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Home My WebLink About301 MONTE VISTA AVE - Building Permits� ` � CITY OF COSTA MESA � ' � O�pMfs,p � BI/ILDING DIVISION > �. � 77 FAIR DRIVE, COS7A MESA, CA 92626 • Q74) 7545273 • Fax (714) 754-4856 • w�wv.ci.costa-mesa.ca.us f � � FOR INSPECTIONS CALL: (714) 754-5626 �tp�� fi PERMIT NUMBER: 610-00074 PERMIT TYPE B_ROOF2 APN: 43913123 JOB ADDRESS Vicinily: ROOF Squares: 2500 STATUS: DATEISSUED: ISSUED BY: 301 MONTE VISTA AV CM Suite/Unit: Valuation: ISSUED 0 311 712 01 0 RMD $4,000.00 SCOPE OF WORK: REROOF UNITS 301, 303 AND 305 (1 BUILDING). REROOF OVER 1 LAYER OF COMP SHINGLES WITH 7 LAYER OF 30# FELT AND 30 YEAR COMP SHINGLES, APPROX 2500 SF. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. OWNER: DAVIS, VICTORIA S Address: MACCO PACIFIC Unit: NEWPORT BEACH, CA PHONE: 949-548-8464 Ciry/State/Zip: 4770 VON KARMAN AVE APPLICANT: JOHNSON, SCOTT Address: 1260 N HANCOCK Unit: :STE 707 PHONE: 714-777-4040 City/State/Zip: ANAHEIM, CA CONTRACTOR: MC CORMACK ROOFING AND WINDOW CO License No. 643700 Address: 7260 N HANCOCKUnit: SUITE 107 PHONE: 714-7774040 City/State/Zip: ANAHEIM, CA 92807 CELL: 949-347-1400 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $97.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 License No. License No. TOTAL FEES $98.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 311812010 - PER Monday thru Friday - 7:00 am Ihru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohi6itied all PHONE: PHONE: IC Sec.13-279 - Sundays and the (ollowing Federal NOTICE: The work authonzed by this permit shall wmply with all applicable handicap access requirements under Califomia stalutes and related regulations. (Ord. No. 92-28, § t, 72-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authonzed under this pertnit to be considered legal, such work must comply vnth all applicable codes, and all required inspections and final approval musl be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit. CODE/, INSGECiIONTYPE DATE INIRIA�S COOEt INSPECTIONTYpE D�TE IXTIiULS 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ^ ■,�q�,� 208 Final Plumbing 200 Final Re-Roof .Y�_,�� .d) � 210 Final Eiectrical 201 Final BIocWRetaining Wall 212 Final Fire Preven�ion 202 Final Factory Fire Place 220 Final Planning App�oval 203 Final Sign 222 Final Site 204 . Pinal Demolilion 250 Final Building/Occupancy ` � WS�RKERS' COMPENSA710N DECIARATION: I hereby a�rm under penalty of perjury one of the tollowing tleclaralions: ❑ I have and will mainiain a certifitate of consent to sel6lnsure for vrorkers' compensation, as provitletl for by section 3700 0( the Labor Code, for Ihe e rtnance of the work for which this permit is issued. I have and will mainiain workers' compensa[ion insurance, as requiretl by sec 3700 of the Labor Code, (w the peAortnance of the vmrk tw which this pertnit is issuedj My workers' compensalion I urance carrier and policy numberare��_ n�%''�� C.yrrier.� / u ( �! �Tnissectionneetlnotbe detetltlrne rtuv�Ne0a1 nurM�etlOMarsyf�St00)wlezs.l Poc�licy Number: M�� I �� (%�� l ❑�i'certi(y thal in the peAormance ot the work !or which lhis permi( is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia. and agree that if I shoultl 6ewme subject to the workers' compensation provisions ot Section 3700 of the Labor Coda, I 5 II forthwith comply with these pmvisions. �- 3:- �,s_� " ooi�m�rs aie WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CQST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby af6rm that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force� d�ect. C� �-, LIc'#��'µ� � Class.iF�' 3�/7��!