HomeMy WebLinkAbout1598 PONDEROSA ST - Building Permits ADDRESS OF MAUXIC: 1598 PONDEROSA ST WIT: CITY OF COSTA MESA - BUILDING PERMIT
awNERSNAYEIFKfKASN ROBB, WILLIAM W PERM NO: P 074089
ADDRESS: 1598 PONDEROSA
COSTA MESA,CA 92626 PERMIT NO: P 074089 PLAN CHECK NO: N GOVT: N SUPP: N
549-1597
ADPL.WIIRIO ADDRESS: CONSTRUCTION TYPE: V-N . PERMIT TYPE: PLU PURPOSE: REP
ARCHITECT OR IBIGNEEN: UC NO: JOB DESCRIPTION : CHANGE OUT DISHWASHER SQ FT:
NCH.OR ENG's ADDRESS: WIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC : /
WNTRACTORSNAI& NOCK PLUMBING ( 714 ) 895-1246
CONTRACTORSYNIDG 11610 SEABOARD CIR COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
moREss: STANTON CA uo.No. 511971 ************SF**+FBF***+EBF**+FSE+F***+E+E***iE*+t+F+FiF***SF*******SF*****SF**ac-**********at-**+F**+E
90680 IIMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Profession Code,and my koense is in full force end effect
Cmuc,No,, 05038 uc.Cuss: C-36 LIC.NO,: 511971 EXP: 02/96 MAIN BUILDING ACCESSORY BUILDING
qq� tl �� Fto�) u� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Date: / /��ILLL / Contractor 1 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I am exempt from the Contractors License Law for the
fdowig reason(Sedion7031.5&mimes and Profession Code:Anywor county which requires a pert to conpae,eller,Ingram. PARKING REQ: PROV: PARCEL: 13931110 ZNE: REF NO:
smote'',or repair any structure,prior r0 its issuance.also requires the applicant for such permit to Be a signed statement that he or she PLANNINGNOTES>
licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)of D,sSion 3 of the
.usineas end Professions Code)Of that he or she ho exempt therefrom and the basis for the alleged exemption.Any violation of Section > _
7031.5 by any applicant for a permit wbieds the applicant to a civil penalty of not more than Ewe hundred dollars(55001). *******************************************************************************
❑ I.as owner o the property or my empkyees with wages as'hair sole cmpensaton,will do the work,and the structure is not intended DEVELOPMENT S E R V I C E S• R E Q U I R E M E N T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply loan Milner of propend
who builds or improves thereon,end who does such work himself or herself or through his or her own employees,podded that such
improvements are not intended or offered for sale,it.however,the building or improvement is sold within one year of contplelsin,the ZONING APPROVED BY DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale),
o Profen owner
wnsCodde:Th Cthe onirmors clusively eLiaw°°does�na rwlicensed�n'�rofp y the whobuflsstm« .Section 7n044,ter�h�wdhand BUILDING APPROVED BY / 2' DATE:
contracts for suds projects with a co trmor(e)Warmed pursuant to the Contractors License Law). - - Q
__
Ellamexemptunder Section: B.AP.C.,for morsdson: APPLICATION ISSUED BY: t', h / DATE: _ SS—
********************** ********** ******
Data: Owner LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N
I do hereby certify that I snit aware of and understand the requirements of California Health end Salary Code Sections 25505.25533,and -
25534,and thin l or any''sure building oaupent will/will not(circle one)need to comply with said Male odes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
e permit for construction or modification from the Ai Quality Management Distrke.Residential construction appiratlane ere exempt from these
provisions. PERMIT 7 . 00
Date: Applicant: 252 L# ✓ SMIP/NON—RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following decorations: ISSUE FEE 20 . 00 - 0,-
j❑El
I ham end wil mainteM a°entice',ol consent to selbinsure for workers'compensation,as provided for by Section 3703 ol the Labor BUILDING-DIV-> PERMIT ISSUE PLAN CCHECK TOTAL PAID DUE
Code,for the performance dthe wank tor which meris pettseaed. TOTALS----> 7 . 00 20 . 00 . t 0 . 00 27 . 00 27 . 00 . 00
C7 WOWS'have and ail maintain M1an'compensation insurance,n requiredSada"by Seon 3700 a the Labor Code.for the performance of the I
4'C work for which the permit is issued.My workers'compensation insurance carrier policy number are:
Carrier: GOLDEN EAGLEd EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 27 .00 OVER/SHORT: . 00
Policy Number: NWL.3411J1UU 09/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
' „This section need not be completed,the perm,is ler one hundred dollars(5100/or lits) 27 . 00
❑ I certify that in the performance d the work for which this pert Is issued,I shall not employ any person in any manner o as to
become subject to the orocompensationcompenion laws of d me that a I become subject to the workers' **************************************•}E****************************************
compensatloe pro Mons of
California,d t sin
