HomeMy WebLinkAbout2072 GOLDENEYE PL - Building Permits CITY OF COSTA MESA
O , , I BUILDING DIVISION
4o,
F l 77 FAIR DRIVE, COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
e. FOR INSPECTIONS CALL: (714)754-5626
"°"""fi PERMIT NUMBER: B10-00173
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 13954320 DATE ISSUED: 06/21/2010
ISSUED BY: KJB
JOB ADDRESS: 2072 GOLDENEYE PL CM Suite/Unit:
Vicinity:
Squares: 3200 Valuation: $18,000.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF.RE-SHEATH ENTIRE ROOF,COVER WITH 50 YEAR COMP.ROOF PITCH IS 4:12.
INCLUDES ATTACHED GARAGE.
OWNER: WIEDEL,THOMAS J Address: 2072 GOLDENEYE PL Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: SANDKAMP,GEORGE Address: 3006 S ORANGE Unit: :
PHONE: 714-542-1742 City/State/Zip: SANTA ANA,CA
CONTRACTOR: SANDKAMP ROOFING License No. 362896
Address: 3006 S ORANGE Unit: PHONE: 714-542-1742
City/State/Zip: SANTA ANA,CA 92707 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $293.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
TOTAL FEES $294.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279
Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays
New Years Day, Memorial Day,Independence Day,Labor Day,Thanksgiving Day and Christmas Day
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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 5, INSPECTION TYPE DATE INIITIALS CODES INSPECTION TYPE DATE INTI11AL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final �L,I//—yam l 208 Final Plumbing
200 Final Re-Roof 6 r/d 4',�VLOV�-1 210 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
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410 11.
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑ No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. f Expires: .,
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership
compensation, as provided for by section 3700 of the Labor Code, for the b Y(type of document,i.e.-property tax bill or deed):
erfo mance 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 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
ry .S-fc.ft `v r'v" or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be completed rf the permit is valued at one hundred dollars($100)or less.) 2 Fut 2,Sec.341,Title 8,California Administrative Code).
tuber: CU/ 9 _
❑ 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
become subject to the workers' compensation provisions of Section 3700 of
Applicants Signature Date
the Labor Code, I shall forthwith comply with these provisions.
C_12, 'C Division of Industrial Safety Permit Number
' rttannsslg Fi.i-- 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 0 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
Lit;-#' 36 2tS q� •ass-#_� C" (Section 25533 of the California Health and Safety Code, with some
M�1 \ exceptions, requires registration with the Costa Mesa Fire Department by
‘.) each business which at any one time has on hand a quantity of acutely
cetaktons iignzwreTr:"' r.5' 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 fa 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 Safety 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 (Section 65850.2 of the Califomia Govemment 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? ❑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 riot 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 contractors)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 to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Signature of Legal Owner(s)
Signature Date /
3057-46(3/07) - "
Autgbriied Appl - t L'"Dale'
t
Prescriptive Certificate of Compliance: Residential • -CF-1R-ALT
Residential Alterations (Page 1 of 5)
Project Nt • te:
IClimate Zone# #of Stories
om W1eJ -1 Le
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KBnGeneral Information
Site Address: 7Godth / Enforcement Agency: Date:
wilding Type L'7 Single Family 0 Multi Family Circle the Front Orientation:N,E,S,W,or degrees
Conditioned Floor Area(CPA): Project Type: 0 Alterations IDEnvelope 0 Fenestration of 0 HVAC
Replacement or Change Out 0 Duct Replacement D'Water Heater
NOTE: This form is not to be used lin Newly Constructed Buildings or Additions
Insulation Values For Opaque Surfaces(/or Furring use the Mass and Furring Strips Construction table below)
Assembly Alteration ,
0 Opening of framed cavity alone-Alterations that involve the opening of the fronted cavity of a wall, ceiling, orfloor must install the
inundatory minimum insulation value per§150 for the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H.
0 Replacement of entire assembly-Replacement of(to entire wall, ceiling,or floor assembly requires the installation of Component
Package-D insulation values in Table 751-C. Fill in Columns A-J. •
Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below.
A 13 C _I D J E - I - F C H . • • .. - l• J
Proposed see Nate Standard Values From JA4 Table
Framing Thickness, Framed Continuous JA4 Proposed
. Tag) Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly
ID' or Type and Size' or Others factor° Number' R-value_ R-Values Cell Values U-factors
Note:For furred assemblies,accountingfoit Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculating furred walls use the Moss and
Furring Cmnstniction table below.
