HomeMy WebLinkAbout1144 GLENEAGLES TERR - Building Permits • CITY OF COSTA MESA .
4 � BUILDING DIVISION
i u r'� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • wwa.ci.costa-mesa.ca.us
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S. fl . FOR INSPECTIONS CALL: (714)754-5626
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PERMIT NUMBER M07-00495
PERMIT TYPE MECH STATUS: APPLIED
DATE ISSUED:
- ISSUED BY: CAC
JOB ADDRESS: 1144 GLENEAGLES TR C'M Suite/Unit ' ,
Vicinity: »' `>`
rt;
SO. FT: 0 f/.- 1 . 1 a r"" .,..-:-.,,:%,,,;,-4,
SCOPE OF WORK: REPLACE-FAU SAME PLACE
:/ '' , 5;4.5:5
"t
F P
OWNER: MAXWELL,OLIVE M - Address - 1144 GLENEAGLES TER Unit:
PHONE: 949-722-2503 1."'-;:,!. 1� ,-. City/State/Zip COSTA MESA CA �- '
APPLICANT: BRIAN SIMKO f �4 Address J,?1953,FEDERALAV Unit} ,
PHONE: 949-548-5665 �.-i a _ - City/State/zZip: 'COSTA MESA CAi -
CONTRACTOR. ALLTEMP HEATING AND AIR CONDITIONING . - License No.''- 70877;5 A- 3?
Address: 1953 FEDERAL AVUnit - PHONE: " 949:-548-5665"-, 7y` • •t v'r" � ;;. i *•1- • ,
City/State: , COSTA MESA CA . ZipCode 92627 - --e.------ :-, LL
CE : . ;� _ ;}
:. . ... _. . .. .:.:.. a
MECHANICAL PERMIT FEE SUMMARY ' '!
MECH ITEM FEE: :'$38.30 ' ',1
PLAN CHECK FEE:
INVESTIGATION FEE: I' _ $0.00 ,
REINSPECTION FEE: -,;'$000 `
I_
1:.,
TOTAL FEES: $38.30 k tr r , r
r`fi
R I 13
) 3 •
•
6
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODES. INSPECTION TYPE DATE INnnALS CODES INSPECTION TYPE DATE ' INTITIALS DA
1616 Fixed System Final Fire Prevention 206 Final Mechanical 10-8 -O7 GR-
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof - 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers a. ❑Yes ❑No
I hereby affirm under penally of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property[ax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. . . . -.r.,- _. !
❑ 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap. 3.2,Grp
(this secon need not be completed lthe permit is valued at one hundred dollars(S100)or less) 2 Art 2Sec.341,Title 8,California Administrative Code).
Policy Number:
❑ As owner-builder, I will not employ anyone to do work which would
I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safely,as noted above,unless
issued,I shall not employ any pe '
•n in any manner so as to become subject such person has a permit to do such work from the division.
to the wo - ' • •ensatiof California. and agree that if I should
become bject to e • compensation provisions of Section 3700 of
Applicant's Signature Dale
the Labor C•t l��^th comply with these proyisions g
Division of Industrial Safety Permit Number:
dr — s Signature D
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WAR • -. AILURE TO SECURE WORKERS'CO'- SATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Sec'•• 7000)of Division 3 of the Bu ' e Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
se is n full force^andmeelle t. a registration form for acutely hazardous materials? ❑Yes 0 No
Li .# O /_i' C ass#
r
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
Lam/ /C0'7 each business which at any one time has on hand a quantity of acutely
ornrad,aturei•D Jate l 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
CONSTRUCTION LE DING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safely Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
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 (Section 65850.2 of the Califomia Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits).
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
0 I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are'not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she , CERTIFICATE OF COMPLIANCE: I certify.that under penalty of perjury the
did not build or improve for purpose of sale.). - information given above is Correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.. . ' t
❑., I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH -
LICENSED CONTRACTORS to constntct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date ,
•property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a cantractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city
. ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not • occupy or allow occupancy of any building
authorized by mit unt' - Inspection.
i... �• er(s) /^ Dale
Signature Dale _ a / t c. c7
3057-46 Ord]) `%C`��j(
And/or A e
•
S. CIT;OF COSTA MESA
'L"-Ar BUILDING DIVISION
F; AI, 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
? �' FOR INSPECTIONS CALL: (7�1:4�'754-5626 • , /
•
PERMIT NUMBER. B07-00992
vori, CO,
PERMIT TYPE B_ROOF2 >' t, STATUS: ISSUED - 'a
i.jY:w1. DATE ISSUED: 10/23/2007 •
ty
ISSUED BY: SOK
r .
JOB ADDRESS: 1144 GLENEAGLES TR CM' SuIte`n/Unit .r,
Vicinity: ROOF
Squares: 3500 x Valuation'' *': $11,984.00
`I
•1
SCOPE OF WORK: TEAR OFF,EXISTING ROOF::INSTAL 7/16"OSB, 1 LAYER OF 30#FELT 5:12;PITCH,40YEAR
COMPOSITION SHINGLES FOR 30 SQUARES:"HOT TAR BUILT UP WITH CAPSHEET ON'FLAT ROOF:S SQUABS%
4' .
OWNER: MAXWELL,OLIVE M ';f
, i - Address: : 1144 GLENEAGLESiTER
--a
Unit:
PHONE:" , ; --4- City/State/Zp: COSTA MESA" CAS ' I., : S
.,,t-k,-,i
_ , I. _ ,4i,‘ .. . .
APPLICANT: DANIELLE MOLLISE 4, ;; 3 Address. 1653 1/2 SUPERIORAVE " 'f;`. Unit .
