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Home My WebLink About3009 FILLMORE WAY - Building Permits� CITY OF COSTA MESA B!/ILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.costamesaca.qov FOR INSPECTIONS CALL: (714) 754-5626 � { PERMIT TYPE B_ROOF2 APN: 14113408 JOB ADDRESS: 3009 FILLMORE WY CM Vicinity: TRIPLEX Squares: 2765 PERMIT NUMBER; B12-00013 STATUS: DATE ISSUED: ISSUED BY: Suite/Unit: Valuation: ISSUED 0111 712 01 2 KJB $6,800.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR / REPLACE SHEATHING AS NECESSARY. COVER WITH CLASS A 30 YEAR COMP SHINGLES. TRIPLEX BLDG. DOES NOT INCLUDE GARAGES. APPROX 2765 SQ FT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment wllnspection Card OWNER: DI PIETRO, NICO�qS PHONE: 949-467-9386 APPLICANT: VAZQUEZ, AGUS7IN PHONE: 949-812-2209 CONTRACTOR: PROFESSIONAL ROOFING Address: 17431 TEACHERS AV�Unit: n� City/State/Zip: IRVWE,CA 92614 ARCHITECT: i: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $139.25 }2einspection Fee: $0.00 Bldg Std Admin Fund 51.00 o', TOTAL FEES $140.25 HOURS FOR CONSTRUCTION ACTIVI :F Monday thru Priday - 7:00 am thru 7:00 pm. SaWrdays New Years Dav. Memorial Dav. Indeoen Address: 3009 FILLMORE WY Ciry/State/Zip: COSTA MESA, CA Address: 17431 TEACHERS AVE City/State/Zip: IRV W E,-CA PHONE: License No. License No. License No. 926316 949-812-2209 CELL: PHONE: PHONE: Unit: Unit: Y; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the followinq Federal ance Dav. Labor Dav. Thanksoivina Dav and Christmas Dav ��{ G: f �! NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related �egulations. (Ord. No. 92-28, § 1, 12-21-92) �EXPIRATION: PERMIT EXPIRES 160 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. ;INSPEC710NS: 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 fnal approval will result in the expiration of this permit. LO�E t. INSPECTIONTYPE 4616 Fixed System Final Fire Prevenlion 1266 Pool Spa Final ?00 Final Re-Roof 201 i'.' 202 103 '204 �' �_.. Final BIocWRelaining Wall Final Factory Fire Place Final Sign Final Demolition onrz IN1111AL5 n �� ,%�1 CODEC INSPELPONTYPE 206 Final Mechaniral 208 Final PlumDing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 250 Final Site Finat Builtling/Occupancy OR IN1111RL � WORKERS' COMPENSATION DECLARATION: I hereby aHirm under penalty of perjury one o� the following declarations: ❑ I have antl will maintain a certificate of consen[ lo self-Insure for vrorkers' compensation, as provided (or by section 3700 0( ihe Labor Code, for the peAormanCe o( the vrork (or whiCh this permit i5 i55uetl. ❑ I have and will maintain �orkers' ctimpensation insurance, as required by seclbn 3700 of the Labor Cotle, for the peAormance of the work for which this pertnit is issued. My vrorkers' compensa�ion Insurance carrier and policy number are:�� Cartier. (ihusec(.anneeEirolDecomdete0d epeimauvaluetlatone1huntlieddollars(St00)orless) Policy Number: r��'� '---� O I� ❑ I certify that in the peAormance of [he vrork 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 Califomia, and agree that it I should become subject lo the workers' compensa[ion provisions of Section 3700 of the Labor Code, I s 1 h'th comply with these provisions. %'�� %.