HomeMy WebLinkAbout359 MONTE VISTA AVE - Building Permits,�
CITY OF COSTA MESA
O�pMFs,9 BUILDING DIVISION
4
F„,., , � 77 FAIR DRNE, COSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
�. ` °$ FOR INSPECTIONS CALL: (714) 754-5626 �
'°°ro�°�' PERMIT NUMBER: B11-00408
PERMIT TYPE B_ROOF2
,4PN: TPN01108
JOB ADDRESS: 359 MONTE VISTA AV CM
Vicinity: 359 AND 361 ATTACHED
Squares: 6500
STATUS:
DATEISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
11118I2011
KJB
$2,600.00
SCOPE OF WORK: TEAR OFF EXISTING FLAT ROOF. INSTALL NEW BUR ROOFING ON GARAGES. FLAT PORTION ONLY.
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: BACK BAY GARDNS HOA SEABREEZE MGMT Address: 39 ARGONAUT Unit: SUITE 10
PHONE: � City/State/Zip: MISSION VIEJO, CA
APPLICANT: OCHOA, JAVIER
PHONE: 714-653-5753
CONTRACTOR: CHAMPION ROOF SPECIALIST
Address: 6142 STEARNS STUnit:
City/State/Zip: RIVERSID�, CA 92504
ARCH17EC7:
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $8325
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
Address: 6142 STEARNS ST
City/State/Zip: RIVERSIDE, CA
License No.
License No.
PHONE
TOTAL FEES $84.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/1i
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm.
New Years Dav. Memorial Dav. Indeoendence Dav_ �abor Dav. "�.
License No. 953467
714-653•5753
CELL:
PHONE:
PHONE:
Unit: :
CMMC Sec. 13-279
iours - Sundays and the following Federal
av and Christmas Dav
�:
NOTICE: The work authorized by lhis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
Fegulations. (Ord. No. 92-29, § 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 al� applicabie codes, and all
required inspections and final approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
COOEN. INSPECTIONTVPE DATE INTPALS LOOEp INSPECTIONTYPE �ATE IN➢TIALS
1616 Fixed System Final Fir� prevention 206 Final Mechanical
1266 Pool Spa Final ���� 208 Final Plumbing
200 Final Re-Roof /� ' AA`I o"'%—� ��� 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 D�CLARATION:
I hereby affirm under penalry of perjury one of the following declarations:
❑ I have and will main[ain a cettifcate of consent to sel(-Insure for•vrorkers'
compensation, as provided (or by section 3700 of the labor Code, for the
erformance of the work for which this permibis issued.
I ve and will maintain vrorkers' compensation ins a ce, as required 6y
n 3700 oi the Labor Cotle, (pr the perfortnance of e rk for which this
pertnit is issued. My w rkers' comp tion Insuran e carrier antl policy
number are:
rC mer: ��" � NL
(Tnissedonneed�rotbe�plelM7A�th�epermrtrs�val/yerl mehunar—e0dollars(St00)orless)
'ool�fJamber-' � � � � lll � / �� "z�
❑ I certify that in the performance of the work for which lhis permit is
issued, I shall not employ any person in any manner so as to 6ecome subject
to the workers' compensation laws o( Califomia, and agree that if I should
become subject lo Ihe workers' compensa[ion provisions o( Section 3700 of
[he Labor Co , I shall forthwith c�mply with Ihese provisions
Irant' i a ure "�Date"""'�
ING FAILURE TO SECURf WpRKERS' COMPENSATION COVERAGE
UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO TNE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby affrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 0( the Business and Professions Code, and
my license is in fu'}ll f�orce a d e�
� �R� ✓ �"C.1a55'R'��F -
_, C �s ig aure � �e "��� �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that Ihere is a consWction lending agency for [he
perfortnance of Ihe work fa which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lentler's Address:
OWNER-BUILDER DECLARATIqNS:
I hereby affirm thal untler penalty o( perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the following reason (Sec. 703L5,
Business and Professions Code: qny ciry or county which requires a permit to
construct, al[er, improve, demolish, or repair any slmcWre, prior to its
issuance, also requires the applicant for such permit ro fle a signed statement
Ihat he or she is licensetl pursuanl to the provisions of Ihe Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of �he
Business and Professions Code) or that he or she is ezempt therefrom and
the basis for Ihe alleged exemption. Any violation o( Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalry of not more than
(ve huntlretl dollars (5500).):
❑ I, as owner o( the property, or my employees with wages as their sole
compensa[ion, WILL DO THE WORK, and the structure is not intended or
oftered for sale (Sec. 7044, Business and Professions Code: The CoMrectors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or [hrough his or her ovm
employees, provided that such improvements are not intended or oflered for
sale. If, however, Ihe building or improvement is sold within one year o(
completion, the ownerbuilder will have the burden of proving that he or she
did not build or improve for purpose o( sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS lo cOnsiruct the pmject (Sea 7044, Business and
Professions Code: The contractorg License Law dces not apply to an owner oi
pmpeny vfio builds or improves thereon, and who mniracts for such project with
a cont2ctor(s) license pursuant to the Contrectore License Laws.).
