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Home My WebLink About100 EUCALYPTUS LN - Building PermitsaCITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (714) 754-4856 BUILDING PERMIT Job Address: 100 EUCALYPTUS LN Suite: Vicinity: BUILDING 17 Parcel Number: 43917218 Zoning: Applicant: LYLE Address: 23015 DEL LAGO 701, rNUMBER -0397 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Phone: (714) 583-1858 Issued: LAGUNA HILLS CA Zip: 92653 Owner: LAUREL POINTE HOA Inspection: $0.00 Address 100 EUCALYPTUS LN, , " Phone: COSTA MESA, CA Zip: 92627 Contractor: PRO -TECH WEATHERPROOFING Address: 23015 DEL LAGO Phone: (714)583-1858 LAGUNA HILLS CA Zip: 92653 License: 620476 Arch Eng: Address: - Address: 701, rNUMBER -0397 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 03/28/2000 Issued: 03/28/2000 Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF - T/O, USE EXISTING SHTG, INSTALL GAF (GRAND SEQUORA) COMPOSITION SHINGLE ROOF FOR BUILDING #17. 100, 102, & 104 EUCALYPTUS LN. FEE SUMMARY Plan Check: $0.00 - Permit: $125.25 SMIP Res: $0.55 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.80 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 Calc Valuation: $5,500.00 Claim Valuation: $5,500.00 Right 0-0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 C 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' �cprppensation Insurance carrier and policy number are: Carrier MPT; T; 0 ✓ AA Policy Number: 7 (This section need not be completed i/ 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 it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith e provisions. ? / plicant Signatur ARNI E TO SECURE WORKERS' CCOPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN Ehoi CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND OOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR OODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONT RS DECLARATION: I here . ensed under provisions of Chapter 9 (commencing with Section 7000) of Divisio 1 the Business and Professions Code, and my license is in full cc a effect. Lic. # %�+ ass l.. Contra ors Signature 7479 Date: - - o� CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 70", 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Onver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code), ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................. ..--..- .... -.__. 2 Does or will the applicant or present or future building occupant need 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 -I -s presently required -,-h as 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 builtling occupant require for the work which is the subject of this a plication aggermit 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 N0 (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ____--m-it---........__...-100 -6---will any part of the facility to be constructed untler this permit be within 1000 feat from the outer boundaries of a school? ❑Ves ❑ 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 Safety Code Section 42303 been made? ❑Ves ❑ No 8 (it "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. Signet ire Of Legal Owners) Date mn ^� CODE #. INSPECTION TYPE DATE I INTTIRLS CODE. INSPECTION TYPE g/JJ INTRIALS 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 2aa6-a6 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 102 EUCALYPTUS LN Suite: Vicinity: POOLHOUSE Parcel Number: 43917219 Applicant: COOTER, LYLE Address: 23015 DEL LAGO LAGUNA HILLS, CA Owner: LAUREL POINTE HOA Address 102 EUCALYPTUS LN Zoning: Phone: (714) 583-1858 Zip: 92653 Phone: COSTA MESA, CA Zip: 92627 Contractor: PRO -TECH WEATHERPROOFING Address: 23015 DEI- LAGO Arch : Address: Phone: (714)583-1858 LAGUNA HILLS, CA Zip: 92653 License: 620476 Phone: Eng: Address: ISSUED BY: Status: ISSUED Applied: 06/21/2000 Issued: 06/21/2000 Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING POOLHOUSE FOR "LAUREL POINTE HOA" (3 SO). TEAR OFF EXISTING SHAKE, INSTALL 1 LAYER OF 15# FELT, & REROOF WITH 30 YEAR "GAF" COMP SHINGLES. 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) 954-5626 FEE SUMMARY Plan Check: $0.00 Calc Valuation: $795.00 Permit: $32.65 Claim Valuation: $795.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $33.15 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) 954-5626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjuryone of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 4f 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 work is' compensation 4✓ nsurance carrier and policy number are: /,� /C4 6 O Q Policy Number: / (This section need not be complot6d i/ 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: 4Date: 6 Z I " O WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL 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 ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full "force and effect. LIC. N b ?