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HomeMy WebLinkAbout1364 GARLINGFORD ST - Building Permits CITY OF COSTA MESA pC BUILDING DIVISION , f •.,,, I 8 DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER V i 1 PERMIT05-01765 nfoll (714)754-5273` 0 • Fax(714)754-4856 • www.ci.costa-mesa.,43UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1364 GARLINGFORD ST Status: ISSUED Suite: Applied: 10/03/2005 Vicinity: ROOF Issued: 10/03/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 14102208 Zoning: Applicant: DOUGHTY, JOHN M Address: 1364 GARLINGFORD ST u,r�/ Phone: 714-556-1393 ISSUED BY: COSTA MESA,CA Zip: 92626 Owner: DOUGHTY, JOHN M Address 1364 GARLINGFORD ST Phone: COSTA MESA,CA Zip: 92626 Contractor OWNER-BUILDER , Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT I/O EXISTING WOOK SHAKE ROOF AND INSTALL NEW SHEATHING,30#FELT AND REROOF W/COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE. FEE SUMMARY Plan Check: $0.00 -Lao, aluation: $5,000.00 Permit: $111.25 tli= aluation: $5,000.00 SMIP Res: $0.50 SMTPh $0.00 Other $0.00 Inspection:. $0.00 Total: $111.75 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(WOO) . DECLARATIONS 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 Insurahce carrier and policy number are: Carrier: Policy Number: (This Ion need not be completed it the permit is -- •••at one hundred dollars($100)or less.) frau A,1y.1Ret in the perfo .nce of the work or 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' = omia and ogre:.that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro • s. ate App Ice 9lghattlre:' - .i .4 IO - 7 -o FAILURE TO SECUR W ORKERS'COMPE ' ON•• ERAG IAUNLAW FUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,003). ADDITION TO THE COST• COMPENSA •; ,DAMAGES AS PROVIDED FOR IN SECTION 3105 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.II Class# Contractor's Signature: Date: 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: 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 properly,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 properly who builds or improves thereon,and who does such work Imself 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.). ' s owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code:The•••'tractors Licse Law does not appy to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) g license purs -, t to the COhtractors License :ws.). ❑ I am exemp der �I . Business and Professions Code for this reason: If Sign' attire i Al—`— id-3. -y3 ._ -v..• Expttesr Z—,Z -o,. Owner ID verified• driver's lice Yes 0 No lkweriiNcenseNo'.--/ Verification of Ow ership by(type of docui t,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 B,California Administrative Code). ❑ As owner-builder, I will not employ an •.r- 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 divisi. Signature: • - .a.. Date: a, Division of Industrial Safety Permit Number: «..'r _, HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: •- 1 Will the applicant or present or future building occupant need Toll a artily a -i:nds'Plan tor emergency response to release or threatened release of a hazardous material? ❑Yes ❑No .;< (Section 25505 of the California Health and Safety Code requires,with sant:. -•f tr,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 '? 'als 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 Safety Coda 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 ermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? Ul Yes 0 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 0 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? 