HomeMy WebLinkAbout1847 IOWA ST - Building Permits CITY OF COSTA MESA •
BUILDING DIVISION
FI 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
%3/4'° '� PERMIT NUMBER: B10-00247
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 13906203 DATE ISSUED: 08/23/2010
ISSUED BY: RMD
JOB ADDRESS: 1i7471OWA'ST CM 4 Suite/Unit:
Vicinity: HOUSE AND GARAGE ROOF
Squares: 2600 Valuation: $6,600.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL A MINIMUM OF 1 LAYER OF 15#FELT ON AN 4:12 OR
GREATER PITCHED ROOF AND REROOF WITH 30 YEAR ASPHALT SHINGLES ON AN ATTACHED HOUSE AND
GARAGE,APPROX 26 SUQARES.REPAIR SHEATHING AS NEEDED.COMPLIANCE FORMS ATTACHED TO JOB CARD
AND CTIY PERMIT.
OWNER: JESTIN, SHANNON Address: 1747 IOWA ST Unit:
PHONE: 714-481-1815 City/State/Zip: COSTA MESA, CA
APPLICANT: KAISER,MIKE Address: Unit: :
PHONE: 714-264-1349 City/State/Zip:
CONTRACTOR: KAISER ROOFING License No. 682897 -
Address: 928 CHEYENNE STUnit: PHONE: 714-979-5314
City/State/Zip: COSTA MESA,CA 92626 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $139.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES $140.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays
New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day
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 X. INSPECTION TYPE DATE INTTALS ;ODE/ INSPECTION TYPE DATE INITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 Pool Spa Final (� ,, It \` 208 Final Plumbing
200 Final Re-Roof )C..�W7/I (1-16.0^) 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. 0 Yes ❑No '
I hereby affirm under penally of perjury one of the following declarations: Driver's License No. Expires:, a
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
numtieLare: person is required to descend,will be made in connection with work authorized
O :_�_ sink CU'Id by this permit,and that no building structure,scaffolding,falsework,or demolition
mer: J / 1 1 or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2.Grp
(Thisseapn need not be mpnpeted/thepenna i valued at one hundred mears(SI 00)a-less) 2,Art 2,Sec.341,Title 8.California Administrative Code).
Poliy Number: /9.63 ta2 -9 C)/d
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued.I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of Califomia, and agree that if I should
become subject to the workers'compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I sh II forthwith comply with these provisions.
`fir it65,38"-,-,./d Division of Industrial Safety Permit Number:
gplfl7p1$Srgnmure Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES, 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons. or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing 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 forceceand effect. �/ a registration form for acutely hazardous materials? ❑Yes 0 No
Lic.#�ea�b S.21 / 7 Class#, d^sl (Section 25533 of the California Health and Safety Code, with some
�iJ /�-c G exceptions, requires registration with the Costa Mesa Fire Department by
//tr✓ /VCLr _ O -?3/a each business which at any one time has on hand a quantity of acutely
_Gamr3tT07¢t51�n7 e ' -_Da ,,, 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 tris permit is issued.(Sec.3097,CMI Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 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
to register acutely hazardous materials with the Fire Department.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications fcc non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penally of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
8. (If"yes".attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature pf Legal Owner(s) �jDate
Signature Date g/`/'/�4/. _ D -27/o
3057-4613/07) /�"'
Andtor.AOtfOrRed'Applirant ("'Dde,
•k
Prescriptive Certificate of Compr._.tce: Residential CF-1R-ALT
Resirlgntiul Alterations (Page 1 of 5)
T1'rdJ'ecf Name: c L / • CGIrnrnteZone.N / ‘t-#-of-Stoies
I ^�N h .x1N
One
General Information
Site Address: ,,71/7 --0 f,,/4 linlirrcemem Agencyy �fj( 'Zy�)/�„tri )dtfte: Q ,'2�._�a
Building Type IA Single Family 0 Multi Family Circle the From Orientaation: ,S. W,or degrees v
Conditioned Floor Area(CFA): Protect Type: ❑Alterations 0 Envelope 0 Fenestration Roof 0 HVAC
R6plaeement or Change Out 0 Duct Replacement 0 Water Heater
NOTE: Tins form is not to be used lar Newfr Constructed Buildings m'Additions
!e`.rtrfa'timr Values For Opaque Surfaces(fa'Furring use the(
Mass mod Furring Sl rips Construction table helms) C.—
Assembly Alteration
❑Opening of framed cavity alone-Alterations that involve the opening of the framed cavity of a wall.ceiling, or floor must install the
mandatory minimum insulation value per§150 for the altered assembly.Fill in Columns A-C and enter mandatory insulation value in Column H.
