HomeMy WebLinkAbout1660 IOWA ST - Building PermitsCITY OF COSTA MESA
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i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.Ce.us
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FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B09-00042
PERMIT TYPE 8_ROOF2 STATUS: ISSUED
APN: 13907502 DATE ISSUED: 03/18/2009
ISSUED BY: BJK
JOB ADDRESS: 1660 IOWA ST CM Suite/Unit:
Vicinity: PITCHED PORTION RES AND ATTACHED GARAGE
Squares: 1300 Valuation: $5,000.00
SCOPE OF WORK: REROOF PITCHED PORTION OF RESIDENCE AND ATTACHED GARAGE ONLY: T/O EXISTING WOOD SHINGLES,
7/16" OSB Si FELT PER MFGR'S SPECS, APPLY "30 -YEAR COMP SHINGLES.' PITCH 3.5:12 1300 SO FT
OWNER:
LAPITE, CHRISTOPHER S
PHONE:
$111.25
APPLICANT:
AKIL, ABDO
PHONE:
714.641.1440
CONTRACTOR: OKAM ROOFING
Address: 2737
S CRODDY WAYUnit:
City/State/Zip:
SANTA ANA, CA 92704
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
$0.00
Reroof Permit Fee:
$111.25
Reinspection Fee:
$0.00
Bldg Std Admin Fund
$1.00
TOTAL FEES $112.25
Address: 1660 IOWA ST
City/State/Zip: COSTA MESA, CA
Address: 2737 S CRODDY WAY
City/State/Zip: SANTA ANA, CA
License No. 841611
UNIT A PHONE: 714-641.1440
CELL:
License No. PHONE:
License No. PHONE:
Unit:
Unit: :UNIT A
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE /. INSPECTION TYPE DATE INT111AL5 CODEO IN$PECnON TYPE OnT INTInaLs
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 3 ' 30—C�s 62j_Z__ 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
1 1
WORKERS' COMPENSATION DECLARATIO .
I hereby 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
perto ance of the work for which this permit is issued.
have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier: I- Z{iTic —V iJ O
(ThissWmne notWmpletWdthepermduraluetlofinehunCretl0o (5100)ales$)
Policy Number. I CiV)L) .t
❑ I certify that in the performance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, I shall f rthwith comply with these provisions.
Applicant's ignature Da e
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect. �'2z
,Lie. # ' u l �O li, k Class #.L-3 6`11 1J
Don-tr�,lgs Signature
CONSTRUCTION LENDING AGENCY:
❑ 1 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:
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.).
❑ lam exempt under sec.
Business and Professions Code for this reason:
3057-46(31071
{ �
Owner ID verified by dyrcense. ❑ Yes ❑ 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 permil, and that no building structure, scaffolding, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) feel 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.
Applicant's 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? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires. with some
exceptions, that a Business Plan be fled 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 forth for acutely hazardous materials? ❑ Yes ❑ 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 an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building Occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ 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? ❑ Yes ❑ No
(If'yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safely Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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. 1 agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature of Lega erfsl Date
Anduor Aumwlz Applicant 1 Dat `\
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY'OF COSTA MESA CONSTRUCTION PERMIT
Project Address
Applicant's Mailin Address
Owner's Name14 4e Phone
Address
Arch/Eng. License No.
Address
Contractor's Nam Phone
Address (mailing)
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing
with section ]000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
1J N�
tens as J s
Date 7�/} S'9 t 1L�Z'�u'
'ORKE RS' (COMPENSATION DECLARATION
ereby affirm that I have a certificate of consent to self -insure Or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Sec on
3800, Lab. / __ � 7 >
!�P�—ol/icy No. � t�1 tl Company %)�/// //�
Datee� f
Certified
o�� ls) it ith Ap the citty�/• in �vr4Li�% ✓—
E%EM TIO FROM WORKERS' COMPENSATION DECLARATION
(This section need not be completed if the permit is for one hundred ($100) or
less).
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Workers' Compensation Laws of California.
Dale Signature
NOTICE: If, after making this declaration, you should become subject to the.
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the performance
of the work for which this permit is Issued (Section 3097 Civ. C.)
