HomeMy WebLinkAbout141 MORRISTOWN LN - Building Permits 4`,4W MFS9 CITY elP COSTA MESA
BUILDING DIVISION
F `i'�' .�I DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
PERMIT 06-01345
St*Pcmano es.
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 141 MORRISTOWN LN Status: ISSUED
Suite: Applied: 08/08/2006
Vicinity: Issued: 08/08/2006
Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N
Parcel Number: 41916273 Zoning:
Applicant: YOUNG, KORY
Address: 141 MORRISTOWN LN
Phone: 949-232-9428
ISSUED BY:
COSTA MESA,CA Zip: 92626
Owner: YOUNG, KORY
Address 141 MORRISTOWN LN
Phone: 949-232-9428
COSTA MESA,CA Zip: 92626
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CHANGE OUT WINDOWS THROUGHOUT S.F.D.TO MEET 1997 U.B.C.EGRESS REQUIREMENTS. REPLACE WINDOWS WITH DUAL PANE,
VINYL,LIKE FOR LIKE.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $5,885.00
Permit: $125.25 Claim Valuation: $5,885.00
SMIP Res: $0.59
SMIP Corn: $0.00 -
Other: $0.00
Inspection: $0.00
. Total: $125.84
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0. - Rear 0-0 Left 0-0 Right 0-0
ACCESSORY . Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
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: This permit shall automatically expire and become void if work is not commenced wlihin 180 days,or if work is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS -r
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: • .
0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This,..,/ section need not be completed if the permit is valued at one hundred dollars($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 as to become subject to the workers
compensation laws of California,and agree that III should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these/pr .sions.
Applicant Signature: ^ � 6- --JN( i GDa(e: f. /,0154
WARNING:FAILURE TO SECU ORKERS'IYA4PENSA COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL TIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100, IN ADDITIONS THE COST 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.LIC.If Class It
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
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).):
O 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 ono 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.).
_0'ff_I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exe •. under sec. Business and Professions Code for this reason: ,, `
Sgnatuia: (a. , ' . X�1/e a— C Date:—a'/bb/ .i.1�
Verification of Ownership by(type of docu ant,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O 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.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 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? 0 Yes 0 No
(Section 25533 of the Califomia 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? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ 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? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safely 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? 0 Yes 0 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: Date:
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 egr a to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-de ed property f r i spection purposes.I agree not to occupy or allow occupancy of any building authorized by this it until final inspection.
caul ' t b1 zc.
— igna, 0f Legal Owner(s) L-Daie--
And/Or Authorized Applicant Date
CODE A INSPECTION TYPE PATE INTRIALS CODE I INSPECTION TYPE PATE INT AL5
•
1616 Fixed System Final Fire Prevention • 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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 X A
.22_ z
- �'.<. - C
in. = s:: eery 4 &a Weda sad e taddecuf
OWNER-BUILDER
04
VERIFICATION
Address: is4I Md -tst'ca-J\ k.Atic 617.I721b Permit# —0/3 q
____-
A
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
unr � �delay in processing and issuing your building permit. No building permit will be issued until this
er' received.
WI personally plan to provide the major labor and materials for construction of the proposed
it► property improvement. [/Yes ❑ No
I(have/have not) \-wie }36T signed an application for a building permit for
the proposed work.
I have contracted with the
afollowing person (firm)to provide the proposed construction:
aC-
Name Ni - ,a.1 V1cto1.) wiKit-,-:-�,1 Vti1C
Address (-A( W. l(*VeLLil Ave- City Ci d &.t
Phone(5Vt') S(Z - 0006 Contractor's Lic. No. —71 B 2L
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address City
Phone ( ) Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the following persons to
provide the work indicated:
Name Address Phone Type of Work
104246 (Rev.11/04)
•
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.
•
1 \
Si• .. /✓v I if i` Date: 42:104
•Name: KUIZ`j "1" ,i✓C4
(Printed or Typed)
C.D.L _- —:
K
For more information call City of Costa Mesa Building Division at(714) 754-5273.
