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HomeMy WebLinkAbout2009 FEDERAL AVE - Building Permits • CITY OF COSTA MESA BUILDING DIVISION ..t 77 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. .us ipoCa FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER E07-00866 PERMIT TYPE ELEC STATUS: ISSUED DATE ISSUED: 10/19/2007 • .ISSUED BY: RMD JOB ADDRESS: 2009 FEDERAL AV CM • ,.Suite/Unit: Vicinity: - - - SCOPE OF WORK: ELCTIRCAL PERMIT TO 233 SFONE-STORY ADDITION TO AN.EXISTING ONE-STORY,SFD WITH A NEW 541 SF ATTACHED GARAGE. 10 LIGHT FIXTS, 16 OUTLETS;'5'SWITCHES, 1 SERVICE 200A. OWNER: WHALEN,DEBRAH I J - ' . Address:-- 2009 FEDERAL AVE Unit: . PHONE: 949-413-3362, • - - -City/State/Zip: COSTA MESA;CA APPLICANT: WHALEN,KEVIN Address: 2009 FEDERAL AVE Unit:' PHONE: 949-413-3362 City/State/zZip: COSTA MESA,CA CONTRACTOR: OWNER-BUILDER - -- - - License No. 000000 Address: Unit: PHONE: - City/State: ZipCode: CELL: • • ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 i Electrical Permit Fee: $88.107 Reinspection Fee $0.00 11 "` TOTAL FEES $88.10 s " NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE INTIALS CODEC INSPECTION1w DATE INIRIALS< 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval • 203 Final Sign 222 Final Site 204 Final Demolition • 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's. .e. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: �( (Expires: o I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation. as•provided for by section 3700 of the Labor Code, for the • performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance, as required by • DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into Which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not ee anp'eted a the permits valuetl al one hundred rkNars(Efed)or less) 2,Art 2,Sec.341,Title 8,California Administrative Code). P icy Number: _ 0 As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless Lissued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compen ation laws of Califomia, and agree that if I should become s bject to th= .rker 'compensation provisions of Section 3700 of the Labo•Cod I s :.I forth 'h comply with these provi/sio s. p Applicant's Signature Dale Ate / /V ^� 7 _0 —7 Division of Industrial Safety Permit Number: pl Tnt's Signature Da1B - HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: .1•NING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my licen e is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No al ) Gass • - ice\ (Section 25533 of the California Health and SafetyCode, with some C Sissy Jt Class exceptions, requires registration with the Costa MesFire Department by .) • 2 a, W / Dale 7 . each hazardouiness which at mate materials equal to or greater than a weighe time has on hand t of500t pounds. or acutely of 1•� volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONS - ION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Lenders Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). G❑JI, as ()Inner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify,that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and • city ordinances regarding Hazardous Materials and Emissions. ❑ I, as owner of the,property,am EXCLUSIVELY CONTRACTING WITH • , LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:-The contractors License Law does not apply to an owner of Signature . . Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)7. license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am+exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to bu'..ing •.nstruction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Me-- to -nter upon the above-described property for inspection pu .• es agree not to occupy or allow occupancy of any building authorized•• his •ermi_41 ' - - spection. Saxe— mgnature d41dr -- Legal Owner(5) (_Dale f�� ,....Signature.