� � r% i f r � � oal�- WARNING: FAILURE T SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND HALL SUBJECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($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 affrm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 0( �he Business antl Professions Code, and my license is in full fo/rce� �and ef'fect. /� Lic. # � � E� Z�L Class # � � �Y r - ,r��- � � C �ature � Dale CONSTRU ING AGENCY: � I hereby that there is a consWction lending agency for the pedormance of the v.urk fa which t�is pertnit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: OWNER-BUILDER DECLARATIONS: I hereby affrm lhai untler penally of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to construct, alter, improve, demolish, or repair any stmcture, pnor 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 Con[racrors License Law (Chapter 9(commencing with Section 7000) o( Division 3 of the Business and Professions Code) or Iha[ he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 703L5 by any applicant for a permii subjects Ihe applicanl [o a civil penalty of not more than five hundred dollars (5500�.�: ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The CoMrectors License Law does not apply to an owner of properly who builds or improves thereon, antl who does such vrork himself or herself or lhrough his or her own employees, provided that such improvements are not intended or ofteretl for sale. If, however, the buildinq or improvement is sold within one year o� completion, the owner-builder will have the burden of proving ihat he or she did not build or improve for purpose of sale.). � ❑ I, as owner of the property, am EXCWSIVELY CON7RACTING WITH LICENSED CON7RACTORS to construct lhe project (Sec. 7044, Business and Professions Code: The contractors License law does not apply to an ovmer of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contrectors License Laws.). ❑ I am exempt under sec. Business antl Professions Code for this reason: JOS]-a6 �JIO]� � Owner ID verifietl by tlriver's license. ❑ Yes ❑ No Driver's License No. Expires: Verifcation of Ownership by (type of tlocument, i.e. - propeny tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CER�IFICATION: ❑ I hereby certAy Ihat no excavation frve (5) or more feet in d�pth into which a person is required [o descend, will be made in connection vnth work authorized by Ihis permil, antl lhat no building sWcture, scaffdding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Atlminist2tive Code). ❑ As owner-builder, I will not employ anyone to do work which vrovltl require a permit from the Division of Industnal Satety, as noted above, unless such person has a permit to do such vrork fmm Ihe division. AOW�u�ofs Signawre oa�e Division o( 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 Ihreatened release ot a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safery Code requires, with some exceptions, thal a Business Plan be fled with the Costa Mesa Fire Department by every business which has at any one time tluring a reported year a quan[ity of hazardous ma[erials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standartl temperature and pressure). 2. Does or will Ihe applicant or present or (uNre building occupant need to file a regis[ration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Cotle, with some exceptions, requires registration with Ihe Costa Mesa Fire Department by each business which at any one lime has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume o/ 55 gallons, or 200 cubic feel of compressed gas at standard [emperature and pressure). 3. Does or will the applicant or present or fulure builtling occupant neetl Io prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of Ihe Calitornia Heallh antl Safery Code provitles that the Costa Mesa Fire Department may require the preparation, certifcation and filing wi[h the Fire Department of an RMPP by businesses which are required to register acutety hazardous materials wilh the Fire Department. 