HomeMy WebLinkAbout1201 DONEGAL PL - Building Permits t00
CITY OF COSTA MESA
p BUILDING DIVISION
).1- ..,I 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: E08-00096
PERMIT TYPE ELEC STATUS: ISSUED
APN: 14104629 DATE ISSUED: 03118/2008
ISSUED BY:
JOB ADDRESS: 1201 DONEGAL PL CM Suite/Unit:
Vicinity: BACK OF HOUSE
SCOPE OF WORK: UPGRADE ELECT.PANEL BOX FROM 50 AMP.TO 200 AMR-SAME LOCATION.
OWNER: NG,MIKE Address: 1201 DONEGAL PL Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: NG,MIKE Address: 1201 DONEGAL PL Unit:
PHONE: 949 757-2145 City/State/zZip: COSTA MESA,CA
CONTRACTOR: License No.
Address: Unit: PHONE:
City/State: ZipCode: CELL:
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $54.00
Reinspection Fee $0.00
TOTAL FEES $54.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21.92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE S. IN$PECPION TYPE DAT IN111IAL$ ME tt INSPECTION TYPE DAR INIRIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical 3--10 /��08 6
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by ddv 0 Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need not be completed/the permit is valued al one hundred dollars(5100)0,less)
2,Art 2,Sec.341,The 8,California Administrative Code).
Policy Number:
❑ As owner-builder. I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
the Labor Code,I shall forthwith comply with these provisions.
Division of Industrial Safety Permit Number:
Applicants Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# Class# (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
Contractor's Signature Date 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safely Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
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 (Section 65850.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications far con-residential building permits).
Business and Professions Code)or that he or she is exempt therefrom and 6. Will any pad of the facility to be constructed under this permit be within
the basis for the alleged exemption. My violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
7
,.-N--I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
-compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for control officer
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 CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
property,am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
0 I, as owner of the
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by th" p rnit until final inspection.
rp-
gi s tr o r - Signature of Legal Owner(s) t
S nature - Date
JOS]-06(J/o]) And/or Authonzed Applicant Date
• CITY OF COSTA MESA •4
BUILDING DIVISION
411.11
Fail 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
t. Oka FOR INSPECTIONS CALL: (714)754-5626 ��
�fi PERMIT NUMBERS308-00102
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 14104629 DATE ISSUED: 03126/2008
ISSUED BY: RMD
JOB ADDRESS: 1201 DONEGAL PL CM Suite/Unit:
Vicinity: HOUSE AND GARAGE ROOF
Squares: 2000 Valuation: $5,000.00
SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT AND REROOF WITH 30 YEAR TIMBERLINE
(CLASS A ASSEMBLY ER 5546)ON AN ATTACHED HOUSE AND GARAGE,APPROX 20 SQUARES.REPAIR AND
REPLACE SHEATHING AS NEEDED.
OWNER: NG,MIKE Address: 1201 DONEGAL PL Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: CAMPBELL, DREW Address: 22365EL TORO RD - Unit: :UNIT 297
PHONE: 949-770-7663 City/State/Zip: LAKE FOREST,CA
CONTRACTOR: BEST VALUE ROOFING • License No. 678356
Address: 22365 EL TORO RDUnit: PHONE: 949-770-7663
City/State/Zip: LAKE FOREST,CA 92629 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY -- --�� —_� —�
r t f--
J : jrN
I r.
Reroof Plan Check: $0.00 _ �r �� I f
Reroof Permit Fee: $111.25 ` �= \
Reinspection Fee: $0.00
TOTAL FEES $111.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE 1 INSPECTION TYPE, DAZE IN1mAL$ CODE E IN$PECDON TYPE GATE INTRIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof .—3 i— 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive❑Yes ❑No •
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance canier and policy
0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are:, person is required to descend,will be made in connection with work authorized
by this permit,and that no building structure,scaffolding,falsework,a demolition
Carrier: .71a.7� ✓1i or dismantlingthereof,will be more than thirty-s#(36)feet high.(Chap.3.2,Grp
(TMS seC.on need not Eecompleted the
�perm(b.aluetl at one hundred dollars(Sr00)aless)
2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number. I g'O bcY l J ICl 0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
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, s?all(o withco,�^ply with these provisions. Applicant's Signature Date
�.0 11/1 3(a(0/0g Division of Industrial Safety Permit Number:
A icanfss nature !� DB1e V6 HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. '7 Z a registration form for acutely hazardous materials? 0 Yes 0 No
Lic,# 7 . a-/ Class# Jv (Section 25533 of the Califomia Health and Safety Code, with some
.1191 �.
texceptions, requires registration with the Costa Mesa Fire Department by
a a(Q/ each business which at any one time has on hand a quantity of acutely
ontractor'.Signature Da a 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Dale
4. If an RMPP is presently required, has Section 25534 of the Califomia
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
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 (Section be furnished the onCnlifomia Government Code requires b thnt the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be applications for non-residential building permits).
Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the Califomia Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
8. (If yes',attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the properly, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contracta(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
grutudre of eget er(s) Date
Signature Date /� r�O,Y Y/ 5/c)41/4)
3057-46(3/07) ndloorrAuu oonlzred"A-pplicant J Date
el
ER-5546
- LEGACY REPORT Reissued 1
ICC Evaluation Service, Inc. Business/Regional Office•5360 Workman NAMRoad,N/hiter,Caccia 90001 •(582) 43
Regional Office•900 Montclair Road,Suite A Birmingham,Alabama 35213 •(205)599-9800
www.icc-es.org Regional Office•4051 West Flossmoor Road,Country Club FGes,Ilfincis 60478•(708)799-2305
Legacy report on the 1997 Uniform Building CodeTM
DIVISION: 07—THERMAL AND MOISTURE PROTECTION shingles are installed in accordance with Table 15-B-1 of the
Section: 07310—Shingles code, except as noted in this report. The roof deck is
minimum 3/8-inch-thick (9.5 mm) exterior-grade plywood
GAF ASPHALT SHINGLE ROOF COVERING SYSTEMS complying with UBC 23-2 or 23-3, '/,e inch-thick (11.1 mm)
oriented strand board complying with UBC 23-3, or solid
GAF MATERIALS CORPORATION sheathing conforming to Sections 2312.2 and 2320.12.9 of
1361 ALPS ROAD the 1997 Uniform Building Code" (UBC). Minimum roof
WAYNE, NEW JERSEY 07470-3689 slope shall be 2:12 (16.67%slope).
Depending upon shingle design, self-sealing thermal
1.0 SUBJECT adhesive is embedded in either the top or the back surface of
the shingle,and bonds overlapping shingles to each other,on
Country Mansion m, Country Estates", Grand Sequoia°,
Grand Canyon", Slateline°, TIMBERLINE Ultra° Shadow the roof, by means of the heat of the sun. In colder climates
Accent", TIMBERLINE° 25, Original TIMBERLINE, and or wind regions where it is questionable whether the thermal
Royal Sovereign°Asphalt Shingle Roof Covering Systems. sealant will activate and seal the shingles,or for roof slopes
greater than 21:12(175%slope),the shingles must be hand-
2.0 DESCRIPTION sealed. Hand-sealing consists of applying 1-inch-diameter
2.1 General: (25.4 mm) spots of shingle-tab adhesive to the back of the
shingle,at a manufacturer-specified distance from each side,
GAF Materials Corporation shingles are three-and five-tab, and 1 inch (25 mm) up from the bottom of the tab. The tab
laminated asphalt shingle roof covering systems, and are must be pressed firmly into the adhesive.
