HomeMy WebLinkAbout931 PRESIDIO DR - Building Permits�PUCAT�fON FOR A BUIIDING PE� T
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� LICENSED CONTRACTOR'S DECLARATION
m
m I hereby affirm that 1 am licensed under provisions ot Chapter 9
t (commencing wit� Section 7000 ot Division 3 ot tha Business antl
Protessions Code, end my license is in tull force antl effect). �y
�j License as — ensa Numb¢r �- ��7 Q�
> Date L7 S� Co/itrecto��R���� �"jT.
E Atldrass ��6� el ��N!p��� � n%
jl CitVandZiP �����a- L-v"( y Phone s�/ /�/
N CONSTRUCTION LENDING AGENCV
� I hereby a�firm that there is a construction lentling a9ency fo� the
d performanca of the work for whith this permit is issuetl �Sac. 3091,
` Civ. C.). %�
Lentler's Nama �"1 <!''Cr' � v�.� /' w� cA.�i
� Lentler's Adtlrez �7 '� d�W ii�/ �/�Y�i+9 /�+/9-
'� OWNER-9UILDER DECLARATION
� I hereby aftirm that 1 am exempt irom tha Contractor's License Law
tO for the following reamn:
� ❑ I, as owner of the property, or my employees with wages as their
� sole compensatinn, will do the work, antl the structure is not
� intentled or otteretl (orsale.
3 ❑ 1, as owner of the property, am exclusively con[rac2ing wixh
licensetl contracrors to consttuM the project.
�d„ ❑ 1 am exempt under Sec. , 8&PC for this reawn
m
a Dat Ownor
E WORKERS' COMPENSATION DECLARATION
� I hereby affirm that I have a certitica2x ot consent xo se�t-insu•e,
O/ a ceriifiwte of Workeri Compenution Insurance, or a cer[ifietl
C copy thereot.
� Policy No Company
❑ Certifietl copy is hereby turnished.
a �'$erti£i c is filetl with Ora C��o��u/p�� E A
a Da[e Z� � APPlicant �/`�"" �
� CERTIFICATE OF EXEMPTION
FROM WORKERS'COMPENSA710NINSURANCE
(This section neetl not be completetl it permii is for $100 or Iess1.
I certify that in the performance of ffie work tor which this permit is
issuetl, I shall not amploy any person in.any manner so as ro bemme
subject to the Workers' Compensation Laws of California.
Deta Applican[
NOTICE TO APPUGANT: It, after making this Certitiwte ot
ExemptiOn, y0u should become subject to tha Workers' Compensa[ion
provisions ot the Labor Code, you must torthwith comply with such
provisions or this permit shell be deemed revoked.
I CERTIFY THAT � HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO
COMPIY WI'7H pLL COUNTY ORDINANCES AND STATE LAWS
RELATING TO BUILDING CONSTRUCTION, AND HEREBV AUTH-
ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON
THE ABOVE /M'E�NTIONE� PROPERTV FOR INSPECTIONpPUR-
PO S. I �P'i'—`-�.-- �V/Z %/p �
Signamre ot Applicant or Agent Date
,��,�Ar,� C'aCcs��o,✓
Print Applicent's/A9enYs Name
All spaces within this box must be campleted to process
CMF 0335-46 (BU-28) rev. 6/80
BUILDING PERMIT NO.
J Uqo �
TYpe of Project: ❑ New
❑ fEepair ❑ Convert
A.P.
Zone
Setbdcks P/L Front
Struct
Heignt
Park FeGs Ves
Requiretl No
Zoning Approved By:
M i5c.
RopoSetl U5¢
of Structure
Otc.
Qass
USE,
1.
No.
C.T
Electrical
Permit No.
Plumbing
Permit No.
Permit N .
❑ Alter Atltlition
Demo ❑ Occupancy Pmt.
5 p. Dist./
I sp. Area
pl. Pmt. No.
/L St. Street Wi
No. of
Family
Fee
Raceipt
Date
Vear
SIZE SQ. FT.
fotal Valuation
2ncroachment Permit Requir ❑ Ves ❑ No
Gratlln9 Pmt. GraOing
Repui�etl ❑ Ves ❑ No Pmt. No.
Rou9h GraCing
Approvetl by: Date
PERMIT FEES
SV uctural 5
Electriwl E
Plumbing S
Mechanical $
Pre-GraGe E
Inspection
Pre-Gratle E
Rec. No.
