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Home My WebLink About632 JOANN ST - Building Permits(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DF�VE, CASTA MESA, CA 92626 BUILDING PERMIT JobAddress: 632 JOANN ST Suite: Vicinity: RESIDENCE AND ATTACHED GAR,4GE Parcel Number: 42215113 App�icant: MARTIN, GERALD W Address: 3103 GINGER AVE UNIT A COSTA MESA, CA Owner: LEMON, MARGARET V TR Address 632 JOANN ST COSTA MESA, CA Contracror: MARTEC ROOFING CO Address: 3103 GINGER AVE UNIT A COSTA MESA, CA Zip: 92626 Arch : Address: Phone: Zoning: Phone: (714)444-1002 Zip: 92626 Phone: Zip: 92627 Phone: (714) 444-1002 License: 752008 Eng: Address: ISSUED BY: Status: ISSUED Applietl: 04IO6I2004 Issued: 04I06I2004 Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. COVER OVER EXISTING SHEATHING. INCLUDES RESIDENCE AND ATTACHED GARAGE. APPROX 2200 SQ. FT. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Fronl 0. 0 PARKING Existinq: 0 NOTES: Rear 0- 0 Rear 0- 0 Reouired: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation Right 0-0 Right 0- 0 s3,aoo.00 53,400.00 NO710E: The work authorized by thls permit shall compty with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) E%PIRATION: Thls permit shall automatically explre and become void il work is not commenced within 7 BO days, or ii work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectione and finel approvel must be obtained. Fai�ure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 75M5626 td4&d8 (0/00) WORKERS'COMPENSAnONDECLAHAnON: I hereby e rtn under penalry of perjury one ot the following tledaretlons: ❑ I ve entl will malntain a certilicate oi conSen� to self-Insure for workers' mmpensation, as proNtleO br by section 3700 0l the Lebor Cade, tor the pertormence of the ork lar which Ihis pe ' is luued. � I have end will main ' o ers' cam nsatlon Insu , az required y SecUon 3700 ot th5 Letwr Cotle, for Ne perfortnance ot ihe vrork for which Vds pertNt Is Lssuetl. My workers' com s r"� end poli ber ere: Cerder: Policy Number: (Thls sectlon neetl nof mp/ete � the pemuNs valuetl a( e hundred d ($100) or less.) ❑ I cenity that in tha pertortnenc ol the w whic this permit is Issued, I s�all not employ eny porson in eny manner so s to hocomo subject to the workers' compensetlon lews of Calif , n ree th If I hould become su��ect to tha workers' compensetlon provislons of Se ion 3700 1 the Labor otle, I shell tort�with camply with Ihese pmWsi Applicent SlBneiure: � Dete: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNL4WFUL PND 5lULL SUBIECT AN EMPLOVER TO CHIMINAL ENAL ES ND CM� Fl 5 UP TOONE HUNORED TIKKISANDDOIUFE($t00,000�,INA00RqHTOTNECWTOFCOMPENSATIpN,OAANGE50.SPROVIUEUFORINSECTION3�O60FiHE RCODE,INiEREST,AN ATTORNEYSFEES. LICENSEO C�NTRACT�RS DECIARATION: I hereby eflirtn Ihat I am lorce entl eflect Lic. a_ Contrector's Signeture: 9(commencing wit� Section 7000) ol Division 3 af the Business entl Professlons Code, antl my license Is in full Class N Dete: _ _ .. / .. � 'V ! CONSTRUCTION LENDINC AGENCY: ❑ I hereby aMirm that there is e construction IB�ding agenty for the peAortnance of the work tor which this parmit is issueA. (Sec. 3097. Civll Code). Lentler's Name: Signature: _ OWNER-BUILDER DECLARATIONS: Lentlefs ACdress: Date: I hereby aHirtn thet under penalry