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HomeMy WebLinkAbout135 DEL MAR AVE - Building Permits - - - - , -'-j' "' - Applicant to fill'in all spaces exceptthosewithin heavy'border lines and sign all appropriate declarations: , - - - ' - CITY OF COSTA MESAr CONSTRUCTION PERMIT -• PERI}/pr`p��) NO. a :TRACT NO. • "LOT NO. 4 UNIT No. . - , _ ( .1995 .8_/2678_6 ` .5:00 Ti, Protect Address' • 13 . V�•MQn_. ��, i'. • .. ' �O I . f r - - - •• I ... Applicant's Mailing Address ' • —Sh M-C - I `. `^;, ' TYPE OF CONSTRUCTION I LJ NEW U ADD:U ALTERATION'H REPAIR - ' • - ``// ' v 17 ❑ CONVERSION=.❑ DEMOLISH '❑ OTHER A.p.# - - Zone Owrier's Name • ' -�V1� • lh•�� Phone _ DE$CR�I TION OF_WO K/USE OF BLDG' P ��bF- �' r - - • - - -- Address IUs I 1 1 tbe_ •Jw•` I loll r � ' ' , • S Main Building:, , i ; • Accessory Building: Z Arch/Eng 1 • License No. • TYPE OF PERMIT :❑ GRAD? NDATION ❑ STRUCTURAL T Front r - - - - - • _ D Address , ' '�' �) 2�p'�/,, �1.r�p. --yT - -❑ TENANT.,❑ ELECTRICA> PLUMBIN• G ❑ MECHANICAL B Rear i ' N 1 Contractor's Name �' �� f'/N✓'Tlfone I✓"U59f - C OTHER{ ' = - , - - _ _ A "- `' _ ' I b'Z Boise, .AV ?j4O4 min 11, 92 �!�' - PROJECT DESCRIPTION SQ. FT) OCCUPANCY' • C Right - • N Address•Imai ling) 7�'f�' K 1 - G p•� I •- ' CONSTRUCTION TYPE 'VALUATION s Left r City License No. ' - 150 f pa A R ZONE • GRADING CU.YOS. ACRES • • LICENSED CONTRACTOR DECLARATION f Ping. Ref. # I Parking Req./Provided I • • - E' I hereby a-f firm that I am licensed under provisions of;Charter 9'(comlmencing i Remarks: '- I I Planning Notes: j (�!'(. "' M with section 7000) of Division 3 of the Business and Professions Code, and RECE• IVED AUG 2 2 19 ' .t� my license'is i full tone -•9 effect. ' , , I j • - -, T , License Cl s L.- '•' *_ • i -n o. - J- ' - - • , - S • I Date ' V • L� • Signature .Lnt' fl .Jilt 11111h. ; • PLUMBING _ , FEES I r 'vORKE-5' OMRENSATION DECLARAtION I - Bar Sink Showers • iereby,affirm that I have a certificate Of consent to self-insure or a certificate , i i ELECTRICAL - - ' ' FEES Workers' Compensation Insurance; or a certified-copy thereof(Section I . , 3800, Lab. ' y_I 1 Backflow Preventer , Service SinkI the-�97� �-'{)u �•r�`1L. Automatic Washer": Transformer 15-50 KW Policy No. 1'W _ Company Backflow Irrigation $ewer Ca ' - ) 0 50+ KW P r Construction Pole'Sub. I Certifi d py is hereby furnished. ' - , Ce '£ S o y is filed with the cit*. dJJ'�Q44 C�IyI , Bathtubs • • Sewer Connection ) Cooking Unit y ;Meter ❑up to 1001amps ' Date ApplicantlIG7•I>7//�'-1r1-f.J�M�IN� I • ' EXEMP O FROM WORKERS'COMPENSATION DECLARATION • Clarifiers- -t • - • -Solar Collectors' I'"" .- - - 'Dishwasher -- ' Meter- over 100 amps ' `- •- - -_ (This section need not be completed if the permit-is for one hundred ($100) or - - less). , '. ' Dishwasher I Solar Piping Dryers ❑Gas' DElectric 'Sub Panel ' I certify that in the performance of the work forlwhich this permit is issued, I - shall not employ any person in any manner so as to become subject to the . ; Drinking Fountains Solar Tank I Fan ?�I Motors❑0-1 HP ❑1i-8 Workers', Compensation Laws of California. i r Date Signature - Floor Drains I . Swimming Pool w/Spa: I f F,A-U. Inc.Solar ❑9-15 HP ❑16-15+ :NOTICE: If,after making this declaration, you should become.subject to the_ . - _ _ _ _ . . Workers' Compensation provisions of.the Labor Code, you must forthwith Floor Sinks j Urinal i - Fixtures ' ' comply .with such --provisions.or Allis",permit shall b_e l deemed revoked: ` - - " • - • , Microwave • CONSTRUCTION I LENDING•AGENCY . ` • t"' I I U ) • Gas Service �DUtleta' • Water Closet/ Cr' ' I • 1 hereby affirm that there is a construction lending agency for the performance �'(G)c.E.1 Z •--�/ Device Boxes ! ) - Pole Light • I - ' of the :work for which this. permit is issued .