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Home My WebLink About104 GEORGETOWN LN - Building PermitsPROJECT ADDRESS: 104 LEXINGTON LN UNIT: /, OWNER'S NAME: WILLIAMS, MONA MAE •.��ADDRESS: MAERTENS 4742 VIA TALA FALLBROOK,CA 92028 ARCHIENGINEER: REO.NO.: ADDRESS: UNIT: PERMITTEE: STOUT ROOFING INC (310)923-6775 ADDRESS: P 0 BOX 4309 DOWNEY CA 90241 LICENSED CONTRACTOR 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. CITY 0r05�/9Y377 -STATE1402536 CLASS: C XP: 10/9d5 ate _� 01 D� Signature: NE RS' CaMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self insure or a certificate of Workers' Compensation IljrYapGezgF �9jified copy thereof (Section 3800, Lao. 65/19/95 POLICY NO.: J O L O 7 EXP. DATE: COMPANY: AIG ,�$( r J Certified Cooppyy isyhereby furnished. 1-'J' Certified copy is filed with the city Building Division. )DI: O(_vZ✓... Applicant/ EXEMPTION FROM WORKERSCOMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) a' less(. 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. Date: Signature: NOTICE: 11, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Codeyou must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ, C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing won Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis lot 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 (Section 7044, Business and Professional Code: The Contractors' State 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 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 for the purpose of sale). 1, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ 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 contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: Date'. Owner: 1 do hereby certify that I am aware of and understand the requirements of California Health a 25534 and that I or any future budding occupant will/will not (circle one) need to comply with permit for construction or modification from the Air Dually Management District. Residential these provisions. Date: Applicant an Safety Code Sections 25505, 25533, and said stale codes and the requirements for a construction applications are exempt from I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. '��///f Date L Signature: // 1 hnAer's License Or Social Security ar 1641-46 White—building. Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069541 PERMIT NO; B 069541 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: ALT JOB DESCRIPTION ; T/O RESTH 6 REROOF W/COMP 6 HOT MOP SQ FT: 2,508 CLAIM VALUE: 2,508,00 CALC—VALUE: 2,508.00 GROUP OCC: R-1 / COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DET. REQUIRED Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKING REQ; PROV; PARCEL: 41916301 ZNE: REF NO: PLANNING NOTES> RE it it * * * * iF 4 iF if if * ie,ie if * * * * iF ie if iF iE lF iE if iF it it 1E iF iF RE iE ie iF k * iF iF iF ie iF Bf iF iF 1f iF if iF if iF k fE iE 1E ie 1f ie 1F iF if 1F it iF iF if ie iE iF te 1E iF 1E iF iF iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N:T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: it iF it le Rf iF*iF iF 1EfE 7E iE 1EfE iF jF it is lEM***iF 1E! iF FiF ik iF iF iF if if it lF iF iF i(-fF 1E iF is ie iFM it iF ie iF iE iF *iE ie if ie aF iFDR TEf Rl if RE 9e aF iF iP if iF 4E RF if iFie 4r ie RE iF it if iF BE iF'tE fF*ie fF iF ie**iF RE iF te 1F fiF Fie ie iF It iF iF if lE if if ie lE it iF lF ie iF is%if aF it+e iF iF iF iF if it*MRE Bt ie iF iE i1- if aF iF *kRf iF iF ie iF iE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54,00 ,50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV.