HomeMy WebLinkAbout336 FLOWER ST - Building Permits1
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OJECT qOUPESS: -i 3� s LOiOEA S.i
OWNEfl'S NAME: ROG�RS ROSE P.Nti TR
aooxEss: 336 FL��Ek ST
CQSTA M�SA,CA
AFCM/ENGINEEfl: 7�i K��� 3 5
AUOflE55: •
, . UNIT:
9262Y- �
flEG.NO.:
UNIT:
PEflMITTEE: �RANNON S� ROOFING '( 7'.4 ) 567-3454
aooness: 15161 LAFAYETTE ST'REET
W��'r�!�NST�'R CA 92E�83
LICENSEO CONTBACTOH OECLAHATION: I �ere y a�firm Ihal I am bcensea under D�ovisions ol Chap�er 9(commencing wilh Section
7000) of �rvision 3 0l Ihe 6usiness antl Pm�essions Cotle, anU my license is in full force antl efiecl.
c�.vu ,�(''�)�-�6ti�,j: srn,e��c.:6099 �0,�// �G1,(Gs-s: �.�y
. �aie'. �p�.-� � (L,J Signa�ure: a� • V" ✓1 �%�
WOHNEflS' COMPENSATION oEClANA7lON: I nereby attirm ihat I have a certilicate of consent to sell�insure or a cenilicate ol workers'
Compensation insurance, or a certifietl copY thereoi (Section 3000, La�. C).
POLICY NO.: 1. ��% A 9 S E%P. UATE: O S I O 1 I y%
,�OMPaNY: c•t�ATE: FIINL�
CeNheO copy is hereby Wmishea. Cenitietl copV is file0 wilh ��e iI/ �y 9uiltling Division.
/l
,Q ('7^
� Oa�e: � �� / / qpplicant: �.�C.fle%
EXEMPIION FBOM WOflNEHS' LOMPENSATION OECLANATION: (7his section need nat be comDleteO if �he permi� is far ane Auntlred (31W) ar less).
I ceriify Na� in ��e pedormance ol the wark �or which this permil is is5ue0: I shall no� ¢mploy any person in any manner so as lo become
sublect Io Ihe Workers' Compensation Laws ol Califomia.
Daie'. ' SignaWre: ' �
�� NOTICE: If. alter making Ihrs declaratioq you should become suhlect lo Ihe Workers' Compensa�ion provisions o� the Labor
' Coae. you must �otl�with camply wiih such pmvisions or IhiS Dermii shall be tleemea revoketl.
I CONSTPUCTION LENOING PGENCY: 1 �ere0y afiirm �hai �he�e is a consimction lending agenCy lo� Ue pehormance Of t�e work �or
which �his permn is issuea (Sec�ian 3097, Civ. C�.
LENUEF:
FDUflESS:
OWNEP BUILOEfl DECLABATION: I hereby al�um �ha� I am exempi �mm �he Conlrac�ors' Staie Llcense Law for the �allowing reason
(Seclion 703L5 8usiness and Pmfessional Cotle: Any ciry ot coun�y which requires a permi� to conSlmci, alter, impmve, tlemolish, or
repair any s�mc�ure. Drior lo ils issuance. also requires Ne applicant tor such permi� �o file a 5ipne0 slalemen� �ha� he/she iS licensed
pursuant �o the OmNsions o� ihe Contractars' S�aie License Law (Chapter 9(commencing wi�h Sec�ion 7000) of �ivision 3 0l lhe Business
and Pmiessions Code) oriha� helshe is exemptther¢Iwm and the basis for��e aileged exempiion. Nny violalion o� Section 7031.5 by
any applicanl lor a permi� suble��s Ihe applicant �o a crvil penaliy ol no� more than �ive huntlreG tlollars ($500).
I. as owner of Ihe O�operly ar my employees with wages as iheir sole compensation, will Oo ihe woM1, antl the
❑ siruqure is noifnlendetl oro��ered lorsale(Sec�ian 7044. Business antl Profe55ionalCotle: The Conirac�ors Slate License Law
tloes not apply to an owner of a pmperty who Euiltls or impmves t�ereon, antl who �oes suc� work himself/her5elf ar ihrough
his or her own empl0yee5. pmm0e0 Ihat Such impmvemems are nol in�en0etl Or 011ere0 fOr Sale. II, however �he building or
impmvemen� is sold wilhin one year ol comple�ioq the owner wi�l have Ihe burden oi pmving �e/she tlitl no� buila or improve
� IOI Ih2 purpOSC 0� Sal¢�.
I. as owner o� the pmpetly, am ¢xclusively contracting with Iicen5e0 cant�ac�ors �o cons�mcl the prolect �Seciion 7044, Business
❑ and Pmlessians Code. The Conlractors' State License Law does no� apDly �o an owner of property who builtls or improves thereon
antl who conirac�s lor suc� pmlecis wilh a conlracior�s)Iicense pursuani Ia Ihe Conlfaclor5' S�ale License Law�. I am aware
Ihal pmoi ot Iheir Worker'S Compensa�ion insumnce shoultl be pmvitletl �o me.