(Section 3097 Civ. C.)' - - ., I 5 - , - Lender's Name - - I , Interceptors Water-Heater - Outlets ' _ Range •' 1 Lender's'Address •- • . • 't ' - OWNER BUILDER UEC LARATION - Kitchen Sink ;- _ - Water Service Switches , Sign I hereby affirm that I am exempt from the Contractor's License'Law fors the ' . ' Lavatories Auto-Wash - I ' following reason (Section 7031.5 Business and Professional Code: Any city or • - - Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap - - - %Laundry Trays-, I 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 DfalnS; .- i I - - 'he Contractor's License Law (Chapter 9 (commencing with Section 7000) of . I - - - 'vision, 3-of the Business and Professions Code) orthat he/she'is exempt I . - • ' I . i ' erefrom and the basis for the alleged exemption. Any violation.of Section '- • ' .031.5 by any applicant for a permit: subjects the-applicant to a civil - _ - ' • 'penalty of not more than five hundred dollars($500). - • - r - - - I , ' I;'as,(caner of the. pro ort or-memplo ees with waged as their sole P MIOn FeeIssue Fee _ $ 3 ' I • I ' compensation, will do the work, and the'structure is not intended or offered Reins eI - - Reinspection Fee t ,1 $15 .Issue Fee t $ 3 1 for sale (Section '7044, Business and yProfessional Code: The Contractor's - • % ; . I$15 , FEES - - - License Law does not apply to an owner of a property who builds or Improves I - MECHANICAL -. ..-.. thereon,'and'who,does such work':himself/herself or'through his or'her own - I` ' DEVELOPMENT SERVICES REQUIREMENTS- ) • employees, provided that such improvements are not:intended or offered'for , Boiler ' - Hood or' Type I ' 0 - I I sale, If, however, the building or improvement is sold'within one year of cbm- -` - • --- Canopy ' Type II. 0 ' "� Zoning Approved By ' ' Date - ' pletlon„the owner will have the burden of proving,he/she did not build or im• • Duct-Under Ground - I ' ' , prove for the purpose of sale). I Building Approved By Date N , 0 I, as'owner of the property, am exclusively contracting with licensed con- : Duct-Structural Refrigeration System . . Application Issued By - Dat: 17IM , tractors to construct the project (Section 7044, Business and Professions Code: • ' _ I . • - - The Contractor's-License Law does-not apply to an owner of property who ' - Duct-Ventilating • --T' '00-100,000'BTU ❑100,000 BTU - ' • - - I , builds or improves thereon,'and who contracts for such projects with a con- . i I SUMMARY OF FEES tract or(s) license pursuant to the Contractor's License Law). I am aware that , BUILDING PERMIT $ $MIP{ ( $ • ' proof of their Worker's Compensation insurance should be provided to.me. Exhaust•System 0 Multiple 0' System Repair/Alteration - ) I PLAN CHECK ' $ PERMIT ' ❑ am exempt under Section B. & P.C.for this reason Fire •I/Fact.Bit. ICBO# i - fire •Dam ors • I % 1 p p ,ISSUANCE • $ - Date Owner! -• HeatingSystem& DuctingRegister's PLUMBING I $ �'�� I i y - g PLAN CHECK 25% $ ENERGY P.C. • $ • I hereby certify that I have read this application and state that the above . ❑0-100,000 BTU 0100,000 BTU I ' information is orrect. I agree to comply with all city and county ordinances : I I ' ELECTRICAL - $ i GRADING ' $ I and-state laws elating to building construction,'and hereby auth rizrepro- , ' ' j sentatives of, city' to e to( u on the above-mentioned pop ty for PLAN CHECK 50% $ MICROFI• LM - $ T • inspection pur -I -r-�i-- 8 8 2a� ' 1 MECHANICAL • $ ' ' T ( 5.00 Signature `/ ur W/'�1• Date .C/G/ ' ' _ ' $ Drivers'•License.or SS _ Reinspection Fee 1 $15 Issue Fee __ $ 3 t PLAN CHECK 25% $ ! 