—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 54,50 0,00 0,00 54,50 54,50 •00 REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVER/SHORT: •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 54,00 ,50 * iE RF 1E it it Rt ae it iF iF it iF ff ie * iF 1t iF 1F it ie ie iF iF iF iF * iF iF ie ae IF 1E * RE 1E iE * * iF of 1h 1t ie If iF iF iF fF ie 1F it 1F iF it iE it it iF iF iE * * * iF 1k M iE it 1F iE ik ie stF r iF i! jk I N D I V I D U A L F E E B R E A K D O W\ I/ TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,508.00 END OF FEES 01 00170587-00170598 TIO T 54.50 DATE: 10/28/94 TIME: 13:03 IA COPJSThUCTION AND PLANNING POOI PA APPROVALS Permit # Date inspector APPROVALS Permit # Date Inspector 1. Teritporary Electrical Service or Pole ., 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3: Electrical Conduit Utility-Undrgrnd. 54. Forms 4r .Electrical Conduit=Undrgrnd. 55. Electrical Bonding 1 Reinfordement 56. Rough Plumbing & Pressure Test ' 6. EI$dtrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE _ �. Foptings 58. Electrical Conduit-Undrgrnd. -' • 8. Fo[Jndation _ - 59. Gas Pipe, d Undrgrnd:, Test 9. Walter Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - 11. Pr party Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains �, •• 64. Plumbing System -Final 14. Rough Plumbing - 65. Electrical -Final 15. Rough Electrical -Conduit , 66. Solar System -Final 16. Rough Electric -Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68, APPROVED FOR PLASTERING 18, Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT :APPROVALS-�.'Permit #_-1 20.;•Rough Factory Fireplace _ T. 21 Ducis, in Stiuctujte '". - -a • . X70. Und6rW,4 Hydro •'t 22. Ducts, Ventilating. 171. Product;Piping Oqas :JOiI 23. -Gas Pfos-Rough & Test - .;72. Underg bund Flush _' A 24. Roof Framing ..- - - r + :73.1; Undergrnd. StoragfLTank'OGas 0 01 25. Roof Sheathing ��R�4S� / 6G!� '741;Qverhead Hydra- ydra26.;T-Bar 26.!T-BarCeiling (Structural) & Monocoat +' i 75"pry Chemical "' ' U' 27. frame and Flashing ' 76.' Dry Standpipe; „• Lathing �- 9 & Sidin 9': ' �<: ••� _ ' 77.' FIXED SYSTENIet'FINALh • 1.29. Insulation ; * - P 782' FIRE PREY. FINAL r.. �. -30. Drywall. Nailing ,• I HEALTHDEPT-. REQUIREMENT '. 31. Plaster Broom Coat' i i ;. INSPECTION _ ., r.. I,. ,39:'FINAL $2: Electrical Pos4er Meter -Final v I• a +;80.TIFOOD CERTlFICASE ISSUED 33. Final Electric "Notes �=' -,07 r iL' .34. Final Heating'& Ail Coriditioning W 00. ^t=: 35.:Final Gas Pipe -Test ,36. Hood or Canopy--,- 37."Final Factory Fireplace . 38. Final Plumbing r ' It '39. Water Service-Fiwl• 140. Gas Service -Final �'-' l Solar Domestic -Final -. •• a <: h `42. -Backflow Preventers ' j, _ •`r. _r 43. Backflow Irrigation -. -• -- ' ;44. Landscape Irrigation System, 45. 'Sound Attenuation ^` - " ` 'r - „-•' - 'r'� ` 46..Handicap. Regulations 47. FINAL STRUCTURE & BUILDING �"ly_j7 (Q�.✓t�' 1 't'> _. 48. FINAL PLANNING r ,. -49.