HomeMy WebLinkAbout1014 PRESIDIO DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ccauiLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 1014 PRESIDIODR
Suite:
Vicinity: HOUSE & ATTACHED GARAGE
Parcel Number: 14164217
Applicant: FAUBART, BRAD
Address: 8902 SAILPORT DR
HUNTINGTON BEACH, CA
Owner: MAHAFFEY, DOUGLAS L
Address 5415 OLD PIRATE LANE
HUNTINGTON BEACH, CA
Contractor, STAR COURSE ROOFING CO.
Address: 8902 SAILPORT DR
HUNTINGTON BEACH, CA
Zip: 92646-2664
Zoning: R1 R1
Phone: (800) 854-0011
Zip: 92646-2664
Phone:
Zip: 92649
Phone: (800)854-0011
License: 532778
Arch Eng:
Address: Address:
ISSUED BY:
•
Status:
ISSUED
Applied:
05/15/2001
Issued:
05/15/2001
Phone: Phone:
Zip: License: License:
REROOF EXISTING SINGLE FAMILY RESIDENCE & ATTACHED GARAGE (28 SQ). TEAR OFF EXISTING ROOFING &
RESHEATH WITH 7/16" OSB. INSTALL 15# FELT UNDERLAYMENT & REROOF WITH 25 YEAR COMPOSITION SHINGLES.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
-- -
FEE SUMMARY
$0.00
$125.25
$0.51
$0.00
$0.00
$0.00
$125.76 �=
SETBACKS `
MAIN STRUCTURE Front
ACCESSORY Front
PARKING Existing
NOTES:
0-6 Rear 0-0
0- 0':- - Rear 0-0
0 Required: -0
Le
Le
Calc Valuation:
Claim Valuation:
i
I&ZONING'-
Left
0-0
Riyni ;a a�
Left 0-0 Right. -,'0=0-
Proposed: 0
$5,100.00
s5,loo.00
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
2446.46(6100)
t
DECLARATIONS
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.
(0--i have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Cotle, for the performance of the work for which this permit is issued.
My workers' mparRation Insurance carrier and policy number are: _. y'7 Q
1Carriery T_ -Policy Noinber.�1, �p
J ' C'
`(This section need not be completed if the permit is- e tone hundred dollars ($100) or less.)
❑ 1 certify that in the performol�fa, this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of ani, andaaf I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with thes ov'afoons.
-Applicant Signatu Data:.
-WARNING: FAIL E T SE RKERS' ODMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND RE1$ . 0),IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370fi OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under p N Ions of Ch comm g with Section 7000) of Division 3 of the Businesnd Prp(@gsions Code, and my license Is in full
force and effect. Lice. J Class
Contractors Signature: Date:
CONSTRUCTION LEND Efi
❑ 1 hereby affirm that there is a construction lending agency for the Performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: 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'Cotle)ror 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 civilpenalty of not more than five hundred dollars ($500).):
R V1 k -Y,
❑ I, as owner of the property, or my employees wlih`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
Cade: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person 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 atstandard temperature and pressure).
.......................................... ............ ................. ......................................................................................... ................................................................................. ......................................... .................... -........................... ................................... I ............
.
3 DDes 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 orpresent or future building occupant require for the work which is the subject this ILI Yes
apermit for such construction or modification
from the South Coast Air Oualiry Management District or from any other air pollution control distract or agency?
y? LJ Yee LJ No
(Section 65050.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
............................... .................................................................................................................................................................................................................................................................................. ............................. ................I............................
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
(It yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
.........................................................................................-ir-....................................................istr..................................p-81.................on-t..........................................................................................................................the.....................................
7 Iia permit from the South Coast Air Quality Management District or other air pollution control district n 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 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 inspe�:'ta9re not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature wner(s) Date
Ot Authorized Applicant - Dale__.::
gag INTITIAL CODE I INSPECTION TYPE DARN INTRIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
04_1a D/Cc/DD DWU IV
Applicant to till in all spaces except those within Heavy bottler lines and sign all appropriate declarations. _ _
CITY OF COSTA MESA CQNSTRUCT^IO�
Applicant's MIlmg _ Ny1PERMIT,
drePERMIT O. -; ! TRACT NO. i cLOT N0.
