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Home My WebLink About3145 BARBADOS PL - Building PermitsCITY OF COSTA MESA �,0�'�pMFS,p B!/ILDING DIVISION 4 i ., ; 77 FAIR DRIVE, COSTA MESA, CA 92626 • Q14) 754-5273 • Fax (714) 754-4856 • www.costamesaca.qov r °. LL °� FOR INSPECTIONS CALL: (714) 754-5626 : '�a>,o,,,�o �' PERMIT NUMBER: BC12-00004 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 01/O5/2012 ISSUED BY: RMD �os a,��Ress: 3145 BARBADOS PL CM APN: 13913312 Zoning:R1, , Vicinity: Const Type: V-B SQ. FT: 0 Suite/Unit: Primary Occ: Valuation: $4,086.00 SCOPE OF WORK: REPLACEMENT OF AN EXISTING SHOWER PAN AND VALVE LOCATED AT MASTER BATHROOM FOR SFD. OWNER: HSU, SHANNON Y Phone: APPLICANT: COLE, R4NDY Phone: 626333-200'I CONTRACTOR: US HOME SERVICES Phone: 214�488-6300 Cell: ARCHITECT: ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTALFEES: "Refer to fee receiots for all fees oaid for oroiarr Address: 3145 BARBADOS PL City/State/Zip: COSTA MESA, CA Address: City/State/zZip: Unit: Unit: : License No. 768707 Address: 405 STATE HIGHWAY 121 BYPASSUnit: A250 City/State: LEWISVILLE, TX ZipCode 75067 License No. License No. $0.00 $11125 $0.00 $0.00 $33.30 $0.50 $0.00 $1.00 $146.05 PHONE: PHONE: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday [hru Fnday-7:00 am [hru 7:00 pm. Saturtlays-9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivinq Dav and Christmas Dav 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 ihe expiration of this pertnit. GOUE A. INSPECTION TYPE 1676 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Finai Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE IN�S� 4QDEg INSPECTIONTYPE 206 Final Mechanlcal 208 Final Plumbing 210 Final Electncal 272 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Building/Omupancy ORT� INTRIALS .X �_ l�i-_t �cJ�- WORKERS' COMPENSATION DECLARATION: � I hereby aNrm under penalty of perjury one of the following dedarations: ❑ I have and will maintain a certifcate of consenl lo self-Insure /or workers' compensation, as provitled for by section 3700 of the Labor Code, for the peAormance of the work for which [his permit is issued. I have antl will main[ain workers' compensation insurance, as requiretl by se tion 3700 ot the Labor Code, for the performance of the vrork for which Ihis permit is issued. My workers' compensation Insurance carrier and policy number are/� �arner ( �,.,,..,�,..¢ rl�G. .-r �',�us��-/ (ihis sectun need nol be mmple[ed flNIe/Oermd Is valuetl at one hundretl tlollars (5100J orlessJ Poli�Number�. ��7't � � ❑ I certify [hat in the pertormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree ihat if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall fo ��co with these pmvisions. �-��/�� ' -� Appl�canfsSigriaWre D �e�,,. WARNING FAIWRE TO SECURE WORKERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN� CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR W SECTION 3�06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, antl my license is in�((ull fio�rce and eflect. /� Lic.G # _ � U�" ( iClass:#.�. (o � G�. onlraclor's.Signa,tu�e lDale�m. CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the perfortnance of Ihe work fa which this permit is issued. (Sec. 3097, Civil Code�. Lender's Name: Lender's Address: 9gnamre Da�e OWNER-BUILDER DECLARATIONS: I hereby affrm lhat under penalty of perjury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the followin9 reason (Sec. 7037.5, Business and Professions Code: Any ci[y or county which requires a permit to consUuct, alter, improve, demolish, or repair any Stmcture, prior to ils issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9(commencing with Seciion 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation o( Sec[ion 7031.5 by any applicant for a permi[ subjects the applicant to a civil penalty of not more Ihan fve hundretl tlollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation. WILL DO 7HE WORK, and the shucture