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Home My WebLink About2811 PORTOLA DR - Building PermitsCITY OF COSTA MESA �g1pMFsq B!/ILDING DIVISION >t�� 77 FAlR DRIVE. COSTA MESA, CA 92626 •(7�4) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca_us � FOR INSPECTIONS CALL: (714) 754-5626 '°°•^^�°fi PERMIT NUMBER: 611-00280 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 14130310 DATE ISSUED: 09/06/2011 ISSUED BY: RMD JOB AD4RESS: 2811 PORTOLA DR CM Vicinity: HOUSE AND GARAGE ROOF Squares: 2100 Suite/Unit: Valuation: $6,200.00 ` SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 15# FELT ON A 4:12 PITCHED ROOF AND REROOF WITH LIFETIME CERTAINTEAD COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE, APPROX 20 SQUARES. ALSO, REROOF 1 SQUARE OF FLAT ROOF WITH BUR. REPAIR AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: BROWN, CHARLES O TR PHONE: 949-830-9583 APPLICANT: ACOSTA, NICHOLAS PHONE: 714-773-1820 CONTRACTOR: HOYT ROOFS Address: 1809 N ORANGETHORPE PARKUnit: ,City/State/Zip: ANAHEIM, CA 92801 ARCHITECT; ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspectipi� Fee: Bldg Std Admin Fund TOTAL F $0.00 $139.25 $0.00 $1.00 Address: 25252 DAYTON DR Ciry/Slate/Zip: LAKE FOREST, CA Address: City/State/Zip: PHONE: License No. License No. License No. 606111 714-773-1820 CELL: PHONE: PHONE: Unit: Unit: : HOURS FOR CONSTRUCTION ACTIVI7Y; EFFEC7IVE 3/75/2010 - PER CMMC Sec. 13-279 Monday thru F�iday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav anA Christmas Dav NOTICE: The work authorized by this permit shall comply wiih all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF fSSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must compty with all applicable codes, and all required inspections and final approval must be obtained. Failure to o6tain inspections and final appmval will result in the expiration of this permit. CODEtl: INSPECTIONTYPE DATE INTITIAlS CO�E/ INSPELTIONTYPE UATE IN71 ALS 1616 � Fixed System Final Fire Prevention 206 Final Mechanicyl �266 Pooi Spa Final 208 Final Piumbing 200 Final qe-Roof � X ld •4• n �� 270 Final Electrical 201 Final qlock/Retaining Wall , . 212 Final Pire Preven�ion 202 Final pactory Fire Place 220 Final Planning Approval 203 FinalSign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy � WORKERS' COMPENSATION DECLARATION: I hereby aKrm untler penalty of perjury one of Ihe (ollowing declara�ions: ❑ I have and vrill maintain a certifwte of consent to selt-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the peAormance of the work for which this permit is issued. ❑ I have antl will maintain workers' compensation insurance, as requiretl by seclion 3700 0( the Wbor Code, fa lhe p rfortnance of the wnrk (or which Ihis permit is issue0. M�` rker ' compen ion I urance carrier and policy numberare: S.!��C �� C> �'1(/l �(i�rss•eclionneetlirol PWTGpIjPfPdilTfhP/py2�nIT1Ri5vdWPd\dIO PIIU/Id�2dddlJ/5(S1�fOIlP55.) PolicyNumber �j� !� VWV �r�1� ❑ I certify that in the pe ance o( lhe work for which Ihis pertni� is issued, I s o ploy r n in any manner so as to become subject to the k mpe a' o( CaliFomia, and agree thal if 1 should bec e lo t sa[ion provisions of Seclion 3700 ot t a e, 1 comply with Ihese provi5�ons. _� y mslfam's Sianawre � 'L' Oate �WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO 7HE 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 Ihat I am licensed under provisions of Chapter 9(commencing with Seclion 7000) of Division 3 of �he Business