1. For Tag/ID indicate the identification name that matches the building plans.
2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors, Slabs, Crawl Space,Doors and etc...Indicate the Frame type and Size:For
Wood, Metal, Metal Buildings,Mass, enter 2x4, 2x6,or etc... see JA4 for other possible frame type assemblies.
3. Enter the thickness for mass in inches or Spacing between framing members enter; 16•'o'24"OC;or Other for all other assembly description
such as Concrete Sandwich Panel, Spandrel Panel,Logs,Straw Bale Panel and etc....
4. Based on the Climate Zone;enter the Standard U factor from Table 151-B, C or D for each d j[ferent assembly Name or type.
5.Enter the Table number that closely resembles the proposed assembly.
6. Enter die R-value that is being installed in the wall cavity or between the framing;otherwise, enter "0".
7. Enter the Continuous Insulation R-value for the proposed assembly; otherwise, enter "0".
S.Enter the row and column of the U-factor value based on Column F Table Number and enter the Assembly U-facto'in Column J
9.The Proposed Assembly U-factor, Column.1, must be equal to or less than the Standard U-factor in Column E to comply.
Furring Strips Construction Table for Mass Walls Only
A 13 C _ D I E _ F C E I J j K L M
Proposed Properties of Masonry and Concrete Added Interior or Exterior insulation
Walls From Reference in Furring Space from Reference
Joint Appendix Table 4.3.5,4.3.6.4.3.7 Joint Appendix Table 4.3.13
V .c P`+ .1 m U
Assembly o� e `t2 g t- c w W Final
Mass Name or JA4 Table o _ v v c E E o t m _ t P. Assembly
Thickness' Type Number' = �. 5 LL r "_ m r U-factor4' Comment
tt 1 1 I 1 I i
Registration Number: Registration Date/Timm: HERS Provider:
2008 Residential Compliance Forms August 2009
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Prescriptive Certificate of Compliance: Residential CF-1R-ALT
Residential Alterations • (Page 3 of 5) •
Project Name: Climate Zone# (' #of Stories
ROOFING PRODUCTS(COOL ROOFS)§151(n11
When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area,or more than 1,000 ft2, whichever is
less,the new roofing area must meet the roofing product"Cool Roof'requirements of§l52(b)1111,152(b)1Hii,or 152(b)IHiii.
Check applicable alternafve or exception below if the roof alteration is exempt from the roofing product "Cool Roof'requirements.Note:If any
one of the alternatives or exception below is checked,the Aged Solar Reflectance and Thermal Emittance requirements for roofing products in
§118(1)ere not applicable.Do not fill table below.
0 Cool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or2:12 pitch.
ool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less
than 51b/ft2.
Alternatives to§152(b)1Hi and§152(b)Hii,Steep-slope roof(pitch>2:12)
❑ Insulation with a thermal resistance of at least 0.85 hrft2-°F/Bat or at least a 3/4 inch air-space is added to the roof deck
over an attic;or
❑ Existing ducts in the attic are insulated and sealed according to§151(1)10;or •
.❑ In climate zones 10,12 and 13,with I R'-.of free ventilation area of attic ventilation for every 150 112 of attic floor area,and
where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or
❑ Building has at least R-30 ceiling insulation;or
❑ Building has radiant barrier in the attic meeting the requirements of§15102;or
❑ Building has no ducts in the attic;or
❑ In climate zones 10, 11, 13 and 14,R-3 or greater roof deck insulation above vented attic.
Exception to§152(b)1Hiii,Low-slope roof(pitch<2:12)
❑ Building has no ducts in the attic.
Other Exceptions
. ❑Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
0 Roof constructions that have thermal mass over the roof membrane with at least 25 lb/n2 is exempt from the below Cool Roof criteria.
- Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise,
Check the applicable box below if Exempt from the Roofrn Products"Cool Roof"Requirement:
Roof Slope Product Weight Product Aged Solar Thermal
CRRC Product ID Number <_ 2:12 >2:12 < 51b/ft2 >_ 51b/ft2 Type2 Reflectance3'4 Emittance SRIs
❑ ❑ ❑ ❑ ❑4
❑ ❑ 0 0 ❑4
❑ ❑ ❑ ❑ ❑4
❑ ❑ ❑ ❑ ❑4
❑ ❑ 0 0 ❑4
1. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolrooTs.ors/products/search.ohn
2.Indicate the type of product is being used for the roof top.i.e.single-ply roof asphalt roof metal roof etc.
