HomeMy WebLinkAbout109 GEORGETOWN LN - Building Permits'.R
UNIT:
ARCH/ENGINEER: REG.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 farce and effect.
CITY LIC .:/�0593/7�17% STATE LIG.:40253f CUSS: C 39 EXP; 0/95
Date. _61.2 V� SignamrE'�{
WORKERSC MPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers'
Compensation Signtti flied copy thereof (Section 3800. Lab. 85/19/ 9 5
POLICY ND.: AIG
EXP. DATE:
COMPANY: ,,..yy
❑ Certified copy is /hereby furnished. OF Certified✓copy
ii��s filed with the city Building Division.
Date: )v .2_`I%��(�-� Applic I / I
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(Sl0o) or 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: If, 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' Stale 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 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 live hundred dollars ($500).
I. as owner of the property or my employers with wages as their sole Compensation, will do the work, and the
El 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).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑
and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a comractor(s) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. B P. C.
for this reason:
Date: Owner:
I do hereby cenlfy 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 Ouality Management District. Residential construction applications are exempt from
these provisions.
Dale Applicant:
I hereby certify that I have read this application and state that the above information is correct. l agree to comply with all city and county
ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
Dale: (0 1 A Signalu
Driver's License or Social Security p:
164146 While—Building; Green—Code Enforcement; Canary, Applicant: Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 069516
PERMIT NO: B 069516 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/ 6 HOT MOP SQ FT: 2,508
CLAIM V'ALUEB 2,508.00 CALC—VALUE :' 2,508.00 GROUP OCC: R-1 /
COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. REQUIRED
***MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM�**MMMMMMMMMMMM�F+r�E�E***�H+r*�E*Err*�*r�r+E**1E�E�E7E�t-yl�E
2 0 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 REQQ•
PROV:
PARCEL:
41916222
2NE: AEF NO:
PLANNING NOTES>
>
M MM MM M M M M MMMM M MM MMMM
MM M M M M M M MMM MMM M MM M M M M M M M M M MMMM
M MMMM M MM MM MMMMM M M M M MM M M M M MM M M
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
APPLICATION ISSUED BY
DATE:
DATE
x xxxxx xx xx xx xx xxx x x x x xxM M M MM MMMMM MM MM M MMMM MMM MM MM M MM M MMM M MMMM M M M MM M M'1EMM * *. �. {(.M M
LEGALIZATION:N FU 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/SHOAT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54,00 .50
MM MM M MMM M M MM M M M M M M MMM MM MM MM MM MM MM MM M M M M M MMit M M MM MMMM M M M MMM MM MM M MMMM M M M M MM M M MM M M M
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
SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 2,508,00
END OF FEES
D? 00170541-00170542 Till 5¢,50
DAT—c= 10!28!94 TI1NE: 12:41 //
.R
CONSTRUCTION AND PLANNING
POOL ,PA
APPROVALS Permit # Date
Inspector
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
-
2. Soil Pipe-Undrgrnd.
53, Steel Reinforcement
3:° Cpctrical Conbf it Sltility'-Undrgrndi
54. Forms
: Itlectrical Conduit-L-indrgrnd. l
55. Electrical Bonding
_�tS.'Sieel Reinfordt ent
56. Rough Plumbing & Pressure Test
C' ne.
�I `tlectrical OF R-Grnd. `�
57. APPROVAL TO COVER-GUNITE
7 7: Footings 70
58. Electrical Conduit -Undrgrnd.
u♦
. Foundation `'r
'
59. Gas Pipe, O Undrgrnd., Test
• •9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, ❑ Undrgrnd.
�10. Structural Floor System `�
61. APPROVAL TO DECK
ill. Property Sewer Ling & House Connection
62. Backwash & Receptor -Final
-
12. Sewer Cap it
63. Heater & Vent -Final
i•
13. Roof Drains -T
64, Plumbing System - Final
14. Rough Plumbing `• J
65. Electrical -Final
15. Rough Electri'ral-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
rAPPROVALS=,;Permit# ' r r"
20:. -,Rough F.g ctory nreplace
.J
_o = +
•E .,. -t
1•
S , L.F STI".''
21�pujs,iaSt�ltturte, y!
T H
«
�• r d
;j ,ya
Y '�`: y'• [T;
70. UndergnotmdHytro
.
_
22"Du Vent lating « ii
s
f
177, product Piping OCSas Oil
r
23":Ga9;Pipet:Rojjgh &'Test
V'.:
Ant C
• «
=
f} .!
