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HomeMy WebLinkAbout1833 PENINSULA PL - Building Permits I. - --:� CITY OF COSTA MESA 66 BUILDING DIVISION Y•4t afffiZTATIZI DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER :et WI.} 1 Alt I PERMITr-- 4itbirpo f P03-00032 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1833 PENINSULA PL Status: ISSUED Suite No Applied: 01/21/2003 Issued: 01/21/2003 Vicinity: ,riplit---- Parcel Nunmber: 42451148 ISSUED BY: Applicant: CRANE, JOHN ' Address: 1833 PENINSULA PL Phone: 949-646-5017 COSTA MESA,CA Zip: 92627-4591 Owner: CRANE, SOHEILA S AND JOHN Address 1833 PENINSULA PL . Phone: 949-646-5017 COSTA MESA,CA Zip: 92627-4591 Contractor: OWNER-BUILDER Address: - . Phone: Zip: License: 000000 Arch / Eng: _ . Address: Phone: Zip: License:- SCOPE OF PERMIT WATER RE-PIPE FOR S.F.D. . FEE SUMMARY AMT QTY AMTQTY AMT QTY ISSUE FEE $23.50 - Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0:00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00. 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $9.80 1 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $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 2446-46(6/00) PECLARATIOMS WORKERS' COd1PENSATION 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' compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued of one hundred dollars ($100) or less.) 1756 1 certify that in the perfA�fomao' work for which th ermit is issued, shall not employ any person in any manner so as to become subject to the workers' �7i compensation laws ofgr a If sh ul become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith c�mSigwth these pro, — z 1 — /1 3 -Applicant Signature: (/YL� DeteJ CJ ,WARNINGi FAILURE TO SECURAIJRKER5 COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL PINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,ODVODITION 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. tr Class q Contractors Signature: Date: 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: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: 1 hereby affirm 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).): ❑ 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 (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 awn 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.). 11, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The c tractors Li ense Law does not appl an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license purs to the ntractor Le e Law .). ❑ I am exempt r s Business and Professions Code for this reason: 'Signature: ) f Date: Z —O LOwner'ID verifie y fivers license. Yes [3No Driv­aLicense er'ense No.! Verification of O tship by (type of do./Mkt, i.e. - property tax bill or deed): l� DIVISION OF INDUSTRIAL SAFETY ERMIT 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 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 a plication appermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ....................................................................................................................................................................................................................................................................................................................................................................I.................. 6 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 Code). ........................... ................ ........-........................... ....-................... ................................................................................................. .. ... ................ ....... .................... 7 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 a h application, have all of the tligclosures prescribed by California Health and Safety Cade Section 42303 been made? El Yes ❑ No .......................................................ific................................................................................................11ut......................................................................................................................................................................................................................... 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: CERTIFICAUCOMMN10E ANWD AUTti'10RIZAp�I OFENTRY:certify under penalty of perjury that I have read this application and state that the information given is correct. I agfith all ta,-tJavlaaJ("s and c'(y rdinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-descrr Inspe ti pu osea. gree of to occupy or allow occupancy of any building authorized by this permit until final inspection. zi o3 SignatureOf Legal'Owner(s)-- Date And/Or Authorized Applicant Date CODE Y. INSPECTION TYPE DATE INTITIALS CODE INSPECTION TYPE INTITIALS 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 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- FinalBuilding/Occupancy §� OWNER—BUILDER 3 VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner -builder verification. Attention Property Owner: An `owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No buildine permit will be issued until this verification is received. lO. 1 personally plan to provide the m•' labor and materials for construction of the proposed property improvement. ❑ Yes ANo 2. 1 (have have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name gE ►�(Z6UIpEt� Address City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but 1 have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lia No. 5. 1 will provide some of the work but 1 have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work IN246 (REV. 9198) 1 hereby affirm that 1 have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my personal knowledge, in compliance with this State law. LSigned: W, LY� Name: 0 .) Q FW W. C R f-1 /" Date: , — a I -" o For more information call City of Costa Mesa Building Division at (714) 754-5273. AN248 (REV. M81 �n IWA cAGINEERS 17390 Bmokhumt Sheet, Suite 100 Fountain Volley, California 92708 (714) 96&1221 • FAX (714) 968-9286 -March 21, 1990 City of Costa Mesa Building Department 77 Fair Drive Costa Mesa, Ca. 92628 Attn: Mr. Victor Clift Subject: Fine Grade Certification L J.N. 207-03 I hereby certify that the fine grading for lots 2,4,5,6,7,8,9,10,50,51,52,53,54,55,56 57 and 58 of Tract 13224 were graded as shown on the approved precise grading plans for - said project. Zol 1 Llewellyn D. Incledon R.C.E. 17593 Exp. 6-30-93 ADDRESS OF BNLgNO: 1 44 .p .m L" Lie 1 r V J V LH r u UNI: Ot NERSW "1Wptt1:CRANE, JOHN W ,,,,:CRANE, SOHEILA S PO BOX 5836 )�_L IRVINE,CA 92716 APPL. MAILING ADDREss: ARCNIIECT OR ENGTIEEN: LIC NO.: AM. OR ENG.'S ADDRESS: UNIT: coNrnAnarswala:D P PLUMBING AND INSTALLA (714)991-9477 CONDIACTORSMAIUNG 1588 S ANAHEIM BL ADORES&ANAHEIM CA Mme, 563793 92805 I,In, 3 LICENSED CONTRACTORS DECLARATION: I hereby ellim oral. Panel, d