HomeMy WebLinkAbout1780 HAWAII CIR - Building Permits ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA C•NSTRUCTI N.PERMIT R`��` IT N TRACT NO. LOT NO. UNIT NO.
Project Address 1 Irl. 1 / 50 _ 6298 5%2878_6 _ 540 . T
Applicant's Mailing Address ,7 l �( TYPE OF CONSTRUCTION ❑ NEW LI ADD U ALTERATION REPAIR - V '
CC'' ff��--pp I 7'� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name T1 Phonet�27�1..Q�2 V DESCRIPTION OF WORK/USE OF BLDG. —
Address S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT U GRADING �,e FOUNDATION ❑ STRUCTURAL E Front 0
. Address y ,�JA /j C 0 TENANT ❑ ELECTRICAL 11��'i PLUMBING ❑ MECHANICAL BOTHER Rear N
Contractor's Namr�llp �Yd /-�Pho�ne C Right N
Address(mailing) T-rw�i[ C�/1/�/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY
3'\^ � CONSTRUCTION TYPE _ _ VALUATION $ K Left G
City,License No. V !
- R
ZONE GRADI NG CU.YDS. ACRES ' -
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req,/Provided E
I hereby affirm that I am licensed under provislon5 of Charter 9 (commencing Remarks: Planning Note •_ O
with section 7000) of Division 3 of the Business and Professions Code,and
•- 'r+ .s 2 1f1Q6 M
my license is in full orce .nd effect. IL. s`�,"a ,I 7 IJO 5
T
License Class 'cense a • ,
Date — Signature fa-.A I I •f1 ' s. PLUMBING FEES
A
WORKERS'COMPENSATION DECLARATION Bef Sink Showers \_ FEES'
•
I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL
of Workers' Compensation Insurance, or a cent( d copy thereof (Section Backflow Preventer Service Sink
3800, Lab.spa$,`� Automatic Washer Transformer 0 15-50 KW
Policy No. Li Company Backflow Irrigation Sewer Cap0 50+KW
Construction Pole Sub.
8 Certifietl copy Is hereby furnished.
/Certs 'etl y Is filed with the city e n DWI n. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date E 1` Applicant /A .1./ p�
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers _ Solar Collectors Dishwasher Meter Dover.100 amps -
ttt-' (This section need not be completed If the permit 14 for one hundred ($100)or
less)-. Dishwasher Solar Piping Dryers ❑Gas OElectric Sub Panel
Lc 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 Drinking Fountains Solar Tank Fan Motors❑0-1 HP 01'h-8
Workers' Compensation Laws of California. —
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. ❑9.15 HP 016-15+
NOTICE:If,after making this declaration,you should become subject to the _ Inc.Solar
•
1 Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Sinks Urinal . Fixtures
Microwave
Comply with such provisions or this permit shall be deemed revok¢tl.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
----• of the work for which this permit Is Issued (Section 3097 Civ. C.) Interceptors - Water Heater a Outlets Range
Lender's Name
Lender's Address Kitchen Sink Water Service Switches '
Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any City or , Garbage Disposal ;Standing Sections
county which requires a permit to construct,alter,Improve,demolish Or repair P—Trap LaundryTrays
any structure, prior to Its issuance, also requires the applicant for such permit Generator 00-5 KW 05-15 KW Trash Compactor
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter.9 (commencing with Section Z000)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 civilI -
pe.nalty of not more than five hundred dollars($500).
