HomeMy WebLinkAbout334 JOANN ST - Building PermitsCITY OF COSTA MESA
�`°"'F= BlIILDING DIVISION
i�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.costamesaca.aov
° ` FOR INSPECTIONS CALL: (714) 754-5626
�''�''' PERMIT NUMBER; B12-00091
PERMITTYPE B ROOF2 STATUS: ISSUED
APN: 41905203 DATE ISSUED: 05101/2012
JOB ADDRESS:
Vicinity:
Squares: 2300
334 JOANN ST CM
ISSUED BY:
Suite/Unit:
Valuation
H�I:�
$4,850.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATHING AS NECESSARY. COVER WITH COMP SHINGLES. ROOF
PITCH IS 4:12. INCLUDES ATTACHED GARAGE. APPROX 2300 S� FT.
NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted unlil access to dwelling unil(s) is provided for
verification of the inslallation of smoke and carbon monoxide alarms by the City Inspeclor. See Attachment wllnspection Card
OWNER: PEARSON, RICK S
PHONE:
APPLICANT: ESTRADA, REYNALDO
PHONE: 7'14-542-0101
CONTRACTOR: KING ROOFING
Address: 1044 W ORANGE RDUnit:
CiEy/State/Zip: SANTA ANA, CA 92706
ARCHITECT:
J t.
ENGINEER:
c�.
EEE SUMMARY
v�
(l�i
[teroof Plan Check:
Reroof Permit Fee:
12�inspection Fee: ,
Bldg Std Admin Fund
pN
TbTALFEES
rr+�4
�ii
$D.00
$111.25
$0.00
$1.00
Address: 334 JOANN ST
CitylStale2ip: COSTA MESA, CA
Address: 1044 W ORANGE RD
City/State2ip: SANTA ANA, CA
License No.
License No.
PHONE:
License No. 759061
714-542-0101
CEIL:
PHONE:
PHONE:
Unit:
Unit: :
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3I1812010 - PER CMMC Snc. 13-279
Monday thru Fritlay - 7:00 am (hru 7:00 pm. Saturdays - 9:00 am Ihru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Day, Memorial Dav. Indeoendence Dav. Labor Dav. Thanksoivino Dav and Christmas Dav
!NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requiiements under Calitornia slatutes and related
,tegulations. (Ord. No. 92-28, § 1. 12-21-92)
fEXPIRATION: PERMIT EXPIRES 180 DAYS FROM DA7E OF ISSUE OR DA7E OF LAST INSPECTION.
INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
lequired inspections and final appraval must be obtained. Failure to obiain inspections and fnal approval will result in the expiration of this permit.
��
'f�QOF 1. INSPEC710NTYPE pA� IN�IR�S �QQ�3 INSPECTION7YPE Q_AjF INTIiIpLS
r 16 Fixed System Final Fire PrevenUon 208 Final Mechanical
`t266 Pool Spa Final 208 Final Plumbing
2�0 � Final Re-Roof X 5•�8 • �2 � 210 Final Electriwl
bC
�20,j � Final 81ock/Retaining Wall 212 Final Fire Prevention
o..
�P1Q .": Final Factory Fire Place 220 Final Planning Approval
03 � Final Sign 222 Final Site
20a Final Demolition 250 Final Building/0aupancy
rr
O
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalry of perjury one of the follovring declarations:
❑ I have and will maintain a cetlificate of consent to self-Insure (or vrorkers'
compensalion, as provided for by section 3700 of the Labor Cotle, tor the
peAormance of the v+ork (or which this permit is issued.
❑ I have and vrill maintain workers compensation insurance, as required by
sectian 3700 of the Labor Code, for the pedortnance of t�e vrork for which this
pertnit is issuetl. My workers' compensation Insurance wrrier and policy
number are: �, )
Carrier: ��� � F' ���� Y� �
(PvssettwrneetlqnoCfD��acoCmp�la- Q� ��atMelruntlratlJ�Neisf1f00)Grku1
Policy Number. / 7� 7�
❑ I cetliry ihat in the peAormance o1 the vrork for which this pertnit is
issued, I shall nat employ any person in any manner so as to become subject
to the workers' wmpensation laws o( Califomia, and agree lhat il I should �
hecome su�ject to the vrorkers' compensation pmvisions of Section 3700 of
the Labor Code, I Ffe�1p 'th wmpy wilh these provisions.
