HomeMy WebLinkAbout1868 PAROS CIR - Building PermitsCITY OF COSTA MESA
��"'"'Fq 1 BUILDING DIVISION
'`� 77 FAIR DRIVE. COSTA MESA, CA 92626 - (714) 754-5273 - Fax (714) 754-4956 • 4,vw.c!.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
°`�°�"° PERMIT NUMBER: BC11-00268
PERMIT TYPE: B_COMBO STATUS: ISSUED F
Sub Type: POOLSPA DATE ISSUED: 05/23/2011
ISSUED BY: CAC
JOB ADDRESS: 1868 PARD$ CI CM
Suite/Unit:
APN: 13942116
Zoning:R1, ,
Vicinity:
Primary Occ: - -
Const Type: V -B SQ.
FT: 0 Valuation: $20,000.00 ..- ._
SCOPE OF WORK: POOL REMDEL RE -PLASTER RE -TILE EXSITING POOL AND 64SF SPA
OWNER: KENT, NIGEL AND MICHELLE D
Address: 1868 PAROS CIRCLE Unit: .
Phone:
City/State/Zip: COSTA MESA, CA
APPLICANT: PAULL ELLISON
Address: 1420 N CLAREMONT BLVD Unit: :CLAREMONT
Phone: 626-332-8731
City/State/zZip: SUITE 200E
CONTRACTOR: MR CARLOS POOLS
License No. 9419056 • C"! '{ .00 2 6%
Phone: 626-332-8731
Address: 1420 N CLAREMONT BLVDUnit: _ CLAREMONT
Cell:
City/State: SUITE 200E ZipCode, 91711
ARCHITECT:
License No. PHONE:
ENGINEER:
License No. PHONE:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
$208.81
Building Fees:
$321.25
Electrical Fees:
$73.00
Mechanical Fees:
$0.00
Plumbing Fees:
$23.50
SMIP Residential:
$2.00
SMIP Commercial:
$0.00 -
Bldg Std Admin Fund
$1.00
TOTAL FEES:
$629.56
Reter to fee recei is for all fees paid for project
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/1812010 - PER CMMC Sec. 13.279 '1�+=--'�%I•f I
Monday thru Friday -7:00 am thru 7:00 pm. Saturdays -9:06 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays:
New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Da
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE t. INSPECTION TYPE DATE INMTIALS CODE r IN SPE00N TYPE DATE INTIMAL
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final x '� 7- myr 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention J `.olid 1.
202 Final Factory Fire Place 220 Final Planning Approval
I .
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
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 permT( is issued.
❑ I h37"'- l mai workers' c sation insurance, as required is
section 37 Labor r ortnance of the work for which this
permit is Issued. eer ' sation Insurance carrier and policy
[,Carrier.-_
r
[Policy Number:
❑ I certify that in the performance of the Jrk for which this permit is
issued, I shall not employ any per n in any manner so as to become subject
to the workers' c�Is
m io a of California, and agree that if I should
become su he er compensation provisions of Secti 3700 of
the L or orf hrth comply with theseprovisio
- s Signature Date
cw� —
W RNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN 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 under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license i . full force and effect.
�—
ass#—
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Signature
Date
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions 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 contractoi license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
305746 LV07)
Owner ID verified by drtvanse. ❑ Yes ❑ 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:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, a demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, Califomia 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.
Applicant's Signature Date
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be fled 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 ❑ 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
fling 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 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? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
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 1 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.
Signature or Legal 0s ene)
,Z::AnE/Or Authorized Appticont
ate
Date- -- _
CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: BC07-00461
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: RES_RRIP DATE ISSUED: 12/10/2008
ISSUED BY: BJK
JOBADDRESS: 1868 PAROS CI CM Suite/Unit:
APN: 13942116 Zoning:R1,
Vicinity: MASTER BEDROOM AND BATH Primary Occ: R-3
Const Type: V -N SO. FT: 465 Valuation: $100,000.00
SCOPE OF WORK: 465 SF EXPANSION OF THE EXISTING MASTER BEDROOM AND BATH IN A SINGLE -STORY SFD. ELEC: 14
LIGHT FIXTURES, 25 OUTLETS, 15 SWITCHES, 1 MOTOR TO 1 HP, 1 SVS TO 200A; MECH: 1 REPAIRS/ALTER COOLING/HEAT,
1 VENT FAN/SINGLE DUCT: PLBG: 1 BATHTUB, 1 SHOWER, 2 WASH BASINS, 1 WATER CLOSET -
OWNER:
KENT, NIGEL L
Address:
1868 PAROS CIRCLE
Phone:
$111.55
City/StatelZip:
COSTA MESA, CA
APPLICANT:
FARTHING, SCOTT
Address:
$10.00
Phone:
949-500-2870
City/State/zZip:
$1,878.19
CONTRACTOR: FARTHING DEVELOPMENT INC
License No. 560875
Phone:
949-500-2870
Address:
904 DOGWOODUnit:
Cell:
City/Slate:
COSTA MESA, CA
ARCHITECT:
License
No.
ENGINEER:
ALEX WHITE PATTERSON
License
No.C24968
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
$645.94
Building Fees:
$993.75
Electrical Fees:
$111.55
Mechanical Fees:
$44.45
Plumbing Fees:
$72.50
SMIP Residential:
$10.00
SMTP Commercial:
$0.00
TOTAL FEES:
$1,878.19
"Refer to fee receipts for all fees paid for project
A
Unit:
Unit:
ZipCOde 92627 -
PHONE:
PHONE:714-848-7866
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE t. INSPUT NTYPE DATE INTMAL CODE/ INSPECTION TYPE DAFT INTRALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electncel
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATIOP
I hereby aflinn under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit Is Issued.
❑ I have and will maintain workers' 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:
Cartier:
(This section need nol 5e ovndetediAthe peanut is valued al one hundred Wllors ($100) orless.)
Policy Number:
�
le
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 Code, I shall to with co ;ply 'th these provissiionnss.�/�/�(�L/�
plimnt'sigruNre al0 e'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN 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 under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in (ul�rce gn7 effect.
Cic: #- 5 l/0_ (`J! Class'#`�
contractor's Signatur ate
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for the
performance of the work far which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Date
OWNER -BUILDER DECLARATIONS:
I hereby afro that under penalty of perjury that 1 am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does Act apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractors) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature
305746(9/07)
I
Owner ID verified by dr .cense. ElYes ❑ 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 mom 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,
Applicant's Signature
Division of Industrial Safety Permit Number:
Date
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 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 ❑ 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 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? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(if "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If 'yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I'certify that untler 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
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.
Sgnatur at (s Dale
And/or AutinonzildJApoidant Date<
1
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMENT
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)."
I q E fA ✓-o< t` �
Address/Permit Number
Permit Applicant or Contractor's Affidavit (Please check appropriate box):
,ISI 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.
5C4y II 14
Name (please print)
Si ature/ e
Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Division (714) 754-5245
FAX (714) 754-4B56 • TDD (714) 754-5244 • vmv.ci.costa-mesa.ca.us
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address:
1868 PAROS CI
Status: ISSUED
Suite No
Applied: 12/19/2003
Quantity
Issued: 12/19/2003
Vicinity:
$23.50
Repair/ Alt Absorbtion Unit
Parcel Number:
13942116
Inst FAU <100 k BTU
ISSUED BY:
Applicant:
STEVE SCHNIERER
$0.00
0
Address:
422 JENKS CIR
0
Ventillation System
$0.00
CORONA, CA
Phone: 714-998-4300
Zip: 92880
4�
Owner:
KENT, NIGEL L
$0.00
0
Address:
1868 PAROS CIRCLE
0
Commercial Incinerator
$0.00
0
Phone:
$0.00
0
COSTA MESA, CA
Zip: 92626-4709
0
Contractor: ALLIED PLUMBING - HEATING - AIR CONDITIONING
Address: 422 JENKS CIR
CORONA, CA
CHANGE OUT FURNACE
Phone: 714-9984300
Zip: 92880
License: 610780
SCOPE OF PERMIT
MECHANICAL TO INCLUDE: INST FAU < 100K BTU AND 1 GAS PIPING
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
2"64e (6/00)
FEE SUMMARY
Quantity
Quantity
ISSUE FEE
$23.50
Repair/ Alt Absorbtion Unit
50.00
0
Inst FAU <100 k BTU
$14.80
1
Repair / Alt Refrigeration Unit
$0.00
0
Inst FAU >100 k BTU
$0.00
0
Ventillation System
$0.00
0
Repair / Alt Cooling/Heat
$0.00
0
Evaporative Cooler
$0.00
0
Inst / Rep. Recess Wall Htr
$0.00
0
Commercial Incinerator
$0.00
0
Refrig Sys <100 k BTU
$0.00
0
Domestic Incinerator
$0.00
0
Refrig Sys >100 k BTU
$0.00
0
Compressors /Absorption Systems
Gas Piping
$6.15
1
Up to 3 hp / 100k BTU
$0.00
0
Factory Fireplace
$0.00
0
3 To 15 hp / 500 k BTU
$0.00
0
Hood w/Meth Exhaust
$0.00
0
15 To 30 hp / 1,000 k BTU
$0.00
0
VAV Box
$0.00
0
30 To 50 hp / 1,750 k BTU
$0.00
0
Vent Fan / Single Duct
$0.00
0
Over 50 hp / Over 1,750 BTU
$0.00
0
Appliance
$0.00
0
Boilers
Fire Dampers
$0.00
0
Up to 3 hp
$0.00
0
Smoke Dampers
$0.00
0
3 To 15 hp
$0.00
0
Inst or Relocate App] Vent
$0.00
0
15 to 30 hp
$0.00
0
Air Handlers < 10000cfm
$0.00
0
30 to 50 hp
$0.00
0
Air Handlers > 10000cfm
$0.00
0
Over 50 hp
$0.00
0
Floor Furnace
$0.00
0
Other Mechanical Fee
Floor or Suspend Heater
$0.00
0
Investigation Fee
$0.00
Plan Check Fee
$0.00
Reinspection Fee
$0.00
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
2"64e (6/00)
DECLARATIONS
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.
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' cc mpen;<a'ion Insurance career and policy number are: 'J
Carrier: Zl )Y-1 C V� /L`\`YYICrtr C..Y� Policy Number: W CZQ 3&ez13 – O I
(This section need not be completed if the permit Is valued at one hundred dollars ($100) or less.)
❑ I certify that in the ped) ante of the work forWhich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws.gl allfomia, and a e d become subject to the workerscompensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these to
Applicant Signature: Date: ) Zl 1 q I0 3
WARNING: FAILURE T SECURE WORK S' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED
DO
THOUSAND LLAR ($100,000), IN 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. If Class 8 CZ0
Contractors Signature: Date: i9 b
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. It, 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 drivers license. ❑ Yes ❑ 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:
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
materiel? ❑ 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 ❑ 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 materiels 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 a plication a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li Yes U No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on .