Plan
Check By: �� .
Plan C ck §
SPetial S
Invest.
e
S
W
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C
D
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' .�oxessaem�m+o: 931 PRESIDIO DR UNT:
�� .� amexswweiriwavx: ENGARD, ALAN J .
�ooxeu:Et�IGARD, IRENE P
931 PRESIDIO DR
C��STA MESA,CA 92626
APPL.IWIAlO il00HES5:
AIILXIIECT OX ENfdlFEP:
AGl OX ENG'S IOUPE55:
c�m��Ton.S�,BEST R6UFING
camncToxsMuuxo 236 VICTORIIi ST
�p�COSTA MESA CA
92626
LICENSED CONfRRCTOHS UECLAHATION: I Mraby eRim �nder panelly d perjury Nm I
(oommendip wilh SMion ]000) d Oivision � W Ihe Busimev eM PMmaiau Coda. uM m
cirv uc No: 0 51 � 1. 8 u¢ cuss: C— 3 9 uc. No.: 6 0�
�S �/ . i 3• q(� �_,...._. ,
lIG NO.:
IIM:
(714)650-1366
� � 603323
uxr:
liceved wqx ywitlwre of Cheqa B
arree ia in lull bece aM eHed.
EXP: 09/97
0 NEN BUILOEH DECLARATION: I hereby eifiim uiMar panaly d derpuy thet I em empl Irom tM ConlraGae Licenee Lew la Na
' B reawn (Seqion ]031.5 Busmeaa end Pmlaesbns Code: Rny cry w munry id� �syuiree e pe�mn to mnvun. aXer. improw.
demdoh, a repei e�ry slructun, priw lo ila beuence, ebo reyuins tha eppl' ant /or pemi� lo fib e eiB�eE ale�ament thet M a eM
o licanaed pu�wenl lo Iha prwriaau d IM Conlredore Licenae lnw [CMpls B(commendnp v.ilh Sepon ]000) d DNebn 3 a11Fs
Busir�em vM Prdmiona Goda] or thet he a she u examp Ihnelmm eM tM betie la tha dlped uamqun. Ny vulmion d Sepion
�aai s M enr eoo��w+� �a e oermn wNad. m. apW�u �o e wa oe�env d na maa men Iive nu�ree eomn IssaoD.
� 1. m owrer M ihe qapenY w mY �Dbyeea xvh wepea m Ihei ade compenaetim. willEo ihe wk. erW Na evuqure e ml imeiMeE
«oflarad lor mb (SMion ]pda. Bueiren e�M PMasriau Cada: The Conlrappe licema LawAom rwl eppF�lo en ownerd pmpe�ry
wlw Wdda a inpovae �hereon, enA who tlros such v.ork Nmxll or Mnelt «�hraph hi a her own smpbyees, pv+ided �hel wch
improvemm4v ara nd inieMad a dbreA lor seb. II. Mwever. IM buikirq a'vnpownw�t n eali xilhin wp Yeer d compblion. tlr
ow�rbuiMm vnll heve tM WNen d pwi�q M ar eM ditl iw build a impmw lor IMW�P�a d aeb).
❑ L a+ow�wr a me wroam. ��auviveN oomreainv wnn �icenaee mnv.nwa m canmw �ne wwea ts.ao� roa. ew'vi....d
a�ma�ans coae: rne camrena. �icense i.w me. na eooN ro en o..�, a wwMr ..no nwda «+mwwe. m.am �e ..+,o
wntrecn In wrl� prqetla v.il� e mntrecor(e) Ice�wd Wnuent to �ha Coniraclara Limme Lnw).
� I em ezemq urMar S«tian: B. 8 P.C.. fa Iho �eeeon:
om.: ow�.,:
i eo nerenr �.nM �ne� i em eware a ene u�d�sw�d me �a��rem<�m a cd�omie �eenn ene sarmv c«b seaion. usos, zssaa..�w
p553G. eM iM� I a em Mun WiWi�q aowpeni will / wil ml (drtb one� need to canpy w�h eeid me�a mdae end ths rpuiremanb la
Dele: Apq'ran�:
WOPKEfl'S COYPENS�TION DECLMATION: I MreW elfirm uMx penelly d parjury an d the fdbwirp detlenliom:
� IheveaMWlmeintaneceNtliWadmnsenitoaall-inwreforxvkam'compenWion,npwidedfwbySWim3�pdtheLebor
coee. �« me peeomierce d un .wix �« wnicn mis o� o h.wa.