of per�ury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Business entl Prolessions Cotla: Any ciry or counry which requires e permit �a construct, elter, Improve, demolish, or repair eny sirucWre, pnor to its issuance, also requires ihe appliwN for such pertnit to ille e signed statament thet he ar she Is IlcensBd pursuent to the prodslons ot the Cantrectors Ucense Lew (Chepter 9(commencing wlth Sectlon 7000) oi DlNslon 3 ot the Business entl Pmfessions Code) ar thet he or she is e:empt therefram entl the basis for the allegetl e:emptlon. Any violetion oi Section 7031.5 by any applicent for e OeRnit sublects Ihe applicant to a ciNl penalry oi nat mare than five hundretl dollars (5500).): ❑ I, es owner of the property, or my employees with wages as Iheir sole compenution, WILL DO 7HE WORK, end Ihe siructure Is not inlen0ed or oHeretl for sale (Sec. 7044, Business and PmtesSions Code: TTe Contracbrs Licensa Lew does not appty to an owner ol properry who builds or imD�oves thereon, and who does such work himsetl or herselt or ihrough his or �er own emplqrees, provided that such imprwemenis are not IntenGed or oXered tor sale. If, hrnvever, ihe building or Impmvement is sold within one year ot wmpleuon, the owna�-builtler will �ave ihe burden of 0��9lhat he or she tlid not build or impmve lor puryose ot sale.). � ❑ I, as owner of the property, em E%CWSIVELY CONTBACTING WfTF1 LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Prolessians Code: The coniractors License Law does no� appty to en owner ot pmperry w�o bulltls or Improves Ihereon, and who contracts for such projeci with a cnntractor(s) license pureuant to the Coniredors Ucense �ewsJ. ❑ I em e:empt under sec. __ Businoss end Professions Cotla tor lhis reeson: Signature: Date: Owner ID venfietl by tlriver's licensa. ❑ Yes ❑ No Drivers License No. Verificetlon oi Ownership hy (rype of document, i.e. - praperty tac bill or deed): Expiras: DIVISION OF INDUSTRIAL SAFE7Y PERMR CEATFICATON: ❑ I hereby certity that no escavatlon five (5) ol more leet In depth Into which e person is requlred to descentl, wlll be mede In connectlon with work au�horized by this pertnit, and that no building struciure, sceHdding, falsework, or demolition or dismantling I�ereol, will be more �han thirry-slx (38) feei high. (Chap. 32, Gry 2, Art 2, $ec. 341, Tille 8, Calitomia Atlminis�fative Code). ❑ As owner-bulldar, I will nal amploy enyona lo tlo work whlch would require a permil irom ihe Division of Intlustriel Safety, es notetl ebove, unless suc� person has e permit ro do such work fmm the division. SigneWre: Date: Divislon ol Intlus�rial Selety Permil Number: CERTIFICATE OF COMPLIANCE AND AllfFiORIY1�TON OF ENTFiY: I certlly under penalty of perlury Ihet I have reetl ihis epplicetlon end state Ihat Iha Infortnetlon given is correct. I egree to wmply wlih ell state lews entl Ury ordinences relating to building wnstmctlon, and euthodze represeniatives ot ihe Ciry of Casta Mesa to enter upon ihe ebove-descnbed property far inspection purposes. I egree not to occupy or ellow occupancy of eny building euthorized by Ihis permit until linel inspection. Ign ner(s) � _ Dat) . AndlOr Aut�orized PDPliwnt �—�rD�e COOE L INSVECTONTYPE 1818 FIxeO System Final Fire Preventlon 1266 Pool Spe Final 200 Finel Re-Roof 201 Flnal