•
•
1042-46 (Rev.11/04)
PROJECT ADDRESS: 141 MORRISTOWN LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069497
W. OWNER'S NAME: LOUDEN LORENE
ADDRESS: 141 MORRISTOWN LN PERMIT NO: B 069497 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; T/O RESTH 6 REROOF W/COMP 6 HOT MOP SQ FT: 2,058
ADDRESS: UNIT:
CLAIM VALUE: 2, 508 . 00 CALC—VALUE: 2, 058 , 00 GROUP OCC; R-1 /
PERMITTEE: STOUT ROOFING, INC, ( 310 ) 923-6775
ADDRESS: 9700 WASBURN RD COMMENTS : REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DET. REQUIRED
DOWNEY CA 90241 y *****************************************yE************sr***********************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMEN TS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LW,: 059377QQQ'''fffSTATE LIC.: 402536 CLASS: C-39 EXP; 10/95
Date:ial_9 gL signature:_ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATIONDEClARATION: Ihereby affirm that lhave acenilicaleolconsent toself-insure oracertificateolWorkers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
Compensation lPGN4tp(e2q }[pddiedcopyhereof(Section3800,Lab.85/19/95 LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
°OLICY NO.: J I[ O J 7 EXP.DATE:
COMPANY: REF x PARKING REQ• PROV; PARCEL; 41916273 ZNE: REF NO:
❑ Certified copy is hereby furnished. LS Certified copy is filed with the city Building Division. / PLANNING NOTES>
Date: ID J9 1gLi Applicant: A *******************************************************************************
EXEMPTION FOM WO KERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($108)or less). DEVELOPMENT SERVICES REQUIREMEN TS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California ZONING APPROVED BY DATE:
Date: Signature: BUILDING APPROVED BY
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE;
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 tending agency for the performance of the work for APPLICATION ISSUED BY: Y' DATE; 9544
which this permit is issued(Section 3097.Civ.C). **************.************* *************************************** *
LENDER: ************************** *M************************************** ** ***
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Lawlor the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish.or PERMIT 54 . 00 , 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
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(S500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
C structure is not intended or of fered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 , 00 0 ,00 54 , 50 54 . 50 ,00
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 REVENUE DIVISION TOTALS--> COLLECTED: 54 , 50 OVER/SHORT: 00
improvement solswithin one year of completion,the owner will have the burden of proving he/she did not build or improve
fororthe purpose
of Sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
p
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 .0
S 0
❑ and Professions Code: The Contractors'State License Law does not apply to an owner al property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law).l am aware *********'******'**********************'******************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAKDOWN
❑ I am exempt under Section: B.&P.C.
1 for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 2058 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 002,058 , 00
I do hereby cemfy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any luture 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 Duality Management District.Residential construction applications are exempt from
these provisions.
Dates Applicant:
I hereby 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 representatives of this city to enter upon the above-mentioned
properly for inspection purposes. 01 00170459-00170$00 1-1226T
f_1T
f �.Q /� DATE: 10/25/94 TiflE: 12:226 54.50
Date: 1 Sia v fig Signature:
Driver's License or al Security s;
1641.46 Wmte—Budding,Green—Code Enforcement.Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
I/ 1c%
CONSTRUCTION AND PLANNING F L & SPA I
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
I
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � ,,;,p 53. Steel Reinforcement
3:-,EItectrical Condu t 41tilityUndrgrnd, 54. Forms
4.,fiectrical Conduh.t.ndrgrnd. 55. Electrical Bonding
5.-•Steel Reinforc rrignt 56. Rough Plumbing & Pressure Test 2 I
C it
Ce.{ectrical UFCRit3rnd. = 57. APPROVAL TO COVER-GUNITE 1
•7.-Footings _ - '4-1 58. Electrical Conduit-Undrgrnd. :'
8.•Foundation 59. Gas Pipe, 0 Undrgrnd.,Test - r• I
9..Water Pipe•Undryrnd, 60. Backwash Lines, P-Trap, 0 Undrgrnd. I
10. Structural Floor System 61, APPROVAL TO DECK I
11. Ripperty Sewer Ling & House Connection 62. Backwash & Receptor.Final I
12, Sewer Cap i, 63, Heater & Vent-Final 'I
13, Roof Drains 64. Plumbing System - Final
14, Rough Plumbing 7,- Electrical-Final 1
15, Rough Electrit4I-Conduit_ 66. Solar System•Final
4.