Protect Adss � ��/. 4 %•.: — r- f ! / i .1
1 I YP )�Gl / /g LTYPE OF CONSTRUCTION'NEW - ADD N ALTERATIOREPAIR -
Mi Address i �
+ �'-, r,�/]il r-�❑ CONVERSION -❑ DEMOLISH ❑OTHER A.P.#. _ _r; i - - Zone - I
Owners Name •• - Phon 11�`y-DESCR I PTION OF WOR K/USE OFB LDG;
Address o + - ' _ S Main Building: - Accessory Budding
Arch/Eo - . • - m - ' E _ I _ Z
g, ' LiCeitse No. j TYPE OF PERMIT GRADINGO..---�I�FOUNDATION ❑:STRUCTURAL - T Font _ O
Address -
TEN ❑ ELECTRICAL RYPLUMBING ❑'MECHANICAL s g - I - ! N
_ Rear c _
Contractor's Name r' c f�/f A� - •/Phone �N !/f/ '❑ OTHER I _ C Ri ht I - N
// �N�l . .�rLl�q• PROJECT DESCRIPTION Sq. FT.' OCCUPANCY K. g _ - - _ G
Address (mailing) /�-7 , CONSTRUCTION TYPE + VALUATION S Left , I '
City License No �/ (//J _. t c - , R v
ZONE GRADING CU. YDS: •ACRES Ping: Ref. # i Parking Req
./Provided E I
LICENSED CONTRACTOR DECLARATION - Q"
1 herebylaffirm that I am licensed under provisions of Charter'9 (commencing Remarks: I Planning Notes: M
with section 7000) of Division 31of the Business and Professions Code, and - , r T
my license is In fu Iffor'and'effect. I U ,
License CI Li o.. S
Date let, S"g t Li �`/b /I I PLUMBING FEES ! I f
WORKER 'COMPENSATION DEC'CAIIATION + ELECTRICAL I I
1 Bar Sink Showers ' ' FEES
I hereEy affirm that I have a certificate of consent;to self -insure or a certificate I i +
'.f Workers' Compensation Insurance, or a cer14. d. copy thereof (Section _ - _ -
\ -too, Lab.- /• %f- /t - '.J-�p�"'s q y//z,I 1 Backflow Preventer -- - - - Service Sink � -- -- - - - 'Automatic Washer•�i �- ,TiansforiiTi E) 15-50 KW' !
•aolicy No.*C2'_I �I I Company / TJ,�H \-('>/(l� Backflow Irrigation 1 50+ KW -
��--r---- 9 Sewer Cap Construction PoleSub. !
y.� �e rtified copy is hereby furnished
cert' " y is filed with the city qy .0i%}j�/•may/y/, I Bathtubs Sewer Connection CookingUnit .7 Meter ❑u to 100 amps
Date ye/�I APplican ��/! .// ./ i/�14/ - p p I
EXEMPT ON! WFR�RKERS' COM NSATI DECLARATION Clarifier Solar Collectors .Dishwasher Meter El over 100 amps
(This section need -not be completed if the permit is for one hundred ($100)`or
less): I Ishwasher ! 1 Solar Piping I Dryers ❑Gas' ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is Issued, I ,
sha u�not •Lemploy any person in any manner so as to become subject to the • Drinking Fountains Solar Tank Fan' - .Motors ❑0.1 HP ❑1'/x-8
Workers';Compensitionaws of California. ' -
Data Signature ' Floor Drains SwimmingPool w/S a I
.NOTICE: If, after making this declaration, you should become subject to the p F.A.U.FAUInc. Solar ❑9-15 HP ❑16-15+
Workers' Compensation; provisions of the Labor Code, you must forthwith Floor Sinks Urinal - 'Fixtures '- -' - - -
comply with: such provisions or this permit ;shall' be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY �1. Gas Service' Outlets Water Closet; Device Boxes I ;
I hereby affirm that there is a construction lending agency for the ,per ,Pole Light
of the work for' which this permit is -issued (Section 3097 Civ, C.) Interceptors WaterHeaterOutlets Range
Lender's Name `
Lender's Address I - - Kitchen Sink' 1 i Water Service Switches Sign.
