HomeMy WebLinkAbout1751 PITCAIRN DR - Building Permitsr CITY OF COSTA MESA
f BUILDING DIVISION
i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.cosla-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER! BC07-00417
AIS
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: RES_RRIP DATE ISSUED: 12/07/2007
ISSUED BY: SOK
JOB ADDRESS: 1751 PITC R - Suite/Unit:
APN: 13933325 .h,. Zoning:R1, ,
Vicinity: KITCHEN 1 Primary Occ:
Const Type: V -N SQ.'FT: 0 Valuation: $9,000.00
SCOPE OF WORK: KITCHEN REMODEL FOR S.F.D. DRYWALL PATCHING, REPLACE/ADD LIGHTS, OUTLETS, SWITCHES,
HOOD, AND APPLIANCES.
OWNER:
SPARKS, FLOYD L
Phone:
$167.25
APPLICANT:
SPARKS, FLOYD L
Phone:
714-967-0180
CONTRACTOR: OWNER -BUILDER
Phone:
SMIP Residential:
Cell:
SMIP Commercial:
ARCHITECT:
ENGINEER:
Address: 1751 PITCAIRN DR Unit:
City/State/Zip: COSTA MESA, CA
Address: 1751 PITCAIRN DR Unit:
City/State/zZip: COSTA MESA, CA
License No. 000000
Address: Unit:
City/State: ZipCode
License No. PHONE:
License No. PHONE:
COMBINTATION PERMIT FEE SUMMARY
Building Plan Check:
$0.00
Building Fees:
$167.25
Electrical Fees:
$43.30
Mechanical Fees:
$34.15
Plumbing Fees:
$59.05
SMIP Residential:
$0.90
SMIP Commercial:
$0.00
TOTAL FEES:
$304.65
••Refer to fee receipts for all fees paid for project
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 inspection; and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE 1, INSPECTION TYPE DATE INTRIAL CODEC INSPECTION TYPE DATE INTMAL
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 206 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final BloddRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Sitep-
204 Final Demolition 250 Final Building/Occupancy p/ /1 �r r 7t1Y 6/ p fi
WORKERS' COMPENSATION DECLARATION"
I hereby affirm under penally 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.
❑ I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' Compensation Insurance carrier and policy
number are:
Carrier:
(This section need not be Compered Athe perm4 is w0uetl at we hundred daears ($100) o. -less.)
Policy Number:
t ern y 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 de, h�L,forthwlth comply with these provisions.
� .
'--�'
Ap2WnU9 Signature Qs Da e�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Cotle, and
my license is in full force and effect.
Lic. # Class #
Contractor's Signature
Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which Ws permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's 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).):
Eit las 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.).
L —ham exempt under sec.
Business and Professions Code for this reason:
l2-07--7
�.':: %'' Signmure-_�•..—�-..r-..-_. --`• Date -f- wrG..
Owner ID verified by dm... It, -. Yes ❑ No
Driwer's-Llcense No. Expires: c- Z
Verificelion-ofOwn'erstiip 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 wilich a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, a demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 6, 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.
Applicant's Signature
Division of Industrial Safety Permit Number:
Date
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 weigh) 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 application 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? ❑ 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 Califomia
Health and Safely 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.
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 p rposes. I a ree not to occupy or allow occupancy of any building
authori ler ntil final inspection.
,_�Slgnat ot legal ownert'ts)) ' % ->' Date +
And/or Authorized Applicant
Date
CITY OF COSTA MESA
BUILDING DIVISION
> 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (714) 754.5626
PERMIT NUMBER: B07-00989
PERMIT TYPE B_ROOF2 STATUS: ISSUED
DATE ISSUED: 10/23/2007
ISSUED BY: SOK
JOB ADDRESS: 1875 PLACENTIA AV CM Suite/Unit:
Vicinity: ROOF
Squares: 2600 Valuation: ' $8,200.00
SCOPE OF WORK: REVISED. 10/25/07:19 SQUARES FOR FLAT ROOF ONLY.