•-Electric Release to Edison '50. ,Gas Release to Southern California Gas Cc1 lit .51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 104 GEORGETOWN LN OWNER'S NAME: GOODIN, WADE VERNON TR ADDRESS: 104 GEORGETOWN LN COSTA MESA,CA 92626 UNIT: ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: STOUT ROOFING INC (310)923-6775 ADDRESS: P O BOX 4309 DOWNEY CA 90241 LICENSED CONTRACTOR DECLARATION: I hereby affirm ;hot 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. CITYLIC.: 0593STATE LIC: 402536 CLASS: C 39 EXP: 10/95 Date: _7 D A 77 Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a canified copy thereof (Section 3800, Lab. Cj. POLICYNO.: 5822699 EXP.OATE: 05/19/95 COMPANY: AIG w�v ❑ Cenitied copy is hereby furnished. LT Canned copy is filed with the city Building Division. June 0 Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permt is lot one hundred (5100) or less). I cedily 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 WorkersCompensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit Shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ, Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: 1 hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code. Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant lot such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' State 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 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 fSectien 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself of 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 moshe did not build or improve lot the purpose of sale). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who conVacts for such projects with a contractor(s) license pursuant to the Contractors' Stale License Law). I am aware that proof of (heir Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. for this reason: Date: _. _. Owner I do hereby candy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505. 25533, and 25534 and that I or 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: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned property for inspectio purposes. Date: G Signature Driver's License or Social Securityg: 1641-46 White—Building: Green—Code Enforcement; Canary—Applicant: Pink—Revenue: Goldenrod—Assessor COMMENTS; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REgUIRED �t�rat*+rirdr�FrriE*etxat***x****�***�E4tirikitleBFifiEierrr9Ei6r+rJrw+FitBe**iE9r***iewifeEB6iEi6a6 it it Btr�F*ar�E�FiFiFiEBE1f Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN CITY OF COSTA MESA — BUILDING PERMIT --------- PERM NO: B 06950 PERMIT NO: B 069509 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION ; T/O RESTH 6 REROOF W/€QEM S HOT MOP SQ FT: 2,508 CLAIM VALUE: 2,508,00 CALC—VALUE; uP 2,508,00 GROUP OCC: R-1 / COMMENTS; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REgUIRED �t�rat*+rirdr�FrriE*etxat***x****�***�E4tirikitleBFifiEierrr9Ei6r+rJrw+FitBe**iE9r***iewifeEB6iEi6a6 it it Btr�F*ar�E�FiFiFiEBE1f Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 41916219 ZNE: REF NO: PLANNING N TES> * * * 7E 4 Jf 1h 1E 1E if BF iE 1E 1F iF if il"le iF'!k'k'k'k 4f'k BF 1k BF ie 1f if i! it 1! * i61E iF i6 i! iF le 1e it %iF aE it iF k ik M i6 * r i61e ik 4 eE * ie iE M if i6 iE 4 iF fF BE ik 1!')f'!<' iF 1E D E V E, L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE; x x x x x x x xlit lie x x x xxx xxx x x x x x x xx xxxxxxxxxxxxxxxxxx MIE if lE iF iE 1f***lf if ie i6lf kik if is {F {e 1F 1ERe w. 1F *al Bt if 9f if LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54,00 ,50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 54,50 0,00 0,00 54,50 54,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 54,00 ,50 **dk if 9fMMif iE lE if ft i!