OWNER BUILDER DECLARATION
-
I hereby affirm that I am exempt from the'Contractor's.License Law for the Lavatories .. t Auto -Wash ' Garbage Disposal Standing Sections
following reason (Section.7031'.5 Businessand Professional Code: Any city or '
county which requires a permit,to construct, alter, improve; demolish or repair P-Trap
I - Laundry Trays Generator ❑0-5 KW El 5-15 KW Trash Compactor
any structure; prior to Its issuance, also requires the applicant for Such permit _ '
to file a,signed statement that he/she is licensed pursuant to the provisions of ROOf'D rains' '
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of - I +
i' Division; 31of the Business and Professions Code) or that he/she is exempt _
refrom and the basis for the alleged exemption. Any violation of Section
.5 by any applicant for a permit
subjects the applicant to a civil
laity of not more than five hundred dollars ($500). - 1 $ S
1, -as -owner of the property or my employees with wages as their•. sole Reinspection Fe 'I $15 Isue F¢e
compensation, will do the work, and the structure is not intended oroffered Reinspection Fee $15 1 Issue'Fee $ 3
for sale (Section 7044, Business and Professional Cade:The• Contractor's - - MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon,tantl .who , does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
Hood or
employees, provided that such improvements are riot intended or offered for Boiler _ Type I ❑ te
,
sale. If, however, the building or improvement is sold within one year•of com- Canopy Type I1 ❑ - Zgmn9 Approved By Da
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). I
❑ I, aur
the property, am exclusively contracting'with licensed con- Duct - Structural Refrigeration System Application Issued By
I tractorsto construct the project (Section 7044, Business and Professions Code:
! The Contractor's License Law does not apply to an owner of property who Duct - Ventilating _ _ ❑0-100,000 BTU 0100,000BTU SUMMARY OF FEES I
builds or improves thereon,and who contracts -for such projects with acon-
tractor( s1 license pursuant to the Cont'ractor's License Law). I am aware that_I 1 Exhaust System 13 Multiple El System Repair/Alteration - BUILDING PERMIT l$ I + SMIPr i$
proof o their Worker's Compensation insurance should be Provided to me.
7 I PLAN CHECK $ PERMIT
❑ Pam exempt under Section 81. 8. P. C. for this reason Firepl/Fact. Bit. ICBG # Fire Dampers pLU MBING $ )( ISSUANCE $
Date ' owner' Heating System &Ducting Registers
PLAN CHECK 25% $ ENERGY P.C. $
I I hereby. certify that I'have read this application and state that the above -00.100,000 BTU 11100,000BT - -- ! I GRADING $
-information is correct. I agree to comply with all city and county ordinances ELECTRICAL :$
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM '$ i
. 5entative5 o thi it Ito n[er u on t e above-mentione0 pope ty for l l I f I
inspection u ' 1 I MECHANICAL '$ - TOTALFEE .$
.
sign at ure !' Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
en
Drivers' Licse or S z, -
CMF 0865-46, rev. 10/84 While - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
- 'CONSTRUCTION AND PL NI NG
APPROVALS Permit #'1� Date
`
Inspector
- POOL PA
- 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 Grrid.
57. APPROVAL TO COVER-GUNITE
7. Footings _
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, O Undrgrnd., Test
::9. Water Pipe-Undrgrnd.
60: Backwash Lines, P -Trap, O Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK
1.1. 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 Plumping -
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
_1 6. RoughElectric 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 1
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping Cl Gas OOil
'23. ,Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank OGas OOiI
25. Roof Sheathing
74. Overhead Hydro
..26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
-27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
' 29. Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final -
80. FOOD CERTIFICATE ISSUED
. 33. Final Electric
Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
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. Special Requirements Completed.
49. Electric Release to Edison -
•--,--
';,
50. Gas Release to Southern California Gas Cv
i
51. CERTIFICATE.OF OCCUPANCYNo. - - Date. -
Applicant
to /ill in all spaces except those within heavy border lines and sign all appropriate declarations.
_
9097 3/ I I /85 p01j TL
-. 1
, 4
''' , I l r f
\'
O'Project
-
CITti.oF COSTA ESA CONSTR CTION PERMIT , -
Address I . C - I
I '
Applicant's Mailing A ress 1 - Owner's Name - +'Phone+ •'
- _
Address, :6,H�`P - 1
A_ch/Eng. - _ License No +� -
1 Ally
Address - ,
PERfyIIT NO. 1
�`J
I I _•
TRACT NO.
LOT NO.
�.'
'UNIT O. '•
� y0.
