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HomeMy WebLinkAbout1213 DONEGAL PL - Building Permits flb CITY OF COSTA MESA • o aa BUILDING DIVISION F I ^� ' DEVELOPMENT SERVICES DEPARTMENT / P98-00416 tb• PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4656 PLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1213 DONEGAL PL t Status: ISSUED , Suite No Applied: 06/01/1998 Issued: 06/03/1998 Vicinity: Parcel Nunmber: 14104631 - Applicant: NOCK, RON Address: Phone: Zip: • Owner: MC CORMICK, GRANT J Address 1213 DONEGAL PL . Phone: . COSTA MESA,CA Zip: 92626 • Contractor NOCK PLUMBING Address: 11612 KNOTT ST Phone: 714 8951246 GARDEN GROVE,CA ' . Zip: 92841 . ' • - License:707775 • • Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT INSATLL NEW DISHWASHER. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer •-$0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator - $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 • Dental Units $0.00 0 Septic Tank . $0.00 .0 Wash Basin $0.00 0 Dishwasher $8.75 1 Sewer Cap for Demo , $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect . . $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line . $0.00 ,0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) . $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION ' $0.00 0 -Tp-nac pee 30."l5 L�� 1 ov EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a 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)754-5626 DECLARATIONS q. r ,, 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 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'corn sati In�suranc/e�carterand policy number are: (�(! "i Cartier: �e co �/ (6 Policy Number. �7� 3 T 7 a (This section need not be completed if the pe is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which •is 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 s become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these prow ns.1 , 6 pp Applicant Signature: .(bE ^' • Date: - 3` ( l7 ` WARNING:FAILURE TO SE RE WORKERS(+ PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOl1ARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapt: 99'. mencln•pith Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force and effect.Lic.k - G Class x C� 1 Contractor's Signature: r - dr Date: 6 – 1 - (rj CONSTRUCTION LENDING AGENCY: In 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 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.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Coda for this reason: Signature: Date: 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,falsework.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,California 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 25513 of the California Heath 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). r 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 California 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? 0 Yes L.1 No (Section 65850.2 of the California 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 Califomia 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 penalty 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 above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. i./ / ArLa9ffb*ner( P 'PA And/Or Authorized Applicant Date CODE L TYPE DADS' 1611814 CDOEt INSPECTION TYPE DATE HEMS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing (j a1)'lf 8 &'1k2j 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Anal Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-46 CITY OF COSTA MESA 4 �9 BUILDING DIVISION :f .. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER J rig" • PERMIT 4tb.,,,,,Ae4b P03-00768 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1213 DONEGAL PL Status: ISSUED Suite No Applied: 11/20/2003 Issued: 11/20/2003 Vicinity: Parcel Nunmber: 14104631 ISSUED BY: Applicant: TIMOTHY NOCK ✓ Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 Owner: MC CORMICK, GRANT J Address 1213 DONEGAL PL Phone: COSTA MESA,CA Zip: 92626 Contractor: NOCK PLUMBING Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 License: 707775 Arch/ Eng: Address: Phone: Zip: License: • SCOPE OF PERMIT . CHANGE OUT WATER HEATER. FEE SUMMARY AMT QTY AMT ' QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow inigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 -0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) - $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $000 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial z $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 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: This permit shall automatically expire and become void if work Is not commenced within 180 days,or If work is suspended or abandoned for a 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)754-5626 2448-48(8/00) DECLARATIONS 9. , 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,es 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 intai workers'compensate Insurance,as required by section 3700 of the Labor Code,for the performance of th w for which this permit Is Issu My workers' pen do Insurance tarda en policy number are: 1 /f U(Y/ Carrier: ) �� '/ \ Policy Number , I l' DOZ (This section need r ,Lelcompleted N 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 b come subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3 00 of the La or Code,I shall forthwith comply with these provisions. I I t 2-C I O0-2DApplicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN TIES AND CI L FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION 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 licens d prgvi sa4cSpt (commencing with Section 7000)of Division 3 of the Business and Professioheode: n ' nse is in full force and effect.Lic.A V �( (( Class M Contractor's Signature: ,L[� Date: I ` 1 2AO 'I CONSTRUCTION LENDIN 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:My 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 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.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: 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,falsework,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,California 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 then 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 Califomla 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 en 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 California 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 a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IYe Yes D No (Section 65850.2 of the California 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? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomla 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 prescnbed 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 penalty 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 penally 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 above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ` Signature Lea r Z4/Uto And/Or utho e A plicant 1 // BODE 0 INSPECTIQNTYPE RATE MIME CODE( INSPECTION TYPE PATE mu. 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 7--/I if V 200 Final Re-Root 210 Final Electrical N' 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 • CITY OF COSTA MESA • BUILDING DIVISION ;se DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER I r.w� ,• I : PERMIT /B03-01548 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BthLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1213 DONEGAL PL Status: ISSUED Suite: Applied: 09/11/2003 Vicinity: RESIDENCE AND GARAGE Issued: 09/11/2003 Parcel Number 14104631 Zoning: R1 R1 Applicant: GARCIA, FRANK Address: 21681 IMPALA LN ISSUED BY: ---_� Phone: 714-968-8754 HUNTINGTON BEACH,CA Zip: 92646 Owner MC CORMICK, GRANT J Address 1213 DONEGAL PL Phone: COSTA MESA,CA Zip: 92626 Contractor: COAST ROOFING Address: 21681 IMPALA LN Phone: 714-968-8754 HUNTINGTON BEACH,CA Zip: 92646 License: 450393 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF COMP ROOF,COVER EXISTING SHEATHING WITH FELT AND 30 YEAR COMP SHINGLES.INCLUDES ATTACHED GARAGE. FEE SUMMARY Plan Check: $0.00 Calc Valuation: 32,890.00 Permit: $83.25 Claim Valuation: 32,890.