HomeMy WebLinkAbout3033 FILLMORE WAY - Building Permits7FOJECTADOHESS: 303:1 : ILLMOR�� WY
owxeesName: GF.ORGfi PH�LPS
aooeets: 5���
u"�' 14 2
AXCM/ENGINEEfl: H 3 L= N E G J qEG.NO.:
aooRess: WILLIAM CORREP, 52ux't?
16517. B4LSA CHICA RD 101
PEPMITTEE: H, B, CA 9� 6 4 9
aooeess: $RIDGcPORT HUILDERS ( /14 ) 7.41-907'%
p,j1�29�y =�T GEARY
LICENSEO CONTHPCTOH OfCLARAT10NA1 h�er�eby a��irm thal I am licensetl un0er po isios a� ch�pter 9(commencing wiih Sec�ion
7000) ot �ivision 3 of the Buslne55 and Pmfessions Cotle, an0 my license i5 in lull �orce antl e��ec�.
ciTr uB-���rnt��2 0 6 3 ss_1i/����_
�a�e'. . Signamre', _ �
WOflNEBS' COMPENSATION OECIAflRTION: I hereDy a�firm t�al1 have a ce�ilicale of consent to Linsure or a cenificate oi Workers,
Compensation Insurance, or a certilietl coDY �hereol (Section 3800. Lab. C�,
roucr xo.: pWC— i i 2161 EXP. OPTE: O 3 I 1 L I9 2
comraNv: GLODr.N �.ACT E Ihl
`� Ceriifietl cooy is here�y tumishetl d Genihed capy is IIfeU wi�h ciry Buil0ln �vislon.
Oale: �� f " N�PI¢ant:� ��� ��'4�- �� � /
E%EMPTIUN FBOM WOBREPS' COMPENSPTION DECNPATION: (ihis seclion neeA not be completeG il �h�brone huntlred �5100) or less�.
I certity �hat m the per�armance of I�e work for which Ihis permi� is issuetl, I shall no� emplay any person in any manner so as �o become
sub�eci lo Ihe Workers Campensation Laws'of Califomia.
Date: Signature:
NOTICE: If, ailer making this Oeclaiallon, you shoulA become subject to t�e Workers' ComOensa�mn pmvisions o� Ihe Labor
Code. you must fonhwilh compty wi�h such pmvisions or �his permit shall he deemetl revoketl.
CONSTXUCTION LENOING RCENCY: I �ereby aflirm �hai there is a consimttion lending agency for �he petlormance o� Ihe work for
which �his permi� is issueU (Sec�ion 3097' Civ. C). .
LENOEN:
FDOflESS:
OWNEfl BWLOEP OECLl�BATION: I hereby aHirm �ha� I am exempt �mm �he Conlrac�ors' S�a�e License Law for Ihe following reason
(Seciion 703L5 6usiness and Pwfessional Code: Any city o� couniy whic� requires a permit to conSimcC alter, impmve. demolish, or
repair any stmclure, prior to its issuance, also requires t�e applicant for such permit to lile a signeJ stalement Ihal he/s�e is licensetl
pursuan�tolhe pmvisions ol�he Coniractors' State License Law�Chapler9�cammencing wi�h Seclion 7000) of �ivision 3 olthe Business
an0 Pmfessions CaOe) or that helshe i5 e�empi Iherelwm anG the 6a5i5 br Ihe allege0 exemptian. Any Nolation of Seclion 703L5 by
any applican� �or a permi� Subleci5 �he applican� to a civil penalry of no� more t�an five hunOred tlollars (5500�.
I, as owner ol IAe D�oDehy or my employees with wages as Iheir 5oie compensation, will Oo the work, an0 the
❑ slmcmre is not imen0etl or ot�erea �or sale (Seaion 7044, Business antl Pm�essional Code: The Comracmrs' S�ate License Law
aoes not apply �o an owner of a pmpe�y who builds or improves ��ereon, and who does such work himsel�/hersel� or thmugh
his or her own employees. pmvi0ed Iha� such impmvements are no� intentled or OflereA �or sale. II, however �he bvilding or
improvemenl is soltl wi�hin one year ol comple�ion. �he owner will have �he bur0en af pmving helshe Oitl no� �uilU or impmve
br ��e purpose ol sale).
I. as owner ol �he propehy, am exclusively contrac�ing with Iicen5e0 contrac�ars to cons�mc� Ihe pmle�� ($ection 7044, Business
❑ antl Pmiessions Code- The Contraclors' S�ate License Law tloes no� aOPry �o an owner of pmDerty who bml0s or imOmves Ihereon
and who conVacls lor such pmlect5 wiN a conVac�oqs�license pur5uan�Io the Contractors' S�ale License Law),I am aware
Ihai pmo� ol �heir Worker'S Compensallon insurance shoultl be pmviDed Io me.
