HomeMy WebLinkAbout1145 PAULARINO AVE - Building Permits PROJECT ADDRESS: 1145 PAULARINO AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 06342' A
OWNER'S NAME: RIJKSCHROEFF, PEGGY J TR /n
ADDRESS: 1145 PAULARINO AVE PERMIT NO: 3 063429 PLAN CHECK NO: 02243-93 L GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
540-4863 L
ARCN/ENGINEER: ALTEL ENGINEERING REc.No.: C1'nO9 JOB DESCRIPTION : 397SF RESIDENTIAL ADDITION SQFT; 397
-
ADDRESS: 1660 N MAIN ST UNtt:
ORANGE CA 92667 CLAIM VALUE: 30, 000 , 00 CALC-VALUE: 29, 378 .00 GROUP OCC: R-3 /
PERMITTEE CASTAGNA CONSTRUCTION (714 ) 974-1751
ADDRESS: 19172 VALLEY RD COMMENTS; FAMILY ROOM ADDITION
VILLA PARK CA 92667 ***************************************%*****x>Ff<* X''****1F**?F)E**************)E3***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIc.: STATE LIC.: 5 0 5 5 4 3 CLASS: B
Date: p -s St1 Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I herebyaffirm that a certificate of c nsen to self-insure or a certificate of Workers' FRNT: FT IN REAR: 27 FT 6 IN FRNT: FT IN REAR: FT IN
Compensation Insurance,or a certified copy thereof(Section 3800.Lab.Cl. LEFT: 7 FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE: -___-
COMPANY: PARKING REQ: PROV: PARCEL : 14114208 ZNE: R1 REF NO:
rl Certified copy is hereby furnished. 0 Certified copy is Bled with the city Building Division. PLANNING NOTES> 397 SOp., FT, FAMILY ROOM ADD TO THE REAR OF AN EX I ST,NG '-
> SINGLE. FAMILY. RESIDENCE,
,.are: Applicant: ***********fE******** *,*,***lE**2E*****************'*********************kBEBE********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it permtis one hundred WOO)or less). D E V E L O P 2. E if-I,=�,,;. S E R V I C E S REQUIREMENT S
I certify that in the performance of the work for which this permit is rssy�"O!I shall not employ .person ny manner so as to become i /'j'
subjecttolitgworkers'Compensation Laws of California. 1( ZONING APPROVED BY 7• L' �.' ,� CDATE: •0&°11q3
Date: Q 5'-9.; Signature: ... -K.i - or {
NOTICE:II.after making this declaration,you should become jest to the Workersamp or
provisions of the Labor BUILDING APPROVED BY ' / DATE: 1.7
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. I.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for k�
which this perms is issued(section 3097,Civ.C). APPLICATION ISSUED BY: �H' % 12-4 C✓ DATE: - " 19. c7.3
******************** ******,Ex*********** * ***** ************************* ****
LENDER: *********************#•***k*iE***************************************************
ADDRESS: LEGALIZATION:N F E E ;'S U M' M•'A,.,R Y// STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'Slate License Law for the following reason ! p moi;
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 2 8 4 . 5 O I ✓ •---, .... 2 , 9 4
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business re I * l `'! SHIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by pLAN 184 . 93 , . -x/
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE / �/
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLANACHEGK . L . `TOTAL PAID DUE
❑ structure is not intended or offered on sale(Section 7044,Business and Professional Cede: The Contractors'State License Law TOTALS----> 287, 44 0 . 00 ,, 1184 . 93 2 ; / 472, 37 472 . 37 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through •
his or her own employees,provided that such improvements are not intended or offered for sale.II,however the building or / f
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COIL ECTED: '' 287144 OVER/SHORT: 00
for the purposed sale). BLDG PMT PLUMBING ELECTRIC MECHANIC, .FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 284 . 50 i, 2 . 94
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon -
and who contracts tor such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ***.*.*.**,***,*,*.*********************1b{ ******# .1#*p'dE*1E#*)E*�***************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E.'••£':=' ,B R E A K D O W N
a
for reasore •TYPE QTY DL S C R I P T ISO N -' s "-, UNIT COST TOTAL COST
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 SFR 397 DWE-TYPE V-WOOD FRAME .a ` GOOD=S 74 . 00 29, 378 , 00
25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a END OF. FEES
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from +
mese provisions. .