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure Is not intended or offered - Reinspection Fee $16 Issue Fee $ 3 1'
for sale (Section.7044, Business and Professional Code: The Contractor's MECHANICAL FEES '
License Law does not apply to an owner Of a property who builds or improves _
thereon, and who does t work Nmm nts are Hot through ende hisr or her own - - DEVELOPMENT SERVICES REQUIREMENTS:
employees,hprovided that such r improvement
are not tor offered for Boiler • Hood Or Type 0
sale. If, ehowever,the building dof pro isgold within one year of com- Canopy Type 11. ❑ _ Zoning Approved By Date
prove the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale). _
O I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By � Date l2i�v�r}�
tractors to construct the project (Section 7044,Business and Professions Code: ((O
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts fpr such projects with a con-
tractor(s) license pursuant to the•Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ /O o PERMIT
O I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers I PLUMBING $ JC ISSUANCE . $ ,
Date Owner • Heating System& Ducting Registers ENERGY P.C. $
•
PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above 00. _100,000 BTU 0100,000 BT GRADING $ '
information is correct. I agree to comply with all City and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repro- MICROFILM $
inspection
fives of this city to enter upon the above-mentioned property for • PLAN CHECK 50% $ �� :l
inspection Pp 49 7 et/•7_ 1�/ - TOTAL FEE $ - L! '
Signature i / Date / 4 C? • MECHANICAL $
Drivers' License or SS# �'�� • 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 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 Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFEFR Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test •
9..Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring - 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOLJSPA 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. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing r 73. Undergrnd.Storage Tank 0 Gas 0 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:7.24nds, L,gar Ca. , LRA
34. Final Heating & Air Conditioning (.yYl (Amaze AC Pet LOSE vpc LCA
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
4451andscape Irrigation System ,
45. Sound Attenuation L.Zj
46.�Flandicap Regulations .
47. INALSTRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. C2ERTIFICATEOF OCCUPANCY
No. 9 Date
n �}- CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO c �O/4- DATE 141 /17-- 7 0
LOT NO, 4
ADDRESS /7?() ` iacac, G��iC !/ Cfri
The developer of the above entitled tract desires to sell the above set forth
lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that (he-she-they)
(was L .Y:_L) i advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa
Mesa as having complied with the conditions of approval which were imposed by
the city at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions necessary
for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the city harmless from any claim
resulting in damage or personal injury to the undersigned by reason of the
aforementioned uncompleted condition.
BY � Oa'
n��fl ch
U"
Bi t? ter. area_
I Developer : • b thorized
ln representa' ve
/ r
110
Lender
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA P/ jJ TRACT NO. LOT NO. •BLDG.NO. �i05Fj (y�Qa DB2 BsOO TU
' CONSTRUCTION PERMIT 3`/ ` ' _ . . . _• _ _„
Project Address /7yo
it LOA Y TYPE OFCONSTRUCTION •
Owner \I.?,
.?hn6i,'/ f2,' 5ci5 Phone4,56— )1((y ❑ NEW g-ADD 0 ALTERATION Vl�p '
Address { / Y,t, fie I:)4; 0 REPAIR 0 CONVERSION ❑DEMOLISH �Q ZONING REGULATIONS
Arch/Eng. UUU 111 �" License No. 0 OTHER
Address - - DESCRIPT ON O WO/p/y'( Pq(•�-IZ Cl /Cc✓ A.P.le
•
Contractor ,_ , , 1 ...0
7 J7) ZONE PLNG. REF.#
✓ l s ,/ , c pyl Phone f a•&i TYPE OF PERMIT BUILDING To BW1I LOSING
`,(_� p /� SETBACK CIL ST- PROPERTY LINE
AddreSS3 HTA boy FotIVEC P -) p. 0 GRADING . 0 FOUNDATIONJ0 STRUCTURAL SID YARD
LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OOPLUMBING ❑MECHANICA LLIEE TARD
I hereby affirm that I am licensed under provisions of Charter 9_(corn- /\ G '
mencing with sectl•n 7000) of Division 3 of the Business and 0 OTHER -
Protessions C.-e, • my se Is in full force - e - . REAR YARD(TO P/L)
- ,F - PROJECT DESCRIPTION
Llcens- /lass • L Li g. NO. — PKG.SPACE REQ. PROVIDED
Date ` Ii Signature .fit -41,-"tee SQ.FT. .. - '
WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE$
I hereby-affirm that) have a certificate of consent to self-insure-or a VALUATION ZONE ZONING APPROVED BY I DATE
tthhereof(Sertificate tt Workers' Comp satlany lnsurafjke, ; ^erpfletl copy GRADING CU.YDS. ACRES _
Policy No.
1p{1f W @0 ,E/plum K G ' r SPECIAL CONDITIONS:
0 Certified copyls hereby furnished. - "" REMARKS:
Certified copy Is filed with the city Building Division. _
EMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section need not-be completed if the permit Is for one hundred • - - .. • - -
($100) or less). •
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 tLu rvG GA HAtat , •
Date Signature BATHTUBS SHOWERS SQ.FT. SO FT ' '
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_I-30 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 LAYS APPLIANCE 10-50 KW 50+ KW - ,
revoked. - -
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP •
I hereby affirm that there Isa,construction lending agency for the per- SERVICE SINKS -• - SUMPS •
(INC.SOLAR) 10-50 HP 50 +HP
formance of the-work for,wry ich this ppcalit is Issued (Section 3097 '
Civ. C.).
