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Home My WebLink About100 PINON TREE LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 100 PINON TREE LN Suite: Vicinity: 100 AND 102 PINION TREE LN Parcel Numtier: 43917201 Zoning: R3 R3 Applicant: MC COLLISTER, ELISE Calc Valuation: $5,300.00 Address: 28816 CONEJO VIEW - Claim Valuation: $5,300.00 SMIP Res: _ Phone: 818-735-7876 SMIP Com: AGOURA HILL, CA ' Zip: 91301 Owner: LAUREL POINT TOWN HOMES ASSN Address 4631 TELLER AV $0.00 - SUITE 130 Phone: - ',NEWPORT BEACH, CA Zip: 92660 Contractor: PRO -TECH WEATHERPROOFING Address: 23261 DEL LAGO MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 STE 5 Phone: (949) 583-1858 Right 0-0 LAGUNA HILLS, CA Existing: 0 _ Required: 0 Proposed: 0 Zip: 92653-1330 License: 620476 ISSUED BY: Status: ISSUED Applied: 04/29/2002 Issued: 04/29/2002 Arch - Eng: ' Address: - _ Address: Phone: - Phone: Zip: License: License: SCOPE OF PERMIT REROOF 100 AND 102 PINON TREE (LAUREL POINT HOA): T/O EXISTING SHAKE ROOF, SHTG PER MFGR SPECS, 1 LAYER 30# FELT, APPLY "GAF GRAND SEQUOIA" SHINGLES. 25 SQUARES NOTES 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: V1 4) 7545626 FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,300.00 Permit: $125.25 Claim Valuation: $5,300.00 SMIP Res: $0.53 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.78;- - - PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 6-0 , Rear 0-0 - Left 0-0 Right 0-0 PARKING Existing: 0 _ Required: 0 Proposed: 0 NOTES 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: V1 4) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 4 ❑ I have and will maintain a certificate of consent to sell -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. 1 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' co nsetlon InsufB/fnL�a c�a�rv�er�a/n�d �policy / n'�u�m,b,s are: Cartier: � tJ rKQiC&�(/L-nb✓( Policy Number: (This section need not be completed it the permit / valued at one hundred dollars ($100) or less.) ❑ 1 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.C lifomia, and ree oma subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these r S. �/ Applicant Signature: Date: � ?f7 — WARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3105 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 Busiz and Professions Code antl my license is in full force and effect. Lic. N 60 ZO K 7 (O Class It C Contractors Signature: AiaP. 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). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER.DECL'ARATIONS: I hereby affirm that underpanaI fy 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 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 Cosa) 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 properly, 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 hes 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)? [3 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 complietl 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 application aermit for such construction or modification from the South Coast Air Quality Management District Or from any other air pollution control district or agency? Ll Yes 8 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residenlial building permits). ........................................................................................................................._........................................................................................................................................................................................................................................................ 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 25536 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 [I No ... .........._.........................._..........................._.___...................................................................-..................................._..............................__........................................................................._..-............_................_...............-..............__.... B (11 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. 