(�r-�O/-G
'� pi Wre —G Oate
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 DOLV+RS
($700,000), IN ADDITION TO THE COST OF COMPENSATION, DMAAGES AS
PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
vrith Section 7000) ot Division 3 ofthe Business and Professions Code, and
my license is in full force antl eHect. q
Lic. # Class tt C- � I
��-�f�1-12
` om f5'qnawre � Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby afirtn Nat there is a consWction lending agency for the
peAortnance of Ne work (or which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name:
Lende(s Address:
SignaWre Oeie
OWNER•BUILDER DECLARATIONS:
I hereby aK�m that un0er penalty of perjury that I am EXEMPT FROM 7HE
GON7RACTORS LIGENSE LAW (or l�e following reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which reduires a pertni� Io
consWcl, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the appliwnt lor such pertnit to file a signetl statement
Ihat he or s�e is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of the
Business antl Professions Cotle) or that he or she is exempt therefrom and
Ihe basis for the alle8etl exemption. Any viotalion of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five huntlretl dollars ($500).):
❑ I, as owner of the property, or my employees with wage5 a5 �heir sole
compensalion, WILI DO THE WORK, and the struclure is not intentled or
oHeretl for sale (Sea 7044, Business antl Professions Cotle: The Contrectors
License Law does nol appty to an owner of properry who builds or improves
t�ereon, and who does such work himsel( or hersel( or through his or her ovm
employees, provitled that suc� improvements are not intenOeC or oftered tor
sale. If, however, lhe builtling or improvement is sold wit�in one year o(
completion, the owner-builder vrill have the burden of proving that he or she
did not build or improve tor purpose of sale.).
❑ I, as owner of t�e properry. am EXCLUSIVELV CON7RAC71NG WITH
LICENSED CONTRACTORS to wnstruct the Drojec[ (Sec. 7044. Business antl
Profe55ion5 Code: The contractors License Law dces not apply to an owner of
property who builds or improves thereon, and who contracis for suth project with
a wntraclor(s) license pursuant to the Contractors License Lavrs.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
aos�-as �sroi�
Owner ID verifed by driver• se. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation ot Ownership by (rype o( document, i.e. - pmperty tax Dill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT GERTIFICATION:
O I hereby cetliry that no eacavation five (5) or more (eet in tlepN into which a
person is required to descend, will be made in connection with vrork au�horized
by this pertnit, and that no building structure, staHOWing, falsework, or demolition
or disman0ing thereof, vnll be more than thirty-six (96) feet high. (Chap. 32, Gry
�2, Art 2, Sec. 341, Title 8, Califomia ACminist2tive Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which vroultl
require a permit from the Division of Industrial Salery, as noted above, unless
such person has a permil lo do such work (rom Ihe division.
Appliwn�'a SiB�alure Date
2 Division of Intlustrial Safery Permit Number:
HALIRDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will ihe applicant or presant or fuWre �uilding occupant neetl to fle 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, lhat a Business Plan De fletl wilh t�e Costa Mesa Fire
Department Dy every business which has at any one time dunng a reported
year a quantiry of hazardous matenals equal to or greater lhan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at SlanCartl temperaWre and pressure).
2. Does or vrill Ihe applicant or present or future building occupant need t0 fle
a registration form for acutety hazardous marerials? ❑ Yes � No
(Section 25533 of the Califomia Health and Safery Code, with some
exceptions, requires registration vrith the Costa Mesa Fire Department Dy
� each business which at any one lime has on hand a quantiry of acutety
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallon5, or 200 cubic feet of tompressed gas a[ standard
temperature and pressure).
3. Does or will the applicant or present or fuWre building occupant neeC to
prepare an RMPP (Risk Management and Prevention Program for acutey
hazardous matenals)7 � Yes ❑ No
(Section 25534 0( the Cali(omia Health and Safery Cotle provitles t�at t�e
Costa Mesa Fire Department may repuire the prepa2tion„certification and
fling with ihe Fire Department of an RMPP by businesses v+hich are requiretl
to regisler acutely hazardous materials vrith Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Heal�h and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building xcupant require for
the work which is Ihe subject of this apDlicalion a Dermil for such construction
or modifca�ion fmm Ihe South Coas� Air Qualiry Management DiStriCl or from
any other air Da��ution conlrol tlistrict or agenq? ❑ Yes ❑ No
(Section 658502 ot the Calitomia Govemment Cotle requires ihat ihe requestetl
informalion be lumished on applications for non-residential building pertnits).