is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply to an owner of property who builds or improves ihereon, and who does such work himsel( or hersel( or thmugh 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 consiruct the project (Sea 7044, Business and Pmfessions Code: The contract«s License Law dces not appy to an owner of pmperty who builds or improves thereon, and who contracts for such pmject with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for [his reason: Signaiure 305]-46(3/09) Owner ID verifed by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verifcation of Ownership by (type of documenC i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation five (5) or more feet in depth into which a person is required [o descend, will be made in connection with work authorized by this permit, and that no builtling structure, scaffolding, falsework, a demolition or dismantling ihereof, will be more than thirty-siz (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, 7tle 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 notetl above, unless such person has a permit to do such work from the division. Apphcanl's Signatvre Date Division of IndusUial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will �he applicant or present or fuNre building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous ma[erial? ❑ Yes ❑ No (Section 25505 of Ihe Califomia 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 tluring a reported year a quantity of hazardous materials equal to or grea[er than a weight of 500 pounds, or a volume of 55 gailons, or 200 cubic feet of compressed gas at standartl temperaWre and pressure). 2 Does or will Ihe applicant or present or fuWre building occupant neetl to fle a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, wi[h 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 Ihan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic (eet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Healih and Safety Code provides that the Costa Mesa Fire Department may require the preparetion, certifcation and filing with the Fire Department of an RMPP by businesses which are required [o register acutely hazardous materials with [he Fire Department. 4. If an RMPP is presently required, has Section 25534 of ihe California Health and Sa(ety Code been fulty complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuWre builtling occupan[ require for the work which is the subject of this application a permit for such constmc[ion or modifcation fmm [he South Coast Air Quality Managemen[ District or (rom any olher air polWtion control district or agency? ❑ Ves ❑ No (Section 658502 of the Califomia Govemment Code requires that Ihe requested information be fumished on applications for non-resitlential building pertnits�. 6. Will any part of the (acility to be constructed under this permit be within 1000 feet from the outer bountlaries of a school? ❑ Yes ❑ No Qf'yes", the facility mus[ meet Ihe requirement of Sections 25534 and 42303 of the Cali(ornia Health and Safety Code). 7. If a permit irom the South Coast Air Quality Management Dishict or other air pollution control district or agency is required for the work which is the subject of this applicatioq have all of the disclosures prescrihed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifca[e of compliance from Ihe appropria�e air pollution contml ofticer). CERTIFICATE OF COMPLIANCE I certify that under penalty of perjury the information given above is correcL I agree to compry with all state laws and city ordinances regarding Hazardous Materials and Emissions. SlgnaWre Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penaity oi 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 ortlinances relating to building construction, and authorize representatives o( the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SignaWreof galOwner(s) Dale �_� I s / Analor.Aut�onze icant �Dale-��_ Applicant to /ill in all soaces except those within heavy Gortler lines antl sign all appropriate tleelarations. CITY OF COST M�E�$ CONST UCTIO��ERMIT PE MIT ryq. � O TRACT NO. LOT NO. UN�IT NO. Project Address 'i `�, - � i, APPlicanYs Mailing A dress � TYPE OF CONSTRUCTION rvEW aDo aL Eaa ioN REPAiR �.�� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # Owner's Name � � Phone-1..�— DESCRIPTION OF 4VORK/USE OF BLDG. � Address ^ Arch/Eng. License No. Address Convacror's Name Phone Address (mailing) City License No. � LICENSED CONTRACTOR DECLA ATION I hereby altirm Ihat I am licensetl untler provisions o( Charter 9(commencing with section 7000) ot Division 3 ot he Business antl Professions Cotle, antl my license is in full Porce antl efi cC LICBOS¢ CId55 License NO. Date Signature _ ' WORKERS' COMPENSATION DECLARHTION . hereby affirm that I nave a terti(icate ot mnsent to self-insure or a certificate of Workers' Compensation Insurance, or a certifietl copY thereof (Section. 3800, Lab. C.) Policy No. Company eCertitietl copY is hereby fumishetl. Certitietl copy is file0 with the city Builtling Division. oate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Tnis section neetl not be cOmpletetl if the pe�mit is fo� one huntlretl ($100) o� less). I certify that in Ihe performance of [he work fo� which this permi( is issuetl, I � snall. not employ any person in any manner so as to becom sub" st to the Worker Ca pensa i n ws of CaliforpJ�� y Date Si9nature � �-""� '� +'+ � � NOTICE: , af er making this tleclaration, y u shoultl become subject to the Warkers' Compensation provisions of Ihe Labor Cotle, y0u must forthwith comply wilh suGh p�ovi5ion5 or this pe�mlt shall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV . I hereby affirm that there is a construction Iendin9 agency for the performance of tM1e work tor whlcM1 this permit is issuetl (Section 309] Civ. C.) Lentler's Name i Lentler's Atltlress , '� OWNER BUILDER DECLARATION� I hereby aHirm that 1 am exempt from Ihe Contractor'S License Law far the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which requires a pe�mit to Const�uct, alte�, improve, tl¢molish o� �epair any structu�e, prior to Its i55uanCe, also �equires the applicant fo� such permit to tile a signetl statement tha[ he/she is IicenS¢tl pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section ]000) of Division 3 0! the Business antl Professions Cotle) or that he/she is exempt there(rom anG tne ba5is for the alle9etl Ezemption. Any violation ot Section 7031.5 by any applicant for a permit subjects the applicant -to a civil �enalty of not more tnan five huntlretl tlollars ($500). LJ I, as owner of the property or my employees with wages as their sole compensation, will tlo the wo�k, antl the SVuctu�e is not intentletl o� otferetl for sale (Section ]044, Business antl Professional Cotle: The Contractor's License Law tloes not apply to nn owner of a property who builtls or improves thereon, antl who does such work'himself/herseH or throu9h his or ner own empioy¢es, provitletl that such improvemenls are no[ in[entletl or offeretl tor sale. If, howeveq the bulltlin9 cr imp�ovement i5 Soltl within one year af com- pletion, the owner wlll have tne burtlen of provinq he/she tlitl mt builtl or im- �rova for the purpo5e of sale). I, az owner of lhe pro0erty, am exclusively contracting with licensetl mn- t�actors to construct the Oroject (Section ]044, BuSinesS antl Profe55ions COCe: The Contractor's License law tloes not apply to an owner of pronerty who builtls or improves tM1ereon, antl who contracts for sucb 0/oject5 with a con- t�acto�(s1 license pursuant ta the ConVactor's License Law). I am awa�e that proot o1 their Worke�'s Compensation insu�ance shoultl be p�ovitletl to me. ❑ I am exempt untler Section B. & G. C. for this reason Date � Owner I hereby ertif that I have reatl t z appl informati n is orrect. I aqree to comply wi� antl state laws relatinq to builtling construcl sentatives of this city to enter upon th¢ InSpection purpose$� �� Siqnature ��/ f}-� � Drivers' License o 55 � —�'. [ion antl state that the above all city and munty ortlinances i, antl hereby authorize repre- bove-mentionetl properiy for TYPE OF PERMIT LJ GRADING LJ FOUN�ATI�/ LJ STRUCTURAL ❑ TENANT ❑ ELECTRIGAL ❑ PLUMBING U MECHANICAL ❑ OTHER PROJECT DESCRIP710N SGt. FT. oCCUaANC,a{ CONSTRUCTION TVPE VALUATION S �� ZONE GRADINGCU.YDS. ACRES— Remarks: Bar Sink Backflow Preventer Backflow Irrigation eathtubs Clarifiers Drinking Fountains Floor Drains Floar Sinks Gas Service Outlets Interceptors Kitchen Sink � Lavatories P-Trap Roof Drains - - Reinspection Fee $75 6oiler Duct- UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Fiiepl/Fact. Blt. ICBO # Heating System & Ducting ❑4100,000 BTU 0100,000 Reinspection Fee � $15 CMF 0865-46, rev.4/84 White - Builtlin9: Canary - AOP�icanq Pink -Accounting; Goltlenrotl -Assessor Showers ServiceSink - Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Typel ❑ Canopy Type II ❑ Refrigeration System � ❑0-100,0006TU ❑100,000 System Repair/Alteretion Issue Fee FEES S Main Buildin9: E T Front ARear C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer Constructior Pole Sub. Cooking Unit D ishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator DO-5 KW 05-15 5452 8/02/84 Zone Parkin9 Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+-KW Meter ❑up to 100 amps Meter �over100amps Sub Panel Motors�0.7 HP�1'/:-8 Inc.Solar �9-15 HP 016-15+ Microwave Pole Li9ht Range Sign ' Standing Sections � _ Trash Compacmr e�,5n FEES Z O N I N G R E Q M T S. $� Rainspection Fee $15 luue Fee $ 3 FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Buildi�g Approved 6y Date Application Issued By �� Dat � - S�/p��/,q RV OF FEES (, BUILDING PERMIT $ `� r `�d SMIP $ � �v PLAN CHECK $ PERMIT PLUMBING � $ ISSUANCE $ P.LAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ Z%•5C7 $ 3 PLAN CHECK 25% $ " CONSTRUCTION AND PLANNING POO� & SPA , APPROVALS Permit# Date Inspector qPPROVALS 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. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � .5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � � 6. �Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE 7..Footings � 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. � Water Pipe�Undrgrnd. 60.� Backwash Lines, P-Trap, O Undrgrnd. 10. �Structural Floor System 61. APPROVAL TO DECK 17. Property Sewer Line & House Connection ' 62. Backwash & Recepior-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof•Drains 64. Plumbing SYstem - Final ' 14. Rough plumbing 65. Electrical-Final . 15. Rougfi Electrical-Conduit � 66. Solar System-Final - . 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign '. � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro � 22.�Ducts, Ventilating 71. Product Piping � 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 Ceiling (Structurap & Monocoat 75. Dry Chemical � 27. Freme and.Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. �Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT, REQUIREMENT 37. Plaster grown Coat 79. FINAL INSPECTION 32. Electri�l Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumb(ng � . 39. Water $ervice-Final � ' 40. Gas Service-Final � 41. Solar pomesticFinal ' � 42. Backilow Preventer ' 43. Backflow Irrigation . . . - 44. .Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regula2ions 47.FINA�STRUCTURE&BUILDING 8i3B¢ � 48. Special Requirements Completed 49. Electrie Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date AOP��cant to fill In all spaces except those within heavY borEe� lin¢5 anO si9n all appropriate Oeclarations. S32S 8/01 /84 �% o:ln T� Cirv oF COSTA MESCA S(�yO�NG]jTRUCTION PERMIT ProjectAddress ��7 T7ilT",1C]c'�i�0'5n 3^' Applicant's Mailing Address •�� `7') � �l'f� YJlt� Owner's Name �'�'F � � �i� Phone�� Address � 1` rJ �� R•d o5 Arch/Eng. License No. Address Contrector'sNam � Nrn �� Phnna %%OiSGj Addresslmailing) 1� W��.Q�%� '�eilFt�wzv c�+--4e�a City License No. 3� 3.