PHONE: 949-642-7222 ' i City/State/zip:'COSTA MESA;CA + hi �;: Y''"
CONTRACTOR: LEE ROOFING OE M
COSTA ESA. .-... ._ .__- .. .. -, License No. ;� 349686
Address: 1653 1/2 SUPERIOR AVEUnit ' -PHONE - '949649-7929 .,
City/State/Zip: COSTA MESA CA < 92627, .._ --,",3:733,CELL '
ARCHITECT: -License No - -iPHONE �
. .. _._ r � ,
E � fit:
ENGINEER: : License No. "/ PHONE:r
FEE SUMMARY
.
Reroof Plan Check: $0 00 . ,
Reroof Permit Fee: m3209:25":7:', rn
Reinspection Fee: 3::::$.0.00::-:::, 4
4.. I "_1
TOTAL FEES $209 25 " `- •
i_"c e
. d
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. :
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE t. INSPECTION TYPE DATE INTITIALS CODEX INSPECTION TYPE DATA, INTITIALS
1616 Fixed System Final Fire Prevention - • 206 Final Mechanical
•
1266 Pool Spa Final �r 208 Final Plumbing
200 Final Re-Roof 69-330 -07 210 Final Electrical
201 Final BIocldRetaining 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv ❑Yes ❑No
I hereby affirm under penalty of perjury one of the owing declarations: Drivd'r's License No. Expires: •
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):,
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued. . , •
��--YI have and will maintain workers'compensation insurance,as required by ` . -
Csecfon 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
-c \\-- Pt.-AAA by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier:_ ��-ic g thirty-six(36)feet high.(Chap.3.2,Grp
`'� VS)
or dismantlin thereof,will be more than
(This swim need not/\completed 4 the permit is valued at one hundred dollen less.) 2,Ant Sec. 341 Title B,C21fOmia Administrative Code).
Policy Number: —,'6 I ��V W
t�----- 0 As owner-builder, I will not employ anyone to do work which would
O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued. I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers'compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I shall forthwith comply with these provisions.
_64- �/� -C;Z /b/a2 / Division of Industrial Safety Permit Number:
( -Appliranfs Signature -'- " - 11�J HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in1 full\\ll`fo1rce anda/ effect. a registration form for acutely hazardous materials? 0 Yes ❑No
Lic..#- 2 _\C1 \D i1 L Q Class.# • — 3 • (Section 25533 of the Califomia Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
jU -2- - le each business which at any one time has on hand a quantity of acutely
—contractor's Signature L.—Date—,-, 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
thereon,and who does such work himself or herself or through his or her own 8 (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to-comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
O I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
., Signature of Legal Owner(s) Date
Signature Date )—`_ ll1 a-2(
305746(3107) . . •- �Ar Authorized Applicant,_ _ / 'Date,._,
CITY OF COSTA MESA
BUILDING DIVISION
> • .,. �I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
� •
. /ti PERMIT • c
s^'atrl VP01-00551
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1144 GLENEAGLES TR Status: ISSUED
Suite No Applied: 09/13/2001
Issued: 09/13/2001
Vicinity: ;. �
ISSUED BY: H '
Parcel Nunmber: 42233304
(C'• _
Applicant: MAXWELL, OL'IVE'M
Address: 1144 GLENEAGLES TER -' 1
Phone: 949-722-2503 /7 7----. -' -
COSTA-MESA, CA -- - - Zip: -92627 . ' ��
/ -/ i -
Owner:, /MAXWELL, OLIVE M.
Address '1144 GLENEAGLES'TER � `\- '
Phone: �' r
' COSTA MESA, CA Zip: 92627 ,
•
Contractor OWNER BUILDER ' `
Address: - - . • _ - . - . ..
Phone: _ '�
Zip: - -
License: 000000 . ,
•
Aid) / Eng : N
' Address: •
Phone: - ' '
Zip: •
- . -
License: . , - -
SCOPE OF PERMIT-
GAS RE-PIPE. -
7FEESUMMARV .
. AMT QTY AMT `t QTY AMT QTY
ISSUE FEE _ $23.50 -1.- ,, ..-,''Laundry Tub/Washer , $0.00, 0.•:, . -::-- - Sump Pump -' $0.00 0
Backflow irrigation $0.00 . 0 Landscape Irrigation $0.00 0 Swimming Pool - 7 -$0.00 0
Backflow Preventer , $0.00 0P-Trap - $0.00 0 -Trap Primer - $0.00 0
Bathtub - '-'$0.00 0 . - Pressure-Regulator - $0.00 0 - •Urinal - - $0.00 0
Clarifier System $0.00•. .0 Process Piping(per 10 ft) $0.00 . 0 . . Vacuum.Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc)' -$0.00' 0 . - Receptors - $0.00 0. Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units '$0.00 . ' 0 Septic Tank $0.00 - 0 -Wash Basin. $0.00 0
Dishwasher ' $0:00 . 0 _ , Sewer Cap for Demo $0.00 0 ,'-Wash Basin"Set $0.00 0
Drain, Floor $0.00 . 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 • ' Sewer Private Line $0.00 0 -Water-Closet(Toilet) $0.00 0
Drain, Roof $0.00 0. . Shower , $0.00 0 - Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 ' . • Sink, bar $0.00 0, - ' ' Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 - Sink, commercial . - $0.00 0 - Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water-Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00
Gas Repipe $9.80 1 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease, Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $33.30
COMMENTS/SPECIAL CONDITIONS
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(6/00)
DECLARATIONS f n
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penally 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 issu9d. .
❑ I have and will maintain workers'compensa•can 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�rrnner and policy number are:
Cartier: C [ Policy Number:
is section need not b.e cdm•eted it permit Is valued at one hundred dollars($100)or less.)