❑Replacement of entire assembly-Replacement of an entire wall,ceiling,or floor assembly requires the installation of Component
Package-D insulation values in Table 131-C Fill hr Columns A-J.
Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. •
A B _ C I) -E ' ' F G H .d
- - .I - i.
Proposed Sec Note Standard - Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly
ID] or Type' and Size2 or Others factor" Numbers - R-value' R-Value' Cell Values U-factor
•
Note:For furred assemblies,accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 9-1. For calculatingfurred walls use the Mass and
' ;Furring Construction table below.
1.For Tag/ID indicate the identification name that matches the building plans.
2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors,Slabs, Crawl Space,Doors and etc-Indicate the Frame type and Size:For
Wood, Metal, Metal Buildings, Mass, enter 2x4, 2x6, or etc...see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24.00;or Other for all other assembly description
such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... .
4.Based on the Climate Zone;enter the Standard U factorf am Table 151-8, C or D for each different assembly Name ar type. .
5.Enter the Table number that closely resembles the proposed assembly.
6. Enter the R-value that is being installed in the wall cavity or between the fronting; otherwise, enter "0".
7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0".
8.Enter the row and column of the U-factor value based on Column F Table Number and enter the Assembly U factor in Column J
9.The Proposed Assembly U-factor, Column J,must be equal to or less than the Standard U-factor in Column E to comply.
Purring Strips Construction Table for Mass Walls Only
A B C D I E F G _ H 1 .1 K j L M
Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation
• Walls From Reference in Furring Space from Reference
. Joint Appendix Table 4.3.5.4.3.6.4.3.7 Joint Appendix Table 4.3.13
.
- v v A =
VY
d 4,22 rA
Assembly 2' M L u e y,'q '�'u .°`v Final
Mass Name or JA4 Table - u 6 -. R R a E V _ $ i Assembly
Thickness' Type' Number' S i s• - = trin ti. 5 u' C 4 '� w r U-factor'"," Comment
I
( •
I I1 I 1
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms August 2009
_Prescriptive Certificate of Compliance: Residential CF-IR-ALT
_Residential Alterations (Page 3 of 9) I
Prp'ject-Name:—. / r Climate-Zone t #ofiSto`riesy
5/1/9NNoh )>0' p,p cr....cr......" - 6 O he
ROOFING PRODUCTS(COOL ROOFS)§151(/)12
When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 fr, whichever is
less,the new roofing area mast meet the roofing product"Cool Roof'requirements of§152(b)1Hi, 152(6)IHii,or 152(b)1Hili.
Check applicable alternative or exception below if the roof alteration is exempt from the roofing product "Cool Roof'requirements.Note:If any
one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Emit:once requirements for roofing products in
((
-,¢'18(10)oi areRoofs notNot appliRequirecable.d Doin noClifillmate tableZones belo
❑Co1-1w.
2, 14,and 16 with a Low Sloped. Less or 2:12 pitch.
QlCool-Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less
({Tan 51b/flt.
•Alt9natives to§152(b)1Hi and§152(b)Hii,Steep-slope roof(pitch>2:12)
"❑ Insulation with a thermal resistance of at least 0.85 hrfl•OF/Btu or ai least a 3/4 inch air-space is added to the roof deck
over an attic;or
❑ Existing ducts in the attic are insulated and sealed according to§151(010;or
❑ In climate zones 10, 12 and 13,with 1 flt.of free ventilation area of attic ventilation for every 150 fl2 of attic floor area,and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or
❑ Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§151(02;or
❑ Building has no ducts in the attic;or
❑ In climate zones 10,11, 13 and 14,R-3 or greater roof deck insulation above vented attic.
Exception to§I52(b)1Hiii,Low-slope roof(pitch<2:12) .
0 Building has no ducts in the attic.
Other Exceptions
. '0 Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
,O Roof constructions that have thermal mass over the roof membrane with at least 25 16/11-2 is exempt from the below Cool Roof criteria.
• Note:If no CRRC-1 label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise,
Check the applicable box below if Exempt from the Roofing Products"Cool Roof'Requirement:
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number' < 2:12 >2:12 < 51b/ft2 > 5Ib/ft2 Typp2 Reflectance3'4 Emittance SR's
❑ 0 0 0 ❑4
❑ 0 0 0 ❑4
0 0 ❑ 0 ' 04 .
