HomeMy WebLinkAbout1829 IOWA ST - Building PermitsCITY OF COSTA MESA
BUILDING DIVISION
i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754.5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754.5626
PERMIT NUMBER BC07-00105
PERMIT TYPE: ' B_COMBO
STATUS: ISSUED
Sub Type: RES_ALT
DATE ISSUED: 07/17/2007
203
ISSUED BY: BJK
JOB ADDRESS: 1829 IOWA ST CM
Suite/Unit:-
Vicinity: HALL BATHROOM ,1..
!'•40
Primary-Occ
Const Type: V -N ;'- .'SQ.�FT
Valuation x$8;50000;,,,
SCOPE OF WORK: REMODEL'OF AN EXISTING HALL BATHROOM
IN AN EXISTING•S3FD: WORK TO INCLUDE CHANGE -OUT
OF A WINDOW, ELEC & PLUMBING. ''-• %`="
OWNER: PEABODY, JON S, :- . --Address:
1829 IOWA ST- Unit:
PHONE:.- -
City/State/Zip: COSTA MESA, CA'- -
APPLICANT: VICTOR O �LAREY
Address: 1742 PINE ST Unit: -
PHONE: 714-374-3376 -- -
City/State/zZip: HUNTINGTON BEACH, CA
CONTRACTOR: VICTOR O LAREY
'License No.1 514239 ,.:
Address: 1742 PINE STUnit PHONE: 714-374-3376
City/State: HUNTINGTON BEACH, CA - --
- -, ,_ .: ZipCode: 92646
CELL: ..
ARCHITECT: '; License No,
-.- . PHONE .
ENGINEER: License No,..
, :•PHONE:'
COMBINTATION PERMIT. FEE SUMMARY-
Building Plan Check: $0.00
Building Fees: $16725.,-
Electrical Fees: $26.80:x_.,
Mechanical Fees: $0.00
Plumbing Fees:.. ;$62.70-,�f...-'
SMTP Residential: $0:85
SMIP Commercial: $0.00
TOTAL FEES: $257.60
"Refer to fee receipts for all fees paid for project
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 I. INSPECTION TYPE DATE INTMALS CODE INSPECTION TYPE DATE INTMALS
1616 Fixed System Final Fire Prevention 206 ' Final Mechanical �q
1266 Pool Spa Final 208 Final Plumbingi� Et
200 . Final Re -Roof 210 Final Electrical /0-k 02
201 212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
Final Block/Retaining Wall
202
Final Factory Fire Place
203
Final Sign
204
Final Demolition
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the to,—wing declarations:
❑ I have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. '
I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are: pp�� —t—(/t
y- ��(n/%
Carrier: J l ,, l (/t(^/C+�-�
(This section need not be completed if tthhe�permal is valued at one hundred dollars ($100) or less.)
Policy Number: o d y
❑ 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 worke�rs' compensation laws of California, and agree that if I should
become s bject to the w Flcers' compensation provisions of Section 3700 of
the La q r od , I shall to thwith comply with these provisions.
ti 1-(-7—O'
App iwnt's Signator Date
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
Owner ID verified by driv nse. ❑ 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 permit, and that no building structure, scaffolding, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
Applicant's Signature
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 filed with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. � a registration form for acutely hazardous materials? ❑ Yes El No
Lic. # 7 2 Class # 7y C3 P // /(S`eetion 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
"1 each business which at any one time has on hand a quantity of acutely
Contractor s signature—T^Date 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued. (Sec. 3097, Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
Signature Date to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
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 contractors) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature
305716 (3/071
Data
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 Duality 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 Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ 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. I agree not to occupy or allow occupancy of any building
authorized by his permit until Inal inspection.