TYPE CONSTRUCTION'- ` NEW ADD AL'TERAT.ION L REPAI R'c
'❑ CONVERSION.'❑ DEMOLISH I OTHER` - - '
'DESCRIPTION OF WORK/ �SEr.OE'BLDG.-��ei]u 1��/
- _ _ + _ [ 1�T 1 - °
A�p'2 _ .- _ .. ( - i = Zone
-
,
S
,Main Building:, - ' _ Accessory Building:?• ,•
,
.TYPE OF PERMIT GRADING FOUNDATION 'STRVCTU RAL •,
❑TENANT ZELECTRICAL m PLUM GING ❑vMECHANICAL
El'OTHER - 1 -
PROJECT DESCRIPTION SQ. FT. •^ 'OCCUPANCY -
,
I' CON STRUCTION TYPE VALUATION$
ZONE GRADING CU. YDS. ACRES ,Ping!i
i
T-
Front ` I +. 1 c
O
13
A
-
'Rear 1 �,;v t
N
'
Contractor's Names Kuk_ 'PICA!+ Phone - 005'
Address (mailing) Yk)AC /
•«
Ci ty License No.
LICENSED CONTRACTOR DECLARATION I _
Lnereby affirm that am. licensed under provisions of Charter,•9 (commencing
with section 7000) of Division 3 of the Business and Professions Cotle, and
my license,is in full or nd effect •'7
License Class _Li5�psa No -SS/ I
7—ST�9c //'/
Dale Signature?^dam
C'
_
'Right _ i + i ••
.I
N
K
$
• -
,Left
O
R
•
Ref: # ParkinRe
9. Req./Provided { t_ 1 ,7 ;-
E
Remarks: , t LED,Planning
_
Notes: + I )-
O
j
_
I
,
A
' PL' i
FEES
j
WORKERS' COMPENSATION DECLARATION
hereby affirm that I have a certificate of consent -to self -insure or a certificate
Bar Sink Showers - i I
+ . ELECTRICAL +FE
if Workers' Compensation Insurance_•or a certif' 'copy hereat (Section
-300-Lab.0.-
'D Company
Certified ropy is hereby furnahetl. i
- -':' - _' _
gackf low Preventer -- Service Sink -
".
_ Automatic Washer - 'Transformer❑ 15150 KW l -
50+ KW
Construction Pole Sub. {
Backflow Irrigation Sewer Cap-
Bathtubs Sewer Connection, i
;Cooking Unit i Meter ❑up to100amps
Cer fled co is filed with the city Bu' gE Wis
Date Applicant F
Clarifiers I f Solar C011ectdro ,
er Dishwash_ _ J _ _ ,Meter ❑Over 100 amps
- r -
EXEMPTION FROM WORKERS' COM ENSATTON DECLARATION
-(Thissection need not be completed if the permit Is fonone'hundred ($100)'u, .
less):
certify that in the performance of the work for which this permit is issued
shall not employ any person in any manner so t become subject to the
' WOrkers'•Compensation, Laws of California. r�
Dishwasher Solar Piping
Dryers ❑Gas i ❑Electric I Sub Panel ' i
- ' !
Drinking Fountains Solar Tank i �
:Fan ' Motors HP ❑1%-8 i
Floor D[ains Swimming Pool w/Spa +
I
-
F.A.U. Inc. Solar.09-15 HP ❑16-15+
. Date ` Signature -
-.
i.
'NOTICE: If, after making this declaration, you should -become subject to the
Workers"Compensatiom provisions of the Labor; Code, you must forth w ith ,
comply with; such provisions or this permit .shall. be deemed revoked.
;CONSTRUCTION ,LENDING AGENCY . <' i >
i 1 hereby affirm that there is*a constructiorilentling agency for the performance
of the work for, which tins permit is fed (Section 3097 Cw. C.)
Lender's' Name !
Floor.Sinks ._ _.- ._y._- _. -Urinal. - -- ---�
-- -
-'Fixtures ` "-' ' - - Microwave '- r
Gas Service'" .Outlets _a Waters Closet ••-O - 1 1
-
V Device Boxes r �POIe Light'
',
_
Interceptors � Water Heater, r_ f _ �
' Z
� Outlets v Range
:: '
- Kitchen Sink - 1, WatenService_'
'-
-�.^
1 i
r Switches P -Sign'
' g l +
Garbage Disposal. 'Standing Sections
Lender's Address '-•- a i
OWNER BUILDER DECLARATIO , [
' I hereby. off irm4hat I am exempt from the Con tractor's'License Law for the
following reason (Section. -7031.5 Business and Professional, Code: Any city or
Lavatories Auto -Wash
- -
' P -Trap - J "Laundry T.rays� �
-
E]0-5'
Generator❑0-5KW❑5-15 KW Trash Compactor
<„ KW
county which requires a permit to construct, alter, improve, demolishror repair
any structure; prior to its issuance, also requires the applicant,for such permit
: •^
'
t0 file a'signed statement that he/she is licensed pursuant to the provisions ofTRDfainS
the Contractor's License Law (Chapter 9 (commencing. wlth Section 7000) of - Division 3 of the Business antl Professions Cotle) or that. he/She"isexempt +herefrom a,nd the, basis for the alleged exemption. Any violationofSection931:5 by any applicant for a'permit subjects the'applicant Aoa civil
malty of not more than five hundred dollars ($500.