Class A roof coverings when installed as described in this Fasteners must have sufficient length to penetrate into the
report. Table 1 shows manufacturing plant locations, sheathing 3/4 inch (19.1 mm) or through the sheathing
dimensions, installed weight and maximum exposure to the thickness,whichever is less. Nails must be driven flush with
weather. the surface of the shingle, and overdriving must be avoided
2.2 Materials: so as to not damage the shingles. Staples must be driven
2.2.1 General:The shingles are fabricated from fiberglass straight,with the crown parallel to the bottom of the shingles.
mats, impregnated and coated with asphalt on both sides. All staple legs shall be a minimum of 1 inch(25 mm)from the
Blends of variously colored granules are applied to the side of the shingle.The quantity and placement of the staples
coating on the weathering surface, and a light mineral is the same as for the nails. Staples are driven with an
surfacing is applied to the back of the shingles to prevent accurately adjusted pneumatic staple gun,to ensure that the
sticking when bundled. entire crown bears tightly against the shingle but does not cut
the shingle surface.
2.2.2 Hip and Ridge Shingles: Hip and ridge shingles are Installation instructions are included as part of the
cut from three-tab Royal Sovereign shingles to 12 inches by identification label attached to each bundle of shingles (see
12 inches (English)(305 mm by 305 mm)or 13V,inches by
13V,inches(337 mm by 333 mm), and are compatible with Section 2.4). Nail patterns for each of the GAF products are
any GAF shingles. provided in Figure 1 of this report.
2.2.3 Fasteners:Fasteners must either be minimum No.12 2.3.2 Underlayment: Underlayment application shall be in
gage, aluminum or zinc-coated steel, barbed-,deformed-or accordance with Table 15-B-1 of the code and the
smooth-shank roofing nails having a minimum 34,-inch (10 manufacturer's instructions.
mm)head,or be approved minimum No.16 gage,galvanized 2.3.3 Country Mansion Shingles: A minimum of four
steel staples having a minimum crown width of 15/,h inch(23.8 fasteners must be installed per shingle, approximately 8
mm). inches(203 mm)up from the bottom of the shingle.Fasteners
2.2.4 Underlayment: Roof underlayment must comply with
must be installed approximately 1 inch(25 mm)and 123/,to
133/4 inches(324 to 349 mm)from each side.The maximum
the code. exposure to weather is 7'/2 inches(191 mm).
2.3 Installation—New Construction: 2.3.4 Country Estates Shingles: A minimum of four
2.3.1 General: When installed in accordance with this fasteners must be installed per shingle, approximately 8
section, the shingles are a Class A roof covering. The inches(203 mm)up from the bottom of the shingle.Fasteners
ICC-ES legacy reports are not to be construed as representing aesthetics or any other attributes not specifically addressed,nor are they to be construed as ANSI
endorsement of the subject of the report or a recommendation for its use.There is no warranty by ICC Evaluation Service,Inc..express or implied,as to
any finding or other matter in this report,oras to any product covered by the report.
-.Warne.'"
Copyright®2005 Page 1 of 5
Page 2 of 5 ER-5546
must be installed approximately 1 inch(25 mm)and 123/4 to shingles described in this report are Class A roof coverings.
133/4 inches(324 to 349 mm)from each side.The maximum The existing asphalt roof covering must be inspected in
exposure to the weather is 7"2 inches(191 mm). accordance with Section 1515 of UBC Appendix Chapter 15.
Prior to reroofing,hip and ridge cover must be removed,and
2.3.5 Grand Sequoia Shingles: Five fasteners must be
installed per shingle, approximately 11 inches (279 mm)up a single layer of minimum Type 30, nonperforated felt
halt
from the bottom of the shingle. Fasteners must be installed underlaymentshigles. Tshinglesmhst be installed ins over in
existinga a with
approximately 1 inch (25 mm), 10 inches (254 mm) and 20 Section
The are installed of accordance se with
Section 2.3 of this report, except as noted in this section.
inches(508 mm)from each side.The maximum exposure to Fasteners must be of sufficient length to penetrate 3/4 inch
weather is 5 inches(127 mm),with an allowable tolerance of (19.1 mm) into the sheathing, or through the sheathing,
+'/e inch (3.2 mm). whichever is less. Flashing and edging must comply with
2.3.6 Grand Canyon Shingles:Aminimumoffivefasteners Section 1520 of UBC Appendix Chapter 15 and Section 2.3
must be installed per shingle, approximately 11 inches(279 of this report.
mm) up from the bottom of the shingle. Fasteners must be
installed approximately 1 inch (25 mm), 10 inches(254 mm) 2.5 Identification:
and 20 inches (508 mm) from each side. The maximum Each bundle of shingles bears a label with the name and
exposure to the weather is 5 inches (127 mm), with an address of GAF Materials Corporation; the product name;
allowable tolerance of+118 inch (3.2 mm). plant location identification; installation instructions; the
2.3.7 Slateline Shingles: Six fasteners must be installed evaluation report number(ICBG ES ER-5546);and the name
per shingle, approximately 8'/8 inches(206 mm)up from the of the quality control agency(Underwriters Laboratories Inc.),
bottom of the shingle. Fasteners must be installed along with an indication of compliance with UL fire and wind
approximately 1 inch (25 mm), 8 inches (203 mm) and 16 requirements.
inches(406 mm)from each side.The maximum exposure to
3.0 EVIDENCE SUBMITTED
weather is 71/2 inches(191 mm).
2.3.8 TIMBERLINE Series:Four fasteners must be installed Data in accordance with ASTM D 3462-97 and the ICBG ES
per shingle, approximately 6 inches (152 mm) up from the Acceptance Criteria for Roofing Systems with Asphalt
bottom of the shingle. Fasteners must be installed Shingles Made with Glass Felt(AC127),dated July 1999.
approximately 1 inch(25 mm)and 13 inches(330 mm)from 4.0 FINDINGS
each side.The maximum exposure to weather is 55/8 inches
(143 mm). That the GAF Materials Corporation asphalt shingle
2.3.9 Royal Sovereign Shingles: Four fasteners must be roofing systems described in this report comply with the
installed per shingle,approximately 55/8 inches(143 mm)up 1997 Uniform Building CodeTM, subject to the following
from the bottom of the shingle. Fasteners must be installed conditions:
approximately 1 inch(25 mm)and 12 inches(305 mm)from
each side. The maximum exposure to weather is 5 inches 4.1. The shingles are manufactured, identified and
(127 mm). installed in accordance with the code, this report
and the manufacturer's instructions.