IT
'
Dale: Applicant: -
1 hereby certify that I have read this application and state that the alio information is corre . .free to comply with all city and county '
ordinances and state laws relating to building construction and hereby.' orize representati ' , is city t,enter upon the above-mentioned _
property for inspection purposes. /71'.4 /f
ate/ Date: .f'1J' signawr.� '+? '-%" 01001446!4-00144515 TOT 287.44
Driver's License or Social Security p: a- /Pr. f j % DATE: 03/09/43 TIME: 14:41
`
Canary-ADOlicanl;Pink-Revenue:Goldenrod-Assessor
s_ POOL PA \`
CONSTRUCT.ON AND PLANNING /
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 UF ER 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
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Rush
24/Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing Oq/93 �I�"" 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 4,1" j jj4 __ 78. FIRE PREV. FINAL
30. Drywall Nailing X11/93 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat tJ93 I ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric I Notes: 2277.7 t
34. Final Heating& Air Conditioning ,._/e2_��
35. Final Gas Pipe-Test
36. Hood or Canopy � •06 /614y14 17207,4,"
-•/p_�
37. Final Factory Fireplace j I ^'�, ��4/// feoste 1 A'/
38. Final Plumbing I ( mo**4_i1. 7 //'�
39. Water Service-Final L- �/
40. Gas Service-Final
//W/ / /d- l(�
41. Solar Domestic-Final ' '
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �Ip
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
City of Costa M. ,a
California 92628-1200 P.O.Box 1200
Insulation Certificate
Permit Number Q <7y
Number and Street City
On7r- . a.
County Subdivision Lot Number
Description of Installation
ROOF
Material 7:0,14/- P14ti(.4-J2—Arivde0 Brand Name
Thickness (inches) / rr Thermal Resistance (R-Value)
EXTERIOR WALL
Material aa/f yfoc(o it-Ar • Brand Name
Thickness (inches) it 1/01 " Thermal Resistance (R-Value)
CEILING
Batt or Blanket Type it-3D Brand Name
• Thickness (inches) %j_ Thermal Resistance (R-Value)
Loose Fill Type Brand Name
Contractor's minimum installed weighUftz_ lb. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
RAISED FLOOR
Material Brand Name
Thickness (inches) Thermal Resistance (R-Value)
SLAB FLOOR
Material r02, a Brand Name
Thickness (inches) n Thermal Resistance (R-Value)
Width (inches)
FOUNDATION WALL
•
Material (fay nCrC Brand Name
Thickness (inches) A.2 "' ),- ,24 yr Thermal Resistance (R-Value)
• Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
t the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
California Adminstrative Code.
C4STA&ar.4 GUS r,—w� r ion Lranyi
G ral ntractor(Builder) License Number
Sig azure and Title Date
Sub-Contractor(Insulation Installer) . License Number
•
Signature and Title Dale
190746
•
PROJECT ADDRESS: 1145 PAULARINO AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06343(
OWNER'S NAME: RIJKSCHROEFF, PEGGY J TR
ADDRESS: 1145 PAULARINO AVE PERMIT NO: E 063430 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA, CA 92626
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD
ARCH/ENGINEER: 540-4863 REG.NO.:
ADDRESS: ALTEL ENGINEERING C1�N1T09 JOB DESCRIPTION : 397SF RESIDENTIAL ADDITION, RE:B63429 SQ FT:
1660 N MAIN ST
PERMITTEE: ORANGE CA 92667 CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /
ADDRESS: CASTAGNA CONSTRUCTION ( 714 ) 974-1751
19172 VALLEY RD COMMENTS : FAMILY ROOM ADDITION
VILLA PARK CA 92667 *******************************************************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING N I N G R E Q U I R E M E N TS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and a ect. '�
CITY LIC STATE uc.: 505543 CLASS: B SETBACKS
Dale: �� '11 Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I h acenificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL : 14114208 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not he completed if t rmit is for one hundred($100)or less). DEVELOPMENT S E 'R V I C E S REQUIREMENTS
I certify that in the performance of the work for which this permit is iss ,I shall not employ 'erson in any manner so as to become
subject to the Workers'rkCompensation Laws of California. Jn/ ZONING APPROVED BY DATE:
` Date: �^ft"^%_T Signature. ( 'Compo /
7 NOTIC It,after making this declaration,you should become s lett to the Workers' revoked. ,
provisions of the Labor BUILDING APPROVED BY DATE:
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 fending agency for the performance of the work for APPLICATION ISSUED B Y: — DATE: €L C9,(9 3
3097,issued(Section .1E*!f.***.fe*.**.1t****.If{(. ¢*.x.*.*****.}I..li.*.*.ytiF.x.*****.x.*.**.N.ih*il.It a .x.xt.fFiE.**********i(..1E***tt**** *it***
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E S U MMA R Y STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 . 00
repair any structure.prior to its issuance.also requires the applicant(or 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 5 0% SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—D IV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 9 , 00 15 . 0 0 0 . 00 24 . 00 24 . 00 , 00
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 REVENUE DIVISION TOTALS--> COLLECTED: 24 . 00 OVER/SHORT: . 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,are exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 00
❑ and Professions Code: The Contractors'State 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).l am aware .**,*.***..****,.*******,*,*,****,****,*,***.*****.**.*,****************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.s P. C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
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 LE 1 FIXTURES LIGHTING 1 S T 2 0 EA. . 75 . 7 5
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements tor a EELE 9 RECEP T/OGT).ET 1 ST 20 EA. . 75 6 . 75
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ELE 2 RECEPT/SWITCH 1 ST 20 EA. . 75 1 , 50
these provisions. END OF FEES
Date: Applicant:
I hereby certify that I have read this application and state that the above in motion is correct.I.t •' co / ith all city and county
ordinances and state laws relating to buildingaot construction and herebyr rte representatives r is c rto er • r pan the above-mentioned
property for inspection purposes.