6. Will any part o( the faciliry to be constructed under ihis pertnit be vrithin
1000 teet from the outer boundades of a sc�ool? ❑ Yes ❑ No
(If'yes', Ihe facilily must meet l�e requirement of Sections 25534 and 42303
of the Califomia Healt� antl Safery Code).
7. If a permit from the South Coast Air Dualiry Management Dislrict or other
air pollution contml tlistrict or agency is required for Ihe work which is the
subject of Ihis appliwtion, have all of Ihe disclosures prescribed by California
Health antl Safery Code Seclion 42303 been made? ❑ Yes ❑ No
8. (If'yes', attach certificate of compliance from the appropriate air pollution
tontml oKcer).
CERTIFICATE OF COMPLIANCE: I certiry that under penalty o( perjury lhe
infortnation given above is wrrecL I agree to compty with all sfate laws antl
ciry ordinances regarding Hazardous Materials and Emissions.
Signalure Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certiry under penalry ot perjury that I have read this appliwtion antl state that
the information given is cortect. I agree to wmDh �th all state lavrs and ciry
ordinances relating'to buifding consiruction, antl authorize representatives of
the Ciry of Costa Mesa to enter upon the above-descnbetl property (or
inspection purposes. I agree not to occupy or allow occupancy of any Guilding
authorized by this permil until final inspection.
�re of �e/ga1l O«ner(s) Oa:e
/✓,C:VNA ( M . /�, fi C. `��'� � � _
A tll A h d ApP� � - Date
2,
1'rescripYive CertiPicsite u1' Compfi.incr.: JtesideuLi.J Cr-1R-A'LT
Re.eidrailial Alceratioi�.c Q'a^e ] ui 51
7'ru'ecI ��'� X-/7l I S �! ` I Clim:nt'Lune H I 9 bl' Storics
Ceneral 1 n lin'm;ition
Sitc Address: �. .,1 linlivicemenl Ageuc�^ I Latc: ,�, !
yv 1
8uilding'fype . ingle Fmnily ❑ Mulii P.imily Cirde the Froni Orienmtion: �', E, S, A', or degrees
Conditimiecl Ploor Am�i (CPA): Projec� Type: ❑ Aliera�ions ❑ Envelope O Fenestraiion fLoof' O HYAC
I<eplucemeN or Chan e Oui ❑ Duci Replucemem O Water Heater
NOTE: 7'6islnrn� ia� unr ro Le uxerl.lor Neu�lp Can.etruc�ed 1luildi��g.e nr �ldditinrrs'
1 rt.ndn(ion Vrdues fnr Opnquc S1�r laces.(1nr Fzn�rine vse dir. A9ass and Furring Srrips Conxu�uctiar mGle below)
Assemiily A�tcratiun
❑ Openine of f�rnmed cnviq� uloue-Aheruiions dia invo(vc 1he opening oJthefi�mnedcnviry� ofn wall, ceiling, or:Jloor-mus� install ihe
mundaia�p rnininunn insidniion vnhir. per §I SQ1or the nhered assemblr. Fill in Cohimns A-C' and enter mandaior�� insulaiiai vafue in Colimm H.
❑]teplacemen� of enlire assembl)'-Repincemeni nfan emire wnll, ceilinb, nr.Jlnnr assem6fj� reguires Uie insiullaiion ofCornyonenl
Yacku e- L insuln�ion values in TuGle I5l-C. Fil! in Cofumns A- J.
Yp�que SIlP3�:lCC lletflllS ror [hc lun�ed pm'tioneA uf Mass Wsdls sec rnrring Strips Construcfion Tablc heloa•.