❑ I am exemp� under sec.
Business antl Pmfessions Code fpr this reason:
Owner ID veri(ied by driver�ise. ❑ Yes ❑ No
Driver's License No. Expires:
Verificalion of Ownership by (rype of document, i.e. - property taz bill or deed):
DIVISION OF�INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby cert'rfy that no excavation frve (5) or more feet in depth into wfiich a
person is required to descend, will be made in connec�ion vnth vrork authonzed
hy this pertnit, and that no building structure, scaffdding, falsework, or demolition
or dismantling lhereof, will he more than thirty-si� (36) feet high. (Chap. 32, Gry
2, Art 2, Sea 341, Title 8, Califomia Atlministrdtive Code�.
❑ As owner-builder, I will not employ anyone to do work which vrould
require a permit fmm the Division of IndusUial Safety, as no[ed above, unless
such person has a permit to do such work from the division.
Apolicanfs SignaWre
Division of Industrial Satery Permit Number
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will �he applicant or present or Future building occupant need to fle and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of Ihe Califomia Heaith and Safety Code requires, with some
exceptions, Ihat a Business Plan be fled 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 �han a weigh� of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
a� standard temperature and pressure).
2. Does or will Ihe applicant or present or future building occupant need to file
a regisVation form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safety Code, with some
ezceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry 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 slandard
temperature and pressure).
3. Does or will the applicant or present or future building occupan� neetl to
piepare an RMPP (Risk ManagemeM antl Prevention Pmgram for acutety
hazardous materials�? ❑ Yes ❑ No
(Section 25534 of the California Health and Safery Code provitles that Ihe
Costa Mesa Fire Depariment may require Ihe preparation, ceAification and
fling with the Fire Department ot 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 fuWre builtling occupant require for
the work which is �he subject of this application a permit for such construction
or modifcation from the South Coast Air �uality Management District or from
any other air polNtion contml district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Cotle requires that the requestetl
informa�ion be Wmished on applications (or nornresidential building permits).
6. Will any part of �he facility to be constmcted under Ihis permit be within
1000 feet from Ihe ou�er boundaries of a school? ❑ Yes ❑ No
Qf "yes", the (acility must meet the requirement o( Seclions 25534 and 42303
of the California Health and Safery Cotle).
7. If a permit from ihe South Coast Air Quality Management DisMct or olher
air polWtion con[rol district or agency is required for Ihe work which is �he
subjec� o( this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes � No
8. pf'yes", attach certifcate of compliance from the appropnate air pollution
coMrol oNceq.
CERTIFICATE OF COMPLIANCE: I certify that untler penalty of perjury the
information given a6ove is wrrecl I agree to comply vdth all state laws and
ciry ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury Ihat I have read [his applicafion and state Ihai
the information given is correct. I agree to comply with all state laws and city
ordinances relating to building cons[ruction, and authorize representatives o(
Ihe Ciry of Costa Mesa to enter upon the above-descnbed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
au[horized by this permit until final inspection.