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 PLANNING 8 ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 00.0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92.28,$ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned for a 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 end final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS 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 pertormanca of the wo ICdI this admit H Issu o� II ! have and a nett(workers'mnpe on insur$ce,as required by on 3700 of the Labor Code,for the performance of the work for which this permit Is issued. \ My works sur canieLantlaoliernumber are: Carrier: J _ / , \j J U/Y'• k Policy Number: / ) + ?/0j 2 0-,� his section rte of be completed i!the permit is valued t one hundreddollars($100)or less.) l ❑ I certify that in the pedormanc: " e work for which this permit is issuedrJ shall not employ any person in any manner so as to become sublett to the workers' compensation laws of Caine, - : d agree that if I yauId become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these provisio', v "' I Applicant Signature: x -yZG'� Date: r i! I -7Th WARNING:FAILURE TO SECUR WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLpeE(5100,0110),IN ADDMON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license• •:r 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.a !-� ^� � Class a Contractors Signature: 4Ar/'C .Y� Date: CONSTRUCTION LENDING AGENCY: O 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: Lenders 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(5500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure 15 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 sate.II,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 did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(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 contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers 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 We(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,falsework,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,California Administrative Code). O 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? G Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Businoss 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 feel 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? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre 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 D 1s or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? 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 Flre 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 California Health and Safety Code been fully complied with? ❑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 a plication aggermit for such construction or modification ast from the South CoAir Quality Management District or from any other air pollution control district or agency? Li Yes LJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). _ ___. _ 6 Will any part of the facility to bee constructed under this permit be within 100000feet 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 II 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 penalty 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 end city ordinances relating to building construction,end authorize representatives of 