❑ 0 0 0 ❑4
O 0 0 0 ❑4
I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www,coolroofc.org/products/search.php
2.Indicate the type of product is being used for the roof top,i.e.single-ply roof,'asphalt roof metal roof etc.
3. If the Aged Reflectance is not available in.the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value firm the same
directory and use the equation(0.2+0.7(ptNaat-0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance,
4. Check box if the Aged Reflectance is a calculated value using the equation above.
5.Calculate the SRI value by using the SRI- Worksheet at hup://wanr.energy.co.eov/tide24/and enter the resulting value in the SRI Column above and attach atopy of
Me SRI- Worksheet to the CF-IR.
1'o apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §118(i)4. Select the applicable coating:
i
❑ Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other
•
Registration Number: Registration Date/Time: HERS Provider:
2008 Residential Compliance Farms • August 2009
•
Prescriptive Certificate of Compliance: Residential • CF-JR-ALT
Residential Alterations (Page 5 of 5)
. . Pro eci-I i , gunman acirt— raSt ivies-�_
HERS VERIFICATION SUMMARY The enforcement agency should pay special attention to rhe HERS Measurer specified in this 1
checklist below. A completed and signed CF-41(Form for all the measures specified shall be submitted ro the building inspector before final
inspection.
Duct Sealing & Testing HERS verification is required for this measure.
O YES 0 NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space,the ducts are to be sealed per 11l52(b)1Dii and the newly installed ducts are to be insulated pet §I 51(010.
❑ EXCEPTION: Existing duct systems that are extended: which are constructed,insulated or sealed with asbestos.
❑ YES 0 NO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the
ducts are to be sealed per 152(b)1Di.
❑ YES 0 NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the air handler,
outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be
sealed per§152(b)1E.
❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS
• verification in accordance with procedures in the Reference Residential Appendix RA3.
0 EXCEPTION: Duct systems with less than 40 linear feet in unconditioned space. .... . .
❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos.
Refrigerant Charge- Split System HERS verification is required for this measure.
❑YES 0 NO YES:In Climate Zones 2 and 5-15,when the existing HVAC equipment is replaced(including the replacement of the air
handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat
— exchanger)a refrigerant charge measurement shall be verified per§.1520:01F.
Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw •
The ventilation requirements of§150(0)do not apply to existing residential homes.
Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure.
- 0 YES ❑NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(HVAC equipment and ducting)is
replaced.the airflow and fan watt draw shall be verified per§152fb))Ci to meet the requirements of§151(f)7B.
Documentation Author's Declaration Statement
• I certify that this Certificate of Compliance documentation is accurate and complete.
Name:�2/ ,/ A JeA
Signature:
Company: rI/,^,, l:/bc'
Date:
/CAS ell '2`°C("9 �'z?-/o
Address: p /� If Applicable 0 CEA or 0 CEPE
9�O ` e i�Pl7 r e �I1 e (Certification I/):
_ 7
City/State/Zip: ^6 r,1 0 �A 3n �� 1 9 /� Phone://^ / 3/�
Responsible Building Designer's Declaration Statement _J
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24,]'arts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance are consistent with the information provided to document this
building design on the other applicable compliance limns,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name: Signature:
Company: Date:
Address: • License:
City/State/Zip: I Phone:
For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: I-h'00-772-3300.