�ure ol Legal Owner(s) f� alp�/ //
SignaWre Date /
309-06 (3I0�) Y — (/q� g/ry61'tdRl �' 9e ��_ �- �
�DDNESSOFBNlqNO: jS9 MONTE VISTA AV
ovmEaswuieivr.xo�vu: VERLENCH, CATHY A
� ' �p� 34 MIRADOR
� IRVZNE,CA 92715
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MCNRECT 011 fll�IFEA: 11C. M�-
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UNi:
UNT:
GARAG CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 076291 PLAN CHECK NO: N
��T�g� ROSS 6 BARROWS INC. (714)557-7440
cam.crorta�uiwo z60 E. ALTON AV
�no�u SANTA ANA CA ucno. 327802
92707 urn:
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CONSTRUCTION TYPE: V—N PERMIT TYPE: STR
PERM NO: B 076291
GOVT: N SUPP: N
PURPOSE: OTH
SOB DESCRIPTION : T/OFF REROOF W/BUILT—UP SQ FT: 1,850
CLAIM VALUE: 1,850.00 CALC—VALUE: 1,850.00 GROUP OCC: U-1 /
COMMENTS: T/OFF EXISTING AND REROOF SOOSF GARAGE W/BUILT—UP
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Z O N I N G R E Q U Z R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 9�9.�4104 ZNE: REF NO:
PLANNING NOTES>
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BLDG PM'1��.�k
o�«�+.. PERMIT 43.00
Ueb: AGG��'xd:
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LENDEP'S NAME:
LENDEF'S AODRE93:
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PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
IE 1E1E1E �E9E 3E9E1EiElElEiEiEiE1EiElE1EiE3EiE1EfElE9E3E3EjEiE�E3E1EiE1E�EiE1EiE
� R E Q U I R E M E N T S
� DATE:
��E'� S U M M A R Y
ELECTRIC MECHANIC
DATE:
DATE: 2 ��
�FiF*rt*�t+�**��* **
STRUCTURAL SEGMENT;Y
FIRE SMIP/RES GRADING
.50
SMIP/NON—RES
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
43.50 0.00 0.00 43.50 43.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 43.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
43.00 .50
ikiF1F1E1E1fk1t1E1EiEfE1E1EiEiflEiFiEiE1EiE1E1EfElfikik1E1E1kfEiflF1ElEiffEfElE�ElEifiElEiF1FfElElEfEklEif1E1k1f1EiEifiEfEffiEfElFfE1Elk1EfE�EfE1EiE1EiE1F1f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N
SFR 1850 REROOF HY VALUE RESIDENTIAL NOZONE
END OF FEES
'` +i. ,.`: =` � �
•t ��� ,i.t._
. a, . �� + .
IDATC �1���� �3�T
UNIT COST
1.00
"�1-
.n�_ .�
TOTAL COST
1.850.00
" ..i'; . L . � .
. . 1 _: ....�.J
.�
CONSTRUCTION AND PLANNING POOL & SPA
♦
APPROVALS Permit#` Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � "
2. Soil Pipe•Undrgrnd. /•' 53. Steel Reinforcement �
3. Electrical Conduit Ucility-Undrgrqd. 54. Forms '
'4, Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electricai UFER Grnd. 57. APPROVAL TO COVER-GUNITE �
J, Footings 58. Electrical Conduii-Undrgrntl. �
-8. Poundation 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Floor Svstem � 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 - Fina�
14. Rough Plumbing . . 65. Electrical-Final `
15. Rough Electri�al-Conduit 66. Solar System•Final •
16. Rough Elettric Niring 67. Fencing & Access ApProval '
17, Rough Wiring Sign 68, qPPROVED FOR PIASTERIM1G �l
7$. Rough Electriral-T Bar Ceiling 69. POOL/SPA S�'$TEhAS FINAL
19. Rough Heating & Ai� Condrtioning . fIRE DEPT. REQUIREMENT
20. Rough Factory FirepJace `. . ,� APPfjOVALS Permit #
21. Outts, in Structurz - 70. Underground HYdro
22. Ducu, Ventifating . 71. Produc[ Piping O Gas ❑ Oil '
23. Gas P�pe�Rouqh & Test ' 72. Underground Flush
24. Roof Franling' - . - 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling �Structurall & Monocoat ' 75. Dry Chemical .