I certify that in the pert- of the wggc for whi his permit is issu0 I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of r aid• la,-and adreb tha ould becomes ' • to the workers'compensation provisions of Sectio ggq 3700 of the Labor Code,I shall forthwith
comply with these pro ••� A °jtnr-,1 .�' / '�/
Applicant Signature: /
Date:
WARNING:FNLURE TO SECURE WORKERS'COMPENSATION COV RAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100.000),IN ADDmON TO THE COST OF PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
force and effect.tic.$ Class k
Contractor's Signature: Date:
I
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 porn*.
subjects the applicant to a dvil 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
yS oId 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.).
ulr I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
1 Code:Th: c•n ctors License Law does not apply to owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license p rs . or to the Co dense Laws.)
❑ I am exe,•• kW./
sec.t ��'///���. ,- Business and Professions Code for this reason: �'} ) /
Signature: ,� NC♦ - 7Vr"'6 Date: —I f/ f 0
Owner ID verified by drivers license. ❑/,/es 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,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 8,California Administrative Code).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
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? 0 Yes 0 No
(Section 25505 o1 the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 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 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? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aEEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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? 0 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:
CERTIFICATE OF COMPLI CE ' D 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 it .(tate lawsand-pity or " es relating to b 'is
•• construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property'' ction pure x .I a e to occupy or j upanc of any building authori by is permit n final inspection.
. ` - ii,3f c�/
Igna re 1 Legal Owner(s) Date
And/Or Authorized Applicant Date
CODE* INSPECTION TYPE OAR MEDALS ccDEi INSPECTION TYPE BAIL MALI
1816 Fixed System Final Fire Prevention 206 Final Mechanical Q
1266 Pool Spa Final 208 Final Plumbing �1-141-o i Ir'
200 Final Re-Roof 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
•
�i PROJECT ADDRESS: 1144 GLENEAGLES TR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 06887:
OWNER'S NAME: MAXWELL, CLYDE R
ADDRESS: MAXWELL,' OLIVE M PERMIT NO; P 068873 PLAN CHECK NO: N GOVT: N SUPP : N
1144 GLNEAGLES TER
COSTA MESA, CA 92627 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
•
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : DISHWASHER REPAIR—C/O SQ FT;
ADDRESS: UNIT:
CLAIM VALUE; CALL—VALUE: GROUP OCC : R-3 /
PERMITTEE: NOCK PLUMBING ( 714 ) 895-1246
ADDRESS: 11610 SEABOARD CIR COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT
STANTON CA 90680 ####******************94********************************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK S
CITY LIC.: 05038 STATE LIC.: 511971 C S: C-36 XP: 02/95
Date-
—�iy'/ Signature: v— — MAIN BUILDING ACCESSORY BUILDING
WORKERS COMPENSATION DECLARATION: I hereby affirm than have a certificate of consent o seg-irimr170907s FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
Compensation Insure c or certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT ; FT IN
Punta: 1167992-94¢ EXP. DATE: 03/01 /95
COMPANY: STATE PARKING REQ: PROV; PARCEL: 42233304 ZNE: REF NO:
7 Certifiedcopyis hereby furnished. a Certified copy is 1i The city Buitdina9ivrsion. PLANNING NOTES> f
/ /9V > V
Date: �� Applicant: ****###**#***#*####*****#####*#***###*#**#*#***********************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERV I C E 5%" REQUIREMENTS
I certify that in the performance of the work for which this permit is Issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY
DATE:
Date: Signature: •
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; / ,,1 DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked, , 11 i
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: - I /:rt DATE;
which this permit is issued(Section 3097,Civ,C). 3434*3434#*94#*#***#*#**3e****3t* #*W. ****i!#*3434**�F********3434*****#*#** # * t ***
LENDER: ***********349494*94*****3494***** }**94*******34*******************34#3434*94***34*34****#**
ADDRESS: LEGALIZATION;N "' E E S,11U M M A R Y STRUCTURAL SEGMENT;N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'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 7 . 00 ‘ /
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed _
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% ,�. _ SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN •
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred ollars($500). ISSUE FEE 20 , 00 '.. '
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DI"1—> PERMIT ISSUE PLANrCHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS——--> 7 , 00 20 , 00 — ' 10 , 00 27 . 0y 27 , 00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through 4
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 : 27 ,00 OVER/SHORT-
. 00
forptheepurrpose sold sale)hin one year of completion,the owner well have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 2 7 • 0 0 .,i 1.
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******#34*#**#**###**34#*#*####*####***********94***************it*****************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL: • ' Fi:E E BREAKDOWN
❑ I am exempt under Section: B.&P.C. - /
for this reason: TYPE QTY D E S C R I P T I O_N"• 1 UNIT COST TOTAL COST
Date: Owner: PLU 1 DISHWASHER {'\ 7 , 00 7 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END 'OF FEES
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 A I
.
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from t
these provisions. "
1
her Applicant: - )
I herebycertifythat I sr relating
this ingtion and state that the above information is correct agree to comply with all city and county ,v//
ordinances and state laws relating to building construction and her prize representatives of this city roenter upon the above-mentioned
property for inspje non oury oses. L71 00167732-00167732 T CE T �7,[:l
Date. 6f/ I if `r`� Signature- — DATE: 09/14194 TIME: 10:04
Driver's License or Social Security)it:
164146 White—Building;Green—Cade Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
i CONSTRUCTION AND PLANNING POO WA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56, Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10. Structural Floor System • 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
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
20. Rough Factory Fireplace APPROVALS' Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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
29. Insulation 78. FIRE PREY. 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:'7 (o 1964/Q to „ n.f „
34. Final Heating & Air Conditioning 1 :CE�S..LJL.LS'SJI l"{'�
he urea ,
L 35. Final Gas Pipe-Test /)
L •
36. Hood or Canopy -
37. Final Factory Fireplace
38. Final Plumbing 3Z-541).
l )r
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 . T
48. FINAL PLANNING
49. Electric Release to Edison
•
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date �%
_ • _ _ -•_ _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations, _
' CITY OF COSTA MESA •
• • - PE IT NO. // TRACT N• O: - •LOT NO. BLDG.NO.. - - " •
CONSTRUCTION PERMIT
y� 7� T r : _;- -
Applicant's Mailing Address!!'// "" - I —it7C'C TYPE OF CONSTRUCTION LI NEW LJ ADO UALTERATION -LJ REPAIR • ,-.j 562, [7�V'1�63 �j,00 : TL
Project Address / •-9.A./y.3.