0 Yes 0 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: • CERTIFlCA •F COMP 4ANCE 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 a! e: to : pl 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-desc'b:•p-''4y •r inspec ion purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspec' y /, _ _____ -_ /0 - 3 -0 ' rrlatDre•Oh vafOwn'er(s) fit And/Or Authori.•d Applicant Date CODE t INSPEcnoNTYPE all It!)IDAU CODE It INSPECTION TYPE PAH !IMMO 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof O L 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 _ _ iii i1I OWNER-BUILDER Eat VERIFICATION / Z, /� n r, n J� address: /3 6Y G/� i 'd" 69`� Y C CA Permit#: I ) ytb2(o A city or county,which is required to give notice pursuant to Section 19830,shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner- builder verification. Attention Property Owner: An `owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. • I personally plan to provide the major/tabor and materials for construction of the proposed property improvement. n Yes 2'No 2. 1(have/have not) ,_7,9t/6.- signed an application for a building permit for the proposed work. -- 3. 3. I have contracted with the following persn(firm)to provide the proposed construction: Name ()Uri— rth 6(G� Address City Phone( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work 1042.46 (Rev.11/04) PROJECT ADDRESS: 1364 GARLINGFORD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT P64M NO; 6 Ubi14b OWNER'S NAME:ROSE MARIE CATHCART ADDRESS:SAME PERMIT NO: E 063146 PLAN CHECK NO: N uUvi : N SUFF; N Let NK3-308( CONSTRUCTION TYPE: III—N PERMIT TYPE: ELE PURPOSE: OTH Cktc ARCH/ENGINEER: REG.NO.: cre5, r-X3-3 JOB DESCRIPTION : 30AMP RECEPTACLE , 2 OTHER RECEPTACLES SQ FT; ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / PERMITTEE:A & S ELECTRIC ( 714 ) 859-1328 ADDRESS: 25422 TRABUCO105 296 COMMENTS- NO OTHER WORK AUTHORIZED BY THIS PERMIT EL TORO CA. 92630 ###X##**4***±E#**************** *****##*******##*# X*>E##******************#***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY uc.:037396 STATE LIC.477024cyss: — LZ-9 `'7 ��� MAIN BUILDING ACCESSORY BUILDING Oale:7.- Signature'. FRNT; FT IN REAR: FT IN FRN1'; FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have:Lute of consen to sell-insure or a certificate of workers' LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). POLICY NO.: E%P.DATE: PARKING REQ: PROV: PARCEL ; 41047203 ZNE: REF NO; COMPANY: PLANNING NOTES> ' ) Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. > Date: Applicant: DEVELOPMENT S .E;;k V I C E S REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). I certify that in the penormance of the work for which this permit is issged; not employ any perso in ny manner so as to become ZONING APPROVED BY r" DATE: subject to the Workers' Compensation Laws of California. �'I//J ) Date: ✓f'—2 /p 1 Signature: _7 NOTICE:II,after making this declaration,you should become subject to Mx Workers'Comite ti I provisions of the Labor BUILDING APPROVED BY : ! DATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. c CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; _ > DATE• ZZ( J which this permit is issued(Section 3097.Civ.C). ******************X'#****W*********-********* ********************** •* • R * -** LENDER: ****#***************************14*****************#*************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT; N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or PERMIT 4 50 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 50$ SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN ' ' and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 15, 00 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTA PAID DUE I, as owner of the property or my employees with wages as their sole compensation, will do the work. and the — e ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS-- —> 4 , 5 0 15 , 0 0 0 , 0 0 19 , 50 19 , 0 0 0 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 REVENUE DIVISION TOTALS--> COLLECTED - 19 , 50 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve forer the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 19 . 