Pwyry thin I Am Damned uMm pomsov of Chap« 9 (commencing cosh Section 7000) of Dimon 3 of the Susineae coal PMeaai«ro Code, sM my bcom.e is an lul have and atlas. Crrs1JC.No.1050672 uc,cu s:C 36 LIC.NO,563793 EXP: 09/97 (Dme: Comroct«: CITY OF COSTA MESA — BUILDING PERMIT 7 —06) HHD 7- 4RM NO: P 081359 IT NO: P 081359 PLAN CHECK NO: N GOVT: N SUPP: N TRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH DESCRIPTION : REPLACE WATER HEATER SQ FT: M VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REPLACE WATER HEATER aE iF iE * iE iF aE aE k aF it aE * * 9E Rf aE * aE RE ar Rr of ar ar * iE aE * 9E aE at aE ar RE 9t Rf Rf of aE k iE iE k * iE aE aEiE aE 9f BE d6 * aE aE RE it iE aE aE aE RE * ar iE aE aE iE df BE aE * iE iF k lf iE 9E 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 •&DA0116R BUILDER DECLARATION: I hoots, moon uMer penaly of mrjuy the, I am asemyl from IM C«treao« Liwnsa Law I« the tdlooing reason (Sectio 7W 1.5 Ramona mad PMevaia« Code: Aro sty or cotvt, which mammae a Penna to ooauua, Deer, impoe, PARKING R E(� PROV : PARCEL: 42451148 Z N E : REF NO ; mocash, «rapeamy Asimaua, pd« b ce as mmou, abo reRtma «permitthe applicant for permit to Ede a agrrod malemNa Dom he or sa PLANNING NCST E S > a licensed mroamt to the movimons of Dal Catmaors Lova Law [Cheper 9 (commernmq okh Section TOW) of Damson 3 of to > Busimea and Rd.. Code] a lhat a «ahs s eeempl therahom sad IM ams la aha B.,d asmplian. A,ry velmom of Section 7031.5 by wry mast la a pemd wbisaa IM spp'cam to a owd penalty of no, more then lam midmd dollen[$S I), aE aE***aE aE*aE iE aE aE aE aEM aE aE aE at aF aE aE iE aE aF*aE 7E 1l•*aE aE it 1E*1E aE*iE iE aE aE aE aE4*aE aE*aE**leaf aE aEkaE aEkaE aE lE fr at aE aE aE aEkat dE aE lE aE aE aE*1E ❑ I,asow,rordtompopsyamyempbyesscoshwagesa has sole com,mominn,will doeawale. mod the stm masnot intended 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 a dlered M vab (Setion7044, eustev end pMaabna Cade: TMCmtrectm Limrua Law does rM W*Io m bwe,d property ova aids a mpova tensa,, aM who doe etch work h . th I tering «Dmough M «Iron own em. year povaled ohm euW improeern«a atonal wadad«offeredlaraab. 1,howmr,tombdbkg«opror the ateldwalla aro year al mnplam, Gro ZONING APPROVED BY DATE: ownerLuddw oi0 have tom dudes d proving M « aM did M bugtl a impoa la the P,mpome of els). ❑ Lacomera IM poywty, am adumm, mntreaag ooh loarsse commumpe m m,av«t the laalect (seaion 7044. Baeimns and BUILDING APPROVED BY : DATE: Pointon Code: The Cwvaons Licwhe Law doa not apply to en osmm of propony ova ddkls or «pole th«eon anal w1ro _ coaecb b wch Waith with a mood m.) licensed gasman to the Comeaas Bene Law). n/�n APPLICATION ISSUED BY: IN DATE: L ,Iam emempt under Seca,: B. 8 P.C., M Iha rentor. Dme: Owmw 1 a hmaby cetdY that I em aware of sod uMerswal to reRukemame of Cold. Beath aM Safety Code Sect. 25505. 25533. and 2553e, eM tome «arty Moro 5comm owpeA htig y wR rM agora one) need b amply wet said mate malas eM tha amPI ham Oa lar e pwmit I«maMction«modifimonhom tMAr�Ty . wropemeru D'mda. Reealmttelomstmction applutbroere eaempfmm Doe pwati«ro. Date: Appliram: WOR KER'S COMPENSATION DECLARATION: I Mreby a i under pomay of perjury aro of the folloom, deden amt: ❑ I hm end oil maintain a canBicale of mnent 10 seliau s for waken' e«npevatbn, as provided for by Section 37M of tom Labs Coda, for the pedormsnce of the coon for amvch this pamtit s bated. XF] I hm sa coil