the Labor code,I shall f comply wion 3700 e I N D I V I D U A L F E E B R E A K D O W N
Det.: /7 C / (' Applicant: ^ G
Warning:Failure to secure workers'compensation coverage is unlawful,and shall subject an employer to criminal penalties end TYPE QTY DESCRIPTIO -14UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(5104000),In addition to the coat of compensation,damages as provided ler In
Section 3705 of the Labor Code,Interest,and attorney'',fees PLU 1 DISHWASHER 7 . 00 7 . 00
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that them is a construction lending agency for the END- OF FEES
performance of the work for which the permit is honied(Section 3097,CN.C).
LENDER'S NAME:
LENDER'S ADDRESS:
' hV
I certify that I have read this application and date that the above information is correct,I agree to comply with all city and county ordinances ,
and state laws relating to btiildmg construction end hereby authorize representatives d this thy to enter upon the above-mentioned propend
for inspection purpuaeM. RON NOCK
/ �- sir 01 00190017-00190017 TOT 27.00
Date: DATE: 09/12/45 TIME: 10:47
Signature of Owner/Agent/Applicant/Contractor %!,
(5151.46.WP) White-Building A Safety:Green-File:Cnary-ApWcant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POO. SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,
3. Electrical Conduit Utility•Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58, Electrical Conduit-Undrgrnd.
8. Foundation 59, Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrrid. - • 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK t-
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final^
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final'- -
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit - 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT-REQUIREMENT
20. Rough Factory Fireplace - -- . • APPROVALS Permit#
21. Ducts, in Structure - ' 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test _ 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas C 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 ' . - - - 7.7. 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 Metet-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes'
q_kI'PS N.D astrdra-Y «,xe1- . r
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test - -
36. Hood or Canopy - •
37, Final Factory Fireplace
38. Final Plumbing U_2?-9s-
39. Water Service-Final -
40. Gas Service-Final •
.
41. Solar Domestic-Final • -
42. Backflow Preventer
43. Backflow Irrigation .
•
44. Landscape Irrigation System '
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PERM O2 - TRACT NO. LOT NO. ,UNIT NO. I ' •
CITY OF.COSTA MESA CON ! UC ION PERMIT p33 Va / - RECE!vEQ M•
AY• Project Address ' - � - ' f] ti
Applicant's Mailing A dress 7 �� .6�'(/
TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION IVJ REPAIR 7
Owner's Name n ftg„.,Le Phone_i` 77 111 CONVERSION III DEMOLISH ICI OTHER A.P.# Zone
DESCRIPTION OF WORK/USE OF BLDG. •
Address _ S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT El GRADING Ly FOUNDATION LI STRUCTURAL T Front 01 1000€4412-00006412 TOT e.ar
Address • /� qq q� ❑ TENANT ❑ ELECTRICAL t3Q PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name L! ,1 ��e// '�phone ���/r/�_r ❑ OTHER A
- C Right N
2 )-{1/2.64
pp,,(( /_ PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G
Address(mailing) /�,�z3 q/I� / �/
Q/� y CONSTRUCTION TYPE VALUATION$ S Left •_ R
City License No. AJC• /a ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
Q
I hereby ioaffirm that am licensedion under provisions Charter i (commencing Remarks: Planning Notes: M
with section 7000) of ' and f 3 of the Business and Professions Code,and T
my license isin full fore and effect. ,,/_:
License s /r__l ic- No. 4LS S
A Date _ C.riaMPE 'Signature ` �_ PLUMBING FEES —
f].1I1F, I /
iir
WORKS•S'C•MPENSATION DECLARATION Bar Sink Showers •
ELECTRICAL FEES
hereby affirm that I have a certificate of consent to self-insure or a certificate
•
WO or rs', Lab. Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
''// h n// Automatic Washer Transformer 10 15-50 KW
Policy No. 7�/C .D Y” --/C7S Company E��' lUf Backflow Irrigation Sewer Cap ,_;•• / Construction Pole Sub. 0 50+ KW •
•
\ yeertified copy is hereby furnished. t�
'-,— Certif'ef rio�.�l f' d with the city Bufr in - v/) 'fi , Bathtubs Sewer Connection '1 %' Cooking Unit Meter Dup to 100 amps
Date Maj f ant �O '2�� (( •
EXEM ON F, OM WORKERS'CO PENSATION DECLARATION� Clarifiers • Solar Collectors ' 1 Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
less). Dishwasher . Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the Work for which this permit is issued, I '
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar TankFan Motors 00-1 HP ❑11A-8
Workers' Compensation Laws of California, _
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ .
NOTICE: If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked. _
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
I hereby affirm that there is a construction lending agency for the performance - g
of the work for which this permit is issued (Section 3097 Civ. C.) tors Water Heater
Lender's Name .� Interceptors iS Outlets Range
Lender's Address Kitchen Sink Water Service
OWNER BUILDER DECLARATION Switches Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains •
the Contractor's License Law (Chapter 9(commencing with Section 7000) of .
r)ivision 3 of the Business and Professions Code) or that he/she is exempt
erefrom and the basis for the alleged exemption. Any violation of Section
131.5 by any applicant for a permit subjects the applicant to a civil ,
enalty of not more than five hundred dollars($500). $ 3
O I. as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves •
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ .
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
prove for the purpose of sale). /�/l�) 6,
/p/(x/
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By l\/ Dara ,/S9 OC
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ElMultiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT-
0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ 5 ,DD ISSUANCE $
Date Owner Heating System&Ducting Registers
PLAN CHECK 25% $ ENERGY P.C. $ -
I hereby certify that I have read this application and state that the above ❑0-100,000 BTU ❑100,000 BT ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to enter upon the above-mentioned property for n •�l�
inspection purp / MECHANICAL $ TOTAL FEE $ : ✓'�
Signature Date n /s- 0
Drivers' License or SS# — Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0665-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND'PLANNING POOL& SPA
APPROVALS Permit.# Date Inspector APPROVALS Permit# • Date' Inspector
1'..Temporary Electrical.Seivice 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
7. Footings 58. Electrical ConduitUndrgrnd. ,y�
8. Foundation �! i 59. Gas Pipe, ❑ Undrgrnd., Test 1.1
i
9. Water Pip(e='Undrgrnd: 60. Backwash Lines,P-Trap, O 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
_ i •
20. Rough Factory Fireplace APPROVALS .- ' Permit# _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑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
r'
HEALTH DEPT. REQUIREMENT i
30. Drywall Nailing
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •
33. Final Electric Notes: • - -
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy •
37. Final Factory Fireplace •
38. Final Plumbing 707jf,f tao •
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backf low Preventer
43. Backflow Irrigation •
44. Landscape Irrigation System
45. Sound Attenuation - .,
. 46. Handicap Regulations "
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date
ADDRESS OF BUILDING: 1598 PONDEROSA ST UMC CITY OF COSTA MESA — BUILDING PERMIT
MINER'S NAME IF KNOWN: ROBE, WILLIAM W PERM NO: B 078500
ADDRESS: 1598 PONDEROSA
COSTA MESA, CA 92626 PERMIT NO: B 078500 PLAN CHECK NO: N GOVT: N SUPP : N
f
APPL.KMUNGADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: OTH
i• ARCHITECT ORENGNEER: LK.NO.: JOB DESCRIPTION : T/OFF WOOD SHAKE RESTH 6 REROOFW/COMP . SQ FT: 5, 000
' MCN.OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 5, 000 , 00 GROUP OCC : R-3 /
CONTRACTORS NAME:
CONTRACTORSMNUNG COMMENTS ; SMOKE DETECTORS ARE REQ3EdE dEUIRED IN EVERY BEDROOM & •
ADDRESS: UG 1E NO.: * RE**iEiE dE3E dE dE***lElE lE 3E iE dE 3E dE*********3E **** *****3E 3E dE 3E 3E*4E**dE3E* *DETECTOR'
WIT: ZONING REQUIREMENT JJ
UCENSED CONTRACTORS DECLARATION:I hereby salon under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS REQUIRED
(commencing with Section 7000)d Division 3 of the Business and Professions Code,and my Licence u in fug tome and effect. R.E,
CITY LIC.NO.: UC.CLASS: LIC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