50 ❑ I,as owner of the property, exclusively contracting with licensed contractors toconstruct the project( 7044.Business and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts fr such projects with acanhactars)license pursuant to the Contractors'Stale License Law).1am aware #*#'*'**'***'*** ***'X'**'*'*'*#%*****#**#**it:f**#*#*#*********#***##**#****##*#***B(-****** mat proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY , DESCRIPTIO N UNIT COST TOTAL COST • Date: Owner: ELE 2 RECEPT/OUTLET 1 ST 20 EA . 75 1 . 50 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and ELE 1 MOTOR/POWR APPARATUS 0 . 0 — 1 , 0 HP 3, 00 3 , 00 25534 and That I or any future building occupant will/will nor(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Duality 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.I agree to comply with all city and county • ordinances and state laws relating to building construction and hereby authorize representatives of;'s city to enter upon the above-mentioned , property for inspection purposes. / / Date: el----24-7.14-3 Signature: �.Gla 01 00143333-00143383 TOT 19.50 Driver's License or Social Security DATE: 07/22/93 TIME: 14:34 164146 White—Building:Green—Code Enforcement:Canary—Applicant Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING Pot SPA • APPROVALS Permit;} Date Inspector APPROVALS Permit == Date Inspector I 1. Temporary Electrical Service or Pole 52. Pool & Equipment Locat e- 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utihty•Undrgrnd. 54. Forms 4. Electrical Conduit•Undrgrnd. - 55 f.'ectrical Bonding 5. Steel Reinforcement 56. Rough Plumbing E. ° -wure Test --, 6. Electrical UFER Grnd 57. APPROVAL TO COVE.R.GUNITE S � 7. Footings 58. Electrical Conduit Urdrnrnel. I J.- -! 8. Foundation 59. Gas P.pe, i Uru:❑rd , Test 9. Water Pi a-Undr rnd. 60. Backwash Lees, P-Tr; P 9 p. C Uc❑rg•^d 10. Structural Floor System • . 61. A°FROVAL TO Lc CK 11. Property Sewer Lire & Haute Connection I 62. Bteet,:.;h & Rrcat-tc• ', _ {-��- I} 12. Sewer CaP 63. Heater & Vent-F.n„• 13. Root DrainsP; i 64. umb:^g System F -al . l 14. Rough Plumbing 65. F lentricaf F.nal , 15. Rough Eiectrical-Condu t 66. So'..: System-F:ru. - 16. Rough ai'Iectric Wiring 67 Fencing& Act-,e5.4 App”o+31 I l-� 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING t-- 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT r 20. Rough Factory Fireplace APPROV rtLS Permit . 21. DLcts, in Structure 70. .rdcrgi ound H1' u �- L 22. Ducts, Ventilating 71. P,educt ':ping ' ,Cas s _'Oil l I 23. Gas Pipe-Rough& Test 72. Underground Fsh 24. Roof Framing 73. Unrizrnrr.d.S:-ir. :Try-.