HomeMy WebLinkAbout1870 PARKCREST DR - Building Permits •
►L' r • • ^ eITY OF COSTA MESA • r 0 1
4cq BUILDING DIVISION
F i •`".�...__st•
, `al i DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER
PERMIT
at• B04-01614
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1870 PARKCREST DR Status: ISSUED
Suite: Applied: 09/15/2004
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 09/15/2004
Parcel Number: 42431208 Zoning:
Applicant: EARNSHAW, GARRET ISSUED BY: Z/I/A
Address: 4913 ARBOR GLEN WY
Phone: 714-348-0682
OCEANSIDE,CA Zip: 92057
Owner: PENRY, ALVIN BRADLY I '
Address 1870 PARKCREST DR f• •
Phone: n ''l
COSTA MESA,CA Zip: 92627-4533 otr .r�
Contractor: GARRET EARNSHAW CONSTRUCTION • 1%
Address: 4913 ARBOR GLEN WY
Phone: 714-348-0682
" OCEANSIDE,CA
Zip: 92057 License: 840616
Arch : Eng:
Address: - Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE:PITCHED ROOF-T/O EXISTING WOOD SHINGLES,7/16"OSB SHTG, 1 LAYER 15#FELT,
APPLY"30-YEAR COMP SHINGLES." 12 SQUARES - -
FLAT ROOF-T/0 EXISTING B.U.R.AND INSTALL NEW B.U.R.7 SQUARES "
•
FEE SUMMARY
Plan Check: $0.00 - Calc Valuation: $6,000.00
Permit: $125.25 Claim Valuation: $6,000.00
SMTP Res: $0.60
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
•
Total: $125.85 -
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front .0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6N0)
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
((TThiiss�saction need not be completed it the permit is valued at one hundred dollars($100)or less.)
Lq I certify that in the pedormanc. • h o •r whi h this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califo �+a.r'e thaty should become subject to the workers'compensation provisions of Section 3700 of the La r Code,I shall forthwith
. comply with these pr. Psion-. /// L/,!�
Applicant Signature: ,0l a4Y Date: • / /c--0
WARNING:FAILURE TO SECU' •RKE• • PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND IVIL FINES UP TO ONE HUNDRED
LA
THOUSAND DOLRE($100,000),I 1 ADDITION TO THE COST OF COMPENSATION,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 ter prpv ns of Chapter 9(commencing with Section 7000)of Division 3 of the Business d Professions Code,and my license is in full
force and effect.Lic.# Cl 4p Lit
j Class# (I /,
Contractors Signature: _ ..I'r..tTGni Date: 0 '7-/(-^DY
CONSTRUCTION LENDING AGENCY:
O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECIARATIONS:
.,,a n ll I/,,
I hereby affirm that under penalty of perjurythat 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:licerised 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 heor`stie 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).):
T
O I,as owner of the property,or my em.ployees 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 net 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.).
O I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers 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,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).
❑ 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: r
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan tor emergency response to release or threatened release of a hazardous
material? ❑Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with 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? ❑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? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit 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 ❑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 slate 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 inspection purposes,I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
rl •/ Signature Of Legal Owner(s) Date
I ( -K-r /
And/Or Authorized Applicant r Date
CODE I. INSPECTION TYPE WE INTRIALS CODEa l$SPECTION TYPE . PATE INTRIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof .37726 210 Final Electrical
201 Final Block/Retaining Wall t./2l2_✓ /1*-- 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
• PROJECTADDRESS: 1870 PARKCREST DR UNIT: CITY OF COSTA MESA -- BUILDING PERMIT PERM NO: B 049980
OWNER'S NAME: CARL HOFFMAN
ADDRESS: SAME PERMIT NO: B 049980 PLAN CHECK NO: 06720-90 S GOVI : N SUMP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER: • REG.NO.: JOB DESCRIPTION 52LF-6FT HIGH DESIGNED WALL SQ FT: 52
ADDRESS: UNIT:
CLAIM VALUE: 1 , 000. 00 CALC—VALUE: 1, 040. 00 GROUP OCC: M-1 /
PERMITTEE: PICERNE CONSTRUCTION ( 619 ) 431•'3700
ADDRESS: 2386 FARADAY AV 220 COMMENTS: X
CARLSPAI.) CA 92008 **********aF***;'F**+F*R ************OFrF*te*****#aEaF*****RE****>t*TE********+r**EEx**3t>E*)r+F+t*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMEN TS
7000)of Division 3 of the Business and Professions Cade.and my license is in lull force and effect. SETBACKS
CITY LIC.: 050679 sTATEuc.;589295 ��� 'Al
Date: /J //4 Signature: ` MAII BRILDING FTCESSONY EAILDING
PN/ FRNT: FT' IN REAR: FT IN FRNT; FT IN REAR; FT IN
WORKERS'COMPE SAT( NDECLARATION: IherebyaffirmthatIk veacentficateolconsenttoself-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
Compensation Insrlrartct 0,c3tifir9 egpy thereof(Section 38 .Lab.fin
/0 1 /91 91
POLICY NO.: 11 1 LL JJ V 7l/ EXP.DATE:
COMPANY:• STATE PARKING RE • PROV; PARCEL• 42431208 ZNE: R1 REF NO:
Cemhed copy is hereby furnished. C cennied copy is filen• n he city Building Division.