Lender's Name OM SCIO` 1tz, FLOOR SIN •.. FLOO DRAINS FIXTURES OUTLETS SWITCHES •
Lender's Address DRINKING •UNT• N GAS TUBE SIGNS
OWNER BUILDER DECLARATION INTERCEPTS•S r 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 •••I P TRAP --- LUNS I NUL 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 SE S. CE 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 SER. ICE OUTLETS SERVICE AMP
(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 ' 1
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 - --
of not more than five hundred dollars ($500). - -
❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - ,
sole compensation, will do the work,and the structure is not intended •
-
or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SVS. `�. ISSUE FEE
'I Contractor's License Law does not apply to an Owner of a property - `',</$ ,
I
1, who builds or improves thereon, and who does such work himself or. ISSUE FEE APPLICATION APPROVED BY DATE
through his own employees, provided that such.improvements are not
intended or offered•for•sale:Vf; however;the building or Improvements `MECHANICA L`'`;7, •'PLAN CHECK.,. �'r ,\ ^ • SUMMARY OF FEES
is sold within one year of completion,the owner will have the-burden -
Li of proving he did not build_or improve for the purpose of sale). BUILDING
.��.tp ❑ I, as owner of the property;Nam'exclusively contracting with HEATING SYSTEM. O-100,000 BTU • PERMIT $ SMIP $
licensed contractors-to construct the project (Section 7044, Business AND DUCTING
100,000 + BTU PLAN CHECK $ `r' PERMIT
and Professions Code: The Contractor's License Law does not apply to ISSUANCE $
an owner of property who builds or.improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ 6 �'
tracts from such projects with a contractor(s) Iicesned pursuant to SYSTEM GRADING $-
the Contractor's License Law). 100,000+BTU PLAN CHECK $ _
0 I am exempt under Section B.& P.C.for this 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 EXHAUST SYSTEM MULTIPLE MECHANICAL $
PLAN CHECK $ LESSANE P
AD-
information is re la I ee to comply-tru with all city and county VANCE PC $
representative-
and taor laws r€ ing-to con t ruction,and hereby uthor2e
representative- offs ' y to erste upon the_above entloJ�sed
property for fins epi io • r••� - 2 ��/v 9 FINAL FEE $
Signature A C - �t� • f+
�
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. Footings • 49. Electrical Conduit-Undrgrn
8. -Foundation - 50. Gas Pipe, ❑Undrgrn,Test '
9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, ❑Undrorn
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 ' '
Rough Plumbing 55. Plumbing System - Final - -
i4. -Rough Electric-Conduit . - _. - -56. Electrical-Final -
- -15: Rough Electric-Wiring - - • 57. Solar System-Final • -
16._ Rough Heating & Air Conditioning.. _ _ bU. Fencing &Access Approval
i 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 • �� i �/ •
I 22. Frame and Flashing - NOTES:- I JO T -�1m+uX,- -Tao. .. - c .
23. Insulation -
24. Lathing & Siding •
25. Drywall Nailing
. 26. Plaster Brown Coat . - -
27. Electrical Power Meter-Final - • • - '
28. Final.Electric - - •
19, Final'Heating &Air Conditioning •
_ Final,Gas Pipe-Test
\.,I. FinalPlumbing -
•32. Water Service-Final _ . .
33. Gas Service-Final ' . -
34. ./ -40-Pr fail ee,1 7ifir/42.yi7ley - seo7/O azo. 3 d 7 e .5"; Ca.r eodg
• 35. Landscape Sprinkling System . _ �';�' ' `_
36. Sound Attenuation i - •
37. Handicap Regulations . . .
38. FINAL 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 .
ea, 4 eeaa 1/faa Remota, V a'saw
1S/INORMODIFICATION APPLICATION
CASE NUMBER: Sr O S 3897
PROJECT APPLICANT:
A- V ±er
PROJECT ADDRESS:
17E5 fo&wu,U, Cutcku
PROPOSED MINOR MODIFICATION:
Z1 -/1 OA Dtthnill-PLI I/ LI-14
10' w �2*ba.cic. lfr An 61/1a -et
_patto Awn axol . volt
REQUIRED FINDINGS: (Y=yes, N= no)
Y_ N_ The improvement will not be materially detrimental to the health, safety and general
welfare of persons residing or working within the immediate vicinity of the project or
to property and improvements within the neighborhood.
