HomeMy WebLinkAbout254 Hill Pl - Building Permits(71d) 754•5273 • Fau (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAtltlress: 254 HILLPL Status: ISSUED
Suite: Applied: 09/27/2005 .
Vicinily: ROOF Issued: 09/27/2005
Primary Occ: R-3 Dwellings/ Cong Res <70 Type of Construction: V-N
Parcel Number: 43933236 Zoning:
App�icant: MURMAN, CYNTHIA DIANE
Address: 254 HILL PL
, . �..Phone: , 949-722-7677 ISSUED BY:
COSTA MESA, CA _�Zlp: 9262Z -
owner: MURMAN, TIMOTHY-J � _ ,'
Atldress 254 HILLPL -� - � - ., - �
� _ Phone. �`d �: . - " - "a �
COSTA MESA, CA � � . - .. Zip: 92627 �"� . � ._
Contracror OWNER-BUI�LDER • � � ��
Address. . �' � '
� ' � Phone: ' ,,, •• �
a�f' �� . .. '
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- Zip: Licensa: 000000 .� .,, . .
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Arch : , . . Eng: '. - � � ' .
Address ):��'r� Address: � - � -
� . . . Phone: ' �,- .. . Phone:. �
. . � , . . . `-a. ., . ,
� Zip: � - � Cicense: � �� � , License: '
. ' ' - _. '_ - _ _ , " ,�" . � -
>.s .. �" - SCOPEOFPERMIT � '� �,� =`, ' �� , bu_. ,
-' 7EAR OFF EXISTING ROOF: INSTALL 7,LAYER OF 30# FELT, 30 YEAR COMPOSITION SHINGLES AND REPAIR/RE�PLACE SHEATHING�AS
NEEDED,. 27 SQUARES WCLUDES ATTACHED GARAGE. - - �x, p, F: `�`"' , y;.., �
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. . . � _ . �, , .
� � FEE=SUMMARY � �- � ���' � ` '
' PlanCheck., ',���$0.00 " � � __, � � � • CalcValuation. � , � Ss,a000'o`
PermiY ; $125.25 � Claim Valuation:; ss,aoo.00
= SMIP`Res ; $0.54 �-�� ,
r�'� SMIP Com � -$0 00� � g_' :. � _.- � .� �,�� � "` ,
r `'. � Other. '$0.00 . ,� _ ._ 'r,;. � ��_. ,
�
�
;� s Inspection �$0`00 � ° , , ��
_. ,� � ,� �;
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Total. $125.79 `
PLANNING & ZONING
SETBACKS � �� ' � �
��•" �' � �
MAW�STRUCTURE-:Front';,0=0 Reai" -�0-0 '�Left 0,,0_�,' - _ Right .0-0� -
ACCESSORY� Front 0.0 " �Rear 0-�0�,, LeN 0 0-';�� �Right_� 0-0 =
� �`^ �s �
PARKING "�� Existina: 0. Reauired 0�: . Pr000sed -���0 - -
� ����,, .. �,
"+.'sl. . � YY,"'' ''
'�4 ^yr _ ' C • -
NO710E: Tha work authorized by this permit shall comply with all applicable handicap access requirements unde� 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 Inapectiona and final approval musl be obtainetl. Failure to obtain inspec�ions and tinal approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
�
WORKERS'COMPENSAnON DECLARAnON: ' - .
I hereby eHirm un0er penalry of perjury one oi Ihe following declarations:
❑ I heve and wlll meintain e certiticate o� �nsent to setl-Insure tor woi
work tor which lhis pertnit is issue0. "'se,
�;z's
❑ I have and will maintain workers' compensaUon Insuranre;�es, requirec
My workers' compensatlon Insurance carrler and policy numtier are:
Cartier.
(rn!s s�
pertni� is veluetl et
3700 of Ne
!'s a^`s
or less.)
ded tor by seclion 3700 of the Lebor Catle, for the paAarmence of Ihe
��
perfo�mance of Ne work for which ihis pertnit is iuuetl.