� I am exemp� untler Sec�ion: B. 8 P. C.
lor ihis reason:
�ate: Owner
i ao hereby cenify ihat I am aware ol and understantl the requiremen�s ol Califomia HeaIN antl Safery Cotle Sections 25505, 25533, and
25534 and Ihal I or any Wture butlding occupan� willlwill no� (circle one� neee lo comply wi�h sai0 state co�es antl �he requir¢men�s br a
permil br canslmc�ion or moddicalion iwm �he Nir �ualiiy Managemeni �islric�. Resitlential constmclion applica�ions are exem0� «om
�hese pmvisions. �
Date: ppplicanP. '
I hereby cerlily Ihai I have reatl I�is applicaiion and state �hal ��e above in�ormalion is correcL I agree �o comply wi�h all ciry and county
ortlinances antl sta�e laws relating Io Ouiltling conslmclion and hereby aN�orize represenia�ives ol Ihis city to en�er upan Ihe above-men�ioneU
propetly I r mspection purpases. n
� Daie'. ��^ � Signalurd�\y����.1t�+i��%��07�,
�river'S License or Social Secun�y q:
i641�46 W�ite—Builtling: Green—Code Enlorcemenl: Canary—Applicant: Pink—Revenue; Goltlenrad—Assessor
CITY OF' COST'A MESA - BUSLllI�G Pc7{MIT P'r:RM NO: B 053541
PERMZT NO; B U53597. PI,Ah CHnCK t�0: N • GOVT': N SUPP; N
CONSTRiICTION TYPE: V-N PERMIT. TYPE; STR PURPUS�: ALT
JOB DESCRZPTION ; T/OFF REkOOF W/CO,uP SQ FT; 1,80G�
CLAI,�i VALtIE: 1,800,00 CALC--VALOE: 1,SU0,00 GROJP OCC: R-3 I
CO,'�iN.�NT� � SMORE DiToCTOR RE�T3IRED IN. TAE HOME
iF3E#�KiE�1F#?e3PtE�]F7EiF��>�3cifii�?4#ielE�if#3ciEdE 4elf��iEY-if�if#�y-scj(-i'r'�(�3�iF?flf�E��i(iei:iEaciFieiF3FifK�%��f�X��kicif?i�iFiFifi4iciEiEiric#afwii.#ck.
Z G N I N GS ER,IEBQAUCIKRSE M E N T S
------------ MAIN BUILDING --------- -------- ACCESSORY BUILDZ�iG --- — -----
^Rt�3T: Fi IN �nAR• r'i IN FRNT; PT IN RGAR: =T IN
LEFT: FT IN RGH'P: FT IN LEFT: FT , IN ?GHT: FT IN
PARKTUG RE� • P20V; PARCEL; 11725410 7.13E: REF NO:
PLANNSNG NC)TES>
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it �lE a: ie if-±E if iF i4 V.�',F �3i� IF 3F �)c if� if� 3f if ±E 3t 3e ih iF 3i� ie ii iF iE IF iE iE ie 9e �e �!f !E �F 3e * ii� ie if� ie 3i� �k if iE 3's f%�% 9f ih i+ k 3i X� �IE �!� �If if �N��k Y:� iE ii-jf.?{';Y:#�.±4 ii- t Y:� ii� #F'r.� 3F iF
D E V E I, C) P M c N T S E R V I C E S R E Q li Z ri c M r. N. '�T S
.^'
ZO'uZNG APPROVBD lY DATE: �':t
BJILl)i;\G AFPROVnD BY : �— DA! "r.'; ' �r;
APYLICATIO:V ISSUr:D BY:`� L• DATE �`'�`23 ��
�#iE�kiFif3f�%3E1i�iEi!�#�1EiF%3fiF1EY?it?F�7'tr.-'�ir ri'��F±�'it ��.:�-3F� +e . . . .. . iEiciF�i-iFiFi's�k-1F1��iFiri-1r+f•#i
�lc iE ii- 3'r �r. a(. if iF K iF iF�% ii� iE le iE ic if� if ��f� k, 3f v� if jF ii� ±? fE # 3E N�'L, �-�IF #E'r �- iE �7{�'.`; 3i� n�?r # 9c is� a's?F } 3i� ii?i- ib i'r f'� u}: }'} �JE i� } i't if !F i:-.?��ir 15.fE 3i 1: k 1�.� jE 1E i!� 3f N�
LcGAi.I7.ATION:N F E E S U,'�1 N A R Y. STRJCTti�7AL' SyGM.:iVT:Y
BLDG PMT PL'JMBIhG ES,ECTRZC NECAANIC FIRE SNLPIRE`a� GRADiNG '
PERNIT 41.,OU ,50..
PLAN ` SM.iP/140N�,R�S
IS,S. i7E FF.E: '�
HliIi,DING-DIV-> PERUIT ISSuE PLAN-CHECK TOTAL PA:CD �# Di7n
TOTAiS----> 41,50 0.00 0.00 41,50 41,50 v�� ,(10
: r ?
RnV�NliE DIVISION TOTALS--> COL,LECIED: 41.SU OVBR/SHORT: "' ,00
BLDG PMT PLUMBING fi'LE(:TRIC NECiiANIC FIRE S,�iIP/TOT GRAllING PiAN-CiiECK
41,00 ,50
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I N D I V Z D U A L F E E b R E A K D O W:�i ,
TYFE QTY D E S C R i P T T U N [iNIT COST TO��.'�.X. COS'P
SFR 1800 Rc.ROOr �Y VALUE RESIDcNTiR.L Nq7.ON�
END On ccES
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DATE: �i�/?3l4i TIhE: i?9�02 � '
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- � . .. POO. SPA '
�- CONSTRUCTION AND PLANNING �
APPROVALS Permit# Date Inspector APpROVALS Permit# Date Inspector
- 1. TemDorary Electrical Service_or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit UtilitY-Undrgrnd. � 54. Forms - �
4. Electrical Conduit-Undrgmd. � - 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-Undrgind.
8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � � 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structurel Floor System � 67. 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 � i
14. Rough Plumbing 65. Electrical-Final
15. Rough Electriwl-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 CAnditioning FIRE DEPT. REQUIREMENT � �
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating - 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test � 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structureq & 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 � -1� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � : 79. FINAL INSPECTION �-
� �.