/ C�wV^aUrNs�SlgnaWre L.:..�pate"" CONSTRUCTION LENDING AGENCY: ❑ 1 hereby aKrtn that lhere is a constructbn lending agency for �he pedortnance of the vqrk for which Ihis pertnit is issued. (Sec. 3097. Civil Code). Lender's Name: Lender's Address: SiqnaWre Dale OW NER•BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW Ior �he (ollowing reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any swcture, pnor to its issuance, also requires the applicant for such permit to 61e a signed statemeM that he or she is licensed pursuant ro Ne provisions of the Contracrors License Law (Chapter 9(commenciqg with Section 7000) of Division 3 0( the Business and Professions Code) or Ihat he or she is exempt therefrom and the basis for the alleged exemplion, qny violation of Section 7031.5 by any applicant (or a permil subjects the appliwnt to a civil penalry of not more than fve hundred dollars ($500�.�: ❑ I, as owner of the pmperty, or my employees vnlh wages as lheir sole compensation, WILL DO THE WORK, and the sWcture is not intended or o(fered for sale (Sec. 7044, Businesg and Professions Code: The Contraclors License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herself or through his or her own employees, provided that such improvements are not intended or offeretl for sale. I(, however, the builtling or improvement is sold within one year of completion, the ovmer-builder will have the burtlen ot proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS lo consWct the project (Sec. 7044, Business antl Professions Cotle: The contractors License Law dces nol apply to an owner of property who builds or impmves thereon, and vfio contracts for such project with a contractor(s) license pursuant to the Contractors license Lav.s.�. ❑ I am exempt under sec. Business antl Protessions Code (or this reason: SignaWre Oate 305]-a6(3I0]) , Ovmer ID verified hy drive icen5e. ❑ Ye5 ❑ No Driver's License No. Expires: Venfcation of Ownership by (rype of documenC i.e. - pmperty tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify that no excavation fve (5) w more feet in depth into wfiich a person is required to descend, will be made in connection with work authorized by this pertnit, and that no building strucWre, scaffddinq, (alsework, ar demolition or dismantling thereof, will be more than lhirty-six (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, T�le 8, Cali(ornia Administralive Code). ❑ As ovmer-builder, I will not employ anyone ro do work which woultl require a permit (rom the Division o( Industrial Safety, as no(ed above, unless 5uch person has a permit to do such work from the tlivision. Appbcanfs Signawre Daie Division o( Industrial Sa(ety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will ihe applicant or present or luture building occupant neetl to file and certity a Business Plan for emergency response to release or threatened release of a hazardous matenal? ❑ Ves ❑ No (Section 25505 0( lhe Califomia Health antl Safery Code requires. wi[h 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 quantiry ot hazardous matedals 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 tempera�ure and pressure). 