HomeMy WebLinkAbout1702 IOWA ST - Building Permits 4 "� CITY OF COSTA MESA
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BUILDING DIVISION
>.4,„„„.,,,,r,,,, 4 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
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. PERMIT
ealli JB03-00956
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1702 IOWA ST Status: ISSUED
Suite: - Applied: 06/09/2003
Vicinity: FLAT ROOF AT REAR OF RESIDENCE ONLY Issued: 06/09/2003
Parcel Number: 13906116 Zoning: '
Applicant: BURKE, MIKE ISSUED BY: 4.1"" -//
Address: 1653 SUPERIOR AVE .. , ,
Phone: (949)642-7222
COSTA MESA;CA Zip: 92627
Owner ROGERS, MARK E , /
Address /1702 IOWA ST •Phone:
COSTA MESA,CA . Zip: 92626-2019 , - - - '
-
Contractor: LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE . •- .
, " , Phone: (949)642-7222 '
COSTA MESA,CA
Zip: 92627 License: 349686 -
Arch : - - • Eng:
Address: • Address:
Phone: Phone:
Zip: • • - License: License:
SCOPE OF•PERMIT
REROOF FLAT ROOF ONLY ON RESIDENCE/ATTACHED GARAGE_T/0 FLAT ROOF ON REAR OF RESIDENCE,INSTALL(1)28#BASE,(2)11#
PLY AND 4-5 GRIT ROCK, HOT TAR B.U.R.500 SQ FT
• FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $2,940.00
Permit: $83.25 Claim Valuation: $2,940.00
. SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00 • .
Total: $83.75
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ,
ACCESSORY Front 0-0 Rear , 0-0 Left 0-0' Right 0-0
PARKING Existing: 0 Required: 0 . . Proposed: 0
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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
2446.46(6/00)
1DECLARATIONS
WORKERS'CISMPENSA'tION DECLARATION: 6
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ tl have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrrrlecandp licy number are:
Cartier: ,S *'7 f romp—a./ t/O Policy Number: 209 k—"OQ `j
(This section need not be completed if rife permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the •• k 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 Calif. nia,a••• •• : that should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with the : - .v': . ..
Applicant Signature:
As
ate: J
WARNING:FAILURE TO SECC�KERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYYER TO CRIMINAL E797°
ENALT S AN CI IL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100•••),IN ••DITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.#., .' / Class# C—
Contractor's Signature: Zen� L�
�_ Date: ' , d
•
CONSTRUCTION LENDIN 'GENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the 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.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
6 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,end authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
a.at
Mr Or Sign ure Of Legal Owner(s) c!' G D e,
�// And/Or Authorized Applicant // ate'
CODE$ J ECTION TYPE PATE JNTITIALS CODE* INSPECTION TYPE PATE INTmALS
1616 Fixed System Final Fire Prevention • 206 Final Mechanical
12 6 Pool Spa Final 0�2 208 Final Plumbing
200 Final Re-Roof 6-+- .IN 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
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
TY OF COSTA MESA PERMIT Q. TRACT NO. LOT NO. •BLDG.NO.
STRUCTION PERMIT 5°-6„/O
Project Address /70R _TotQQa- _` TYPE OF CONSTRUCTION 3466 8/16/81 50011 Ti
.Owner Tehhicft5S Robe<f Phone ski-.227z ❑ NEW 0 ADD 0 ALTERATION
Address 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS
Arch/Eng. License No. 0 OTHER
DESCRIPTION OF WORK - A.P.t
Address 1l,, ZONE PLNG. REF.qp
Contractor Lactic, //acNr4rn Phdne•$�s-Y(O1 TYPE OF PERMIT BUILDING Tp gt�I�pING
/ SETBACK CAST. PROPS RTV LINE
Address /BS 6 Ps.k, �is•r•�t. [7. 0 GRADING 0 FOUNDATION 0 STRUCTURAL 10 YARD
LICENSED CONTRACTOftr''DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICA S5IEppE y
I hereby affirm that I am licensed under provisions of Charter 9(com- - RIG I-IT
mencing with section 7000) of Division 3 of the Business and 0 OTHER _ _
Professions Code, and my license Is in full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L)
License Class License No. PKG.SPACE REQ. PROVIDED •
Date Signature SQ. FT.
WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEES
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION - ZONE ZONING APPROVED BY DATE
cartificate of Workers' Compensation Insurance, or a certified copy
sol (Section 3800,Lab.C.). GRADING CU.YDS. ACRES
SPECIAL CONDITIONS:
,y No. Company -_-
La Certified copy is hereby furnished. REMARKS: -
-
❑ Certified copy is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION •
/This section need not be completed if the permit Is for one hundred - -- -
`$100) or less).
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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK
subject to the Workers'Compensatio0"Laws of Calif rnl3,�
RAUE
Date 84 -ref Signature �^^'s-w�-`� / BATHTUBS SHOWERS SQ.FT.INU SO S .
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+KW
revoked.
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 + HP
formance of the work for which this permit is issued (Section 3097
Civ. C.). . • •`FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES
Lender's Name ` ` - '
Lender's Address - . • DRINKING FOUNTAINS GAS TUBE SIGNS •
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS
I hereby affirm that I am exempt from.the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNSI HULIIUN
Any city or county which requires a permit to construct, alter, POLES METERED SUB
improve,demolish or repair any structure, prior to its Issuance,also re- WA E ALTERATION PANELS MAIN SUB
quires the applicant for such permit to file a signed statement that he
Is licensed pursuant to the provisions of the Contractor's License LawOUTLETS 5 a -- SERVICE AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the
'ess and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT
for the alleged exemption. Any violation of Section 7031.5 by
applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ` ,•t • vt
of not more than fivehundreddollars ($500).
❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS '
sole compensation, will do the work,and the structure is not Intended - ` '
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE
Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE
who builds or improves thereon, and who does such work himself or ISSUE FEE
through his own employees, provided that such improvements are not -
intended or offered for sale. Ir, however,the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
is sold within one year of completion,the owner will have the burden
of proving he did not build or improve for the purpose of sale). BUILDING
0 1, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT S SMTP E
AND DUCTING
licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK S PERMIT
and Professions Code: The Contractor's License Law does not apply to - -- -- m` ISSUANCE E
an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ rls•V v
tracts from such projects with a contractor(s) Iicesned pursuant to SYSTEM GRADING S
the Contractor's License Law). _ 100,000+BTU PLAN CHECK S
❑ I am exempt under Section _ - - B.& P.C.for thisBOILERS BTU ELECTRICAL S S
reason — PLAN CHECK S MICROFILM E
Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE S
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE • - MECHANICAL S
Information is correct. I agree to comply with all cityand countyPLAN CHECK S VAN E PC pY VANCE PC E
representatives
and state laws city to enter upon the above mentioned
property for i Pec[ion purposts. J n_/Y_�/ `./T)�
Signature •(�-W_pa— Date Q - FINAL FEE 5 J v
Drivers'License or SS yt ISSUE FEE
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspecto
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location '
2. Soil Pipe-Undrgrn 44. Steel Reinforcement.
3. Electrical Conduit Utility-Undrgrn 45. Forms •
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
5. Steel Reinforce 47. Rough Plumbing& Pressure Test
6. Electrical UFER Grn •
48. APPROVAL TO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn •
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test
9. Water Pipe-Undrgrn 51. Backwash Lines. P-Tran. ❑ Undrgrn
10. Structural Floor System - 52. APPROVAL TO DECK
11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final
12. Street Sewer Connection 54. Heater & Vent-Final
13. Rough Plumbing - 55. Plumbing System -Final
14. Rough Electric-Conduit - - •56. Electrical-Final
15. Rough Electric-Wiring - 57. Solar System-Final
16. Rough Heating &Air Conditioning bd. Fencing & Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating '
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathing
22. Frame and Flashing NOTES:
23. Insulation cr- rip-
24. Lathing & Siding v �-
25. Drywall Nailing
26. Plaster Brown Coat ' _
27. Electrical Power Meter-Final
28. Final Electric •
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test f /7'-t/ -
31. Final Plumbing f•-/rf•f/ •
32. Water Service-Final
33. Gas Service-Final -
34. Solar Domestic-Final
35. Landscape Sprinkling System - -
36. Sound Attenuation
37. Handicap Regulations -
38. FINAL STRUCTURE& BUILDING •
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No Date
JR Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
JCITY-SIf COSTA M SA CONSTRUCTION PERMIT PERMIT NO. TRA...g NO LOT NO. UNIT NO.