32. Electrical Power Meter-Final ,� 80. FOOD CEFTIFICATE ISSUED �
33. Final Electric �Y„ Notes:
34. Final Heating & Air Conditioning ^
35. Final Gas Pipe-Test 11 � - �
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 � ��
L 5
48. FINAL PLANNING �� •
49. Electric Release to Edison •
n _
50. Gas Release to $outhern California Gas Co � ;/�
51. CERTIFICATE OF OCCUPANCY
No. qate �
�
�
PpOJECT AOOBESS: 3B 6` FLOWER ST �:� �'�
OWNEfl'S NRME: ROGERS ROSE ANN'"1'R
nooness�336 FLGWER ST
;;''COSTA MESA,CA 92627
• RPCM/ENGINEEH: S 4 8— 4 Z 3 5
AUOflESS:
HEG.NO.:
UNIT:
UNIT:
PENMITTEE: AOSE ANN ROGERS ( 714 ) 548-4235
aooness: 336 FLOWER`
C.M. CA 92627 '
LICENSEO CONTflACTON �ECIAflATION: I hereby aflirm Ihai I am licensed untler provisions ot ChaO�er B(commencing wi�h Section
7000� af Oivision 3 0l �Ae Business antl Pmfessians Cotle�.`+an0 my license is in full force antl e�fec�.
CITY UC.: STRTE LIC.: ��,/ CLASS:
}
�ale: SignaWre:
WOPREBS' CUMPENSATION OECNflRTION: I hereby aflirm t�at I have a cenifitate of consent m sell-insure or a certificate of Workers�
Compensation Insurance. ar a cenifietl copy Ihereol (Seclion 3800. Lab. C�.
POLICY NO.: E%P. OIITE:
COMPANV:
�] Ceni�ietl copy is hereby fumishetl. ❑ Cetlified copy is �iletl wi�h [he ciry Building Division.
oale: Aop�ican[.
E%EMPTION fNOM WONHEPS' COMPENSATION DECLAflATION: (This section nee0 not be comDleteO il ihe permit is tar one hundre0 (5140) or less�.
1 ce�ify ��ai in �he peAormance o� the work for which I�is Derm�t ,is issuetl, I shall nol empluy any person in any manne� so as lo Oecome
subject lo Ihe Workers' Compensalion Laws oi Calibmi� / 1 ^�
�} G i � �Q _ I �
Oate: 7� �' ��� 7 Z SignaWre: (�t-�/� ���'�`^' �'
NOTICE: If, after making �his aeclara�ion. you shoWA'6ecome sublec� �o ihe Workers' Compensation pmvision�
COAe. you musl Iorlhwilh comply wii� suth pmvisions Or IhiS Oermi� Shall be tleemed revokea.
CONSTflUCTION LENOING AGENCY: I hereby a�lirm tAal9here is a constmc�ion lending agency for �he performance o� the work for
w0ith IhiS p¢rmil i5 iSSu¢tl ($¢C�iOn 3097. Civ. C). �
LFNOEfl:
ADOflE55:
OWNEfl BUILOER OECLANPTION: I hereby aifirm Iha� I am exempt fmm tAe Coniracmrs' S�ale License Law tor �he following reason
�Seclion 7031.5 Business antl Prolessional Cotle: Any ciry of couniy which requires a permi� to cons�mci, alier, impmve, demolish, or
repair any s�mc�ure. Drior �o ils issuance, also requires ��e applicant br such permit �o file a 5igne0 5�a�emeni Ihal he/she i5licen5e0
pursuanl m the provisions o� �Ae Contracbrs' Sta�e License Law (Chapter 9(commencing wi�h Section 7000) of �ivision 3 0� �he Business
antl Pmiessions Code� or ihal he/she is exemp� iherefmm and the basis for ihe alleged eKemption. Any violation of Section 7031.5 by
any aDVlicanl fo� a permi� suble��s lhe applicant to a civil penalty o� not more �Aan five hundre0 tlollars (5500�. .
I, as owner of the pmDe�y or my employees wit� wages as �heir sole compensa�ion, will Jo ihe work, antl �he
❑ simclure is not inlen0e0 or offeretl lor sale (Section 7044, Business anU Pmfessionai CoOe: The Coniractors' S�ate �icense Law
tloes not aDDly to an owner of a D�oDehY wno builtls ar improves therean, and who does such work himsel(/herself or ihmugh
his or �er own employees. D�ovitle0 ihat such improvemenis are not intenJed or aflereA for sale. If, however the builtling or
impmvemenl is soltl wilhin one year ol comple�ion, Ihe owner will have �he burden o� pmving he/she Aid not 6uild or impmve
for the purpose of sale�.
�-I, as owner ol�lhe prope�Y. am extlUsively conVacting with licensetl coNrac�ors �o constmc� �he pmle�� (,���ion 7044, Business
antl Pmlessions CoOe: The Coniractors' State License Law tloes not aDPly to an owner ol propeM who bml0s or improves thereon
and who contraclsior such Dmlecis with a coniractoqs)license pursuam to Ne Coniractors State License Law�. I am aware
that prool of Iheir Worker's Compensalion insurance shoultl be pwvitlea lo me.
� I am e�empt under Sec�ion: B. 8 P. C.
�or Ihis reason: ./�
(y� G J
�a�e'. T� ' � � � C �- � Owner: �-f '"`� ��"f/iiC'12
I tlo here�y cerlily thai I am aware ol antl untler5iand I�e reQuiremenls af Caiilomia Heatt� antl Safety Coae Sections�25505, 25533, an0
25534 anA Ihai I or any INure builtling occupant will/will nol (circle ane) neetl �o comDly with saitl 5tate co0e5 antl �he repuiremen�s �or a
permit for cons�mnion or moGi�ication tmm the Au Ouabry Managemem Ois�ric�. flesidential constmciion aOPlicatians are exempt Imm
Ihese pravisions.