+ Gas = 0: 25. Rco4 Sheathing j 74 ot iri-c.ad •4.., ---- -- -- 2o. T-Bar Ceiling (Structaral; & 7ionocoat 75. Cry Cheruai 27. Fame and Flashing 73. Dry Standr.ne 28. Lathing& SidingI 77. FIXED SYSTEM FINAL 29. Insulation • I 7E. FIRE PREV. FiNAL 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT , i 31. Plaster Brown Coat i 1 79. FINAL INS?ECT.CN i T 32. Electrical Power Meter•Fina, ! B0. FOOD CERT:FICA- E ISSUED 33. Final Electric U/�"j/9j, 1� Notes: ]-Z8-q3 � e-O on4E' /wW- - s - /�r"-///tel , 1 ' 34. Final Heating & Air Conditioning • l , -- - I - -- -- ---- -- --- -- - -- -- . • 35. Final Cas Pipe-Test l 33. Hood or CanoPV • • 4__ 37. F.r.al Factory Fireplace 38. Final Plumbing -- _-- --_ - --_ 39. Water Service-Final I 1Service-Final --- -- 40. Gas Service Final 41. Solar Domestic-Final • 42. Backflow Preventer -- - --- ' 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Hacd'cap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison ' • 50. Gas Release to Southern California Gas Co I 51. CERTIFICATE OF OCCUPANCY .-J i No. Date I I ? C `'i t .Q2 .j c,, r 2 Q) Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA ' CONSTR UCTIO' PE 7 MI i �.' PER T NO. �7j� • TRACT NO. LOT NO. UNIT NO. • 9370 8/22/85 �S.BQ TL • Project Address r L t."sa / I 'J.LSdL, �e K gD 9V " - l - ' Applicants Mailing Address 131.ot4 uc{'ty-c.Nn eafill �f TYPE OF CONSTRUCTION 0 NEW U ADD U ALTERATION U REPAIR • Owner's Name 1-11..4., Rostrrx< ' ( � .\ ,efafw• . �.74p c7 7 ❑ CONVERSION ❑ DEMOLISH © OTHER �'�P�ncs- X10 �A�.t4./{I A.P.# Zone ; it n\rti. r • DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building:' • Accessory Building: TYPE OF PERMIT U GRADING U FOUNDATION 0 STRUCTURAL E Front Z Arch/Eng. - _ License No. T O Address 0 TENANT 0 ELECTRICAL IXI PLUMBING 0 MECHANICAL • B Rear N Contractor's Nanirab,O. Ov.O.. �y...Mrs .�`y.y L,+0onet03b-'Nbt� ❑ 'OTHER A - • • I ' TCG C lll}»> til PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right - G Address(mailing)(_VZSa S� �a85 oZ CONSTRUCTION'TYPE VALUATION S Left R City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.# P rk' g R rOvided E LICENSED CONTRACTOR DECLARATION AUG 'y/ lg�(yy Q I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: • Planning Notes: RECEIVED AV �a �,aV with section 7000) of Division 3 of the Business and Professions Code, and • - M my license is in full force and effect. 3�i9 qe T Dien, ass • — a ' No. 0O PLUMBING FEES Date 'y, Signature trr WORK:RS' C.MPENSATION DECL• RATIO A Bar Sink Showers ' •ereb affirm that I have a certificate of conse . self-insure or a certificate ELECTRICAL . FEES Workers' Compensation Insurance, or a certified copy thereof (Section • Backflow Preventer Service Sink - - - .,d00, Lab. C.) '- - Automatic Washer .Transformer-0 15-50 KW Policy No. (.o0ly( 1 Company hAVio.-. W'A:_ Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW Certifi d copy is hereby furnished. f Cer ' a copy i fiJ�with the • y a,g • =ion Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps ( Date 3 Applican - ' EXEMP ION OM WORKERS'CO PENSATIO ' CLARATION • Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This se ion need not be completed if the permit is for one hundred($100) or - t� less). Dishwasher Solar Pipin 1�1♦(.t LLE° Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is Issued,1 - 1 shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank DATE 7/15151(43y1-.0 erP anyrrue(' Motors 00-1 HP ❑1 X-8 Workers' Compensation' Laws of California. . Date Signature Floor Drains' Swimming Pool w/Spa , ....im, F.A.U. 'NOTICE: If,after making this declaration, you should become subject to the , •Inc.Solar 09-15 HP 016-15+ , Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal Fixtures - comply with such provisions or this permit shall be deemed revoked: - • • ' Microwave- CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet • Device Boxes I hereby affirm that there is a construction lending agency for the performance 'Pole Light of the work for which this permit is issued (Section 3097 Clv. C.) Interceptors ( Water Heater 0 — i Outlets•( Range Lender's Name