2.3.10 Hip and Ridge Shingles:Hip and ridge shingles must
be placed evenly over hips and ridges, and fastened to the 4.2 The shingles are installed in areas subject to a
roof deck using two fasteners,one 55/8 inches(143 mm)from maximum basic wind speed of 80 mph (129 km/h),
the exposed end on each side, 1 inch (25 mm) up from the on structures a maximum of 40 feet(12 192 mm) in
bottom edge. Nails must penetrate through the double-ply height, in Exposure B areas.
area. Weather exposure shall not exceed that permitted for
the field of the roof. 4.3 The products are manufactured at locations noted
2.3.11 Valley Construction: Valleys must be flashed in in Table 1 of this report, under a quality control
accordance with Section 1508.2 of the code. program with inspections by Underwriters
Laboratories Inc.(AA-668).
2.4 Installation—Reroofing:
When installed over existing Class A or Class C asphalt This report is subject to re-examination In two years.
shingle roofs in accordance with this section,the GAF asphalt
Page 3 of 5 ER-5546
TABLE 1—PRODUCT DESCRIPTIONS AND MANUFACTURING LOCATIONS
PRODUCT SHINGLE PLANT LOCATION DIMENSIONS NOMINAL MAXIMUM LOCATION OF NAIL
TYPE (height by width) INSTALLED EXPOSURE TO LINE(APPROXIMATE
(inches) WEIGHT WEATHER DISTANCE UP FROM
(pounds per (inches) BOTTOM OF
100 square SHINGLE)(Inches)'
feet)
Country Laminated Mt.Vernon,Indiana 17 x 40 360 T!, 8
Mansion TM
Country_ Estates" Laminated Mt.Vernon,Indiana 17 x 40 360 7'/, 8
Grand Sequoia° Laminated Fontana,California 17 x 40 360 53 11
rand Canyon" Laminated Fontana,California 17 x 40 446 5' 11
Slateline° Five-tab Mt.Vernon.Indiana 17 x 40 266 VI, 8'/,
TIMBERLINE Laminated Dallas,Texas; 13'/,x 392/, 335 5'/, 6
Ultra°Shadow Fontana,California
Accent"
TIMBERLINE°25 Laminated Dallas,Texas; 13'/,x 39'/, 255 55/, 6
_ Fontana,California
Original Laminated Dallas,Texas; 13'/,x 39'/, 283 55/, 6
TIMBERLINE2° Fontana,California
Royal Sovereign° Three-tab Fontana,California; 13'/,x 3934 225 5'/8 6
Mt.Vernon, Indiana
Fontana,California; 12 x 36 225 5 5'/,
Vernon, Indiana;
Dallas,Texas
Royal Sovereign° Hip and ridge (field-cut) 13'/,x 13'/, — See Footnote 1 —
12 x 12 — See Footnote 1 —
For SI: 1 inch=25.4 mm, 1 pound per 100 square feet=0.0488 kg/m'.
'Weather exposure shall not exceed that permitted for the field of the roof.
'Nails or staples shall be located below any face-applied self-sealing adhesive, through both laminations where applicable, but shall not be
exposed to weather.
'Allowable tolerance is+'/,inch.
Page 4 of 5 - ER-5546
-I 10'(254mm) 1.— 4m 0,016mm) _110'(25a m1 I 110'(254mm) 1.--- 40'(i3Ot6mm) _ 110'(254mm) I—
I—Alignment SOU --I 1.— u�pnlrem sou —�I j
1 Outside Nags 1'(25mm)-1.5'(38mm) Outside Nalle 1'(25mm)-LS'(38mm1
I Inside Nags 13'(330mn)-14'(35emm1 1 / Inebe Nelle T(1]emml-6'(203mm)
f 13'(330mm)'14'(358mm)
(432) ! ! Sell-Seal ! I { . (432)
1 Adnatel
On Back /
19.5'(485 mm) 1
8' 20.5'(521 mm)
(203mm1 / 1203mm1
_amu u� _ � �\
Standard nailing pattern-Four Nags per shingle Seven Nall application where Code requires 6 or more nails
COUNTRY MANSION
40'(1,016mm) 40'(tpl6mm) - -
—i 10'(254mm) 1•— —•I 10'(254mm) I 10'(254mm) )'— —1 to'(254mm) •--
1I—Alignment She ^ PlpnmenlS a—.1
Outside Naga 1'(25mm)-l.5(38mm) Outside Nags 1'(25mm)-1.5'(38mm)
Inside Nails T(l)8mm)-8'(203mm)
Inside Neils 13'(330mm)-iC(358mm) Sell-Seal 13'(330mm)-IC(356mm)
(4 2) ' I 1 p ' ' onAdnBack . 1 esive ! /• ! •. (432)
B' 8' 205'10.6'/ 1(521 mmrn)
•
(203mm) 1203mm1
Standard nailing pattern-Four Nals per shingle Seven Nall application when Code requires 6 or more nails
COUNTRY ESTATES
40'(1,016mm)
Alignment Slits 1 I ' II
I ~l4 41/71.–•
� Nell Guide line I tzn/mons �1T IYl4�mr.asimml
IT
mM' Nell Guide Line
(432mm)– { _ _r I e,T nmml—
~ 1--(25-38mm I-I 1/7(25.38 nim)-1 ` I.-
- 1-112' t
1 ) I 19'-21' (25-35mm) 1-112'(2536 mm)–id
11.(219mm) (48319-2? ) I i'f2llmm1
— nOMna)unexposed nominal unexpbsetl
ISell-Seal Deck
Adhesive
on Oeck L_
— —
Standard Nailing Pattern-Bye nails per shingle So Nall Pattern-where required by local code
GRAND SEQUOIA/GRAND CANYON
FIGURE 1—SHINGLE NAIL PATTERNS
Faye 5 of 5 _ ER-5546
I 40•(1.016mm) lx) I fa"(lgimm1-e11rz'(21Mun)
I-v. /�I 1 1...._1512•(314mm
Bim .-12'13osmmI—I a'grmen1 Sire 1�..1 U05mm)-� 1012'NIYmm
(2almm) �. It-1(IEmml•192'(33mm) • I-. -
1 - - - - - - - 3 - ■ - - - - a - - a - - a - - ■
ml s- - - - - -a- - -..- - 3r \ /a s — - - - - - a - - -- - S1
T Doublen
I Sell Seel B'1220mm1
7 UT MhaMe nominal unexposed
(1B1mm)
on Front
Single OIrMMbns&Sp.WP1bM Nailing Pattern
SLATELINE
I 39-St(I000nmI 8.1/2')216nm)-9-I2'(241m
m)
l1(26mm)•.1.12 (3e )T mm11112'(343mm)
`14.12'(3mm
I(25mm)•1.1213Bmm1--.4 — 1^1(25mm11-12'(351mm) -1I6T(432mm)
I
•
I(26mm)-I-yr(38mmIL.-1
13.1/4' 0 0 0 O
(331mm) / 11 Sall Saat I
S I62mmnmouch Alnulee
111
6•(,52mmr)nominal layersSi
LI
aro uupu0n an Beck ��wee
ban layers / Mm
Standard Nang Panora-lour nails per shingle Nat&Ade Sia Nall Pattern-wMu ngWretl by local code
Una
TIMBERLINE
1 36•1014mm1
1192'-12.117 1-112' 129' 121' 1112'
I~(2B2mm31Bmm) (21
-3Bmm) (13mm25mm) (13mm-25mm) (25mm3Bmm)
1- -,12 25mm_) 2•�2s -36 I 4- —I I— -+I 1-- —1
1r o, — � 0 �o o\ / 0 0 0 0 0 0
(30�) s mm SeIl Seal
131 /nominal ASnnsNe y nominal4 1 e.