*ie*ifi iE k if iE iFit9k**iE ie Bt iF ieefltBeit ik iF iE ik4*1f ifi Jt ieie iF if*iE it 4e 9e it BFk BEle Jt if %it 6k***1f**ie if lE i6 iF *if �F iE it I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFA 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 2,508,00 END OF FEES 01 0017015-007.70516 T O T 54.50 DATE: 10/28/94 TIME: 12:32 CONSTRUCTION AND PLANNING POOL 'A APPROVALS Permit =P Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ,., °,� - 53. Steel Reinforcement '3=Electrical Conduit Utility-Undrgrnd' - - 54. Forms - "_1. -Electrical Conduit-E7ndrgrnd. 55, Electrical Bonding . 5. -Steel Reinforceiheht 56. Rough Plumbing & Pressure Test T "It• 1 ,.� 6.;.E.IectricalUFERGrnd. _ 57. APPROVAL TO COVER-GUNITE �i 7 ;Footings.;_ 1`? 58, Electrical Conduit-Undrgrnd. - =.3.8.; Foundation -t ," 59. Gas Pipe, Ln Undrgrnd., Test ' 9.,Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 17 Undrgrnd. •10. Structural Floor System 61. APPROVAL TO DECK 1,1,. Property Sewer Line,& House Connection 62. Backwash & Receptor -Final 12. Sewer Cap63. Heater & Vent -Final u 13. Roof Drains n 64. Plumbing System - Final 14. Rough Plumbing' •" 65. Electrical -Final 15. Rough Electric'a'l -Conduit , 66. Solar System -Final 16. Rough ElectricWiring - 67. Fencing & Access Approval , 17. Rough Wiring 5gn 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT rAPPROVALS. •:Permit '*• 20::Rough Factory Fireplace 7 'r r 21.-Y'_DuCrs, in,Strijctur;e-`;70. 6itderground; Hydro 22. Ducts, Ventilating. . i .i' r -' Y •71. ProductPlPing (3lGas •v^Oil 23CGas-Pipe5Rou6h &'Test i. t '"� x -.72. Underground Flusft�. z. ;.. 24:.RooFr`amingni t.%, "•J r _-73:`Underyrnd.StoraosTarkGGas 0 25. Roof Sheathing ` ��,..(pr �Y ( 74. --Overhead Hydro"' ` 26.',T -Bar Ceiling (Structura0 &`iv�nnocoat r ,tr _ - s t 75.rDry Chemical 27.'"Fra me and Flashingf '" 76. Dry Standpipe - x c Lathing &Siding;q,,� y;-'�•j t<'' ..1 ..'t�, 77..-FIXEDSYSTEMFINAL. V 29. Insulation yr - " "e 01 78:, -FIRE PREV. FINAL 30. Drywall NailPq :r)v - r r r - HEALTHDEPTrREQUIREMENT Plaster Brown Cod' 0I I (! FINAL INSPECTION �G1. v ,,79. n32.�„Electricai;Pow`,er AM Ite,r,Finali - i t'4 { ,80. rFOOD CERTIFICATE ISSUED "� s .• y 33.Finat Electric ' = 1 ' "34. Final Heating& A6;C6nditionin4 ' 35.^Final Gad Pipe-TeSi t :• .y I I f k iWE " .__�r Hood or COAopv �t .36.' t,. t j e - _ • -$7.4inarF2Et6ry Fir9tolacer ' e i; v 38. Final,Plumbing ' `' F - 39. Water Service -Final t.. I I 'q r t •r, -, Ir a• I I V F k °40. Gas Service-F)nall ; n F , ?.41. Solar Domestic -Final _'. �l , 'l I t Iti t -42.-Backflow Preventer" 43. Backflow Irrigation . - .,. , n• 44. Landscape IrSuiation System7, ;n:, .. ., i ' ,.;. F 11 ' i. 1.1 :1- ,1 ,i •,-, -, ,45.'Sound Attenuation` ;r a :46.°Handica p,Regulatibns - f , 47. FINAL STRUCTURE & BUILDING 48'.:FINAL PLANNINGq ` _ 49. _Electric Release to Edison '50..Gas Release to Southern California,Gas Co 51. CERTIFICATE OF OCCUPANCY -71- No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations CITY -QF COSTA MESA CONSTRUCTION PERMIT - PERMIT NO. TRACT NO. - LOT NO., UNIT NO. Project Address .. ' Applicant's Malting Address' s_ L r' itI62 ��1 L.,:i ' ; TYPE OF CONSTRUCTION' NEW ' ADD ' ALTERATION= REPAIR ' _ .7 _ ISI ❑ CONVERSION ❑ DEMOLISH yA OTHER- A.P. # _ Zone ' C �� - , 1 Ain s1e Good,") Owner shame YV a G r -phone _ r_ _ - _, DESCRIPTION OF WORK/USE OF BLDG. �KiI 4'teg - Addiess I'd - �_y S - Main Building:, Accessory Building ArchlEng. License No., 1 TVPE.OFPERMITI1��' GRADwG. ❑.FOUNDATION 'STRUCTURAL T Front - 1 2 O _ _ I 1 ❑ TENANT I(ELECTRICAL I1S�I1 ❑ PLUMBING ladMECHANICAL' B _ N Address _ I - 1 1 A Rear :T- - 1 Contractor's Name' Phone994-4iun'. -❑'OTHER'-- C Right T •' I - N' t� r�'(7��1-AA 41 G � "� �'t PROJECT DESCRIPTION SO. FT. - - OCCUPANCY' K' --� _ - G Address (mailing) y q�� CONSTRUCTION -.TYPE I 'VALUATION $ Left, �j � � � , 1 .