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Home My WebLink About1140 GLENEAGLES TERR - Building PermitsI ... ,._.--.- ._.,._,.-..___ ------ ---BUILDING PERMIT Job Address: 1140 GLENEAGLES TR 'C Status: ISSUED Suite:- Permit, Applied: 04/29/2005 Vicinity: ROOF ",'. $1.00 EXT ED Issued: 04/29/2005 - Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V -N Parcel Number: 42233305 Zoning: DATE Applicant: " MIKE VOGELGESANG -. , ; r,-, .. t_' rr w.. i. _ ISSUED BY: G— Address: 103 W ESCALONES- - y�iC s SUITE A�t SAN CLEMENTEi CA�� Phone - I Zip 949+-498 2274' 92672/ 'v, Left , 0 0)1 �� Right' ,0 °, PARKING Existing: -EV ;, Proposed-{--O INTER EVELYN-M�k-- Owner WINTER; L � Address 1.140 GLENEAGLES TER i Phone fiCOSTA MES A? Zip. 92627 Contracio: J:L3RAY, COMPANY,INC Address: 103 103 W,ESCALONES :'„`,�� SUITEA;� Phone: 949-498-2274 ` SANOLEMENTE, CA -`Zip: 92672" "z License:, 567238 b Arch'.., , f / Eng: 4Address:_ , r �.% {,+ _ -� _ -- ,Address:" oa . •Phone. - >c Phone: t O 1` i Zip: _ =l '-� License: License: ' TEAR OFF EXISTING ROOF. INSTALL 2•LAYER; SPANISH RED: ICBO #3984; 5.9 LBS/S:F.'2,000' SCOPE OF PERMIT'. 30#'FELT, REPAIR/REPLACE SHEATHING AS NEEDED, FEATHERSTONE, MISSION TILE, INCLUDES ATTACHED GARAGE`„y 'C PlantCheck " ; $0.00 Permit, $181.25 ,'SMIP Res; ",'. $1.00 SMIP,OOmi $0.00 Other: $0.00 Inspection: 'mbo Total: -tr $182 25 SCOPE OF PERMIT'. 30#'FELT, REPAIR/REPLACE SHEATHING AS NEEDED, FEATHERSTONE, MISSION TILE, INCLUDES ATTACHED GARAGE`„y 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 workauthorized.under.this.permit.to be considered legal;: suchwork must:comply with all applicable codes, and all required Inspections and final:epproval, must be obtained. Failure to obtain inspectionsandfinal approval will result in the expiration of this permit. -FOR INSPECTIONS CALL: (714) 7545626 2aae4e (s=oo) 'C j' " . rPLANNING& ;Calc Valuation. ''� ' $6;995.00� _ Y j N Claim Valuation: �',�� -$9s9s;00 ;' SETBACKS .:\� � 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 workauthorized.under.this.permit.to be considered legal;: suchwork must:comply with all applicable codes, and all required Inspections and final:epproval, must be obtained. Failure to obtain inspectionsandfinal approval will result in the expiration of this permit. -FOR INSPECTIONS CALL: (714) 7545626 2aae4e (s=oo) 'C j' " . rPLANNING& ZONING SETBACKS .:\� � iUr 0-0/�%!)rRear0 0. -- —Left ;-0 0-" Right ^0 0 ACCESSORY Front 0=" 0---, ", ;Rear 0- 0' 'v, Left , 0 0)1 �� Right' ,0 °, PARKING Existing: 0�i1'-Required: 0 --`" ;, Proposed-{--O 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 workauthorized.under.this.permit.to be considered legal;: suchwork must:comply with all applicable codes, and all required Inspections and final:epproval, must be obtained. Failure to obtain inspectionsandfinal approval will result in the expiration of this permit. -FOR INSPECTIONS CALL: (714) 7545626 2aae4e (s=oo) 'C j' " . rPLANNING& ZONING SETBACKS .:\� MAIN STRUCTURE�Fronl, 0-0/�%!)rRear0 0. -- —Left ;-0 0-" Right ^0 0 ACCESSORY Front 0=" 0---, ", ;Rear 0- 0' 'v, Left , 0 0)1 �� Right' ,0 °, PARKING Existing: 0�i1'-Required: 0 --`" ;, Proposed-{--O 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 workauthorized.under.this.permit.to be considered legal;: suchwork must:comply with all applicable codes, and all required Inspections and final:epproval, must be obtained. Failure to obtain inspectionsandfinal approval will result in the expiration of this permit. -FOR INSPECTIONS CALL: (714) 7545626 2aae4e (s=oo) DECLARATIONS WORKERS' COMPENSATION DECLARATION: - I hereby affiml under penalty of perjury one of the following declarations: V- ❑ 1 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' compo sation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is Issued.' . My worker f°,m?Qpsatio urance r policy number are: /' Carrier;:B- r�7'�I G '1 '-�� 5` Policy_Number. /3i11 (This section need not be completed it the permit is valued atone hundred dollars ($700) or less.)'=%�- ❑ I certify that in the p r o-imance of li work for which this Demi is Issued, I shall not employ any person in any manner so as tp become subject to the workers' compensation law i California, a agree t t' I should b ome subject to the workers' compensation provisions of Seclu 6 3700 of t e Labor Code, I shall forthwith comply with these rovisions. //p !.� Applicant Signature:'- - C Date: —• / Z • 0 5- .WARNING7'FZQREfO CURE WORKERFCOMPENSAT10OVERMfIS UNLAWFU A SHALL SUBJECT AN EMPLOYER TO CRIMIN L PENAL7`lV6 AND CAVIL FINES UP TO ONE HUNDRED THOUSAND E ( OO,ODO). IN ADDITION TO THE COST OF COMP SATION, DAMA AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am 1IcensaJ_wDd,1Tis f Chapter 9 (comme 'ng with Section 7000) of Division 3 of the Business d P f ions Code, and my license is in full +.