the property or. -my employees) with wages as their soleSpeetion
, compensation, ofthe work, and the structure is not intended or offered
for sale (Section 7044, Business, antl+Professional Code: The Contractor's
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
I sale. If, however, lire building or Improvement is sold within one year of com- 1
pletion, the owner'will have the burden of proving he/she did not build or Im- ':
Prove for the purpose of sale). ,
❑ I, as owner of the property, am exclusively contracting l with. l icensed con-
to construct the project (Section 7044, Business and Professions Cotle:,The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, antl-who-contracts-for-such projects with a con---
tractur(s) license pursuant to the Cantiactor's License Law). I am aware that
proof of their Worker's Compensation iosmyce should be provided to me.
. ❑Lam exempt under Section,// B. & P. C. for this reason
1 Date l ' Owner _, !
I hee certify that.l haves.read in is.appl !Cation. and state -that the above
information is correct. hagree to comply with all city and county ordinances nces
and state laws relating to building construction d hereby authorize repre-
senlatives of 'this cit o ter ;u the e -mentioned property for
inspection purposes. ,(//
'Signature ! i[/ Date '
Drivers' License or SS
i ..
c'
'
�iasownerof Fee `,
j$15 , Issue Fee -'
$-
j ,Reinspection Fe_e ,p
-- u
$15 Issue.Fee
- MECHANICAL_rFEES'
'
- p,
Boiler - ,�
Hood or Typal ❑
,Canopy Typ¢ II ❑
i i
•'
' DEVELOPMENT SERVICES�REQUIREMENTS:,
_ :^
Zoning lApprOy¢d By r _ Date
Building Approvedi,By i,' Date
1 ,
. Application Issued By x' 1 Dottractors
Duct -•Under Ground I
-
Duct - Structural I
Refrigeration System
❑0-100,000BTU ❑l00,000 BTU/
-
Duct- Ventilating
, ^ I ij..'SUMMARY OF FEES
i
'" BUILDING PERMIT $ SMIP $
PLAN CHECK' �� $ PERMIT +
PLUMBING j 'r '$ S OCY ISSUANCE $ j I
PLAN CHECK :25°%t'$ ENERGY P.C. $
ELECTRICAL )$ GRADING $ f
1 ,
' MICROFILM ,$
PLAN CHECK 50%.:$
MECHANICAL /' $ TOTA''L FEE $ /ord
i ,
PLAN CHECK 25% •$
Exhaust System ❑ Multiple ❑
-
'System Repair/Alteration '
-
L
Firepl/Fact. Bit. ICBO # ,
I Fire Dampers i
Heating System & Ducting I
&106,000 BTU ❑100,00087 —
, I
Registers
--- - - - - -1
i
--
,
i +r•
f 1
-
i
Reinspection Fee
---
$15
Issue Fee
$ 3
CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
(CONSTRUCTION AND PLANNING %�
-Date
?;' APPROVALS Permit # v
Inspector
POOL PA
-
APPROVALS Permit # -
Date
Inspector
,1. Temporary Electrical Service or Pole
-J
52. Pool & Equipment Location
-2. Soil Pipe: Undrgrnd. - ry
' 'u
53. Steel Reinforcement
-
`3.. Electrical Conduit�Utility-Undrgrnd. -
j
54. Forms
;fir
4:� ElectcalConduit-Undrgrnd.