4. It an RMPP is presently requiretl, has Section 25534 0( the Califomia Health antl Safery Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occuDant require for the work which is the subject of ihis appliwtion a permit for such consWction or motlification from the South Coasl Air Quality Management Distric[ or from any other air polWtion control dislrict or agency? ❑ Yes ❑ No (Sectbn 658502 of the Califomia Govemment Code requires Ihal lhe requested infortnalion be fumished on applications for nomresidential building pertnits). 6. Will any part of the facili[y to be consWcted under this permit be within 1000 fee[ from the outer boundanes ot a school? ❑ Yes ❑ No Qf yes", Ihe faciliry must meet the requirement o! Sections 25534 and 42303 of Ihe California Health and Sa(ety Code). 7. If a permit (mm the South Coast Air Qualiry Management Districl or other air pollution control district or agency is required for the work which is Ihe subject of this application, have all of the disclosures prescribetl by California Health and Safety Code Section 42303 been made? ❑ Ves ❑ No 8. (If'yes", attach certificate of compliance from the appropnate air pollution control oKcer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury Ihe intormation given above is correct I agree to comply with all state laws antl ciry ordinances regarding Hazardous Materials and Emissions. SignaWre Oa1e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certify under penalry of perjury that I have read this application antl state that the information given is correcL I agree to comply vnth all state laws and city ortlinances relating to building construction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described pmperty (or inspection purposes. I agree not to occupy or allow occupancy o( any builtling authorized by this permil until fnal inspection. SignaWre egal eqs) oate � �-1 ->�- �r%� �M l�� dAppllwnl Da�- ce: Residenfial N:unc: CF-IR-AL7' (Pa e 1 oi' S) Zune N n �# uf Stories Gencral Lifurmidion Sita Addrenti: � � � Lnl'orcement Agency: Late: _ ,� I3uilding Type 0 Single Family ulti Pamily Circle the Front Orientation: N, E, S, N�, oi degrees � Conditioned Floor Area (C�A): Projem Type: ❑ Alterxtions D Envelopr D Fenestration Roof D HVAC Ite lacemem or Chnn�e Out ❑ Duci Re lacement O Water Heater NOTG: T/ei.r jnru+ i.e ixn 10 he u.sed for Ne�vlr GnaslructeAl3uildin�s' nr Adrlitinns � Dt.eulttfimi Vnlues Fnr Opntpie SurJ'nces (/'m' Fw�ring use the Mass Anct Furring 57rips Consn�action mhle below) Assem6lp Alter:rtio❑ � ❑ Openine of 1'ramed cavita• alone—Al�era�inns thal ir�volve (he opening of the fi�amecl cnvity ojn ��all, ceiling, orjloor mus! i�ts�all (he mandcimrr mirvimum n�sldniimi vn/ue �er §150 fm� Ihe n6ered assemb(��. Fill in Colimnts ft —C and enler' mandra(or'�� insulation vqlue in Colunvn H. ❑ Repls�cement of entire aFsembly—Replucer��e�v oJ�an emire wa(1, ceiling, orJloor assembl�� reqa�ires the ins�allation qJ'Cornponeni !'ucku e- D ina'iJntion vuluea in Tn�le l51-C. Fi11 in Columns fl — J O a ue Surface Details Rur the iur A B C Pro �osed s��noe Framing Tag/ Assembly Name Material ID� orTy e� andSize` No�e' For;(urred assembliea, accountingfor Cmi of Mass VJalls see Furrine Strips Cunstruction Table below. � Standard Ve Thiclaiess, Framed Spucing, U- lA4 Table Caviry or O[her� factor° Numbers R-value� � InsulQlion R-value, see Pnge JA4-3 and Eguatiwr 4-1. For ;s From JA4 Table Continuo�s JA4 Proposed Insula[ion Assembly Assembly R-Value' Cell Values U-facror9 use !he Moss and 1. hor I ag//U indicale the identJicqtion name that mntches ihe 6uildmg plans. ?. Indica�e (he Assenabh� Nnme or rype: Rooj/Ceiling, Wa11s, Flow'a�, S[abs, Craw! Space, Doors and elc...lndica�e Ihe Frame type and Size: For N�ood, Meml, Metal Buildings', �Llass, en�er- 2z4, 2x6, or eic... see JA4 for other yossible fi�ame ry ye assem6lies. 3. Enier the thidmess_fa� mass in inches m� Spacino 6etween ¢aming members enter; 16 "m� 24 "OC; or Other jor a[I odier assembl�� descriptimi a'uch a.r Cnncrete Sandwich Pane(, Spandrel Panel, Logs, Sn'an� Bale Panel ond etc.... , 9. Bnsed on the Clineale Zone; enter the Standard U-7actw� fi�om Table 151-B, C or D for each difjere�el assenrbl r� Namc or t� pe. 5. Enier d�e Table numGer dia; closelv resemGles the proposed asa�emblr. � � 6. L•i�(er dte R-i�alue /haI is' being inslal/ed i�t Ihe wa!! caviq� or between the fi'a�mng; o0ieiwise, en�er "0 ". 