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HomeMy WebLinkAbout1570 CORIANDER DR - Building Permitsr � vND9-(/( rah ( Z [_MUHESSOPS0ILDl% 15"10 CORIANDER DR MNERSNAMEIFFOIDAI: STERRETT SUEKO TR Amfvm 2677 GEM'IMI CT CAMARILLO,CA 93010 APPL. NAIIAM ADDRESS: ARCHITECT OR ENGNEER: ARCK OR Still ADDRESS: coNmTwslwwfE ALLEGIS SERVICES CONTRACTOWSMNl1NG 775 W 17TH ST ADDRESS: COSTA MESA 92626 LICENSED CONTRACTORS DECLARATION: I hereby a9km under panel) (commencing with Section 7000) of Division 3 of the Business and Prdmsio CITYLIC.110,059590 uc.cuss: C 36 uc. - -_/�a ,9SY UNT: UC. NO.: UNIT. (714)646-3299 CA uc.No.: 674731 UNIT : F ry r,w tem licensed under provision of Chapter 6 Ifs 7 N -FIWNER BUILDER DECUBATION: I hereby, affirm under penekykf�pdelurV=1 that I am exam rode tin ComC� law 1« the following reeesk(Serxion 7031.5 Surtaxes, ded Professions Code:AM city « county whid, vires a permit to trod, ater, improve, 'emdoh, or repel my structure, prior Wks nauance, aso repuirea the applicant Ian such rink to fib a ep stat Ihm he «she licensed Worker n the prestaions d ma Comredore Lionm Law (Chapter 9 lookers minN wilh Sad' 0DD) d Divsbn 3 d the tineas and Prdessbm Cartel or that he or she is exempt therefrom and the basis for 0 alleged mem My ski of Sedan 4 1.5 by any appWarst f« a permil subjects the applicant to a ctrl penalty of not make than five hundred dollen (550111). ❑ I, as owner tithe property or my employees with wages m their sole connWmation, will do the sock, and IM stwonme is not intended wdlered I«a (Section7014,Budressend Profmsbns Code: The Comrm LIrareaLawdomnwappylomownardpropety who bulls or inpoyea thereon, dead elan does cud, wank himmt or henel w through he or har own employees, provided that such improvements we on, intended «dlered for sale. 9, however, the builling or imprommed is sob within one year of oompdion, the ownerbulder will have the buMen of proving be or she did ask dull or impnre lar the purpose of acts). ❑ I, as owner of the propend. am exdusivaN conlredirp with licensed conaactom W construe like project (Section 7014, Buainesa end Prof. Code: The Contrast. License Law does not appy to an awrer of property who bunks or improsar Thereon and who nantWce lar such projects wait a mmrector(s) licensed Westar to the Contractors License Lew). ❑ I sin exempt under Section: B. A P.C., for this reawn: Data Owner: I do hereby canny that I sin ewers d del undentard the reRuirememe d California Nmkh and Safely Cade Section 25505, 25533. and 25534. and Ihd I or are, Mum building occupant will / wN not (tiros one) need to comply with said "a ooders and the reBuirsmenb far e pemah t«mmmction«maklifrationhomthe Airy de lCanio.ResMmt®I mmtxudion appicet.. exempt from these prnisions. Date: Appbam: WORKER'S COMPENSATION DECLARATION: I hereby affirm ander pdeafty of perjury are of the hulowin, deddede'an: ❑ I hese and will maintain a centicda of coneent to sat-insureM w«ke,s'compensatlan. m Provided for by Section 37W of the Labor Cods. f« the pedorm,«a of the work Iak which this prank n issued. )❑ I hays end oil meiman wo 'c mn,atbn insurence, m recuired by Sedim 3700 d the Labor Code. W the pedormwm d the work f« which Mn permit is issued. My w«ken' compensdwn insurers carrier end poky number are: Carrier: GOLDEN EAGLE EXPIRES Policy Number: N 1. 7 i y U L 02/28/98 =:This seclien need nor he eomPMNd / the pensk is M ore hundred ddkn /5100 r ,.) ❑ I redly Ihel in the pMomame d the work 1« which tan psm s s ionmya/. {I NI ml em y ere, become subject to the veodrem' com"mmtien rive d California. e e tad t I /A�uM mbjed o Iha oompenmtlon prnisions of $action 37M of the Labor ChM, I shell/�dh 1 campy wt P .../// n1.11 t,�isa� Failureonro «m.