_
55. Electrical Bonding
5. Steel,Reinforcement
56. Rough Plumbing & Pressure Test
- 6.• Electjical UFER.G nd. f;
57. APPROVAL TO COVER-GUNITE
'�
;Footings //1
;;.•'�
_
58. Electrical Conduit-Undrgrnd.
g
!�
8. Foundation
59.-Ga's Pipe, O Undrgrnd., Test
9. Water Pipe,Undrgrnd'.�'\
\
60. Backwash Lines, P -Trap, C1 Undrgrnd.
'10. Structural Floor System _,`I
'•''
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 0 Gas ❑ 011
23. Gas Pipe -Rough &Test ^
72.,lUnderground Flush
24. Roof Framing
73. Undergrnd. Storage Tank 0 Gas 00il
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: 8/ry1e6_ L•10P-C4e A G4,rQ•
34. Final Hearin g'& Air Conditioning
y a29 d'.i- /YOON� /•/ON'/� G•��J
35. Final Gas Pipe -Test
oIYE /-/vy✓/ri"- C.C,3
36. Hood or Canopy
37. Final Factory Fireplace
.
38. Fihal Plumbing
�� • - �^�
39. Water Service -Final
40. Gas Service -Final•
41. Solar Domestic -Final
42. Backflow Preventer
i
'
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
- -
�j
50. Gas Release to Southern California Gas Go
'{+
51. CERTIFICATEOF.000UPANCY
No. - Date' -
- -
I
- 4
�l
- . - - Applicant to fill in all spaces except those within heavy
CITY OF COSTA MESA'.CONSTRUCTION,PERMIT
Project Address Col L'4 P•KE 51 DI o DR.
Applicant's Mailing Address p.sp
Owner's Name INNDRF— W kANKh Phone !(JJ Z
Address 1014 1p1RE5I tj% 0 09 - —
Arch/Eng. R%"x% D 1"VEI " License No. 4044
Address 4`815��--MAIN SLT���140MW LINiD►t '1
Contractor's Name -ESRD C7 S�TZ Phone 3—
Address(mailing) 3772 C-soI..DENW�ST ST 222
City License No. e5Tlu IWSTE(i C
LICENSED CONTRACTOR DECLARATION
I hereby affirm thattl am licensed.under provisions of Charter 9 (commencing
with section 7000) of Division 3 -of the Business and Professions Code, and
my license is in f II force and effect. 43
License Class •^� Lia se O
Date '3--— Sigpawre
WORKERS' COMPENSATION DECLARATIOr
I hereby affirm that I have a certificate of consent to self -insure or a certificate
Workers' Compensation Insurance, or a certified copy thereof (Section
300, Lab. C.) 2:J
Policy No. �' Company
BCertified copy is Kerebyfurnished.
Certified copy is filed with the city Building Divislori.
Date " It ('Applicant
EXEMPTION FROM,WORKERS' COMPENSATION DECLARATION
(This section need not be,completed if the permit is for one h no red ($100) or
less). ff . K•
1 certify that in the performance of thew k for which thi pyrmit is uetl I
shall not employ any person in any m er so t les to the
Workers' o engt Laws of Califor
2 606006-11?
Date ��Signature
NOTICE: If, after making this declaration, you s 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 _
of the work for which this permit is issued (Section 3097 Civ. C.)
Lender's Name
Lender's Address
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
pivision 3 of the Business and Professions Code) or that he/she is exempt
'.e refrom and the basis for the alleged exemption. Any violation of Section
-?ti?31.5 by any applicant for a permit subjects the applicant to a civil
Ynatty of not more than five hundred dollars ($500).
._.L] I, as owner of the property or my employees with wages as their sole
Compensation, will do the work, and the structure is not intended or offered
for sale '(Section 7044, Business and Professional Code: The Contractor's
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If; however, the building or improvement is sold within one year of com-
pletion, the owner will have the burden of proving he/she did not build or im-
prove for the purpose of sale).
❑ I, asowner of the property, am. exclusively contracting with licensed con-
tractors to Construct the project (Section 7044, Business and Professions Code: —
The Contractor's License Law does not apply to an owner of property who
builds or improves thereon, and who contracts for such projects with a con-
tractor($) license pursuant to the Contractor's License Law). I am aware that
proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exem Pt under Section B. & P. C. for this reason
Date Owner
I hereby certify that I have read this application and State that the above
information is correct. I agree to comply with'ail city and county ordinances
and State laws relating to building ons ruction and hereby authorize repre-
sentatives of t1poil city to enter n the ve-mentioned property for
inspection our P P Q Q
Signature . Date 2 a 6
/ 6F 0865-46, rev. 10/84
and sign all appropriate declarations.
