HomeMy WebLinkAbout910 EVERGREEN PL - Building Permits(714) 754-5273 • Fax (714) 754•4856 • www.ci,costa-mes2
JobAddress: 910 EVERGREEN PL
Suite:
Vicinity: ROOF
Primary Occ: R3 Dwellings/ Cong Res <10
Parcel Number: 42252103
Applican�: O'CONNOR, KATHERINE A
Address: 5038 TITANIUM AVE
CITY (�F COSTA MESA
'Lp%NG DIYISION
'MENT SERVICES DEPARTMENT
I PERMIT
Type of Construction: V-N
; Zoning:
LAS VEGAS NV
Ownec O'CONNOR, KATHERINE A, _:" +
Address 5038TITANIUMAVE ``��d���- .�?'�
LAS VEGAS N�/ �a. : t ����-
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Contrecror. OWNER�-BUILDER '"`�' �A�'
Address , � ' ;�,, , ,„, ,,, ,
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TEAR OFF EXISTING f
NEEDED: 1,400 S.Fi-1P
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' Phone
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9 ;Y- . ,d�'s?�.
Plan Check � $0 00°� _
Permit �_. ' $83 25„ �\
'SMIP'�'Res r$0 50 �
SMIP,Com �$0 OOz
Other. � $0 00
Inspection �;$0 00'� �r
a�: �
�Total � $83 75 �� = x;;
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SETBACKS a d-„ i
MAIN STRUCTURE Front 0. 0 ��
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ACCESSORY -: Front "O�b„ -�
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PARKING �Ezistino�^"to
a
NUMBER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: OB/22/2005
Issued: 08/22/2005
Phone: 949-422-3227 ISSUED BY: � _
Zip: 89120-1577
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Address:
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OF 30# FELT, 30 YEAR COMPOSITION
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NOTICE: The work authorized by this permit shall comply with all ipplicable 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 1 BO days, or if work is suspended or abandoned
for a period of 180 days. � '
INSPECTIONS: In order for the work euthorized under this permit tolbe considered legal, such work must comply with ell applicable codes, and all
requlred Inspectiona 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 I
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WORKERS'COMPENSAY�ON DECLARATON: - . 1 .
I hareby eKrtn under penalry a� perjury one ot the tollowing tleclaretions:
� I have flnd wlll malnta�n e certiTicate oi consent to self-Insure for workere' comDensatian, as pravitled tor by section 3700 of the Lebor Code, for ihe peAortnance of the
work for which Ihis pn�it is issuetl. .
❑ I have and vAll mainta�� workers' compensetion insurance, es requiretl by section 3�00 of the Labor Code, for Ne peRortnance of the work for which this peimit I5 Issued.
My workers' wmpen5etlon Insurance carrier end palicy number are:
Cerder.
Me perm/f is velued et are hunared dollars ($100) or less.)
Policy Number.
���Ig�`pity thet in the peAortn ca ot ihe wark for which t�is pertnit is issued, I shell not employ eny person in any manner so as w became w6�ect to the waflcers
compensation le �, i 'a B d rae at � shoul De esub�ect to the workers' compensatlon provisions of Section 3700 of Ihe Lebor Code, I shell forthwiih
wmpy with Ihes � 1/ � 4 �7 ^�'�(�.,
Ap 9neture: -' . �— _ �=.hI�LL V,J
. A RE TO SECU E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL rWD SHFLL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
SAND DOLLARE (5100.OW). IN ADOfiION TO TME COST OF COMPENSAiION, DAMAGES AS PROVIDED FOR IN SEGTION 31060F THE LABOF CODE, IMEREST, AND ATTORNEI"5 FEES.
UCENSED CONTRACTORS DECIARATION: �
I hereby ettirm Ihet I em Iicensad under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Profeuions Cotle, and my license is In full
force entl eHect. Lic. N Class k
Contractors Signature: Date:
CONSTRUCTION LENDIliG AGENCY: '
❑ I hereby affirm that there is a constructlon lentling agency for the perfortnance of the work for which t�is pertnit is issued. (Sec. 3097, Civil Cotla).
