HomeMy WebLinkAbout112 GEORGETOWN LN - Building PermitsCITY OF COSTA MESA Dn /�
A �s`p"'F, BUILDING DIVISION Qp
:� 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.Ca.us
FOR INSPECTIONS CALL: (714) 754-5626
��09°RO� PERMIT NUMBER: P07-00575
PERMIT TYPE PLUM STATUS: FINALED
APN: 41916215 DATE ISSUED: 11/06/2007
ISSUED BY: RMD
JOB ADDRESS:12% OE RGET.OWNsLN.CM Suite/Unit:
Vicinity: GARA
SCOPE OF WORK: WATER HEATER CHANGE OUT, SAME LOCATION (GARAGE) FOR A SFD
OWNER:
CONNER, CHRIS
Address:
112 GEORGETOWN LN
PHONE:
714-546-2595 -
City/State/Zip:
COSTA MESA, CA
APPLICANT: LITTLEFIELD, SCOTT
_ Address:
24707 SAN FERNANDO'RD'
PHONE:
888-611-4328- -
City/State/zZip:,
SANTA CLARITA, CA -
CONTRACTOR: AFFORDABLE WATER HEATERS AND PLUMBING
License No. 627368
Address:
24663 RAILROAD STREET
- -
PHONE:
661-259-7131 -
-
-
City/State:
NEWHALL, CA ZipCode: 91321-1742
CELL:
ARCHITECT:
ENGINEER:
License No.
License No.
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL FEES: $35.80
PHONE:
PHONE:
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.
CODE INSPECTION TYPE DATE INTTIALS CODE INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing ) 0 - 15 -10 (3
200 Final Re -Root 210 Final Electrical
201 Final BlockJRetaining 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 Buildmg/Occupancy
WORKERS'COMPENSATION DECLARATION:
I here f r ria ty of—
on
f perjury one of the following declarations:
'r.1(�Id t
❑ I h a ai0t �in'alcertifcate of consent to self -Insure for workers'
compen on, a ro ed fo-tiy section 3700 of the Labor Code, for'the
performance of the work for which this permit is issued. -
❑ 1 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 carrier and policy
number are:
Carrier:
(Thisse ioo need trotcemtndeted eche perm9 is valuedat one huouled"ars(Slee) wless)
Policy Number:
❑ 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, and agree that if I should
become subject to the Workers' compensation provisions of Section 3700 of
the Labor Code, I shall forthwith comply with these provisions.
Appt¢ant's Signature
Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5700,000), IN ADDITION 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
Win Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
Lic. #
Contractor's Signature
Class 7t
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirn 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:
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 cmtmctor(s) license pursuant to the Contractors License Laws.).
❑ [am exempt under sec.
Business and Professions Cade for this reason:
Owner ID verified by drivers license. [-]Yes ❑ No
Driver's License No. Expires:
IT Verification of Ownership by (type of document, i.e. - property tax billor 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, falsevmrk, a 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.
Applu,ant's Signature
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? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed 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? ❑ Yes ❑ 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 Safely 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? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ 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 ❑ No
.8. (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: -
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, and 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.
Signature of Legal Ownerts)
Date
M57-ne (=7) Andlor Authonzed Appllaant Date
CITY OF COSTA MESA
BUILDING DIVISION
to 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us
r
�. FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: P07-00575
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.
CODE I1
INSPECTION TYPE
1616
Fixed System Final Fire Prevention
1266
Pool Spa Final
200
Final Re -Roof
201
Final Block/Retaining Wall
202
Final Factory Fire Place
203
Final Sign
204
Final Demolition
DATE INTITIALS
CODE/
INSPECTION TYPE
206
Final Mechanical
208
Final Plumbing
210
Final Electrical
212
Final Fire Prevention
220
Final Planning Approval
222
Final Site
250
Final Building/Occupancy
DATE INTInALS
10-1s -to
WORKERS' COMPENSATION DECLARATION:
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.