Lender's Address - ' Kitchen Sink Water Service 'Pi Switches Sign • OWNER BUILDER DECLARATION - _ 1 hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbe a Dis osal following reason (Section 7031.5 Business and Professional Code: Any city or +s 9 P ,Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P-Trap LaundryTrays - , any structure, prior to its issuance, also requires the applicant for such permit Y Generator 00-5 KW 05-15 KW Trash Compactor to file a signed statement that he/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 - -- -- - erefrom and the basis for the alleged exemption. Any violation of Section ;31.5 by any applicant for a permit subjects the applicant to a civil • eenalty of not more than five hundred dollars($500). LJ 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: employees, provided that such Improvements aro not Intended or offered for Boiler • Hood or Type I sale. If, however, the building or improvement is sold within one year of com- Canopy Type II o Zoning Approved By Date ' Motion, the owner se have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Dat• e // prove for the purpose of sale). • - J i: I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Appllwtion'Issued By Dat 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 ❑100,000 BTU builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration - BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ �//1�y�•A�PERMIT 0 am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers• PLUMBING $ arQQ 5.'/./ ISSUANCE $ •-..a Date Owner Heating System& Ducting Registers ^ PLAN CHECK 25% $ ENERGY P.C. $ • I hereby certify that I have read this application and state that the above 00-100,000 BTU-0100,000 BTU GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws re :ting to building construction, and hereby authorize repre- , MICROFILM $ sentatives city t. -rater upon the above-mentioned property for PLAN CHECK 50% $ inspectio 471.90 f, MECHANICAL • $ TOTAL FEE $ DO Signature ;� • '� Reins ection Fee $15 • Issue Fee Drivers' Lice se or SS# � ' P $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building;'Canary - Applicant; Pink--Accounting; Goldenrod - Assessor - - CONSTRUCTION AND PLANNING PO( SPA APPROVALS Permit# Date Inspector APPROVALS ' Permit# Date Inspector ' 1. Tee .porary'Electrical Service or Pole 52. Poor& Equipment Location . 2. t,Soil Pipe-Undrgrnd. 53. Steel Reinforcement :, ; 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ? 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5: Steel Reinforcement 56. Rough Plumbing & Pressure Test v .6' Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE _ 7.'Footings 58. Electrical Conduit-Undrgrnd. v• -8. Foundation I 59. Gas Pipe, O Undrgrnd.,Test i. 9. Water,Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. r r -10. Structural Floor System 61. APPROVAL TO DECK 'J.\ 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof brains 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 20..Rough Factory Fireplace APPROVALS Permit# • 21. Ducts, in Structure 70. Underground Hydro . 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil -`, 23. Gas Pipe-Rough &Test • 72. Underground Flush ' 24. Roof Framing73. Undergrnd.StorageTank OGas boil • 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame and Flashing76. Dry Standpipe - 28. Lathing & Siding 77. 'FIXED SYSTEM FINAL. . 29. Insulation : 78. FIRE PREY. FINAL 30. Drywall Nailing k7 I HEALTH DEPT.REQUIREMENT . ( . 