- - - !_. City License No. �J (!/ $ R a , R - ' ZONE - GRADING CU.VDS. ACRES d ':A-----' Parkiogi Req./Provided'r E- LICENSED CONTRACTOR DECLARATION ,sting,:Ref.# hhereby affirm that I am licensed under provisions of Charter'9 (commencing Remarks:; 1 ;, -Plapning'Not¢s: ,1 _ / with section 7000) of Division 3 of the Business and Professions Code, and _ my license is in full force and affect. ; 1 , ti1;l .� S (, License Class'` License No �- fr.�i1 _ 1 i Date IZ� Gy"uLi Signature ( PLUMBING FEEA Inl V WORKERS' COMPENSATION OECLAR T:I I hereby affirm that I have a certificate of consent to self -Insure or certificate Bar Sink I Showers - �-� -' : }{31O 1y [ FEES a If Workers' Compensation Insurance, or a certified' copy thereof (Section y o 800, Lab. Cp.)-- "" "" - Backflow Preventer- - -Service Sink _ y;,;' -- AutomaOc Wjsher- •", -'ELECTRICAL —'I - :Transformer ❑-15-50 KW y h No.4s/-�lAQj9 Q4 4' Company!1et4-g � 54 6dte rfi 1 '❑ 2obcy .l•�,.. Certified copy py is hereby firm )shed. a., Backflow Irrigation Sewer Ca p I t Iy. Construction Pole Sub. 50-+ KW' LJ Certified copy Is filed with the city B 'Id Ing Divisi Bathtubs • $ewer Connection Cooking Unit Meter ❑up to 100'amps Date._j,%��•-� Applicant - ' EXEMPTION FROM WORKERS' COMPENSA N DECLARATION Clarifiers Solar Collectors Dishwasher I 'Meter El over 100 amps . (This section need not be completed if the perm 'is for, onehundred ($100) or -' Dishwasher Solar Piping - - .. - - Dryers ❑Gas ❑Electric -�-_ - - �---w - I certify I certify that in the performance the work for which this permit is issued, - :Sub Panel 1 I an to t shall; not employ any person in any manner so :as to become subject to the Drinking FountainsSolar Tank Fan 'Motors 110-1 HP ❑1 % 8 Workers' Compensation, Laws of California.) - Date' Signature 'NOTICE: , Floor Drains; ( Swimming Pool w./Spa , ' p,q. U. _ Inc. Solar 09-15 HP ❑16-15+ If, after making this declaration, you should become subject to the Workers' Compensation` provisions of the Labor Code, you must forthwith - "or Floor Sinks -., 1- _ .. _ Urinal- - -- - Fixtures ` - Microwave ' comply with such provisions this permit 'shall be deemed revoked. CONSTRUCTION LENDING -AGENCYL - Gas Service :Outlets .Water Closeti Device Boxes 1 - -� 1 hereby affirm that there is a construction lending agency for the performance -� POIe'Light . of the work for which this permit is issued (Section 73097 Civ. C.) interceptors - Water. Heater Outlets Range Lender's' Name _ - , g LentleF's Address- ! '- - Kitchen Sink Water Service - Switches - •Sign OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law fogthe =. 1 Lavatories. 1 •; - Auto -Wash ° _ - Garbage Disposal Standing Sections . following reason (Section 7031.5, Business and Professional Code: Any city or _ county which requires a -permit to construct, alter, improve, demolish or repair 1 _ P -Trap'. a� 1 - - _ 'Laundry Trays , Generator ❑0.5 KW ❑5-15 KW Trash Comp actor any structure, prior to its issuance, also requires the applicant for such permit .to file alsigned statement thaLhe/she is licensed pursuant to the provisions of _ ROOF Drains - - ' the 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 - 'herefrom and the basis for the alleged exemption. Any violation.of Section - f 731:5 by any applicant for a' permit subjects the, applicant to a civil malty of not more than five hundred dollars ($500).,- -my -Reinspection ' - $ 3 _3 I,�as owner of the. property or employeeswith wages as their sole Fee $15 