� I am exempi under Sec�ion: B. 8 P. C.
foi ihls reason'.
oaie: ow�e�
I do Aere�y cendy tha� l am aware oi an0 underslana Ihe requiremenis of Calilomia Health ana Salely Catle Sec�ians 25505, 25533, antl
25534 an� ihat I or any fulure budtling occupant will/will not (circle one) need ta comply with saitl s�a�e codes antl ��e requiremenis for a
permi� �or cons�m[lion or modilicalion Iwm �he AirOuality Management Di5lricL Re5i0enlial cons�mc�ion aDPlicalions are exempt trom
UIeSe provi5ian5.
Daie: Npplicanl:
I hereby cerlily��at I have reatl�his apPlicaiion and s�ale thalthe above iniorma�ion is correct.l agree�o comply with all city antl counly
or0inance5 ana slaielawsrela�ing�o butleing con5�nidion antl here0y aulhorizer¢presenla�iv¢5 a�IhiScityio enleru0onihe ahove�mentioned
pmpetly for ins ecllon pur}�oses ,�� �
Oale'.���[_�/—`—/ SignaNre'. �is•� �•.
.
Oriver'S license oi Social Seariry p: �.,
164La6 Whi�e—Bmlding'. Green—CODe EnbrcemenC Canary—Hpplicant; Pink—Revenue; Goltlenratl—Assessor
CITY OF COSTA MESA — BJILDT_NG PERN.IT
PcRkIT NO: B U53S71 PLAR CHECK NO; 03242-91 S
CONSTRUCTTON TYFE: V—N PERN,IT TYPE; S'fR
JOB DESCRIPTION , rOOTINC� AAMAGE REPAIR
PERM NO: B 053571
GOVT: N SUPP: N
PURPOSE: A�D
S� FT; �,000
CLAIM VALUE; 2,UOU,00 CALC—VALUE; 2,000.00 GRC1iTP OCC; R-3 /
COMMENTS: NO OTHER STRUCTURAL WORK PERMITIED
1t if 3f if !f iE if iF iC�-� jE 9i if i�-!"s )f lE?E iF i4 !'r !E iE !f ie 1't if i't!E if iE �IE ib iF 1f %iF fE # iE )f fF ff #}{(� if ff !E ie 141E ii� if # ic ik �1F iF iE j:. # 3E ie 3'r-li- if iE 1!� iE i"s � IE iflE #)Fi't 3f
Z O N I N G R E Q U I R E M E N T 5
S� 7' B A C K S
------------ MAI1� BIIILDING ---------- ----- — -- ACCESSORY B[iILDINC, ---------
FRNT: FT IN REAR; FT IN FRNT; FT IiV REAR: FT IN
I.&rT; FT IN RGHT: FT IN LEFT; FT IN �GAT: FT IN
PARKiNG REQ • PROV; PARCEL; 13944405 ZNE: REc h0;
,PLAt�NING N6'PE5>
i '
iE 3E iE iE 3f-# ### iE # if )f i'r 3'r ##� iE }�F # iE 1F iE 3f if �k k if 3E �k'�i(� iF 3f lE 1E �1F X iE dE• iE iE if 3E jf ic 3e if iE ii� 3f 3i� � iE 3hiF if i% k k#� ie Ik %F iP ii� K� 4; H�� �%c ic 3i i4 k?E-k ie #
D E Lr E L O P M E I� T S E R V I C E S R E Q U I R E M E N T S
ZONING APFROVED HY DATE;
BUiLDItJG APPROVED BY ; r f/� DATE;
APPLICATIO�I ISS'UED BY: �d�"� I`� DATE:'Z�l�(���
ihiFi'r#ifiFif�)fii�i(•liifiF!¢1Eif�3i�if'3'rifl(iF � , h y' hX h�n� .. � iF�7eiFihiF�h'�143e�3Fi4iF'}F;R'�£3"e3- v 1i�if
IF �C� if iE # i(� # if iP i?-iF ?f #�)C� # 3F % lE # iF i: if 3E iF iF If ## 7f # iF 1E #!F iF iF ik if # iE iI� if 3F w� fE ii� lE if 3f iF # if iF ii� iE�3t #� if If ## if # if 3E ic 3F# # j(- 3r 3f if if iE N i(� #
LEGAI.l7,ATION:N r E E S' U M M A R Y STRIiCTUR�L SEGN,ENT;Y
BLUG PMT PLUN:HIIVG ELnCTkIC MECHANIC FIRE SMIP/RES GRATSENG
PcRNIT 95.00 ,50
S,MIP/NON—RES
PLAN 7.9.7.5
ISSuE F'EE
BUILDING—DIV—> FERNII 1SSiiE PLAN—CHECK TO?'AL PAID D;;E
TOTALS----> 95.50 0.00 29.25 79.%5 '74,75 ,OU
REVEN:3E DIVI�ION TOTALS---> COLLECTED: 74.75 OVER/S}iORT: .UU
bLDG PM.T PL[7MBING £LECTRTC MECHANIC FIRc SMIP/TOi GRAD�NG PLAN—CricCK
45,00 ,50 �9,25