Si Legal wner(s1 Dale
%/ Date
And/or Authonzed Ap N Date
PRWECT ADDRESS: 1829 IOWA ST UNIT:
OWNER'S NAME: WOLF
,jv ADDRESS: SAME ,
�``546-2963
c11RCN/ENGINEER: flE0.N0.:
ADDRESS: UNIT:
PERMITTEE: WESTERN SIERRA ROOFING (714)660-8505
ADDRESS: 17932 SKYPARK CIRCLE
IRVINE CA 92718
LICENSED CONTRACTOR DECLARATION: I hereby a0irm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Prolessens Code. and my Ocense is in NII force and effed.
CITY uC.: 39991sTATELC.:49259 CLASS: C-39
Date: Signature: C'1 HIAA A/Vl
w)RKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cin ificate of consent to self -in m or a certificate of Workers'
;pens ition Insurance, or a cemfied copy thereof Section 3800, Lab. C).
,ucYNO.:OIWCP12072A EXP. DATE: 04/01/91
COMPANY: SUP. NATL
❑ Certified copy is hereby famished. IR Certified copy iis-a 1E 41 s'filed witch tth1e_city Building Division.
Date: y` 3 '"r � Apppunt:. (( AA 0
ExEMPDON FROM WORKERS' COMPENSATION DECLARATION: Pius section few notb B the pe ad is mi one Andrea ($100) or less).
I certify that in the performance of the work for which Otis permit is issued, I shall n eM411:0.y person in any manner an as to become
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: If, after mating this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you most foNmith compby, with such provisions or tion pemdt shag be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a consmaction leading agency for the performance of the work for
which this permit is issued (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm Out 1 am exempt from the Contractors' State License Law tar the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure, prior to its issuance, also regulms the appricant for such permit to We a signed statement that he/she is licensed
pursuant to the prov¢ions of the Contactors' Sure License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that hefshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
•nv applicant for a permit subjects the applicant to a civil penalty of not me than five hundred dollars ($500).
I, as owner of the propend or pry, a aryees with wages as their sale compensation, rill do the work. and the
structure is riot intended m offered for sae (Section 7044, Blsloess and Professional Code: The Contactors' State License Law
does not apply to an owner of a property who builds or improves that=, and who does such work hinselllberself or through
his or her own employees, provided that such improvements are rut intended or o0ered for sale. IL however the building or
improvement is sold within one year of completion. Oce owner will ban the burden of proving he/she dM not build or improve
for the purpose or sale).
I, as owner of the proverty. am exclusively contracting with Licensed contractors to conswm the project (Section 7044• Business
❑ and Professions Code: The Ciontradar5 Sate License Law does not appy tow owner of property wad builds or Improves thereon
and who contracts for such projects with a canOactor(s) Acetate pursuant to the Contradms' State License Law). I am aware
that proof of their Worker's Compensation Insurance should be provided to W.
❑ I am exempt under Section: B. S P. C.
for due reason:
Date: Owner:
I do hereby certify that I am aware of and understand the requirements at California Health and Safety Code Sections 25505. 25533, and
25534 and that I or any future building occupant wiN01 not (circle one) need to comply with said sate codes and the requirements lot a
permit fm construction or mor iliatan from the Air ality Management District. Residential canStrntl'lon applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have mad this application and sate that the above information is warted. I agree to comply with an
ordinances and sate am relating to building construction ami hereby authorize representatives of this city W enter upon the a
property tar inspection pr
Date: urpeses. Signature:
Driver's License or Social Security A:
184146 White—Building; Green—Code Enforcement; Canary—Applicant; Pink --Revenue; Goldenrod—Assessor
and
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 047055 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: STR
JOB DESCRIPTION : REROOF 3600SF W/SIERRA TILE ICBO#4361
CLAIM VALUE: 8,000.00 CALL—VALUE: 8,000,.00
PERM NO: B 047055
GOVT: N SUPP: N
I:IiF:T;Z�Fy�1��➢YG
SQ FT: 8,000
GROUP OCC: R-3 /
COMMENTS:
ISSUE FEE
itiEieit***ie****eL*****Be*****i!k*iLB6kk*kit*ie*iE**iritic*iteF*****iE**it**ititieiEi69E1FBE*N****9t
B4aE*at
ZONING
REQUIREMENTS
TOTAL PAID
SMOKED_MYOR
TOTALS ---- >
99.56 0.00 0.00
S E T B A C K S
.00
REVENUE DIVISION TOTALS--> COLLECTED:
------------
MAIN BUILDING
---------- ---------
--�� E.