Oa�e: ApPlicant:
I �ere�y certify �hat I have reatl thls applica�ion and 51aie Ihat �he above in�ormation is correct I agree Io comply with all ciry and counry
orAinances antl slatelawsrelatingio building constmction antl �ereby authorize re0�esenta�ives oi�his cilyto en�erupon�he aDove-men�ionetl
pmperty( ylor' inspeclian pcurpases. /^) / �y�n1',� ,� ^ �,
Oa�e: 1� � � � '� ! � Signaiure. `��-C "Q T�"'�� ✓"�
uriver's License or Social Securi�y a:
16at�a6 White—Builtlinp: Green—Code EntorcemenL Canary—Aoolicanl; Pink—Revenue: GolOenrod—Assessor
' . CITY OF COSTA MESA — BUILDING PERMIT PERM NO; IB 058552 T
PERMIT NO:'IB 058552 PLAN CHECK NO: N GOVT: N'SUPP: Y
CONSTRUCTION TYPEc ' PERMIT TYPE: OTH STR PURPOSE: OTH
JOB DESCRIPTION : 55LF CITY STANDARD HLOCK WALL SQ FT;
"CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: REINSPECTION FEE RE:ItB58456
*��r*****�r****�***�r*x �r���r�**x�r*******x �r�r*�*****�e**�******�e�r***�***�e****�r**�r *****
' " Z O N I N G R E Q U I R E M E„N,T S.
' ` S E T H A C K' S - `''
------------ MAIN BUILDING ---=------ --------- ACCESSORY BUILDING ---------
FANT:-.--.-:,.FT . IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT '- IN "'""'
PARKING REQ• PROV: PARCEL: 11725410 ZNE: REF NO:
PLANNING NfSTES>
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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 : DATE; "'" '
BUILDING APPROVED'BY': "" �r,, , DATE:
APPLICATION ISSUfiD BY: - �h�--- DATE: lg � �
ifikifiFiF�f�1F�f�fiE3kikikifififlf�kifitif�k�iFif 'A�F"!F{F�kiE�F�klfiElfik�ffF lE�f
ik ikik �t 1f if �E �f if iFk IE 1f iflE fFlf !t if iE 1t �f 1k 1F �t if 1f �f 1F 1f if �f if k iflf �E �lk 1Fff �k �t 1t �f k 1F��tlt k �f if iF iE �flf if 1f 1F ff �flf �k 1f �f �F iF�k 3F �k iF iE iF IF ff 1k kiF iE it "
LEGALIZATION;N F E E S U M M A R Y STRIICTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/RES GRADING
PERMIT 30.00
PL� .._ ,.. „ . SMIP/NON-RES
ISSUE FEE � -"
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECR TOTAL PAID DUE
TOTALS---->, 30.00 0.00 0.00 30,00 30.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT• 00
HLDG PMT- PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30,00 �
1t 1FiflE it iF k if if 1E if 1FiF iE IE 1F 1f if if ik if Iflf 1k M�t iE it iF iE iF if it �F it If if �E�f iE 1klt �E if it iE it k if if if if k k�kitlf iliFlf if it iF if iF iE iF �f iFit 1Flt k iF if iF if iF iF
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I,O N
INS 1 BUILDING RE—INSPECTION FEE
END OF FEES
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UNIT COST TOTAL COST
30.00 30,00
G! D012'i`,3�—GOi�iS?3 � �o Tf G, ��i
PATE: 08/1?/Sc^ i I�iE:: %:':(� � .
CQNSTRUCTION AND PLANNING POO�.. SPA
Date Inspector Date Inspector
"APpROVAIS Permit # . APPROVALS Permit #
� 1. TemporarY Electricat Service or Pole . � � 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd._ - 53. Steel Reinforcement
�,���I$'str�l Condt,��tAUt:lity-Undrgmd. , 54.rForms- �
'�¢:'Ei�ctriial Conduit�iJndrgrnd. - 55. Electricai Bonding,
n
`�5 �:$'c�el R'2'inforce�ent 56.'Rough Piumbing & Pressure Test
,J:@�€ISctrital UFEGi:Qrnd. . - � 57. APPROVAL-TO COVER�GUNITE
�^i.���6�ptings � -r �'/!�5`1 ���- 58. Electrical Conduit•Undrgrnd.
E_�; Foundation ;t; ( 59. Gas Pipe, O Undrgrnd., Test
�� Water Pipe-Undrgrnd. 60. Backwash lines, P�Trap, O Undrgrnd.