Number:
I cenify that in the peAortnanca oi Ne work for which Ihis pertnit is issueQ I shall not employ any person in any manner so as to become subjecl to Ihe workars'
compensation lews of Califomia, and afl�ee Ihat It I should become subject Io the workere' compensatlon provisions of Section 3700 oi Ihe Lebor Code, I s�all forthwlih
comply with Ihese prohsions/�•1 //��%��� � �} /
ant-Signeture: ! �/ .�"%�f � / ��"'�M'� �---Dete_ 7 �� �' � 7
IINO:'FAILURE TO SECURE WORKERS' CddFjP�'1SAT�W1 COVERAGE IS UNLAWFUL AND SHP11 SUBIECT qN EMPLOYER TO CRIMINAL PENA�TIES NND GVIL FlNES UP TO ONE HUNDRED
iAND DOLLARE (E100,OOO�.IN ADOfTION TO TME COST OF COMPENSAiION, DAMAGES AS PROVIDED FOFi IN SECIION 3�O60F THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARA710N:
I �ereby aHirtn that I am licensed under proV�sions oi Chapter 9(crommencing with Section 7000) of Division 3 of the Business and Professlons Code, end my license is in full
force an0 ettect. Lic. a Cless q
Comrectofs Signeture: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirm that there is a construction IenOing agency for the pertortnance ot t�e work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lendels Name: Lentler's ACdress:
Signature: Data:
OWNER-BUILDER DECLARATIONS:
1 hereby ettirtn that under penalry of perjury lhat I am E%EMPT FROM 7HE CON7RAC70RS LICENSE LAW tor the tollowing reesan (Sec. 7031.5, Business end Professions
Code: Any ciry or counry whic� requires e permit to construct, alter, improve, tlemolish, or repair any slmaure, pdor to its issuance, also requires the appliwnt for such permit
to tile a signatl statement thet he or she is Ilcensetl pureuant to the provisions ot ihe Contraaars License Law (C�apter 9(commencing with Sectlon 7000) at Division 3 oi t�e
Business end Professions Code) or that he or she is e:empt therefrom antl t�e 6a515 for ihe allegetl exemption. Any violation of Sectlon 7031.5 by any applicant for e pertnit
subjects ihe applicant to a civil penalry oi not more t�an five hundred dollers ($500J.J:
❑ I, as owner ot Ihe properry, or my employees with wages as ihair sole compensaiion, WILL DO TME WORK, antl Ihe structura is not Iniended or oHered for sale (Sec.
7044, Busineu antl Professions Cod6: The Coniractors License Law does not apply to an owner of proDerty who builtls or improves Ihereon, and who tloes such work
himselt or herselt or ihrough his or he! own emplqrees, provided that such improvemenis are not intended or oHered for sale. If, however, Ihe builtlin9 or improvement is
/ sold within one year of wmpletioq thB wmerDuiltler will have Ihe burden ol proving that he or sha ditl not build or improve for purpose of SaleJ. '
�`",1; as owner of t�e property, am EXCLVSIVELV CONTRACTING WITH LICENSED CONTRACTORS to wnstruct the pmject (Sec. 7006, Business anC Profeuions
�-•Code: The wNrectors License Law tloes not apply to an owner of propeny who �uiltls or improves ihereon, and who wntracis lor such project with e coniractor(s)
license pursuant to tha Contractors LiGense Laws.).
❑ I em eaempt unq9r sec. gusiness and Protessions Code tor ihis reason:
SignaNre: �- � �.LN✓1^o— - �. -•-- -
Own'ei ID venfied by dnvers lice se. a �es ❑ No �riveta�license No. /
Venficatian of Ownership by (type of document, i.e. - property tax bill ar tleed):
DIVISION OF INDUS7q1AL SAFE7Y PERMIT CERTIFICA710N:
❑ I hereby certity Ihet no excavation five (5) or more feet in depih into which a person is required to descend, will be made in connaction with work authonzed 6y �his
pertnit, and that no builtling slrucNre, scatfolding, talsework, or demolition or dismantling thereof, will be more than thiny-six (36) teet high. (Chep. 32. Grp 2, An 2, Sec.
341, Title B, Celifomia Atlministrativa Gade).
❑ As owner-builder, I will not employ enyona to tlo work which would require a permit from the Oivision of Industnal Safety, as notetl ebova, unles5 such person hes e
permit ta do such wodc tram the divisi0n.
Signature: Date:
Division of Industnal Sefery Permit Number:
CEHTIFlCA7E OF COMPLIANCE AND AIIT1�OiiVA710N OF ENTRY: I certify under penalry oi perjury that I have read this application end stete that ihe infortnation given is
correcl I agree to comply wlih all slate laws and ciry ordinances relating to builCing consWction, and authorize representatives ot Ne Ciry ol Costa MeSa to enter upon the
ebove-tlescnb d property f�or /in/s/p%ection purposes. I egree not to occupy or allow occupancy of any building euthorized by thisqpertnit uniil final in�ection.
/ / / L� ��--�'... . .''_. / � � 7_Q .s
�gnature:0f Legfll Owner(s),.;'. '�;'-"': �= � - �Da�a,,,�- :-
And/Or Authoh�ed Ap0licant Date
COOE 1. INSPELTIONTYPE
1618 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Root
201 Final Block/Retalning Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
PdIE II1IIIlAhfl
� ��
GODEt INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecincal
212 Final Fire Preventian
220 Final Planning Approval
222 Pinal Si�e -
250 Final Builtling/Occupency
P�IE 1[�LS
.
C� °� C?oQta �zleda �uit� Du.�ia,�o�L
OWIV�R-B[.ItLDER
VERIFICATION
Address: dS�t � �� P I Permit #:�� ���0 y
i .