• / 7#,. to , s SEM - 2/ 7 3 JI
. Project Address �— 4661 11 /22/65 2E70le` TL
` Applicant's Mailing Ad• ss Ll_•• �/' " W41. i TYPE OF CONSTRUCTION . NEW i' ADD MI ALTERATION . REPAIR
x r re' p _ ❑ CONVERSION DI DEMOLISH ❑ OTHER A p # 3 —e // --/o
Owner's Name • _al 0;.;$010y-a'- a Phan-
•`r - DEV(��/1 I N F hey, /S OF BLID D0
Address •
Of - - °• -<.( x ..=-��' /• .Cr...:. 4•�'' h e� �� r I ! ! ON r`-w�"� E Main Building: don A • • ' Accessory Building: Z
Arch/Eng. - License No. TYPE OF PERMIT .ALJ GRADING U FOUNDATION STRUCTURAL T Front c • • 0
Address ❑ TENANT ELECTRICAL ❑ PLUMBING MECHANICAL BB Rear 12/ N
„i5
❑ OTHER p
Contractor's Name /1--
Phone 3.�Q R_3 C Right 5 f N
PROJECT DESCRIPTION SQ. FT._ OCCUPANCY 1 G
Address(mailing). 1
CONSTRUCTION TYPE y VALUATION$ /7 77e 77e S Left ✓ R
City License NO. ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided E
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and ;f/ /f
my license is in full force and effect. PC. V V v. * X/ D — Sis T
License Class License No. eV $
Date Signature PLUMBING FEES
PORKERS'COMPENSATION DECLARATION
1111Bar Sink Showers ■M ELECTRICAL FEES
.hereby affirm that I have a certificate of consent to self-insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
3800, Lab. C.) - Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigation Sewer Cap . - - ConstruII I
ction Pole Sub. • 0 50+KW
8 certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection, Cooking Unit Meter ❑up to 100 amps
Date Applicant -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 Alps
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher Dishwasher Solar Piping _ ., Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for wh ch lhi mit is Issued, I - -
shall not employ any person in any man so as be subject to the Drinking Fountains ■ Solar Tank - _S Fan Motors❑0-1 HP ❑1'h-8
Workers',C�r�l4pgpla l n sof Califon, •
•
Date / (/,p�fSiignature • Floor Drains Swimming Pool w/Spa F.A.U.
NOTICE yLf 3f re` g this declaration, ou should become subject to the
Inc.Solar ❑9.15 HP ❑16-15+
Workers' ompe cation provisions of the Labor code, you must forthwith Floor Sinks Urinal Fixtures 0
comply with such provisions or this permit shall be deemed revoked. Microwave •
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes POI¢ Li h[
I hereby affirm that there is a construction lending agency for the performance 9
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range /
Lender's Name
Lender's Address Kitchen Sink Water Service Switches Sign 0
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories ■ Auto-Wash �
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal ;Standing Sections
county which requires a permit to construct,alter,improve,demolish Or repair P-Trap
structure, prior to its issuance, also requires the applicant for such permit p Laundry Trays Generator 00-5 KW ❑5-15 KW Trash Compactor ,
•O file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
to Contractor's License Law (Chapter 9(commencing with Section 7000)of '
Division 3 of the Business and Professions Code) or that he/she is exempt
' therefrom and the basis for the alleged exemption. Any violation of Section ' ,,^
703k555- by any applicant for a permit subjects the applicant to a civil -
>e y of not more than five hundred dollars($500).
w
I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 /• ,
compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law 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 _ - DEVELOPMENT SERVICES REQUIREMENTS: / (� (yC,
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 r' Zoning Approved By Orr-4 We) Date I/./2'C.J✓
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type I I ❑
diction, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date
pr_ove.for the purpose of sale).