kegtsvwiou hhmther Registration Date/Time: HERS Provider:
2001:Residential Compliance Forms August 2009
":" °`BaLON°' 1847 IOWA ST UNT: CITY OF COSTA MESA - BUILDING PERMIT
OWNEBSNAMEDKND"N: CHRISTIANSEN, WILLIAM FLOOD : AE-37 PERM NO: B 080578
mi"cs4i LESLIE
n CHRISTIANSEN, PATRICIA P PERMIT NO: B 080578 PLAN CHECK NO: N GOVT: N SUPP : N
184f7WLDIOWA ST COSTA MESA, CA 9262E
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: ANO' JOB DESCRIPTION : T/OFF ROCK ROOF 6 REROOF W/COMP . 30YEAR SQ FT: 3, 800
MCN.OR Dal ADDRESS: WIT:
CLAIM VALUE: 3, 800 . 00 CALC-VALUE: 3, 800 . 00 GROUP OCC : R-3 /U-1
cot(mA ORSNAME: DA SILVA ROOFING ( 714 ) 364-1826
CONINACTOR]MAIITA 27325 NUBLES COMMENTS : REROOF W/ FIBERGLASS SHNGLS
ADDRESS: MISSION VIEJO CA utNO_ 403901 ********X**xx**)E*)E)e******eta********-**-***********xs*)E*****-**********************
92692 UM ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby tern under penally d perjury that I am licensed under provisions of Chapter S SETH ACK S
(commencing with Section 7000)of Division 3 d the Business end Professions Code,end my keret is in lug force end effect
CITY 1.1C.NO.: 051352 LIC.CLASS: C_39 Lt.NO.: P : 00/00 MAIN BUILDING - ACCESSORY BUILDING
1 ,-40
�5_(�� �� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT : FT IN
LEFT: FT IN RGHT: FT IN
• -' BUILDER DECLARATION:I hereby effuse under pe sly d per'jey Nal I am areal from the C«CMon UMW"Law for the
•.•wing reason(Section 7031.5 Buaueas and PmlwcreCode:Any city arcounty with requires a permit to comm'°•eher,improve. PARKING RE : _ PROV: PARCEL : 13904101 ZNE: REF NO:
Palish,or repair any smabae.prior to is Stance.also requires pfm
es the epK for such perms to Mee signed wenn'that he o she Q
b licensed pursuant to the provisions of the Contractors License Law(C lather 8(commenting with Section 7000)of Division 3 of the PLANNING NOTES.$ .•
&SOPS end Professions Codes or that he or the is exempt therefrom and the bas's for the elaged ezrrptbn.My violation of Section >
7001,5 by any eppliceafor a Manu subleds the applicant toe civil pally dnot more than 0.e hundred doors MOOD. ********************************************************************3E**********
❑ I.as owner of the Property«my emPlyeea wih wages as their ide comprvmion.wiz do the work,and the sown is not intended
«off ered for the(Section 7044,Business and Professions Cade:The Contractors Ls «
e hew does not apply to an owner of opM DEVELOPMENT V E L O P M E N T S E R V I C E S R EeQU I R E M E N • T S
who builds or inpo es thereon.and who does suds work himself«Mor throughploy
rd he or her own emees,provided that such ,
improvements ars not intended or dfesed for sale.It.howeer,the building or inpvemedSeM within one year of completion.the ZONING APPROVED. BY DATE;
ownerbuikler wig have the burden d posing he or she did not build or improv for the pupae Si esb). _
❑ I.ea owner of the proprty.em exclusively contra:01g with fmnsed contractors to construct the project(Section 7044,Business and
Professions Cade:The Contractors License Lew does set apply lo an owner d property who builds«improves thereon and who BUILDING APPROVED BY : • DATE: _
contracts for such projects with a corarador(s)licensed pursuant to the Contractors License Law). p�
❑ iameaemmundrsedion: B.&P.C..for tisreaaon: APPLICATION ISSUED BY: O DATE: \
Dols: Owner: ***************************************x.:- '.* *********5 x ** I 9 V
LEGALIZATION: N F E E SUMMARY STRUCTURAL G ENT:Y
I do hereby candy thel I am aware d and understand the requirements d Celi«nes Neagh end Slay Code Sections 25505,25533.end
25534.and at I or any Mum building occupant will/wig nor(drab one)need 10 comply with said state codes and the requirements for
a pents for otheation or modification horn the Air Quay MaringeMeth District Residential=revue:the appications an exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 87 . 2550.
Gam: APPfpaa: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm dpy of p y ore d Oe bwin
log dedraliom: PLAN
UnderUnderrag
❑ I have end will maintain•certificate of consent to sdm
ias for workers'compensatdprovided ian,as forby Section 3700 of the Labor ISSUE FEE
Code,tor lhepd« p
mr .oteworkfowlwNispeaicissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ Ihave and MImaintain workers'comperaS ,insurance,asrsmredbySake37WdIMLaborCodefortheprl«menoeathe TOTALS----> 87 . 75 0 . 00 0 . 00 87 . 75 87 . 75 . 00
work dor which Ibis pmt is issued.My woken'compensation Mance atrial.and PINY member ase:
Crier: REVENUE DIVISION TOTALS--> COLLECTED : 87. 75 OVER/SHORT: . 00
Poky Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
is sadiron need nmees eoormpked0 the pantis for one hundred dated 5t00510010,Am.j 87 . 25 . 50
I teddy that In the performance a the work for which this permit is brad,Ishag not employ- •- • In any manner m as lo
becosubjectto the wonds'w
ersPeneriontaws of Cehmb,and -.• i I . - subject Io Ihe worker *******************************************************************************
M^aation prowpns d Sect 3700 d 104 labor Cods,l ibel I• .. time.... •. ..
