HomeMy WebLinkAbout105 MORRISTOWN LN - Building PermitsApplicant
to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
/68,i2/1 b/:-_ i.
. •�
CITY OF COSTA MESA CONSTRUCTION PERMIT
PERMIT NO.
TRACT NO.
I
LOT NO.
I
UNIT NO.
I
Project Address 105 MORRISTOWN
I'
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
E:1 CONVERSION 11 DEMOLISH 1:1 OTHER
DESCRIPTION OF WORK/USE OF BLDG.
Applicant's Mailing Address 10422 TRASK AVE. GARDEN (:ROVE
Owner's Name RANF.Y Phone 540- Si5
Address 105 MORRT CTOWN (:OSTA MFCA
q.p; #
Zone
S
Main Building:
Accessory Building:
Arch/Eng. License No.
Address
TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALB
ElRear
OTHER
-
PROJECT DESCRIPTION 5R. FT. OCCUPANCY
1 CONSTRUCTION TYPE VALUATION $
ZONE GRADING CU.YOS. ACRES
T
Front
-
O
N
I
Contractor's Name—A-AMFS PII1MRTNG—HFATTNelone 59Q -244Q
Address (mailing)— 10422 TRASH AVE GARDEN GROVE
City License No.
LICENSED CONTRACTOR DECLARATION
A
C
^
Right
-
N
K
S
Left
G
Ping. Ref. #
Parking Req./Provided
E
Remarks:
Planning Notes:
M
I hereby affirm that I am licensetl Charter 9 (co encin9
with section 7000) of DIv151 of the Business antl Pr sio e, and
my license is in full Ipr�gan et ct. Q7
s. .-JJ UO
T
S
License Class Lice a No
Date 3-1-85 Sign lure
PLUMBING
FEES
Bar Sink
Showers
ELECTRICAL FEES
WOR KERS'COMPENSATIO RA
I hereby affirm that I have a certificate of o ant to self -insure or a certificate
Backflow Preventer
Service Sink
Automatic Washer
Construction Pole Sub.
Transformer ❑ 15-50 KIN
❑ So+Kw
of Workers' Compensation Insurance, certilled copy thereof (Section
3800, Lab.
P84076419 FREMONT
Policy No. Company
8 Certified copy is hereby furnished.
Certi ed c p I filed with the city 2W§ D v z n
�-1�— �t.riM$ING—HEATING
Backflow Irrigation
Sewer Cap
Bathtubs
Sewer Connection
Cooking Unit
Meter ❑up to 100 amps
Date � Applicant A
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
Clarifiers
Solar DOIIQC1or$
Dishwasher
Meter Dover 100 amps
(This section need not be completed If the permit Is for One hundred ($100) or
Tess)
certify that in the performance of the work for which this permit is Issued, I
Shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California.
Dishwasher
Solar Piping
Dryers ❑Gas ❑Electric
Sub Panel
,
Drinking Fountains Solar Tank
Fan
Motors ❑0-1 HP ❑1'A- 8
Floor Drains
Swimming Pool w/Spa
F.A.U.
Inc. Solar E19-15 HP El 16-15+
. Date Signature
'NOTICE: If, after making this declaration, you Should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith L
comply with such provisions or this permit shall be deemed revoked.
Floor Sinks -
Urinal - —
Fixtures
Microwave
Gas Service Outlets
Water Closet -
Device Boxes /
—1
Pole Light
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.)
Lender's Name
Interceptors
Water Heater
2
M
Outlets � •
Range '
_
Kitchen Sink
Water Service
Switchk
—
Sign
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 t0 the provisions of
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 Of the Business and Professions Code) or that he/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
nenalty of not more than five hundred dollars ($500).
IJ I, as own 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 does not apply to an owner of a property who builds or Improves
thereon, and who does such work himself/herself or through his or her own
employees, or Ovided that such Improvements are not intended or offered for
If, however, the building or Improvement Is Sold within one year of com-
pl elle n, the owner will have the burden of proving he/she did not build or im-
prove far the purpose of sale).
