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HomeMy WebLinkAbout167 ALBERT PL - Building Permits • PROJECT ADDRESS: 167 ALBERT PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 058983 OWNER'S NAME: CROWELL, DAVID W ADDRESS: CROWELLWHENDE G PERMIT NO; E 058983 PLAN CHECK NO; N GOVT; N SUPP; N 167 ALBERT PL COSTA MESA,CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE; ELE PURPOSE: ADD (714 ) 646-3421 ARCH/ENGINEER: GEORGE H. MAYERHOFER REG.ND.: NONE JOB DESCRIPTION ; ADD TWO BDRMS, MAST BATH, CLOSETS & HALL SQ FT: ADDRESS: P.O. BOX 1760 UNIT: SANTA ANA CA 92702-1760 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: DAVID CROWELL (714 ) 646-3421 ADDRESS: 167 ALBERT PL COMMENTS; REF B58982 CM CA 92627 *********************************** ******* *****ttx****>E**iE***TL***** *** ****** LICENSED CONTRACTOR DECLARATION: 1 hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 71100)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE UC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a cemfied copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN t POLICY NO.: EXP.DATE: 'OMPANY: PARKING REQ: PROV: PARCEL: 42606306 ZNE: REF NO: . Certified copy is hereby furnished. El Certified copy is tiled with the city Building Division. PLANNING NOTES> > Date; Applicant: ******************************************************************************* { DEVELOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This secti,n need not be cemph..if me,:'• . r one hand �r icor less). I certify that in the performance of the work for which this permit is i . ed,I shall note oy any. r . '.ny mane . to become subject to the orke 'Compensation Laws of California. // / / ZONING APPROVED BY DATE; _ Date: tT1 Signature: L...... ��N '-��� BUILDING APPROVED BY DATE; v NOTIC :II, er making this declaration,you should become sue-ct to the Workers'Co pensati.- .rovision if 11.r - Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 11191 ���� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perform. ce oft ' irk for APPLICATION ISSUED BY; ,����— DATE: b tya C7' which this permit is issued(Section 3097,Civ.C). *********************{F ****************** * LENDER: ******************************************** ******************WV* ********* ADDRESS: LEGALIZATION;N F E E S U M - A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC . ECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 3 0 , 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 50% SMIP/NOiN—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 700)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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). ISSUE FEE 15, 00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 30 . 00 15 . 00 0 , 00 45 , 00 45 , 00 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property 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 REVENUE DIVISION TOTALS--> COLLECTED: 45. 00 OVER ISHOR , 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ithe purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PL - .. ,y; I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 . 00 6a and 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 contractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY D .F„ S C R I P T I O N UNIT COST TOTAL COST Date: 1tT/���2" Owner: OW ELE 10 FIXT RES LIGHTING 1 ST 20 EA, . 75 7. 50 I do hereby certify that am aware al and understand the requirements of California, alth and Safety Code Secti/.25505, 0 ELE 12 REC T/OUTLET 1 ST 20 EA. . 75 9 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes an. e requir. enf' 7 5 7 . 50 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt 17.m ELE 10 RECE /SWITCH 1 ST 20 }. EA, . mese provisions. ELE 1 RES A PLIANCE NOT OVER 1 0 HP 3 . 00 ELE 1 MOTOR POWR APPARATUS 0 , 0 — 1 . 0 HP 3 . 00 r 3 , 00 Date: Applicant: END OF FEES EXPIRED I hereby certify that I have read this application and state that the ab. e information i .Direct.I age .comply wi all 7 and county IST ordinances and stale laws relating to building construction and hereby.uthorize repres�X tines of toy to enter up. the/rive-mentioned \ oati Inspect,. property for ins ection purposes. —, / / / //1'�� Date'. 