72. Underground Flush = '
9 ,r_,
s t 07- .u..i
24..rf?oof Framing [:; T r --r-• ••t-•
-
F '
... •.-
r'73Undergrnr7.StorargTankrLGas Ci
25. Roof Sheathing J • ` "1�
,���'
'� +
'746*Over head fiydro�`-
26.-T-6ar Ceiling (Structural) &_Nonocoat
7;
i7 :111 t
757'Dry Chemical r:
27.'•Frameand Flash lj �n;T
'
ut
76Stan
."Diy
_28y'Lathin & Sidin :'r -'•' •i;
9� 9',+ �� 'I <.,I:"�
ti
. _
` =
77.y FIXED SYSTEM -
29. Insulation '' ';; •'' '• '
k t`t
; :
7&;�FIRE PREY. FINAL
n
30. Drywall -Nailing tp y
I �• _
HEALTH:OEPTr. REQUIREMENT
r,
---------------
'31. Plaster %own CAti !
1
FINAL INS,;ECTI,QN •'; "
., „
_�,
..79.
-32,:Electrical Power_MatetrFinal:.-,�
..
( > a
O:r=FOOD CERTIFICATE ISSUED
V33:"FilfW
Electric �' i �_
` •
_r•f` 'T
''Nd4es: L «
34. Firiaf Heaiingi& r^1
(
!l.
1
❑• �`- `mit= " ,
i
35?Final Gas Pipe-Testr to
36: Hoo j o0''nopyr; . _
. n I
( .
i
_
n.
-37 CFinal Fttory Fireplace,, . • ''
t-' I
1` i
'• �ti
.. "
I 11
+
.. .. .o
-38. Final Pluinbing tr1 • `'u I
t
-
, 39. Wazer Se?vice-Finals
a �• .
Fn•
« n
G
;940. Gas Service -Final
All. Solar Domestic -Final _
I
u
r
r • •,
2.`Backflow ``
I"4 Preventer,
43. Backflow Irrigation^ '1:.!z
v
r
T
,44. Landscape Irrigation Systemn;n
; to
r;-
:45.=.Sound Attenuation -''":r+
'n
va
~Y
F c,
46.'HandicapRegulatlpps
`trt
T
_
'47. STR-UCTURE & BUILDING �
�7�•qs
7 t'��
-,FINAL
1Q'W
46.:�FINAL PLANNING.
Release to Edison t
I «
T� -1
.49.=£lect>•ic
i50.. Gas Release to Southern California, Gas Co
51. CERTIFICATE OF,OCCUPANCY
No. Date
'
JOB ADDRESS luy ueorgeDown Lane BUILDING PERMIT NO. Gife5ft
GENERAL CONTRACTOR same VALUE $ 13. 95.00
AP No. _. - LOT 314 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK res W/att
F `ECTIONS Signature DATE GROUP 1AJ TYPE V ZONE
I
?,PERMITS
Gas _ = SUBCONTRACTOR
ISSUED
DATE
NUMBER
Water �%J—f/���j
Rough Cafn. Refr'I7�T Aif Cond. El
Rough Heating
Rough Plumbing 2/
-
Miscellaneous r '
Prop. Swr. Line O m[ St. Swr. ❑ House Co-c�'f
EC �19Ti3-
4 O 8
S rp inkling System
Construction Pole
Underground ❑ Power,p
l
Rauh Wiring - G "
Trenches'R Forms Ele Steel Reinf. 3
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing o
Frame and Flashin
Lathing — In Out f 5V
Plaster, brown coat
£ ❑ Air Con. p Final
Final - 5 eE .ser n
Plumbing Fixtures, Final �,
Wei
Final Gas Test /G Ir,' lolllab o.<.
Electric Fixtures, Final z- -
Building, Final
OCCUPANCY
Form BU4-SM-3-63--S-BP __.��.. .-ten envr•TA7
C16STA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOR 317 COSTA MESA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
ILDI sG 109 Georgetown Lane
ETNC
FT.
BET. MAINS
COSTA MESA, CALIFORNIA
a
INER San Vista Buildin Co. -
qHl
DRESS 1166 E. 58th Street
BUIL
ADDI
DATE
Y Los Angeles 11, @alif.No•AD 37187
ioNl
^H'G ENEER'RayIIOnd L2VSna5 Na•OR 37010
APPS
BY
.<Ess 3432 Via 0 orto New ort Beach
In
O E
NTRACTOR o
iLL
iR VALUATION 18 FOR THE
IG A PERMIT FEE .ONLY.
1166 E. 58th Street
DRESS'
LEGA,
DEECI
rY Los Angeles 11, Calif.