iF ih if # 1f ik 3i� 3F iE iF If% iE if if ie 3f iF k� 3f !h �k iE iE # N.� SF �7E i� i(- iE 3F iF if- # IE if� �IE 1E?: lt� �1F � 9c iF 3E ii� i't if 3E;F iF #� � If �4 �!� ie iE i? �!!F if- ii� if ie �k #�!f >#f� �14 iE J) i4 {#f #E �3E
I N D I V I D L A L F E E B �2 E A K D O W iV
TYPE QTY D E S C R I P T I O N JPiIT COST TOTAL COST
SFR 2000 �LTER HY VALUE RESIDfiNTIAL NOZO1vE 1.U0 2,UOO.OU
ENn OF FEES
^ ' _ '
�RiE���J:1�!e;9SU�IF�E� ;u.t`. �
CONSTRUCTION ANDPLANNING -POOI .�A
Date I�spector Date Inspector
APPROVALS Permit # F APPROVALS Permit #
ti'i
1. Temporary Electrical Servic�i Pole �'� � 52. Pool & Equipment Location ,,i
2. Soil Pipe•Undrgrnd. � �=} 53. Steel Reinforcement �;�
3. Electrical Conduit Utility-U�rgmd. rt 54. Forms - j
4. Electrical Conduit-Undrgrndi- '' 55. Electrical Bonding �
5. Steel Reinforcement _ $_� 6W(}f' 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings ��� •�Gi/� 58. Electrical Conduit-Undrgrnd.
8. Foundation `[, f% 59. Gas Pipe, O Undrgmd., Test �/
. �*.
9. Water Pipe�Undrgrnd. 'r �% 1 60. Backwash Lines, P-Trap, O Undrgrnd. { f.
10. Structural Floor System f' =' ,' � 1 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection �t 62. Backwash & Receptor-Final
12. Sewer Cap �� r � 63. Heater & Vent-Final T��'
13. Roof Drains Y� f�t 64. Plumbing System - Final a,T
14. Rough Plumbing Zt /! 65. Electrical-Final �
L'
15. Rough Electrical�Conduit i �� 66. Solar System-Final i
16. Rough Electric Wiring ' 67. Fencing & Access ApProval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditloning FIRE DEPT. AEQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StoregeTank OGas ❑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 I S0. 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 pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �'tLv��I �'�_
48. FINAL PLANNING �
49. Electric Release to Edison .
50. Gas Release to $outhern California Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
PflOJECT AOOBESS: 3O 3 3 FILLMORE WY
OWNEH'SNAME: SEALS JAMES RIMPAU TR
nooRess: gpHEL�S GEORGE M TR
5200 IR�INE BLVD tt515
IRVINE,CA 92720
APLNIENGMEEH:
noonEss:
HEG.NO.:
uxir:
uxit:
veeminee: WEATFIERLZNE ROOFING ( 714 ) 798-9707
aooeess: 12002 MORGAN LANE
GARDEN GROVE CA 92640
UCENSEO CONTflFCTOB OECIABATION: I here0y af�irm thai I am Iicen5e0 untler O�ovision5 of C�aD�e� 9(commencinA wilA Seciion
7000� ol Drvision 3 o�ihe Business antl PwleSsions Coae. ana my license is in tulltorce antl eBeci.
/ciry�/c.:055169 sTaTeuc.:62695se��`—_s C39
' p _� �j �� y Signaiure:
W BS' COMPENSATION OECLABATION: I �ereUy afiirm Iha� I �ave a cerlititale al tonsen� ro self-in5ure or a terlifiWfe 01 WOfrcers'
ompen5a�ion Insu�ance. or a cenili¢d coDY �h¢reo� (Se[Iion 3800. Lab. C�.
voucrxo.: 1256868-93 EXP.OPTE: O%/OII94
comrnxr: STATE FUND
❑ Cetlifie0 ca0y is here�y �umi5�e0. � Certified copy Jis ti�letl vrit� Ihe ciry Builtling Oivision.
oate� �— / `s �� AOPlicam: �L����
EMPTION FROM WOBKEPS' COMPENSATION OECLAflATION: (Thi55eqian necd not be completg0 i� the permit i5 forone hunUreO (5100) or 1e55�.