2 Signature: q/./ I-�• /��/✓fir._ _ ,/ �i�I .S, • Driver's License Social Security / / (ii •_'------ 164146 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Mae •• )) EI q N\ CONSTRUCTION AND PLANNING POi .v 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 UF ER 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, ❑ 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 ` -'�I 16. Rough Electric Wiring - 67. Fencing & Access Approval - 17. Rough Wiring Sign - - 68. APPROVED FOR PLASTERING` L ' 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 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 j j 78. FIRE PREV. FINAL 30. Drywall Nailing I l HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric j Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test III 36. Hood or Canopy 37. Final Factory Fireplace I I 38. Final Plumbing39. Water Service-Final 40. Gas Service-Final • 77• S 41. Solar Domestic-Final I , 42. Backflow Preventer I j ( "' r .••,, 43. Backflow Irrigation 44. Landscape Irrigation System , , - 45. Sound Attenuation C, . 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date • PROJECT ADDRESS: 167 ALBERT PL UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 058984 OWNERS NAME: CROWELL, DAVID W L. ADDRESS: CROWELL WHENDE G PERMIT NO: M 058984 PLAN CHECK NO: N GOVT: N SUPP: N 167 ALBERT PL COSTA MESA, CA 92627 CONSTRUCTION TYPE: 5-N PERMIT TYPE: MEC PURPOSE: ADD (714 ) 646-3421 j ARCH/ENGINEER: GEORGE H . MAYERHOFER REG.NO.: NONE JOB DESCRIPTION : ADD TWO BDRMS, MAST BATH, CLOSETS 6 HALL SQ FT: ADDRESS: P.O. BOX 1760 UNIT: SANTA ANA CA 92702-1760 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / PERMITTEE: DAVID CROWELL ( 714 ) 646-3421 ADDRESS: 167 ALBERT PL COMMENTS; REF B58982 CM CA 92627 **************** ** **** ********* *>Ei<-x;'E** ********u** **** *************+EBF** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S E TB ACK S CITY LIC.: STATE LIC.: CLASS: Date Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR : FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL; 42606306 ZNE; REF_ NO: 1 Certified copy is hereby furnished. El Certified copy is filed with the city Building Division. PLANNING NOTES> Dale_ Applicant ******************************************************************************* 73. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This sect need not be :'ted if t / for one hued i(. I l or less). 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" I certify that in the perform ce of the work for which this permit is i d I shall n��ploy any any mann: so. o become subject to the rkers' gmpensation Laws of California. / ZONING APPROVED BY DATE: ._— Date: 10 a `Z— Signature: ' .� T NOTICE u.aft making this declaration,you should Dec me s led to fie,kers' mpensaT provisio if th i.', BUILDING APPROVED B Y DATE; / Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm That mere is a construction fendingagency for the dor .ice a work for -------------t--- --C--- APPLICATION »a g y oe APPLICATION ISSUED HY: DATE: C` / au 2 which this permit is issued(Section 3097,Civ.C). ********************** ************* *** **** LENDER: ****************************************** ************************************ ADDRESS: LEGALIZATION:N F E E SU . MARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 13. 50 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5* SM I P/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Cade)or that he/she 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(S50g). ISSUE FEE 15 . 00 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 13 . 50 15. 00 0 . 00 28 , 5O 28 . 50 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property 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 REVENUE DIVISION TOTALS--> COLLECTED: 28 . 50 OVER/SHORT• 00 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). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK Ki I,as owner of the property,am exdusive)y contracting with licensed contractors to construct the project(Section 7044,Business 28 . 50 and Professions Code: The Contractors'State License Law does not aDPN to an owner of properly who builds or imOmves(hereon and who contracts for such projects with acontractor(s)license pursuant to the Contractors State License L.w).l am aware ****************************;e******)e?f?K*****/R* ?