O. 1 :UNIT NO.
5975 3/01/60
119,30 TL
FEES
Z
O
N
I
N
G
R
E
Q
M
T
S
Reinspection Fee
$15
Issue Fee
TYPE OF CONSTRUCTION LJ NEW LJ ADD ALTERATION 11 REPAIR
❑ CONVERSION ❑ DEMOLISH- ❑ OTHER
'DESCRIPTION OF WORK/USE OF BLDG.
-
A.P. #
Zone
S
-
Main Building:
Accessory Building:
TYPE OF'PERMIT El GRADING 0 FOUNDATION STRUCTURAL
:E] TENANT' El ELECTRICAL ❑PLUMBING ❑MECHANICAL
.El OTHER -
T
Front
A
Rear
.._ _ -
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
CONSTRUCTION TYPE VALUATION$ 5/DOD.
s ZONE GRADING CU.YDS. ACRES
C
Right
Duct - Under Ground
S
Left
Refrigeration System -
1-10100,000 BTU 0100,000BTU
Ping., Ref. #
Parking Req./Provided
Remarks:-,Q�p N�.a
'Planning Notes:
t„^
X1 (- I N A- w An j., FC,# 1l 89S
System Repair/Alteration
f PLUMBING -
FEES
Fire Dampers -
Bar Sink Showers
Heating System & Ducting
❑0100,000 BTU 11100,000BT
ELECTRICAL
Backflow Preventer ._ Service Sink
Automatic Washer
Construction Pole Sub.
Transformer ❑ 15-50 KW
❑50+KW -
Backflow Irrigation Sewer Cap
-
' Bathtubs- - Sewer Connection'
Cooking Unit
Meter ❑up to 100 amps
Clarifiers - Solar Collectors
- Issue Fee
Dishwasher
Meter -Dover 100 amps
Dishwasher Solar Piping
Dryers ❑Gas ❑Electric
Sub Panel
Drinking Fountains Solar Tank
Fan
Motors ❑0-1HP❑1X-8
Floor Drains Swimming Pool w/Spa
F.A.U.
Inc.Solar 1-19-15 HP ❑16-15+
Floor Sinks Urinal
Fixtures
Microwave
Gas Service Outlets Water Closet
Device Boxes
Pole Light
Interceptors i. Water Heater
Outlets
'Range
Kitchen Sink - Water Service
Switches
Sign
Lavatories ?% Auto -Wash -
Garbage Disposal
Standing Sections
P—Trap Laundry Trays
Generator E10-5 KW 115-15 KW
Trash Compactor
Roof Drains -
-
Y}
119,30 TL
FEES
Z
O
N
I
N
G
R
E
Q
M
T
S
White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
Reinspection Fee
$15
Issue Fee
$ 3
'Reinspection Fee
$15 Issue Fee $ 3
MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREMENTS: ``�.� 0 .
Zoning Approved By � ` ' Date a
ate
Building Approved By S: —Date-
Application Issued By 'S+ Date
Boiler
Hood or Type ❑
Canopy Type I I ❑
-
Duct - Under Ground
Duct
Duct - Structural
Refrigeration System -
1-10100,000 BTU 0100,000BTU
Duct - Ventilating
SUMMARY OF FEES SD
BUILDING PERMIT $ �t SMIP $
PLAN CHECK $ PERMITISSUANCE $
- PLUMBING - $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $�� 30
.TOTAL FEE $
PLAN CHECK 25% $
Exhaust System ❑ Multiple ❑
System Repair/Alteration
Firepl/Fact. Bit. ICBG #
Fire Dampers -
Heating System & Ducting
❑0100,000 BTU 11100,000BT
Registers
'
Reinspection Fee
$15
- Issue Fee
$ 3
White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING
gPPROVALS 'Permit # .
Date'.
Inspector,
POOL & SPA
APPROVALS Permit #
Date
Inspector
1- Temporary Electrical Suite or Pole
52. Pool & Equipment Location
-
c.
2. Soil Pipe-Undrgrnd. •'
53. Steel Reinforcement
a.