uneapon0 on Front uncapped /
Standard Nattng Pattern-lour nab pn shingle Slx Nell Pattern.when required Oy IoW coda
ROYAL SOVEREIGN(ENGLISH)
I_ 30Qr6•n.wnmm) I
1 I 1312'!11.12' 11 I2' l 129' 1 129' I 1-1 I2'
I~1345mmafiemm�' (25mm-3amm) (I3mm-25mm) (13mm26mm) (25numJ&rvn)
-� I-o-Li lly(25mm35mn) 19 l2•(esnvnJ6mml�l I..- -"I I.- -1.I I^ ---'1
IS92• O0 0 0 \ / 0 0 0 0 0 0
(331mm) \ 1 5-0
52
mn) 1 ' /Sall Baal 4 ' 5•(162mm( " /
.11111Eromlnal
,pond hesl
on HIanHN nominal
ON unexposed
Standard Ne71r2 Pelton-tour nails p4'shingle Six Nall Palter.whose pWed by local cod.
ROYAL SOVEREIGN(METRIC)
FIGURE 1—SHINGLE NAIL PATTERNS-(Continued)
•
• Applicant to fill in all spaces except those within heavy-border lines and sign all appropriate declarations.
-CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. - • - '
CONSTRUCTION PERMIT � -/O� 73 . - - •'
Project Address MD/ ®Onrv Ir 1 �( - TYPE OF CONSTRUCTION 161 NEW LI ADD U ALTERATION U REPAIR . -.. .,, •..„ r r,
Applicant's Mailing Addre - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone
I' DESCRIPTION OF WORK
Owner's Name
'J �A A Ay►fJME . •_ Phon A Or ,e_r Aii: A"6' - S Main Building: Accessory Building: Z
Address /20i D !IO� P3`l tel` ^�a, e5em TYPE OF PERMIT 11. GRADING rr++yyil FOUNDATION • STRUCTURAL T Front , N
Arch/Eng. License No. , ❑ TENANT ❑ ELECTRICAL IKfWLUMBING ❑ MECHANICAL - B - I
A Rear - _ N
Address I� (1119,
///... (((��y''''''/! • ❑ OTHER - '
1 1 N , . k01" Phon /j��t/�f PROJECT DESCRIPTION SQ. FT. ' OCCUPANCY C Right G
Contractor's Name Phomati 7MK Left R
Address')mailing) 3�� �� �� CONSTRUCTION TYPE VALUATION$ S E
Z nz3-3q ZONE GRADING CU.YDS. ACRES Q
City License No. �r �..J 7 Ping. Ref.# Park.Fees $
LICENSED CONTRACTOR DECLARATION - Remarks: ' Parking Req./Provided _ )
•
U
I hereby affirm that I am licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and • ) Use of Building: R
my license Is in full fore.nd •f ect. r
Licens: as `' ns- o. clic/ 2c-Sc/
PLUMBING - FEES Planning Notes: - M
•
•
Date - � Signature s`• -a... • E
/th
x WORKERS' COMPENSATION DECLARATION Bar Sink Showers . T
N
' \ •,ereby affirm that I have a certificate of consent to self-insure dr a certificate Backflow Preventer Service Sink II S
Workers' Compensation Insurance, or a-certif le copy < ereof (Section
.400, Lab. 2e,...,....„.... •.�/ ,({p7 • Backflow Irrigation Sewer Cap , i • ELECTRICAL i FEES
Policy No. - in /1 v"•' Company (\°l '� '
1�y7,Certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washei, Transformer ❑ 15-50 KW i
Date
iTh with the city Bu g '- vi•'. .
Date I �leV`d Applicant `.fit .} . ..4/�) Clarifiers Solar Collectors Construction Pole$ub. ❑ 50+KW
EXEMPTION-FROM WORKERS'COMPENSATION D CLARATION - Dishwasher - - -
(Thissection need not be completed If the permit is for one hundred ($100) or Solar Piping - 'Cooking Unit ri 'Meter ❑up to 100 amps
less). DrinkingFountains
•
I certify:that in the performance of the work for.which this permit is Issued, I Solar Tank Dishwasher ;+< I Meter Dover 100 amps
shall not employ any person in any manner so as to become subject to the "
•
Workers'. Compensation,Laws of California. Floor Drains. Swimming Pool w/Spa Dryers ❑Gas RElectric - ,'Sub Panel
Date Signature
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan v'f
Workers' Compensation provisions of the Labor Code, you must forthwith - -- -. - Motors❑0-1 HP ❑1•h-6
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet - - F.A.U. f%) Inc.Solar 09-15 HP 016-15+ '
CONSTRUCTION LENDING AGENCY '
I hereby affirm that there is a construction lending agency for the performance Interceptors - Water Heater • Fixtures
of the work for which this p t is issued (Section 3097 Clv. C.) - - Microwave
Lender's Name N! �r (� Kitchen Sink • , Water Service I •' �-- Device Boxes Pole Light '
Lender's Address • ['/C1f✓ -
OWNER BUILDER DECLARATION - Lavatories Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap .
following reason(Section 7031.5 Business and Professional Code: Any city or . - Switches Sign '
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 Roof Drains - Garbage Disposal Standing Sections
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 __ Generator ❑0.5 KW❑5-15 KW Trash Compactor
'vision 3 of the Business and Professions Code) or that he/she is exempt p
refrom and the basis for the alleged exemption. Any violation of Section
31.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee I $25 Issue Fee $• 3
ehalty of not more than five hundred dollars($500).
