HomeMy WebLinkAbout104 PINON TREE LN - Building Permits(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
PLUMBING PERMIT
Job Address: 104 PINON TREE LN
Suite No
Vicinity:
FEE SUMMARY
Parcel Nunmber:
43917230
Applicant:
NOCK, RON
Address:
11612 KNOTT ST
QTY
GARDEN GROVE, CA
Owner:'
- LUCKENBILL, DAVID JAMES
Address
1502 IDAHO AVE
QTY
SANTA MONICA, CA
Contractor:
NOCK PLUMBING
Address:
11612 KNOTT ST
0
GARDEN GROVE, CA
Arch/Eng:
0
- Address:.
$O.OD
0
Landscape Irrigation
$0.00
WATER HEATER CHANGEOUT.
Phone: 714 895-1246
Zip: 92841
Phone:
Zip: 90403
Phone: 714 895-1246
Zip: 92841
License: 707775
Phone:
Zip:
License:
SCOPE OF PERMIT
NUMBER
V I P99-00373
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: 07/06/1999
Issued: 07/06/1999
0
COMMENTS / SPECIAL CONDITIONS
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
FEE SUMMARY
AMT
QTY
AMT
QTY
AMT
QTY
ISSUE FEE
$22.OD
Laundry Tub / Washer
$0.00
0
Sump Pump
$0.00
0
Backflow irrigation
$O.OD
0
Landscape Irrigation
$0.00
0
Swimming Pool
$0.00
0
Backflow Preventer
$0.00
0
P -Trap -
$0.00
0
Trap Primer
$0.00
0
Bathtub
$0.00
0
- Pressure Regulator
$0.00
0
Urinal
$0.00
0
Clarifier System
$0.00
0
Process Piping (per 10 ft)
$0.00
0
Vacuum Brkr Bkflow(1-4)
$0.00
0
Connect (Ice,Soda,etc)
$0.00
0
Receptors
$0.00
0
Vacuum Brkr Bkflow(5+)
$0.00
0
Dental Units
$0.00
0
Septic Tank
$0.00
0
Wash Basin
$0.00
0
Dishwasher
$0.00
0
Sewer Cap for Demo
$0.00
0
Wash Basin Set -
$0.00
0
Drain, Floor
$0.00
0
Sewer Connect
$0.00
0
Waste and Vent System
$0.00
0
Drain, Rainwater
$0.00
0
Sewer Private Line
$0.00
0
Water Closet (Toilet)
$0.00
0
Drain, Roof
$0.00
0
Shower
$0.00
0
Water Heater/vent
$11.00
1
Drinking Fountain
$0.00
0
Sink, bar
$0.00
0
Water Piping (Inst or Rep.)
$0.00
0
Expansion Tank
$0.00
0
Sink, commercial
$0.00
0
Water Re -pipe
$0.00
0
Gas Earthquake Valve
$0.00
0
Sink, Floor
$0.00
0
Water Service
$0.00
0
Gas (14 outlets)
$0.00
0
Sink, kitchen
$0.00
0
Water Softener
$0.00
0
Gas (Over 4 outlets)
$0.00
0
Sink, service/mop
$0.00
0
OTHER
$0.00
Gas Repipe
$0.00
0
Spa (private)
$0.00.
0
VIOLATION
$0.00
Gas Service
$0.00
0
Spa (public)
$0.00
0
PLAN CHECK
$0.00
Interceptors (Grease, Oil)
$0.00
0
REINSPECTION
$0.00
0
Interceptors (Sand Auto )
$0.00
0
TOTAL CALCULATED F
$33.00
COMMENTS / SPECIAL CONDITIONS
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
DECLARATIOMS
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
w for which this permit is issued.