Lender's Name
Lender's Address
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section ]031.5 Business and Professional Code: Any city or
county which requires a permit to construct, alter, improve, demolish or repair
any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he/she is licensed pursuant to the provisions Of
'he Contractor's License Law (Chapter 9 (commencing with Section ]000) of
)ivision 3 of the Business and Professions Code) or that he/she is exempt
herefrOM 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
Enalty of not more than five hundred dollars ($500).
1, 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 (Section 7044. Business and Professional Code: The Contractor's
License Law does not apply to an owner of a properly who builds or improves
thereon, and who does such work himself/herself or through his or her own
employees, provided that such Improvements are not Intended or offered for
sale. If, however, the building or Improvement is sold within one year of COm-
pletion, the owner will have the burden of proving he/she did not build or im-
prove efor the purpose of sale).
1, as owner of the property, am exclusively contracting with licensed con-
tractorsto construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a con-
lractor(s) license pursuant to the Contractor's License Law). I am aware that
proof off their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section B. & P. C. for this reason
Date
I hereby certify that
Information Is correct
and state laws relatin
sentatives of in cit
inspection pur
Signature
Drivers' License or SS
— Owner
I have read this a
I agree to comply
to building copSt
_ to enter—upon
CMF 0865-46, rev. 10/84 White - Building: Canary - App
FHM3o6II NU
P
HHUI NV.
.LVl lvv.
UNIT NO.
Backflow Preventer Service Sink
%'203 1.0/12/87
Jp00
TYPEOF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION REPAIR
Bathtubs Sewer Connection
$
Clarifiers Solar Collectors
❑ ❑ ❑
Dishwasher Solar Piping
PERMIT
Drinking Fountains Solar Tank
CONVERSION DEMOLISH OTHER
A.P. .
Zone
Floor Sinks Urinal
DESCRIPTION OF WORK/USE OF BLDG.
Gas Service Outlets Water Closet
25%
Interceptors Water Heater
ENERGY P.C.
Kitchen Sink Water Service
ELECTRICAL
S
Main Building:
Accessory Building:
S
Roof Drains
50%
E
- MICROFILM
$
MECHANICAL
Z
TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL
T
Front
PLAN CHECK
25%
O
TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL
B
N
O
A
Rear
OTHER
C
Right
N
PROJECT DESCRIPTION SQ. FT.OCCUPANCY
K
G
CONSTRUCTION TYPE VALUATIONS
$
Left
R
ZONE GRADING CU. YDS. ACRES
Ping. Ref. #
Parking Req./Provided
E
O
Remarks:
Planning Notes:
M
T
S
' PLUMBING
FEES
Bar Sink Showers
SUMMARY OF FEES
Backflow Preventer Service Sink
BUILDING PERMIT
Backflow Irrigation Sewer Cap
$
Bathtubs Sewer Connection
$
Clarifiers Solar Collectors
Dishwasher Solar Piping
PERMIT
Drinking Fountains Solar Tank
PLUMBING
x Floor Drains Swimming Pool w/Spa
$
Floor Sinks Urinal
$
Gas Service Outlets Water Closet
25%
Interceptors Water Heater
ENERGY P.C.
Kitchen Sink Water Service
ELECTRICAL
Lavatories Auto -Wash
$
P -Trap Laundry Trays
S
Roof Drains
50%
Reinspection Fee I $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact Bit. ICBO #
Heating System & Ducting
❑0.100,000 BTU 1:1100,000 BTi
Reinspection Fee 1 $15
Pink - Accounting; Goldenrod - Assessor
Issue Fee
Hood or Type ❑
Canopy Type ❑
Refrigeration System
❑0-100,000BTU 11100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 1:10-5 KW E15
-
ELECTRICAL FEES
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
. Motors E10-11 HP ❑ 1 % - 8
Inc. Solar 09-15 HP C1 16-15+
Microwave
Pole Light
Range
Standing Sections
5 KW I Trash Compactor
I I Reinspection Fee I $15 1 1 Issue Fee 1 $ 3 1- 1
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By /
SUMMARY OF FEES
BUILDING PERMIT
$
SMIP
$
PLAN CHECK
S
PERMIT
PLUMBING
$
_,5700ISSUANCE
$
PLAN CHECK
25%
$
ENERGY P.C.
