HomeMy WebLinkAbout180 DEL MAR AVE - Building Permits •
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4 _ ., CITY OF COSTA MESA
). ,",,,t,t. gi ) BUILDING DIVISION
F i . : DEVELOPMENT SERVICES DEPARTMENT
FQR_DOR9q NV
PERMIT PERMIT NUMBER
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 180 DEL MAR AV Status: ISSUED
Suite No Applied: 06/25/1998 12A
Vicinity: Issued: 06/25/1998
Parcel Nunmber: 43922147 •
•
Applicant: BROCKMAN, CARLA
Address:
Phone:_
�i/, �/ Y 1 1 I 1 ,
Owner: BROC/ /1/,- WILLIAM T J _ '1 ‘7/7 // �?��,N
Address 2700 FIARBORVIEW DRr\ \ �I ' k__,,,i, / -�
4:17/(' <7 \\ cc,- i Phone :-y .`� i� • \\
/NEWPORT BEACH,CA ;%>• "Zip: 92625"'=-� `:�, ��``�N \
l// 7;;;<-C:-;> \. N. i \
Contractor: v ,�' V'• / \\::\''
Addreg �/ i\\\
/�/�' ,/,,, Phones \h� �,_ �A
1t /-`-� r/ --:-7-1
-I A ,j,l��-"` \ .) , Ail
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OW l ) //// �) 1 I..� „'C-,-t^ t }I i w ; - ' V'tel
ML,. = 2.SCOPE OF PERMITA-C •‘..es.,‘, r '
AND PLUMBING REPAIRS: 1 FIX., 19 REC.,3 SW., 1 SERVICE UPGRADE TO 100 AMP Vr
' zl - li V
ill �f t__/ /7I I'�la) gF.EESUMMAR. ai / (-7-HI ,0.�No " t k
•
t -1 , Quantity< 'VA. ---- •ti _ ' Quantity , _. _� .Ai
ISSUE�FEE tk'rjl ' $22.00 A Temp Dist System/Lighting I $0.00 0 ;••, ._ •' i
Temp service lest/)1,..‘I , $0.00 : /'" Busway/100 ft '. $0.00 0 y" r i
Res'-a/c package \lulT $0.00 h_.,,r'\'`r'`•� Z Standing Se°ction�-�1-.?. $0.00 0 i ,� r. � ' ,VI
New Res(1''-2 units) 1/4f)rd $0.00 -,0, - �-Misc Electrical:Equipment ' $0.00 0 ',/'• !1 '
New Resl(3+units) AV�ii',;; $0.00 , 0 •-. - Transfonnersupto 1 kva/kw : $0.00 0/�i /' / -� l/
Pool/Spa C____•-• \' ,!\ $0.00 0 �• up tojl0 kva/kw L $0.00 9///,' / r,-i 1
Lighting Fills \\/ \ $1.00 J 1 up to�50 kva/kw $0.00 /0, N� ` !f l/
Recept Outlets C� ',1/4,>\•\$19.00 j 19 ='up to.100 kva/kw ,x$0.00 /;o// / / 'I'
Switches $3.00 3 over 100 kva/kw '$0.00 /0 /
Non Res Appl � ) \x$0.00 t 0 /,Low,,Voltage Equipment 1/4$0.00 0 Com//4 /
Res Appl V.\ \\$0;00 1 0 1I'Lrow Volt Wiring System/Ckt S0.09/;-2,./0• //
Service to 200a) j.y $27'25 1 4'1-Vv"'`?Misb.Conduit, $0.00/2/ 0"1 /0/
•
Service to 1000aA $0.00 0 Misc.Conductor $0.00" 01-,� "'/
Service over 100oa,A /$0 00„�" "0(" `;��� 1 t Circus(gen ornde)'"g • - $O-00�v 0 `ql •/
Motors to 1 hp " N //$0 00 `v A 0 ?•,+-.� I t� o �Cucus(mach ndeyor lights) 2 i$0 00/2 0 7
Motors to 10hp c/$0.00 '�0 r�.�On\•/;',.-,9•& Y \-Christmas Tree Stand'4 j $0 00 0 ^(y
Motors to 50hp A _ $000j� 0 �1 °� :y Fireworks Stand,: $0.0o>A,�0i/l
Motors to 100hp - _ $0.00 :.LA0 �' - -1"�"'- ,Other Electrical Fees" ,y-0$000/ 'i'
Motors over 100hp `$0.00/t,' l,O .. --_� . _�------" _, \\•,1/4F/- %�'�
Communication drops $0.00 �`'-/ 0-�/f�� Investigation,Fee( \ )1'$0.00'2
Sub panel to 200a '$0:00: 40\,,'�.' ,(F- f-.=',PIan,Check Fee.1I\ ,,$000 '"
Pole Light Pkg $0.00 - ,. 0 ' _, ! , ` Reinspection Fee}' - "$0.00
Sign Circuits $0.00 A�-�_0=- ---, I IN - ' .,
Temp Pwr Pole . $0.00 -�0- .-- ... - _ .,...TOTAL CALCULATED:FEES $72.25
Intermed Pole $0.00 0 r'` =
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COMMENTS/SPECIAL CONDITIONS .