*?%iF?!-•********i%*** ********iF**IF**** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. ' for this r son: TYPE QTY DESCRIPTION I UNIT COST TOTAL COST Date: Ioj� 1 1 Ownec NEC 1 INST FORC-AIR/GRAV FURN <-A 100 K BTU 9 . 00 I. 9 . 00 I do hereby Aartdy th I am aware of and understand the requirements of California He h and Safety Code Sectio, 25585, MEC 1 VENT ILAT ION FAN CONN TO SINGLE DUCE EXPlRE $1. 50 4 , 50 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes ani a requir. encs A END OF FEES permit for construction or modification from the Air Duality Management District. Residential construction applications are -xempi from h'ICOmplete I fSQ Ctioni these provisions. • �x� Date: Applicant: Oslo Sig- I hereby certify that I have read this application and state that the above' ormation is f///4t I age mply with al ity a•i county I+_� ordinances and state laws relating to building construction and hereby. mire reprise 'oflh�(� iter upon l ..bov: entioned ,! property for ins epclrion p poses. ,� �— Date: I d 1 Signature: 7' /�i, ✓.. i I le Driver's Lic nse or Social Security 4: t J - 1641-46 white—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. 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= I, r'-•. 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 Si Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 - I 77. FIXED SYSTEM FINAL 29. Insulation I 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 I Notes: .34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace - • 38. Final Plumping I - 39. Water Service-Final -i - 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. FINAL STRUCTURE &BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date P'OJECT ADDRESS: 167 ALBERT PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: PV. U:)8 8D b3WNENAME: CROWELL, DAVID W ADDRESS: CROWELLWHENDE G PERMIT NO: P 058985 PLAN CHECK NO: N GOVT: N SUPP: N 167 ALBERT PL COSTA MESA, CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: ADD ( 714 ) 646-3421 ARCHIENGINEER: GEORGE H. MAYERHOFER REG.NO.: NONE JOB DESCRIPTION : ADD TWO BDRMS, MAST BATH, CLOSETS & HALL SQ FT: ADDRESS: P.O. BOX 1760 UNIT: SANTA ANA CA 92702-1760 CLAIM VALUE: CALC—VALUE: GROUP OCC ; R-3 / PERMITTEE: DAVID CROWELL ( 714 ) 646-3421 • ADDRESS: 167 ALBERT PL COMMENTS; REF B58982 CM CA 92627 ****************+E****** 616 *****************+t>f************ ***********N****** ** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK S CITY LIC.: STATE LIC.: CLASS: Date: Signature: _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: Thereby affirm that lhave acertificate of consent mself-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EXP.DATE: QQ ':DMPANY: PARRKKNIGGREQ: PROV: PARCEL; 42606306 ZNE: REF NO; I Certified copy is hereby furnished_ 0 Certified copy is filed with the city Building Division. > Date: Applicant: ******************************************************************************* /EXEMPTION FROM WORKERS'COMPENSATION DECIMATION: (This e need not be pleted it I . , '/ for one h area .100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is i ed,I shall 'employ ar .:('/in any m./ars.as to become ZONING APPROVED BY : DATE: subject to the orkers' ompensation Laws of California. J/t Date p\ Z Signature: F`/• BUILDING APPROVED BY DATE: NOTIC :If,aft maag this declaration,you should become s ject to the Workers'Compensi in pravisio .of Code.you must forthwith comply with such provisions or this ermit shall be deemed revoked. I CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the porter an.:, •• or APPLICATION ISSUED B Y; i-- DATE: C ( (7°) .- whichthispermitisissued(Section 3097.Civ.C). **********************" " " '—'—" ' 'a ' ' ' " " ` ' ' " '************ ** ****** LENDER: ******************************************** • ********************************* ADDRESS: LEGALIZATION:N F E E S U M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors'Slate License Law for the fallowing reason BLDG PMT PLUMBING ELECTRIC M CHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or PERMIT 28 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed �5% SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she 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). ISSUE FEE 20.00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 28 .00 20 . 