� I heve eM vAI meinlen xoMere' oompanWion imurence. o reyui�ed by $epim 3]00 d Ihe Leba CoEe. M IM peAamenca d iM
work Iw xAich �hia pem�� ia ioueE. My wakere' mmpaneetbn inwrarra umar aM pdicy number era:
c� .
PdicyrNumber:
..�� „«d �or ne wmvb�oe e rn. Po�a � ro� o� n��d,ud dww fsiooi w re�.l ���///
i oenM �nv in �ne ro�«meiwe a ma wwk m. »nrn �na w�n �a �muea. i eneu ia eppw e�Y Vereon in anY menmr vo m �o
bacome aubpa ro iFa wurNxe' compenm�ion lexs of CefAanu. eiM prea Mel itNehouk bxane wbjae lo tM xa�kers'
e ronsa�im peovreane a smion mao a ine �� . � snen � n- 71Ji W/1ryl mo« pwi.ion..
/2•9G �`/ fl�'
� ���" ,
Wem/ny: F�llun ro ucuro �rorkwi rompawtlon mvsnps la lawlu( �ne�he sW/1e1 en b'ploysr ro MMreI peneMs� �ntl
c/vll flnn up b ons �,ndreJ Mouaand AMbn (SfaqaaoA In etltlltlon ro tlrs cwt ol rorrpemetlon am�Gs� u perlWG br In
Sxtlon 31P6 0l fhs La6o�Cotls, Intaut, aM atbmsyl lsu.
CONSTflUCT10N LENOIIW AGENCY: I Mreby elfirtn umbr peneM1y d per'ryry the� �hera w e mnYruann Mndi�q apmry lor Ihs
periormence d tM r.ah M whiW Ihi parmi ie'snuad (Seeun 309'!. Crv. C).
LENDEfl'S NNME:
�ENDEp'S RUORESS:
I ce�M �M1a� I Mre reeE Nia epplicelion eM �eta Ihm ihe ebova iMametbn is m�. I epree lo compy xnh dl dry ud countY adirwioes
eM eiete lewe rdm'vp to buildne ro��� �d hereM eWwrrze rapreaentelivee d Ihe ary io eMx upon tM ebwa�memioneE popeiry
�a��=v��o�roo�s.JIM GOULD
.n
(515148.WP)
o�,.: //%� � °�b
� � ' � �
8 Selery:Oreer�-Fle: Cenery-Rpplrenl:Pink-Revenue:(3dEenro�Aeeaavu
CITY VF CUS'rA t9ESA — HUTLDING PERMI'C
PERMIT NO: B 080427_ PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR
PERM NO: B 0809r�
GOVT: N SUPF: N
PURPUSE: OTfl
SOB UESCRIPTION : T/O BOR 6 RERUOF W/COMP. SHINGLES SQ FT: 2,367
CLAIM VALUE: 2,367.00 CALC—VALUE: 2,367,OU GROUP OCC; R-3 /0-1.
COMMENI'S : X
��e***�c����x x*�*�e��rt��e��*x��**x**�*��********+��u��*#�*�+t�+�**�****���rx+��***�**�**
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 BOILDING ---------
FRNT: F'I' IN REAR: FT IN FRNT: FT IN REAR: FT iN
LEFT: F'P IN RGHT: FT IN LEFT: FT LN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14132507 ZNE: REF NO;
PLANNING NOTES> � �
,�. ,.-r
�lE 1f %iE 1f !E iE if 1E i(-iE #E iE if iFlE iE if �l( 9E� iE iE iE'k if !k 1f iE 1E iE 1f iE 1E 1E iE iE iF'lE iF IE iE 1f 1E%1E 1E ##�)k �f if !E iE X-!F if iElElF 1F i(-�E iE iF iE if if 3E if�1F 1E iE iE iF iE iE fE �f 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
/. ,�
ZONING APPROVEii BY DATE;
BUILDING APPRO�G�EL� BY :
.i .