. applications for non-residential building permits).
.........
..........................................................................................................................................................................................................................................................................
fi Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cade).
..............................................................I—-._...................................................................._.......................................................................................................................... ..__...._..........._..............__........._..._._..._
7 It a permit from the Soum Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
............................... ........................ ...................................-........_........ _............ ................................_........................................................................................................................................... _........... _...................... _................ _........
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.
e at Owner($)Date
rz/ ill 9 o3
An Or Authorized Applicant —� Date
CODE If INSPECTION TYPE PAM INTRIALE CODED INSPECTION TYPE �I�
1616 Fixed System Final Fire Prevention 206 Final Mechanical1 C / /�I,^
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92625
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
1868 PAROS CI
13942116
Applicant: STEVE SCHNIERER
Address: 422 JENKS CIR
CORONA, CA
Owner: KENT, NIGEL L
Phone: 714-998-4300
Zip: 92880
Address 1868 PAROS CIRCLE
Phone:
COSTA MESA, CA Zip: 92626-4709
Contractor: ALLIED PLUMBING - HEATING - AIR CONDITIONING
Address: 422 JENKS CIR
CORONA, CA
Phone: 714-998-4300
Zip: 92880
License: 610780
Status: ISSUED
Applied: 12/19/2003
Issued: 12/19/2003
ISSUED BY:
SCOPE OF PERMIT
ELECTRICAL TO INCLUDE: 1 LIGHT FIXTURE, 1 SWITCH AND 1 OUTLET LOCATED IN ATTIC
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
214646 (6100)
FEESUMMARY
Quantity
Quantity
ISSUE FEE
$23.50
Temp Dist System / Lighting
$0.00
0
Temp service test
$0.00
Busway /100 ft
$0.00
0
Res. a/c package
$0.00
Standing Section
$0.00
0
New Res (1-2 units)
$0.00
0
Misc Electrical Equipment
$0.00
0
New Res (3+units)
$0.00
0
Transformers up to 1 kva/kw
$0.00
0
Pool / Spa
$0.00
0
:...............up to 10 kva/kw
$0.00
0
Lighting Fixts
$1.10
1
.................up to 50 kva/kw
$0.00
0
Recept Outlets
$1.10
1
.................up to 100 kva/kw
$0.00
0
Switches
$1.10
1
..................over 100 kva/kw
$0.00
0
Non Res App]
$0.00
0
Low Voltage Equipment
$0.00
0
Res Appl
$0.00
0
Low Volt Wiring System / Ckt
$0.00
0
Service to 200a
$0.00
0
Misc. Conduit
$0.00
0
Service to 1000a
$0.00
0
Misc. Conductor
$0.00
0
Service over 1000a
$0.00
0
Circus ( gen or ride)
$0.00
0
Motors to the
$0.00
0
Circus (mech ride or lights)
$0.00
0
Motors to 10hp
$0.00
0
Christmas Tree Stand
$0.00
0
Motors to 50hp
$0.00
0
Fireworks Stand
$0.00
0
Motors to 100hp
$0.00
0
Other Electrical Fee
$0.00
Motors over 100hp
$0.00
0
Communication drops
$0.00
0
Investigation Fee
$0.00
Sub panel to 200a
$0.00
0
Plan Check Fee
$0.00
Pole Light Pkg
$0.00
0
Reinspection Fee
$0.00
Sign Circuits
$0.00
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
214646 (6100)
WORKERS' COMPENSATION DECLARATION: MW MW
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.
1 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' compen9/\anon Insurance carder and policy number are:
Carder: 7(lr\C h1TYlef\CQ VI Policy Number: WCZQ , 3-01
I'This section need not be completed if the permit is valued of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this pemlit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of alifomia, en gree hat if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with thes IORe—
Applicant Signature: – � Date:
WARNING: FAILURE T SECURE WO RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLIARE ($100,000), IN 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full
force and effect. L ic. is CQ I C)?&O Class a
Contractors Signature: T _ Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby alfirn that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not Intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ 1, 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 drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 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
Dennis, 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 e
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 cerl a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a re cited 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 ❑ 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
apartment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.................................................... _.................... ............. _.......................................... _... ___._............................ _.............................. _................................................................ ................................... .......... _................ __....... _.......
._.._.
4 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
........................._................................................ —__..................................... _.... _..... _._........................ _................................................................................................... _............................ _......... _............ _.......... .............
_._...
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No
(Section 65050.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Wiil any part of the facility to be constructed under this pernil be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
.................... ..................... .............................._.._.._................................ _..... _..... ..._....................... __......................................................................................... _................................. _... .................... ___........ _......
___..._.
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
............................... ....................... .................................. _......... ............. _.... _............... ............................. ......... ....................................... ............................... ............................ .................................. .................. ........................................................
8 (If yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: 1 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: Data:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the informat]voncorrect. 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 ent
above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
I Owners)) Date
1 z./gk3
And/or Authorized Applicant Date
CODE If INSPECTION TYPE PAI% INTMA65 CODEC INSPECTIONTYPE PATE INnnALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical �-
201 Final BlocWRetaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Buili ing/Occupancy
Farthing Development Ine.
June 12, 2008
Burt Morgan
City of Costa Mesa Building Department
926 Van Ness
Costa Mesa, CA 92626
Dear Burt:
904 Dogwood
Costa Mesa, Ca 92627
949.645.9325
Fax: 949.645.7927
We have project in plan check (bc07-00461) on 1868 Paros Circle. Today is the
last day for plan check I would like to ask for an extension of the plan check. The
engineering is not complete yet. The Engineer assured me that the project should
be done by the end of next week. Your understanding in this matter will be much
appreciated.
This year 2008 marks our 29th year in business if you have any questions please
feel free to call me or e-mail me.
Making Your World Better From Within,
Sincerely,
Scott Farthing
President
. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Making Your World Better From Within
htro://wwiv.fanhim:d�elay�ntrom
Uc 9 B560975
V�
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
h
CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; GO Iden rod -Assessor
TL
lqm
/!Y OF COSTA MESA
sONSTRUCTIONPERMIT
F—PFERMIT Ng.. p
TRACT NO. LOT NO. BLDG. NO.
75G
:ll/
i
TYPE OF CONST CTI ON
❑ NEW ❑ D - ❑ ALTERATION
❑'REPAIR CONVERSION ❑DEMOLISH
-
❑ OTHER
.11L,,��r -
- -
—
ZONING REGULATIONS 1
Project Address 1 aro ISG -
Owner n( Phone -1
b
1
Address Q IG lGLL�'
Arch/Eng. License No. - -
DESCRIPTION OF WORK
A.P. # 1
ZONE PLNG. REF. 'X
•Address - -
_Contractor VEM TlboLsAV. PhomtobL-eflZ
',
TYPE OF PERMIT -
❑ GRADING ❑ FOUNDATIO ❑ STRUCTURAL
BUILDING
SETBACK LST.OPERTY
SIDE YARD
IliRp gIJI DING -
LINE
Addr-
❑ TENANT ❑ELECTRICAL LU MBING
❑OTHER -
. PROJECT DESCRIPTION
❑MECHANICA
r
SI E 'YAR
RIGHT
REAR YARD (TO P/L)
,LICENSED CONTRACTOR. DECLARATIONLEF
I hereby affirm thut I am licensed under provisions of Charter 9 (com-
men Ing with section 7000) -of Division 3 of the Business and
arofeions Code �ntl y license I In full for and ffe t.
:-ice
a Class License o.
. PKG. SPACE REQ.
PROVIDED
Date - Slgnat urelal�
WORKERS' COMPENSATION DECLARATION
1 hereby affirm that I have a certificate Of consent to self -insure ora
-e'rtificate of Workers' Compensation Insurance, or a certifie copy
ereof (Section XQO, Lab. /
SQ. FT.
OCCUPANCY—CONSTRUCTION TYPE
VALUATION ZONE
STREET WIDTH
ZONING APPROVED BY
PARK FEE $
DATE
GRADING CU. YDS. ACRES SPECIAL CONDITIONS:
-
i
iicy Nam �QO( _I _!� pan lAMFiQIC/4A% Mb
Li Certified copy is hereby furnished. $94Ua44JG6J' a
❑ Certified copy is filed with the city Building Division.
-
REMARKS: -
seleeleell
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
-
(This section need not be completed if the permit for one hundred
-
-is -
(E300)br less).
I tertrfy that In the performance Of the work for which this permit is
-
-
- -
,
issued, 1 shall -riot employ any person in any manner so as to become
subject to the Workers' Compensation Laws of California.'
PLUMBING, . PLAN CHECK
ELECTRICAL PLAN
CHECK
BATHTUBSSHOWERS
Date Signature
NOTICE: If after making this declaration, you should become subject
to the Workers' Compensation pro Jislons of the Labor Code, you must
forthwith comply with such provisions or this permit shall be deemed
TOILETS URINALS
LAVATORIES DOUBLE LAVS
GENERATOR 0-1 KW_
TRANSFORMER
APPLIANCE 10-50 KW_50
1-10 KW
+ KW.
revoked.
KIT. SINKS DISHWASHERS
'
'MOTORS 0-1 HP
1-10HP
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction lending agency for the per-
formance of the work for which this permit is Issued (Section 3097
SERVICE SINKS' SUMPS
'(INC: SOLAR) 10-50 HP_
50'+ HP
FLOOR SINKS - FLOOR DRAINS
FIXTURES OUTLETS
SWITCHES
Cl, -
Lender's Name
Lender's Address
DRINKING FOUNTAINS
GAS TUBE SIGNS
OWNER BUILDER DECLARATION •
1 hereby affirm that I am exempt from the Contractor's License Law for
INTERCEPTORS CLARIFIERSUD
POLE LIGHTS
the following reason (Section 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 re-
quires the ap, Iicant for such permit to file a signed statement that he
SWIMMING POOL PTRAP -iNbt
POLES METERED
SUB
WATER SERVICE ALTERATIONPANELS MAIN
SUB
'
GAS SERV ICE OUTLETS
SERVICE
AMP
is licensed pursuant to the provisions of the Contractor's License Law
•'k^hapter 9 (commencing with Section 7000) of Division 3 of the
WATER HEATERS BTU OUTPUT
i,.siness and Professions Code) or that he is exempt therefrom and the
iS is for the alleged exemption. Any violation of Section 7031.5 by
14° applicant for a -permit subjects the applicant to a civil -penalty
of not more than five hundred dollars ($500).
SEWER CONNECTIONS
_ -
SOLAR TANK - COLLECTORS
-
❑ 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. (Section 7044, Business and' Professions Code; The
_
SOLAR PIPING 515.