Lenders Neme: Lendefs Address:
Sipneture: Date:
OWNER-BUILDER DECLAAATIONS:
I hereby eHirm that untler penalry of perjury t�et I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business and Professlons
Catle: Any ciry or wunry which requires e permit to conslruM, elter, improve, demolish, or repair any slruMure, prior to its issuance, also requlres the applicant for suc� permit
to flle e signed stetemem tdet he or she Is Ilcensetl pursuaN to ihe provisions of the Contrectors License Lew (Chepter 9(commencinq with Sectlon 7000) of Dlvislon 3 of Ihe
Business end Protesslons Code) or thet he or she is exempt therefrom and the besls for ihe elleged exemption. Any violation of Sedion 7031.5 by any epplicant for e parmit
sub�ects Ihe a0011cant to e Clvil penalry of not more than tive hundretl dollars ($500).):
❑ I, es owner ol Ihe proPeM1y. or my employees with weges es t�eir sole wmpensation, WILL DO THE WORK, antl the structure is not intended or oHered tor sele (Sac.
704d, Business end P�ofessions Code: The Contractors License Law tloes not apply to an ownar of property who builds or improves thereon, and who does such work
himselt or harsetl or throu9h his m her own emplqrees, provitletl that such improvemants are not imentlatl or offerad for sale. if, however, Iha builtling or Improvement is
sold within one year o1 completion, the owner-builder will have the burtlen of proving that he or she did not build or improve tor purpose of sale.). •
❑ I, es owner of the properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CON7RACTORS to consiruct tha prolect (Sec. 7044, Business and Profeuions
Code: Theg� ntractors License Lew does not apply to en owner of properry who builtls or improves thereon, antl who coniracts for such project with e contractor(s)
-iicensepy�uent )o,the Contractors License Laws.).
and Professions Code for this reason:
Owner ID veritied by drivefs license. ❑ Yes ❑ No -
Verificailon of Ownership by (rype at tlocument, i.e. - Oroperry tex bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby ceNty t�et n0 exwvatlon fNe (5) or more feet in depth into which a person is required to descend, will De mede in connection wlth work euthorized by ihls
pertnit, antl ihat no ba�ltling siruIXure, scatfdding, falsework, or demolition or dismantling thereof, will be more [han thirty-six (36) teet Aigh. (Ghap. 32, Grp 2, AM1 2, Sec.
341, Title 8, Celifomla Administrative Cotle).
❑ As owner-builCer. I wlll not employ enyone to do work which would require a pertnit from the Divlsion of Indusirial Safery, as notetl ebove, unless such person has a
pertnit to da such work �rom the division.
Signature: Date:
Division ot Industrial Sefery Pertnit Number:
CERfIFlCA7E OF COMPLIANCE AND AUTHORVA710N OF ENTFiV: I cenify under penalry oF perjury ihat I have read this epplication end state that the infortnatlon given is
correct. � ree � mply Wi�h all stete le end ciry ordinances relating to building construction, end authorize representatives of �he Ciry of Gosta Mesa to enlar upon Ihe
ebove-d � d y o�i tion ry e ree not t c r allow occupancy ot any building euthorized by ihis permit until tinel � e n.
����° �-� .�
Slgnature.0 �Leaa��,Own r sl. . � �-te - r
And/Or Authonzed Applicant Date
COOE �. INSPECTION TYPE
1816 Fixetl System Fina� Fire Pravention
1286 Pod Spa Final
200 Final Re-Raot
201 Finel BIocWRetaining Wall
202 Final Fectory Fire Place
203 Pinal Stgn
200 Final Demoliiion
PaSE INTITIRLS
E
�� �
CODE� INSPECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electrical
212 Final Fire Prevantion
220 Final Planninq Approval
222 Final Site
250 Final BuiltlingiOccupency
BDIF I[�!L$
Applicani lo filt in YII spaces within hmvy borEer lines antl.sign all apP�opriale Eeclarotions.
�, CITY�OF COSTA MESA PERMIT N�. ,.TRACT NO. LOT NO. •BLDG. NO.
CONSTRUCTION PERMIT
Project Address .].� Ever reen � '' ,T^YPE OF CONSTRUCTION
, OWnef 5ki �Ta man Ph��a t!— JL NEW .� ADD ❑ ALTERATION
�Addr¢55 -� Saj�]e ' - O REPAIR ❑ CONVERSION ❑DEMOLISH
' Arch/Eng.' " � - ' �" - " License No. � � - � oTHER- - - - -
. _ _ _ � _ . __ . - .. _ DESCRIPTION OF WORK O `dY� LO
Address ^ � - ,. � . 7 n nnrtn # e 9l c C
/.
, . ---,•�. ' 8959 12/02/81
r �"�t . -rt : . .. _..