PLANNING N REQ:_
5 2 LF OF 6 FT HIGH BLOCK WALL.
>
Date:
p
/i b Applicant:_ *************3**IE********************3)F*1F******1E***********lf****1E*TETE***3***)f***
DEVELOPMENT SERVICES REQUIREMENTS
EXEMPTION FROM WO ERS'COMPENSATION DECLARATION: (Thi• ection need not be completed if the permit is for one hundred(5100)or less).
I certify that in the performance of the work for which this permi is issued,I shall not employ any person in any manner so as to become ZONING APPROVED BY
subject to the Workers'Compensation Laws of California. C-� DATE: ‘t C.. _ lCe (q n
Dat : Signature; BUILDING APPROVED BY
NOTICE:II,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE:
Code.you must
NGcomply I her such provisions
lbls a consshainending agency o. APPLICATION ISSUED BY: Vjft— DATE• k� 1�p1
CONSTRUCTION LENDING AGENCY: 17ereby affirm that there is a construction lending agency for the performance 01 the work for stat it*'+*�"
which this permit is issued(Section 3097,Civ.C). af)F Kat aE it aF at at at aE 3f It**********************'******** �'******�'****��*****'****�* * ****
LENDER: *********************************************1F***************IF**fE**************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: (hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 7. 00 ,50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN 17. 55
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500).
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I. as owner of the properly or my employees with wages as their sole compensation, wit do the work, and the TOTALS----> 27. 50 0. 00 17. 55 45. 05 45 . 05 . 00
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 45, 05 OVER/SHORT: ,00
improvement is sold within one year 01 completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for the purpose of sale). 27. 00 .. . 50 17, 55
I.as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: The Contractors'State License Law does notapply to an ovmer ofpropeny who builds or improves thereon **, *,**,*,*,*„µ*„x,************************************************************x-***-***
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
mr this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
•
Date: Owner: SFR 52 RES—CONCRETE BLOCK WALL / FT. 20. 00 1 ,040. 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/all not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from
these provisions.
Date'. Applicant'.
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above.mentioned V
property for Inspect n purposes.
Date: // 9 go Signature:_ 01 00074:71—OG0 457,i TOT 45r0
Dover's License or Social Security 02324902 DATE: 11/19/40 TINE: 14(53
1641-46 White—Building,Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
-r
' ' CONSTRUCTION AND PLANNING Pt. & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole_ . • 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ,t' - 53. Steel Reinforcement
.,
1:3.. Electrical Conduit Utility-Undrgrnd: 54. Forms
• 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
. -5. Steel Reinforcement L ,! y/p0 o� 56. Rough Plumbing & Pressure Test 't
- +_6. Electrical UFER Grnd. - / lI/// 57. APPROVAL TO COVER-GUNITE
' 7. Footings _ 1�/t•�ry}o P� 58. Electrical Conduit-Undrgrnd. r
8. Foundation •- 7 _I^ 59. Gas Pipe, O Undrgrnd., Test ,
9. Water Pipe-Undrgrnd. i; ' ,• !- 60. Backwash Lines, P-Trap, 0 Undrgrnd. is•
10. Structural PithSystem
or 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•Eactory Fireplace • APPROVALS= - Permit # •
21. Ducts,in Structure; .. . - . - '70. Underground Hydro
22. Ducts, Ventilating ' ' , t _ •71. Prod uc2'f'_iping O'Gas 0 Oil
23: Gas'PipejRough &Test ! ' s.:. rI r- _• •. .
.. 72. Underground Flush, '
24rRoof Framing k • _ 73. Undergrrid.Storage Tank'0 Gas 0 Oil •
25. Roof Sheathing " t .• - - •74=„Over.head-Hydro-
26.T-Bar Ceiling (Structural) &.Monocoat-' 75, Dry Chemical - - '
27;. Frame and Flashing z., ,.- . 76. DryStandpipe I '
28: Lathing& Siding : 1 r.- .. -...• _ .•. •• 77, FIXED SY,STEM'FINAL
29. Insulation . , •" " ,;IT' ''t I 1, •
I, 78. FIRE PREV. FINAL • . ,
30. Drywall•Nailing I i I: •HEALTH DEPT.'REQUIREMENT
. 31. Plaster Brown Coat I ' I; ,, , 79.• 'FINAL INSPECTION
32. Electrical Power Meter-Final ;}
r. 80: FOOD CERTIFICATE ISSUED
. 33: Final Electric • • ', I I ; _ ' Not+ - ,"` g 4
•34. Final Heating & Air Conditioning. - I �. r , ,z., •
35i•Final Gas PIPe-Test'. _. :' •• '
' _ . '
III •
, 36. Hood or-Canopy • _ _ • -
37. Final Factory Fireplace,
I I• • _It III
_
,:
38._ Final Plumbing ~t ' I I . .
