HomeMy WebLinkAbout1064 EL CAMINO DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address: 1064 EL CAMINO DR
Suite:
Vicinity:
Parcel Number: 14162204 Zoning:
Applicant: GRELLA, GERARDO
Address: 1064 EL CAMINO DR
-.Phone. 714-754-4536 -
COSTA MESA(CA - - Zip: 92626
Owner: GRELLA; GERARDO `
Address 1064 EL CAMINO DR
COSTA MESA, CA'
Contractor:
,Address: -'
Zip:
r Arch
j Address:
Phone:
Zip: - License:
MAXIMUM).
Phone: -
Zip: 92626
Phone:
License:.
Status:
ISSUED
Applied:
11/20/2000
Issued:
08/01/2001
ISSUED BY:
Eng: GLENN ALMQUIST
Address: 1303 AVOCADO
255' '_ Phone: 949-644-8725
NB, CA _ •"
92660 License: 2353
SCOPE OF PI
i CONSTRUCT 300 SQ. FT. ONE CARGARAGEATTACHLD TO EXIST.:
Plan Check:
$108.71
Permit:
$167.25
SMIP Res:
$0.86
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$276.82
SETBACKS,
7T. GARAGE (700 SQ. FT GARAGE SIZE
FEE SUMMARY.
— --- - - Calc Valuation:
Claim Valuation: ;
- ; PLANNING & ZONING
MAIN STRUCTURE Front -21'0 Rear 42-0
ACCESSORY Front 0- 0 Rear 0-0 .
PARKING Existing: ' 21 - Required: 2
NOTES:
Left 5-0
Left 0-0 .
Proposed: 3
Right 5-0 ,
Right.`" 0-0,-:
$8,595.00;
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cafifbmia 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 iftviork 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) 7545626
2446-46(600)
DECLARAhONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of Consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued. w
❑ 1 have and will maintain workers' compensation Insurance, ss required by 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 number are:
Cartier: Policy Number:
(This section need not be completed i/ the permit is valued at one hundred dollars ($100) or less.)
❑ 1 ceNty that in the performance of the work for which this permit Is issued, 1 shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (5100,OD0), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37O6 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. 4 Class N
Contractoes Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 1 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).
Lenders Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under.penally of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons
Code: Any city or bouhry_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 tieyorrshe is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 01 the
Business and Professions Cade) 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 per fi
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
�-.rr;l
❑ I, as owner of the property, or my empldyees 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 Cod( :_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 hia,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"llie 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 tip to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license p rs nt a Contractors License .1.
m u r sec. Business and Professions Code for this reason:
lure:
v ed by tlriver•s license. es ❑ No Drive e Expires:
Vedficatlo Ownership by (type of ument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 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 6, 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 e
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 WIII the applicant or present or future building occupant need to file and cartity a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ 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 anyone time during areported 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 fila a registration form for acutely hazardous materiels? ❑Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some excetions, 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 o1
compressed gas at standard temperature and pressure).
3 Does or will the
❑ Yes [:1No ;To
or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
(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 en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
...................................................... ....................................... ... ..............................._....... ........................................................................... _._...._....................................... __...................._..............._......... .................. _....................... _.............
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aemit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes B No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
...........
............................................................_............................___......................................_...____.....___.........................................._..__......................................................................................................_........................ -...........................
6 WIII any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
.........._......... ................................................................................................................................................................................................................. ...................... ... ................................. ................ I..............
7 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? ❑ Yes ❑ No
8 (If yes', attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: 1 cortity 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 stale that the information given is
correct. I agree to comply with ell to ws and city ordinances re tin building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for' ti urposes. I teen Ilow occupancy of any building authorized by this per final in tion.