70. Structural Floor System 67. APPFOVAL TO DECK
11. P�perty Sewer Lin€'& House Connection � 62. Backwash & Receptor-Final �
12. S�GGer Cap . � 63. Heater & Venrfinal
13. Roof Drains � 64. Plumbing System � Final �
14. Rough Plumbi�§ '� 65. Electrical-Final
15. Rough ElectricaLConduit 66. Solar System-Fina� '
16. Rough Electric �iring 67. Fencing & Access ApP�oval -
17. Rough Wiring S'tgn � . 68. APPROVED�FOR PLASTERING -
18. Rough Electric�f�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating�& Air Conditioning FIRE DEPT. REnUIREMENT �
' � �r �7 ._;r _ x .ti
20.:Rou�h F!'atto� Fic2place � �T �'� '� O J+' � �liPPRC1VA'GS'���PernYit # � �' S
�F. > C7 � r. • s- �`. Y �. S : R C S.^: -J 7' �
21. u�ts, ir�tractur-6 < .• :�5 O r+ .� �--70. Uadergr.qv�d:Hy�o � - •
22.�Duc4�. V.Onti[2tin�q-K �' � ��, S S*' x' 1. Product�Prpirjg �'t,a�s ❑�il
: K :i F-.F. :� .T.i I . �
23.�'ias ip o h &' est '� "` ;. �.Y �` "" ' �p
�� � � � � �.T.S M m 2 ,:,x �: �2. Underground�Flusr�:..• �< "5
24.eflootFraming� =�� =e- - •' } G - %� �<3/3`�Rlnder mcl?Storal���,[' ik �Gas O01t'
�� T �i NT.�. � 1 .VL� M
25. Roo�:Sh`e?thin 5•K � :�: x.r ;� �Jx �^ - v ;-;E-u w �
9:..a d v� z 'v � rox x�'14.;�7gerhead Hydro;�
26.�iT�Bar, Ceiling (Structurai) &'ffilonocoat x � � C !n* < 75.- ry Chemical '� �' H =� �
I�.' C' ti 1 � .Y < Cu!1 \
27._Frame and Flashin ' 's r x *' "y::' :�� �` : �`� "i
, ,9,: x 6 7.. ,D� a 76.` bry Stand�ipQ ,,..�p Y
28.�lLathing & Sidingsx v � +'s �x S_ ••� �••# x 77,aFIXED SYS�E .�F`��NALk � ��
29. Insulatioa "K � � •• � '' # ?' � r'` `�'fIRE PREV. FI� )A • �. �`
;7:< 5 K �< 78.: iV �, > c
!80. DrywalliPlailing ^ � �� * �+ . � a'� � HEALTH:BEPT*RfQUIRENIENT
n n x
�1. Plaster &ow�..Coa(X � � .�.,�. t �:,��.:,79.r'FINAL INSf;ECTI(�7�J x � r' -'
�
�� sx
'�32.eElectrica�Pow4.er hleteTFinal ! r� x�:,; k> c+80. �FOOD CERTIF GY>T.E IS9iJED �
- ^ - �' �• � -. L+ Y G
`33.'�SEinalEleGtri� `�'� T . � vtr � >: r r(Vo�es� � _ �D-;����.�� '- • �
. ,� .. � ,
;�4.;f�in_,Hea,tingpAU7�orttiitioni39a C: ti•� <> i� ; ('.^,, : s .^.`--
� 4 A1 t
35.;�inal�Ga¢Pip"'PTestY '' ` �` �' ^� "'-' � � r`=
x^s` s �-+ r�� x0 t7t-a s i�t*
� . Y • a r { .e. ..� . .� i . t � :•i
Cy6. �iood or�GanoPY t.c+- -- w �; � F_ g C�O +[ th[�'
r
� ��7.LFinai�Fac ory Firep c2^ � s" ` "�" x k r ' � � '�
,� � x � x j..K s � t
� „� � .. .. .� .a .., .,
�38. FinalyPlutt�bing r r„+ i a . � -'�.�: �7 �: �.'x !zi
•�39. Watei Service�Final.' � G " � �-: �' . . +--r T �
�c Z �C i[ '? Y O #.
'40. Gas�Service-Final ::� .r Qq,:-. S .e �-q x� p^� �_n. i`�'
:41 . Solar pomesticFina1 S ^ • �� Js I I� � K % � -
ic xc ?: [T '70 :} :C J
`42.�Backflow Preventer� F �y � x � I * x „`�-�" �� ;� - _
��
43. Backflowlrri�ation' �c-s '� r'- �`-' ��= U
� i :.� +-LG +:x:�7 / ?t �: •
S !
."44. �andscape i�patioq System; T ^ - .*c �,7 p ^, �,s - ;,-, �� p� .i : x' ^ .,
� :A5.1=5ound AttenUatiortK `^�'- iT "� - `•" -`" � �1 '� ^ �T % �g `' �
�f �'� 'k "r7 �i.w :: E- i: G' V` ' H � #
' �- c- r' ..' S a: f:� .. ..< ac - / � ..� ••r .
, �6.E}Jandicap,Re9fjlatio�s � x .: >� q � 5 ._>o S �'
47. •EIMAL STRIYCTURE & BUICDING Y '. �a j D�'('� x-� ti S � x
48. jIN;AL PLANNINGr i�� t N I �* �� �r h� K * "-
�
d9.:Electric Release to Edison � Y � ; _� r � � " J
`_50.-�'i.as Reiease to Sout�em CaliflomiaGasCo � � �i � '�; � . =.,y :� j .
51. CEf31,TIFICATE OFjOCCUPANC x i: fi N ;; r� � r. _ „
No. Date
.i
G
a
rt
�
(
PNEJECTADOHESS: '3'36� `�'�WL�-'.R �T
OWNEfl'S NAME: '�OGEr'CS RO.�E ANN TR
nooness: 336 �LbWER ST
��,. CO5TA �'�ESA,CA 92527
548-4235
AHCHIENGINEEfl:
� ADOflESS:
PENMITTEE: ROSE ANN R(.1GERS
nooaess: 336 Fi,OWEF.
C.M,
UNIT: I CITY OF COSTA MESA - BUILDZNG PcRMST
PF.RMZT NO: B OS8455 PI,AN C3iECK NO: Q2951-92 S
CONSTRJCTSON TYPE: PERMIT TYPE: STR
nec.No.:
uNiT:
(714)SQfl-A235
CA 926?.7
LICFNSED CONTpACTOB OECLAflFTION: I hereDy affirm ��a� I am licensed under provi5�ons ol Chapter 9(commencing wi�h Section
i000) ol Oivision 3 of Ihe Business antl Prolessions CoOe. antl my license is in �ull brce an0 eflect.
