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HomeMy WebLinkAbout1144 EL CAMINO DR - Building Permits CITY OF COSTA MESA i, Ib` BUILDING DIVISION o - > • „„r ,1 DEVELOPMENT SERVICES DEPARTMENT PER NUMBER PERMIT 03-00881 4`beronano A`' (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1144 EL CAMINO DR Status: ISSUED Suite No Applied: 09/25/2003 Vicinity: - Issued:_ 09/25/2003 Parcel Nunmber: 14161211 Applicant STEVE SCHNIERER ISSUED BY: YAC/'/ Address: 2057 MANDARIN DR - - Phone: 714-557-7081 - - COSTA MESA;CA' ' - Zip'. 92626 . . , " - - - . Owner:% DUFFY, VICTORIA A . Address /1144 EL CAMINO , - Phone: - COSTA MESA,CA Zip: 92626-5529 - - Contractor: PREFERRED AIR CONDITIONING SERVICE CO. Address: 11 WRANGLER CT . -'Phone: (949)766-9500 ' .TRAB000 CANYON,CA Zip: 92677 • License: 750418 SCOPE OF PERMIT - , INSTALL 1 A/C UNIT,4 HP IN REAR YARD! - ' ELECTRICAL TO INCLUDE: 1 MOTOR TO 10 HP FEE SUMMARY Quantity - Quantity , ' ISSUE-FEE $23.50 Temp Dist System/Lighting ' $0.00 0,,- Temp service test $0.00 Busway/100 ft $0.00 0 .', • Res.a/c package $0.00 Standing Section New Res(1-2 units) $0.00 0 .' MisEElectrical.Equipment $0.00 --0 ' New Res(3+units)- " $0.00 0 ,4,- Transformers up to 1 kva/kw $0.00./ ',0 Pool/Spa v $0.00 0 - -up to 10 kva/kw $0.00 ;' 0 Lighting Fixts $0.00 . 0 - up to 50.kva/kw •: -- $0.00 ' 0 ' . Recept Outlets; . $0.00 0 up to 100 kva/kw' '- $0:00 0 Switches ' $0.00 ' 0 over 100 kva/kw $0.00 ' 0 Non Res Appl $0.00 0 Low Voltage Equipment ' "$0.00 0 , Res Appl $0.00 0 -Low Volt Wiring System/Ckt $0.00 v 0 - ' Service to 200a . $0.00 0 Misc.Conduit : $0.00 , 0, , Service to 1000a - , $0.00 0 Misc.Conductor $0.00.. 0-j . Service over 1000a $0.00 - 0 Circus(gen or ride) • . $0:00 ' -0- , Motors 0- Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $12.30 1 Christmas Tree Stand $0.00 ' 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 . 0 Other Electrical Fee , - . $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: 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 2446-46(WOO) DECLARATIONS ( -1 WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance 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.) !certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws o alifornia,any that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these . . Applicant Signature: / 7 f Date: q1 ZC /6 3 -WARNING:FAILURE T+SECURE W•-KERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),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 licensed under p ovisions 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.Lie.# Class# C Z C 3 C, Contractors Signature: Date: cr iS/03 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).): ❑ 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 properly,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 C No Drivers 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? ❑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 application aoermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes L-I 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 ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safely Code Section 42303 been made? ID Yes ❑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. j/��� �j/T/ And/OrA•th Legal Owniantc3/Z� Date Z'i�✓'rJT`/�//� And/Or Authorized ADPlicant DateSODE 6 INSPECTIONTYPE • PATE It♦TnAL3 CODEC INSPECTION TYPE PATE j 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 PoolSpa Final 205 Final Plumbing 200 Final Re-Roof 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 CITY OF COSTA MESA 44. t9 BUILDING DIVISION > , ,, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 41 j 2 i PERMIT ifi M03-00466 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1144 EL CAMINO DR Status: ISSUED Suite No Applied: 09/25/2003 Issued: 09/25/2003 Vicinity: Parcel Number: 14161211 40 ISSUED BY: r Applicant: STEVE SCHNIERER / ' Address: 2057 MANDARIN DR ' . Phone:. 714-557-7081 - COSTA MESA,CA ' Zip: 92626 Owner: DUFFY, VICTORIA A " Address: 1144 EL CAMINO /, Phone: COSTA MESA,CA Zip: 92626-5529 - " ' Contractor: PREFERRED AIR CONDITIONING SERVICE CO. Address: 11 WRANGLER CT _-Phone: (949)766-9500 - TRABUCO CANYON,CA • Zip: 92677 License:750418 - " SCOPE OF PERMIT , INSTALL 1 A/C UNIT,4 HP IN REAR YARD. - / MECHANICAL TO INCLUDE:ONE 3 TO 15 HP/500K BTU. . .. - FEE SUMMARY __Quantity _ _ - Quantity ISSUE FEE ' $23.50 . . Repair/Alt Absorbtion Unit c $0.00 0 Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit . $0:00 -0 Inst FAU>100 k BTU $0.00 0 Ventillation System / ' $0.00- 0 , , Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 , Inst/Rep.Recess Wall Htr $0.00 0 " Commercial Incinerator .$0.00- 0 Refrig Sys<100 k BTU .. $0.00 0 -...Domestic Incinerator Refrig Sys>100 k BTU $0.00 0 ` 'Compressors/Absorption Systems ' - Gas Piping $0.00 0 _ Up to 3 hp./_100 k BTU $0.00 ,, 0 ' Factory Fireplace $0.00 0 =. 3 To 15 hp/500 k BTU- ,, '' $0.00; 0/ Hood w/Mech Exhaust $0.001'-:0 • " 15 To 30 hp/1,000 k:BTl1 - ' $0.00' '0 VAV Box - - .$0.00 0 30 To 50 hp/1,750 k BTU ^ , ,." $0:00: 0 Vent Fan/Single Duct $0.00 - 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance , $0.00.. 0 ' Boilers - , Fire Dampers . $0.00 0 - - , Up to 3 hp _ - / $0.00 0 Smoke Dampers , $0.00 _-0 - 3 To 15 hp Inst or Relocate Appl Vent' $0.00 0 . 