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wuuac �i pvlqt- Gluct L'11U1 V. rnone.7�'Y-4'�' iTVPE OF PERMIT
, AddtE55 1 Bandilier �ili�. Ftn: VI� �. ❑ GRADING ��. ❑ FOUNDATION ❑ STRVCTURFIL
LICENSED CONTRACTOR'"DECLA0.ATION' ' � -- � O TENANT .� ELECTRICAL+�PLUMBING ❑MECHANIC%
I hereby atflrm-that I am Ilcensetl untler provislons of Charter 9(com- '
mencing with section ]000) of Dlvislon 3 of tne 'Business antl ❑ OTHER � " ' "' -
Pr0785510n5 C y Iiceq 5� IS In fUll (O! }f¢Ct: • " ' •
J�� � - �SCWf � I�,P].�; PROJECTDESCRIPTION = � . -
License I s L cense . ' '
Date 519 t i� SQ. FT. �
.WORKE S"CO PENSATION'DECLARATION " " " OCCUPANCV �=CONSTRUCTION-TYPE -
�I hereby affirm that I have a Certl(itate Of tonsent_�o 5elt-insure`or a VACVAtION ' ' ZONE
�c¢ftlflUt¢ Of WOIkefS' COmpenSatlon InSurdnt¢, tl� a Certitietl Copy
thereof (5@Gt�,oq g(1p,J�p C.). GRADING CU. YDS. ACRES
'.y No bUU�'/,�/ 7G Compa�y TY'2.Y143D12Y'1C`d -
srtlfied'copy is hereby furnishetlT- ' - - "' - ' "" ' REMARKS: ' " _ ' - ' ` ' , - ' -
.Jertitletl capy is filea with the <ity Builtling Division.. . _ _
EXEMFTION FROM WORKERS' COMPENSATION DECLARATION �� - �
(Tnis sectlon neetl not�be�complatetl if the�permit is (orone huntlretl � ^- � �� - - + .-- -- �-.-
($300I or less). • ��. ' . � � ` ' .
I ttrff/y that in�the pe�fo�mance of Ihe work tor whlch thiSpermlCls
i55ued, I shall not emPloy any p¢rSon In dny mannC� so as to becom¢ � PLUM6ING � P�AN CHECK
sub�ect to the Workerz Compensation Laws ot Califomia. �-� ��-
Date •Signature � BATHTUBS SHOWERS
NOTICE: I� after makin9 Lhis tleUaration, you shoUltl become sutiject TOILETS URINALS
to th¢ WOrkers' Compen5ation provisions o� the Labo� Cotle, you must �
forthwith comply with suth provi5ion5 or this permit shall be tleem¢tl LAVATORIE$ DOUBIE LAVS
/¢vOk¢p. " ' ' " ' '- - - - ' ' '- KIT. SINK$ DISHWASHER$
CONSTRUCTION LENDING AGENCV �
I hereby affirm that there is a constructlon lentling agency for the perv SERV ICE SINKS ' SVMPS
tormance of.the_work for-which this permit is issqetl (Section 3097
Civ.AC)'^ , FLOORSINKS_ FLOOR.DRAINS— —
Lentler'S Atldress �i3S �O. DRINKING FOUNTAINS
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS
I hereby affirm.that I am ezempt from.the Contractor's License.taw.for
the followin9 reason (Settion �031.5 Business antl Professions Cotle: SWIMMING POOL PTRAP
Any clty.or county.which reqWres a permit tn construct,_alter,
improve, tlemolish or repair any structure, prior to its issuance, also re- yyqTER SERV ICE ALTERATION
qWreS the appliWnt Por Such pe�mitSo tile a signetl statement Ihat he.
is litensetl pursuan[ to ihe provisions of the ContraG�or's License Law GAS SERV ICE OVTlETS
(Chaptec 9(commen<in9 with Section ]OOO�.of DiviSion 3 of tne
musiness antl Pro(essions Code) or that he is exempt theretrom and the yyqTER HEATERS BTU OUTPUT
': for the allegetl exemption. Any vlola[lon of Section �031.S.by.
appll�nt for a permit subjects the applicant �o a civil penalty SEWER CONNECTIONS
�t more-than five nuntlretl tlollars ($500). .
� I, as owner of the property, or my employees With wages as their SOLAR TANK 3, OO ^LLECTORS
SOIE COfOp¢n5ation, wlll tlo the work; antl'tM1e'structur¢ is nOt intentletl '-- '
or offeretl �or sale. (Seclion 7044, Business antl Pro�esslons Cotle: The SOLAR PIPING SVS.