00 0 . 00 48 . 00 48 . 00 . 00 does not apply to an owner of a property 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 REVENUE DIVISION TOTALS--> COLLECTED; 48 . 00 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ithe purpose sale).). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 48 O O (� and 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 contractor(s)license pursuant to the Contractors'State License Law) lam aware **************************************'***'*'*'**'**'N'*-****'*'N'*'****'N'**'*'***"N'********'***- that proof of their Worker's Compensation insurance should be provided to INDIVIDUALA L F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. L / for this son: • TYPE - QTY DESCRIPTIO N UNIT COST TOTAL COST Date: ' 7--- owner: _AL,' 1 BATHTUB 7 . 00 7. 00 ///pa I do hereby c ily that aware of and understand the requirements of Catitomia Hea and Safety Code Section-e•505,25 y' •LU P U 2 WASH BASIN S• 7. 00 14 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirem:' PLU 1 WATER CLOSET (TOILET) t 7. 00 47. 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are ex: pt from END OF F p'CES these provisions. Date' Applicant: EXPIRED xxXk�P I R E D I hereby certify that I have read this application and state that the abov nformati%otthsscfnthea:. I.I ag 'th an city d c ,nty Incomplete Inspections { ordinances and state laws relating to building construction and hereb a rrze repre -me. oned ,,/// property for in. ¢)lion p poses. '-� _ a y Date: tD 9 y Signature: Driver's Li arts¢or S lei Security a: C 1641.46 White—Dmldino.Green—Code Enforcement:Canary—Applicant,Pink—Revenue:Goldenrod—Asses..r A. 1 - -.CONSTRUCTION AND PLANNING POC_. .v SPA APPROVALS Permit # Date Inspector Date Inspector APPROVALS Permit # Temporary Electrical Service or Pole _ 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - - J .. 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 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. 1 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 Drains64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final ' . _ 15. Rough Electrical-Conduit 66. Solar System-Final I 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING,'' , ,----:t 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air ConditioningFIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating _ 71. Product Piping 0 Gas goo 23. Gas Pipe-Rough & Test - 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 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 I I I 78. FIRE PREY. FINAL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION 32. Electrical Power Meter-Final I I 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy I _ 37. Final Factory Fireplace I 'i.. 38. Final Plumbing • I Y"' . S 39. Water Service•Final • . 40, Gas Service-Final In " ; 41. Solar Domestic-Final 42. Backflow Preventer ( t -ti 7 • 43. Backflow Irrigation 1 44. Landscape Irrigation System u ' 45. Sound Attenuation i 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison i • 50. Gas Release to Southern California Gas Co • I 51. CERTIFICATE OF OCCUPANCY No. Date 1l*PRDd. 3,ADDREss: 167 ALBERT PL UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 058982 OWNEWS NAME: CROWELL, DAVID W ADDRESS: CROWELL WHENDE G PERMIT NO: B 058982 PLAN CHECK NO: 01210-92 S GOVT; N SUPP: N 167 ALBERT PL COSTA MESA, CA 92627 CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ADD (714 ) 646-3421 ARCN/ENGINEER: GEORGE H. MAYERHOFER REG.NO.: NONE JOB DESCRIPTION : ADD TWO BDRMS, MAST BATH, CLOSETS & HALL SQ FT: 623 • ADDRESS: P.O. BOX 1760 UNIT: • SANTA ANA CA 92702-1760 CLAIM VALUE: CALC-VALUE: 47, 679 . 00 GROUP OCC: R-3 / PERMITTEE DAVID CROWELL ( 714 ) 646-3421 ADDRESS: CM +t�6�t�t�r�6�E 167 ALBERT PL CA 92627 COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME*4*** *********�r�L�6�6�t> ** *** *********, ** *******N*********************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONI NG REQUIREMENTS-_ 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETH ACK S CITY LIC.: STATE 110.: CLASS: HOLD FOR SPECIAL REQUIREMENTS Date: Signature: MAIN BUILDING ACCESSORY BUILDING_ WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: 21 FT IN REAR: 50 FT IN FRNT: FT IN REAR,;-�' "FT'--- -IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab,C). LEFT: 5 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: ‘ COMPANY: PARKING REQ• PROV; PARCEL• 42606306 ZNE: R2 (REF NO; DR-92-06 / 1 Certified copy is hereby furnished. 