Dale: Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the
following reason(Section 70.31.5 Busi ass and Professions Code:Any city or county whim requires a permit to eonseuet atter,improve, PARKING REQ: P RO V: PARCEL: 13931110 Z N E: REF NO:
emolch,or repel any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Dbeion 3 of the PLANNING N TES> -
dusiness and Professions Code]or that he or she is exempt therefrom and the basis Myfor the alleged exemption. violation of Section > ' t
7031.5 by any applicant for a permit subjects the applicant to civil penally of not more thenfre hundred dollars POD)). .)E.N..IE.K..1(..K..N.1E.lE.IE.IE1E1(.iE:i(..lElFif..N..IE!(..IEiEi(.iE.N.iF1E.K-.K.lF.IF1Eif.lE-0EfFi(.1Eff..lE1Ei(..IE1E.N.1E.lE.K.if-.1f.N,.K,1f.K,1f,if1k1F3E.1E.N,1E1EiE.N..1ElF. iEif1E##lF1FlF1E1E
❑ I.as rammer of the property or my employees with wages as their sole compensation,will do the work,and the structure is not intended D E V E I L O P M E N T SERVICES R E Q U I R E M E N T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property
who bolds or improves thereon,and who does such work himself or Mend or through he or her own employees,provided that such /:> J...
improvements are not intended or offered for sale.It however.the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE:
vownerbuiler will have the burden of proving he or she did not build or improve for the puryoee of safe). •
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7000,Business and BUILDING APPROVED B Y 3
Cade:Professions Co :The Contractors License Law does not apply to an owner of property who builds or improves thereon and who : DATE:
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). •
❑ Iern exempt under Section: B.AP.C..for this reason: APPLICATION ISSUED BY: DATE;
C7
77 -9A1%. owner: /Gt/4..42....- (41- BtBERE -BEx-+r*it«-Bix�r*,*BE*x-*Rtx-x-
herebycenitythatlemeweredaMUMarslendtMrequirementeofCeliomieNmtthandLEGALIZATION:N F E E SUMMARY STRUCTURAL SfGME T:Y
Safety Code Sections 25505,25533,and `
25534,and that 1 or any future building occupant will/wil not(circle one)need to comply with said state codes end the requirements Lir
a permit for construction or modification from the Ai OualtyManagement Distdd.Residential conMnucionappicetions are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
Provisions. PERMIT 99 . 75 1 , 50
Date: Applicant i_' SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following decimations: PLAN
ISSUE FEE
O Ihays
e,fort ilmainminceoftradeofconsent t self-insurekrworke 'compenwions,providedforbySemon3700ofthelabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
cum.ImiheperfomenceofNework for which tniepemkeesaee. TOTALS----> 100 . 25 0 . 00 '" 0 . 00 100 . 25 100 . 25 . 00
❑ I have and tel maintain workers'oompensatdn insurance,es 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 we: I
Carder: REVENUE DIVISION TOTALS--> COLLECTED : 100 . 25 OVER/SHORT: . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed 1 the perms is for one hundred dollar 15 100)or less.) 99 . 75 . 50
❑ 1 candy that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so an to
bacon*subject to the workers'compensation laws d California, and agree that if I should become eubjed to IM workers' #************it***#**fit-*di-************1E*****ii**********3E**********1E***3****3E*****
- compensation provisions of Section 3700 of the Labor Code.I shall forthwith comply with those provisions. INDIVIDUAL F E E BREAKDOWN
Date: Applicant:-- _
Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N; UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars($100.000),In addition to Me coat of compensation,damages as provided tor In
Seddon 3706 of the Labor Code,Interest,and attorneys fates SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of peruty that there is a construction lending apermy for the END OF FEES
performance of the work for which the permit is issued(Section 3097,Civ.CI.