�-!-ml
gnature a LOwne ate
Arl Authorized Applicant Date
CODE r. INSPECTION TYPE - gAIE INITIALS CODE# INSPECTION TYPE INTMALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical
201 Final Bloclr/Retaining Well 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
(714) 754-5273 • Fax (714) 754-4856 BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 1064 EL CAMINO DR Status: ISSUED
Suite: Applied: 05/18/2000
Vicinity: HOUSE & ATTACHED GARAGE Issued: 05/18/2000
Parcel Number: 14162204 Zoning:
Applicant: GRELLA, GERARDO ISSUED BY:
Address: 1064 EL CAMINO DR
Phone: (714)754-4536
Zip: License: 0
Arch Eng:
Address: Address:
COSTA MESA, CA
Zip:
92626
Owner:
GRELLA, GERARDO
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE & ATTACHED GARAGE (28 SO). TEAR OFF EXISTING WOOD SHINGLES
Address
1064 EL CAMINO DR
FEE SUMMARY
Plan Check:
Phone:
(714)754-4536
$97.25 Claim Valuation: $4,000.00
COSTA MESA, CA
Zip:
92626
Contractor:
OWNER -BUILDER
$0.00
Inspection:
Address:
Phone:
Zip: License: 0
Arch Eng:
Address: Address:
Total: $97.75
SETBACKS
Phone: Phone:
Zip:
License: License:
ACCESSORY Front 0-0
Rear 0-0
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE & ATTACHED GARAGE (28 SO). TEAR OFF EXISTING WOOD SHINGLES
& RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 1 LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH
'PRESIDENTIAL" 25 YEAR COMPOSITION SHINGLES.
FEE SUMMARY
Plan Check:
$0.00 Calc Valuation: $4,000.00
Permit:
$97.25 Claim Valuation: $4,000.00
SMIP Res:
$0.50
SMIP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total: $97.75
SETBACKS
MAIN STRUCTURE Front 0-0
Rear 0-0
ACCESSORY Front 0-0
Rear 0-0
PARKING Existing: 0
Required: 0
NOTES:
PLANNING & ZONING
Left 0-0 Right 0-0
Left 0-0 Right 0-0
Proposed: 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
AOL
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 performance of the
work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued.
My workers' compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this pernit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (S100.000). IN ADDITION 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 licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
force and effect. Lic. # Class #
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders 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 ($500).):
❑
],Bs 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. It, 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 pursua o the Contractors License Laws.).
❑ I am axemp sec. Business and Professions Code for this reason:
Signature: + Date: , – – 00
erlD veli' by drivers license. Yes ❑ No DFivars Liconse No: �' ��
Verification f wnership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 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 6, 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? ❑ Yes ❑ 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 t0 file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, Or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ 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 a.Lemit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 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 ❑ No
(II yes", the facility must meet the requirement Of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all Of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8 (If yes", attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I cenify 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 ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agreato comply with all state laws and civ ances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
eboved c 6 (1 arty for ins tion p ses. not to Occupy or allow occupancy of any building authorized by this permit ugtil final inspection.
� S-/ Zo 0
Signature Legal Owner(s)
And/OrLAuthorized Applicant Date
CODE I, INSPECTION TYPE DATE INTMALS CODE INSPECTION TYPE DAM INTmALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof CL7-re 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
264646
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations
C?/ OF COSTA MESA -
PERMIT NO.
TRACT NO.
LOT NO.
BLDG. NO.-
- - - - - - '
-dONSTRUCT,ION PERMIT
— S y
5368 9!08/83 7.00 TL
'
/
Project Address 1'06V' ?2. 1-1'
Applicant's Mailing gAddress .�Z �^•, /9!p S^T`
Owner's Name - /',cBf%2 Cz _[��-Q/Z Phone' k_`lC'S_Z
Address �OG�! /i<.�t(/V,O. -
TYPE OF CONSTRUCTION, U NEW LJ ADD LJ ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK P 4
w U o
A.P. # - - Zone.
S
.