- ,force end effecL.Llc ;11-- �- �Class,tl.T. -Conlr�Signature:.-- �� 6 Data: B CONSTRUCTION LENDI GENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an Owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cade: The contractors License Law does not apply to an Owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers 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 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 6, 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 hes a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ 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 2DO 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 theappplicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department Of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .._...................................._........_........_..........._..............._.........................._.._...........__.__._...._..._..__..._._.__......._..__.................................._.... ..............__....................._............. _.............._........._....... 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ONO ................................................................_.........._.................._.......................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a plication aermit for such construction or modification from the South Coast Air Quality Management District Or from any other air pollution control district or agency? Yes a 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). ..........................._.........................._............._........................._.._...................__.._....._.....—_..._......._.._._.....................I....__.._.__............. _............ _.......... _...... 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 ................f..y.............................................-._..............................................................................................................................................................................................................................................................,..................................................... B (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 AUTHORIZAT10N 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. Si a Of g wner(s) Date d/Or Authorized' Ilcant 1 - kk D te,.,,,,--,ti CODE L 11 TYPE- -4 '. PAIE ILLS CODE#- INSPECTIONTYPE ... 26M IKIITIAL�} . 1616 Fixed System Final Fire Prevention - - 206 -Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 -Final Electrical' ' 201 Final BlocWRetaining 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 ' W eatharproofing cop/�a�f�� s 610` 17 0ral C0ntTa April 29, 2005 103 West Escalones, Ste. A • San Clemente, CA • 92672 Phone: (949) 498-2274 • Fax: (949) 498-3744 www.jlrayco.com Lie.# B/C-39 567238 City of Costa Mesa Building Department: To Whom It May Concern: This is to certify that Mike Vogelgesang is a representative of this company and he is able to pull permits for the J.L Ray Co. Inc.. If you have any questions or concerns please do not hesitate to call us at the above number. Thank you, ti LEGACY REPORT ER -3984 Reissued August 1, 2003 ICC Evaluation Service, Inc. Bus'ness47egiona' ofioe 0 5360 Wmrnan Mill Road, Whittier, Cal 90601 ' (562) 699-0543 Regional Office • 900 Montclair Road, Suite A, Birmingham, Alabama 35213 • (205) 59}9800 WWW.icc-es.org Regional Office• 4051 West Flossrnoor Road, Country Club Hills, Illinois 60478•(708) 799-2305 Legacy report on the 1997 Uniform Building Code TM, the 2000 International Building Code® and the 2000 International Residential Code® DIVISION: 07—THERMAL AND MOISTURE PROTECTION Section: 07320—Roof Tiles WESTILE CONCRETE ROOF TILES WESTILE DIVISION OF OLDCASTLE ARCHITECTURAL WEST, INC. 1742 SOUTH ROOFTILE ROAD CASA GRANDE, ARIZONA 85222 1.0 SUBJECT Westile Concrete Roof Tiles. 2.0 DESCRIPTION 2.1 General: Westile rooftiles are interlocking, extruded concrete roof tiles. Various accessory tiles are provided for roof ridges, hips and rakes. The regular -weight tiles are composed of portland cement and selected sand aggregates. Lightweight tiles are composed of portland cement and lightweight aggregate. Anchor lugs are provided on the underside of all tiles, to overlap wood battens. Holes are provided in each the for fastening where the installation requires fasteners. Interlocking ribs are provided on the longitudinal edges ofthe tiles, to restrict lateral movement and provide a water stop. Transverse bars are provided on the undersides, to serve as weather checks. The tiles are cured to reach required strength before shipment. The tiles have dimensions and installed dry weights as noted in Table 1. See Figure 1 fortile profiles. 