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 Insur@gnce card nd policy num r are: f� x , f
Carrier: /91,/%7.1 " Policy Number 0-j, - -Y' / / 7
(This section need not be completed if the permit is valued at one hundred dollars ($100) or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERSCOMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provyions ofS,Ilap r 9 (commencing with Section 7000) of Division 3 of the Business and PjQfes s Code, and my license is In full
force and effect. Lic. x 7O ) % l Class N
Contractors Signature: Date: % _ — )
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
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).):
❑ 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 Cotle: 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 dead):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity that no excavation five (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department,
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
13—will an ry p --------- ---------------- ..----
y part of the feclll to be con- under this permit be within 1000 feet from the outer boundaries of a school? [3 -Yes ❑ Na
-------
(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 ❑ 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 complyfo,wifh 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 `r inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
ign bre Of Legal Owners) Date
And/Or Authorized Applicant 7 Date
CODE 1, INSPECTIONTYPE g,,¢, IIIIITIAI@ C.Q F INSPECTONTYPE DA¢ IN IITAL,j
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing .4-:0-07 L (]OU I hG 1
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
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ccaUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 104 PINON TREE LN
Suite:
Vicinity: 104 AND 106 PINION TREE
Parcel Number:
43917201 Zoning:
R3 R3
Applicant:
MC COLLISTER, ELISE
04/29/2002
Address:
28816 CONEJO VIEW
SMIP Com:
$0.00
Phone:
818-735-7876 -
$0.00
AGOURA HILL, CA. Zip:
91301
Owner:
LAUREL POINT TOWN HOMES
Address
,ASSN
NEWPORT BEACH, CA Phone:
-
'4631 TELLER AVE SUITE 130 Zip:
92660
Contractor:
' PRO -TECH WEATHERPROOFING
Address:
23261 DEL LAGO
STE 5 Phone:
(949) 583-1858
LAGUNA HILLS, CA
Zip:.
92653-1330 License:
620476
Status:
ISSUED
Applied:
04/29/2002
Issued:
04/29/2002
ISSUED BY:
Arch Eng:
Address: - - _ Address: ,
Phone: Phone:
Zip: License: License:
SCOPE OF
REROOF 104 AND 106 PINON TREE (LAUREL POINT HOA): T/O E
LAYER 30# FELT, APPLY "GAF GRAND SEQUOIA" SHINGLES. 25 SQUARES
FEE SUMMARY
Plan Check:
$0.00
Permit:
$125.25
SMIP Res:
$0.53
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
li - . .
SHAKE ROOF, SHTG PER MFGR SPECS, 1
Calc Valuation: $5,300.00
Claim Valuation: $5,300.00
Total: $125.78 _
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0
PARKING Existing: 0 Required: 0
NOTES:
Left 0-0
Proposed:, 0
Right 0-0 -
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2"646 (SM)
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 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.
r❑nI have and will maintain workers' cormpensadon 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 carder and policy number are: (
I -Cari Oj f'LLK CAVY• JQQM5a1't7 0kJ 1615 � Vf01 P.olicY.N^umD�er�
-(This.section need not be completed d the permit /s 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 California, an ree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith
complywith these sions. r.//// Q,
Applicant Signature: �/{7� Oa`t� �- 2 I __0
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 DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37M OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of.the.Business and Professions Code, and my license is in full
. LU_, Ll "
to roe and effect7 & Blass al _S
C 9 , 13, C 33
NiConbactors-Slgnalur' e= 4Atan PkW-C--mss- Date: I -I -29-O2
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirn that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lenders Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I em 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 ofnot more than five hundred dollars
❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec.
7044, Business and Professions Cade: 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,ihe 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 Low 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 Cafe 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:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires. with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet ofCompressed gas at standard temperature and pressure).
...................................................._.............................................................................................._... -............................. -.................................... -...._.......................................................... ................... _-.............. __............. _............. _...........
_
2 Does or will the applicant or present or future building occupant need to file a registration toren 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 ❑ NP0
(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 Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No
........................ .......... ............................................................................. ........ .......... .......... .... ........................ ...................................... .... ........................................... ................. ............ ......................... ............ ....................... ................................
_...
5 Does or will the applicant or present or future building Occupant require for the work which is the subject of this a plication a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yea u 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 Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
................................................................................... _-------- _.-.__._............................................... ................................. ._....................................... -.-..-_._--.......... -.................................................. __............. _............ _.........
8 (II'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 property for inspection purposes. I agree not to Occupy or allow Occupancy of any building authorized by this permit until final inspection.
e ga w DVtu7
And/Or Authorized App hl� Date f�—
CODE.. INSPECTION TYPE gd¢ IKIIB9LS CODE INSPECTION TYPE PAIS IiiTrrIAL$
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/OOcupancy
5.7
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
7931 10/30/76
7931 10/30/78
215.00 TTII
215e001KA``
11011111111lisss ---
APPLICATION FOAVRUMkA MlIT Q
For Applicant to Fill it Completely — Use Ink Only
RECEIVED BY
DATE RECEIVED
GATE ISSUED
BUILDING
A DR,
��� (�
PERMIT NO.
OWNER
A.P. NO.
MAIL
BUILDING
ADDRESS
ADORES AW
TEL.
CITY NO.