- 39.-Water Service:Final _ ,_ I I I. - : ' '
, 40', Gas Service•F.inal . , - ,.l I�, ,
` 41'.•Solar Domestic-Final`-. - • '- i 1 ' ' ;
• •
42.'Backflow Preventei ,: I I I, , i. '
43. Backf low Irrigation A • ` -
, 44. Landscape Irrigation System •, -. . . + • •- _. ,
45. Sound Attenuation - " . •
•; „ '1 ' , -
46. ,Handicap Regulations - C; •• w '}/ ' _ -, ,
47. FINAL STRUCTURE & BUILDING / an - .'
48. FINAL PLANNING ip I iv i'
. 49: Electric Release to Edison • I I !• .
i;
• 50., Gas Release to Southern California Gas Co r i I j;
'51. CERTIFICATE OA-OCCUPANCY I i , , , ;A • . •
No. Date
CITY OF COSTA MESA REQUI FOR OCCUPANCY
•
TRACT NO, / y7 • DATE �/,7 Z
• •• LOT NO. •
•
•
•
ADDRESS /I/O Lk CSL si
The developer of the above entitled tract desires to sell the
above set forth lot prior to the time that the tract has been
completed and its streets accepted by the City of Costa Mesa .
The undersigned, by executing this agreement, acknowledges
that (he-she-they) 7/1-!-E-c/ (was or were) ex--/ advised
that this tract has not been given final inspection nor has
it been accepted by the City of Costa Mesa as having complied
with the conditions of approval which were imposed by the city
at the time the final tract map was approved.
The city assumes no liability for the enforcement of the condition
necessary for approval other than those conditions protected by
surety bond.
The undersigned agrees to indemnify and hold the city harmless
from any claim resulting in damage or personal injury to the
undersigned by reason of the. aforenenti ed u ompleted condition.
•
•
Pure aser
B& d4K
Deveopez and/or authorize
pre' ��
BY
Lender.
frutz_pcs-G G --
770 nota- /)L .
j.
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. 1061 1 /21 /82 5j.00 TLI
CONSTRUCTION PERMIT /Q '�iQ .. • -
` •
Project Address / 7Tt
1 q Address/X74,)cl��/C/1'/rest- Ur-, ✓G TYPE OF CONSTRUCTION I
k) Owner C- f �4 T�y'1 Ai 0 Phone%s[!!(-79/4 0 NEW 0 ADD 0 ALTERATION 1 /
I Address/120 r,,9 p (7Yy
CST // /✓C 0 REPAIR 0 CONVERSION ❑DEMOLISH �(�j��
Arch/Eng. License No. ❑ OTHER ZONING REGULATIONS
I Address DESCRIPTION OF WORK A.P.#
ZONE PLNG. REF.yp
Contractorrh, 4s-/I PG/H„11111 ilk,Phune47) --3VZ� TYPE OF PERMIT . BUILDING Tp 6t1I L,pING
Address II SETBACK C/L T.
PROPERTY LINE
Ic QQ Lr) ,L./Jet/,f) 0 GRADING 0 FOUNDATION 0 STRUCTURAL S DET YARD
LICENSED CONTRACTOR DECLARATION ❑ TENANT 0 ELECTRICAL %PLUMBING ❑MECHANICAL SIDE YARD
I hereby affirm that I am licensed under provisions of Charter 9(com- RIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER
Professions Code, an my license Is in full force and effect. - REAR YARD(TO P/L)
L�- 3 L• �i14.r7 PROJECT DESCRIPTION
License Class License No.�1-- PKG.SPACE REQ. PROVIDED
Date /- 4/- k: Signature�✓/A-4 --76-7 t • rT //7 -7 SO.FT. STREET WIDTH PARK FEES
WORKERS'COMPENSATION DECLARATION OCCUPANCY ' CONSTRUCTION TYPE
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY I DATE
certificate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS:
-eof(Sect)gP 3 00, Lab. C.). GRADING CU. YDS. _ ACRES
•
y No. //4.1-a 1 Company 7,WLIf//✓ -CC/ S
-ertified copy is hereby furnished. REMARKS:
Certified 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).