Block/Relaining W ell 202 203 204 Flnel Factory Fire Place Flnal Sign Finel Oemolition P6IE It�ELi �/faft'��..7� CODE 1 INSPECTION TYPE 206 Pinel Mechanical 20B Finel Plumbing 210 Finel Electnwl 2t2 Finel Fire Preventlon 220 Finel Planning Approvel 222 FIneI5lte 250 Final Building�Occupenty PdIE It�l.i Pfl61ECT ROONEES: 6� 2 JOANN S i OWNEB'SNRME: LEMON� MARGt�.RLT V Z�R �ooeess: 53?. JOANN ST � COSTA NESA,CA �� RHCHIFNCINEEfl: 6 3 1. -O A% S �onxess: , uxiT: 92627 flE0.N0.: uxir: � PEflMITTEE: MARGAREi iEMON ('714)631-0875 ! nuoxess: �3i JOANN ST C M_ CA 52627 I� 110EN5E0 CONTNRCTON O�CUM710N: I IrereGy aKrm ttat I am IicenseA un0er pmvisions of Chapler 9(wmmencinp wit� Section ' 7000) 01 Oinsion 3 of tAe Business and Rofessons Code, anC my license is in lull lorce an0 etlect. CITY L1C.: ST�iE 11C.: C1A33: �ate: Signature: WOBKEBS' COMPFN&1TION OEClANR7I0N: I hereby aKrm tMt I Aave a certificate nt consent to sell-insure ar a ceriitiwte of Workers' ComOensaGon Insurance. or a cenifie0 copy ihereof (Section 3000. Lab. C). POLICY NO.: E%P. ORTE: COMPRNY: � CertifieE coOY is hereby tumishe0. ❑ CenitieE coOY � fAeO wit� Ihe ciry BwlEinq DiNsion. Oate: ApWicanL E%EMPIION FPOM VIOPI(ENS' COMPEN&TION OECLANATION: (Ihis sxtlon �ree0 irol Ee mmpleteU tl tha pemit is ta one AuntlrW (5100) or less�. I certity t�at in tAe pedarmance of t�e work for which this permit a issue0, I shall not employ any persan in any manner so as ro became suhjttt �o �he Workers' Compensa�ion Wm ol Calitomu. Oate: Sipnature: NUTICE: Ii, atler maldn0 �his tleclaratbn, you shoul0 hecome su�l�� o I�e Warkers ComDensation D�ovisions al the LaUor CoEe, you mustfortAvnt� comply vnt� such D�ovisions or tlns DermR s�all Ee GeemeA revoke0. CONSiPUCTION LENUING �GENCY: I �ereDy allirm tlut there is a wnsiruction lentlinq apency tor tAe pertormance of t�e work lor w�ich tAis Dermitis issue0 (Sectlon 3097. Gv. C�. lFNOEfl: nooeess: OWNEB BUILOEP OECUMTION: I AereCy aKrm I�at I am exampl imm the Cantractors' State �icense Law lor tAa I011ovnnA reason (Sectian 7031.5 Business an0 Prolessional CoCa: My ciry ai counry which reQuires a permit to construct, atler, imD�%'e, Uertwlish, or repair any itmcWro, O�or to its issuanca, also requiru Ihe applicant tor such permit to fde a s'ryneA statement Itut hUshe I5 IicenSeE pursuanl to IAe 0�� a� �� ractors' State Licerxe Law (Chapter 9(wmmencinp wil� Sectlon 7000) ai Oidvon 3 0l the Business and Pmlessbns Catle) or Ihat AUshe 6 emmpt Nealmm anE ihe Oasis far t�e allepe0 exemD�bn. My violation of Sectlon 7IXi1.5 Ey any applkant for a Dermit suDlects ttre applicant ta a civA penalry of not rtwra tlun five �unAreO Uollars �5500). n 1, az awner of Ihe pm0erty or my employees with xapes as t�eir wle com0ensation, xill Uo IAe work, anU l�e yq simcWre is noi ImenUeU ar aHeretl lor sale (Sectlon 70ad, Business an0 Pmtessional COEe: The Contractars' State Licenu Law Oces not appty to an ovmer of a Dmperry wta WJEs ar Im0« Nermn, an0 who Eoes such xrod Nmsetf/Aerself ar throu0h �is or �er own employees, D�a��tletl tlui wc� ImD�ovements are not inteMeO or oBered for sale. If, �owaver the �uil4inA or Improvemenl is 5010 vniMn one year al completion, I�e awner wiil twve the 6urtlen ol pmvinq �els�e Gid noI huilU or imD�ove lar t�a purpase ol sale). I, az owner ol tAe