I cerlify Iha� in Ihe pedarmance ol Ihe work tor w�ich ��is permit is issueQ 15hall nol employ any person in any manner so as to �ecome
sublecl �o Ihe Workers' Compensation Laws ol Calibmia.
�aie: SignaNre:
NOTICE:II. af�er making ��is Oeclaration, you 5�oW4 �ecome su�le�� �o �he Work¢rs' Compensation Drovi5ian5 01 Ihe Laho�
Caee. you must fonnwilh comply witn such o�ovislons or this Dermit shall ee aeemed revoke�.
CONSTNUCTION LENDINC PGENCY: I here�y afii�m tha� ihere is a ronSlmciion IenOing agency lor �Ae De�ormance 01 the wOM �or
wnic� I�is permii is i<suea �Section 3097. Civ. C�.
IENUEN:
AODflESS:
OWNEB BUILOEB OECLAflPTION: I �ereby aflirm �hai I am exemp� �mm Ihe Conlmclors' State License Law lor Ihe lollowinp reason
�Sec�ion 7031.5 Business antl Pw�essional CoOe: Any ciry o� counry which reQuires a permii to cons�mct, alter, impmve, demolish, or
repair any slructure, prior lo its issuance, also requires ihe applicant lor such Dermit to file a signetl slalement Ihat nelshe is licensetl
Dursuant to ine pmvisions oi ihe Comracwrs' Siate License Law (Chapter 9(commencing with Section 7000) ol Division 3 oi the Business
and Pmlessions Catle) or Ihal �e/she is exempi I�eretrom antl Ihe basis lor t�e allegetl e�emption. Any violalion ol $etlion 7031.5 hy
any aOPliwntlor a permit subjecls Ihe aOD�ican� to a civil penalry oi no� more tlun Irve hunO�eA tlollars (E500�.
I, as awner ol Ihe pmpeny or my empioyees with waAes as iheir sole comDensatian, will ao ihe work, and tne
❑ stmcmre is not intentled or ofierea for sale (Section 70aa, Business antl Pmiessional Coae: 7he Contractors' State License Law
does nol apply Io an nwner 01 a D�oDe�y who bwltls or impmves ��ereon, anE wha does such woM himself/�ersell or IAmuph
�is or her Own employees, pwviCetl Ihai 5uth imprOvements are n0� intentletl or oifered for sale. II, �owever the building or
impmvemeni is soltl wilhin one year ol comple�ion, Ihe owner wi0 have ��e burden o� proving he/she diA nol 6uiltl or improu¢
lor Ihe purpose ol salel.
I. as owner o� �he pmpeny, am erclusively contractinq wi�� Iicense0 comrac�ors m wnstmct �he pmject (Sec�ion 7044, Business
❑ and Pmfessions Code: TAe Coniraclors' Staie License law does noi aDDly lo an owner o� pmDeM who �mltls or impmves IAereon
antl wh0 Canlratis IDr SUCh pmjec�s with a ton�rattoqs) lic¢nse pur5uan� �0 Ihe ConVacrors' Sta�e Litense Law�. I am aware
Nat pmol oi Iheir Worker'S Compensa�ion insurance shoultl be pmviAeO Io me.
� I am exem0� unGer Section: 8. 8 P. C.
10� I�iS f2d5011:
�ale: Ownec
I oo nereby cenily inal I am aware ol anU unAerstantl tne reauirements ol Califomia HealtA an0 Safety CAae Sections 25505, 25533, an0
2553d an0 Nal I or any Iuiure builAing oc[upanl will/will not (circle one) nee0 to comply with said state codes anG Ihe requi�ements �or a
Oermil lo� conslmc�ion or mo0ilicalion �mm t�e Air Oualiiy Managemenl DiSlricL Resitlen�ial constmetion aOP�icalion5 are ¢aempi trom
tnese orovisions.
Oale: ADOlicanC
IhereOy Ceriity I�al Ihav¢ reatl lhis appli�alion and Slatelhailhe aboveinlormation i5 tOrrecL lagree la tamply vn(h alltily anG [ounry
orCinances and s�ate laws relating to Duilding con9mctian antl hereby aulhoni¢ repre5eniative5 oi IN5 nry Io enter upon Ihe a�ove-mentlonetl
IorinSDettion purposes. ��
�e !� y' �yy signamre.
