HomeMy WebLinkAbout1983 FLAMINGO DR - Building Permits 11110
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CITY OF COSTA MESA
•bfil BUILDING.DIVISION •
)•• r •.. � 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us
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FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBER: BC08-00430
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES ALT DATE ISSUED: 09/09/2008
ISSUED BY: YH
JOB ADDRESS: 1983 FLAMINGO DR CM Suite/Unit:
APN: 13947207 Zoning:R1, ,
Vicinity: Primary Occ: R-3
Const Type: V-B SQ. FT: 0 Valuation: $2,000.00
SCOPE OF WORK: REPLACE 2'X4'WINDOW IN BATHROOM WITH LARGER WINDOW 4'X4'WINDOW, REPLACE 200 AMP.
SERVICE PANEL W/SAME SIZE, INSTALL 3 LIGHTS, REPLACE PLUMB. IN BATHROOM- 1 SHOWER, 1 BATHTUB& 1SINK.
OWNER: DAVIDSON, ROBERT E TR Address: 1983 FLAMINGO DR Unit:
Phone: City/State/Zip: COSTA MESA,CA
APPLICANT: BEWLEY,RON Address: 11832 MAC ST Unit: :
n n.1
Phone: 714-534-7010 City/State/zZip: GARDEN GROVE,CA
CONTRACTOR: R AND R CONSTRUCTION License No. 609338 •
Phone: 714-534-7010 Address: 11832 MAC STUnit: •
Cell: - City/State: GARDEN GROVE,CA ZipCode 92626
ARCHITECT: License No. • PHONE:
ENGINEER: License No. PHONE:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $0.00
Building Fees: $69.25
Electrical Fees: $57.30
Mechanical Fees: $0.00
Plumbing Fees: $52.90
SMIP Residential: $0.50
SMIP Commercial: $0.00 •
TOTAL FEES: $179.95
—Hafer to toe receipts for all fees paid for project
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
gohEA INSPE01lQN1YPE p Donuts CODE/ JNSPEc110N TYPE peIE PN1nMAL$
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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 /_-3,(� ,[&�
C
204 Final Demolition 6
250 Final Building/Occupancy —/ '_
. `
WORKERS'COMPENSATION DECLARATI Owner ID verified by ense. 0 Yes 0 No
I hereby affirm under penalty of perjury one of the following ddeclarations: Driver's License No. Expires:
❑ I have and will maintain rtificate of consent to self Insure for worker ' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provid for by section 3700 ofrlhe Labor Cade, f e
performance of the for which this permit is issued. -
a I have and maintain workers'compensation insurance. required by
section 3700 the Labor Code,for th performance of the for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: '
permit is ' ued. My workers' co ensation Insurance mer and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number e: person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffolding,falsework,a demolition
Ca ' r: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This seem need not be cum elect Ithe penny is vahed al one hundred lobo/'WW1 odes') 2,Art 2.Sec.341.Title 8,California Administrative Code).
Policy Number:
❑ 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
'sued, 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 California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
Ayr Code.I s r-I forthwith comply with these provisions Applicant's Signature Date
• a C a' Division of industrial Safety Permit Number:
Applicants Signature ' t' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPE SA•ON 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 ❑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 force a''nddY effect. ,/QI I a registration form for acutely hazardous materials? 0 Yes 0 No
Li �7 �T-1 Class# Y.D (Section 25533 of the California Health and Safety Code, with some
r/ exceptions, requires registration with the Costa Mesa Fire Department by
�. a. each business which at any one time has on hand a quantity of acutely
Condaaor'a Signature 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 pernit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 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 0 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 furnished on applications for ran-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 penalty 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
employees, provided that such improvements are not intended or offered for B. (If-yes",attach certificate of compliance'from the appropriate air pollution
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
13I, 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. .