0 Certified copy is tiled with me city Building Division. PLANNING NOTES> �� `y PROPOSED ONE-STORY ADDITION TO AN EXISTING UNIT-,.----' ) _/ Date: Applicant: *************** *Yeh1F16********************************************************* I ceMPIt a FROM WORKERS'COMPENSATION of the workrDECLARATION:this 2inSrmtbecdtetedif I5forone der•as$103)or omeD 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 certify that in the pedormanp of the work for which this perised, shall ploy a n• 1n in any her •as to become / subject to th Worker Compensation Laws of California. / ZONING APPROVED BY G� DATE: Date: �� y�R2 Signature: t NOTI E:IL a er making this declaration.you should become su ct to the Workers'Compo abort provi- !nal]r BUILDING APPROVED B Y : DATE Code,you must forthwith comply with such provisions or this permit shall be deemed revo . _��� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pular 6. rk for APPLICATION ISSUED BY: �,.IIIIrfspia�2. ' — DATE• 0 `- / 0 x- _Z which this permit is issued(Section 3097.Civ.C). *********************** ' :x's'. - ********************** LENDER: ***************************************** •• ************************************ ADDRESS: LEGALIZATION:N F E E SU MARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 401 . 50 . 4 , 77 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 260 . 98 and Professions Code)or that he/she 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). ISSUE FEE I, as owner of the property or my em Ioyees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 406 . 27 0 , 00 260 . 98 667, 25 667 . 25 , 00 does not apply to art owner of a property 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 REVENUE DIVISION TOTALS--> COLLECTED ; 427. 40 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK for the pupurpose of sale). I,as owner of the property,am exclusively contracting with licensed contractors to construct the protect(Section 7044,Business 401 . 50 4 . 77 21 . 13 ixi and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts tor such projects with a contractors)license pursuant to the Contractors'State License aw).I a' aware **************-***************************************************************** that proof of their Worker's Compensation insurance should be provided to me. /// / INDIVIDUAL F E E BREAKDOWN ❑ I amt exempt under Section: B.8 P.C. p/ for this Cason ,A(.-- Date: TYPE QTY DESCRIPTION UNIT COST yTOTAL COST �It i2 r. Date: Owner: SFR 691 DWE-TYPE V-WOOD FRAME -GOOD 69 . 00 47, 679. 00 I do hereby certify Ih I I am aware of and understand the requirements of California ¢alto and Safety Code Se i, s 2 1' nn. END OF FEES' 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes a •the req/a SIJ or a permit for construction or modification from the Air Duality Management District.Residential construction applications a•ex from EXPIRED . these provisions. (4nISS _ I pate Inspectons Date: Applicant: - `y� .` �J I hereby certify that I have read this application and state that the abo information i4.t ect.I agree, i ply with. 'and county NO L� v A.Jr(L \ 63 � //{ ordinances and state laws relating to building construction and hereby thorize repre ves of this er upon ve-mentioned KK.V �� "� x/x/y yy►_r,.►� properly for in pectm purposes. 4I�p , Date: 7, Signature: \ \ '>' " Driver's License or 'ocial Security it: I II i 164146 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor 10 POO, SPA CONSTRUCTION AND PLANNING APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector 11,-: 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 6. 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 Wiring 1111.1. 67. Fencing & Access Approval 17. Rough Wiring Sign , 1 68. APPROVED FOR PLASTERING r,. ,. 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 'i 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 2o. Rough Factory Fireplace - APPROVALS Permit # 21. Ducts,in Structure . 70. Underground.Hydro 22. Ducts, Ventilating . 