1 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 property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ig r f Le al A f_ �J pr D 6 nd/Or Authorized Applicant [/ / Date CODE I. INSPECTIONTYPE 17AIE IdTITAL3 CODE INSPECTION TYPE 26H IWTI1AL5 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 Well 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 100 PINON TREE LN FEE SUMMARY Status: ISSUED Suite: $41.05 Applied: 08/22/2000 Vicinity: PATIO AREAS Issued: 08/22/2000 Parcel Number: 43917232 Zoning: Applicant: FRANK ODDO ISSUED BY: Address: 1412 S CENTRAL PARK AVE #A Inspection: $0.00 Phone: (714)991-7773 Total: ANAHEIM, CA Zip: 92802 Owner: LAUREL POINTE HOA PLANNING & ZONING Address 2521 POPLAR LN MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Phone: (949)645-8217 Front 0-0 COSTA MESA, CA Zip: 92627 Contractor: ORANGE COUNTY FENCE Address: 1412 S CENTRAL PARK AVE #A Phone: (714)991-7773 ANAHEIM, CA Zip: 92802 License: 506245 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 86 LF OF 5'-6" HIGH BLOCK WALL TO REPLACE EXISTING WOOD FENCE FOR ADDRESSES AT 100, 102, 104 & 106 PINON TREE LN. NOTES 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 2aa646 (6W) FEE SUMMARY Plan Check: $41.05 Calc Valuation: $1,720.00 Permit: $63.15 Claim Valuation: $0.00 SMTP Res: $0.00 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $104.20 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 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 2aa646 (6W) DECAARATIONS WORKERS' COMPENSATION DECLARATION: I hereby alliin under penalty of perjury one of the following declarations: - [J I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Cade, 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 sacdon need not be completed if the permit is valued at one hundred dollars ($160) or less.) ❑ 1 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 lawsof Celifomi�agree that' I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with then to ''j14�s. Applicant Signature: � y� j� r Date:( WARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AD CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license or rovisions, of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and r ssio s Code, an my license is in full force and effect. Lic. p Class N (� Contractors Signature: I Date: 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. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I 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 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 Profossions 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. It, 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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, talsework, 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). ..............................................................................................................................................................................................ratI................................................zSr*..................t'e"r............................s._...................................................................... 2 Does or will the applicant or present or future building occupant neetl 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. ........_.......................__............................._,.__._...._.................................................___lifo....................__........................Code b.._................... milli.__._.._........._.... ....._..._............0........... _........... ..........___.......... 4 If an RMPP is presently required, has Section 25534 of the California Health end Safety Code been fully complied with? ❑Yes ON D ....................................................................................................................ildi...........................................................................................................................this..........................................................................................................difi............... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of thisa�ppplication epermlt 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 ❑ 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 pert 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 II 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 ❑ No ..................._..................._—.._...........-.............................................._...........____.11ut..... control ._.....................___......................_.__.__.—___......._................ ... _......._._..........._...._..__... 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 t0 enter upon the above-described property for inspection purposes. 