7. Erver !he Cantinuous ]ns'tda(ia� R-ra(ue for the proposed usseinbl�t- o�her-wise, enter "0 ". 8. L•n�er the roun and column af the (I-(ac�or value Gased on Calwmi F Table Number and e��ter /he Assen7b7�� U-faetor in Column J '). Thc Propnsed dsa'emblv U_fnc�m�, Colwnn ,/, must 6c equa7 m or lesr thun the Slmidard U facia' i�r Col�min E!o conepl��. FurrinF Strips Construction Table For Mass W alls Only A S C U C F C H 7 .1 I< L M Propused Pruperties uf Mi+sonry smd Cuncrete Added Interior ar Exterim' ]nsuldtiun Walls i�rum lieference in Rurring Spacc frum Referencc Juinl A>>en[lia'fable 4.3.5, 4.3.fi. 4.3.7 Joint A� iendix Table A313 v � � .-S � q - V � ` o " c. � J ,., Assembly F- j ``o ° �" v� u,"� �, ,�"v Final Mass Namea� JA47abic ' v' F - 9 r_ Q' ` � Assembly, 2 0 Thickness� T e' Num6cr' ��` c� ^ � �,r� � C C=` � C jJ-{gCt01'�'� COmrqeN I I I I I Regi,sn�ntirui A'umbei:' Regielratiar Du1e/Tinre: HGRS' Prm�ider: 2006 Residervtial Compliunce Forms Augus� 200y Certificatc o}' IProject Nnme: Zone 3 aT ROOPINC PRODUCTS (COOL ROOFS) §IS](n72 WHen the nren oJcrterinr rnoJ'surfi�ce tn be repluced ezceeds more lhun 50% nf the existing raof aren, or more thun I,000 fC, whichwer ie� less, Uie ne�n roofing aren ��u�s9 mee! tlae roofrng product "C�ol Rnof'reyuiren�ente� oj§752(b)IHi, I52(b)IHii, or ]51(b)IHiii. Check applicable n!len:ntive a� eecepfia� 6elow if the roojalie�wtian is esempl j�am 1he roofing producl "Cao! Raaf" reqirirements. Nate: /Jan�� one oj�he al�ernu�ives or exception be/ow is checked, the Aged So/ar Reflec�ance and Thennuf Emitmnce reguiremen�s for roofingproducts in ,¢l18(i) a�e not applicable. Do rm� r7l 1able below. ❑ f�ool Roofs Not Required in Climate Zones 1-12, 14, and IG with a Low Sloped. Less or 2:12 pitch. � ��ool Roofs Not Required in Climate Zones 1 through 9 and 16 with a Steep-Sloped Roofs (pitch greater than 2:12) and product unit weight less than 516/ft�. Allernetives to §152(b)1 Hi and §152(b)Hii, Steep-slope roof (pitch > 1:72) ❑ lnsulation witl� a(hertnal resistance of at ieast 0.85 hrft �°F/Bhi or at.least a 3/4 inch airspace is added to the roof deck over an auic; or ❑ Existing ducts in [he attic are insulated and sealed acwrding to § l51(� 10; or ❑ In elimate zones 10, 12 and 13, with 1 f?� of free ventilation area of attic ventilation forevery 150 R� ofattic floor area, and where at least 30 percent of Ihe fiee ventilation area is within 2 feet venical distance of the roof ridge; or � . ❑ Building has at least R-30 ceiling insulation; or � ❑ Building has radiant barrier in the attic meeting Hie requiremenu of § I51(�2; or ❑ Building has no ducts in the attic; or ❑ In climate zones ]0, I l, 13 and 14, R-3 or greater roof deck insulation above vented attic. Cxception to §152(b)1Hiii, Low-slopc roof (pitcl< <2:12) ❑ Building has no ducts in the a[tic. Other Exceptions � � .. .