❑ 1, 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-
tractors) license pursuant to the Contractor's License Law). I am aware that
proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. & P. C. for this reason
Lavatories Auto -Wash -
Garbage Disposal
Standing Sections
P—Trap Laundry Trays
Generator 0D-.5 KW E15-15 KW Trash Compactor
Roof Drains.
-
Reinspection F.00
$15 Issue Fee
$ 3
_ -
Reinspection Fee
$15 luue Fee $ 3'
MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approve By Date
J J
Building Approved By Date
�. _
Applicationllssued, By _ — 0_i Dat
Boiler
Hood Or Type 1 13Sale.
Canopy Type It ❑
Duct -Under Ground
Duct - Structural
Refrigeration System
0.100,000 BTU 0100,000BTU
Duct - Ventilating❑
_-
t / it
BU�L•DING,PERMIT
PLAN.CHECK$
PLUMBING
PLAN'CHECK 25%
'
ELECTRICALinforma
PLAN CHECK 50°b
MECHANICAL
SUMMARY
$
$
$
$GRADING
$
$
OF FEES
SMIP• $
PERMIT
ISSUANCE $
ENERGY P.C. $
$
MICROFILM - $
TOTALFEE $ 5.00
Exhaust System ❑ Multiple ElSystem
Repair/Alteration
Firepl/Fact. Bit. ICBO #
Fire Dampers
Date Owner
I hereby ify .that I have d this a tic tion antl state that the above
p
n is correct. I agree c m I wjlrt all city and county ortl financesantl Ste a laws relating Idin co t tion, and hereby authorize repre-
Santini of JAl t0 enter d the ove-mentioned op
inspect purp
Heating System & Ducting
❑0100,000 BTU ❑100,000BT
Registers
43'�
Reinspection Fee $15
Issue Fee
Signa to
Drivers' nse or S
PLAN CHECK 25%
$
MF 0865-46, rev. 10184 White - Building; Canary - Applicant; Pink - Accounting;
Goldenrod - Assessor
C/
CONSTRUCTION AND PLANNING
APPROVALS Permit #
c
Date-
Inspector
- POOL .& SPA -
APPROVALS Permit #
Date
Inspec,*nr
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. APPROVAL TO COVE R-GUNITE
7. Footings. -
..
58. Electrical Conduit-Undrgrnd.
8. Foundation '
59. Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-UndrgmW
60: Backwash Lines, P -Trap, ❑ Undrgrnd.
10. Structural Floor System
j
61. APPROVALT0 DECK
11. Property Sewer Line,& House Connection
62. Backwash & Receptor -Final
12. Sewer Cap j
63. Heater & Vent -Final
"
13. Roof Drains -
64. Plumbing System - Final
14. Rough Plumbing
65. Electrical -Final
15. :Rough Electrical -Conduit
66. Solar System -Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. •Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPASYSTEMS 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 0Gas ❑Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. 'Roof Framing
73. Undergrnd. Storage Tank 0Gas ❑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
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: ,�` i
34. Final Heating & Air Conditioning
35. FinalGasPipe-Test
36. Hood or Canopy
"�Z �7 -'
37. Final Factory Fireplace
38. Final M
/W
36, ervice-Final
40. Gas Service -Final
41. Solar Domestic -Final
-
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound. Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
- -
49. Electric Release to Edison
-
50. Gas Release to Southern California Gas Co
51. CERTIFICATE.OF OCCUPANCY
Nn. Date
' ,
. Applicant
to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
-
CITY OF COSTA MESA CONSTRUCTION PERMIT
. Project Address A 5 a h _J � 4-G 1,&1
PERMIT NO.
� � zoo 2
TRACT NO.
LOT NO.
UNIT NO.