1 agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. atu Of Legal Owner(s) 'AITCYCIMUMUTIZed Applicant Date CODE r. INSPECTION TYPE PATE 1NITTA CODE I INSPECTION TIDE PATE (N®ELE 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 Well _�� (04'x/ 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 The Site c UVI_ L 26 A I An A —noun J MONIE VISIA 21A 20A^ 19 Bn IB _, 17An 16A E NOTE ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIVISION APPR®YD CITY OF COSTA MESA PLANNING DIV. ,ren RLDG. DEPT. REG. EbCuwI�S uK BCD-C)12-bo N OB DINDIVISF ILING AFETY CITY OF COSTA MESA By APPROVED mbadaip1lemawsDedf>rafbreAlUsrbe BaW 22IDD makearryd�9esaalfarafipnonthisjobata9tknesafdnlsunlawfult ardSafety,CiyO Cwaf�esaon keDt. "wg�"To^Pem6swhmmeomsi nofBui*: If the niPllonof DlanandsPedCglbMSH4uIMThehaktto MM 'If the io^afbn o/ any Pmvhioos of any . ty or 0051, .48sr CMt or o ban approw: State ^Gas and rcouPllmShall expire dd aditatiun and oarnraa null and void if the buitinf, v�orR s r:n: ccrrunan�ad and mamlamad active fm• UBC;303 (d) within 180 dz;, of i Sua:,c 0� CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. 10097 DATE: LOT NO. ADDRESS 102 PINON TREE LANE, COSTA MESA The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. By executing this agreement, the undersigned acknowledges that he/she/they was/were advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having cciTplied with the conditions of approval which were inposed by the City at the time the Final Tract Map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncotcpleted u� vL V E7 nc C^q-1 .,mac•. X7.19,9 AN PM 7j8i9jIDj11i12j ij2j 3A5i 6 6 4/79 authorized representative CALIFO IA/MFRAL SAVINGS & LOAN ASSOCIATION BY (Signature of er) Richard A. Gaunt, Assistant Vice President F5 CITY OF COSTA REQUEST FOR OCCUPANCY TRACT NO. LOT NO. 46 ADDS 100 Pinon Tree Lane, Costa Mesa, CA 92627 DATE: January 14, 1980 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. By executing this agreement, the undersigned acknowledges that he/she/they was/sere advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having conplied with the conditions of approval which were imposed by the City at the tirre the Final Tract Map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition(s). RL V L CIT JAN 14- 1980 AM PM 7igI'd iiuIII iiGI.LI M 0141516 4/79 W, authorized representative CALIFORN FEDERAL SAVINGS & LOAN ASSOCIATION BY Z e ` ffSi nature of. Le Richard A. aunt, Assistan ice Presiden FE� PROJECT ADDRESS; UNIT: 100 P I NON TREE LN OWNEfl'S NAME: MC KNIGHTrMARY JANE ADDRESS: Ill PTNON TREE LN COSTA MESA,CA 92627 ARCH/ENGINEER: 1546-7128 flEG.NO.: ADDRESS: UNIT: PERMITTEE: EARLS PLUMBING (714)772-3470 ADDRESS: 1533 W. LINCOLN ANANHETM CA 92801 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code. and my license is in tug force and effect. CITY LIC .:Q0593R STATE LIC .:217657 CLASSIC 3 Date: s -3' b �� Signawre:—/_2i��a—✓t4��G/CJ WORKERS' COMPENSATION DECLARATION: I hereby alfirm that I have a certificate of consent to self -insure or a Certificate of Workers' Compensation Insurance. or a certified Copy thereof (Section 3800. Lab. C). POLICY NO.:UCA-11686 EXP. DATE: 03/01/92 ;OMPANY: UNIT CARE Cenilied copy is hereby furnished. Q Certified copy is filethe city BuildingDivision Date: -140-90 Applicant: UI��T /1 10�a�,a�% EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: Pis section need not be completed it the all 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 became subject to the Workers Compensation Laws of California. Dale: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you most forfharm comply with such provisions or this Permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 70315 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Processions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I, as owner of the property or my employees with wages as their sole compensation• will do the work• and the F1 structure is not intended or offered for sale(Section 7044• Business and Processional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon. and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It. however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusive) contracting with licensed contractors to construct the project (Section 7044, Business E) and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. lot this reason. Date: Owner I do hereby certify that I am aware of and understand the requirements of Califomia Health and Salety Code Sections 25505. 25533, and 25534 and that I or any future building occupant wilUvdll not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Call Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and'/tC�fO�W/��aothomee representatives of this City t/o` enter upon the above-mentioned property for inspeclmn purposes. l .C!