ACCESSORY BUIL��991��rrrXGd LMR
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 REQ:
PROV:
PARCEL: 13905603
ZNE:
REF NO:
I,ePLANNING NOTES>
itiritititiritititititititititititititititiEiEiEitititit�raE�E*+r�r��*�E*�*�r1���*�r*�L**�E�E*�r�E�E*�**��*�r�r*x.���r���E***��
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:
etNiFifetMiFeFit9tiE*iF****ififkkif iritititit***ititifi et*
iF*1FMM MMMBF if it*M9t*****iEkeEiEiEiE%iE it iE iEKiE♦fiE♦E iE iFit it iE%it*it*it*KMitrit it**it et Btlhit et it iE it*iE eF iE it***iE it iF*iE*iF
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 99.00 56
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—>
PERMIT ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
99.56 0.00 0.00
99.56 99.56
.00
REVENUE DIVISION TOTALS--> COLLECTED:
99.56 OVER/SHORT:
.00
BLDG PMT
PLUMBING ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
99.00
.56
*et*it it if*Bt it it it it it it*iE iE*it it itrit it ititit***it*it if it fit it it*it it itis it it et it it if it***iE itrit iE iF if*iE itit iE it iE*iE it it iF iE*it it it it
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
.7
SFR 8000 REROOF BY VALUE RESIDENIAL NOZONE 1.00 8,000,00
END OF,FEES
01 00059222-00059223 T IC1 T
DATE: 04/23/90 TIME: 09:28
99.56'
r
*)NSAVCT10N AND PLANNI,.
)OL & SPA
-
APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole; 1:
_
52. Pool & Equipment Location
2., Soil Pipe-Undrgrnd.y ° 3c
53. Steel Reinforcement
=., S_Electncal Conddit-135'tility-Uncirgmd.-S
54. Forms
= 4. Electrical Condit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement < >:
56. Rough Plumbing & Pressure Test
-
6. Electrical UFER Grnd. '•'
57. APPROVAL TO COVER-GUNITE
u
7. Footings
58. Electrical Conduit-Undrgrnd.
B. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor.�S'ystem - r_
-
61. APPROVAL TO DECK
11. Property Sewer •Line& House Connection
62. Backwash & Receptor-Final
12. Sewer Cap c�
-
63. Heater & Vent-Final
-
13. Roof Drains - -
64. Plumbing System - Final
14. Rough Plumbing
65. Electrical-Final
15. Rough Electri I•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
#
20 Factory Fireplace m�•
-a ..:APPROVALSFPermit
�Roc4gh SC••
_
im
21!-Ducts, in,Struaurei •• •• '-ice
+ S
O -mow r
-%70. U_ndergiound?Hydro
22.. ct,'s, Venti�atirg� :JS
#
��
<71 Product-.Piping ❑'Gas 0"Oil
Q
c�
23.--Gas-Pipe-Rough & Test ?1r
K n•1
7,,72. Underground FlusK'c_'•' r `^
r.n
r rr
rH c'r i
J
•�.
" ..
24:�Roof Framin- ' ^F' ••F
9 w
t :'• 6.
t~ x
s +r^
•Undergrnd.Storayep7;ank bGat OOiI
,:(
41
zz,yI r
..73m:
25. Roof Sheathing t 4�74,^Overhead
HydroO
4
y i
26."T-Bar Ceiling (Stru�tural) &`Monocoatr
Lin
x
75 Dry Chemical •.t r" '`
O
HD
and Flashing, �x_c;
a -
aiw i
76^Dry Standpipe
_27.`-'Frame
..., . :=.