most. waken' campeamon'uwrenca, a me irod by Section 37M of tom Labor Cods. for IM Idmmarce d oM wok for which that perms a sued. MywMrornAnprRigura o patter aM policy musbea ms: EXPIRES Cd02/01/9 7 Pber (This session need not a compbred lits genre s l« one hundmd dollen j$IWf a ba.) ❑ 1 coniy that in IM pedoon. of the wc* for which this p .it Is reed, 1 shot ma employ any person in any manner n as to becare wbjae to the workers' mmpnatbn laws of Celdomia, arm agree that N 1 shouN became subject to the women' canpenamon povisons of Section 37W of the Labor Code, I shill Icnhmth comply oily Iloe pmaicm. as aagare warren' Applicami: m Is ualloom 1, M. atoll eu6Jact an employer rat ednasalmoahlo os earl m eddltlon ro tlra spar of eonpmasr/on canape sa Provided to, /n CONSTRUCTION LENDING AGENCY: I hereby affirm uMer Paraey of parNrY that there is a construction bMi,g agemy for Gro pad«msm s d la wok for which this pamN is Swed (Seton 3097. Cs. C). LENDER'S NAME: LENDER'S ADDRESS: I comity that I have reed that application eM ams IMI the above i do motion b cmect. I pre to comply wkh ag cry end county adovces as sloe lam mbag to Waking wnstnWion small Mreby mamiza repeeentatrvee d Ihb city to arms, upon tom eboye-mentioned popery for iapection mrpoen�.�rP $ Doe: i N_4 7 (515146.WP) Whit uiNng B today; Onean-Fb; Conat"pacam: Pink-Rsyenue; Goldenrod -Amara« EGALIZATION:N F E E S U M M A R Y STRUCTURAL. SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ERMIT 11.00 25% SMIP/NON—RES LAN SSUE FEE 22.00 UILDING—DIV—> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE. OTALS ---- > 11.00 22.00 0.00 33.00 33.00 .00 EVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT; •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33.00 ' I 1E * 1E 1E 1E aE iE iF ♦f * aE iE 1E aE aE * aE ar iE RE dE aE iE aE 1E aE aE aF ae k aF aE 1E aF k aF iE aE aE aE aE aF aE aE at aF aE * aE * aE at aE fE 1E iE of 9E aE k iE * aE SE * 1E iE aE aE ♦E aE if iE aE aE aF k aE I N D I V I D U A L F E E B R E A K D'O W N YPE QTY D E S C R I P T I O N UNIT COST TOTAL COST LU 1 WATER HEATER AND/OR VENT 11.00 11.00 END OF FEES VOID 82-84-1997/81:85 PN/533.88 PERMIT:081359 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PO( . SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. 'Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' c3.;.Etectrical Conduit Utility-Undrgrnd. 54. Forms _ 7..4 E]ectrical Conduit=Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcer nen 56. Rough Plumbing & Pressure Test 5 Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE _ - .7. Footings = - M'8. 58. Electrical Coniiuk-Undrgrnd. c) Foundation ? T 59. Gas Pipe, O Undrgrnd., Test '9. Water Pipe-Undrgrnd : 60. Backwash Llnes,.P•Trap, O Undrgrnd. 10. Structural Floor•System 61. APPROVAL TO -DECK 11. Pripperty 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`Wirtrtg 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED Fop PLASTERING 18. Rough Electri6l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. flough Heating & Air Conditioning - _ E,IEE CEPT. REQUIREMENT APPR01f/��.5 ' Permit # ~ - ~ 20.: Roagh Factory Fireplace _ - - - w = - ; ; 21, Ducts, irvStructuLe' 70.-Undtirgryt td Hydro 22_Due`fs, Ventifsting •� 71, Prod acr:PipingrIjGas -O Oil 23.'Gas Pipe•fto h & Test - _ r ;, 72. Underground .flush .' 24: Root Framing .- 73- Undergrnd. Storage Tank CJ Gas ❑Oil 25. Roof Sheathing < _ y =' 74. Overhead Hydro, 26_T -Bar Ce(ling (St'ructural) &-Ivforiocoat i , 76. Dry Chemicals 27. --Frame and Flashing - _ - _ ' 76. Dry Standpipe? - = 28. Laihing.