15 to 30 hp Air Handlers< 10000cfm H - $0.00 0 - 30 to 50 hp ' - $0.00 0 Air Handlers> 10000cfm $0.00 - 0 _ , '' Over 50 hp • , - $0.00 0 Floor Furnace ' $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0:00 0 . . Investigation Fee $0.00 Plan Check Fee- - _ $0.00 Reinspection Fee $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: 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 2446-46(WOO) DECLARATIONS (l ("1 WORKERS'COMPENSATION pECLARATION: i I hereby affirm under penalty of perjury onetof the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be.tomplefad if the permit is valued et one hundred dollars($100)or less.) , I certify that in the performance of the work for ,hich this permit is issued,I shall not employ any person in any manner s0 as to become subject to the workers' compensation laws• alifornia,an.41 roe ..r- •ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with lhes% � Aar / !-- Applicant Signature: de . int Date: �/�`7kY WARNING:FAILURE T•SECURE WO' ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($100,600),IN•r DITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F 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 Coneand rsSigLac.e__yQa�1d.�GLQ Date: GZO) Cab Contractor's Signature: Date: A/7 S/n3 J CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply t0 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 Drivers 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: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response t0 release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Secti0n 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 2ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑Yes IJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 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 Duality 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 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. a. f Legal Owner(s) D C;lzs b-5 And/Or Authorized Applicant ate - y00E I INSPECTION TYPE PAR INIti1AL4 QO12E1 INSPECIIONTYP[ t IIII.1: 1616 Fixed System Final Fire Prevention 206 Final Mechanical Z//r/" /.I 1266 Pod Spa Final 208 Final Plumbing 200 Final Re-Roof 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 IILIH EI Camno br PL A �ea( e 'Yoord 4)c Un.* v io' PL NoOSe_ PL APPROVED CITY OF COSTA MESA PLANNING DIVISION SUB]FCT TO RI no DEPT. RFf'ti } NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. BY: OA.- DATE: 9/ZIff o3 'fAn-- co-it `I' ,G 4 - •, 44, ,501 ' 9 CITY OF COSTA MESA BUILDING DIVISION F „„ ►1 DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 PERMIT le B01-01540 B01-01540 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1144 EL CAMINO DR Status: ISSUED Suite: Applied: 10/01/2001 Vicinity: RESIDENCE&ATTACHED GARAGE Issued: 10/01/2001 Parcel Number: 14161211 Zoning: Applicant: LEE, MIKE ISSUED BY: Address: 549 DEL REY DR _ .„ - - _ -Phone: (949)635=9054 PLACENTIA,CA-/'-, -- Zip: 92870 Owner: DUFFY FRANK JOSEPH TR Address ,1144 EL CAMINO - • - - - - - ' - N. ,N\ - Phone: N, -COSTA MESA, CA Zip: 92626 1 Contractor: 'ROOFING'STANDARDS 5�� orr . -Address:. 549 DEL REY DR �• Phone: (949)635-9054 �/ . PLACENTIA,CA 0 - Zip: 92870 ; • License:- 741302 . • - - H Arch :- ,. -' Eng; Address: - Address:; - - '�. Phone: PI one: Zip: - , License: 'License: SCOPE OF PERMIT ' REROOF:T/O EXISTING WOOD SHAKE,7/16"OSB SHTG, 1 LAYER'30#FELT, INSTALL 40-YEAR COMP SHINGLES. 27 SQUARES t , ' FEE SUMMARY .` ' Plan Check: $0.00 - ' - Calc Valuation: $6,000.00 Permit: $125.25 • Claim Valuation: -$6,000.00 SMIP Res: $0.60 - . . SMIP Corn: $0.00 Other $0.00 , Inspection: • $0.00 - - Total: $125.85 • - t: - PLANNING &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 ' 0-0 , 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 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 2446-46(6/00) DECLARATIONS cri' (-) WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: ` V "�.�-C./�,m. . Date: t0 (" 0 1 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 DOUARE 3100.000).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 licen tle 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.N ->0 Class M L. ' 3 9, Contractors Signature: . Date: /D _Q 1-o 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: _- 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-Co-e),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 perr4' subjects the applicant td'a civl enalty of not more than five hundred dollars($500).): peh - f ❑ I,as owner of the property:Adr,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 fie,dwn 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 doe'snotapply 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. ❑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,Callfomia 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 Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the Califomia 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 ❑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_aPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Govemment 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 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 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. at:Legal Legal Owners) /0-0f—of / And/Or Authorized Applicant Date CODE t INSPECTION TYPE PAIL INTIRAL@ CODE! INSPECTIONTYPE PAIL IKTA1,ALS 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 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 . PROJECT ADDRESS: 1144 EL CAMINO DR UNIT: • CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05806E OWNER'S NAME: DUFFY FRANK JOSEPH TR ADDRESS: 1144 EL CAMINO PERMIT NO: B 058065 PLAN CHECK NO: 02518-92 S GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REMODEL KITCHEN, INSTALL NEW CABINETS SQ FT: 5, 000 ADDRESS: UNIT: CLAIM VALUE: 5, 000 • , 00 CALC—VALUE: 5,000 . 00 GROUP OCC: R-3 / PERMITTEE: FORMALINE CONSTRUCTION ( 714 ) 434-1428 • ADDRESS: 3214 S LINDA WY COMMENTS ; CREATE NEW CEILING & ENLARGE WINDOW S,A, CA 92704 ****+r**x******;•E*Ra***�E *RR**RR*********ER******************�R+ESt+t�k+E* ***i4.