D�ope�y, am exGusivery cantractlnp xiN GcenuO contnctors to comtruct I�e D�ojecl (Sectlon 7044, Business ❑ antl Pmte55ions CaOe: The COnvaClod SUte L'ICe�6e Law Oces not appy to en awner ol properry who Gmltls or impmves thereon anU w�o contracLs lor suc� prolects vnU a wntractoqs� license Dursuanl to ihe Cantractors' Stata License Law). I am awam tAat Drool al their Woder's Compansaiion insuance slrould Ue DmviOetl ro ma. � I am exempt unEer $etGon: B. 8 P. C- lor t�is reason: jjj /� / Date: _�/� �i � � . � I Eo hereby certiry ihat I am aware of aM uMerstantl Ne repuirzmenis oi Califomu H A an0 Safery Code Sections 25505, 25533, and 25534 and IAat I or any luture GuilOinq acupant wilNvill not (drde one) neetl to wmD �� sxid sute coEes and I�e requiremenis for a permlt lor consimction or moEiliwtion Irom t�e N�� Manapement Oistrict. HesideniW canstmction applications are eKempt from ��es0 prOvl5ion5. Date: MD�� I I hereby certity that I Aave reaa tks aOP��tiw sGte IAat t�e aDove inlarmaWn a cortecL I aqree �o mmpy wi�A all cRy an0 counry I or0inances an0 state lavrs reWtinO to DuilOinq arW here6y aulhor� reD�ntativw ol ttus dty to rnter upon ihe ahovementione0 I Properry �or i�ction purpa es. �� W[e: �9�ature Driver's License or Social Secunry N: � tfi41i6 W�ite-BuilEi�g; GreerCoOe Enbmemanp Canary-Appikan�: Pink-Revenue; GolEenroG-Asseawr CIiY Oc COSTA MESA - BIJILDING PERMIT PaRMIT NO: BE 052545 PLAN CHECA NO: 02226-91 S CONSTRUCT'ION TYYE; PERMIT TYPE: ELE STR PERM NO: 3E 05254:, GOVT: N SUPP: N PURPUSE: ADD e JUB DESCRZPTION : LEGALI7.E 306Sr PATIO COVER SQ rT; 306 CLAIM VALGE: 1,500.00 CALC-VALTJE: 4,Z22,8U GRQ OCC�,s: R-3 / CUMMENTS: X `��0/�� N�iFK��IfN•K�aei(�iE1PX�i(�IFi(�ifY.?fi4iFiEifkiFjfi4#�F3EiEii�i:�Ei(ii�ififiERi(�i:iEi(�IE�IEiFX�ii'#iEi41i�3Fifli�iE9EN�k�1E;i#��ifki6li�+F. Y.� a( i( �i�� Z O N I N GS ERTtB�AJ`IKRSE N E N T S P-��r1��tl�� df ------------ MAIN 3UILDiNG ---- ----- --------- ACCtSSORY BJZLDING --------- r.. FRTJT; FT IN REAR: 11 FT IN FRNT: FT IN REAR: rT TN LE£T; 13 FT IN RGHT; 30 FT IN LEFT: FT IN RGHT: FT 1N PARKING REQ • FROV: PARCEL: 42215113 ZN:.: R1 REc NU: FLANNING NCiTES> LEGALIZE AAF EkZSTING 17' X 18' PATIO, AND 5 PATIO LIGiiTS, > �_ iF if iF iElf iF�1E if N� ii� ii 7� Ik iE if �N� ii� iF iE iE iE iF iE?E 1f 3E # iF �i� 3'r 3E j(� aF ie if �� X- i�� iF iE iF iE iE iE M: iF� 36 if if li� k ii� i4 3f iF ii� IE ic aE ie aF ii� df� iF # R 3E 3r 3F if if i'r *# i(� iE iE %;'r D c V E L O P M E N T S E'ft V Z C E S' R E Q U T R E N E N'!' S ZONING APPRUVED BY ��. DATc: �� 2' �� BUILDZNG APPROVED 8Y : DATE: APPLICATION ISSUED HY: /�- DATE: �o�� I��J� tFiE�?F�'t3Eii�iF�?'�h�k�iC�iEiEii•�IFX�%)EiFaE1F1f�iFir�7riF7Fi��t'F3T'io-7t:�i:7FiFiF73�F�iCi�fFS.'R��FlF7�TtiF7tii�l��TrFrF%IF3eiFiF3k1FX��7riE .�':�. iF i+.�* M� �M` iF �lE iF N�±f� �if N� iE 7f 1E iF if iF 3(� 3F lf 3f iF 3E 3E ii� aF u if 3E i(� iE IE IF af iF iF # fE N� aE 3E 3't iF IF iP;E iE IPif iF iF K� R�f 7�� Y r ic �i� i¢ i4 �7F if k K i4 i!� lik R i4 IE )f 3f 3F?a 3F it �7'r+'. y.3f. L�EGALI7,ATION;Y F E E, S_U M M A R Y STRUCTURAL SaGMENT:Y BL.DG PMT PLUMBING EI.ECTRZC MECiiANIC FIRE SMIP/RES GR�.D2NG PERMIT 144.00 12.00 .50 �508 SMIP/NON-RES .. PLAN 93.60 ISSGE FEE I5.,00 BUILDING-D'iV-i PERM1'C IS5UE PI�AN-CHECR T'OTAL PAID DUF 'LUTALS----> 156.50 i5.00 : 46.