1 1 O . • TAL FEE CMF 0865-46,rev,10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING PO0 SPA Date InspectorDate Inspector APPROVALS Permit# -APPROVALS Permit# - 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2: Soil Pipe-Undrgrnd. - 53. Steel Reinforcement - 3. Electrical ConduitUtility-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. Foundation59. Gas Pipe, U Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, D 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 20: Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing . . 73. Undergrnd.Storage Tank D Gas D 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 ' 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 G L-1f7 39. Water Service-Final ' 40. Gas Service-Final :1 1 • C 41. Solar Domestic-Final !� _ 42. Backflow Preventer i r-- - 43. Backflow Irrigation • _;.. _ - . 44. Landscape'Irrigation System C') 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 ' 51i. CERTIFICATE OF OCCUPANCY • _ - No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF ME$A C STRU ION PERMIT 1 PER N TRACT NO. LOT NO. UNIT NO. 3266 1,0/3'I /85 ' ' •, 6000 .TL' LSD% , , i.,. i 5' cue/ il//K c _ , . . I Project Address - - Applicant's Mailing•P/.(jf)1�rens// - // - TYPE OF CONSTRUCTION '❑ NEW U ADD U ALTERATION U REPAIR ' ' - Owner's Name - POW Phonein-47(Zr/ III CONVERSION ❑ DEMOLISH El OTHER AP,# - ',I •Zone f • _ 'DESCRIPTION OF WORK/USE OFBLDG. • Address • 1 _ ' - f' = _ ' S Main Building: i , Accessory Building; Arch/Eng. - - � - License No. TYPE OF PERMIT ❑ GRADING-❑FOUNDATION ❑ STRUCTURAL T Front , . -• ZO Address L I '/ I LL - ! -❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑.MECHANICAL 1 BA Rear ' 11 1 , - I . ' N • Contractor's Nam 7S 650 - r' I ❑ OTHER I - - I - - I- b - N , • -%. i ✓" PROJECT DESCRIPTION SQ. FT. ` I - OCCUPANCY C Right Address(mailing) - l�vl rC-t.r' •H /j.V • K _ - G ., �y f c— , CONSTRUCTION TYPE VALUATION$ • s Left _ ' , _ R I City License No. V© /• J1 - ZONE GRADING CU-YDS. I ACRES •' . LICENSED CONTRACTOR DECLARATION '' Ping Ref.# Parking'Req /Provided, E' ' I hereby affirm that.) am licensed under provisions of Charter 9 (commencIng Remarks: • . - I Planning Notes: = Q with section 7000) of Division 3 of the Business and Professions Code, and - I ' my license is in ful foi e..nd effect. !n( Cr • - , I - I T License C: ' -- 'I •Le se pio _ //,, v • ' ) w S'1 Date '� Signature • �/1�• / .� ''� ! I i PLUMBING j , FEES I I . I 'YORKERS'COMPENSATION DECLARATION I Bar Sink Showers ' I hereby affirm that I have a certificate of consent to self-insure or a certificate - i f Workers' Compensation-Insurance, or a certifietl copy. thereof-(Section Backflow Preventer • - y - - - Service Sink - - --!" - --- - ■ 1 t� 3800, lab. C, r • 1 Policy No. `�t/•�/�./(1 t/Company 'n(;,/ � /125 Backflow Irrigation i I Sewer Cap I • - ■ 1 I ertified copy is hereby furnished. • U ertifi j�cop s filed with the city Itljt�niyibi Bathtubs Sewer Connection ■ . 100,amps Date J(J {/r/ Applicant % / LL/L p`pg LL.i . \.