HomeMy WebLinkAbout2052 PHALAROPE CT - Building Permits •
7, MF CITY OF COSTA MESA
% F1.• , • BUILDING DIVISION
""�. ' DEVELOPMENT SERVICES DEPARTMENT
a•, g" PERMIT PERMIT NUMBER I ,
B99-00029
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT•
Job Address: 2052 PHALAROPE CT Status: ISSUED chUP
✓
Suite: Applied: 01/06/1999
Vicinity: Issued: 01/06/1999
Parcel Nunmber: 13953111 Zoning: R1 R1
Applicant: SAWYER, TOM
Address:
Phone:
Zip:
Owner VANASEK, BEVERLY L
Address 2052 PHALAROPE CT
Phone:
COSTA MESA,CA Zip: 92626
Contractor UNDERCOVER ROOFING
Address: 18196 SHARON LN •
Phone: 714-842-2980
H.B.,CA
Zip: 92648 License: 687961
Arch : Eng:
. Address: Address:
Phone: - Phone:
Zip: License: License:
SCOPE OF PERMIT
T/O EXISTING AND REROOF WITH MIRA VISTA SHAKE-ROOF CERT ATTACHED TO PERMIT.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $2,900.00
Permit: $74.75 Claim Valuation: $2,900.00
•
SMIP Res: $0.50
SMIP Com: $0.00
Other $0.00
Inspection: $0.00
•
Total: $75.25 •
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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 finalapproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the perform ce of e wo for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Calif ia,a agre that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith
comply with these pr v' s.
Applicant Signature: l Date: / H///g 7¶y
WARNING:FAILURE TO SE RE WORKE PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND OO't ARE($IW,0001,IN ADDI TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3100 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licens'• u ser 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.Lie.# / , Class*
Contractor's Signature: , rA'. Date: iG/
tel'
CONSTRUCTION LENDING AGE CV:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
1 hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to fife a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I.as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number. •
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled 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 gag 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 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 compiled with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application n permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? p Yes ❑No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: _, Date:
• CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described erode 'for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
_,� Sig ':cure Of Legal Owner(s) //�j�q Date
XI. % prnd/Or Authorized Applicant / Date
C . •, F., DATE ItQIDALS CODEF 11f PFC..TIfN TYPE DAZE IBTITIALS
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 Final Building/Occupancy _
2446-46
PROJECT ADDRESS: 2052 PHALAROPE CT UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 05587E
OWNER'S NAME:'VANASEK BEVERLY L
ADDRESS: 2052 PHALAROPE CT PERMIT NO: M 055878 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V N PERMIT TYPE: MEC PURPOSE: OTH
546-1848
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : CHANGE OUT FAU SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: IRVINEWEST HTG & AIR ( 714 ) 979-1337
ADDRESS: 638 SOUTHERN AVENUE COMMENTS• SMOKE DETECTOR REQUIRED IN THE HOME
ORANGE CA 92665 ********it****yr+E�E�E*yE*�E*y6*�E�E*iX******a(******yr******iE********** ***************)E***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am tic ,under provisions of Chapter 9(commencing with Section Z OWING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my tic: . in full force and effect. SETBACK S
CITY a .: 0. 3 STATE UC.:468609 ' °t '�
P.e: ---2-7--��Z..— Signature: �� MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I axe a certificate• ,.nsert to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
Compensation Insurance.ar a certified copy thereof(Section 3800.Lab.Cl. LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: WCP12760-1 EXP.DATE: 07/0 /92
COMPANY: CITATION INS. ;} PARKING REQ• PROV: PARCEL: 13953111 ZNE: REF NO:
A J Certified copy is hereby I niched. ® Certified copy is filed with t tit,:wilding Divis'.. PLANNING NOTES>
2L � �� >
e:.4 Applicant: ***********************************iF ******************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section oeeA of be completed if the permit is for one hundred($100)or less), DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY • 1
• DATE:
Date: Signature:
NOTICE:U.after making this d¢daratioet,you should become subject to the Workers'Compensation 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 APPLICATION ISSUED BY• LsLgamdd DATE; / �}p
which this permit is issued(Section 3897.Civ.C). *********************4 •••,�- •***.*******. —- - - - - **
LENDER: ***************lF******************************** ************iE********ff#******
ADDRESS: LEGALIZATION;N F E E SUMMARY 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 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 45% SMIP/NON—RES
and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN •x
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE _
/ 15. 00
I. as owner of the properly 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,Businessand Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 15 . 00 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 _
hiimor her provement is within one year of completirovided that such on,improvements
ownerare will have tht e burden of proving he/shed or offered for sale. e did however
build or ie mprove ove REVENUE DIVISION TOTALS-->or
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.am 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 rt
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).lam aware *******************)E1c**M******)E***' ******* (.*.****.*******•***.1(.******•*********.*..76***,
that proof of their Worker's Compensation insurance should be provided to me. IND IV I D U A (: F E E BR EAKDOWN
❑ I am exempt under Section: B.&P.C.