O I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work, and the structure is not Intended or offered FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - - - - -- - -_-'— -- - PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑
thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date
employees, provided that such improvements are not intended or offered for Canopy Type II ❑
Duct-Under Ground
sale. If, however, the building ve improvement fro i sold within one year d com- Application Approved By (� Date
pletion,the owner will have the burden of proving he/she did not build or im- y /407-/--c4/2
>w/�
rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By /1-,) . ��� / Date/aX�'
t I, as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU
tractors to actor'construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES •
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- Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMTP $
tractor(s) license pursuant to the Contractor's License Law). •
• PLAN CHECK $ PERMIT
❑-I'am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ S 7 6d ISSUANCE $ _
Date Owner Heating System&Ducting• PLAN CHECK $ ENERGY P.C. $
' I hereby certify that I have read this application and state that the above - ❑O-100,000 BTU 0100,000 BT GRADING $
Information-is correct: I agree to'com•ly with all city and county ordinances - - ELECTRICAL $
and state laws relating to bui di g co struction,and hereby authorize repre-
sentatives of thi it to : ••r the above-mentionetl •j pe ty 1y ,
Inspection pure- s. - / ll MECHANICAL $ •
Signature • •//1 ' i/Iii- Date '--U TOTAL FEE $ sccQa
Dnvers',LIcense or 55•>p • - '� _ Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $
CMF 0865-46 rev. 7/63 White-'Building;Canary-Applicant:Pink-Accounting;Goldenrod -Assessor - - - --- - _ - _
' CONSTRUCTION AND PLAN�L',ING > s POO, IPA
- APPROVALS Permit# L /01� Date- •Inspector APPROVALS Permit# Date Inspector
•
' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ' . 53. Steel Reinforcement • • '
s
.3. Electrical Conduit Utility-Undrgrnd. . - .`' .1 54. Forms
4.i Electrical Conduit-Undrgrnd. ••, s- 55. Electrical Bonding
,5.`Steel Reinforcement:.' r ;•i: 56. Rough Plumbing & Pressure Test
-6. Electrical UFER Grnd.' �• . i • 57. APPROVAL TO COVER-GUNITE
7:,,F. •.' ' 58. Electrical Conduit-Undrgrnd. ..
8. Foundation • ‘ , 59. Gas'Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd.1 _ - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
•10. Structural Floor System I " .. 61. APPROVAL TO DECK
11
11. Property Sewer Line & House Connection -• 62. Backwash & Receptor-Final •
12. Sewer Cap •
! 63. Heater & Vent-Final ,
13. Roof Drains ' •-i _. 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 Ceilig . 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning '
9 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. Insulation78. 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`9y &f $f €9
39. Water Service-Final `/ ,
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backflow Preventer
43. Backflow Irrigation - '
44. ,Landscape Irrigation System .
45. Sound Attenuation
46. Handicap Regulations _ '
47. FINAL STRUCTURE & BUILDING .
48. Special Requirements Completed -
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ;,.
51. CERTIFICATE OF OCCUPANCY -
No. Date •
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. 'BLDG.NO.
' CONSTRUCTION PERMIT RE 18 I '
Project Address -2)0A4.6_44_ - , ,' 8659 I I /24/81 15.00 T_I,
/o20/ Ac . TYPE OF CONSTRUCTION�/ -.-. - ...._. _ _ .
OWrs G Phone 75/. ..0 0 NEW t� ADD 0 ALTERATION
Address SiThine 0 REPAIR ❑ CONVERSION ❑DEMOLISH Leh A
-1ArchfEng. License No. 0 OTHER ZONING REGULATIONS
'Address '
DESCRIPTION OF WORK A.P.t
ZONE PLNG. REF.It
Contractor Air- At. _ BUILDING TO BRI Lp N
vi TYPE OF PERMIT BUILDING
• C PRO I V GNE
'd a • ❑GRADING 0 FOUNDATION ❑ STRUCTURAL SIDE YARD
LICENSED CONTRACTOR DECLARATION - ❑ TENANT JaiLECTRICAL LUMBING ❑MECHANICA SIDE YAKS'
I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER
Professions Code, and my license Is in full force and effect. REAR YARD(TO P/L)
License Clas C-70 C-93... License No.37d9 PROJECT DESCRIPTION
3PKG.SPACE REQ. PROVIDED
Date ///iU Signature 2 SQ.FT.
WORKER COMPENSATION D LARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE$
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY I DATE
certificate of Workers' Compensation I surance, or a certified copy
thereof(Section 3800,Lab. ). ,,// GRADING CU.YDS. ACRES SPECIAL CONDITIONS:
icy No.:W. 4e-dr'al Company Ant SyE7gnt5
ertified copy is hereby furnished. REMARKS:
.:ertified copy is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - -
(This section need not be completed if the permit is for one hundred - .
($100) or less).
I certify that In the performance of the work for which this permit is ;f
issued, I shall not employ any person in any manner so as to become PLUMBING .PLAN CHECK ELECTRICAL 0 PLAN CHECK '
subject to the Workers Compensation Laws of California.
BATHTUBS SHOWERS UWtLLING LAHAGE
Date - Signature - - -- . '
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW •
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW
revoked.
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 01 HP 1-10 HP, - s-
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) - 10-50 HP 50 +HP -
formance of the work for which this permit is issued (Section 3097
Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES
Lender's Name
Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS „
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNSI HUt-I UN
Any city or .county which requires a permit toconstruct, alter, POLES METERED SUB
improve,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB '
quires the applicant for such permit to file a signed statement that he.
Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT 81-01.-42a . / aZ
b—'- for the alleged exemption. Any violation of Section 7031.5 by
pplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS .
,t more than five hundred dollars ($500). - -,
V I, as owner of the property, or my employees with wages as their SOLAR TANK 6, COLLECTORS® o ♦'s • ) a
sole compensation, will do the work,and the structure is not Intended 7
•
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. / - I ISSUE FEE
Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY
who builds or Improves thereon, and who does such work himself or ISSUE FEE •• DATE
through his own employees, provided that such improvements are not
intended or offered for sale. If, however, the building Or improvement MECHANICAL PLAN CHECKSUMMARY OF FEES
is sold within one year of completion,the owner will have the burden
of proving he did not build or improve for the purpose of sale). BUILDING
HEATING SYSTEM 0-100,000 BTU
\ 0 I, as owner of the property, am exclusively contracting with AND DUCTING PERMIT $ SMTP $
Wand
contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT
and Professions Code: The Contractor's License Law does not apply to ISSUANCE $
•
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ /1. XV -
tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ IV
the Contractor's License Law). 100,000+BTU PLAN CHECK $
4.1 0 I am exempt under Section B.& P.C.for this $
_ BOILERS BTU ELECTRICAL $ CM l
reason MICROFILM $ \
it SYSTEM REPAIR,ALTERATION PLAN CHECK $
V
`C Date Owner - - TOTAL FEE$ - ryI
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL E 'I
information is correct. I agree to comply with all cityand countyPLAN CHECK $ VANCE -
9 t Y VANCE PC $
representatives
and state laws relating to enterrstupon the and hereby at: horsed
of t city to upon above me ti ed -
property for ins Ion purposes. ll f.:5, ---
Signature
Signature �/� Date // /� Y/ •
-■ FINAL FEE $ el
Drivers' Liceq or SS$ ' ISSUE FEE
CMF 0865-46 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING - - . POOL&SPA - -
Date Inspector
APPROVALS Permit# P E - IR IP APPROVALS Permit# - Date Inspector '
a
1. Temporary Electrical Service or Pole _ . 43. Pool & Equipment Location - • . .
2. Soil Pipe-Undrgrn- - 44. Steel Reinforcement - .. .
3. Electrical Conduit Utility-Undrgrn - - 45. Forms
4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding -
5. Steel Reinforce 47. Rough Plumbing & Pressure Test _
. - 6. Electrical UFER Grn - • 48. APPROVAL TO COVER-GUNIT.E _
7. Footings - 49. -Electrical Conduit-Undrgrn
8. Foundation 50. Gas Pipe, ❑ Undrgrn,Test
! 9. Water Pipe-Undrgrn 51. •Backwash Lines, P-Trap; ❑Undrgrn
- 10. Structural Floor System- 52. APPROVAL TO DECK - - - -
11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final • - '
12. Street Sewer Connection . . 54. Heater & Vent-Final
13. Rough Plumbing _ 2 55. Plumbing System -Final - -
14. Rough Electric-Conduit .- -56. Electrical-Final
' 15. Rough Electric-Wiring - - 57. Solar System-Final - - -
16. Rough Heating & Air Conditioning b8. Fencing & Access Approval
17. Ducts, in Structure . - ' • 59. APPROVED FOR PLASTERING '
18: Ducts, Ventilating .