ISSUE FEEContractor's
License Law tloes not apply to an owner of a propertywho builtls or improves thereon, antl whodoes such work himself or
ISSUE FEEAPPLICATION
APPROVED BY
DATE
through his own employees, provided that such improvements are not
MECHANICAL PLANCHECK
SUMMARY OF FEES
intended or offered for sale. If, however, the building or Improvement
is sold within one year of completion, the owner will have the burden
of proving he did not build or improve for the purpose of sale).
❑ I. as owner of the Property, am exclusively contracting with
licensetl contractors to construct the project (Section ]044, Business
antl Professions Code: The Contractor's License Law tloes not apply-loISSUANCE
an owner of property who builtls or Improves [hereon, and who con-
from such projects with a contractor(s) .ticesned pursuant toSYSTEMGRADING
the Contractor's License Law).
HEATING SYSTEM 0-100,0BTUBUILDING
AND DUCTING
100,000PLAN
REFRIGERATION 0.100,00PLUMBINGtracts
100,000PLAN
-'
PERMIT 5
CHECK E
CHECK $�❑
SMTP ;b
'PERMIT
$
b
1 am exempt under section ' B. 8'P. C. for this
BOILERS BTELECTRICAL
$—[-
$
reason
REPAIR, ALTERATPLAN
EXHAUSTSYSTEM MU
CHECK $
NICAL $
PLAN CHECK $
MICROFILM 5SVSTEM
TOTAL FEE E
LE55 AD -Information
VANCEPC $ordinances
FEE $
Date Owner
Informs certify that I have read this application and state [hat the above
is correct. I -agree to comply'with all city and'county
and slat ws relating to construction, and hereby authorizenttives tis city nl r upon [he abs vemfor a es. IFINAL
Oaten
suers' License or SS .�
ISSUE FEE
CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; GO Iden rod -Assessor
TL
lqm
CONSTRUCTION AND PLANNING,
APPROVALS Permit # £'S Date Inspector
POOL & SPA.. • - '
APPROVALS Permit # - Date - Inspector
1.
Temporary Electrical Service or Pole _
43.
Pool.& Equipment Location -
2.
Soil PiPel-Undrgrn
4
Steel Reinforcement
3.
Electrical Conduit Utility-Undrgrn
45.
Forms
4.
Electrical Conduit-Undrgrn
46.
Electrical Bonding -- -
5.
Steel em orce
47.
Rough Plumbing & Presiuie'Test:- -
6.
Electrical UFER Grn
48.
APPROVALTO COVER-GUNITE
7.
Footings
49.
Electrical Conduit-Undr rn
S.
Foundation
50.
Gas Pipe, ❑ Undr rn; Test
9.
Water Pipe-Undrgrn
51.
Backwash Lines P-Tra'❑ nd
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
14.
Rough Electric -Conduit
-56.
Electrical -Final
15.
Rough Electric -Wiring
57.
Solar System -Final
16.
Rough Heating & Air ConditioningFencing
& Access Approval
17.
Ducts in Structure
59.
APPROVED FOR PLASTERING
18.
19.
20.
Ducts, Ventilating
Gas Pipe -Rough & Test
Roof Framing
60.
-.
POOL/SPA SYSTEMS FINAL
21.
22:
Roof Sheathing"
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
-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
SERVAMATIC SOLAR SYSTEMS, INC.
NameRoSS I onnrE &5HHoo5e
Address 1 Q 6 g Pa roi G•rclr
ity & Phone #COStom- mfl - �Sy_ Iz39
Truss Rafter 19/
Size of Members 2 "xi> "
Centers 2 `1 inches
Roof Span feet
Roof Type SHAIKE
Weight Lode 1
Pounds per square foot
-
APPROVED
CITY Cr CCST�,4 POEUSA
Mechanical Division
Buildu Department
Approved....
S
51311 (Rev. 8/82)
PLOT PLAN
Datc
Installed by
Permit #_C ,z
THIS NUMBER MUST AJCOMPANY
ALL INSPECTION REQUESTS
i
Note any existing roof problems before starting the job and have the
customer sign to acknowledge that they have been made aware of them.
O cL-
ADDRESS OE BUILDING: 1868 PAROS CI
OwNERSNAMEIFKNDM`;KHORRAM MAJID DAVID
ADDRm:RAMEZAN'I-KHORRAM, MITRA
1868 PAROS CIR
COSTA MESA,CA 92626
APPL. MAIWNG ADDRESS
ARCHITECT OR ENGINEER:
ARCK OR ENG.'S ADDRESS:
UC. NO.:
OONIRACTOR'S NAME
CONTRACTORS MAAM
ADDRESS: UC NO.:
UNIT:
UNIT:
LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury Mat I am Operated] under Worrisome of Chapter 9
lmmmoncng with Section 7000) of Division 3 of Me Bute. and Professors Code, and my licence is in fufl force and effect.
CRY LIC. NO.: LIC. CLASS: LIC. NO.: EXP:
Date: contractor.
OWNER BUILDER DECLARATION: I hereby affirm under penally of perjury that I am exempt fmm the Contractors license law for Me
Mowed, reams (Section 70316 Business and protrusions Cada: Any city or county which nRuirse a peril to coretmct. after, imwows,
emolah. Or repel any tlnatu s, prior to Na amamm, sac requires the applicant for each permm
it to fib a signed isfemem thin ha he or a
e licensed Wnuanl to the provisions d the Confronters License Lew (Chapter 9 (commanang with Section 7000) o Minion 3 of the
Busirwss and professions Curial or tied he in she a prompt therefrom and IM basis for the alleged exemption. My violation of Section
7031.5 by any applicant for a permit subjects IM applicant to a coil penalty of not more then We hundred dollen PWD.
)❑ I, a3 owner of IM property or my employees with wages m their cob mmmmutsion, will do the work. ane the atmdure is nor mfeMed
or offered for cele (Section 7044, Business and Professions Code: The Conlractore License Law down not apply to an burner of property
who buidm or inpnwas thereon, and who does much work fimseU or herself or throrNIh his or her own employees, provided that such
improvemams ane rot ima ded or offered for sake. 1. W.r. IM buidird, or knpmernerp is sod within ors year of completion. dor
oeunw uiber win have the burden of pro rim , he or thio did not buiM or imprare for the purpose d mete).
❑ I, as owner d the pmpedy, per exclusively contracted, with, licensed canlrmlae to conminM the project (Seton 7044. Business and
io
profes ns Coda: The Contractors License law ems rhe owner of b an owd e bu
properly w1ilds or imprmm Ihmeon and who
comacts for assn piped. with a cemMa sor(.) licensed pursuers to the Contractors Lionise law).
❑ 1 am prem t under Section: B.
B. A P.C., for this remain:
Deb: ' y 1.1 i _ .1 Dories: t;o_m ,A
I do hereby cony, that I son aware of and understand the reyuiremeM3 of California Neafm and Soley Code Sectiom 25505, 25533. and
25534, vol that I or any future building omrpanf will / will net (arca one) need to campy with said sale oodm sent the n arirements he
a permitdor ewuvuetionamodinratonhorntMAi3ue lhTly errepament Datdd. Recdendiel oenstrudion applmiomarearempt from lhma
provisions.
Donde: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury are of the fdbwirp dedarstbm:
❑ I have and will maintain a cen9kate of cencent to self -insure ler workers' campeneeton, as provided for by Secbn 3700 of the labor
Coda for the performance of the work for which this perlt a issued.
❑ 1 haw and wit maintain workers' m pe w on once ro, m reyuiree by Section 3700 of Me Lehar Code. ler the performance of the
work for which Mia permit is issued. My waken' eampaneation inmrence carrier and policy number are:
Carrier:
Pact' Number:
(This eedion meed nor M rompleltrd d the peso is lar one hundred dWhim /SI0o1 or lass.)
❑ I ceddy that in tM mdomence d the wok for with thio peril is inose, I ehdl nal empoy any ne in any manner m m to
become subject to the workers' eompanufion aws of California. and agree Mat 9 I should! become mbjed to the wadrers'
mmpenmton pieta ns of Section 37M of the labor Code, I shell forthwith comply with More prodaiau.
Wsmhg: F.H. to....*. rompansatlon covernps /a un4wTrl, and slWl aW/ect en employer to Imolnel panaytles ad
chill fines rd, so one huntlrad thousad doyen ($100,0001 M sdditlon b Me cost of comps fien, damapu ser proyMad ler In
Settlors 37M of Me Labor COW, /menet, and .11., va fess.
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury Mae liew, a e construction ledi, aperncy, M the
perform.. of the work for which this panni he issued (Section 3097, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I candy that I have read this application and state that the above information is correct. I apron to comply with dl cry and oounty ominenom
and state ower minting to building conshudan and hereby auNorae representatives of Mis cry to enter upon the above-menfoned property
fonimapdken purposes, DAVID KHORRAM
�[J Print Nemo
IJI� Done: ti I p
Smgreture d Owmr/Agent/Appkcant/Contrador
(5151+Ie.Wp) WhusBmrioiq A Slaty; GreenmFb; Canary -Applicant: Pink-Noenue; pooenrod-Ansasv
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 086246
PLAN CHECK NO: 05338-97 S
PERM NO: B 086246
GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
JOB DESCRIPTION : 168SF STORAGE AREA UNDER EXISTING ROOF SQ FT: 1,200
CLAIM VALUE: 1,200.00 CALL—VALUE: 1,500.00 GROUP OCC: U-1 /
COMMENTS: NONHABITABLE STORAGE AREA, ACCESSIBLE FROM OUTSIDE
k*df 9b 9E 9h df dE dElFMiF*if iF St BF 9E iE 9F 9i IE iE irk MRE 1l*1E 9Elb iE 9E BF iE 9i**iE9E*9a iE*iF*9E*dfk±F9Eit*9F if 9l Rk 9E Rt*9E 9E dE lir iE dl•Nt if *BE RE BE**9k if**
Z O N I N GS E R T E B Q A U C I K R S E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQQ• PROV: PARCEL: 13942116 ZNE: R1 REF NO: 7
PLANNING NbTES> 127'SQ. FT. ROOM ADDITION TO AN EXISTING SFD, NO CLOSER THAN
> 5 FT. TO SIDE P/L.
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY G)CF DATE:
BUILDING APPROVED BY': DATE:
APPLICATION ISSUED BY: DATE: Q_ 9
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECiHANIC FIRE SMIP/RES GRADING
PERMIT 48.50 ry •50
PLAN 31.53 ? SMIP/NON—RES
ISSUE FEE v.