CITV LIC.: STATE UC.: CIASS:
�aie: Signamre:
WOflNEflS' COMPENSATION OECLANATION: I hereby aliirm that I have a ceni�ica�e oi consen� to sell�insure or a certtlicate of Workers'
Compensalian InsuranCe. or a terlified toOY ��ere0i (Settion 3800. lab. C�.
POLILY NO.: E%P. DATE:
COMPANY:
� Cenified coOY is hereby furnishetl. ❑ Certi�ietl copy is filed with �he city BuilOinA Division.
�ate'. Applican�:
E%EMP710N FBOM WOBKEPS' COMPENSATION DELUBATION: (This seclion neeA no� be completee il ihe permit is for one hunOreO (510�) o� less�.
1 cetlily iha� in ihe petlormance at �he work tor w�ich ��is Oermit is issued, I s�all not employ any persan in any manner so as to become
subiect lo Ne cWorkers' CompenCsation Laws of Califomla.
Date'. �"� � � / a SignaNre'. �/ �
NOTICE: Ii, atter making this declaration, yau shoul0 Uecome subiec� �o ��e Wor1 rs' Compensation pmvisions oi IAe Labor
CoOe. you must �orihwil� compry wi�h such pmvisions or �his permi� shall �e tleemed revoke0.
CONSTNUCTION LENOING AGENCY: I here�V aflirm �ha� �here is a cons�mction lentling agency for the pedormance ofthe work �or
whicA I�is permit is issuetl (Section 3097. Civ. C).
LENDEP:
aooAess:
OWNEP BUILDEB �ECLABRTION: I �ereby aifirm tha� I am exempl Imm the Con�ractors' State License Law �or the �ollowing reason
(Seclion 7031.5 Business antl Pm�essianal Code: Any ci�y o� counly which requires a permi� to cons�mct, al�er. improve, tlemolish, or
repair any slmclure. prior �o ils issuance. also r¢Quires t�e applicanl �or such permit �o file a 5igne0 s�atemenl that he/she is licen5ed
pursuant m ine pmvisions of Ihe Coniracmrs' State License Law (ChaD�er 9(cammencing vnih Section 7000) of Oivision 3 of ihe Business
and Pmlessions Cotle) or Iha� he/she is exemp� ihere�rom antl ihe basis for �he allege0 exemp[ion. Any viola�ion of Section 7031.5 by
any aDPlicani lor a permit suble��s t�e ap0lican� to a civil penalry o� no� more than five huntlretl tlollars ($500�. '
I, as owner oi Ihe properiy or my employees with waAes a5�i�eir sole compensation, will ao the work, and Ne
❑ stmcWre is nm inlen0ed or oileretl �or sale (Seclion 70aa, Business an0 Professional Cotle: The Coniracmrs' Sia�e License Law
tloes nol apply to an owner o� a pmpetly w�a �uilEs or impmves �hereon, an0 who tlaes such woB himself/hersel� or �hmugA
�is or her own employees. pmvitlea iha� such impmvements are no� intentletl or oneretl for sale. If, however lhe building a�
improvement is sola vnt�in one year ol comple�ion, the owner will have ��e burUen ol proving he/she Eitl not build or impmve
lOr ��e purpose ol 5ale)-
ti' I, as awner of ihe Dmpeny, am exclusively contracting wilh licensea contrac�ors �o constmct the prnjeci (Sec�ion 7044. Business
� antl Pm�eSsions Code: The Coniracmrs' State License Law Ooes nol apDly to an owner ot propeM who EutlAs or impmves ihereon
antl who conirac�s br such O�olects wi�h a canVaclor(s)license pur5uani to Ihe ConVac�ors' S�a�e License Law),I am aware
ihai pmof of �heir WOBer'S Compensa�ion insurance shaula be pmvidetl �o me.
� I am eKempi under Section: B. 8 P. C.
for this reasort (� /� / �`, A t
Da�e: �—`� � 7 �' Owner: ti��ni/ (1^""� Y"--
I do �ereby cenity ��al I am aware o� and undersland I�e requiremen�s of Calilomia Heallh ana Sa�ely Code Sections 25505, 25533, antl
25534 an� �ha� I or any fuiure buil0ing occupani will/will no� (circle one) need to comply wi�� sai� sta�e maes ana the reQuiremen�s fo� a
permit lor mnsime�ion or moaification imm the Air Oualiry Management Districi. ReSitleniial conslmction applica�ions are exempt �mm
��ese pmvisions.
Oale: ADplican�:
I hereby ceriily I�al I have reatl Ihis appliw�ion antl s�ate Ihai Ihe a0ove in�ormation is correct. I agree �o comply wi�� all cily antl counry
or0inances antl slale laws relaling ta �uilaing conslmdion antl hereby aulhotlze representa�ives ot this ciry lo enier upon �he above�mentione�
pmperly for inspeclion purposes- //�/�� �%//�_�� ��/(��
Date: g � y'� � � SignaWre: '�^-�"u �""\ � " �
oriver's �icense or Soaa� Securiry x.� ��
i6a1-a6 W�i�e—Buildino: Green—CoOe EniarcemenL Canary—NoolicanC Pink—Revenue; Goltlenrod—Assessor
JU$ D£SCRIPTION , S5LF CITY STANDARD SLOCK 47R1.L
CLAIM. VALiJE: 1,100,00 CAi,C-�IALUE: ' 1,1UD,0U
�. -cv_..._^�'. V ..