"- At J4 'Af�FS )' '/ ❑ CONVERSION ❑ DEMOLISH •'❑ OTHER' - , -
Owner's Name - 1& / -S " •
l PhonC `�'3-�t' DESCRIPTION OF WORK• _ - - ZONING REGUI=ATIONS-
i ' // / (.LPi[i.�i4�-e-FS": -
Address ' TYPE OF PERMIT L) GRADING U FOUNDATION ❑"STRUCTURAL A.P.k •ZONE
Arch/Eng" - - - License No. "' ❑ TENANT •❑ ELECTRICAL ❑ PLUMBING' ❑ MECHANICAL - PLNG.REF..9)t j •
• BUILDING - -
eFTearlr rIi err
•
❑ OTHER i '' • - I -;REAR YARD (TO'P/U: +
Address ' /.�/ - •,- `/ - -- - I.
TOPRBUILDING
DINTY LINE
Contractors Name /Ale-,/c. '_�''57'9'C`E Phone S• 7.2,g - PROJECT DESCRIPTION• SG,FT. • OCCUPANCY• ' ' - -
AddlenJmailing) •���-r ( e/1L -a_i •��ic? CONSTRUCTION TYPE ' ;VALUATION$ - LEFT SIDE YARD RIGHT SIDE YARD - •
1 - • - - - ZONE - GRADING CU. .ACRFe PKC.SPACE REQ. 'PROVIDED � ' -'
License No: __ . •. .. - .
•
LICENSED CONTRACTOR DECLARATION Remarks: - - STREET WIDTH -PARK FEE$
I hereby affirm ,)unwed that-1 am,) under provisions of Charter 9 (commencing • - -
with section 7000) of/Div Ion 3 of the Business and Professions Code, and - ' SPECIAL CONDITIONS: - ' •
my llcense Is in full force'- d effectI , ', ' !' • • •-
ucenie C ss' AP Lice No.‘ • PLUMBING : l ; I
Date signature - Off -6�� .�/�d'Y� • , . '
ORKE S'COMPENSATION DECLARATION I Bar Sink Sealer Cap ELECTRICAL - j •_ ,
ereby affirm that I have a certificate of consent.to Self nsure oro certificate Backflow Preventer $ewer COnnectiOft Automatic-Washer {Meter Dover.100 amps
Workers' Com nsstion Insurance, or a certJfle opy then of (Sec Ion _ I
800, Lab. CJj��(°/ C� ( �y�i Backflow Irrigation Solar Collectors + Construction Pole Sub Panel •Ii.
Policy No. '•"�I(`/�/w// CDmpan - - - '- ' Cooking Unit Sub Pole
BUfied•cop 1s hereby furnished. - " ' Bathtubs Solar Piping , '
Certified cb y..' Bea with the cIty.Bullcling bi "Ion ! Dishwasher I •Motors 00-1 HP 01''48
_Date /1%/ n Applicant �� �' % ��''�.,, • Ciarifi �l Solar Tank _ __ f
EXEMPTION'FROM WORKERS'COMPENSATION DECLARATION ' / Dishwasher '-� ' 4' Swimming Pool w/Spa , Dryers ❑Gas ❑Electric l lna Solar 09-15 HP 01645+ , •
(This section need not be completed if the permit Is for one hundred ($100)or \ •
less) 1 ^Fan. !Microwave
1 certify,that in the performance of the work for which this permit Is issued I ' Drinking Fountains Urinal , - _
' shall not employ any person In any manner so.as to become subject.to the : F.A.U. • Pole Light
workers' Compensation Laws of California,; • • Floor Drains ' , , Water Closet. .Po•
le
If,'after-makin his ec '
Date ' .g this declaration,you should become must-
ot to the i, - Floor Sinks-- ' --Water Heater. - Fixtures - -- _ , :Range ,-
c orkers5 Compensation provisions,Of the Labor, Call beou forthwithmust- I - , -r Device Boxes
comply with such ;provisions",or./his?permit shall `deemed' revoked: Gas Service Outlets Water Service r� • Sign '
CONSTRUCTION LENDING AGENCY ' f - ' ,
' I hereby affirm that there Is this trumion lending agencyti or the performance Interceptors �' i {,�/� / r Outlets Standing Sections
. of the work for.which this permit is 'issued,(Section 3087 Civ. C,)- - /v' li' '
Lenders Name - Kitchen /\ / �\� + - Switches' ••
I .
' ;Trash Compactor ,
, 'Lender's Address . '' - - - 1 `, v 0 1•� - Garbo epi
I - Lavatories + �\ 9 sposal
OWNER BUILDER DECLARATION + 's \ . If
Ihereby affirm that I am'exempt from the Contiactor's.License Law for the \ Generator 00-5 KW 05-15 KW
following reason Sectio perm 1.5 Business and Professional.Code: Any city or • . -- Trapl ' , •� �( ! : •
county which requires a its issuance,'to construct,alter Improve;demolish-or-repair pair - - - t r " -
prequirespelican bloc such permit . ' Roof Drains , ,i ' r, - Transformer
anystructure;prior to also the a /`� 0 015.50 KW ,. I I j
to file a signed statement-that he/she is licensed pursuant to theoprovisions of . - - a 05U+KW ' - +
' the Contractor's License Lawn hapten sions ode) g with SectIon'7000)exe of , ' - ' - '., ; �$15 ; • ) �Reinspemion Fee $15�
• sion j3-of the,Business and Professions Cotle)"or that,he/she f exempt i " , Showers , I - I - ' ; Reinspection Fee .