APPLICATION ISSUED BY:
�IElE 1E iE iE iE iE �7E 1E 1E 3E 1E iE iE 1E 3E ?E if' #'-IE 1E 3F
LEGALIZATZt�N:N F E E S M M A R Y
BLL�G PMT PLUMBING ELECTRIC MECHANIC
PERMIT 74.75
DATE: ,
DATE: G
������,�*�,�,� � ,�g*
STRUCTURALr 5 GME T;y
FIRE SMIP/RES GRADING
.50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 75.25 0,00 0.00 75.25 75,25 �00
REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
74,75 .50
iE iE iE iE iF iE iE 1E iE iE 1E iE iE 1E iE aE jF iE �E iE iF iE iE iE iE iF iE iE iE �)E iE �E iE iE 1E fE iE iE iE �)E iE jF iE iE it iE iE aE iE �1f iE iE iE iE iE iE �F iE �lE iE 1E it 1E it 1F 9; iF 1E �)E jE iE iE �E 1E iE iE �f 4 iE
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
ISFR 2367 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,367.Op
END OF FEES
oi �ozisma-ao�ivo�s TEFT iz,2�
DpTE: ill13/9S TIHE: 12:42
CONSTRUCTION AND PLANNING '• PO�� & SPt�' -
APPROVALS .Permit # Date Inspector - APpROVALS Permit # Date inspector
� t. TemPorary Electrical Service orPole : 52.� Poo� & Equipment Locat�or�- '� . � ' f•
. •
2. Soil Pipe�Undrgmd. � 53. Stee� Reinforcemeni ,�° -
�/ ���..
3. Electrical Conduit UtilityUndrgrnd. � 54: Forms �� �
4. Electrical Conduit�Undrgrnd. . , 55. Electrical Bonding� -� ' �,
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Tesf -
6. Elettrical UFER Grnd. . 57. APPROVAL TO COVER•GUNITE
7. Footings 58. Electrical Condui[-Undrgrnd.
8. Foundation � 59. Gas Pipe, � Undrgrnd., Test �
9. Wa2er Pipe�Undrgmd. �. 60. Backwash lines, P-Trap, � Undrgrnd. -
r
10. StrU�tural Floor SYstem - 67. APPROVAI TO DECK . �
11. Property Sewer Line & House,Conoection � 62. Backwash & Receptor�Final .��
� 2• Seeve� Cap .�' - 63. Heater & Vent�Final
73. Roof Dratns � 64. Plumbing SYstem � Final � �
14. Rough Plumb(ng , '65. Electrical-Final � '
55. Roogh Elearical-Condnit . 66. So�ar SYstem-Finai �-
i6. Rough Electric Wiring � 67. Fencing & Access ApProval ''
17. Rough Wiring Sig� 68. APPROVED FOR PLASTERING
18. Ro�gh Electrical�T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
79. Rou9h Heating & Air Conditioning - FIRE DEPT. REQUIREMENT �
20. RoUgh Factory Fireplace APPROVALS Permit #
21. Duds, in Siructure � 70. Undergraund Hydro
22. D�Cts, Ventilating � 71. Product Piping � Gas D Oil
23. Gas P�pe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheaihing � ���.�, 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flathing 76. Dry Standpipe
28. Laihing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAI
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Ptaster Brown Coat 79. FINAL INSPECTION
32. Eleetrical Power MeterFinal ' 80. FOOD CERTIFICATE ISSUED
33. Finai Elearic . Notes:
34. Find� Heating & Air Conditioning �
35. Final Gas Pipe•Test � �
36. Hood o� Canopy
37. Final Factory Fireplace '
38. Final Plumbing
39. Water Service-Final ,
40. Gas Service-Pinal •
41. SolBr pomestic-Finai
42. Backtlow Preventer
43. 8ackflow 4rriqation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING /Z-Z -R�j 6Cq/
�
48. FINALPLANNING . '
49. Eiectric Release to Edison � ,
50. Gas Release to Souther� Caiifomia Gas Co
51. CERTIFICATE OF OCCUPANCY '
No. Date
�_�� s2
COS�A MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX H17 GOBTA M68A. CALIPORNIA
For Appl?cani fo Fill In Complefely
TYPE OR PRINT � �
nooRe�ss 931 Presidio Drive
COSTA MESA. CALIFORNIA
owNes Mesa Del Mar Develo ment Co.