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK) TOTAL PAID DUE
TOTALS ---- )s 49.00 0.00 .1 1.53 11, 80053 .80.53 .00
REVENUE DIVISION TOTALS--> COLLECTED.: !80.53 OVER/SHOAT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC, FIRE SMIP/TOT GRADING PLAN—CHECK
48.50 .50 31.53
iE#9FlE*if iF if*BF irk#df RE 9F 1F 9E irk 9f iE 9i 1E'IE iE*9E iE*9F SERF 9E dF dF****9k#*dFM iE iE iF 1FiF'if NE RF iE iE Bt 9E RE*iE*iE 9E oft irk*ibit9E**RE eE*off dE iE*iE*9E
I N D I V I D U A L F E B"R E A K D 0 W N
TYPE. QTY D E S C R I P T I O N , UNIT COST TOTAL COST
SFR 1500 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 1,500.00
END.OF,FEES' 1
n
12-19-1997/12:32 P7/880.53
tCPTN:Oi4017110
�• PERNIT:086246
fir
CONSTRUCTION AND PLANNING
POS s SPA
APPROVALS Permit #
Date
Inspector
APPROVALS Permit•#
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2_ Soil Pipe-Undrgrnd.
53, Steel Reinforcement
•. j�j'r� ctrical Conduit Utility-Undrgrnd,
54. Forms
=44 Electrical Conduit-Undrgrnd.
55. Electrical Bondng
- •? r
I Reinforcement
56. Rough Plumbing & Pressure Test
6"9El€ctrical UFER Grnd.
57. APPROVAL TO COVE R-GUNITE
-
_�7�•Footings
58. Electrical Conduit-Undrgrnd.
y8;_�oundation
59. Gas Pipe, D Undrgrnd., Test
l9: Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd.
.1ld- Structural Floor System
61'. APPROVAL TO DECK
1 V. Property Sewer Line & House Connection
62. Backwash & Receptor -Final
.1: ^J
12. Suver Cap
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing ?'
9 9 ,•
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,& ijigConditloning,
cr PDRE:DEPT; REOUIREMENT
APPEEOV I-" P mit # "'
20. ;Rou§h FattorK Fireplace 1 ST 7'et,
x S
-+ a+ c
21. Ducts,ir=, trticturP==;
70.FUndergra,tsid F3_ryd_ro x
22. 'Ducts. Ventilating--!+: C;
* t:j J
C�)
71. Prod uy`t'Piping-abas POil
O -
23. Gas R1 pe Ftou t & sest
72. Underground F Vks x
n,m
y
o r _
24. Roof >Framing Sic
r
73? UndergMd.StcA e:an D(Sas ❑Oil
Nx t
25. xr
m
74.c_Lver'iead HydriaC-14
,Roof.Sheathing H
* y
x
26. i-Ba,iCeiling IStruetural) & MoFlotoat -!
2i
U_^ O %+nj
•';"
7�C','l.Dry"Chemiyal '7
.n
�;� 5- r�
27.' ramean`d Flashirj �•'`^^
Cep
- •/'W
44-111111"t,J6.
+�'1
Dry Star_Prpe,f, X 3 'u t:
28. Lathing_&Sling` O �H 0
V77?
FIXED'STTE.MFINAI C
n
^S
-
>
•!r
.. 29. Insulation, - O* -
']a l
s
' �
x
78;i FIRE PREV, FV4L
s n
I. !
:+
30. Drywall Nailing �'� `^
.x ~~ I
�*
s' r,HEALTIR DEPT`REOUIR'EMENT
31. Plaster Brbwr�Coa`t�r - ;rte �
�r
" 79. FINAL I'N,S}'ECT,-(QN .D •�
X t
32..lectrical Power Muer-f:ioal
�
.-k
�* •
Bbd FOOD CERTIFICATE ISSUER+
...
33. �ina(:EI2��
I ff
Notes:
lx�:
34. �inahHea'ing� Aif Gonditioriing -' � �
'r > 1
� ' p
i.-• ;n "
35.'Final Gas`_Pipe'-TesV� G '`�'
�'
-
`- •`•"`�'r" `'"
36. Jiooa-or 7> anopy n; ?<
fcEzz .`i ..
37. Final'Fa YbrY FireplCu
M `J
j*
�K'L�Q •••Q�l'-
y 38. Plu�mjbing '~>t •r;•u
,Final
v 39. Water Service-,Fin3V x:
It "
r
+,t^w•
40. ,Gas Service -Final r7*
'+ 41. Solar Domestic.F itrak. -• :�,
rr _.
{ ti
T
42. Backflow•`hrevente;:
43. Backflow Irri�atiory , :••+� �
t;
4 1 4 _•.lam
j
r.5 Irnr.^gation.<System . .tl n1:1..,
A,4. l,.andscap2 -; �; t,l ,
K
,�y,g
,u i
- v- :r •_ J
i
_
45.'*und AttenGationi' • ••
'x
tr;
<f -
46. Hand cap'Regulatio s
r
X
,
S
t
0.'0I1\1A'LSTRU6TURE&BUILDING
c X F+
48. _FINAL PLANNING X F,,�
w r
i
tri
!ti *
f:
-a
49. bect4c RQIease to Edison i
I t,
¢ r. r
r
50. has Release to Sou4rn California -Gas
51. CERTIFICATE OF OCCUPANCY
No. Date
,1lo3ECT OREss: 1868 PAROS CI UNIT:
OWNER'S NAME: JACKSON
ADDRESS: SAME AS ABOVE
714/966-1695
ARCHIENGINEER: REO.NO.:
ADDRESS: UNIT:
PERMITTEE: WESTERN SIERRA ROOFING (714) 660-8505
ADDRESS: 17932 SKYPARK CIRCLE
IRVINE CA 92718
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and efWt.
CITY LIC.: 039991 STATE uc.:4 9 2 5 9 c ss: C. 9
Date: .��o —Signature:
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a ce1/101/91 tate o onsent to self -mauve ora certificate of Workers'
.Compensation Ipsyranc`P a caitiff ¢g cop. thereof (Section 3800, Lab. C).
POLICY._
U 1 / H E%P. DATE: O / 01 / 91
COMPANY: SUP . NAIL
❑ Certified copy its hereby furnished, ® Certified copyis Xe with tit ciry Bui i Div'
Date: r)—I� I "11� Applicant:
EXEMPTION PRGhl WORKERS' COMPENSATION DECLARATION:QI is section need be a tpleted if the permit is for one hundred ($100) or less).
I certity that in the performance of the work for which this permit is issued, s II not employ any person in any manner so as to become
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the
structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. It, however the building or
improvement is sold within one year of completion, the awner will have the burden of proving he/she did not build or improve
for the purpose of sale).
1, aand s owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑ Professions Code: The Conors
tract' Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Date: Owner:
1 do hereby certify that I am aware of and understand the requirements of California Health a
25534 and that I or any future building occupant will/will not (circle one) need to comply with
permit for construction or modification from the Air Quality Management District. Residential
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above
ordinances and state laws relating to building construction and her tit
property for iinnsspection pur oses.
ri
Date: `� Signature:
Driver's License or Social Security a:
nd Safety Code Sections 25505, 25533, and
said state codes and the requirements for a
construction applications are exempt from
is correct. I agree to comply with all city and county
ntatives of this to enter upon the above-mentioned
164148 White—Building; Green—Coda Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO:.. -B' 048745
PERMIT NO: B 048745 PLAN CHECK NO: 05468-90 S GOVT:'N SUPP: Y
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : ADD SKYLIGHT TO REROOF SQ FT: 800
CLAIM VALUE: 800.00 CALL—VALUE: 800.00 GROUP OCC: R-3 /
COMMENTS: ICB044631 REF B47317
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN
BUILDING
----------
---------
ACCESSORY
BUILDING ---------
FT IN
REAR:
FT IN
FRNT:
FT IN
REAR: FT IN
LEFT: FT IN
RGHT:
FT IN
LEFT:
FT IN
RGHT: FT IN
PARKING REQ:
PROV:
PARCEL:
13942116
ZNE:
REF NO:
PLANNING NOTES>
ie**TE*iE iE eE 3E iF iE****ie aE ik±E
iE jE 3e ie iE ee iE jE iE*ik ie yE ie ie aE ie ie iE if iE ie iE Te BE TF iF BE iF iE iE
iE*iE �E iE ae 3E eF iFk
iE iE at iE 9E ie aE**3E iE ie 3F iE of iE aE iE ae
D E V E L O
P M E N
T S E R V I
C E S R
E Q U I R
E M E N IT S
ZONING APPROVED BY
DATE: ,
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:Z O
iE aE iE iE iEirie*iE ie iF jE TF iE BE *iE iE ih ie ie ie itn t ..xis .- ;iFF�iF3FiF iF ar dE TE eE %aE 1F iEiFiF�:$F�7FiF iFTFiF iE
itiEiFiEiEiEiEiEikifii3Eie*3EiEaEaETEiEiEibiEeEieaETE*TEBeaEiEifie��eicieiEi *i ' E9E1eiEiEi(�iFihTFlE3EiEie*iFiFiE*TE*fE3fiEiF*iEiEiFiEiFiEiETEiFieae
LEGALIZATION:Y F E E S U' M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC 'MECHANIC FIRE SMIP/RES GRADING
PERMIT 42.00 .50
SMIP/NON—RES
PLAN 27.30
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN'='CHECK TOTAL PAID DUE
TOTALS ---- > 42.50 0.00 -.13.65 56.15 56.15 .00
REVENUE DIVISION TOTALS--> COLLECTED: 56.15 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
42.00 ,,50 13.65
* of i! iE iE aE ilk ie iETF iE ae of 3F aE TE * iF iE 3e BE dE je 3f eE 3F * at ie eE iE iF aE iE * 3E iE iF it eP dE * aE aE aE aE iE 3e ik ie * Bf ae ee iE±E iF * yE aE TE x- 3E Bf iE Te iE iE jF iE i4 aE 1e jE iF Be iE iE TE
I N D I V I D U A L ;F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N'. UNIT COST TOTAL COST
SFR 800 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 800.00
END OF FEES
01 Boe6��7�-BO00068270-000601`80TO 9
SMOKE DETECTOR
REQUIRED
DATE: 08/24/90 TIME: 09:45
1;2,1_0
�0UP! aCle!tTE RECE_PY=: I
01 00068291-00063281 POET
DATE: 03124%90 Ti:1E: 09:45
j
CONSTRUCTION AND PLANNING
.APPROVALS Permit #
Date
Inspector
OL & SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings -
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60, Backwash Lines, P -Trap, O Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor -Final
12. Sewer Cap
-
63. Heater & Vent -Final
13. Roof Drains
_
64. Plumbing System - Final
14. Rough Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16, Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
-
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas ❑ Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREV. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
i
79. FINAL INSPECTION
-
32. Electrical Power Meter -Final
I a
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating &Air Conditioning
Z j
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
i
38. Final Plumbing
39, Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
FINAL STRUCTURE & BUILDING
6w
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cc
51. CERTIFICATE OF OCCUPANCY
No. Date
,t
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UJECT ADDRESS: 1868 PAROS CI
OWNER'S NAME: JACKSON
A009ESS: SFEKE AS ABOVE
UNIT:
714/966-1695
ARCHIENGINEER: REO.NO.:
• ADDRESS: UNIT:
! PERMITTEE: WESTERN SIERRA ROOFING (714)660-8505
ADDRESS: 17932 SKYPARK CIRCLE
q IRVINE CA 92718
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing minSection
7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect:
CITY LICf��(� 4 9 91�1STATE lit.: 4 gn 2 5 9LCLASS:C
Date: ✓ �FJ: �y Signature: ( b-ftJ yFcown 4 So, J
"ORKERS' COMPENSATION DECLARATION: them affirm that I have ace m O consent to self4mum or a certificate of Workers'
npensation Insurance, or a cenilied CoD thereof (Section 3800, Lab. Ct.
jLICYNO.: OIWCP12072A Exp. DATE: 04/01/91
COMPANY: SUP . NATL
❑ Certified copy is__heereeby2'furnished, ® Certified co isr,�it dd th the city Building Divisio7n..