� � LICENSED CONTRACT00. UECLARATION 1 hereby affi�m thai I am licensetl untle� provisions of Charte� 9(commencin9 with section ]000) of DiviSion 3 ot the Business antl P�ofessions Gotle, antl my license is in iWl tyc antl eitect. � �(J License CI ss �� Lj9ense No.- 0 �ate� Si9nat A/�a fr,-�+�.+ WORKE�S'COMPENSATION DECLARATI N I hereby atiirm Ihat I have a certificate of consent to self-insure or a certiilcate ot Workers' Compensation Insurance, or a certitietl wpy Ihereof (Section 3800, Lab. C.) -� Policy No. Company eCertitied copy is hereby furnishetl. Certifietl copy is filetl with the <ity Builtling Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Tnis section neetl not be completetl if the permit is for one huntlre0 ($100) or I¢55). I certify lbat in the performance of the wo�k to� which thiz pe�mR is issuetl, I shall not employ any person in any manne�s o as to come s bjecy t to the Worke Co/np a ion Laws ot Califomia. y hr�_ Date — � Si9nature �1�9 �a-+ 1�� NOTIC : It, afte� making this tleclaration, u sho Itl become subject [o the Wo�ke�s' Comp¢nsation provi5ion5 of [he Labor Cotle, y0u must forthwitM1 comply with such p�ovisions o� this pe�mit shall be tleemetl �evoketl. CONSTRUCTION LENDING�AGENCV I hereby atfirm tM1at theve is a construction lentling agency (or tne Oertormance of the work for whicM1 tM1is permit is issuetl (Section 309] Civ. CJ Lentler'S Name Lentler's AEtlreSz OWNER BUILDER DECLARATION I hereby at(irm thal I am ezempt from the Contractor4 �.icense law tor the followinq reason (Section �031.5 Business antl Professional Cotle: Any ciry or county wttich requires a pe�mil to Construct, alte�, improve, tlemOlish o� repai� any structure, prior to its izsuance, also requires the applicant for such permit l0 file a siqnetl statement that he/sne is licensetl pursuant [o the p�ovi5ion5 of the Con[ractor's License Law (Chapter 9(commencing witb Section ]000) of Division 3 of the Business antl Professions Cotle) or that he/she is exempt the�eM1om antl the basis fo� the allegetl exemption. Any violation of Sectioni 7031.5 by any applicant for a permit subjects the applicant to a�vil .eenalty of not more than tive huntlretl tlollars ($500). LJ 1, as owner ot the property or my employees with wages as their e� cortipensation, will tlo the work, antl the structure is not intentletl or' retl for sale (Section ]044, Business antl Pro�essional Cotle: The Contractor's LicenSe Law tloes not apply to an owner ot a Droperty who builtlSor improves thereon, antl who tloes sucn work himselt/herselt or through his or her own employees, provitletl tha[ such improvemen[s are not intentletl or offeretl for sale. It, howeve�, the builtlin9 cr imp�ovement is soltl within one yea� of com- pletion, the owner will have the burtlen of provin9 he/she�tlitl not builtl or im- �rove for the purpose of sale). � 1, as owner ot tM1e property, am exclusivety contf3cting wi[h IicenSeG con- tractorsto construct the project (Section ]044, Businessantl Professions Cotle: The ConVattor's License Law does ml apply 6an owner of property who builtls or imOroves thereon, antl who contrac fof_such p�ojects witn a con- tractor(z1 license pursuant to [he ConVactor's icense Law). I am aware that proof of their Wo�ker'S Compensation insurance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date certify �n is c� Signature Drivers' License — Owner 1 have reatl this application antl state that the above I agree to compty wrth all city antl county ortlinances 3 to builtlinq construction, antl hereby authorize repre- y to en upon the above-mentionetle prooer(��Jy /pr �� Date O� � � �+ a °� (� �� I TRACT TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALT RATI LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTH�E_v S DESCRIPTION OF WqR K/USE OF �Lp G. �ra�fDZ SF'1e,�YmtnU Zr� �F'• RO F TVPEOFPERMIT ❑ GRA�ING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ.Fr oCCUVANGv�� CONSTRUCTIONTVPE