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
fora 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)754-5826
0
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I 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.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carter and policy number are:
.Carrier: Policy Number.
(This section need not be completed it the permit is valued at one hundred dollars($100)or less.)
•
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL NO SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND COIL ARE(s100,000L IN ADOMON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full
force and effect.Lic.# Class#
Contractor's Signature: Date:
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.(Sec.3097,Civil Code).
Lender's 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 Code)or 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 civil penalty of not more than five hundred dollars($500).):
❑ 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(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
/.`XX`//"-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.).
�L.1'�as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
i Code: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.).
❑ I am exe under sec. Business and Professions Code for this reason: O
SIgnature:�7 LSA ! ] 'r
Owner-ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I 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,faisework,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,Califomia 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? 0 Yes 0 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? 0 Yes 0 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 at standard temperature and pressure).
3 Does 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 Califomia Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes ❑No
(Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or 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? 0 Yes 0 No
8 (if"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penally 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
ascribed prope r inspecti9n purposes.I agree not to occupy or allow occupancy of any building authpDze .by this permit until final inspection.
.Bignel ur�gal Owners) �at� e—
And/Or Authorized Applicant Date
GOOF L INSPFCTIRN TYPF PAIL INTlALS DOGE. g1SPECTION TYPF DATE IMALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1268 "Pool Spa Final - ' 208 " Final Plumbing '
200 Final Re-Roof • 210 Final Electrical ltr'10•`ITJ1C417,2.—/
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 _
2446-45
AODPE95 OF BNLOMG: 180 DEL MAR AV UMT: CITY OF COSTA MESA — BUILDING PERMIT
OWNERS NAME IF KNOWN:BROCKMAN, WILLIAM T PERM NO: P 082354
ADDRESS27O0 HARBOR VIEW DR
NEWPORT BEACH, CA 92625 PERMIT NO: P 082354 PLAN CHECK NO: N GOVT : N SUPP ; N
760-6785
"P°` IW ADDRESS: 19Q CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT ORENNNEER: UC.NO.: JOB DESCRIPTION : REPLACE SEWER & WATER SERVICE SQ FT:
ARCH.OR ENG.'S ADDRESS: UHT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /
CONTRACTOR'S NAME:COLE, C C PLUMBING AND HE ( 714 ) 645-1161
CflBACTORSMn412841 WESTERN AV COMMENTS : RESIDENTIAL SEWER AND WATER LINE REPLACEMENT
ADDREss:GARDEN GROVE CA LIC.NU.: 718978 ****+ESE** ic-******N*N******1ESESE -***N-Eng-****+t-*******x-u-****************x-**tre******ir:iE#
92841 UM: D Z ON ING REQUIR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACK S
(commenting with Section 7000)of Division 3 a the Business and Professions Code.end my license Sin full force and effect. '
CITY LIC.NO.:O66,01 LIC.CLASS:C-36 uC.NO.: 714278 ,Xr /98 MAIN BUILDING ACCESSORY BUILDING
� Dae: Contractor �tYA✓� A�R� �_.XP . 02 /98 FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I ern exempt from the Contractors License Law for the
',Sowing reason(Section 7031.5 Business and Professions Code:Any ay or county which requires a pend to construct,alter,improve, PARKING REQ: PRO V; PARCEL : 43922147 Z N E: REF NO:
notch.or repair any structure,prior tolla s issuance.also requires the applicant for such permit to file a signed statement Nhe or she Q:
casae pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with section 7000)of Division 3 of the PLANNING NOTES> ,f •
,eine®and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >
7031.6 by any applicanl fore permit subjee,+the applicant to a civil penally of not mate than five hundred dollen H:sagD ***********************************************,********************************
❑ 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 70u,Business and Professions Code:TheContrmos License Law does not apply to an owner ofpaperty DEVELOPMENT S E R V I C E S " R E Q U I R E M E N T S
who bride or improves thereon.and who does such work fimsef or herself or through he or her own employees,provided that such )L.