A city or county, which is reqttired ro give notice pursuant to Section 19830, shall attach to such notice, and, as
a condition precedent ro issuing a building permit, require the completion and require the retum 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 retum this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building perniiL No buildinY permit will be issued imtil this
verification is received.
l. 1 personally plan ro provide the major labor and materials for construction of the proposed
property improvemenL ❑ Yes �No
2. I(haveAiave not) �tLV� signed an application for a b�ilding permit for
the proposed work.
3. I have contracted widi the following person (firm) ro provide the proposed construction:
Name �'YC�r�k Ft�V n 0.n(�e �
Address
Phone ( )
a �e
City � m�s �
Contractor's Lic. No.
4. 1 plan to provide portions of the work, but 1 have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone (
City _
Contracror's Lic. No.
5. 1 will provide some of the work bu[ I have contrac[ed (hired) [he following persons ro
provide the work indicated:
Name
10a2-A6 (Rev.11/Oa)
Address
Phone Type of Work
I hereby affirm that I have received a copy of the infortnation se[ forth in Section 19830 of the State of
Califomia Health and Safety Code and have completed the above informa[ion to the best of my personal
laiowledge, in compliance with this State law.
Signed: � {�1"�� � Date; � � q ' � 7 � � �
Name: �>"1 N 1-�y J"t U�' �� �
(Printed or Typed)
C.D.L. # OR S.S. # ���- �'
For more information call City of Costa Mesa Building Division at (714) 754-5273.
tOC2<6 (Rev.11/Od)
AOOPE55 OG BWLqNO:
ONNER9 NAME IF IQlOWTI:
�ooxEss:
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dPCX.ON ENO.'S �DDXE55:
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CONiN�C7dY5N�ME:
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AODXESS:
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MOTHY
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,CA 92627
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LICENSEO COMflRCTOfl3 DECLARRTION: I henby N'vm under penelly ol parjury the� I em lironeed uMer poviaona W Cheqer B
(mmmandnB �h SMion ]000) d Diviai� 3 W ihe Buaimes eM Pm/eanione Cade, eM my lioenea ia in hll brca end alled.
cmuc.No.: uc.cuss: uc.No.: EXP;
oda: comma«:
�WNER BUILDEfl DECLAflATION: I hereby dfi�m under penely W perjury Ihei l em i
Ilowin0 reeson (Sedion ]�Jt.S &n'vroee aM PMeeciom Cade: Rny ciY a muntY wM1
Eemoloh, w repair eny evuciure, yior lo h� bwence, eho requirsa the epplicenl lor euc
ia liceneetl W�euent m the prwieionf d Ihe Contredon Lironas Lew �Cheplm B(cam
Buaineae eM Prdeuions Code� or Ihe� M a ehe ia esamq Iherehom eM Iha buie /a
)W 1.5 by eny epdiceni Iw e permn eubjade IM upplicenl io e dvil penely d rot more
GJ i.do�,din.c�wnro.mr�dw�.w�nwea<amina:.aa�ro�eaua,
a oflered Iw aele (Section l0aa, Buw�ev end PMession� Coda: The Conlredon L
who Wdde a'vnDb� �hereon, end � tloea such work IimaeH or Mnetl a thra
im0�manle ere rol imeMed a oMered la eele. M, however, iha buikirq w'unprt
oweror-buiNar wiil heve iha buken d q�'i'p hs or ehe Ek rat build a imD� fa
� Pma'��ncoa�.°Tne�co'm�aao:l'��C:�'ia»'maaM�ioe�»acon�rena.m�
app!/ to en owne� d p
� convecb Iw wrh prqeaa wnh e cOmreGoHa) IcenaeJ punueni io tM CoMreda
� I am eeempl uMer Seclion: B. 8 P.C.. lor ihie remon:
om.: ow�:
I da Mreby cenity thet 1 em ewme W vW uMersienE �he repuiremame d Cel/omie Me'
2553a, enE ihel I a eny Mure buiNirp om+pam will I wdl nm (dreb aw) nead to can
e peimn lorconeliucibna moEiFulion hom�MAi�epement Oibria. Reu
pIOVI81IX19.
Dele: S- S- � qppcem�
Irom �M CaNrerlon lirome lew iw the
iiro� e permu to mnaWct, eller, impova.
t lo fib e ei0� �wament �het he w eM
p wnh Seaun )000) d Divuion 3 0/ ihe
qped exemqion. My videtbn M Seaion
b �uMrad dollue �SSOop.
Ihe xoM, eM IM sVuclura o nM imeMeE
irpoee W eele).
� tM v�ol� (Seaun )Oba. Bueiiwea eM
wfa bxtis a lmpwm therean uW wlw
se Lew).
553�. eM
anu la
Imm iheee
W OflKEH'S COMVENSATION DKLAP�T�ON: I hereby dfirtn uMer penelly d pe�jury aia M tM Idbwiip dedvazions:
� I heve eM wil meinten e cenNicele a��i m setl-ineure M wak compemelion, n pwided Iw by Sedian 3)00 al �M lebar
COEe, lar IM peNortnence W tM W�M br wlJch �M1ie pe�mil ie inued.