�p u C 7) � �� � F I G I H I 7� I �
Pro iosed "�O1 Stnndm'd Values From JA4 Table
Frami+�g Tliielmess, Frr�med Continuous 7A4 - Proposed
Tag/ AssemblyName Material Spacing, U- JA47'able Caviry ]nsulation � Assembly Assembly
1D' or Ty e' and Size� m� Other� factor" Numbei° R-vafue° R-Value' � Cell Value° U-fac[ory
'ae For jurred assemblies, accounting fm� ConGnuous lnsula�ion f-voiue, see Page JA4d and Eg�mrion 4-1. For calculafittg firrred wplls use the Mass nnd
1. ForTag/ID indica�e �he idervificaiion nome thai nmtches �he building plans.
?. Indicnte �he Assembir Name w� ,rype: Roo(/Ceiling, N�aifs, Floors, Slabs, Crawl Space, Doors and e�c..Jndica�e the Frame ryye and Size: Far
Wood, Metal, Metal Buifdingr, Moss, eiaer ?s4, ?xG, or elc... see JA4 jor ather yossible fi�ome npe assemblies.
3. Emer d�e ihidmess fm� muss in inches or Syacing 6enveen {rmning mem6ers en�er; 1 G"or 24"OC,- or Otherjar all odier assenrbl�� descripiion
sucb as Cnnere�c SandwicH Panel, Syandrel Panel, Logs, Su�aH� Bale Panel and eic.... .
4. Based on !he Clima�e Zone; ettter 7he Stai�dard U Jaclor: fi•om Tahle I51-B, C a� D for eacly d�erem assemblp Nmne ar rype.
S. Emer die Table nwnber Iha� closelt� rexembles' die propo.sed aaa'emblp. �
G. L'mer IHe R-nalue lhul ix being inslulled in !hc w�ll caoiq� w� Leiween the f'nming; alherwisc, e�ver "0 ".
7. Erver ihe Con�irtunus Insuln�ion I1-nnlue for Ihc �n•oposed aaa'emb{7�; o/herwise, emer "0".
b'. L• nler !he rmv mid coh�mn of nc� U-facim� ruluc ba��ed ar Calunw F Tuble Num6er und e�uer �hc Aa�.xem6lp U-fuc�m� in Colunvi J
9. The Propn.��ed dssemblr L�-(aclor, Co(umn .l, nm.vl bc equal io or les.s thmr (he Slrnulnrd U-faclor in Colunvi E 1n cnmpll'.
FmrinR StriPs Construction Table for lvlass Walls Onh�
A ]S C ll G F G }1 ] ,l IC L M
Prupused 1'ruperlics of M�ixonrp and Cuncretn Addcd Intcriur or lxtcriur ]nsulxiinu
\04�IIs �rumltePerence in Tim•riug Sp�icc frum ]tefereuec
:Iuin� A i�midia'I'n61c 4.3.5, 4.3.G. 4.3.7 .lninl A i�endix 7':iblc 4.3.13
_ v �; _ _
U VF �� 1 i — U
p U G G � m
� � o F H o v,.. �' j'1021�
QSticml>Ip —r"• 7 . `t .9 • oe � G..0 v �.0
INusx t N�uncai JHG'Inb�c �.,� 'i, o� E R� t m � a � �� Assert�b4i
'fLickn�ss 7 r' Numhcr' <� ' = �;i =" � u: 5 � e '_`� p w c Uductor • Comment
-� �
Ifegi.t�uv�ianlvurnLcr: � Ite�iaira�ionUaie/7'imc: I/EIiS'Prnvider:
2(1(lb' liea�idenlial Cm�ip]innce!'orms dx�gusl 20(I)
Certific;�ce of Cumnliunc�. iicsideutiul
/fcsir(en[ip/ Alte�•ntinn.s
Ih•qjecl Nnihc:
%amr.
tl of 5tnries
Yll
�ioor�Nc rRonucTs �cooi, uoors) ,gis��pn
11�6en Um nren nf ce[erinr rnnJ',cm•ftme tn br, rep(ncad ccceed.c umr{; tl�mi .SO% njUie erisririg rnnf nre«, nr omre tluu� !,0!l0 �'t, �vLicliever is
le.�u, !he nern rnnftng m�en must u�eer H�e rnnTng prnr(ucr "Cnn/ llno/" reryuiremeuLc oJ,$152(h)INi, 152(bJlflii, ar /52(6)IJliii.
G'hr.cl; uppli¢nG/n, nlrernntiva ar ezceplinn be(nrv if Ihe rnof al�eratior+ i.c ezempr fr�om tha rnnQttg prnducr "Cnol /tonl" requirements. Note: /%nr�7,
ann. nf Ihe uLerna(ive.r or ezcep�inn 6elnw ia� c{recked. ihe �ged So/m� 2eflecianca und T6enunl Gminnnce requirement.c jor ronfing product.e in
.¢I lk(Q nre no� npplicable. Da nni,fifl �ub(e Lclmv,
❑ Conl Rnol's No� Required iu Climn�c Zmie4 L I2, 14, nnd I( with a Low Slaped. Less or 2:12 pitch.
