097, Qvil Code). Lender's Name: Lender's Address: 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 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 contractors) license pursuant to the Contractors license Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature 305746 (3107) Owner ID verified by driver s license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, t, 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 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. Applicant's Signature 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 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 ❑ 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. Signature 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 Ao 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. e of Legal lsl Date � And/or Aut'bonz plant Date V/- 0031 S Prescrintivc Gierti]'icate, of Compliance:'. Residential CF -112 -ALT liasidentiul Alterariitnx (Ya�,e 7 o''5) Yru,jeci tYnnhc: ER c Di Q« Climate Lone Y/ 9 u1 Stories Value'From JA4 Table General 1niormation - Sile Address. - Li nforcemenl Agency: Date: Building Typ, Single Family D Muld Family Circle the Front Orientation: 14, L, S, W, or degrees Conditimhed Floor Area (CPA$: Projeei Type: D Alteration:; D Envelope D Fenestration 'Roof D HVAC kenlacemenl or Change Oul ❑ Duel Ite lacethe', CI W eh eater NOTE: Thio )a•nr a not It, be usall 1nr Need, Consn•ucmd Buildings at Additions hlsulatiar Values Tor Opaque Surfacer (fa' Furring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑ 6pening of framed cavity alone— Aerations that involve the opening of theft •mued cavity of 41 wall, ceiling, or..flom mull install the inundator•), minimum insulatiah value per ,¢150 for the altered assennbl), Fill in Columns A —C and enter mandatory insulation value in Cohmm H. ❑ Repiacemeni of entire assembly— Jtepluaennent afar entire wall, ceiling, orJlaor assembly requires the installation of Component Package- D tnsulnlion values in Table 151-C. Fill in Columns A — J. I (marine Rill -face Details For the lurred portioned ofMass Vtralls see Furring Strips Construction Tobie belom.. i C D L F I G H... .l. .J Proposed bu Mt, Standard Value'From JA4 Table Framing Thiclmess, Tag/ Assemblyl4ame Material Spacing, III or Type and Size' or Other' U- factor" JA4 Table Number$ Framed Cavit)� P -value Continuous Insulation R -Value' JA4 Assembly Cell Value ° proposed Assembly U -factor" Audi , Interior (it Exterior Insulnli it I iu Tarring Space from lielerenec Joinl h I Joint A rendiz Table 4.3.13 f Note: Foram•nd assernbiies, accounting fur Continuous Insulation lt-value, see Page JA4-3 and Equation 4-1. For calculalino furred ways use the Mass and ,F . ..... . v Consirn rim) table below For Tag11D indicate the identiTcanon name tier, matches the building plans. indicate the Assembly Name or type: RooflCeflfng, Walls, Floors, Niabs, Crawl Spade, Doors and etc ... Indicate the Frame type and Size: For )]rood, Metal, Metal Buildings, Mass, inner 2x4, 2x6, or etc... see JA4 for other possible frame type assemblies. Enver the thiclmess for mass in inches a Spacing between gamine members eruct; )6"a 24 "OC, or Other for all other amembiy description such as Concrete Sandwich Panel, Spandrel Panel, Logs, Straw Bale Panel and etc.... 4, Based at the Climate Zone; enter the Standard U facla:fi•om Table 151-B, Cor D faeach d ffe•eiv assembly Name or i)rpe 5. Enter the Table number that closely resembles the proposed assembly. 6. Liter flit, R -value ihnf is being installed in the wall cavity M between the fanning; otherwise, enter "0". 