[/pr/� INDIVIDUAL F E E BREAKDOWN
(Derl, I I- 75- I N Applicant:
warning:F•iure to secure wO*sc:mnpanuUon coverage IsnlawM, • subject an rdolorarrocriminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil"nes u to one hundred thousand dollars($IOGO%),In adlldon to the cost of compensation damages as provided for In
Section 37PBohthe w
abtods,lnramm
tandarorya/ese SFR 3800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 800 . 00
CONSTRUCTION LENDING AGENCY: I hereby ea under peaky d perjury that is,is a cmdnmicn lending agency for the END OF FEES
performance of the work for which this penal is issued(Section 3087.Cb.CI,
LENDER'S NAME:
LENDER'S ADDRESS:
I cantly that I have read this application rd dale that the above isdortWian is canal.I agree to comply with an oily and ooWy ordinances
and state hews relating to Wilding mmuction and hereby authorize ref.eeerdrives a this COY to over upon the els ethane oned Property
for inspection purposes.
DAVE DA SILVA
�`=�r� Prim 0100219776-00219777 TOT 87e75
�Sena oma:_42-5-11k- DATE: 11/25/95 TIME: 10:07
Sig ..ure a Owner/Agent/A.. .. r,v mar
(5151.46.WP) White-Building d Safety:Green-Fb:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL & SPA -
6 APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer CaP •
63. Heater & Vent•Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing /2_2•-''16 beg/ 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 PREY. 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:
34. Final Heating & Air Conditioning i3-'?4 at-Q,ch Czw tn ,,4. -2
35. Final Gas Pipe-Test ��'�� "� C/.
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. F INAL STRUCTURE & BUILDING o(,tjt
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
FEE RECEIVED
- 12021 (\ MAY 16 1960
COSTA MESA BUILDING-SAFETY DEPARTMENT • FINANCE DEPT. n
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to FBI In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING BUILDING
ADDRESS 1847 1&owa St•
COSTA MESA. CALIFORNIA For Office Use Only
OWNER New York Avenue Properties_ Inc. IRECEIPT NO. I
F8R}*Pf NO��
JI.�''u'�y
MAIL ' 1 REC81V�.�" DA EC81 ED DATE ISSUED
ADDRESS 419 E. 17th St. ..a`� I ..— 17—bei MAY 1 7 1560
TEL. BUILDING
CITY CnSt.a Mega NO.11181159 ADDRESS
ARCHITECT Carlson & TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
Middlebrook
FIRE
ADDRESS Garden Grnve ZONE TYPE GROUP Q,
CONTRACTOR Dike & Colegrove. Inc. APPROVED J
BY DATE
ADDRESS 419 E. 17th St. ZONING Cie .
CITY Costa Mesa
ZONA-1 I NO.OP I 6IL-fun.2
sic No. 167293 No:Li. 8-1159 DDESCRIPTION tot 33, Tr. 36L8
SIZE „ 1 1 NO. OF SLOGS.
OF LOT 8G X 100 NOW ON LOT non A P NO none
USE OF YARDS EVES
EXISTING BLDG. None APPROVED ALLOWED
SETILACK LINE FROM (CENTER LINE ST.
CENTER OF STREET 501 REAR YARD 251 FRONTFT. IN.
SIDE YARD I LEFT 61 RIGHT rj I 1 ��Y11 ��
R.SIDE 5 FT. IN.
DESCRIPTION OF WORK L.SIDE 'Ft IN.
NEW I X II ALTERATION I II ADDITION I /
REAR �, � FT. IN.
REPAIR I - II MOVING I II DEMOLISH I APPROVED
BY W . L. D. DATE 5-13-60
BUILDING NO.
SIZE7/150 Sfl.ft NO. OSF 6 STORIES 1 41-7
EXTERIOR WALLI ROOF
t
COVERING cnnon COVERING corm.
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage. 40AR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON•
PURPOSE OP ESTABLISH!NG A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
VALUATION
SIGNATURE OF
`1 /j-' PERMIT FEE $ 55♦
PE MIITTEF o
$ 152045. PLAN CHECK $ 17.50 Av
AUTHORIZED AGENT Dike & olegrove, Inc. p
N TOTAL FEE $ 52.50 0