�Conl Itoofti Noi Itequired in Climate Zones I through 9 and I( with u Steep-Sloped Ronts (pitch greaier thun 2:13) ;mA product unit weight less
Jlcrnatives to §152(b)(Hi nnd §152(b)}lii, SU�ep-slnpe roof(pilch > 2:12)
❑ Insulntinn with u thermnl resistance of a� lenst 0.85 hrttZ�°F/Bm or at.least n 3/4 inch nirvspace is added to the roof deck
over au nttic; or
❑ Existing ducts in the attic are insulated tmd sealed according to § I51(�10; or
❑ ln clim�te zones 10, ]2 and 13, with I ft2 of free ventilation . reu of attic ventilution for every I50 ft of attic Floor nreu, and
wherc at Icast 30 percen� of die fi�ee ventilntinu area is wilhin 2 feet verticnl dismnce of the roof ridge; or
D Building has at least R30 ceiling insulation; or
❑ Building has radinnt ban�ier in the �ttic meeting the requiremen�s of § I51(�2; nr
❑ Building has no ducts in thc attic; or
❑ In climnte zones 10, 1 I, 13 and 14, R-3 or greater roof deck insidacion above vented attic.
Exceptinn to §752(b)IHiii, l..nw-slope rooT(pitch <p,:12)
❑ Building has no duccc in Ihe aitic.
Other Cxceptinns
❑ Koofing tirea covered
❑ Roof constructions th�
Notc: If no CRRG 1 lah�
Check Ihe anolicahle
building integrated; photovoltaic panels and solar [hermal panels are exempt from Ihe helow Cool Roof criteria.
ave thermnl mass over Ihe roof inembrane wiih at Icast 25 Ib/ft is exempt from the below Cool Roof criteria.
Produat ID Number�
rom the 2oi
Roof Slope
2:12 > 2:
cannot be used, use the Performance Approac6 to sliow compliance, otherwise,
� Products "Cool Rnof' Requirement:
���
�o�•�
Weight I Product I A6ed Solar I Thermal I
> Slb/ftZ Tyoez Reflect�nce�'4 Emittance 5It15
u
�
�
�4
❑4
�4
■ . 00��
��00��
The G2/tC produci /D NwriLer cmi Ge nGinined fi�nrn Ilie Con( Roof Rating Cwmcil's RnredYrodum Direc�my al w�vir caoL�ooE�.ore/nrncLrcNsem'cl �fin
Indico�c ihc i�y�e ofprodnci is Leing i�.sed fnr ihe rnqJiop, i.e..ving(e-p(p ironf usphall rnnL ���eml rnaf, e�c.
/flhe dged Re/7eciance is nal avnilaLlr. irtUir Cool RnofRaling Coiarci/ lr /Zaredlrnd��cl Direcroi�� lben u.m Ihc 4ailiu! I[eJleclmrcc vuluc fiont fHe.rnnte
direcmr7� qnd use Ihe eqimlinn (0.7+0.7(P�ni�ioi— 0.?) m abiain o rnlculoted aged vuhrc. Where p is ihe Initial Salur ReJleciance.
Checl� Lns iflhe Aged Re/7ecmnce is n cnlmda�ed voltm vsing tlie egua�ion nGove.
Calculaie Il�e SR/ value Lp usinglhe S/U- WorksHeei a! hlrn�/hvw� � enerm�.rn env/liticl4/ond emer �he resuhing value in �he SRI Column aLnve and attach aco
fhe SR/- H�prkshee! m �he CG-IN.