Si. atur .t Legal• er(s) •r to
Signature Date `,..„._�- .. a 1r� Cr 1 Q a3057-06 1310])
And/or Authonrod Appbra t • e
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PROJECT ADDRESS: UNIT:
OWNER'S NAME: 1983 FLAMINGO DR CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 060705
ADDRESS:DAVIDSON ROBERT E
t 1983 FLAAINGO DR PERMIT NO: B 060705 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
Z ARCH/ENGINEER: 546-0780 REG.NO.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/COMP SHINGLES SQ FT: 7, 000
ADDRESS: UNIT:
PERMITTEE; CLAIM VALUE: 7,000. 00 CALC-VALUE: 7,000 . 00 GROUP OCC: R-3 /M-1
ADDRESS: TOP NOTCH ROOF CO ( 714 ) 846-86 25
17541 CROWN CIRCLE COMMENTS: T/OFF REROOF 3300SF RESID & GARAGE W/COMP SHINGLE a
• HUNTINGTON BEACH CA 92649 *****************************************�P�E�r�E+r*�E�E*�e�E******* 1�4 Ew°eireecr0R
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q U I R E M E N T S
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. •
CITY uc.:0 2716 srATEuc.$93077 ss, 39 S E T B A C K S REQUIRE®
DaTe:_�2,I -`t3 Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have certificate of consent to self-insure or a certificate of Workers' FRNT: FT . IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance,or a certified copy thereof(Section 3800.lab.Cr. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY ND.:1 2 0 0 2 3 9-92 EXP.DATE: 04/01 /93
COMPANY:STATE PARKING REQ.' PROV: PARCEL: 13947207 ZNE: REF NO:
• '� Certified copy is hereby furnished. 0 Certified copy is 4fding cit 'Wing Division. PLANNING NOES>
>
Date: ._ .(— ¶3 Applicant:EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: not be completed if the penial is for one hundred WO or leu). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY • DATE:
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. f , 1
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: C � DATE: kJ QMI 3
which this permit is issued(Section 3097.Civ.C). *************'******************************iiittt ********************** *** *****
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM IP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 90 . 00 , 70
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING-DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 90, 70 0. 00 0. 00 90 . 70 90 . 70 . 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 90.70 OVER/SHORT' 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 90.00 . 70
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(5)license pursuant to the Contractors'Slate License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 7000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 7, 000 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any luture building occupant wilVwill not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant: � Q Ay �!
I hereby certify that I have read this application and state that the above intormabon is correc.I agree to comply with all city and county .Z''_'1, o—''•'m:_c••;? S
ordinances and state laws relating to building construction and hereby authorize r�. -nta' of this city to enter upon the above-menlionetl 7—/y� �"•1
property for inspection purposes. ,
:� JAN 2 1993
CI Date: I-�I — Z) Signature' / 1
Driver's License or Social Security 4: N
1641-46 Wbue—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor '�I• • O� COSTA MESA'
POO. SPA
CONSTRUCTION AND PLANNING
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole-. 52. Pool & Equipment Location
2. Soil Pape-Undrgrnd._ - - 53. Steel Reinforcement
3: E(ectrieal Conduit Utility•Undrgrnd. 54. Forms
4. Electrical Conduit-UQdrgrnd. f. - 55. Electrical Bonding
S.-Steel Riainforcernent 56. Rough Plumbing & Pressure Test
' 6. :Electrical UFERdrnd. _ 57. APPROVAL TOCOVER-GUNITE L.
7.footings - 58. Electrical Conduit•Undrgrnd. ,
8. Foundation ' 4 59. Gas Pipe, 0 Undrgrnd.,Test
9, Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgnd.
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 i 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical•Final
15. Rough Electricat•Conduit 66. Solar System-Final
16. Rough Electric Viring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. RoughElectricaj-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Ayr Conditioning FIRE DEPT. REQUIREMENT
20.jRoitlh Fdctor�Y Fi{eplace L 7- ' - , - APPROVALS Permit#
21. Ducts,in-Structure' ' • - ` -70. Underground-Hydro
22._Duct's, V4nti ating4.; - - -71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough & Test - 72. Underground FlusiS `24.-Roe Framing ", q
> //,� 73. "Undergrnd.Storage.Tank 0 Gas ❑dii
25. Roof Sheathing • y,, %7e0r;::,4";t 74,"•Overhead Hydro' '26.'_T-Bir. Ceding (Structuralll/& Monocoat ^ ` "C ; .. 75.:pry Chemical
27 -Frameand Flashilig- r" >- : •• 76`Dry Stand@tae
. , - .. _
28. Lathing& Skiing' ' - i i I , ; 77._FIXED SY$TEKANAL -
29. Insulation 78: FIRE PREY. FINAL •
I.
'30. Drywall Nai6fig t, HEA_ LTH�OEPT.:REQUIRFMENT
. .