$0 2i8.3U 218.3U ,00 � , REVENUE DIVISIC)N TO'tALS--> CQI,LECTED: i18.3U OVER/SiiURT; 00 HT.,DG PMT PLUi�IHING ELECTRIC MECAAN:CC FIRE SMIP/T'OT GRAI)ING PLAN-CFiECH 144.00 27.00 - .50 46.80 if +f� K if if li �14%dF IE % lE �Y� IF 9F N�� % 7f % dE 1F �E if a(� if iE dF �)f iE iEiF �%�7F tiE�Y� �Y }E-Yc iF•1E 9F �X iE �K �lE N dF •� if �% 3f �If� � 1E �i �?E iE �k N iF �%� iF if �%� �iF �X� %�M iE �lE IE i! �i( �M X� �1F iF i: I N D I V I D U A L '.F E E H R E A K U () W N TYPE QTY D E S C R I P T I Q N,1 UNIT COST TOTAL C051' uFR 306 RES-PATZO COVER-POST & SOLID ROOF i3.80 4,222.80 ELE 5 FIXTUR£S, LIGhTING �,I ST 70 EA. .75 3.75 F'I.E 2 RECEPT/OUTLET i ST 20 EA. .75 1.50 ELE 1 RECEPT/SWITC:H � ST 20 EA. .75 .75 END OF FEES . , � . "i _ '_ - 1 '�1 � 1 CONSTRUCTION AND PLANNING P��' 'P'�' APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Poo� & 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. flough Plumbing & Pressure Test 6. Etectrical UFER 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, O Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 73. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar SVstem-Final 76. Rough Electric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOfl PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heaiing & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rouqh Factory Fireplace APPROVALS Permit # 21. Ducts, in Stiucture 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (SvucWral) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. �athing & 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 otes: 6 � � 34. Final Heating & Air Conditioning ' Q� �� 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 'I � � 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. �.Date K CITY OF COSTA MESA BUILDING DIVISION OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require ihe completion and require the return of, an owner-builder verification. Attention Praperty Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction ot the pro- posed property improvement. �Yes ❑ No 2. I(have/have not) �1,�1/Uti/N.�'� signed an application for a building permit for the proposed work. � 3. I have contracted with Name AAh7LU e Address Phone ( fallawing person (firm) toP rovide the proposed GL /�'it�i..tit..I/— //.� nr.�-./'%r'n.�/.N/i � " City Contractor's Lic. No.. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and p�ovide the major work: Name _ Address Phone ( City Contractor's Lic. No. _ 5. I will provide some of the work but I have contracted (hired) the following persons to pro- vide the work indicated: Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 ot the State of California Health and Safety Code and have completed the above intormation to the best ot my per- sonal knowledge, in compliance wit this S te law. //�_— Signed: ' � L Date: �'�� 9 � Name: �� RG�%�ET Y- 1—�� l� (Printed or Typed) C.D.L. # or S.S. # � 754-5273 PPOJECT POONESSt 6 3 2 'JOANN CJ T . OWNEP'S NAME: j�EMON MARGARET V TR aeoxess:632 JbANN ST COSTA MESA,CA 92627 � / I . AflCMIENCINEEB: AOOflESS: flEG.NO.: UNIT: UNIT: PEXMITTEE: THUNDER ROOFING ( 714 ) 646-41.27. A�OHESS: $S4 W, 19TH STkEET COSTA MESA CA 9?.627 LICENSED CONTXRCTOP OECIAHAiION: I �eie0y allirm Ihal I am Ii�enSeU un0er O�ovisions ot ChaD�er 9(commencing wilh Section 7000� ol �rvision 3 0l Ine Business an� Pmlessions CoUe. dnU my licen5e is in lull �orte ana eflecl. c�Tvuc.:0557/38� srnreuc.:638149 c ss^39 Oatc', ��—T� Signalure:_ _�,�,fjJ2?