• from-and the;basis for the alleged exemption:Any violation bf;Section I " , - - - '-� Meter Oup to 100 amps 'Issue Fee ' ;$ 3
:5 noty applicant for -a+permit' ubjects'the';applicant to a.civil - • I I 4' - - - -_ _
,penalty of not more than five hundred dollars($500). - -/ :,- , . ,.i • Service Sink: -` , Issue Fee fI
• LJ
I - - ,, r j 3t /Zoning Approved By 'Data •
I;'as-owner it,-doe;property orimy employees with wages as their sole , -, ' f t - MECHANICAL
I compensation' will'do the work,and the.st essio e:Is not :•The ed or offeredI '
for sale((Section 7044', Business,and I Professional. Cotle:'The;Contractor's - _- - - - -: -'- - - �- 1 -..- - If ApPliiation Approved ey gate• �L )
License Law does not apply to'an owner of a property.who builds or improve2 . Boder, ! ' Refrigeration System I �1. 1y`� ✓' ' D i- v.Pq
tmplo employees,
who does such work himself/herself or through his or her own y - Y" a Application Issued By i f—�( Date /�� •
employees, ejer,provided that such improvements ist Intended or offered for ' Duct-Under,Ground 00-100,000 BTU '0100,000 BTU' Y" i MM f
sale. If, however,the buildinge or improvement sold within one year of im- I , , f'"- ✓ t SUMMARY OF FEES
! Pletion,the owner will have the burden of proving he/she did not build or im- - - I
rove for the purpose of sale)." I •, ' I , Duct-Structural . I • System Repair/Alteration in !BUILDING PERMIT $' - SHIP $
! I, as owner of the property, Se exclusively mntrabting;wit h,llcensed con- , i - ! ) ) '
tractorstoactor'uctthee Lawt.(Sectlon.7044,.Business and Professpertyode: — Duct;Ventilating_ , i • ,".+--J ___ _;'_" i r1' 'PLAN CHECK( $:r ) PERMIT • - I
, The Contractor's License does not apply to an owner of property who ' — . - .' I KS/ ISSUANCE • . $
builds or improves thereon,and who contracts for such projects with a con- i I Exhaust System 0 Multiple 0j_ ! .I .+ re' PLUMBING -
' tractor(s) license pursuant to the Contractor's License Law). I 1 I I J i _ v; tiI i • , GRADING • ( $ , "
'PLAN CHECK' $
❑ lam exempt under Section . B,& P.C.for this reason t Fiiepl/Fact.lilt.ICBG# • 1 -V, _ •
' ; • $
- i - ELECTRICAL' $
' Date :' + owner/ Heating'System& Ducting i 1 ,
i I r A - $ MICROFILM ' $ 1
-1-hereby-certify-t Shay •rea t)is'-applicat ion•and state"tfiat otdiabove- ,- 00.100,000.BTU 0106,000BTU ' -I - '- r/ r' v. PLAN CHECK' ( j -
; information is correct- ogre comply with all city and county ordinances , 1 i I- 1 ai .i el r, / f TOTAL FEE, $ '
antl'�state laws relating t but Ing struction,and hereby authorize repro- - 'MECHANICAL $� - ( )
sentatives of�thls;e t tom r u o the above-mentioned pr pert for 1 Hood Or Type I 0, - LI; I
' inspection pu4poseS,- ••/; ( �2Q�� 1 ' PY TYPe II ❑: I ; Reinspection Fea, er x$15: A, LESS i
Cano ,PLAN CHECK. $' i ADVANCED PC $ �l
S19nature \ /
i • Registers , . Issue Fee y$ 3' , , y (_• �)
55 ' '� 1 . f ( FINAL FEE I $
CMF 0865-46 rev,12/32 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor . ,,J
Z OCONSTRUCTION AND:PCANNING. o• - �C 1 rr m u ? ,? JPOOI++.:. .,oA 1- 1 ' -v c n
n
s. cfAPPROVALS o Permit#' rna - o :'Date2 ,Inspector ;.-"APPROVALS`,_ Permit# ` ..y bat e •• Inspector '
. . n; 1 (. , m Fl is 'a r. :., i n 11 : - . .-_it 'pr F. ,i - r ' ,. _ i - m - r. . ..:1-.&. : -,.:
fryl. Tempo ary•Electricarl Service or`,,Pole••I'r.s ci • ' enr: o: :52`,Pool 8-Equipment Location`-4r a' ?- -
ki , 1 , a c ' ue6: , °. .i" 1 4 co cpQ ,r rt ''l
-- _ 1.. : p1 _ ' .
ra ,2! Soil Pipe Undrgrnd- a tS-e 6: i 1 - L ! y, . ^2 r• r_53 Steel Reinforcement , -_ .. . I
3:. Electrical Conduit Utility-Undrgrnd; . ti c z ' -.- - - _'_� ' 54�'Porms;i - _�;• _.� _ = 1 _ _•- - ,
a -
'n 4'Electrical Conduit-Undigrndh= =,1,1 t -7,1, c � %; j ro _ Z�,,! x.55'Electrical•Bondingt cr..?� - - :��- •
tl -
5: •Stel.Reinfbrcement I ' ` '''1 o qi 74 _56.• Rough Plumbing & PressureTest A' I :' 1 I •-
6: (Electrical LIFER Grnd.1 I x,s« ',j 2,, % 0=;.•' ?: :,..-5-17. •57:1,APPROVA L1TO'COVER-GUNITE? + .