27. Frame and Flashing - 76. Dry Standpipe . 1 F
28. Lathing & Siding ' ' 77. FIXED SYSTEM FINAL
29. Insulation � ' 78. FIRE PREV. FINAL -
30. Drywall Nailing ' � HEALTH DEP7. REQUIREMENT
31. Plaster Brown Coat � ' 79. FINAL INSPECTION
32. Electrical Power Meter�Final ' � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � . ' Notes: � - "
34. Fina! Heating & Air Conditi0ning _ . " ' - .
35. Final Gas Pipe-Test . _ .
' 36. Hood or Canopy - - . ' �
37. Final Factory Fire0lace � �
38. Final Plumbing . � '
�
39. Water Service-Finai
40. Gas Service-Final _ ,
41. Solar pomesi+c-Final. � � �-
42, Backflow Preventer ' . , _ ,
43. Backflow Irrigation � �
44. Landscape� irrigation System , - -' , �. � � '
45. Sound A2tenuation � . -� • - _ ..
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING , .
48. FINAL PLANNING '
49. Electric Release to Edisoo .
50. Gas Release to Southern California Gas Cn
51. CERTIFICATE OF OCCUPANCY
No. Date
\
AOp��cant to fill in all sDaces exceD� t�ose within IfeavY �orEer linei antl si9n all appropriate Eeclarations.
CITV OF COSTA MESA CQ NSTRUCTI N pERMIT PER IT NO. TRACT N0. LOT NO. UN�IT�yO. �•
� jSG Y/111�1 fP (/(�i�C 2-Z . �7 , 6552 7/ I I/85
0.00 Tl
. Pro'ect Address '
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
ApplicanYs Mailing dress ❑ CONVERSiOrv ❑ pEMOLI$H ❑ O7HER q,p, � ' Zona
Owner's Name /I • Phon DESCRIPTION OF WOFK/USE OF BLDG. -
Address L/�.��� E Main Building: Accessory Building: Z
Areh/Eng. Licenu No. TVPE OF PERMIT GanoiNG�� FouivDAnOrv STaVGTuaAL T Front ' p
Address ❑ OTHERT ❑ ELECTRICAL IdPLUM8ING ❑ MECHANICAL A Reaf • N
Contracwr'sName Phone r9�ro�< - � Right i N
Address (mailingl %�_l/ • PROJECT DESCHIPTION SQ. FT. OCCUPANCV K � G
� CONSTRUCTION TVPE VALVATION $ S Left
' R
Ciry Licensa No ZpryE GRADING CU.vDS. ACRES ping. Ref. # Parking Req./Provided � E
LICENSED CONTRACTOP DECLARNTION Q
I hereby atiirm that'I am licensetl unUer Orovisionsof Charter 9(commencing Remarks: Planning Notei: M
with section 7000) of Division 3 of the Bu5ine55 antl Protesslons Cotle, antl T
my �icense is in tuu Pr pd elfecL S
License CI s LI e o.
Oate Signature _ PLUMBING FEES �
WORKERS' OMPENSATIONDECLARATION BarSink Showers ELECTRICAL - FEES
I M1e�eby affi�m tha[ I have a ce� iflca[e ot consent to self-Insure or a C¢rtifiCate '
of Workers' Compens Ih nce, or a c¢rtitietl copy the�eot (Section BackflowPreventer $¢fvic2Sink -�
3800, Lab. C �� Flummatic Washer Transformer ❑ 15�50 KW .
PolicyNo. Company • Backflowlrrigation SewerCa ❑SO+KW
P Construction Pole Sub.
❑ Csrtifietl copy is nereby turnisheC.
[]�ertiti tl ap is filea witn the city ia' i' i Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Oate " Applitant
EXEMPT FROM WORKERS' COMPENSATION DECLARATI Cldfifi¢�5 � $Old� C0112C[O�5 Di5hwd5h¢f M¢t¢r ❑OVB� t00amps .
(Thi55etti n need not be mmpletetl if the permlt Is fo� one huntlretl (E100) or ,
less). Dishwasher , Solar Piping Dryers ❑Gas ❑Electtic Sub Panel
I certily tha[ in [h¢ performance of the work for which this perm�t is i55uetl, I �
shall mt employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors �0.1 HP �1 h- 8
Wo�ke�s' Compensation Laws ot California.
. Date � Si9nature Floor Orains Swimming Pool w/$pa F.A.U.