tar this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner MEC 1 INST FORC—AIR/GRAV••FURN <= 100 K BTU 9 . 00 9 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and TEND OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt tram r•
these provisions.
Date: Applicant:
1 hereby Gently that I have read this application and state that .above in ormation is correct.I agree to comply with at city and county
ordinances and slate laws relating to building construction and her . author"e reprr - , Ihd city to enter upon the above-mentioned _ _
property for inspection pert es. �1 �C�C'r'= 11 J:�7
I- 3 // 1y L`r;aE: U1:3.1/.'_' lir::: ..i.'! 7. .
1i Signature: r.
Driver's License or Social Security P: /
1641-46 Whne—BUOding:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POL � SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
. .2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
E 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, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System .q • 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 O 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 I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1
33. Final Electric • Notes://Z3/g& No one.VomEL- L€PCgan-c -CIO
34. Final Heating& Air Conditioning �7_p/'2-1-47.0
35. Final Gas Pipe-Test _ - - ,
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer .
43. Backflow Irrigation
44. Landscape Irrigation System.
45. Sound Attenuation
46. Handicap Regulations
47. -FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
-
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY . •
No._. _ _ Date
. • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - '-
PERM NO. TRACT NO. LOT NO. UNIT NO.
CITY OF COSTA MESA C NST UCTION PERMIT - "8346 6%26/86 -.; " TL
oaSo1 �ha�� aye_ l?� NO..
?roject Address 1 .. •
Applicant's Mailin ..Address /'fl /AI/1 y1'fld/A� gAI44e/I77' TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION LI.REPAIR '
El CONVERSION ❑ DEMOLISH ❑ OTHER A.P-# Zone
Owner's Name ...3• a k Phone 4' DESCRIPTION OF WORK/USE OF BLDG.
Address J 4/h e • - • E Main Building: Accessory Building: Z
Arch/Eng. ' - License No. TYPE OF PERMIT '❑ GRADING IL-yl FOUNDATION ❑ STRUCTURAL T Front Q'
Address ❑ TENANT ❑ ELECTRICAL I PLUMBING ❑ MECHANICAL g _ N
-' %;� / III OTHER A Rear I
Contractor's Name- e 6p� Y11)mhfd�' /41 -3�00
n(( J PROJECT DESCRIPTION SQ. FT. OCCUPANCY .0 Right N
Address(mailing/25.-3
nse N gl<�3 1 tido)Aiedii, t7N/7 h 1,9/m 9�8O/ K G
S 3 r CONSTRUCTION TYPE VALUATION $ • s Left •
R
City License No. ZONE - GRADING CU.YDS. • ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# I Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencingRemarks: - Planning Notes: - Q
with section 7000) of Division 3 of the Business and Professions Code, and M
a✓26r . RECE1vtu JuN 1 8 1985 T
my licensers in full rce .n• effect- �j
License-Class /� s�� Lic• se Y / S
nate :SI-41- .Signatur- ri "r > a• .res— PLUMBING FEES '
ORKERS' COMPENSATION DECLARATIO / A
Hereby affirmthat I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
•
3800, Lab. Ca ,/c,/ ''�"�z� Automatic Washer Transformer 0 15-50 KW
Policy No. o y'0 7"O Company/Je4✓G/- --L4/5. Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW '
Certified copy Is hereby furnished. r
GCertifi tl copy Is f p with the city B'f•Itlin�'Divi$lon. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
\ Date ? O - / - r/o Applicant/M PENL.3..e-Q /�TION4 -
EXEMPTion nee OM WORKERS'.CO PENSATIO ECLARATION Clarifiers- Solar Collectors - Dishwasher- _ Meter Dover 100 amps
•
less). eclion need not be completed if the permit is for one hundred ($100) or Dishwasher
less). Solar Piping Dryers ❑Gas ❑Electric Sub Panel '
I certify that in the performance of the work for which this permit is Issued,I •
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan , ❑0-1 HP ❑1'h-a
Workers' Compensation Laws of California. — •
ODate Signature Floor Drains Swimming Pool w/Spa F.A.U. •