•handrad thoausand ddNntl Sf00.0Wl. In sedditlon In ma vat of alat. and shall w�e6Aue W a measa ea,Srov em br� CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction Mndirg agenry M the pedomeaus of the work lar alu in the perms is issued (Section 3097, Cw. C). LENDER'S NAME: LENDER'S ADDRESS: I ceniy that I have re a plicdion and date 1hde the above informal is coned. I agree to campy ani r all city and county ordinances and stele isbutm reto bodsdsp constrWXah end hereby srthorike repreeentanoms of the dry to enter upon the adwsmembned Mop" for inspa4ion W — NDRFW WP tZHT / J / (515146.WP1 WNit"Wiclig A Sesty; Greei,-Fde: Caren-AWkcenl: Pink -Revenue: CaddennakFbseasun CTT—TY OF COSTA MESA — BUILDING PERMIT P S — 00 PERM NO: P UH7000 PERMIT NO: P 087000 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION : REPIPE WATER LINE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: U-1 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ----------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42417107 ZNE: REF NO: PLANNING NOTES> t r{. > ####j('########jti!'##'IE#3h#.h'.{'##'h'iC#3f'iE#�E?i"####'###"x'1i'#'x'##jE##%('#'###•###'###�F#########�: if•iF i{"iE #'if i%# 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 : APPLICATION ISSUED BY:1l1I LEGALIZATION:N F E E S U M M A 'R Y PERMIT BLDG PMT PLUMBBING ELECTRIC MECHANIC .75 25% PLAN ISSUE FEE 22,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 8.75 22.00 0.00 DATE: DATE: 2 .giF TziE###iE####iEia�'�' x3F3't iF?f STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 30.75 30.75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30.75 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 WATER RE—PIPE 8,75 8.75 END OF FEES 82-18-1998/89:15 NN/$30.75 RCPTN:01-0819775 PERM I T = 087000 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector _ POOL � SPA _ 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 Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test - 1 9. Water Pipe-Undrgrnd. ,, 60. Backwash Lines, P -Trap, C3 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection i 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 Electrical -Conduit '66. Solar System -Final 16. Rough Electric Wiring 67: Fencing & Access Approval - 17. Rough Wiring Sign66. APPROVED FOR PLASTERING ` 18. Rough Electrical -T Bar Ceiling - •69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oi� 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 -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing S� 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer - 43. Backflow Irrigation 44. Landscape Irrigation System _ 45. Sound Attenuation - 46. Handicap Regulations r 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING _t 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1570 CORIANDER DR OWNERS NAME: STERRETT SUEKO TR ADDRESS: 2677 GEM N I CT CAMARILLO,CA 93010 ARCHIENGINEER: ADDRESS: REG.NO.: UNIT: 206 UNIT: PERMITTEE: EXCEL ROOFING (714)965-0314 ADDRESS: 9331 LITCHFIELD DR HUNTINGTON BEACH CA 92646 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am ' ed u er provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and icen is full force andel CITYLIC.: 0477/244 STATE 155233 C C ` Date: � � 4—/ ? Signature: _ 45' 14 WORXERS' COMPENSATION DECLARATION: I hereby affempprhave a certificate of consent to sell insure or a certificate of Workers' Compensation IgsrApn�g, Ig yce(hfie0.capy thereof (Section 00, Lab. 66/01/94 POLICY NO.: STATE FUND P. DATE: COMPANY: ,,��(( ❑ Confined copy is hereby furnished. L4 Certified Copy is fil with city But In ry alez—/y-9.