**�R***�R�t*+R* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: 05`.55 STATE LIC.: 449242 CN S: Date: 72779 / MAIN BUILDING ACCESSORY BUILDING WORKER.s-77/7 /COMPE ATIOx DECLARATION: 5herebyaffirmthatI ave acertifi consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800, Lab.CI. LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: 0662888-92 EXP.DATE: 05 01 /93 COMPANY: STATE k PARKING RE • PROV: PARCEL: 14161211 ZNE: R1 REF NO: —] [n Certified copy is hereby furnished. Certified copy is filed with he city Buildig Division. PLANNING N TES> KITCHEN REMODEL. NO ADDED SQUARE FOOTAGE PROPOSED, Date: 'L- APPlica- . 4 / / )(-****************-1”t *****************************************.*********,9F********* EXEMPT!, FROM I RAERS'COMPENSATION DECLARATION: his section need not•ompleted if the permit is for one hundred($100)or less). D E V E L O f P M E N T SERVICES R E Q U I R E M E •N T S I certit that in the performance of the work for which this permit is issued.I sha,4 4.1 employ any person in any manner so as to become • • subject to the Workers'Compensation Laws of California. ZONING APPROVED BY4C- : SC( DATE: X(21 %/— Date- Signature: NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED B Y : DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. / r , CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• l\ DATE•( r{5� tL - which this permit is issued(Section 3097.Civ.C). **********************************,*********.** ******.************** * *, *****, LENDER: *******************************************************************{ f********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL% SEGM ENT;Y "3 OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 72 , 00 . 50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 46 , 80 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 72 . 50 0 , 00 46 . 80 119 , 30 119 . 30 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or altered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 119. 30 OVER/SHORT: . 00 tor the purposeof sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 72 . 00 50 46 . 80 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon - and,who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *.*.***,**.**.***,.*,**.*******.***.*.*..**,**.*..**,**.** *.**.*-,*,***.*..**.*.*,.**..**.*,*.*,*.**.*..*.**,*.*.**,***..***,*,**,* that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN for this reason'. TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I do hereby cenilythat lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 5000 T, I , MISC RESIDENT, BY VALDE/$i 1 . 00 5, 000, 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 FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date- Applicant. I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county • ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspec in purioses. , Date: Signal '. -AC 1 Driver's icense, Social Security a 01 0]11:�3g 00>169813 §g T • ° 4 .' Green—Codeite—auilmno: DATE: 0 /07/92 TT."47t (I?;5: tsar-as wh I. Enlor0ementl Canary—AoolicanC Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNINGf POOL PA • APPROVALS Permit # • Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53.-Steel Reinforcement - • 3. Electrical Conduit Utility-Undrgrnd. 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. Foundation59. Gas Pipe, 0 Undrgrnd., Test • 4 • 9. Water Pipe-Undrgrnd. • 60. Backwash Lines,P-Trap, ❑ Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & Houie Copnection - 62. Backwash & Receptor.Final , 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit • 66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access_Approval 17. Rough Wiring Sign • 68.- APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20..Rough Factory Fireplace - APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe•Pou h & Test 9 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical 27. Frame and Flashing 3/!'Z 1,19- 76. Dry Standpipe 28. Lathing & Siding - - 77. FIXED SYSTEM FINAL 29. Insulation I 78. FIRE PREV. FINAL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final I • 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 Preventer , I 43. Backflow Irrigation • - 44. Landscape Irrigation System • 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING etti%L • 48. FINAL PLANNING L( 49. Electric Release to Edison ' .50. Gas Release to Southern California Gas Co I i 51. CERTIFICATE OF OCCUPANCY - No. Date _ PROJECT AOORESS: 1144 EL CAMINO DR UNIT: CITY OF COSTA MESA — BUILDING PERMITrciv, ,vv; r v_7i Z.0 OWNER'S NAME: DUFFY FRANK JOSEPH TR _____ __ ADDRESS: 1144 EL CAMINO PERMIT NO: P 059128 PLAN CHECK NO; N cG3V y ;. .JVL C • .. COSTA MESA,CA 92626 • CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ALT N ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REMODEL KITCHEN. INSTALL NEW CABINETS SQ FT; ADDRESS: UNIT: CLAIM VALUE; CALC—VALUE; GROUP OCC; R-3 / PERMITTEE: FORMALINE CONSTRUCTION ( 714 ) 434-1428 ADDRESS: 3214 S LINDA WY COMMENTS• INSTALL SINK, RELOCATE GAS LINE, #1358065 S.A. CA 92704 ********Tt*****************+ ********** ****** *****fFSE****it******* ************* S LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R E Q U I R E M E N T 7000)of Dm 0"'tithe Business and Profession CO e d my license is in f force and effect. S E T B A C K S �°� �� 44134 CITY LIC.: STATE LIC.: i MAIN BUILDING ACCESSORY BUILDING Date: p /7�cZ signawr ._ FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN 'YORKER COMvENSAION DECLARATION: I hereby affirm that have a ../cate of consent to self-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN mpensation Os Ban