31. Plaster Brown Coat •0' 79. FINAL INSPECTION 32. Electrical Power Meter-Final l' 80. FOOD CERTIFICATE ISSUED 33. Final Electric 1 Notes:4133-2.V,%- 'L€er- C4e.4. Ci-0 /0:34 _ 34. Final Heating & Air Conditioning a at-Zr 110 0ry 4:3 7' E nE G.Y,a 35. Final Gas Pipe-Test 36. Hood or Canopy --Ca nc4.C.. ArS PER_ ?w0.3 V Pc,- LA.,0 37. Final Factory Fireplace , 38. Final Plumbing J 39. Water Service-Final - 40. Gas Service-Final 41. Solar Domestic-Final r_) 42. Backflow Preventer ' - 43. Backflow Irrigation I . t 44. -Landscape Irrigation System - 45. Sound Attenuation X.: 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING • - 48. Special Requirements Completed . 49. Electric Release to Edison . - - t • .50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY - , . . No. Date • OWNER . HARBOR HALL OF FAME HOMES, INC. DATE DEC 1 1 1962 JOB ADDRESS ar1ttgford St. BUILDING PERMIT NO. �t GENERAL CONTRACTOR Lifetime Hes.Hldg. Corp. VALUE $1155.00 P ` 400 _AP No. LOT 21 TRACT 1+355 FIRE ZONE DESCRIPTION OF WORKRes.w/att.(rar. I. ECTIONS Signature DATE GROUP I & J TYPE V ZONE Rl Soil y/ /-/C-C-2 PERMITS ISSUED Gas « /1- - 3 SUBCONTRACTOR DATE NUMBER Water _meta—/9/-&I Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating p' -�- 3 __ _ 6,-.L / �'_ Rough Plumbing ,�G_? _-., J`,' 21-e_g_ 3- .5791_040 Miscellaneous _ Prop.Swr.Line 0 House Con. St.Swr. 0 y ' i / - Sprinlding System T Construction Pole /9 G,3 r(s it eke/, _ Underground 0 Power !] N�A _ _��{{-- 't /y Z�` 9 Rough Wiring 4/ .) 3"/4�z r�lxy77_ 6r9G-t.�9fi., i-/.5�� �'j Trenches Q' Forms 2' -Steel Remf. 0 /tom r-'2.-6,, Floor System 1_7/-0ig Bond Beam ❑ Steel Reinforce ❑ Sheathing i7 3-¢-“ Frame and Flashing net a -'y'e Lathing - In ®r Out / -//- ' F ,r, brown coat p •-j'-z/y�-£3 h.._..g. 0 Air Cond. 0 Final _ �� -6 Heating, Final - PlumbingFixtures, Final 7.: [=2,7e� .. ... .�_h - 18403 iic�EN ED COSTA MESA BUILDING-SAFETY DEPARTMENT Lot 21, Tract 4 5 1 bb P. O. BOX 917 COSTA MESA. CALIFORNIA DEC 1 1 1962 For Applicant to Fill In Completely APPLICATION tiff DEPT. TYPE OR PRINT Rreb�TA MESA BUILDING / 6 BUILDING ADDRESS /3`� r V�Y�•y''�l'�.I SNL COSTA MESA. CALIFORNIA For Office Use Only OWNER Harbor Hall of Fame Homes, Inc. I RECEIPT NO. � .IL ) . =A TI.O• Box 2066 RECEIVED BY I DATE RECEIVED DATE ISSUEDSSED ADDRESS' h ^1. JJ a- z‘,7,/, /4, DEC 1 1 1962 CITY Santa Ana NoKI 9-2204 BUD EIN OR DECARCHIT1 1 CT Jamison NE,44-0040 COSTA MESA., I`j-C/ALIFORNIA ADDRESS 225 "D" St., Tustin ZONE TYPE V GROUP ((//JJ�1 FIRE t CONTRACTORLifetime Residential Bldg Corr APPROVED / DATE ADDRESS 2131 So. Artesia ZONING CITY Santa Ana, ION NO.OF I USE OF NEW SJ 40.4.411."-/ PLANE a BUILDING W/A// 9., , STATE 208676 TEL.KI 9-2204 LE LIC.NO. NO. DESGALCRIPTION LOt a.II 7R '13 S3 SIZE 60001 NO. OP BLOCS. o OF LOT NOW ON LOT A.P.NO. USE OF _ None YARDS EVES EXISTING BLDG, APPROVED ALLOWED SETBACK LINE FROM A8148.701 (CENTER LINE ST.) j_,CENTER OF STREET REAR YARD FRONT /B FT. IN. SIDE YARD LEFT 51RIGHYSC1 R.SIDE 'S— FT. ,-- IN. DESCRIPTION OF ppWORK L.SIDE / � FT. IN. NEW I X II ALTERATION I III [ ADDITION I REAR / /7FT. �— IN. REPAIR II MOVING I DEMOLISH I APPROVED 'unfit DATE 1/r/fL SIBUIELDING1400 NO. OF 8 ROOMS STORIES 1 Z EXTERIOR WAL IROOF COVERING Master COVERING Shake USE OF BUILDING AND WORK TO BE PERFORMED Single family residence i ...F' —/41/4 u YA rde5 a• I HEREBY ACKNOWLEDGE T. T I HAVE READ THIS APPLICATION AND STATE THAT THE ABO IS CORRECT AND AGREE TO CON- THH AMOUNT SHOW UNDER VALUATION IS FOR THE PLY WITH ALL CITY 0-•I. CES AND STATE LAWS EGULATING PURpOBB OP ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRU y�N /}n ///�� VALUATION { SIGNATURE OF �r�� 1 i` v D//(• PERMIT FEE $ L57.-.— N/� N PERMITTEE ` �_c.� /6 5 $ PLAN CHECK $��SD E AUTHORIZED AGENT G TOTAL FEE - .SU 4