TYPE OF CONSTRU CTION NEW ADD: ALTERATION REPAIR
p� Al'-
❑ CONVERSION ❑ DEMOLISH 'P' OTHER -A e�b� QC ..4
DESCRIPTIONOF WORK/USE OF BLDG'.
e
Applicant's Maili g Address /��11.7.%-Q L. 1<j��-'X ' II
Ownei's Name -�I) V G /'1 A n.a. -/ �'/
Phone Q_ S�5
Address ��S MOS•^s'�d�
A.P. # � � Zone
S
'Main Building: Accessory, Building:
Arch/Eng.. License No.
Address -
TYPE OF PERMITGRA OIrvG ❑ FOUNDATION 'STRUCTURAL
TENANT LyJ ELECTRICAL �.❑ PLUMBING MECHANICAL_
❑ 'OTHER -
PROJECT DESCRIPTION So. FT.-OCCUPANCY—
CONSTRUCTION TYPE VALUATION$
ZONE GRADING CU.YDS. ACRES
T
Front -
O
B
Rear
N
A
Contractor's Name T��pU,� M n PhoAe ��a_. �_a"v3
C
Right
N
Address (mailing) N� 7 5 t L�( Q,h, •'X
City License No. 3�q
LICENSED CONTRACTOR DECLARATION -
- 1• hereby' affirm that am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
License Class License No. 4 � Z q ��
Date �-22- V Signature -
K
S
Left` I
G
R
{ -
Ping. Ref. # - Parking Req./Provided -
E
Remarks:
9 t j i,i:;.tJl
Planning Notes: ` `'i `INJ 1
M
�
_
T
S
- PLUMBING
FEES
-
--
'
Bar Sink
Showers
"
ELECTRICAL FEES
E
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate of con5e to self-insure or a certificate
of Workers' Compensation Insurance, or a certifled,copy thereof (Section
3 00 Lab. C.)
P li No. Co p y r1r f
rtifie c py h reby f rn shed.
C tiff c Py s fi ed w' h t e ci Bui tl ng Dlv' io �
Backfiow Preventer
'Service Sink
- -
Automatic Washer Transformer ❑ 15-50 KW
❑ 50+ KW
Construction Pole Sub.
Backflow Irrigation
Sewer Ca .
P
Bathtubs
Sewer Connection
Cooking Unit _ Meter ❑'up to 100 amps t
Date - ApP 11 t
EXEMPTION FROM WORKERS' CO MPE NS I DECLARATION
Clarifiers I
Solar Collectors
Dishwasher - Meter ❑over 100 amps,
(This section need not be completed if the permit is for one hundred ($100) or
Tess).
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 became object to the
Worker Compensatjpo Laws of Califorr}�A
Dishwasher
Solar Piping
Dryers ❑Gas ❑Electric Sub Panel
Drinking Fountains
Solar Tank
_
r Fan / Motors ❑0-1 HP1 % -'8 I sp
Floor Drains
Swimming Pool w/Spa
F.A.U. Solar❑9-15 HP 016-15+
Date L SC 7 Signature
'NOTICE: It, after making this declaration, you Id become subject to theInc.
Floor Sinks
Urinal -
Fixtures - -
Microwave
Workers' Compensation provisions of the -Lab Code, you must forthwith
comply ,with such provisions or this permI shall be deemed revoked.
Gas Service Outlets
Water Closet
Device Boxes Pole Light
9
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance
Interceptors
Water Heater
Outlets Range
of the work for which this permit is issued (Section 3097 Civ. 'C.)