-----' Date—� 305746(3/07) And/or Authonzea Applicant Date , • 1-71TCy„ CITY OF COSTA MESA BUILDING DIVISION • • , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER y PERMIT B07-00579 '"pro.mw (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaBLUEDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2009 FEDERAL AV Status: ISSUED Suite: Applied: 05/04/2007 Vicinity: Issued: 08/01/2007 Primary Occ: R3/U1 Type of Construction: V-N Parcel Number: 42250316 Zoning: Applicant: WHALEN, KEVIN Address: •' Phone: 949-413-3362 ISSUED BY: �I/J�i Zip: "Or Owner: WHALEN, DEBRAH I J Address 2009 FEDERAL AVE Phone: COSTA MESA,CA Zip: 92627 Contractor OWNER-BUILDER Address: Phone: Zip: License: 000000 • Arch : Eng: Address: Address: Phone: Zip: License: License: • SCOPE OF PERMIT 233 SF ONE-STORY ADDITION TO AN EXISTING ONE-STORY SFD WITH A NEW 541 SF ATTACHED GARAGE.WORK ALSO INCLUDES NEW 220 HABITABLE ATTIC SPACE FOR STORAGE;COMPLETE KITCHEN REMODEL;REROOF OF(E)STRUCTURE WITH COMP SHINGLES;AND,CONVE A PORTION OF THE EXISTING GARAGE TO A STORAGE ROOM.- 1 - - 3 BEDROOM, 1 BATH SINGLE STORY SFD WILL REMAINSAME _ - - FEE SUMMARY Plan Check: $627.74 Calc Valuation: $95,003.50 Permit: $965.75 Claim Valuation: $60,000.00 SMIP Res: $9.50 SMIP Com: $0.00 Other $0.00 Inspection: $0.00 • Total: $1,602.99 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-46(8/00) • DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Insurance carrier and policy number are: Carrier:r,,$5555...sssPolicy Number: (Vection need not be completed If the permit Is valued at one hundred dollars($100)or less.) 1 certify that in the performance Of the, ork for ch this rmit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,e • :gree If I sho become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions Applicant Signature: Date: — / ' U -7 WARNING:FAILURE TO SECU • •R •S'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,.",IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: _. _ Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commendng with Section 7000)of Division 3 of the Business end Professions Cale)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjabts the applicant to a civil penalty of not more than five hundred dollars($500).): •I.d. I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to en owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors Ljsense Laws.). ❑ I am exempt u er c. / /' Business and Professions Code for this reason: Signature: C��L�. / Expires: I —(—Oc? Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑. I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be-Tore than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health end Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Alr Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for i pectio urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. nature Of Legal Owner(s) eza -•!: And/Or Authorized Applicant 'U Date yeas I INSPECTION TYPE QATE MALS COOP INSPECTION TYPE PATE 1111MitLa 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site pp 204 Final DeDemolition250 Final Building/Occupancypp 5 iUG//{tom-xt y r 0 " ,44..._ CITY OF COSTA MESA 4,., P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 Th /1.:'i . v9 ati, DEVELOPMENT SERVICES DEPARTMENT J d a New State Law: Swimming Pool Safety Act of 2006 (Assembly Bill 2977) Effective January 1, 2007 California Health and Safety Code Section 115928 "(d) Whenever a building permit is issued for the remodel or modification of a single family home with an existing swimming pool, toddler pool, or spa, the permit shall require that the suction outlet of the existing swimming pool, toddler pool, or spa be upgraded so as to be equipped with an anti-entrapment cover meeting the current standards of the American Society for Testing and Materials (ASTM) or the American Society of Mechanical Engineers (ASME)." 