-EXEM PTio need WORKERS'COMPENSATION D ARA N �� _ Clarifiers 1 I Solar • Collectors ■� DishwasherCover• 11 amps section need not be completed if the permit is-fpr one hundred ($100) or , less). Dishwasher Solar Piping I - Dryers ❑Gas ❑Electric - Sub Panel • I certify that in the performance of the work for which this permit is-issued,et I - - ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank ` I - Fan. r5 ' ' Workers' Compensation Laws of California, I Motors❑0-1 HP ❑1'/a-8 Date ' Signature Floor Drains I 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 - -- . - - ' comply •with' such provisions or this permit shall be deemed revoked. I Fixtures . --- Microwave - - -- . - CONSTRUCTION LENDING,AGENCY ' - Gas Service Outlets Water Closet Device Boxes Pole Li ht 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.) Interceptors ' - Water Heater • - ' Lender's' Name ' t - p 1 / Outlets •, .Range Lender's Address - - - - ' - ' - - Kitchen Sink _ - Water Service OWNER BUILDER DECLARATION _ Swi[Ch¢e• Sign I hereby affirm that I am exempt from the Contractor's License.Law for the Lavatories - c ' , following reason (Section-7031.5 Business and Professional Code: Any city or - Garbage Disposal ''Standing Sections county which requires a permit to construct;alter,improve,demolish or repair • ' P-Trap - - p - ' '-any structure, prior to':its issuance, also requires the applicant for such permit' t - ' - ._ - - ' • Generator ❑0-5 KW ❑5-15 KW Trash Compactor ' Jo file a signed•statement'that he/she is licensed pursuant to the provisions of • ROOF Drains - ' ` - • 'he Contractor's License Law (Chapterl9(commencing with Section 7000)'ot - - ivision 3 of the'Business and Professions Code) or that he/she is exempt • - t - - I ierefrom and the basis for the alleged exemption. Any violation of Section-1 - - I .031.5 by, any- applicant for a permit subjects the: to.a civil ' - - . - . ' { enalty of not more than five hundred dollars($500). - I - ' a I, as owner of the property or' my-employees with wages as their sole Reinspection Fee I 15 - Issue Fee compensation, will do the work,and the.structure isnot intended or offered ttt Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL - I 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 goiter ■ DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such improvements are not intended or offered for Approved 8 Date sale. If, however,the building or improvement is sold within one year of com- - ■ Zoning pp y • pletion,-the owner will have the burden of proving he/she did not build or im- Duct- Under GroundBuilding Approved By - //�� - Date rove for the purpose of sale). ./0":3/7- I, as'owner of.the property, am exclusively contracting with licensed con- Duct-StructuralRefrigeration Application Issued By ``J - Date 'S' 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 ■1 11 111 : ■ I. 111 : ' SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- - - - - 1 tractor(s) license pursuant to the Contractor's License Law)- I am aware that' Exhaust System 0 Multiple ❑ BUILDING:PERMIT $ SMIP ' '$ ' . proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ ?CD )) • PERMIT • ❑'I am exempt under Section B.& P.C.for this reason Firepl/Fact:Blt. ICBG# ' PLUMBING $ • �J JI) ISSUANCE $ • Date' Owner - - PLAN CHECK 25% $ ENERGY P.C.: $ -I hereby certify correct. I haverread this application and state that the above irnall ELECTRICAL $ GRADING $ information is c elatin I agree tocomply with all city and y countyrtrepre- ordinances and state laws relating'to buildingeteconstruction, and'hereby authorize rPLAN CHECK 50% $ MICROFILM $ sentatives of this c'y to enter upon the wove-mentioned property for inspection our::.e a MECHANICAL $ • TOTAL FEE $ ' x��'✓ Signature i 4 /. l � - - Date 1 a l 9 - I Drivers'•License or SS# _. ®. ' - `' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ' CMF 0865-46,rev.4/84 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor -' - - - .. ' — . -- - - CONSTRUCTION AND PLANNING - j POS .SPA Date -Inspector ' - •- • Date Inspector , APPROVALS Permit# - ,APPROVALS 'Permit#. 