❑ Roofing aren covered by building integrated; photovoltaic panels and solar Ihermal panels are exempt from the below Cool Roof criteria. , �� Q Roof eonstructions [hat have thermal mass over the roof inembrane with at least 25 Ib/R� is exempt from [he below Cool Roof criteria. --I Note: If no CRRC-1 label is available, this compliance method cannot be used, use the Perfortnance Approach to show compliance, otherwi Check the aoalicable box 6elow if Exemnt from the Roofine Products "Cool RooP' Requirement: RoofSlope I ProductWeight I Product 2:12 > 2:12 < 516/ft' > 516/ft� Tvoe� Aged Solar Reflectance�'4 ❑4 ❑4 ❑4 �4 ❑4 Thermal Emittance SRIs The CN/tC Prroduc� lU N�nnLer can Ge obinined fi'om Ihe Cool ftoofRaling Cmmcil's Hated Producl Direclory at ww�v cooL�oo(s ore/producla'/.cem'cle.Phe ludicnte !he q/>e ojprnduc� ia� Geing used fm� the rooJ�op, i.e. singlepl�� roof, aspha6 roof rne�al roof, etc. If Ihe Aged lief7cclonce is nu( uoniluL/e iu.lhe Coo! RoafRaling Cmumil'a Raled Prnduc( Direcfory (Hen use Ihelnilial Ref/ecla�ce value fi'om !he snme directm�� mid use Ilie eyua(ion (02+p.7((l��iiial — 0.2J lo nbmin n culculaled uged valne. Where p is Ihe /ni(in( Solar Refleclanee. Check Gn.t' ('(die dgcdlteRec�mrce is n calculaled vali�e us'ing ihe cqunlion aLave. C'alc�dale (he Sft/ vulue fn� ��a'ing Ihe SRI- Workshee� n( h1(n�/Rvrv�v enerim cn envAillc24/und erverlhc resul(ing value in 1he SRf Cnlumn above and a((ach acoln� d�e SRI- Wnr'kaheel m(he CG-IR. � apply Liyuid Rield Applied Contings, the coating must bc applied across Ihe entire roof surface and meet the dry mil Ihickness or coverage commended by the coatings manotacturer and meet minimum performance requirements listed in §ll 8(i)4. Select the applicable wating: Aluminum-Pigmented Asphalt Roof Coating Cement-Based Roof Coating Other Regislrutian NumGer: Regis4�ation Du(e/Time; HERSProi�ider': 2008 Residenlial Compliance Forms � �l ugust 2009 1'rescriPlivc Ceriificat.e uf Cumuliance: Residential CF-1 lt-ALT Jtcside�xtia/Alterations (Pa�'e 5 u1'�) Pru,jecl]Vnme: � Ciimate'Lunei! � �Jo1'SWries H�KS YEP�II�1CATl0f� SUMMAR)' The en(orcemem ngenershoidd pqr special une�vion �0 1he HLRS Meoswrx speci/ied in ihis checkfist Ge(ore. A canpleted and signed CF-4R Fonn (or oll the rneasures syecilied shull Le rutimined io tiie bui(ding inspec�or Le(m'c Jinol DuCt $t"nll�le B: TCSLIIIp HEliSrerilicn�ionisreyuiredla'lhisnreururc. ❑ 1'ES ❑ NO YLS: lu Climate Zunes 2 and 1-16, if'more than 40 lineur feet oTne�v or replucement ducts are ins�alled in uncnnditianed space, [iie tiucls arc lo �C SCHIC(� �JCf S�iJ�(b�IDlf Htid LIiG I1CN'I}' IIIS�BIIB(I (IIICIS LIC f0 bC IfISUlated per § I51(1110. ��XCCPTIO�: Lxistine duct systems thai are extended, �vhich are cunstructed, inxulated or sealecl �ridi :�sbestos. ❑�'�S ❑ NO YBS: ]n Climam Zones 2 and 9-1 G, if d�e existin@ space-conditim�ing system (HVAC equipment and ductingj is repinced, the ducts are m be sealed per §152(b)7Di. ❑ YES ❑ NO TL'S: ]n Climate Zones 2 and 9-] 6, if'the existing HVAC equipmem is replaced (including t6e replacement of Ihe nir handler, ouidoor condensing unil of si splii system, cooling or henting coil, or the furnace heai exchnnger) ihe ducts are l0 6e sealed per §152(b)lE. ❑�XCC]'TIOn: Duct systems fLat oire ducumentod tu h�ive Leen previousl�� sealed coni'irmed thruugli HCP.S veriticntion in accurdance witli prucedures in the Reierencc Residential Appendia' IiA3. �� ❑��RCEPTJON: Uuct systems with less thau 4U linnar feel in uncunditiune� spxce. � . . ❑ EXCGPTIOR: Ezistim� ducl s��stems cons[ructed, insula[ed m'sealed with asLeslus. Ref'ri�erant Charee - Split St�stem HERS veri/ica�iar rs reqerired Im this meorane. ❑ 1'�S ❑ NO YES: In Climate Zones 2 and S-] 5, when the existing H V AC equipmenl is replaced (including [h: replacement of the air handler, outdoor condensine unit of a split system A/C or heat pump, cooling or heating coiL or the furnace heat exr.hanorri a rofrio,>ram r.h�rae me.nsuamem sh211 b¢ vC�1�IC(I OP� �152(o11F. Centra] Fan Inteerated (CFI) Ventilation S)'stem and Fan VVatt Draw The ventila[ion renuirements ot §150(oj do not aoolv to existine residential homes. Ducted Split Systems - Air Conditioners and