NOTICE: If,after making this declaration, you should become subject to the Inc.Solar ❑9.15 HP 016-15+ _
N. Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures '
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes '
I hereby affirm that there is a construction lending agency for the performance - Pole Light '
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater pZ 00 Outlets
Lender's Name ' , Range r
Lender's Address Ki• tchen Si• nk Water Service' Switches Sign •
OWNER BUILDER DECLARATION • '
I hereby affirm that I am exempt from the Contractor's License Law for the . Lavatories . •
_ Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or - - g p ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap , Trays • - Generator ❑0-5 KW ❑5.15 KW
any structure, prior to its issuance, also requires the applicant for such permit - Trash Compactor
'o file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains -
he Contractor's License Law(Chapter 9 (commencing with Section 7000)of ' •
Division 3 of the Business and Professions Code) or that he/she is exempt - ,
therefrom and the basis for the alleged exemption. Any violation of Section - - ,
7031.5 by any applicant for a permit subjects the applicant to a civil - •
enalty of not more than five hundred dollars($500)., - ' -
LI I, as owner of the property or my employees with wages as their sole Reinspection Fee I ' $15 Issue Fee. ' $ 3
•
compensation, will do the work, and the structure is not Intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's FEES MECHANICALReinspection Fee $15 Issue Fee $ 3
.
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 -' DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered.for Boiler • Hood Ors Type I 0 .
sale. If, however, the building or improvement is sold within one year of om- - - • Canopy, Type I I ❑ - Zoning Approved By Date •
pletlon, the owner will have the burden of proving he/she did not build or.im- Duct-Under Ground
prove for the purpose of sale). _ Building Approved By ^ Date��-_a_._�-i
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By lecj> Dat
e-�/L7'11�=!yrlF•
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of:property who Duct'-Ventilating ' - ' ❑0-100,000 BTU ❑100,000 BTU ... • SUMMARY OF FEES
builds or improves thereon, and'who contracts for such projects with a con- •
tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP
proof of their Worker's Compensation insurance should be provided to me. Ex•
haust System ❑ Multiple ❑ System Repair/Alteration $
• •
7
i.: I am exempt under Section B.& P.C.for this reason PLAN CHECK $ PERMIT
PLUMBING $
Firepl/Fact.Blt. ICBG# Fire Dampers /kj a1SSUANCE $ "'t'a"`• •
•
Date Owner - Heating System& Ducting • RegistersPLAN CHECK 25% 5 ENERGY'P.C. ' $
I hereby certify that I have read this application and state that the above 00-100,000 BTU ❑100,006BTL. GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize PLAN CHECK 50% $ MICROFILM $
repre-
sentatives of this city to enter pen the above-mentioned property for .
inspection P s. [ ` p/-/ /
�Ce /) ') .J C (O MECHANICAL $ 5 G�
Signature / - •
Pink -Accounting; Goldenrod - Assessor -S---- 31-P6
CONSTRUCTION AND PLANNING PL - &SPA
APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector
1, Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
• 38. Final Plumbing ; C:46 -ct o
Th
39. Water Service-Final Fri
• 40. Gas Service-Final rri
41. Solar Domestic-Final
42. Backflow Preventer
43: Backflow Irrigation
44 Landscape Irrigation System
45: Sound Attenuation
4B' Handicap Regulations •
47 FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51CERTIFICATE OF OCCUPANCY
No. Date _
OWNER PEMBA SUBDIVIDERS, INC. DATE 2-4-b6
•JOB ADDRESS 2052 Phalarope Court BUILDING PERMIT NO. 25249
GENERAL CONTRACTOR Same DESCRIPTION OF WORK Res. lett. garage
Al' No. LOT 79 TRACT 5493 FIRE ZONE VALUE $ 3156.00
INSPECTIONS Sign Date GROUP I&J TYPE V ZONE R-1
Ixs � X/-',� SUBCONTRACTOR I PERMITS ISSUED
Date I Number I Signature
Water- )c y Z3-� /' ids d-y 1 Plum�1'•.