7, Footings 'I I VII 1 1 7` ! 1 F 9- ^�r ,t_ +58 Electrical Coriduit-Undrarrld ' .. t -
1 1 1 .I loan 1 _ _ _
B. •Foundation I •'I • 1 : :. .,„•:. ! ,•-:,;
! ,r '' •` • ';59. Gas'Pipe,:O.Undrgrnd-;Test
9. Water PipeUridrgrnd. ,l I o. . . • Fr` ' :- - *" i 16_0. Backwash,_Lines,`P:Trap,:E Undrgrnd._: : _t : ! - • ' ,!
10. Sthicturral Floor System I ; o t n _ 461 APPROVAL TO`DECK -- ` L' '
11. Property Sewer Li:ne&'FHous`'Connection r-', '-` c: ' X62 Backwash& Receptor Final _ _ r--- l • 1 ••
12. Sewer'Ca 1 I n '.{ I �' - • r e , -e - _ _ 1 -
} ,.1p ;. n ' I .F o -'63. Heater &.Vent-Final.. =_' r j ',
13. Roof;Dialns !"4' I F. II.;ge '11 1 r I i '64. Plumbing System Final o e
r 14. Rough-Plurribing . , ! Fac c _ _ - - . e. c _, , '
1 •65. Electrical=Final-
0
' `15=Rou h-ElectricarConduit•�T�1 T "'- 1,-;!--
1T 1 - •r--T-""'"-•!-' "T" '�
::'4 L. Ai,_. g _ • .. I .-i I I ' -1-..:1--,::4,-----.-+- 66.E Solas SYstem-Final•- -1
d:16. "Rough_Elect`r1ic,Wlr-tng. I ` 1 II '... 11-.;....:, : •--:-1 , It• :.. ng -!---+ - 4 q
n l,••' rr , 4 I m, 'I / .:...‘ y I 11 1 t i_ ! �,I _ !' 6Z. Fee.ncing & Access Approval , r -i, :1-1„, , o-
ctI17..RoughrWiring1Sign m I• I iI 1151:_ I ' I '1 a I - I 1 i. 1681 APPROVED FOR-PLASTERING - 1; ! ` ' I y ! --
n 18. 1Rough;Elecincpl.T.BaDCeiling' II h I - ).-; I I - I I'-, 1 P!' 169,1 POOL/SPA SYSTEMS FINAL 1 - !• •.• 1 •I 1 •
•
a Q 191eRoughrHeating & Air Conditioning 11 1 _ I d I I I i^ I ' 1 I FIRE DEPT. REQUIREMENT I '-. I ! ' • ,
i 1 1 i i ' Ir • i � 3 -a
2Q.'Rough-Factory Fireplace I I 11 II I ! I , I• L I APPROVALS1 i Permit# ii , : ` ,!
JI ; 1 n ._ f m I S r f , 1! 1 1 I 15 i I •.Y 1�- I .I
21. Ducts,im Structure 4I I1i r I ` UH
,22. Ducts, Ventilating 1. I e I I II I1 I I 1 I 11 I j 71_1 Product Piping O Gas OOil : 1 ,r' ; I I
: °G t ,. , I -TIM-
- i- , ';-T nci7 o i - -- I - - -• - - , - --"n---
ri23. as is. -Rough&Test ;,21, I !I°� - I I I l 1 1 72.1 Underground Flush I ,� , �1 I !
124. i ° ' I. II-H I s ts m I v.1 1 s -; 73,1 Under rqd.Storage Tank' ID Gas.O.Oil. 1 I I
Roof Framing- I I 1 I ., I . I I , i o . t ! I , - 1 _ - t om ' I I
5 }Roof
,L•,. u , 9
c t.25- fioof Sheathirij I ' 1 t I I r5II I r 1 ' I 7- 1 .i i ' is I _ i- I
.-. a c 1 I 1 •> Ih-1 -. , I n.I°' ! { ' = 1 74:!Overhead HYdro .7-r.'.•1-'7 i
C l-26. T-Bar Ceiling (Structural):& Mon 1 l n • � I" lit i I ' •75-j Dry`Chemical I r• 1 - • i ` ; 1 _lc" Ir-.r. ' . Io 1 Is I n 11
E"77,`� 11 s 1 -, 1 {1 t I I- ! I 1 1 ,
.27. 9;am,e and Flashing' I I .I !, _I " I ' ' I 176.1 Dry Standpipe ' - ! r
c 1 28. /Lath•; &YSidln i1 t I li I I I I I I r ,1 -* - -t
_ 'i G g Si:Siding!: 9I r, { ( 11 II I. I 1 . I= ` I 1 77 1 FIXED SYSTEM FINAL _ 1
M , ,
. y 29. rlosulatiori r`. I Q H I tI II I, 11 I I ) 1 I 178.1 FIRE PREV,. FINAL ` l i !
P,730.30. Drywall Nailing I n 1 1 1 I II '1 i I I. I I I I I INotes:I, l• I ' 1 1
Q ain's ¢r/ /a:,"�d re •,,,,,./��
T- / /, �/
a ,.31. Plaster Sr
Brown Coat I I i I I II h: I 1 ! 1 I I4v/8/roe
e�+/8 � �an da,/� ,74,0,•,./327 slrf!iT� ^s7_►�I
y i 32. Electrical Power Meter Final I 'I I I I I I I I 1 I S,it 1;. 1litja3 i7r ^ A: fpr 1fl a;I
33. Final Electric t• 1 i .I,if�,_-L,J _ 1 I _ 1 I_ I ( i ( _1 " !. ,} • - _� fitI;
34. Final Pleating &IAiir-'!Conditioning �1 I i 1� I i ? I I I .• g ,
., -, r Ix 11-1 n.- it 1 I I I 1 I
11 '•I IJ LL1r !2, IC: ,7 [l , c ri 1... -_
35. FinalGasiPiper.-In. • • I n! rl d I � I . ,_-I _;I-" Ic ! I 2._ - _ , ;� e i '
36. Hood orCanopV2'1 :°niSi _-I ni : . 1' 1 ;.{ I . I ' 1 aI - ) _Li IIII_ r ' _ -. - _
Y 1: 1 ! , lin n1 Q I ,_: i• - iJ !' � ., - ! - f•. - ,• "
i 1 1 r- 1 r, , 1- 1 b l - , i 1 7 ! l 1 t o 1i
37. Final Factory Fdeplace^ o "- n . '� •a r,
,1 x 1 •^1 I -1 II 1 r 1 ^• I 1 ., I •r 7 .0
t! 1 t I 1' I I 1 1 -• i• 1 5.