3. If the Aged Reflectance is not available imthe Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the sante
directory and use the equation(0.2+0.7(pi„roar—0.2)to obtain a calculated aged value. Where pis the Initial Solar Reflectance.
4.Check bon if the Aged Reflectance is a calculated value using the equation above.
5. Calculate the SRI value by using the SRI- Worksheet at hits://www.enerrv.ea.snv/title24/mid enter the resulting value in the SRI Column above and attach acopy of
the SRI-Worksheet to the CF-111.
To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recommended by the coatings manufacturer and meet minimum performance requirements listed in §1180)4. Select the applicable coating:
❑ Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other
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Registration Number: Registration Date/Time: PIERS Provider:
• 2008 Residential Compliance Forms • August 2009
Prescriptive Certificate of Compliance: Residential CF-]R-ALT
_Residential Alteration& (Page 5 of 5)
, - Project Name: Climate Zone.# ( ^ I *of Stories
HERS VERIFICATION SUMMARY The enforcement agency should par special attention to the HERS Measures specified to this
checklist below. A completed and signed CF-4R Farm,for all the measures specified shall be submitted to the building inspector before final
_inspection.
Duct Sealing & Testing HERS verification is required for this measure.
0 YES 0 NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement ducts are installed in unconditioned
space,the ducts are to be sealed per§152(b)1Dii and the newly installed ducts are to be insulated pet §151(1)10.
O EXCEPTION: Existing duct systems that are extended, which are constructed,insulated or sealed with asbestos.
O YES ❑ NO YES:In Climate Zones 2 and 9-16,if the existing space-conditioning system(HVAC equipment and ducting)is replaced,the
ducts are to be sealed per§152(b)1 Di. •
0 YES 0 NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced(including the replacement of the air handler,
outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be
sealed pet §152(b)IE.
❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS
• verification in accordance with procedures in the Reference Residential Appendix RA3.
❑ EXCEPTION:Duet systems with less that 40 linear feet in unconditioned space. -
❑ EXCEPTION: Existing duct systems constructed,insulated or sealed with asbestos.
Refrigerant Charge- Split System HERS verification is required for this measure.
❑YES 0 NO YES:In Climate Zones 2 and 8-1 5,when the existing HVAC equipment is replaced(including the replacement of the air
handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil, or the furnace heat
exchanger)a refrigerant charge measurement shall be verified per§152(b)1F.
Central Fan Integrated (CFI)Ventilation System and Fan 'Watt Draw
The ventilation requirements of 8l50(o)do not apply in existing residential homes.
Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required tSr'this measure.
- 0 YES 0 NO YES:In Climate Zones 10 through 15.when the existing space-conditioning system(HVAC equipment and ducting)is
replaced.the airflow and fan watt draw shall be verified ner§152(b)ICi to meet the requirements of*1 S?(f)7B.
Documentation Author's Declaration Statement
• I certify that-this Certificate of Compliance documentation is accurate and comolete.
Name: clSignature:
eorei e 50. vtcike.-k-ft0
Company: Date:
SAnCIkan )7 1004 no, CO -21 - /
Address: If Applicable D CEA or 0 CEPE
\\ef30 0 s 0 a2 -�ct�— ,
ty/State/Zip: C� Li CPhone:
Jo- -f& Ano. - • g2707 7J'/ -69 2--17Y2
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Responsible Building Designer's Declaration Statement
• I am eligible undo Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on
this Certificate of Compliance.
• 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform
to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations.
• The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this
building design on the other applicable compliance 'arms,worksheets,calculations,plans and specifications submitted to the enforcement
agency for approval with this building permit application.
Name: t Signature:
Company: Date:
Address: • License:
City/State/Zip: I Phone:
Fpr ussisttmec nr questitms regarding the Energy Standards, contact the Energy Hotline at J-800-772-331/11.
Regtstrwion Number': Registration Date/Time: HERS Provider:
2008 Residential Compliance Forms A ugust 2009
Applicant to fill In airspaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMITNO. "� TRACT NO. LOT NO. BLDG.NO.
