HomeMy WebLinkAbout2128 RALEIGH AVE - Building PermitsPflOJECTA00flES5: 11ZA RALEIGH AV
OWNEfl'SNAME: KEELER WILLIAM H
aoosess: A15 W �9TH ST
� COSTA MESA,CA 92627
RPCHIENGINEEH: S 4 S— S 1 9 Z qEG.NO.:
, aooxess:
UNIT:
uxiT:
PEflMITTEE: HUDSON iRA COST$UCTION ( 714 ) 530-2771
nooxess: 11901 {JESTMINSTER AVE
GARDEN GROVE CA 92643
LICENSEO CONTBACTOR DECLANATION: I �ereUy alhrm t�al I am licensed un0er provisions ol C�aple� 9(commencing wi�� $ection
7000� oi Dinsion 3 al t�e Business anG Pmiess�ions Catle, antl my li[ense is in �ull�orce anG ¢I�eci.
arr uc.: 016 Q STATE UC.: x p 8 S 0 3 C�/�G y�.� 9.,� �
r 2G y �.,.• /
oate: _� Signaiure: �% __l L
WOBKEPS' COMP SRTI N OECLAflFTION: 1 her¢Gy allirm IIWI I luve a Certificafe ol ton5eni lo Selt-in5ure or a teM1ilicate 0� Workers'
Compensation Insurance. or a cetlili¢a cooY �hereol (Secuon 3800. la�. CI.
POLICY NO.: E%P. �ATp:
LOMPFNY:
Q Cenilie0 wpy ¢ here�y Wmis�ea. ❑ CertilieE copy is IileU wif� t�e ci�y BuilOing Division.
pate: Applicanl:
EAEMPTIONFflOMWOflREflS'LOMPENSATIONOECIAB�TION: Qhisse[6onneeanalbecompletetli�Uepermili5�orwehunOre0�5100�orless).
I cetlity Ihal in Ine petlormance ol Ihe work far ¢� this permil is iss,ye41 5� not em0loy any per on in any manner so as �o become
su01e�� �o I�e Worker5' Comp nsation Law 1 Calilornia. y///^j��/,� /f
�a1e: _ � � � Signamre: T/p////' "/ �
NOTICE: II. a r mak g Ihis Oeclaration, you shoula become sh6lect to Ihe Workers' Compensation provisions of the Labor �
Code. you must fanmvnn comply witA sucn pwvisions or ��is oermit stull 6e JeemeO revakee.
CONSTHUCTION LENOING FGENCY: I h¢reCy a�fifm Iha� Ihere is a tOnsimCliOn IenOing agenty for the periormante o� lhe wOrk �or
which Ihis permil is issuetl (Section 3097. Civ. C�,
LENOEfl:
AOOHE55:
OWNEB BUILOEfl OECLABATION: I herehy aliirm I�ai I am exemp� �rom Ihe Conlratiofs' State License Law for ine following reason
(Section 7031.5 Business and Pmlessional Cotle: Nny ciry ol [ounry which �equires a permit lo con5�mci, al�er, impmve, demolish, or
renair any siruclure. Orior to ils issuance, also requires Ihe applican� �or such permit to file a signetl statement ihal he/she is licensed
pursuant �o I�e pmvisions o� Ihe Comracmrs' Slaie License Law (CtlaDier 9(commencing wi�h Seclion 7000) of �ivision 3 ot ihe Business
an0 Pm�essions Code� or Ihal M1e/she is eKempl therelmm and Ihe Cdsis lar Ihe allege0 exempiion. Any violaiion a� Section 7031.5 by
any apPlicant lor a permil su�lects I�e applicant to a civil penalry oi noi more than live hunGretl dollars (5500).
I, as owner ol Ihe pwpetly or my emVloyees wit� wdAes as t�eir sole comDensation, will tlo t�e work, an0 ihe
❑ s�mcture is noi imen0e0 ar oneree br sale (SecUon 7Uad, BuSiness an0 Vmfessionai COUe: The ConVac�ors' Siate License Law
tloes noi apPly lo an owner ot a property wtlo �uilds or improves Ihereon, antl w�o do¢5 such work himself/�ersel� or IAmugh
hi5 or her Own employees, pmvidetl t�ai such impmvementg are na� intentle0 or O��eretl �or Sale. I�, however the bUiltling or
improvement is soltl wiihin one year af compleiion, the awnCr will have I�e burtlen ol O�oving he/she diU not 6uiltl or impmve
�ar Ine purpose ol sale�.
I. as owner of i�e pm0eny, am exclusively con�mcting wit� Iicense0 conirac�ors m consimcl the Drole�� (Section 70a4, Business
❑ antl Prolessions CaJe: The fqnVaCiors' Slaie License law aoes noi aDD�Y �o an owner o� Dmpehy who DuilQs or impmves Ihereon
ana who contratls �ar such pmlecls wi�� a conirac�or�s) IicenSe Dursuani to Ihe Contractors' Siale L¢ense Law). I am aware
Ihat D�oal ol their Worker'S Compensation in5urance S�oWG �e pmvi0e0 lo me.
