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Home My WebLink About904 HYDE CT - Building Permits0 (714) 754-5273 • Fax (714) 754-4856 . www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job/+ddress: 904 HYDECT Suite: Vicinity: Parcel Number: 41808205 Applicant: BAIN, DEREK D Address: 904 HYDE CT COSTA MESq-, CA Owner: BAIN, DEREK D Address 904 HYDE C7 � �-COSTA MESA, CA � Contractor: O W N ER-BU ILDE R . Address: , " � Zip: Arch :, Address Zoning: Phone: 714-751-0657 Zip: 92626-6900 Phone:� 714-751-0657 , Zip: 92626-6900 Phone: • License:-� 000000 i ' �� . - Eng: � ' Address' Status: ISSUED Applied: 01/09/2004 Issued: 01/09/2004 ISSUED BY: . . - ,. , Phone: , Phone: . , 'Zip: , � - License: Cicense: � _, SCOPE OEPERMIT . � ENCCOSE ONE BALCONY ON THE SECOND FLOOR TO ENLARGE THE BEDROOM BY 112SF. SMOKE DETECTORS ARE REQUIRED ON EVERY BEDROOM AND HALLWAY LEADING TO THE BEDROOMS: � � � � � � - � � � � ' � �' ' PLNG. - REAR SETBACK WILL NOT BE AFFECTED. -� .. - � � , � FEE SUMMARY Plan Check: $117.81 -� Calc Valuation: . Sio,000.00 Permit: � �� ' SMIP. Res: SMIP Com: Other: Inspection: Total: $181.25 $1.00 $0.00 $o.00 $0.00 . $300.06� SETBACKS � MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existin : 0 e Claim Valuation: r g�o,000.00 .. � ; ' � ,-,: .,��w - ' l, � � ` � .. „ � � - .. � , �- � � � PLANNING & ZONING - Rear 0- 0 Left 0- 0 Rear 0- 0 - Left 0- 0 Reauired: . 0 Pr000sed: "-0� � ,: Right � -0- 0 � � Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access iequirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) / f EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or� ork is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all required inspeetlona and tinal approval must be obtained. Failure to obtain inspections and final approval � II result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 750.5626 � 2d4fM6I6�00) // p l WORKERS' COMPENSATION DECLANATION: � I hereDy atlirm under penalry of perjury one ot the following tleclarations: ❑ I have entl wlll mainiain a certificate ot consent to selbinsure tor workers' compensetion, as pmvided for by section 3700 of the Labor Code, for the peMormenca of the work tor which this permit is issuea. ❑ I have antl will mainlain workers' compensetion insurance, as requiretl by section 3700 of the Labor Cotle, for Ihe peAortnance of the work lor which this pertnit is issuetl. My warkers' wmpensation Insurence carrier and policy number are: Carrier: POlity Number: (This sectian need not be campleted i/ the permi( is veluetl a( one hundred dollars ($ f 00) or /ess.) ❑ 1 certity t�et in the peAormance ot the work for which this pertnit is issueQ I shall not employ any person in eny manner so as to bewme subject to the workers' wmpensation laws oi Calitomia, and egree t�ei If I should become subject ro the workars' compansation pmvisions of Section 3700 oi the Labor Cotle, I shell forthwith cOmpiy with U�858 provisions. Applicam SignaNre: Dete: WARNINO: FAILURE TO SECURE WORKERS' ODMPENSNTION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTES AND CIVIL FINES UP TOONE HUNDRED T}IOUSAND DOIJ.ARE (3100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PFOVIDEO FOR IN SECTION 3�O60F THE LABOR CODE, INfEHEST, AND ATTORNE'fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am licensed under provisions of Chapter 9(wmmencing with Section 7000) of Division 3 of iha Business and Professions Code, entl my license is in tull force antl effect Lic. a Class R Contractor's SigneWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is a consiruc�ion lendinq a9enty for the peAormanca of the work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lender's Name: Lenders Address: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn Ihat under penalry of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business end Professions Cotle: Any Uty or wunty which requires e permit to wnsiruci, alter, improve, demolis�, or repair any structure, pnor