7. Liter the Continuous hnstderlion R -value for theproposed assembiy; otherwise, enter "it" L'. Lite+' the rota and column of file U -favor value based on C'ohnim FTable Number and enter the Assembly U-facfov in Column J 9. The ProOavail Ass'emhh, U fvclar. Calmmn J, Masi be equal m 06= than flit, Standard U-faclor in Column E In comply. Funliv Scrips Construction Table far 1Viam: W ulls Only A Proposed Tropertics orMasenrp and Concrete Audi , Interior (it Exterior Insulnli it MInils Tram llulcrmtce iu Tarring Space from lielerenec Joinl h )aullis'I:dde 4.3 �, 4.3.G. 4.3.9 Joint A rendiz Table 4.3.13 f LL a G G F G U•' m 0,„ Final hnsenhlp �-, � i, 'a ., v � ry �• •' Miss Wilim. or .I)+4 Will. P "type < a ui w �. G cc 4 c U-itector�'� G.nmmeni Thi elm es � Numhcr � 5 i I I ' C Prescriptive Certificate of Cgmoliat :ouideutial RLWdeinlia/ Aileration.v Prolecl Name: CF -'1,12 -ALT (Yat v 3 of 5) - It it nf`Stariac ROOTING PRODUCTS (COOL ROOFS) .1151(f)12 Whmr title area of extorter ran/'.surface to h(! rapBmarl excaarbr rnorr! than 50% air tire.- existing ronfaraa, or acorn, then 1,11!1({I , ivltichavar Lr lee.e, Ura nen rnnfing area utu.n neat lite rnnftng product "Can! Rnnf" raquiramantr gU152(h)ME, 152(b)lfru, lir 1.52(b)1fllll. Check applicable altarrmAva or auvaptlan below If the, roof alteration i.e. exempt from the roofing pr•oduci "Cool hoof" mquiremarna. Note: Ifany one Of the allarnaliva.v no excaptlmr hnlour is rhockad. the. Agad,Tolar Reflectance and Thermal Enuuance requiremenae,for roofing produm.r in 18(1) are not applicahie, lin nnr fl// !abbe balaw. ❑ CaRoofs Not Required in Climate Zones 1-12, 14, and Il with a Low Sloped. Less or 2:12 pitch. Wof Roofs Net. Required in Chronic Zones I through q and 10 with n Steep -Sloped Roofs (pitch greater thin 2:12) and product unit weight leas. til t 516/fts. Alternatives to §152(h)IIII and §I52(b)HII, Stoop -slope roof (pitch > 2:12) ❑ Insulation with a thermal resistance of at least O.RS hr•f12"F/Bm or at lent a 714 inch air -apace.. is added to the. roof dcclt over no attic•, or ❑ Existing ducts in the attic are insulated and scaled according to § I51(t)10; or ❑ In climate zones 10, 12 and 17, with I ft . of free ventilation area of attic ventilation far livery 150 Rz of attic Floor area, and where at least 30 percent of the free ventilation aren is within 2 feet vertical distance of the. roof ridge{ or ❑ Building has at lent R-30 ceiling insonation; or ❑ Building has radiant barrier in the attic meeting the requirements of § 151(1)2; or ❑ Building has no ducts in thcattic; or ❑ in climate zones 10, 11, D and 14, R-3 or greater roof deck msulation above vented attic. Exception to §152(b)IHlli, Low -slope roof (pitch <2:12) CI Building has no ducts in the attic. Other Exceptions ❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are exempt from the helow Cool Roof criteria. ❑ Roof constructions that have thermal mass over the root membrane with at least 21 Ihttt` is exempt from the below Cool Roof criteria Note: If no CTURC- I iabel is available, this compliance method cannot be used, use the Performance Approach to show compliance, otherwise, Check the a licable box below if Exemnt from the Roofing Products "Cool Roo"' Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product IU Numherl _< 2:42 > 2:12 < 5l6/ftt > 5lb/ftz Tyne e Reflectance" Emittance I SRI' I❑ I❑ I D I ❑ 10^ 1 1, The CRRC Product 1D Number can be obtained front, the Cool Roof Rating Council's Rated Product Directory at www.cooly'oo(s.ore/tn'oducts/sear•cl nim 2. Indicate ilia type of product i.e. being used for the roof top, i.e. tingle -ply roof, asphalt roof, metal roof, etc. 1. If the Aged Reflectance is nat available, in.the Cool Roof Rating Council's Rated Product Directory their use the Initial Reflectance value from the some directory and use the aquation (0.2+123(pb,ota1— 0.2) to obtain a calculated aged value Where p is the hi tial Solar RaRroctmrce. 