2r)c) FedA/ 7-6161-S- 77 Address/Permit Number Permit Applicant or Contractor's Affidavit (Please check appropriate box): ❑ There is an existing swimming pool, spa, or toddler pool on this property. I will install an anti-entrapment device that conforms to this law, and I understand that the installation of this device is required prior to final building inspection approval. Il There is no swimming pool, ssa, or toddler pool on this property. �42v ( A r,.... 12 Name (pi:.se :rir i. S. ature/D_ e Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 - TDD(714)754-5244 • www.ci.costa-mesa.ca.us DECLARATION OF AUTHORITY BIdg. Permit# 3O7ooS79 FOR AGENTS OF PROPERTY OWNER This Permit# TO APPLY FOR PERMITS Street Address: 2 a O -b 6e ,� e_ -,c p 1` U AP Number: 1. I (we), ('`-�H,c7�yL/�'d , declare that I am the Owner of Title of the above referenced real property, and that I (we)hereby authorize: EV-ev r rJ W 1- K x-IJ Telephone Number: 449 S` 'U3 c StreeAddress: 00° F — PJ kO C City? a() $ vut.� Pv stato zp l Zlo a� to obtain permits in my behalf,as owner/builder,for at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa,as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa.Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. IH' � Executed this 1 day of c.._t.._-1 20 0 ft ,at COSq-k- �"j�SY(., , California. • Print Name: -- A��\\[�+S 14 1)ft cy ��t'•J Signature: a._ J J J ci Date: 'G I Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. 0779-46(rev.11/00) •. Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CI•Tf OF• COSTA MESA - '" • 5273 3/02/64 -69.42. TI. PERMIT NO. TRACT NO. OT NO. BLDG.NO.' • • CONSTRUCTION PERMIT ,�[(� � E- /1436 !d 1 a, lit 8 project Address Ll ca A-4_4V • TYPE OF CONSTRUCTION NEW ® ADD Li ALTERATION Ll REPAIR App;{icant's Mailing Address : SAME ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A-P.# ')S— .J y 1 6 Zone Owner's Name Iy��6��ir:_ M.)}WiZJ. 4 Phone !-/0711 DESCRIPTION OF WORK E'"TCAJ� �j '-*�J E_ / A — 1Llil.:k'� - �� ,/ S Main Building: Qlejx.!`-/VN Accessory Building: ZO Address 7+.0'�/IfE.OB.^.A IS T• TYPE OF PERMIT,/ U GRADING L FOUNDATION LH STRUCTURAL T Front l ? , 5 _ N Arca/Eng, NL� License No. J.I�At ❑ TENANT in ELECTRICAL L7 PLUMBING ❑ MECHANICAL B Rear ) ys 5 N Address /� _ ❑ OTHER A j Contractor's Name '8tJ'JI � Phone PROJECT DESCRIPTION SQ. FT l4L OCCUPA V„ail_ C Right 50 ^ G Address(mailing/ CON ST RUCTION TYPE ✓�� VALUATION$ ebb $ Left 5 — E ZONE GRADING CU.YDS. ACRES Ping. Ref.*• Park.Fees $ O City License No. U LICENSED CONTRACTOR DECLARATION Remarks: C `33- d'SG s Parking Req./Provided _ I I hereby affirm that I am licensed under provisions of Charter 9(commencing R with section 7000) of Division 3 of the Business and Professions Code,and - Use of Building: ., E my license Is in full force and effect. / LlcenseClass License No. PLUMBING FEES Planning Notes: }� M Date Signature $A _ }F /:Mrs J n7- -2.-- iN ' Bar Sink Showers v2C. / WORKERS'COMPENSATION DECLARATION �1 - T ereby affirm that I have a certificate of consent to-self-Insure or a certificate Backflow Preventer Service Sink - - S Workers' Compensation Insurance, or a certified copy thereof (Section -.00, Lab. C.) .