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. cr' L Ofgal Owne-(s1 And/or Authorized Applicant Date LODE I lU$pt fl2tf EA PAIL EMU LODE! INSPECTION TYPE PATE IDEAL$ 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final7 - 208 Final Plumbing O 200 Final Re-Roof L%9'D4 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Flre Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy mass: 1213 DONEGAL PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NU: d UiVbbl TACOMPANY: `S NAME: MC CORNICE, GRANT J ADDRESS: MC CORNICE PATRICIA A PERMIT NO: B 059661 PLAN CHECK NO: 04158 92 S GOVT: N SUPP: N se 1213 DONEGAL PL COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: NEW ENGINEER: REG.NO.: JOB DESCRIPTION : 390SF OF' PATIOCOVERSQFT: 790ADDRESS: UNIT: CLAIM VALUE: 5, 000 , 00 CALC—VALUE: 6, 172 , 00 GROUP OCC: R-3 /ERMITTEE: GARY GORDON ( 714 )964-0490ADDRESS: 10164 CLEAR RIVER CT CO[4M 'N;fS•:. 390SF W"DOD DECK. bNDER PATIO FOUNTAIN VALLEY CA 92708 **XX, XtX******x•** E'*x.XXX,X,'X XX*XXIE****X X*****'X****'X... xTEK•>ENTEx****xx*****#*XXX**XX/ --"- D CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of C 9(commencing with Section Z O N I N. G REQUIREMENT' S Division 3 of the Business and Professions Code.and my license is in full force and elle, S E TBACKS .: STATE LAC.: 4s 0 016 3 CLASS:IQ-7Z— �Z Signature: / / a�� MAIN BUILDING ACCESSORY BUILDING !' FRNT: FT IN REAR: 22 FT IN FRNT; FT IN REAR; FT IN S'COMPENSATIION DE LARATIDN: I hereby dm that l have etificate of consent to se -insure or a certificate of Workers' LEFT: 22 FT IN RGHT: 29 FT IN LEFT; FT IN RGHT; FT IN ation Insurance.or a certified copy thereof(Section 3800.Lab C)O.: EXP.DATE:NY: PARKING REQ. PROV: PARCEL: 14104631 ZNE: R1 REF NO; '7 Cenieiedcopy ishereby furnished. ❑ Certdiedcopy¢filed with the city Building Division. PLANNING fuTES> 390 SQ. FT, PATIO COVER ATTACHED TO REAR OF EXISTING , > SFR, Date: Applicant: ******************** ********************************************#************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the perm r one hundred($too)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit sued,I shall not empl•y i perso . y manner so as to become / subject to the Workers'Compensation Laws of California. ,r , (� ZONING APPROVED BY t A ) � DATE: (D ZL / S Date:I q.—Z rL Signature: ` y Ay T I " n NOTICE:If,after making this declaration.you shoo become subje4. I e Wor ers'Compensa ion provisions of the Labor BUILDING APPROVED BY : C.\V DATE: V 'It/et L Code,you must forthwith comply with such provisions or this per hall be deemed revoked. ��s '.7T CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: f A,(rV l DATE: Co t LL ici U which this permit is issued(Section 3097.Civ.C). ********************************sr*********ieti-It**it*******fe***1E#******frit Rxxx#x *** LENDER: **************************************************************************X**** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESt GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 90. 00 6 2 repair any structure,prior to its issuance.also requires the applicant for such permit to fife a signed statement that he/she is licensedSNIP/NON:—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN S B . 5 0 and Professions Cade)or that he/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). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 90. 62 0 . 00 e.' 58 . 50 149 , 12 149 , 12 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If.however the building or REVENUE DIVISION TOTALS--> COLLECTED• 149 , 12 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG 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 90 , 0 0 • 6 2 58 . 50 ❑ 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 ***********************************************aE******************************* that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L FEE BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTION '. UNIT COST TOTAL COST Date: owner: SFR 390 RES—PATIO COVER—POST & TRELLIS 14 . 