improvements are not intended or offered for sale.f,however,the building or improvement o sold within one year of completion.the ZONING APPROVED BY i DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the property.am exclusively contrading with licensed contractors to construe,the project(Section 7044,Business and
Professions code:The Contractors License Law does not appy to an owner of properly who builds or improves thereon end who BUILDING APPROVED BY : i DATE:
contracts for such projects with a mntractor(s)licensed pursuant to the Contractors License Law). 7-
❑ l am exempt under Section: B.a P.C.,for this reason: . APPLICATION ISSUED BY: l DATE: /
Date: Owner: *************************************************** ************************ ***
I do hereby certify that lam aware of and understand the requirements of California Heath and Safety Code Sections 25505,25533.and LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N
ts for
25534,
permit for thatconswctionor more dification impfmomtlhe Maus*t will l Ma(circle one)
Dn,"a eSdemto dcomaa'state codes aa msareeeexemmptfom these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. . PERMIT 30 . 75
Dae: Applicant:_ 2 5% S M I P/NON—RES
4
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penury of one e of the following clod/venom: PLAN
Ell have and will mainlai a certificate of consent to sedinsure for workers'compensation,as provided for by Section 3700 of the Labor ISSUE FEE 22 . 00
Code,for the performance of the work tor which this penideissued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
L7 Ihave and wimaintaiom
workers' re�
ioninsar ,asrequiredbySection3700oftheLaborCode,fortheperformanceofthe TOTALS----> 30 , 75 22 . 00 0 . 00 52 . 75 52 . 75 . 00
X work for which this permit is issued.My workers'compensation insurance carrier and policy number are:
Cad«: epi. MMP EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 52 . 75 OVER/SHORT: .00
. Policy Number: G971117A -41 02 /28/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
as section need not be completed I'the pool is for one hundred dollars($100)or less.) 52 . 75
❑ I caddy that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to
become subject m the workers'compensation laws of California, and agree that if l should become to the woken' *******************************************************************************
compeneaim provisions d Section 3700 a the Labor Cade.I shell Dae: Applkenc �forthwithrril3yNosa
/� l INDIVIDUAL• _. FEE BREAKDOWN
Warning:Failure to secure wo*e's'compsruedonWarne ls unlawful,end Nell abject an employer toclrmnl penalties and TYPE QTY D E S C R I P T I O' N UNIT COST TOTAL COST
civil Nus up to one hundred thousand dollars f$lO4000A In addition to the cost of conpersatlory damages as provided for In ,(f
Section 3706 of the Labor Code,Interest,and attorney's lees.
PLU 1 WATER SERVICE k•:., 8 . 75 8 . 75
• CONSTRUCTION LENDING AGENCY: I hereby seem under penalty of perjury that there is a construction lending agency for the PLU 1 SEWER, CONNECT ION /TO' BUILDING EACH 22 , 00 Q 22 . 00
performances the work for which thispenmi is issued(Section 3097,CS.C). END OF FEES /� ti
LEN'S AS: ,J� d+.w+ ,,) e,,,,,;
LENDER'S ADDRESS: / gct"rr
I certify that I have read this application and Male that the above information is cored.I agree to comply with all city and county ordinances ,✓_' 1997
and state laws relatcg to building coritrucion end hereby authorize representatives of this city to enter upon the above-mentioned property APR 0 7
for inspection purposes.