�] I hm erd wil meimen woMen' om�Denmtion inaureme. n iayui by Seqion �10p d ihe Lebar CaEe. br iM pe�ormeMe d tM
work la xfiich �hia permn ia asued� My wakere mmpenaetion iro rence ur�iar eM poliry number ua:
c� .
PdcyrNumber.
(This se tiwr nesd iw hs canpbted / �he permAw /w mro h�Mred Ed rs RIOJI w Iw.1
� I cenAy �hel in ihe pMormance W �� w� �w wh'rh �hia peimil �'ueuaE, I e1W1 ria empby erry pemn in vry menmr o es to
� beewna wbl� �o tM xwken' a�pe�� �a�re d Celtlor�e. vk apeee iM1m il I ehouM beeome eubjep lo iM wMn'
compameiion proviabne d Sedion J]W W �he lebor Coda. I ahhll Iorlhxilh camp�y xilh ihoae provitione.
Ome: Apd�
W�m/ny: F�llun b ucun wortlr�' M�V�tlon cmorap� h unkw/u( end �hsll su6/�cf an wrp/oysr ro eAMnel p�neltlu eM
clvll flrro� up ro ons huntlrW fhouuid �Il�n (St00,000A ln edlltlon ro N� cast ol romparulbM1 tlamspu u proWtlstl br In
SxHon ])OS o/ fh� LeborCorJs, inMNt, en0 /ffomsy'I /ww
CONSTNUCTON LENDINO 10ENCY: I hsaby elfiim uMor pereM1y W perjury Ihet IMre u e oon¢IriMion bMiip epmcy M iM
penom,enoe a �ne w�x �o, wnid, �nc oa�� b ea�ed (seiaoo aos1. cw. cl.
LENDER'S NANE:
LEN�EP'S AUDNES4:
I ceniN �� I heve reeJ thia epd�im ud Yele Iliel �he ebove iMormetan ia corted. l epree to compF/ xiih dl ciry eM caumy ordiriar�oe�
vM eime lawe reW'rp to Wikiq consVua� � Mreby eWwr¢e �epreaentelivm d �hn dlyb enter upon tM ebo.e�mentioiwC poparly
la impadion purpoees.
�iH.e f�� J. vrw,-G v�
,/[J /� Pnnt e �`
�!-�j��� �,:/,L/ � �_^....r----�� oe�e: �/� l �
O�ip uR� re d Oinw�AB�VAppYranVCanireqw
Whno-B�iknp 8 Sde7: OreemFb: Carary-Appicenl: Fnk-Rmnue; (aolEenrod-A+emw
\ �
CITY UF COSTA Mq�SA — SUILUID]G PERP9IT
PERMIT NO: B U72322 PLAP] CHECK P70;
COr]STRUCTION TYPE: PERA9IT TYPE; S'TR
JOH DESCP.IPTION ; T/UFF REROOF W/COP1P SHIPIGLES
ra
PERhd NU: y 072322
co�.�T: r� soPF: r�
PURPOSE: c�TY.
SQ FT: 2,90U
CLAIP9 C�ALUE: 2,900,OU CALC—VALUE; 2,40Q.00 GROUP OCC; H-3 /M-1
CUMP9ENT5: SMUKE DETECTOAS REQUIRED FER 41UBC, REROOF 240QSF P,ESIDENCE
�.*�*����.�..������**�.���x��*��**�*�����**��*.�**<,��**�.»����*,:�p������x�:���:«�.�
Z U N I N G R E Q U I R E M£ N T S� ��,!-�-rp����
S E T B A C K 5 1 C i..+
------------ h1AID1 HUILDING --------- ---- ACCESSORY BUI�3�C:�����p�---y�'�
FRNT: FT IN REAR• FT IA7 FRNT• FT IN REAR: FT '"""'!N
LEFT; FT IN RGHT; FT Irl LEFT: FT Itl RGHT: FT IN
PAP.KING P,EQ• PP,OLT; PP.RCEL; 4393323E ZDIE: AEF NU;
PLANNING NOTES>
} r,:,_
iR'lE �T iE if iF �lE �lE iF 1f if # iE �lf 1f iF'lf -1F if il' M i if iF � if �E it�+f if if if iF �Y 3f �1F if aR Y iE Jf af a-1f Y�'1F 1f iE iF iG Y iE iE if'N' ��lE if� iFY- if 1f if if iF #�Y �t ic iF �1F if •L iF if� i: iE � iF
D E V E.L O P T1 E N T S E R �.' I C E S R E Q U I R E M E N T— S
ZONING APPROVED EY DATE;
BUZLDING APPROVED HY ; DATE; %v.'