B Bc$tifil c9py thereof(Section 3800, Lab.. .5/0 1 /9 3 ,LICY STATE EXP.DATE: PARKING REQ: PROV; PARCEL : 14161211 ZNE: REF NO; COMPANY: PLANNING NOTES> ❑ Certified copy is hereby furnished. Cf Certified copy is filed with the city Buildin• Division. > ******************************************************************************* �> Date: � �7 9L Applicant: DEVELOPMENT SERVICES', REQUIREMENTS EXEMPTIO ROM WO ERS'COMPENSATION DECLARATION: (T is section need not•- ompleted if the permit is for one hundred($100)or less). . I certify that in the performance of the work for which this permit is issued.l sha 'A employ any person in any manner so as to become ZONING APPROVED BY • _ DATE subject to the Workers'Compensation Laws of California. .! Date: Signature: BUILDING APPROVED BY : DATE: NOTICE:Ifalter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor . / Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED BY• % DATE• 9 ( 7 l q L CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for ***,*,**,*„***,***********iE********************* ************************** ******** which this permit is issued(Section 3097,Civ.C). *********************************)t*************.*******36************************ ADDRESS: - LEGALIZATION:N F E E S U M M A''R Y STRUCTURAL SEGMENT:N • OWNER BUILDER DECLARATION: thereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRAD ING PERMIT 12 00 (Section 7031.5 Business and Professional Code: Any city of 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 • 5% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 20 . 00 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID • DUE I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the TOTALS----> 12 . 00 20 . 00 0 . 00 32 . 00 32 . 00 . 00 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law doesnot apply loan owner pfadertythat who improvesbuilds )noned ooffefor ale.kif,however the orthroughor REVENUE DIVISION TOTALS--> COLLECTED: 32 , 00 OVER/SHORT: . 00 his or herown toemployees.provided that such improvements or pro are not n,intendedaor offeredesfor sale.If,however the buildingro gh improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). 32. 00 I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ****.*.*******.*.*********.*.**.**.***.*.*.**.****.**.******************************.*.K.******* and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale. Owner: PLU 1 SINK KITCHEN 7 . 00 7. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS J . 00 5. 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 FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authori rep esentatives of this city to enter upon the above-mentioned property for insp clion put ses. Date: Signator . M 00124220-00124220 TOT 3200 Driver's cense or ial Security N. O4TE; 09i!7, 92 T'tiE: 11:13 154 t'46 Wlute—Buildin:Green—Code Enforcement:Canary—Aoolicam;Pink—Revenue:Goldenrod—Assessor --,:-.1 ' . _ CONSTRUCTION AND.PLANNII_ - OL SPA Date Inspector Date Inspector. APPROVALS Permit # _ - Permit# 1. Temporary Electrical Servit.,* 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 :1-. , • 9. Water Pipe-Undrgrnd. • - 60. Backwash Lines,P-Trap, 0 Undrgrnd. f' !'" 10. Structural Floor System }!f j' «;, - 61. APPROVAL TO DECK - - • ,i d 11. Property Sewer Line & Houl onnection %� C62. Backwash & Receptor-Final • 12. Sewer Cap `! 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing 65. Electrical-Final . 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring. 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - • 20. Rough Factory Fireplace - APPROVALS Permit # - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test , 72. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & SidingI I 77. FIXED SYSTEM FINAL 29. Insulation I I - 78. FIRE PREY. FINAL - 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I I 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric I I I Notes: . 34. Final Heating& Air Conditioning I I I _ 35. Final Gas Pipe-Test I I 36. Hood or Canopy : 37. Final Factory Fireplace i •1 38. Final Plumbing ./A4,--I%; 39. Water Service-Final I I 40. Gas Service-Final - I 1 41. Solar Domestic-Final - 1 42: Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison _ I 50. Gas Release to Southern California Gas Co ! I,..j 51. CERTIFICATE OF OCCUPANCY No. Date • en ill PROJECT ADDRESS: 1144 EL CAMINO DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 058066 OWNER'S NAME: DUFFY FRANK JOSEPH TR ' ADDRESS: 1144 EL CAMINO PERMIT NO: E 058066 PLAN CHECK NO: N , GOVT: N SUPP; N COSTA MESA,CA 92626 CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; REMODEL KITCHEN. INSTALL NEW CABINETS SQ FT; ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALL—VALUE: GROUP OCC; R-3 / FORMALINE CONSTRUCTION (714 ) 434 1428 ADDRESS; 3214 S LINDA WY COMMENTS; RE: #B58065 S.A CA 92704 • +t�t�E�E�E�c�E�E�6� xx4***�E�E**aE****�6*xr.>faL�E>E*>ESE+e>f>E*+E+ESE**�E*>F�6aE�F�E�E�F�E�En>E x�6**�E�E>E*�E *�E�E�E�E�E�E�E�E>E LICENSED CONTRACTOR DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect SETBACK S CITY LIC.: 0 5 ppqSTATE LIC.: 449242, ` ' .91 Date': 77L Signal' '— • MAIN BUILDING ACCESSORY BUILDING WORKERS' MPE ATIONDECLARATION: I hereby affirm shall have a te of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: 0662888-92 EXP.DATE: 1 5/01 /93 COMPANY: STATEPARKING REO• PROV: PARCEL: 14161211 ZNE: REF NO: n 0 Certified copy is hereby furnished. 