Lender's Name
Kitchen Sink
'Water Service'
Switches Sign
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 permitP
to file a signed tor' Statement that he/she i9 licensed pursuant to the provisions of
the Contractor's License Law (Chapters (commencing nq with Section is exe of
Division 3 of the Business and Professions Code) or that he/she is exempt
alleged exemption. Any applicant to Section
therefrom and the basis t for
7031.5 f any applicant for a permit subjects the appllca nt to a civil
een 1, a of not more than op rtylord dollars ($500).,
employees with wages as their sole
compensation, will do the work, and the structure is not intended orofftractortl
co I, as owner of the a work, an the
for sale (Section 7044, Business and Professional Code: The Contractor's
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own
employees, provided that such Improvements are not intended or offered for
sale. If, however, the building or improvement Is Sold within one year of com-Canopy
pletion, the owner will have the burden of proving he/she did not build or im-
prove for the purpose of sale). i
❑ I, as owner of the property, am exclusively contracting with licensed con-
traCtors td construct the project (Section 7044, Business and Professions Cotle:
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(s1 license pursuaht to theContractor's License Law). 1 am aware that
proof oft their Worker's Compensation insurance should be provided to me.
❑ am exempt under Section e. 8. P. C. for this reason
Lavatories
Auto-Wash
Garbage Disposal ;Standing SectionsIt
IP-Trap -
Laundr Trays V V
Generator ❑0-5 KW ❑5.15 KW Trash Compactor
ROOF Drains
'
Reinspection Fee
$15
I
Issue Fee
$ 3
,
Reinspection Fee $15 Issue Fee' $ 3
MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Data
Building Approved By Date
/y", /�
Application Issued By Dat
Hood or Type 1 ❑
Type II ❑
r Ground
tural
Refrigeration System
D40-100,000BTU ❑100,000BTUSUMMARY
MGround
lating t
,
OF FEES
PERMIT $ SMIP, $
CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK 25%' $ ENERGY P.C. $
ELECTRICAL $ c{-• sC7 GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ � I -CC) TOTAL FEE $ I Jam-
1_PLAN
tem ❑ Multiple ❑
System Repair/AlterationBUILDING
. Bit. ICBO #
Fire Dampers
Date Owner
'Ihereby certify that I have read this application and state that the above
information is correct. I agree to comply with all city and county ordinances
and State laws relating to building construction, and hereby authorize repre-
sentatives of this city' to ent upon the above-mentioned property for
inspection purgp5e�s. /
f� �`�"`� Date 7� Z Z-S'S
Heating System & Ducting
9§00.1001000 BTU 0100,00067
Registers
0
,
I
Signature -
.-_.. __ _ ," _
Reinspection Fee
$15
Issue Fee
$ 3
PLAN CHECK 25% $
CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
POOL & SPA
APPROVALS 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 Grna.
57. APPROVAL TO COVER-GUNITE
7. Footings - I
58. Electrical Conduit-Undrgrnd.
-
8. Foundation
59.' Gas Pipe, D Undrgrnd., Test
9. Water Pipe-Undrgrnd.,
-
`
60. Backwash Lines, P -Trap, 0 Undrgrnd.
10. Structural Floor System
- i
_
61.'APPROVAL TO DECK
11. Property Sewer Line & House Connection.
62. Backwash & Receptor -Final
12. Sewer Cap I
63. Heater &Vent -Final
13. Roof Drains' ,
64. Plumbing System - Final
14. Rough -Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory. Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping EJ Gas []Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank 0Gas LJ 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
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final ,_
80. FOOD CERTIFICATE ISSUED
33. Final Electric7/
(Typ
Notes:
34. Final Heating & Air Conditioning
Z
L�
35. Final Gas Pipe -Test
36. Hood or Canopy
- -
37. Final Factory Fireplace
38. Final Plumbing -'
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation.
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
-
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
..
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. - Date
-
OJECT ADDRESS: 105 MORRISTOWN LN UNIT:
OWNER'S NAME: CARMODY, THOMAS J
ADDRESS: CARMODY KRISTIN M
105 MORAISTOWN LN
COSTA MESA,CA 92626
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: STOUT ROOFING INC (310)923-6775
ADDRESS: P O BOX 4309
DOWNEY CA 90241
LICENSED CONTRACTOR 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.