CONSTRUCTION PERMIT - /9zy 9028 12/03/BI 6_.00 TIN
Project Address 2.e7! , nLd.D_t -e-Y ` TYPE OF CONSTRUCTION ^
Owner S±4.4r 11,QN J1rs'-f c Phone94(..d9r7 0 NEW 0 ADD 0 ALTERATION C^
Address '--J 0 REPAIR 0 CONVERSION ❑DEMOLISH (J —
Arch/Eng. License No. 0 OTHER ZONING REGULATIONS
Address DESCRIPTION OF WORK A.P.
*
q ZONE PLNTG.. gR UEF..p'+
Contractor, Jr PhoneS.3l-�/ J' TYPE OF PERMIT BUILDING P ROPEY RI/NLINE
Address 7 Le,/ 0 M „ri+�
SETBACK D/L ST.
0 GRADING 0 FOUNDATION 0STRUCTURAL SIDE YARD
LICENSED CONTRACTOR DECLA R'R'FION ❑TENANT 0 ELECTRICAL LUMBING OMECHANICAL LFE YARD
I hereby affirm that I am licensed under provisions of Charter 9 (com- RIIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER
Professions Code,,sad my license is in full force an afact. REAR YARD(TO P/L)
License Cla�S15 ^ , ense Non^l / PROJECT DESCRIPTION PKG.SPACE REO. PROVIDED
Date 1/-017— l Signature \, .;-'7-11 SQ.FT.
WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE$
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY DATE
certificate of Workers' Compensation Insurance, op certified COPY
thereof(Section 38_11I0..Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS:
P-'Icy No:,[O `'MI" Company 4-41--44'
ertified copy is hereby furnished. REMARKS:
_ fled copy Is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION '
(This section need not be completed if the permit is for one hundred
($100) or less). A J
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 PLUMBING PLAN CHECK v#, it
ELECTRICAL PLAN CHECK
subject to the Workers Compensation Laws of California. p b UW tLLINb GARAGE
Date Signature BATHTUBS SHOWERS sn aµ+ 50.FT SO FT
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS ., APPLIANCE 10-50 KW_50 + KW
revoked. r
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS + ' (+ MOTORS 0-1 HP 1-10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS , ft (INC.SOLAR) 10-50 HP 50 +HP
formance of the work for which this permit Is Issued (Section 3097CA_&
Civ. C.)C. .s Name FLOOR SINKS FLOOR DRAINS \iv FIXTURES OUTLETS SWITCHES
Lender's Address - - - - DRINKING FOUNTAINS GAS TUBE SIGNS •
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS
I hereby affirm that 1 am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP • - LOINS KUt.I IUN .
Any city or county which requires a permit to construct, alter, POLES METERED SUB
improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION / PANELS MAIN SUB
quires the applicant for such permit to file a signed statement that he
is licensed pursuant to the provisions of the Contractor's License Law GAS a -. OUTLETS SERVICE AMP '
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and the ATER HEATERS BTU OUTPUT !7
b ss for the alleged exemption. Any violation of Section 7031.5 by
a$$rA:,pplicant for a permit subjects the applicant to a civil penalty - - • NECTIONS '
n more than five hundred dollars ($500).
L%.'as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS. \J
sole compensation, will do the work,and the structure Is not Intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE
Contractor's License Law does not apply to an owner of a propertyAPPLICATION APPROVED BY
who builds or improves thereon, and who does such work himself or ISSUE FEE 00 APPLICATION
through his own employees, provided that such improvements are not
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
is sold within one year of completion, the owner will have the burden
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDINGRMIT
❑ I, as owner of the property; am exclusively contracting with AND DUCTING $ SMTP $
licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK SPERMIT r
and Professions Code: The Contractor's License Law does not apply to ` — ISSUANCE $
an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ (o
tracts from such projects'with a contractor(s) licesned pursuant to SYSTEM GRADING $
the Contractor's Ucense Law). 100,000+BTU PLAN CHECK $ "
❑ I am exempt under Section B.& P.C.for thisBOILERS BTU ELECTRICAL $
$
reasonMICROFILM $
Date Owner SYSTEM REPAIR,ALTERATION PLAN CHECK $ TOTAL FEE$
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD-
information is correct. I agree to comply with all city and county PLAN CHECK S VANCE PC
repres nta and state laws relating to construction,r and hereby authorize
ordinancesivgs of t s relyy to on r upon the above mentionedh
property forrivetn purpos .