'NOTICE: If, after making this tleclaralion, you shoultl become subject to tM1e Inc.Solar �9-15 HP �16-15�
Workers' Compensation provisions of [he Labor Cotle, you mus[ forthwith Floor Sinks Urinal Fiztures ��
comply �wi[h such provisions o� this permit shall De tleeme� �evoketl. MiC�owav¢
CONSTRUCTION LENDING AGENCV ' Gas$ervice Outlet5 WaterClotel DeviCeBUxes
I hereby affl�m t�at there is a consVuclion lentling agency for tlte Oerformance POIC Liyht
o� the work for which this permit is issuetl (Section 309] Cfv. C.) Interceptors � Water Heater Outlets � Ran e
Lentler's Name �. 9
Lentler's Atltlre55 Kicehen Sink Water Service Switches, Sign
OWNER BUIL�ER DECLARATION
1 Ite�eby affirm IM1at I am exempt Irom Ine Conl�acto�'s Llcense Law fOr the Lavatories AUtO-WdSh
following reason ($ection ]031.5 Business antl Professional Cotle: Any city or Garbag¢ Disposal ; Standing S2ctions
counry which requires a permit to construct, alter, improve, tlemolish or repair P—Trap � ' Laundry Trays Generator DO-5 KW 05-15 KW Trash Com actor
any st�ucW�e, priOr [o ils Issuance, also r¢quires [he appllcant for Such pe�ml[ � P
to file a signetl statement tnat he/she is licensetl pursuant to the provisions of Roof Drains
tne Contractor's License Law (Chapter 9(commentln9 with Section 7000) of A •
Division 3 of [he Business antl Profe55lons Cotle) or [hat he/she is exempt ' .
tnere(rom antl [ne basis for the allegetl exemption. Any vlolation'ot Section �
]031.5 �y any applicant for a p¢rmi[ subjec[s the applicanl to a civll �� �
�endlty of not more lban five huntlre0 tlolla�s ($500). ' "`
1, as owner o/ the propertY or my employees with wages as lheir sola ReinspectiOn FBe $15 IStua FBB g 3 � ";
compensation, wiu tlo lhe work, antl lhe structure is not intentletl or oHered - fteinspeition Fee $15 luue Fee $ 3
for sale (Section �044, Business antl Protessional Cotle: The Contracmr's .• MECHANICAL PEES
License Law tloes nol apply to an own¢r 01 a property who builtls or improves
thereon, ana wno tloes such work hlmsMf/hersel( or [Ivou9h his or her own DEVELOPMENTSERVICESRE�UIREMENTS:
emplayees, O�oviEetl tha[ such improvements aro not intenaetl or oReretl tor Boiler HOOd O� Type I ❑ '
sale. If, however, the builtling or improvement is soltl within one year of com- Canopy Type I I ❑ Zoning Approved By Date
pletion, Ihe owner wlll have lhe burtlen ot proving h¢/she Oltl not builtl or im- DUCt - Und¢� GfOuOd BUilding Approvad By DetO
prove for tM1e purpose o1 sale).
❑ I, as owner of the property, am exclusively cont�ac[ing wilh licensetl con- DUCt-St�uctu�21 Refrigeration $y5t2rtt AppliwtiOn ISSued 8y Dat
tractors lo mnstruct lhe plOj¢CI (Section ]Oa4, Business antl Professions Cotle: p
' The Connactor's License Law does not apply ro an owner oi properry wno Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU .� �% SUMMARV OF FEES
builtls or improves thereon, antl who conVacts for such projecl5 with a con-
tractor(s) license pursuant'to tne Contracmr's License Law). I am aware that Exhaust System ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of cneir Worker's Compensation insurance shoWa be proviCetl to me. _ PLAN'CHECK $� PERMIT
❑ 1 am exempt untler Section B. & P. C. tor tnis reason FirepVFact. BIL ICBO # Fire Dampers t'PLUM ING $ ISSUANCE $
Date Owner Heating System & Ducting fiegisters pLqN CHECK 25% $ ' ENERGY P.C. $
I hereby certity that 1 have reatl this aoP�ication antl state lnaf'the above ❑0.100,OOOBTU �100,OOOBT - �� GRADING $
iMormation is correci. I a9ree to comply with an city antl county ortlinances ELECTRICAL $
anG stale laws relating to builaing construction, antl hereby authorize re0/e- . - $ MICR�FILM $
sent5tives oi this city to enter upon me above-mentionetl property for PLAN,CHECK 50°� ,
inspection p s . MECHANICAL $ ��U
Si9nature Date� i� TOTALPEE $
Drivers' License or 55 � Reinspection Fee $75 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46, rev. 10/B4 White - Builtling; Canary - Applicant; Pink - Accounting; Goltlen�Od - Assesso�
CONSTRUCTION AND PLANNING . POOL & SPA �
APPR�VALS Permit# Date Inspector qppROVAIS Permit# Date Inspecror
1. Temporery Electrical Service or Pole 52. Pool & Equipment Location
_2,� $pil Pipe-Undrgrnd. 53. Steel Reinforcement
3. ElEctrical Conduit Utility-Undrgmd. 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical Bbnding �
5. Stsel Reinforcement 56. Rough Plumbing & Pressure Test
..6. Electrical UFEft Grnd. 57. APPROVAL TO COVER•GUNfTE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation ' , 59. Gas Pipe, O Undrgrnd., Test
.9. Water Pipe�Undrgrnd. 60. Backwash L+nes, P�Trap, [7 Undrgrnd.