o apply Liquid Tield Applied Cuntings, the coaling mnst be applied across the entire roof surface and meet tiic dq� mil thickness or coverage
:commended by the coatings. manufacturer and meet minimum performance requirements listed in §] 18(i)4. Select the applicable coating:
Aluminum-Pigmented Asphalt Itoof Coating ID Cement-Based Roof Cnating ILI Oiher
Hegis�rution Number: Regisiration Du�e/Time: ilEAS Provider:
2008 Residentia! Compliunce Forms• � �lugusi 2009
tirr Cerciilctitc of Cumnii�itice: 7tesidential CT-7R-AL
Jtesidentird Alteratiuiac IYa�'e � u1
ProjecllVumc: , I Ciimate"LuncY I A'ufSturies
I-I�RS VEI�II�ICA"P101� SUAIMAR)' The mrJorcemeiv ngenc)� shmdd ptq� speciul cmemion io �hc HLRSl�9easmr.r specified in thie
chec/dis� f�elorr. A compleied und signed CF-4Jf Farm ja' a)! !hc mrA.un'e+'speci/ied shu/I Le e�uLmined m li�e Lvilding inepec�or befm�e Jin�d
inSDecliolr.
lluct Sexlinp & 7�eSfing HE/tSi�cri/itu�ian i.e required for �hia mcuswr.
❑ �'ES ❑ NO Y�S�.lu Clima�c Lones :' autl y-16, if mortihaii 4ll llueur feei ofliew nr repincemeni ducu: m�e iusttilled in unctinditioned
space, tirc duc�„ nre to 6e seadecl per �152fb)1Lii u��d the newly insialled ducic ure w b: insultited per { I51(1_110.
❑ LXC�1'T10�: Lsisting duct systems thnl m�c extended, which :ve cm�structed, insul:ued ur scided �eitli ais6estas.
❑ YES ❑ NO 1'E5: ]u Climate "Lones Z and )J G, if the existing space-conditioning slBtem (HVAC eyuipmenl aud duciin�J i;; replaced, the
ductc ure m 6e sealed per � I 52(bp DI.
❑ 1'iS ❑ NO )BS: 1n Climote Zones ° und 9-I G, if tlre existing HVAC equipment is repl�ced (including th: repincem.nt of the t�ir liandler,
outdoor condeusiug unil of n spli� sys�em, cooling or heating coil, or the furnace heai er.changerj the ducts �re tn be
sealed per ¢152(b)lE.
❑�RCEPTION'. Duct syetems th�t v�e ducumented tu havebeen prr.viousl�� se:iled conilrmed thruugli H�P.S
verificatimi iu accordance with procedures in the Reference Residential Appendix ItA3.�
- ��� ❑��XC�PT10�: liuct systems witli less thon 40�linenr teet in unconditiuned spxee. . .
❑ ESC�PT10�: Ezistin�� duct svstems cunstruc[ed, insulated m'sealed with usbestns.
R�iYigerunt Charee - Split S.l'stem HERS veriiicaiion is requireci for ihi.r meosin�c.
❑ Yi5 ❑ NO YCS: ln Climate Zones 2 and 5-15, wl�en the existing HVAC equipmem is repiaced (including [he replaeemeni of the air
handler, ontdoor condensing unit of a split system A/C or l�eat pump, cooling or heating coil, or th: fumace heat
exr.hanneri a refriaeren� r.liaree measuremenl 5hB1� be vC�l{�ed �ei' � 152('o11F.
Central Tan Inte;rated (CFI) Ventilation Spstem and ran Watt DraH�
The ventila[ion renuirements of 6] 50(ol do not apolv tn exis[ine residential homes.
Ducied Split SYstems - Air Conditioners and Heai Pumps: Airilow HERS veri/icaiia� is reguired for rhis n,easurc.
❑ YLS ❑ NO ]'ES: ln Climate Z,ones 1 D through 1 S, when Ihe existin� space-condi[ioning sysiem (H\+AC equipment and ductingj is
reolaced. the eirflow and fan watt draw shall be verified ner § 152(b)1 Ci tp meet the renuireinents of § I� 1lfi7B.
Autlior's Declaration Statement
this Certificate nf Cmm�li�nce documentntion is accurnte and
l� � ST2�1 i� A-
Lat^_:
O�—ri —/�� �.�.
11 Applicable � CEH or � CEPE
(Certif�calion N):
Phone:
71 u) � r-f � 010
ronsible }iuildiug Desi�ner's Lecl;u•utiuu Statemenl ' -
] um cligible under Uivision 3 of the Caliiomi�i Business nnd 7'rofessions Code tu �ccep� respunsibility lor the buildiug design identi5ed mi
this Ccrtifmate of Compliance.