Heat Pumps: Airflow HERS veri/ica�imi is reguired jor �his measurc. ❑ Y�S ❑ NO 1'L�S: ln Climare Zones 1 D thmugh 15, when the existing space-conditioning system (H VAC equinment and ducting) is � repiaced. the airflow and fan watt draw shall be verified oer § 152(b) 7Ci to meet [he requirements of § i i I(t17B. Documentntion • I certif�� that Name: ,, _ � v (Certification CEA or � CEPE '- �i5� 2- 22 7tespnnsible 13uildiue Desi�ner's Declaratiun Surtement � 1 am eligible under Division l of the California Busiuess and Professions Code to uccept responsibiliq� (or lhc buildiug design identiGed on this CerliLcate of Complilnce. � • ] cerlify thai thc energy feuwres and perlormance speci5cntion;. Ibr the building design identiLed on ihis CeniLc,ue of Compliance confonn «� thc requiiements of T'iUc 24, Pans 1 and 6 of the Califurni,i Code o( Regulations. • Thc building design fc�wres iden�iGed on this Certificnic nf Compliunec arc consisiem with lhe inibrmatiun �>rovided tu ducumem this buildiii� desi�n on Ihe oiher;�pplieable enn�pliauce i'onns, woil:sheeis, enlcula�ions, plans und specifica�ions subniiued lu the enforcenaent ueenc�� for iipproval with this buildinE permii applicution. Neme: Si�naturc�. Date: License: For aa.ci.raancc nr quastir�r�.c reb,mdrr�g thc Lncrgl' S[andrud.s, co�viact �6c Enragr Hotlinc u�: ]-k00_i i7-�31111. I(egr.en�aninn A�uniber: !(egi.rvaiirm Dme/7'imc: FlEI;S (rorider: 100b' Ra.sicleiv[iu! Cvrttpliunca Forms Augaei�i 3p(1% PH0.IECTA�ONE55: '�009 F�LLMORE i�TY uxiT: 106 CITY OF COSTA MESA - BUILD'ING PERMIT PERM NO; B 053569 OWNEN'S NAME GEO,�GF.. PHE �PS nooeess: S�ML , PERMIT NO: B 053569 PLAN CHECK NO: 03744-9i S GOVT: N SUPP: h' • COA�STRtiCTIGN TYP�: V-N PERMIT TYPE: STR PURPOSE: ADD ABCHIENGINEEH: 8 3 2— g 6 6 J BEG.NO.: ��, AODflE55: i 69 � Z HOL�SARCHICA RD S� uxR� S O1 � PEHMITTEE: H,B. CA 92649 aooeess: ��IDGEPORT BliIi,DERS ( 714 ) 241-9077 124 E. GEAkY n TII n7�� 7p7 LILENSEU CONTHACTOH OEC�LAflATIOM'7 hcrtUy auirm �ha� � am �icensea undef vA isions � Ch�dpier 9 �commencinp with Sec�ion 7000� of OiWsion 3 0l IAe 9usiness anG Pmlessions Code. anE my license is in fulllorce antl e�fecl. CITY LIL.: $TRTE LIC.: IASS: 1+71`9 �12063 /„�.�,L Da�e:.��-G-� �'_� Signaiure: —�Q��'J�••— � WOHKEHS'COMPENSRTIONOECLAPATION: I�er¢Oyallirminallhaveace�ilica�eo�consenito -insureoracerlilica�eolWOBers' Comoensalion Insurance. o� a cenifieA coDY ��e�eo1 (Section 3800. Lab. C�. eoucr xo.: p�C -112161 E%P. �ATE: O 3 I S Z I9 i COMPANY: GIaC�DtN �ACT F ZN � Ceni�i¢0 m0Y �s ere6y lurms etl. ertihed coDY is IileO wM ciry BuilOing pivision. Oale: _�,� � / � � r AOVlicam _�'� E%EMFiION FBOM WOflKEflS' COMVENSATION OECIABATION: (i�i55ec1ion nee0 not be wmpleteE il ih erml ¢ fa one hunUreG �Si00) or less�. I cerlity Ihal in ihe pedormance al I�e wark lor whic� ��is perrtti� is issued. I shall not employ any person in any manner so as Io betome 5ub�et� 10 Ihe Workers' ComDensa�ion Laws oi Cabiontia. Date: Signamre: NO71LE: il, atte� makinA ihis Oeclaration. yau shwid 6ecome subl�� to t�e Wofners' Compensation p�ovisions of the Lahor Code. you must laMhvnih tomply with sucn Dmvisions at ihis permit snall De OeemeO revoketl. CONSTFULTION 1EN01NG AGENCY: I hereby altirm �nai there is a constmction lending agency for t�e Derlormance of the vrork for . wnicll Inis De�m�t is issuM �Seclion 3W7, Civ. C�. , '� �enoee: ' ' I AOONE55: OWNEfl BUILOEfl OECIAPPTION: I IlertUy a�lirm Ihal 1 am exempl imm Itle fAnifatlorS' State license Law for the Iollowing reamn ISection 703t.5 Business and Prolessional COOe: Any city af county wnich repuires a permit to consirutt, alteL improve, tlemolish, or repair any SimCWre. prior to it5 i55uance, also reQuir¢5 Ihe applicanl �or suc� permil lo lile a signetl 5�atemeni that he/she is licensea Oursuanuo t�e pmvisians ol the Comractors' State Litense Law �ChaO�er 9(commenting wit� Seciion 7000) ai Divivon 3 aR�e Business antl Pr0�es5ions Cotle) m tha� Oe/s�e is exempl �herefmm and Ihe Easis lor I�e allege0 exemption. Any Wolaiion ai $eclion 7031.5 Dy any appli[an110r a pBrmi� 5u�leci5 �he applicant to a civil penalry ai nol more t�an �ive �undred doliars (3500�. 