� Applicant: EXEMPTION FROM WORKERSCOMPENSATION DECLARATION: his section need n t be complete the permit is for one hundred (5700) or less). I certify that in the performance of the work for which this rmil is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Californi . Date: Signature: NOTICE: If. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ, C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031 5 Business and Professional Code: Any city of 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 delete is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the properly or my employees with wages as their sole compensation, will do Inc work, and the ID structure is not intended or offered for sale (Section 7044. Business and Professional Cool The Contractors' State License Law does not apply to an owner of a properly who builds or improves 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 sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I.as Owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business L� antl Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: Date: Owner I do hereby caddy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said slate codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date. Applicant: hereby certify that I have read this application and slate that the ov ordinances and stale laws relating to building construction and he y th property for inspection purposes. Date: ! � 3 Signature Driver's License or Social Security a: I agree to comply with all city and county this city to enter upon the above-mentioned 1641-46 Whne—Belding; Green—Code Enforcement; Canary—APPlicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM : Bw 0i PERMIT NO: B 063968 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; T/O S REROOF W/COMP. SHINGLES SQ FT: 7,700 CLAIM VALUE; 7,700,00 CALL -VALUE: 7,700.00 GROUP OCC: R-3 /M-1 COMMENTS: REROOF 5800SF W/25 YEAR COMPOSITION SHINGLES Z O N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REO• PROV: PARCEL: 13949117 ZNE: REF NO: PLANNING N TES> _ > MMMilMMM M M MMM M1l MM MMMM M M MM MMMM MMMM MM M MMMMMM MM M M M MMM M MMMMMM M M M M MMMM MM M M M,M MM M MMMM M M D E V B,;L 0 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 DATE: AnnT T/ RT TA11 TCCTTTln GV. //'1 _ (� nxTn_ ,-1 2 J MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM;M MMMMMMMMM LEGALIZATIl F E E S U M M A R Y STRUCTURAL,SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 99.0077 PLAN SMIP/NON,RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID 7' DUE TOTALS ---- > 99.77 0.00 0.00 99.77 99.77 .00 /r• REVENUE DIVISION TOTALS--> COLLECTED: 99.77 OVER/SHORT: ' ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 99.00 .77 n M MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM7FMMMMMMMMM I N D I V I D U A L F E E B R E A K D O W N A• TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 7700 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 7,700.00 END OF FEES i 01 00146926-00146927 �,T j 99,77 Di 09/15/93 TlIE':" 15:43 AND PLANNING POOL & r CU'NSTRUCTION ,APPROVALS .Permit # Date Inspector APPROVALS Permit# Date Inspector r 1. Temporary Electrical Ser4,�e or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd� -�c: 53. Steel Reinforcement ` ., : .r G int 'q... .lectrical Con °yi utility-Undigrnkb 54. Forms is affi, Electrical Conainkidrgrnd. 