2. Does or will the applicant or present or fuNre buiMing occupant need to file a registration form for acu[ely hazardous materials? ❑ Yes ❑ No (Section 25533 0! the Califomia Heal[h and Safety Cotle, with some exceptions, requires regisiration with ihe Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acu[ely hazardous materials equal to or greater than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic (ee[ of compressed gas at siandard temperaWre and pressure). 3. Does or will the applicant or present or future building occupam need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous malerials�? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Cotle pmvitles that the Costa Mesa Fire Department may require the preparalion, certifica[ion and filing with the Fire Deparlment of an RMPP by businesses which are required [o register acutely hazardous materials vrith the Fire Department. 4. If an RMPP is presenuy required, has Section 25534 of the Califomia Health and Safety Code been fully complied vrith? ❑ Yes ❑ No 5. Does or will the applicant or present or fuWre building occupant require for the work which is the subject of this application a permit for such constraction or modificalion from the SoWh Coast Air Qualily Management District or from any other air pollution control tlistrict or agency? ❑ Yes ❑ No (Section 658502 of the Califomia Govemment Cotle requires that the requested infortnation be fumished on applications fa noo-residential builtling pertnits�. 6. Will any part of the facility to be constructed under this permit be within 1000 (eet from the outer bountlaries of a school? ❑ Yes ❑ No (If "yes". lhe facility must meet the requirement of Sections 25534 and 42303 o( the Califomia Health and Safety Code). 7. If a pertnit from the South Coast Air Qualily Management District or olher air pollution coMml district or agency is requiretl tor the work which is the subject of this application, have all of the disclosures prescribetl by Califomia Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No 8. Qf yes", attach cenifcate of compliance from the appropriate air pollution control oKcer�. CERTIFICA7E OF COMPLIANCE: I certity that under penalty of perjury the information given above is correct. I agree to comply with all state laws antl city ordinances regartling Hazardous Matenals and Emissions. SlgnaWre 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 ciry ordinances relating to building construction, antl authorize representatives ot ihe Ciry of Costa Mesa to enter upon the above-0escribed property for inspection purposes. I agree not to occupy or allow occupancy o/ any building authorized by this permit until fnal inspection. SignaWreotL wner(s) Da�e � 3'� �� An^0�/o�Ayt�arz¢�AOOlirant t-313IC .- ;'rescriptive Certificxte uf Cumnliance: Residentiul dtesitlential AlYeivUio�as' ]'ru,jec� Namc: �nu� s _ �2�r�v Geucr:d Inlormation A��, �,, 3 � J-:� °s n� Buildiug Typc CJ Single Family j(Multi Family ri�o� nrr� rcr•a�: 300 � '17�is /nriu i.v ni�l io Ln usu�l fa� Ncroli� Crm.s�rpeted � R'aee 7 oi' I Clirnate 2une it / ( N of S�uriee � r4 �'�PI 4 I llntc: S_/i �/ O Circle the Froni Urientaiion�. n, L, S, W, or de�rees Prqjeci Type: ❑ Alteratians ❑ Gnvelape O Fenesvation oof �}IVAC Ilepinceinent or Ch�in�e Gw O Uuct Itenlucemeni ❑ Water Heater iiltlinrs nrdtlditinns l�eridntinn VnL�e.a Fi�r Opnque Surinees (/or Fiirring u.se d�c Mass cu�d Furri�ig S�rip.c Cons•u�uction mLle helo�al Apsemhlp Altcration ❑ Openin� nf tramed cm6q' alone- Alterutions dia� im,oh�c d�e opening oj�hefrmned cnvil7' 4f n wall, cciling, w;/ionr mus! insi�l( Ihe mundcrrvrr mirrinuun insulation vnlue per,¢'I SO,Jar 11re alrered asa�emblr. Fill in Cnlennne� A-C m�d enter niundurw�i� insularinn vulue i�i Cofirnm H. ❑ 1Leplacemen[ of entire :�ssembll'-2eplacemenl o/-un entire rrnl(. ceiling, m;/loor us'scuibll' ��eguires Ihe inaiu(lation ofCompaiem Packo¢e- D+n.