CITY LIC.: 05 3'(�70p7 STATE 14025336CusS: C 39 EXP: 10/95
Q�Date'. '�"F' Signature: —J_Y
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or spent of Workers'
CompensalionI�tg2dg 2tc 3ce[Wled copy thereof (Section 3800. Lab. 85/19 / 9 5
POLICY NO.: 7 7 EXP. DATE:
COMPANY: AIG �/
ElCejrtifiie�ed copy is hereby furnished. ff Cendied copy filed with the city Building Division.
Date. J_lL Ll Applicant'
EXEMPTION FIROM W RKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred (5700) or fess).
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 WorkersCompensation Laws of California.
Date: Signature:
NOTICE: If. alter making this declaration. you should become subject to the Workers' Compensation provisions of the Labor
Codeyou 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).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7037.5 Business and Professional Code: Any city of 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 Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the
E-1structureis not intended or offered for sale (section 7044, Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. It, however the building or
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
1. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Professions Code'. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contraclor(s) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
I am exempt under Section'. B. 8 P. C.
for this reason:
Date: Owner:
I do hereby cenily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the
ordinances and stale laws relating to building construction and Iff I
property I� inspeclio purposes,—_— /
Dale:. l, Signature:(
to comply with all city and County
to enter upon the above-mentioned
1641.46 White—Building) Green—Code Enforcement; Canary—Applicant: Pink—Revenue; GoldenrOtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069500
PERMIT NO: B 069500 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION T/O RESTH 9 REROOF W/CO1(J? 6 HOT MOP SQ FT: 2,508
CLAIM VALUE: 2,508,00 CALL—VALUE: 2,508.00 GROUP OCC: R-1 /
COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. REQUIRED
�t+r+tat7rx*etit*itir�r�rit�r�r****ir�tir�tir*x*�r*�r****at it**�ritit�t*�t�*****irr�t**+t*tar*�t at�r�r*�tar**x�t+t*****
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN
BUILDING
----------
---------
ACCESSORY BUILDING---------
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 REO•
PROV:
PARCEL:
41916201
ZNE:
REF NO:
PLANNING N TES>
PLUMBING
ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
54,00
>
,50
M kkkkkkkMMkkkkMkkkkkkkkkkkkMMMkkkkkMkkkMMMMMMMMMMMkMkMMMMMMMMMMMMMMkMkkkMMMkkkk
k kk kkkMkkk k k k kk kitk
k k k kk k k k kk kk k k k k k kkkk MM M M Mk MM MitMMMMMMM
kM k kk M M M MMMMiFkk M kMM k k M M
D E V E L O
P M E N
T S E R V I
C E S
R E Q U
I R E M E N T S
ZONING APPROVED BY
DATE:
BUILDING APPROVED
BY :
_
DATE:
APPLICATION ISSUED BY:
kk MkkMkMMMMMMMMMMkkkkMMkMkMMiitEMkMMMkMMMkMkMMFIFMMMMDMMAMMTkMEkkMk
M
LEGALIZATION;N kkM MMM MMMMMMM
E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54,00 •50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—>
PERMIT
ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
54,50
0,00 0,00
54.50 54,50
•00
REVENUE DIVISION TOTALS--> COLLECTED:
54,50 OVER/SHORT:
•00
BLDG PMT
PLUMBING
ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
54,00
,50
M kkkkkkkMMkkkkMkkkkkkkkkkkkMMMkkkkkMkkkMMMMMMMMMMMkMkMMMMMMMMMMMMMMkMkkkMMMkkkk
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
UNIT COST
TOTAL COST
SFR 2508 REROOF BY VALUE RESIDENTIAL- NOZONE
END OF FEES
1.00 2,508.00
01 00170493-00170494 TOT 54.50
DATE; 10/28/?4 TIME: .12:23
r -CONSTRUCTION AND PLANNING
POOL & SPA
1
APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
Date
Inspector
I
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location j
2. Soil Pipe-Undrgrnd. _�'1
53. Steel Reinforcement
..�. 1eEtrical Conilui qtilitY'-Undrgrnd'.