$
ELECTRICAL
-
$
GRADING
S
PLAN CHECK
50%
$
- MICROFILM
$
MECHANICAL
$
TOTAL FEE
$
PLAN CHECK
25%
$
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
POOL &SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrbrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings '
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, ❑ 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. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas ❑ Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas ❑ 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: 10 oZq• 37 4 946r c,g2O. /-,ED
34. Final Heating & Air Conditioning
ZIIt'a7 G►ru.EL As We, 2a3 UOG L.Ir- D ,t
35. Final Gas Pipe -Test
--
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
'
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
'
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
t
PROJECT ADDRESS: 1660 IOWA ST
OWNER'S NAME: CANO, MOYSES
ADDRESS: 1660 IOWA ST
COSTA MESA,CA
ARCHIENGINEER:
AGGRESS:
UNIT:
92626
REG.NO.:
UNIT:
PERMITTEE:DEPINHO ROOFING (714)632-7663
ADDRESS: 1152 NORTH KRAEMER BLVD,
ANAHEIM CA 92806
LICENSED CONTRACTOR DECLARATION: I hereby affirm that) am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect.
CITY LIC.1051640 STATE LIC .:44672CLASSIC-39
Date '._7 - L — Signature:
WORKERS' COMPENSATION DECLARATION: I hereby f that I have a certificate of consent to self -insure or a certificate of Workers'
Compensation Insurance. or a certified coy thereof (- tion 3800. Lab. CL
POLICY No.:285-93UNITg148 EXP. DATE: 01/01/94
COMPANY:STATE FUND
7 Coligqfied copy is hereby furnished. ® Certified copy is filed with the city Building Division.
J
Date: —Z —13 Applioant: /qaQ/f
EXEMPTION FROM WORKERS' COMPENSATION DECLAMT}BD (TN section neetl not he completed iI the permit is fw one hundred ($100) or less).
I certify that in the performance of the work for whicibill permit is issued. I shall not employ any person in any manner so as to become
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: If. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor
Code. you must footmtn comply with such provisions ar this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency tar the performance of the work for
which this permit is issued (Section 3097. Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the ContractorsState License Law lot the following reason
(Section 7031,5 Business and Professional Code: Any pity of county which requires a permit ro Construct, alter, improve, demolish, or
repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing wish Section 7000) of Division 3 of the Business
and Professions Code) or that he/she is exempt therefrom and the basis lot the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars (3500).
I, as owner of the property or my empployees with wages as their sole compensation, will do the work, and the
❑ structure is not intended or offered for sale(Section 7044, Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon, and who does Such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or
improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the properly. am exclusive) contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Professions Code: The Contractors' Stale License Law does nor apply to an owner of property who builds or improves thereon
and who contracts for such projects with a conrractons) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Dale: Ow net
I do hereby certify that I am aware of and understand the requirements of California Health and Solely Code Sections 25505, 25533, and
25534 and that l or any future building occupant vi ll/vnll not (circle one) need to comply win said state codes and the requirements for a
permit lar construction or modification from the All Ouality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant
I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorae representatives of this city to enter upon the above mentioned
property'nsXo
for Inspection purposes.
—2�)
Date: . �� Signatures Ssd�
Driver S License or Social Security 0:
1641-46 White—Bmldmg: Green—Cade Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor
CITY OF
COSTA MESA — BUILDING PERMIT
PERM NO; B 061199
PERMIT NO; B 061199
PLAN CHECK NO; N
GOVT;
N SUPP; N
CONSTRUCTION TYPE; 5—N
PERMIT TYPE; STR
FT IN
PURPOSE; ALT
JOB DESCRIPTION ; APPLY FIBERGLASS OVER EXIST. WOOD SHING
SQ FT;
3,100
CLAIM VALUE; 3,100,00
CALC—VALUE; 3,100,00 GROUP
OCC;
R-3 /M-1
COMMENTS; SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC.