7 ccrtily tht�i t6c eucrgs (eaturc:: and perlormancc speci6critiom; lor thc building dcsign idemificd on ihis Certificatc uf Comp�iance conform
tu thc requlrenrems of Tille "L4, I'aric 1�md G of Ihe Caliibrni�i Cndr of Itegulatiuns.
Thc building design feaWres IdemiGed on lhi:�. Certificaie ul'Cumpllanec tu�c eonsistenl wilh Lhc iniormatiun provided tu ducumem ihis
buildin� desigu ou lh: olher appllcublc compliancc iunnc, woiltshee�c, cdculations, plan:; und speciLctaium: su6miucd tu thc cniivicenrenl
;menc�' tui �inu��uv�il willi lhis huildiu:' ncrmil upnliculion.
1Jamc:
hddress:
SignaLurc:
Liccnse.
Far �avsisuuicc nr gucs(iaia:: re�urdin�; ihe Lnm�bP Stmidrerds, can�uc! [6c Lnerbi' Hollinc �u: 1-R(1f1-i7'l-iJllll.
teni�•u'ttlum hum icr' /(egi.xu'uiiou Uuic imec !/Ll;.`.' 1'rmacler:
OWNER SHERWOOD FYJREST DEPELOPLRS #3 DATE 5-23-57
JOBADDRESB 3q�� ,j�gnn Stree'E - BUILDINGPERMITNO. ���'�_
GENERALCONTRACTOR Ll[�O CoriStP77Ct1oR CoMI VALUE � lj�$Fj�G nn
L... (13 BLOCK TRACT 28(y5 j�,eS. W�Btt. �3T.
GROUP I Sc J TVPE V ZONE Rly FIRE DISTRICT SZOA
PERMITSISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE I NUMBER
_ .. _ � , _.,, � r
Forms and Grade to
Plumhing, Rougl
Temporary Pole
Wirinp. Rough
Sewer, House O�y Sewer, St./yys I�-�7_S-� ' v _io _
�� `�e Tank or Cesspool
\ ,ng,ln Out -9 ,a_ ,
e�_�._..... i�.� sn�v.-. 7
Plum
Final. Fixtures Complete
Final
____r......, . . pL,�,i �i� �
r
FORM 210 3M lO�vS
. .. _ . - s��8
• COSTA MESA BUILDING DEPARTMENT
P. O. BOX 31]
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
B""��"� 3g4 doann Street
AODRE55
COSTA MESA. CALIFORNIA
OWNER Sherwood Forest Developer:
MAIL 31�04 Via Lido
ADDRE55
c�rY Newport Beach TNo. AA 71'
oa` �''--Tea Raymond Levanas N'o: C 747
nooRess 3432 via oPorto, N.B.
ADDftE55 3�4 Via Lido, NB
LEG/LL LOT �!��]
DESCRIPTION NO. TJ BLOGK
A.P. NO.
5'ZE 63 x 120
OF LOT
USE OF
EXISTING BLDG.
$ETBACK LINE FROM
CENTER OF STREET S�
FEE RECEIVED
`y�,1 , v-, � � �''1 -�- �
fINAN�DEPT,
CITY OF COSTA PdESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
Aec[iveo av
FIRE
ZONE
�� Na: 643�
TEI. � 1�1� 6V
NO.
TRACT ��S
uo.oF e�ocs. O
NOW ON LOT
��. o .,. e., lt2 �
SI�E YARD RIGHT J, LEFT S'
DESCRIPTION OF WORK
NEW � ][ ALTERATION I ADDITION
REPAIR MOVING II DEMOLISH
5 ZIE DING �1 �•�� $• 1 Y• ROOMS O STORIES 1
141n1
EXTERIOR WA46O� StuCC ROVERING �1Kane-Shingle
COVERING W
BUILDINGEW Dwelling �.� � /�, 2.
onrc iss�Eo
COSTA MESA. CALIFORNIA
CORRECTIONS
$TATE TM4T THE n80VE IS COliRECT ANO 4GREE TO COMPLV WITH 4LL
CITY OROINANCES <ND $TFTE LFWS flEGULATING BUILOING CONSTFUC-
T�o�. VAIUATION
SIGNATURE OF PERMIT FEE S
PERMITTEE
I /// R ��� PLAN CHECK $
f $ V
eiirunoiorn nncur ' TOTAL FEE S
�err