- i. Backflow Irrigation Sewer Cap ,. ELECTRICAL FEES Policy No. Company ” ' , ACertified copy is hereby furnished.. •'/. Bathtubs Sewer Connection _ .;. Automatic Washer . Transformer 0 15.50 KW Certified copy is filed with the city Building,Dlvision. , - - - - 0 50+KW Date - Applicant , Clarifiers - Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping Cooking Unit Meter ❑up to 100 amps i (This section need not be completed If the permit is for one hundred($100)or , less). Drinking Fountains •'. I certify that In the performance of the work for which this permit is issued, I 9 Solar Tank • ,‘ Dishwasher Meter Dover 100 amps shall not employ any person In any-manner so as to beco a subject to te worker orrrppppensatlon Laws of Calif n Floor Drains Swimming Pool vv/Spa Dryers ❑Gas ❑Electric Sub Panel . : X Date i/R T declaration, � irk NOTIC l softer making this declaration, you should beco subject to the Floor Sinks • Urinal Fan Motors 00.1 HP 01%-8 Workers' Compensation provisions of the Labor yo must forthwith comply with such provisions or this permit shallhall be deemed revoked: • Gas Service. Outlets Water Closet ._ F.A.U. Inc.Solar 09-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY - _ i 1 hereby affirm that there is a construction lending agency for the performance Interceptors . Water Heater . . /L Fixtures v of the work for y� ch this permit Is Issued (Section .3097 Clv, C.) P Microwave • 4 Lender's Name C:�D(-y EQ. fits✓ - _ Kitchen-Sink - Water Service Device Boxes Pole Light Lender's Address' 44hlttbia Bbib COSTA vnEG4 - OWNER BUILDEFI DECLARATION . . Lavatories - Outlets Range 0Q I hereby affirm'that I am exempt from the Contractor's License Law for the P-Trap following reason (Section 7031.5 Business and Professional Code: Any city or - _ -2 Switches Sign 0 county which requires a permit to construct,alter,improve,demolish or repair - - ' any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains , -. . - Garbage Disposal Standing Sections to file a signed statement that he/she Is licensed pursuant to the provisions of , the Contractor's-License Law (Chapter 9 (commencing with Section 7000) of •• _ - • • vision•3 of the Business and Professions Code) or that he/she is exempt 1 - Generator 00-5 KW 05:15 KW Trash Compactor , v':,4refrom and the basis for the alleged exemption:Any violation'of Section - _ - — .31.5 by any applicant for a permit subjects 'the applicant to a civil Reins coon Fee r ` $ 3 - - a•natty of not more than flue hundred dollars($500). , -_Pa $25 Issue Fee , fn1 � ' I, as.owner of the property or my employees with wages as their sole - 'Reinspection Fee $25 Issue Fee $ 3 \1 t- -, MECHANICAL FEES compensation, will do the work,and the structure is not intended or offered 1 • for sale (Section 7044, Business and Professional Code: The Contractor's . l - _ v- - , PUBLIC SERVICES REO.IJ,I¢EfvT${JTa47 ril0 License Law tloe s not apply to an owner of a property hrwho or Improves Boiler Hood or Type 1 ❑ 1 1/x�{/}/'�`employ, antl whd d th t su work himself/herselfe(f of In ende hir or err own Zoning Approved By date 3employees, ever, th that sing or I prove nth are not within o or of/eretl fpr Duct:Under Ground Canopy Type II ❑sale. If, however, the building or Improvement Is sold within one year of com- Building Approved By pletion, the owner,will have the burden of proving he/she did not build or Im- _ Date pptove for the purpose of sale). ! Duct-Structural , Refrigeration System Application Issued By - gate 7J I,as owner of the property, am exclusively contracting with licensed con- • ❑0.100,000 BTU ❑100,000 BTU tractors td construct the project (Section 7044,Business and Professions Code: Duct-Ventilating _ _ _ SU MARY OF FEES The Contractor's License Law does not apply to an owner of property who • �•- builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ ..�a SMIP $ O'�1 O tractor(s) license pursuant to the Contractors License Law). . PLAN CHECK '$ ' 2C,07 PERMIT ® I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt.ICBG# ISSUANCE $ PLUMBING' $ DateL/T H Owner '• =i'•' I . ..i. 1 Heating System&Ducting PLAN CHECK 25% $ ENERGY P.C. $ i I hereby certify that I have read this application and state hat the above 00.100,000 BTU 0100,0008 - A information Is correct. I agree to comply with all city and co y ordinances 4 ELECTRICAL $ . p6po GRADING $ m and state laws relating to building construction,and hereby authorize repre- , PLAN CHECK 50% $ 10.C90 MICROFILM $ • sentatives of this cit . to enter'u•on the above-mentioned property for Inspection purpo MECHANICAL $ TOTAL FEE ,$ l'• Signature • - • /J _ -ra4t - DateS/C/Sr • $ S�Z Drivers' License or S$ ' ' - •• Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK 25% CMF 0865-46 rev.12/83 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor .I "CONSTRUCTION AND PLANNING - -- 'APPRiVALS- Permit# _ Date Inspector APPROVALS Permit.# - . ., Date : Inspector • 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location , - � -. - - - - - 2. Soil Pipe-Undrgrnd. 53: Steel Reinforcement _ _ _ • 3. Electrical Conduit Utility-Undrgrnd. '54.i Forms i - - . - - 4. Electrical Conduit,Undrgrnd. 55'. Electrical-Bonding - • 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test . e- : - - . 6. Electrical UFER Grnd. - 5. 9.8+.- • c AL_ 57. APPROVAL TO'COVER-GUNITE- 7. Footings 3.8.m.- C m 58. Electrical Conduit-Undrgrnd.' ': '- 8. Foundation 5 L. fs 3 _q-7Y J p 59. Gas Pipe, 0 Undrgrnd.,Test - '' - - 9. Water Pipe-Undrgrnd. 60. Backwash Lines,-P-Trap, O Undrgrnd.-: : = ' . 10. Structural Floor System - • 61. APPROVAL TO DECK - - 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final : . - ' 12. Sewer Cap - 63. Heater & Vent-Final, •-m - . ' 13. Roof Drains 64. Plumbing System - Final - • - 14. Rough Plumbing 65. Electrical-Final•- rt - ' - ' 15. Rough Electrical-Conduit --- - -)/ - . " `66. Sdlar System=Final - -"-- ' -- - . 16: Rough Electric Wiring L//71. 411 0 e • 67. Fencing & Access Approval„-: - - -• _- - 17.' Rough Wiring Sign' r _ 68: APPROVED FOR PLASTERING ' 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL - - 19..Rough Heating & Air Conditioning I FIRE DEPT. REQUIREMENT , •20.- Rough Factory Fireplace ' APPROVALS Permit# 21. 1 Ducts, in Structure ! 70: Underground Hydro , I 22. Ducts, Ventilating 71. Product Piping O Gas- 0 Oil , I i •^ 23. Gas Pipe-Rough& Test • ••72. Underground Flush 1 24. Roof Framing 73.- Undergrnd.Storage Tank'10 Gas- 0 Oil . 25. Roof Sheathing 3-27_,r P 74. Overhead Hydro , B 26. T-Bar Ceiling (Structural) &'Monocoat - 75.• Dry Chemical ' - . ,- - ; • • • • . _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . CITY OF COSTA MESA . ' PERULT NO. TRACT NO. • LOT NO. BLDG.NO. • 8426 4/11 /194 9.60 TL • CONSTRUCTION PERMIT /259'5 . - ' N.Project Address capO¶ , od Orn l 4JP, C.H. 9'a, acs TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR , ' Applicant's Mailing Address , Vr1G i1I ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.4 Zone Owner's Name �nhef-l-FShelle.I Mut\o/ Phone -�7 DESCRIPTION OF WORK ' / S. Main Building: Accessory Building: Z Address . anOq Fedpn l /FJe- C M. 4.a.0.-7 E 0 TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALB Rear 1 Address ❑ •OTHER AN Contractor's Name Qwr,Pis f\DU\�(-c,C Phone _ PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right G CONSTRUCTION TYPE VALUATION$ s Left R Address(mailing/ - E ZONE GRADING CU.YDS. ACRES City License No. Ping. Ref. # Park.Fees $ • Q - - r LICENSED CONTRACTOR DECLARATION Remarks: e- 1/6.3 �j Parking Req./Provided U 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing •-� R with section 7000) of Olvision 3 of the Business and professions Code,and Use of Building: R my license Is in full force and effect. License Class License No- PLUMBING FEES Planning Notes: M E Date Signature WORKERS' COMPENSATION DECLARATION - Bar Sink Showers N hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service SinkS Workers' Compensation Insurance, or a certified copy thereof (Section - - ,00, Lab. CJ •' Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. CompanyBuilding Division. -, - Cerertitified fied copycopy Iss filed herebwith