r
APPLICATION ISSUED BY: S� DATE: �
�EaciEiEicifiF*�ci�ac{CaF+f+hir�fii�e�iEic�ricr�s�Rr��-iF��faZ+e*�k�R��a�'�i+r+'+Fr�+t�ic ic?c+t.F*jcj:�c�Y���c;Eic+EaFsvc wi.+.ir�+ =�r-r�Y-
LEGALIZATIOAI;N F E E S U M M A R Y STRUCTURAL SEGh4EDlT;Y
HLDG PMT PLUMBIb7G ELECTRIC MECHANIC FIRE SP7In:'RES G^r.ADZ"]G
PERMIT 54,U0 ,50
SMIn/NON—RES
PL�r�
ISSUE FEE
bUILDING—DIV—> PERMIT ISSUE FLAA]—CHECK TOTAL PAID DUE
TOTALS----> 59.50 U.OU 0.00 59.50 54.50 .�JO
REC'ENUE DI�'ISION TOTALS--> COLLECTEU; �9,50 OVEA;SHOR?: .00
BLDG FhtT FLUMBING ELECTRIC MECHANIC FIRE SMIPr'TOT GRP.DIPdG PLAP1—CHECK
54.00 ,5Q
-i! V�1f ik'IE'K tE iF �)f #'K iF 1F if �1E i=df if iF if 4 tf'lf lf'V 1f # M 1f �lf if #'If �f if if k iF 1f fE �1M if aF if �1(� �E )f if Yc'M �f iF i� Y- jF Y Y�'lc M 1�' k= AF JF ?t 1 if y+Y. if if iF if i4 K iE-IF }'. ji
I N D I V I D U A L F E E B R E A K D O 41 N
TYFE QTY U E S C P. I P T I U N UNIT COST TGTAL iOST
SFR 2400 P,EROOF bY VALUE RE5IDENTIAL NOZONE 1,00 2,40p,00
ET7U OF FEES
�� �,.Pisza-ao�e�Pa� Ta�-r s�.sn
o:,*E: rr��isi�s zir�: ov:a;
, _ _ .
CONSTRUCTION ANO PLANNING � - & SPA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electricat Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinfortement '�
3. Electricat Conduit UvVity-Undrgrnd. 54. Forms '
4. Eiectrical ConduiFUndrgr�d. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � �
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE .
7. Footinqs 58. Electrical Cqnduit-Undrgmd.
$. Foundation 59. Gas Pipe, C Undrgrnd., Test �
9. Water Pipe-Undr9md. 60. BackLvash lines, P-Trap, � Undrgr�d.
10. Structural Floor Svstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Bacjcwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Final
13. Root Drains � 64. Plumbing SYstem - final
14. Rough Plumbing 65. El�ctrical-Final .
15. Rough Electrical�Conduit 66. Solar SYstem-Final .
76. Rough Electric�Viring 6J. Fencing'& Access Approval �
77. Rough Wiring S�9n 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heat(ng & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Dutts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGaz ❑Oil
25. Roof Sheathing �-�2.��j33' 74. Overhead Hydro
26. T�Bar Ceiling (Structuralf & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Sidin9 77. FIXED SYSTEM FINAL
29. Insulation 78. fIRE PREV. FINAL
30. Dryevall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or CanopY .
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuetion • .
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �a (
48. FINAL PLANNING
49. Electric Release to Edison �
50. Gas Reiease to Southem CaliFomia Gas Co -
51. CERTIFICATE OF OCCUPANCY
Np, Date
PNOJECT AO�AESS: z S 4 H I LL PL �
OWNEfl'SNpME:SIMS, JAMES A JR
aooREss:SIMS KAREN M
254 {iILL PL
COSTA MESA,CA 92627
( AHCHIENGINEEfl: 6 3 S ' S O B C7 qEG.NO.:
aooness:
UNIT:
UNIT:
PEBMIttEE:A—AMES PLUMBING 6 HEATING ( 714 ) 530-2440
aooqess:10922 TRASK AVENUE
GARDEN GROVE CA 92642
LICENSEO CONTppCTOB DECIANATION: I �ereby aHirm t�at I am licensed untler provisions o� Chapter 9(commencing wiih Seciion
]000) o� Oivision 3 of �he Business and Pm�essions Cotle, and my license is in full force and e�tect. .
cirvu�cf.:006664 STAiELIC.zSO3O7 -F�'S/SC� 6/�
Oa�e'. 5���� i 3 Signa�ure: �/��`
WOBNEflS' COMPENSATION OECLABATION: I hereby a�hrm �hal I �ave a cerliticate of conse self�insure or a certihcate of WOBers'
Compensaiion Insurance. or a certifietl coDY �hereol (Sec�ion 3800. Lab. C�.
ro��cvNo.:pC941094 E%P.DFTE:O3IOSI93
comrnxr:]� E PUB L I C
❑ Certitied copy is hereby tumishetl. �] Certitietl copy is IileO with �he cily Building Divisio .