28 Lathing`& Siding
77. FIXED SYSTEMj'El NAl'e
- 29. Insulation V 9 ,, ••
X
�t x
78ZFIRE PREY. FINAL * ••` -� �'
30. Drywall,
�_ HEALTH'DEPT�REQUIREMENT
.Nailii6g
')31. Plaster Brown Coati- r _. (.,
` r .
-79. FINAL INSPECTION x J
r;32;_Electrical Power Meter�Einal'
r ,t
y *
T80.YFOOD CERTIFICATE IS�UyED,
33.rFinaj Electric •t
+
I t
Notes: •-
! zl
_
g �yi^ l�
34..-Final Heatin`t& Aid-Cc riditioning`
j.
P,
35`-:Final Gas Pipe-Test] .:
'4 i
r
7 _xo Or+ -�•T'
'36. �Hobd orCanopy
_
H N :i lT y
-•�37.`.Final Factory Fireplaces 0
fi
1 t
L l i
_ ,
X38. Final PlumbingJ
y N
39. Water Ser vlce.Finala
n
�A
s
R
y
y w
R:40. Gas Service.Final x 1 4tvC
T:41. Solar D'oinestic-Final-Y'' m ••
t
i s
777-
y n
42. Backflow Preventer..
43. Backflow Irrigation.
p
r Y.
U , C.
y,
X44. Landscape lrrigatidn Systeme'
45. Sound Attenuatio
j r
q
tr Cr
6.46. Handicap Regulations O'
y
^ice,?• t
,�;
�,
•
:i "1 y.
'FIN`AL STRUCTURE & BUfLDING
ct ct
�.
�
'�^1 z
«
X47
•,.
�,
48^FINAL PLANNING
X49, Electric Release to'Edison
L
b50%Gas-Release to Southern California Gas Co
v
I
51. CERTIFICATE OF:000UPANCY
No: - Date
I
ADORES$ OF BwyGNa. 1 8 2 9 . IOWA STUNT: _ UNT:
DWAM
NERSNEIFK3gM WOLFGEORGE B FLOOD _ AE=3
AODRESs:WOLF,, BARBARA M
1829 IOWA ST
OSTA_MESA,CA 92626546-2963
APPL.M URID ADORE59:
MCNRECT OR ENGINEER: LN:. NO.:
ARCK OR ENG.'S ADOREW: UNIT:
cDwAcTwsRU.,,D P PLUMBING AND INSTALLA (714)991-9477
CONMACTORSIDJUNG 1588 S ANAHEIM BL _
aDOREs4ANAHEIM _ ._ CA ,reo, 563793 _
92805 Uw.. 3
LICENSED CONTRACTORS DECLARATION: I hereby alma under parody of pi he I sin firmed under provisions of Chapter 9
(commaharp with Section 7000) d DMi iim 3 d tM Buanesa and PMesaom Cadeand m li0eam is in lull force and effect.
CLIC. .. 50 72 P4uacLAss:C 36 uc.1rld: 637 .EXP: 09/97. _
Dale: Cimmedp: / % A
OWNER BUILDER DECLARATION: I hereby al5rm under pendly Of perluY that I am exempt burn the Comrmm Limine taw for the «
ilbwin9 reason (Section 7031.5 Buness and Prdeseam Code: Any city or county whits require, a permit to construct. Mer, improve,
,md'sh, m repo any sIn ctma. pia to de asuanm, also require, IM applicant for such pants to file a sipped statement that he or end
a licensed Moment to the aoviaims d he Cmtractms IJcame Law (Chapea 9 (commenciN with Section 7000) of Division 3 of the
B.si. W Professions Codel Or that he or she a exempt harahom and the baps for he a0eped uemof.. Airy yiclmm of Sedicn
7031.5 by ,try applicant far a p m subjects the applicant to a dl candy of ml mare Than fine hundred dollen 155OOD.