TEAR OFF EXISTING ROOF. INSTALL 4 PLY BUILT UP ROOFING SYSTEM, CAP SHEET, 21 SQUARES FOR "PK
BURGERS"
OWNER: KALOGEROPOULOS, - Address: KONSTANTINOS
POINT, CA - - - - - -
PHONE: City/State/Zip: 33041 SEAWATCH ,
APPLICANT: SAL LOPEZ I .. Address: 23881 VIA FABRICANTE
PHONE: 949-360-0670
CONTRACTOR: SO CAL ROOFING COMPANY,
Address: 23881 VIA FABRICANTEUnit:
City/State/Zip: MISSION VIEJO, CA 92691 -
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
TOTAL FEES
City/State/Zip: MISSION VIEJO. CA ,
License No. 797707
SUITE 521- PHONE: - 949-360-0670
._ .. - CELL:
License No. - PHONE:I
License No. PHONE:
Unit: DANA
Unit: :SUITE 521
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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.
CODE i. INSPECTION TYPE DATE INTITIALS CODE INSPECTION TYPE DAIS INnnALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208Final Plumbing
200 Final Re -Roof /o/ag o1p/� 10 Final Electrical
201 Final BlockJRetaining 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
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.
C�'; I have and will maintain workers' compensation insurance, as required by
se tion 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: /� e
Carrier: s 11
(This section need not be completed it the pelmrt A valued atone hundred dollars ($100) or less)
Policy Number:
❑ 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 wor mpensation laws of California, and agree that if I should
become suct the workers' compensation provisions of Section 3700 of
the Labor d shall forthwith comply with these provisio
n
Applicant's Signature Da
WARNING: AILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and effect.
Lic. # 710,7707 Class # (_' c ?9
Z61A
Contractor's Signature D e
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
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 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
3057-46 (3107)
Owner ID verified by driver's . ,e. ❑ 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, a 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.
Applicant's Signature
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 fled 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 application 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? ❑ 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 ❑ 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.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the infoInurpo
n given is correct. agree to comply with all state laws and city
ordinanlatin o building construction, and authorize representatives of
the CitCost Mesa to enter upon the above-described property for
inspec[i s. I agree not to occupy or allow occupancy of any building
sthi permit until final inspection.
Owners) Date
A
4ppliocrt vD.t.
MDRESSOFSMLON(: 1751 PITCAIRN DR UNIT:
OWNFITS NAME IF MDW CAMP, PATRICIA A
ADDRESS: 1761 PITCAIRN DR
COSTA MESA,CA 92626
549-3482
APPL. MMIDIO ADDRESS:
ARCNREOT OR ENGINEER. LIC NO:
MCH OR ENC'S ADDRESS: UNIT:
CONTRACTORS NAME:
CO INACTOR'S MAIM
ADORESS: UQ NO:
UNIT:
LICENSED CONTRACTORS DECLARATION: I hereby etfrm under pahaby of ptnory Net I mit lomwd oda prwebns of Chapter 9
Icmnhe«ip with Section 7000) of Dbbon D of the Buebnm end protectionist Code, and my Doerse is in hA force and effect.
CT' LIC. NO.: LIC. CLASS: LIC. NO.: EXP:
Dela: Contract..
OWNER BUILDER DECLARATION: I hereby a/5m under penally of mjMy that I am exempt from IM Contrailm Limme Lew for that
IoOewip pawn (Sefton 7001.5 Business and Pmlmeeom Cade: Any city or county which reacher a parmd to construct, after. approve,
drmaleh, or repair am/ alruiclun, prior to b eauenoe. aeo retunm the Wicara 1« such pamn to Be a spud mmement dmt M «she
I. ecamad pumnant to IM prombm of the C«tredm licema Law [Chapter 9 (.&ndl with Sacton 7000) of Divan 0 d Ne
Businam and Prdenom Cade] or lheI M or she is exempt therefrom end tM hme la the ellegnd mmp(on. AM vtoW nn of Section
7051.5 W story appticont for a permit aubpcta the applicant to a duil Fortuity of not mm than five hundred doum (S500D.
® I. as owner d Na pmpeny on my, empkryeas with wapm m than ante mmpeneeMn, will b the wont. aha the abuct«w a not Mended
or pllerad for Bele ISecMn 70u, B.. and Prdmeefom Cada: TM C Wrm Liowwa law dome rid apply to an owner of property
who huida or knprover tMnon, end who done rush wad, h'rneetl «herself or Wouph his or their own anplossme, provided IM such
improvements pra m inua rtim a offered for cob. 1. however. the huYinq «inpnmanera a sold within one y" of mmpbtion. the
wnerbuJder will hew the burden of previp M or ON, did not bdM or improve M iM puryme of wile).
