HomeMy WebLinkAbout1190 GLENEAGLES TERR - Building Permits •
CITY OF COSTA MESA
r F BUILDING DIVISION
Vw �l 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
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pea FOR INSPECTIONS CALL:(714)754.5626
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PERMIT NUMBER: P08-00063
PERMIT TYPE PLUM STATUS: ISSUED
APN: 42233108 DATE ISSUED: 02/28/2008
ISSUED BY: RMD
JOB ADDRESS: 1190 GLENEAGLES TR CM -_ Suite/Unit:
Vicinity: THROUGH OUT HQUSE -
SCOPE OF WORK: 1 COPPER REPIPE THROUGH OUT SFD. SEPERATE FROM BATHROOM REMODEL.
OWNER: HECKROTTE, ROBERT P .. Address: 6132 EAGLECREST DR
PHONE: - City/State/Zip: HUNTINGTON BEACH, CA
APPLICANT: JOHNSON,JAMES - ' "• Address: 560 LIBRARY ST :
PHONE: 800-806-7374 ' :; -. - • . City/State/zZip: SAN FERNANDO, CA
CONTRACTOR: MASTERSERV INC' • LicenseNor 580017
Address: 560 LIBRARY ST PHONE: 800-806-7376::
City/State: SANFERNANDO,.CA ZipCode: 91340 - - - CELL:
ARCHITECT: License No. - - PHONE:
ENGINEER: • I - ' " License No. PHONE:
• PLUMBING PERMIT FEE SUMMARY
PLAN CHECK.FEE: $0.00
PERMIT FEE:• • •$3330 •
TOTAL FEES:' $33.30
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE S. INSPECTION TYPE DATE INnnALS CODER INSPECTION TYPE DATE INnnALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical Q
1266 Pool Spa Final 208 Final Plumbing 3-21-O$ iSir
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 _
1-
WORKERS'COMPENSATION DECLARATION: • - Owner ID verified by driver's lice. . ❑Yes 0 No
I hereby affirm under penalty 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 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.
• ❑ 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 ❑ 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
MAL by this permit,and that no building structure,scaffolding,falsework,or demolition
Carrier:— w or dismantlingthereof,will be more than thirty-six
(Thisserton need not be completedn the permit is valued al one hundred dollars($100)or less) tratv (36)feet high.(Chap.3.2,Grp
_ '� !I '' 2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number:' 6 j 9t.t set- 1.0 0 18)1
❑ 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 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
becom- stect to the workers' compensation provisions of Section 3700 of Applicant's Signature Date
the L. .. de,I sh. rt •'th comply with these provisions.
/ 0_8-Fe Division of Industrial Safety Permit Number:
Apptita s gnalure —- °' Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
C 1. Will the applicant orbuilding occupant•G: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE PP present or future occu ant 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 El No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force a d effect. _ 2 a registration form for acutely hazardous materials? ID Yes ID No
Licr#-®$ S:l i (-Class# -_CJ (Section 25533 of the California Health and Safety Code, with some
_o,/r 2e-f_i texceptions, requires registration with the Costa Mesa Fire Department by
_ /� (J` w(i each business which at any one time has on hand a quantity of acutely
---Con C.w's Signature Date : - hazardous materials equal to or greater than a weight of 500 pounds, or a
r�
C.
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONST• CTIO LENDING AGENCY: temperature and pressure).
El 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)? IDYes ❑ 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 Safety Code been fully complied with? ❑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 ❑ 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
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? El Yes ❑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: I
a contractOr(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
•
❑ 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.
.iggnat ,AI Owners) D to � -
Signature Date
ams]-a613/0]) —Andlopp _tnorized Applicant __ - L-Date��G
{
w• CITY OF COSTA MESA
•>;r' r•11 BUILDING DIVISION ��
FI' "" "' ' DEVELOPMENT SERVICES DEPARTMENT
4PERMIT ERMIT NUMBER
Ittw,thiarso;#.1 P98-00611
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1190 GLENEAGLES TR Status: ISSUED
Suite No Applied: 08/04/1998
Issued: 08/04/1998
Vicinity:
Parcel Nunmber: 42233108 - • .
Applicant NOCK, RON
•
Address:
'` `- Phone:
, Zip: .
N' 1 i --- /
Owner: /CHAT,�GENE�E <_
Address/,l/ 90 GLENEAGLE TER'` ' • \,✓ \\:c
/I/
%7//K ' Phone: .` .� ! N-i .\,
E /i _
��� COSTA MESA;CA;' � Zip: 92627 ���� '., � '�- \�
!l/ //�i .;,,Nv
Contractor.'c NOCK:PLUMBING F
/1n �s I Orin ..-
Address:-,./ 11612 KNOTT ST iy,, ; A
/ lit r J„./N - �, , - t �'���
n/ / `-, j,,,c / i' a 1 ,,,Phone •7148951246 "I ,�\
�4 i /C�1 /GARDEN GROVE -CA t -- ;-'Zip .92841 i '
( �i i </N / . ,‘ l
1:0'l _ J 1% d ✓- / ,. t‘'.
_ -License:` 707775• _ _ �,
-A'Arch/Eng °-- ,\
Address ,,) , \ 1
' ,V: t/ ' t I // Phone:. _ / .' , ,
�! :!:/,,= r < , Zip a
\s' _ iii i, I - =--License: _ n
�\N\t V -- Vvk:V r.( , SCOPE OF PERMIT �• .