to its issuance, also requires t�e epplicant for such pertnit b file a slgnea stetement that he or sha is Iicensed pursuani lo Ihe provisions oi the Contractors License Law (Chapter 9(commencing with Sectlon 70W) of Division 3 ot Ihe Business and Professions Code) or that he or she is ezempt t�erefrom and the basis for the alleged exemption. Any violation oi Section 7031.5 by any applicant for e permlt subjects the epplicant to a civil penalry ot not more than tive huntlretl dollars (5500).): -� I as owner of Ihe property, or my employees with wages as their sole wmpensation, WILL DO TME WORK, and the struciure is no� intende0 or oMared tor sale (Sec. 7044, Business end Professions Coda: The Coniractors License Law tloes noi apply to an owner of property who builds or improves thereon, end who does such work himselt or hersell or through his or her own employees, proviaetl that such impmvements are not intentletl or oHered for sale. If, however, ihe building a improvement is sold within one year of completion, ihe owner-builder will hava the 6urden of provinq ihat he or she did not builtl or improve for purpose ot sale.). ' ❑ I, as ownar of ihe property, am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRAC70RS to construct the projeci (Sec. 7044, Business antl Professions Code: The comractors Licensa Lew does nat apply to en owner of property w�o bullds or improves thereon, and who contrects tor such pmject with a coNredor(s) license pursuent to ihe Contrectors License Laws.). ❑ I em exempl under c. Business and Professions Code tor this reason: 4 i�auue: 4�... �oete. \ - 9 0 4- Owner ID verified by drivefs license. fRj es ❑ Na Drivers��icense No. ��Fjcpires: 03 -O ��0,( Veritication ol Ownership by (rype otdacUmeni, i.e. - pmperty tac hill or deed): � l--'�� DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify that no excavation five (5) or more feet in depih into which e person is requiretl to descend, will be matla in connection with work euthorize0 by Ihis permit, end Ihat no building structure, scattolding, falsework, or demolition or dismantling thereof, will Oe more than thirty-six (36) feet high. (Ghap. 32, Grp 2, Art 2, Sec. 341, TIUe B, Celitomla Adminisiraliva Code). ❑ As owner-builder, I will not employ anyone to tlo work w�ich would require a pertnit irom the Division ot Intlusirial Safery, as notetl above, unless such person has e permit to do such work from tha division. Signature: Date: Division of Intlustrial Safery Permit Number: 7 ARDOUS MATERIALS AND EMISSIONS CERTIFICATION: Will the epplicam or present or tuture 6uilaing ocwpant need to file and certity a Business Plan for amergency response to release or t�reataned release of e hazertlous meterlell ❑ Ves ❑ No (Section 25505 of the Califomia Health and Safery Code requires, with some exceptions, ihat a Business Plen be filetl with the Coste Mesa Fire Depanment by every Dusiness which has at any one time during e reported year a quantity ot harardous materials equal to or greater ihan a weight of 500 pountls, or e volume o1 55 gellons, or 200 cubic leet of compressed gas at standard temperature and pressure). .........................................................................................._........................................................................................................................................................................................_ ....... ......._.............__........._..........._ Does or will Ihe epplicaN or present or imure builtling occupant need to file e regisiration fortn for acutety harartlous matenals7 ❑ Yes ❑�No (Section 25533 0l Ihe Califomia Health antl Satety Cotle, with some exceptions, requires registratlon with the Costa Mesa Fire Department by each busineu which at any ona time has on hand a quantiry ot ecutety �azertlous materials equal to or graeter than a weiqht of 500 pounds, or a volume oi 55 gellons, or 200 cubic teet of compressed ges at standartl temperature antl pressure). .................................................._........