�oaie:?h99 3 APVlican� �(�^�"�1 IJ���
E%EMPTION FflOM WOBNEFS' COMPENSATION OECIAPRTION: (Thi55¢t�ion need not b¢ compl¢Ietl i� �he Dermii is br one hUndre� (5700) Or Ie55�.
I cenify thal in Ihe perbrmance of 1he work lor which I�is permil is issuetl, I shall noi employ any person in any manner so as to �ecome
suble�� �o t�e Workers' Compensalion laws ol California.
Date: Signalure:
NOTICE: II, alter making this tleclaration, you should become su�ject to t�e Workers' Campensaiion pmvisions ot the LaUor
Cotle, you musl �ort�wilh comply with such pmvisions or ihi5 permit shall be deemetl revokea.
CONSiFUCTION LENOING AGENCY: I Aereby al�irm ihat there is a cons�mctian lending agency �or �he pedormance oi ihe work lor
which Ihis permit is issued (Sec�ion 3097, Civ. C).
LENOEfl:
FDDPESS:
OWNEB BUILOEB DECtAPpTION: I hereby allirm �ha� I am exempl imm I�e Contractors Stale License Law br Ihe following reason
(Sec�ion 7031.5 Business antl Pmtessional Cotle: Any ciry o� county whic� reduires a permit to conSlruci, alter, impmve, demoli5�. or
repair any slmqure, priar �o i�s issuance, also requires Ihe applicant br such permii Io lile a 5igneU 5�a�emeni ��at he/she is licensetl
pursuanl �o t�e pmvisions o� the Comracmrs' Sta�e License Law (Chapter 9(commencing with Seciion 7000) o� Oivision 3 of Ihe Business
antl Pm�essions Code) or �ha� he/she is exempt I�erelmm and Ihe basis lar the allegetl exemption. Nny violation o� Sec�ion 7031.5 by
any applicant for a'permi� subjects ihe applican� to a civil penalty ol no� more t�an five hundretl tlollars �5500):
I, as awner ol �he pmperty or my employees wi�h wages as their sole campensation, will tlo �he work, and Ihe
❑ slmcture is no� �ntentletl or oiteretl for sale (Seclion 7044, Business and Pmfessional Cotle: The ConVactors' State License Law
tloes no� apply to an owner ol a pmperty who builAs or improves ihereon, antl who tloes such work himself/herself or ihmugh
his or �er Own employee5. D�Ovided Ihat Such impmvemeni5 are nol in�en0ed Or ofleretl �o! 5ale. I�, however �he bUiltling or
imD�ovement is soltl wi�hin one year ol comple�ion. �he awner will have the hurAen af Droving he/she did noi builtl or impmve
�or Ihe purpose o� sale).
I, a5 owner Of t�e pmperty, am ¢xClusivety COniracting wiih Iicen5e0 CanVattors to wnsimt� �he pwjeti ($etlion 7044, BUsiness
❑ antl Professions Code: The Coniracmrs' Staie License Law Ooes noi ap01y lo an owner of DroDe�Y who bml0s or improves lhereon
an0 w�o contrac�s for such pmlects wii� a canVactor(s) license pur5uani�o Ihe Con�ractorY Slate License Law�. I am aware
�hal pmof o� Iheu Worker's Compensation insurance shoultl be pmvided ro me.
� I am e�emp� uneer Semion: B. 8 P. C.
br Ihis reason
�ate: Ownec
1 do here�y ce�ily t�at I am aware ol an0 underslantl Ihe requiremenis ol Calilomia Health antl Safely Cotle Sections 2550.5, 25533, antl
25534 an� ��al I or any IUNre �uilding occupanl wilVwill not (circle one) need ro compty wiih SaiA slaie cotles and the requiremenis lor a
permil lor consimclion or modi�ication �romihe Air �ualiry Managemenl Disiricl. Fesi4eniial constmclion applica�ions are exempt irom
Ihese pmvisions.