‘\'\‘ ,••• \VINSTDISHWASHER- -, .- -t ' - j Ai'
V11 • ' \ti, -
\` FEE SUMMARY
\}.,\\ c\� A V\\AMT QTY AMT QTY AMT QTY
ISSUE FEE\ \\,..--- $22:00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation^' $0:00, 0 ' Landscape Irrigation _ $0.00 0 Swimming.Pool '.J /x$0.00 0
kfl
Bacow Preventer $6.00.>„,:, 0 P-Trap '.et •$0.00 0 Trap.Primer /X;,$0.00 0
Bathtub A.�v t"7 $0 00A,'*�' ) Pressure'Regulator i- 'i $0.00 0 Urinal , _ / ' $0.00 0
Clarifier System,AN $0 00 0\ .-.i. Process Piping(per10,ft)- ,$0.00 . 0 „-Vacuum Brkr Bkflow(1?4), $0.00 0
Connect(Ice,Soda,etc) $0.00, A0� , ecReceptors Y r $0.00 0' .J'Vacuum Bikr Bkflow(5+)/ $0.00 0
Dental Units \ <$0.00,,. 0` ,Septic Tanky .:`,,',2, .$0.00 0 -7,.: '-/-Wash Basin / 'I $0.00 0
i
Dishwasher �., $8.75`x, 1 :-.-Sewer Cap m
for Deo.- $0.00 0 - Wash Basin Set_i $0.00 0
Drain,Floor Ac,'>$0.00"/,/Cl-',- -Sewer Connect _'$0.00 0 Waste:andVent System $0.00 0
Drain,Rainwater \ $0.00 .0'. N, 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 ' r /\ ' Sink,bar , ‘, $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 ` 0- .` Sink,commercial $0.00 0 Wafer-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,kitchens., ., .$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 $0.00 0 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: $30.75
COMMENTS/SPECIAL CONDITIONS SV
0°
lass
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.
1
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
DECLARATIONS r )
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
ork for which this permit is issued.
Jar I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'comper}{etiop Insur_an/�a p'V policy number are: Policy
5 VYo
Canter: /V't�� '(/ ( Poli Number.
(This section need f be completed if the perngit is valued at one hundred dollars($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 become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor C999ddda,I shall forthwith
oomph/with thesepro 91
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOUARE($100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECRON 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed uncle provi on5 Qf C ter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
• force effect.Lic.N ! '-/1 Class p �'
Contractor's •-Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction tending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Data:
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).):
❑ 1,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 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:
❑ 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,lalsework,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).
❑ 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 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 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 Califomia 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 a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0No
(Section 65850.2 of the California Government Code requires that the requested information be fumished 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? ❑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 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.
SIgtre Of k:Ann& r Authorized Applicant Date
CODE 6 INSPECTIONtYE DATE IM81..5 SiQLE1 I6SPFm1ON TYPE PATE MEALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical ', /',,,,
1266 Pool Spa Final 208 Final Plumbing j-eT -' v 1y n.) `)
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
2446-46
Oil
, n CITY OF COSTA MESA - '
t . BUILDING DIVISION •
F4 `Trernr Ii 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
vq, FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBS BC07-00409
PERMIT TYPE: B_COMBO STATUS: ISSUED
Sub Type: RES_RRIP DATE ISSUED: 12/03/2007
ISSUED BY: BJK
JOB ADDRESS: 1190 GLENEAGLES'TR CM ''Suite/Unit:
APN: 42233108 _, -_ -Zoning: - i. _
Vicinity: BATHROOM Primary Oc : .'
Const Type: V-N .,,y,- SO FT 88 ' 'valuation: $10,000.00
SCOPE OF WORK: 88SF REMODEL OF•ANEXISTING BATHROOM IN A SFD. WORK-INCLUDES REMOVAL OF TUB/SHOWER
WITH THE INSTALLATION OF A SEPARATE TUB&SHOWER WITH TILING, 1 WASH BASIN, 1 WATER PIPING. ELEC: 3 LIGHT
FIXTURES, 2 OUTLETS, 3'SWITCHESY,!'
OWNER: HECKROTTE,ROBERTP r Address:' 6132 EAGLECREST DR
- - Unit:
•
Phone: - - -.City/State/Zip: "HUNTINGTON BEACH,CA
APPLICANT: HECKROTTE, ROBERT, _ Address: 1190 GLENEAGLE TR ii:' Unit: :
Phone: NO TELE i -- - City/State/zZip: COSTA MESA,CA
CONTRACTOR: OWNER-BUILDER . - -. . - - . . . License.No. 000000 -
Phone: Ih0yii, Address: Unit F
i
Cell: -:-City/State: - _ . -ZipCode
ARCHITECT: -- License No.
ENGINEER: License No. - - -PHONE:
.COMBINTATION PERMIT FEE`SUMMARY, -
Building Plan Check: - .$0:00-
Building Fees: $18125,'
Electrical Fees: $32 30
Mechanical Fees: .,t - $0.00-T- - ''l -I`
Plumbing Fees: $$2 00 -
SMIP Residential: - •-•,••, "$1.00,..';
SMIP Commercial: •"j '$0.00 - .