TRACT
LOT BLOCK
CONSTRUCTION
N W
ADD I
ALTER IREPAIR
LENDER
BRANCH
OWNER
ADDRESS
V UE
USE $
ARCHITECT TEL,
OR ENGINEER
FIRE
ADDRESS
ZONE TYPE GROUP
APPROVED
CONTRACTOR
BY DATE
ADDRESS
TEL.
TNOE
ZONE
NO. OF
USE OF NEW
CITY
PLANS
BUILDING
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
FRONT FT.
FT.
USE OF
EXISTING BLDG.
R cing r,.
FT.
Separate permits are required for
L. SIDE FT.
FT.
electric, plumbing and healing work.
REAR FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLDGS.
ACCESS. SLOGS.
VAR.+
DATE
C.U.P. 515
APPROVED
APPROVED
BY
DATE
I hereby acknowledge that I have road this application and state
'n
n
m
that the above Information Is correct and agree to comply with
all laws 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 1 am properly licensed as a contractor under
SO. FT. a
THE AMOUNT SHOWN UNDER VALUATION IS FOR al
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Bustness
VALUATION
PERMIT FEE o
$
and Professions Code, Division 3, Chapter 9.
PLAN CHECK $
Signature of
TAX $ LL
U
Permittee
$
TOTALPAID $
A. ,.�orized Agent
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING i A ... / n.- . .Iw _j _
fu -i -q- lvf�='
780210/27/78 111.96 TL
7776002 1G/27776 111e96CKTD
A;: t1GCTURA(LPERMIT 1A
RECEIVED By "DA E C=1VED DATE ISSUED
OWNER Monte Vista Townhomes, Inc. A.P. NO//j'C:!i c-" d_�z_. '10
MAIL
BUILDING
ADDRES 0101 Dove St. #225 ADDRESS
-/Sl�
CITY Newport Beach TD 52-5071 TRA LOT BLOCK
CONSTRUCTION NEW IADDIALTER I REPAIR M V
BRANCH
O W N E
(d�jw.
�{µ•�
ADDRESS G
TEL.
W j
VALUE //� Jf
S Y �"'
ARCHIT T TE
OR ENGI ion Jeannette & Alfls e
v WIJUL-L 0 r %�
Reach
E
fAPPFIOVET�
TYPE
I''7�ADDREsENewnOTt
GROUP.+L-r7CONTRACTOR
YARDS APPROVED
LIC. NO. LIC. NO.
DATE W L�7�
ADDRESS
ZONE i
NO. OF
USE OF NF.W J
TEL.
CITY NO.
/7
PLANS Z
BUILDING at�hn2/i
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF BLCHiS.
(FROM C/L S REETI
OF LOT
NOW ON LOT
FONT FT.
FT.
USE OF
EXISTING BLDG.
a. S1129 FT.
FT.
Separate permits are required for
J
L. SIDE (j FT.
FT.
//
electric, plumbing and heating work.
REAR (i�FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET, MAIN &
W Townhomes Project
MAIN SLOGS.
ACCESS. BLDGS.
VAR. # ;
,-0� -
DATE
APPROVED/?�77"�
APPROVE G /d .
"91,1) FQI2 S,'
t• _
NTP
1 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 person in violation of the workman's compensation laws of
m
Z+17 80l
!�'rl [_ SO' FT' C�
the State of California.
I hereby certify that I am properly licensed as a contractor under
ry
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State o6C.mila usiness end Professions Code, Division 3,
DChapter
9,h licenses are In full force and effect, or I
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempovisions I he Sia of California BuslnassVALUATION
7and
$PLAN
Profesvislon 3, r 9.PERMITFEE
CHECK $
Signature o
Pefmiitee
/ 3 �/r%1 /
$ IrYA (/ U
v
LL
TAX $
r
/
U 0
TOTAL PAID $
Authorized Agent
Tr 1�r v CITY OF h
1
RBWEST FOR OCCUPANCY
NO. 10097
LOT NO. 44
ADDRESS 104 Pinon Tree Lane, Costa Mesa, CA 92627
DATE: April 3, 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 obnpleted 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 complied 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 uncompleted condition(s). _nn
\A
CITV IC ("OT
MOO P1�
�8�9►`11
1yLl Izi;514016
4/79
BY
BY
uS&tICALIFORNIA FEDERALAVW �NASSOCIATION
BY e -
(Signature of Le )
Richard A. Gaunt, .Assistant Vice President
r��l9Jyl
PROJECT ADDRESS; 104 P INON TREE LN
OWNER'S NAME: j UCkENBILL, DAVID JAMES
aoDREss` 104 PINION TREE LN
COSTA MESA,CA 92627
ARCH/ENGINEER:
ADDRESS:
REG.ND.:
UNIT:
UNIT:
PERMITTEE. GEORGE BRAZIL (714)535-7905
ADDRESS: 3021, N.pHESPERIAN WY 7n 101
SANT. i h' ( F
LICENSED CONTRACTOR DECLARA IONAM ereby affirm that I am licensed unit Cr pA'rodsio s o C apter 9 (commencing with Section
7010) of Division 3 of the Business and Professions Code. and my Int nmC is in lull force and effect.