54. Forms
w
' 4.^Flee?rical Conduit-8ndrgrnd.
55. Electrical Bonding
1
s:-5:•St'eea Reintorc'e m'knt
56. Rough Plumbing &Pressure Test
,�.• 6,.Eleetrical UFBR Grnd. „
57. APPROVAL TO COVER-GUNITE
7,Footings
58, Electrical Conduit-Undrgrnd.
-
-"`FBundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
-
60. Backwash Lines, P -Trap, 0 Undrgrnd.
I
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 A -
64. Plumbing System - Final
14. Rough Plumbing -
65. Electrical -Final
I
15. Rough Electrical -Conduit,.
66. Solar System -Final
16, Rough Electric.Wiring
67. Fencing & Access Approval
j
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
j
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS' OPermit # '^ *e
20: :Rough F-gctory i -fireplace sr �; 'y
"
i - i
-e;
0u'c�s, insSaPct ;' ,�"•
�� -y
;70. �Jnde"r r: tinct Hydro j rtt
,;
22.` Duczs, Venn: ating- _
«
%71. Product Pining !'i G''as 00il
, r
23-.Gas-Pipe-Ro` h & Testit
J , ',72.
Under rounii FIuC.ck'
24 ,•hoof FSamigg in _
, > ri
_
,.•
`.710 Undergrn&. Storago T nk {J Gas 0 Oil
25. Roof Shreathmg <? %: '��`iZ=9
'' 74, -Overhead Hydro-
j
_.
yu
;
26.:T -Bar Ceiling (Structural) &-wlonocoat
a
_ ,t<
75._Dry Chemical ° •-' ' t'
27. Frame and FlashL'AJ
;'
76. Dry Stan pipe ti ; '' It �:
I
o,�
„'. ,'
_28, Latkind& Siding; . -, O ;;j i;
_ ••
77 FIXED SYSTERtF.INAL'
''29. Insulation v
78 FIRE PREV. FINAL
:30. DrywalLNailirg I-
HEALTFfbEP-f. REQUIREMENT
Plaster Brown Coat',-
*
FINAL INSP_xCTICIN +
_31.
.•31.
.,79.-
Z2. Electrical Power Metep-Final(
p)
l it i
rMwFOOD CERTIFICATE ISSUED r
33: Final Electric
t ,
')Nates:1z
X34. -Final HeatA_j& Qi,Conditionv+ci,
I
1
, �:
- - -
_
n
35. -Final Gas Pipe-Te,,W
I r or
X_ -
,,36. Hogd or' -Canopy„
�37: -Final Factory Fireplace
'38. Fin41 Plumbing ;0 r U
39. Watet Sesvice�Firtat• "
..
*
_
+.- ..r
';¢0. Gas Service-EjnalF-; .,t to, k,
.
s
�_•
41. Solar Domestic - Fine Il' r'• ••
r
I
"^" !
n ♦ .T
I
I+
q
-
h• r1 .)