1. Temporary Electrical Service or Pole - ., . _ 52. Pool & Equipment Location • -2. Soil Pipe-Undrgrnd. I - • . . ' :53. Steel Reinforcement '3. Electrical.ConduitUtility-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 - • 1. 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 . Backwash & Receptor-Final . 12. Sewer Cap - : r 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 I ' ' 19. Rough Heating & Air Conditioning - .FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure , 70. Underground Hydro ' • - . :.22. Ducts, Ventilating i•• 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test - '72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil , 25. Roof Sheathing • - 74. Overhead Hydro 26. T-Bar Ceiling'(Structural) & Monocoat 751 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 , . I HEALTH DEPT. REQUIREMENT ' 31. Plaster Brown Coat , . 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOb 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 �4/�Fj (,L!) - 39. Water Service-Final , 40. Gas Service-Final - • - . 41. Solar Domestic-Final , 42. Backflow Preventer , • ' l , , 43. Backflow Irrigation ,_ , „ - _ - 44. ,Landscape Irrigation System ) , 45. Sound Attenuation i I ' i I - ' ` - • 46. Handicap Regulations . . - I - 47. FINALSTRUCTURE & BUILDING i , . 48. Special Requirements Completed - 49. Electric Release to Edison 1 - . .- - .a 50. Gas Release to Southern California Gas Co ' ; . 51. CERT.IFICATEOF.OCCUPANCY . _ . - , ' , No. - Date .r- • . • PROJECT ADDRESS: 135 DEL MAR AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06538C OWNER'S NAME: DAVIS, DIANE A . ADDRESS: 135 DEL MAR AVE PERMIT NO: B 065380 PLAN CHECK NO: N GOVT: N SUPP: N .' COSTA MESA,CA 92627 0 ' CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION : T/O, RESHEATH & REROOF W/COMP . SHINGLES SQ FT: • 4 , 945 ADDRESS: UNIT: CLAIM VALUE : 4 , 945 . 00 CALC—VALUE: 4 , 945 . 00 GROUP OCC : R-3 / PERMITTEE: TOM BYER ROOFING ( 714 ) 847-9332 ADDRESS: 17662 METZLER LN B COMMENTS : REROOFING TO INCLUDE UNIT 4t 133 ONE ATTACHED BUILDING. HUNTINGTON BEACH CA 92647 ********+E**********>F**+r* aF********* ***********>F***********uc+P****>E********ac**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING R EQU IR EMENTS 70001 at Division 3 of the Business and Professions Code.and my license is in ful farce.nd effect. SETBACKS CITYLIC.: 044732 STATELIC.:57500' C39 Date I -z— Signature: �_ MAIN BUILDING ACCESSORY BUILDING ' 12 ( •/ I FIXERS'COMPENSATION DECLARATION: thereby affirm larra certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance., copy,or a certified thereo. (Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICYNO.: ZaD-9i UNl025 EXP, DATE: 01 /01 /94 COMPANY: STATE FUND PARKING REQ: PROV: PARCEL : 41218101 ZNE: REF NO: Certified coy is hereby furnished E Certified cop is Bled with the city Building Division. PLANNING NOTES f 7 Dat . 1 a I _ - >Applicant ********************************************************************r********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This c ion need not be completed if the permit is for one hundred($100)or less). D E V E L O P M E N T SERVICES R E Q U I R E M E N'/T S I certify that in the pertormance of the work for which this permit is issued,I shall not employ any person in any manner so as to become 2- subject subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE; Date: Signature: NOTICE:IL after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: _ Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. � p �I I F'b ' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: C'/1"—& DATE: • �t yV( which this permit is issued(Section 3097.Civ.C)- **********************************,T,r Tr3F***.41M-*x.iF'*d'1 4'***..1f***.)f.ic***** •1(.