A.P.
nTNO '192782 .N�' AD 37187
NOTE
so^'
® SIZE
[SETBACK FROM LINE M 13 E
CENTER OF NESTREETFRO REAR YARD
SIDEYARDI LEFT 0 'RIGHT O'
DESCRIPTION OP WORK
IS,
BUILDING^ O X
61ZE r2
EXTERIOR WALL
TO BE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE 10 CORRECT AND AGREE TO COM.
PLY WITH ALLCI Y ORDINANCES AND STATE LAWS RHOULATING
BUILDING CON R ION.
SIGNATUR of _ j%„ - „ / /1 /1 �( �( Jd
W AUTHORI
FEE RECEIVED
my i e to
FINANCE DEPT.
APPL1&T 0AFF&Q`�7PER/,tITSA
BUILDING
For Office Use Only
RECEIPT NO. I RRIIT'�
JUN TH-1819641
TYPE �,( GROUP_ /> 4--
DATE
ZONING
OF USK OF
is BUILDIN4
r
act 5160 - Tnt 4141
VERHANG SHALL BE LESS THAN
1YARDSAPPROVED YARDS APPROVED
MAIN BUILDING I ACCESSORY BUILDING
VAR.
_ /d 4 7SD. FT.
THE AMOUNT SHOWN
PURPOSE OF ESTASI
VALUATION
FT.
l
FT.
BET. MAINS
ACCESS. BLDGS.
a
DATE
APPROVED
a
DATE
U
W
CIL
w
In
iR VALUATION 18 FOR THE
IG A PERMIT FEE .ONLY.
p Lh1
m
V
5
IMIT FEE' $
IN CHECK S
'AL FEE S i 76-6 I LL
Mr. Charles SPADE I DATE
141-701-03 LOT Por 1 TRACT 5160 FIRE ZONE VALUE'$ 150.00
CTIONS Si nature I
Date
GROUP TYPE
ZONE R
Su„
SUBCONTRACTOR
PERMITS ISSUED
GAS
Date Number Si nature
WATER
Plumbin
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING
Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REIN F. ❑
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN ❑ OUT ❑
PL«TER, BROWN COAT
'1RAL, FINAL
Elect,ic
W j, VENT., REFRIG. AND A.C„ FINAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
—`
3'ld
} COSTA MESA BUILDING -SAFETY DEPAF
P.O. BOX 1200 COSTA MESA, CALIFORNIA
For Applicant to Fiffin Completely
BUILDING
ADDRESS ,E
OWNER
MAIL /� `�O
Z ADDRESS Cs
WILL! /^ /_ TEL.
MU CITY C'd�3r %>��� NO.
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Z Q CONSTRUCTION -
ON LENDER
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ADDRESS
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APPLICATION FOR BUILDING PERMIT
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ARCHITECT
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OR ENGINEER
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ON
STATE CITY
LIC. sL� 6 LIC. NOI
SIZE
NO. OF
OF LOT
NOW O
USE OF
EXISTING BLDG.
PAill
00
APPLICATION FOR BUILDING PERMIT
j�_.Z%
TRACT .,) /E
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OWNER h/l-
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FIRE
ZONE
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APPROVED
BV
BLOCS.
N LOT
49 LOT BLOCK
!�/-ales S'/liar_
VALUE
02 $
VPE GR UP
FON _3 I PLOAOWPOZ� BUILDING SE OF NEW
�
YARDS APPROVED YARDS APPROVED
MAIN BUILDING ACCESSORY RUILDING
F-rt
E OF NO. OF
Z BLDG. ROOMS Tee
ORIES L.SIDE FT.
UERIOR WALL ROOF
VERING COVERINGREAR FT.
E OF BUILDING AND WORK TO BE PERFED DISTANCE BET. BET. MAIN
V d?i[.MAIN SLOGS, ACCESS. BL
Q VAR. DATE
O C.U.P. APPROVED
APPROVED
NBY
Z
Verebyacknow ledge that I have read this apion antl state
t the above information is correct and agrcomply with
laws regulating building construction, antll not employ
r person in violation of the workman's coation laws of
(nState of California.
Zreby certify that I am property licensed asractor underSO. FT.
State of California Business antl Professione, Division 3, THE AMOUNT SHOWN UNDER VAL
pter 9, and that such licenses are in full fod effect, or I THE PURPOSE OF ESTABLISHING A PE
exempt from the prpv' ions of the State ofrnia Business VALUATION
Professions Cotla rv' on 3, Chapter 9.PERMIT FEE $
ature of r / y !// fmittee (�'L.J�iJC.G P' -vim?`. $ (/j/I V[/ PLAN CHECK $
horized Agent`'
TOTAL FEE $
Still