HomeMy WebLinkAbout1138 PAULARINO AVE - Building Permitsr
,_.CT ADDRESS: 1138 PAULARINO AV UNIT:
OWNER'S NAME: CARPENTERWILLIAM L
ADDRESS: 3168 I N C L f NADO
SAN CLEMENTE,CA 92672
498-9011
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: JIM BECKER CONSTRUCTION (714)650-5402
ADDRESS: 1956 ANAHEIM AV
COSTA MESA CA 92667
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
70DOI of Division 3 of the Business and Professions Corte. and my license is in lull force and effect.
CITY LIC.: 050169 STATE l506061 cuss: B
Date: Signature:
WORKERS' COMPENSATION DECLARATION: I hereby alum that I have a certificate of consent to sell insure or a certificate of Workers'
propensities J%a�bd; y ffied, copy thereof (Section 3800, Lab. 87/01/93
'OLICY NO.: STATE 77 FUN7D EXP. DATE:
VCOMPANY: ,,
A ❑ Cenilied copy is hereby furnished. LJ Certified copy is filed with the city Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Phis section need not be Mmpletcd it me permll ¢ fa one hundred (3100) or less).
I cenify 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 WorkersCompensation Laws of California.
Date: Signature:
NOTICE: II, 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. CI,
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt Irom the Contractors' State License Law for the following reason
(Section 7D31.5 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 (3500).
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the
3 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. If, however the building or
improvement Is sold 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 property, am exclusive ry Contracting with licensed contractors to Construct the project (Section 7044, Business
❑ and Professions Code: The Contractors' State License Law does not apply to an owner of promwho bolds 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:
I do hereby Certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any luture building occupant will/will not (circle one) need to comply with said state tortes and the requirements for a
permit for construction or modmcation from the Air Duality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant:
/I hereby certify that I have read this application and stat[
ordinances and state laws relating to building construction
propen inspection p poses.
y
Date: Ignature:
Driver's License or Social Security x: �
information is effect. I agree to comply with all city and county
vize representatives of this city to enter upon the above mentioned
164646 Whim—Bmldma. Green—Cade Enforcement: Canary—Aoplicem: Pink—Rovenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NU: d V�yC l9
PERMIT NO: B 059234 PLAN CHECK NO: N Liuvl: N SUL'r N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : WINDOW REPLACE,SHWR TILE SQ FT: 25,000
CLAIM VALUE: 25,000,00 CALC—VALUE: 25,000,00 GROUP OCC: B-2 /
COMMENTS: MISC REPAIR
7, 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 RE •
PROV:
PARCEL:
11737328
ZNE:
REF NO:
PLANNING N TES>
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.• DATE: O'Zz,<
###ie#####N•##N•######### nac yr rr fc ry w,<wa-n-xxnr x l fo-vFN 1F#####)i-# a• fiw t .rt##
########M#################################i'###################################
LEGALIZATION:N F E E S U N M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC{ MECHANIC FIRE SMIP/RES GRADING
PERMIT 252,00 / 2,50
PLAN /,; SMIP/NON—RES
ISSUE FEE n.
BUILDING—DIV—> PERMIT ISSUE PLAN—C ECK TOTAL PAID DUE
TOTALS ---- > 254,50 0,00 ,00 2.54,50 254,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED`: 254,50 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIPZTOOT GRADING PLAN—CHECK
IF AF
I N D I V I D U A L ,!�'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 25000 ALTER BY VALUE RESIDENTIAL N07,ONE 1,00 25,000,00
END OF.i .FEES
" ,Tr;
.r
V (
I
CONSTRUCTION AND PLANNINu jOL & 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
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4, Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd,
8. Foundation
59. Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, C1 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 0Gas OOil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank OGas ❑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
i
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. Final Heating & Air Conditioning
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 Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
,
48. FINAL PLANNING
49. Electric Release to Edison
50, Gas Release to Southern California Gas Co
`
51. CERTIFICATE OF OCCUPANCY
No. Date
Fill ADDRESS: 1138 PAULARINO AV UNIT:
OWNEllNAME: CARPENTER WILLIAM L
ADDRESS: 3168 I N CL f NAD O
SAN CLEMENTE,CA 92672
498-9011
ARCNIENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: JIM BECKER CONSTRUCTION (714)650-5402
ADDRESS: 1956 ANAHEIM AV
COSTA MESA CA 92667
LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 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 fun force and effect.