orivers uce�se or Sociai Sewrity +:
i6G1-a6 W�ne—Bwlding; Green—Catle Enlorcemem; Canary—Applicam; Pink—Revenue; GolUenroO—Asseswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06606
PERMIT NO; B 066060 PLAN CHECK NO: N GOl'T: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE: ALT
JOB DESCRIPTION ; T/OFF 6 RE—ROOF WITH COMP. SHINGLES SQ FT; 1,800
CLAIM VALUE: 1,800,00 CALC—VALUE: 1,800,00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS REQOIRED PER THE 1991 EDITION OF THE UBC
�r*�rir*ir*�r*+tir�r*�r�r+r*it�fr**i�*x��r*�r*�r*�r+r*x�************x��x�+r*+�x�****+t**x�****�*�rx�+�****�*+r*�r
Z O N I N GS EATEB�AUCZKRSE M E N T S
------------ MAIN HOILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGAT; FT IN LEFT: FT IN AGHT: FT IN
PARKING REQ • PROV; PARCEL; 14113404 ZNE: REF NO:
PLANNING NOTES>
i
*�r�r�r*�r+t�r�r*u�****x�***�r+��t***x��r�t�r****�rt��r+�***�r+r*+r**�+�***�r�r****+r�***�r**+t*�r*i�*�r*******
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 ,
BUZLDING APPROVED BY ;
DATE:
DATE:
APPLICATION ISSUED BY: DATE: � ll�-
1fjlillEifififikiEiEfFitififlEiflfiEikififif iEiEififiEitiEfEfFiE jfiE
if iF iE if if # iE iE ik * iE aE if if iE iE 1E if iE fE �E iE 1E Yr 1Elt iE iF 1E it iE 1t jf if 3E �k 1f if fE iE f!� k if it ik if if %jF i! �F iE fE * it if 1f iE iF iE 1E iE iElF �Elf it i! iE i! iP 1E iE iE iE if if iE if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 41,00 .50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 41,50 0,00 0.00 4 50 41.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 4�� OVER/SAORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
41.00 .50
iE tE k iE �f fE 1F 1E iF iE iklt 1E iE if ik if if ik if iE if iElE iE IE fk 1t ik �E 1f 1f if �E i! 1E iE if if iE if fE i! iE iE fE if 1F jE iEltlf 1f 1! i! iE i! iE iE if iF iE jE 7f if if ik it �E i! if ik 1E iE fE fF jf fE if
Z 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
SFR 1800 REROOF BY �'ALUE RESIDENTIAL NOZONE 1.00 1,800.00
END OF FEES
O1 00155435-00155436 T U T 51.50
DATE� 02/15/94 7IqE: 30:36
CONSTRUCTION AND PLANNING
APPROVALS Permit#
1. TemPorary Electrical Service or POIe
2. Soil Pipe�Undrgmd.
3. Elecirical Conduit Utility-Undrgrnd.
4. EleGtrical Conduit-Undrgrnd.
5. Steel Reinforcemenc
6. Electrical UFER Grnd.
7. Poatings
8. FoUndation �
9. Water Pipe-Undrgrnd,
10. StrUctural Floor SYscem
7 7. Property Sewer �ine & Hause Connection
12. Sewer Cap
13. Roof Drains
14. Rou9h Plumbing
15. Rough Electrical-Condu;t
16. Rou9h Electric Wiring
t 7. RoUgh Wiring Sign
78. Flou9h Electrical-T Bar Ceiling
79. Rough Haating & Air Conditioning
20. Rough Factory Fireplace
21. Ducis, in Structure
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Rodf Sheathing �
26. T�Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. InsU�ation
30. Dryrvall Nailing
37. Plaster Brown Coat
32. Electrical Powzr MeterFinal
33. FinA� Electric
34. FinB� Heating & Air Conditioning
35. Fina� Gas Pipe-Test
36. Hood or Canopy
37. Fina� Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic-Final
42, BacKflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STqUCTURE & BUILDING �
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Q
51. CEF7TIFICATE OF OCCUPANCY
Date
�ate
i
POOL ts SPA
Inspector APPRQVAlS Permii# Date
52. Pool & Equipment Location
53. Steei Reinforcament
54. fotms
55. Electrical Bonding
56. Rough Pfumbing & Pressure Tzst
57. APPROVAtTOCOVER�GUNtTE
58. Electricai Cenduit•Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash �i�es. P�Trap, C1 U�drgsnd.
61. APPROVRLTODECK
62. Backwash & Receptor-Finat
63. Heater & Vent-Finat
64. Plumbing System � Final
65. ElectricabFinai
66. So�ar SYstem-Final
67. Fencing & Access A�proval
68. APPROVED FOR PLASTERING
69. POOL(SPASYSTEMSFINAL
FIRE DEPT. RE�UIREMENT
APPROVALS Permit #
�0. Underground Hydro
71. Product Piping C Gas � 0��
72. Underground Flush
73. Undergrnd.'Stora9e Tank � Gas ❑ Oil
� C(/ � 74. Overhead Hydro
75. Dry Chemicai
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUfREMENT
79. FiNAL INSPECTION
80. FOOD CER7IFICATE ISSUED
Notes:
0
�
inspector
�
�
0!�'RoosEss: 3033 FZLLMORE WY
OWNEN'S NRME: SEALS JAMES RIMPAU TR
aooRess: gpHEL{�S GEORGE M TR
5200 Ikt7INE BLVD tt515
832I86�i5A 92720
AflCNIENGINEEH: NEG.NO.:
FDOflESS:
uxiT:
23�--
UNIT:
PEHMITTEE: C�L—BRITT ROOFING CO ( 714 ) 675-394 3
AODFESS: 3J3S E COAST HWY 360
CORONA UEL MAR CA 92625
❑CENSEO CONTNNCTOB UECUIHATION: I hereby a��irm that I am licensetl untler pmvisions of Chapter 9(commencing with Sec�ion
7000) o� Div��sian 3 0l �he Busmess antl Pm�essions GoOe n� my license is in �ull lorce antl e��ec�.