Rough lumbmg ' ?>�/ae�� i_�. f;�`�.>�� � �5�
Prop. Swr. Line In--House Con. I ,/C -I'_' ef [ •rfl -
Sprinkling System . i
RMiscellaneous hHeatin
Rough Heating and Air Conditioning �' 411111V-6.1.,
Temporary Service or Pole
Underground ❑ Power 0 1�
Rough Wiring a 4. - G Heating and Vent.
Trenches ® Forms'® Steel Reid. al 14M 2/9/6¢ . .11�1�1)�ar _. `�
Floor System RJ/9 ,yf/g/CF / -=
Beam 0 Steel Reinforce O
_�__
Sheathing A� 3%7446- _
Frame and Flashing /03-49y G/�e
Lathing — In Ri Out E r 5/ 0-Lt
Plaster, Brown Coat 4'»f9 ch.co s
Structural, Final Electric
H--`ung, Vent., Refrig. and A.C., Final netta �//il1,._.R. e elks. &y4. 3:a>-66,'6766
i ging, Final and Gas Test Pd'
Electric,uilg Final �fjGt `1-7.-��
Building, Final aj 1
Fr. 5493 .
Lot 79 , - 25249 ; CITY OF COSTA MESA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA,CALIFORNIA
�EB 2 1966 •
For Applicant to Fill In Completely APP ICATTIION�JFOR PERMIT
TYPE OR PRINT Frff7�„jil •
nl
ADDESNS 2052 Phalarope Court r
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA F'
REcel O BY DATE RECEIVED ZE 2,49
. a6-6,6
OWNER Pemba Subdividers, Inc. Fa 4 &16ity
MAIL Oq n„ BUILDING
ADDRESS 2850 Mesa Verde Drive ADDRESH i �'�� �J_/ l I „ff. ,
TE L ZONE TYPE GROUP Le IL
FIRE
CITY Costa Mesa, Calif. W549-039,
LAPPROVED
Or INFER Kaltenbach N J547-804 BY DATE '
ZONING
ADDRESS1823 E. 17th St. SantaAna d�rtyied(YF
ZO NO.OP USE OF NEW.
C-/ PLANS BUILDING ,/„µ/ C�
CONTRACTOR Pemba Subdividers, Inc. ���YXX�..•• �Cll L[�f-1
LEGAL /.�/- 19 - '�(� S 49 3
ADDRESS 2850 Mesa Verde Drive DEecRIrtloN✓1�..(� �IJT 4, -- L:
CITY Costa Mesa, Calif. A.P.NO.
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIG.NO . 187318 No' 549-0395 90"TO SIDE REAR P.L.
EAVES
OSIZE
LOT 65 x 105 I NOO.OPOLCIS. 0 ALLOWED (U.B.C.REQUIREMENT)
USE OF Single Family Residence - YARDS APPROVED YARDS APPROVED
EXISTING BLDG. g MAIN BUILDING ACCESSORY BUILDING
with ntt . . ,arag.��
(FROM C/L STREET) 000��� p
',
SETBACK LINE FROM 52 W IivI,/y�-�x'�
CENTER OF STREET REAR YARD 25. 75 T. V
FRONT
SIDE YARD LEFT 7 I RIGH 8 R.SIDE g FT. FT.
DESCRIPTION OF WORK L.SIDE t FT. FT.
•
NL ALTERATION - ADDITION REAP S FT.
DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN BLDQS. ACCESS.SLOGS.
BUILDING NO.OF VAR.$t .DATE
SIZE 2393 ROOMS 13 STORIES 2 C.U.P. APPROVED
EXTERIOR WAIeLi, ROOF Shingles & APPRO S `-�, b
COVERING L7 LLLCCO I COVERING shnkeq EY DATE ��
USE OF BUILDING AND WORK TO BE PERFORMED
cola/ . - S7 ,L„
390 BQ.FT. .4---/n Cr
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE _i',
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION
00
BUILDING CONSTRUCTION. ` 95—.5° H
PERMIT FEE $
SIGNATURE OF �
' PERMITTE a i _i 4 15 ;
$ 3h4/.-.)16PLAN CHECK $ . a-
D
AUTHORIZED AG 'T
j ]43 2- 4.