TOTAL FEES: $277.25
"Refer to fee receipts for all fees paid for project
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 S. INSPECTION TYPE DATE INITIALS CODEC INSPECTION TYPE DATE INTITIALS
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 Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign - 222 Final Site /�) ] �j
204 Final Demolition y,M T,250 Final Building/Occupanc //' rtirc JsAjt.(,W:
r
IDWORKERS'COMPENSATION DECLARATIO AOwner ID verified by dri). .u. Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: (/� ,.,n,
Drivers License � Expires:� ���/�/
0 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.
❑ 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 ❑ 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 section need not be completed if the perms(is valued at one hundred dollars($700)orless)
2,Art 2,Sec.341,Title 6,Califomia Administrative Code).
Poli Number:
0 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 Safety,as noted above,unless
ssued, 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.
Poli
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 Cod al forth h m with these provisions.
6 T"�r Division of Industrial Safety Permit Number:
�� ��/ 7
Ap s ignaturE Dae 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 California 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 in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No
Lic.# Class# (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
Contractor's Signature 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)? CIYes IDNo
(Section 25534 of the Califomia Health and Safety Code provides that the
Lender's Address: Costa Mesa Fire Department may require the preparation, certification and
::4rct.- filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
Signature wnl'Date.
M' f`, V;' ' 4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: .LL:=g`;;-t, Health and Safety Code been fully complied with? ❑Yes ❑ No
I hereby affirm that under penalty of:perjury that Lain 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. dernolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia 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 Laiv.(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? ❑Yes ❑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
mpensation, 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? ❑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: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
CI 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 p rposes. I agree not to ccupy r Ilow occupancy of any building
author ed this p n tl fina nspec
; � 9i-lN 3I�1(7a 7 /(•�/v�} 3 /21-R707
] SignoE f lens) Date
gn turn Date
305]46(3/0])
And/or Authorized Applicant Date
/6010-7-4#4-- CITY OF COSTA MESA
c.„...._
^ P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
10,4 T'
o,;
07 DEVELOPMENT SERVICES DEPARTMENT •
NC9-!eORF1p$'',•
New State Law:
Swimming Pool Safety Act of 2006 (Assembly Bill 2977)
Effective January 1, 2007
California Health and Safety Code Section 115928 "(d) Whenever a building permit is issued
for the remodel or modification of a single family home with an existing swimming pool,
toddler pool, or spa, the permit shall require that the suction outlet of the existing swimming
• pool, toddler pool, or spa be upgraded so as to be equipped with an anti-entrapment cover
meeting the current standards of the American Society for Testing and Materials (ASTM) or
the American Society of Mechanical Engineers (ASME)." Al
// 90 b�% , — e /x—
Address/Permit Number
Permit Applicant or Contractor's Affidavit (Please check appropriate box):
There is an existing swimming pool, spa, or toddler pool on this property. I will
install an anti-entrapment device that conforms to this law, and I understand that the
installation of this device is required prior to final building inspection approval.
There is no swimming pool, spa, or toddler pool on this property.
�
E�2T �.L2AAPTTir
ame please print)
ignature/Date
•
Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245
FAX(714)754-4856 • TDD(714)754-5244 • www.ci.cosla-mesa.ca.us
ii
3.31,2 psign0737 4/05/05 3.Se33 ;'
Applicant to fill in all spaces except those within heavy border lines and all appropriate declarations. cr1
• CITY'OF COSTA MESA - , -' P MIT NO. - - TRACT NO. 'LOT NO. - BLD -N . -' - 1,. L
CONSTRUCTION PERMIT : JOB_ #,3362 • — 3d I I
\ Project Address: • ! _ . L- - '. . ' •TYPE OF CONSTRUCTION ' -H NEW HADD-❑.ALTERATION-- `. REPAIR • - - '
Applicants Mailing Address ii;IL). Dupon Drive,/. •
_ ❑ CONVERSION LI DEMOLISH. ❑ OTHER S - A.P.# _ Zone .