1. as owner ol t�e propeny or my employees wilh waAes as iM1eir sole compensation, will Do ihe work, and t�e ❑ slmcmre is nol imen0e0 or o11ereG lor sale (Seclion 7044, Business antl Pro�es5ional Code: T�e CanVac�ors' S�ate LiCense Law Coes not apply to an awner of a o�op¢rIY w� builes or im0�oves ihereon, an0 who aoes sucA work himselOnerself or througn �is or ner awn emD�oyees. O�ovi4e0 I�a� such impmvements are no� intentletl or aflereE tor sale. IL tlowever the builUing or imD�ovement is soltl wilhin one year of complelion, ihe owner will �ave the burtlen o1 pmving �e/she Aia not bui10 or improve � , lor �ne W�pose ol sale�. I, as owner ol I�e pmperiy. am exclusively comracting wilh licensed conVactors lo conslmci Ihe pmjeci (Section 7044, Business ❑ an0 Pmiessions CaEe: TAe Contractors' S�a�e License Law dces nol apDN �o an owner o� pmpeny who huilOs ar impmvu ��ereon dn0 wh0 LOnlfdtl5 IO! Su[II O�OIQ��S WIIII d COnlfat�0l(5) li[Qn5¢ puRudn� l0 Ih¢ COnffaLl0f5 $Iate Lit¢nse Ldw). I dm dwdf¢ Ihal pmof Df Iheir Workei 5 Compen5aiion insurance S�oultl be pmvi0e0 Io me. � I am exempl un0er Se[lion: e. 8 G. C. mr Ims reason: Dale: Owner: I Do �ere�y cetlity ihal I am aware o� ana unGerSiand Ihe repuirements ol Calibmia Nealth anA Safery Cotl¢ Sec�ions 25505, 25533, and 25534 antl Iha� I or any fuiure Duiltling ocaDanl vnll/will no� (circle one) neetl Io comply vnlh saiU state co0es antl lhe �epuiremenis for a permil lor cansimction or moaifica�ion imm Ihe Fu Ouabty Management OislricL ReSiUen�ial constmc�ion apPlications are exempt �mm ihese O�ovisions. Dalc', �pplican�: I heie0y c¢rltlyl�a� I �ave reaUl�is apPlit on an� s�ale IAaI t�e above inlormation is correc�. Iagreeio comply with allcily antl county ortlinanceSdnAsiatelawsrelalingta�uiltlin conslmciionandherebyaulhar repreSenlativeso�IhiScity�oenterupon�hea6ove�menlione0 0/OpEtly �Of10 CUi00 pp� OSES. Oate: _�� r9 �_ Signamra ��'�/��ti � Oriver's license or Social Securily k� , � 16<1�46 Whllo—Building: G�een—CaEe Enlomemenl; Canary—AOPlicanf. Pink—Revenue: Goltlenrotl—Assessor JGB DaSCRIPTION .:001TNG DAMAGE REPAIR SQ rT; 2,OOU CLAIM VALUE: 2,000.00 CALC-VALUE; 2,OOU,OU GROUP OCC; R-3 / COMMENTS: NO OTHcR STRUCTIIRAL WORK PERMITTED ce��r*#��*±�#**�-�e**�**;�#**+t*�-#*�*�xt�� x�*� rt*ce�-�t�#��t*�r**+��rx��**x*x� �*+�*tt #r��t�c�*�*v# Z O N I N G k E Q i7 I R E M E N T S S E T B A C K S ----------- N.AIN BUILDING ---------- --------- ACCES50RY 3UILDIAIG --------- FRNT: FT IN REAFt: FT IN FRNT; FT IN REAR; FT IN LEFT; F't IN RGHT: FT IN LEFT: FT IN RGHT: FT IA' FARKING REp• PROV; PARCEL: 13944505 ZNE: REc NO: PLANI�ZNG i�UTES> > ��**�*�**�t x*x�**�;��##�***� �*�*�r� �#**�#*��tx**�r•#� �**��*��t �-+��t*#*+�x*#��*� �x�+� x D E V E L O P M E N T S E R V Z C E S R E Q i3 I R E M E N.T 5 20NI1dG APPROViD BY DATE: � BUILDING APPROVED 3Y ; C DATE; : AF�PLICATION ISSLTcD BY: "�� DAT�: ��,�� kifif-1hiEiF�EiEir-iElElEiEiEit�f#lEif?fIFiE3F3c3F;:3r#iFiFtiFiF�iF3FiFiFTtiFiFiFiF3tiF'fi' ir3F3FiF�7E&r.�cifiE%�iFikii�ff�#�1e+EFR'� i(� iF 3f iE� 1E # 7F �It �lE if i(� iE #%�e iE if 3'r iE Y.� # iE ie If it iE IE IE iE iP if i%iF it ###?% 3f iE ff # 1E iE iE # iE if #f if iF ii af it 1t 3f iE if # IE iF if iF ii� ,w,. #f i!