& Siding.; A. FIXED SLtSTEA FINAL 29. Insulation L I n.-FIRE'PREV. FINAL 30. Drywall -Nailing ; -- -_ �• - HEALTH DEPT: REQUFJiEMENT 31. Plaster Brown Coat' ' _" _ - 79. FINAL4NSPECTION 32 7Electrical Power Meter -Final ' T 80. FOOD CERT(FIG`ATE'ISSUED 3=Final Electric'. - - 34i,Firial Heating& Air Conditioningr _ 35.-Firial Gas Pipe-Testi r.-- Nt.'.: -? l0 9' = nom c� ' - rt�c�%�IQ - 36._Hodd or Canopy 37. Final Factory Fireplace 4 38. Final Plumbing ,. ;` z _• i 39. Water Service -Final - 40. Gas Service -Final T _ -. _- -• 41. Solar Domestic -Final - 42 Backflow Preventer. 43. Backflow Irrigation - - :-44. Landscape Frriqatidn System' 45,. Sound Attenuation T. -_ 46.Handicap Regulations _47.-F14AL STRUCTURE & BUI'LDING- 48. Flr4AL PLANNING - 49: Electric Release to,'Edison 50. Gas Release to Southern California Gas Co - = 51. CE14TIFICATEOF'OCCUPANCY No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 3 CITY OF COSTA MISA CONSTRUCTION P.�r� MIT Project Address I k� 3 �+ Ewr..SIJLK► �I f-iCF - 1 Applica,'sWiling Address 180 N_ RTVFRVTFD DR- Owner's Name KAUFMAN AND BROAIbhone 921- PERMIT�jVO. � © TRACT NO. LOT NO. UNIT NO. s A P # 44024— � - Zone 7ppp f4,Q S Main Building: Accessory Building: ... TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR OO ❑CONVERSION 1:1 DEMOLISH 1-1 OTHER DESCR IPTION OF WOR K/USE OF BLDG SFD PLAN 3R E T 1 Front 15 Z O A Rear � % N 1 Address SAME AS ABOVE C Right N Arch/Eng. MIKE WOODLKA icense No. C1573O SAME AS ABOVE TYPE OF PERMIT 0 GRADING LXJ FOUNDATION U STRUCTURAL ❑ TENANTX❑ ELECTRICALX❑ PLUMBINGX❑ MECHANICAL ❑OTHER IINTT-9371 (;ARACP. 462 DFC'K - 76 S Left / R Address Contractor's Name -mss' s%#tilE Phone Address (mailing) City License No. 'Ping. Ref. # F) —1/0 Parking Req./Provided 07,5 Q E PROJECT DESCRIPTION SQ. FT.SEE ABOVE OCCUPANCYR/ 1694'117M CONSTRUCTION TYPE 17T1 VALUATIONS 16!4'117,M ZONE NA GRADING CU.YDS.46894 ACRES-iii Planning Notes: HOLD FOR SR� REQUMEMNTS Q M TN.�_ S. LICENSED CONTRACTOR DECLARATION Remarks: I hereby affirm that I am licensed under provisions of Charter 9 (commencing ELECTRICAL FEES with section 7000) of Division 3 of the Business and Professions Code, and my license is in full forcaalld effect. 334495 PC 234-t59-1 License Clas cen e Date Signature WORKE CO PENSATION DEC RATION reby affirm that I have a certificate of consent to self-insure or a certificate Yorkers' Compensation Insurance, or a certified copy thereof (SectionBackflow ,0, Lab. C.) 4189-,1090 trans. ins. Policy No. C pa 1k�-lyCertifi coo is hereby furnish (/ LTJ Car '/" tl filed with the cl Building ivision.}.v / Date Applicant ;S E%EM ION FROM WORKERS' COMPEN HTION DECLARA IO (Thisseclion need not be completed If the pfl mit Is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is Issued I shall not employ any person In any manner so as to become subject to tke PLUMBING FEES Automatic Washer Transformer ❑ 15.50 KW Construction Pole Sub. ❑ 50+ KW Bar Sink �' Showers oO Pr¢vente! - Service Sink Cooking Unit Meter ❑up to 100 amps Backflow Irrigation $ Sewer (ap - - - Dishwasher- ^, Meter ❑over 100 amps - Bathtubs / Sewer Connection DO Dryers ❑Gas ❑Electric Sub Panel - Clarifiers Solar COII¢CLorS ' 4 Fan Motors CIO-1 HP ❑1'h-8 Dishwasher Solar Piping Q(� F.A.U. Inc. Solar 09.15 HP 016-15+ Drinking Fountains Solar Tank Fixtures Microwave 