c i
38. Final Plumbing ! I V I I I o1 ,L1-, 1 H I , 1 r ; i I I I ' '' t&-H- 1., 't
39. Water Service-Final! I "I k I •
1 1' 1 1 I I 1 C. I I I 1 . r• I I i i I I 1.. 1? . I i„ !z.. - s .. -,
40. Gas Service-Final I I i I i ; I I I I I I 1 I ,r:. i ` 1 1!; t I 1 I ,
41. Solar Domes}tic-Final t 1 ! I . 1 !, i F • ;_� f i ; t
II�I i i 1 I 1 I I I- `I--i-�- - -�---- -�' .'I---- -- I- 7 .0. '•,,- _ t.f'? ! 1
tl-I' 1 I tI I i 4 I •
42. BackflowiPreventert u I I I I lyml_ 1 ' 1_1 ! -4- 1 _i I. I - 1p;�, • f'i; t • •
e ta' r� , „ '-'11
I 1+I,• J .v g 1 "'; -•'` .I ::1 ^s. 7. . 1 I t I. 1 1,
hl . I , I �1 I u , tr-
43. Backfiow111drig�atlonl r I. I ! I i',F -. 1 , }0 1 1 .1 ! : ( 1 1 I t i r 1 i .
14.-01 1 -l1 r; FJ1- 1 i 1:-;/ - 1 :0 0 1 = 121 '•7- 1 1 I f. ,-.; ' 1 - 1 . 1
44. Lands pe Irclpati ri System 1 1 SS _ Iz __ y_i c-f'n - - -,Fi _ -
`45. Sound Atteriiiaiiori ;i1;(5,11, ¢.1' I k I i i I I ' + . 1 ` . i ` i
P11 I ', c'I ^ I'- ' 1 �1 1 1 =s 4 ' ']
-46. HandicaplRegulations'I i ,11 I it t I it ! ,i 1 1 1 1 1 .`1 '1 1 , 1 ,71 ' ' .2 : r, ,
47. FINAL STRUCTURE& BUILDING ! I• i I I 1 I 1 i I I I ! _ i . m it
ti I: I 1 I - 1 1 1 i' I 1_> •.'I I 1 I I I i • 1r 1 . I? _
48. Special'Requirements Completed 11 i 1 e•', 1 I i IJ j1 ' -.. n r. �, :, 1 n1 <]
11 11 1 I 1 I I 11 1 , I IV : 1 i I ! I I
49, Electric Releaseto EdisonI I I i i _1 1-_; - 1 } ll ,.. 1i i_-1 1 -_,, 1 ',,•)I 1. 1 i I ' t 1•
50. Gas Relelse LIo Southern Cslifornla Gas Co I I 1 I I I I ! I I 1 R i°'i 11�'`' ! 1 ��-
;I 1 I 1 , 1 n 1 1 I I 4, Il .•
51. CERTIFICATE OF OCCUPANCY ll 1 I .....4_..i_ i i1.___.!_.......f.).2., 's;!ft, i ' ' 1 • is
No I. I I I Date I I A l I-R -- I I If11 I
I
,TOWNER ARKUSH. JOHN DATE 9_17-73
JOB ADDRESS 1144 Gleneagles Terrace BUILDING PERMIT NO. 37286
'p G..4„:'`• L CONTRACTOR Owner/Builder DESCRIPTION of WORK Addition-Hobby Roozp
OAh -c15-633-04 LOT 53 TRACT 3470 FIRE ZONE VALUE $ 6,700.00
INS c TIONS Signature Date GROUP I TYPE ZONE Rl
Sol ,cj'a1 flfee.c4rryG //-IC/0"3 -73 SUBCONTRACTOR 1 PERMITS ISSUED
\p GAS �"' 7 Date Number I Signature
PlumbingOUCH PLUMBING et-yy1.y�,`tt� _ err /0 -2_13 &'1374 'ROP. SWR. LINE Q HOUSE CON. 0 0, -{� /j�tjl'X�. W'NI,. /1- a-7? E, q 63 —TATER
PRINKLING SYSTEM O iJ
31
SirMISCELLANEOUS
OUCH HEATING AND AIR CONDITIONING fri 67/--2.`J;3
EMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER S
��ROUGH WIRING r�p TO Jc/3 /J Heating a VenB}�/l�/�L
`tiT RENCHES 0 FORMS 0 STEEL REINF. //�/I�,} /� 'J�j L�Yj44 �/ ` //. 204/-7 /Q5fcr&� —
LOOR SYSTEM / 2 Gt•O '4'-/,J -- -- -®j / •' a
BOND BEAM n STEEL REINFORCE n
SHEATHING �'Y�" QrZ�/�J 5
FRAME AND FLASHING
tPATHING — IN OUT
l , BROWN COAT ��JJ � I,//�� EE}I}I'�w"-f� //99 n q�J ,(
HEATING,
F VENT 1N REFRIG. AND A.C., FINAL riT 7'/ etth(dt#11, 41,7*,, /O.217 /44,1
IMBING, FINAL A• . GAS TEST Pi ' f.e. .,,/ /,U//, /
ELECTRIC, FINAL 4 ix/'+
BUILDING, FINAL --e---) /; 7ti
Jr
• 37286SEP 17-73Pnc000 531* 53.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
4,ILION
FOR BUILDING PERMIT
For Applicant to Fill in Completely
/ /�•jJ'��j� �/�/����C rr REO ER�EjCEIV O D��(s TE ISSUED
ADDRESS/I/'T VL' Ammeri �5 / 4R q�I /7 l — 11—73
' 1A.P. g ? PERMIT NO.