_............._............._._............................................................_....................................................................................................._........................................_...._................_........._............................ Does or will Iha applicant or presem or future building wcupant need to Drepare an RMPP (Risk Managemem end Prevention Program for ecutely hazardous matenals)7 en 25534 0l em of an i ar will Ihe applicent or present or tuWre 6uiltlir the Souih Coast Air Quality Mflnegement Dlsin� lion 65850.2 of Ihe Califomia Gwemment Code �ovides ihat ihe Costa Mesa Fire Department may require the preparation, certifcation end filing with ihe Fire b register aatety hazardous materiels with ihe Fire Depenment. occupant require for �he work which is the subject of ihis e plication a germit tor such construction or or trom any other air pollutlon comrol tllsMct or egency? � Yes p No aquires Ihat ihe requestetl information be tumished on applicetions lor non-resitlentiel builtling pertnits). ............... ......................_.................................. ............................_.........................._....... Wnl eny pert ot tne tatiury to be consWcietl untler tnis pertnit he within 1000 �eei from Ihe outer bountlaries ot a school? ❑ Yes ❑ No Q/ yes', the taciliry must meet the requirement ot Sections 25534 antl 42303 of lhe Gelifomia Heal�h an0 Sa ........_.........__........._........._......._........__........._ ................._..................._....__..............................................................................................__ It e pertnit trom Ihe South Coest Air Oualiiy Menegement Distnct or ot�er alr polWtion con�rol dislnct or application, have ell ot the disclasures prescnbed hy Califomia Health antl Safery Cotla Section 42303 been B Qf yes', atlach certificate of compliance trom ihe appropnate air pollution control otticer). CERTIFICATE OF COMPLIANCE: I certiy that untlar penalry ot perjury the iniarmation given above is correct. I agree to comply with all state laws antl ciry ortlinances regarding Harardous Matarials and Emissions. Signature: Date: CER7IFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I ceniry under penalry of perjury that I have read this epplication and state that the intortnation given is wrrect I agree to wmply with all state laws end ciry ordinances relating to builtling cons�ruction, and authorize representatives of the Ciry o� Casie Mesa to enter upon t�e ebove-described Oroperty for inspection purposes. I egree not to occupy or ellow occupancy of any building authorized by this permit un il fn inspection. ��Q._ _v_g�b� Stpne 'ega ner(s) \ _ ate�� — _ And/OrAuthorized Applicant Data CODE �. INSPECTIONTYPE i676 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final Block/Retaining Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolition Q�g ��j ' �Qjlj,! INSPEGTONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Qdffi 1[{ID�L9 ' Z-!O -,vY l' �,,� I ;..: �..: C''.it�y a� C''.adta ��%�a �u�:��uuy Du.ioioc� OV1/NER-BUILDER VERIFICATION . . . . .:.� A city or county, which is reyuired to give notice pursuant to Section 19A3Q 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: �� 1 An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the cnvelope provided at your earliest opportunity to avoid unnecessary delay in prncessing and issuing youi building pennit. No buildin¢ permit will be issued until this verification is received. I. I personally plan to provide thc major labor and ma[erials for construction of the proposed roperty improvemenc ❑ Yes ❑ No ��' 1(have/haverat) f-l.4✓� signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed consWction: Nume Addrecs City _ Phonc ( ) Contractur's Lic. No. 4. 