CITY LIC.: O� STRTE LIC.�j 3 3 1. 9 S�(,��J3 9� �} - �..�
Da�e � —22 / � Signa�ure: — _V �� ! `"� _
WOPNEHS' LOMPENSATION OECLAHpTION: I hereDy allirm �ha� I �ave a certifica�e of consem m�elf-insure or a ceni�iwte of Workers'
C�mpensalion Insurance, or a ceriihed copy Ihereol (Seciion 3800. Lab. C�.
POLICY NO.: E%P. OFTE:
LOMPFNY:
❑ Cer�ifie0 copY �s hueby Wmislied. ❑ Certihetl mpy is IBeA wii� Ihe clly BuilONg �ivision_
�a�e: Ap0licanl:
E%EMPTIONFHOMWUPNEflS'COMPENSpTI0N0EClAPRTION: Qhi55ec1ionneMnolDecomDle�eai�Uepermi�is�oronehunOre4�5100�ar@55�.
1 certity tha� in Ihe peAormance o� the work lor which ihis permil is iSSueA. I shall noi emplay any person in any manner so as ro 6ecome
subjeci �o �he Workers' Compensalion laws o� Calilomia.� ^ �
�__✓I
�ate: 2� Z2 —� 3 Signature: �
NOTICE: II. atter making Ihis Oeclaration, you shoWa become sublecl �o IAe Warkers' Compensa�ion pmvisions oi the Labor
Cotle. you mus� lotlhwnh com0ly wilh 5uch provisions or ihis permii 5hall �e OeemeE revoketl.
CONSTFUCTION LENOING pGENCY: I hereby allirm I�at I�ere is d constmction lenaing agency br �he pertormance of �he work lor
�� which Ihis oermii is issued ($ection 3097, Civ. C�.
LENOEX:
AOOflESS:
OWNEN BUILOEH OECIANRTION: I hereby aifirm Ihat I am exemp� ��pm �he Contractors' S�a�e License Law for ihe �allowing reason
(Sectmn 7031.5 Business antl Pm�essianal Catle: Any ci�y of county which require5 a Oermit �o consimci, al�er, impmve, Oemolish, or
repair any struc�ure. prior �o iis issuance, also requires �he apDlican� �or suc� permi� �o �ile a signed 5[atement that he/she is licensed
pursuanl Io Ihe pmvisions of Ihe Coniraqors' 9ale License Law (C�apier 9 �commencing with Section 7000) of �ivisian 3 ot �he Busines5
and Pm�essions Cotle) or �hal he/she is exempl Iherefmm an0lhe basis lor �he allegeA exemption. Any viola�ion ol Section 7031.5 �y
any applican� far a permil sublects �he apPlicani lo a civil penal�y o� no� more �han live hundretl tlollars �$500).
I. as owner of Ihe pmpetly or my employees wi�h wages as �heir sole compensation, will do Ihe woB, antl ihe
❑ s�mcWre is nai imentletl ar ot�eretl for sale (Section 7044, Business anJ Pmfessional Cotle'. The CanVactorY State License Law
Ooes not apply Io an owner o� a pmpetly who builds or improues ��ereon, and who does such work �imsel(/herself or through
his or her own employees, pmvidea �hat such impmvemen�s are not in�entled ar oHeretl for sale. If, however �he building or
improvemen� is sold wi�hin one year o� compleiion. �he own¢� will have Ihe burtlen o� Dmving he/she tlitl not build or impmve
for ihe purpose ot sale�.
I, as owner oi I�e properly. am exclusively contracting wi�h li�¢nsed canVactors lo conslmc� ��e pmlec� (Sec�ion 7044, Business
❑ antl Pmlessions COUe: The ConVac�ors' Slaie License Law daes na� apply �o an owner of proDerry who builds or impwves Ihereon
ana who comraqs �or suc� pmlecls wit� a conlracior(s�license pursuan�lo Ihe Contrac�ors' S�a�e License Law�.l am aware
Ihat Omoi ol Iheir Worker's Compensalion insurance 5�oulA be pmvitled Io me.