Date: n-15 "I V Applicant: Cp Y JII A 1 lM01m,N_
EKEMPTION FROM WORKERS' COMPENSATION DECLARATION: tRrs section of b Completed U on permit s forme hundred (5100) or less).
I certify that in the performance of the work for which this permit is issued, all rwt employ any person in any manner sur as to become
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code. you must forthwith Comply with such provisions or tNs permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the work for
which this perms is issued (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Prolessional Cade: Any city of county which requires a permit to consWct, alter, improve, demolish, or
repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9 (Commencing vAth Section 7000) of Division 3 of the Business
and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I, as owner of the property or my amyloyees with wages W their sole Compensation, will do the work, and the
J 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 himselihersetf 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 old within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the propeM. am exclusive N Contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Professions Code: Thhe Contractors' State Llcense Law does not apply to an owner of propefly who builds or Improves thereon
and who contracts for such projects Lith a communist license pursuant to the Contractors' Slate License Law),I am aware
that proof of their Worker's Compens:fmn insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Date:
I do hereby certify that
25534 and that I or any
permit for construction
these provisions.
Owner:
am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
future building occupant vAIVW 11 not (circle one) need to comply with mid state codes and the requirements for a
or modification from the Air Ouality Management District. Residential construction applications are exempt from
Date: Applicant:
I hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county
ordinances and state laws relating 10 building Construction and hereby audionze representatives of this We enter upon the abovrmenumed
property for inspection puryoQses. t/� --�
Date: IS� q Signature: ` �1 xt
Driver's License or Social Security x: \
164146 White—Building; Green—Code Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Asvessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO:'B 047317
PERMIT NO: B 047317 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION. '_',-REROOF W/SIERRA TILE OVER MED. SHAKE SQ FT: 10,000
CLAIM VALUE: '10,000.00 CALL—VALUE: 10,000.00 GROUP OCC: R-3 /
COMMENTS: ICBO,#4'.3.61'./SMOKE DETECTOR REQUIRED
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13942116 ZNE: REF NO:
PLANNING NOTES>
> a
ee*iE***eEeEefiEee**ie BE ieiF'aeiteEfEifetiEiaifiEiEiEea*eE*itee**ie itiEiEiEiEiFBEiEieiEetaeiEfEiEikieiF*iteEiEif**iEiEiE*iteFiEieiEiEeEiEiE*ie 9E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY DATE:
APPLICATION ISSUED BY: (/ILS DATE: i� 9
iE iF*eE ei iE eE iE*if et of is**iE ie ee**iE* 'N�9E 3f ie dk ef?E 3E*iE iF eE jE
*if aF ie iE iE iE*1E iE fE iE iE de ee 3e eE*%et it if iE ee if ie ie ie iS iE teat*kiF ee ie �e iF**ie iE iE iE iEit iF 3e iE if iE iE dE TE 4E eE 343e iF iF iE iE iF iE*iE*if *iE if**iE 9E**9E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 117.00 .70
SMIP/NON—RES
PLAN -' ,
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 117,70 0,00 0,00 117,70 117,70 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 117,70 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
117.00 / /' .70
iE 1E iE 9e jE !e BE eF eE je Bt et ee * ee et ie iF'k iE iE 4e iF Te ea 34 iE it * ee aF ee of iF ee�E lE ee et it ie 1f ik iE iE ee je k * ie k iE � eE ie iE ie ie * iE eE dE ie lF ie iF iE * 4E eE TE iE eE iF jE iE 3E iF iE
I N D I V I D U A L F E E' , B R E -'A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 10000 REROOF BY VALUE RESIDENIAli , NOZONE i 1,00 10,000,00
END OF FEES y
_ l
_r
t �
Cci 'r
J
/(i' 01 00050850-00050&51 TOT n7. %0
ti�� N7 DATE: 05/15170 TIME: 10:36
CpNSTRUCTF9N lZND PLANNIIv
APPROVALS Permit #
Date
Inspector
. JOL & SPA
APPROVALS Permit #
Date
Inspector
1 fTemporary Electrical Service or Pole
-
52. Pool & Equipment Location
2. $oil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
_
59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK
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
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas OOil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas O Oil
25. Roof Sheathing
Pp
��
74. Overhead Hydro
26. T -Bar Ceiling )Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79, FINAL INSPECTION
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:. f7
34. Final Heating & Air Conditioning
�L
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
-�
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
4 FINAL STRUCTURE & BUILDING
829
�N�L
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
ICBO Evaluation Service, Inc.
e O'
A subsidiary corporation of the Intern ation a I Conference of Bui I ding Off id a I
EVALUATION REPORT
C111111.1: 'CIO d,,.'.w s..... •. �,
Fling Category: ROOF COVERING AND ROOF DECK CONSTRUCTION—Roof Covering
SIERRA ROOFING TILE
SIERRATILE
9615 OATES DRIVE
SACRAMENTO, CALIFORNIA 95827
1. Subject: Sierra Rooting Tile
it, Description: A. General: The roofing tiles are pressure formed from
No. 26 gauge G90 galvanized sheet steel complying with ASTNI Designa-
tion A 446 Orade B. Overall kite size is 16 inches by 50112 inches with an
installed exposure of 14'/, incl.es Fy 49 inches. Each tile weighs 8.5 pounds
and is designed to lap 1 1z inches over the adjacent lite to prov ide a weather-
tight construction. The leading edge is bent down I'/. inches while the
traiting edge is stepped up I inch and back from I to 2 inches to provide
weather protection and support.
The the Is treated with a currosion-Inhibiting primer on the underside and
a urethane coating on exposed surfaces. Slone granules are embedded in the
urethane coating over which a clear aliphatic urethane is applied.
B. Battens and Counterballens: Battens must be 2 -inch by 2 -inch and
counterbattens must be I -inch by 4 -inch nominal size No. 2 Douglas fir.
larch or better.
C. Installation—New Roofing—Class A: The tiles are installed on
spaced or solid sheathing at roof pitches of 3112 minimum. An underlay-
ment of one layer Type 30 felt must be installed as specified in the code for
concrete roofing tiles. Underlayment draped over the rafters must comply
with the ICBO ES Acceptance Criteria for Concrete Tile Underlayment on
Spaced Sheathing. Measuring from the fascia board, battens placed 143/4
inches on center are fastened to supporting members with nails of sufficient
length to penetrate the framing at least I inch, with 16 -penny
nails as the minimum. Battens installed aver open rafters act as the spaced
sheathing. Hips and ridges are framed 2 inches above the installed batten
height. Valleys are framed to receive No. 28 gauge corrosion -resistant metal
flashings extending at least 8 inches from the center line each way. A splash
diverter rib not less than 3A inch high at the flow line must be formed as part
of the flashing. Valley flashing end laps are 4 inches minimum. Full tiles are
placed and nailed, starting at the first full course down from the ridge board.
Tiles may be staggered. Tiles are fastened to the wood battens with a
minimum of four 6 -penny 2 -inch -long No. I1 gauge galvanized roofing
nails. One nail is placed near the bottom on the downturn of the the I inch
from the flutes of the overlapped edge. The remaining nails are placed on
every other pan of the tile at the same location as the first nail. Tiles are
fastened to the side of hip or ridge boards after mitering and bending them to
match the framing lines. Tiles are cut and bent down into the valleys leaving
either an open or completely covered valley. Tiles may be cut with a
guillotine, tin snips and skill or sabre saws with metal cutting blades. A
portable brake press is used to bend the the for hips, ridges and valleys.
Sierra trim pieces are overlapped and nailed along the ridges, gable rakes,
and hip boards with 6 -penny 2 -inch -long No. I I gauge galvanized roofing
nails. Trim pieces ore either pressure formed or roll formed from No. 26
gauge galvanized steel and the surface is treated the same as the tile.
Openings in the roof are to be flashed with standard roof jacks and flashings
as required by code. Care should be taken to adequately weatherproof the
flashings and to support them with additional blocking or roof framing as
Report No. 4361
May, 1919
necessary. Additional details are shown in Figure No. 1. Sierra roof tiles
installed in accordance with this report on new roofs are recognized as a
Class A roof covering under Section 3204 of the code.
D. Re -Roofing Applications: 1. General: With the old roof covering
removed, all conditions noted in Section Il A through It C apply. Tiles map
also be installed user existing medium wood shake, wood shingle, asphalt
shingle or gravel -surfaced roofs, provided the roof slope is minimum .3:12
The existing roof must be inspected as ser forth in the appendix of Chapter
32 in the Uniform Bui:ding Code.
2. Class C: Ridge and hip caps must be removed and the exisitng roof
covering cut back flush with the fascia or barge cover. On shake routs, the
first course may be cut back sufficient to allow a build up of 2 bv'_ batten
and I by 4 counterbattens in order to match the roofline and provide
foundation for the roofing system. I by 4 counterbattens are in -tailed
parallel to the framing members at a maximum 20 inches on center. Cour
terbattens are fastened at 12 inches on center with nails penetrating at least I
inch Into or through the roof sheathing or framing member. Battens, spaced
143/, inches on center, are nailed to the counterbattens with 16 -penny nails.
The tiles are fastened to the batten system In the same manner as in Section It
C. New flashings is installed over and around all existing flashings, vents
and chimneys in accordance with this repurt and the code. The valley used in
re -roof npplicatiuns must be as shown in Figure No. 2.
3. Class B: Installation is the same as Class C except an underlayment of
listed Manville 14, -inch -thick foil faced fiberglass batt insulation is in-
stalled with foil face up and 2 -inch head laps over the existing roof surface,
prior to the installation of the battening systems.
4. Class A: Installation is in same as Class C except, a layer of a
minimum'/: -inch -chick water-resistant gypsum sheathing complying with
U.B.C. Standard No. 47-10 is installed over the counterbattens using 4 -
penny drywall nails- The wallboard joints are tightly buried..Additionally,
one layer of Type 30 asphalt -saturated felt is installed over the gypsum
sheathing with a 2 -inch minimum head lap in accordance with the code.