4. Check bas tf7lre Aged Re(lecta¢•e is a calculated value using the equation above. 5. Calculate the SRI value by ruing the SRI. Worksheet at hits:./hvoar.enermtca.eov/tti c24/and enter the resulting value in the SRI Column above and auuch atopy elf dee SRI- WorleTheet to the Cr -IR. n apply Liquid Field Applied Coatings, the coating must be applied across the entire roof surface and meet the dry mil thiclmess or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in § I I 8(i)4. Select the applicable coating. Aluminum -Pigmented Asphalt Roof Coating Registration Number: 2008 Residential Comptiance Forms Cement -Based Roof Coating !❑ Other Registration Dale?ime: HERS Provider-, August 2009 t J'rescriptivr Certificate of �Cumpliauce: Residential •CF-11:-AL7• Resirleniial Alterations 5 of 5) 1'ralecl lW,mc; Climntr GoncA Ot of Storm, 1IEJLS VERI1r1CAT10N SUNIh ARY Thr), enforceulem agent),should par special aaeuion if, ME )MR, L9easw'es specifier) a, lhes checklist below cauplered nail signal CF -4R Ion>r. far all dx ureanmer epectJied shall Lc auLmi7led ru lets building irrspeclar Lefore• finrJ Du c1 SenJlnp d TeSti7le NEVI'vel y "lion is regzrirvd 1o) lhi.r uwmmrt. ❑ YES D NO vEs: In Climate Zones _ nail 9-16, if more than 40 linear feel of new or replacemem duct:: are 'installed it unconditioned space, the ducts are to be seated per G152(1b)IDii and the newly inaulled duces are to be insultuetl pee 7 51(f)10. ❑ EXCEPTION: Lxisting duct systems that to e esteuded; whleh arc ctuedyltcted, hitUbu.e(l m' sealed with asbestos. D YES D NO Y.Lrs: In Climate Zones 2 and 9-) G, if the existing space -conditioning system (HVAC equipment and ductjngl is replaced, the ducts are to he sealed per (152(b)1Di. D YES D NO TES: In Climate Zones 2 and 9-16, if the existing MAC equipment is replaced (including the replacement of the air handler: outdoor condensing nail of a split system, cooling e r heating coil, or the fnmace Leal er changer) the ducts are to be sealed per (152(b)IE. ❑ EXC);PT10I: Duct systems that are documented to have been previously seated confirmed through I-ILRs verification in accordance with procedures in the Reference Residential Appendix I2A3. ❑ EXCEPT70KI: Duel systems with less than 40 linter feet is unconditioned space. - EXCEPTIONI. to sealed with Refrigerant Charge - Split System HERS verification is required fm this measure. D YES ❑ N0 YES: In Climate Zones 2 and 5-15, when the existing HVAC equipment is replaced (including the replacement of the an handler, outdoor condensing unit of B split system A/C or heat pump, cooling or heating coil, or the furnace heat exchaneert a refrigerant cheree.meesurement shall be verified par (152107. FTCentra] Fan Integrated (CFi) Ventilation System and Fan 'Watt Draw he ventilation requirements of §750fof do not aaa)y to existing residential Mines. Ducted Split Systems- Air Conditioners and Heat Pumps: Airflov HERS verification is reguired.for this measure. D I YES D NO TEs: In Climate Zones 10 through 15, when the existing space -conditioning system (HVAC equipment and ducting) is replaced. the airimow and far wan draw shall he verified ver §1 J2(b)) Ci to meet the rettttiren)enu of 6151 (MB. Documentation Author's Declaration Statement • 1 certify that this Certificate of Comalianee documentation is accurate and complete. % Company: r ACCT /�C Address: If Applicable D CEA cr D CF -PE I 1jq�r/111 / R /�jl/s/'� Y'' �1 G (Certificautio11)'. f' C CiIY/Seale/Zip: A16Q h4i� t �C�/ �r� O a42 Phone: 1. 