+'arintion vnlue.r i�v 7n6(e /51-C. Fill in Cohrmn.s A-./. _ __ _ 78[jUL' Su� fuL•21.)e[uil5 For [iie furred a u I c 7ag/ I Assembly Name j Materiai ID or 7voe � and Size' af Nlass N4dls sec rurrin�� L r S[andard U- � 7A4 Tabie r.cnr' Num6er5 For /imred ossemblies. accountino%or Carrinuous inaularioe R-vaiue, ree Page v^ Cwisvucrimr mble belmr. . Cnnstructiori Tubic Lelmr. Values From JA4 Tabie Framed Continuous I ]A4 � Proposed Caviry ]nsulacion Assembty i _Assembly ?J. Fw' cafarfa(ino Ju�'�"e� ��Ifs :rse �he Mats mrd 1. For 7ng/ID i�idicaie tiie ide+vi%ica�ia� name thai matches the building plans. 2. Indicnie the Assem6lr Name or rype Roo(/Ceiling, W'alls, Floars, Slabs, Crawl Snace, Loors and eie..lndica�e the Frame rype and Size: For Wooc! Meta!, Metal Buildings, Mass, enter ?i4, ]xG, or eec... se� JAS far olher possible finn�e p�e asse�nblins. 3. Emer lAe thiduiess for mass in inches ar Spacine Len+�een 1��aming members enter; 7G'or� 24 "OC; or Oiher far all oiher assembl�� descripiim� sudr as Cnncrele Sandwidr °anel, Spandrel Pane1, Logc, Su�aH� Bale Panel a�ed etc.... 4. IInsed on Uic Climaie Zone; emer d�c Smndw�d U-{acroi ,jrom Table I51-E, C or D jm� euch dif{erent pssembfp Nome m� qPe. 5. Enter �Be Table number �ha� closelv re.��emGles dic yroposed aa•semGh�. 6. Lmer ihe R-value (hn� is heing insm(lecl in ihe mull cai�irn a' beerneen the irnmino; odmrwise, enier "0 ". � 7. Enier ihe Corninuous L�su(aiiai R-i�alue for the propnsed assern6l��; n(herwisc, enrer "p ". 6'. Liner �he rnw aud cn(unm q(thc U-(acmr volur. Gased ar Colurnn FTuble Number artd enter Ore /lssemblv L' facla' in Colunm ./ I. Thc 1'rnpased de•a�emblr U-fac�or. Column J. nru.t7 6e equal lo or les.e Ihan !he 5'tm�dnrd U-(ucior in Column E in compl��. Purrinp Su'ins Construction Table for Mass W ulls Gnh' A ]S C D � G T G N 1 1 IC L � M I'ropused I'rapm'tics uf M.unnrp ant3 Cuncrete Added Interim' ur L''xleriur �Insul:�linn \4�:�Ilsfnnulteference iul�m'riugSpaecfram IielCrcucr Juinl A�peudin' 9'ablr 4.3.5.43.G. A.3.7 .luinl A� reudia''fablr 4.3.13 U � c� � 4 L 'Y V G: •� c � - '- v.. R .,.. Final hssenibl)• ti � _ �.- r r o o�� v �. � n, Ivtass Nnme o� .IAd �nble i,_ � _= E rt c 'r A �_ �� I A55e1➢hly Thici�nes�' l'y :' I Num6er � = �;; =' � �� " ,�„ �. Uiuctnr�.� Cammem I I !I I � I { � I I I � � I� I �i � I � � ( � � kegLi�irwionld�nnber: Registro�ion Dalel7'imc: HEItS7h�nniaer: �OOd'Itesiden�iul ComplicmceForma� �lu�oe}�r 2001 � ��'� / /,rescriptive Certific:rtc uf t � /Resirfentir+l Alterutinns ' f 1'rnject Niimc: �G'�lS i 1tOOPINC I'ROI)UCTS (COOL ROOI�S) §I5�(nl? Y�IV ` t )�" I l 3 uf N'dcu Ihe nrv�n of ccicrinr ronf.eurjace m Gc replaced ciceeds u+nrc lhan 50°L njUie cxis�ing raojuren, nr uiore lpun 1.000 j�, ivhicl�ever Lc /esa�, fhc new ranT ng rtre�� mus! n�eet 71�c neo firtg prndtec[ "Can( Koa(" reqairerne�t(s of 4'I S?(L)I (!i, ! 5?(bJ I Hii. or I S?(L) I Hiii. Check applicaLlc nl�ernntivc a� erceptia� Le/ow i(d�c rnoJal�erarion ia ezemprj�an d�e roafingproduc� "Coal Itoaf" i�equii�ernents�. No�e: /f un�� one af [he al[errtatives ar ezccprim� befow i,e cl�ecked, nc� Aged Sofa� 1feJlecmr�ce nnd 7(ierrrca( E�+dt�aricc rega�iremcnts. jor roofing produc�s irt .87)N/iJ nre nol �q�plicablr. Dn nnrT!! ioute Letn��. ❑ C�ol lLoufs N�t ]Lequired i�� Climate Zcmes I-12, 14, and I( wiQi a Low Slupecl. Less or 2:12 pitcls. �ol Roofs �Not Requited in Climate Zones ] ihrough J and 1 G with a Sieep-SVoped Roofs (pitch gretuer than 2:12) and product unit weight Vess Atternutives tu §152(U)1Hi uud §152(6)Hii, Stecf�-s�ope rtrot (pitch > �_1?) ❑ Insufation witL a t}�ermul resistence of a� least Q851v�ft' °F/Btu or at.least � 3!