� ie a; 3E )F �k af ie 3f 3f i'r i6 )f 3F LEGAi17.ATION:N F E E S❑ M N, A R Y STRUCTiIRAL SEG,`:Ehi;Y BLDG PMT PLUMBING ELECTRSC MECHANiC FZRE SNIP/RES GRADING PERNIT 45.OQ SU S2•'.I P /NON-RES PiAN 29.25 ZSSUE FEH BUILDING-17IV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID D(IE TOTALS----> 45.50 0,00 29,25 74.75 74,`75 ,00 REVENliE DIVISION TOTALS--> COLiECTED: 74,75 OVER/S:IORT: ,OU HLDG PM? PLUN.BZ2�G ELECTRIC ;:ECHANIC PIRE St✓.IP/TOT GRADING PLRN-CHECK 45.00 ,50 29.25 14' if if i6 �!' if if if # if if if 3c'k' it i'r iF 1E if if if' if if 7FiE if if if �(' iE if i(' if if if if if'iE if if ii' ih if if i4 iF if if if lhif' ii if if #�f !f ii' if iF K' it if if Y i't i%i%ii' ii")i' 7f if ii'!(' af' if' ie # I N D I V I D U A L F E E B R E A FC D O W N TYPE QTY D E S C R Z P T I O N UNZT COST TOTAL COST SFR 2000 ALTER 3Y VALUE RESIDENTIAL NOZONE 1,00 2,OU0,00 END OF FEES � Q90iroi!-' Lil�:ch�t -�; , � �;�T: Qui?u; S 1 'i Ii9t. �_ a 1�, . CONSTRUCTION AND PLANNING POO �PA APPROVALS Permit #�_ Date Inspector AppROVALS Permit # Date Inspector ✓ 1. Temporary Electrital ServiceLo1r Pole �� 52. Pool & Equipment location ,/ 2. Soil Pipe�Undrgrnd. �� '� 53. Steel Reinforcemen[ `' 3. Electrical Conduit Utility-Ur�drgrnd. Q 54. Porms ��j.� 4. Electrical Conduit-Undrgrnd'� r 55. Electrical Bonding 5. Steel Reinfarcement $ �,�.v1y 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVEfl�GUNITE 7. Footings -�-�� W � 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test �' 9. Water Pipe�Undrgrnd. „�=�� . a, 60. Backwash Lines, P�Trap, O Undrgrnd. �� , , 10. Structural Floor System A'� f 61. APPROVAL TO DECK ' 17. Property Sewer Line & Hou e Connection 62. Backwash & Receptor�Final �% 12. Sewer Cap `�� /%` 63. Heater & Vent-Final 13. Roof Orains ,� � G� i, 64. Plumbing System - Final � 74. 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 OGas ❑Oil 23. Gas Pipe�Rou9h & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Stora9e Tank O Gas O Oil 25. Roof Sheathing 74, Overhead Hydro 26. T�Bar Ceiling (Structurall & 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 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Fower 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 pomesticFinal 42. Backflow Preventer ' 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation . 46. Handicap flegulations 47. FINAL STRUCTURE & BUILDING �_3 q� G�,!¢. 48. FINAL PLANNING 49. Electric Release to Edison • 50. Gas Release to Southem California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date LOT Z� TRACT �ZS� �; � � �� GOSTA MESA BUILDING-SAFETY DEPARTMENT �sl P. O. BOX 917 C08TA MEBA. CALIFORNIA For Applieant io Fill In Complefely - TYPE OR PRINT ^ �q BUILDING J� r( G aoeaEas znno FiiuMnac Wav ii i� MAIL COSTA MESA. CALIFORNIA FEE RECE�V�ED ��aN i i �ss fINANCE DEPT. ClTY OF COSTA MESA APPLICATION FOR PERMi7 . BUILDING For Offiee Use Only PECEIPT NO. I PERMIT jlpA (� R� �D l SJti BY I o/� /In'i/. � I �A7E I��GO NEWPORT BEACH CALIF7ELMI. 6-3z UILDING � NO. ADDRESS ' iE�. COSTA MESA. CALIFORNIA :ea NONE No.-------- "__"'_'_�'_'___"'_____'__�__ FIRE � f ZONE TYPE �GROUP �j/ _' I! 1./ �1:.. � /%...�1„ ../ . _ �. APPROVED ��rj PLACENTIA A NEWPORT BEACH NO. OF BLDGB. ' x 120' xow oH �or 8¢TOACK LIN6 PROM �� i I LEFT �� I RIGHT 5� DESCRIPTION OF WORK SFNO. OF SF.ROOMS WALL BY DATE ZONING ZONE// NO. OF U8B OF N8W "rb � /� — 3 PLAN9 Z. BUILDING �„/� � �sa�e,�,,,,. Lef' Z� Ti4' Y z 8 EYES 8D ALLOWED LIN6 9TJ � �� FT. -^ � FT / 3' � 6L 1 H6RElY AGKNOWLCDaH THAT 1 XAV2 RlAD iHIB APPLIGTION THE AMOUNT BXOWN UNOER VALUATION IB FOR THE �1ATE THAT THE I�BOVE I6 COPHECT AND AGRE¢ TO COM- pURP08E OF ESTABLIBHING A PERMIT FEE ONLY. PCY WITX w�� cin onn�xwxcee �NO BTAT¢ LAW6 q60U1.�TING 9VILDI{!O CONBTRUGTION. VALUATION $lL+Dlh URE OF PERMIT FEE $ � O'�' PERMITfE � �Ll � ` � C� , $ PLAN CHECK $ S�� AUTHORIZED AGENT TOTAL FEE `5 0