PURPOSE: OTH
SQ rT; 55
GROUP OCC: R-3 /
COMMENTS: X
*�*�t�#*#*�x-*�*�#�**�t�*x�a��c���*x���**�x�x�**��i!�x����x-i�f�x-�t�*�c�x�**�x�i�i�*�-��t�c�at�**x��+�x-x����-*��**�r�ta:x�**�x�
Z O N I N G R E Q U I R E iy B N T S
S E T H A C K S
------------ MAIN BliILDING --------- --------- ACCESSt�P.Y BUZLDING --------
FRNT; FT IN REAR: FT IiV rRNT: FT IN RcAR: FT IN
LEFT; FT IN RGHT: F7' IiV LEFT: FT IN RGHT: FT IN
PARRING REp • PROV; PARCEL: 11'72�410 2NE; R1 REF NO;
PiAI�tdSNG NC5TE.5> 55 LYNcAL FE£T OF 6' HIGH BLUCK WALL ALt]NG SIDE OF PROP,
> BUILT TO CITY STDS.
�7E aE af lE 3F if 3F-% iE jE ii� �k �iE iE iF jF ie if 3E iE 3E jE iE jf jE if �lE if� iF iF if �1F iF K� iE 3e ff �k iE Y.- 3h jE iF iEjE 3E iE �14 i!� 3E IE �%� iF �)f iE 3E 1f iE if aE iE 3f� # i!� �7G i'r 1E 3E 3% )F j(� iF if 3F 3!� i��?<j!�
D E V n 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 �
20NING APPROVED BY SC-C DATE; ��_��b1-
BUILDING APPROVED BY ; DATE: �
APPI�ICATION ISSUED BY; SSc-i� DATE: '���/`''��� L'
]fiE3FiE1F1FiEifIFiE1Elf-iEiE#iFiEiFiFihiFiE . . .. '�F'iFiFi�"�F'i�.—£%3Eif'ii�(�#�IE�x�3i�ii�ib ie' "iFiF3F�?EF.
3F iF iE �E iF iE �7F �iF IE �f� iE%�i� #f *?F if �Y 1E 1E iE if if 3E �1E 3E �1F N� if ii� j!- iE 3f iE 1E ii� �7f iE iF 1k if iF � i(� If -%� iF iE ii-�?f �E jf 1E * iE if if iE 1f iE%9f if ie �1E iE iF 1f )E fF 36 ic 34 ff �)E k� �lE k� 3F
i..EGAI.I7.ATION;�7 F E E S U M M A R Y ST:tUCTURAL ScGMEAiT:Y
l .�
BLDG FMT PLli!`4HING ELECTRIC �KcCHA�IIC FIRc ,V SMIP/RES GRAI)�NG
PEnMIT 27,00 ,; '-� � ,50
PLAN ] 7.55 r: 5,�3�PyfNON-RaS
; r;�
ISSTJE FEE • `'j., "'
BUILDING-DIV-� PERMIT ISSUE PI�AN-Cii�CR TOTAL ' 'r+P};ID DUE
T'OTALS----> 27.50 0,00 17,55 45,05 ^,, 45i;�05 ,00
REVENUE DSVISION TOTALS--> COLLECTED; 45.05 OVaFt%SHOR'i'; ,00
BLDG PMT PLUMBING ELECTkIC MECHANIC FIRE SMIP/TO,�'� �RA1?I2QG PLAN-CHECK
27, 00 . 50 ��; 1'7, 55
, ,•t.
* aE 3f� 3F iF1E 3E 1F N� 1E �k±c aE-k 3E jE 3E af i!� je #�1E!(� if� ik iE 3E 36 �E if 3f if �E �)f 3f 9E iE if iE �?F �If # if 7E j(� �IFiF 1E iE �lE #� 3f *�7F iE 3E iE �1E 3i�'i43F iE iF')E,'�E #�1F df� 3F �1F 3E if if 3f k� if f� 3i� iE
I N D I V I D C7 A L F E E B R E A K D O�W N/�
TYF�E � }
QTY D E 5 C R I P T I O N UNIT�-COST � TOTAL COST
" �` i
SrR 55 Ra5-CONCRETE BLOCK WALL / Fi. 20.00 �_ 1�100,00
END OF FEES �, /�
r�
• ;. n i,
1 J.�
f
+� F
. �
}?
!v .
�77 4�7121A�54-�1�].21DSb '�n� �`'
QA7E; C��`:{� 9= iIilE: t�.3.`
+7. t5
CCJSTRUCTION AND PLANNING - POOL .. SPA � - .
APPROVALS Permit #- Date , �Inspector qppROVALS Permit # _ Date In:pector
1. Temporary Electrical Service or Pole �.. - �52. �Pool & Equipment Location
2. Soil Pipe-Undrgmd. _ -- 53. Steel Reinforcement
3. Electricai Conduii Util'tty-Undrgrnd. ' S4. Forms �
4. Electrical Conduit-Undrgrnd. = , - 55. Electrical Bonding
5. Steel Reinforcement �� 56. Rough Plumbing & Pressure Test
6. Electrica� UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Footings -. 58. Electrical Conduit�Undrgrnd. �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Struciural Floor System 61. APPROVAL TO DECK "• _
11. Property Sewer Line & House Connection 62. Backwash & Receptor=Final
12. Sewer Cap - 63. Heater & Vent-Final .
73. Roof Dreins � 64. Plumbing System � final ,
14. Rough Plumbing - 65. ElectricabFinai �
15. Rough Electrical-Conduit 66. Solar System�Final �.
76. Rough E�ectric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI
19. Rough Heating &•Air Conditioning � FIRE DEPT. REQUIREMENT
20, Rough Factory Fireplace APPROVALS Permit #
21. DuMs, in Structure 70. Underground Hydro
22. Ducts, Ventilating _ 71. Produci Piping � Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiiing IStructural) & Monocoat 75. Dry Chemical
27. Frame and F�ashing 76. Dry Sta�dpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation ' 78. FIRE PREV. FINAL
30. Drywail Nailing � � HEAITH DEPT. REQUIREMENT
31. Plasrer Brown Coat i � ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final ' � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � i � Notes:
34. Final Heating & Air Conditioning �
35. Final Ga5 Pipe-Test '
36. Hood or CanoPY �
37. Finat Factory Fireplace -
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer ,
43. Backflow Irrigation g-7�Z� � J ��.
� �i ✓
44. Landscape Irrigation System � /' �
SGtec . � - G�. T�qfi '�✓
45. Sound Attenuation �. �c�. _ /�
u-� �(1
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING � �7
48. FINAL P�ANNING
49. Electric Release to Edison �
. 50. Gas Release to Southem California Gas Co � �
51: CERTIFICATE OF OCCUPANCY
No. Date
� �.