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 Floor Drains Swimming Pool w/Spa Device Boxes Pole Light Floor Sinks Urinal Outlets Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 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's Name nnnP Lender's Address —(�{qp OWNER BUILDER DIE'NATION- I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ;`.wision 3 of the Business and Professions Code) or that he/she is exempt ;� refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant t0 a civil ienatty of not more than five hundred dollars ($500).$ ❑ I, as owner of the property Or my employees with wages as their sale compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 tom- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Cade: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for such projects with a con- tractor(s1 license pursuant to the Contractor's License Law). I am aware that proof of( their Worker's Compensation Insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason S Gas Service Outlets Water Closet OD Switches Sign Interceptors Water Heater av^ W Garbage Disposal Standing Sections Kitchen Sink / Water Service '- Generator 1:10-5 KW [35-15 KW Trash Compactor Lavatories Auto-Wash g4 ?c _ 03.5X 2172 P-Trap Laundry Trays 02 ROOF Drains _ S " - Reinspection Fee $15 Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By (�-� Date / Building Approved By. Date 7 Issqed By Date�f %rtQ� Reinspection Fee $15 Issue Fee 3 MECHANICAL FEES Boiler Hood Or Type I El Canopy Type II ❑ SUMMARY OF FEES t BUILDING PERMIT $ 4&1r 62 SMTP $ r PLAN CHECK $ ZY71 73 PERMIT {� PLUMBING S 'gyp r 00 ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL S—L!IMGRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ fir 50 TOTAL FEE $ /.�p•1 PLAN CHECK 25% $ o'tL..2277 _ :' a.�---q'_O'I jiC1 - R,. ?' � -. : /��4 TTPi Duct - Under Ground Duct -Structural Refrigeration System 00,000 BTU ❑100,000 BTU Duct - Ventilating Exhaust System ❑ Multiple ID System Repair/Alteration / Firepl/Fact. Bit. ICBO =lk?,507 Fire Dampers v Date owner 1 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 ting to building construction, and hereby authorize repre of this City to ger upon above mentionetl prop Y r inspection inspection phi Date Signature Drivers' License r SS � - �% Heat System & Ducting LIMI BTU ❑100,000 BT Registers Reinspection Fee $15 Issue Fee 0865-46, rev. 5/98 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POC SPA APPROVALS Permit# Date Inspector 1. Te PAporary Electrical Service or Pole - 52. Pool & Equipment Location '. 2. Soil Pipe-Undrgrnd. t{-/3' -4y% LOO 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 i EE 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. .,,2,0. - CAV� 60. Backwash Lines, P-Trap, 0 Undrgrnd. . Structural Floor System 61. APPROVAL TO DECK `17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 1.2. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing Vi7e LtW 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 1 ?6 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 EJ Oil 23. ;Gas Pipe-Rough & Test 72! Underground Flush 24. hoof Framing 73. Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing/4-10 76. Dry Standpipe 28. Lathing & Siding v 77. FIXED SYSTEM FINAL 29. Insulation r 78. FIRE PREV. FINAL a-`�i�oljf 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat gp 79. FINAL INSPECTION 32. Electrical Power Meter-Final d 80. FOOD CERTIFICATE ISSUED 33. Final Electric otes: r. 