19. Gas Pipe-Rough &Test ,. • - 60. POOL/SPA SYSTEMS FINAL
• ' 20. Roof,Framing - ,
21. Roof Sheathing '
• 22: Frame and Flashing NOTES: G,V-. �' r ) _• 23.' Insulation r� �A . �. • 11 v.. �! • _(J t, 4.1
24: Lathing & Siding 7 ',°s` c ',�,�e
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final - •
28. Final Electric - ..
29. Final Heating & Air Conditioning ' •
30. Final,Gas Pipe-Test -'
31. Final Plumbing • .
I 32. Water Service-Final
33. Gas Service-Final •
34. Solar Domestic-Final•, • (1. ^'0 22...-12_2.-42_ ..
35. Landscape Sprinkling System -- -
•
36. Sound Attenuation
37. Handicap Regulations -
38. FI NAL STRUCTURE & BUILDING
- -
39. Special Requirements Completed
40. Electric Release to Edison - - - - -
• 41. Gas Release to Southern California Gas Co. - - -
42. CERTIFICATE OF OCCUPANCY _ _
. No - Date I • ,
Mile simits-
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751 -646,10 O trri��i i,• L
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Permit #_252-.6-3-2-13--_-2-13--_
7HlS NUMBER ALL INSPECTION jREQUESTS
NY
~ APPROVED
CITY OF COSTA MESA
Mechanical Division
Building Department
Approved ..-C-...-..Date/.!./kit..
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SPECIFICATION SHEET
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BEA and BEAC Models
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iNTP.C_DUCING
The modular SUNBURST Glass glazed solar collector.
APPLiCATiLI'JO -
Pool and Spa Heating
Domestic Water Heating
Space Heating and Cooling
Industrial Process Pre-Heating
.1.7:i RES
REPUTATION: A major solar manufacturer since 1974, SUNBURST is prominent on the CAL-SEAL Solar
Manufacturers' List. SUNBURST collectors guarantee the contractor total design freedom, fast installa-
tion, and excellent service.
LOW COST: Efficient production methods provide top quality, low cost, and maximum heat collected per
dollar invested.
10-YEAR 'S°IARRANTY: Extensive 10-year warranty on the absorber plate and 3-year warranty on the glazed
box fully qualify SUNBURST collectors for the California Solar Tax Credit. 1
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METAL ABSORBER PLATE: High thermal conductivity. Invulnerable to ultraviolet degredation.
COPPER '-VATERWAYS: Perfectly compatible with pool, spa, and domestic water — no different from
copper waterways in natural gas heaters.
GLAZED BOX: Patented standard box accepts absorber plates and glazings Interchangeably.
DURABLE GLAZING: Solatex is a strong, tempered, high transmittance solar glass. Very resistant to
breakage and impervious to ultraviolet degredation.Solatex brings the beauty and permanence of glass to
\ your project.
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1. Solar and Domestic: Valves # 1 and 2 horizontal, 3 and, 4 open.
2. Solar only: Valves # 1 horizontal, 2 vertical, 3 closed,and 4 open.
3. Domestic only: Valves # 1 and 2 vertical and 3 open, and 4 closed.
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PATIO COVER DETAIL 6/1 /61 TYPICAL JOIST ANCHOR
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STATE--jam_^ `t1� �.i�-.
SIZE
SPACING SPAN • f�!! ) "'� ;=
OVERHANG ! AOR' •,c �� n l N
RAFTERS:Eat\ ' * `'�
, • ., / '�`it f�
FOR ORM ” ;' y
��SLOPED ' � ��
STATE LENG SPAN 'Ida
p =i}r O
MAXIMUM /s CONTINUOUS
yy it 3�x5•Lags 32% LEDGER .'�Y BlockingPredrill Led er9% �--4` % MAXIMUM 9:6\ Predrill Existing '/y3 Deep
(�� JOIST HANGER
or other approved methods NOTE : USE REVERSE SIDE FOR PLOT PLAN.
BEAM of support • tie.
" x /0• lit . _
STATE SIZE �� AF ER — CHART NO 2
ALL LUMBER DOUGLAS C
OPEN EGG CRATE FOR SOLID SHEATHING.
alit
3/I6X2"-T-STRAP "CONSTRUCTION" GRADE C RIR PLASTIC SHINGLES OR BUILT UP
COVERING ROOFING.
MUM SPAN ' ZE SPACING MAXIMUM SPAN
' x 7' 0" 2x6 12% 15' I •
s • 2'x 6' 16% 13' 3"
i POST-BEAM 15' 0 " 2"x 6' 24% 10' 11"
CONNECTION 12' 0• 2"x 4" 12% 9' II"
11 ' 0 " rx 4' I6% 8' 8"
POST I o' o" rx a• 24°r< 7' I"
`1• 9 x At" /a' G • NOTE: FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO
, ' SHOW SIZE SHOW SPACING WALLS ARE TO BE BUILT. USE NO. 2 CHART ONLY.
I
SHOW LOCATION ON REVERSE SIDE. WIDER RAFTER SIZE MAY BE INTERPOLATED FOR
--` SPACING ONLY.
DROP PATIO FLOOR •
FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO RAT[
. DRAIN
WALLS ARE TO BE BUILT SUBMIT COMPETE HOUSE AND ADDITION PLANS
. ° I
PUDDLED SAND FILL A .�
. sxrnv ' SLOPET Remove Grass And Weeds Down To Natural Grade
12' CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT " '
POST ANCHOR I ., .M1. 71 GALLONS PER SACK CEMENT.
For Pipe Post. Embed 1 124 Provide 26 Go G.I. Flashing At Wood Floor Const. COSTA MESA BUILDING DEPT.
Pipe In Footing.
Provide Flange Or Weld Plote Screwed Or Bolted To Frame.
77 FAIR DRIVE 834-5273
CMF 00012-46 (BU 40)
i .
APPRUVE �
City oyyTa Mesa Building Uepr
_ I
�, BY._...,..._ DATEI2. /..t.. J9.'�t
THESE PLANS MUST BE ON JOB AT ALL TIMES
MAKE NO CHANGES WITHOUT PRIOR APPROVAL
�L(A.G_ OF DEPT.