Main Building: Accessory Building:
Z
TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL -
❑ TENANT ❑ELECTRICAL - PLUMBING; ❑,MECH ANICAL
o "OTHER •. - -
PROJECT DESCRIPTION 5G. FT. � _ - OCCUPANCY
,.CON STRUCTION TYPE ' -1 VALUATION $
ZONE GRADING CU. YDS. ACRES
l _ _
E
T
-
Front
O
N
Arch/Eqg. License No.
r_0�a y� 1 .:
B
A
Rear - ,. - •-
N
Address -Y•:A,Js2$ �` GK_?/Z a-(
Contractor's Nam Phone I
Address (mai3<��T,.ry/Zys
I
1 -
City.License No.
C
Riglit -
O
K
,s
Left,E'
R
- -
Ping. Ret. # Park. Fees $ _
Q
U
Remarks: '
Parking Req./Provided
-
(�
LICENSED CONTRACTOR DECLARATION I
( �•
(commencing
Professions
With section 7000) of Division 3 of the Business and Professions Code, and
with bynaffirm that I am licensed under provisions and
rtiy license is in full rce nd effect. q
U ns Cl - �' Li se No. Y? 91 3 (<
Date Z`TL' Signature
WORKERS' COMPENSATION DECLARATION. ''
'•ereby affirm that I have a certificate of consent to selsure r a certificate
Workers"copy Insurance; or a certified copy thereof (Section
- J 1
Use of Building:
R
E'
PLUMBING
FEES
,
Planning Notes: .
M
E
Bar Sink
Showers'
-
I
N,
Backflow Preventer
-
Service Sink - -
T
S
Jo, Lab. C.) + / �,•-; f�+r/�
Policy No. 1 I Company-
❑ Certified copy is hereby furnished. I
Backflow Irrigation
Sewer Cap
";.i - l ELECTRICAL ) FEES
Bathtubs
Sewer Connection j
1
Automatic Washe7 Transformer 0 15-50 KW -
�Q Cer fj edglpY s filed with the city Builr�M�DiviSy+p
Date 7- `S • yJ il withtheant �G� '� •
_ 'El
Construction Pole Sub. 50+ KW 1
Clarifiers
Solar Collectors r
EXEMPTION FROM WORKERS' COM�P.TION�DECLARATION - -
(Thisseclion need not be completed if the permit is for one hundred ($100) or
Is ss). i I
I certify that in the performance of the work for wnicn this permlt islissued, I
Dishwasher--SOlar
Piping -
P g
-
Cooking Unit' n. -1 Meter Elup to 100,amps -
Drinkin Fountains
9
Solar Tank
Dishwasher `-17. •Meter ❑over 100 amps ' I
shall, not employ any person In any manner so -as to become subject tothe-
Workers' Compensation Laws of California. '
Date Signature �
-
Floor Drains' ISwimming
-
Pool w/Spa t
� - �
Dryers [:]Gas .OElectric Sub Panel !
-. �
�
NOTICE: If, omper making this declaration, you should become subject to the
must forthwith"-
Workers, Compensation provisions -of the Labor hall bei -you deemed
comply with such provisions -or this. -permit Shall be!tleemed revoketl-
CONSTRUCTION LENDING•-AGENCV - '.
Floor Sinks : _
- - -
Urinal _ t ! 1
;
..
Fan -_ _'-/• 1•V I Motors 00-1_HP 01Y2-8 �,
- -
Gas Service 'Outlets -Water
-' -
'Closet -
F.A.U. Ina Solar' 0915 HP 016-15+
-
'
Interceptors 1
P
Water Heater I
-
Fixtures 1 ' {
i Microwave
I hereby affirm that there i5 a construction lending agency for the performance
of the work for which' this permit is Issued (Section: 3097, Civ. C.)
Lender's Name; - = l
Lender's Address- - '
OWNER BUILDER DECLARATION T '- •` 1
I hereby affirm that I am exempt from the Contractor's License Caw for the
following reason (Section 7031:SBusiness and Professional Cotle:-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/she is licensed pursuant to the provisions of
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/she. is exempt
Kitchen Sink r'.