and Professions Code, and my license i�rcp�dd effect. ' r_- N.s �� p� � � � COKSTRUCTION LENDING AGENGY: ❑ I hereby a(firtn that there is a constructbn lending agency for ihe performance o( �he wvrk fp wfiich �his pertnit is issued. (Sec. 3097, Civil Cade�. Lender's Name: Lender's Address: SlgnaWre Date OWNER-BUILDER DECLARATIONS: I hereby aKrm lhat under penalty of perjury thal I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permit to conslruct, alier, improve, demolish, or repair any swclure, prioi to its issuance. also requires the applicant (or such permit to file a signetl stalement that he or she is licensed pursuanf to ihe provisions of the Contractors License Law (Chapter 9(commencing with Seclion 7000) of Division 3 0( me Business and Pmfessions Code) or Ihat he or she is exemp[ Iherefrom and the basis (or the allegetl exempiion. Any viola�ion of Section 7031.5 by any applicant for a permi� subjects the applicant lo a civil penalty of not more than five hundred tlollars ($500�.): ❑ I, as owner o( Ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the sWcture is not intended or ottered for sale (Sec. 7044, Business and Pmfessions Code: The Contrec[ors License Law does not apply to an owner of property who builtls or improves thereon, and who does such work himself or herself or thmugh his or her ovm employees, provided that such improvements are not intended or offered for sale. I(, however, the builaing or improvemen[ is sold wilhin one year o( completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as ovmer of Ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct ihe project (Sec. 7044, Business and Pmressions CoOe: The contractors License law dces not apply to an owner of propeAy wfio builtls or improves thereon, and who con[2cts (w such pmject with a contractor�s) license pursuaN to the Contrectors License Laws.). � I am exempt under sec. Business and Professions Code for this reason: Ovmer ID veri(ed by driver a ncense. ❑ Ve5 ❑ No Driver's License No. Expires: Verifcation of Ownership by (type of tlocumen�, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: � ❑ I hereby certify that no excavatbn frve (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by [his permit, and that no building sWcture, scaffdding, (alsework, a tlemolition or dismanHing thereof, will be more �han �hirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TM1Ie 8, Califomia Admini5lra�ive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permi[ from Ihe Division o( Indusirial Safety, as noted above, unless such person has a permit to do such work lrom the tlivision. Applif2nfs SignaWre Division of Industrial Safety Permit Number. _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: i. Will Ihe applicant or present or fu[ure building occupant need to fle and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec�ion 25505 0( Ihe Cali(omia Heallh and Safery Code requires, with some exceptions, that a Business Plan be fled with the Costa Mesa Pire Department by every business which has at any one time during a reported year a quantiry of hazardous malerials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cuhic (eel of compressetl gas al stantlartl lemperaWre and pressure�. 2 Does or will the applicant or presen[ or future building occupant need to file a registra[ion (orm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of Ihe California Health and Safery Code, with some excep�ions, requires regisUation with �he Costa Mesa Fire Department by each business which ai any one lime has on hand a quantity o( acutely hazardous materials equal lo or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at stantlard lemperature and pressure). 