ty furnheishecity d. • Bathtubs Sewer Connection . Automatic Washer Transformer 0 15-50 KW Date C DApplicant Clarifiers - Solar Collectors Construction Pole Sub. 0 50+KW • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher (This section need not be completed if the permit is for one hundred ($100) or - Solar Piping Cooking Unit Meter up t0 100 amps �dC less). DrinkingFountains ' I certify that in the performance of the work for which this permit is issued, I Solar Tank Dishwasher Meter Dover 100 amps Shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Callfor, Floor Drains Swimming Pool w/Spa Dryers OGas ❑Electric Sub Panel Date f.1-/I- 8 Signature . _ •/ -4-. NOTICE:!Clatter making this declaration, yo II. curd •ecom$ubject to the Floor Sinks Urinal Fan Motors 00-1 HP 01%-8 - Workers' Compensation provisions of the Labor Code, you ust forthwith - comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar 09-15 HP❑16-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater �1 Fixtures Microwave '961of the work for which this permit is Issued (Section 3097 Civ. C.) .1- Lender's Name Kitchen Sink - Water Service • Device Boxes . Pole Light Lender's Address OWNER BUILDER DECLARATION Lavatories - # Outlets Range f!/^ I hereby affirm that I am exempt from the Contractor's License Law for the !-Tra - p ", following reason (Section 7031.5 Business and Professional Code: Any city or p �1 Switches Sign .e.� county which requires a permit to construct,alter,Improve,demolish or repair -- %� 1 T any structure, prior to Its issuance, also requires the applicant for such permit Roof Drains Garbage Disposal Standing Sections to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law(Chapter 9 (commencing with Section 7000) of • - nlvislon 3 of the Business and Professions Code) or that he/she is exempt • Generator 00-5 KW 05-15 KW Trash Compactor 'refrom and the basis for the alleged exemption. Any violation of Section• - 31.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee $25 Issue Fee $ 3 natty of not more than five hundred dollars($500). ❑ I, as owner of the property or my employees with wages as their sole MECHANICAL ' - - Reinspection Fee $25 Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered FEES in 1 \ _/ for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for Canopy Type 11 0 Zoning Approved By nate Sale. If, however, the building or Improvement is sold within one year of com- Duct-Under GroundBuilding Approved ByDate -• pletlon, the owner,will have the burden of proving he/she did not build or im- - 1 rove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By Date <//// • D I, as owner of the property, am exclusively contracting with licensed con- ❑4100,000 BTU ❑100,000 BTU . tractors tO.construct the project (Section 7044,Business and Professions Code: Duct-Ventilating . . SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property whoBUILDING PERMIT $ SMIP builds or Improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple❑ System Repair/Alteration $ tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. IC8O 4 PLUMBING $ ISSUANCE $ Date owner Heating System&Ducting PLAN CHECK 25% $ ' ENERGY P.C. $ ' t hereby certify that I have read this application and state-that the above 00.100,000 BTU 0100,000 BTL . - - ELECTRICAL $ %• BOO GRADING $ • Information is correct. I agree to comply with all city and county ordinances • and state laws relating to building construction, and hereby authorize repre- MICROFILM $ sentatives of.this city to enter upon the above-mentioned property for PLAN CHECK 50% $ Inspection pure. es. ,/ �/ MECHANICAL $ 9. 4,e Signature . -_-7 - /..