42.`Backflow Prevenzenfirs
43. Backflow Irrigation V li'
�44. Landscape 4rri9ation System;
, )il'.J ,
t
t •r)
s
IA5._Sound Attenuation ���'"
'T. •
- ��
ri +� _ ri;�1 r
r
aI r s
p
-:46.'Handica:-P. Regulations -,
Y47.•
G o• �= ` r
FIhfAL STR'UCT;URE & BUI'LDING
�� g
�Gt/ t
"• - _ * '
r
48.'!HNAL PLANNING
49r.Electnc Release to Edison
;50. Gas Release to Southern California Gas Co
'51. CERTIFICATEOF�OCCUPANCY
>• -
No. Date
OWNER SE VISTA 13IRT.11TNf: COMPANY DATE 6-1-64
JOB ADDRESS 105 MQrrj StCWn r,=e BUILDING PERMIT NO. 22318
GENERAL CONTRACTOR anmw VALUE$ 15-7'49-00
AP No. LOT 335 TRACT FIRE ZONE
INSPECTIONS Sienature I DATE_ I GROUP
DESCRIPTION OF WORK
Tp --T TYPE v ZONE R-4
Soil
Gas — SUBCONTRACTOR
PERMITS
SSUED
DATE
NUMBER
Water G
Rough Co . Ref ig. Air Cond. ❑
Rough Hcaung
Rough Plumbing—
—
Miscellaneous _/
Prop. Swr. Line ❑ House Con. & St. Swr. ❑
DEC 9 IM
S rp inklingSSystem
Construction Pole
Underground ❑ Power {7
Rou h Wirin
Trenches Forms Steel Reinf. ❑
Floor System
Bond Beam 0 Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In E�'Out
Plaster, brown coat
Refrig. ❑ Air Con. ❑ Final
Heating, Final �-
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final z_
Building, Final
_
OCCUPANCY
norm uua–Mm-oa--n-u F tanT n FUK byr, .A� —
c_ 1 22318
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 317 COSTA MESA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING ADDRESS 105 Morristown Lane
BUILDING
COSTA MESA, CALIFORNIA
OWNER San Vista Building Co.
S@LE
s Angeles 11, Calif.No'AD 37187
rER Raymond Levanas TEL -OR 37010
3432 Via Oporto, Newport Beach
Ess 1166 E. 58th Street
Los Angeles 11, California
O, 192782 No' AD 37187
T 20 X 7O I NOW ON LOTS
NG BLDG. None
:K LINE FROM
t OF STREET 13 1 REAR YARD_
IARDI LEFT 0 I RIGHT 0
DESCRIPTION OF WORK
BUILDING
EXTERIOR WALL,
COVERING JtllCCO
TO
Pi
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 1E CORRECT AND AGREE TO COM.
PLY WITH ALL C RDINANCU AND 8TAT8 LA WB REOOLATINO
➢DILDINO CO NH RY ON.
S'GNAT'RE OF
PERMITTER A A,� •(i(��v
N AUTHORIZED
FEE RECEIVED
W 10 Iasi
FINANCE DEPT.
IINANCEDEPT..
APPLICTT1y0QF1FKPW
SA
BUILDING
For Office Use Only
z
LU
21
J W
CK
oU
:a
O
N 0
0o
�0
RECEIPT NO.
PERMIT NO.
O
E l9i9ue0RECEI
=O/Y
JUn is
sa
BUIL ]NO
ADDRESS
FIRE
ZONE TYP GROU
APPROVED
BY DATE
ZONING
Z 6
NO. OP
USE OFN
PLANS
BWLOI Q_
LEGAL Tract 5160 - Lt t 335
DESCRIPTION
L L
A. P. NO.
NOTE: NO SAVE OVERHANG SHALL B ESS THAN
90' TO SIDfi a REAR P. L.
EAVES
ALLOWED (U. B. C. REQUIREMENT)
YARDSAPPROVED
YARDSAPPROVED
MAIN BUILDING
ACCESSORY BUILDING
(FROM C/L STREET)
FRONT FT.
FT.
R. SIDEpp� FT.
FT.
L. SIDE `% FT.
FT.
REAR 0 FT.
FT.
DISTANCE BET.
BET. MAIN B
MAIN BLDGS.
ACCESS. BLDGS.
VAR.#
V
DATE L
C. U. P. # '"
APPROVED 0
APPRO
BT
IC
DATE i L�
lie
a� D
SD. f*r.
THE AMOUNT SHOWN DER VALUATION 1E FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
PERMITFEE $
73s
MAN CHECK Sz�
TOTAL FEE /I�
z
LU
21
J W
CK
oU
:a
O
N 0
0o
�0