Contractor's'License Law tloes not apply-to an'oWner of a•property ,
who builtls or improves [hereon, antl who tloes such work himselt or ISSUE FEE
through his own empioyees, p�Ovitl¢tl thdt such improv¢ments are not
intenaea or ofteretl for sale. If, however, the builtlin9 or Improvement MECHANICAL PLAN CHECK �
is solE within-one year oi completion, tne owner wi�l have the burtlen
of provinq he_,tlid not builtl or improve �or the Purpose of sale). ,HEATING SYSTEM 0-100,000 BTU_
❑ I, as owner o( the property, am ezclusively contracting with qNDDUCTING
Iicensetl wntrdc[or5 to con5truct.the.proj¢ct,,(SeCtion 7044, Business _ 100,000+BTU_
antl Professions Code: The Contractor'S License Law tloes not apply to
an owner.of.property.who Duiltls or improves ther¢on, antl who con- REFRIGERATION, 0-100,000 BTV_
VactS from sucn D�ojects wi[h a<ont�acto�(s) IICRSn¢tl pur5uant to SVSTEM '
the Contractor'S License Law). .� .. 100,000 + gTU _
❑ 1 am exempt untler Sectlon B. 6 P. C. for this
_ _ . . . . ... . . - .- _ .. BOILERS _ BTU _ _
�eason
Date �� Ownar � - `-" - -SVSTEM REPAIR,ALTERATION
Phereby certifythat 1 have�reatl this appllcation antl�state that the above EXHAUST SVSTEM�-�' MULTIPLE
informatlon is corl¢cL.l-aqree toicomolv with all city antl county
Signdture
Dete
Drivers' Licenze or 55 �.
CMF0865-46 White-Builtling;Canary-Applicant;
ereby�authorize
ove entionetl ,
� ISSUE FEE
k-Accounting; Goltlenrotl-Assessor
0
0
"A.P.,�#
20NE
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SETBACK C/L ST.
IDE V�
EF
�IDE V
IGHT
REAR VARD (TO
PKG. SPHCE REQ.
STREET WIDTH
15.50 T�
' PLNTGp. RUEFL. p�`ry • �
PROPE�RTV LGINE y
/L)_ .. r
� PROVIDEDi � .�
' �PARKFEE�$ ��
D BY � •� . � OATE -
SPECIA� CONDITIONS:
��
�
'ELECTRICAL
� � I
PLAN CHECK ,
�GENERATOR 0-1 KW_1-30'KW _
�TRANSFORMER —_ _. .
APPLIANCE 30-SOKW_SO+KW_
.MOTORS 0-1 HP 1-10 HP _
(INC.SOLAR) 30-SO�HP_SO+HP _
GAS TUBE SIGNS
POLE LIGHTS
PANELS MAIN
P
SUB
AMP
APPLICATION %�PPROVED BY DATE
SUMMARV_OF.FEES � ,
BUILDING � � �
PERMIT $ . SMIP' � $
PLAN.CHECK E „PERMIT ' �
������%f ISSUANCE $
PLUMBING $�� _
GRADING E
PLAN CHECK E � �' �
ELECTRICAL y�� ! ' E �
PLANCHECK E '_MICROFILM E -
MECHANICA� $ � ' ' TOTAL- FEE § -- �
PLANCHECK S ' ,,. VANCEPC $ ,
� FINAI FEE E �� � �
CONSTRUCTION AND PLANNI q � � i� -�' j POOL & SPA `-
APPROVALS Permit # � /� � Date � Inspector � qppROVALS �• ;.F� - Permit # ` ' � Date Inspecto'r" �
1. Temporary Electrical Service or Pole • � 43. Pool & Equipment Location ._ . . .
2. ' Soil ipe-Undrgrn � 44. Steel Reinforcement �
� 3. Electricel Conduit Utility-Undrgrn•� '' � - 45. Forms
4. Electrical Conduit-Undrgrn � 46. Electrical Bonding � '
. tee pin o�ce � - 1 � 47. Rough.Plumbin & Pressure Test • ' ' -
6. Electricyl UFER Grn • ' 48. APPROVAL TO COVER-GUNITE •
7. Footings -- " - 49. Electriral Conduit-Undr m �
8. Foundation - � - '�50. Gas Pipe, ❑ Undr m, Test ` �
9. Water Pipe-Undrgrn � � � 51. Backwash Lines �P-Tra ❑� ndr m" -
10. Structural Floor Systerri 52. APPROVAL TO DECK �
11. Property Sewet, Line & House Connectiom% ' 53. Backwash,& Rece tor-Final 4� -
12. Street $ewer Co'nnectiori 54. Heater & Vent-Final � �
13. Rough plumbing � - �� - -
14. Rough ElectrioConduit' . ' - •56. _Electrical-Final
15. Rough Electric-Wiring � � - • 57. Solar System-Final ` � � ' �
16. Rough Heating & Air`CondiFioning � encing & Access Approval • �
17. Ducts in Structure - 9. APPROVED FOR PLASTERING
16. Ducts, Ventilating • �
19. Gas Pipe-Rough'&Test, ° 60. POOUSPA SYSTEMS FINAL
20. Roof Framing � ' - � '
21, Roof Sheathin � • � �
22. Frameand Flashin NOTES: � ,� . , �_^ {p _�, � �D � �
. 23. Insulation ' - _ - - -- t+: - �- .w- =_�^� _ - ' R�:� .