E. Identification: A tag containing the manufacturer's name, address,
product name and evaluation report number is affixed toeach pallet.
tit. Evidence Submitted: Reports of uplift, accelerated weathering,
wind -driven rain, structural calculations, and fire -retardant roof tests and
installation instructions.
Findings
IV. Findings: That tiles described in this report comply with the 1988
Uniform Building Code, subject to the following conditions:
1. The tiles Are manufacturered,identified and installed inaccord-
ance with this report and the manufacturer's instructions.
2. The tile roofing system Installations are limited to areas having a
maximum basic wind speed of 80 mph, Exposure B as deter-
mined in Section 2311 (b) or the code on buildings not over 40 feet
in height.
This report is subject to re-examination in one year.
Evaluation reports of ICBG Evaluation Service, Inc., are issued solely to provide information to Class A members of /CBO, utilizing the code upon
which the "part is based, Evaluation reports are not to be construed as representing aesthetics or any other attributes not specifically addressed nor as
an endorsement or recommendation for use of the subject report.
This report is based upon independent tests or other technical data submitted by the applicant. The ICBO Evaluation Service; Inc., technical staffhas
reviewed the test results and/or other data, but does not possess test facilities to make air independent verification. There is no warranty by ICBG
Evaluation .Service, Inc., express or implied, as to any "Finding" or other matter in the rtport or as to any product covered by the report. This
disclaimer includes, but is not limited to, merchantability.
page i or 3
.�.., e........ aBENDUD
&A0R7/.RJOIn
FL SHING
BEND UP
MURE NO.1-4;Ew CONSTRUCTION
0
WOR'
%CED
FATHING
'xr
Olf SHWSBACK .. -�
APPRQLA•
7 x 7 BUwjp —
7T: SEE REPORT IVa FOR ROOF INSUTATA>N•ETC.
A
FIGURE N0.2–RE-A DOF APPLJCATION
m
ON. ETC. _ -
1• x r COUNTERBATTEN-
.
7 x 2' BATTENS VA IA
_
MAIL
- - CLOSED `- OPEN
- 'CUT AND
NEWYILLEy
.
_
FLASHING
METE
7 x 7 BATTENS
.. HNGLE 1 DEPM2�d' .
SOLID OR SPACE SMCE SNFATHI ". 2 CENTER OLITJ ,
O OVERALL MEASUREMENT 7V4'
1
RIDGEANDHIP _ •
^�
_ _ ....
TW02'w2'SATTENSORONE
%y•
MAXRAFTER—.____..
_. SHAKESSHINGLES
SOLD OR SPACE SHEATHING ._
t x 7 BATTEN .
1'* ACOUNTERBATTEN
FIGURE N0.2–RE-A DOF APPLJCATION
m
SIERRA TILE
Paul Zambeck
President
Western Sierra Roofing Co., Inc.
October 5, 1987
I am sorry for the confusion surrounding our ICBO report #4361.
It reflects the batten spacing at 20" on center, wherein our
installation instruction call for 24" on center. They assure
me the error will be corrected on the next printing. I have
also found two spelling errors which I have also brought to
their attention.
I want to congragulate your company for exceeding September's
Installation Goal by 728, at this rate you'll soon be the
largest metal roofing company in the state. Also I have talked
with Prank Schwartz and he assured me he will have the testimonial
from the Rancho Pales Verdes Home Owners association to you next
week.
Thanks again and I look forward to seeing you at the Association
Meeting on the third.
Best Personnal Reguards
Lee Pruitt
President
('f
ti
1�
ADDRm"BMLOP3: 1868 PAROS Cl UNT:
ONNERS NAME IF 1UKwm: KHORRAMMAJID DAVID
ADmRus RAMEZANf—KHORRAM, MITRA
1868 PAROS CIR
COSTA MESA,CA 92626
WL. MulDa ADDRESS:
ARCHITECT OR ENGINEER: UC. NO,
WN. OR END'S AOONEW: UNT:
CONTRACTORS NAME:
COMACTONS NAM
ADDRESS: Ull N0:
UNT:
LICENSED CONTRACTORS DECLARATION: I hereby af1sm under pwtaly d peiAvy Rel l am licw«
erd provivws d
iChooser e
lose..., with Semon loon) of Dhabn 5 of ths Brew W Pmlssekau Cods, aW mY licence r n 10 brw aW .Ns".
CRY Uc. NO, UC. CLASS: UC. NO.: EXP:
Dwe: C«arador.
OWNER BUILDER DECLARATION: I haMy atlurrl under penally of pwj y that I em smrnpl hom the Cmnwm Howse Lew 1« the
lbs np ressan (Section 703115 Buaiwe ser Pro— Cade: Arty ay or oo«Yy xl:idi n rtues a pass/ to aordbud, am. improv.
unolah, Is read any ebud«e, prior to its am". ebo rsatatse UN eppI 1« eudl Perth to Ne a ei0ned attosga Otto M «shs
a Ftceneed pu.t Io tM prov®ma of this C«gnp«s LkLaw (Chooser O (ossnerdM vith Semon 7") of Diveion 9 of Its,
Buinaa sW Praevins Cade] or that M or she is eumos theahorn shot IM bar 1« Ihs deDed asempbn. AM viJtobn of Swion
1091.5 by smy appfranl 1« s Perold sbiscts IM aPpganu to a da petslY of M man Ihsn Ixe MrldW dolWe M!iOOD.
-Li
1. Is, re
owr d tM plop"or my ensbyewapee es ush as their dwmpamalim.W dws
e doth* k. ol this SD«aue c not hiendel
X" «dieted lar mle(Seasn7W.BI>mam sol prda+ism Dods:TM Caumfmlreroalnwdoet not epplyto en Owmra«opem/
MIIO LIuida «in««M dMnp1. a11d ntU aMe Wdt YIXk tNleeB «hwsa or throog I M or Isis aNT empAIIOY, praVlded til« Wdl
imoswemma se w traerMed or d ecul 1« sat. B. Igwever, IM balding or knptownw I. add whhn ars Yes of mmp1slion. On
owrord Ylr oiO Mw Ne d dPshn,Its «she old not Odd«impma f« Us Pur«ss of Ws).
❑ I. a ovmer of IM properly. am epduiv* omlrwinD will) BmnW CaNlaanM to o«ICrW Os Paled (Swot 10 U, Buehme W
Prd ' ds: TM C nmaore tins, Lew doss M appy to m ovner al Pv " wM Is or inprovss IMnm ad wM
s 1« N prajeda wah a omared«(a) ficomed punuem to IM Cors Liowma Lew).
❑ I ss PNer Section: B. & P.C.. for fttssem:
OLa Mi
Dote:
I do herby ceniry hs, I rn erase d ser udw.MW the, h maenleho. of CeMomta Nsalh sat Bdery Code Swbss 45505. 25.3` ], ars!
4S.59s,
ass! that I or ay Muse b WV oodsed twill / N w (drer me) ueW Is mryaY wah aid sets mdse ser the MQL!hsrtlera Its
eparrla t«aoromsdmamWdwbnhmlMAi3i 1ui�me0onwtl D'olw.RaeidWWoprWnrdian.ppka!'vsw Bump hom ghees
Povisbna.
Das: Appficera:
WORKER'S COMPENSATION DECLARATION: I hrel y affi utder persist, of psrjry oss a DN bDoshq dedsei«n:
❑ IhaweW wD me'vaenscanJiusaopssrn neWLsurs rot woMrs'mrnpaatobn.nPoided la b/swan 0100d1M labor
Cods, l« tM pMomlence a tls work 1« width Ocie passer r iaued.
❑ I hew W wD meihoeo wakrY mrttperlsatbn khms shoe. as rvgs&W by Swim 5100 of ds labor Cods, los IM perbrmencs of IM
work for w this; penia b weued. My w«lun• carnperutoion kmrtscs osis old policy number se:
Gander.
Policy Numb..
(ThL ssdio, rN.d m os mroland e the passe Is b ars huW W does. (5100/ «raj
❑ 1 ceP1y Ow in Os pMormxium ' IM work br which of permit u rwsl a 1 sa th s employ sry plan In sry manor b a Io
bea«ne wbpd to IM era Boo 3700 cation rwe d CaNmd...ih ith oo Nat e I sMOd brave eubiw to lM wallas'
wmpaaelbn Poviaim d Seddon 5100 d 1M lob« Cade. I sheD lonhwhh campy wih Ilea pmvrbs.
Date: Awp :
Wan/np: F.H. ro .stun twreen'rnrrlpwNWon aoYer.v.1. urls ,, sod "I sub/.cf a sm;,h jw to cdMrNl Panama and
g,/W1 ors. W ro as huMrW thou.ssl "W. (SIDG000), n.m/eon to IM cost of rornpe I.4 d ns0s. u Pnv/dw for In
Sacdan 910601 dls Labor Cod., Infwesl ttd.du W.1 .