❑ I. m owmr d the property. am aduaivdy cont actiry with Aoerued ronvam«a to cornu a, Be project (Saxon IGH. BhMoma and
Ptdamebnr Cob: TM Cmradm Licanm law does not apply to an over of property who Molls or inprovm thaaan end who
contrecia for nrN pajapa with a mmremod.) licensed pwaue/mJ1. th. }Crintred«a Licosa law).
❑ t m+ exem�section: B. & P.C.. M N-
DNa: �i/ J�-
I b hereby mndY UiM am ewpre d end hmbnMrhd Urs rwdranam d CalEamie I(eefth and Cods Sedam 25505. 25503, ad
2553x, and Ur I «ary Mitre Miduhp oosgam. wiA / wR non (amb one) mad ro
blcompo
alweb mid Mme �ic m rnd IM reameroa dv for
•permit torornstruMion«modSralonhantMAr�i aohepemaa Diprict.RmidatluhMoumon appirAomea assnq ham them
povifi«ns.
Data: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby alfum under pahafty of perjury am d IM Idland, decimations:
❑ Ihevw andhnl menlen ec olthero dmmenihNtlinsae forwhatic. connpemmion,m pwilad la fry Saxons 3700diM labs
Cob, l« the pedormenca d Ns soak I« which Nb permit a eahsd.
❑ I have W wits meoMih warlen' aannemmon kwnarh«, m owu'vsd by Sadon 3700 d Na lab« cab. b Ne pafomrrs d the
work 1« which Nb penmen a esual. My warken' rorhhpemmion im«enc�a soda end pagcy amber w:
CaMW7.
Policy Numbs:
(this esffion coed not be completed I the permi his for one hundred dollen IS1001 «fon.)
❑ I tensity that in IM pMormame d the woM la xfioA the penin h iasoad, ehe0 co empty eery peen o ant' coroner so m to
becomes mbjerf to tM worlara' cornmrawlon east of C aomist, and pt Nm A 1 rhould become aubjw to the soda«'
compernsmon pmvi.iprs d Sector 3700 of the labor Cab, I .heft faNwnh comply with them provisions.
Dms: Appi au:
Waming: Fail. m secure woninw.- mp.Up- covanpa la cab f,, and atoll aublem en arai to «ImbW prr«Idm aha
clyll Rma w or oro h.drW thouaand ddhw ($IOAMA M a if/don m IM coat o/ roalveruadon darresgm m provltlM for In
Sacdon 3705 of ft Labor Coda, InteraaL aha.Camey'• lees.
CONSTRUCTION LENDING AGENCY: I hereby aHom under mnafty of per a, [het Ihm I, a constmcton blip apemy for the
mdormance of the wook for which the mmn o owed (Sadon 3097, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I tarty thin I neve reed the application end Mme that the above intammon a canact. I orae io.* with eA city end county ardneocme
and state laws nlmng to Wilding cone storm and hereby edhorice repreeentmives of the only to enter upon the above-meraoned pmpery
for inspection purppwa. FLOYD SPARKS
Print Nemo
�n Dae:
Sigraum/ narfApendAppbcamv;onnad«
Winn -Building& Wary: Gmrn File. Canary-Applican:Pink-Revenue; (loldemod-Aeaenor
CITY OF COSTA MESA — BUILDING PERMIT
, PERM NO: B 078892
PERMIT NO: B 078892 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH
JOB DESCRIPTION T/OFF REROOF W/RUSTIC SHAKE SQ FT: 9,000
CLAIM VALUE: 9,000.00 CALC—VALUE: 9,000,00 GROUP OCC: R-3 /
COMMENTS: REROOF 3200SF RESIDENCE W/SHAKE, ICBO#5075, 4,75PSF MAX WEIGHT
BE 1E iE 1E 1i iE 1f iE )E ♦E 1E 1E 1E 1F 1E 1E 1E * 1E 1E 1E 1E * * 1E irk 1E if 1E * 1E 1E 1E 1k 1f 1f iE 1E * * iE iE 1k 1E iF 1E iE iE )E if 1E 1f 1E 1E )E iE 1E )E 1E * 1E 1E 1E 1E )F * 1E 1E iE 1E 1E * 1E 1E 1E ie 1E 1E 1E