MIKE COTTLE -. . -
„tint
" CITY OF COSTA MESA
Date: V'
7—,7
Si ure of ,Agee I/Contractor
(5151-46.WP) White-Building&Safety:Green-File:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING ,- POO SPA
' APPROVALS Permit # - - 'Date Inspector APPROVALS Permit # - Date Inspector
1. Temporary'Electrical Service or Pole= - . 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. - • - 53. Steel Reinforcement •
•3. Electrical Conduit Utility-Undrgrnd. '. • 54` Forms - _ - .
4. Electrical Conduit-Undrgrnd. .. ' - 55. Electrical Bonding- ,
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
.
6. Electrical UFER Grnd. - APPROVAL-TO- , 57_ APPROVATO COVER;GUNITE - - ;•.�, _
7. Footings _ - - 58., Electrical Conduit-Undrgrnd. .;
8. Foundation a - . 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. - - , 60. Backv4ash Lines, P-Trap, 0 Undrgrnd.-
10. Structural Floor System - " 617 APPROVAL TO DECK - . • - '
11. Property Sewer Line & House Connection, _ .
- ; ,63: Heater & Vent-Final - ' . _ . '
13. Roof Drains - , ' . 64. Plumbing System
_ - Final - -
14. Rough Plumbing 65. Electrical-Final ' '
15. Rough Electrical-Contluit 66. Solar System-Final -
16. Rough,Electric Wiring 67. Fencing & Acces's Approval -
- 17. Rough Wiring Sign : . - St APPROVED,FOR PLASTERING.
18. Rough Electrical-T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL •
19. Robgh 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 - 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 ElectricNotes: ,4,Q _P '
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test -
t
36. Hood or Canopy
37. Final Factory Fireplace
4-
38. Final Plumbing "H -
39. Water Service-Final
40. Gas Service-Final '
41. Solar Domestic-Final
42. Backflow Preventer ( --
-I
43. Backflow Irrigation - (( ` !..-2
44. Landscape Irrigation System - r-
ff' o
45. Sound Attenuation - }:•
7
46. Handicap Regulationsi=
47. FINAL STRUCTURE & BUILDING
kr.,-.`, v �_
48. FINAL PLANNINGr,____„. R.
49. Electric Release to Edison �..,, t ~
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No. Date
•
•
•
PROJECT ADDRESS: 180 DEL MAR AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 061127
OWNER'S NAME:BROCKMANWILLIAM T r
ADDRES5: 2700 HARBOR VIEW DR PERMIT NO: B 061127 PLAN CHECK NO: N GOVT: N SUPP: N
NEWPORT BEACH, CA 92625
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
t 760-6875
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF W/COMP SHINGLES SQ FT; 3, 345
ADDRESS: UNIT:
PERMITTEE:
PERFECT COVER ROOFING ( 714 ) 434 1566 CLAIM VALUE: 3, 345 . 00 CALC—VALUE: 3, 345 . 00 GROUP OCC; R-3 /M-1
ADDRESS: 3303 HARBOR BL D-5 COMMENTS : SMOKE DETECTORS REQUIRED, REROOF 2100SF REBID & GARAGE
C.M. CA 92626 ************ ** EN ***x**** *********** **Tx *** 6*******SVKC* CV V
R
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENT
7000)of Division 3 of the Business and Professions Code.and my license is in fun farce aid effect- SETBACKS
cmucDate:_.:054055 ELIc.:Ej225 c��Ass: � �
Date:_� rz'(- .3 signawre: rf- MAIN BUILDING ACCESSORY Bg1)IRE
D
rt WORKERS'COMPENSATION DECLARATION: I hereby affirm that have a 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.or a certifiedopy hereof(Section 3800.Lab.CLEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
OLICYNO
P .:1263623-92 EXP.DATE: 017/01 /93
COMPANY:STATE FUND PARKING REQ: PROV; PARCEL: 43922147 ZNE: REF NO:
r3 Certified copy is hereby furnished. ® Certified copy is filed with the city Building Didlwn, PLANNING NOTES>
/l �— >
Jute: --7.--,1:— 'f Applicant'.— K �-- ' *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(8100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE:
Date: Signature:
NOTICE:If,atter 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.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; DATE; Z I-4(CI
which this permit is issued(Section 3097.Civ.C). ********************************************iPiE IE********************iE ********* *
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that em exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 63. 00 , 50 •
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON—RES
pursuant to the provisions of the Contractors'State 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 A
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE
I. as owner of the property or my employees withwages as their sale compensation, will Oo the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ti,• DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 63 . 50 0 , 00 0 . 00 63, 50 63 . 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 i
his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 63 . 50 OVER/SHORT.: /I. 00
improvement
f sale).