I, are owner Of the popery or ey omploysee %sh wnpm are their sola mmponseim, will do the work. and the etmcture ls int intended
Or Offered for seds (Seim 7044, Business end Poleeabns Code. The Contractors License I.awdoss not apply to an ownerd promM
who allots or vnpro ria thereon, end wtho does such, work NmseN or MMM orIhra h he or aan own emplaym,, pnwided tIt each
impowmonta ore int intended Or ansa d for say, ff, however, the WiLdur, or enprmaneM a sold whhin aha Yea of oomplmion. he
ow 4mider will hove IM burden of pwilp he or she did not Wind or impure for the Mrpme of saki
I, se corm, of the coots. am sxdiruvely contracting wah licensed cont.w. y construct the pr ject (Section 7044, Buainese and
PMleepons Coda: The Contractors License I,aw does not appy Io an owner of Properly who builds or impMea 1Mreon end who '—
contracts for such projects wUa a mmncta(s) licensed womml to the Contractors License Law).
I am memp under $action: B. & P.C., for h s realm:
Done: Ownm:
I do hereby ceNy that I sin owane OF snd underma d the recu'vemaw of Cellona Neehh and Safety Code Section 25505, 25533, end
3553 c, and that I m arty Man Wiya9 compost will I will not (circle one) mail to wady ash said ante codes end the hequiromava for
e pmmillawvuwtiananwdifralianhonlMAi slylrmhe9enwu District. Residential wMmctyn eppirmiowen uemd from hese
P'..
Done: Applicants:
WORKER'S COMPENSATION DECLARATION: I Mreby, d les udar penuby of papay one Of he foloryag dederatipn:
I Iva vol ad rawness a cenAimle of coneere to sMtiwre for waken' mmmnsndicn, as, porided to by Section 37M of the labor
Cede, for the part. of he wak for which this oma N um,ac.
] 1 lye and wile meinlaa wrkeri mmcenutyn imurmwe, m r midi by Section 37W d he labor Cods. b the peripmafnas d tae
work fa which this penM te I Hued. My wak�a)ymanwa inter and potty mpnbar ane: EXPIRES
Carter: J
pefwy Number. 02/01/98
(Me saaion reel int M wnGlanal i IM Pisani is M atm heldred dollen (S1O01 or eese.d-
❑ I only Nm in IM Po!10 e d IM wok for v rich Ib s pemit a asuedljduyM anploy any penin a any mmmr so m to
bacanhs subject o tM wonlws' conrh0erweimn awe d Cellante, end/ell��eeee Uhei 1 dwyld �ecmha phpd to tM wnbn'
d Section 3)00 dim
labor Code, I MM 1W� #. Ih l I �9w/q'Plbv®n '
Dine: ApdFaN: �[p U�((ll•[e
Waanep: F.H. for sacun win .' ms amessan rove vpa /i unlamU and shall msblacl an employer to Marla d pants. may
dye nines W M me amassed thousand "face (110000% len esteem to UIs seat of mnlpans0on, danro9ss u proyMsd for In
Secdm 3705 of she Labor Code, Interest sed aeon%'s Iowa.
CONSTRUCTION LENDING AGENCY: I hereby algin oder mash d perjury There at tha e mneructipn lending apmwy ha he
W.. d IM work for "id, the pend is asusd (Solan 3(197. Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
1 candy the 1 eve Moot this application and areae land the above slormeion is coned. I agree to comply ween all city and cc sny ordinarhros
and acme Iawa doing to building construction, and hereby auambe repesentalivm of this oily to enter upon the prepert,
for inspeai purpee PAT PADILLA
sane
xz / is Dee: / r
Sigreture d OvmedlpanVAmimnbGantrectw
(5151<O.WP) White-BuiMn9 & Soley; Ormn-File: Cenery-Appimnl; Pink-Rerenm; (bMenrod-Assesxr
_C.I.TY_OF__COSTA.MES,A._— BUILD ING.-PERMIT,_
PERM NO: P Otl1tl10
PERMIT NO: P - 081810 _ .__ PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION.TYPE: V—N_ _ _. PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION REPLACE WATER HEATER SQ FT: .
CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /
COMMENTS: X._
***sE*iF*1E iE*****k*****lE SE 9E 9E*9Edt**iEiE**SE st di dP 9i 7E*iE fk*dE 1E**k*kick*kdEk*fE 9E dE**9p**ii***Rp dE SE SE*kdP**k
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
----r:--r --- MAIN BUILDING ---------- ------ ACCESSORY BUILDING-.--_-----
FRNT:.,_- .FT. ... IN REAR:_ FT IN FRNT: FT IN REAR: FT IN
LEFT:._ _FT IN- RIGHT: FT IN LEFT: FT IN RIGHT: FT IN
PARKING REQ: PROV: PARCEL: 13905603 ZNE: REF NO:
PLANNING NOTES>
>
*df dF**1E iE 1F 1F dF 49FM dF lh dh df dE RF dF dF IE iF dE IE***dE*dP*k41E 1l dE dE lh M1E4*1E*1i dE dE 7t lE dE dE IE*iF**dF*iF IE dE Rf iE *1E iE iE iE RE dl dF lE 9F dF4 MdE 5E
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; 2 Z
dh*Sf lE if if ii di*1fk*9EkkdF dh dE dEkiE dE kdE**ih iE dE dE dE* iFM
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 11.00
25% SMIP/NON—RES
PLAN
ISSUE FEE 22,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 11.00 22.00 0,00 33.00 33,00 ,00
c
REVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33.00
k 41E iE dF dF fEk*ilk*dE lE**lE iE dE 1E*1E lE****MlE*1E RF lE IE RE fE ilk*Ni♦E1E*1f***ih lk iE lE 9Fkk*1F dh dE*lE*1flE 161b*1k 1E SE dk dF dE*1i 1E*iE db dh*4
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
PLU 1_ WATER HEATER AND/OR
ENT ENDFEES 1.0 n 11.00
��
a DFEB 2 7 1997
EXPIRED CITY OF COSTA MESA
DATF o)P)AJ-
CONSTRUCTION AND PLANNINGP>Or
'1' FDateInspeMor
APPROVALS Permit #
d
.I SPA
APPROVALS r.rmit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. 5oj1 Pipe•Undrgrnd.
53. Steel Reinforcement
3 -Electrical Conduit -U Iity•Urtdrgrnd.
54. Forms
C
G
3' -Electrical Conduidrgrnd.
55. Electrical Bonding
_
-C&Steel ReinforceLrleng
56. Rough Plumbing & Pressure Test
`-6.<Electrical UFER. ' nd.
57. APPROVAL TO COVER•GUNITE
_
otings '='.
58. Electrical Conbu- Undrgrnd.
a;
�8. Foundation T
59. Gas Pipe, 0 Uc4tifyrnd., Test
9. Water Pipe-Undrgrynd,p60.
Backwash Line,,,_;Trap, 0 Undrgrnd.
10. Structural FloowSystem
61. APPROVAL TO DECK
11. Pryperty Sewer*ine-& HouiZ Connection
62. Backwash &Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final
.I3. Roof Drains
64, Plumbing System - Final
:14. Rough Plumbing -
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -r -el
-16. Rough Electric:Viri a- e_
67. Fencing & Acc Approval
17. Rough Wiring Sign
68. APPROVED R'PLASTERING
18. Rough Electric'J-T Bar Ceiling
69, POOL/SPA Sys%EMS FINAL
19. Rough Heating & Air Conditioning
r r n ..