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:
13933325
ZNE:
REF NO: ,
PLANNING NOTES>
1f * * 1E 1E 1E 1F 1E 1E 1E 1E ♦E iE 1E1E if 1E 1E
1f 1E 1E 1E ♦E 1E )E 1E 1f 1f * irk iE 1E iF 1F )t iE iE 1E 1E 1E 41E iE 1E 1E 1E * * k if
)E irk ♦E * 1E 4 iE iE 41E
1E * 1E if 1F )E iE dE.lE ♦E * * k iF iE iE 1F k 1E
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
C_
ZONING APPROVED BY
DATE•
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
iEk*1E 1E 1E )E iE 1E 1f iE**1E**irk 1E*♦E IEM
LEGALIZATION:N
F E E S U M M A R Y
DATE:
DATE:
STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 149.75 ,90
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 150,65 0.00 0,00 150,65 150,65 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 150.65 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
149,75 .90
*1E#1E 1b 1E iE df lb**1E 1E 1E 1E 1E 1E*1b)E)E iF 1E)E 1E 1f 1E****)f 1E i5 i5 ib,#1b#1b 151E)F 1E CE 1E 1f 1E 1E 1F*k*151E 1E)f 1E 15)t lk ib* IF 1E 1E 1E 1E 1E 1E)E***1f 15 i(1h#
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
SFR 9000 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 000,00
END OF FEES p
TAUG011996 Dk'
CITY OF COSTA MESA
CONSTRUCTION AND PLANNING
APPROVALS Permit # -
Date
Inspector
PO SPA
APPROVALS Permit #
Date
Inspector '
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd,
53, Steel Reinforcement
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.
r
B. 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
r
63. Heater & Vent-Final
13. Roof Drains
�.
64. Plumbing System - Final
14. Rough Plumbing -
1
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 11 Gas 0Oil
23. Gas Pipe-Rough & Test
72. Underground Flush
24, Roof Framing
73. Undergrnd. Storage Tank OGas ❑Oil
25. Roof Sheathing �%
C�O
a GC.�%
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
34. Final Heating & Air Conditioning
35. final Gas Pipe-Test
Notes:�f--
/0 C,�ttcsv.� (+"•��4
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
1
47. FINAL STRUCTURE & BUILDING o`Col-fP6W
48. FINAL PLANNING
,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
JOB ADDR
\GENERAL
A— `ro. 13
F
M. W.
1751 Pitcairn Dr.
Modern Const.
DATE OCT 7
BUILDING PERMIT NO. 20771
VALUE $ 90.00
333-25 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORKComIl. Block Wal
I, ECT ONS Signature
DATE GROUP J TYPE III ZONE R1
Soil
SUBCONTRACTOR
PERMITS
ISSUED
Gas
DATE
NUMBER
Water
Rough Com. Refrig. ❑ Air Cond. ❑
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line El House Con. ❑ St. Swr. ❑
Sprinkling System
Construction Pole
Underground ❑ Power ❑
Rough Wiring �
Trenches., Forms Steel Reinf.
..
Floor System
Bond Beam ❑ Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In ❑ Out ❑
F r brown coat
Rt—. g. ❑ Air Con. ❑ Final
Heating, Final
Plumbing Fixtures, Final
Final Gas Test
E ctric Fixtures,
uIldin Final
OCCUPANCY
corm nix--arvr—s-o.>—o.yr I pr)771
-. = 1 20771
i
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 817 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
COSTA
IA
TEL.
[ADDRESS
TY NO.
R' --TELT TEL. I
iINEER ` NO.