I;zeIle:Ct)dl n a DESCRIPTION• OF WORK _ _e _ •- - _ - -
Owner's Nome - 'Phone 1030 A 3409 , - ' ` '- '- -S Main Building. .. Accessory Building. Z
Address,- 1190 Gleneagles Terrace Costa Mesa E o
. , .. _ i ' TYPE OF PERMIT- . ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T. Front .. _ N
Afch/Eng." - License No. • _ • r❑4 TENANT 'III ❑ PLUMBING. ❑ MECHANICAL B •Rear • - +
Address > , t=r CoTHER I-POofing ' .. -
` _ A - N
' • CAL-PAC ROOFING 'INC. - 978-2668 PROJECT DESCRIPTION: 50: FT.3600 OCCUPANCY C Right -
.Contractor s Name r Phone : •, ., - _ _ R
K Left
r AddressI mailing) 2220 S. Dupont Dr3Ve ;Anahe1R1) CA = - ,C O N ST RUCTION TYPE ' VALUATION $ S�ANN�N:- $ .•. -
027633• ' ( _ ZONE GRADING CU.YDS. 'ACRES ping;Ref.# I Park:Fees $, s • .. U
City+License No. .. i.-
NO LICENSED CONTRACTOR DECLARATION - 1 Remarks: I - ' - Parking Req./Provided
osoI hereby affirm that I.am licensed under provisions of•Charter 9(commencing - - - - - - R
with section 7000) of Division 3 of the.Business and Professions Code,and I (. :Use'of Building: I , •_-'I`: E
my license,is in full force and effect. , I 1 - - - - - •
1 bicense CJa • C Li` n., No. �wr�� • • _ , PLUMBING , , ' - , FEES Planning Notes: j , _ . E
Date • 4 e Signatur./AW'i.. A -�_i..�-h1�ie' . . i
i , Bar Sink Showers . _ i ' '. •
N i
WORKERS'COMPENSATION DE LARATIONr , T
hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink• , i-
P Workers'-Compensation Insurance;or a-certified copy thereof (Section- •••-' - . • - -- -- - - - -- - --- - - - :-- - _ ,
\V. 4800, Lab- C,) ' - 1 i_ , Backflow Irrigation , Sewer Cap i I ELECTRICAL 'tr..' ` FEES
- N. Policy hio. RCS `J 37 6 i company loyal Ins' CO 1
Certified copy is hereby furnished. • i - ' Bathtubs' ' , 1 Sewer Connection I. -Automatic Washer •Transformer ❑ 15 50 KW
Certified Copy is filed with the city iv role _ p i I � b 0 50+KW , ( r
Date 1 1 85 - Applfce YAC/ , Clarifiers i• I Solar Collectors ,, Construction Pole Sub !' r
-EXEM TI N FROM WORKERS'eCO P NSATION'OECeARATION••-• • •-I -->. Dishwasher',`-- -- `. , - - Solar Piping �- , '(' --s ' "- -' Cookm Unit 'Meter' Oup t0•1001amps' • - '
(This section need not be completed if the permit Is for;one hundred ($100)or 9 t ,� •rV ,
less), , . ; i I i i ,. j ...i,
I all,not ''in the performance of the work for,which this peruR isji55uetl I ! Drinking Fountains • ,1 Solar Tank . ' ' I' 1 Dishwasher I r- I .Meter Dover 100 amps(
shall.not employ any person in any manner so:as to become subject to the , - , ,•
Workers' Compensation,Laws of California. ,, j= Floor Drains;' Swimming Pool w/Spa Dryers OGasf OElectric, Sub Panel', 1 ••'
Date • '. ' Signature ' I '
NOTICE: If,after makin this declaration, you should'become subject to the I Floor Sinks I. 1 Urinal I Fan! ! I
Workers'-Compensation'
provisions-of The Labor.Code;"you must forthwith ' I - '" - --- - - - - .--- -- _ - • I :Motors 041 HP X1/:8 _
. comply ' permit Shall ,be:deemed revoked. I' '. Gas Service 'Outlets' .. + Water Closet' I F.A.U," ' • Inc.Solar 09-15 HP 016-15+ `
.witT such,ENDllons. or •this,.pe
CONSTRUCTION LENDING AG ENCY� I ' '- + ' - - I i
1 hereby affirm that thereis a construction lending agency for the performance - = Interce tors; ' - Water,Heater I - Fixtures ' - I •
'of the.,work rfor 'which- this; permit..:Is issued (Section :3097 Civ. IC.) • p - '• - • I •- ,. ',Microwave ,
Lenders Name l - 1 '- - •9 , ' - , _ -
• Kitchen Sink 'Water Service i ,
Lentler's lid dress - _' ' •- - i f- - - - •� Device Boxes .Pole-Light I f
OWNER BUILDER DECLARATION , : •> Lavatories ' ' ' • `r: i." ! -J V,- i I _ s-' Outlets ' - I •Range -
I hereby;affirm:that I am:exempt from the Contractor's License Law for the - - •
.following reason (Section.7031',5 Business and,Professional'Code: Any city or P,Trap -- i": r,_ _ i _ _ - Switches, Y ) .Sign i
county which requires a permittoconstruct,alter,Improve,demolish or:repair . ' -
:any structure; prior to its issuance, also requires theapplicant for such permit (Roof Drains - - - .a ry ' • 1' - Garbage Disposal , Standing�Sections -
• to file a'signed statement;that,he/she,is licensed pursuant to the provisions of ' - 1 - ' " - - - I
,the Contractors License Law(Chapter 9(commencing with.Section 7000)of. - ' ' .. ,i, „ - ! ' i - _ _ •
'Division.3-.of the Business and Professions Code)/or that he/she is exempt ,', i is ; _ - - Generator 00.5 KW 05-15'KW 'j Trash Compactor ; l i
'herefrom and the basis for alleged exemption. Any violation of Section - . ' - • , - .—. -
703115 by.any-applicant-for"al permit subjects the}applicant to.'a civil .Reins coon-Fee - - •
enalty of not more than five hundred dollars($500). - i pe - ,I •$251 Issue Fee ' '�- $ 3 - - i
,LJ 1;'as:owner of the=property,or my employees.with wages as t •
heir sole - 'Reinspection Fee i $25 •Issue Feel
compensation, will=do the work,and the"structure is not intended or offered t 4 , - 14 5 _ . et. . • ; t i MECHANICAL I I .- II FEES
for sale (Section ;7044, Business and, Professionab Code: The Contractor's - - - - : _ - _ PUBLIC SERVICES REQUIREMENTS: - ' 1, _
License Law does not apply to an.owner of a property who builds or improves , Boiler t r ' 1 - Hood or- Type I 1 0 I C' ' ' " • I n . I ^I ' .