(SY(B_ _ WOHNERS' COMPENSATION DECLABATION: I �¢rtEy inai I have a certificaie of consem m s s e ar a certificate ol workers' Campensation Insmance. or a cenified cavY �hereol ( ron 3800. LaO. CI. POLILY NU.: EN➢. DATE: LOMPANY: , Cendiea copY is �ert�y Wmisnea. ❑ CenifieG copy is IileU witn ine ciry BuilUing Div6ion. Date: ApplicanC E%EMPTION FXOM WOflRENS' fAMPEN5ATI0N OECIAflATION: (Th6 secUon neeE roi De comWeteE i� Ne pum161p we huMrM (5100� or less�. I cetlity Ihal in ihe peAormance of �he work for whic� �hi50ermii is ¢SueO. I s�all no� empl y any Oerson in any manner so as �o become 5u�let� �o lhe Workers' Co ensation Lavrs ol Calilamia. �ale: � � Signaiure: NOTICE: It, aller making inis aeclaration, you sAo ecome suDiect to ihe W rs' Comoensation pmvisians o ine La�or Coee. you mu9 �atl�wiih compfy wi�h SUC� 0� 5i or IN5 D¢rmil Shall Ce 4¢eme0 revOkeE. CONSTBUCTION LENOING AGENLY: I �ereDy allii I�ere is a conSimciion IenOing agenry �ar Ihe pehorm e work IOr wnich ihis permit is issued 1Section 3W7. Civ. CL .� LENOEfl: nooxess: OWNEP BUItDEB OECLNPRTION: I nere0y atfirm Ru� I am e.empi imm ��e Contractors State License Law for t�e la9axinp reaspn ISeoion 70.11.5 BuLness ana Pmlesvonal Coae: Any city ol county whicn repuires a permit to constmct. atler, imo�ove, eemolish, or repai� any sVucWre. prior lo its issuante, also reQuireS Ille apD��Ent lor suctl pefmil Io file a SigneU statemenl Ihai �PJsOe is Iicense0 puRuanl lo I�e Dmvisions o� I�e fAnlrat�oR' State License Law �CtuD�er 9(wmmenting vnt� Seclion 7000) of Oivivon 3 0l �he Business antl Piolessions CAtle� or that hels�e �s exempt I�eretrom dntl t�e CasiS for I�e allege0 eKemption. Any violation ol Section 703t.5 by any applicanl far a Dermil suGiects IAe applitant to a Civll ppnally ol not m0a inan live nunareE Eollars (`3.�00). I, as owner ol IAe Oropeny or rtry em loyees y��p waBes as t0eir sole compensation, will Oo the work, and Ihe ❑ sUucWre is noi imenCetl or offeree mr sale I�Uon 70aa. Buvness anE Pmfeuional COEe: The Coniractars' Siate License Law aoes nol apply to an owner ol a o�openy wno Ouiltls or impmves ihereon. anA wno tloes such work nimsclllherselt or inmugn �i1 or �er own ¢mDl0yeel. pmvitl¢E IOaI 5uth improvemenl5 are nOt iniended of oilereG br Sale. It, hawever Ihe Ouilding or impmvemenl is Soltl wil�in one year oi comD�elion, Ihe awner vnll �ave ihe �urAen ol O�a��ng Aelsne Aitl no� Uuiltl or impmve lar I�e purpose ol sale�. I, as owner oi ��e D�openy, am exclusively comractiqq ��p littnsea conVac�ors to consimc� I�e prolect (Section 7044, Business ❑ ane Vroiessions Coee: Tne Contractors' SWte Licenu Law Ooes irot apON �o an ovmer ol pmperry wM bWOs or imD«s t�emon antl w�o comracls �or suc� O�oletls vn�� a camiaz�oi�s� licenu Dursuam m me Camracmrs' $Iate L¢ense Law). I am aware , I�al Omol ot I�H� WOrkei 5 Comp¢nsalqn in5uranCe S�ouIG 0¢ prOvi4e0 la me. I� I am eeemD� un0er Section: 8, d P. L. lo� inis reason: Date: Q.mer. I do �ere�y cenily ��at I am aware ol an0 un0ersianG Ine repuiremenis ol Califomia Heal�h ana Sa�ery CoOe Seclions 25505, 25533. an0 25534 anU tnat I or