Water Service '•
Device Boxes , .Pole Light
'
Lavatories _ -
-' -
/S%7�j-�
t%
Outlets. Range - '
.Sign
_
P -Trap I
./y7j�Py - - '/�
6Q
Switches l '
Roof Drains
_ -,
Garbage Disposal Standing Sections
-
_
-
-
Generator 00-5 KW 05-15 KW ,Trash Compactor i
P
herefrom and the basis for the alleged exemption. Any violation of Section
,Reins etion Fee' '
Pa $25
Issue Fee
< $ 3
031.5 by any applicant for a permit. subjects Yhe�applicant to a civil
enalty of not more than five hundred dollars ($500). -
I,, as, owner of the' property or my Lenlployees with wages as their Sole
compensation, will do the work, and theLStructure is not intended or offered
RelnSpectlon Fee $25 ISSUE Fee $-3
- 'MECHANICAL
1 '^
FEES
PUBLIC SERVICES REQUIREMENTS: ' -
Zoning Approved By Date
Application Approved By Date p
Application Issued By r Date
•
for sale (Section 7044, Business and Professional Cotle:, The Contractor's
License Law does not apply to an owner of a property who builds or improves
thereon, and'who does such work himself/herself or through his or her own
employees, provided that such improvements are not intended or offered for ,
sale. If, however, the building or Improvement Is sold within one year of cam-
Mpletion, .the owner will have the burden of proving he/she did not build or im-
rove for the purpose of sale).
, as. owner of the property, am exclusively contracting with licensed con-
tractors to construct the project (Section 7044, Business and Professions Code:
The -Contractor's License Law ddoes not apply to an owner of -property who
builds or improves thereon,•and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law)_ r
ElI•am exempt under Section—,B. & P. C. for this reason
goiter 1 =
+
-
Hood or Type El'
Canopy 1 Type Il: ❑
Duct_ Under Ground t
Duct -Structural
-
Refrigeration •_
I System
00-100 000 BTU 0100,000 BTU
I
Duct - Ventilating
t SUMMARY OF FEES
'
BUILDING PERMIT $ SMIPI $
PLAN CHECK $ PERMIT
PLUMBING $ 'ISSUANCE $
PLAN CHECK $ ENERGY P.C. $ -
ELECTRICAL $ $
PLAN CHECK MICROFILM $
$ ;
MECHANICAL $ TOTAL FEE $
PLAN CHECK I $ i
Exhaust System 0 Multiple 01
System Repair/Alteration
Firepl/Fact. Bit. (CBO #
Date .Owner
I hereby certify that I have read this application and statethat the above
Information i5 correct. I -agree to comply with all city and bounty ordinances
and=state laws relati to building construction, and hereby authorize repre-
'sentatives of this it to'anter u n the above-mentioned (property for
inspection puipo O 3- 3
Signature Date �•�
Drivers' Licen a or 55
Heating System & Ducting
00-100,000 BTU 0100,000 BTUGRADING
'
-
-
I 1
Reinspection Fee -$25 Issue Fee $ 3
CMF 0865-46 rev. -7/83 ' White-- Building; Canary - Applicant; Pink - Accounting;
Goldenrod -'Assessor
CONSTRUCTION AND PLAWI
APPROVALS Permit # �J Date
Inspector
POOL ,;PA
'APPROVALS ,Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
-
52. Pool & Equipment. Location
2. Soil Pipe:Undrgrnd. •'
-
X53. Steel Reinforcement
3. Electrical -Conduit Utility-Undrgrnd..
-
.54. Forms
,•
4. Electrical Conduit-Undrgrrid. -
55. Electrical Bonding
-
` Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. -
r
-
57. APPROVAL TO COVER-GUNITE
•�
7. Footings'
r
58. Electrical Conduit-Uhdrgrnd.
-
8. Foundation °
-
59. Gas Pipe, O Undrgrnd..,,Test
9. Water* Pi pe-Undrgrnd. _
-
60. -Backwash Lines; P -Trap, O Undrgrnd.