_ FIRE DEPT. REQUIREMENT _
AP O�I�� P P {mit #
20.RFiough Fgcto&y Fka; lace �T
* 5
- C X
21.Ducis, irr.Str=ura= •• •• 1-S
x S
'? �-ff `
70.".UndeF F-eq?d ffYdro t'
22._Ducis, Venti- tin`''
s '.� egJ
pn T(Gas
. Prod r''Ii
71Pd yq 9 b oil
23.-Gas.Pipe.Rotlyh & T.est _ ^5
•: r? cF
`;
72. Undergricund Ftu-ch x-
24.`Roo? Framing _
x C
trA �n
it UndergFnd, St0>ip+"e Tani 0 Gas Mil
25. Roof,Sheathing x c,
`• p
j Nx `•
74, Overhead HydiO
26.4•85 Ceiling (Stru uraq &;v15}itcoat
"~ ^
'rx
c=
Dr Chemical
v
27.DFrameagd Flashing;=c1:.:
* T
> w_.
76, Dry StIrOpipe�-•c'.. 0 ` M
28. LatAmg'& Siding Y r'- -'�= =�
a.
7,7•, FIXED"Y,ST 7-§N4L-,
29. Insulation t - -- ••
x _-
I
28;-FIR&PREV. PIISAL * > •- C
yl,
30. Drywall,Vailingr�HrEAUMDEV7REQUINEMENT
7
31. Plaster Biown,Coat: S rr
> !
1 t*•
7A._FINAL3�PEC@fON t .�
• 32. _Electrical'PoWer Me+t,Ftnal
,'K• r�'--`�
Bpi. FOOD CERTI�ICATE.(SKUED
33.ina4 EIQGtrig,
iI
r.
flutes:
- 34..-FinSf Heetin�.& Air+t,ork)itionwg�
- x .
*
r•,
35.,'-Flna_7 Gas` Pipe-Testi Ca
i t
T
� F
_C; C r m
' 36. Hood or Canopy `-^" `"
cr:
* �' I
X
j E
t
E `"10 * • iT'
m P1,0 z!*? m
ndY. Factory Fireplacex
37. I,.FI. N P ce;
38. Final Plumbing M T
39. Water Service -Final, "
x
I >
40. Gas Service -Final s m ¢r-
! 41. Solar Domestic•Finij ``• 7j^ •'
s `-� ?
i;
r;, ..,`
n
42. -Backflow Preventerx N
m ✓
I :xC,
el
43. Backflow Irrigation,
^44. Landscape luigation Systerrct-C:� M
A. - 7
n c' x 7
N n: '^% �' n; c$" G7 • _
::45.' --Sound 6tte6uatio
x: r
r•,
T r:
r
:�6..Handicap•ReguIatI0a.+s r•
x
r: c`,
a S ^ C. _ r •-•fl c' -r
47.aFINjj4L STRUCTU.$E & BUI?LDINGF,
l
-r
`o N
48. INAL PLANNING - -
* :�
c r•
l -_--= ti; ;
-49.-electric Release todison
tr
I s
C •r- ,, -
50._5as-Release to Southern California Gas Co
r
- _- Z)r F
r - -
-51. CERTIFICATEOF+OCCUPANCY
No. Date
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING 1829 Iowa Street
ADDRESS
COSTA MESA. CALIFORNIA
FEE RECEIVED
"FINANCE
1 61950
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
OWNER Amherst Development Co.
RECEIPT NO. PERMIT NO.
nis.
AMAIL DDRESS 1533 Baker St.
RECEIVED BY
/�
I DATE�ErvED� S�A»e vBBRM
CITY Costa Mesa NO. KI 11 1
ADD EISS
ARCHITECT arisori & TEL.
OR ENGINEER I NO.
COSTA MESA. CALIFORNIA
I
ADDRESS Garden Grove Calif.
FIRE
ZONE
APPROVED
BY
�
TYPE GROUP Y �
DATE t/
CONTRACTOR Dike & COle rove Inc.
ADDRESS 1533 Baker Street-
ZONING
ZONE NO.OF USE OF NEW .
R-1 PLANS 2 BUILDING
W 8r
Costa Mesa Calif.