Date •
S S signmure. 1 0100144616-00144616 TOT 24.00
Driver's License or Social Security#: DATE: 08/09/93 TIME: 14:42
1641,46 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
� _ CONSTRUCTION AND PLANNING POOL 'A
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, 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
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &Test 72. Underground:Flush
24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 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 I 80. FOOD CERTIFICATE ISSUED
33. Final Electric' /Z-3-1/31/ Notes: .
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
I I
36. Hood or Canopy
37. Final Factory Fireplace
I _
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
i
41. Solar Domestic-Final • 1
42. Backflow Preventer ' � I
43. Backflow Irrigation
'44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING I
48. FINAL PLANNING I
49. Electric Release to Edison I I
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
l
PROJECT ADDRESS: 1145 PAULARINO AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 063431
OWNER'S NAME: RIJKSCHROEFF, PEGGY J TR
ADDRESS: 1145 PAULARINO AVE PERMIT NO: M 063431 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA, CA 92626
CONSTRUCTION TYPE; PERMIT TYPE: MEC PURPOSE: ADD
540-4863
ARCH/ENGINEER: ALTEL ENGINEERING REG.NO.: C17n09 JOB DESCRIPTION : 397SF RESIDENTIAL ADDITION, RE:B63429 SQ FT:
ADDRESS: 1660 N MAIN ST xR'
PERMITTEE: ORANGE CA 92667 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
ADDRESS: CASTAGNA CONSTRUCTION ( 714 ) 974-1751
19172 VALLEY RD COMMENTS : FAMILY ROOM ADDITION
VILLA PARK CA 92667 *****************+E#*********x*** ******** ****+¢****************yr*x**kI**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force a d effect. SETBACKS
CITYLIC.:p STATELIC.: 505543 f CLASS: B
Due: d'-9'',.? Signature: I V MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I•.ve a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR : FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a cenitied copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
SOMPANY: PARKING REQ: PROV: PARCEL : 14114208 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Cenified copy is filed with the city Building Division. PLANNING NOTES>
• J ., > '
Dale: Applicant: *******)E***********************************44*,,,k**********************************
ample EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be d if the permit is for one hundred($100)or less). /- DEVELOPMENT S E R V ( C 'LL'S REQUIREMENTS
eciaitI certify that in the performance of the work for which this permit is issued,I shall note any p son in any manner so as to become . „
subject to the Workers'Compensation Laws of California. ',ZONING APPROVED BY DATE:
Date: �fn —f? Signatures. / •
NOTICE:II.after making this declaration,you should becomataject to the Workers' mpensation provisions of the Labor ' BUILDING APPROVED BY DATE:
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 f Z CAT Z ON ISSUED B Y: 1%1 DATE
which this permit is issued(Section 3097,Civ.C). 7t•p '�
LENDER: ***********3P***********************************************sEle******************
ADDRESS: LEGALIZATION:N F E E SU M-M A R Y STRUCTURAL SEGMENT:N
�
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city Of county which requires a permit to construct,alter,improve,demolish,or
PERMIT
• 41•1 o,, 15 5 0
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 ' . 2 5t SM I P/NON-RES
.and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
•any applicant for a permit subjects the applicant to a civil penalty of not more Than live hundred dollars($500). ISSUE FEE • /.. r,-' 15 . 00
• I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK , TOTAL PAID DUE
•❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 15 . 5 0 15 . 00 ' 0 . 00 30. 50 30 . 50 . 00
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 It
• improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED :' : 30 . 50 OVER/SHORT• 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC A FIRE SMIP/TOT GRADING PLAN-CHECK
30 . 50
I,as owner of the property,aria exclusively contracting with licensed conttors to construct the project(Section 7044,Business
❑ and Profession a
Code: The Contractors'State License Law does notapply le an owner of property who builds or improves thereon n
j and who contracts for such projects with a contractor(s)license pursuart,ta the Contractors'Slate License Law).l am aware ****.*,*************************************.************************************
that proof of their Worker's Compensation insurance should be provided'hx me.