80 5, 772 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 400 STRUCTURAL BY VALUE PER $1 , 00 1 • 00 400 .00 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 END' OF FES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from E P I E l (hese provisions. IncorrlpI:,•' : r:ee. 44 TT Date: Applicant: �Af w 1, I hereby certify that I have read this application and state that the above information is correct.I agree to with all city and county `•t470:47.7.•::f,�1nx►�� `; ordinances and stale laws relating to building construction and hereby authorize representatives of this city to ,n the above-mentioned a • •..x....:s>se property for inspection purposes..L, �'� � _ . - _. . ._ Y Date: IC `Z.2-41 l-- Signatur i M ���_ J a � / Driver's License or Social Security a: `, _ 1641.46 Whne—Building:Green—Code Enforcement:Canary—Aeolic t:Pink—Revenue:Goldenrod—Assessor . ' . ..J.RUCTION AND PLANNING POOL PA WAPPF4VALS 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final , 13. Roof Drains 64. Plumbing System - Final 1 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 3Oil :- 25. Roof Sheathing 74. Overhead Hydro t. 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation ' 78. FIRE PREV. FINAL • 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION 32. Electrical Power Meter-Final I j 80. FOOD CERTIFICATE ISSUED N 33. Final Electric Notes: 34. Final Heating& Air Conditioning i j 10 - /Z - 77. s....-1- kos....` € le 35. Final Gas Pipe-Test L _ I /COL KKP e_ F!r - 6e_, 36. Hood or Canopy 1 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backf low.Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47'. FINAL STRUCTURE & BUILDING tQ_/y_R3 G <eV- 5t....elict_ a*, 0k_ J�•D 48. FINAL PLANNING i T�• 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 PER IT NO. TRACT NO. LOT NO. BLDG.NO. - " CONSTRUCTION PERMIT / —aSL6 / - I Pro'ect A d q is 1.185 ! as 7,.00 ' T • 1 r'/sty S}3�Re' JJp AL -� �!((j TYPE OF CONSTRUCTfON - - - Owne ivy v 41 7nrC/.d- Phone ❑aNEW 0 ADD 0 ALTERATION •%{, Address 0 REPAIR 0 CONVERSION- ❑DEMOLISH Li ZONING REGULATIONS Arch/Eng. • " -License No.- ❑ OTHER lVO • _ _ DESCRIPTION OF WORK A.P. * . ' Address . • I ZONE PLNG. REF.-*. - ' c' Contractor,AsAFAC,_„ .6'7-e , - Ph6neO7f It?f TYPE OF PERMIT BUILDING TO BUI LDI NG f , {, SETBACK CAL ST, PROPERTY LINE • Address wfi2�' se .r centn,e/Lh �fjvp,eea'. ❑ GRADING 0. FOUNDATION- 0 STRUCTURAL SIDFET YARD ' N. LICENSED 'CONTRACTOR DECLARATION -- - --- - _ 0 TENANT 0 ELECTRICAL DPLUMBING DMECHANICAL SIDE YARD , I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT , mencing with'section 7000)-of 'Division -3 or the-'Business and -❑ OTHER -- -- - - Professions Code, and my license is In full force and effect. REAR YARD(TO P/L) , .I• I - PROJECT DESCRIPTION LicenseClass - Licens or?,A 692 a 1 ' PKG.SPACE REQ. PROVIDED., Date "`7'p71--- Signature WORKERS'COMPEN$ATIOND A I ,STREET WIDTH ON -- -' - - OCCUPANCV_CONSTRVCTION TYPE • ,PARK FEE,$ . .1 hereby affirm that I nave a c ifs a of cons nt to self-insure dnaVALUATION • - ZONE ,ZONI NG APPROVED BY DATE, 1 certificate of Workers' Compensation Insurance, or a'certified copy' • the reof(Section 3800, Lab.CJ. GRADING`C U.YDS. _ ACRES_ SPECIAL CONDITIONS: pn,,y No. Company .. . F ertifietl copy Is hereby furnished.- - -- - - ---- .REMARKS: - • I- n '''• .