1 _• - 55. Electrical Bonding Reinfort-., E 56. Rough Plumbing & Pressure Test �+ Fk'. Electrical UF611-Qr d. ry 57. APPROVAL TO COVER-GUNITE I 1 1~aotingsm 58. Electrical Conduit. Undrgrnd. ^' FL'Tr'" . .. ';L$r Foundation y!t ' 59. Gas Pipe, 0 Undrgrnd., Testy, .t rr; •`9. Water Pipe-UndrgSnd. - - 60. Backwash Lines, P -Trap, 0 Undrgrnd. -- G: _ 10. Structural Floor �ystem- = r., - 61. APPROVAL TO DECK 11, &operty Sewer Lioa & Hduse•Conaa'ction. 62. Backwash &Receptor -Final ' o .g 12. $�wer Cap 63. Heater &Vent -Final - 13. Roof Drains- _ 64. Plumbing System - Final Gi l 14. Rough Plumblfig '-o 65. Electrical -Final 15, Rough Electrical -Conduit 66. Solar System -Final 16. Rough ElectrrWiring 67. Fencing & Access Approval 1 17, Rough Wiring . ign 68. APPROVED FOR PLASTERING 18. Rough ElectritQ' I -T Bar Ceiling 69. POOL/SPR SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 1 - '---i-z" -I --- Gi M.-," W ,n .-: u? _. a: r :u 2ft!tRc@ghr acvq-v Fireplace I c:;a �. a zr. x. APPROVAtiU:+GPel9nit?� 2r;Dirts,;oStructH?r r, r r a-,70. bndeerrgr'ja' Hglro 22. Duats,,Ven0atien # I i1S .x- t + , 71 produq'?^ p'ng ©',c"gas n Oil n n ._ m$ 1 n :,27 •; ii ...rex, > 2 ,G{' Pifer-Rc gh tS {7est a: a r m C i 2 G i ; , 72. Undertr` nrl G< k 9 ou d Ffij'.. 24rRoof ff;mir:g I•,> �• ^• * _ 73,Undergrri?.StoftkreTank{0 Gas 09il -... -y -^ 1 T ^ .T 25. R Qf S'ieathing ` 1 n /��/i/-.,3 7h ,@verheadv Hydrrvj'-"� f ,• . t `m ai{ x - 265T -Bar Ceiling (StrLxaural) �P:rosocoat ■ - 7 r z. u .f '-+ ,7 ❑: Cry Chemical _ - . r -n 21t' Frame and FIas7 i co o' 'i' - 761.4�Dry Stant) t '.:. rJ f, R ..)a:t. r ry MI to F�.,c`y _ 28. Lam thin{;& Siding ,s -1 -'� a' 77J' FIXED S-!STES1:9INA M J 1� 29. Insulation - 7e; FIRE PREY. FItV„L 1 30. Drywa[aNarling „I; la a :-+ I�.IEALTH^.DEPF.rRECiUIMMENT 41 31. Plastery" i l '• ra^. I 79? FINAL It'g;SFECTfrdN �Cpa�;1 32.- Electrical Pctvei-4tte,-Fina -,80:aFOOD CERTIFJC9tTE ISSUED iz. 33'" Fi"^.',al Ffgctr,(� x I c' s V x • 1 Noes. i" * S ..-1 i; 3e(7I FirydI tLratA &ten, 641ditiarul . ;^, x 351 Film[ Gas Piae-Tse$ _ i I i : , J 1-. 36.'H d Cano 37:-FiiMI F�;tory F&�138e.,, 38. Firul W:ymbing o; r 'cu R C -t r - I,1" (j * I r* i_ i 39. W3nbr Service-Filntl - u- I r) rt 40. Gas ServiceinaYjr t,t ^ nil' m a, nr x -u 41. Solar DomcQic-Pha'S { C= is rf t - N - m ' 42:'Backflow Preveme+ 1-' 1 � '--F� '� ' ' r "-'d 43. Backflow IrPigatiort ;r,=='=• ' { _ fir_- x C) -, X��44. LandweZ'rigatignSyster3r i o 5: 46DSound At18; uation ?'o: cv'. 46t:Handic�I'p R`?hulatiens t' ,' ° `'! •� t t --, ,� _";,' •" 47:.FIt;hAL STrL'JCTU;iE & BOLDING <Q Cj� 4 (,�4�•'ti , t �� 4�''FI L PLANIN 49^El6'ctric Release to�Edison 50, -Ga) Re�yase�o Sou kern Caflfo;nig Gas Co ;• r' ti0 j� = - - _ _� ,51. CPTIFICATEO, OCCUP, No. Date Properti Owner CITY OF COSTA MESA r BUILDING DIVISION ROOF COVERING CERTIFICATION Permit No. 13 (a 3 l Contractor State Contractor License Number %Z 33p Classification eff_— 19 I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. 1119 1 further certify that I am the owner of the property. (Owner -Builder permittee only). ❑ I further certify that I am: R Owner of sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: Initial Date I 099046 White -Building Div.; Canary-Contractw; Pink -Owner Company or Corporate Name Zx 707i ' Address K-�4 . s ig ure �— /� S ^ Date Printed or typed name ADDRESS OFBUILDING: 1570 CORIANDER 'DR GNNERSNAMERMIDMN: S T ERRETT , SUEKO TR ADDRESS: 2677 GEMIMI CT CAMARILLO,CA 93010 APPL. MAILING ADDRESS: ARCHITECT OR ENGINEEM LIC. NO, ARCK OR ENG.'S ADDRESS: UNIT: CITY OF COSTA MESA — BUILDING PERMIT 26 PERMIT NO: P 074306 PLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU JOB DESCRIPTION : R & R WATER HEATER UNIT: CLAIM VALUE: CALL—VALUE: CONTRACTOR'SNAIIE: THE EARLS PLUMBING (714)524-4300 C@NRACTOKSMAIIING 501 N. PLACENTIA ADDRESS: FULLERTON CA uc.No.: 217657 92631 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under nenaly of perjury Thal 1 Am licensed under Provisions of Chapter 9 (commentla with Section 7000) of Division 3 of the Business end Prdeasbru Cade, end my license is in lull force end effect. Cm LIC. NO.::005938 ucuass: C-36 LIC.No.: 2211776657 EXP: 06/96 Date: / "?.z^f-'� Connex«: ��G/`>�✓Gl OWNER BUILDER DECLARATION: I hereby AS. under, d Pwp'p1 all am exempt from IM Contractors Lloense law for the following reason (Section 7031.5 Business and Professions Cada: Any city or county which squires a permit to cararuc . eller, improve, demdieh, or repair any structure, poor to its issuance, also requires the applicant fa such awned to file a signed statement that he or she is licensed pursuant to the lroviaona d the Contractors License Lew (Chapter 9 (avneencing with Section 7") of Dveion 3 of the Business and Professions Codel or that he or die a asempt Iherehom and the haws fa IM alleged exemption. Any y6letion of Section 7031.5 by any applicant la a wont subjeW the aaptkanl to a civil peneffy of M maw than five hundred dtllerc 155001). ❑ 1, as owner of the Property or by empbyees mh wages as their wale compensation, will do the work, and the structure a rot intended m offered for sale (Section 7000, Business and Professions Code: The Contractors License Law does not appy to an owner of propend who burns or inproves hereon, and who does auoh soak Nmaeff or Meed or through his or her own employees, provided tines such improvemasts ere not intended or blared la we ff, however, the building or mprowerml is said within ale year of completion, the owner4atlder will Mve the burden of proving M 0r she did not build or imamve la the W pose of ads). ❑ I, as owner of the pmpeM. am exclusively contracting with licensed contractors to construct the prows (Section 7000, Business and Pralw soros Code: The Contractors License Law does net appy 10 an owner of propend who Wilda or tmprovas hereon and who contracts for such pgeas with a consumerist licensed punuanl to the Contractors Licame ❑ I Am exempt under Section: B. A P.C., la this reason: Dae: Owner: I do hereby coniy Run I am aware of and understand the requirements of Caroms Heath end Safety Coda Sections 25505. 25533, and 25530, and her I or any future Wilding occupant will I will net (circle One) need to coolly with said saws codas and the requirements for apamnlaaolstmd'anamodifimionhantMAi u yy a mentD ha.Raskmtidoonamaionappiralionsaeaempt(mmheas provisions. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under parWly d papry arta of the Idbwirg decimations: ❑ 1 have and wit mountain a cenuicata d aornam to selhinsure ler workers' compormabo , as provided for by Section 3700 d the Lahr Coda, for the performance of the work for which This pembil is issued. ❑ I haves end soil mainfarr vwrMrs' soak /a which the permiie insured. My workers' connpter enetbmn Insurance ncurenca eceartdoan 3ared! tl IM labor Cade. ler iM perfamence tl the poky number we: Carder: CALI COMP EXPIRES Policy Number: i 03/01/96 (This weaken need net be completed if the permd is ler one hundred doyen (Stool a leas.) ❑ I coney the in the pedoererae d IM work ler whkh this permil a Issued. I ahal rat empby any person in any manner oro w to become subject to the workers' aanpensation laws of California, and agree that U I should become subject to she workers' compens�tio7n provisions of Sedbn 3)00 of the Labor Code, shall with compy h lineae p iaicne. Dae: ��/P /� Wam/ng: Fallun as secure w *.' cumpenvtlon rovllage b.1. 