1 plan to pruvide portions of the work, hut 1 have hired the following person [o coordinate, supervise and provide the mujor wurk: Namc Addrecs City one ( ) Contractor's Lic. No. 5. 1 will provide some of the work bu[ 1 iiave contracted (hired) [he following persons to provide the work indicated: Name Address Phone Type of Work oHa /Sc.t.� p�/73 �`%Br �� — Roa,Hr�c%nis/c�J Co,S�,4 rf,.�k �!.t-92�27 1M2a6 (REV.9/90) I hereby affirm that I have received a copy of the infortnation set forth in Section 19830 of the State of Califomia Health and Safety Code and have completed the above infortnation to the best of my personal knowledge, in compliance with this State law. Sigr�ted> ��, Date� � �l O ¢ d. /J Name: � H�K . � J A-/l✓ (Prin[ed or Typed) C.D:L.—# OR S.S. # �¢ For more information call City of Costa Mesa Building Division at (714) 754-5273. 1M2J8 (REV. 896I 1 �V ..�:'. 1 . .. � . . • �4 � . . ' � (714) 754-5273 • Fa�c (774) 754-4856 • www.ci.costa-mesa�ELECTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 ,lob Address: 904 HYDE CT Suite No Vicinity: Parcel Nunmber: 41$08205 Applicant: BAIN, DEREK D Address: 904 HYDE CT C057A MESA, CA" Ownec BAIN, DEREK D Address ,'904 HYDE�CT ' " CO5TA MESA,�CA Convactor: OWN ER-BU I LDE R Address: , r . , , Phone: 714-751-0657 Zip: 92626-6900 � Phone: 714-751-0657 Zip: 92626-6900 Phone: Zip: License: 000000 Status: ISSUED Applied: 01/09/2004 Issued: 01/09/2004 ISSUED 8Y: ' � � , � � .�� .. � / �� :t �� ' ��, . ` �� .."� - , SCOPE OF PERMIT - ' , ENCLOSE ONE BALCONY�TO CREATE A BEDROOM: SMOKE.DETECTORS ARE REQUIRED ION EVERY � � BEDROOM AND HALCWAY LEADINGTO THE BEDROOMS. � � � � ' "' � � REF 804-001132. 2 SWITCHES. ' � ISSUE FEE Temp service test Res. a/c package New Res�(1-2 units)� New Res (3+units) Pool / Spa , � Lighting Fixts - Recept Outlets� � � Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to thp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp $23.50 $0.00 $0.00 $0.00 `.$0.00 $0.00 $0.00 $0.00 $2.20 $0.00 $0.00 $0.00 � . $0.00 � $0.00 ' $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 � -�� 0 2 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY,, Temp Dist System %_Lighting Busway /100 ft ,� ' Standing Section ,-,_:��^ " Misc ElecVical Equipment - � Transformers'up to 1 kva/kw ...._:.........up to 10 kva/kw�;.'�, ..:......:.......up to 50 kve/kw-� - .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment . Low Volt Wiring System / Ckt . Misc. Conduit _ . Misa Conductor - � � Circus ( gen or ride) � " � Cirws (mech ride or lights) , �Christmas Tree Stand Fireworks Stand . Other Electrical Fee ' Quantity' ,� - $0.00 0 � � , � $0.00 0 ��!� $0.00 ,j;0' <, $0.00 , �. �,0 - $0.00-';'i 0 $0.00" 0 $0.00' 0 . $0.00 0 $0.00; "�;'0 $0.00 0 , � 50.00 0 �$0.00� 'p' %.. $0.00 �0% $0.00 0 $0.00 ' 0 50.00 0 $0.00 0 $0.00 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 pe�iod of 180 days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all ap�licable codes, and all required Inspeetions and finel epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expira�ion of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 f� 2448�481R/OO) ,�I WORKERS'COMPENSAnON DECLARAnON: � I hereby eHirm under penalry of parjury one ot the following declarations: . ❑ I have and will meintain a cenifiwte of wnsent to sel4lnsure far workers' compensation, es providetl for by section 3700 of the lflbor Code, tor the pertormance ot Ihe work for which thi5 pertnil is iuuetl. ❑ I have end vrill maintain workers' compensalion insurance, es requiretl by section 3700 of the Labor Cotle, for the pedortnance oi the work for which this permit is issuetl. My workers' compensation Insurence carder and policy number are: Carrier: Policy Number: (This sec(ion need not be complered il the permit is velued af one hundred dollars (3100) or less.) ❑ I cenity that in the performance of the worK for which this pertnit is issued, I shell not employ any person in eny manner so as to become suhject to ihe workers' compensation lews of