I ,���� L� THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL
I^ 7 I / 47 r ,jJ OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED
O� a"� l/'�''� TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION
,
/ OFC COSTA- ESA OF ANY OF THE PROVISIONS OF THIS COVE. NO PERMIT PRE-
‘../...,
7h -,/f PLANNING DEPT. SLIMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
Z Jam\ / 'Y�a2.
5UB1EQ TO BLDG. DEPT. REG. PROVISIONS OF THIS CODE SHALL BE VALID. EXCEPT IN SO
,. \ 33�� ( �(' ,C(/Q �^ ��r�� FAR AS THE WORK OR USE WHICH 17 AUTHORIZES IS LAWFUL.
>(�- 36' / �1/�r �"1 DATE L J THE ISSUANCE OF A PERMIT BASED UPON PLANS AND
10 20 DIRECTOR OF PLANNING SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL
FROM THEREAFTER REQUIRING THE CORRECTIO;; ,F ERRORS
IN SAID PLANS AND SPECIFICA77OdS OR FROM 'RF_`/ENTl716
• ' ..`.D'NG OPERATIONS BEING CARRIED ON THEREUNDER WHEN�_-- '`' `.''CLATION OF TR'S CODE OR OF ANY OTHEP ORDINIICE
- -V I CITV
•
STRUCTURAL APPROVAL ONLY-7
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SEPARATE PERMITS ARE RF";IR D
: _
FOR ELECTRfc:.^,L p/o F ®/k,a,._
HEATING, V P!� . !
REFRIGERATION 0/0"?!.< Se,I- Hu-aSe o'r P/u,,k
P2Y6 # f sW /1r /v Shaw
THIS NUMBER MI'IS:, 4',CCCQ ip% i (I Skoct, C� �o sides
ALL INSPECTIOREQUa.srS !
i 4N rtwr o / /a &
StHL E DJ tI ,;ARE TOlis-(NTEODAlTEsEENITLipiii:LilyilkS ,iE � _ST in,J THE
C LiFU N;A D! OF
S FET•: ✓ISION
ADDITIONAL REQUIREMENTS.��LT`O FOR I
DEA.II VK 11P,I tt1 L9ML. 11NLN.E. v..., .—wt."
JOB ADDRESS 1201 Donegal Place BUILDING PERMIT NO. 49415
GENERAL CONTRACTOR Pete Bland DESCRIPTION of WORK Patio Add
AP No. 141-046-29 LOT 178 TRACT 2671 FIRE ZONE VALUES 1475.00
INSPECTIONS Sign Dote I TYPE GROUP ZONE R1
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR I I e
Dote Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. O
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME ANO FLASHING
LATHING - IN n OUT El
PLASTER, BROWN COAT
STRUCTURAL, FINAL D S Electric
HEATING. VENT., REFRIG. AND A,C., FINAL
PLUMBING. FINAL ANO GAS TEST fl '
ELECTRIC. FINAL a
BUILDING. FINAL �q 1-51-qt)
SPECIAL REQUIREMENTS
It '1042 12/24/79 27.50 TL
•
COSTA MESA BUILDING-1,TV DEPARTMENT APPLICATIOPIR STRUCTURAL PERMIT/
. P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
RECEIV ;BY PERMIT 1�T0 49415
For Applicant to Fill in Completely —Use Ink Only ..“ 1 V
BUILDING/^O/ /J �I A.P. NO. — *9- —2 /
ADDRESS p1 l'{'`/ BUILDING /
TENANTOWNER OR. 'ilt �' �� ADDRESS/ r
MAILING /, UNIT OR
ADDRESS SPACE NO.
T
CITY �Q�i�(j.. .4�i NO/757-9420 THE ADD� ALTER �REPAIR MOVING DEMOLISH
CONSTRUCTION A /J
LENDER �r_�_py_(�//]
BRANCH //t
OWNE 4:18b J �j �/
ADDRESS USEr3Z�I�{,(Q(�,e.(/ -/w ]'i�J ALUE V31 .5
ARCHITECT TEL.
OR ENGINEER NO,
ADDRESS ZONE SR.\ TYPE GROUP
APPROVED .
CONTRACTOR A. 3.B0--2,
BY DATE
ADDRESS 3061 ,( A��,, tAi
-111 TEL.
E••• CITY �.rd'4 ?aa NO. 5/40.1531
1531
STATECITU ,) D4 a /„ APPROVED SETBACKS
LIC.NO. LIC.N -1 Y/
I...1
SIZE INO.OF BLDGS. (FROM C/LS7 REE
0. OF LOT I NOW ON LOT ! FRO . illi
a
USE OF W/_ _ Q lT
N EXISTING BLDG. l��-YLK-. R.SIDE (J FT.
Ct) t t
[x^ Separate permits are required for L.SIDE 3O FT.
electric,plumbing and heating work, REAR 0 1 FT.
1—, USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
Q
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,, l?—�SFC�'y c/%L/thO�(�/ DAPPROVED
ATE
-a po —fly ROV Ell/' ' /Cl DATE I `I� ` J R
W
0 I hereby acknowledge that I have read this application and state °�'
y that the above Information is correct and agree to comply with
0. all laws regulating building construction, and I shall not employ >:
Z any person in violation of the workman's compensation laws of
,WW the State of California. -,
m
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE $ ig,00 ,n q
and Professions Code,Division 3 Chapter 9.
�� 1� �� ix
Signature of / //( PLAN CHECK $ .V.Q 2
Permittee y $ /� /✓ t /a� TAX $ O,CO U
Authorized Agent ate / O( / r`-,9 / / TOTAL PAID $ 2 7 t fC'0
OWNER CQLLECE -MESA COMPANY DATE 10-11-56
JOB ADDRESS 1201 Donegal PI POP BUILDING PERMIT NO. #3834
GENERAL CONTRACTOR The HaJe Co. VALUE $ 10,2)18.00
•
LOT 178 BLOCK TRACT 2671 Single dwelling w/att. gar.
GROUP I & J TYPE V ZONE R4 FIRE DISTRICT 3864
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench kfr/`� /®J,, -56*
Foundation Forms and Grade to Gar2aag��e t- //- 9-
Rough Framing �! 1 r _
Plumbing,Rough to Slab SfM > " 'f,w.� I*
/� a . / /L. n /O '30 Sb 7a 93 b---
Plumbing, Rough Complete j fc-5 ).4.5-
Temporary
.)g- 'Temporary Pole �1� �n
Wiring, Rough �vp//� �_ -Se., i Pte- - //:.2L• .SL 3636
Heating,Rough IV i5 S •
-
H ating, Final /, /?S , . . -5- '• i ttiw.i '_ F -i_ . 2+.-74 -2,1-,/.2 a"""-77ewer, House Sewer,St. MfFS ,;2G s7 I. � ►I L77,C
Septic Tank or Cesspool r / ,
Lathing, In x Out $ g4 6 / -4--s r
Plastering / - 2%f" 7
Plumbing,Final,Fixtures Complete /IJ ;l S- / t..