2.2 Installation: Installation shall be in accordance with the Roof Tile Institute's Installation Manual for Moderate Climate Regions, recognized in evaluation report ER -6034P. 2.3 Roofing Classification: When installed as described in this report, the Westile concrete roof tiles are Class A roof coverings in accordance with Section 1504.1 of the 1997 Uniform Building Code TM (UBC), Section 1505 ofthe 2000 International Building Codes and Section R902.1 of the 2000 International Residential Codes; and are noncombustible roof coverings in accordance with Section 1504.2 of the UBC. 2.4 Identification: Labels on pallets of tiles bear the installed tile weight specified in this report; the Westile name; the tile profile; and the evaluation report number (ER -3984). In addition, the company name (Westile) is imprinted on the underside of each tile. 3.0 EVIDENCE SUBMITTED Data in accordance with the ICC -ES Interim Criteria for Clay and Concrete Roof Tiles (AC180), dated January 2002, and a quality control manual. 4.0 FINDINGS That the Westile concrete roof tiles described in this report comply with the 1997 Uniform Building CodeTM, the 2000 International Building Code®, and the 2000 International Residential Codee, subject to the following conditions: 4.1 The tiles are manufactured, identified and installed in accordance with this report and the manufacturer's instructions. 4.2 The tiles are manufactured at plants located in Littleton, Colorado; Casa Grande, Arizona; and Corona, California. This report is subject to re-examination in one year. ICC -ES legacy, reports are no/ to be construed as representing aesthetics or any other attributes not specifically addressed, nor are they to be construed as an endorsement of the subject ofthe report or a recommendation f r its use. There is no u.arranry by /CC Evaluation Service, Inc., press or implied as ro i anvfiuding or other matter in this report. or as to any product covered by the report. �c`6�,.✓ Copyright 0 2003 Page 1 of 2 Page 2 of 2 r ER -3984 TABLE 1—TILE DIMENSIONS AND INSTALLED WEIGHTS TILE PROFILE PRODUCT NAME INSTALLED WEIGHT' (psf) TILE DIMENSIONS (length x width x height) (Inches) MANUFACTURING LOCATION MIe ��• Sierra Mission 9.0 17 x 12% x 3 Casa Grande S -Tile Mission 9.5 161/, x 13 x 21/, _ _ Corona lower course of Wee. — FeatherStone Mission 5.9 16Y, x 13_- 2'/2_ _ Corona Coronado 9.3 17 x 12% K 2'/a Casa Grande Low Profile Verona 9.5 102 x 13 x 2'/a Corona FeatherStone Verona 5.9 102 x 13 x 2'/a Corona Double Roman 9.0 16'/2 x 13 x 21/a Littleton Dublin Shake and Dublin Slate 10.3 17 K 12% K 11/, Casa Grande Shake and Slate 10.3 161/2 x 13 K 1 Corona Flat Profile Double Notched Shake and Slate 10.75 161/,-13-1 Littleton Shake and Slate 10.3 161/, x 13 x 11/, Littleton FeatherStone Slate and Shake 6.95 161/, x 13 K 11/, Littleton Featherstone Slate and Shake 5.95 161/,- 13 -1 Corona For SI: 1 inch = 25.4 mm, 1 psf = 0.0479 kPa. 'Installed weight was determined with a 3 -inch headlap. LITTLETON SHAKE or VERONA SLATE Fired ru TOP VIEW OF TILE MIe ��• Configuration of surface and imodacline joint UNDERSIDE VIEW OF TILE Headi,ri real an scr d sheathing or Into, over battens Naaej and UNDERSIDE VIEW OF TILE Rory .' rest an sdd sIn or here over hettere NosNuga andi here v. lower course of Wee. n W IrM RSI M '•.,-,_ :'�_ �. -.- jxaa of filee.N0Y lower cwxse of 1 les. ooeaLEROMAN Fled TIM CORONA SHAKEor VERONA TOP VIEW OF TILE configuration of aurtce aand SLATE Rod '"d.. TP, ---' er , Reid TIM - -� - of aurraoe and intadockng joint UNDERSIDE VIEW OF TILE Headi,ri real an scr d sheathing or Into, over battens Naaej and env. Mae weather checks normally regi on en hangover eM neat over nattene. Novi lower course of Wee. rea eatnor checks normally real on '•.,-,_ :'�_ �. -.- CASA GRANDE DUBLIN SHAKE or SLATE Raid Tile TOP VIEW OF TILE Configuration of aurraoe and intadockng joint w\ - ` UNDERSIDE VIEW OF TILE m not solid enanibnd w en hangover eM neat over nattene. Novi y rea eatnor checks normally real on '•.,-,_ :'�_ �. -.- lower cause of tiles. CORONADO Held nk, ev ? I uw¢ FIGURE 1—TILE PROFILES FEATHERSTONE FlNd TIM wA_ t MISSION Red Tlk SIERRA MISSION Fledne j a ��v (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.caBUILDING PERMIT 77 FAIR DHIVE, GUS IA MtSA, GA 92626 Job Address: 1140 GLENEAGLES TR Suite: Vicinity: GARAGE Primary Occ: U Type of Construction: V -N Parcel Number: 42233305 Zoning: Applicant: FACCHINA, DANTE D Address: 1140 GLENEAGLES TR COSTA MESA, CA Owner: JENKINS,CHRISTINE�" �(-I Address 1140 GLENEAGLES TER,'—'\ 1 /Zip: r ` h REMOVE CENTS // r •r j ( Plan -Check; Permit: �I {SMIP Res SMIP Corn t Other'.) I nspectlon:� Total: Phone: ..I, UI ", " License:� ATTACHED GARAGE Phone: 714-717-8849 Phone: License: 000000 Status: ISSUED Applied: 07/11/2006 Issued: 07/11/2006 ISSUED BY: Eng: LSI LAN[ Address: 3939 LONG J$54.11J — T Valuation: 1 $83.25 CTI T 1! �F -7F5, a;v daim Valuation: $0.50 $0.00 ?' $0.00 JA. '�/ .,�•^,v-T-"i::`%�!)r $0.00 $137.86 \ .... Front `,0 0 Rear Left �00 r- 'Fronto= 0� Rear-" 0 Or, ��,� „deft 0 0 Ewstlnc: 0 Required.0, Proposed.