10. Structural Floor System
61. APPROVAL.TO DECK'
11. Property Sewer Line & House Connection
e•
-
62. Backwash & Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final
13. Roof,Drains
64. Plumbing System -.Final
14. Rough Plumbing '
, 65. Electrical -Final
15. Rough Electrical -Conduit-
66. Solar System -Final - -
-
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68.'APPROVED FOR PLASTERING '
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19.* Rough Heating & Air Conditioning
FIRE DEPT'. REQUIREMENT
.APPROVALS Permit
20. Rough Factory Fireplace
21. Ducts, in Structure
• 70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping 0 Gas 'OOil
23' Gas Pipe -Rough & Test
72. Underground Flush -
24. Roof.Framing
73. UndergrndyStorage Tank OGas 0Oil
25. Roof Sheathing
-
74. Overhesd'Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
'
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding -,
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREV. FINAL
30. Drywall Nailing - ` �r
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
39. Water Service -Final '
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Prevdnter
,
43. Backflow Irrigation
--'
-
44. Landscape Irrigation System
'
45. Sound Attenuation'
.
r
46. Handicap Regulations'
47. FINAL STRUCTURE & BUILDING
_
48. Special Requirements Completed
49. Electric Release to Edison
- • -
- - -
- -
50. Gas Release to ,Southern California Gas Co
r
51. CERTIFICATE OF.00CUPANCY'
No. Date-
i
VIED
d Ib {.,
PLANNING DEPT.
/SUB ECCT,�T/OO BLDG. DEPT. REG. p
i40el" _ ATE- "2.17.," -
DIRECTOR OF PLANNING
r
A'pl;"
1 �
1)rb�
STRUCTURAL APPROVAL ONLY
ITS ARE REQUIRED
:OR ELECTRI'.AL, PLUP�MBi�IF_.,;
HEATING, VE'''1TIL )TING .AND
REFRIGER MON 'WORK
THIS NUiJi3ER
ALL INSPECTION REQUESTS
FOR 61}{LOtid 5 :; `_dE PEdSO vS ARE TO
BE EMPLOYED, WE SUGGEST THAT THE
STATE OF CALIFORNIA DIVISION OF
ADDITIONAL
APPROVE®
City of Cogp Mesa BuildingDept.
—/
BY._.�._.
-----._DATE.(�._�_Ze—
THESE PLANS MUST BE ON JOB AT ALL TIMES
MAKE NO CHANGES WITHOUT PRIOR APPROVAL
OF DEPT.
THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL
OF PLANS AND SPECIFRU
ICATIONS SHALL NOT BE CONSTED
'TO BE A PEMII1T FOR, OR AN APPCOVAL OF, ANY VIOLATION
OF ANY OF THE PROVISIO::S OF THIS CODE. NO PERMIT PRE.
SLIMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
°ROViSIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO
i M AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL.
\F(CATMNS
ISSUANCE OF A PERMIT BASED UPON PLANS AND
SPSHALL NOT PR(IVENT THE BUILDING OFFICIAL
REAFTER REQUIRING THE CORLYCTION OF ERRORS
INANS .AND SPECIFICATIONS OR FROM PREVENTING
?PERATIONS BEING CARRIED ON THEREUNDER WHEN
N DF THIS CODE OR OF ANY OTHER ORDINANCE
g <q •tiL5
C�/77=D f�iC fl..i;�17 'TIE"✓ : v`.T" /ti) Fti --
ia • (c)a)r-�:
�l
rcf i%G'
' PATIO COVER DETAIL 6/1/61
STATE—N----Y
SPACING SPAI
SIZE.
OVERHANG j'(;,' °� y 5 •,-
RAFTERS: �' °*J,
.r�. I.TH �---- SLOPED FOR DRAIN
_ - - —+-
4, ^/c
'- P EAM
ATE SIZE
3/16 X
Ls
Z POST -BEAM
f 1 1 \ CONNECTION
3/g'x S�Lags 32% —�
Predrill Ledger
Predrill Existing 'ADeep
JOIST HANGER
or other approved methods
of support . tie.