VALUATION$ � �'7 O 20NE G0.ApINGCU.YDS. ACRES Remarks: Bar Sink � Backflow Preventer Backflow Irrigation Bathtubs 100� loor Reinspection Fee Duct-UnderGround Duct - Structural Showers Service Sink Sewer Cap Sewer Connectii �� lar Cotl r' Sol . �IO. . i i / o ank — � � imming Po I � Urinal le ater C set a1�r Heater � $15 Duct - Ventilating Exhaust System ❑ Multiple Firepl/FacL BIL ICBO # Heating System & Ducting ❑0.100,000 BTU � 100,000 Reinspection Fee � $15 CMF 0865-46, rev. 4/84 White - Builtlin9; Canary - Applicanp Pink - Accounting; Goltlenrotl - Assessor Issue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑o-ioo,000eTu ❑ioo,000 System Fepair/Alteretion Issue Fee $ 3 FEES $ 3 A.P. # S Main Build E T Front 8 Rear A C Right c Left Ping. Ref. # Planning Notes: Automatic Washer Consnuctior Pole Sub. Cooking Unit Dishwasher Accessory Building: Parking Req./Provided ELECTRICAL Dryers LJGas LJElectric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator 00.5 KW �5-15 KW Zone Transtormer ❑ 15�50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100amps Sub Panel Motors �0.1 HP O1 %� 8 Inc.Solar 09-15 HP �16-15+ Microwave Pole Light Range Sign Standing Sections Tresh Compactor Fee �$15 � � Issue Fee FEES $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Appliption luued By �i1� Date ¢,�/ SUMMARV OF FEES S BUILDING PERMIT $ Z7� .i� SMIP $ � PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ z7�� PLAN CHECK 25% $ Z O N I N G R E Q M T 5. CONSTRUCTION AND PLANNING POOL & SPA APPROVALS 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. Forms ' 4.-Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5., Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical 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. „ 10. Sfructural 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 14. Rough Plumbing `. 65. Electrical-Final 15. Rough Electrira6Conduii 66. Solar System-Final 16. Rough�Electric Wiring 67. Fericing & 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 # �i. DuC[s, in Structure � � . 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing . 73. Undergrnd. Storage Tank � Gas ❑ 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 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Notes: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-7est � 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 Irri�ation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co . 51. CERTIFICAT��OF OCCUPANCY No. � - Date - . .-� - _ 4�� , ,� , COSTA MESA BUILDING DEPARTMENT P.O.80X 31� COSTA MESA, CALIFORNIA �� ECEfv�D `l�� c� a, � � s:1 �INANCE DEPT. n�rv nc r.nsTA MESA _� � ��. _. --- FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT AODRESS ��I, ; �, n� �,� � BUILDING " COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY r RECEIPT NO. ��I�� I OWNER Su,nmerland Ll.�iiQ VQ. vz BECEIVED BV DATE RECENE� p4TE �SSUE� MAIL S-a•� MAY g ADDRE55 TEL. BUILpiNG aTv Los .i;lp;eles� Calif� NO. AOORESS ARCHITEGT uc. COSTA MESA. CALIFORNIA ORENGINEER i�J].1-1].$7j�s �10. FIRE AOORE55 ZONE Swnmerland L`c�ild C�TY LIC. �orvE p�qHs 1vPc // cr+ouP CONTRACTOR I'+� NO. �j ft� Y TEL APPROVED ADORESS S tlTl%'Ele C8� NO. BV DATE �E�•� �or CORRECTIONS oescaianoru NO. � BLOCK TRACT %�� A.P. NO. SIZE ' qOW Orv �01�� none OF LOT u000 USE OF E%ISTING BLDG. SETBACK LINE FROM � c[rvi[A oF sinEei �O � REAR YARD � SIDE YARD RIGHT � � LEFT � � I DESCRIPTION OF WORK NEW � ALTERATION ADOITION REPAIR MOVING DEMOLISH BUILDING NO.OF / SIZE � �i ROOMS r STORIES EXTERIOR WALL ROOF COVERING �� ,1 ,(` COVERING � ,l USE OF NEW BUILOING 'j pt^� P ji 4thl � lv 1ltP� � l il L I HEREBY FCNNOWLEDGE TNqT I HnVE REnO THIS nPPLICFTiON 4NO STFTE TMRT THE ABOVE I$ CORFECT ND 4GNEE TO CO LY WITH ALL CITT OPOINANCES l�NO STI� i LtW /REGVLA I/IG 1 NG CONSTRUC- T�Orv. VALUATION SIGNATUR +� PERMIT FEE 5 '�� PEFMITTE � pLAN CHECK $ ZL � OO , s /,/ f�a S� AUTHORIZED AGENT TOTAL FEE $ f-�-� •��% eMr OWNER SU IM�%I,AND LAND CO. DATE 5—j-5% JOBADDRESS 311�5 Barbados Place BUILDINGPERMITNO. #�19j13 GENERAL CONTRACTORQWR6P Bldr. VALUE $ 11�(12(�•QQ LOT ]1 BLOCK TRACT 2'j53 R,gS W�Bt'Y.. g3T. GROUP I Bc J TVPE V ZONE R]. FIRE DISTRICT Ll9Jj PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE I NunasFw Footing Trench 7'�/� 6 _�} " Foundation Forms and Grade to Garage Rough Framing � Plumbing, Rough to Slab .,{� Plumbing, Rough Complete �� 3� ,s/ Temporary Pole u Wiring, Rough p��.