,.;;,:,:::
wY
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this
August 1992 , by and between Rose Ann Rogers
hereinafter referred to as "LANDOWNER," and Max Owen
hereinafter referred to as "ADJACENT PROPERTY OWNER:'
It is hereby agreed that a party wall will be constructed on the property line
between 336 Flower St C�sta_Mesa�C,, nnL
(Address of djoining�es
332 Flower St. Costa_Nlesaa Ca o?�2?
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
day of
in Book 3�— , Page 28 of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach 4 inches or m�re of
footin� on adjacent propertv., alone a�Z lineal feet of block wall.
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER ADJACENT PROPERTY OWNER
G'e-� �tw � �,� �ifZ/� Q C/ ,,J-��
( igna�ure) (Signature)
Rose Ann Rogei
Name (Typed or Printed)
336 Flower St. Costa Mesa
(Address)
1906-46
Max Owen
Name (Typed or Printed) .
�32 Flow�r �t�C�ta_�.e.sa—
(Address)
NOTARIZATION REQUIRED
vwn �rt ...,.�,.. .., � .... . ...
10BADDRESS ower treet
GENERAL CONTRACTOR Owner-Bui
(''���=�� 117-254-10 LOT 15
M1 ld;;�x�CTIONS
soi�
\� GAS
OWATER � .yy
ROl1GH PLl1MBING
PROP. SWR. LINE [] NOUSE CON.
SPRINKLING SVSTEM
MISCELLANEOUS
ROl1GN MERTING AND AIR CONOITIONING'
TEMPOR�RY SERVICE ON POLE
UNOERGROUN� POWER �
ROUGH WIRING
TRENCHES FORMS STEEL REINF.
FLOOR SYSTEM
BONO BEAM -STEEL REINFORCE
SNEATHING
fRAME ANO FL SHING
�ATHING — IN OUT
PI "cTER, BROWN COAT
' TURAL, FINAL
M�._iNG. VENT., REFRIG. AN� A.C., FINAL
PLUMBING. FINAL /NO GAS TEST
ELECTRIC, FIN/L
BUILOING. FINAL
SPECIAL FEOWREMENTS
VMIG �—i—//
BUILDING PERMIT
SUBCONTRACTOR
J
� � �'9 Fi—� l-` �.R� '.'�. .i� �
I 11 I� i�' ; 9 "'., ;t i�
. . . . - . . . �U i.� . '
," I 4358 g
COSTA MESA BUILDING-SAFETY DEPARi
P.O. BOX 1200 COSTA MESA, CALIFORNIA 9
For Applicant to Fill in Comple[ely — Use [nk
BVILOING. �
ADDRESS
OWNEF [�//r�/ ��(�
F
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W
6.
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CITV
BRANCH
ADDRESS '
ARCHITECT
TE
TEL.
_ �_
ADDRESS
CONTRACTOR "'
ADDRESS
TEL. .
CITV . ' NO. �
STATE - CITV �
LIC. NO. LIC. NO. , '.
OF LOT �"X' /� I NOW ON LOT �
USE OF � �/ �
EXISTING BLDG. �j�/,/V�
„ � Separate permits are required for-. �,
electric, plumbing and heating work.
N. �, �,::,; .
,,�,F�, _ �.-�,�.,-,:(�r� c��s:; � �I G1.16
FORSTRUCTURALPERMIT
A.P. NO. II ! -" ZSY /�J
BUILDING�
ADORESS
TRACT /f ��
OWPIER
YARDS
MAIN
ROM Gl
DI5TANCE BET
APPROVED
��
I� • „•
1��
DATE �`) �� �
OF USE OF NEW
NS � BUILDING
. BEf. MAIN &
ACCESS. BLDGS.
—I t4Z DATE II-/S —%6
APPROVEO
3�j_77.
Tti SPECi�L F'.ECi�c:i�',"4It1
I hereby acknowledBe that I have reed this epplicailon and state S�j f'/qry J � � �
that the above information is corraci antl a8ree to comply with y� ,
all lews ragulating builtling conrtruction, entl I shell not employ �
>
any person In violaUon of ihe workmnn's compenseiion laws of ' ' ' �� m
the Stace ot Celifornia. . � _ -
I heraby certify ihat I am p�ope�ly licensed as a contracior untlar SQ. FT: ' a
tha State of California Businass antl Profassions�Cotle, Oivision 3, HE AMOUNT SHOWN UNDEF VALUATION IS FOR m.
Chapter 9, and that cuch licenses are In�full tpr nd effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE " '
am exempt from tha �ovisions ot the Siate of Ca ornia 8usiness � y
� / VALVATION. PERMITFEE $
antl Professions Cotle Division 3, ha �� 9. J�
m
�` OY� PLAN CHECK § �. � o
Signature`of �/ A ^ `
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFORNIA
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OCT 3 i�i
FINANCE DEPT. n ��
CITY OF COSTA MESA .
APPLICATION FOR PERMIT
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For Office Use Only
REGEIFT NO. I �PEqMITlNO.
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