16, Rough Electric Wiring - 67. Fencing & Access Approval 1
co
17, Rough Wiring Sign °') 68. APPROVED FOR PLASTERING }
18, Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1
I
19, Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20.nRough Factory Fireplace i 7:nj ..•y * _i • * ^APPROVALSOOPermit# ' ' ^'
J' C T Y . 1 -,r,- .''S i i-j ? . . a T, r. •F c. r, t n1 C:
21 ,Pusis,in.Striictt ti; ;.1." '� * -' e ; i ge "`� 'l , '-,
_ 70. finder cutin H ra
22. Ducts, Ventiiatirjy i it P9in
* f ?71. ProducCg 3G.s OOii
231:: -Rguyh &Test -. t : r r • ) �t
.,t - _� ,� , 72. Underg'roun�l Flush)
i.
24.IRopf Flaming ,;. i Mc • r 471 cr + [;73:0Underyrnd.Storage'Tank�Gas 0 Oil
in t 4• . .. ".•rn
25. Rolf Sheathing 4 = 1/.41--?C( rtk . - 74;,Overhead Hydro
26.-T-Bar Ceiling (Structural) & ton_ocoat * J, '� J e 1 75-y'Dry Chemical •• t .-4 I n;
27. Frame and Flashtsr� 37 r.t, i cr ,� ; ; 76"D'ry Stan j]�e `�:r; • "- -rt x
.i28. 'Lathing-fir Siding`,; , as "1 .i^:; {II _ ••1 r1 ••1; . 7747 FIXED SYSTEM F.INA12 -'
ri
.29. Insulatigp , r - _ I * 4. 78s-FIRE PREV. FINAL _ > rc Y
30, Drywalt-i*1ai4ng ,n . , s .1 44EALTHTDEPT.. REQUIREMENT
31. Plaster 3Sowq Cosa , 1 tl,T t ; „792FINAL INSPECTION ; •i I
32.2ElectncatPo er,MatgryFinali J4 „t I • * t n80mFFOODCE�RTIFICATEISSUED
_ •-e_ • , -
7.
33.':Final Electric) - : I `' t 1 1: e 'Nofgs: :a "LI'1I Y7:, ♦ -t., t
34, Final Heating & Ai;CogditicinTRI I i N E g - t 71
I I. > -
35.'Final Gas Pipe-Togr, 1 •• , � I. , - ij r:, -
,36. Hoo orCano rte ' t .. J -i
PYn•. 1 n-t _ I _ J .. r -,n
37. .Final Factory FiFd',fiacC_, I 27-.:44t' . I ; . • 'y $Vi
• .. .. 1 . 'l 1 a , a,
38. Final Plumbing n: I* • • 1" i,
39. Watee Service•Finels 1 ,, t I It ' n'
•.
,40. Gas Service-F,{nal : . .., , •ri p - J4. J
41. Solar Domestic-Final 7. '• * :* 1 rt t r:R• •-1 •
42. Backflow Preventers 0' =.
43. Backflow Irrigation' a:`:= t ' * '..•'-)
r . t ,
,44. Landscape Irriga;ion Systemn,q -• u• r _ • •♦ c' u - .:-
A5. Sound
t45. .Sound Attenuation n;t�1 '' ., �. '^ " F E : - t.- ri:.y '
D: .. .. a to ill t t_ _
46. Handicap;Regulaf,ops 1, ' Irl •• •• •+ • 'i _ _
47. FINAL STRIVCYURE & BUILDING 6/fes/I !li44/- -_,-
i _
t r '
48. FINAL PLANNING 1 `I, _ . I I. : ,j rs-
49.I:Elecvic Release to Edison ' I I It - ' r .
.. - . ' ;n 4 . - n
50. Gas Release to Sout}lern Califggtia Gas Co i it f`r
51. CERTIFICATE OF:OCCUPANCY' - - • . r :
_—
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA- - '-- - PERM NO. - - " TRACT NO. LOT NO: . •BLDG.NO. - • -' - - •
-
CONSTRUCTION PERMIT `?7%9S ,
Project Address/W 4/27 o Pi.S7`te"14.... ,./..-n ' TYPE OF CONSTRUCTION - -
Oivner� ,....-t
ex) ' - Phonef •,54;v0 ❑ NEW 0 ADD ❑ ALTER=^`ON 6241 10/02/61 - GeC' TL
Address - - - 0 REPAIR 0 CONVERSION ED DEMOLISH
ZONING REGULATIONS •
Arch/Eng. -- License No. 0 OTHER - _
DESCRIPTION OF WORK A.P. _ .