�40. Structural Floor System 61. APPROVAL TO DECK -
11. ProPerty Sewer Line & House Connection 62. Backwash & Receptor-Final
12, Sewer Cap , 63. Heater & Vent-Finaf
13. Roof Drains 64. Plumbing System - Final
74. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYsiem-Final
i 6. Rough Elec[ric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica6T Bar Ceiling 69. POOI(SPA SYSTEMS FINAI
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20' Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Undergraund Hydro
22. DuGts, Ventilating !]'. 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test Ci 72. Underground Flush
24. RoofFraming =T 73. Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing �:� 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
:s:
30. Drywall Nailing •• � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. EleCtrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Fin&I Electric Notes:
34. Fin81 Heating & Air Conditioning
35. Final'Gas Pipe-Test _ �
36. Hond or Canopy
37. Final Factory Fireplace � "
3 . in21 Plu in
ater - inal
40. Gas Service-Final
41. Solar pomestic-Final • .
42. Backflow Preventer � .
43. Backflow Irrigation
44. Landscape Irripation System - -
45. Sound Attenuation �
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING �
48. Special Requirements Completed � �
49. Electric Release to Edison � -
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY ,
Nn. - Date
DOYLE & SHIELDS Develoxmment Co.,Inc.
C:�
N0.
i FIRE ZONE DESCRIPTION OF WOR% ites.w
DATE IGROUP I&.7 TYPE V ZONE R-',
SUBCONT1tACTOlt
,a5s� FEE RECEIVED
bSTA MESA BUILDINGSAFETY DEPARTMENT JU N 3 1963
P.O. BOX 9f] C09TA M86A. CALIPORNIA �NANCE DEPT.
�ITY Of COSTA MESA
For Applicant to Fill In Completely APPLICA ON FOR PERMIT
TYPE OR PRINT BUILDING .
3�� � For Ofilce Use Only
BUILDING
ADDRE53
MBCEIr1'NO. P���/�
COSTA MESA, CALIFORNIA J
R6CH 6D pY DATB HEC8IVE OATEIBSUED
OWNER p� I � S� ; � ��, �.iK. L �/�J,,- 3 /'uri s�9sa
ADDRESS SJ I ✓D. ^ Q�'� C.hCf.� )"' [� ADI E59 eJd C'"'-'� ✓^�-� -"'
CITY 0.-�C •M �-�✓� ��• N6.T �^p �� ZONH TYPE 6ROU �
APPftOVED
ARGHITECT �` �1 i�� , NEOL.G /^�tr/ BY DATE
ORENGINEER 0.1 l O 6
..{I_{1 ZONING s
AODRES9 � O � WL � {'ti {'�� OY� UF�+L `✓� ZO _� rv0. OF !1 I U5H OF NE
(^��— PLANB�T 0t11LDl �
CONTRACTOR J
`^ LeOAL / � y1� T
AODRE88 V:I-H+ e� D86CR�R�ON �0 1 � • 0.�� �3 3
CITY S�'"h` �+ A. P. N�
'`� � O NOTE: NO EAVE OVERHANO SHALL BE LESS THAN
STATE /s/ .�fo lR,� / TE /Q y U 90' TO BIDB @ RHAR P. L.
LIC. NO. NO. • \
EAVEB
SIZE � � no.o�a�oos. A�LOWED (U.B.C.REOUIREMENTI
OF L0T33. X S'-? � 6 �ow a„ �or —
YARDSAPPROVE� YARDSAPPROVED
USE OF � MAIN BUILDING ACCE650RY BUILDING
E%ISTINa BLOO.