any lumre Ovilamg occupant wilVmll noi �cirde one) nee0 m compry wit� uitl state coAes an0 �ne reQuirements for a p¢imit lor conslmclion or mo0ilication �mm tne Ai� ua0ty ManaAemenl Disvicl. Nevaemial conslmction ao7iicaiions are exem0� ��am I�esc provi5i0n5. �ate: Ppplicani: InereDy ceriily Ihat I haverea01�i5 aDDlitaiion ane Slaie IIW� �pe a0oveintOrmatian ¢ CorrecL Iagr¢e la mmply vnlh all orQinances an0 slatelawsrelatingto Guiltling consimclion aM pereGy aNtqraereD�esentalives o t k ciryto enleruDonihe: pwp¢iiy Ior inspeclion pur0�se5^. � Daie:,) —II '�� ..1 Signawre: Dnver's License or 5mia� Seanry <: i6aLn6 � wnne—BmNvg: Green—Cope Enbrce�m: �nary—ADOlicanC Pink—Revenue: CITY OF COSTA MESA — HOILDING PERN,IT PERM NO; B 061324 PERMIT NO; H 061324 PLAN CHECK NO: N GOV�; N SUPP; N CONSTRUCTION TYPE; PERNIT 1'YPE; STR PURPOSE; ALT JOB DESCRIPTION ; T/OFF REROOF W/BUILT UP SQ FT: 550 CLAIM VALUE: 550.00 CALC—VALUE; 550.00 GROUP OCC: R-3 / COMMENTS; REROOF 3UOSF PATIO COVER W/BUILT—UP iF if �lE 1f 7! 7t if i! 1E if 1k �lk 1l�lE ii�lE �1F iE IE # If it # i4 It 1f lE i! �lE �1(�'IE 1E i! iE # if �lE iE if !k M� iF k'IF i(� ff �X� �I(- k IF if� IE iF 1(� %�7F # iF H� 1E ff 1k If i4 i!!k i4 ## ff # H� 7E 3E iP ih i4 i( ?t 2 O N I N G R E Q U I R E M E N T S sETHAcxs ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT ZN RGHT; FT IN LEFT; FT IN kGHT: F7' IN PARF(ING REO• PROV; PARCEL; 42215113 ZNE; REF NO; PLANNING NZSTES> � � i af��*x x x��'ie�x'�tx.�if*ieiFiFiex'it*x�riex'*ieififJt'x�xit'�*iEx-it�ir�x"x'�"x'itififififrtit�ii'ieit��'iaififief�ie.�f�cieie�'**ie�y D E V E-L O P M E N T S E R V Z C E S R E Q[I I R E M E N T'S ' /i.' ZONING APPROVED BY DATE: - BLIILDING APPROV.ED BY ; DATE:• APPLICATION ISSUED BY; �— DATE; �3,�� if3tiE1E1FiElfifiEikifiFfEfflfiflE#if#iklt�3t�iF3fie3F�if3fi�FifiF�liifiFiFif%if I x—Fi�� FiTt��F;fit%�F�1FiEiflFiFjEiflElEi! Fj't3eif ifiEiFikiFiEiEiflEiFlElFifillflEik-IflflfiEltlEiE#1EififiliFlElfifafifiE!Eifi(-ik#!klFlti(�IFikill4#3kK�#i(�#%lklFlE##K#M�iF1f' �1tif)l'�(�lE#ii##iiikit LEGALIZATION:N F E E S U M M A R Y STRUCTU�AL'SEGA�iENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 17.00 50 SMIP/NON—RES PLAN ZSSUE. FEE HUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 17.50 0,00 0,00 17.50 1%.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 17.50 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GHADING PLAN—CHECR 1%,�Q ,50 iE if iF ih iF i! il� if ik 1! ik if ik it it it iE k ik iF if i4 IE if i(� if if # iE k iF it iE iFiE iE �k jf ii it # iF ik iE Ik iE �lE 1f fh if K� % it iElF # ik 3E ##�k iE if if # iF it 1F if� ### 7t # ii� iF :�f if if I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COSI' SFR 550 REROOF BY VALUE kESIDENTIAL NOZONE 1,00 550,00 END OF FEES - 4-�� y CONSTRUCTION AND P�AfvN4NG APPROVALS Permit � I Date 1. Tempor9ry Electncal Service or Poie 2. Soil Pipe•Undrgrnd. 3. Electrical Conduit Utility•Undrgrnd. 4. Electrica� Condurt�Undrgrnd. 5. Steel Reinfo�cement 6. EfectncP� UFER Grnd. 7. Fooungt 8. Foundation 9, Water Pipe�Undrgmd. 10. Structural floor SYstem 11. Proparry Sewer Line & House ConnecUon 12. S.