Califomia, and agree Ihat If I shoultl become subject to the workers' compensation provisions ol Section 3700 ot the Lebor Cotle, I shall forthwith comply with these provisions. Applicant Signeture: Date: WARNINO: FAILURE TO SECURE WORKERS' COMPEN5�ITION COVERAGE IS UNIAWRIL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES ANO GVIL FlNES UP TOONE MUNDRED TFIOUSAND DOLUAE (5100.000). IN ADDIiION TO THE �T OF GOfdPEN$ATIIXJ, DAN,AGES AS PROVIDED WR IN SECTION 3]O60F THE LABOfl CODE, IMEREST, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that 1 am licensed under provisions of Chapter 9(wmmencing with Section 7000) of Division 3 oi iha Business and Prolessions Cotle, and my license Is In tull farca antl ettect. Lic. N Class N Comractofs Signawre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm ihat ihere is a consiruction lending agency for the pertortnance of the work for which this pertnit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: __—. Date: OWNER-BUILDER DECLARATIONS: I hereby eMirtn that under penelry of perjury thet I em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Protessions Cotle: Any ciry or county which requires e parmit to construct, alter, improve, demolish, or repair any sWcture, pnor to its issuance, also requires the applicant for such parmit to flle a signetl statement that he or she is licensed pursuant to Ihe provisions ot the Contractors License Lew (Chapter 9(commencing with Sectlon 7000) 01 DlWsion 3 of the Business end Professions Cotle) or that he or she is exempt therefrom and the basis tor the alleged exemption. Any violation of Section 7037.5 by eny aOP�icant for e pertnit subje ts the epplicanl to e civil penalry oi not more than five huntlrea dollers ($500)J: �I, as owner oi Ihe property, or my employees with wagas es their sole compensation, WILL DO THE WORK, and the structure is not intentletl or ottered lor sale (Sec. 7044, Business and Pmfessions Code: The Contractors License Law dces not apply to an owner of properry who 6uilds or impmves thereon, entl who does such work himsalf or herself or ihrough his or her own employees, provided that such improvements ere not intended or otteretl tor sale. If, however, ihe building or Improvement is sold within one yeer of completion, the owner�huilder will have the burden of proving that he or she did not build or improve for Durpose ot sele.). � ❑ I, as owner ot ihe property, am EXGLUSIVELV GONTRACTING WITH LICENSED CONTRACTORS to consiruct iha project (Sec. 7044, Business antl Professions Code: The contractors License Ww does not epply to an owner oi properry who Duilds or Improves theraon, and who contrects for such project wit� a contrector(s) license pursuant to t�e Contracmrs License Laws.). ❑ lam Owner ID veritied by drivers Vedficatian of Ownership by Business and Professions Code for ihis reason: �s ❑No Drivers,Licansa�Na. �(�� --� / / Expires: OJ–O¢'O( i.e. - property ta: Dill or deed): �--�—� �_� DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATION: ❑ I hereby certity ihat no excevetion five (5) 0� more feet in depih into w�ich a person is required to tlescen4 will be made in connection with work authonzetl Dy ihis pertnii, and that no builtling strucNre, scallolding, talsework, or demolition or dismantling thereoi, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, California Administrativa Code). ❑ As owner-builder, I will not employ anyone m do work which would require e permit irom the Division of Indusirial Sefery, as noted abave, unless such pereon hes e permit to do such work from the division. Signa�ure: Date: Division oi Indusirial Safery Permil Number: CEFiTIFlCATE OF COMPLIANCE AND AIJTHOR�TON OF ENTRY: I cehity under penalry of perjury that I have read this ap0�ication and state thet the information given is correa. I agree to wmply with all state laws and ciry or0inances relating ro builtling construction, and authorize representatives of Ihe Ciry oi Costa Mesa ro enter