CITY LIC.: 050169 STATE LIc.: 5 0 6 0 6 1 Cuss: A
Date: Signature:
WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to sell insure ora certificate of Workers'
ampensation Ns arc o, dr copy thereof (Section 3800. Lab.
roucYNO.' L`�J`J>y — z EXP. DATE: 7/01/93
COMPANY: STATE FUND
El Certified
Certified copy is hereby furnished. I 1 Certified copy is tiled with the city Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: Uhs secCon need Cot W MnV§etea if 0e pWM Is lM are hundred (S100) W less).
I certify that in the performance of the work for which this permit Is ISSoed, I shall not employ any person in any manner so as to become
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: Il, after making this declaration, you should became subject to the Workers Compensation provisions of the Labor
Code. you must forthwith Comply with such provisions or this permit shah be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency lot 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, atter, 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 at 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 penally of rot more than five hundred dollars ($5110).
I, as owner of the property or my empployees with wages as their sole compensation, will do the work, and the
L7 structure is not intended or offered far sale (Section 7044, Business and Professional Code: The Contractors State License Law
does not apply to an owner of a properly 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 owner win have the burden of proving he/she did not build or improve
for the purpose al sale).
I, as owner of the property, am exclusively contracting with licensed contractors to Construct the project (Section 7044, Business
11 and Professions Code: The Contractors' Slate License Law does not apply to an owner of propeny who builds or improves thereon
and no contracts for such projects min a conuactar(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. d P. C.
for this reason:
Data Owner
I do hereby certify that I am aware of and understand the requirements of California Health and Salary Code Sections 25505, 25533, and
25534 and Ictal Ior any future building occupant wilNwill nor (circle one) need to comply with said state codes and the requirements for a
permit lot construction or modification from the Air Duality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby Cenity that I have read this application and yate
ordinances and state laws relating m building constru ,on
proper lOr in5peCli pure
Dat . ^ — Signature:
Driver's License or Soc al Security a:
inlormation is correct. l agree to comply Win all city and county
)rile ftlourientaiives of thus city to enter upon the above mentioned
164146 White—Building: Green—Code Enlorcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PER NO: E U�y2J�
PERMIT NO: E 059235 PLAN CHECK NO: N UVT: N SUNY: N
CONSTRUCTION TYPE: V—N PERMIT TYPE; ELE PURPOSE: ALT
JOB DESCRIPTION : RENTAL REHAB PROGRAM SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: MISC REPAIR 9-0-F (3.S_"`)Z34-
#E#SX-X-*XYI##if-#%########S#####%###Ex.XS I(..X#####EPC#%X##IXEX.KELX##N-#S#CP#LX••##EI#L##
Z O N I N G S E T B A C K S R E Q U I R 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 REQ•
PROV:
PARCEL:
11737328
ZNE:
REF NO:
PLANNING N TES>
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
>
DUE
TOTALS ---- > 20,00 15,00 0,00
35,00 35,00
,00
REVENUE DIVISION TOTALS--> COLLECTED:
35,00 OVER/SHORT:
,00
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
I N D I V I D U A L F E E
B R E A K D O W N
DATE;
BUILDING APPROVED BY :
DATE:
APPLICATION ISSUED BY;
DATE: GgZ497
LEGALIZATION:N F E E M M
rO%
A R Y STRUCTURAL
SEGMENT:N
BLDG PMT PLUMBING ELECTMECHANIC
FIRE SMIP/RES
GRADING
PERMIT 20
SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- > 20,00 15,00 0,00
35,00 35,00
,00
REVENUE DIVISION TOTALS--> COLLECTED:
35,00 OVER/SHORT:
,00
BLDG PMT PLUMBING ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
35,00
L PCUUP##SS#S##CISE#IE#I##II###C#PC#SU#SI CS NU ICE#UPC#PSCIe#N•##LL#L#UCC###I#IIL##S
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�. P T 1 O N
UNIT COST
TOTAL COST
ELE 6 FIXTURES LIGHTING 1 ST 20
ELE 6 RECEPT/OOTLET 1 ST 20
EA,75
EA,, ,75
4,50
4,50
ELE I MISC CONDUIT NOT LISTED REQ
PERMIT 11,00
11,00
END OF FEE
CONSTRUCTION AND PLANNINu
APPROVALS Permit#
Date
Inspector
SOL & SPA
APPROVALS Permit#
Date
Inspector
i. 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.
B. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor-Final
12. Sewer 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 0 Gas 0Oil
23. Gas Pipe-Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank IDGas 00il
25. Roof Sheathing
74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREY. FINAL
30, Drywall Nailing
HEALTH DEPT. REOUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter-Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
-Zq'i�
I
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
t
;
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
t
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51, CERTIFICATE OF OCCUPANCY
No. Date
q'3
6((2
17295
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA, CALIFORNIA
For Applicant to Fill In Complefely
TYPE OR PRINT
BUILDING/ / a
ADDRESS ClG ZjV
COSTA MESA. CALIFORNIA
FEE RECEIVED
JUN 2 5196!
fIMANCE DEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
}�
OWNER S@dview AQmeS Inc. �
RECEIPT NO. Per"'7/N 5
Per"'745
MAIL 16 2 W. Almond
ADDRESS
RECEIV;t: DA RECEIVED DATE ISSUED
/L�' 7 - i (I ,
TEL.
CITY Orange NO.
BUILDING yVA
ADDRESS
HITECT
ORCENGINEER Ramberg & Lowrey NO.iQ7-6131
COSTA MESA. CALIFORNIA
ADDRESS 2127 NR Main 8tR Santa Ana
FIRE
ZONE TYPE GROUP
CONTRACTOR S. V. flansaker 61 SORB
APPROVED
BY DATE
ADDRESS 15855 Edna Place-
ZONING
ZON NO. OF USE OF
_r IN
POI BUILDING
LEGAL y TR ys6Rv�
DESCRIPTION
Irwindale
STATE TEL. NEO' ED 8-7361
rSTA
T n vNO. OP BLDOB. DNow oN LOTA.
P. NO.
FYARDS
BLDG.
EVESING
APPROVED ALLOWED
K LINE FROM /(CENTER
R OF STREET REAR YARD32
LINE ST.)
FRONT SZ FT. IN.
SIDE YARD I LEFT /6 �(
I RIGHT
R. SIDE FT. IN.
DESCRIPTION OF WORK
L. BIDE FT. IN.
NEW I $ I ALTERATION I ADDITION
REAR 2. [ FT. IN.
REPAIR I MOVING I DEMOLISH
APPROVED A� DATE/T"/6
BUILDIJ�t? Y � NO. OF
SIZE /' ROOMS STORIES 1
EXTERIOR WALBSidinCC I C
COVERING HOVERING Shin les
USE OF BUILDING AND WORK T RE PE RMED
Single Family Dwelling w1v
Attached Garage
G op
Plan
-24f
p
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES ANtl STATE LAWS -REGULATING
THE AMOUNT BROWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
BUILDING CONSTRUCTION.
SIGNATURE OF SP V. $nn8aker & VOn6
PERMITTE
�j
S /�i %//�
PERMIT FEE $ Icz—
LL_ O
PLAN CHECK S �J ,S
eJ
AUTHORIZED AGENT
TOTAL FEE ,%
I
PROJECT ADDRESS: 1138 P AULAR I NO AV UNIT:
OWNER'S NAME: CARPENTER, WILLIAM L
ADDRESS: 3168 I NCL I N AD O
SAN CLEMENTE,CA 92672
498-901]
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: JIM BECKER CONSTRUCTION (714)650-5402
ADDRESS: 1956 ANAHEIM AV
COSTA MESA CA 92667
LICENSED CONTRACTOR DECLARATION: I hereby affirm than 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.
CITY LIC.: 050169 STATE 1506061 CLASS: B
Date- Signature:
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate Of consent to sell -insure or a certificate of Workers'
Compensation Von
of Sldiel copy thereof (Section 3800. Lab. 67/01/93
POLICY No.: 11S VTATE FUND
EXP. GATE:
COMPANY:
❑ Certified copy is hereby furnished. 1� Candied copy is filed with the city Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($110) a less).
I cenity 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. -
Date: Signature:
NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor
Code. you must fonhwnh 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. Q.
LENDER: I
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
CITY OF COSTA MESA — BUILDING PERMIT Nr KM Mu; l• uay4,u
PERMIT NO: P 059236 PLAN CHECK NO: N LJu E: N ,uNY: N
CONSTRUCTION TYPE: V—N PERMIT' TYPE; PLU PURPOSE; ALT
JOB DESCRIPTION RENTAL REHAB PROGRAM SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: MISC REPAIR
Z 0 N I N GS ERTEBQAUCIKRSE 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 REO• PROV: PARCEL: 1173'1328 ZNE; REF NO:
PLANNING N TES>
>
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; DATE; 09_Z4 -
ix ##
######################### ut#########-########%########-%####%###########-%####
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECT .IC MECHANIC FIRE SMIP/RES GRADING
PERMIT 62A25� SMIP/NON—RES
pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
PLAN
SHOWER
7,00
700
PLU
and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
ISSUE FEE
7,00
20.00
PLU
1
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).