71. Product Piping 0Gas 0OiI 72. Underground Flush ' - 24. •• 73. Undergrnd.Storage Tank 0 Gas 0 Oil725. Roof Sheathing 4. 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 I 78. FIRE PREV. FINAL . - 30. Dryvvall Nailing HEALTH DEPT. REQUIREMENT Brown31. Plaster 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ..- 33. 33. Final Electric Notes: ' - 34. Final Heating,8{ Air Conditioning I ` 35. Final Gas Pipe-Test I - 36. Hood or Canopy I ® -. 37. Final Factory Fireplace ' 38. Final Plumbing 39. Water Service:Final f. 40. Gas Service-Final • .•E 41. Solar Domestic-Final ' 1 2 L�- 42. Backflow Preventer T. 1 I . 3 . . 43. Backflow Irrigation ' ` - { 44. Landscape Irrigation System , 1 -$ --`,`f 45. Sound Attenuation i :7 46. Handicap Regulations I. -- 47. FINAL STRUCTURE &BUILDING t , 48. FINAL PLANNING . 49. Electric Release to Edison--. f ,-rt, 1 . 50. Gas Release to Southern California Gas CoI 51. CERTIFICATE OF OCCUE1ANCY No. Qat§, I t164p • OWNER VIGNAROLI, P. L. DATE AUG 0 1960 JOB ADDRESS 167 Albert P1. BUILDING PERMIT NO. 22789- • aGENERAL CONTRACTOR Owner-Builder VALUE $ 2,1100.00 k AP No. 118-083-15 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORKAddRUmpus r to p INSPECTIONS Signature DATE GROUP I TYPE V ZONE R2 Res _ Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line ❑ House Con. St. Swr. 0 Sprinkling System Construction Pole Underground 0 Power 0 Rough Wiring 7PM' % -6' .2 30.5- " Trenches i❑ Forms 0 Steel Reinf. ❑ _ Floor System Bond Beam 0 Steel Reinforce 0 Sheathing finer Frame and Flashing / e.. OSA r Lathing— In ❑ Out 0 / _ Plaster, brown coat Refrig. 0 Air Con. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final IA' f,p7_6.s Building, Final ✓ "''�12 VC S OCCUPANCY Form 13U4-5M-3-63—S-B P 22789 Cib Ct tt- bM)u5 Theytta_ W\z, RAtTICE We gcci uc-zQ ycvua A-511672- 2cR9 u Di o wR. LA-1)Cbl e pc�2vnc{-s /i.,.�c0 nn ��2 2 x p/c i k h o vld,i-fe,-DA / CJ C f m,Jetkl cDjP1 C(l�liv-5 We l/I, vs- ExpneciuceD +1Ass pks+ ye-a_ U Cepstut .cl b, o41 Out Te-Ocr n ri i knbA) knS 10C-cm UDC M2c Still f litiuioity 1O Gib Ou It Rzpc� � i Ni AN& i P ?ossi blc, wou.lc lilac t0VV hAve 07-02_ peIL lik Som ht.-4p Ars ma-f n w oL I Q lac:- aREAtiy f}ppRzcie, 111.}n) k KMS ICto-0 amc12 0414 0161An20_,C Ib? & -Bctr Cos4 144E54 , CA. . V-6a7 6c -3uo- 1 PERvailg 3 5878a2 l2cvncc061 + . _ _ , _ • • _ .. _ _ -. _. _. . .__ . ._ _. ._ . __. . . . - _ ._ ._._ _ _ _ _ _ J 22789 I{ COSTA MESA BUILDING-SAFETY DEPARTMENT AUG10-64PD,W1-1531' ****18.P0 P.O.BOX 317 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING j6 C faced p� For Office Use Only BUILDING / !7 ADDRESS RECEIPT NO. PERMIT NO. DCOSTASA, CALIFORNIA 727$`j D OWNER / k ��/fx1/`fy/��//// � 'r/q _ ! RE081V BY � �0 yE 7fB UjG. / AMAIL DDRESS /th ?. , IL[([i{K//I I PI�j•. ADDRESS l6 7 .B�/52r// 1�/�L�J`(— CITY �� X/^`�l•4 NO. N 4/4'd a ONE //..TYPE GROUP�/ l ARCHITECT T.�-�� TEL. ABy PPROVED IR DATE oft OR ENGINEER N �A+F- �Q t. NG ADDRESS jj��NB,�� NO.OF USE OF NEW � N'�II �� 1 PLANS .-2.....1: BUILDING „4 -N` CONTRACTOR 6�[Z'�.B1L . � L'� /� U�) I // �. ADDRESS I- .,..... ..... ......----. - - DESCRIPTION !IG /� API f Q4 y nit/tit -�— A.P.NO. // 7 - 673 is CITY NOTE; NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL. .—� SO^ TO SIDE @ REAR P.L. LIC.NO. NO. EAVES SIZE ,'5yy� ��))' NO.OP LDGB. ALLOWED (U.B.C.REQUIREMENT) OF LOT /' �L�U: U NOW ONBLOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING - ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STRE ) _ SETBACK LINE FROM �/1- 6 C/ FRONT /}FT a- 4//Z-de / FT. CENTER OF STREET // / REAR YARD YYYY///// tut v SIDE YARD LEFT ,'D (* I RIGHT / /S-� R.SIDE 7 FT.j FT. DESCRIPTION OF WORK "...Ir.-REAR SIDE )0 FT. FT. NEW _ ALTERATION ADDITION !� REAR ( FT. FT. DISTANCE BET. BET.MAIN ft REPAIR MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS. BUILDING t./d ROOMSNO.OF STORIES / VAR.# DATE SIZEX '�/L//y�+�,'��//// C.U.P.# to 8 APPRpVED D-6 kli COVERIOF BUILD( NOWOI TOVERINGF R BYF PROVED ' 44//..JJ�I COVERING E s .82e) 0-4b `R02 - l c a,, t %C i 2i0 $a.Fr. SG boat. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 0 BUILDING CONSTRU 10IL: f.X✓ /c�J /[l PERMIT FEE $ I Z N SIGNATURE OF/e ! I • �r B PERMITTEE 1 !\ $ �/Da PLAN CHECK $ S AUTHORIZED AGENT II Si LL TOTAL FEE 5 6