- `0 I Right ' 0- l� C y— 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) 7545626 244646 (6/00) ,License: 4124 \ , J$54.11J — T Valuation: 1 $83.25 CTI T 1! �F -7F5, a;v daim Valuation: $0.50 $0.00 ?' $0.00 JA. '�/ .,�•^,v-T-"i::`%�!)r $0.00 $137.86 \ .... Front `,0 0 Rear Left �00 r- 'Fronto= 0� Rear-" 0 Or, ��,� „deft 0 0 Ewstlnc: 0 Required.0, Proposed.- `0 I Right ' 0- l� C y— 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) 7545626 244646 (6/00) DECLARATIONS C�) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will meimain 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' compensaffon 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: Cartier: Policy Number: (This 8 O need not be completed if the perMt is valued at one hundred dollars ($100) or less.) I certty that in the pedormance 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 law fomie,pn�d a that if I sh uld become subject to the workers' compensation provislons of Section 371X) of the Labor Code, I shall forthwith complywith these provlq ns. Applicant Signaturo ^; f WARNING^RVLLIRE TO 5 RE WORKERS• COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI--NAL PENALTIES AND CML FINES UP TO ONE HUNDRED T(SAND IXXIARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: 1 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. 4 Class M Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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). Lenders Name: Lenders 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 Lew (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.). 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code' The cont Mors 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 pursu to the ContLloense Laws.). ❑ 1 am exempt de rac Business and Professions Code for this reason: _Signature: , r _ Expires Verification of Ownership by (type of document, i.e. - property tax bill or doat:!T` ` 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, An 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which w0uld require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building occupant need to file and comity 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 Fre Department by every business which has at any one time during a reponed 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). _..........._....._........._....... applicant present .............__.........ildi...................._..........__._._._...__......_...........................................................___..__......................... ........_............._..... ...._........ _...... _._..... 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 i�r will th❑e applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? (Section 25534 of the California Health and Safety Cade provides that the Costa Mess 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 Ii en 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 a plication aemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency' Yes 15 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). _E 8 Will any pan of the facility to be constructed under this pertnit 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 prescnbed by Calitomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _....__....__.___ttach.._....cale........_....._..._..____..........._._—.._....................'"""'..................................... ............._.__..._..._....__.__._._........__"'...._.._......._....... _........_....... 8 (If yes', attach coNflcate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, 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. t{;n Of Laga1 e'is) Date OnAuthorized Applicant "^��^+,�„� . Date. CODE It INSPECTION TYPE gAIE INTMALS CODE INSPECTION TYPE 2AM WITTIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site i� 204 Final Demolition 250 .Final Building/Occupenry DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS Bldg. Permit # This Permit # Street Address: 11 4p 6L&0C-A6LEs AP Number: 1. I (we), Crim fl-ii/✓E J Aplr<tii.5 declare that I am the Owner of Title of the above referenced real property, and that I (we) hereby authorize: Name: .LAPM �3- rACC 044 Telephone Number: 71 q-7/7^VNI Street Address: (I qo G Tj:/t/t Ar -6 City: C09M /11E04 State: CA Zip: ?z 67- 7 to obtain permits in my behalf, as owner/builder, for at the above referenced property. CNR,f 5;�rr.