-0 incli uir-spece is uddeJ to �he roof deck Ovef a0 �[tiC; ol' , .. . � � ' ❑ Existing d�cts in the atuc are insulatetl and seafed�according to §I51(�10; or ❑ Li climate zones 10, 12 and 13; with I ft''�otfree ventilatioo-area ofnttic ventilation for eveq� 150 fi� oTattic'floor erea, and where at leust 30 percent of the ftte ventilation erea is within 2 feet vertical distance oTthe roof ridge; or O Building hos at least R30 ceiling insulation; or ❑ Buildinghas iadiantbazrierinthean�cmeetingthereq�iremenuol§ISI(�2;or ❑ Building has no duc�s in the ani:; or ❑ In eGmate iones 1 Q 11, 13 and l4, R3 or greater roof deck insulation above vented ariic. 6sception [o §152(b)1Hiii, Low-slope roof (pirch <2:12) . ❑ BuildinR has no duccs in the attic. Q RooSng area covered by building integated; phomvoltaic panels and soler thermal panels are exempt from [he below Cool Roof criteria. ❑ Roof constructions tha� have thermal mass over the roof inem6rane with ae least 2S Ibfft� is :xempt from the below Cool Roof cmesia. Note; If no CRILC-1 label is available, Iiiis complience me[hod cannot be used, use Ihe Per%rmance Approach to show compliance, otherw: Check the aoolicable box below if Exemnt from tne Roofinc Products "Cool RooP' Requirement Stoof Slope I Product ''�12 > ?:12 < 516/R' n I � I ❑ ❑ � ❑ ❑ ❑ o ❑ � I o 0 0 0 n a 0 0 0 � Proouct � Aged Solar n4 o' o' ❑4 Thertnal Emittance SRIS 7'he C/iRC Yroclucl fU Number cm� be o6tainet! 1�'��n� Ihe Cno( /ioolliu(in�; Co�mcl!'s lfamd 18nducl Uir'ecro�y ni ++,mm.r.00L�on6x.m�el��ruducislsenrc�hn ]ndicoir Nrc q��c nfprnducl ia� bcing �ued (nr tlrc: i��af mp, i.e. single-pll'+'�Uf, urphalf roo(, me(nl rnnj, elc, /f/hc dged/fe/lec�nnce ie' no� uvni(nLle m.�Lc Cnn/ /fnn//to�ing Council's IimeAProduc! Direaay /Ben use !Gc h�i�i�d 1lefleclonce vtduc /�oix /hC mme diretlorp nnd �uc ilie e9imiim� (0?+p.7(Pmiim�— �.?J ln oLivin n calcula�ed aged vohre. N'Gm�c p i.v ihe b�i�ini Solnr /ieliecimicc. ChecA bo.r i/�/hc Aged Repeclnnce i.0 n cnlculaled nahre ruing Ihn rqunliou nLnve. Cb(cidnec 11ie SR( vulue fir u.emg dre S/t/� Wbrk.eheel a� h�lp'/�ivrvu�.a�erer.ca env((itle14/and amer 1Le res�d�ing �,�duc in �hr S!U Col�unn above mid aunch �ico ibc Sltl- Wm'hdmei in Ihc CF-11i. � npply Liquid I�ield Applicd Cuatings, the coating musl be upplied ncross the entire r�ol'surfssee aoc! meet t4ie dq• mil tliickness or covesage cummcuded b>' the coa�ings manufacuver and meet minimum pertoimanee requirements Sisted in ¢i 18(i)p, Select Ihe npplicabie coating: Alwniuum-PigmcntedNsphah IloofCoaiing ,� Cement-BasedRoofCoating �� Gtlicr , Regi.sn�tuimrNumLer: liegia'u�ationDme/I'ime: F/LILSYrorider� 200d' Rcsidentiu( Contpliance Forms , 9 � � �� / 'resc�•fuYivr cate oi Cumulitwce'. Residentixl licsirientinl Alteratioizr �' fljc('141YLuiL: ��V�S --- . .