Y 4_ The improvement is compatible and enhances the architecture and design of the
existing and anticipated development in the vicinity. This includes the site planning,
land coverage, landscaping, appearance, scale of structures, open space and any other
applicable features relative to a compatible and attractive development.
I Approved _ Denied
PROJECT PLANNER: WI U 20 U Wale - 1/
te'bATE:3/45'17
NOTES: ,,, .. o1 YOpWA (tihl2 _5(c±4:o ldnc,a.A,
a0 WW .
White-Case File;Canary-Minor Mo ification File;Pink-Applicant
May 1997
CITY OF COSTA MESA -
< 9@ BUILDING DIVISION
:f ,"$ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
rit ! PERMIT
Sb 0- hip B01-00350
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1780 HAWAII CI Status: ISSUED
Suite: Applied: 03/19/2001
Vicinity: RESIDENCE&ATTACHED GARAGE Issued: 03/19/2001
Parcel Number: 13957212 Zoning:
Applicant: GURNEA, SEAN ISSUED BY: (� U
Address: 1013E WALNUT ST •
• Phone: (714)731-3425
SANTA ANA,CA Zip: 92701
Owner: BUNTING, RUSSELL C
Address 1780 HAWAII CIR
Phone:
COSTA MESA, CA Zip: 92626
Contractor: WEATHERLINE ROOFING INC
Address: 1013 E WALNUT ST
Phone: (714)731-3425
SANTA ANA,CA
Zip: ' 92701 License: 729560 "
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
• SCOPE OF PERMIT
REROOF:T/O WOOD SHINGLES&INSTALL 7/16"OSB SHTG, 1 LAYER OF 30#FELT,APPLY 25-YEAR COMP
SHINGLES.ALSO,T/O ROCK ROOF&INSTALL A TORCH ON SYSTEM.
2600 SO FT
N
1.
- FEE-SUMMARY
Plan Check: $0.00 Calc Valuation: $4,100.00
Permit: $111.25 Claim Valuation: $4,100.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00 - -.
Inspection: $0.00 - -
Total: $111.75 ,i7'
PLANNING 8,-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 '
NOTES:
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 within 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 expiratlon.of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-48(6lee)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I here affirm under penalty of perjury one of the following declarations:
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.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of tho 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($100)or less.)
O I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,end agree that if I should become subject to the workers'compensation provisions of Section 370 of th Labor Code,I shall forthwith
comply with the ns.
Applicant Signature: Date: />
WARMNO:FAILURE TO SECA: ORKERS'W NSATION COVERAGE IS UNLAWFUL NW SHALL SUBJECT AN EMPLOYER TO CRIMINAL NALTIE AND CNIL FINES UP TO ONE HUNDRED
THOUSAND DOLLA ),IN ADDmON TO THE MST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE R CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.A Class$
Contractor's Signatur. .� � _ Date:
CONSTRUCTION LENDING AGENCY:
O 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).
Lender's 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).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,faisework,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 0 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 California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If en 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 appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes U 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 ❑No
(If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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 agree 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-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
• • eggOwn: ate
a /
A,:O • orized Applicant D e
CODE If INSPECTION TYPE PAIL' tNTRIALS cODE. INSPECTION TYPE 2IE fNTMAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final7 � 208 Final Plumbing
200 Final Re-Roof 3'7-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
UWNtF APOLLO DEVELOPMENT DAIt 1-22-70
JOB ADDRESS 1780 Hawaii Circle BUILDING PERMIT NO. 31295
(' ORAL CONTRACTOR Same DESCRIPTION of WORK Residence W/Attached Garage
- LOT 29 TRACT 6694 FIRE ZONE VALUE $ 26,638.00
INSPECTIONS Signature Date GROUP I & J TYPE V ZONE R-1.