CONSTRUCTION LENDING AGENCY: I hwaby toenn ands, PenalY d PerjaY that Ihse I. . eortanwian Wtdirq wency' Its Us
,darmau d the work for which thr psmi u raed (Section 9061, Civ. C),
LENDER'S NAME:
LENDER'S ADDRESS:
1 candy Iha I Mw real this application sol sae Iha IM abws nl«mation is coned. I Noss to mmpy with tol oily tool munly ort inmoss
eW state leis rMaIN to b WM mrmudion eW Meby sotMcs npreereaivee of thu oey ro show uPm IM ebave membnW PopeM
for inapwionv .ee.DAVID KHORRAM
PnM Nemo
Dae: Iy�2 I�
IWun of OwnedAtlenUApplumCmrssw
(515148 WP) Whd"Uibiq S Salary; Oren -File: Carmt Appkreru; Nnk-Rsanue; Gddsnro ssssor
CITY OF COSTA MESA — BUILDING PERMIT
EER"O: E 086366
PERMIT NO: E 086366 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTION : 168SF STORAGE AREA UNDER EXISTING ROOF SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: U-1 /
CO�MeiMtdEEdNEdTEdSed: NONHdAEBiIEdTrdAEBdLedEEdEdSTORAGE NAREA ACCESSIBLE r�N+FROM E�NOUTSIDE 48r+RE:B+862E**BE�k�E�r�E*�N�E
Z 0 N I N GS E R T E B Q A U C I K R S E M E N T S
------------ MAIN
BUILDING
----------
---------
ACCESSORY
BUILDING---------
FRNT: FT IN
REAR:
FT IN
FRNT:
FT IN
REAR: FT IN
LEFT: FT IN
RIGHT:
FT IN
LEFT:
FT IN
RIGHT: FT IN
PARKING REQ:
PROV:
PARCEL:
13942116
ZNE:
REF NO:
PLANNING NOTES>
26,00 26.00
.00
REVENUE DIVISION
TOTALS--> COLLECTED:
26.00 OVER/SHORT:
>
BLDG PMT PLUMBING
ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
IE dE*kdE***dE*iEk*k*kdE dEk
iF iE 1E*iE dE iE BEMiEiE dE iEdE iE fE iE****SE*dE ie iE iE if 9Eih iF*iE*dE*k*iE
itkk**dE
iE iEk*kiE*iE iE***iE*dE
D E V E L O
P M E N
T S E.R V I
C E S R
E Q U I R
E M E N T S
ZONING APPROVED BY
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
Re ifdEdEdEdEdE*dEit**dE**NdEiEdt**N
LEGALIZATION:N
F E E . S U M M A R Y
DATE:
DATE:
Wil l 9
STRUCTURAL SEGMENT:N
BLDG
PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES
GRADING
PERMIT
4.00
502
SMIP/NON—RES
PLAN
ISSUE FEE
22,00
BUILDING—DIV—>
PERMIT ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
4.00 22.00 0.00
26,00 26.00
.00
REVENUE DIVISION
TOTALS--> COLLECTED:
26.00 OVER/SHORT:
.00
BLDG PMT PLUMBING
ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
26.00
dE iF*Kif dFKdF iF lF iF iE dE 3F iF if iF Be df****Rf)EKBF if*iFiE*dE,Yt***dE iE BE*iE*dF*iE iE 9F RE Rt iE iE*dE iF*Rt•*RE i4 if dE iE iE iE iE**df BF 9E*****iE dE iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 3 RECEPT/OUTLET 1 ST 20 EA, 1.00 3.00
ELE 1 RECEPT/SWITCH 1 ST 20 EA. 1.00 1.00
END OF FEES
12-31-1991/:2aD , r",/u26
ss�ss
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
P0, & SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2; Soil Pipe-Undrgrnd.
53. Steel Reinforcement
Ele9trical Conduit Utility-Undrgrnd.
54. Forms
•.•4 Elettrical Conduit-Undrgrnd.
55. Electrical Bonding
;
Reinforcement
56. Rough Plumbing & Pressure Test
.6:• Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
=
7,.Fo?tings
58. Electrical Conduit-Undrgrnd.
8;; Foundation
59. Gas Pipe, O Undrgrnd., Test
9.' Water Pipe•Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd.
1d. Structural Floor System
61. APPROVAL TO DECK
t 11:^ Property Sewer Line & House Connection
-
62. Backwash & Receptor -Final
12. Sower Cap
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit ••
,. Solar System -Final
16. Rough Electric Wiring
L
7. 7. 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"Conditionings
c;
,- .to.
-, FIRE'DEPT:REQUIREMENT -•
"APPROV,6L'S-' Permit
� J-� .•) -�-
20. Rough Factory Fiieplace '"
1. is � l
21. Ducts-, in,,$tructureg- j ••
;
f
70.. Underground Hydro
22. .Ducts, Ventilating':-
* -' �
"� '•
71. Prod uc't fi ping.0$as poll
23. Gas Pipe-goug¢ &-Test
72. Undergro nd Flush
24, goof Framing t:
L, n
t -
731 Undergrnd.StoFEge Tank O Gas ❑ Oil
25. RoofSheathing ;'". •r
.
-
74: Overhead Hydrg. .
26. T•Bar-Ceiling (Structural) & Monocoat
` 1
-'
75. Dry Che .'ical �;- „ �- .1'1
TI
. 27. Frames Flashing,' '�•''
and ,;..
„r
-
76. Dry Standptpe,e _
28. Lathing&iSidin .• r �- '
9
,j'
77? FIXED SYSTEM FINAL. _
29. Insulation -'
78; FIRE PREV. FINAL -
30. Drywall Nailing -
-
HEALTH DEPT. REQUIREMENT
, 31. Plaster Brown Coat-
79. FINAL INSPECTION
C 32. •ElectricalT Power MeterlFinal
t
8 .: FOOD CERTIFICATE ISSOED
33. FinaT.Electric " ` r- m.34.
Final Heating & Ai(;Conditioning
.._ -
35. Final Gaspipe-Tesfl
n
36. Hood or Canopy -;,; J,
.37. Final Factory Firep)ace-
`
38. Final Plumbing
-
39. Water Service-Findr
X40. Gas Service -Final
+41. Solar Domestic -Final
1
i
42. Backflow Preventee
43. Backflow Irrigation
:t
44. Landscape Irrigation System = - -
�•
--
-
45. Sound Attenuation •
46. Handicap Regulation's
47. FINAL STRUCTURE & BUILDING
48. FJNALPLANNING.` 'L
'
49. Electric Release to Edison
50. cos Release to Souttiern California,Gas Co
..
51. CERTIFICATE OF OCCUPANCY
No. Date
9�l
1!,
'ly x'+h" L43 bolts
R,aiters :Z4, O.C.
2w
SOLAR
WA TER H
I
L
AAPPR®VED�COSTA MlEl l
Mechanical Division
Building Departed •.. •........ Date ..... ...........
I
Permit .��NY�
THIS NUMBER hWST ACCOMPA
ALL INSPECTION REQUESTS !
TYPICAL MOUNTING OF SUN FLOW
SOLAR WATEZ NEATER. .
U.M
. . .- --
NOTE : SHLOING AND W
MATERIAL NOT SHOWN. BUTYL -
RUBBER SEALER TO K USED
AROUND All LAG BOLTS
MouNnra c�rct
•i_=•lam �`•����
WAPE 7k -e, A CN=
HOT WATER TO HORSE
"y
HOT TO WER
HEATER
xxw A.TiNG wm—
' -OLDUSNG `oglU HEATER
I�
II �
•� I
LOID TO WITS
6ATE NAIVE
Karch 1. 1-4
ROOF INSTALLATION GUIDELINES
—_ - — - --
-_- -" -SUN FLOW SALAR MATER HEATERS rj �►r
1. All existing roofs where sun flow water heaters
to be installed shall, be visually inspected by the
installation foreman.
2. Any defect, such as excessive sag or flea, usually
observed shall be recorded. If required, a bracing
system may be. ins talled'to strengthen the roof system.
3. If a roof is determined to be fifteen years. or plder,
the installation foreman shall inspect the underside
of the structure where solar units are to be installed.
Note any defective menber, condition of material, size
of material, over all span and spacing. If it is
determined that the framing system ri11 not support
the additional loads imposed by the solar units. an
engineered bracing system shall be installed.
4. ;he following is a guide to determine the adequacy of
the structure, to support sun flow so Lar units. normally
encountered in the home building industry.
a. 2X4 rafters spaced at 24" 0/c and maximum
span of 7'-0 center to center. 7'-0 span may
be supported by intermediate purlins or walls.
b. 2X4. rafters spaced at 16- o/c and maximum
span of 9'-0 center to center.
c. 2x6 rafters spaced at 24" o/c and maximum
.span of 12'-0 center to center.
d. 1x8 rafters spaced at 24' o/c and maximum
span of 14'-6" center to center.
t. 2X10 rafters spiced at 24- o/c and a maximum
span of la' -0 center to center.
f. 4X6 rafters spaced at 36- o/c and a maximus
span of 14'-0 center to center.
g. 4X6 rafters flat roof spacediat 36- o/c and
naximtizi span of 14'-0 center to center.
h. Fabricated Roof Trussezz
2x4 members - Trusses spaced at 24' O/C and a
maximum span of 24'-0.
2X6 members - Trusses spaced at 24" o/c and
a maximum span of -36'-0.
PA
f
_,- SEYAZ ENGINEERS
B Cons:rlinp StruClural.Env fonn*mial --
2020 N Brvaov+ay. SAe 200. VOhUl Deet
--- Catdo�tia 9e596-RYy-e tLt33s-01D7 = _- ..
Servamatic Solar Systems, Inc.
1641 Challenge Drive.
Concord, CA 94520
-- - ---- .-. -Zeki u Bryat, PS
Itarch 1, 1982
Gentlemen:
Enclosed please find a set of Structural"ea.lculations on
the adequacy of roof systems to carry.Odditional loads
imposed by the "Sun Flow - Solar Water.Heeters'. We have
investigated a typical rafter and ridge'beamtype roof
systems. Calculations are based on a different rafter
spacing and different spars with a roof pitch of 4 to 12.
Most conventional home roof framing falls within the
spans investigated. In each case, the loads of the solar
units were P.3aced on the roof as it will be Installed.
our investigation show that the existing roof systems are
capable to carry two or more of the solar units
with a three or more mer..Ser distribution. The spans and
spacings investigated do not require any strengthening
or additional bracing.
We also investigated a conventional prefabricated roof
truss systems, one with 2X4 members, 24'-0 span and
37'-4" spar, and one with 2x6 members, 36'-0 span and
35'.-2" span. These trusses were selected from actual
ro6f installations. In all the cases investigated, due
to additional loads, the stresses were within the
allowable member stresses, therefore.. trusses are capable
to carry two or more of the solar units without any
strengthening or bracing.-
.. a
Please feel free to call on no if You have any Questions.
Sincerely yours,
2eki !!. l►eyat
Za/jv
'�' -
INTERNATIONAL TESTING CORPORATION
l 6173 Cherry Ave., long Beach, Calif, — long Beach GA 2-6550 - GA 2.7500 - NE 6-7821
�— 1670 Babcock Avenue, Costa Mesa, Cali(, - Costa Mese Ml 64626 - KI 5-8688
3552 Buena Vista Ave., lemon Grove, Ceh(. — Lennon Grove HO 37751
REPORT ON 3qHMSPECIKLN TESTS
Identification No.: P-363-474- ,ogITE
Client: C. E. Moseley
Architect or Engineer:
Contractor:
Structure:
Sample From:
Mix:
Total Water:
Field Nos.:
Age:
Specimen Nos.
Date Made:
Date Tested:
Average Size:
Area, So. In.
COMPRESSION
Tahitian Pools
15 x 35 Pool
Garry Evans, 1868 Paros Circle, Costa Mesa
North Wall @ B. Beam
4, to 1 P.S.I. 3,000
7 Days
GE -1
9-3-63
9-10-63
5.875 inch dia
27.09
Total Load, Lbs. 74,000
Lbs. Per Sc. Inch: 2,740
Specimens Made By: John Poleski
Specimens Delivered By:Carl Moseley
Specimens Received: 9-5-63
cc: C. E. Moseley (4)
DML:r
28 Days
9-3-63
10-1-63
CREE9GE-2
5.98 inch
dia28.07
85,250
3,040 L/
INTERNATIONAL TESTING CORPORATION
IrA
J
CITY OF COSTA MESA
CALIFORNIA, P.O. BOX 317
From the Office of the Planning Department
Building Permit No. 20143 Date: 11-1-63
1868 Paros Circle, Costa Mesa.
Pool Owner:
The Costa Mesa Planning Department called at your property to inspect
d the Swimming Pool. Our interest in pools is for the purpose of safety
and to be sure all provisions of Section 9298.9 of the Municipal Code
have been met.
i
Section 9298.9:
1. No swimming pool shall be constructed closer than five (5) feet
to any property line, measured from water line of pool.