Signature J 6r. ----n-7----n-7 'Date(// e/qq
—k •
FINAL FEE S
Drivers' License or SS t ISSUE FEE
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNI uPOOL&SPA
APPROVALS Permit# 9�` 1 Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil Pipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
5. Steel Reinforce 47. Rough Plumbing& Pressure Test
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test
9. Water Pipe-Undrgrn •
51. Backwash Lines.P-Trap, ❑ Undrgrn
10. Structural Floor System 52. APPROVAL TO DECK
11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final
12. Street Sewer Connection 54. Heater & Vent-Final
13. Rough Plumbing 55. Plumbing System -Final
14. Rough Electric-Conduit '56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final
16. Rough Heating & Air Conditioning bB. Fencing & Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathing
22. Frame and Flashing NOTES:
23. Insulation
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning •
30. Final Gas Pipe-Test
31. Final Plumbing WAY e2-
•� t'
32. Water Service-Final
33. Gas Service-Final
34. Solar Domestic-Final
35. Landscape Sprinkling System
36.- Sound Attenuation
37. Handicap Regulations• .
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No Date
28054
. Tf:t2=6106 .466* ***135.75
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA,CALIFORNIA
/
it For Applicant to Fill In Completely APPLICATION FOR PERMIT
TY? 5492 TYPE OR PRINT P1 . 64-AR BUILDING
BUILDINGFor Office Use Only
ADDRESS 2072 Goldeneye Place RECEIPT NO.
COSTA MESA. CALIFORNIA 28054
R[C[I [pElY DATE JAN/--/�O^I6 pr ISSUED
OWNER Mesa Verde Builders
(JY 1 6 �ggg
MAIL o e BUILDING /-/
ADDRESSFIRE
2850 Mesa Verde Drive ADDRES8 0 /D2 �}^ aL
TEL. ZONE TYPE �(�-- GRO T,
CITY Costa Mesa No.5490395 111//////
ARCHITECT TEL. ABYPROVED DATE
OR ENGINEER Kaltenbach NO.a478046
ZONING
Al .55 1823 E . 17th St . S.A. zonaI NO.OF I USE Or NEW Sing!. Fair.
PLANSBUILDING
CONTRACTOR Mesa Verde Builders 2 w/
aft �T
LEGAL
Lot 42, Tract 5492
ADDRESS 2850 Mesa Verde Drive
CITY Costa Mesa, California A.P.NO. none
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.
TNO. 181269 NE o' 549-0395 SO"TO SIDE @REAR P.L.
EAVES
SIZE
OF LOT 66 x 105 I NOW ON LOTNO.OF S O ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM Cf,LSTREET/
SETBACK LINE FROM 4 rlFTFT
CENTER OF STREET 4 52' REAR YARD 32 ' FRONT
SIDE YARD I LEFT 5 I I RIGHT 5 ' R.SIDE ) ET. FT.
DESCRIPTION OF WORK L.SIDE J.. / Fr. Fr.
NEW X ALTERATION _ ADDITION REAR 13! FT. FT.
DISTANCE BET. BET.MAIN @
REF. MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
BUILDING 2163 Sci 1 NO.OF 8 2VAR.$i DATE
SIZE ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALLS
ALL Wood ROOF APPROVED
COVERING LStuc�.' COVERING Wood BY W. L. D. DATE 1-3-68
USE OF BUILDING AND WORK TO BE PERFORMED447
Single Family Residence
£v/ ,9W .
1 v d/(r3BQ.Fr.(//y///�/d o9 �/l o°�io
I HEAHBY AC LEDGE THAT 1 HAV[ READ THIS APPLICATION THE AMOUNT RHQjIN UNDER VALUATION IS FOR THE F
ANO STA CT
137
ABOVE IB CORRHtt AND AGREE TO COM. PURPOSE OF a ABLISMING A PERMIT FEE ONLY. J} O
PLY WI ALL CITY INANC88AND ATE 4"l BB flH -/ VALUATION ��.�(/ B
BUILOI CONS R ION. PERMIT FEE $ n
SIGNATU C
PERMITTEE $[TL�y/,j/ PLAN CHECK $ �`LC"�<J 0
AUTHORIZED AGENT �.I ��/ TOTAL FEE 5�j�7�7v—
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