one year of completion,the owner will have the burden of proving he/she did not build or improve
for thepurpose oBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63 . 00
5 0
❑ 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'State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me INDIVIDUAL F E E BREAKDOWN r 1 ' '
❑ I am exempt under Section: B.8 P.C. j
for his reason: TYPE QTY DESCRIPTIO N UNIT COST r; TOTAL COST
Date: owner: SFR 3345 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 345 . 00
I do hereby certify that l am aware of and understand the requirements of California Health and Safety 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
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ,
these provisions.
P
Dale: Applicant EXPIRED
I hereby certify that I have read this application and state that the above information is correct I agree to comply with all city and county
ordinances and stale laws relating to building construction and hereby authorize representatives ofithis city to enter upon the above-mentioned I OCom plete Inspect lolls
property for inspection purposes. c—__
44, Date. _ _ _ _ .,
r '�i�' S Signature-� _ Date Sig
Driver's License or Social Security —Tr� , ), T
1641-46 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor y' ---'--•v
CONSTRUCTION AND PLANNING POOL PA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool& Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. .1 - 54. Forms
•
4. Electrical Conduit-Undrgrn : - 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. t
8. Foundation 59. Gas Pipe, 0 Undrgrnd:,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
r'
10. Structural Floor System ' % • 61. APPROVAL-TO DECK
11. Property Sewer Line & House•Connection r 62. Backwash & Receptor-Final
7
12. Sewer Cap 7 63. Heater & Vent-Final ;
13. Roof Drains ` •
a . 64. Plumbing System - Final , ij
i
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 74. Overhead Hydro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
'27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding I , ) 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL •
30. Drywall Nailing , I HEALTH DEPT. REQUIREMENT
I c 31. Plaster Brown Coat 79. FINAL INSPECTION e�
32. Electrical Power Meter-Final I 80. FOOD CERTIFICATE ISSUED
33. Final Electric • j ,� Notes:
34. Final Heating & Air Conditioning -
35. Final Gas Pipe-Test ; " •,
36. Hood or Canopy I I-N
37. Final Factory Fireplace 1.-moi
38. Final Plumbing I I NI
39. Water Service-Final Ii I I
40. Gas Service-Final I I I
41. Solar Domestic-Final
• 1
42. Backflow Preventer
43. Backflow Irrigation-7h' - ,
44. Landscape Irrigation System -
45. Sound Attenuation , t' , ,
E-X-P-I-R-E-D
46. Handicap Regulations i. -
, .i Iticompletelnspections
47. FINALSTRUCTU &3t1JILDING I I oat.
---77-4/99--
//9 Sin B_t
48. FINAL PLANNING- '-i- I t••1
1
49. Electric Release to;Edjson.l I i I +
50. Gas Release to SOtJtfT rn California Gas Co I !
51. CERTIFICATE OP-O'CCUPANCY • - •
i
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION —I
Permit No. h(-0 112
Property Address 72°
/
Owner C a—<- / L- A ✓G fritG..--
Contractor ?...-cIe_d-t 4 [/t4
State Contractor License Number ‘2- 2-67C Classification P — 3 5(
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
�S 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.