iale'. Applicant:
�ereby rertify Iha� I have read Ihis applica�ion antl s�a�e �ha� �he above in�arma�ion is mrrecL I agree Io camply wilh all ciry and couniy
. or0inances an� 5laielawsrelatingta �uilaing conslmclion and �ereby auihoriierepresen�a�rvesot�his cirylo enler upon�he above�meniioned
pmperty lor inspec0on purpases. �
' -�/ �� ��
� oate: � 2 �1�3 SignaNre:
, Orivei s License or Soaal Securily
t641-a6 Whue=Buildmg�, Green—Cotle Enforwmenl', Canary—Applicant; Pmk—Revenue; Goltlenrod—Assessor
i'
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 060871
PERMIT NO: P 060871 PLAN CHECI{ NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE; OTH
JOB DESCRIPTION : REPLACE WATER HEATER SQ FT; �.�,
CLAIM VALUE; CALC—VALUE: GROUP OCC; R-3 /
COMMENT5; NO OTHER WORK AUTHORIZED BY THIS PERMIT
**����e��e�r�*�r�r�r�r*�x*��r�*�**�t�r�t�t�r+t�t**�r+t�t�r****�r****�****�r**�r�**�r*�*�r+t**�c**�******�r
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 RGH1': FT IN
PARKING REQ• PROV; PARCEL; 43933236 ZNE: REF NO:
PLANNING NL7T'ES> �
i
1f iE iElE if !f it jf iE if iFik it iE iF iF iF iE i! if it 1t it iE iF if iE iF�E iklF iF 3E jE iE iE ik 1E iE if iF iE iE iE if iE iE iE 1E iE iE IE iF iE 9E iE iE iF iE iE iE iElF 1E iE iE 1E iE 1klE iE iE iE IE iF iEiE iE ik
D E V E L O P,M E N 3' S E R V I C E S R E Q. U I R E M E N T S
r
'LONING APPROVED BY , DATE;
BUILDZNG APPROVED BY : DATE:
APPLZCATION ISSUED BY• �-- DATE; 2IZi�l�
ifiElfiEit�lkiElafkiFiFifiEifiEkiFiEifiFiElEiF�FiFif3F3FiF3F7F'iFiF3FiF3F±f�F'�F3FiF iFiF�r7F3F3FifTFif3FiF3Fif�F�lk�lfifiEafiE3E-IkiEiE�iEit
iE iE iF 1f 1F iF iE ik �lk 1f 1E 1E iE iE iE iE iE if !f if iE iE *�IE it IF If iF it iE �lE iF if iE it iE iE 1k iF iF i4 ik'lf if iF 1E iE if �lE iE 1F iF iE iE iE If #�lE 1f N- iE 1E IE 3f iE lt iE iF IF ih k i!� ik 3E iF if if if it
LEGALIZATION:N F E E ,S U.M,,M,A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC-: MECHANIC FIRE SMIP/RES GRADING
PERMIT 7,00 ' - ,
25t �� ,;, �y SMIP/NON—RES
PLAN � ';v •:� �y. —�
ISSUE FEE 20.00 ` .
BUILDING—DIV—> PERMZT ISSUE PliAN—CHEGK ;, TOTAL PAID DUE
TOTALS---_� %,OO ZO,UO C) O�,OO r; Z%,OO 2%,OO ,OO
REVENUE DIVISION TOTALS--> CQLliECTED:y:; - 27,00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHAN�IC ` FIRE SMIP/TOT GRADING PLAN—CHECK
Z%.QD y, � '
��T —.+
3F 3E if 3f i! i! iF i! iF if iE i! �E iE 1E iE iE iF iF iE if iF �f iE iE 1E iF ik 3k if iE iE iF if fk iE iE�it iF j(� iF ftiE iFlE iE if if if 3E 3E iF iE �F'IE ik iF 3F iE iE k iF 3F iF �E jE �E iE iE iE ik 1E 1E if iF 3E iE iE it
I N D I V I D U A �;� ; 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
PLU 1 WATER HEATER AND/Op,VENT —� 7,00 7.00
$ND'• OF F,fiES
� !. �' �
li W ' ' /T �
I r � mp �J ��i ���
„ 1 i Y'� � .
� 7 � f, ,,,� FEB 0 2 1y93 �'. .
`� '=� :1 � CITY OF COSTA MESA
�-
CONSTRUCTION AND PLANNING POOL & SPA' . .