thereon;and iwho.does such work himself/herself or through his or her own r e ` • - ^ - i Zoning Approved By - Date
employees, provided that such:improvements are not intended or offered for • Canopy • 'Type II; ❑ j . , -
sale. If, however, the building or Improvement is'sold within one year of com- Duch Under Ground i • - Application A
P Y PPApproved By i• • ) Date I / • l;
' pletion, the owner will-havelthe burden of proving he/she did not build or,im- ( j !1�, • /,lZ-/�j"
tmrove:for the purpose of sale). ; : I Duct-Structural (• { Refrigeration System Application Issued By__ '/CEJ 1 • Date
LJ I,as owner of the property, am exclusively contracting-with licensed con- . -
tractors to construct the project (Section 7044,Business and Professions Code: I ' Duct-Ventilating• i i 00-100,000 BTU 0100,000 BTU • -. : SUMMARY OF FEES '
The Contractor's-License Law does not apply to an owner.of property who--, 50
4 .
builds or improves thereon, and who contracts for such projects with a con ' Exhaust System ❑ Multiple 0. System Repair/Alteration •
• - BUILDING PERMIT $ • 36.00 $MIP $ _
tractor(s) license pursuant to the Contractor's License Law): - PLAN CHECK $ PERMIT •i
0'I am exempt under Section B.& P.C.for this reason I Firepl/Fact.Bit. ICBO:# ' PLUMBING $ I ISSUANCE $ -
- - Heating System& Ducting -; ' PLAN CHECK $ ENERGVP.C. ; $
Date I' " t Owner' '
. - I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BTL i ' GRADING I,.
-information is correct. I agree to comply with all city and'county ordinances - ' - . - ' ' ' - -- _ ELECTRICAL $ - $
andr.state laws relating ito building construction, and hereby authorize repre- . . - - PLAN CHECK $ MICROFILM ' $ '
sentatives of his' city. to' -nte poEn`)�he aabbovve-m"e_ntiooned ,property for ' '
iins9Pec�tl-on ;+1,:.: v , '(7y1 %GC:/�" `�C..Dete 4/1/85 - MECHANICAL $ TOTAL FEE $ •36.50 '
Drivers' •cense . SS Reinspection Fee • I $251, Issue Fee • ' l• $ 3 PLAN CHECK $ - - •
'CMF s:65-46 rev.'7/83 ' White-Building;Canary -Applicant;Pink-Accounting;Goldenrod -Assessor - i ` , - , - -- -- . . . - . . . . , . . .- . . 1 .
_
' CONSTRUCTION AND PLANNING ' ` - - - - - - POOL .,SPA-.-
Date- Inspector•: _ •- Date Inspector
APPROVALS _ Permit# - .: - :. • rAPPROVALS '. Permit#
':1.'Temporary Electrical Service or Pole • - - - - 52. Pool & Equipment Location ' 1 . . .
▪ ...'2., Soil-Pipe-Undrgrnd. , • :.53.'_Steel;Reinforcement=. -r '
•
• ' 3. Electrical Conduit Utility-Undrgrnd i - - •, : .54. Form; '''L
-4. Electrical Conduit-Undrgrnd. - n 55. Electrical'Bonding -• .;:• • '
.5.. Steel Reinforcement _ -56.-,Rough Plumbing& Pressure.Test: .•
•6: Electrical UFER Grnd. • • - - , 57....APPROVAL TO COVER--GUNITE ,, ' .
. 7. Footings _ 58._Electrical,ConduitUndrgrnd.=, -: .
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.• Sewer Cap63. Heater &.Vent=Final-
13. Roof Drains , , . - _ _ 64. Plumbing'System-;Final`- '
•-
•
14: Rough Plumbing ' - - 65. Electrical-Final . .4 '
`15=,-Rough Electrical-Conduit.• --_ - - ,---1 -Ti j - 66. -Solar-System:Final; - `-- ; ,
• - 16, Rough Electric Wiring : -i r. - _ , 67..Fencing &Access Approval c'•-
17'. Rough Wiring Sign. I 68. APPROVED'FOR.PLASTERING . ,
18.. Rough.Electrical- Bar Ceiling , It i - • , 69.'POOL/SPA SYSTEMS FINAL . ,
19. Rough Heating & Ail- Conditioning ' - , ' FIRE DEPT.REQUIREMENT, - '
20. Rough Factory Fireplace ; APPROVALS .' Permit# ' ` - .
21. Ducts, in Structure i ' • I I 70. Underground Hydro ,
22. Ducts, Ventilating ' ,. • I , , • 71. Product Piping 0 Gash •0 Oil : i -
23. Gas Pipe-Rough &Test ', ;,. , 1 , 72. Underground Flush _
24. Roof Framing - - :73.,Undergrnd.Storage Tank'0Gas 0Oil
25. Roof Sheathing _ ` 74. ,Overhead Hydro - ' - .
26. T-Bar Ceiling (Structural) & Monocoat. - 75...Dry'Chemical: d , '
27: Frame and Flashing • '; . ' ' , • - 76. Dry�Standpipe _ •, ;
28'' Lathing &'Siding? : , yl r- ' ' ' 1 • 77. FIXEDISYSTEM FINAL ' .