- •%..L-/' Date Li-N-Li-N-41-/ TOTAL FEE $ Drivers' License or SS•,- • - - Reinspection Fee ;$2$ - - Issue Fee - $ 3 PLAN CHECK 25% $ _ - CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor :CONSTRUCTION AND PLANNING POOL! 4 Date Inspector - • - Date Inspector APPROVALS Permit# APPROVALS Permit# - 1.:Temporary 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-Undrgrnd. 55. Electrical Bonding • :. '5.-.Steel Reinforcement . 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' "y. Footings 58. Electrical Conduit-Undrgrnd. . • 8. Foundation 59. Gas Pipe, EI Undrgrnd.,Test - .._• - ,9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final , 12. Sewer Cap 63. Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final i f - 14. Rough Plumbing 65. Electrical-Final - . ' -. J 15. Rough Electrical-Conduit 66. Solar System--Final " I- .. 16. Rough Electric Wiring -- gab( (1c - 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 D Gas D Oil , • 23. Gas Pipe-Rough & Test 72. Underground Flush 24! Roof Framing 73. Undergrnd.Storage Tank 0 Gas D Oil _ ' ' • , h5: 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 I ' 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED /911W( e_Q_ 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test -- : 36. Hood or Canopy - • _-- _ - • . - - 37. Final Factory Fireplace - I - - n 38. Final Plumbing . - 39. Water Service-Final ' 40. Gas,Service-Final f 41. Solar Domestic-Final - - - 42. Backflow Preventer _ 1 " 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation -• 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING . 48. Special Requirements Completed . 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY -- - - • No. Date - _ ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT 1 636 North Oy BUILDING SANTA ANAA,. CALIFORNIALI FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY RECEIPT NO.) $// s PERMIT NO. yyyggq BUILDING / SI-4 / ( 3( y ADDRESS 2009 Federal Ave. G(j� ` (0 !Y- -- � / SCHOOL DIST. RECEIVED BY DATE OF APPL. DATE ISSUED OR TOWN NEAREST IIIVVV/_ -1YS ‘ -2-K-1.1) CROSS ST. 19th.S t. aBANNOCK HONES, INC. BUILDING n 9 / „/' / .?%- e OWNER ADDRESS 00 B{^ / jT MAIADDLRESS 0363 WILSHIRE.' Cast. /BLVD. SCHOOL DIST. / . OR TOWN BEVERLY HILLS TEL. CR. 54361 CITY NO. NEARE CROSS S T. /T /'e114 r ARCHITECT,oR TEL. ZONE NO. S TYPEI GROUP ENGINEER LAIN & MCKERRAHER No. Sr. 614891 PI ' I PLANS I i� ` _ ADDRESS 2110 E. WALNUT Sr.,SPASADENA SETBACK LI II%� M CENTER OF ST. Tg1 t•• V TEL. REAR YARD M j�. y SIDE YARD 71 Q --i • I I NTRACTOR NEWPORT VISTA CO.NO. CR. 511361 APPROVED ..UDRESS 9363 WILSHIRE BLVD. , BEV.HILLS BY DATE LEGAL 1118 n CORRECTIONS DESCRIPTION I LOT NO. I BLOCK 1712 (ATTACH METES B BOUNDS/ TRACT NO.OF SIZE OF LOT 67 x 110 I NOW ON LOTS 0 USE OFNO. OF NO. OF EXISTING BLDG. I FAMILIES I ROOMS DESCRIPTION OF WORK 0 NEW I x I ALTERATION I I ADDITION I 9 D REPAIR 1 I MOVING I I DEMOLISH I Z BAILDING NO. I ID"' SIZE 1034 SQ.FT ROOMS 5 STORIES 1 WALL I ROOF COMPO COVERING STUCCO COV ERINGjIfI N0LC' USE OF NEW BUILDING RESIDENCE at-- "�t //���j/ Y// APPROVALS FOU DATION:UNDER-PINNING RMLOCATION INSPECTOR Is 3DATE 5 i I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS. MATERIALS, , �J APPLICATION AND STATE THAT THE ABOVE IS CORRECT ���� //yy �f� 3 AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME:BRACING.RETOPS. . 5 ' f',{ J AND STATE LAWS REGULATING BUILDING CONSTRUCTION. LATH. INT. » iA (I1 7/ SIGNATURE OF /� %Op 1 PERMITTEE NEWPORT VISTA CO.CDLATH. EXT. ,!I'4,.., r . I -A'_ AUTHORIZED A 1 PLASTER. INT. PLASTER. EXT. .11-./.3 /6'' Yi[� p � $ 4830.00 P. C. S _ MASONRY REINFORCED FEE /7^ S 1 BOND BEAM VALUATION I I i /-//�/ a FEE FINAL orf/�� `/ _ Z •. a . - # PLOT- PLAN . ' - rc - o a a a � .\ _. • ._ _ • .;`. 1, .7!' � k .19^, . 7J...:\ 1! • Ci\� \ V. ♦ 3 . V '. :: 1 II::.' I'. f . 1. ... !• 3t" _-! - I - .Y c • .,.7.. 111 A: • f. . _ . _ : I'. 1, . . _ 3'. I l'7.'I . • • U 0 • Cif x m STREET- - X 79. -- = I::: - ___ O77Uf2 • • • _ .3. AT IV 7200. J3:.