Address - - ZONE -- PLNG. REF.
Contractor Phone(f� - BUILDING -. Tp BUI LDI NG
�4C /. SI<J��✓FPS Xf/�1)J TYPE OF PERMIT. SETBACKpC/L ST. PROPERTY LINE
Address "f',S " .114/7Jat C� C/!�,In (/anip 0 GRADING ❑ 'FOUNDATION ❑ STRUCTURAL 7 'LIEFT YARD •
LICENSED CONTRACTOR DECLARATION - ❑ TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICAL SIDE YARD -
I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT
mencing with section--7000) of Division 3- of. the Business 'and 0-OTHER - _-. -
Professions Code, d my license is in full force and_reef t. PROJECT DESCRIPTION REAR YARD(TO P/L)
License Class / n mens¢ ���rr i PKC:SPACE REQ. PROVIDED
Date 9,9. ' Signature /kms 'aT-c_r-�- : ' SQ.FT. _
WORKERS'COMPENSATION DECLARATION - . OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH -PARK FEE $
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY DATE
certificate of-Workers' Compensation Insur nce, or a certified'copy - . . . - - . . -- _ - - - - - -
thereof(Sectign 38pg.0+ Lab. C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS:
Policy No. 0-44: // Company /Lt l(L �_L-w_-LdJ+[` .- _- - 1 - - - -
❑ Certified copy is hereby furnished. . . . REMARKS: • '
- - .. .. -.
❑ Certified copy is filed with the city Building Division. -
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - -
(This section need not be completed if the permit is for one hundred _ - - -r 1
($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 as to become PLUMBING '- ' '"PLAN"CHECK- - ' '- - ELECTRICAL -' PLAN CHECK - --
subject to the Workers'Compensation Laws of California. - _. - - - uw ELLINb - GARAGE
Date _ Signature
BATHTUBS SHOWERS SO FT. 50 FT - - .
NOTICE: If after making this declaration, you should become subject TOILETS • • URINALS- - - GENERATOR - oy'KW_1-10-KW - •
to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER „ •
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - - APPLIANCE 10-50 KW-50+KW-
revoked. . _ � a./. •
CONSTRUCTION LENDING AGENCY KIT.SINKS' - ' DISHWASHERS - '3' -4IB Ca MOTORS' 0-1 HP=1.10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS ' ' SUMPS' ' ' - - . - (I NC.SOLAR) -10-50 HP 50 +HP
formance of the work for which this permit is issued (Section 3097
Civ. C.). - - - - - - - FLOOR SINKS -- FLOOR DRAINS - - ' FIXTURES' 'OUTLETS 'SWITCHES --- '
Lender's Name -• _ • _ _ - •
Lender's Address DRINKING •
FOUNTAINS 1• ' - " - -"- -GAS TUBE-SIGNS - - -
OWNER BUILDER DECLARATION INTERCEPTORS—CLARIFIERS- - POLE LIGHTS -' -- -'
I hereby affirm that I am exempt from the Contractor's License Law for
the'following'reason (Section 7031:5 Business and Professions Code: -SWIMMING POOL -P TRAP ' ' '- - CONS I RUL I IUN _ _ -
Any city or county which requires a permit to construct, alter, POLES METERED SUB -
improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE - ALTERATION - ' PANELS . MAIN SUB-
quires the applicant for such permit to file a signed statement that he - ' --
is licensed"pursuant to the-provisions of the Contractor's License Law GAS SERVICE - OUTLETS ' SERVICE -'
(Chapter 9 (commencing with Section 7000) of Division 3 of the •
_
Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT- - - " ' ' - " --- - '
basis for the alleged exemption. Any violation of Section 7031.5 by -
any applicant for a permit 'subjects'the applicant-to a civil penalty SEWER CONNECTIONS - - - I'- ._ ' - -
of not_ more than five hundred dollars ($500).