-Alf .TEN 4/N5 2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Workers Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. 1 agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. 1 declare under the penalty of perjury that the foregoing is true and correct_. / Executed this /O day of ��L 7 20 MR , at 077946 (rev.t 1100) do57A 1;'I4C0A- Print Name: Cl/ Q/$T/n/�e— S Signature: Date: Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. California. --_ •• L'rrt.�y °� C''aata ��a �uu� Du<cdio4t OWNER-BUILDER VERIFICATION Address: J� ya G �E✓ �AG LES Permit #: 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. 1. I personally plan to provtd the major labor and materials for construction of the proposed property improvement. [Yes ❑ No 2. I (have/have not) R4j l,6 ^lbr signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name /..5. C&05TRUC.Tl0N Address 50 5E45PRAY Eat ri City LA& 040A NIL uOL - Phone(gllq) z35�- Clf45S Contractor's Lic. No. %16%(61 4. I 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) I I air _ _ Applicant to fill in all spaces except those within heavy border CITY OF'COSTA MESA STR UCrTION PERMIT (PERMIT NO. TRACT NO, L Project Address ' � =6 Q „'�-3a'�3� S4,7o - Z .. Applicant's MailinddressqY"arl2 bY� Phon�79(IR Ownerr's Name Address Arch/Eng. License No. Address Contractor' Namelow(ii Phyq Address Imo ling) R 2,0 S V10 -AQ �.4 ,,// City License No. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that. I am licensed under. provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full i�gQce and effect. License Class ham-- 1 License No. J Date Signature WORKERS'COMPENSATION DECLARATION - hereby affirm that I have a certificate of consent to Self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section ,00, Lab. C. ttQ ry/r Policy Na. `�'S �b Z�%—"� Com Pany�+ Certified copy is hereby furnished. CertifJJ'��yyd copy is -f1 d with the city B 1 di • Date' j'— LA / Applicant EXEMPTION FROM WORKERS' MPENSATION DECLARATION (Thissection need not be com pl d if the permit is for one hundred ($100) or less). . I certify that in the perfor ante of the work for which this permit is Issued, I shall not employ any pe/son in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature - NOTICE: If, after making -this declaration,you It Id become subject to the Workers' Compensation provisions of the or Code, you must forthwith comply with such provisions or this p mit shall be deemed revoked. CONSTRUCTION LENDING'AGENCY I hereby affirm that there'is a construe ' n lending agency for the performance of the work for which this per It is issued (Section 3097 Civ. C.) Lender's Name Lender's Address - OWNER BUILDER DECLARATION I hereby affirm that Iam exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 Stoned Statement that he/she Is licensed pursuant to the provisions of i antl Professions `Code) cr that he/she is exem t Oi vis ion 3 of the Bus gess / p 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 analty 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 Contractor's License Law tloes not apply to an owner of a property who builds or improves th d he does such work himself/herself or through his or her own YYPE OF CONSTRUCTION LJ NEW 4NAOD ❑ CONVERSION,. ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. V TYPE OF PERMIT GRADING ❑ FOUNDA- r❑TENANT ELECTRICAL ❑ PLUMBING ❑ OTHER andsign all appropriate declarations. ia O., UNIT NO. 1 ALTERATION REPAIR' LJ STRUCTURAL MECHANICAL PROJECT DESCRIPTION SQ. FT. OCCUPAr CONSTRUCTION TYPE VALUATION $ _ 'ZONE GRADING CU.YOS. ACR 1 Remarks - , ar Sink ackflow Preventer ' ackflow Irrigation athtube arifiers Iishwasher Irinking Fountains loor Drains loor Sinks ias Service Outlets nterceptors ;itchen Sink - - -avatories —Trap Reinspection Fee ! $15 ereon, an w employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- S E T B A C SLeft Boiler 'T Duct - Under Ground ' prove for the purpose of sale). I Right ' Duct- Structural ' ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of -property who builds or improves thereon, and who,cont cts for Such projects with a con- . Duct - Ventilating Planning Notes: Exhaust System ❑ Multiple El tractor(S1 license pursuant to the Contra or's License Law). I am aware,that • Proof o their Worker's Compensatlo nsurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason -$- — Firepl/Fact. Bit. ICBO # Date Owner -'. ' PLAN -CHECK Heatin System & Ducting 9 Y g ' 1 hereby certify that have read this application and state that the above ENERGY P.C. ❑Q100,000 BTU 0100,000 BT information Is correct. -I agree to comply with all city and county ortlinanoes - and State laws relating to building construction, and hereby authorize repre- $ - sentatives of tglS city to enter upon the above-mentioned propart- inspection purlJes_ /1 ,C1 n $ =_ - Zd MICROFILM $ ' Reinspection Fee $15 t1Y Signature �J �,�,% \ Date-_ Drivers' Li S5 IF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Sewer Cao - - Solar Collectors Solar Piping. Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service - Auto -Wash Issue Fee Hood,or Type ❑ Canopy 'Typell ❑ Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTU System Repair/Alteration Fire Dampers Registers , Issue Fee $ 3 $ 3 I Automatic Washer Construction,Pole Sub. - Cooking'Unit Dishwasher - Dryers ❑Gas ❑Elec(ric, ` 1 { Zone . Accessory Building: I 1 eq./Provided, 1 ELECTRICAL' , Transformer El 115-50 KW ❑ 50+KW Meter' 0 u to 100 amps Fan 40" ai -�- F.A,U. _ Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0.5 KW ❑5-15 KW I Sub. Panel- Motors 00.1 HP 01 Y.-8 Iric.Solar ❑%15 HP ❑16-15+ Microwave 1 Pole Light Range Standing 10I FEES / T S Reinspection Fee -! $15 Issue Fee ' $ 3 DEVELOPMENT SERVICES REQUI/qT/E MENTS: /yf Zoning Approved By ` I Date • ' /� Building Approved By Date-�-87 ' S E T B A C SLeft Main Buildi 'T Front 1 Rear 1 Right ' SMIP $' Ping. Ref. # Planning Notes: I Automatic Washer Construction,Pole Sub. - Cooking'Unit Dishwasher - Dryers ❑Gas ❑Elec(ric, ` 1 { Zone . Accessory Building: I 1 eq./Provided, 1 ELECTRICAL' , Transformer El 115-50 KW ❑ 50+KW Meter' 0 u to 100 amps Fan 40" ai -�- F.A,U. _ Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0.5 KW ❑5-15 KW I Sub. Panel- Motors 00.1 HP 01 Y.-8 Iric.Solar ❑%15 HP ❑16-15+ Microwave 1 Pole Light Range Standing 10I FEES / T S Reinspection Fee -! $15 Issue Fee ' $ 3 DEVELOPMENT SERVICES REQUI/qT/E MENTS: /yf Zoning Approved By ` I Date • ' /� Building Approved By Date-�-87 ' - SUMMARY OF FEES L/ ' BUILDING PERMIT.- $ Sa' SMIP $' PLAN CHECK PERMIT .. PLUMBING - -$- -'ISSUANCE $' PLAN -CHECK 25%' $ •• ENERGY P.C. $ ELECTRICAL $ w -GRADING , $ PLAN CHECK 50%' $ =_ - Zd MICROFILM $ MECHANICAL $ TOTALFEE-$�,y�tp/.��-� PLAN CHECK _ 25% $ CONSTRUCTION AND PLANNING APPROVALS Permit # Date - Inspector - , POOL & SPA .. - APPROVALS Permit # Date ' . Inspector .1.! Temporary Electrical Service or Pole 52. Pool & Equipment Location C 2. Soil Pipe-Undrgrnd,' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. , 54. Forms 1 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement! .. 56. Rough Plumbing & Pressure, Test 6. Electrical LIFER Gr6d. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. r 8. Foundation ' I ; I i 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd" - - 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK j 11. Property Sewer Linei& House Connection 62. Backwash &Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final- r ' .13. Roof Drains 64. Plumbing System - Final' 14. Rough Plumbing 65. Electrical -Final _ 15. Rough Electrical -Conduit - 66. Solar System, -Final - r 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 Ii 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 20. Rough FactoryFireplace- - 21. Ducts, in Structure 70. Underground Hydro, 22. Ducts, Ventilating- 71. Product Piping L1 Gas ❑Oil ' 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank O'Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75- Dry Chemical' 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL ,1 - - 29. Insulation 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 _ 35. Final Gas Pipe -Test V- 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 I 46. Handicap Regulations 47. FINAL STRUCTURE Zh 96 10,0-. •' I. -• -. 48. Special Requirements Completed 49 Electric Release to Edison r 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No.:.'.. Date 1 PL01"'YL'H:V"'—'""•...-.�c-„-_r. (- i' e 7. 4 qr -n:y it , ,I Nr II �.' 1• '1 il! SSI P!S?1AN C4 - t, 0. DATE 31 �7 7 NAME U 6 ( CITY (2Mq-,e, LQ Cz } ADDRESS 1140 HOME PH ' WORE PH # Mr/Mrs MAP PAGE MAJOR CROSS STREET ASSESSORS PARCEL« `-E� LOT # 1 TRACT # I NEW COVER: ALUM WOOD' SIZE ENCLOSURE SIZE _1QX�l—X / D ELECTRICAL WORK A OF'PLUGS: P Move Meter: ti•es,no a OF LITES: adn�oe.IS" I PLUMBING: _yes:.o -- EXPi LAIN: OTHER: IEXPLAI" IF ENCLOSING EXISTING COVER, SPECIFY WOOD OR ALUM.':ALSO DOESIEXISTING'COVER HAVE:'A PRESENT BUILDING PERMIT? SIZE: X MATERIAL: WGOD/ALUMINUM BRIEF. DESCRIPTION OF CONST: Fireplaces, windows or doors, added to NOTE housewali, air conditioners, new roofing ADDITIONS, DELETIONS, OR CORRECTIONS SHALL materials (not tar) , etc... 1 BE APPROVED BY THE PLANNING DEPARTMENT PLE:,SE SHGN SHAPE OF LOT AND ALL SETI n ::..... -AA C 1-L r .; - TT r �-1-+«L �.J .