1Zespialill •.Iluildine Desfgu n''s Declaration Stntentcnt ' 1 anof d eligible under Division 3 the California business and PI(dessjons Code it' accepl respunsibiliq' for the hujidiu design identified oil this Certificate of Comphancc ) sanity that the energy b attu'es Bell performanec specihca low.. for the building design identified on this Certif icatt of ComI)hanGe cunlonn to the requirretnenls ofTik 24, Para, I and h of the Calilomja Cnde of Rr;gulatjuns. • Tht building design lcauilul: Identified un flit. Certificate of Comp)humc tilt consistent ynill the 14110rintilion provided to tluoumcnl thir. buibhjl,I design ml the olber appiWIlble cumphm)cc fount, wm'Itshcets, el lculali nn, plow: find:;peeiliclumm• submlilod to tl: enforcnmcnl naency he nonnrval will Ili:: builtfn)r nenuft appllca i0e, Nmnc: Signature. nal l)intl•: Date: 11 es: Liuensr. DIPJ t�letl/II111'. 1191 D)II:: X \�I /' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Trrm CITY OF COSTA MESA CON$TJ3UCTION PERMIT PERMIT NU —1-11� TRACT NO. LOT NO. UNITT N Project Address __�f / i3 /,, ✓+�rw �+--� _ �� Applicant's Mail Address / Owner's Name _T� '(� n �F 7/ Address Arch/Eng. License No. Address Contractor's Nam - -Phone • 1 , Address (mailing) - - City License No. LICENSED CONTRACTOR DECLA ATION I I_hereec!io itm 00)that'lo am licensed under1thprovisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and rsiy license is in full force antl�eff I License Class License No. Date Signature . _ WORKERS' COMPENSATION DECLARATION, reby affirm that 1 have a certificate of consent to self -insure or a certificate +�iNorkers' Compensation Insurance, or a certified copy, thereof (Section h Lab. C.) -_71cy No. ' Company -®Certified copy 1s hereby furnished. 1 1 Certified copy is filed with the city Building Division. Date Applicant ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if 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'a become subl to^t ¢ems Workers'.;"e s Laws of Callrb i p ^ iAA /i.Lll DateSignature `fS NOTICE f, aft mal ing this declaration, you sh uld become bject tot e Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) i Lender's Name _ Lender's Address OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000), of. niYision 3 of the Business and Professions Code) -or that he/she is exempt refrom .and the basis for the alleged exemption. Any, violation of Section 1.5 by any applicant for a permit subjects the,applicant to a civil alty of not more than five hundred dollars ($500). � I .� 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 (Section 7044, Business and Professional Code: The Contractor's License Law tloes not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his orher own employees, provided that such improvementsare not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- 1�rove for the purpose of sale). Ll I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and.who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). 1 am aware that proof o their Worker's Compensation insurance should be provided to me. I am exempt under Section B. & P. C. for this reason DateOwner I hereby certi y that I have read this application'and sta a that the above information is correct. I agree to rmmnly with all city mrn,mty nrdinanrez ' sentatives of this city to ter upon th above-mentionetl or arty or inspection ses- ^ �� Signature Date L Drivers' License or 55 # TYPE OF CONSTRUCTION. LJ NEW. LJ ADD ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE Ola_fflr� TYPE OF PERMIT LJ GRADING ❑ TENANT ❑ ELECTRICAL ❑ OTHER \/ PROJECT DESCRIPTION SO ET CONSTRUCTION TYPE L(.Y.ctn 'ALTERATION LJ REPAIR FOUNDATION LJ STRUCTURAL LUly1)BING ❑ MECHANICAL ZONE' GRADINGCU. Remarks: Preventer Bathtubs Clarifiers Dishwasher Drinking Fou Floor Drains Floor Sinks Gas Service Outlets, Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System &Ducting 00-100,000 BTU El 100,000 Reinspection Fee 1 $15 CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING A.P. # S Main Building: E T Front ARear v Cooking Unit Meter ❑up to 100 amps C Right ' V ALUAT10N$ "I y z-STi g ILeft DS. IAC RES Ping. Ref. # I Planning Notes: FEES 5042 7/27/94 37o5i7 f' Zone' Try Building: Z O N - I N G R ,Req./Provided E' Q M T S. Showers $-3 ELECTRICAL I , Seivice Sink - Automatic Washer - Transformer ❑ 15-50.KW - - Construction Pole Sub. ❑ 50 + KW ' Sewer Cap Reinspection Fee Sewer Connection Cooking Unit Meter ❑up to 100 amps Solar Collectors FEES Dishwasher Meter ❑over 100 amps Solar Piping Dryers ❑Gas ❑Electric Sub Panel Solar Tank Fan Motors❑0-1 HP❑1X-8 ' Swimming Pool w/Spa F.A.U. Inc.Solar 119-15 HP 01615+ Urinal SUMMARY OF FEES $ 3-7.D0 $ $ $ ' $ $ - $ $ Fixtures - Microwave Water Closet _ Device Boxes Pole Light Water Heater Outlets Range I Water Service Switches I Sign - - Garbage Disposal - 'Standing Sections 1 Generator 1:10.5 KW 1-15-15 KW Trash Compactor _ Issue Fee $ 3 Issue Fee $-3 Reinspection Fee $15 Issue Fee$ 3 AANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By millML , Date Date Date Hood or Type ❑ Canopy Type I I ❑ ' Refrigeration System 00-100,000 BTU 0100,000 BTU BUILDING PERMIT PLAN CHECK ' PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK '50% MECHANICAL PLAN CHECK '25% SUMMARY OF FEES $ 3-7.D0 $ $ $ ' $ $ - $ $ SMTP $ Ski. PERMIT ' ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ System Repair/Alteration - _ Issue Fee $ 3 CONSTRUCTION AND PLANNING '_ APPROVALS Permit# - Date Inspector POOI 'A APPROVALS Permit# Date Inspector rt. -Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement ' 3r Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit-Undrgrnd. - - L 55. Electrical Bonding . -5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. - - 57. APPROVAL TO COVER-GUNITE , 7. Footings - - - 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test .:9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. - - 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62; Backwash -& Receptor -Final 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final , 14. Rough Plumbing - 65.- Electrical -Final - 15. Rough Electrical -Conduit - '- 66. Solar System -Final 16.. Rough Electric Wiring - - 67. Fencing & Access Approval - 17. Rough Wiring Sign - ', - - 68. APPROVED FOR PLASTERING 18. Rough. Electrical-TBar Ceiling I - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT.'REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace • 21. Ducts, in Structure 70 Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 111 Gas 00il 23. Gas P e -Rough & Test 72. Underground Flush 24. Roof raming 73. Undergrnd. Storage Tank 0 Gas O Oil 25. Roof',iheathing - - _ 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation_ - 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH'DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning l 35. Final Gas Pipe -Test 36. Hood or Canopy - - 37. Final Factory Fireplace - - - 38. Final Plumbing i . ' - •� 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, I' 47. FINAL STRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - i 51. CERTIFICATE OF OCCUPANCY No. Date JOB ADDRESS 1693 Minorca Place GENERAL. CONTRACTOR owner -builder AP No. I -�q-9PP-6 LOT - TRACT DATE VALUE$ 4560.00 FIRE ZONE '3 DESCRIPTION OF WORK Fam. Rn. St. &Pati( INSPECTIONS_ Signature DATE GROUP I & d TYPE V ZONE R 1 S''-, - SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Rough Com. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing—�j',Qd^ _ Miscellaneous Prop. Swr. Line ❑ House Con. ❑ St. Swr. ❑ Sprinkling System Construction Pole Underground L❑ Power ❑ _ Rough Wiring .