1,
0 as owner of the property,or my employees with wages as their • SOLAR TANK - COLLECTORS„ :y __ A ,
sole compensation, will do.the work,and the structure is not intended __ _
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. -.4 ` _. - -
• - ISSUE FEE -
'Contractor's.License Law does not apply to an owner of, a property -. - — APPLICATION APPROVED BY - -DATE- -
who builds or improves thereon, and who does such work himself or ISSUE FEE
through his own employees, provided that such improvements are not _ _
intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES r
is sold within one year of completion,the owner will have the burden • _ '
of proving he did not build or improve for the purpose of sale). • •
HEATING SYSTEM 0-100,000 BTU PERMIT G $ - -• SMIP - ,$
❑ I, as owner of the property, am exclusively contracting with AND'DUCTI NG - - - - -
licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT
and-Professions Code: The Contractor's License Law does not apply to - _ � U ISSUANCE $
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ }
tracts'from such projects with a 'contractor(s)-licesned pursuant to SYSTEM' - - - • GRADING $
the Contractor's License Law). 100,000 +BTU PLAN CHECK $ - -
❑•I-ant exempt under Section • B.& P.C.for this - -" 1 $
BOILERS BTU 'ELECTRICAL $ -
reason - - PLAN CHECK $' •
MICROFILM,$_
Date Owner
SYSTEM REPAIR,ALTERATION - TOTAL FEE$
I hereby certify.that I.have read this application and state that the above EXHAU_ST SYSTEM MULTIPLE - MECHANICAL $ - •
-
- - LESSANEP
ordinances is correct. I agree in to comply with all her. and county rize PLAN CHECK $ VANCE PC --_-
repres nt and state laws rel ting to construction,and hereby authorize -
represent five of this ci to enter upon the above rationed • - - ' '
property iyn$�¢then urpo@es, L _ /� • 00 •
Signature "' Date _•' ��� FINAL FEE $ £0
Drivers' License or SS 7P -� ISSUE FEE- -
•
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING -. POOL&SPA . - -
APPROVALS Permit# Date Inspector APPROVALS Permit# Date ` Inspector
•
1: Temporary Electrical Service or Pole 43. Pool & Equipment Location -
2. Soil Pipe-Undrgrn - 44. Steel Reinforcement - -
3. Electrical Conduit Utility-Undrgrn ' . , 45. Forms -
4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding -
5. Steel Reinforce - 47. Rough Plumbing & Pressure Test - ' ' . • `
6. Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE- - - '
7. Footings49. Electrical Conduit-Undrgrn
8. Foundation .. . _ 50. Gas Pipe, E Undrgrn,Test
9. Water Pipe-Undrgrn - 51. Backwash Lines, P-Trap. ❑Undrgrn - ''
10. Structural Floor System - 52. APPROVAL TO DECK - •
.11. Property Sewer Line & House Connection, 53. Backwash & Receptor-Final
12. Street Sewer Connection 54. Heater & Vent-Final _. . .
"1. Rough Plumbing - 55. Plumbing System - Final
_ . Rough Electric-Conduit - 56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final
16: Rough Heating & Air Conditioning - 58. Fencing &Access Approval
17. Ducts, in Structure - - 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing ._ -
21. Roof Sheathing •
22. Frame and Flashing - . NOTES:
23. Insulation .
24. Lathing & Siding - . .
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric - -
_ 29. Final Heating & Air Conditioning •
. Final Gas Pipe-Test
..I. Final Plumbing. 7ofjeevj 8
32. Water Service-Final
33. Gas Service-Final -
34. Solar Domestic-Final
35. Landscape Sprinkling System •
36:--Sound Attenuation ,
37. Handicap Regulations .. ' -
38. FI NAL STRUCTURE & BUILDING ..
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY ,
' No Date - . - . . r
OWNER AftN VWJ.h Mini ; UO. DATE b-22-b'(
JOB ADDRESS 1 1 Morristown Lane BUILDING PERMIT NO. 27188
GENERAL CONTRACTOR Owner-131dr• DESCRIPTION OF WORK Res.w/att.gar.