❑ Z N D Z V I D U A L F E y B R E A K D O W N
I am exempt under Section: B,g P.C. ✓ • �.
for this reason:
TYPE QTY DESCRIPTIO g,....:-
i,...9 UNIT COST TOTAL COST
)Dale'. Owner: t %'
•
I do hereby certify that am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,ani MEC 1 REPAIR/ALT HEATING UNIT/SYS W/CNTLS 9 . 00 9 . 00
25534 and that I or any future building occgpant will/will not(circle one)need to comply with said state codes and the requirements for a MEC 1 FACTORY FIREPLACE• 6 . 50 6 . 50
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from END", OF FEES
these provisions. .•
Dale: Applicant: n
i~
I hereby certify that I have read this application and slate that the aboveinformation is correct.I, re o comply ' all city and county
ordinances and state laws relating to building construction and hereby a idolize representatives a i ty to enter •.n the above-mentioned 4 X
property for inspection purposes. - /
Dale: / 5p Signature: / / 01 00144617-00144617 TOT 30.50
Driver's License or Social Security x: '/ :/.. DATE: 08/09/93 TIME: 14:42
1641.46 White—Building:Green—code Enforcement:Canary—AoolicanC Pink—Revenue:Goldenrod—Assessor 1
. . . • POOL' ;.'; -,_t •
CONSTRUCTION AND, 'CANNING ,
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 UF ER 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, 0 Undrgrnd.
10, Structural Floor System 61. APPROVAL TQ DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-1 i a 1
12. Sewer Cap '---r'
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 f ,z!i1l FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace /,-=-,U- APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 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' I ; Notes: q-.17..gj Nor vzgat ' '«
34. Final Heating & Air Conditioning • Q
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace t.9/� Y 197,r-
38. Final Plumbing C�-� /,
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
LOT. 50 TRACT 4395
. !Ai i• - X5325 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENTN 3 11992
P. O. BOX 317 COSTA MESA. CALIFORNIA VANCE DEPT.
Applicant to Fill In Completely CITY OF COSTA MESA
For
P Y APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING '/�+ n
ADDRESS
BUILDING //
pc,"/OY/n n ,Qz'tfa P.
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. I PERMIT NO.
OWNER K & K DEVELOPMENT CO. , INC, F/6325
MAIL RUC VED BY DATE RECF�IVE DATE IS
6UED
ADDRESS • . :1 . L- O'�7I'
CITY NEWPORT BEACH NE`:MI 6322 BUILDING
ADDRESS
OOR .INEER NONE TE .
- -- COSTA MESA. CALIFORNIA
ADDRESS FIRE // I�/.
ZONE TYPE {� GROUP--1), - Kay
CONTRACTOR K W Km f APPROVED
BY DATE
ADDRESS 1555 PI AGENT IA AVFNUE ZONING
CITY NEWPORT BEACH LONEC I NO.OF 2 I USEOF NEW � /.h go/` -i PLANS BUILDING k, riA •
ucTNO. 61195 No. .MI . 6-3227 LEGAL Lot so 7/C /l39r
OSI
p DESCRIPTION
SIZE
OF LOT G ry x �p /7� NOW DONBLOT B 0 A.P.NO.
USE OF NONE YARDS EVES
EXISTING BLDG o /J` APPROVED ALLOWED
SETCENTER OFCK INE STREETM �a / REAR YARD C2 " FRONT(CENTEI/
LINE ST.)I/ 19 FT. ,—� IN.
SIDE YARD ILEFT �J7'
/ 4 I RIGHT R.SIDE 7/ FT. IN.
DESCRIPTION OF WORK L.SIDE FT. IN.
NE\ I XII ALTERATION I II ADDITION I REAR zs FT. IN.