�{eY Heating, Rough � 814q� ,� Heating, Final 2 s_s=; 8ewer e Seweq St. '�/�/L!' �b�� Septic Tank or Cesspool Lathing, In Out � Plastering /D —/� Plumbing, Final, FixtU�es Complete/yJ%{j� /2'S'S i Plumhing, Fin.al Gas Test /S ii/f'S �R-.$'—T; Wiring,Final ��L _'� 7 Occupancy Mi�S 12 S'Si FORM 210 3M 10�•v3 -9-57 1 .r/.2 - ' �ss�� CO�A MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 GOBTA MEBA, CALIFORNIA For Applicanf fo Fill In Complefely ■ 6UILDING ■ MAIL ■ AftCHITECT COSTA MESA. CALIFORNIA ��,� Ta��c—,r�� r �� 1/�ll� I TEL. s.riq. 1`'� �'� No. TEL. t NO. �� TEL. NO: ' �c 41.�7 � itfG .r ��o. oF a�oa. NOW ON LOT � _ �.. ^-i- /1 � ♦. � � 96TBACK LINE PROM DESCRIPTION OF WORK BUILDING � µ YZ I� NO. OF SIZE ! ✓[ / ROOMS EXTERIOR WALL��`' O I ROOF COVEHING �� COVERII USE OF BUILDING AND Y✓ORK TO BE FEE RECEIVED �OV 6 19�9 FINANCE DEPT. CITY Of COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only RECEIPT NO, PlFMIT NO. I r�� BY � pATE qECE1VEO I UATE 169UED COSTA MESA. CALIFORNIA FIRE ZONING ZONE � I NO. OF Ij I U8E OF PLAN9 �L BUIL�I� DE6CRIPTION � / �7 -` A. P. NO. ['� � ^ YARDS� ,,, EVES APPROVE� ALLOWI (C¢NTEP L�NE 9T.)� ��7 _ I HEREBY AGKNOWLEOGE THAT 1 HAVE READ TXIB APPLICATION ANO BTATE THAT THE A90VE IS CORRELT AND AaqEE TO COM- T�E AMOIINT 6HOWN UNDEN VALUATION �9 FOR TNE PURP09E OF EBTpBL19HING q p¢RMIT PEE ONLY. PLV WITX ALL QlY ORDINANCEB ANO eTATE LAWB FtE6ULATIN6 PGRNA' �RE OF��ON. � VALUATION �a pERM1T FEE $ /(',_C z 9yo_� ^ � $ PLAN CHECK $ � AUTHORIZED AGENT J � � o� OWNER TROEGNER, PAUL JOB ADDRESS 311y5 Bar GENERAL CONTRACTOR G AP No.113-371—EI LOT 1NSPECTIONS coat OCCUPANCY ORM BU4 � SM — : APR 1 1 t962 TRACT PII2E ZONE �Signature� DAT� GROUP !— BUILDING PERMIT NO. 15BOH VALUE $ 2,91�0.00 res. D�SCRIPTION OF WORKAdd iam.T7n.t0 TYPE tr ZONE o i SUBCONTRACTOR Z . aU Z Z Q � � am J � J � Q W m J • 0] J Q U N Z a W � aw W Z J � m Z J � W w O= 2 F- W � N � � � �"' Z Q U J a a a 0 F N Z O F U � � F � z 3998.9 �f COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Foi Applican t to Fill in BUILDING �... �i _ .n / OWNER J�� r MAIL �f AODRESS �j CITY CANSTRVCTION BRANCH ADDRESS ARCHITECT A CONTRACTOR ADDRESS CITV STATE LIC. NO. SIZE OF LOT USE OF EXISTING BLOG. SIZE OF NEW BIDG. EMERIOR WALI COVEflING USE OF BUILD PAiU "AY 15-75ciis,�fl 6u6;.� �*�.�,.5.50 �N FOR BUILDING PERMIT DATE RECENED nnTc wsui � , A.P. NO. /J � ADORESS J I7 S B�L TEI. 7S . TRACT NO. W OWNERCL�Y�� / TEL. NO. CITV LIC. NO. INO. OF BLDGS. NOW ON LOT NO, OF FOOMS STORIE: ROOF OVERING WO TO BE PERFOR�O I hereby acknowlatlga that I have reatl ihis application antl state that the above information is correct antl a8�ee to comply with all laws regulating builtling construction, and I shall not employ any person in violatian ot the workman's compensation laws of the State of Celifornia. I hereby certify that I am proparly licensetl as a contrector untler the State of Californie Business antl Professions Cotle, Divisicn 3, Chapter 9, antl thet such licenses ara In full force and effect, or I am exempt from the provisions of the State of Calitornia Businass and Profess�s COtla, Divis on�apxer 9, . SlOnatura of t Permittaia Autfiorhed Ageni FIqE APPROV ZONE NO.OF USE OF NEW PLANS � BUILDING VARDSAPPROVED YARDSAPPROVED ' MAIN BUILDING ACCESSORV BUILDING REAR / DISTANCE BET. � BET. MAIN & ACCFSS. BLDGS. DATE APPROVED S- � ` STA7E THE AMOUNTSHOWN UNDER VALUATION I$ FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: VALVATION � � PERMIT FEE $ � $ �� PLAN CMECK $ m � O � 6 m N � m E `o LL