Issue Fee - compensation, will do the work, and the structure is not intended or offered Reinspection Fee $15 Issue Fee' $ 3 for sale, (Section 7044, Business and Professional Code: The Contractor's'; :_ I MECHANICAL 1 1 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 I 1 ' _ •- - ( , DEVELOPMENT SERVICES REQUIREMENTS: ( employees, provided that such improvements are not intended or offered'for Boiler HOOd Or. Type ❑ " t sale. If, however, the building or improvement is sold within one year of corn- - Canopy Type 11: ❑ Zoning Approved By Date I pletion, the owner, will'have, the burden of proving he/she did not build or im. 1 Duct - Under Ground Building Approved By Date prove far the purpose of sale). i 11I, as owner of the property, am exclusively contracting with licensed con- Duct -Structural Refrigeration System Application Application Issued By �� - Date1�L •' %gid i i tractors to construct the project (Section 7044, Business and Professions Code: does to who ,�a_ - &100,000 BTU 0100,000 ' 'SUMMARY The Contractor's License Law not apply an owner of property f Duct - Ventilating .BTU Q , OF FEES builds or improves thereon„and who contracts for such projects with a con- tractor(sl license pursuant to the Contractor's License Law). I am aware that ❑ Multi le ❑ Exhaust System p S System V em Repair/Alteration BUILDING PERMIT $ - SMTP' $ ' - proof o, their Worker's Compensation insurance should be provided to me. f( ❑I am exempt under Section B. 8 P. C. for this reason - _ Firepl/Fact. Bit. ICBG # Fire Dampers PLAN CHECK $ I PERMIT 1 , ;ISSUANCE I $ ' PLUMBING• • $ 1 Date 1 Owner ' I eating System & Ducting I Registers. PLAN CHECK 25% • $ ENERGY P.C. $ I hereby certify that I.have read this .application andstatethat the above- • -/ 100,000BTU-❑100;00067 GRADING $ information is correct. I agree to comply with all city and county ordinances 1 ELECTRICAL 1 ' $ 1 andatate laws relating to building construction, and hereby authorize repro- PLAN CHECK 50% :. $ MICROFILM , $ I Sentatives of this city;to enjterJpon Ire above-mentioned property for inspection purpos /{! , r I ( 1 '. t 1 MECHANICAL , ;$ , 1 r TOTAL FEE $ Signature_ Date--,:�q_`f Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25%' $ Drivers' License or SS CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor ' •CONSTRUCTION AND PLANNING `4 -Date 1 APPROVALS Permit # _ - Inspector - - - POOL .?A - APPROVALS Permit # Date Inspectnr _11. Temporary Electrical Service or Pole 52. Pool & Equipment Location ` r.2, Soil Pipe-Undrgrnd. "' - 53. Steel 'Reinforcement X3:7 Electrrica'I Conduit Utility-Undrg nd. �`• ` .154. Farms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding5.S teel,Rei'nforcere t 56. Rough Plumbing &Pressure Test ' 6.',Elecfrical UFER Gr;rid. - - 57. APPROVAL•T0 COVER=GUN_ ITE ty " :,J.'FootPngs °''' _ 58. Electrical Conduit-Undrgrnd. -^Z: - 8.-;Foundation r s •; 59'. Gas Pipe,.O Undrgrnd., Test -9. Water Pipe-Undrgrnd. , • -Y -•� 60.. Backwash Cines, P-Trap, O Undrgrnd. •61. '10. Structural Floor System Y ,� APPROVAL-TO DECK _ 1. Property Sewer Line & House Connection 62. Backwash & Receptor=Final _ 12. Sewer,Cap 63: Heater& Vent-Final - -- " , f-Drains R 90, s ,3. 64. Plumbing System - Final - �. 