3. Does or will the applicant or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Pmgram (or acu[ely hazardous matenals)? ❑ Ye5 ❑ No (Section 25534 0( Ihe Calitornia Health and Safety Cotle provides lhal Ihe Costa Mesa Fire Department may require the preparation, certifcaiion antl fling with the Fire Depahment of an RMPP by 6usinesses which are required to register acutely hazard0us materials with the Fire Department. 4. If an RMPP is presently require0. has Section 25534 of the Calitomia Health and Safey Code been fully complied with? ❑ Yes ❑ No 5. Does or will �he applicant or present or fuNre building occupant require for the work which is Ihe subject o( Ihis application a permit for such construction or modifcation from the South Coast Air Quality Management District or from any other air polWtion control distdcl or agency? ❑ Yes ❑ No (Secibn 658502 of the Calitornia Govemment Cotle requires Ihat Ihe requestetl informa�ion be (umished on applications for nornresidential building permits�. 6. Will any part of [he faciliry to be cons[ructetl under Ihis permit be within 1000 leet fmm �he outer boundaries of a school? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the Cali(omia Health and Safery Code). 7. If a permit from the South Coast Air �valiry Management Districl or other air polNtion control district or agency is required for Ihe vrork which is �he subject of this application, have all o( the tlisclosures prescribed by Califomia Heaith and Safery Code Section 42303 been matle? ❑ Yes ❑ No 8. Qf "yes", attach certifcate ot compliance from ihe appmpriate air pollution control o�cer). CERTIFICATE OF COMPLIANCE: I certify ihat under penalty of perjury Ihe information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazartlous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cenify under penalty of perjury that I have read this application and state that the informa[ion given is correct. I agree to comply with all state laws and city ordinances relahng to bu� mg cons ruction, and aWhonze representatives of the City o( Cos 4 o en u on ove-described propeny tor inspection pu s ee y or allow occupancy of any builtling � ��ec er(s� �at 9gnaWre Date - � 305]a6 (3/01) a.Authorized Apphcam Da�e z� ADo�icant to fill in ali spaces except tnose with(n heavy Dortler linez antl sign all apDropriate tleelarations. CITY OF COSTA MESA �NSTRU�ON PERMIT . �t�M1T NO_ _ _ TRACT NO. LOT NO. UNIT NO. - Project Address z g�� e'PJ'eLM aPi✓f _ Applicart's Mailin dress 2 S S ONp r[%' ,Z6; ' Owner's N me, . Phone 3�+ �_�_-� � Address ZSL�SL_DR�s �.7 �R �l/O�U rj'2Lj D Arch/Eng. License No. Address Contractor's Name ��E� � Phone Address (mailing) � City Licenu No. IICENSED CONTRACTOR DECLARATION I hereby affirm fhat I am licensetl untler prOvi5ion5 of Chd/te� 9(commencing . with Section ]000) of Division 3 of the Business antl Pro(¢Sslons Cotl¢, antl my license is in full fofce antl effect. Lirense Class _Licenze No. Oate Si9�ature WORKEFS'COMPENSATION OECLARATION � I hereby aifirm that I have a certificate o/ mnsent to selLinsure or a cerUfitate of Workers' Compensation Insurance, or.a tertitietl copY thereof.