*} 3c**4'V** LENDER: ******************************************************************* ********** ADDRESS: LEGALIZATION :N F E E SUMMARY 1 STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM I P/RES' GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 72 • 00 . 50 repair any structure,prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed SM I P/NON R E S pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 'any applicant or a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE /(' I. as owner of the properly o1 my employees with wages as their sole compensation, will do the work. and the BUILDING—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ ,structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law TOTALS----> 72 . 50 0 . 00 0 . 00 72 . 50 72 . 50 . 00 :.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 in /improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 72 . 50 OVER/SHORT: ), 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK <l,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72 . 00 , 5 0 r! ❑. :and Professions Code, The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Stale License Law). l am aware ************.y-******************.***.M.*.********.x.**.*.******.*.****.***.**,*****,*****-*,**** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. mr this reason: TYPE QTY DESCRIPTIO N UNIT COST 'TOTAL COST Date: owner. SFR 4945 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 945 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505.25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a /c permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from rn these provisions.' .. Date: Applicant: 41 I hereby certify mat I have read this application and state that the above information is correct.I agree to comply with all - . my ordinances and state laws relating to building construction and hereby authorize representativ his city to enter •above-mentioned ropenyforinT ectiarpurposes. cc C,tT 7?.g0 0. 17-- Signature: 01 00152489-00152490DATE: 12/17/93 TIME: 08:23 • Driver's License or Social Security e: 1641,46 White—Building;Green—Code Enforcement:Canary—Applicant: Pink—Revenue;Goldenrod—Assessor CONaTRUCTION AND PLANNING - POC A SPA Date Inspector Date Inspector APPROVALS Permit # APPROVALS Permit# 1. i mporary 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-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 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 0 Gas 0 Oil 25. Roof Sheathing (Z-.z(- t CJ/tt 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 i 35. Final Gas Pipe-Test r- 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Fin& 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation y J 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING (L-z2-41 y b 4 48. FINAL PLANNING tra 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION / p Z Z a Permit No. 13 (p 5 3 O O Property Address I J 13 be � 3 M<. r Owner > 1 c✓�C '61 �L�rr Contractor IC1-2,1 �-/(1 A/6 6 t-► in`1 State Contractor License Number I C - J °C5-2— Classification 6-3 ✓ C( I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner-Builder permittee only). I further certify that I am: ❑ Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. (--Olin `tt(( Z04)1/17 �� company or Corporate Name/ et 0, r`ao)C 3 ?-1. i I Address Received by 'Division C � 1) I • k 90 (,4' 43 tune to I -44 , "3. v I G✓t tVo is Initial Date Printed or typed n e 0990-46 White-Building Div.;Canary-Contractor',Pink-Owner