REPAIR I I MOVING I II DEMOLISH I APPROVED 1'AIA DATE //jd/gY
BUILDING da1sy Fe' NO. OF
SIZE G ' r / ROOMS STORIESi
EXTERIOR WALL I ROOF .O N-iyJ
COVERING STII CDO COVERING G OGi.e.
•
USE OF BUILDING AND WORK TO BE E
PERFORMD y 1'
. . . ,- 1, kir
ATTACHED GARAGE.
PLAN # W/4
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF ---fr7 N PERMIT FEE $ '�
PERMITTEE 6- a– �j 5-1:7
u
$ /6-
J ? PLAN CHECK $ /7,J
AUTHORIZED AGENT l /rd 0
TOTAL FEE - OC J
WN ER KSCRROEFF, R.J. DATE 3-7-78
OB ADDRESS 1145 Paularino Avenue BUILDING PERMIT NO. 45621
ENERAL CONTRACTOR R.M. Wilson DESCRIPTION of WORK_ Patio Cover
•P No. l41-142-08 LOT 50 TRACT 4395 FIRE ZONE VALUES 500. _
INSPECTIONS Signature Date TYPE V GROUP J ZONE R-1
• OIL PERMITS ISSMED
I�Cb SUBCONTRACTOR
AS Date I Number l
Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE • HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE •
UNDERGROUND 0 POWER C
ROUGH WIRING Heating and Vent. •
I
TRENCHES Li FORMS G STEEL RE1NF. 0 I
1
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN FT OUT I^
PLASTER, BROWN COAT _
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST I'J
ELECTRIC, FINAL
BUILDING, FINAL `j3ea�� A
45621 6887 3/07/78 5050 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
• •P 1 CA- ION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only f
/��/ ,p,//�s p /1 RE 'D�; DATE RECEIVED' ppTE IS BUILDINGUE
ADDRESS/Jq f'a 9,eiM, fI r ` /pJs
!, 1r/a/ICS e,�n 1," NO/V77999 PERMIT NO.
OWNER A.P.
MAIL '•� //tt"" BUILDING
ADDRESS //ylr/fH/.LA/;/.w /yam ADDRESS /41(Aatlitaa tr
CITY 5Th ///ECn NO. -/%7 TRACT �j LOT _ BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR MOVING !WWII ISH
LENDER
V.
BRANCH �i �,/
OWNER l� scmeaat f,
ADDRESS (/�� -I ////`/L.ry ��r�'�'L E ^, '�'
ARCHITECT TEL. USE 4tuni !71/d Or
OR ENGINEER NO.
FIRE If
ADDRESS _ 't ZONE - TVP ROUP
/-��a����. �__ / APPROV
CONTRACTOR 4---;---_-_-- - '7 /, .e�r�i'- BY �� DATE -7-
ADDRESS /flV' mate /il//Z .//
CITY S�1/2/`�j �j�/�. NOL cjie t) ZONEA9 / IPL-NO.OF BUILDING NEW 0� �r
F STATE CITY Z YARDS APPROVED YARDS APPROVED
LIC. NO. a c,-/53--,246 LIC.NO.0,J��_/ MAIN BUI DING A ESSORY BUILDING
U.1 SIZE NO.OF BLOCS. (FROM WI_ EET�I n
G. OF LOT NOW ON LOT PROW /7 FT.
USE OF E 7
co EXISTING BLDG. R.SIDTin FT.
'I,
F Separate permits are required for L.SIDE ,j FT.a /r FT.
• electric,plumbing and heating work. 2 e •-f"
REAR 3 FT. -- FT.
-
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN Si
G MAIN BLOCS. ACCESS.BLDGS.
', //i/ilj/ /'I7//0 OvjtiC— C.U.P.VAR.0
#' DATE
APPROVED
/ X(,r r/
i r y X /(L r‘ APPR i /l ,_DATE ✓ -7/S.
Ow
O I hereby acknowledge that I have read this application end state of
g that the above information Is correct and agree to comply with to
av ail laws regulating branding construction, and I shall not employ b
Z any person In violation of the workman's compensation laws of g
rrW,O,
the State of California.
3 I hereby certify that I am properly licensed as a contractor under /l/ SQ.FT. m)��
the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Sim
Chapter 9, and that such licenses aro In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE Olte.>, b
em exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ L.V—/ ,1
and Professions Code,Div don 3,Chapt: • _J/
CI
\ ! PLAN CHECK $ G
Permitter YJ•�_ S337 TAX $ o.U
Authorized Agent TOTAL PAID $
S. D