OWNER . . LTol1r Ig,-kept* NOJ/SO J -C, y
MAIL ��ssw���I�'�G BUILDING //,, / o ''7�
ADDRESS �I //J al-eg4 ADDRESS ,/yy 6. e"/Arc t13s /Ipr,
0-0 CITY easy* /f&5. r NO(p42�O TRACT' S'7n[ LOT 44 BLOCK//
ZZ -
Q CONSTRUCTION '�)) NEW ADD ALTER REPAIR MOVING DEMO!ISH
-N LENDER /✓,,//ola
am
jr BRANCH •
G
_i V) OWNER T)/ 4 kisL
<W ADDRESS ✓ ' /J /�
d) J ARCHITECT /�Jt ^/Q/��'/) �' s,//,TE L)/j� $ d /C(,(7 /�_/ALU$ 47,w Q4
J Q OR ENGINEER'`r/��{//L'vr r' �<` '��/^•-��.NyyO&G up (mss.���/�� S /
Z a '� 4 7d7 C07'T MESA FIRE �f
w K ADDRESS ZONE TYPE GROUP
APPROVE /yy
J Z CONTRACTOR /r/®.[/.y BY .. DAT /(�f
73
CO Z
J gc ADDRESS
W w TEL. ZON NO.OF USE OF NE '
Z_= CITY NO. - PLANS— BUILDING•• .0 Ld.
H
to STATE CITY. YARDS NGD YARDSSAPP•'•CED
fn� LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
D O �}�/I (FROM C/L S EET) ,,�//
SIZE
LOT `T?K�� s/ rigegie NOW ON LOSS `/I�r FRONT /j///FiT-.'��// FT.
USE OFEXISTING BLDG.v1///Qr 1ti. �,T/lf‘y 0-4.4 . B.SIDE y�JFf FT.
ZI— SIZE OF
Z NEW BLDG. Zy)(i / / ROOMS NO.OF / STORIES / L.SIDE /r FT. . FT.
EXTERIOR WAL{r../� ROOF �/ F.T.V COVERING Jr7JCL 0 COVERING dIrO REAR FFT.
J USE OF BUILDING AND WORK TO BE PERFORMED
11 DISTANCE BET. BET.MAIN&
CL MAIN BLDGS. ACCESS.BLDGS.
0
ao
I" DDirTdd/ bs<O/7/7y R ✓1 oo CU.P.# y}�r
APPROVED
- APPROVED '
V) _RV D pDATE / /-771
Z
O
l�
UI hereby acknowledge that I have read this application and state $jA
7 that the above information is correct and agree to comply with ,rt •
x all laws regulating building construction, and I shall not employ /v
l— any person in violation of the workman's compensation laws of .
fn the State of California.
111SQ. FT,1 hereby certify that I am properly licensed as a contractor under T o
the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
CC
am exempt from the provisions of the State of California Business VALUATION
and Professions Code, Division 3,Cha ter 9.
PERMIT FEE $ D
f m
Signature of 676,--d
�s� 1
Permittee $6 76 U PLAN CHECK $ / 2 E
IIIVVV // l S� p
Authorized ant - 5
` TOTAL FEE $
.�./ 12718
COSTA MESA BUILDING-SAFETY DEPARTMENT /tN‘ 63 D- cs "t
P. O. BOX 317 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely APPLICATION)FOR PERMIT
3 ii7P TYPE OR PRINT4eC#1. j BUILDING
BUILDING
ADDRESS 1144 O1pneagin Terrane 3t2
COSTA MESA. CALIFORNIA For Office Use Only
3 RECEIPT NO. I PERMIT NO.
OWNER M rrn rnrpnrarinn ?. 1S
MAIL REC AEC-BY DATE. / HIV 4 .v. ISSUED
ADDRESS 3800 E. Coast Highway i t%
- (/�" 6 A,L. n ,. 1001ek
_ TEL. BUILDING v w
CITY Crops dol Mar saw 1-4770, ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER George Wiseman NOOR 3-422
FIRE /// _ 0 n
ADDRESS - -" ZONEIRTYPE . GROUPxl /\/--
CONTRACTOR Mace() Corporation ' BYPROVED DATE
ADDRESS :A il _ . , ZONING sie://,
ZONE NO.OF USE OF NEW
CITY rot'(i
CITY -Ma A I PLANE ebUILOINGf.j, i iii,/
ucTNO. - -.TEL.• OR 3-4220 DESCRIPTION am` Ca . TR.... 17n
SIZE 1 NO. OF BUDGE.
OF LOT 60 X 100 NOW ON LOT 0 A.P.NO. --1
USE OF YARDS EVES
EXISTING BLDG. APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT 3+7 4�T. IN.
SIDE YARD I LEFT 51011 1 RIGHT 51011 R.SIDE / '7/FT. IN.
DESCRIPTION OF WORK •
L.SIDE J .3� /FT. N.
NEW I XII ALTERATION ( V ADDITION I REAR / n FT. IN./
REPAIR I (MOVING I VDEMOLISH APPROVED /i I .y 1 �) DATE ccs (? ,c
SIZE
BUILDING NO. OF 29 x 49 ROOMS STORIES 1EXTERIOR ROOF
LV /� / C ��
COVERING WALLStucco ( COVERING Cedar Shakes
USE OF BUILDING AND WORK TO BE PERFORMED
Complete Construction
p„I,fQ cq_ Fr_ -1450 '
Garage Sq. Ft. 420
i HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF PERMIT FEE $
PERMITTEF Mnrrn Corporation �-- . //'y/ y n
421—i
/(////7�7 ) $' L /` / 7� PLAN CHECK $ /--7
'—
AUTHORIZED AGENT /Ll'"L(�"�� � ���'L, �.-/_ ¢
" TOTAL FEE - D
LL