AP No. 141-701-03 LOT 263 TRACT 5160 FIRE ZONE VALUE $ 17,640.00 _
INSPECTIONS Signature Date GROUP' & J TYPE V ZONE R-3
Soil Aciffiar-'-L7 PERMITS ISSUED
Gas grin. g SUBCONTRACTOR I Date I Number I Signature
Water kei/L¢/-C)-/3-ten • �L//"� Plumbing ,,[[�7 /� p
Rough PlGgmbing r-n-0 /YGLytjljdfnr}prL(rilOp. 4- -ZN -re;/74
Prop. Swr. Line f] House Con. //��a - /
Sprinkling System
Miscellaneous _
Rough Heating and Air Conditioning /Kra -2- -!-
Temporary Service or Pole
Underground 0 Power {]
Rough Wiring I /-W 7a•(?Y Heating and VenttA
TrenchesFors� @
I Steel Reinf. I_�,yT
fx{e -4 T/Lc,7s_772..„...v, (- �.y-& 7 ,Ca/0 4:6/
bloor System mI , {N o- 1/3 67
Bond Beam 0 Steel Reinforce 0
Sheathing t
7n a- i / 7
Frame and Fla�sh�i E
Lathing — In f9' Out f�
n 4,9
Plaster, Brown Coat C- G n
Structural, Final ears �� qy�/�� _
Heating, Vent., Refrig. and A.C., Fin. /e yt74' t(C1 �- _ -"-F--�/4fe'
Plumbing, Final and Gas Test TA ti; .,
Electric, Final . /e•3/-6 '
Building, Final i/ 2)1t' (D/S/[7
27198 Pato
COSTA MESA BUILDING-SAFETY DEPARTMENT JUN 19-67M001625* A 85.50
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92628 -
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
■UILDIN? !4/ , 1 O('I/� �� � For Office Use Only
ADDRESS •'LM�-
R[C[IPT NO. [RNI4 O.
COSTA MESA. CALIFORNIA ,- i,Q
//�� / ' R[c(cfyO��OT p/,,�R[CEI ED D_ISS.UED
OWNER nat.,. L/L L / (!�' i (!/ 1�,� - 7 `� a�-G�
1�i/ eulLDlna /�/ yyt/L!C/
MAIL a LI (/ 0 ADDRESS ,//
ADDR[eQ/ LIC;��({(\/�W�/.C4^"nCAD SO �Q']� (�� I (//�J
FIRE
CITY (t f`L(.L 640- 4/0 NOL8+•l,2-1 r( ZONE //�TTYPE {I/ OROUPI�}! '/'1/ -
(/}• • �j///����ra� QL/j APPROVED /l .�J 69.-14
1 -
OREMITNadSEBR\ 1 �y'i`v'y.L NT Q.723�IZZI BY' ,/P\ DATE f0 V
C �7/L�L/�(/ C F. 'q ZONING '5,_,,,,e)
ADDRESS (.d,�, (� E. x�,`�l-?-u�P ti
CONTRACTOR 41/014-4.
#ON *T 3I
'LAN'2--I SDILSE b!Teo, �7NEW ce / "
LEGAl. ON
ADDRESS r,.l.L(C ^�
CITY Q CC,66V✓- A.P.NO. / it/-- /2 0 I -- o )
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL SO"TO SIDE a REAR P.L
LIC.NO. NO,
VES
SIZE T� / ( NO.or'LonAL (U.B.C.REQUIREMENT)
OF LOT .ALO )C7(0 I NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET)
SETBACK LINE FROM - 'Rom- UFT. PT.
CENTER or STET REAR TAR
SIDE YARD LEFT RIGHT R.SIDS OPT. IT.
DESCRIPTION OF WORK L SIDE 0 FT. FT.
NEW ALTERATION — ADDITION I REAR V PT. Pr.
DISTANCE DBT. BET.MAIN ft
REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.BLDGS.
BUILDING I HO.OF LL VAR.* ,/ DATE
SIZE r/LO 'C O ROOMS T STORIES C.V.P•# —lY� APPROVED 12-I g-(02
EXTERIOR WALL ROOF l / / /� --'J
COVERING / ! ',n COVERING 1 .11{' 111;17/7.1V. � � DATE 6 � c b��p /
USE OF UILD Ne )WORK TO,E P ttMED /l HOLD FORaSpec AL REQUIREME TS a
/ IGCC CC�i
C-- 1.99 ---7-g-,
y'�/ �� 1
/,2.3o2SO.FT. -
I HERESY ACKNOWLEDGE THAT.I NAVE READ THIS APPLICATION THE AMOUNT• N UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE.IR CORRECT AND AGREE TO CAM. PURPOSE OF ABUSNING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND RATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. 5� q
SIGNATURE OF .. 00 PERMIT FEE 5 /O a
PERMITTEE � ? .L a ��� ` ' $// /,/� PLAN CHECK $ �o ��� w
AUTHORIZED AGENT, //_/'Y L
.,. i TOTAL FEE $ erS,SO