- ✓ _ Z _ - - ' 7 7 3�5/ -�?3 b -3 Trenches ❑ Forms ❑ Steel Reinf. ❑ Floor System Bond Beam ❑ Steel Reinforce ❑ _ Sheathing _ Frame and Flashing C•/ -c y Lathing — In,O Out ❑ Plaster, brown coat f1,7 S� ;r 1y' 16.4 Refrig. ,❑ Air Con, p Final F.rg, Final =ding Fixtures, Final -.q - Finh�l Gas Test/r j.S E Electric Fixtures, Final •�/:S E Building, Final n-�ifd-- OCCUPANCY Form 21786 21736 FEE RECEIVED / CCSSTA MESA BUILDING -SAFETY DEPARTMENT BOX 317 COSTA MESA, CALIFORNIA - I I NAN MAR 6j QTp 7p For Applicant to Fill In Completely pp2� Ap1 [Vc4.t, APPI(�kTl®FJ tlVItTPEIlMN� TYPE OR PRINT BUILDING For Office Use Only BUILDING �,/ / .}T ADDRESS b Y RECEIPT NO. PERMIT NO. COSTA.MESA, CALIFORNIA - 0 - AT[ EIV DATEISSUED OWNER. -� - BUILDINGMAIL di �C ADDRESS ADDRESS Jr� FIRE TEL CO ES TELNO. ZONE TYPE GROUP CITY -ST 01 APPROVED a� ARCHITECT �.-�. TEL. BY ATE OR ENGINEER N INC `� A. i6 A. Z NO. SEOP QW Pune BU.o S CONTRACTOR /LSE- LEGAL e, OA4L DESCRIPTION ADDRESS — �� AfCITY S� G A. P. NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE „�-_ TEL. - S L.I �' SO' TO SIDE a REAR P.L. LIC. NO. NO. i SIZE y 77 / NO. OP BLOCS. I I o EAVES ALLOWED (U. B. C. REQUIREMENT) OF LOT ^ .i NOW ON LOT - YARDS APPROVED YARDS APPROVED USE OF {-� )�,+/-�- /� MAIN BUILDING ACCESSORY BUILDING, EXISTINGBLDG. I��S(,1/CN/ �/"7-� ( FROM C/ SETBACKLINE FROM / FRONT A[UFT. CENTER OF STREET REAR YARD LEE. SIDE YARDI LEFT RIGHT Z R. SIDE FT. DESCRIPTION OF WORK L. SIDE FT. FT. NEW ALTERATION ADDITION REAR FT. FT. DISTANCE BET. BET. MAIN & RE. MOVING DEMOLISH MAIN SLOGS.ACCESS. SLOGS. VAR.* DATE BUILDING NO.OF SIZE -ROOMS STORIES C.U.P. APPROVED EXTERIOR WALL I ROOF APP COVERING COVERING BY GATE USE OF BUILDING AND WORK TO BE PERFORMED M/L 00 — O 4 �6 SO. O. Fr. IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE wND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCE[ AND STATE LAWS REGULATING VALUATION B UILDINO CONSTR CTION, PERMIT FEE SIGNATURE OF PLAN CHECK PERMITTE - 7Sco $/'�� AUTHORIZED AGENT _ - TOTAL FEE Lot 37 ,�' 1-3957 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 617 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING . ADDRESS \61\ P M� o/C.. \. COSTA MESA. CALIFORNIA F E RECEIVED l 5 1981 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only Investors Marine Inc. RECEIPT NO. PERMIT NO. NER " L- 1600 w. Coast Higftway REDE O BY DA RECEIVED I 11 „ITE IBBU6073 RESS'- —�, Newport Beach,Cali£. EL i BUILDING Y [CONTRACTOR ADDRESS o HITECT Same TEL. COSTA MESA. ALIFORNIA 'INEER NO. FIREZONE 3 TYPE GROUP Mesa Verde Builders, Inc. APPROVED BY DATE 1653 Minorca Drive ZONING ADDRESS p� OS a S , 1 . ZONEIUSE OF NEW , V CITY PLAN8 BUILDIN STATNO. 181269 NO. Ki 9-0395 LIC. DESCRIPTION `i. L'�(]ti SIZE841X1061 I NO. OF BLDGS. 0 OF LOT NOW ON LOT A. P. NO. USE OF YARDS EVES EXISTING BLDG. APPROVED ALLOWED NSTREEOTM 501 331 61 LINE BT.) CENTER OF REAR YARD FRONT(CENTE FT. IN. 81 SIDE YARD I LEFT r RIGHT R. SIDE ?FT. IN. DESCRIPTION OF WORK L. SIDE FT. IN. NEN' X I ALTERATION I I ADDITION I REAR FT. IN. REF I II MOVING I DEMOLISH ASYFROVE 1 DTE $ Z LDING ISOO -SQ.Ft •No. OF ROOMS 6 STORIES 1 502 'EXTERIOR W LL Slding ROOF sninTe [� '/Q/ COVERING ll CO COVERING — / 7 USE OF }JIL ING ND, l ORK TOS PERFOR S�ing4ie Mly resi ence 9Aa garag Model No. - Attached garage - 462 5q.kt. 1 HEREBY ACKNOWLEDGE TH�T i HAVE READ THIS APP bATION AND STATE THAT THE'ABOV 16 COHRP T AND A O COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PLY WITH ALL CITY DRLVN CES AND AT.LA E LATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION BUILDING CONSTRUCTO //// J�/"F'� SIGNATURE OF/'i CIOPERMIT FEE $ PERMITTE O7O [(/� jJ / 1 / $ PLAN CHECK $ AUTHORIZED AGENT TOTAL FEE