Z O N I N G S E T B A C K S R E Q U I R E M E N T S
------------
MAIN
BUILDING
----------
---------
ACCESSORY BUILDING---------
FRNT;
FT IN
REAR;
FT IN
FRNT;
FT
IN REAR; FT IN
LEFT;
FT IN
RGHT;
FT IN
LEFT;
FT
IN RGHT; FT IN
PARKING
RE •
PROV;
PARCEL;
13907502
ZNE;
REF NO;
PLANNING
N TES>
D
E V E"L O
P M E N
T S E R V I
C E S R
E Q
U I R E M E N T S
ZONING APPROVED -BY DATE;
BUILDING APPROVED BY ; _ DATE;
APPLICATION ISSUED BY;
DATE:
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63.00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE r•
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 63.50 0.00 0,00 63.50 63.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 63.50 OVER/SHORT;/ ,00
BLDG P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOOT GRADING PLAN, -CHECK
I N D I V I D U A L IF 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 3100 REROOF BY VALUE RESIDENTIAL NOZONE `- 1,00 3,100.00
i� END OF FEES
`i
EXPIRED
Iricoftl le a Inspections
Date Sig —
bA. /
_I
CONSTRUCTION AND PLANNING
APPROVALS Permit # Date
Inspector
POO. - SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
.-
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57, APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
Foundation
59. Gas Pipe, 0 Undrgrnd., Test
'
I8.
_ 9. Water Pipe-Undrgrnd.
I
60. Backwash Lines, P-Trap, 0 Undrgrnd.
i 10. Structural Floor System
i
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor-Final
1
12. Sewer Cap I
1
63. Heater & Vent-Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing I
65. Electrical-Final
15. Rough Electrical-Conduit
66- Solar System-Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68, APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21, Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank 171 Gas 001
25. Roof SheathingI�
/Jc
74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat
1/"
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
j
78. FIRE PREV. FINAL
30, Drywall Nailing
HEALTH DEPT. REQUIREMENT I
31. Plaster Brown Coat
79. FINAL INSPECTION
-
32. Electrical Power Meter-Final
-
80. FOOD CERTIFICATE ISSUED
33. Final Electric
-i I
Notes.�/ /� I
/j� ,tee �_by,N� 3-j -(7
34. Final Heating & Air Conditioning
;
35. Final Gas Pipe-Test
r
36. Hood or Canopy
37. Final Factory Fireplace
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I
38. Final Plumbing
r
1
39. Water Service-Final
'
40. Gas Service-Final
I
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
t' 9
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
;
X P m-E D
ncomplete_II)SpeCtionn5
Nate
50. Gas Release to Southern California Gas Co
^,
51. CERTIFICATE OF OCCUPANCY
No. Date
$jr,
;\ I
OWNER MODULAR Technology, Inc.
DATE 7-15-71
JUn AUL)Ktn Loov Iowa mxe I- DING PERMIT N0. 33325
WOR GENERAL CONTRACTOR Same DESCRIPTION of WORes w att gar.
AP No. LOT 17 TRACT 6614 FIRE ZONE VALUE $19. X95.00
INSPECTIONS
Si
nota ra
Date
GROUP T & T TYPE
ZONE
SOIL
— ,'7
SUBCONTRACTOR
Dat.
PERMITS ISS ED
Number $i nature
GAS
WATER
Plu in
ROUGH PLUMBING
PROP. SWR. LINE -HOUSE CON. �
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER 0
ROUGH WIRING
Heating and Vent
TRENCHES FORMS STEEL REINF.
_
/Q -
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
PLASTER, BROWN COAT
-�
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. AND A.C., FINAL
J/
PLUMBING, FINAL AND GAS TEST
{
ELECTRIC, FINAL
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33325
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
Pala 0' 11 U0
JUL 7.0-71�n�.00176
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECELV3D BY]
Vf.1/ �/7�/__
QATE 2RE^E�7
//
ppTp ISSUED�
BUILDING
ADDRESS
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PER
OWNER Modular Technology, Inc.
A.P. NO.
BUILDING
MAIL
1104 E. 17th Street
ADDRESS COd
16/
ADDRESS
CITU Santa Ant. Not. JC47-
TRACT 6614
LOT 17 BLOCK
CONSTRUCTION
W
A AREPAIR
LENDER
X
BRANCH
OWNER Modular Technolo In
ADDRESS
VALUE 1
S Residence /
ARCHITECT TEL
Kermit Dorius ATA
ORENGINg, N ,-644-7111
FIRE
ADDRESS 111 2nd Ave ron M
ZONE TYPE GROUP
APPROVED
CONTRACTOR Owner
BY DATE
ADDRESS Same
ZONE
NO. OF
USE OF NE /
TEL.
cfry Same No.
PLANS
BUILDING
STATE CITY
LIc.No. 252549 LI C. NO. 1690
YARDS APPROVED
MAIN BUILDING
YARDS AP OVED
ACCESSORY BUILDING
SIZE NO. OF BLDGS.