BUILDING—DIV—>
PERMIT
ISSUE PLAN—CHECK
TOTAL PAID
DUE
I, a5 owner the property or my am men with wages a5 their sole will the work, and the
❑
TOTALS ---- >
62.00
20.00 0.00
82.00 82.00
00
alCoensaThe co
not bon 71'or i Business and Professional Code: The Contractors' Slate License Law
structure is not intended or offered for sale who
does not apply to an owner of a property who builds or improves (hereon, and who does such work himself/herself or through
PLU
1
GAS PIPING SYS OF,* 1 TO 4 OUTLETS
5,00
5,00
his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or
REVENUE DIVISION TOTALS--> COLLECTED •
82 .00 OVER /SHORT •00
15,00
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
BLDG PMT
PLUMBING
ELECTRIC MECHANIC
FIRE SMTP/TOT GRADING
PLAN—CHECK
for the purpose of sale).
82.00
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑
,r
and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractors) license pursuant to the Contractors' Slate License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
I N D I
V I D U A L F E E
B R E A K D 0 W N
❑ I am exempt under Section: B. 8 P. C.
for this reason:
TYPE QTY
D E S C
R I P T I O N
UNIT COST
TOTAL COST
Date: Owl
I do hereby cenity 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 Duality Management District. Residential
these provisions.
an
Safety Code Sections 25505, 2551 and
said state codes and the requirementsfor a
construction applications are exempt tram
Date: Applicant:
I hereby poorly that I have Bad this application aCstoa.l'. that the above inff at ion is correct. I agree to comply with all city and county
ordinances and state laws tela iog tO building wristnd hereby autho z epresentatives of this city to enter upon the above-mentioned
proper or inspectionDate— Sig
Driver's License or Soca ,Security N:
164146 While—Building: Green—Code Enforcement: Canarv—Apolicarh Pink—Revenue: Goldenrod—AASesser
PLU
1
SHOWER
7,00
700
PLU
1
SINK, KITCHEN
7,00
1,, 00
PLU
1
WASH BASIN
7,00
7,00
PLU
2
WATER CLOSET (TOILET)
7,00
14,00
PLU
1
WATER HEATER AND/OR VENT
7,00
7,00
PLU
1
GAS PIPING SYS OF,* 1 TO 4 OUTLETS
5,00
5,00
PLU
1
SEWER, BUILDING / TRAILER
15,00
15,00
END OF FEES
r.
CONSTRUCTION AND PLANNING -
APPROVALS Permit#
Date
Inspector
POOL & SPA
APPROVALS Permit #
Dale
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, 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
12. Sewer Cap
�,/
,(
_
62. Backwash & Receptor -Final
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing
65. Etectrical-Final
15. Rough Electrical -Conduit
66. Solar System -Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Hough 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 OGas OOil
25. Roof Sheathing
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75, Dry Chemical
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing
I
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
-
32. Electrical Power Meter -Final
I
80. FOOD CERTIFICATE ISSUED
33. Final Electric
I
Notes:((` dqZ- s /!qn Cx ("Oso
34. Final Heating & Air Conditioning
i
35. Final Gas Pipe -Test
•
(/r
36. Hood or Canopy
37. Final Factory Fireplace
,
38. Final Plumbing
1!j3
(FQ
39. Water Service -Final
40. Gas Service -Final
,
41. Solar Domestic -Final
42. Backflow Preventer
I
i
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE &BUILDING
48, FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER
GENERAL CONTRACTOR S. V. Hunsakez
AP No. LOT 4 TRACT
DATE 6-19-62
BUILDING PERMIT NO. 17?95
VALUE $ 15:41.. oo -
FIRE ZONE DESCRIPTION OF WORK res W att gar
INSPECTIONS Signature
DATE
GROUP J&j TYPE v ZONE rl
Soil -✓S -•{y
SUBCONTRACTOR
PERMITS
ISSUED
Gay
DATE
NUMBER
Water
Rough Com. Refrig. ❑ Air Cond. ❑
Rough Heating
Rough Plumbing 6f/
/C=Ck�t5�
lv'?�'�Y
✓
MiscellaneoujQw Prop. Swr. Line (� Iou3e Con. eSt. Swr. El
Sprinkling System116
ConstrctionPo e
to
Underground ❑ Power ❑
Rough Wiring -�
_
_
_w -by
o0
renc es ❑ corms tee e. L1 /m
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In p- Out p/ 6 c"4 :a
P
Plaster, brown coat !J
62
e ng. ❑ Air Cond. ❑ Final
Heating, Final
�Q-
Plumbing Fixtures, Final
7.
Final Gas Test i
tS
-�
Electric Fixtures, Final
-g-
Building, Final
OCCUPANCY
FORM BU4 - 5M - 1.61 1 70�
7