51 Certified copy is filed with the city Building Division. PLANNING NOtES> ;v > 7 Date: 1---2— Applic **********************************)K-********1E**3E*****************1F************** EXEMPT r'FRO 'ORKERS'COMPENSATION DECLARATION: (This sectio eed not mpleted if the permit is for one hundred(5700)or less). D E V E L O P M E N T S•'E-R VICES R EQU IR EMENTS I certify that int e performance of the work for which this permit is issued.I shal employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY /d DATE; Date:_ Signature: NOTICE:II.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : i1 DATE: Cade.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• . 4 ` DATE: ') ' L— whichthispermitisissued(Section 3097.Civ.CI. *********************************.75,********** *********************** ** *..K..Fie* LENDER: *********************************'********************************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N 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/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 3 . 75 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 Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ',0% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15 . 00 I. as owner of the property or my empvloyees 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(Section7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 3 . 75 15. 00 0 . 00 18 . 75 18 . 75 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.It,however the building or improvement pose of sale).aBLDGPMT PLUMBING ELECTRIC MECHANICFIRESMIP/TOT one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE V __ OD18 . 75 %OT GRADING/S torthe pPLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 18 . 75 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: ELE 3 RECEPT/OUTLET 1 ST 20 EA. . 75 2 . 25 I do hereby cendy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 2 RECEPT/SWITCH 1 ST 20 EA. . 75 1 . 50 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned I property for inspec on pure. es. • 9 Dale: ' A Signatur. , i /x Driver's01 0TOT cense . Social Security a: DATEU107/0 /9)2 TIRE: 33:530113941 T�: "lc 1641-46 White—Building:Green—Code Enlorcemenq Canary—Applicant:Pink—Revenue;Goldenrod—Assessor . ` CONSTRUCTION AND PLANNING POOL & SPA - Date Inspector Date Inspector APPROVALS Permit# _ APPROVALS Permit # - 1. Temporary-Electrical Service,ogPole ' ' -52. Pool& Equipment Location - A •' 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. ii;10. Structural Floor System- :, - 11 61. APPROVAL TO DECK 11. Property Sewer Line & House-Connection . . C 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 a �1 16. Rough Electric Wiring 0.3 se faz:. I e - 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 8/Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - - 77.• FIXED SYSTEM FINAL 29. Insulation 78. .FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - - 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric' �j/z Q Notes: 34. Final Heating& Air Conditioning �ff 35. Final Gas Pipe-Test ,36. Hood or Canopy I . - 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service-Final . - 40. Gas Service-Final 41. Solar Domestic-Final • i 42. Backflow Preventer I I 43. Backflow Irrigation 44. Landscape Irrigation System . . ' 45. Sound Attenuation , 46. Handicap Regulations - 1 47. FINAL STRUCTURE & BUILDING , , 48. FINAL PLANNING - - 49'. Electric Release to Edison • 50. Gas Release to Southern California Gas Co I 1 ' . 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ _ .- . . _. - • CITY OF COSTA ESA C N TRUCTION ERMIT PERMIT NO.. TRACT'NO., LOT NO. UNIT NO. t 1 /GJ ,/p� -_ N �7�`' 0380 4/01 /8�S - ;•.00 It Project Address /I Liy E9 l a.m%( r Of ' { PtU Cil S- - . - I 1 Applicant's MailinJq,/Q dd�refss� 'gee C`e.-c .' - TYPE OF CONSTRUCTION . U NEW. U ADD H-ALTERATION H R•EPAIR N �-'}� - - !f[� e.7.� :❑ CONVERSION' ❑ DEMOLISH ❑ OTHER '- -- • A P.# 1 - 'O . . . I Zone Owner's Name:, �� t-t J - I _ PhoneQ,l9 3 DESCRIPT ION OFWORK/USE SOF BLDG. ` - .Address "- •, - ' -. I - S Main Building r . _ , Accessory Building. - - Arch/Eng. ""4/�_ . License No., - • TYPE OF PERMIT U GRADING FOUNDATION •❑ STRUCTURAL T Front: O', Address 1� // ❑.TENANT -❑ ELECTRICAL PLUMBING ❑ MECHANICAL @ Reaf II - 'ft N Ili - Al: - .-f� 1-. / W-F.y `:�.'1.,� A 03 Con actor's Nam' Phone '9005'. 0 'OTHER' ` 1 C Right ` �• �s.� gy' " ' PROJECT DESCRIPTION SO. FT. •— • - • OCCUPANCY g - - ' - I Addressmailing/ '15/71-c- G..:( of /y� !✓f1C L'0.. Qa y' - K Left. I - - G •J�� � _ _ i -CON ST RUCTION TYPE 'VALUATION ' s I , , �' City'License No. j - R ZONE GRADING CU.YDS. ' ACRES • Pin Ref. 4 ,arkin Req./Provided • LICENSED CONTRACTOR:DECLARATION 1 , --- 91 9 , ( E \,y,;� I•hereby affirm that I am licensed under provisions of Charter 9,(commencing ; Remarks: I : Planning Notes: I V with.section 7000) of Division 3 of the Business and Professions Code, and , • - - _ for . ��// /�--sq i, • 'I I f i I _ �(' T License Class .L. License No.i !Via X 7 - , _ $ • /�� S� - i • PLUMBING .FEES Date._=� 5ignature • ' WORKERS'COMPENSATION DECLARATION: i ' - , - ' ' . Bar Sink Showers •- • I hereby affirm that I have a certificate of consent to self-insure ora certificate . I I I of Workers' Cmpensation Insurance, or a certifi copy t reof (Section -" -- '� Wash ELECTRICAL FEES • Backflow Preventer- -' Service':Sink - 3800,"Lab, 9i-�- - "/ - , ' If Automatic era Transformer ❑ 15-50 KW , yohcy No. 1a C ]p!-I�+ 0/ Company �C{.@ Backflow Irrigation I Sewer Ca I I ❑ 50'+ KW • , V]` I / ` J P Construction Pole Sub Certified copy is hereby furnished. CedJtie copy is filed with the city Buil Divi{ion. Bathtubs Sewer Connection Cooking Unit .r, �1 Meter ❑up to 100 amps • Date >- s--sc Applicant at Ps' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers 1 • ' • Solar Collectors _ , Dishwasher ;Meter_❑over 100 amps,-:-. ,1 (This section need not be completed if the permit is for one hundred($100) or -- less): I Dishwasher Solar Piping Dryers DGas ❑Electric Sub Panel I i - : f I certify that in the performance of the work for which this permit is Issued, I • , ' • or ' employ any person in any manner so as to become subject to the i Drinking Fountains i' Solar Tank • r '® Fan r i Workers' Compensation Laws of California. 