(Sectlon 3800, Lab. C.) Polity No. Company BCertifietl copy is hereby furnishetl. Certi i d o i with the city Builtling Division. Date Applicant . EXEMPTI N F OM WORKERS' COMPENSATION DECLARATION (This section neetl na[ be roTpletetl if the Oe�mit is fo� one huntlr¢tl ($300) or Ie55). I certify that in the perfOrmance ot the wo�k fo��which this permk is i55uetl, I shall not e ploy any person in any manner so o become subject to the Warker j n Laws of Califor i Date Signature ��- � o�-�""' NOTICE: f, ait r making this tleclaration, yoU sltoultl bewme subje<t to the Workers' Compensation provisions of the Labor Cotle, you must torthwith comply with such p�ovisions o� this pe�rt��t shall b¢ tl¢em¢tl revokEtl. CONSTRUCTION LENDING AGENCV 1 hereby affirm that there is a construction lending agency tor the performance of the work for whicM1 this permit is issuetl (Section 309] Civ. CJ Lentler's Name Lentle�'s AtltlreSs OWNER BUILDER DECLARATION I nereby af(irm lhat I am ezempt from the Contractor's License Law for the following reason (Section ]031.5 Husiness and Protessional Cotle: Any clty or county whlGh r¢quires a pe�mit to con5truc[, ANer, improve, tlemolish oi �epair any structure, prior to its issuance, also requiles the applicant for such permit to tile a 5igneU statement thd[ he/sne is licen4etl pu�suant to the provi5ian5 of the Contractor'S Licenze Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Cotle) or that he/she is exemp[ therefrom antl the basis tor tM1e allegetl exemP�ion. Any violation of Sectlon 7031.5 by any applicant for a permit sunlects the applicant to a civil �enalty of not more than five huntlretl tlollars (5500). 1, as OwnEr of [he p�operty or my employees with wd9¢s as thei� Sole Compensation, will tlo the wo�k, antl the st�u[tur¢ i5 m[ intentletl or-otf¢�¢tl � for sale (Section �]044, BuSinesS antl Prof¢55iOnal Cotle: Th¢ COntractor'S Lice�se Law tloes not apply to an owner ot a property who builtls or improves, Ihen on, ana who tloes such work himself/h6rseli or throu9h nis or her own employees, provitletl that such improvements are not intentletl or offeretl for sale. if, nowever, the builtling or improvement is soltl within one year of com- plelioh, lhe owner will have the burtlen of prJ��ng he/she tlitl not builtl or im- p�ovG ��or Ihe purpo5e of sale). I, as owner of the property, am exclusivelY tontracting wlth licensetl Con- tra tors to construct the project (Seceion ]oa4, Buziness and Protessions Cotle: The Contractor's �icense law tloes not applY �o an owner of pr000rty who builtls o� imOtoves thereon, antl wM10 cont�aGts for Such oroiects with a con- tractor(sl Lcense pursuan[ to me Contractor'S L��ense Law). I am aware that p�oof oF their Worker'S Compensation insu�ance Shoultl be p�ovltletl to me. ❑ I am exempt untler Section B. & P. C. for tnis reason Date �z-�3- � owner I hereby certity tnat I have reatl this appliCation antl state that the above information is correct. I agree to <omply witn a11 city antl county ortlinances antl State IawS relating to builtling mnstrucbOn, antl he�eby authoriie rep�e- sentatives of thi511ty to enter upon the above-mentioneC property for Signature l: , CY� Drivers' License or 55 q/ 0865-46, rev. 5/88 TYPEOFCONSTRUCTION U NEW U�ADD IJ ALTERATION LI�REPAIR �� ❑ GONVERSION ❑ DEMOLISH ❑ OTHER ' TYPE OF PERMIT LJ GRADING LJ FOUNDATION L17 STRUCTURAL �❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5q. FT. oCCVaarvCv CONSTRUCTION TVPE VALUATION $ ZONE GRADING GU. VDS. ACRES Remarks: / NO �LA,v s 1. � Bar Sink Backflow Preventer Backflow Irrigation rinking Fountains loor Drains loor Sinks ' as Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspecti0n Fee � $15 Duct-UnderGround Duct - Structural Duct - Ventilating ExhaustSystem ❑ MWtiple Firepl/Fact. Blt. iC80 # Heating System & Ducting ❑ o-i ao,oao aTu O i oo,000 Fee � $15 White - Builtlin9: Canary - Applicanh Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Hearer Water Service Auto-WaSh Issue Fea Hoodor Typel ❑ Canopy Type II ❑ Refrigeration System �a� oo,000 sTu ❑ i oo,000 eT System RepaiNAlteration Fire Dampers Registers IsSua Fee � FEES aa $ 3 A.P. # S Main Building: E T Front B Rear A C Right K Left S Ping. Ref. # ' Planning NOtes: Automatic Washer Construction �Pole Si Cooking Unit Dishwasher Dryers ❑Gas ❑EI Fan F.A.U. Fizture5 Device Boxes OuUeii Switches Garbage Disposal Generator �0.5 KW Zone Accessory Building: Parking Req./Provided ELECTRICAL � Trensfo�mer � 75-50 KW ❑ 50+ KW 75 KW Meter- ❑up.to lOOamps Meter ❑over 100 amps SubPanel .�� : Motors OO-1 HP � 1%- 8 Inc.Solar �9-15 HP 016-15+ Microwave � �� Pole Light , _ Range d Sign � Standing Section's Trash Compactor I Reinspection Fee !$75 ' I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Aouliption Issued Bv FEES $ 3 � SU MARV OF FEES BUILDING PERMIT $ �0 SMIP $_ O�SO PLAN CHECK $ PERMIT. PLUMBING § ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ �7� MECHANICAL $ TOTALFEE $ , GIrS�O PLAN CHECK ZS% $ I N G R E Q M T S. o� 0002zza�-o�o�a2oz -rn� '-zi.sa DA7E: 1?li4l$$ TIME: O�.�JS CONSTRUCTION AND PLANNING POOL & SPA � . APPROVALS Permit# Date Inspector AppROVALS Permit# +�� _�� Date Inspector .i� -,. 1. Terti orary Electrical Service or Pole �-� 52. Pool & Equipment Location - 2. Soil PiRe:Undrgrnd. .'' 53. Steel Reinforcement �. 3.'Electrical Conduit Utility-Undrgmd. �� r 54. Forms ' ?� 4.-Electrica6Conduit-Undrgrnd. 55. Electrical Bonding � 5: Steel Reinforcement 56. Raugh Plumbing & Pressure Test . 6.�ElectricalUFER,Grnd. . 57. APPROVALTOCOVER-GUNITE � ,,,� � � 7. �FootirYgs' �� , ' 58. Electrical ConduiDUndrgrnd. � S.�Foundation -j 59. GasPipe,O Undrgrnd.,Test , �� 9i.Water'Pipe-Undrgrnd. ' � 60. Backwash Lines, P-Trap, O Undrgmd. �'� 10%Structural Floor System �' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 72. Sewer Cap - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final }:. 15. RougFi 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 �:-t 70. Underground Hydro 22. Ducts. Ventilating � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe/Fiough & TRsi � � 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat ' 75. Dry Chemiral � ' .- � � 27. Frame and Flashing 76. Dry Standpipe - 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat '� 79. FINAL INSPECTION 32.�Electrical Power Meter-Final . S0. 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 pomestic-Final 42. Backflow Preventer � : 43. Backflow Irrigation " 44. �Landscape Irrigation SYstem � • 45. Sound Attenuation , ' .� ' 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING � y 48. Special Requirements Completed - 49. Electric Release to Edison � j 50. Gas Release to Southern California Gas Co � �• ' � 51. CERTIFICATE OF OCCUPANCY ` �. No. Date • �. .,,;� ��', �� g��JJN ncar�a�t m tiu i� au:oace: e:eeat enose w�enin nea�y eoraer rnes a�a s�yn a�i aparooriate aeciaraeo�s. [ I 3B I 0/ I 4/86 %��0 TL CITY oF COSTA MESA CONSTRUCTION PERMIT • PERM NO. TRACT NO. LOT NO. UNIT N6. �„ -• . ProjectAddress b Z-- � �' " �� ApplicanYSMailinqAdd ' 71t7Z �1T[�PY TVPEOPCONSTRUCTION NEW /�DD ALTERATION REPAIR' ❑ CONVERSION ❑`DEMOLISH ❑ OTHER q.p.