CITY LIC.: STATE LTL.: LLASS:
02�919�,� 443064 C
CI -a( 2B— Signature: _.
WORKERS' COMPENSATION DECLARATION: I hereby affirm 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.:R0298489-01 EXP. DATE: 01/01/93
COMPANY: RELIANCE I*TS,CO
bp Certified copy is hereby furnished. [ Certified copy is failYg with the city Bu ing Div Ion.
Applicant: w'Af'/�/�
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be Completed if the permit is for one hundred (5100) or less).
I Teddy 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.
Date: Signature:
NOTICE: If, after making this declaration. you should become subject to the Workers Compensation provisions of the Labor
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 o1 the work for
which this permit is issued (Section 3097, Civ. Q.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that) am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 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 life a signed statement that he/she is licensed
pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7DDO) of Division 3 of the Business
and Professions Code) or that helshe 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 live hundred dollars ($500).
I, as owner of the property or my amyloyees with wages as their sole compensation, will do the work, and the
❑ structure is not intended or ollered for sale (Section 7044, Business and Professional 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. If, however the building or
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
1-1andProfessions Code. The Contractors' State License Law does not apply to an owner at properly who builds or improves thereon
and who contracts for such projects with a contractors) license pursuant to the Contractors' Slate License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
I am exempt under Section: B. A P. C.
for this reason:
Date: Owner
I do hereby candy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
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 Duality Management District. Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby Certify that I have read this application and state that the above information is correct. I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
.Date'. -9, ;2_& `I�P— Signature: �[/ y-��"'�✓
Driver's License or Social Security x.: ,
1641.46 Whne—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 056361 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
JOB DESCRIPTION : CHANGE OUT WATER HEATER
CLAIM VALUE:
CALC—VALUE:
PERI. NO; P 05636:
GOVT; N SUPP; N
PURPOSE; OTH
SQ FT:
GROUP OCC; R-3 /
COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME.
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ ,MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL; 43917230 ZNE: REF NO;
PLANNING N TES>
>
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• •c��"�oL
######################i
##�(#####%#####x###################!(# .. tF#xi(-!E########)E#####if•#3F####x###k#}.##ie#####
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG
PMT PLUMBING ELECTRIC MECHANIC
FIRE SMIP/RES
GRADING
PERMIT
2,00
258
SMIP/NON—RES
PLAN
ISSUE FEE
3,00
BUILDING—DIV—>
PERMIT
ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS----->
2.00
3.00 0,00
5.00 5.00
,00
REVENUE DIVISION
TOTALS--> COLLECTED:
5.00 OVER/SHORT:
,00
BLDG PMT
PLUMBING
ELECTRIC MECHANIC FIRE
SLIP/TOT GRADING
PLAN—CHECK
5.00
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND/OR VENT 2,00 2.00
END OF FEES
> "fir_}'_-
l'J:
CONSTRUCTION AND PLANKING
APPROVALS Permit# Date
Inspector
POOL _- oPA
APPROVALS Permit #
Date
Inspector
i. 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 LIFER 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 O 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:?,/27,QZ Hb 00-'6GL40AiZ- Lrt VEC4.Q,p ^L��
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
.3//'fQ2
L 21%
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
g .'
51. CERTIFICATE OF OCCUPANCY
No. Date
i.
Q/16ol
COSTA MESA BUILDING -SAFETY DEPARTMENT 7802 10/27/78 o 96 TO
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 78Daa2pp x/27/78 '1-1-1"IA-- 0'
F0 8STRUOCTURA4L PERMIT I A ^-
For Applicant to Fill in Completely — Use Ink Only
BUILDING I -w . .— / rf.. . _- _L_ _ f _
OWNER Monte Vista Townhomes, Inc.
MAIL AIDIRIES0
01 Dove St. #225
MAIL
CITY Newport Beach Nt(52-5071
CONSTRUCTION
BRANCH
ADDRESS
ARCHIT T
OR ENGIN1
OU
ADDRESSNe
CONTRACTOR
ADDRESS
Separate permits are required for
electric, plumbing and heating work.