Compan Corpor e Name _
r-S
,[ r Address
Received by Building Division rers ` '1 . ?L-G 2i C0
By:
Sign-ture Date
2-I 2-q (5,3 Z: ce_. `
Initial Date Printed or typed name
•
0990-46 White-Building Div.;Canary-Contractor;Pink-Owner
•
COUNTY OF ORANGE - • // /J p�
BUILDING DEPT. .. _. _ - Permit No 4164/ 6.d
636 No.Broadway . ' ' - - 1
Santa Ana,California;. t., Application for Building.•Permit - .. -- --�
Phone:KI 2-6211 AND FOR A - .
Certificate of Use and Occupancy •
•
7— '/ �—�
Q.� � �,,, � ` Date r
I. OWNER'S NAME ��((��c'—`'" U-R_---.-1��--rc`.�'�__ P L PHONE. ��,�'/
MAILING ADDRESS P 0, 11-0-/-- ac { CITY ` O "keti �Q &tf
Name 6.--t-rwt-e4-• Name 0.3 A 1rt(Cons
(Architect or Engineer) (Contractor)
Address Address
City City
State State
Lic. No Phone Lic. No Phone
PROPOSED USE `(� /-
-.)..„2. JOB LOCATION.....t. it 0 E.pc ,i% o R ,f 4�`, Ca--#
(House No.) L } (Name of Street) (Town or School District) l
3. LEGAL DESCRIPTION: LOC.. ..J • • I Block Tract 3)47
(Metes and Bounds Description—Use reverse side of form)
4. CORNER LOT ( ) INTERIOR LOT ( V) THROUGH LOT ( ) SLOPE OF LOT ( L)/
5. SIZE OF BLDG • f AREA:...../...0..S D SIZE OF LOT ' 6� X,/ 6, 6" AREA:.. L..t b
6. HEIGHT OF BLDC-.• I CP ff CEILING HEIGHT b y NO. OF STORIES
7. NO. FAMILIES / Size of Smallest Bedroom. `/ n p
]c l ' 1 .�-�� I
I !! Size of Kitchen--- ...t5.�� r�� p pa,
pp
8. EXTERIOR WALL CONSTRUCTION Ji--.:9•9••^+�y. 1TERIOR WALL COVERING � Q
(Frame, Stucco, Etc.) U U0 (Plaster-Drywall, Etc.) 1�`��{k
9. SETBACKS: Front Yard From Center Line of Street 551 ,
Nearest Side Yard 5 / Rear Yard &'O r Distance in Feet Between Bldgs. on Same Lot
10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
11. For (a) Footing: Width �- D Depth in Ground..i X Width of Wall_...571
Accessory
Bld s. and �� HAROwoe l' IN 13dgee^
Similar (b) Size of Studs aI\y Spacing. _LS U L '•CC Material of Floor..-na-ur.roa ..-...N...Re_4T 2e trees'
Structures: y / !r Ant ouen Bap Pioet2
(c) Size of Floor Joists .a.Me, Spacing / L..-...Q ce . -CC
(d) Size of Rafters a i r{ . Spacing 7- 1) L "CC
12. VALUATION OF PROPOSED WOR_ K: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and
sewage disposal $ 2-Si°0 _—
13. I HEREBY CERTIFY THAT TO THE BEST OF MY-KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Signed -'% _ ao Art._
(Owner)
Plans Filed /"` / Cr .2 •
By•
"""(•Authorized.Agent)
FOR DEPARTMENTAL USE ONLY
FEES: CHECKING BY
Bldg. Permit - $ a0
oil' GROUP... APPLICATION A HEALTH
Plan Check - $ 6 G G _ TYPE -.1 "---- ZONING._ I FIRE
Total - - - $.2.... DIST. so q,- AND MARSHAL
Receipt No. ! ' MAP L SPEC'S �- STATE •
Paid to - - CP SHEET NO 5' CORRECTIONS ENGINEER
Date 17-rt -re. VERIFIED CAL
PER ' ^ -.• kiNi•Y' -
11 r Q. ' �� COIJN P 6UILDING
�7 .. lJ• !`'_ 1',S 'TOR
DATE / —/11 `'� A
5 M-e-51 L EPUTY
VAN