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 2/57/10 GED 36. Hood or Canopy BID 37. Final Factory Fireplace L� 38. Final Plumbing QQ 39. Water Service-Final 40. Gas Service-Final - 41. Solar Domestic-Final, ' 42. Backflow Preventer 43. Backflow Irrigation - r, 44. Landscape Irrigation'System 45. Sound Attenuation'' 46. Handicap Regulations: 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed /(,Lr io r 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I; 51. CERTIFICATE OF OCCUPANCY No. Date "' IWA ENGINEERS 17390 &ookhurst meet, Suite 100 Fountain \k71k?y, California 92708 (714) 968-1711 • FAX (714) 968-9286 March 21, 1990 J.N. 207-03 City of Costa Mesa Building Department 77 Fair Drive Costa Mesa, Ca. 92628 Attn: Mr. Victor Clift Subject: Fine Grade Certification I hereby certify that the fine grading for lots 2,4,5,6,7,8,9,10,50,51,52,53,54;55,56,57 and 58 of Tract 13224 were graded as shown on the approved precise grading plans for - said project. - 4-a� -- Llewellyn D. Incledon R.C.E. 17593 Exp. 6-30-93 �T 3 5/l 2- / / tq i•os4 /v %sic 1 BN FORM 116 CALIFCRNIA SEAB'EEZE PHASE 1 BIA FORM 1486 INSULATION CERTIFICATION This is to certify that, in conformance with the current energy regulations (California Adminis- trative Code, Title 25, State of (alifornia`) and approved plans, insulation has been installed in the building located of - Costa Mesa Orange City c1..ty 1833 Str..l X1. of M.n.bl.) ROOFS Peninsula Place str 57 Lal X.m DESCRIPTION OF INSTALLATION 13224. Tnd a.. Type of Material _ Manufacturer Thickness— R Value"_ EXTERIOR WALLS OWENS CORNING Type of Material FIBERGLAS BATTS Manufacturer FIBERGLAS Thickness 321f R Value" 11 lot Tnd. CEILINGS - pWENS CORNING 6u" 19 BATTS:FIB�,AS BATTS Type of Material Manufacturer FIBERGLAS Thicknear911 R Value** -30 (or Yr a 11.114 Sq. FL Covered BLo1NN: Type of Material Manufacturer Thickness --No. Bags_ (or had. 14.) WL/Bae Sq. FL Covered R Value"_ FLOORS Type of Material Manufacturer Thickness R Value"— (or in" 11.4 SLAB ON GRADE Type of Material Manufacturer- to, anufacturer_ca Yr1M 14aW Width of Insulation Inches FOUNDATION WALLS (if required) Type of Material Manufacturer_ (or Tnd1 14-4 REMARKS (if desired) Thickness R Value". Thickness --R Value"_ General Contractor (Builder)_ Kauflnan & Broad- License Number_ &6tontractor (Insulation Applicator)._ pccenL insu1 n.w,b 19 ) (Sbb "SAME' M ae. By— / Title—L YCY:I>wu Ad.:dm.ri.. rsd., Enq> Imlarl« sl. d•, dwla•.•, ..�Y V... .I !b.:mM1llari« .l i •.l.ri«, rand a111,iM NH N. iwl.l:r 111• bwn iw•M114.i Iw onl.,..wp �:N N. 'r.l......n .f Nor. ,v.•I.l,m •MII M ay..l.M1d ..d .•mM ti �+ 1.•H.�« roll •v M1. «d 6i rb. b.Il1.r. TAI. !-:.I.rir wvllry •.nl d.il w .yy N . i«rN•+w• l.ud« aNi. Ib. d.Hl�ry."( 1"1 vYw l• rA..wrm N r4 .W.Ivw N • .v.r4 DvIN:.y 71w r.J•M1wo •.Iw 111 a .u•-hV. IFHni M. d.11 M lw.l.d. M .vlw Iv nf4Ww IbM-) o::te ticens! Number 274283 Date March 2, 1990 nairr Iv. Svc 1r VS .r d•. N«IN r.r S.r y (;adv ar Cis. SM1+.. "M. •.r!ifi.Y. a a[n,pv.c, r ..il. er%RmNr NH'. nw.!) n► •IM1at.d \.MI, .YHA sDerr..nl bw r, b.... M .Nw ...id.M a1 hdnq b bHPab4 doll M :uwJ >ti •.d . bPd�y Mp.C.w.+l wl.r !bv rr+vatvw .l .r.l wlifio M ti u'p, .rNY.r 1M1wd.rd• .,Islll.bwi pww«I I.• NI• dNlvw Y Form 116 —9 BUILD!4G NEWS. INC_ 3055 Overland Ave., Los Angeles, Calif. 90034—(213)a7499T1 Form 1486—D BUILDING INDUSTRY . =fATION OF CALIfORNU4 INC., 1571 Beverly Blvd, Los MyeM, Calif. 30026--f21A 5255771