ADORess 3800 E. Coast Highwa.y
TEL. Ur101@
c�rr Corona del Mar
uc No. 98808-SB-1 No.Oriole 3-4220
BIZE NO. OR 6LDG6
OP LOT 6510 S F - I NOW aN LOTL,On
USE OF .nOne VARDB
EXI8TIN6 BLOG APPROVEo
66TOAGK lINB PNOM ICBM¢w LIN6 8TJ
C6NT6POPlTR[6T � REARYARD � -----
SIOE YARO LEFT 5'-3'� I RIGHi 51
DESCRIPTION OF WORK
L�O�� T�a����$,�lan 500 A
F � � U
li SEV 6 ,ssr
� FINnA�NC�En�TDeEPT�.�p �
CfTYAPPLICA'T7t�IV"FC)R PERMIT
BUILDING
For Offiee Use dnly
RECEIPT NO. �R¢f��
BY
DAT¢ IBBUED
COSTA MESA. CALIFORNIA
FIRE
ZONING
ZONE I NO. OF I UB¢ OF NEW
�Q" i PLAN9 � BUILDING ,�
LHOAL .��.17 �/� ��l e�--'
' -9"x50' Roonis 6 sroaiEs 1
�LL .WOO RQap Compo. an
[ll� FYuCCO COVERING Gravel
)ING AND WORK TO BE PERFORMED
L. SIDE r
REAR � �
AoVPROVED GV ��
ea
EVE6
3
1652
Gara e Area 433 S F.
Covered Porches
tc. - rea, 21 S F
I HBPHBY AGKNOWLGDGE THAT 1 XAVE RE�D TX19 APPLIGTION THE AMOUNT BHOWN UNDER VALUATION IB POR TH6
ANO BTAT! TX/�T THE ABOVE IS GORNEGT AND AGP6E TO COM- pUIiPOBE OF EBTA6LIBHIN6 ♦ PERMIT FEE ONLY.
PLY WRH ALL CITY ORDINANCEe AND BTATE LAW! R60ULATN6
9uLLOING CONaTRurnoN. � VALUA710N p �J
SIGNATURE OF(�eSg DEL M3T D8Ve10�1ID2IlY CO. PERMIT FEE $,_J /� �% D
PERMI7TE �(�y� s D
. $j� ; ' $ 1 � , 769. 00 PLAN CHEGK $ /V '
AUTHORIZED AGENT 't SS.SO
TOTAL FEE
FS
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Cl`i� A MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING T ��.
ADDRESS Jl �rJ���°
T�ENANT�R ///�LON
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CONSTRUC710N
BflANCH
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ADDRESS T( J CC/�J�/y .�%' D��7G
CONTRACTOR �fJRC/GL W�S�•
ADDRE55 y/O� CC�/✓�^�� (//r•
CITV D��(� ' NOLS��
L C Na. �3 / 2�o� Pf/ LI4 NO.
SIZE NO.OF BLDGS.
OF LOT �O X�OO ( NOW ON LOT
USE OF �J�
EXIS7INGBLDG. �J([CFt'��
Separate permits are required for
electric, plumbing and heating work:
USE OF BUILDING AND WOPK TO BE PERFORMED
OQ'1 /7y/`cv /%"fei✓ �
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APPLICA
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A.P. NO. �� `. "�
BUILDING (7 �/
ADORE55 -!
UNIT OR
SPACE NO.
I I /04/80`' ^r�'.;=�'yl�3�.,�8 . TL'
TRUCTURAL PERMI'f" "' .' ` "
` N° 50901
5 —��
Y'a s i �'0 1� d"
7 N� LOT�
NEW ADD ALTER REPAIR
OWNER �� f //Q/VL
use ryy�,
20NE TS� n TVPE—Y�V
APPFOVED�. //
APPROVEDSETBACKS
(FROM C/L STREET)
PLANNING ACTION
BLK.
MOVING DEMOLI51
vc,�uea / / 7/�
DATE
DATE
APPROVED
I hereby ecknowledga that I have read this application and stete °�'
that the above infarmation is correct antl agree to comply wlth �
all laws raguletin8 building construction, antl I shall not employ �
any parson in violation of the workman's compensation laws ot d
tha Stata of California. / a y/`/
SQ. FT. � � � n'
I hereby cartify that I am properly licensed as a cont�acto� untler
the State of California eusiness antl Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chaptar 9, and that sueh licenses are In full forca and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
am exempt from tha provisions ot the State of Cellfornia Businass VALUATION PERMIT FEE �t a
and ProfessionsCoee, Oivisfon 3, Ghapte� 9. $ .C.- � uf
9 ��l t�------- . m
PLAN CHECK $ G � "�
Si nature of �
Permittee $ �p��y � TAX $ /, 3 S f
AvthorizedABant �a�e %U 27 TOTALPAID s/2 9? 4, u