'Motors❑0.1 HP ❑1'/:,8 Date I ' Signature Floor Drains' Swimming Pool w/Spa • F.A.U. ' 'NOTICE:If,after making this declaration, you should become subject to the 'Inc.Solar, HP ❑16-151 Workers_' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . Urinal - - f Fixtures ' ' I Mic-roWave •comply with. such provisions or this permit shall be,deemed revoked. ' _ CONSTRUCTION•LENDING AGENCY Gas Service • Outlets Water Closet - - Device Boxes I hereby affirm that there is a'construction lending agency for the performance 1 Pole.Light I ( of the work for which this pe i is issued (Section 3097 Civ. C.) Name Interceptors' Water•Heater 2-110 Outlets • .Lenders ' - • - . Range Lender's Address I - Kitchen Sink • „ ,Water Service ' OWNER BUILDER DELLA A N - _ _ _• __ _ Switches' Sign , • - I hereby areaso•that I am'exem t from the Contractors License Law for the Lavatories Auto•Wash ' ' • Garbage Disposal following reason (Section 7031.5.Business and Professional Code: Any city or ;Standing Sections .County which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundf Tra 5 - any'structure, prior to its-issuance,-also requires the applicant for such permit • Y y Generator ❑0-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - • ' ` - ' • '•Ihe: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 - - - - therefrom and the basis for the alleged exemption. Any violation of Section - i 7031.5 by any' applicant for a permit subjects the applicant to a civil i .�nalty of not more than five or hundred dollars($500). - _ '3 , I LJ I„as owner of the property or my'employees with wages as their 'sole • Reinspection Fee $15 ll Issue Fee • $ compensation, will do the work, and the structure is not intended or offered - - Reinspection Fee .I $15 Issue Fee.. $ 3 for sale (Section '7044, Business and Professional Code: The Contractor's . . - - MECHANICAL - FEES License Law does not apply to hl er of a property who builds or improves • thereon; antl.who does such work himself/herself-or through his or'her own • - - DEVELOPMENT SERVICES REQUIREMENTS: employees, ever, ed that sing or improvement nts are not intended or offered for , Boiler ' 1 H&cor Type I ❑ , 1 sale. If, however, the building or improvement is sold within one year of com- Canopy ' Type II 0 Zoning Approved By Date • pve , the owner will have the burden of proving he/she did not build or'im- DUct-UnderGround - Building Approved By - " Date Prove for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By ' ' Date l�r tractors to construct the project (Section 7044,Business and Professions Code: - - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ' ' - ❑0-100,000 BTU 171,00, ,000 BTU _ - • I SUMM RA Y OF FEES builds or improves thereon,'and who contracts for such protects with-a con- • - - ' tractor(s) license pursuant to the Contractor's License Law). am aware thatIII ' . BUILDING PERMIT $ ' SMIP ; $ • proof of their Worker's Compensation insurance should be provided to me,. Exhaust System 0 Multiple❑ System Repair/Alteration - I PLAN CHECK 1 $ PERMIT ' 1 O 1 am exempt under Section B.&P. C.for this reason MilFire I/Fact Blt. IDBD# I Fire Dampers • , a p ■ p PLUMBING $ ' S-o0 .ISSUANCE • $ Date • Owner • / • Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. - $ I. hereby certify that I-haveread this ap li tion and state that the above --- 00-100,000 BTU D100,000 BT - ' . .. • - " ELECTRICAL GRADING - $ ' - information is correct. I agree to comply wit all city and county ordinances - - - , $ - • and state laws relating to building construction, an. eby authorize repre- - • MICROFILM $ ' sentatives of,this city, to enter upq�y e abo boned property .for PLAN CHECK 50% $ inspection purposes. //%GU r 8" MECHANICAL $ 7 I Signature /�' I%/l'`. Date %'S7 TOTAL FEE ; $ Drivers' Licen or 55# Reinspection Fee ,I $15 Issue Fee $ 3 • PLAN CHECK 25% $ , CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor -• 'CONSTRUCTION'AND-PLANNING _ r. POOL .. SPA Date - Inspector I Date Inspector . ' APPROVALS " Permit•# •• - I _ APPROVALS - Permit# _ Ti. Temporary Electrical Service or Pole - _ - 52. Pool & Equipment Location • .2. Soil Pipe-Undrgrnd.- - _ - - •53. Steel Reinforcement _ •. 37Elecirical Conduit Utility-Undrgrnd. ' . ` 54. Forms_ , ',4: Electrical Conduit_Undrgrnd. '. . - _ .55. Electrical Bonding .5. Steel Reinforcement - - - - - - 56' Rough Plumbing & Pressure Test' . "6. Electrical UFER Grnd. . - - - 57. APPROVAL TO COVER:GUNITE _ - ° 7. Footings ' -_ 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test - - - ' ,:9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. - - , 10:Structural Floor System - - 61, APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - • ' 12. Sewer CaP • - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing ' - • 9 x - '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 O Gas 0 Oil • • 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - • 27. Frame and Flashing 76. Dry Standpipe ,. 28. Lathing & Siding. 77. FIXED SYSTEM FINAL - 29. Insulation • 78. FIRE PREY. FINAL ' 30. Drywall Nailing - .' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79., FINAL INSPECTION 3• 2. Electrical Power Meter=Final • 80. FO0D CERTIFICATE ISSUED 33. Final ElectricNotes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test,. . [ ' 36. Hood or Canopy - - 37. Final Factory Fireplace - - _ ' 38. Final Plumbing L/�� L - - .' - • - 39. Water Service-Final -�/ 40. Gas Service-Final • • i 41. Solar Domestic-Final • � , • ' 42. Backflow Preventer - ' - - 43. Backflow Irrigation - 44. .Landscape Irrigation System ' - - 45. Sound Attenuation - I _ ' • '46. Handicap Regulations _ : . 47. FINAL STRUCTURE & BUILDING - - - S - - 48. Special Requirements Completed I - - ; , 49. Electric Release to Edison ' i - I i - - _ - - - I 50. Gas Release to Southern Californ'i'a Gas Co , ; . ' ' , i • n ' 51. CERTIFICATE OF OCCUPANCY � - _ _ t_ - i Nn. - - Date - - - - - - - - -- L ' - . _ _ . - f Applicant to fill in all spaces except those within heavy.border lines and s_ign-all appropriate declarationss. _ .. _ _ _ PER T NO. TRACT NO. LOT NO.: I , CITY oF'• ;cosTA MEfS�A�"/� CONSTRUCTION PERMIT UNIT NO. I • 1 • Project Address �/7 e (—/ : CO/l7rr�f(� I a7 9.75-S . I I i .` I � 5129 3/3,1 /8`/ - .5.90 'T� Applicants Mailing ddre5 1 /c111i/A ,0x) • TYPE OF CONSTRUCTION '❑ NEW ' U ADD, ❑,ALTERATION REPAIR I l Owner's Name I � f/'� /,+tPhone9 :ElCONVERSION,, ❑ DEMOLISH ❑ OTHER • _ Zone . f , 'Y]�� I r/� DESCRIP,TIGN OF.WOR K/USE OF BLDG. - Address • Y/ / %/1 ( s7 . - i • 1 S Main Building: Accessory Building:, • E Z Arch/Eng. • License No. ' • TYPE OF PERMIT El GRADING' ❑pF UNDATION ElSTRUCTURAL • t Front I ' , ' I 0 ❑ TENANT ❑ ELECTRICAL ,LUM GING ❑ MECHANICAL B t • I I ' N Address �p / I Rear , Contractor's Name r _ I / / / Rhon Xl5 41 ig)a •'❑ OTHER _. - .' , - _.. _. . 1 - - C' Right G )'4" A -f 7 L[ '/ PROJECT DESCRIPTION 5Q. FT. OCCUPANCY - Address(mailing) ) a �/ l ��V ,CONSTRUCTION TYPE VALUATION $ S Left 1 1 ` R City License No. ZONE GRADING CU.YDS. ACRES 1 - LICENSED CONTRACTOR DECLARATION - ' - • •- ,PIng. Ref.# P ¢ rGx�ro Ideid Tawas E I herebyaffirm that I am licensed untler revisions of Charter 9 (commencing I �C�'� �•��" S`r`r� I M • ,P ( g Remarks: Planning Notes:: - with section 7000) of Division 3 of the Business and Professions Code,and - - I T my license I5 in (ul/OKe -0tl of(ect: J �� , • , ' • - • License Clas `L"-'S L n ` .. ._ S jI�\'�p Date - -`f /' Signature i�U -� /, I1;./ • • PLUMBING - _ -FEES • I i .. _ - 1 WORKERS' COMPENSATION DECLARATION ' Bar Sink ', • "Showers ELECTRICAL FEES �I I hereby affirm that I have a certificate of consent to self-insure or a certificate • - . . - • _ - • _ _ of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer, 'Service Sink: - - ._ - ' ' - • Transformer .❑ 15-50 KW j 3600, Lab: C Automatic Washer• - Policy No. _I 7���C/ %1 /' CornPanytND1T t'4� / ' '����t Backflow'lrrigation 'Sewer Cap - - - ❑ 50+;KW • - �ertified copy is hereby furnished. - • ' Construction Pole Sub. i - 1 - - ' Cel ifs ycopy.iy(iled with the city B it , y 4ly n' /,rt{ Bathtubs• _ Sewer Connection r Cooking-Unit: Meter'❑up to 100:amps ., Date.1/S / Applicant C, / f(/ .�//�PFv�li - - • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION : Clarifiers: Solar Collectors , Dishwasher ' , - • Meter Dover.100 amps, (Thissection need not be completed if the permit Is for one hundred ($100)or - - -_ less). , j Dishwasher . - ' ',4 . 'Solar Piping. ' - • Dryers ❑Gas. ❑Elecir is Sub Panel, ' I certify that in the performance of the work for which this permit is issued;I 1 ✓ " - • _ _ shall not employ any person In any manner'so as to become subject to the Drinking Fountains Solar • Tank Fan • Motors 00-1-HP - 1'h-8' 1 Workers' Compensation Laws of California, - ' - '" - - • Date 1 Signature I Floor Drains Swimming Pool w/Spa , F.A,U. I Inc Solar 09-15 HP ❑16;15+, ! -NOTICE:If,after making:this declaration;you should-become Subject to'the- • - - -- - - -• -. - , Workers' Compensation provisions;of the Labor Code, you must forthwith Floor Sinks . • Urinal Fixtures ' comply with such provisions or I this-permit shall be deemed revoked. i Microwave CONSTRUCTION LENDING AGENCY ' Gas Service ,Outlets ' Water Closet Device Boxes - Pole Light i °' I hereby affirm that there is a construction lending agency for the performance I _ of the work ,for 'which this permit:is issued- (Section 3097 Civ. Cl) - Lentler's Name 7 Interceptors ' Water Heater Outlets ' Range � • I •-Lender's-Address_ _..-. e._ --« _ _. ' - -- _ - -_i- ._ _.. y • KitchemSink t -Water Service- Switches OWNER BUILDER DECLARATION I Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories , .Auto-Wash • Garbage Disposal Standing Sections ' following reason (Section 7031.5 Business and Professional Code:Any city or , county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays , Generator ❑0.5KW ❑5-15 KW ' any structure, prior to its issuance, also requires the applicant for such.permit - Trash Compactor _ • to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ' - - , the Contractor's License Law(Chapter 9(commencing with Section 7000) of I ' 'Division 3 of the Business and Professions-Code) or that he/she is exempt - --' -'- - - ' -' --- -'' ' • therefrom and the basis for the alleged exemption. Any violation of Section • j - ' 17031:5•by any applicant 'for a permit subjects the applicant to a civil - • • ' ,J • I penalty ofinot more than five hundred dollars:($500). : : LJ I ,as owner, of the property or my employees with wages as their sole Reinspection Fee I $15 ,Issue Fee. I ., $ 3 I . i compensation, will do the work, and the structure is not intended or offered - - - Reinspection Fee _l $15' Issue Fee - -$ 3 • I for sale (Section.7044, Business and Professional Code: The Contractor's I; I MECHANICAL 'FEES License Law does not apply to an owner of a property who builds or improves . thereon, and who does such work himself/herself or through his or her own - - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvementsare not intended or offered for Boiler ; , , Hood or Type I ❑ • sale. if however, the building-or improvement Is sold within one year of com- •• Canopy Type I I ❑ Zoning Approved By I Date - ' pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground - ' prove for the purpose of sale).. Building Approved By , - - • - Date�� . ❑-I; as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By - 1 Date T tractors.to construct the-project (Section,7044 Business,and Professions Code: The Contractor's License Law does not apply to an owner of'property,who Duct-Ventilating ❑0-100 000 BTU ❑100,000 BTU - - - SUMMARY OF FEES - -' - builds or improves thereon,;and who contracts for such projects with a con- - - - - _ ' tractor(s) license pursuant to the•Contractor's License Law). I am aware that . - BUI LDING PERMIT $ • - 'SMTP { $' f Ekhaust System ❑ Multiple,❑ System Repair/Alteration _ proof o their Worker's Compensation insurance should be provided to me. - - -- - . 1 - PLAN CHECK $- • CN ' -PERMIT - _ 0 I am exempt under Section' B.& P. C.for this reason Firepl/Fact.Blt. ICAO- # Fire Dampers - PLUMBING $ •- •DU ISSUANCE • $ ,Date ' owner Heating System&-Ducting Registers - - - • - ENERGY'P.C. $ ` PLAN CHECK 25% $ ,I hereby' certify that 9 have read this application and state that the above 00.100,000 BTU ❑too,0006 GRADING $ ' ' 'information is correct. i.agree to comply with all city and county ordinances I - TIMI - - ELECTRICAL _ $'- - - -( !and state laws relating-toity buildingeteconstruction,and hereby authorize repre- _ - I .I _ PLAN •CHECK .50°x' ,• MICROFILM - $ ,sentatives of this city to enter upon,the above-mentioned ;property for .v • - I r • 1 $ 1 - .,1 ..✓D - inspectlon p :.se / o l -� _ ' MECHANICAL $ TOTAL FEE $ (�, Signature • 'L , ii i' AA'r i� Date. r/2!I- ✓ Reins-action Fee $15 'Issue Fee ! ' 'Drivers' License or SS# , ^ '/ ✓ - - P $ 3- : PLAN CHECK X25% $- I i I MS CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • r CONSTRUCTION AND PLANNING POI SPA ' • . Date Inspector ' Date- Inspector APPROVALS Permit# • APPROVALS Permit#, 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement tic , !u 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ;_, • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ('% 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test y. • 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE '. 7. Footings r� 58. Electrical Conduit-Undrgrnd. • 8. Foundation • - 59. Gas Pipe, 0 Undrgrnd.,Test 'a ' } 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap - 63. Heater & Vent-Final ' 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit . 66. Solar System-Final 16. Rough Electric Wiring ' - ` 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING - 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - APPROVALS Permit•# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil ' 25. Roof Sheathing • 74. Overhead Hydro' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . • 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding " - 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREV. FINAL 30'- Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric Notes: 34. Final Heating & Air Conditioning , 35. Final Gas Pipe-Test . ' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing q-27-Y/ tlyr) 39. Water Service-Final . 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigation System • ' . 45. Sound Attenuation - 46. Handicap Regulations . . - : 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed • -49. Electric Release to Edison 50. GasRelease to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date 2n2.05 i COSTA MESA.BUILDING-SAFETY DEPARTMENT FEC RECEIVED P.O.BOX 017 COSTA MESA,CALIFORNIA ' FEE rl Y ' iN i 2 5 1963 For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT Fl NPiiiiEDi&a°T. . ' • ADDRESS " 1144 El Camino Drive BTPr UILDING h4t!'S ' RECEIPT NO. PERMIT NO. COSTA MESA. CALIFORNIA 20205 ' RICEZD BY 10RECEI D BY 107RECEEIx D DATE ISSUED OWNER Mesa Be Mar Develo• ent Co ,JUL 2 4 1963 MAILp - BUILDING - ADDRESS 3800 E. Coast Highway^ ADDRESS // ��/)/C/� TEIXr101e IRE ZONE TYPE V GROUP�L./ CITY Cnrnna Del Mar Calif. NO. 3 423] APPROVED ARCHITECT TEI- OR ENGINEERMaCCO Realty CO. NO. Oriole BY DATE j-4 2u ZONING , ADDRESS Same as above - I oingl Tom. ZONE NO.OF USE OF NEW • R-1 I PLANS 2 BUILDING res {a/ aft. CONTRACTOR Macco Realty Company' L, LEGAL garage. ADDRESS Same as above DESCRIPTION Telt. 7 Trart. 023 CITY Same as a thve A.P.NO. none NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC.NOATE 2O7343. A-8H-1 NO.` Oriole SO'TO SIDE ft REAR P.L. SIZE - • 1EAVES OW ONOWNott, ALLOWED (U.B.C.REQUIREMENT/ OF LOT 721 X 971 YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. Nene (FROM C/L STREET) SETBACK LINE FROM 1.[I REAR YARD 261l011 FRONT Li 4,rr. rr. CENTER OP STREET .40V ,/ SIDE YARD LEFT .5 t 611 I RIGHT 51 R.SIDE y FT. FT. I DESCRIPTION OF WORK L.SIDE 5. 6 FT. REAR aG(FT. /0 FT. NEW X ALTERATION ADDITION DISTANCE BET. BET.MAIN Et REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.SLOGS. VAR.# DATE ID{!•L 51G size 16a X 54 121%ROOMS 6 STORIES 1 C.U.P.# APPROVED EXTERIOR - + COVERING W/A��LL,Wood � - ROCOVVERING Shake Shingl BYAPPROVED W. Ti. D. ATE 7-22-63 USE OF BUIL`BI ^RIBil/ORK TO BE PERFORMED Single family res W/attached garage Dwelling 18965. • Plan IlnQ-4 _ Garage 483 S.F. N SQ.FT. O I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O •PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION // --- 0 BUILDING CONSTRUCTION. SIGNATURE OF PERMIT FEE $ 66/: j PERMITTE Cr -a COmpaII "' G X71 v $ 20,288.00 L CK se 0 AUTHORIZEDA ANT O'' (l l�^'�'�� �, E TOTAL FEE.