11. Plaster Brown CoatY i a79. FINAL INSPECTION
.32. Electricat Power lyletdr-F,inal I I- ' "80.700D CERTIFICATE ISSUED
t� 1 1 •f_
33. !Final Electric _ _ _ 1 I I Notes: -..r. r : 2 . .
-04. Fine( Heating & AirConditioning_ I 1 I1 t
35. Final Gas.Pipe-Test. . I . - .
•
'-36. Hood or Canopy ' -L.
-37.`Final Factory Fireplace-- :C:-'. •I. I �
?8. Find} Pltimbing - :: -.; ' -
39. Water Service_Final` • - _ ... . r . 1 t
•40. Gas Service-Final • - - i -
141. Solar Domestic-Final ' i .. - r
42. Backflo Preventer• ' .
43. Backflow Irrigatioh .
r
-r44. Landscape Irrigatioh System ^t _; r - $"S. • •
45.Sound Attenuation . r - ^'ice
:46.-Handicap Regulations - r '
47. FINAL STRUCTURE & BUILDING 44( f 3 o - : •
- •-
48. FINAL PLANNING -• {{ - - ,
'„49.-Electric,Release to'Edison j 1; - ..
50.-Gas Release to Southern California Gas Co I 1, - -
51. CERTIFICATE OF-OCCUPANCY
No. Date
1
PROJECT ADDRESS: 1983 FLAMINGO DR uxlT. CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05555E
owxEflsAamE: DAVIDSON ROBERT E
• ADDRESS:
1983 FLAMINGO DR PERMIT NO: B 055556 PLAN CHECK NO: 05220-91 S GOVT: N SUPP: N
r, COSTA MESA,CA 92626
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
SWENGINEER) 545-8841 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : 117SF ENCLOSED PATIO COVER PER 4901 APPS SQ FT: 117
PERMITTEE: CLAIM VALUE: 2,000 . 00 CALC-VALUE: 1 , 614 . 60 GROUP OCC: R-3 /
ADDRESS: ROBERT DAVIDSON ( 714 ) 545-8841
1983 FLAMINGO DR COMMENTS: PATIO UNDER EXISTING ROOF qh_
C M. CA 92626 �E+E�E�E�E�ES6**iE�E�ESESE�E+E�E�E�E*yE�EyEyESE*�EyE+PyESE�P�E+E*�E�r�ESE**�E�E�P�ESESP*�E�ESE�E�E*�E�E�EIE�f(t KC* kClr I
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E U I R E M E N T "'
70001 of Division 3 of the Business and Professions Code.and my license is in lull force and effect, SETBACKS
CITY LIC.: STATE LIC.: CLASS: al
Fl EC)Li I R E[)
Date: Signature: MAIN BUILDING ACCESSORY BUILDING E
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: 45 FT IN REAR: 26 FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: 55 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ• 2 PROV: 2 PARCEL: 13947207 ZNE• R1 REF NO:
4Cendvedcopyflerebyfurmsh S. 0 Certified copy is filed with the city Building Division, PLANNING NOTES> PROPOSED 117SQ FT. PATI• ENCLOSURE ATTACHED TO THE SOUTHWEST
> REAR SIDE OF THE S.F.
Applicant: ************************************** ****************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: Qhs section need not be completed if the permit is forme hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become --T
subiectto the Workers'Compensation Laws of California, ZONING APPROVED BY J '1.)