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 ELECTRICAL PLAN CHECK
subject to the Workers Compensation Laws of California. UWtLLING GA KAGt
Date Signature BATHTUBS SHOWERS 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- - .
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 (INC.SOLAR) 10-50 HP 50+HP
formance of the work for which this permit is Issued (Section 3097
Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES
Lender's Name _
Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL ' P TRAP • LUNS I KUL I IUry
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 SERVICE OUTLETS SERVICE AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the
r ''ness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT 0.2 D d
for the alleged exemption. Any violation of Section 7031.5 by
applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS '
u. not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS
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 property 4 APPLICATION APPROVED BY DATE
who builds or improves thereon, and who does such work himself or ISSUE FEE
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). BUILDING
❑ I. as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT E SMTP E
AND DUCTING
licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK S. PERMIT Ig=
and Professions Code: The Contractor's License Law does not apply t0Ap ISSUANCE $
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ t.o
tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING S
the Contractor's License Law). 100,000+BTU PLAN CHECK S
❑ I am exempt under Section B.8 P.C.for thisBOILERS BTU ELECTRICAL E $
reason — PLAN CHECK $ MICROFILM S
Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE E
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $
AD-
information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $_
ordinances and state laws relating to construction,and hereby authorize
representatives of this city to enter upon the above mentioned
property for inspection/ p Pbses. - �`
Signature A Pn 7..71",..---e,,,^ Date I-S-/.Z FINAL FEE $ : i"G
Drivers' License or SS* ISSUE FEE
CMF 0865-46 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
j"-- CONSTRUCTION AND PLANNI G POOL& SPA
APPROVALS Permit# 7> 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 58. 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 �yLZJ
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
} r:1025
-, MR 26-71v-ty5�00 674* ***133.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
lot-8 For Applicant to Fill in CompletelyArtRECEI EDBUILDING 1041 � ..-1-a9
B1V1� DATE RECEIVED DATE ISSUEDtt
ADDRESS i $ '_ _ I / _1 1 s i�v- ?/
PERM5AI?
- q
OWNER Imperial Savings & LO gTl. A.P.NO. I Jr.�
ADDRESS 3366 Via Lido.
MAIL
ADDRESS 1870 Parkcrest Dr.
Z
d U CITY Ne$port Beach- TEL.ui L 673-133e. TRACT 7043 LOT 8 BLOCK
ZZ CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOLISH
Z
O- N LENDER Same x
am
J D BRANCH
_1 co OWNER Imperial Savings & Loan
a W ADDRESS
CO J
VALUE, i6
o.0^
J m ARCHITECT R. LevaasOR ENGINEER TNE 17370]0US
Z Q FIRE '7'(�
W2 ADDRESS 3.4,32 Via Oporto,Newport Bch. ZONE TYPE GROUP ¢ �w/I
w 7—VAPPROVED
mO CONTRACTOR Calah Construction Corp- BY ATE
Z r
W w ADDRESS I20 Bir .h Rt. TEL ZONE NO.OF USE OF NEW Sgl ,ham.
Z CITY Newport Beach. NO 1.0-8833 R1 PLANS 2 BUILDING Res/Att.Gar
w O STATE CITY YARDS APPROVED YARDS APPROVED
N CC LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
7 O (FROM C/L$,((STi3EET)
SIZE NO.OF BLDGS. X
OF LOT 50 X 100 NOW ON LOT 0 FRONT FT. FT.
USE OF
EXISTING BLDG. R.SIDE 7 FT. FT. .
I— SIZE OFNO.OF /—
Z NEW BLDG. 16208(1. 1 ROOMS 6 STORIES 2 L.SIDE S FT. FT. _
Q EXTERIOR WALL ROOF / / ,y
V_ COVERING stucco coVERINGshake-comp. REAR 9IJFT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
a
0. • MAIN BLOCS. ACCESS.BLDGS.
''
Q (� VAR.# DATE
1- _ residence 7 'J C.U.P.# APPROVED
v .---APPROVED WLD:am B.YDATE 3-24-71
Z
0
VI hereby acknowledge that I have read this application and state
✓ that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I•" any person in violation of the workman's compensation laws of
the State of California. // m
z I herebycertifythat I am /v �� SO. FT. o
properly licensed as a contractor under
the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UN R VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISH! G A PERMIT FEE ONLY:
am exempt from the provisions of the State of Cal'fornla Business
and Professions C.• , •Iv Ion. , hapter 9. VALUATION 8/. N
PERMIT FEE $ / _ O
Signature . /�/ /�c�{/ v m
Permittee ��//// `��� $ t .s�\ PLAN CHECK $ % . z o
Authorize• •nt -� TOTAL FEE $ 04.8-5/
.