�-4-1- •-1 -: � y-yyy� .-�-r�.� r -.�, �� ..- _ __-r_ r' .�♦-1 - t [:OTE: GARAGE L( L OTPER SUI PRE CRITICAL I I I C J �yOFt 44e - TYE i:•iP _ECO'tCA KN FROM 1NEREi SAIL) PLAN, J Uv < 1'r `A lo, tN O InE CM City of Costaeso Building Dept, By DATE, 19-r�' THESE PLANSMUST BE ON JOB AT ALL TIMES MAKE NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. THq ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF PLANS AND SPECIFICATIONS SHA! 1. NOT BE CONSTRUED TO BE A PERMIT FOR, OR AN APPROVAL OF, ZM/ VIOLATION OF ANY OF THE PROVISIONS OF THIS CODE, NO PERMIT PRESUMING TO ONE AUTHORITY fO VIOLATE OR CANCEL THE PROVISIONS OF THIS CODE SHALL BE VAi*, E%CEPi !N SO FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LMWUi. THE USJANCE OF A PERMIT BASED UPON PLANS AND I SPECIFICATIONS S4A,.t NO` PPEVENT THE BUILDING OFFICIAL I FROM THEREAFTER RE00PING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING 13MOING OPERARONS BEING CARRIED ON THEREUNDER WHEN AN VIOLATION'OF `THIS CODE OR OF ANY OTHER ORDINANCE OF I 'RIE (CITY. f PROJECT ADDRESS: 1140 GLENEAGLES TR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 070063 OWNER'SNAME: WINTER, EVELYN MAE RUDE ADDRESS: 1140 GLENEAGLES TER PERMIT NO: P 070063 PLAN CHECK NO; N GOVT: N SUPP: N COSTA MESA,CA 92627 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: ADDRESS: REG.NO: UNIT: PERMITTEE: NOCK PLUMBING (714)895-1246 ADDRESS: 11610 SEABOARD CIR STANTON CA 90680 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 Cotle. and se Is In full tort nd effect CITYLIC.: 050386 sATEuc.:511971 cLAss: C-3 EYP: 02/95 to % Z�j�_ Signature. KERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers Cone far on s a fified,C thereof (Section 3800, Lab. POLICY NO.: g � �� L —7 $py EXP. DATE: 3 / 0 1 / 9 5 COMPANY: STATE ,,yy l emfied copy Is hereby furnished. L" 1 Certified cop Is TAB wom the city Buifflng inion. e: Applicant 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 performance of the work for which this permit is issued, I shall not employ any person in any manner so as to became subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It. 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. Co. 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 (CRapter 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 (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 Cotle', 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 contractpgs) 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. 8 P. C. for this reason: Date: 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 Quality Management District. Residential construction applications are exempt from these provisions. Date'. Applicant. hereby certify that I have read this application and state that the formation is correct. I agree to comply with all city and county ordi nano Slate laws relating to PaId'he construction and he y autho ze representali s o city to enter upon the above-mentioned perty )pr inspecctio/n�purpd n,?,l Dat 1 Signature: Dnver's License or Social Security— 1641 46 While—Budding, Green—Code Enforcement; Canary—Applicant Pink—Revenue; Goldenrod—Assessor JOB DESCRIPTION CHANGE OUT OF DISHWASHER SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT 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 ZEST.:- FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKING REQ; PROV: PARCEL: 42233305 ZNE: REF NO: PLANNING NOTES> D E V E L O P M E N T S E R V I C E S4- R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY: �DATE: #+r- LEGALIZATION:N F E E iS U M M A R Y STRUCTURAL SEGMENT:N t BLDG PMT PLUMBING ELECTRIC,' MECHANIC FIRE SMIP/RES GRADING PERMIT 7,00 PLAN 25% SMIP/NON—RES ' ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 7,00 20,00 0,00 27,00 27,00 ,00 REVENUE DIVISI0N TOTALS--> COLLECTED: 27,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 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 PLU 1 DISHWASHER 7.00 7,00 END,,,OF FEES s — r fi D B 0017250? -00172509 T ri_1 T 27. CID DATE: 11/29/94 TIME: 13:42 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POO 3PA 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 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings 58. Electrical Conduit-Ur•,drgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sever 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 # ' 20. Rough Factory Fireplace 21. Ducts, in Structure 70, Underground Hydro 22, Ducts, Ventilating 71. Product Piping 0Gas -3 Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 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 35. Final Gas Pipe -Test !Z'7�- N� wee�77t722 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 2 Q 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 46. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _ CITY OF COSTA MESA PLANNING uEPARTMENT A. P. No. Bldg. Permit No. �5 PAID I„`d 18-7?F.,;; 00 557Ra****75.00 PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address 1140 GLENEAGLES tr� EEE COSU MES4, MIFORNIA- Owner's Name KIRK R. CORLETT Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units @ $40.00 = 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units 1 @ $75.00 = Total Fee Total number of Dwelling Units Planning Department Approval Date 11-1-71 / Park Area No.. c� 10 By W_1 ,0_ nm Applicant's Signature $75.00 PAID CITY OF COSTA MESA PLANNING uEPARTMENT 'n" 78 77cwst@@ 557RcJa***PSA@ A. P. No.r Bldg. Permit No. PARK AND RECREATIONAL FEES - Apartment Developments Fee Payment Receipt Project Address Owner's Name Bachelor or 1 - Bedroom Units @ $25.00 = 2 - Bedroom Units @ $40.00 = 3 - Bedroom Units @ $55.00 = 4 - Bedroom Units @ $70.00 = 5 - or more Units @ $75.00 = Total Fee Total number of Dwelling Units $75.00 Planning Department Approval Date Park Area No. 11-1r-71 By 67 I [L nMApplicant's Signature _ OWNER CORLETT, Kirk R. JOB ADDRESS 11 0 Glenee GENERAL CONTRACTOR Owner ,.115- 33-05 LOT i TRACT FIR DATE im 1-18-72 XTIONS Si nature Date GROUP 1 too J TYPE V ZONE R-1 s01L 7 1 = 2 SUBCONTRACTOR PERMITS ISSUED GAS Date Number Si nature WATER • I � > a-- PIa in ROUGH PLUMBING G^ e PROP. SWR. LINE M HOUSE CON. SPRINKLING SYSTEM - o - ' MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING r e in nd Vent. TRENCHES [D FORMS STEEL REINF. C z� FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING �. C LATHING — IN OUT PLATER, BROWN COAT O7 y URq L, FIN AL`sIg 5 — Electrit c X h. .G, VENT., REFRI . ANDA ., FINA ,' •��,7 PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL •Z -sL- F U 7 cc NCn z id 17711-1 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fillin Completely RECEWEOBV (� r DATERECEIVED /_ _ DATE/ISSy/U/.ED /_` t/ 7 DING�y�. BUILADDESS J L / YE NO. A.P. NO. IIS—(o -7% OWNER �.r MAIL BUILDING' ADD RES., ADDRESS L 7/v TEL. CITY a NO.6 TRACT 3-�� LOTS BLOCK CONSTRUCTION r e W S _ W A P LENDEFI Z) I" _ BRANCH OO A/-/{ Ad A 51[ Q e(_ OWNER ADDRESS VALUE USE $ ARCHITECT TEL. OR ENGINEER 'N FIRE 7 ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR O W/VEIQ BY DATE ADDRESS ZONE �/ JP USE OF NEW TEL. \' LO PLANS �Ii BUILDINGS CITY NO. STATE CITY YARDS APPROVED YARDS APPROVE LIC. NO, LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZEyy. NO. COSLOGS. OF LOT ('0',4000 S r r I. NOW ON LOT •••� (FROM C/L FEET) FROM J QFT. FT. USE OF ft EXISTING BLDG. R. S -5FT. 3 FT. SIZE OF O. OF --11 2 NEW BLDG. DO MISSTORIES L SIDE K' FT. FT. EXTERIOR WALLS �r�%GGO ROOF I M COVERING COVERING S .4 REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & Sjp4 64,c L. MAIN BLDGS. ACCESS. SLOGS. VAR. # DATE r C.U.P.$ APPROVED / / APP V _ , RF .n ID VQT 7T.17:s 1111 - I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all latus regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of �� SO. FT. 3Z the State of California. I hereby certify that I am properly licensed as a contractor under THE AMOUNT SHOWN UNDERLUATION IS FOR ASAMIT the State of California Business and Professions Cod., Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 THE PURPOSE OF ESTABLISHING FEE ONLY: am exempt from the provisions of the State of California Business VALUATION and Professions Cod., Division 3, Chapter 9. PERMIT FEE $ Signature o // /[ !3? Permittee /f s�tr MU� � �L $ �N -51J � PLAN CHECK $c•J �,J Authorised Agent TOTAL FEE $ r '' 337'78 I:1?a i s -r7" „00 555 J*** 106.50 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY 'b11 DATE RECEIVED 1-18- 2 DATE ISSUED 1V 7 1-18-72 BUILDING 1140 Gleneagles Terrace ADDRESS Kirk R. Corlett PERMIT NO. OWNER A.P. NO. MAIL BUILDING ADDRESS ADDRESS TEL. CITY TE TRACT LOT BLOCK CONSTRUCTION NEWA ADD AL FRI REPAIR LENDER BRANCH OWNER ADDRESS VALUE S $ ARCHITECT TEL. OR ENGINEER NO, FIRE ADDRESS ZONE TYPE GROUP Owner APPROVED DATE CONTRACTOR BY ADDRESS ZONE NO. OF PLANS USE OF NEW BUILDING TEL. CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SIZE NO. OF BLOCS. OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. FT, FT SIZE OF NO. OF NEW BL ROOMS STORIES L. SIDE FT. FT. EXTERIOR WALLROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VA.* DATE Single Family Dwelling CURP..* APPROVED APPROVED - BY nATF I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with ' all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I -THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALVATION and Professions Code, Division 3, Chapter 9. l '-50 PERMIT FEE $ ----- Signature of 00.00 Permittee $ PLAN CHECK $ Authorized Agent 106.50 TOTAL FEE $