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 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 Ca' rola Business and Professions Code, Division 3,
Chapter 9, a t t such licenses are in full force and effect, or I
am exempt f e provisions he State of California Business
and ProfessI 'vision 3, 9.
Signature of
Permittee AAME
Authorized Agent
RECEIVED BY
TEL.
CITY
NO.
STATE
CITY
LIC. NO.
LC. NO.
SIZE
NO. OF BLDGS.
OF LOT
I NOW ON LOT
USE OF
FIRE_77 �t
ZONE TYPE ROUP L
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
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 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 Ca' rola Business and Professions Code, Division 3,
Chapter 9, a t t such licenses are in full force and effect, or I
am exempt f e provisions he State of California Business
and ProfessI 'vision 3, 9.
Signature of
Permittee AAME
Authorized Agent
RECEIVED BY
I VIEC IVED DATE ISSUED
(.�.')�� it P IT NO.
A.P. NO -� 7/ h2 R (1,0
BUILDING f
ADDRESS .�[ %J,[y q .�(ay(rc
TRA LOT BLOCK
NEW
1ADD IALTER IREPAIR
IMOVINQ
OWNE
//-
S w� VALU$ Y � •��
FIRE_77 �t
ZONE TYPE ROUP L
APPROVED
By
1-)r2 �1
DATE - /
ZONE P NO.OF
/�� PLANS
2
USE OF NEW ��� J/q
BUILDING CrJ""��
YARDS APPROVED
MAIN BUILDING
YARDS APPROVED
ACCESSORY BUILDING
(FROM C/LS BEET)
FRONT FT.
FT.
E 16�FT.
FT.
L. SIDE FT.
FT.
REAR ( FT.
FT.
DISTANCE BET.
MAIN BLDGS.
BET. MAIN &
ACCESS. BLDGS.
VAR.
C.U.P. qyr y.�% ��]
DATE
APPROVED !7
APPROVE K /�
All .Q ^a%-7 Q
V
HOLD FOR
Z+(7, SQ. FT. I 6
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY;
VALUATION d"PERMIT
$63 ?a
/
FEE $
PLAN CHECK $
TAX $
TOTAL PAID $
4 -
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDINGj,, /w/ / _ _ �
OWNER
L
CITY
MAIL
ADDRESS
/
CITY
TEL.
NO.
CONSTRUCTION
LENDER
OF LOT
BRANCH
IND.OF
NOW ON LOT
ADDRESS
NO.OF
ARCHITECT
OR ENGINEER
TEL.
NO.
ADDRESS
BUILDING
CONTRACTOR
ADDRESS
CITY
TEL.
NO.
STATE
CITY
LIC. NO.
LIC. NO.
SIZE
BLOGS.
OF LOT
the State of California.
IND.OF
NOW ON LOT
USE OF
NO.OF
EXISTING BLDG.
AMOUNTS
Separate permits are required for
BUILDING
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
a 7931 J0/30/78 2'I55.0o0 T
777q9�3� ' InnDnYtnn3n(0�L/yy7�(8,qG -215e00CK4
APPLICATION FDA%UCIORALTFAINIT A
RECEIVED BY DATE RECEIVED DATE ISSUED
/v-27-7
PERMIT NO.
A.P. NO.
BUILDING
ADORES
TRACT I LOT BLOCK
V UE
E
NE TYPE
GROUP
PROVED
any person in violation of the workman's compensation laws of
DATE
the State of California.
-ABLISHING A PERMIT FEE ONLY:
NE
IRONT
NO.OF
USE OF NEW
AMOUNTS
PLANS
BUILDING
YARDS APPROVED
YA RDS APPROVED
MAIN BUILDING
ACCESSORY BUILDING
OM C/L STREET)
FT.
FT.
VAR.*
I APPROVED
APPROVED
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 person in violation of the workman's compensation laws of
VN UNDER VALUATION IS FOR
the State of California.
-ABLISHING A PERMIT FEE ONLY:
I hereby certify that I am properly licensed as a contractor underrVALUATION
SQ. FT,
the State of California Business and Professions Code, Division 3,
AMOUNTS
Chapter 9, and that such licenses are in full force and effect, or IPOSE
OF
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
TAX $
Signature of
Permittee
Authorized Agent I TOTAL PAID $
m
i
m
m
N
VN UNDER VALUATION IS FOR
m
-ABLISHING A PERMIT FEE ONLY:
PERMIT FEE $
m
PLAN CHECK E
^
0
V
TAX $
V
U
Authorized Agent I TOTAL PAID $