upon the ebove-descnbed property for i cti n purposes. I lgree not to occupy or ellow occupancy of eny building authorized by this permit until finel inspection. ��4�0� � re OI'Legal a+'ner(s) =".Date—� AnNOr Authonzed APP�icant Date COUE �. INSPECTIONTYPE ' P� INf1ilALS 1818 Fixetl SySlem Finel Fire Pravention 1268 200 2�1 202 203 204 Pool Spe Final Finel Re-Roof Final BIocWRetaini�g Wall Final Factory Fire PlaCe Final Sign Final Demolition COOE� INSPECTIONTYGE 206 Final Mechanical 20B Final Plum6ing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Oaupancy GeIF. ltl�:$ / i L1 �/1J�I' � �,�T :;�, 10445 i.o� r;o, 5 !in1�r•. July 29, 1980 ADDIZrSS ann uv.lo rn�r�{�,--�g.5.td.�-M@5�,--Gd-1-�f^"�„�r;�_�i��6 Devclopmr.nt Services Dep:�rt:sen[ Plannin�, Division City of �;osta Nesa 77 i�air Drive Cost� ?1csa, CA 92626 Attention: tir. Paul Dudlcy Dear Ftr. Ihidley: . Please be aware that the undersigned are aware tha[ a certificate of occupaney on the above refcrenced lo[ and imit is bcing requcsted priot to the entire [ract and its streets and cor.anon areas being completed and accep[ed by the City of Costa Atesa. AUTIlORI' Y:D REPRESEFJI?1TIVC) BY C'�� Ta Tod� G`� �•sicn•,ru�F: or• r.e�R�r:r.) REC�IVED cr;, oF c^;�a ,,.,�sr�. r��,,,�,,�, � .JU!_.�� i�80 AM P� �'i8i9i1uillil't�iiti��i4i5i6 0 � B. __DING AND SAFETY DIVI�N FIRE DAMAGE INSPECTION REPORT (Required Prior To Permit Issuance) Address: / v � _ ! /_ �J/� O � �• � Owner: �� F �� Gi � Owner's Addres/s,(if different from a ove): �� f��j �e ��• Street � � Structural permit required, � Repair or replace as necessary. ❑ Plans required. / Comments: S7YGl C. S�7.� v -%, o.� �� // //l ..v N /G / L �' .. / / ._ � / L� jt Gr v-� G. � Electrical permit required. `� Repair or replace as necessary. Comments: � Unit: City �o -�G� �.., , / T /�5��. G. /o S�i, /,�� ,v �P.. a. , � �f-� t � i r ` �Z�z 6 State G f -f r � -E G�F-r'i , �� Plumbing permit required. � Repair or replace as necessary. �/ / Comments: iD ��c. w� �J i h q T'O �JP f�.�� c.�� /G! r �-'PG !_� � 7'� l�-e ❑ Mechanical permit required. ❑ Fiepair or replace as necessary. Comments: _ /�1m.��Li. !� .�,-� �' �6~7z Inspector Date 18]2-6fi Tripli<ate: Original-Owreq Vellow-Contramr, pink-Building Division %�i��_c�6 Phone :^F CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION Property Address . Owner Permit No. /O � � �� U Z Contractor � � �^�� `��` State Contractor License Number �� Classification �� / I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above aqdress in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner-Builder permittee only). ��I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company O�mited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Receivetl by Building Division By: `-1 2 �� I rtial ate �9� N'�i�aBuilOing Div.; Cenary-ConVactor, Pink-0wner /� E- / Y y G � �J//Pt(��/ PrinteC or ryped name �. .�' VflOJEC�eonFss: 904 HYDE CT b,OWNEN'SNAME: BAIN DEREK D aoosess: 904 HYDE CT COSTA MESA,CA AflCHIENGINEEfl: pU0NES5: UNIT: 92625 XEG.NO.: UNIT: PENMITTEE: HILT—WELL ROOF AND MATERI t714)739-12$8 aooness: 3310 VERDUGO ROAD LOS ANGELES CA 90(165 LICENSEU CONTBRCTOfl OECLAflATION: I �ereby a�firm I�al I am licensetl under provisions ot Chapter 9(commencing wi�� Seclion 7000) ol Oivision 3 0� Ihe Business antl Prolessions Code. and my license is in full force antl eflect. ciTvuc.:0?9076 srnTeuc.:458005 C;) EXP: 05t95 �ale'. ��/�_—_ SignaNre:. WOflNEBS' COMPENSPTION OECIAPpTION: I hereby afli ertificale of consent m self-insure or a certificale of Warkers' Compensa�ion In urance. ar a cerldietl c pY �hereaf (Sec�ion 3800. Lah. C�. voucvxo.:�yj�1UZ4tl�P EXP.UATE: U7�23/94 campaxr. CAL COMP � CerlifieU copY is �er/ey y furnished. U� Certifie0 coDY is lilea wi�h o-6i� uildi g�Division. Daie: ��'L_L[�_/___ ApPlicam� E%EMPTION FflOM WOflREflS' COMPENSATION OECLABFTION: Q i sec ion need no� 6e comple�eU il ihe permit is �or ane huntlretl ($100) or less). I certify Ihal in Ihe