# Zone Owner'sName.. ..Phone�� DESCRIPTIONOFWORK/USEOFBLDG. ' Address 'L��^12�_��L � F ��r` •�e S MainBuilding: � Accessory_Building: • E Z Arch/En9� LicenseNo. TVPEOFPERMIT Gaao�NG'OFOUivDATiO�N/ STRUCTURAL T Front O ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING L� MECHANICAL � g N Address �� Rear � - ' ' ' � Contractot'sName �� +� �� Phone�y�( �/�j 3 �'OTHER ' %� . N r—��j�` PROJEC7 DESCRIPTION Sp. FT: ' OCCUPANCV - C Right ._ G Address�Imailing) "Z?�L�n�C�S�{ �� Ji a C�1Ga� . K . . � City License No. .-��i��i "� 1 —�— CONSTRUCTION TVPE VALUATION $ g Left . � R 'ZONE GRADINGCU.VDS. ACRES p�n Ref.# Parkin e ided� � Q LICENSED CONTRACTOR DECLARATION . � ' 9' 9' 9 I hereby affi�m tM1at I am licensetl untler provisions of Charter 9(rommencin9 Rema�ks: -�` a ' � Planning NOt25: � - M with section ]000) of Divislon 3 of the Business antl Professlons Cotle, antl � my license is in full f02e antl eftect. � � ' , , , , � T License Class' License No S � Date�—S'�G'�o Si9nature � -' � � ' ' PLUMBING FEES � �WORKERS' COMPENSATION DECLARATION � BdfSink ShOw¢�5 ' 1 hereby afiirm fhat I have a certificate of consent to seli-insure or a certificate ELECTRICAL FEES \ of Workers' Compensation Inwrance,, or a certifieC cooY thereot (Section Backflow Preventer Service Sink � 3800, Lab. C�.J� Qp� -�- � ' T P�utomatic Washer -- �Transformer � 15-50 KW ' I Poiicy No. j��i �.v�� Z� Company � a��11.e�_} ��0� Backflow Irrigation Sewer Cap� ' Coretruction PoleSub. � 50+ KW � Certi(ietl copy is hereby fumishetl. ' - . - �Certifietl copy s i' eE with the city9u+I(� in9 Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up ro 100 amps Date l�'J •� APPlicant C'A ]O•-��.�'�'� ' � EXEMPTION FROM WORKERS' COM� NSATION DECLA0.ATION Cld�ifi2�5_ $Ola� Collectors '� Di5hWa5h¢� �M¢tE� ❑Ov¢f 100amp5 � (This section neetl not be completetl if the pe�mit is fo� one huntlretl.(5100) or � less). � � � Dishwasher _ '-� � Solar Pipin9 +f Dryers ❑Gas ❑Electric Su6 Panel I certify•that in the pertormance of th¢ wo�k to� which this permk is issuetl I � shall no[ employ any person in any manner so as to become subject to t�e Drinking Fountains Solar Tank � Fan - Motors �0-i HP 01 %- 8 Workers', Compensation Laws of California. , . oate � Si9nature � Floor Drains � Swimming Pool w/Spa, � F.A.U. ' �NOTICE If,after making this tleclaration, you shoultl become subject fo Ihe IncSoldr,�9-15 HP �16-15� Workers' Compensation provisions of the Labor Cotle, you must tortbwitM1 � FloorSinks Urinal Fixtures comply with such provi5ion5 or [his permit shall be tleemetl revoketl. ' Microwave CONSTRUCTION LENOING AGENCV. GaSService .Outlets W2LelCIOSBt Device8oxes � ' 1 bereby affirm that there is a consiruc[ion lentling agency for the performance - ' POI¢ Light of the work for which this permit is Issuetl ($ection 309] Civ. CJ IOt2�CBpt0�5 � ' Wate� H¢dte� Qut12t5 Lentler's Name — Range �enaer's Atldress ' Kitcfien Sink Water Service ' Switches Sign ' OWNER BUILDER 6ECLARATION -. -' . I nereby atiirm that I am exempt irom the Contractor's License Law tor ttie Lavatories ' Auto-Wash . � ' Garbage Disposal ; Standing Sections following reason (Section ]031.5 Business antl Protessional Cotle: Any city or _ county which requires a permit to con5truct, alter, improve, tlemolisM1 o� repair P—T�dp Ldund� T/d 5 - any structure, prior to its issuance, also �equires the applicant fo� such permit Y Y Generamr �0-$ KW �5-15 KW 7r3Sh COinpacto� to file a signetl statement that he/she is licensetl pursuant