Date: DATE: \"L'1 E 1 ci
Signature:
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. C I
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• , \ ^ DATE• o L 1 k 6
which this permit isissued(Section 3097.Civ.C). *********************{F**************************************************** ***
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 39 . 00
..;50
repair any structure,prior to its issuance.also requires the applicant for such permit to fife a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON,RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 25 . 35 - - 4
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(5500). ISSUE FEE ,
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
LX structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 39 . 50 0. 00 25. 35 64 . 85 64 . 85 0 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through -
his or her own employees,provided that such improvements are not intended or offered for sale.It. however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 64 .85 OVER/SHORT•i1 /''` 00
albtor the propose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 39 . 00 . 50 ! 2 5. 3 5
and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******.**********************************.**************.***.****,******************,
that proof of their Worker's Compensation insurance mould be provided to me. INDIVIDUAL F E E BREAKDOWN '
0 I am exempt under Section: B.8 P.C
mrthis rea;or / \ 64 TYPE QTY DESCRIPTION UNIT COST 1TOTAL COST
Dale: sr ` t ( Owner: (4-1v851/4-5—../V-
� P� C/ 4
•
SFR 117 RES-PATIO COVER-POST & SOLID ROOF 13. 80 1 , 614 . 60
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I of any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from , ^ "
these provisions./
Date: I Z Applicant: 48 ,
I hereby certify that I have read this application an state th ave information is cor ct.I agree to comply with all city and county
ordinances and state on laws relatingposto building can action an he by utho representatives 's city to eine`pan the above me soiled \�g; j
property for in ection purposes. ,\vl/ (�llTf\L�- „\ •
Date: I L L /LII ignature: �" i <` Oz 0010,1750—"C''ll-:7 - --
Driver's License or Social Security a:
164t'46 White—Building:Green—Code Enforcement:Canary-Applicant:Pink—Revenue;Goldenrod—Assessor
r
rONSTRUCTION AND PLANNING POOL 111
'APPROVALS Permit# Jate Inspector APPROVALS Permit # Date Inspector
_it. Temporary Electrical Service or Pole 52. Pool & Equipment Location -
2. Soil Pipe-Undrgrnd._ 53. Steel Reinforcement •
i$ti lectrigal Conduit_,Utility-Undrgrnd. 54. Forms
-4;I Electrical Condtiit-Undrgrnd. 55. Electrical Bonding
'1 ,5t. 1 Reinforcement 56. Rough Plumbing & Pressure Test
• Y:6. EFcrctrical UFER7Gtnd. 57. APPROVAL TO COVER•GUNITE :,.
::7; Footings �:� 58. Electrical Conduit-Undrgrnd.
8.;foundation _ 59. Gas Pipe, 0 Undrgrnd., Test
`s 9.. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. '
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line--8, House Connection 62. Backwash & Receptor-Final ,
12. Sewer Cap - 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing 7 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. POO USPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20.-Rough Factory Fireplace z'• a :. v R APPROVALS 1' Permit # • `
, m t *• C'a. _ -
+ Y , 7.r. x .a t r •
21.'Oucts, i_Structures 1 .. ,. _ -,: a 70. Undergrouctd` _Hydro
22.Ducts, Ventilating. , ., _71. Product ipmg Duds 0Oi1
23. p ugh&test v'_
�iasrPi e'TRo , T. - i _ - • -72. Underground Flush':
24. Roof Framing r -73.u'UndergrndittorageTagk £Gas 0Oil
25. Roo Sh'eathin - , t• J '"
�. 9 .) r Y S.4.c;0•yprhead Hydro ,
26.�T-Bar Ceiling (Structural) & Monocoat - x c .. 'r+ ' • 75.'r�ry Chemical La n
27.•Frame and Flashing r -' -; ` " � -r•` - � v •ti
n , , 76. D'y S[andg qe ,
'28. Lathing•& Siding : ;rr .7 T7 : - , ••Sr r 77. FIXED SYSTEM FINAL ' i
•'29. Insulation a ' - •-• " ,:' r I . 78.7IRE PREV. FINAL x -, •
30. Drywall NailiAg _ - ..� v HEALTH DEPT.-REQUIREMENT
r.
31. Plaster Brown Coit s i R r R,` .I; 79.'FINAL INSPECTION .,
-32..Flectrical Power MeterFinal r,;rr `.T -0 I I • -I. 80.tFOOD CERTIFICATE ISSUED
, _
.33.Final Electric, .. , 0 • ; re i r `Notes: -, -- -
a
34. final Healing`& Air,Conditionirtq.� 2 .�. t l ••• a -A _ LS
.35...final Gas•Pipe-Test" - r - ` . ' I '" ' - t'` •
36.--Hood or Canopy r - 44.1 ti - i tr. 4.4 -: 3. c -
N.
37.•Final Facttory Fireplace • ;-.1-iti •_ " I _ " ,. >: -• -
c' 1.
38. PinaljPlumbing - • r
39.4ater Ser.vice_Final t-' :- t ,• r n -c r ' v
A0.Cas Serv1ce-Final . • IL
• r
Q r- r I I t. r
P
41. Solar Domesttc-Final - - ` - `- S.
., r x .-- 4.