� I am exempt under Seclion: B. 8 P. C,
far �his reason:
Date: Ownec
I Ao hereby cenity tnat I am aware ol antl uneers1an01ne requiremen�s of Califomia Healih ana Safery Cotle Sections 25505. 25533, anU
2553d antl Iha� I or any IUWre building accu0ani will/will nai (circle on¢) neeU lo compty with saitl staie cotles antl the requirements lor a
permit lo� mnsimction or motlilicaiion imm Ibe Aii Ouaiily Managemeni Dislrict. ReSiAen�ial constmc�ion applica�ions are exempl irom
inese vrovisions.
�aie'. Applicanl:
I here0y cer�tly tha� I �ave read Ihis applicalion and sta�e �Aat ihe a�Uve inlormalion is correcL I agree to comply wil� all ci�y an0 counry
ortlmancesantlslatelawsrelatingtobwltlingcons�mcl� aiClydA2lCb Nhorizerepresemativesofihiscirymemeruponlheabove-meniionetl
pmperry �or inspec�lio7n purpases. _�
�ate: ` �2' ` � � � Signaiure' � ;f�'�1 .
oriver s Cicense ar soc7m Secuniy n:
164t�66 Whne—Building�, Green—Cotle Enbrcement', Canary�qpplicanf, Pink—Fevenoe, Goldenmtl—Assessor
CITY OF COSTA MESA — HUILDING PERMIT PERM NO; B 061100
PERMIT NO; B 061100 PLAN CHECR NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE; ALT
JOB DESCRIPTION ; T/OFF REROOF W/CLASS A COMP SQ FT; 1,500
CLAIM VALUE; 1,500,00 CALC—VALUE: 1,500,00 GROUP OCC; R-3 /
COMMENTS; SMOKE DETECTOR RE�UIRED PRIOR TO FINAL
I iPi6#if1F)ElkitlEiPiE1Pk!!'iElEifiFN�ih1E1FiE-rtdFiEiE if3EiFiElE�kit7EiEi6iE1EiF1F�f#itif)fifiEikikiElfifiEiEiEiEiEiFiEifiEiF�EifiEff3EiPi!-%iFiFifiEitkiE
'`' 2 O N I N G R E Q U I R E M E N T S
•�= S E T B A C K 5
------------ MAIN BUILDING ---------- --------- ACCES.`,'ORY 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 RE • PROV: PAHCEL; 14113904 ZNE: REF NO;
PLANNING N TES>
,i
iE iF iE 3E i! 1E �E iE 3E N ik �t �k iE�i�.iF iE iE iF dE if !E iE �lE-IE if iF 1E ik iE 1! ik �F iElE 3ElF iE 7f iE iF iE ik.i! iE ihlE iFfF iEiElE iE iE iElf 1t iE iE iE iE 1E �1f iE iE iF if �f iE ik N� if iF if iF �)E iE iE?E
D E V'E-L O F M E N T S E R V I C E S R E{� U I R E M E N T S
ZONING APPROVED^BY DATE:
BUILDING APPROVED BY : — DATE;
/
APPLICATION ISSUED BY; � DATE;
1ElflEiEiEfEfffElfikifif�lEiEiEjEfkiEililiEif . .. ifiEfk9klEiFif�k!(�16 x iEif
ifiElEffiEiEiEiEikiFiE%1EiE1EiE�EiFiEiEiEitiEitiEiflEifiElElEiEjF3EiElEifiElFiEiEiklFiklEiEiEA '�iE3EiEifiFiEfElfikiF��iFiFlFifiEiE3Eif N-iFif itiF�fiEif
LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMi PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 35,00 " ,50
;, SMIP/NON—RES
PLAN ,
ISSUE FEF: ?,
RUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID . DUE
TOTALS----> 35,50 0,00 i. 0.00 35.50 35.50 ♦ .00
� —
REVENUE DIVISION TOTALS--> COLLECTED; 35,50 OVER/SHOftT„' .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECR
35.00 " ,50
iF iE M iE iE iE iE ik 1E iE if itlF iF iE iE �k 3F %!E �lE �E iF iFit �)E iE iFiE iklF iE iE if ik ik?f ihik iE�IE if if iF iklt * 3! iF 1E k fE iE 3f-if if iE iE iE i(� 36 3f �f df 1P�iE if ik iFlF iE if iP ik dF #�f �E �F
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 TOTAI, COST
SFR I500 REROOF BY VALUE RES'IDENTIAL NOZONE 1,00 � , 1,500,00
END OF FEES
� � �
9 a
EXPIRED
Incorciplete Inspections
UOtE ., _ - - —y-- S�S
r�
d
ti , -J--
� � POOL ,PA
� CONSTRUCTION ANOPLANNING
APPROVAL& Permii # Date Inspector APpROVALS Permit # Date Inspector
1. Temporary Eiectrical Service or Po�e 52.. Pool & Equipment �ocation
2. Soil Pipe-Undryrnd. 53. Steel Reinforcement
3. Electrical Co�duit UtilitY•Undrgrnd. 54. Forms
4. Electricai Conduit�Undryrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
). Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structuroi Floor System � 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Pinal .