❑ I 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 carrier and policy
number are:
Carder_
� (Thit seiaion need hal be wmdeleftl+aa the dermit i valued at one hundred dollars (S 10) or less )
Policy-Number:
f
Z 007 a -74
❑ III c -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 subject
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Code, I shallfrfr�hwith co ly with these provisions.
Hyl u) 1/-6-O %
s'Sgnature Dat( a—�-y
r
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000). IN ADDITION 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.
Class #t- C 3 6
cgy rsctoYs Signature �Dateyw...
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. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Signature
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, stricture, -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.).
❑ 1 am exempt under sec.
Business and Professions Code for this reason:
3057-46(0/07)
Owner ID verified by driver's .e. ❑ Yes ❑ 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: '
❑ 1 hereby certify that no excavation We (5) or more feet in depth into which a
pension is required to descend, vnll 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, The 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.
Applicant's Signature
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? ❑ Yes ❑ No
(Section 25505 of the California Health and Safely Code requires, with some
exceptions, that a Business Plan be filed 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? ❑ Yes ❑ 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 Safely 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? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for nor -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 ❑ No,
8. (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: 1
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, and 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.
Signature of Le#1 0.ens) Date
t.-�Mdforia,ffiwzed Applicant Data+:.-:--..:.. -.+.--
A
.i
PROJECT ADDRESS: 112 GEORGETOWN LN
OWNER'SNAME: BEIBIN, HAROLD TR
ADDRESS: P 0 BOX 10755
COSTA MESA,CA 92626
ARCHIENGINEER:
ADDRESS:
REG.NO.:
UNIT:
UNIT:
PERMIITEE: STOUT ROOFING INC (310)923-6775
ADDRESS: P O BOX 4309
DOWNEY CA 90241
LICENSED CONTRACTOR DECLARATION: I hereby affirm that) 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.
CITYuc.: 5933q77 STATEuc.:402536,�LASS' C 39 E$P; 10/95
Date. "I Signature:
WORKERS' dOMPElliSATION DECLARATION: I hereby affirm that I nave a certificate of consent to self -insure or a certificate of Workers'
Compensation Ill or a cenlfied copy thereof (Section 3800. Lab. C1
POLICY No.: 5822699 EXP. DATE: 05/19/95
COMPANY: AIG
Certified co�zpy is herebq tumkhetl. CY Certitudes copy iSbkuf/w�itthh the city Budding Oiviskm.
Date to ✓� r ApplicantC
EXEMPTION FROM WO KERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred (51 00) 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 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. 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 10 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 (S500).
I. as owner of the property or my employees 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 himsell/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' State License Law Ones not apply to an owner of props who builds or Improves thereon
and who contracts for such projects with a Courtrai license pursuant to the Contractors' Stale 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:
Dale'.. Owner
I do hereby certify 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 oualily Management District. Residential construction applications are exempt from
these provisions. -
Date: Applicant.
I hereby certify that l 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 t0 enter upon the above-mentioned
property for mspecbopurposes.
Date. Signature �
Driver's License or oda) Security r:
1641-46 White—Building; Green—Code Enforcement Canary—Appleant: Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06951
PERMIT NO; B 069513 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION ; T/O RESTH & REROOFW/A�P�1 & HOT MOP SQ FT: 2,508
CLAIM VALUE; 2,508,00 CALC—VALUE;(Q{iE 4 2,508,00 GROUP OCC: R-1 /
COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. RE?UIRED
MMMMMMMMMxMMxMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM*MMMMMxMMM xMMMMMMMMxxMMx
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 REO•
PROV;
PARCEL:
41916215
ZNE:
REF NO:
PLANNING N TES>
>
MxMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMxMMMMMMMMMMMMMMxMMMMMMxMMMMMMMMxMMMMMMxMMMMMMMM
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; -_ n
BY:
DATE
xxxxxxxxxxxxxMMMMMMMMMMMxxxx M MMMMMMMMMMMMMMMMMMMMMMxMxMMxMMMMMxMM M'M MiEMMMMf1txMM
LEGALIZATION;N 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
M MMMMMxMMMMMMMMMMMMMMMMMMMMMMMxMMMMMMitMMMMMMMMMMMMMMMMMMMxMxxxxxMMMxMxxMMMMMMMM
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
01 00170547-00170548 T CET `4,`0
DATE: 10/28/94 TIME: 12:43
CONSTRUCTION AND PLANNING
POOL ?A
APPROVALS Permit;* Date
Inspector
APPROVALS Permit#
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
I
L
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
'O..Electrical Conduit WtilitY-'Wndrgrnd.