l.4}'I as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code: •
The Contractor's License Law does not apply to an owner of property who ( Duct-Ventilating 00-100,000 BTU 0100,000 BTU 2 •O SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuaZ./
nt to the Contractor's License Law). I am aware that - BUILDING PERMIT $ /22•SO SMIP $ 5T
r f of their Worker's Compensati• in.urat ' should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration -
V; I PLAN CHECK $ in•SZ PERMIT
am exempt under Sectio I. C.for this reason . Firepl/Fact.Blt. ICBG 4 ■ Fire Dampers ISSUANCE $
//j v / •
i PLUMBING $
Date - - - Owner . +' I., . - -" Heating System& Ducting Registers PLAN CHECK 25% $ / ENERGY P.C. $
(
I hereby rtify hat I have read this application and state that the above ,❑0.100,000 BTU ❑100,000BT ■ ELECTRICAL $ •6o GRADING $
information is correct. I agree to comply with all city and county ordinances '
and state laws rola to buil n ruction, and hereby authorize repro- PLAN CHECK 50% $ [r e0 MICROFILM $
sentatives of Ihi y to en the above-mentioned pr•perty forEll 11
.�r
•
inspection purp / MECHANICAL $ S.00 TOTAL FEE $ 227• /6
Signature
' Drivers' Licen e or SS /�"/ • ' Reinspection Fee $15 Issue Fee $ 3 • PLAN CHECK 25% $ 0, St
( NA 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting: Goldenrod - Assessor . /
P &SPA • 1
1 • CONSTRUCTION AND PLANNING
F Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit#
-k
-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 /J-4C yr /i_ 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings /2k/yi L.AC-- 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
t6. Rough Electric Wiring I i/tics C1 67. Fencing & Access Approval
1.7. Rough Wring 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 Factoi-y Fireplace APPROVALS Permit#
21.` Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough & rest • 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil
25. Roof Sheathing Q-3; 1$ ✓__�. 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing • /70 � VC_ 76. Dry Standpipe
•
28. Lathing & Siding 7/7/f v(i 77. FIXED SYSTEM FINAL
29. Insulation #7/Si 78. FIRE PREV. FINAL
30. Drywall Nailing OL G &/c- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
l
33. Final Electric • 3 to l�lo (1 �E Notes: � l� �d`�_
I �
34. Final Heating & Air Conditioning ,iS £ .r
35. Final Gas Pipe-Test 1 / �'%�-
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
�I
43. Backflow Irrigation
44. Landscape Irrigation System •
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 511 16
v
'/
48. Special Requirements Completed
49. Electric Release to Edison
501 Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY • ; 14•
No. Date
Tr 100 FEE RECEIVED
T 22
•
COSTA MESA BUILDING-SAFETY DEPARTMENT ac , , ' -Go _m' Q
P. O. BOY 317 COSTA MESA. CALIFORNIA
FINANCE DEPT.
For Applicant to Fill In Completely APPLICATION-FORMFPERMIT
TYPE OR PRINT BUILDING
BADDRESS 1702 Iowa Street
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. PERMIT NO.
OWNER K & E Development Co._,Inc._ .pq n,(f�[��S
MAIL - RECEIVED BY DATE RECEIVED -*-S itiSSUED
ADDRESS -' (555 -PLACENT1A AVE - _ //e.----. I /0-/O-t JI gf;T1 41961
p TEy�y1I,,,;,;yy I - Zz BUILDING
CITY NEWPORT_BEA CH NORXX XXXI/ ADDRESS
AR ECT TEL. COSTA MESA. CALIFORNIA
OR . 4INEER . NO.
ADDRESS FIRE I/ ^ Ae 1 {�
ZONE TYPE ✓ GROUPV`-\
CONTRACTOR K.W. KOLL APPROVED
BY DATE
ADDRESS 1555PLACENTIA AVF . p
ZONE NO.OF USE OF NEW S 1
ALle,1C d41.
CITY NEWPORT BEACH R-1 IPLANS 2 'II BUILDING w/ att garb
LIC.NO. 61 195 NO. .M I 6-32277 DESCRIPTION Lot 100, Tract 3722
SIZE OF LOT 63x100 I NO. ORBLOTB. 8
NOW ON LOT A.P.NO. none
USE OF YARDS EVES
EXISTING BLDG. NONE APPROVED ALLOWED
LINE PROM C C (CENTER LINE ST.)
SETBACK
CENTER OP STREET 50 REAR YARD 25' FRONT 17 FT. IN.
SIDE YARD I LEFT 71611 I RIGHT 7.1611 R.SIDE FT. --4�/+ IN.
DESCRIPTION OF WORK- - L.SIDE .I7Fr. . IN.
NEV. I X II ALTERATION I I ADDITION REAR f'1 5 FT'
(� IN.
REPAIR I II MOVING I D DEMOLISH I BYPROVEDW L. D. ONV\DATE 10-10-60
BUILDING v NO. OF U1i 1
SIZE 1597,5 ROOMS 6 STORIES I
EXTERIOR WALL ROOF Rock
COVERING STUCCO COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
SINGLE FAMILY RESIDENCE
and Attached Garage
Plan 2-BR
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 COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE PERMIT ONLY.
BUILDING CONSTRU ON. ���/yy�/ VALUATION/ �J
PERMITTTEF OF l.7.2.-2--al 9.7{r7Tr,'R+C /� (1// PERMIT FEE S. J�
N
$ / PLAN CHECK $ ,e."--
AUTHORIZED AGENT ('c//
N TOTAL FEE $"---. / y