LENDER'S NAME:
•
LENDER'S ADDRESS: • '
I certify that 1 have reed this application and Mate that the above information is conch.I agree to comply with all day and county ordinances
and stale laws relating to building construction end hereby authorize representatives of this city to enter upon the above-mentioned property ,
for inspection pnpoees. WILLIAM �OBB --
l •
Print dame /,/ ,- •
Data: *--
Signature of Agent/Applicant/Contractor I
(5151 J6.W P) White-Building A Safety:Green-Ate;Canary-Applicant;Pink-Revenue:Goldenrod-Assessor
,.
CONSTRUCTION AND PLANNING • POC SPA
APPROVALS Permit # Date Inspector i• APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 6" 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 1
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 y
16. Rough Electric Wiring 67. Fencing & Access Approval
17- Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - - - APPROVALS - Permit# •
21. Ducts, in Structure- - 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping ❑Gas 0 Oil
23. Gas Pipe-Rough & Testr . - 72. Underground Flush -
24. Roof Framing - • - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - /7_ Q% 6'." ,- 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat `. - - ' -� 75. Dry Chemical
27. Frame and Flashing _ 76. Dry Standpipe . '
28. Lathing& Siding ' - - 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat - 79. FINAL INSPECTION
32. Electrical Power Meter-Final . . , 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning i; -2-0-16Ji°""' ' Plia44
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 7 22...6't , 44e .
48. FINAL PLANNING._
49. Electric Release to Edison-'_. ,..
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY -• - -
No. -Date
10 39 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT li / i/- v f I
P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
•
• FOR APPLICANT TO•F/LL IN COMPLETELY APPIOT4-p,P003T MEa33RMIT
TYPE OR PRINT BUILDING
ADDESNS 1598 Ponv
erosa Street
•
COSTA MESA. CALIFORNIA FOR OFF/CE USE ONLY
•
OWNER Knightwell Land Company RECEIPT No. h cPpR IJ.V.--1.
ADDRESSMAIL 419 E. 17th Street RECEI ED Y DATE PEC IVSD DATE ISSUED
/� // r' S9 i �'� u iSFI
' GITY Costa Mesa, Calif. TNO:LI 81159 DDD E55
,. ARCHITECT Carlson & LIC.
OR' 'INEER Mi AAl Phrnnlc NO. COSTA MESA. CALIFORNIA
ADDRESS Garden Grove FIRE �J(��
ZONE TYPE Set/ GROUP
Dike & Colegrove, Inc. STATE APPROVED
CONTRACTOR LIC.NO,167293 BY DATE
ADDRESS • E _ • S • M- ZONING
• LEGAL LOT62 3487 IDN NO.OF USE OF NEW
DESCRIPTION NO.' BLOCK TRACT � (- PLANS �I'BU ILDING
APPROVED (LV /
BY W 41,2DATE 1 ��
SIZE 701 X 1001 I NO.OF BLDGS.None YARDS ES
OF LOT I NOW ON LOT REQUIRED LLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. None FRONT ( FT. IN.
SETBACK LINE FROM 5-73
CENTER OF STREET 531 REAR YARD 221 R.SIDE j FT. IN.
. SIDE YARD LEFT 51 RIGHT 51 L.SIDE 3FT. IN.
DESCRIPTION OF WORK • )/F.1- IN.
REAR
NEV I XII ALTERATION II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
SE
IZBUILDING 1647 ROOMS 7 STORIES 1
EXTERIOR WALL 4, ROOF _
COVERING 5 UCC0001IICOVERING Shake
; USE OF BUILDING AND WORK TO BE PERFORMED
' Single family residence with gar' G
attached garage. ------
, 9/
' an 7.0 DR —�1J
• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
• AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF_fie, PERMIT FEE $ 36.00
PERMITTEE
$ 16,862. PLAN CHECK $ 18.00
' AUTHORIZED AGENT Dike & olegrove, Inc. = ' 54.GG
TOTAL FEE $