perlormance o� Ne work for whic� this permil is issuetl, I shall not employ any person in any manner so as to become su�lecl m ihe Workers' Compensa�ion Laws of Califomia. �ale: SignaWre: NOTICE: If. aiter making ihis Declaration, you should Oecome suElect m the Workers' Compensation provisions of the labor Catle. You musi forihwi�h tomply wi�� SUth pmvisions or Ihis permii Shall 6e OeemeO fevOketl. CONSTPUCTION LENOING AGENCY: I here6y afiirm �hat ��ere is a ions�mction lending agency �ar �he De�ormance oi [he work for which ihis permil is i=sue4 (Seclion 3W7. Civ. C) LENOEfl: IIODflE55: OWNEN BWI�EB OECIAHRTION: I heBby aflirm Ihai I am ezem0� ��om the Con�rattors' $late License Law tor �he �ollowing �eason (Sec�ion 7031.5 Business antl Pmfessional CoOe: Any city of county which requires a permi� �o cons�mc�, alte�, improve, tlemolish, or repair any slmclure. prior to its issuance, also requires ihe applicant for such permit to lile a signe0 statement that he/she is licensed oursuant m the provisions of ihe Contractors' S1ate License law (Chapter 9(commencinp with Section 7000) ot Division 3 of the Business antl Pmlessions Coae� or tha� he/she is eKempt therefmm ana �he basis for ��e alleAed exemption. Nny violation o� Sec�ion 7031.5 by any apD�icani lor a permi� subjec�s Ihe applicant to a civil Denalry af no� more �Aan five huntlre0 tlollars (5500�. I. as owner ol �he proDehY a� my employees wilh wages as t�eir sole compensation. will Co ��e wo�k, and ihe ❑ stmctureis notintende0 orolfere0 lorsale (Section 7044, Busness antl PmiessianalCode: The Contractors' State License Law aoes no� apply �o an owner of a pmDetly who Ouilds or improves therean, and who does such work himselOherself or �hrough his or Aer own employees, pmvitled �hat such impmvemen(s are nat intentletl or ottered �or sale. I�, however Ihe builtling or imomvemeni is sold wilhin one year o� complelion. �he owner will have ��e burtlen of pmving he/she did no[ 6ui10 or improve �or ��e purpase o� sale�. I,as ownero�ihe O�operiy.am evclusivety conlrac�inp wiih bcensetl conVaclarsio cons�Nc��e prolec1�Seciion 7044, Business ❑ an0 Pmfessions Cotle- The Contracmrs' Stale License Law tloes not apply to an ovmer of pmDerry who bml0s or improves ihereon and w�o conVacis for 5uch Dmle��s wi�h a conlracior�s)license Dursuanito Ihe Coniractors' State LicenSe Law�.l am aware Iha� pmol al ��eir Worker's Compensa�ion insurance shoWd be D�o�itled lo me. � I am exemo� untler Section: B. 8 P. C. far Ihis reason: oa�e: Owner I tlo here0y cetlity Ihai I am aware ol ana un0erstantl Ihe reQuiremenis oi Califomia Healt� an0 Sa�e�y CaOe $eciions 25505, 25533, and 2553a antl ihal I ar any fuiure builtling occu0an� will/will noI (circle one� nee0 to comDly wi�h saiA state co0es ana the requiremenis lor a permit for consimclion or motlifica�ion imm ihe Air Oualiry Managemen� �iSVicL Fesitlential con5tmclion aDDlica�ions a�e exem0� ��om Ihes¢ provi5i0ni Da�e: Npplicanl: I �ereby cer�ily I�a� I have read ��i5 applitaii0n and Sla�e Ihai Ihe above ini0rmalion is cOrretL I agree lo comply with all Ciiy and munry ordinancesanEstatelawsrelalingloDuilamgcons�mclionandherebyauthorizere resenlaliv a�ihiscirytoenteruD�ntheabov¢-men�ionetl propeny im m e ion p/u�p ases. Oale:�%��' / S'o t ro �river's License ar Social Securily N: "' � �"% !/_�`� 164i�G6 W�ile—Builtlmg: Green—Co�e Enlorcement: Canary—Applicam; Pink—Revenue; GOICenmd—Nssessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 068002 PERMIT NO: B Q68002 PLAN CHECK NO: N GOCTT: N SUPF: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STA PURPC�SE; OTH JOB DESCRIPTION : T/OFF 6 REROOF WITFI COMP. & BUR IN HACK SQ FT: 1,100 CLAIM VALUE: 1,100,00 CALC—VALUE; 1,100,00 GROUP OCC: R-1 /M-1 COMMENTS: SMOKE DETECTORS ARE REQUIRED Irl EVERY BEDROOM & HALLWAY ��***��*��-x�*�r****�***��c*xiF��:�*�***+r***�**;E***��r�r*x*��*��iE�-*ecit�*iF**�*�*iE**+� 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 ---------- --------- ACCE5SORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAA: FT 3N LEFT: ET IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41808205 ZNE: REF NO; PLANNING NOTES> . > iE iF it if it iE iE # 3f iF iF it iE 3E iF i(� 3F iE iE iE if �IF iE d(� iE iE iF iE iE iE iE iP if if iF �E iE iE �lE iE iE if df iM1 # iF iF iE iE it iE if if iE i(� ih # jE iF iE iF if iE iE �E iE �3E iF iE"Fi jF ic �IE 3c� K� i(� %* 9E D E V E L O F M E N T S E R V I C E S R E Q U I R E M E N�' S ZONING APPROVED BY DATE; :I BUILDING APPAOVED HY : DATE: APPLICATION IS:SUED BY; � L�ATE; �,1 —I�� iPi(i:iE3riEiF#-iE1Ei[�iEic�iF.?�`#iEiEi6X•iEiErtyt?rTtstiritxitx�FlTrit�tirit�lxititfr itirx itxit��t�r�'titiFitiEi4iEiEiE#iE�IE ��R+i� itxit x�#ic �E iE iF iF if iF iE iF iE 3f 7h %' i'c #�1FlE iF IF iE 9E i6 iF iF ## if iF iF iE iE if !E iE iF iE iE N� #!f 15 9F iF i(� ik %if # iE iF if iF!(� 1f if if �lE ic 3f iF iR #� 1F iF V-�7F 3f iF iE iE if # iE ## ik iC 1E �)E tE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLPG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 27,00 ,50 PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL TOTALS----> 27,50 0.00 0.00 27.50 SMIPINON—RES PAID DUE 27.50 .00 REC'ENUE DIVISION TOTALS--> COLLECTED: 27.50 OVER/SfiORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIPlTOT GRADING FLAN—CHECK 2%.�� .5� iE # f! i(� if iE iE iE iE iF #� it �E iE iE iF iF-)E!t ih ie i(� 1E iE iE if� iE 1f ft A` iE iF IE ih iF iE �k� iE iF iE iE if iE iP 1: ih if iF if iE 1f i! iE iElF iE iE iE ik iE fE iE iE 9E 1k if iE �E 1E iE iE 9E �k if if iF �F iE iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1100 REROOF SY VALUE RESIbENTIAL NOZONE 1.00 1,100.00 END OF FEES 01 �0163955-00163946 T� T y7,gp DATE� 07/13/94 TI�lE: 12:Sb "� CONSTRUCTIQN AND PLANNING POOL a SPA �Date in:pector Date Inspector i APPROVALS Permit # APPROVALS Permit # 1. Temporary Electrical Service'or Pole � 52. Pooi & Equipment Location .' �� .• : J / �. 2. Soil Pipe�Undrgmd. j �, 53. Steei Reinforcement -� ; � :. 3. Elsarical Condui; Utility-Undryrnd. ��" 54. Forms '` ':' 4. Electrical Conduit-Undrgrnd. 55. Electrical 6onding �' 5. Steel Reinforcemenc ' 56. Rough Plumbing & Pressure Test � 6. Electrica� UPER Grnd. 57. APPROVAL TO COVER�GUNITE ' �. Footings � 58. Electrical Conduft-Undrgmd. �� 8. Foundation �. 59. Gas Pipe, O Undrgrnd., Test i � 9. Wa[er Pipe-Undrgrnd. �� ' . � 60. Backwash lines, P-Trap, C Undrgrnd. � :� 10. Structural Ploor SYstem ��`, J, ��;,' 67. APPROVAL TO DECK ,•..�,� 71. Property Sewer Line & Hou�Connection. r' 62. Backwash & Receptor-Final �� ' n� � 12. Sewer CeP / %' � � , - 63. Heater & Vent�Final 73. Roof Dr2ins 64, Plumbiny System � Final �� 14. flough Plnmbing 85. Efectricaf-Finaf . :� 15. Rough Elecrical-Conduft 66. Solar SYstem-Final `�' 16. Rough Electric Wiring 67. Fencing & Access Approval ^ ,J 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING � � 78. Rough E�ectrical-T Bar Ceiling 69. POOL/SPA SYSTEh;1S FINAI 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ � 20. Rough Factory Fireplace APPROVALS Permit # 21. Dutis, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Produci Pipin9 C Gas ❑ Oil 23. Gas Pipe�Rough & Test _ 72. Underground F�ush 24. Roof Freming 73. Undergmd. Storage Tank � Gas ❑ Oil 25. floof Sheathino 7 L�,.Gly/ �(�/ 74. Overhead Hydro 7 26. T-Bar Ce��ng (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe i 28. Lathing & Siding 77. FtXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drytvall Nailing � HEALTH DEPT. REQUIREMENT 31. Plasrer Brown Coat 79. FINAL INSPECTION 32. Electrical Powzr MeterFinai 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-Finai 41. Sofar pomesticFinal . 42. Backflow Preventer . ' � 43. Backflow Irrigation 44. LandscaPe irri9ation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL 5TfiUCTURE & BUILDING /Z G�,j�- G � 48. F4NAL P�ANNING � 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co � 51. CEflTiFICATE OF OCCUPANCY "' No: Dace �