-•- -- - - " LJ Certified c_opy,is filed with the city Building Division. ' - _ , • • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION r _ - - - - - - (This-section need not be completed-if the permit-is•for.one-hundred ._... _ .. _ _ -- - -� j ($100) or less). I ' . " -' • 4 - - I-certify-that-In the performance-of the work for which this permit Is _ ._ ,__ _ issued, shall not employ any person In any manner so asito become PLUMBING,`. .I i- N PLACHECK I ELECTRICAL PLAN CHECK ' subject to-the Workers Compensation Laws of California. - - - - UW tLLING GA NAGE - - -- Date Signature 1 BATHTUBS • SHOWERS • SQ FT SO FT - - .. NOTICE: If after making this declaration, you should become'subject TOILETS u" ;URINALS • ;GENERATOR 0-1 KW_110 KW l 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 0-1 14P_1-10 FiP I.hereby affirm that there Is a.construction lending agency for the per- SERVICE SINKS ' , - SUMPS ''(INC.SOLAR) -10-50 HP_50'+ HIP -- formance of the work'forwhich 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 -._ ' .•I- - - - -- OWNER BUILDER DECLARATION - POLE LIGHTS _ - I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS . , , • the following reason (Section 7031.5 Business and 'Professions Code: SWIMMING POOL P TRAP - - LUNSI RUL I ION - - - - - - - _ _ . . Any. city, or county,which. requires a permit to construct, alter, (POLES METERED 'SUB + improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION (PANELS MAIN f SUB.- - - quires the,apOicant for such permit to file a signedstatementthat he •_ _ _ ' Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS _SERVICE - -- (Chapter. (Chapter__9 (commencing with Section is ejc of Division 3 of the _ B^sinefo and allege Professions Code) or that he is exempt therefrom and the by WgTER HEATERS BTU OUTPUT. \ • r - ^ - - -" „-, - for the alleged exemption. Any violation of Section 7031.5 by - __ _'_ _ _ __ _ _ ...applicant for a permit sublects the applicant`to-a civil penalty SEWER CONNECTIONS - - - "" .ot more than five,hundred dollars ($500). _ _ _ - _ - I.•' ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK • COLLECTORS - - r• sole-Compensation;will-do-the•work,.and the-structure is-not intended _ _ • or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE - - - Contractor's-License.Law does-not apply to an owner of a property l - - APPLICATION"APPROV ED'BV -- -' DATE--�", • who builds or improves thereon, and who does such work himself or ISSUE FEE , through his own employees, provided-that such-improvements are not - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK I SUMMARY OF-FEES,. (v. 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). HEATING SYSTEM 0_100,000 BTU ✓ i 'BUILDING " _. _ _ .(PERMIT, - __ $ - ❑ I, as owner-of the-property, am exclusively-contracting-'with - _ AND DUCTING I ' licensed essions tors : Contractor's-License the to s-Licet (Section 7044, Buslyess 100,000 + BTU y ,a0 'PLAN CHECK $ ISSUANCE- r - and Professions Code: The build ctor's'provese Law tloes not apply-to "' -' - - - - '- ISSUANCE- $ - - - an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU I ,PLUMBING $ • .ir,-+ tracts from-such projects-with a contractor(s) Ilcesned-pursuant-to 'SYSTEM - - --' -� -' 1- - - - - -- -- the Contractor's License Law). -1-00-,00-0!+BTU (PLAN CHECK $ - I _ -, "- ❑ l am exempt under Section • B.& P.C.for this - ELECTRICAL $ $ BOILERS BTU -i _ __MICROFILM S. - I • ..- - --_ - _ _. _SYSTEM REPAIR,ALTERATION PLAN CHECK $- - �y •OO - , 'MECHANICAL $ /. TOTAL FEE$ I hereby certify that I have reed.this application and statethat the above EXHAUST SYSTEM MULTIPLE _ L • ESS AD- information is correct. I agree to comply with all city and county - 4PLAN`CHECK $, _ ' - VANCE PC $_ ortl inances.a ntl state laws relating to construction,and hereby.authorize .. i .. - -.- - - ' re sentatives of this city to enter upon the above mentioned - „x /erty tor. e I n rposes�. )� _ - FINAL FEE $ (/ �� attire �R-x/C�}'/ Date r'��t-it V .S -. _ • - _ _ Drivers'License or SS# ySAr. -ISSUE FEE" J; ,� �® CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor . CONSTRUCTION AND PLANNING q POOL& SPA - APPROVALS Permit # mAYlel Date Inspector APPROVALS _ Permit# Date Inspector 1. Temporary Electrical Service or Pole -43. Pool & Equipment Location -- - - . _ 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - - . 3. _Electrical Conduit Utility-Undrgrn i 45. Forms _ 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . 5. Steel Reinforce r 47. Rough Plumbing & Pressure Test. _ . . _ . 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE • - _ _ 7. Footings 49. Electrical Conduit-Undrgrn , . ' 8.- Foundation _ ____ M: 50. . Gas Pipe, ❑Undrqrn,Test 9. Water Pipe-Undrgrn 1 51. Backwash Lines, P-Trap, 0 Undrorn: ' - - -- 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 i ., - ' i''''-- -.55 Plumbing System - Final' - - - - ,< 14. Rough Electric-Conduit . .- - 56. - •Electrical-Final ." . . . 15. Rough Electric-Wiring . . . - . _. _ 57.- Solar System-Final • v . , . - c - "' t - 16. Rough Heating & Air Conditioning = _ e - 58._ •Fencing &Access Approval 1 17: Ducts, in Structure - l ••• 59. APPROVED FOR PLASTERING , 18.. Ducts, Ventilating • . ' _ i • _ - 19. Gas Pipe-Rough &Test • _ _ . • 60. POO L/SPA SYSTEMS FINAL • 20: Roof Framing. s _ ' - • 21. Roof Sheathing ._. - . . - ' . ' 22. . Frame and-Flashing - -. ' ' - ..t. NOTES: 7772 e ...//r2.-� 23.. Insulation . . ' . _' - _- - - • 24. Lathing & Siding - - ' .l ,_ _ _ _ ' • . ' _ . _ . ._ _ . .. i , 25. Drywall Nailing _ - . . ' - l 26: Plaster.Brown Coat - • - ; . - . . , 27. Electrical Power Meter-Final 1 I 28. Final Electric _ _ • . . - _ 29. Final Heating & Air Conditioning ,__, �-' ?-42Z � _ - ' 30. Final Gas Pipe-Test - _ . .. , 31: Final Plumbing I - - - ._ ..- 32! _Water Service-Final . _. . . . . __ . • . • 33. Gas Service-Final --.. _ + _ . . ' • 34. Solar Domestic-Final - • ' . • . . _ ' , ' ' ii 35. •Landscape Sprinkling System •. ' ' ' - 36. Sound Attenuation . i . •' - • - • 37. Handicap Regulations + I . . _ • . . - . . - . 38. FINAL STRUCTURE & BUILDING - - . . . ' 39. Special Requirements Completed _. - - . 40. Electric Release to Edison- I - - _ - .41. Gas Release to Southern California Gas Co. ' - • . . - 42. CERTIFICATE OF OCCUPANCY _ . - Date - - • • I .. OWNER COLLEGE-)ESA COMPANY DATE 10-11-56 JOB ADDRESS 1213 Donegal Place BUILDING PERMIT NO. #3836 GENERAL CONTRACTOR The Hale Co. _ VALUE $ 10,248.00 LOT 180 BLOCK TRACT 2671 Single dwelling w/att. gar. UP I & J TYPE V ZONE Rh FIRE DISTRICT66 INSPECTIONS DATE SUBCONTRACTOR PERM IT91 SUED DATE NUMBER — Footing Trench - /0-"t9-,ft Foundation Forms and Grade to Gera,e 1/ - ,S 1%1 Rough Framing �--1;_ itaL Plumbing,Rough to Slab�W. 9.Vis— „ S'. "4.__ +-1 ie AO-3U-s..4 7a-fj !// Plumbing, Rough Complete »7C-S - 6-S-L / Temporary Pole jamC,,,,/ - / �/ Wiring, Rough ' /2 a-6. /moi.-____ _ It _ . to .3632 t...— Heating, Rough 40 ' a-18.56 H sting, Final AIN s • -23- -5-7 ,c1c�Ge.,,-- /'(LX {}' /9- 2- "/-� <` ✓ 5 Sewer, House Sewer,St. s - - y.S . (9 St,L( 1 / : 6 (0 7 7 7 Septic Tank or Cesspool Vv L �J ) PlaLatstering Outn &4-' 7 Plastering v 2^' f bing,Final,Fixtures Complete/VMS 5=$$S7 Pmmbing,Final Gas Test/S MttS S/ N ` " , )t 4./..-"Wiring,Final MAY 2 8 40,-....- y / ' _ Occupancy Adhk5 6- o-Sj in.2,n 1m ,n..., - co1R 1A ' Costa Mesa Building Department APPLICATION IOU i'tiltiVlIT ' P. O. Box317 BUILDING -�. "COSTA MESA, CALIFORNIA ' FOR OFFICE USE ONLY 7 FOR APPLICANT TO FILL IN Receipt No. Permit No. Building Address 1213 Donegal Place ,-,1-rJ'37 Received by Date Recd. Date Issued Costa Mesa, California Nearest ' /4 -id -a Ay "//-SZ Cross st. Loren Lane ' Building Address Owner College Mesa Company Costa Mesa, California Mail Address 1777 W. Lincoln Avenue Nearest Tel. Cross St. City Anaheim No.KEY 3-3161 ZoneNo.of Type ' - Grouy Architect or Lic. I I /Plans �,/ d� Engineer Davis & Quigley No. C-1790 Approved by Date AlMdress43 Malaga Cove Plaza,Palos Verdes CORRECTIONS City Lie. ;,^: tractor The Hale Company No. 3422 Address 1777 W. Lincoln Ave. , Anaheim - - Legal I Lot I _ Description I No. 180 1 Block t Tract2671 (Attach Metes and Bounds) Size of Lot 64 x 120 1NN onBldgLots. None 0 Use of I No.of I No.of S Existing Bldg. Families Roomst yr Setback Line from Rear Yard 49.4 Center of Street 50 Side Yard 6/7 > DESCRIPTION OF WORK . New I X I Alteration I I Addition I o Repair I I Moving I I Demolish I ca —.4 Building No.of I—+ Size 1181 Rooms 5 Stories 1 'a +rior WallStUCCO I Roof ering Covering Rock _ APPROVALS 1 Use of New Foundation Location Inspector - Date Building Single family dwelling with Forms,Materials, attached garage. Under-Pinning w Frame: Fire Stops, .0 Bracing,Bolts __ I hereby acknowledge that I have read this Application c 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 HE HALE CO t Permittee '; Plaster, Int Authorized Agt. , • r ' Plaster,Ext 0. . LI Valuation Permit Fee $26.00 Masonry Reinforced O. Plan Check $ 13.00 Bond Beam $ 10,248.00 Total o Fee $39.00 FINAL CD `\FORM 204 10.55 0.P.4 S. o • i. 0 j C a J a� a a 2 • a • Street i. PLOT PLAN Show location and distances from rproperty line and between buildings. �—i c - %.,i9 Cl. 0 IA • r " O • , w ,, , .. f 11 , . . V141 Alt 1.1M, 1;. L. y^«'' S .Li JOB ADDRESS 1213 Donegal Place BUILDING PERMIT NO. 28302 GENERAL CONTRACTOR Costa Mesa Lumber DESCRIPTION OF WORK Add FamilyRoom to Res. 'q 4AP No.141-046-19 LOT 180 TRACT 2671 FIRE ZONE VALUE $ 6,000.00 INSPECTIONS Signature Date GROUP I TYPE V ZONE R-1 ``�� SUBCONTRACTORPERMITS ISSUED I Date I Number I Signature Water Plumbing Rough Plumbing Prop. Swr..Line 0 House Con.0 Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power • Rough Wiring re fa 2DMF Heating and Vent. _ Trenches 10 Forms 0 Steel Reinf. 0 la •-vi- 6 b% Floor Systetn 40- g-ag-at Bond Beam 0 Steel Reinforce 0 ,IQ,A Sheathing 69t' 17-v—et Frame and Flashing 4(.-17..pj- Lathing—In g0 Out ® M 4-At.-cc" Plaster, Brown Coat ,T-i-bP Structural, Final Electric i F '`ng, Vent., Refrig. and A.C., Final , i`.' , —d-t-aW1 jair.f1�'�1� 1 oing, Final and Gas Test 0 Electric, Final `f/SLS'V Building, Final 10-1/%(o Si • 28302 e1tzu�,, COSTA MESA BUILDING-SAFETY DEPARTMENT IL$3113Oa* 330* ****3130 P.O.BOX 317 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUIDING For Office Use Only ADDRESS 10-13 C�NCGAL- FL_ RECEIPT NO. P Iy }�COSTATMESA. CALIFORNIA AST(} ,C(q /p,A(�// gALpC '7 /d OWNER F iY�L-G Tv \I L.,' Rete. t J'f�✓�V{!i0 /'1'E�J MAIL eey' BUILDING ADDRESS \ Vl Poo I4- �Lt ADDRESS FIRE CITY ` //��_._‘ , l i TEL. NO. ZONE TYPE GROUP Maj� APPROVED CS" I, ARCHITECT -' - TEL. BY 1 ATE 111 OR^'GINEER Ir9. �� NING / /sf ADL..e$$ /� �O ZO [ ( I NO.OF I BUILDING CONTRACTOR M) ADDRESS , `00 �U y-L.0 2 Pt c pEsc !%r / v 1..1C)-6 '7J URITON / CITY .�v` 1 A.P.NO. itl/ - bl!C - / ]T�--I I NOTE: NO EAVE OVERHANG SHALL BE LESS THAN SIC. STATED. NO. Dq'g IL^(n 1 30'TO SIDE B REAR P.L. EAVES SIZE (.0OF LOT 1. l 1!fl�e I NOW ON LOT 1, ALLOWED (U.B.C.REQUIREMENT) /� USE OF � YARDS APPROVED YARDS APPROVED EXISTING BLDG. 1/ LN'� �(D F'O'��_1 MAIN BUILDING ACCESSORY BUILDING y-. -IS.. � /FROM C/L STazETA SETBACK LINE FRONT ..•)ITT LI �1 ( rr. CENTER OF STREET REAR YARD t// 1 R.SIDE o FT. FT. SIDE YARD I LEFT G I RIGHT R ....-- DESCRIPTION OF WORK L.SIDE n 5 FT. F J REAR ) PT. FT. NE" ALTERATION ADDITION n DISTANCE BET. BET.MAIN S MAIN BLDGS. ACCESS.BLDGS. REPAIR MOVING DEMOLISH VAR.# DATE BUILDING �/ NO.OF `1 SIZE I /�rl`� ,IyR�OOMS i ,STORIES_^ f C.U.P.# j APPROVED/ COVERINGEXTERIOR WALL�IJCC.L{/COVERING FLeCiL BYPROVED l ' �,A / /3 // USE OF BUILDING AND WORK TO BE PERFORMED /vVv DATE j b -Pita) 9-P.ml t.:/ earn I. SQ.FT. D I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 0 PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION w BUILDING CONSTRUCTION. D r o 0 SIGNATURE OF i�M• Oyyfe�.� �_ .__1�. PERMIT FEE $ S PERMITTEF Vrl st+ T I�o(a V "Y�'W �- 1 (� !i •� 00° PLAN CHECK $ /0"S6 0re AUTHORIZED AGENT 1Q/'V1.s_LS'/V^'OLASL“j_ �J I ca 4 TOTAL FEE $ cJ! L!