•
29. Insulation ' • j 78. FIRE PRE,V. FINAL '
. 30. Drywall Nailing. , I i HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ,1 I , j 79. FINAL'INSPECTION - '
• 32. Electrical Power Meter-Final+ , " ' i , � ; ; ; 80. FOOD CERTIFICATE ISSUED , . : '
33: Final Electric I . ' • , Notes:
34. Final Heating & Air Conditioning_ ', I ,
35. Final Gas Pipe-Test, • i _ -
36. Hood or Canopy , : -
37. Final Factory Fireplace ; . ! ' i ( ! - - _ -
38. Final Plumbing i ! I , i -:. I ! t,•
39. Water Service-Final ' ' ' ' 1 ' ' - - .-
40. Gas Service•Final 1 I ! ! I 1 , 1 , -
1
I
41: Solar Domestic-Final ` ' • ; ^ ; F 1 '
42. Backflow Preventer 1 ' I ' ,- ' "; : ' ,
43. Backflow Irrigation ,, ' r• ; :, _ I - < i ,,
44. Landscape Irrigation System _ - - Ii 4. I:
45. Sound Attenuation , ' , i t ' I i + I -
•
46. Handicap Regulations I i " E ' '' ! 1 • i1 - • , : ..--, ' _
47. FINALSTRUCTURE & BUILDING ,seifj1 , r ' ' ; ,
48. Special Requirements Completed • , ' • • -
49. Electric,$eleaseto Edison --,-- i i-- -•'-• • .; ,
50. Gas Release to Southern California Gas Co 1;.!;, : • ' ; ' j
51. CERTIFICATE OF,OCCUPANCY'.-- _ -' ' -_-_ " . - !- . - - ' '
No. ' n - Date ...,r.- ,. ., : , . ; . ,
OWNER LANCASTER, John T. DATE 11-2-62
JOB ADDRESS 1190 Gleneagles Terrace BUILDING PERMIT NO. 18031
GUNERAL CONTRACTOR John E. Backman Co. VALUE $ 22,365.00
:0.115-631-08 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Res.w/att.gar.
INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-1 ib2'ZWy
Soil �'/-f /7-2-4- :„..0r-' _ PERMITS ISSUED
Gas L ,� SUBCONTRACTOR .DATE NUMBER
Water �� 7/�ff Jam'/ � _it. i .
Rough om. Refrig. ❑ Air on ❑ 1 /t��� .r,--
Rough
Rough Heating 1=-/�� f. ,'-", /07-2/LA /6Yo _ —
Rough Plumbing _�' / /_° _ _! /7-45-Cr p��
/- .1-13.9-'.‹;`?".-
Miscellaneous .i/1.1/Mjnirini __ _ _ ic! A 4-9-/0 3e// � �g��
Prop.Swr.Line Li House Con. I St.Swr. ❑ �. j ., • __War /-070= :S__air/_O "l
Sprinklingnuti System
Pole Z7117:7
' p
Construction Pole
Underground 0 Power ❑ _ 71/ �3
Rough Wiring ni; /-//.c 2 jna-e,.�,a.r er.-14-e—r —V is-a7-6v /g149
trenches Ly Forms E' Steel Reinf. ❑K/y(Q V-20- fl-
Floor System .
Bond Beam 0 Steel Reinforce ❑
Sheathing- J( /�
F' and Flashing I L 1 - --1� -(9/70
— In ❑ Out ❑ �jf / 4.
I. .r, brown coat F,---ft 1_ -45:,
Refrig. ❑ Air Cond. ❑ Final
Heating, Final 44t$ 7-1'3
Plumbing Fixtures, Final ,t-q-f-5' 4//12-L'3
- W. 18037FEE CE
IVED
COSTA MESA BUILDING-SAFETY DEPARTMENT 1 C1 2 7962
P. O. BOX 917 COSTA MESA. CALIFORNIA
FINANCE
DEPT
•
For Applicant to Fill In Completely APPLICATION-IFOR FERMITMESA
TY R PRINTBUILDING
BUILDING ��9 _ n_ea s Terrace
ADDRESS
1 COSTA ME . CALIFORNIA For Office Use Only
V k T Lan c ast le I RECEIPT NO. I P1f4
OWNER Q Y1 1 /PER,MJ
MAIL RECEIVED BY DATE RECEIVED I DATE IBSUIT D
ADDRESS 3f y.� BPtt>,.(Alla D, C.Y)') _ D/7 • /O H //-,2 -/a 7/
�l� //�l�� TELm�/a,y� BUILDI G / / `1
CITY GoS/A 44 ca NOAM."DJ 7G7 ADDRESS . [ /J 6[,Q
ARCHITECT /� TEL. " COSTA MESA. CALIFOR
OR ENGINEER 4/0/ye. NO.