SETBACK LINE FROM
OF WORK
BUILDING NO. OF
SIZE ROOMS STORIES
EXTERIOR WALL �_. ROOF
COVERING I COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
1HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IB CORRECT AND AGREE TO COM.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION
SIGNATURE OF 'i
PERMITTEE r�J'�J
AUTHORIZED AGENT
FEE RECEIVED
OCT 7 1963
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
7 For Office Use Only
m
RECZIFT NO.-2
PERMIT NO.
�-77
RECEI ED BY
DATE RECEIVEDDATH
IHBUEO
O� z
BUILDING
A 11111
FIRE
ZONE TYPE—azl6ROUP
APPROVED
BY DATE
ZONING
UBE NEW
FDNB
NO
7BUILDIOI
LEGAL//
DESCRIF 1044 / / �V DR
A. P. NO. — n
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
90' TO SIDE S REAR P. L-
EAVES EAVES
ALLOWED f . C.REQUIREMENT)
YARDS APPROVED
YARDSAPPROVED
MAIN BUILDING
ACCESSORY BUILDING
( FROM C/L STREET)
FRONT (1 C7 FT.
FT.
R. BID F7.�
FT.
L. SIDE O FT.
FT.
REAR FT.
FT.
DISTANCE BET.
BET. MAIN Q
MAIN BLDGS.
ACCESS. SLOGS.
VAR..#
DATE
C.U.P.
APPROVED
/ U ' 73
BPP �M
DATE
4z-�iC sQ. Fr. fo
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
PERMIT FEE
CHECK—'
DPLAN
9
LQ
/
.
TOTAL FEE
m
150-43
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
I For Applicant to Fill In Completely '
TYPE OR PRINT
PA,
COSTA MESA. CALIFORNIA
FEE RECEIVED
JUL 311961
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
Pacesetter Jt. Venture
RECEIPT NO.-{�pERM�ITY I�Q�
OWNER
MAIL 1653 Minorca DriYe
RRC BY I DA Ecervm OATH ISSUED
ADDRESS
- TEL. %i
BUILDING
CITY eF;ANO.
ADDRESS
NEER NO. ?CT TEL.
.
[ADDRESS
COSTA MESA. CALIFORNIA
FIRE.�/
ZONE TYPE GROUFJ
)jesa Verde Blinders Inc.
APPROVED
CONTRACTOR
BY DATE
ADDRESS lAiqZONING
-PoSta MesaZONE
�� I
NO. OF �j
I
USE OR NEW /
CITY
PLANS
STATE TEL
LEGAL / ./
� (1 �aO D
NO.
117
DEHCRIPiION Lp/r / / fT
SIZE NO. OF SLOSS
r/ ry�
OF LOT 1500 S .Ft. NOW ON LOT O
A. P. NO.
USE OF
YARDS EVES
EXISTING BLDG
APPROVED ALLOWED
SETBACrMNROPI NSTRESTH0 3D
(CENTeR LINE 8T.)FRONT
REAR YARD
O FT. IN.
ARD LEFT
I RIGHT %
R. SIDE FT. IN.
DESCRIPTION OF WORK
L. SIDE FT. �� IN.
NE% I x II ALTERATION I II ADDITION
$4
REAR J CD FT. N.
REPAIR I MOVING I II DEMOLISH I
APPROVEDBY 4V J� DATE 7/4 p
/S
G 1750 Sq.FtRO.OF 7 1
SSIZE STORIES
EXTERIOR WAL StUCCOI ROOF anKRe �.ng e
_ a
COVERING OOd COVERING
J
USE OF BUILDING AND WORK TO BE PERFORMED
Sinale familyresidence and garage
Standar Plan No. 750 BR
-garage 450 Sq.Ft.
1 HERESY ACKN LeDOE THAT 1 HAVE
AND STAT 8 T He ROVE IB
R THIH PPLICATION
A D A EE TO COM-
THE AMOUNT SHOWN UNDER VALUATION 18 FOR THE
PLY WITH ALL 1 O INANCES
BTATH RHOULATiNO
PURPOSE OF ESTABLISHING A PERMIT RHH ONLY.
VALUATION
SUILDINO CON N.
SIGNATURE OF
PERMIT FEE $ K
PLAN CHECK S rY/�
PERMITTE
$
AUTHORIZED A NT
l'
p�P 731 ,06
6j
TOTAL FEE