ALL LUMBER DOUGLAS FIR
CONS7RUCTlON' GRADE
L—POST
SS O� SHOW
SHOW LOCATION ON REVERSE SIDE,
DROP PATIO FLOOR
-�— SLOPE TO DRAI14
PUDDLED' SANDa FILL
Remove Gass And Weeds Down To Natural Grade-�
12 CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT
POST ANCHOR J_ U GALLONS PER SACK CEMENT.
For Pipe Post. Embed Provide 26 Go G.I. Flashing At Wood Floor Coy
Pips In Footing.
Provide Flange Or Weld Plate Screwed Or Bolted To Frame.
CONTINUOUS
LEDGER
TYPICAL JOIST ANCHOR
NOTE: USE REVERSE SIDE FOR PLOT PLAN,
NO I
FOR OPEN EGG CRATE
A tK_—
(-MAN
I _ NO 2
FOR SOLID SHEATHING.
ALUMINUM OR PLASTIC
SHINGLES OR BUILT UP
ROOF COVERING
ROOFING.
MAXIMUM SPAN
SIZE
SPACING
MAXIMUM SPAN
17' 0"
2x6
12%
15' i
1 6, 0"
2'x 6"
16'0/,
13' 3"
15' 0 "
2'x 6'
24%
10' I
.--I _�_«_.
0
2'x -4»__._
—._-I2%-
9, 11
II• 0'
2'x4'
16%
8' 8-
10' 0"
2x 4"
24%'
7, 1"
NOTE: FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO
WALLS ARE TO BE BUILT. USE NO.2 CHART ONLY.
WIDER RAFTER SIZE MAY BE INTERPOLATED FOR
SPACING ONLY.
FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO
WALLS ARE TO BE BUILT SUBMIT COMPLETE 14QUcLE
AND -ADDITION PLAMS
COSTA MESA BUILDING DEPT.
77 FAIR DRIVE
556-5273
—l3t'AM
\
ALL PCSTff -f—
/�4/L%L04P 771E7
TarAr� U-)
_
cr�oso>�
Pc j7 ` 13 CA 1A
1
CO rJ/�i EC i //0
Po57 �/
C�n7TiNffOJ;
1
I j
OWNER DILLMAN-BRUIyLL
JOB ADDRESS 1.46 F
DATE MAR 12 1963
BUILDING PERMIT NO.
VALUE
AP No. LOT ho TRACT qWP FIRE ZONE DESCRIPTION OF WORKh._„i<,. , /-++
INSPECTIONS Signature
DATE
GROUP H&j TYPE V ZONE _ _ 8$
SUBCONTRACTOR
PER
ZITS ISSUED
Gan
b-
DATE
NUMBER
Water
Rough Com. Ref rig. ❑ Air Cond. ❑
_
Rough Heating
' -j"1?
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. Iii St. Swr. ❑
Sprinkling System VA41v
�-'
_ /%! .
—O_
—
Construction Po e
Underground Power
17_
tough Wiring
Trenches ❑ Forms ❑ Steel Reinf. ❑
— a6
a
Floor System JY/
Bond Beam ❑ Steel Reinforce ❑
_
`,
Sheathing �M�2
Frame and Fl
Lathing — I ut
�
/�
_
Plaster, brown oat
_�3
P 'g. ❑ Air Cond. ❑ Final -
I -mg, Final
Plumbing Fixtures, Final
y-
-
/r
Final Gas Test
Electric Fixtures, Final
-/ -
Building, Final
- �)
OCCUPANCY
ruaM soa - cM — i 61
COSTA A BUILDING -SAFETY DEPARTMENT
P.O. 317 COSTA MESA, CALIFORNIA
NNNNNL
for Applicant to Fill In Completely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
N MAIL
STATE
LIC. NO. 207.
SIZE I
OF LOT
USE OF
EXISTING BLOC.
SETBACK LIN! FROM
EFT 51 I RIGHT 91
DESCRIPTION OF WORK
6' I GI TRRATIffN II AOOITIIIN
BUILDING 541x4116
RICCIFT NO.