2. No swimming pool shall be constructed under any electric power
lines or on any electric power easement.
3• No swimming pool shall be constructed unless the yard surrounding
such pool is completely enclosed by a six (6) foot fence or the
pool itself is enclosed with a fence six (6) feet in height and hav-
ing a self-locking type gate or gates.
Note: (Gate should close and latch on a free swing).
Your pool will not receive final approval until the requirements of the
aforementioned Section of the Municipal Code have been completed.
The following disposition is noted in reference to your pool:
No one was at home.
No springs on gate.
Q Improper latch or defective hardware.
U Wall surrounding pool not 6' high.
0 Other.
Telephone 646-2411 and ask for the Planning Department so
that an appointment may be arranged.
Since you have incurred certain liabilities through the installation of a
pool, it is requested that these matters be taken care of as soon as possible
so that your pool will be a safe one.
Sincerely yours,
Planning Technician
OWNER EVANS, GARY
GENERAL CO
AP No. Lot
IN""ECTIONS
DATE
BUILDING PERMIT NO.
Signature DATE GROUP Y001 TYPE ZONE
Gay
SUBCONTRACTOR
PERMITS ISSUED
DATE NUMBER
Water I
Rough Com. Refrig. ❑ Air Cord. ❑
Rough Heating
Rough Plumbing
.-
Miscellaneous
Prop. Swr. Line O House Con. ❑ St. Swr. ❑
"
S2rinkling System
Construction Pole
Underground ❑ Power,❑
Rough Wiring
/ wzl>
7—i0 -L3
�03�3
Trenches [y Forms ❑ Sleel Reinf. 1n,
Floor System
Bond Beam Steel Reinforced
Q—
Sheathing
Frame and Flashing
Lathing — In ❑ Out ❑
Plaster, brown coat
F ;. ❑ Air Con, ❑ Final
3. .ng, Final
Plumbing Fixtures, Final
'
Final Gas Test —
Electric Fixtures, Final
Building, Final
OCCUPANCY
20143
CbSTA MESA BUILDING -SAFETY DEPAR_.cNT
P. O. BOX 917 COSTA MESA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
S COSTA MESA, CALIFORNIA E
■ MAIL
' CITY (..F� 1�Q a ryOL.
ARCHITECT --',I 1 TEL.
CITY -.
Y`r-\ot
MAIN BUILDING
STATE C
LIC. NO.
L`
C �`�
TEL.
NO.
SIZE
OF LOT
LEGAL
Lot
9
NO. OF SLOGS.
NOW ON LOT
USE OF
EXISTING SLOG.
�-
R. SIDE Fr.
SETBACK LINE FROM
CENTER OF STREET
FT.
REAR YARD
SIOEYARDI LEFT
A. P. NO,
I RIGHT
FT. --'
DESCRIPTION
OF WORK
NFW V
SHALL BE LESS THAN
e1 TFo eTlnul
FT.
enn,T,nw,
BET. MAIN
FEE RECEIVED
Oft APgLI N FOR PERMIT
BUILDING / O'# Q/ d/ 1 // '
ZO
NO. OP
MAIN BUILDING
USE OF NEW f�� /
—j
�
PLANS
.t
BUIILDING
LEGAL
Lot
9
rIL
DESCRIPTION
�-
R. SIDE Fr.
FT.
�^ -
/6
A. P. NO,
FT. --'
�
NOTE: NO EAVE OVERHANG
SHALL BE LESS THAN
YARDS APPROVED
YARDS APPROVED
MAIN BUILDING
ACCESSORY
BUILDING
(FROM C/L STREET)_
.t
befWCPry
FRONT —FT.
FT.
3 3 '
�-
R. SIDE Fr.
FT.
�^ -
/6
L. SIDE FT.
FT. --'
�
3a
REAR FT.
FT.
DISTANCE BET.
BET. MAIN
d / {-
MAIN BLDGS.
ACCESS. BLD69.
VAR. .ii
DATE
EXTERIOR WALL I CROOF OVERING BYPROVED ..✓A/ DATE /7 IO /�
COVERING !N?'V ! (Y�
USE OF BUILDING AND WORK TO BE PERFORMED HOLD FORS A REQUIREMENTS
S . �.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THB MOUNT 9DBROWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. '
SIGNATJ
a PERMIT FEE $ /G
OR —�
PERM ITTE L 'r-{ /... 6
4
AUTHORIZED AGENT
UWANK rR. rHtl Izl AvuU l u
VA, --
.-, --
SOB ADDRESS 1868 Paros
Circle
BUILDING
PERMIT N0. 26288
GENERAL CONTRACTOR Hi -Lo
Contractors, Tr1C.
DESCRIPTION OF WORK Add
Fam. Rm. to res.
AP No. 139-421--16 LOT
TRACT
FIRE ZONE VALUE $
,500.00
Plumbing
Rough Plumbing
c.
Prop. Swr. Line 0 House Con. 0
_
Sprinkling S stem
I ECTIONS
Signature
Date
GROUP I TYPE V ZONE R-1
80..
SUBCONTRACTOR I
PERMITS ISSUED
Date Number I Signature
Gas
Water
Plumbing
Rough Plumbing
c.
Prop. Swr. Line 0 House Con. 0
_
Sprinkling S stem
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring
;?,V
JL -21- 6-4.
Heating and Vent.
Trenches ,oi- Forms 0 Steel Reinf. ❑
, 13f�/i-w-�F
Floor System
_
Bond Beam 0 Steel Reinforce 0
_
Sheathing
ii-zi 66
Frame and Flashing
Lathing — In b Out
Plaster, Brown Coat
�+ms1
re�9
, _Gs
i�-7 c_Eo
Stura], Finalsctric
I- .ng, Vent., Refrig. and A.C., Final
I�//2/o
Plumbing, Final and Gas Test 0
'
Electric, Final
Ruil Aino Fins]
I APA
/l.Jt..G1
�., r i /oto c i o.� /i0(�G1 iLLJ �(j 1L/ �j/Q/Arb
88
Lbw
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 12W COSTA MESA, CALIFORNIA 925M
1101101111
For Applicant to Fill In Completely
p
TYPE OR PRINT
\DDRE119
COSTA MESA, CALIFORNIA
a,
CONTRACTOR IIX'20 aAgrN'c'70?J'-"d ,
ADDRESS /0 8Fa
CITY cy%iS'i✓ /TD ✓. �/�//
Tff
LIi� 7
T. .2�
C. ]
NO//!O NO. W/�/- -21/(j/
6IZE
OF LOT /J d /1 / 33 now oN LOT
USE OF
USEDEIISTINGBLDG. Fe�i
SETBACK LINE FROM lam/
DESCRIPTION OF WORK
BUILDINGOF
NO. �1r//
SIZE /I NO. air
/
A&- T/r t
1 HEREBY ACKNOWLEDGE THAT I HAVE READ D THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM.
PLY WITX ALL CITY ORD'lINCO AND STATE LAWS REGULATING
SUILOING CONBTRUCTIO .
SIGNATURE OP
PERMITTER
_.
AUTHORIZED AGENT
OCT 25-66 124 ****18.00
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
RECEIPT NO.
PERMITpNO�./
Z C� L b"d'
RE 11RD BY
-DAYS RECEIVE
DAYS ISSUED
BUILDING
ADDRESS
PI RE
ZON! TYPE GROUP
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//A.
3
A. P. NO.
NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
90' TO SID! a REAR P. L.
EAVES
ALLOWED (U. B. C. REQUIREMENT)
YARDS APPROVED
YARDS APPROVED
MAIN BUIL 1
ACCESSORY BUILDING
.(FROM C
FRON t
FT.
R. SID
FT.
L. SIDE FT.
FT.
REAR PP.
FT.
DISTANCE e[T.
BET. MAIN e
MAIN BLD S
ACCESS. BLDOS.
VAR.#
DATE
C.U.P.#
APPROVED
//
9 PROVED �S
dg
DATE
r? SQ. PT.
THE 4KOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
_I
(J
PERMITFEE
,,
S�I�UQQIJ��.
TOTAL FEE $
• J-CI8248
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 317 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
"nVZ.7-h"P11�05�a5R4a eaw+t911:5�
APPLICATION FOR PERMIT
BRAPI K�1cO3TA i4412 ,yy**94511
For Office Use Only
�N �`T�i7/
RECEIPT NO. PBRMIT NO.
.
OWNER �1�^•� /I
MAIL % /J�
REC KO BY O TE RECESVED EIAS
ADDRESS / '. 1 O;e
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67,51-2P�J
BUILDING
CITY `�/trJ %?%I////'F-`Jf� NO G
ADDRESS
HITECT L
COSTA MESA. CALIFORNIA
ORCENGI EE ' L,0• ////��//N
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ADDRESS 14e •
ZONE TYPE GROUP /
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APPROVED
CONTRACTO - N
BY DATE
ADORE68
ZONING
USE OF E
CITY
PLANBO.OF {/
I BUILDING
STATEv
/ Djrl�
LEO
LIC. NO. J NO.
DESCRIPTION
SIZENO.
OF BLOGB.
OF LOT O
Now ON LOT
A. P. NO. �—
USE OF
YARDS EVES
EXISTING BLDG
APPROVED ALLOWED
SETBACK LINK MOM(CENTER
CENTER or DTRERT REAR YARD
LINK ST.) L
FRONT `!5_6 FT. 7 IN.
'
SIDE YARD ILEFT IRIGHT
/D
R. SIDE D FT. IN.
DESCRIPTION OF WORK
17
L. SIDE FT. IN.
NEW I II ALTERATION II ADDITION
REAR FT. IN.
REPAIR I II MOVING I II DEMOLISH
APPROVED /
BY DATE l
BUILDING NO. OF
SIZE ROOMS STORIES
EXTERIOR WALL ROOF `
COVERING %T(C'W COVER IN(7 F -
USE OF BUILDING AND WORK TO BE PERFORMED
SLG//Y6 L
_
o,Q � �O -ra D - �O yV •
1 HEREBY A KNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AMOUNT SHOW UNDER VALUATION IS FOR THE
AND STATC THAT THB BOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITN ALL CITY 1 CE8 AND STATE LAWS REGULATING
VALUATION
BUILDING CONBTRU O
91GNATURE O
PERMIT FEE $
PLAN CHECK $ 3/
PERMITTE
AUTHORIZED AGENT iQn%
TOTAL FEE ,6O
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