14. Rough Plumhing%> a 65. Electrical-Final -•• 15. Rough Electrical-Conduit 66. Solar System-Final - - - 16. Rough Electric Wiring - 67. Fencing &Access Approval 17. *Rough Wiring Sign 68: APPROVED FOR PLASTERING , 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. 'Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20.' Rough Factory Fireplace t 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas El Oil 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0Gas OOiF - 25. Roof Sheathing 74. Overhead Hydro - -26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - - 27. Frame and Flashing n 76. Dry Standpipe - 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. ;Insulation I 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 Notes: 34. Final Heating & Air Conditioning 14IJ-11 Gen 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 Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation' 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING, , 48. Special Requirements Completed; , - •r: - ' 49. Electric Release to Edison I - •• - - - ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE.OF'OCCUPANCY '• No. Date' -. - _. - _ ' i l OWNER SAN 3MMA BLIiLL= COMRANY DATE ri_i _(,4 JOB ADDRESS 104 -Georgetown TaBUILDING PERMIT NO. GENERAL CONTRACTOR same VALUE $ 15.735.00 AP No. LOT 1�7 TRACT $16() FIRE ZONE DESCRIPTION OF WORK res /wBtt_ ga INP^FCTIONS Signature DATE GROUP TRT TYPE ZONE Sc SUBCONTRACTOR PERMITS PERMITS I UED Gas _ NUMBER Water Rough Corn. efrig. Air Cond. Rough Heating— Rough Plumbing / Miscellaneous Prop. Swr. Line ❑ House Con. EKSt. Swr. ❑Cf 9 11963 Sprinkling System Construction Pole e. -2- Underground ❑ Power 0 Underground Rough Wiring ( Trenches Q' Forms Steel Reinf. ❑ - 2I - — Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing g 44' Frame and "VMAboi Lathing — In Out G {„ • �'% Plaster, brown coat P 7. El Air Con, ❑ Final 1. ag, Final y Plumbing Fixtures, Final Final Gas Test _ - - Electric Fixtures, Final Building, Final OCCUPANCY Form BV4— M -3 -63—S -B P H 1 22-00 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 817 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT wooiiess 104 Georgetown Lane RHCEI/F NO. COSTA,.MESA, CALIFORNIA R[C[IV BY OWNER San Vista Building Co. ' CATC15SUED MAIL 1166 E. 58th Street ADDRESS 3 / — CITY Los Angeles 11, Calif.No'AD 37187 OR ENARCHGTECTINEER Raymond' Levanas TEL.OR 3701C ADDRESS 3432 Via Oporto, Newport Beach CONTRACTOR San Vista Building Co. ONING ADDRESS 1166 E. 58th Street PLANS Hu ILD1 CITY Los Angeles 11, Calif, 1 A. P. NO.`— ucNO. 192782 N'0' 60 37187 SO" TO SIDE 9 REAR P. L. �• OF LIZ8OT 20 X 70 I NONO.W ON LOT OF BLDGS. 0 USE OF EXISTING BLoa_ None _ YARDS APPROVED SETBACK LINE FROM nev+vn nn ernvve t '] 1 DESCRIPTION OF WORK BUILDING x3; / NO. OF Y CL SIZE JD )(11 ROOMS STORIES EXTERIORWALL StuCCOI ROOPp.... Shingle 1 HEREBY ACKN LEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE T T E ABOVE 18 CORRECT AND AGREE TO COM- PLY WITH AL1, CITY ORDINANCEB AND STATE LAWS REGULATING BUILDING CONHTRU ION. FEE RECEIVED MAY 10 ft FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RHCEI/F NO. P �1000 R[C[IV BY DTH [Cy VHD CATC15SUED 3 / — JUN 1 1964 BUILDING ADDRESS FIRE ZONE TYPE GROUP APPROVED BY DATE ONING ZdN NO.OF USEOF PLANS Hu ILD1 LEGAL TrRef .5160 - of 317 D18CRIP4IO4 1 A. P. NO.`— NOTE: NO EAVE OVERHANG SHALL BE LESS THAN SO" TO SIDE 9 REAR P. L. �• EAVES ALLOWED <U.S. C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROM C/L REET) ' FRONT FT. FT. R. SIDE FT. FT. L. SIDE PT. FT. REAR FT. FT. DISTANCE BET. BET. MAIN Q MAIN BLDGS.. ACCESS. SLOGS. VAR.# C. U. P. *fr1w.1` i DATE X APPROVED APPO BY LUA / DATE ^ �/ - / SQ. FT. dC 0 THE AMOUNT SHOW NDER VALUATION 15 FOR THE PURPOSE OF EGTA LISHING A PERMIT FEE ONLY. VALUATION _ PERMIT FEE $ PLAN CHECK 5 TOTAL FEE 7('J '-