FIRE 1
ADDRESS 1 r bb � �) ZONE TYPE
/� GROUP Y
CONTRACTOR JO A •..1 L. /78l.I1�„aT CO •
APPROVED �� i//—f /DATE// 6 411/
ADDRESS f 7e Si w / ! 5J . ZONING U „Vise
ZO111 NO.OF USE OP N' l+ 47
CITY `5pj .. 1,• 091-7.1 ]/ r '�/ // I PLANS •t I BUILDING , 4 p"/�'
LIC.STATE NO./ / / I D5v NO..4/ n �� LEGAL J O I D'" /J 75 3 yo
/oI/0
[n DESCRIPTION7 �[F
SIZE -J C • 0 3 f 0.0 l)- H. OF SLOGS.• /' / Q
OF LOT % 40 1 q7 1) -
. .J / I NOW ON LOT N' AS A.P.NO. // y ' G q ( G /}
USE OF J YARDS EVES
EXISTING BLDG. _AIO NC APPROVED ALLOWED
SETBACK LINE FROM1 / (CENTER LINE BT.)
tin
CENTER OF STREET 6 L! t REAR YARD�T1 G FRONT 5D FT. # j� IN.
SIDE YARD I LEFT c IRIGHT AS i R.SIDE FT. it IN.
DESCRIPTION OF WORK
'/I� L.SIDE 4P FT. IN.
NEW I PHI ALTERATION I II ADDITION I REAR '3... fff) FT. i �T IN.
REPAIR I II MOVING I II DEMOLISH APPROVED 17L---
/�V D DATE 1 0 /Y 'Vj
BUILDING NO. OF / v (}1,4/,
l O
SIZE ROOMS STORIES
EXTERIOR WALL 7��' ROOF C/e�� �
COVERING S/MLGd COVERINGI.Cgd . S�//7!�/C
USE OF BUILDING qND WORK TO BE PERF M iVV
4IP IA) RAS-MIA 71C i W/ REeze
W d. d.-7 CIO w 1j t8 b le a. a_...
20660 44 6›,444, 1.2 ileA7 !
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION �/
THE AMOUNTVALUATIONIF FOR THE
PURPOOSESEOF
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- F SHOWN UNDER ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY N S AND BTA LAWS ¢G LATINO
BUILDING CONSTRUCTION. i[.�ye RR VALUATION �I
SIGNATURE OF E 4����. J PERMIT FEE S 7/1-.00
PERMITTEF jV�� �'���' �C���CCC��ff���KKLL •')� la
N
• / /I MC I $ ^ J(G��O PLAN CHECK $ �'fp7'O qk
AUTHORIZED A T " B G_g/4Ali/G/ % Ol` TOTAL FEE $I0/J ,oD 0
OWNER BACKMAN, John - DATE 4-15-63
JOB ADDRESS 1190 Glenegale Terrace - BUILDING PERMIT NO. 19290
GENERAL CONTRACTOR Distinctive Masonry Co. VALUE $ 737.00
AP No.115-631-08 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Pvt.Blk.Wall
7 nECTIONS Signature DATE GROUP J TYPE - III ZONE R-1
SUBCONTRACTOR PERMITS ISSUED
Gas SUBCONTRACTOR - NUMBER
Water
Rough Com. Refrig. ❑ Air Cond. 0
Rough Heating
' Rough Plumbing
Miscellaneous
Prop.Swr.Line 0 House Con. 0 St.Swr. ❑
Sprinkling System
Construction Pole
Underground 0 Power ❑ -
Rough Wiring / -
Trenches Forms 9 Steel Reinf. Mane.. -
Floor System
Bond Beam 0 Steel Reinforce ❑
Sheathing - -
Frame and Flashing
Lathing — In 0 Out ❑
Pl"4+er, brown coat
. 9 Air Cond. ❑ Final -
1- .ng, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final _
Building, Final l�m - 4,z - n - C
OCCUPANCY
FORM 6114-5M — 7-61 19290
. 19290 E 'E RECEIVED
APO 1
COSTA MESA BUILDING-SAFETY DEPARTMENT 5 1963
P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT,
•
ITY
For Applicant to Fill In Completely APPLICATION FORCPERMIT ��STA MESA
TYPE OR PRINT - BUILDING - '
BUILDING )(/ For Office Use Only
ADDRESS /J /0 el Er F,a7LEC T2.(/PACZ
RECEIPT NO. PE77) c/D
COSTA MESA, CALIFORNIA `��11 77
RHCH �BY OA 7 1 O 3 / ISSU/DJ-
-
�
OWNER SONIN a pc it m4e4
BUILDING
ADDRESS /9/ 9z 'VeoIt'o r e& , ADDRESS
,_- \ FIRE //// y
• TEL. ZONE TYPE . IJ�GROUP CITY is crnv -
APPROVED
ARCHITECT ... FEGr� BY DATE
OR ENGINEER NO.
ZONING r)
ADDRESS
"Judi('
ZO I NO.OF I UBE OF NeW , 1
//�� �� �7 /� PLANS BUILDING �/
CONTRACTOR P/)// keg i-1ia..to iMp, l V ( . -/�. n
0
ADDRESSS ' 4L or N. . /14,13.71//14,13.71/114; JI
CITY DE9cRImoNZ a- �—� - ! 3 /
J_744/1/ZAfyp ` 'n 6'1 A.P.NO. // 6 .t') I — O
- NOTE: NO EAVE STATE �j TEL' r 90"TO SIDE a REAR POVERHANG SHALL BE LESS THAN
LIC.NO, Oto/ 13Thtit,
NO. Tc )39z3
SIZE ,/ !Q�t /a' No,OF BLDG'S.• / EAVES
ALLOWED (U.S.C.REQUIREMENT)
OF LOT 3,O OW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING - ' ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET) //.��
SETBACK LINE FROM FRONT FT. /0 FT. /
CENTER OF STREET REAR YARD i
,I/
SIDE YARD I LEFT I RIGHT • R.SIDE FT. FT. /
/ //
DESCRIPTION OF WORK L.SIDE FT: FT.