//"i !, / Ju✓vJ✓Y Dale: x/-aG-Qa Signature: 7 Drivers License or Social Security p: 164.146 White—Buildme: Green—Cade EnOnCemenL Canary—Aootrrarh: Pink—Revenue: Goldenrod—Awesor C.LTY OF COS"A ,MESA - BLS .Lll PERM!: PERM!' NO: P 05636'1 PLAN CHECK NO: 14• CONSTRUCTION TYPE: V -N PERMIT TYPE: PLU JOB DESCRIPTION : CHANGE OUT WATER HEATER CLAIM, VALUE: CALC-VALUE: PERM \O: P 05636 GOVT: N St PP: N PURPOSE: OTH SQ FT: GROUP OCC: R-3 / COMMENTS: MAIL IN PERMIT ########################%######%%############X***%#################DC##%##%%%##X 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 BU.ILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT f LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING RE8: PROV: PARCEL: 43917232 ZINE; REF NO: PLANNING NTES> > D E V E L O P M E N T S E R V I C E S°' R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ., DATE: APPLICATION ISSUED BY: DATE;� ��- LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N 117 BLDG PMT PLUMBING ELECT&IC MECHANIC FIRE SMIP/RES GRAD -NG PERMIT 2,00 2 58 '" SMTP/NUN-RES PIAN n' ISSUE FEE 3,00 BUILDING -DIV-> PERMIT ISSUE P%At3-CHECK TOTAL PAID DUE TOTALS ---- > 2.00 3,00 0,00 5,00 5,00 00 REVENUE DIVISION TOTALS--> COL ECTED: 5,00 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 5,00 I N D I V I D U A f o F E E B R E A K D O W N TYPE QTY D E S C R I P T I Q NM UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR VENT 2,00 2,00 END OF FEES n - r. • r a r 4.: CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector Pf & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. - 54. 'Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final , 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65, Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0 011 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. FOODCERTIFICATEISSUED 33. Final Electric Notes: -71&014z. t-400 .Cff0WWG-Lfr.FT GACA •L" 34. Final Heating & Air Conditioning No O Ke 6:-om LoE Fi CA ez4l • coev 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 F C COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING /L„ r .— r/. +tip / w OWNER Monte V1.Sta 7'ownnomes Inc. MAIL ADDRESf9Ol Dove St. 225 TEL. CITY e ort Beach ND. 752-507 CONSTRUCTION LENDER BRANCH ADDRESS 815 H ARCHITECT TEL. OR ENGINEER 504 NN. NBeach Blvd #202 ADDRES CONTRACTOR w . _4 .iI/"/L ADDRESS k cl 7801 780'( TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE NO BLOBS. OF LOT I NOW ON LOT USE OF Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any parson In violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under the State of California usiness and Professions Code, Division 3, Chapter 9, and t u licenses are in ull force entl effect, or I am exempt fro r vi sot the t ate W California Business and Professions DI ' I , Ch t 9 Signature of Permittee -_ Authorized Agent RECEIVED BV I&AA E/FlECEIVED pgTE2��Li A.P. FIRE i W7. ZONE NO. OF USE OF NEW PLANS Z, I BUILDING YARDS APPROVED YARDS AF MAIN BUILDING I ACCESSOR' DISTANCE BET. BET. MAIN & MAIN BLOW. ACCESS. BLDGS. VAR.+ j'C _r DATE C.U.P. 7 /I APPROVED .>�.�'�77 APPROVED/i K /0'�1/-7P_? HOLD FOR /SPECIA RE UI oo�� `�% N sa m 7ZSQ. FT. SD` THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ o Jizt vI PLAN CHECK $ y�� i Nj S -73 0-" (/ TAX $ -U TOTAL PAID $ cl 7801 780'( 10/27/7B 121.61 TL 10727/78 F21'sOUT0 780T '00004469 63 APPLICATION FOR STRUCTURAL PERMIT RECEIVED BV I&AA E/FlECEIVED pgTE2��Li A.P. FIRE i W7. ZONE NO. OF USE OF NEW PLANS Z, I BUILDING YARDS APPROVED YARDS AF MAIN BUILDING I ACCESSOR' DISTANCE BET. BET. MAIN & MAIN BLOW. ACCESS. BLDGS. VAR.+ j'C _r DATE C.U.P. 7 /I APPROVED .>�.�'�77 APPROVED/i K /0'�1/-7P_? HOLD FOR /SPECIA RE UI oo�� `�% N sa m 7ZSQ. FT. SD` THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ o Jizt vI PLAN CHECK $ y�� i Nj S -73 0-" (/ TAX $ -U TOTAL PAID $ i /, COSTA MESA BUILDING -SAFETY DEPARTMENT 7930 10730/78 7aqn iniani78 233.00 TL, -233e000KT0 PPL[CATION F47&U� PEHINIT IA For Applicant to Fill in Com letely — Use Ink Only R C I E BV I DATE RECEIVED DATE ISSUED ADIDRESS-DINGDO V L. PERMIT NO. OWNER A.P. NO. MAIL ADDRESS BUILDING ADDRES 2 TEL CITY NO. TRACT LOT BLOCK W A A P CONSTRUCTION LENDER BRANCH OWNER ADDRESS ,reL�ic S �''S ARCHITECT TEL. OR ENGINEER N 0. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR By DATE ADDRESS ZONE NO. OF PN USE OF NEW BUILDING TEL. CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. FROM C/L STREET) OF LOT NOW ON LOT FONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT,FT Separate permits are required for L. SIDE FT. FT. REAF T. FT. electric, plumbing and heating work. USE OF BUI LOING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLDGS. VAR.* DATE C.U.P. 36 APPROVED APPROVED I hereby acknowledge that I have read this application and state m that the above Information is correct and agree to comply with all lows regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, m SQ. FT. N D THE AMOUNT SHOWN UNDER VALUATION IS FOR 00 Chapter 9, and that such licenses are In full force and affect, or I am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b VALUATION PERMIT FEE § �+ m PLAN CHECK § ^� o TAX § � Signature of Permittee §n A=a icrized Agent TOTAL PAID