�v-�ii—�— -- - - - CP-1 R-ALT (Y.i�t�; u1�51 FI�I:S VI''.I:1FJ CATJ01� SUMII4AR�' The en(arcerneni �ryener sl�oulcl ynt'spacip/ tiuemiar w ihc HL1;S /deasm-er a��eci/ied m d�ie chceh(isi Gelair. A carq�feied eu�d s��neil CF-4Ji Fnrnr,lnr nll ihc me��sure.r sueciJ�acl s�hcJl Le.rutiu�itred iu 7iic builduit; fr�spec�or Lefor'c lii��d J)uCl ,5'enliLLe� 6: i�CStill� HL•RSnei�i/icnrion ia requn�ed./orllvi•: nrcnsxur. ❑��'�' S ❑ NG 1'CS�.lii Ciimo�e Zunes ° nnd 9-I G, illnore thai� 40 lineai ieei of ne�v nr repine�mem Aucis nr: insitilled in uncnnditiuned space, tiie duc�s am io U� seuled p�r 11 S2(b11Dil and th: newip inswlfed ducis are to be insulated pei p151(117 b. ❑ LXC�PTJG�: L�isting duci systems [i�nt urr. eztended; �vhich �u'e cuustructed; inxWated or seuicd u•iUi :�SLesius. ��'LS ❑ NO 1'ES: ]n Climate Zunes 3 and )-1 G, iT tLe er.isting spece-condiiioning system (NVAC eyuiumeni and duciin�l is replacec, the ducts ure io he s�aled per §152(Up Di. � YES ❑ NO Y�S: ]n Climam Zones ° and 5-I G, if [he er.istin� HVHC equiameni is wpluced (including the rplac�meni of O�e ai� handler, owduor condensing unil of �i sulii system: cooling o� iienting coil, ar tir fim�ne: heai e> change�7 ti�t ducts sre to Ue sealed per §152(b)lE. ❑ L.3;C�7'T]0�: Lua syscems that arc dueumen[ed tu Lnvc Leen previnuslr senled conllrmed thruugL H�]•C ��verificatiou in accurdnnce �vith prucedures in�the Re(erence kesidential Appendix RA3. � � ❑ EXCLPTJON: Luct sYstems with less tLan 4U linenr teet in uncundiiioned spnce. � ❑�SC�PTION: �sistin� duct srstem,v constructed. insulated or sealed �vith nsb�stus. � .�Z�j�i'1�8Y8nt (,'h�P�C - CujJllt �S}�SiBN HERS verijicnlim� ie'reqvired for thia� mea,na�c. ❑ Y�S ❑ NO YLS: ln Climate Zones 2 and 5-15, wl�en tha er.isting HVAC equipmem is replaced (including [he reolacement of the air handler, omdoor condensing unil of a split system A/C or lieat pump, coolin; m� heacin� coiL o; the fumace heat exchaneeri a rvirieerant charee meesuremen� shall be veriiied ner §li2(bllF. Centf•al Fan Integ; aied (CFI) \'entilaiion Sl�stem and Fan V��att DraH� The ventilation reauirements of bli0(ol do not anoh� tn existine rsidential homes. 1�lucted Suiit SVstems - Air Conditioners and Heat Pumpst Airflow HERS veriJica�imi ir re9uirec� jor inis measure. ❑ Y�S ❑ N 0]'ES ln Climate Zones 1 U throu�h ] 5, wl�en the existing space-condieionin� sysiem (H\+AC equinment and ducting) is � reolaced. the airflow and ian watt draw shal I be ve� i5ed ne� § 152lbU Ci to mee[ the reauiremencs o: & li I(fl7E. • I certii�� that tnis ��f'r � "�^'^S�� n,.^ 1A,� �y/�. � / I �C L� /" C � � f"`i Hddress:q-� / v !!ib and �J I La4: �' / / / O l /�sf � �� li HppiicA�l� rJ CEP. or ❑ �� iCertiiication fl): y,.�.: � C 4 �'i 2�0`7 � � � y'o �f D ponsiblc 13uildine Desi_�ner'e� liecfaratiuu Stntement 1 um eligibl:: under Livision ; of tiic Culifornin Business �ncl Prolessions Code �o uccept respunsibility lor thc ouildi��g design identified on thi;: CcniLcaue of Coinpliamcc. ] certily thai Ihe energ)• femurs nnd performanec speciGcation:, lor th�c building desigu identiiie0 on tiiis Certii�c,ne of Complianec conform �u the i�quirements of Tillc 24, ]'�me 1,ind G of the Californiii Codr of kegula�iuuc. 'Pl�u bulldln,- desl�n lentorea ie'tentified ou ihi:. Cerli{�icate oSCon�pllanec are cunsis�em wilti ihe inlomm�iun prnviued ti� cinemnenllhls building [hasi�u ou the olhei npplicxMu cumplit�ncc lonm, wail:sheet:, culculutiuns, I�lan:�, und speciTictuiom: suhnuued tu lhc unfiirccmcm xucnco lui anurnvnl ivitii iiil�� 6uildiuu nunnii tioulicu�ioi�. Nrmic. Cutrqrin>': Y.(101E5S. �� II \'�SL�LJ�.I�i: Signulurc: Latc: L.ICL'pS.: 1��r assisuuicc r�r questiutt:: regm��iing ihe Ene;or Suu�dard::, coniucr rhr r: nergr Hoilinr us 1-hOd_; 7_-:;300. i,,,,,,,,,,,,,�.,,,. �.�....,,.