(FROM C/L STREET)
OF LOT 1305 SF NOW ON LOT
FONT 54`++)
FT.
FT.
USE OF
L
EXISTING BLDG. --
R. SIDES FT.
FT.
SIZE OF NO. OF
NEW BLOG.1 05 SF ROOMS 5 STORIES I
L. SIDE IT.
FT.
EXTERIOF WALL
COVERING rer Plans
ROOF
COVERING Wood Shin les
REAR T. ITi3
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLDGS.
ACCESS. BLDG$.
Construct new residence with
C URP # - ��
DATE / (%
APPROVEDS/C/t0a
attached garage.
APP E r
/
I hereby acknowledge that 1 have read this application and state
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that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
QUIRE MENTS
any person in violation of the workman's compensation laws of
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✓ D�O• FT.I /
the State of California.
hereby certify that I am properly licensed as a contractor under
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Divislcn 3,
Chapter 9, and that such tenses are In full force and affect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the ov ions of the Sta!9,Pf California Business
and Professions Cod D's3, C
VALUATION
i'i L�
_J
pt nsion
(
PERMIT FEE $ —
Signature of
Permittee
$ -S =
S
/
2 -*-
PLAN CHECK $ / '
Authorized Ag
J
ent
TOTAL FEE $
OWNER CAMPAGNON, FRED DATE 5-6-74
JOB ADDRESS 1 owa Si.
GENERAL CONTRACTOR Owner
AP No. 139-075-02 LOT
BUII DING PERMIT NO.3b356
r• DESCRIPTION of WORK legalize a io over
TRACT FIRE ZONE VALUE 700.00
INSPECTIONS
Si nature Date
TYPE V GROUP
J ZONE
SOIL
SUBCONTRACTOR
PERMITS ISSUED
GAS
Date Number Si nature
WATER
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING
Heating and Vent.
TRENCHES ❑ FORMS= STEEL REINF.
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING '
LATHING — IN 7 OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
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A83576
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 A /
,)hY _6-71.Irfvai,s�d0 1511•r ***yr14.50
A
P LIPTION FOR BUILDING PERMITRE
For Applicant to Fill in Completely
I V
DATE RECEIVED
DATE ISSUED
BUILDING j
(L,
ADDRESS CJeG
`
/q'�
OWNER ��. d ep
] _OZ PEM.&
A.P.NO. 3 —O
MAIL 1 \_\__
AODRESS \�O(GU
BUILDING r_Z-
ADDRESS l Q �-p (�J
TEL. /
CITY C C Q, NO. 6
//''
TRACT(CGp
LOT1:7
BLOCK
CONSTRUCTION
NEW
I ADD
ALTER RIEPAIR
LENDER O
BRANCH
r
OWNER T
ADDRESS
�EC1AL1 VALUE
S $ O 0'Z
ARCHITECT TEL
OR ENGINEER v1 P `r N
FIRE
ADDRESS
ZONE YPE GROUP
APPROVD
Id
CONTRACTOR Otc>�e-\ ~
BY
DAT
ADDRESS
ZON
NO.OF
USE OF NE
?V?v
CITY NOL
PLANS 2
BUILDING CO
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
(FROM C/L STREET)
[ /�
S1ZE/ _7<
(00 too
NO. OF BLDGS.
OF LOT (�
NOW ON LOT
FRONT FT.
FT.
USE OF 1
EXISTING BLDG.
R. SIDE FT.
FT.
SIZE OF 4T so pN L"T NO. OF
_
NEW BLDG. `( ROOMS STORIES
L. SIDE FT.
FT.
EXTERIOR WALL
ROOF
COVERING
COVERING 1't n
REAR FT.
FT.
USE CJF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
E
MAIN BLDGS.
ACCESS. BLOCS.
r7
VAR. #`
DATE
�00`Z' 6
C.U.P.#
APPROVED
APPROVED 1 .L�
W
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/ \\
I hereby acknowledge that I have read this application and state
j N
NN9
that the above information Is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Divisicn 3,
Chapter 9, and that such licenses are in full force and affect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from it,. provisions of the State of California Business
VALUATION(�
and Professions Cnce, Division 3, Chapter 9.
PERMIT FEE $
Signature of
Permittee :44
00_
PLAN CHECK $
Authorized Agent
/OIL
TOTAL FEE $