—�� b Class # Cl � Contractor's Signature: rye/ Date: 1. 21 0 0 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: 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 Cade) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a 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.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need 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 a plication a ermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? UYes U No (Section 65050.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (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 Safety Code Section 42303 been made? ❑ Yes ❑ No 6 (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. Signature Of Legal gwner(s) / Date / And/Or AuthorizedApplicantDate 1 CODE L INSPECTION TYPE DATE INTITIAL CODE I INSPECTION TYPE Q/jE INTRIAL 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 2446.46 CITY OF COSTA REQUEST FOR OCCUPANCY TRACT NO. 10097 LOT NO. 38 ADDRESS 100 Eucalyptus Lane, Costa Mesa, CA 92627 DATE: February 15, 1980 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. By executing this agreement, the undersigned acknowledges that he/she/they was/.ere advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having corrplied with the conditions of approval which were inposed by the City at the time the Final Tract Map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted conditinnrcl_ RECEIVED CITY OF COSTA MESA FEB 19 1980 PM 7i8i9iIDillil2i11213141516 6 4/79 authorized representative CALIFORNIA FEDERAL SAVINGS & LOAN ASSOCIATION BY r rrSignature of.Le Richard A. Gaunt, Assistant Vice Presiden FF"nal PROJECT ADDRESS: 104 EUCALYPTUS LN UNIT: OWNER'S NAME: BRITTAIN WAYNE ADDRESS: 104 EUCALYPTUS LN COSTA MESA,CA 92627 714) 753-2541 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: GENERAL INSTALLATION (213)753-2541 ADDRESS: 6558 WEST BLVD L,A, CA 90043 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 0l Divi o of the B siness antl Proles s C e. d my license is in ful fp c antl eNpscl. lid 9�i ��1�3'� ��6 ER J8 /95 C LIC.: �rS,TAITE Date' _a/D Signature: KERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a certificate of Workers' Compensation Ip$ut_'an4e7ol �yUd)ed3copy thereof (Section 3800, Lab. 0.7 / 0 1 / 9 5 POLICYNO.: CALIF. COMPENSA EXP. DATE: COMPANY: 15 Cenilietl�cjopy is hereby furnished. LJ Cell' lietl copy is fJiled with�t�h�e c�it�B�urild�ing�D/ivi's^io/n. \ Dal Z/Y '— _ L y Applicant: _-f�ti��''��'a�s� PTION FRO M WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). 77777T''"'cerlily 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. Dale: Signature: NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must foMvalle 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 which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt tram the Contractors State License Law for the fallowing reason (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 in 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 and Pmlessions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($510). 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 (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or lhrapgh his or her own employees, provided that such improvements are not intended at offered for sale. It, however the builtling or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 11 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 conlractor(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. ❑ 1 am exempt under Section: B. S P. C. for this reason: Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505. 25533, and 25534 and that l or any future building occupant will/will not (circle one) need to comply wild said state codes and the requirements for a permit for construction or modification tram the Air Dually Management District. Residential construction applications are exempt from these provisions. Dale: Applicant I hereby certify that I have read tons 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 authed7e representatives of mss ci linhernt aabave mentioned DietakIIy for inspection purposes. Bale: ' 6—(O^ 5PI/ SignaturA/� m's License or Social Security x: 164646 While—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT VtLhm NU: E, l , PERMIT NO: P 069171 PLAN CHECK NO: N U is N SUMP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION WATER HEATER REPLACEMENT SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ############################################################################### Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- PERMIT --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING REQQ• PROV: PARCEL: 43917220 ZNE: REF NO: PLANNING NOTES> 27,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY APPLICATION ISSUED BY: LEGALIZATION:N F E E S U M M A R Y DATE: DATE: _ J p T / 1 DA E. / 1 STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7,00 253 SMIP/NON—RES PLAN ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSU£ PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 7,00 20,00 - 0,00 27,00 27,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 27,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 27.00 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N, UNIT COST TOTAL COST PLU 1 14ATER HEATER AND/OR VENT 7,00 7.00 END OF FEES 01 00169114-00169114 TEST 27.00 DATE: 10/06/94 TIME: 13:19 CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL & SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pi Pe-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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit Undrgrnd. ' 8. Foundation 59. Gas Pipe, C Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash. Lines, P -Trap, C Undrgrnd, 10. Structural Floor System .I 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 i 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 20, Rough Factory Fireplace 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping El Gas COil 23, Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Uhdergrnd.Storage Tank CGas ❑Oil 25. Roo` 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 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No. Date _ _ 1! 5- F _04 6 :1 J J COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING r.— ___ -. r—. 1.- r _ - OWNER MAIL CITY Newport Beach NO. CONSTRUCTION BRANCH l 1'�l!718 bbq 216.51 TL, �� 779310/27/78-21'6.51CKT0 .3 7793 '00004469 55 I A'' aA ION FOR STRUCTURAL PERMIT RECEIVED BY I gfyrrEji Fr'bIVED naT� p mitpn 'BUILDINGS z /j HS �� ■ ADDR ESSI/Yi iA2-iY}�% ® CONTRACTOR �/�eir-4, /1 ' ADDRESS TEL. CITY NO. F STATE CITY LIC. NO. LIC. NO. fa7SIZE NO. OF BLDGS. 0. OF LOT NOW ON LOT Q USE OF ,�. EXISTING BLDG. rn FSeparate permits are required for electric, plumbing and heating work. [W. USE OF BUILDING AND WORK TO BE PERFORMED a oNpw Tniunhomeq,13roject G Q 06 ..l C w 1 hereby acknowledge that I have read this application and state p: that the above Information is correct and agree to comply with a' all laws regulating building construction, and I shall not employ Wany person in violation of the workman's compensation laws of .2 the State of California. 3 1 hereby certify the,I am properly licensed as a contractor under the State of Califor is Business and Professions Code, Division 3, Chapter 9, an Wpr force and effect, or I am exempt of California Business and Professi s Signature of Permittee Authorized Agent OWNER 1,1w � USE i- eiga FIRE ZONE APPROVED BV ZON E,�r NO. OF /A PLANS YARDS APPROVED USE OF NE/W� � BUILDING YARDS APPROVED ACCESSORY BUILDING DISTANCE BET. BET. MAIN & MAIN BLOCS. ACCESS. BLDGS. VAR .# y'y - DATE APPROVED 121,2 APPROVE DATEn✓' D -J7 HOLD FOR SPECIAL REOUIREMIENT_' THE AMOUNT SHOWN UNDER VALU THE PURPOSE OF ESTABLISHING A PERP VALUATIONPERMIT FEE $ PLAN CHECK $ SO0 TAX $ TOTALPAID $ n m i v m' N ON IS FOR m FEE ONLY: a o� N �I s� O,00 LL ,w1 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 7922 .10/3078 320.00 7922 10/30178 _ 32040CI(TT�� 7922 00004U6955 '14 . APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink On y RECEIVED BY DATE RECEIVED DATE ISSUED /,. ADILDINGDRESS `eL I `--7 PERMIT NO. OWNER h e— MAIL BUILDING -r ADDRESS Q6 /o? �� G S I ADDRESS 1� TEL, TRACT LOT BLOCK CITY NO. NEW AD A T P CONSTRUCTION LENDER BRANCH OWN&bd Q ADDRESS t U, LUE S �d-"�S ARCHITECT TEL. OR ENGINEER N . FIRE ADDRESS f ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS ZONE NO. OF I PLANS USE OF NEW BUILDING TEL. CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SIZE NO. OF SLOGS. OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R. SIDET FT Separate permits are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. SLOGS, VAR.# DATE C.U.P. els APPROVED APPROVED TE I hereby acknowledge that I have read this application and state 0 that the above information is correct and agree to comply with n as all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of v the State of California. hereby certify that I am Properly licensed as a contractor under SO. FT. H1 THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Coda, Division 3, m Chapter 9, and that such licenses are 1n full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV� am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. VALUATION PERMIT FEE $ u+ m PLAN CHECK $ Signature of 0 TAX $ Permittee $11 s 2 Authorized Agent hh TOTAL PAID $