54. Forms
��:4nElectrical Conduit-U'hdrgrnd. o'
55. Electrical Bonding
- 5 Sieel Reinforcement
56. Rough Plumbing & Pressure Test
-
,r. 6."Electrical UFE$ Grnd.`;
57. APPROVAL TO COVER-GUNITE
�r •7. Footings
58. Electrical Conduit-Undrgrnd.
-
`�) r�. Foundation ,_
59. Gas Pipe, 0 Undrgrnd., Test
t
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
u
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 j'
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
' FIRE DEPT. REQUIREMENT
- -ul - tr v
:APPROVALS{ _'. Permit
20. Rough Factory F%replace
21.20u'"is in,Stryctur�eA ', '' �_
:
_
'170. Undei'g'rpun& HY�!ro }
r '
_
_'
22 rDut'ts, Ventilating: r i C.
�`. •�71.
ProducPPFping C91Gs 'Oil
23 Gat Pip -�Rou`gh &Test .�j�
,r _
;72. Undergr'o rind Flui
I
ti
24. {Roo{ Framing at : -• ti
"73.Undergrnd: Stora j Tank £Gas ❑ Oil
25. Root Sheathing
.'74.-Overhead'Hvdrq._� 4':-
,fir K~Lg-q!�
(dG/!.►.
26. :T-Baf Ceiling (Structural) &dvjonocoat
t. w
^ �^: t
75.'Dry Chemical `-+ 'ZI :r
27.'�mFl.a, Flashing'
76. Dry Stand'"piQ'e "`= + •f: PI �.
:
x -•
>. T' .
F -m
28. -Lathing-& Sidingv;. ., % J 7 u;
u
r -
77,_ FIXED SYSTEbti73NAL, a'
>29. InsulatiQp
76: FIRE PREV. FINAL �. •s
•J
30. Drywall^Nailing 'l4k
HEALTH.DEPT+REQUIRBWIENT
own ni°
31. Plaster BrCo
I I' '
FINAL INS`P_ECTION '
_
ti , , ,
�
. {,
,79.
_32._ElectricaJ•Power Meier -Final{ 'r
-, •+�
„fir -
r80. -:FOOD CERTIFICATE ISSUED
`'
33. Final Electric
`Noyes:
O i•t
,34. Final Heating '& AirCondition ag--
35. -'Final Gat Pipe Test
•
�. 4
_36.'Hoo,4 or=Cranopy .�• - ;,r.i
•
,
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1) • . l .., -111
- :,__, x wa=•
Y
-37. Final Factory Fir�pyace '{ --!" •'i
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'38. Fina[,, Plumbing .1 i
39. Water Service-Finalx
40. Gas Service- FjpaI:....
01
.41. Solar Domestic -Final - :, •-
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42. Backflow Preventer
43. Backflow Irrigation
''-. �-+
4. Landscape Irrigation System, 7 �; ,{,
,;,
.,7 ;;' •_
45. Sound Attenbationt
4
46. Handi;:A,Regulatorfjs
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING,
,-
-49. Electric Release to Edison
I
:
$0. Gas,Relii" to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY'
No. Date
OWNER SAN VISSA BUILDING COMPANY DATE 6-1-64
JOB ADDRESS 11.2 Georgetown T,ane BUILDING PERMIT N0. 22304
GENERAL CONTRACTOR same VALUE $ 15,735.00
AP No. LOT 321 TRACT15 6O FIRE ZONE DESCRIPTION OF WORK res Watt 1
T" F.CTTONS I Signature I DATE I GROUP TR.T TYPE V ZONE Rq
S. 1
GasSUBCONTRACTOR
'
PERMITS
ISSUED
DATE
NUMBER
Water
Rough Com. ReIrig. Air Cond. ❑
Rough Heating
i —
37,r�_
Rough Plumbing,i
—
SC[ Sz�,7
Miscellaneous
—�
Prop. Swr. Line ❑ House Con..arSt. Swr. ❑
S rp inkling System
+ ' I
Construction Pale
7`
Underground ❑ Power El
a
ou h Whin LLtn 7 _ v
Z__
Me
Trenches Forms Steel Reinf. ❑
Floor System
_
Bond Beam ❑ Steel Reinforce ❑
Sheathing e
Frame and Flashin .
Lathing — In Out c
EP -ter, brown coat
I ;.p Air Con..p Final
Ht. ang, Final Z `O
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final
OCCUPANCY
eor r mnTf) FOR SPECIAL
J-
22.304
'COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 317 COSTA MESA, CALIFORNIA
For Appi_icagt to Fill In Completely
TYPE OR PRINT
ADDRBUILESS 112 Ceorgetvwn Lane
COSTA. MESA, CALIFORNIA
OWNER San Vista Building Co,
ADDRESS 1166 E. 58th Street
TEL..
CITY Los Angeles 11 Calif.
LIC. 182782 TEL AD 37187
SIZE NO. OF SL
OF LOT 20 x 70 NOW ON U
USE OF
EXISTING BLDG. None
--.=aa LINEFROM 131 evwevwnw-
DESCRIPTION OF WORK
��=DIN•]G[•1
COV RINGWALL St COVERING COVOERING Shingle
COVERIONGUSE OF SUI L.DING AND WORK TO BE PERFORMED
U
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
ANO STATE THA E ABOVE
IS CORRECT AND AGREE TO CON.
PLY WITH ALL ITY RDINANCES AND STATE LAWS REGULATING
BUILDING CONEYS. ON.
FEE RECEIVED
dAy 19' Im
rI�FIINnA�N tC�EE DEPT.
�
APPLIPiTXOR FdR PERM'R"p
BUILDING
For Office Use Only
"
RECEIPT NO,
PERMJJ�
RECEIV Y
1 6Yi¢
DAJ&REC IV D
�
DATEISSUED
III
BUILDING -
ADDRESS
FIRE
ZONE TYPE . GROUP
APPROVED
BY DATE
ZONING
Z
NO.
PLA
USE OF
RUI I
LEGAL Tract 5160 - Lot 32
DESCRIPTION
A. P. NO. 3 -
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
30- TO SIDE at REAR P. L.
EAVES
ALLOWED (U. S. C. REQUIREMENT)
YARDS APPROVED
MAIN BUILDING
YARDS APPROVED
ACCESSORY BUILDING
(FROMC/ REET)
FRONT FT.
FT.
R. SIDE FT.
FT.
L. SIDE FT.
FT.
REAR 0 FT.
FT.
DISTANCE BET.
MAIN SLDGS.
BET. MAIN
ACCESS. BLOGS.
VAR.#(
C.U. 1
DATE
APPROVED a
BYP DW�y
DATE
THE AMOUNT SHOW DER VALUATION IS FOR THE
PURPOSE OF ESTA SHINO A' PERMIT FEE ONLY.
VALUATION
$ /� / ✓ �/
_
PERMIT FEE _
PLAN CHECK S
TOTAL FEE 5 / �� ✓