3. Electrical Conduit Utility-Undrgrnd.
54. Farms -%
t
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure'Te-st .`
6. Electrical UFER Grnd.4 .`�
57. APPROVAL TO COVER-GUNITE(•�-,
7. Footings j„,%��� -
_
��
58. 'Electrical Conduit-Undrgrnd. /.'^,
r
-
8. Foundation.; 1.
59. Gas Pipe, 0 Undrgrnd., Test; (
9. Water Pipe-Undrgrnd. -
-
60. Backwash Lines, P -Trap, ❑ Undrgcndr
10. Structural Floor System
61. APPROVAL TO DECK t a .
11. ,Property Sewer Line & House Connection
62. Backwash & Receptor -Finale
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
'
W. Rough Wiring Sign
-
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL t
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit
20. Rough Factory Fireplace
21'. Ducts, in Structure
70. Underground Hydro '7
22. Ducts, Ventilating
71. Product Piping 0 Gas 0_.001,
%
23. Gas Pipe -Rough & Test
72. Underground Flush
r 1
24. Roof Framing
73. Undergrnd. Storage Tank 0 Gas ❑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 11
-
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION-•
•,
32. Electrical Power Meter -Final
80: FOOD CERTIFICATE ISSUED
�r
33. Final Electric
Notes: 3 2$ p 15 -L DG- Lec4ceV' f '
34. Final Heating & Air Conditioning`-
35. Final Gas Pipe -Test -
36. Hood or Canopy
`•• e -
37. Final Factory Fireplace
•- 1
38. Final Plumbing
39. Water Service -Final
V. �• ',' 1
40. Gas Service -Final
41. Solar Domestic -Final
�� • ,
42� Backflow Preventer
• •43. Backflow Irrigation
i��� •.�' " ;.
•44. '. Landscape Irrigation System
..>
/ --
45! Sound Attenuation
-
46. -Handicap Regulations
47. FINAL STRUCTURE&BUILDING
48? Special Requirements Completed
49. Electric Release to Edison
`y• '*-
50. Gas Release to Southern California Gas Co
`� !
51. CERTIFICATE OF OCCUPANCY
No. Date
rte---�
18887
COSTA MESA BUILDING -SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING 1�
ADDRESS 1014 Presidio Dr.
COSTA MESA. CALIFORNIA
COSTA 1 RSa ****9450
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
Mesa Del Igar Development Co.
RECEIPT NO. PERMIT NO.
OWNER
i
87
MAIL
Coast-Hcnr
REC81 BY I
OA RECFJ1/(/_
rrJHh
ADDRESS 1
///(
(/G- V
Corona Del Kar NO.OR 3h220
BUILDING
CITY
ADDRESS
ORCENGIN'TErEH _TER I CC Realty CO T o.OR (x220
COSTA
MESA. CALI ORNIA
ADDRESS E O H
FIRE
ZONE
/
TYPE GROUP
CONTRACTOR Macco Realty Co.
APPROVED
BY
-
DATE
ADDRESS 3800 E. Coast Hwy.
_
ZONING
CITY Corona Del Mar
ZON
I NO. OF
PLAN9
7 �
`I
UH8 OF N
BUILSTADUIfg
uc.TNo. _A -SB -1 No.OR 220
LEGAL
Lot
25 Tract 4808
SIZE
6
NO. OF BLDGB.
NOn
"I1
OF LOT S.F.
NOW ON LOT
A P. NO.
USE OF
YARDS
EVES
EXISTING BLDG
APPROVED
ALLOW9D
SETBACK LINE FROM 221 -211
501
(CZNTUR LINE 8T.) 1
CENTER OF STREET REAR YARD
FRONT
FT. J IN.
1
I
1
1
SIDE YARD LEFT 10
RIGHT 5
R.61DE
FT. IN.
DESCRIPTION OF WORK
L. SIDE
� FT. IN.
I II
IIADDITION
I
NEW
ALTERATION
REAR
FT. IN.
REPAIR I II
MOVING II
DEMOLISH
ABYPROV�(�
DATE
SIZE DINgO I X 01 -1011 ROOMS 6 STORIES
/
EXTERIOR Wt 'tIICCO RooWood shake & Rock
COVERING 2Y. Wood COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
tt
Living Area:
1780 S.F.
G ar,
Plan #450-C
Garaee Area:
460 S.F.
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION 18 FOR THE
A.STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COM-
PURPOSE OF ESTABLISHING
q PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
VALUATION
BUILDING CONSTRUCTION.
1^yiGNATURE 011e-sa- Del Mar Development Co.
PERMITFE
s ly 065.00
1
PERMIT FEE $
PLAN CHECK S
By:_
AUTHORIZED A tsA
TOTAL FEE rJ"