42. Backflo.d:Preventer - - i I ,, e
g
-
43. Backflow Irrigation r S.S = - C - a
7{14. Landscape Irrigation System r r , : _ , - - -a -
. L C
215.'Sound Attenuation- r - ~ ' -
46.-Handicap Regulations ' , . i • �
C 47r.
. & BULEDING ' � Jt_ . _ _�
48..gINAL PLANNING I. i
1 .
49.•Electric Release to Edison is ' 4. -
50. Gas Release to Southern Califorpia.Gas Co , I •r
51. CERTIFICATE OF OCCUPANC'7 : - r .
No. Date
\
City of Costa Mesa
ATTENTION: David Hartke
Building Division
77 Fair Drive
Cosa Mesa, CA 92628-1200
Subject: Permit # 55556
Patio enclosure/1983 Flamingo Drive
Dear Mr. Hartke:
I have received a letter from you which states that work
has been done under the above permit number at the above
property. This is incorrect; work has not even been started
as after completing plans, building permit, etc. I found
that funds were not available.
When we can proceed with this project we will either update
the above permit if possible, or re-apply.
Sincerely,
Robert E. Davidson
Lot 50 9 186 FEE RECEIVED
NAA 31 .1964
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.Box 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING For Office Use Only
ADDRESS 1983 Flamingo Drive -
RECEIPT NO. .... `O.
COSTA MESA, CALIFORNIA
RECEI ED BY D TE REC,7VED OATH ISSUED
OWNER Pemba Subdividers, Inc.
�..3/- 6y/ APR 1 9 1y64
BUILDING
MAIL ADDRESS
ADQRESS 2850 Mesa Verde Drive
• FIRE
TEL. ZONE TYPE GROUP
CITY Costa Mesa NO. 5490395 If. ARCHITECT TEL. ABYPROVED DATE
OR ENGINEER E.G. Kaltenbach No. 5478046
ZONING
A zss 1833 E. 17th St. , Santa Ana ZONE 1 NO.OF I USE OF Flit Lam
/��_ , /� me-
LEGAL R-1 PLANS 2 Bu1LDI NG att gar•
CONTRACTOR CeWrfG1 Ccs
DESCRIPTION Lot 50, Tract 5289
ADDRESS
/�/ / A.P.NO. none
CITY `i !{`� L' ,{ O %L Do /
• LIC.N STATER, ✓1`8731 TEL.
NQ. ' 30"TO SIDE a REAR OVERHANGNOTE; NO EAVE SHALL BE LESS THAN
EAVES
VSIZE iewite- I NO.OR ELDOB. A ALLOWED (U.B.C.REQUIREMENT/
ETE r�'TV1rIOV Now ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. ..-
(FROM C/L STREET ..�/`� I) `
SETBACK LINE FROM 28 FRONT.�V FT, - -" ., V"��V
/VFT.
CENTER OP STREET SOI REAR YARD 1
SIDE YARD LEFT 61 I RIGHT 61 R.SIDE � FT. FT.
DESCRIPTION OF WORK L.SIDE 6 FT. Fr.
Nr'n X ALTERATION._ ADDITION REAR �:) FT. FT.
' DISTANCE BET. BET.MAIN&
R..AIR MOVING - DEMOLI8H MAIN SLOGS. ACCESS.BLOCS.
VAR.# DATE
S ZEDING 2, 139 NO.OF
ROOMS 6 STORIESpp 1 - C.U.P.# APPROVED
EXTERIOR WALL &
Siding I ROOF Shake APPROV�L �.� 0 /(�
COVERING r�StUCCO COVERING Sh•n. - BY A' l DATE- 7C^//
USE OF BUILDING AND WORK TO BE PERFORMED rItti
�,
Single fnmily with nttnrhed gar . -
Hnuse 1,714 sq.ft.
2 s• ft Plan 41-AR i l Goy/ N
. .. - s4.Fr.
B
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
' PLY WITH ALL CITY ORDINAN ES AND STATE LAWS REGULATING VALUATION
s
BUILDING CONSTRUCTION. —
SIGNATURE OF PERMIT FEE
PERMITTEE /YN20 i {•rs✓ , B
/ sa03o� _ o
AUTHORIZED AG/K 1 i CJO is.
N.
TOTAL FEE $ / / "�
Li