SOIL 30. j.'J PERMITS ISSUED
GAS US' !/ { SUBCONTRACTOR
n US' C (4.7•-70 Date I Number Signature
WATER UG- a,(6( -2n /A_ �(//�^7 1 Vita
ROUGH PLUMBING // U '7 //-Zt) di �/ ( L y bAriti—,4-7.° tram.- .
PROP. SWR. LINE HOUSE CON. /4 / aa�i // IC ne�� --jj .. - , •-:••. , [.i .
SPRINKLING SYSTEM rin /'Ann �, -/ -70$''„ - /'
MISCELLANEOUS �) y-
ROUGH HEATING AND AIR CONDITIONING 3� x/77�7/// L..r O
TEMPORARY SERVICE OR POLE i7 l0 7O
UNDERGROUND ® POWER 0 iA• 7t)
ROUGH WIRING /'J ]�� / Naaling an Vent,
TRENCHES FORMS STEEL REINF. I /- ,-]sem / /e�? li ... ''0/-20--0 44:97'/
FLOOR SYSTEM id .3-/ -/D �9'A C-✓7o A74'4' ---
BOND BEAM n STEEL REINFORCE n
SHEATHING fite 3-2 y')-O
FRAME AND FLASHINGrnIJ`t
� � le AI-b' 70
l--HUNG - IN l OUT (j_20-re
rER, BROWN COAT 1-7-70
SInUCTURAL, FINAL i EI; 1C
HEATING, VENT., REFRIG. AND A.C., FyML /6_P-70 _ /
PLUMBING, FINAL AND GAS TEST Y�I/ 4G)!^�J� SP° 4 4 t • e•/, .,,,-4.--- 50 ,c4'6' -.4
ELECTRIC, FINAL 7
BUILDING, FINAL ,,/#4,t
31295f/a tip 2 3G-$0 736* ***141.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
''J X n /�,s RECEI V /g�N� DAT_ 1 D DATE ISSUED
ADDRESS / / ✓ `� /41_4_0_62
-f�C/ ajii,r�rE, !0 i / 0 /_r7a-7()
_
PERMIT NO.
OWNER Apollo Development Corp. A.P.NO. 'a 1 ''95
MAIL BUILDING / �� / / n
Z
ADDRESS 1104 E. 17th Street ADDRESS I>;1-,eet)...e//i C_
.0 CITY Santa Ana NO. 547-9673 TRACT 6694 LOT 29 BLOCK
I- Z
Z < CONSTRUCTION NEW (ADD ALTER REPAIR MOVING DFM/11 ISH
—I- LENDER U. S. National Bank X III
a m Main c BRANCH Office
JN ADDRESS 190 S. Broadway, San Diego OWNER Apollo Development Corp.
m m ARCHITECT TEL USE Dwelling VALU$ 15,700
Ja OR ENGINEER Kermit Dories No.675-1164
0 N
FIRE
W c ADDRESS 3111 2nd Ave., Corona Del Mar ZONE TYPE GROUP-2-("---
0_
ROUP-2-'•tl W APPROVED
mZ CONTRACTOR Apollo Development Corp. BY DATE
:lir Z ADDRESS 1104 E. 17th Street
W 20 / INO.OF USE OF N
0 W TEL. PLANS 'BUILDING �(L�l/
Z F CITY Santa Ana 547-9673
—0 STATE CITY YARDS APPROVED YARDS APPROVED
y¢ LIC.NO. 252549 LIC.NO. 1690 MAIN BUILDING ACCESSORY BUILDING
0 SIZE NO.OF BLOCS.
(FROM C/L SET)
OF LOT 60 X 110 I NOW ON LOT -- FRONT Lt y FT. FT.
USE OF ___ ^�
EXISTING BLDG. R.SIDE , O- FT. FT.
I- SIZE OF NO.OF
Z NEW BLDG. 1782 S.F. ROOMS 8 STORIES 1 L.SIDE 0 FT. f FT.
UEXTERIOR WALL Per ROOF
_ COVERING'. Plans COVERING Shingle REAR 13 FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET. BET.MAIN&
Cl.
d MAIN BLDGSACCESS. BLOCS.