� I am ¢xempt un0er 5¢ction: B. 8 P. C. �
�or1�5 reason:
Oa�e'. Owner.
I Oo here0y cetli�y I�ai I am aware af anG unUe�SWnE Ihe reQuiremenis al Calibmia Heall� an0 Salery Cotle $etlions 25505, 25533. antl
2553a ana �na� I or any �mure ouitaing octuoant will/will not (circle ane� need lo comON �+�h saie state cooes ana ihe repuirements lor a
permi� for constmclion or mo0licalion Imm �he Air ualily Manaqemeni DislriCl. Fesiden6al cOnslmciion apDlitalion5 are e�emp� �mm
mese o�o�sions
�ai¢: D�itanl:
I h¢reCy ceiidy Ihal I have �eaG ��is applitalio ana sla�e llul I�e aOOVe inlormation is correci. I agree Io comply vnlh all ciry an0 unty
oiainanwsanesta�eWwsreWlinglaGuilOingc nstmciionarq�ereDyapihoruereD��ema�ivesoltlns irymenteruponlhea�ove- ntione0
O�operly lorinspec�ion purposes. / �/
Wte� �� � Signawre: v �GI�
orive�'s �icense o Soci, Securiiy a:
I6at�a6 W�ne—BmlOing: Green—COEa EnlorcemenC Canary,qpplicam; Pink—Revenue; GolOenroE—Assessor
CI'fY OF COS'TA MESA — BUILDING PERMIT PERM NO; H 05529
PERMIT NO: H 055290 PLAN CHECR NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION : T/OFF REROOF W/ COMP. SQ FT: 3,000
CLAIM VAI,UE: 3,000.00 CALC—VALUE: 3,000.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR RE�IUIRED IN THE HOME *�
***��r��c**+r**+��*�*�***�**�*x **�***����***�*****��*x�*�+�***��VI� * **u�*+�**+�*
ZONING REQUIREMENTS ����T��TOF�
S E T B A C K S C .�
------------ MAZN BUILDING ---------- --------- ACCESSORY. BU��i��t1��---
FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR; FT ZN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42246309 ZNE: REF NO:
PLANNING NtST'ES>
i
*�***��**��*��«****x**�*****�*�,e**�*�**��*�«�*��*�*x�*******��*�**�*��i�'*+��*���*�*
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 iJ�. T: S
ZONING APPROVED BY DATE: '
BUILDING APPROVED HY : DATE: .°'
APPLICATION ISSUED BY• �� DATE: ���t
if�Ek*aFiEiflkiFifiEiEiEiFiE-IEiFiElFlElEiEiFTF7FiF7F'iF7F3F7FiF�iFiF�iF3F if iFifiFiEififiF'iF3F7FiFiF7FifikiElFiF�FN��fi4i! 1FiF
iF �E iE iF if ic i! �k iE aE If IF iE iF iE iE iF 1P iE if iF if if i61f if if 1E i(� iE jf IF if if iF iF 1F aF iF 1E iF �! if if IE if if �f iF at if 1f iF if 1E aE �k �f �f iF if M�f iF �f ik if ik �F iF 3E+E iE iE iF±E 1f iF i4
LEGALIZATION;N F E E S U M M A R Y STRUCTUFiAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RE5 GRADING
PERMIT 54.00 ,50
PLAN
ISSUE FEE
BUILDING—DIV—> PERMTT ISSUE PLAN—CHECK TOTAL
TOTALS----> 54.50 0.00 0.00 54,50
SMIP/NON—RES
PAID DUE
54.50 ,00
REVENUE DIViSION TOTALS--> COLLnCTED: 59,50 OVER/SHORT: 00
HLD59PU0 pLUMBING ELECTRIC MECHANIC FIRE SMIP/TOO GRADZNG PLAN—CHECK
iF iF 1k iE N 1E IE iF It 1f if 1E 1E if if if IF iE )f if 1F 1E if it 1E iF iF if �lf iE if �F iE iE ik iF 1E if if 9E iF if iF iF iE 9F iF iF iE iEiE iE if iE �)F iE iE iF iE iF iE if 1f if iF i4 iE 7F if R iF if if f ii� if iE iF �lE
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 3000 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 3,000,00
END OF FEES
i.
' � " rr�ir'� _' _
�_I �J'_'J_�_ �. � . . .
�ii� •,��' ��• -T �t � '
� POOL & SPA
CO��STRUCTION AND PLANNING .
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electriwl 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. E�ectrical Bonding �
' 5. Steel Reintorceme�t 56. Rough Plumbing & Pressure Test
6. ElectricalUFER,Gmd. -- 57. APPROVALTOCOVER�GUNITE ,
7. �Footings • 58. Electrical Conduit•Undrgrnd.