24. Lathin & Siding - - � - - - " " °A:.f^ :°�.:-�'d� ��
25. Drywall Nailing - ' ' �
26. Plaster Brown Coat -
27. Electrical Power Meter-Final �
28. Final Electric � � ' '
29. Final Heating & Air Conditioning � - '
30. Final Gas Pipe-Test � �
' 31. Final Plumbing � -
32 � Water Service-Final - � � -
. 33. Gas Service-Final ' ' � �
' 34. Solar pomesticFinal {--2-�7� � � � � - �
35. Landsca e S rinklin S stem � � � � �
36. Sound Attenuation - � ' '
37. Handicap Regulations " ` -� " ' ��- - ' � ' - � '' � � � ' �'
38." FINALSTRUCTURE&BUILDING ; � ' ' " ' ' "
39. � Special Requirements Completed • ' - - - � - ��
� 40. Electric Release to Edison - � " -" - - ' ' -- ' -- � - - - � - - - - - �� - - - ---
: 41. Gas�Release�to Southern California Gas Co.' ' ' '- ' - '- ' -' ' � ' - ' -- '� ' - - - - -
. .. . , . , F . . . , . . . . . . .. _ , . .. .
' 42. CERTIFICATE OF OCCUPANCY ` ' ' � � � ' . ' �' � � '
, . _ . . _ . .. .
�No Date • . . . - . - , , � -
.
ORANGECOUNTY BUILDING`DEPARTMENT
`"' • 636 Noreh Broadwoy I ,
' SANTA'� ANA, CALIFORNIA ' �•
FOR APPLICANT TO FILL IN
�
ADDRESS 9l � Fvergreen P��ace
SCHOOL �IST. tl- I
ORTOWN COBtA 1•1cSr1
NEAREST r �
CRO55 ST. �ypi]2+�V1�.
OWNER Chinonk HnmeB InC.'
ADDRESS 9363 Ta113hi ra Rl vA �
TEL.
��TY Beverlv Hill s NmR �a��i
ARCHITECT/tOFj ' LIC.
ENGINEER Valil & McKerraehe?m
ADDRESS 2110 E,��lalnut-Pas� d n
t� LIC.
NTRACTOR y`jeQfin01't �%j QiA No. ]�c,AA9
noorxess q.iF,R Wi'I chi i+o�Rotr� ..�:, vt i i
USE OF NO. OF� NO. OF
EXISTING BLDG. Fnvwes ROOMS
SETBACK LINE FROM: REAR YARO �
CENTER OF STREET �(� 'PY. SIDE YARC� .'{1
•
DESCRIPTION OF WORK
NEW I� I ALTER TION I I IqD�IT10N
REPAIR I � I MOVING I I IDEMOLISH
eu��o�N� NO. OF ;
SIZE 1O;{LL R(1 'P'tROOMS Ca 'STORIES �
EXTERIOR WALL �,�_ � I ROOF �, OIJ1IiO„
R
NEAREST
APPLICATION POR PERMIT �
�� �� ��._'
-FOR OFFICE USE ONLY -
RECEIPT NO. PERMIT NO.
.�3�� soi��
Y DATE REC'O. OATE ISSIiED
� �2-� y 3-53
�'7/n0 Fp �.,�wni i�
'T./� Ai1 V._i�V ,
CORRECTIONS
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FOUNOATION: LOGATION
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS,
APPLICATION ANO STATE THAT THE ABOVE IS CORRECT UNOER-PINNING
AND AGREE TO GOMPLV WITH ALL COUNTY OROINANCES
FRAME: FIRE STOPS,
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. BRACING, BOLTS
AUTHORIZED AG]�
�v � /
VALUATION 5 4830��,r0
FEE $ •�� MASOf
�ecrc 8 � BOND
s � FINAL
ALS
r�.v� ra.ea�
Show location ond distances from
property Iine and between buildings.
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