to the provisions ot RoOf D�2in5 - ' the Contracto�'s LicenSe Law (Chapter 9(Commencing with Section 1000) ot . � Division 3 of the Business antl Professions Cotle) or that ne/she-is exempt � . � dherebam antl the basis for the allegetl eaemption. Any violat�on ot Section � ]031.5 by any applicant for a Permit subjects tM1e applicanY to a civil ' penalty of not more than five huntl�etl tlollars ($500). � ❑ I, as owner of the property or my employees with wages as their sole Reinspectian Fee $15 ISSu9 Fee $ 3 compensation, will do the work, antl the structure is not intentletl o� otte�etl RBinspection F08 $15 ISSUB F¢0 $ 3 for sale (Section'7044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES License Law tloes not apply to an owner ot a property who builtls or improves thereon, antl who tloes such work himselt/herself or through his or her own goiler ' Hood or T e I ❑ DEVELOPMENT SERVICES REQUIREMENTS:' emO�oYees, provitletl that such imp�ovemenis are not intentletl o� offeretl (or YP _ Zoning Approved By� Date sale. If, however, tM1e builtlinq or improvement is soltl witbin one year of com- Canopy Type II ❑� pletion, the owner will have the burtlen of proving �e/she tlitl not builtl o� im- DuCt - Unde� GrouOd Building ApproVed By ' Date p/Ove for the purpose of sale). � ❑ I, as owner of the property, am exclusively cont�acting with licensetl con- DUCt -$tiuctutdl Refrigeration Sysiem Appliwtion ISSued By DOt� fYdCtO�5f0 COnSfIIICI LhE plOj¢CL (S2CL10l1 %044. BUSIO255 dOtl PlOfQ55I005 COGC: " � The Contractors License law �loes not appb fo an owner of property who Duct - Ventilating ❑4100,000 BTU ❑100,000 BTU SUMMARV OF FEES builtls or improves tM1ereon, antl who mnVacts for such projects with a con- � iractor(s license pursuant to the Contractor's License Law). I am aware that ' BUIIDING PERMIT $ SMIP $ Exhaust System ❑ Multiple ❑ System Repair/Alteration proof o� their Worker'S Compensation insurance shoultl be provitle0 to me. PLAN CHECK $ PERMIT y� ❑ I"am exempt untler Seotion e. & P. C. !or this reason PirepUFact.8lt. ICBO # Fire Dampers ' PLUMBING $ ISSUANCE $__�_ oate owner � • Heating System & Ducting Registers � ENERGY P.C. $ I �'D-100,000 BTU �t00,0008T PLAN CHECK 25% $ I hereby certity tnat I have reaa tnis application and state that me above . � �'ji GRADING $ iniormation is mrrect. I agree to comoly wim all city antl county orainances - ELECTRICAL $ antl state laws relatin9 to builtling construction,.antl hereby authorize repre- ' PLAN CHECK 50°k MICROFILM $ 5¢ntatives of this city Fo ente� upon [he above-mentionetl O�oDe�ty fo� � � inspettion pur5y�ec��., ,�� .J1 b�� e,., „� MECHANICAL $/�� TOTAL FEE $� Signdhre A dl fX—� Date �ZL Drivers' License or 55 � Reinspection Fee $15 � Issue Fee $ 3� PLAN CHECK 25% $ CMF OB65-46, �ev. 30/84 ' White - Builtling; Ganary - AppllcanL Pink - Accountln9; Goltlenrotl - Assesso� � �CONSTRUCTION AND PLANNING � � ' � POOL & SPA � - � �APPROVALS - Permit# � Date �Inspectbr , qppROVALS� � Permit# Date Inspec*or , 1. Temporary Elecvical Service or Pole _ - � , 52. Pool & Equipment Location � . ' � ` 2. .Soil Pipe-Undrgrnd. ., �, _ 53. Steel Reinforcement _ � . ' 3. Electrical Conduit Utiliry-Undrgrnd. , - " y � �54.� Forms � . - . � - i � 4. Electrical Conduit-UndFgmd. � � � 55. Electrical Bonding � . � � 5: Steel; Reinforcement - '� 56. Rough,Pluinbing & Preswre Test - . 