Q: Foundation .� 59. Gas Pipe, O Undrgmd., Test '-
9, Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor System 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains .. 64. Plumbing System � Final
14. Rough Plumbirig 65. Electrical-Final
15. Rough ElectricaG-Conduit 66. Solar SYstem-Finai
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica!•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
. i
20. fiough Factory Fireplace . _ • ' APPROVALS -Permit # -
,_ i
21.'Ducts, in Structur� . - - " t 70. Underground� Hydro �
22. Ducts, Vent�latin9 •� � J1. Product Piping QG�s ❑Oil
23. Gas Pipe-Rough & Test '� � - 72, Underground Plu�h- , -
24. Roof Framing . � . + �� �-.73. Undergrnd. Storage Tank O Gas ❑ 011
25. Roof Sheathing ' � , i2 3��� P� 7q.-Overhead Hydro - �- .
26. T�Bar Ceiling IStructural) & Monocoat � • 75. Dry Chemical �
27. frame and Flashing ' . " 76. Dry Standpipe -. ' �
28. Lathing & 5iding _ . � - . . 77, FIXED SYSTEM FINAL � ��
'29. Insulation ' - � ' �� ' ' 76, FIRE PREV. FINAL
�30. Drywall Nailing � ,. � • � �� � HEALTH DEPT. RE�UIREMENT
31. Plaster Brown Coaf ' 79, FINAL IN5PECTION �
32. Electrical Power Meter-Final' , �. ,80..FOOD CEfiTIFICATE ISSUED
33. Final Electric _ � ' Notes: � \I !� %% ,r��
. . . . � � Q! ! 1.��?==��Ytt �P�cJ F� �'
.34. Final Heating & F,ir Conditioning ; . - / - i
35. Final Gas Pipe-Test - ' � -
- �
.36. Hood or Canopy . . . � . ' ° _ ' , � �
37. Finat Factory FicOplace � " " �' � ' � - '
:. �
'38. Final Plumbing . � � ,� �' �
39. Water Serviae-Final � � � � �, �
� ��
-40. Gas Service•final " , , , , � - ' �
;,41. SolarpomesticFinal,: � -' � - �
�
42. Backf�ow P�eventer � � I ' , � � _ ,
43. Backflow Irr�ation T�.-. -� • i�'� :
44. Landscape Icripation System, . - i , - � � - � ,
;45.�Sound Attenuation . • • � - _ � , �
_46.� Handican Regulations , � ? � ' ' ' � �
>
47..FINAL STRUCTURE & BUILDING � � gJ�[ , , _ 'i.� ,
� ri �
48. FINAL PLANNING ,;, .
-49. Electiic Release to Edison � � . � � .
50. Gas Release to Southern California Gas Co "
'� -
51. CERTIFICATE OF OCCUPANCY' ; � '
No. Date
OWNER- j(Qj,iy KEPINETH W�. �ArE 3-9-56 �
JOBADDRES3 2128 Ralei�h Ave. BUILDING PERMIT NO. 2L5%
GENERALCONTRACTOR QH*ngr VAWE � lO�iZ0.00
LOT 1� BLOCK TRACT 23�18 Residence & Gar,
GROUP I& J TVPE V ZONE � FIRE DISTRICT 2�=�3
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
�, �„ _ / DATE � NUMBEN
Foundation Forms and Grade to Garag
Rough Framing • �
Plumbin8, Rough to Sla� .z
Plumbing, Rough Complete � —
Temporary Pole
Wiring, Rough ' i
Heatiag, Rough
Final 6 // /S{✓ ,,,�(��,n.G�.. ,�-yk3`/�. � �"G � —
ouse.{',/�..'0 Sewer.St. 9-7..� y.,.. IJ_e.��_ �� c-�9-sL t-n >i �
Septic Tank or Cesspool
Lathing, In Out I , .{lt
Plastering �� �
Final, Fixtures
Fin,al GasTest
occupaney �
FORM 210 9M 10�0! �
,. �, _ rnsta�iVlesa Bnilding Department APPLICATION FOR PERMIT
�� COSTA MESA? CAL FORNIA ��53 B� � � D l N G '
FOR OI+'FICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permi
nddre� 2128 Ralei h Averrue I I���
Costa Mesa, ri&�OTIIIa, Re iv@d by Date Rec'd. Date Issu�
� I3— S—S (c. MAK 9 1.
W
2826 rewport Blvd.
Tel.
Newoort Beach No. Hr
or Lic.
Address
GT.l•1'S.F'�.-1
Size of Lot
Use ot
"�o Ph � aty ua
e
No.
1% I Block � 7ract [
�unds)
No. of Bidgs
lOO Nowon Lot
INo.of I No.o'
Families Roon
Rear Vard
SM cu_w_w t
1,200 i
Wall
StllCCO
:w
Residence
I Demolish I
6 sco��Pa 1
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply
with all City Ordinanoes and State Iaws regulaRng
building mnstruction.
8ignature of
Permittee
Authorized Agt ' � v �CB / ..(? .t�,.....-
Valuation Permit Fee $ 26.00
Plan Check $ 1 .00
$ 10,32o Toe�� 39.00
Fee
RM 204 3-BP 2DS 8-fiS
Costa Mesa, California
Nearest
Cross St.
CORRECTIONS
APPROVA7C
Foundation Loeation Inspector
Forms, Materials,
Under-Plnning
Frame: Fire Stops,
I nL
E�ct
Date
��
PLOT PLAN
Show location and distances Trom
property Iine and between buildings
cosr,,
�.r,n —a•ss��UESA 3�� � � :: ��39.r