72. Seyrer Cap - 63. Heater & Vent-Pinal
73. Roof Drains 64. Plumbing SYstem - F�nal
14. Rough Plumbing � 65. Electrical�Final
15. Rough Electriral-Conduit 66. Solar SYstem-Final
76. Rough ElectricYViring 67. Fencing & Access Appruval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
1.8. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS PINAL +
19. Rough Heat�ng & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rou9h Factory Fireplace APPROVALS Permit # I
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Venx��ating 77. Product Pipin� C1Gas OOiI
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergmd. Srorage Tank O Gas ❑ Oil
25. Aoof Sheathing � � �� 3��f 3�f 74, Overhead Hydro
26. T•8ar Ceiling (Structural) & Mor7ocoat 75. Dry Chemicai �
I
27. Frame and Flashing 16. Dry Standpipe
28. lathing & S�ding , 77. PIXEp SYSTEM FINAL �
29. Insulation ' � 78. FIRE PREV. FINAL �
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT �
37. Plaster 8rown Coat � I � J9. FINA6INSPECTION
32. Electrical ?ower Meter-Final � _ � 80. POOD CERTIFiCATE ISSUED _ _ ;
33. Final Eiectric � ; ' Notes: J6 L,¢.,�0 w �/�Y�-O�P/ - 71����
34. Final HeatiPg & Air Conditioning � i ' : �
i /
35. Final Gas PiPe-Test � ; � lq_ �/�
i � �(�/�/3 /�Li�--�< � �O/
36. Hood or Canopy � � � �
37. Final Facto�Y Flreplace ' � � .
i
38. Final Plumbing � �� I
39. Water Service-Finai . ( �
40. Gas Service�Finai �
�
41. Solar pomesticFinal � � �
i �
42. Backflow Preventer .
I
43. Backflow Irrigation �
44, Landscape Irriqation System 4
45. Sound Attenuation � X P� R��ti�ns
46. Handicap Regulations �1
incomPletel�SP�
4Z PINAL STRUCTURE & BUILDING � � i �t� �/ �-1�-- S�� �
46. FINAL PLANNING j � j
A
49. Electric Release to Edison ' i � a
' �. -
50. Gas Retease to Southem California Gas Ca �
51. CERTIFICATE OF OCCUPANCY
No. Date
LOT �7 TRACT 4PH�
�� ; � � ista�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX Sf7 C08TA MHBA. CALIFORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
e���oiNe �m� r�� �..o.,o� �.�.., �.�C�
I� MAIL
COSTA MESA. CALIFORNIA
FE RECEIVED
JAN 1 1 1962
fiN�NCE DEPT.
cirr oF costa a�Esa
APPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
aece�rr no. rerpny; qo.�„
BY
"`' COSTA MESA. CALIFORNIA
R. NONE No.
FIRE
-"--'-"'-"----'--------'- ZONE TYPE GROUP
r K_ W Knii CONSTRUC��ONA CO APPROVED _�
I ov ior 50' X � 20' I�o. or etooe.
NOW ON LOT
ZONING
zoHe Ho. or uae on new T�
R� 3 I PIAN9 Z I BIIILOINO w/Q .aL Q
M
�eo.� ��`- �7 T/� 'lzb'/
oescrt�rrioH
A. P. NO.
YARDB EVES
BR9ACK LIN[ PROM li � �/❑ � � (C6NTlR LINe BTJ
� ceMeR OP BTneeT 4 V REAR YARD FRONT I
61DE YARD I LEFT� ( l� � I RIGNT � O� R. SIDE I�
DESCRIPTION OF WORK _ _ R
. �� � SFNO. OF
OWLDINO gCONBTR � NINANCEB AND� A� WB�RlGULATIONO
BIGNANRE OF ���
PERMI7THF
AUTHORIZED AGBNT
/�
��
6 ,�.
��
IN.
IN.
i���� IN. .'
�erw �� 9�6 l
TXE AMOUNT BHOWN UNDER VALl1ATION 19 POR THE
PUHPOB[ OF CBTABLIBHIN6 ♦ PBRMIT FEH ONLY.
VALLIATION
f PERMIT FEE $ J����
$ � l /n� PLAN CMECK $ •�� •S'
�� F
n