Plumbing, Final Gas Test/S. /V/ . -22---s-7 _ 4/. / _ l/Li"
Wiring,Final mAY 2 ; %OSI Vitt /
Occupancy /11/4S -.26-'
FORM 210 3M 10.25
Costa:Mesa Building Department APPLICATION FOR PERMIT
P. O. Box 317 SRR BIB / ` ING
COSTA MESA, CALIR ,IA
a "IIIMMINIMIW FOR OFFICE USE ONLY
i'OR APPLICANT TO FILL IN Receipt No. Permit No.
Building
Address 3�3 (T/
1201 Donegal Place
Costa Mesa, California Received by Date Recd. Date Issued
Nearest 7° /0—/O -.16 a -// -f
Cross St. Loren Lane Building
Address
Owner College Mesa Company
Mail Costa Mesa, California
Address 1777 W. Lincoln Avenue Nearest
Tel. Cross St.
City Anaheim No.KEY 3-3161 zoneNo.of Type, Group
Architect or Lie. I Plans I \ tie,-
Engineer
ieEngineer Davis & Quigley No. C-1790 Approved
by Date
Address43 Malaga Cove Plaza,Palos Verdes CORRECTIONS
City tic.
Contractor The Hale Company No. 3422
Address 1777 W. Lincoln Ave. , Anaheim
Legal I Lot
Description I No. 178 I Block I Tract2671
(Attach Metes and Bounds)
No.of Bldgs
Size of Lot 78 x 125 I Now on Lot None o
Use of I No.of I No.of A
Existing Bldg. Families Rooms X 6
Setback Line from Rear Yard 34.4
Center of Street 52 Side Yard 1018.8 D
DESCRIPTION OF WORK r
New I X I Alteration I I Addition I
In
Repair I Moving I Demolish I t
Building No.of I-,
Size 1181 Rooms 5 Stories 1
Exterior WallI Roof
Covering Stucco Covering Rock APPROVALS •
Use of New Foundation Location Inspector Date
Building Single family dwelling with p
Forms,Materials,
attached garage. Under-Pinning W
Frame: Fire Stops, .0
Bracing,Bolts 0
I hereby acknowledge that I have read this Application e
and state that the above is correct and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating Al.
building construction. Lath. Ext.
Signature of
Permittee THE HALE CO NY Plaster, Int
P\ Authorized Agt. j� jaL Plaster,Ext. O
N
Valuation Permit Fee $26.00 Masonry Reinforced tl
Plan Cheek $ 13.00 •
Bond Beam
$ 10,248.00 Total
Fee $39.00 I FINAL CI
FORM 204 10.55 D.P.0 S.
V y . ..
C Y
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a
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•
Street
PLOT PLAN
Show location and distances from
property line and between buildings.
a-
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OWNER MAC HiNES ROBRRT AT, DATE 2-8-79 .
JOB ADDRESS 1201 Donegal Placw BUILDING PERMIT NO. 47396
¶ . GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Blockwall
4 APNo141-046-29 LOT 178 TRACT 2671 FIRE ZONE ' VALUE $1 400.00 _
t INSPECTIONS t Signature Date TYPE V GROUP t,T ZONE R-1
"'-oIL SUBCONTRACTOR PERMITS ISSUED
GAS Date I Number I Signature
WATER
A ROUGH PLUMBING Plumbing
PROP. SWR. LINE ❑ HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
, •
ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER
ROUGH WIRING /� .y� Heating and Vent.
TRENCHES FORMS STEEL REINF. 6�rjT .M I I
FLOOR SYSTEM
BOND BEAM in STEEL REINFORCE 7
SHEATHING
FRAME AND FLASHING
LATHING — IN fl OUT Il
PLASTER. BROWN COAT
STRUCTURAL. FINAL Electric
HEATING, VENT.. REFRIG. AND A.C.. FINAL
PLUMBING, FINAL AND GAS TEST rl
ELECTRIC. FINAL , J
BUILDING FINAL " -
r' 4 ' . ' : -
t 18 2/08/79 21 .50 TL
4218 2/08/79 21'.50CAT0
,,e"COSTA MESA BUILDING-SAFETY DEPARTMENT 218 0000447896 "IA
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . . -
!�/tt
For Applicant to Fill in Completely — Use Ink Only APPLICATION FOR STRUCTURAL PERMIT
/� /� RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING / ?O/ QD//IP yr4/
ADDRESS OJ ✓ / o PERMIT NO.
OWNER A.P.NO.it/./'—c0 e/4_ '.2/
// //�J ,I ///rrr�5, BUILDING �Gl/ n
ADDRESS / 1 01/ /J49,,c,..2.
^Q/f/P y 4/ � ADDRESSA: 0 / ./..If ry/ N .r.
CITY COS id / /e c� NO.TETRACa7/ L x BLOCK
CONSTRUCTION ,v( NEW ``ADD�f ALTER REPAIR MOVING( r1FMOLISH
LENDER /(/l v
BRANCH /1^` ,(,, ,,I- I
OWNER ri / 'J�J) 6/724/4.14
�f/lnS
ADDRESS // /,f �y ALOE -[/y]
ARCHITECT TEL. USE ,0 I7l.ti s �/'w
OR ENGINEER NO
FIRE
ADDRESS Ac
/-�f ZONE ��/j�TYPE GROUUPP (�
(wilier — l: Jv/llo'e APPRO� Z��//4 ' 0���/
CONTRACTOR BY DATE ((//
ADDRESS lir
ZO / NO.OF USE OF NEW • /r
TEL. PLA , BUILDING
CITY NO. V� ify
.F-- STATE CITY , YARDS APPROVED YARDS PROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE I NO.OFBLDGS (FROM C/L STREET)
0. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
4 EXISTING BLDG. R.SIDE FT. FT,
FSeparate permits are required for L.SIDE /`t a LI /t ,L
W
electric,plumbing and heating work. REAR FT. FT.
I.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
0 MAIN BLOCS. ACCESS.BLDGS.
d /�0 / r I� G / VAR.+ DATE
Q {/C� ��O LC C.U.P.qf` APPROVED
t� I+'1 -RPPRO9 �f J��1 7
a "�D Ctq e/ rcf/ 0/Ph! RV 6�ff:7.�i1 DATEZ— g
C0 . (J /r// -E/+1 ' /
W
I hereby acknowledge that I have read this application and state
N
'
00 that the above Information is correct and agree to comply with
' 00 all laws regulating building construction, and I shall not employ
/
n.
co
Z any person in violation of the workman's compensation laws of e
the State of California.
I hereby certify that I am properly licensed as a contractor under SO. FT. c`ev
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business e
VALUATION PERMIT FEE $
and Professions Code,Division 3,Chapter 9. �0 m
/� 'g /� PLAN CHECK $ /44 00 o
Signature of/y_y„_��py, 'IA� // ��z9t9 7c
Permittee ViP/7�•'c'! vt �j L1C(� .r s'h,s/y $/ / _ TAX $ �/'� U.
o
/ v 2
' Authorized Agent
TOTAL PAID .0,1175