11 RNO. OF
OOMS
RlCIIV[G OY
A/CY
--,,
��'I`
ExrERIOkS
COVERING WALL
S.tu C
1 COVOEI
USE OF BUILDING AND WORK TO BI
APPROVED'
ri
ZONING
garage.
Plan
5001!
/s
2
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.
SIGNATURE OF M......_ O_..T+t. ('-........
AUTHORIZED AGE TNT_ / ..
FEE RECEIVED
W I.PPLfS5CATIdN FOR PERMIT
FFN' Off ce- - ly
CITY by Luafh ITIERR
F
1
RICCIFT NO.
pFl NO./�
RlCIIV[G OY
A/CY
DATE ECBIV[D�
1 bb��lll�"1111
DATE I�UED/^
2 4 196
BUILDING
ADDRESS
FIRE
ZONE TYPE GROU
APPROVED'
BY DATE
ZONING
ZONENO.
OF
UBE OF NEW ISj :L am.
R 1
FLANS 2 -1BUILDING
LEGAL
DESCRIPTION Tnf, 17 Tract. 5023
A. P. NO. none
NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
SO" TO SIDE @ REAR P. L.
EAVES
ALLOWED (U. S. C. REQUIREMENT)
YARDSAPPROVED
YARDS APPROVED
MAIN BUILDING
ACCESSORY BUILDING
(FROMC REST)
FR NT FT.
FT.
R. BIDS. FT.1f
FT.
L. SIDE - FT.
-FT.
REAR FT.
FT.
DISTANCE BET. -
BET. MAIN @
MAIN BLDGS.
ACCESS. SLOGS.
VAR.#
DATE
C. .P.SF .
APPROVED
APPROVED
Y
DATE
Dwe' 2266
Garage .460 S.
, -
'SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
�f •� GO
PERMIT FEE
5
PLAN CHECK 5 0,9
$ 23,925.00
.m
TOTAL FEE
-
F
1
Ti
of
STA MESA BUILDING -SAFETY DEPARTMENT
O. BOX 1200 COSTA MESA, CALIFORNIA 92626
596E 9%28/78
APPLICATION FOR STRUCTURAL PERMIT
or Applicant to Fill in Completely —� Ink Only
RECEI4fyS
'G_
DATE RECEIVED D E D
L]
/Use
DDRESS /O6 zu elf lw
✓
ERMIT NO.
'WNER
A.P. NO.
MAIL
BUILDING •�
O
����++
ADDRESS 5,4,Pfly
ADDRES .
CITY CO 5r4 - G NO`t5''
TRA C LO
BLOCK
CONSTRUCTION
W
ADD I ALTER
R P
LENDER
BRANCH
OWNER
ADDRESS
VALUE
S $
ARCHITECT TEL.
OR ENGINEER N
,
FIRE
ADDRESS
ZONE VP GROUP 19
n
ONTRACTOR O,4A,42
f%/r
APPROVED
BY AW DATE
ADDRESS
ZON
NO. OF
PLA
USE OF N
BUILDIN
TEL.
CITY NO.Zj
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
(FROM C/L STREET)
SIZE NO. OF BLOGS.
OF LOT NOW ON LOT
FRONT FT.
USE OF
EXISTING BLDG.
R. SIDE FT.
FT.
_ /
Separate permits are :required for
L. SIDE FT.
FT.
/ 1/
electric, plumbing and heating work.
REAR FT.
FT.
USE OF BUILDING AND WO
DISTANCE BET.
BET. M NFL
MAIN BLDGS.
ACCESS. BLDGS.
VAR.* VAR.
DATE
ICY
APPROVED
APPROV
I hereby acknowledge that I have read this application and state
that the above Information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
1 hereby certify that I am properly licensed as a contractor under
SO. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
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 provi sio syf the State of CP {fornla Business
VALUATION
PERMIT FEE $ Q
and Professions Code, Divis n 3' Cha t 9.
A
PLAN CHECK $
Signature of
Permittee
TAX $
TOTAL PAID $
Authorized Agent