� �� (FROMG//j'��STREfiT)
9ETBACK IINE FROM /� �� FR NT ✓ FT. FT.
CENTER OF 8Tfl8R / V RHAR ARD
SIDEYARDI LEFI' � I RIGHT �� R.SIDE Ff. FT.
DESCRIPTION OF WORK �. a�oe ��. F-r.
NEW �/�`I ALTHRATION _ AODITION R6AR FT. F�.
OISTANCE BET. BET. MAIN 8
REPAIR MOVIN6 DHMOLISH MAIN BLOGS. ACCE59. BLDG9.
SZ'Eo'Ng33' S�SOROOMS STORIE9 y GAU.P.� APPROVED
EXTERIORWALI�+L.J�Q I COV�ERINO ��'^ O BYPROV {�� DATE S^�-�—�
GOVERING J /
USE OF BUILDING AND WORK TO BE PERFORMfiD
�e e�..�a `^� A--j-�c��. (a'ar.
� a A � 1 3 ��T �,�J 60. FT. T� Q,
1 HEHEBY ACKNOWLEDO@ THAT I XAVB FBAD TH�B ApPLICATION TME AMOUNT 8H N UNDEH VALUATION IB FOP THE
ANp BTATE THAT TH8 ABOVC 19 CORRECT AND AORHB TO COM� PURPOSE Op H BLI9HIN0 A PEftMIT FEE ONLY.
PLY WITH ALL CITY OpDINANC88 AND iTAT[ LAWB XHOULATINY yALUATION
BIJILDINOCONSTRULTION. � q
SIGNATUREOF I PERMITFEE S
PERMITTE r, �. O% q� N
S/G� �D LA C C d
AUTHORIZEO A66NT ��,\/( � � O�0
TOTAL FEE
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant tu Fill in Completely - Use Ink
ADIDRESS ��� �CfC.S� � �.
OWNEfl `_�
MAIL
ADDRESS
CITV
CONSTRUCTION
LENDER
BRANCH
ADOflESS
ARCHITECT
OR ENGINEERC
ADDRESS ��
CONTRACTOR
TEL.
NO.
T
ADOFiESS ,6�0\�L,�ZGJ�-�SN'��W
./� TEL
CITV � '~� /"� NO. �a1�
STATE CITY
LIC. NO. ' LIC. NO.
SIZE INO.OF BLDGS. '
OF LOT NOW ON LOT
USE OF CCiCi�G
EXISTING BLDG.
Separate permits are required for
electric, p(umbing ai�d heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
�
I hereby ecknowlodBe that I hnva raetl thb epplieation antl state
thet the ebove Information is c0�rect entl epree to comply wit�
alt lews raqulatinB o�uat�e oo��r��no�, a�a i shall not employ
eny perwn In vlolation of tha Workmen'a compensation laws of
the State of Celifornle.
I heraby cartify [hat I em prOOa�ly IlcenseC es e to�t�attot unEet
the State of Gallfornio Butinosa e�d Profassionf Code, Divislon 3,
Chapter 9, entl thnt sue� Ilcenms ero In full foree antl effoct, or I
am exempt trom the provlcions of the Stote of CelHornla Businesa
ontl Profeaelona Cotla, Divislon 3, Chaptar 9.
Slenetura of(,1�. . �^ � �e+'� q
Permittea '\ �- l V4� L—_ i�
Aut�orizatl ABe�� � � ``
BUI
AD
T
'.P� -F-77°d�=�0 z13" ��=`u -a4.5u
�::
FORSTRUCTURALPERMIT
DATE FECEIVED nerv ic<iicr
FIRE
20NE T
APPROVE (�
BV ♦
ZO NO.OF
PLANS�
YAROSAPPROVED
MAIN BUILDING
DISTANCE
MAIN BLO
VAR. #•
APPROVED
��
RMIT NO.
DATE
USE OF NEW
BVILDING
DATE
APPROVED
&
BLOCK
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPpSE OF E5TABLISHING A PERMIT � O V;
VALUATION PERMIT FEE § ��
9 �(/ PLAN CNECK E
g � � TAX S
TOTALPAID S . �
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m
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