AVPRQVALS Permit # Date � Inspector qpPROVALS Permit # Date tnspector
i. Temporary Elecvical Service or Pola 52. Pool & Equipment Location
2. Soi1 PiPe-Undrgrnd, - � � 53. Steel Reinforcement
� 3. Electrical Conduit WtilitY•Undrgrnd. - 54. Forms
4. Electrical Conduit�Undr9rnd. . 55. Electrical Bonding
5. Steei Reinforcement' 56. Rough Plumbing & Pressure Test
6. Etec[tical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
� 7. Footings � ! 58. Electricai Conduii-Undrgmd. �
�; Foundation � 59. Gas Pipe, fl l3�drgrnd., Tett
9. Water Pipe�U�drgmd. 60. Backwash �ines, P�Trap, t7 Undrgmd. �
10. Structural Floor.System '- • 61. APPROVAL TO DECK
17. Property Sewer Line & House,Connection 62. Backwash & Receptor-Finai �
12. Sewer Cap .. 63. Heater & Vent-Final '.
13. Roof Oroin: . 64. Plumbing System � Fina�
14. Rough PI�mUing 65. Electricai�Final
75. Rough Electrica�-Condwt 66. Solar System-Final �
16. Rough Elect�ic Wiring 67. Fencing & Access ApProval
17. Rough 4Viring Sign 68. APPROVED FOR PLASTEftING .
18. Rough Etectrical-T Bar Ceiling 69. POOI./SPA SYSTEMS F INAL
19. Rough Heating & Air Conditioning FIRE D�PT. REQU4REMENT ,
. .i
20. Rough Pectary Fireplace ' ' _� APPROVAIS Permit ��� i
�21. Dutts, in�$tructure� ; 70. Under9round Hydro
�
22. Ducts, Ventilating� � i . . ,' 71. Product Piping 0 Gas �.Oii .
23. �fias Pipe-RoUgh & Test �' -72, Underground, FItrSM� `
24.'Roofi Framing ' � ' 73. Undergmf�.StorageTank bGas OOiI �
25. Roo� Sheathing � �, . 74; pverhead Hydro'- �
26. T�Bar CeilinglStrudtural) & Monocoat ' 75..Dry Chemica� - I
27. Frame and Flashing. , � 76. Dry Standpipe ��
28. Lathing & Sidingr °" � � 77.' FIXED SYSTEb::FI�NAt�
29. Insulation - - �� , � - I � 78.� FIRE PREV. FINAL � - �
30. Drywail Nailing -' . � �.' ' _'HEALTI-! DEPT, REQUIREMENT
'37. Piaster BrowM1Cozt , �. 79, FINAL IRISPECTION � �
32. ElectricabPoWer M�tAr'�Final ' !' 80. FOOD CERTIFFCATE ISSUED.
33. Final Electric . . ! . Nates:2�-qJ1 �p���y�' L,��C.4(Cp���.F.O
34. Final Heating & Air Conditioning � � � i Z,.t��clS '�`(.p �yK �q.6M�•. L�r-(p�ILO�(,�,p
35_ Final Gas Pipe-Test �. � ��:.I a.��q� �j OM� �(�O�'1E' i.�r�'°�'�-�%�
36. Hood or Canopy.. - , . - ; I' � �� � �-./�� ��G/L�n �'r G4v1G:.C.t'N� 61.5 � larE2
37. Final FactorV Firepiace � � � �
�.� Zv• 3 v vc.-- L��
38. Finat Piumbing . � � " ' i I - . . - ----
I
39. bVater ServicC-Final � � ' -
, � ; '
40. Gas Service-final • � � I '-._ .
41, Soiar pomestio-Final . � i i � . _
42. Backflow Preventer � 1 i -� -
43. Backfiow irri9atiori ' - � �
44. Landscape I�riqa�ion System � . : ._ ' • .
�45. Sound AttenLation � .
46. Handicap Regulations . .
i -
47. FINAL STRUCTURE & BU1IDING I ; - '
48. FINALPLANNING ! ' '
t�
49. Electric Release to Edison � -' �
i �� -
50. Gas Release to Southern Calitornia Gas Co � � '. � � -
�51. CERTIFICATE OFOCCUPANCY � � � �
N0. Date
1
OR�NGE COUNTY BUILDING DEPARTMEt{T ,
� 636 North Broadway
s SANTA ANA, CALIFORNIA
BUILDING
nooRess ,�'�-
SCHOOL DIST. /'�
OR TOWN [_,�(T
NEAREST !��
CRO55 ST. Vl
vfli�.a+ /' � L�r TEL.�d G
CITY �. NO.
ARCHITECT OR TEL.
ENGINEER NO.
ADORE55
CONTRACTOR / ��_(� TEL.
b `� NO.
ADORE55
LEGAL
DESCRIPTION LOT NO. � BLOCK
IATTACH METES 8 BOUNOS) I,,, I �
TRACT I �(r 9
�;� Qe � �.'NO.OP BLDG9.
SIZE OF LOT NOW ON LOT
USE OF NO. OF NO.
EXISTING BLDG. I Fnmwes ROOI
DESCRIPTION OF WORK
ROOF
USE OF NEW
BUILDING
r� �13� �
.� Z �
1 HEREBV ACKNOWLE'JGE THAT I MAVE READ THIS
APPLIGATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL COUNTV ORDINANCES
AND STATE LAWS REGULATING BUILDING GONSTRUCTION.
SIGNATURE OF �` � �. � ��
PERMIITEF
AUTHORIZED AGT.
� P. C. 5 ��QpwC
� � Y Y FEE �.. ♦ �l L
VALUATION s �^�,-q
FEE v �
u-sz
APPLICATION FOR PERMIT �
__.__B_U . .D. .lel_G._.-- - -
� FOR OFFICE USE ONLY
RECEIPT NO. PEftMIT NO. '
1 �
� 3 ao.q . �so�g � .
RECEIVED BV I OATE OF A PL. I DATE ISSI�ED i
NEAREST �j (� �j
CROSS 5T. /�( r
20 NO.OF
IiPLANS
I
SETBACK LIN QL+1 CI
REAR.VAR
APyR D '/
BY 1 CO
;
' ; - i _
! _ �__ { _ �_
BOND
FINAL
OF ST. � �
_ YARD "C (' -
".�' _ _' _ _ _' I
.. ---- —. � _. _o.�
a
�
i
a
r
\ APPROVALS
no : �ocnnon iN�,�c
M5. MATERIALS, }G
IER- NNING
FIRE TOPS. . ,�
J -/ 4 -VU
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