NEW X ALTERATION _ ADDITION REAR FT,
DISTANCE BET. BET.MAIN Q '
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
BUILDING VAR.# DATE
SIZE ROOMS STOR E9C.U.P.# ///III APPROVED
EXTERIOR WALL APPROVED( / / A// E" 1 t / j -moi
_ COVERING BY
COVERING A AM
/
USE OF BUILDING AND WORK TO BE PERFORMED DAT
I 7
y " alock wall ' /50' 617 Ni
p � I
O 0 F 34) H 4' 60.FT.. o
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDIN CES AND STATE LAWS REGULATING VALUATION 6 ^ j
BUILDING CONSTRUCTION. //�/�C. N
SIGNATURE OF I. PERMIT FEE $
.PERM ITTEF �R/ �j G
$ / �7'- PLAN CHECK $ a
AUTHORIZED AGENT 4'-
a TOTAL FEE $ 6'
j1OWNER LANCASTER, JOHN DATE 11-1-67
' JOB ADDRESS 1190 Gleneagles Terrace BUILDING PERMIT NO. 27772
v GENERAL CONTRACTOR Kool Metal Awning Co. DESCRIPTION of WORK Aluminum Patio Cover
115-631-08 LOT 29 TRACT 3470 FIRE ZONE VALUE $1,260.00
.CTIONS Signature Dote GROUP 3 TYPE ? ZONE R..-1
PERMITS SUBCONTRACTOR PERMITS ISSUED
GAS - Date Number Signature
WATER - Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE-CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER f
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT I^
J
PLAcTER, BROWN COAT
URAL, FINAL Electric
t. .:, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST ❑
ELECTRIC, FINAL y�/J {/
BUILDING, FINAL 4' „/ e- /e 4 g
7 1
r 27772
:nv I �� I;f, ,00 01 i3.
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA,CALIFORNIA 92620
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUDRILDING For .Office Use Only
ADESS //90G'/eu EA /e. 7r,eAc
RECEI- PT NO.
COSTA MESA. CALIFORNIA 27772
1 RECEIV D BY DATE RECEIVED DATE ISSUED
OWNER ajOIf a) LH 00ns-I-eC (
q A"RE // - /-67
BUILDING //QO /,U
.MAIL S /116 PB _0. te—leKtHGr 8 ZONE y� 3 TYPE �U( GROUP yCITY(InrLA He S � NO.
, 6,y7
APPROVED �f�/ �
� // l"
ARCHITECT TEL BY' f7 ��/ DATE
OR ENGINEER NO. ZONING
7
ADDRESS NO.OP _ / USE of New ✓
Kr
1 (� l/1' 1/ PLANE "�/ BUILDING
CONTRACTOR
GGK r Cit-Pe ! t j Atoninc\ vo • � \ I / /j p 6`:
ADDRESS 30( 6 E )2 t� DESCRIRION L (1 t/ �/% `�QTI 70
CITY ,t 0 Y Cit� efic.h A.P.NO. /IS -10 .1) / _ O O
{i1 ,I NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
r1s%.C_bi-&19 101 IT:::-.HE H -3 11 SO'TO SIDE B REAR p.L.
/ EAVES
SIZE ((t(� )•-03 k JUL(.�3 / I NO.OF BLOWS. ALLOWED (U.B.C.REQUIREMENT)
OF LOTS n (/ 3 V /`7 NOW ON LOT YARDS APPROVED YARDS APPROVED
USE OF Z LI1I/O m MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG jsf
c� (FROM C/LSTRH
SETBACK LINE FROM
CENTER OP DE STREET REAR YARD FRONT d PI'.
SIYARPILEFT I RIGHT R.SIDE /7 FT.L PT.
DESCRIPTION OF WORK ` REAR )-S PT. FT.
, L.BIDE (/3 PT./ PT.
NEW ALTERATION ADDITION
7[
DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGB.
BUILDING 9,�/ y 1 NO OF VAR.# DATE
SIZE ,{ /Q ROOMS I STORIES I C.U.P.# APPROVED
EXTERIOR WALL. i ROOF Q APPROVED ' �Ego ) / 7
COVERING COVERING T( I U m . S7 LN`' /Y� DATE // .i ��(p �/
USE OF BUILDING AND WORK TO SQ PERFORMED V M
N
•9' 1' 7 0 ' A 1 u-m PAA-1 a Q. 0 0 tic
10 RPNC o ^ bk. oa f SQ.FT. 1
I HERESY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE D
AND STATE THAT THE ABOVE.IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION /`-z
BUILDING CONSTRUCTION.II�aL,,� ,(� m PERMIT FEE S 9 V ✓ O
SIGNATURE OP�__1' 'III AQ L[ 1{..I Qp.
PERMITTEE IT'aannnn "1 u tc'ILUAIL�MMRAAA ���/T ^
$/✓I ? O PLAN CHECK S 5C/ w
AUTHORIZED AGENT �j
•,e Ac ':a,;-. ... :w TOTAL FEE $ /3'✓o