CITY )
STATETEL. KI. 9-1151
LIC. No. 167293 NO.
LEDAL
DESCRIPTION
Lot 2 Tr. 8
SIZE1�
OF LOT 75 X 104
O75
NO. BLDG'hs
NOW ON LOT on
A. P. NO.
none
USEOF None
EXISTING BLDG.
YARDS
APPROVED
EVES
ALLOWED
SETBACK LINE FROM 281
CENTER OF STREET 11 REAR YARD
(CENTER LINE BT.)
FRONT
FT. IN.
SIDE YARD ILEFT 3.01
(RIGHT 101
R.SIDE
L. SIDE
0 FT. IN.
U FT. P h— IN.
DESCRIPTION OF WORK -
NEW X
II ALTERATION
ADDITION
REAR
FT. IN.
REPAIR
MOVING
(DEMOLISH
BYPROVED W.
L. D. DATE 9-15-60
ELDING NO OF
SIZE1560 S .ft ROOMS 7 STORIES 1
/
EXTERIOR WA�.ItUCCO ROOF WOOd shingle
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage. Plan 21BR
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANDSTATE THAT THE ABOVE IS CORRECT AND AORE O ON.
PLY WITH ALL CITY ORD ANCES AND TE LAWS EATING
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
$ 167101•
PERMIT FEES 36.
BUILDING CONSTRU O
SIGNATURE OF J /L 1 �Q��
PERMITTEE
1Q
PLAN CHECK $ .
AUTHORIZED AGENT Dike & C egrove, Inc.
51
4.
TOTAL FEE
E RECEIVE 11
COSTA MESA BUILDING -SAFETY DEPARTMENT "
P. O. BOX 317 COSTA MESA. CALIV liiji��yM
PT %)Q1
For Applicant to Fill In
TYPE OR PRINT
COSTA MESA. CALIFORNIA
For
V 1WR+ PERMITI
a -T _:NT
&ICER
COLLECT•JR
OWNER
RECEIPT NO.
r .
PQF; 7
MAIL
RECEIVED BY GATE R3Ce1VHD
DATE ISSUED
ADDRESSJaZ9
o I .r- �. .. /
_ / _ G
TEL.
BUILDING
CITY NO.
ADDRESS
ARCHITECT TEL.
COSTA MESA. CALIFORNIA
OR ENGINEER NO.
FIRE
ADDRESS
ZONE TYPE // GROUP
.
APPR E
CONTRACTOR
BY DATE
ZONING
ADDRESSZ I'- v -
ZON `
NO. OF
US8.OF NEW
CITY
I
PUNS
I BUILDI
STATE TEL
1
LEGAL 2
2
LIC. NO. I NO. —
DescRIPTION O .l
✓1
SIZE �'
NO. OF BLD08.
OF LOT Z,S
NOW oN Loi
A. P. NO.
USE OF
YARDS EVES
EXISTING BLDG PEII C
APPROVED ALLOWED
SETBACK LINE FROM /
CENTER OF STREET REAR YARD Z
(CeNTEP LINE Sr
FRONT
I
1
SIDE YARD LEFT
RIGHT 9
R. SIDE FT.
7" IN.
DESCRIPTION OF WORK
L. SIDE FT.
IN.
NEW II ALTERATION I ADDITION I
REAR 2 FT.
IN.
I I I
/l _/
REPAIR MOVING DEMOLISH
APPROVE / DATE •�
^`
BUILDING NO. OF
ZO
v
SIZE ROOMS STORIES
EXTERIOR WALEL� ROOF
COVERING -S�i1 (% COVERING gHIULLti=
`y
✓/( Z-"
USE O BUILDING AND W K TO BE PERFORMED
IHEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IB FOR THE
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COM-
PURPOSE OF EBTASLISHINO A PERMIT
FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
VALUATION
PERMIT FEE $PERMITTER
_> k
BUILOIHG CONSTRUCTION.
SIGNATURE OF
X-C.
/.
Fg=--
-
$
PLAN CHECK S
AUTHORIZED AGENT
TOTAL FEE
41