�.. ,. . . _.. � Aoplicant to fill in all spaces exceot tnose within heavy Doraer lines ana sign all appropriate aeclarations. CITY oF�Cosrn MESA CONS7RUCTION PERMIT PERM O� /�� TRACT NO. LOT NO. UNIT NU. lL Project Address 30 � 1' �a�a_ V_ � _��} w ApplicanYsMailingAddress GY�6�S �5��'� Sgr`�G.rg Owner's Name s� � a- �(�Or�` V S'�S.,,Phone Addreu � Arch/Eng. License No. Address ' Contractor's Name��,.le,.�.b'��Phone�� s-S Q U Addresslmailing� G S y5"t�'U \i.�wln 4 City License No. �� LICENSEO CONTRACTOR DECLARATION 1 hGreby af/irm that I am IicenseU untleY P�ovl5lon5 of Charter 9(commencing witM1 5ection ]000) of Division 3 of the Bu5ine55 antl Pro solong �¢tle„antl my license is in fyH forc a tl eftec[. - � d`�� Licenu Cias g"' �nste� NoQ. Date/� - - � Si9 � '�'�'^'� y�� W00.KER5' COMPENSATION OECLAHATI � I hereby atflrm thai I have a certiflcate of consent to solLinsure or a certiticate • Workers' Compensation Insurance, or d cerUfletl copy thereot (SectiOn 00, �ab. C.) �licy No. Cof�Pany 8 Certifietl copy is'hmeby furnishetl. ' Certltietl copy is (iletl with the city Builtling Dlvision. Date Applicant E%EMPTION FROM WORKERS' COMpENSATION DECLARATION (Thissection neetl not De mmpletetl if the permit is tor one huntlretl ($300) or less�. I certify that in the pertormance of tha w c Por which this perm�t is issuetl, I shall not employ any person in any ma so as b come sub'� c the Worker omp� sa Laws of Califo . Date �� D -��25igna[ure � NOTI[E:Jf, after makmg this tleclaratio�. You oultl become subject to the Workers' Compensation provisions ot the Labor Cotle, you muzt forthwiro tomply with Such provision5 or IhiS �ermit SM1all be tleemetl �evoketl. CONSTRUCTION LENDING AGENC`� 1 ber<by dtfirm Ihat Ihlr¢ is a cons(ructia� IGntling d9¢ncy to� the perto�mance oi tho work for which this petmit is issuetl (Section 309] Civ. C.) Lentler's Name L.entler's Aatlress _ . OWNER BUILDER �ECLHRATION I hereby affirm [ha[ 1 am exempt from �he ConVac[o�'s License Law (or the followinq reason (Section 7031.5 Business antl Protesslonal Cotle: Any ci[y or county which requires a permit to wnstruct, alter, improve, tlemolish or repair any structure, prior to its issuance, also requlres the aoP��ant tor, such permit t0 iile a 5ignetl statement that he/she Is ��censetl purSuant to Ihe provisions of the Contractor's License Law (Chapter 9,(Commencin9 �+ith Section ]000) of Dlvision 3 of the Businesvantl Profe54�on5 Cotle) or that he/she is exempt �4erefrom mitl the bazis for [he alleqetl exemption. Any violation of Section 31.5 by any appiicant for a perm�t subjects lhe applicant to a civll �alty of no[ more than five huntlretl tlollars (E500). � ' _+ I, as owner of Ihe property or my employees witn wages as their sole campensation, will tlo the work, antl the SVucture is nof intentletl or offeretl fOr sale (Section ]044, Business antl Profezslonal Cotle: The Contractor's Licen52 I.aw tloes not appty to an ownef oi a property who bW Itls or improves thereon, antl who tloes such work himsell/herselt or through his or her own em0�oyees, prOvitletl tbat such imOrovef*�en[s are not IntenOed or offeretl to� sale. It, however, the builtlin9 or impro�ement is soltl within one Year of <om- D�etlon, tbe Owner will have the burtlen Of prOving hC/she tlitl noI builtl o� im- �rove for tM1e purpose ot sale). I, a5 owner of ihe proper[y, am exdu5ively contracting wlth licensea con- tractors to consVuct the pro)ect (Section �044, Business antl Proteszions Cotle: � T�a ConVactor's License Law do¢5 n0� apply to dn owne� ot pw0erty who