Q f .VAR.* I' DATE ,`
0 Construction new dwelling with C.U.P. to J�&.0 APPROVED S—>o— J
Nattached garage. :7ROVED (0,40 E (ehb 49
a
o 1 HOLD 1 OR R QU( rM
U I hereby acknowledge that I have read this application and state ANTS
D that the above information is correct and agree to comply with
C all laws regulating building construction, and I shall not employ
I— any person in violation of the workman's compensation laws of
the State of California. b
Z I hereby certify that I am properly licensed as a contractor under / 7� SO. FT. t 0
tho State of California Business and Professions Code, Division 3, THE AMOUNT glOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2
am exempt from the provisions of the State of California Business VALUATION ?5/,-
^y'/
and Professions Co Division 3,Chapter 9. /5/l DD w
PERMIT FEE $ DN
Signature of / //// �J y/y L/.z� m
Permittee •M�f r r/'Fs-. $ 01a // PLAN CHECK $ / /�0� E
f8
Authorized Agent // LL
TOTAL FEE S /// 0 D
4)
OWNER BURANDT Ferdinand A. DATE 4-5-72
JOBNADDRESS 1750 Hawaii Circle BUILDING PERMIT NO. 34536
ERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Patio Cover
Ar No.139-572-12 LOT TRACT FIRE ZONE VALUE $ 400.00
'SINSPECTIONS Signature Date GROUP J TYPE V ZONE R-1
OIL PERMITS ISSUED
GAS SUBCONTRACTOR
Date 1 Number 1 Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM
BOND BEAM rl STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING�-
T
I NG — IN L I OUT n
F .ER, BROWN COAT
• STRUCTURAL, FINAL Electric
HEATING, VENT.. REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL
'.PP 7?PafBOIO 157ct t*** .
� 5 Q3
34536
• COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
AT,E ISSUED
BUILDING} I"1 go HkWk1t CI 62 cc(„ REC V BY -/jDATE I1-- 41— 0776'
ADDRESS '1�✓ c� r,,. M. �,I "�+ t < 'y
OWNERTE R.DI NAND At 3u RA ' ., /� A.P. NO./.1 .. ;—/c PERMIT NO.
BUILDING
ADDRESS Ii 8O I`kWA- ( I Cl RCL-+ ADDRESS/7/��JO// - V r __-�
tl 0 CITY COS i A_ M iz SA- N0.04-LU t• lf TEL.— 27SL TRACTT/ ' 7 I LOT097 BLOCK
Z
Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOLISH
O cn LENDER
J D BRANCH /�/J /��J,/� // J{..
_IV) OWN t d/ /Jzwz +id
Q W ADDRESS
c0 JVALUE M
m ARCHITECT TEL. USA//7t^—
J Q OR ENGINEER NO. , ...
U Cf) FIRE
W cc ADDRESS ZONE TYPE , GROUP
J O CONTRACTOR 'H O H F D w 1 - F R. BYPROVED A DATE 51 —27--
co Z ,
J ADDRESS •
W w TEL. ZONE NO.OF 4 USE OF NEW
lea
• = CITY NO.
_ / IPS' r BUILDING C
ZF-
W O STATE CITY YARDS APPROVED YARDS APPROVED
on IL LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING -
D 0 SIZE iNO.OF BLOGS. / (FROM C/L STREET) �t�
OF LOT NOW ON LOT FRONT FT. / FT.
USE OF .
EXISTING BLDG. R.SIDE FT. } /V FT.
__F SIZE OF NO.OF / / i ',..a-
2
/�
2NEWBLDG. ROOMS • STORIES . L.SIDE FT.
2 EXTERIOR ROOF
U COVERING WALL i COVERING _ REAR FT. ��� FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 MAIN SLOGS. ACCESS. SLOGS.
0 9 I D C D E tiDATE
RCUP#0QjAPPROVED
)
EGG- DATE IV—<5.--702/�-- fO/
RY J
20
VI hereby acknowledge that I have read this application and state C2N
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of N the State of California.I hereby certify that I am properly licensed as a contractor under SQ. FT.the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNIS FOR
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2
am exempt from the provisions of the State of California Business
and Professions C /��D�ivyi/si�on 3,Chapter/�/�py9. VALUATION `� az
/ PERMIT FEE $ rO N
Signatu dL ta/ K /set tF rJ / , / pez
Permittee /data/ $ ( .�� e, PLAN CHECK $ '—_ E
/ v / o
Authorized Agent cq/-t g-
%
` TOTAL FEE $