6. Electrical UFER Grnd. - � .57. APPROVAL TO COVER-GUNITE . -' 7. Footings _ � - . ' 58. Electrical Conduif-Undrgrnd. . . � ,� 8: Foundation � ' 59� Gas Pipe,.O-Undrgmd., Test � . ' 9. Water Pipe-Undrgrnd. �' � . � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor Sysfem � . ' , 61.� APPROVAL TO DECK �� - 71. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final � � 72. Sewer Cap . 63. Heater & Vent-Final - 13. Roof Drains . � - 64. Plumbing SYstem - Final , � ' 14. Rough Plumbing �� . 65. Elecvical-Final � - 15. Rough Electrical-Conduit ' � 86. 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. POOUSPA SYSTEMS FINAL � , � 195 Rough Heating & Air Conditioning � - FIRE DEPT. REQUIREMENT . . 20. Rough Factory Firep�ace APPROVAL$� Permit # 21. Ducts, in Structure � � 70. Underground Hydro � � 22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil 23. Gas Pipe=Rough & TOst ' 72. Underground Flush ' 24. Roof Framing . 73. Undergmd. Storage Tank � Gas ❑ Oil - � 25. Root Sheathing - 74. Overhead Hydro � - � 26. T-Bar Ceiling �StructuraVf & Monocoat . 75. Dry Chemical • � 27. Frame and Flashing 76. Dry Standpipe� - " 28. Lathing & Siding ' � 77. FIXED SYSTEM FINAL ' � 29. Insulation ' � 78. FIRE PREV. FINAL � - i 30r Drywall Nailing , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION � � � 32. Electriral Power Meter-Final ' 80. FOOD CER7IFICATE ISSUED . 33. Final Electric Notes: - ' 34. Final Heating�& Air Gonditioning �a�� (��, � 35. Final Gas Pipe-Test � �' � . � 36. Hood or Canopy " � • ' , ' , _ , � " ' - 37. Final �Factory Fireplace . . ' � • . ' � � ' ,r, , 38. Final Plumbing � 39. Water Service-Final �.� � � � 40. Gas Service-Final � � � � - • '�"; Y - 41. Shcar pomesticFinal �:� � , � _ _ .. _ . � 42. Backflow Preventer � -• � _ . _� _'. 43. Backflow Irriga[ion � �-` ' � � � x..� R' 44. �Landscape Irrigation System ' � ' - � ' � . � � � �� 45. Sound Attenuation • �"" � � � , � � � � - � F�., � � - - " : 46. Handicap Regulatibns r:t, � . � - . , - a7. FiNAL STRUCTURE & BUILDING ' , � , . � , 48. Special Requirements Completed � , � : . . . � . � • � tt 49. Electric Release'to Ed�son ' - - � � � � - - � � , i � 0 50. Gas Release to Southem California Gas Co � � � , ' ' ' � ;1 � � � ` 51. CERTIFICATE:OF OCCUPANCY. . . _ . . � '. �-- � � � d � .�. , . No. ' � D'ate � � I_ ' . . u- _ ' - - - -- ' � - - C 12333 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA MEBA. CALIFORNIA - For Applicanf fo Fill In Completely � TYPE OR PRINT ADORE169 2811 portola Drive COSTA MESA CALIFORNIA owNER Mesa Del Mar Development �o. �Su3te 1,�3800 E. Coast 1 Corona del t4ar No:Or IF_FR Ravmond Levanas NEO VL ■ 6TATE ' TEL. unw�n..eLDTB. O � BHTBAGK LINE FROM DESCRIPTIOM OF WORK 'eui�°iN�O x 37 srze Construct with at� 1 HEREBY AGKNOWLEO wHa Btw>8 THAT THS PLY WITN •u. nn oi BUILOINO CONBTIiUCT1 SIGNATURE OF L PERMITTE� AUTHORIZED AGENT F�E REGCI�ED /\ � JUN 17 1960 �'` F(NANCE UEPT. CITY OF COS�A MESA . APPLICATION FOR PERMIT Loe � 98 gUILDING Ylan 4B For Office Use Only RECEIPT NO. I � �� RECEIVED BY D TH fiECEIVE� DATE �S6OEO —�'+-'�/'-� � /5�`GD � �� /� 6n 4DD e�ss 2811 Portola Drive �COSTA MESA. CALIFORNIA FIRE ZONE APPROVED ZOPIING ZONE I NO. OF I U6E OF NEW PLANB BUILOING LB�AL / OC .. �t n�in 39 , �carvren uNe er.i JO. OF 200MS 7 STORIES � COV�ERING WoOd ShinqlE K TO BE PERFORMED. ;le Family Reaidence d garage r; t i� .%_. 0 7 p' .Y, f I HAYE READ TH�9 APPLI ION }XE AMOUNT BHOWN UND¢R VqLl1ATION IB POR THE �S CORRELT AND AGREE �COM- Project Manager 1T'NQ PURPOBE OF EBTABLISHING A pEPMIT FEE ONIY. VALUATION PERMIT FEE $ 34.00 $ 14,563.0� pLAN CHECK $ �'�•oo N