^.svcr C�p 73. Roof OreinS 14. Rough Plumbing 15. Rough Electrical•Condu�t 16. Rough �lectric Wiring 77. Rough Wiring Sign 18. Rough 6lectrical-T Bar Ceihng 79. Rough Heating & Air ConditiOning 20. Rough Factory F:replace 21. Ducts, in Structure 22. Ducts, Ventifating 23. Gas Pipe•Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-8a� Ced�ng (Structurall & 1��onowat 27. Frame ar.d Flashing 28. Lath�ng & S�ding 29. Insulatio� 30. Orywall Nailing 37. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Finai Hea[ing & Air Conditioning 35. Final Gas Pipe�Test 36. Hood or Canopy 37. Final Factory Firepiace 38. Final PlUmbin9 39. Water Service-Finai 40. Gas Service-Final 41. Solar pomestic-Final 42, Backflow P�eventer 43. Backflow irrigation 44. LandSCaPe Irripation Sysiem 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILOING 48. FINALPLANNING 49. Elec[ric Release to Edison 50. Gas Relsase to Southern California Gas Cc 51. CERTIFICATE OF OCCUPANCY Date POOf PA Inspector qppROVALS Permit iP 52. Pool & Equipment Locat�on 53. Steel Reinforcement 54. Forms 55. Elcctrical Bond�ng 56. Rouqh Plumbing & Pressurc Test 57. APPROVALTOCOVER�GUNiTE 58. Electrlcal Cor.duit�Undrgrnd. 59. Gas Pipe, O Undrgrnd., TeSt 60. Backwash Lines, RTrap, �7 Uncirgmd. 61. APPROVAL TD DECK 62. Backwash & Receptor-Final 63. Heater & Ven[-Final 64. Plumbing System � F�na�. 65. Elcctrical�Final 66. Solar System•Final - 67. Fencing & Access Appr�val 68. APPROVED FOR PLAS7ERING 69. POOUSPASYSTEI�7SF�NAL FIRE DEPT. REQUIREMENT APPROVALS Permit;r 70. Underground Hydro 77. ProductPipi�g�Gas OOiI 72. Underground Flush 73. Undergmd. Storagu Tank O Gas � Oi� Q,� 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe . 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSFECTION 80. F000 CERTIFICATE ISSUED Notes: u Date � Inspector OWNER Santa Ana Ranchos DATE 9-30-58 IOB ADDRESS 632 w. JOailil Street B[lILDING PERMiT NO. 7fi9'� GENERAL CONTRACTOR D1�tC & Colegrove AP. No. LOT �O TRACT 2215 F�E Z GROLIP I Rc J TYPE V ZON I� /ECTIONS I DATE coat Test VALllE DESCRIPI'ION OF WORK BUBCONTRACTOR PERMIT$ 18SUED NUMBER . � '7��3 COSTA MESA BUILDING DEPARTMENT P.O. BOX 31� COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN AooR'Ss 63z W. Joann COSTA MESA. CALIFORNIA OWNER Sas�ta Ana Ranchos � lF19 E. 17th St. CITY �/VJYti lYlOO6� v6y11• NO. J14• V' ARCHITECT C$T1SOD � LIC. OR E' VEER �j��phT.nnk NO. AOORE55 Garden �QQe CONTRACTOR�eCV1CgP048�111VT� NO. �Y� ADDRE55 �9 E• 1/th St• TNOJ••r �� EGAI LOT / oe5caivlioN NO. YD 6LOCK TRACT � A.P. NO. �'�E 6o s l00 OF LOT USE OF EXISTING BLDG. "� �` a`�°� none riow orv �or K LINE FROM ^ �j(� CENTEA OF STIVEET SL� REAR VARD ^"�'' � ' SIDEYARD RIGHT 5�_ LEFT 5� DESCRIPTION OF WORK NEW p ALTERATION ADDITION REPA�R MOVING OEMOLISH SIZEOING�qL�) 3Q Di ROOMSV STORIES 1 JO 1 Y EXTERIOR WALL COVERING USE OF NEW BUILDING oiugle ia¢a.g.y with attached V Vl:1FJ • residence �=i�� R�CEaUE� �36yL � fi NCE PT. sm oF c-asrA t�► APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY .�-� I/`"sa -a c � o v 9UILDING ADDRE55 COSTA MESA. CALIFORNIA FIRE ZONE 20NE NO.OF TYpE GROVP .I PLTNS // �� Y BV ' DATE CORRECTIONS , Plan 110AR I HEREBV LCKNOWLEOGE THPT I HqVE PERO THIS APPLICFTION RNO STPTE THAT THE A90VE IS COPRECT ANO 4GREE TO COMPLY WITH ALL ROINPNCES AND ST<TE L<�NS REGVLATING BUILDING CONSTRfIC� T�o�.o VALUATION SIGNATURE OF PERMIT FEE � PERMITTEE /�/� ' ' $ 13,919�w �'LAN CHECK � AUTHORIZEO AGENT �e & Colegrove 1yi(.'• TOTAL FEE $ VBM{