TOTAL FEE 5 r
V
v..••v.. 1\VV31• 1'11.1. upas+. V 4/—vv
JOB ADDRESS 2052 Phalarope Court BUILDING PERMIT NO. 25862
'O GENERAL CONTRACTOR Steve's Landscaping DESCRIPTION OF WORK; Comm. Block Wall
p'^ AP No. LOT 79 TRACT 5493, FIRE ZONE VALUE $ 525.00
/ INSPECTIONS I Signature Date GROUP J TYPE III ZONE R-1
\\S-' PERMITS ISSUED
SUBCONTRACTOR I Date I Number I Signature
Water Plumbing
VVV Rough Plumbingir
Prop. Swr. Line 0 House Con.a _
Sprinkling System
Miscellaneous _
Rough Heating and Air Conditioning
emporary Service or Pole
Underground 0 Power 0 I
Rough Wiring Heating and Vent.
Trenches S Forms 0 Steel Reinf. a of ehr,/EA
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing —In 0 Out 0
Plaster, Brown Coat
Structural, Final Electric
Heating, Vent., Refrig. and A.C., Final
F ling, Final and Gas Test 0
E1__,ric, Final
Building, Final /05.>t` 7'/9/C6
� �6. CITY OF COSTA MESA
. •Inr.•1
• COSTA MESA BUILDI�1C�r5AfETY DEPARTMENT
. P.Q. BOX 1200 COSTA MESA, CALIFORNIA 92626 • JUN 29 'I(I(��
For Applicant to Fill In Completely PLICA N •
I,F•RdELIry
TYPE OR PRINT gins
CO-
ADDRESNG S
Vl Q I U .�,aarx.anEQ, t.(
Aft RECEIPT NO. P
COSTA MESA. CALIFORNIA/-
C-0
ALIFORNI ��Gy) . . Z
�.`/I' _ RRCRIv/��'BY DAT E, ECEIVRD DATE ISSUED
OWNER l , v( r p crel\•%/t //( r( -- i 1-( `rte:Zr-../
MAIL {/ BUILDING
ADDRESS 2or2- P407/ rope et ADDRESS
/� FIRE
4117 � y� /L,�� NO. Y ZONE TYr5. GROUPP ,A
IITECT TEL BYPROVED DATE
1
'L
L _NGINEER NO. ZONING
ADDRESS
1,
2?"- IPNLA.ONOSF.-"y/' BUIaDImNsEW
CONTRACTOR (SI"ri �Lr.1-1Cfi
�!
1 DESL 1,G 2 L/✓Jj, f 1(szE /{1
CO /
cif q Rorer'', e
DESCRIPTION
ADDRESS • J
CITY tqY/d lei 3,-... A.P.NO. gam—-r
! NOTE: NO HAVE OVERHA O SHALL BE LESS THAN
LIC..NCO./ YSO NO. 30"TO SIDHe REAR P.L.
VES
SIZE J /or I NOO�OON ALLOWED Cu.B.C.REQUIREMENT)
OF LOT /� `
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET) .5.--ti
SETBACK LINE FROM FRONT FT S `i FT
CENTER OP STREET REAR YARD
/f
SIDE YARD LEFT I RIGHT R.SID[ FT. FT.
DESCRIPTION OF WORK L.SIDE FT. 0 FT. 6
NEW REAR PT. PT. / �i
ALTERATION ADDITION
DISTANCE BET. BET.MAIN IN
REPAIR �_MOYINO _DEMOLISH MAIN BLDG! ACCESS.BLDGB.
BUILDING NO.OF VAR.dC DATE
SIZE ROOMS STORIES C.U.P.# �� f� � //�/I/ APPROVED C
EXTERIOR WALL AI I COVERING
USE
APPROVED H/�1/I� TE V
COVERING /^,,'p-Ar
u r/nILDINGAND ORRPERFORMED I/•" O.
SQ.PT. 'r5
0
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COY• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. R1
PLY WITH ALL CITY ORDINANCES ANDSLRf,LAWS REGULATING VALUATION
BUILDING CONSTRUCTION. Jl
��
KI
SIGNATURE OFS �, PERMIT FEE $ J —
PERMITTEF / �. W
$ �JJ"` PLAN CHECK $
AUTHORIZED AGENT 5 �—
.., ,+1> :•�•x• 4 ..�.�� e. 1 , :. TOTAL FEE