1 and atoll subject an amploya to cdMml pena/tlas and civil Snag vD he one hundred lhouaasd "lam ($/0200(g), In addtdon to Me coat of compensation, clarregls as provided lex In Sidon 37W of Me Labor Coda, Interest and agomay'a fees. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of pwjurY that Ime is a construction ending aenry ler the performance of IM work for which she panel is Issued (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I candy het I hew read this application and want that the Abera information is coned. I ane to canpy with an any acrd county ordinances and were laws relating to Wilding construction end hereby aulMr¢e ream antaives of this city to enter upon the above meaionnd propend for inspection purposes. OMAR AL FAROUK Print —f-y,-e Dae: /Signature of O. medaenuAppllcanUCOnlredor (515146 WPI While-Buildi g A Seery: Greed.: Canary -Applicant; Pink -Revenue: Goldenrod-Aammor PERM NO: P 074306 GOVT: N SUPP: N SQ FT: GROUP OCC: R-3 / COMMENTS: X Z O N I N G R E Q'U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ----------- ACCESSORY BUILDING ---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13949117 ZNE: REF NO: PLANNING NOTES> > _1 D E V E L O P M E N T S E R V I C E Sf- R E Q U I R E M E N T S c� ZONING APPROVED BY ^ DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: _ CId'C DATE: ########dE#############'if'iF TflF7F"iFiF iF iF3F3f�F 3F3F ii'iFiFiFiF is TF TETE 3FiF3f'iFiF' ####DATE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING EL£CTR-IC MECHANIC PERMIT 7.00 PLAN 258 1: ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PIAN --,CHECK TOTALS ---- > 7.00 20.00 1(-„ 0..00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 27,00 FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 27.00 27.00 .00 27.00 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN—CHECK I N D I V I D U A L-) :5F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N. UNIT COST TOTAL COST PLU 1 WATER HEATER AND/OR7YENT 7.00 7.00 END OF FEES �I �) V �0190i21-00191772i 7t�T 2i,00 DATE: 0?/22/9` TIME: 11:53 d .J 7 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA 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 i 5. Steel Reinforcement 56. Rough Plumbing & Pressure Tesi 6. Electrical LIFER Grnd. 57, APPROVAL TO COVER-GUNITE . 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 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 14. Rough Plumbing 65, Electrical -Final " 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval '. 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS, Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure - 70- Underground Hydro , r 22. Ducts, Ventilating - 71. Product Piping -7 -Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 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 PREY. 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 - 34. Final Heating & Air Conditioning Notes: td ' !: ri � ,^ �0 Z5 4 -/Ac _ 35. Final Gas Pipe -Test. 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39, Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final, - 42. Backflow Preventer + 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46- Handicap Regulations _ 47. FINALSTRUCTURE & BUILDING 48. FINAL PLANNING ' 49. Electric Release to Edison rt_ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY N? - 2223 C P, O. Box 317 Costa Mesa, California The Building located at 3,570 C,:!'