builtls or .ImDroves thereon, antl. who contracts tor such projects witn a con- tractor(s license-pursuant to tne Contractor's Llcense Law). I am aware that proof o�their Worker's,Compensation in5urance should�'be proviCed to me. ❑ I am exempt untler Section � B. & P. C. for this reason , Date Owncr I hereby certi(y that I have reatl this applicatlon and state that the above In(ormation ii mrrecL I agree to complY �+�th all dty antl County ortlinances antl state laws relating to builtling consbuction, antl hereby authorize repre- senlatives of fb"' c'ty [o pon the above�mentione� roperty fo� TVPE OF CONSTRUCTION U NEW LJ ADD LI ALTERATION LI REPAIR ❑ CONVERSION �DEMOLISH ❑ OT�jER ` l�ESCRIPTIQNOFWORK/USEOFBLDG.��ar"�'�"a-�-�� . �e). � .,. � � TVPEOFPERMIT � �J GRAOING LIFOUNDATION U STRUCTURAL ❑ TENANT ❑ EIECTRICAL �PLUMBING ❑ MECHANICAL ❑ OTHER � PRO�ECT DESCRIPTION Sa.FT. oCCUPANCV— CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VDS. ACRES_ Remarks: Bar Sink BackflOw Preventer Backflow Irrigation C�arifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories Roof Orains Heinspection Fee Oudets $15 Duct � Under Ground Duct � Strucmral Duct � Ventilating Exhaust System ❑ Multiple FirepUFact. BIL ICBO # Heating System & Ducting ' ❑ o� i oo,000 eTu 0 i oo,000 insDecUOn purp e5 � /{/� /o� ' Signature [�� Da4f' i-._Driverz' LI<ense or 55 � ' Roinipection Fee ^- -"' •'o -. w�iltllny: C�Y - APO��an[; Pink - ACcountin9; GoltlenrOtl - A5sE55o/ $15 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service � Auto-Wash Issue Fee FEES $'3 A.P. # S Main Buildi E T Front 8 Rear A C Right K Left S Ping. Ref. # Planning Notes: Automa[ic Washer Construction Pole Si Cooking Unit Dishwasher Dryers ❑Gas ❑E Fan , F.A.U. Fixwres Device Boxes Outlets $WiICh25- Garbage Disposal Generator �0-5 KN lectric Parking Feq./Provided ELECTRICAL Transformer ❑ 15�50 KW ❑ SO+KW Meter ❑up m 100 amps ' � Meter �over 100 amps Sub Panel Motors �0-1 HP O1'h - 8 Inc.Solar �9-75 HP �16�15+ Microwave Pole Light - Range Sign Standing Sections 5-15 KW � Trash Compactor IANICAL Reinspection Fee $75 Issue Fee FEES Hoodor T - DEVELOPMENTSERVICESREQUIREMENTS: ypel ❑ Canopy Type II ❑' Zoning Approved By ^ __. Building ApProved By ' i ` Refrigeration Sys[em ❑o-ioo,000eru ❑�oo,000 System Repair/Alteration Fire Dampers � Registers Issue Fee �� $ 3 FEES $ 3 SUMMARV OF FEES BUIL�ING PERMIT $ 'SMIP $ PLAN CHECK $ . PERMIT PLUMBING $ � �SSUANCE $ _ PIAN CHECK �.25% $ � ENERG� P.C. $ ELECTRICAL $� � GRADING $ PLANCHECK 50% $ MICROFILM $ S.�O MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $�� Z O N I N G R E Q M T S TL ICONSTRUCTION ANDPLANNING POOL&SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO 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. Strucwrel Floor System 67. APPROVAL TO DECK � 7 7. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap Z�/� / i� 63. Heater�& Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electriral-Cqnduit 66. Soltir System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1S. Rough Electrical-T 9ar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Procluct Piping O Gas ❑ Oil 23. Gas Pipe-Rough & 7est 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical, 27. Frameand 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. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Piumbing . .' 39. Water Service-Final � 40. Gas Service-Final , al ' �n System . i ms �E & BUILDING its Completed � Edison them Califomia Gas Co OCCUPANCY _ Date _ "