-;=agr L'Itl_y Ua';ltr A -B has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 13 & a Occupancy. Use of Building 8cat,>s Gi:1t AS`%'°?:t*SA A11% aG " tgd mme ag& leluan Legal Description.t".'x'@d- " 1&4 35 (See reverse side for Metes and Bounds) BuildingPermit No. tf'.C'7it S 7 ""r .� Electrical Permit No. p�J�J � plumbing Permit No._(. Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate.of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms T 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments and/or guest rooms ISSUED TO: Building Off' cial Date J=- 71 3465 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Fon„ so34—lM-11-63-s-s P 2377.q COSTA MESA, BUILDING -SAFETY DEPARTMENT P.O. BOX 917 COSTA MESA. CALIFORNIA ' For, Applicant to Fill In Completely "TYPE OR {�PRINT BUILDING !� 4p—(AA( A( ADDRESS �S 7 [� I COSTA MESA, CALIFORNIA OWNFR r A.I — '2' 0 ARCHITECT I TEL. Z— , NO. 'S - -% Z E FROM TREET REAR YARD ( V LEFT I RIGHT DESCRIPTION OF WORK IN /II ). OF WALL I ROOF IHEREBY ACKNOWLEDGE THAT 1 HAVE.READ THIS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT. AND AGREE TO COM. PLY WITH ALL CITY ORD( ANCES AND STATE LAWS REGULATING BUILDING CONSTRUOD N SIGNATURE OF PERM AUTHORIZED AGENT RIM MAR 24 1965, 1PPLI AT R For Office Use Only RECEIPT NO. PERMIT NO. //tel -7Q RECEIV BY DAT RECEI D TE IB EO z i BUILDING ADDRESS & 92 FIRE ZONE PE GROUP APPROVED BY DATE ZONING 20N� l ( NO. OF PLANS I P/ USE OP NN0 El11LOI _ S ✓ AYEW L n LEGAL DEeCRIPTION A. P. NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN BO" TO SIDE 9 REAR P. L. EAVES ALLOWED (U. B. C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROMC/ STREET)' ' FRONT Fi. C. L FT. R. SIDE FT. L. SIDE IFT. FT. �.— REAR FT. — FT. DISTANCE BET. BET. MAIN Q MAIN BLDGS. ACCESS. BLD S. VAR.# DATE C.U.P.# APPROVED APPROVED BY J lP SO. FT. THE 'AMOUNT SHOWN UNDER VALUATION IH FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION - r7- PERMITFEE $ /J $ (PLAN CHECK TOTAL FEE 5 232.74 e COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 817 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE. OR PRINT BUILDING ADDRESS 3 ' oc _p C a der Drive .COSTA MESA, CALIFORNIA OWNER T11 DEVELOPMENT CO MAIL ADDRESS FIRE ZONE TYPE GROUP CITY No8-823.' ARCHITECT OR ENGINEER TEL. NO.' ADDRESS LEGAL DESCRIPTI CONTRACTOR L D CONSTRUCTORS ADDRESS IT h Euclid CITY Fu erton AA F. LIC.TNo. B 102 641 N'Q 871-823:1 SIZE _ _ I NO. OF BLDDE. GAISI INO GLUW. SETBACK LINE FROM CA t EFT 1 r 1 1 RIGHT DESCRIPTION OF WORK BUILDING SIZE EXTERIOR 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AOREJ['TO COM- PLY WITH ALL CITY ORDINANCE, AND STATE LAWS BEOULATING BUILDING CONSTRUCTION. SIGNATUREOF AUTHORIZED AGENT _ FEE RECEIVED DEC 1 1964 11���TTFIINnAFNC�E��7D�EPT. APPiICATR POR`PERNITTMESA BUILDING For Office Use Only RECEIPT NO. PERMIT NO. RECEIV BY DAT !C IVKD I X-zz 111964 BUILDING ffDECn ADDRESS FIRE ZONE TYPE GROUP APPROVED BY DATE ZONING ZO AZII NO. OF /"j PLANE i/�C Ue80F NlW _ Eu1LDirva LEGAL DESCRIPTI A. P. NO. NOTE: NO EAV E OVERHANG SHALL BE LESS THAN 90- TO SIDE 8 REAFf P. L EAVES ALLOWED (U. B.C. REQUIREMENT) YARDSAPPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING (FROM C/L STREET) FRONT FT. R. SIDE to Fr. FT. L. SIDE Fr. FT. REAR Z)FT. FT. DISTANCE BET. MAIN SLOGS. BET. MAIN IN ACCESS. SLOGS. VAR.# C.U.P. DATE APPROVED APP E B7 D / _ DATE (e L Lso. FT. E 1 Uge 1 THE AMOUNT SHOWN UNDER VALUATION 19 FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. VALUATION //// •7 J PERMITFEE PLAN CHEC� TOTAL FEE