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HomeMy WebLinkAbout1812 ALASKA AVE - Building PermitsCITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: M09-00020 PERMIT TYPE MECH APN: 13958109 JOB ADDRESS: 181,2LMS'7KA�AU CMS Vicinity: SQ. FT: 0 STATUS: ISSUED DATE ISSUED: 03/03/2009 ISSUED BY: BJK Suite/Unit: SCOPE OF WORK: CHANGE -OUT OF FAU AT AN EXISTING SFD. 1 INST FAU < 100K BTU OWNER: BANTEL, MICHAEL K Address: 1812 ALASKA Unit: PHONE: $0.00 City/State/Zip: COSTA MESA, CA APPLICANT: RODRIGUEZ, FONZ Address: Unit: PHONE: 714-379-4757 City/State/zZip: CONTRACTOR: EMPIRE PLUMBING HEATING AND AIR CONDITIONING Address: 7050 LAMPSON AVUnit: PHONE: 714.530-7320 City/State: GARDEN GROVE, CA ZipCode: 92841 MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.30 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $38.30 License No. 794154 CELL: / D Da 14 Dead I rime- secs+ NOTICE: The work authorized by this permit shall Comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE #I INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INnnALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. have and will maintain workers' compensation insurance, as required by sec an 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: ,Carrier: _Ff/e ie s! 667";"`r / (This section need not be completed if the permit is valued al one huntlretl dollars ($100) orlessJ Policy Number: A r_,013'%0 41030rl ❑ I certify that in the performance 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 that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor C de, I shall forthwith comply with these provisions. --5 33 A;5p1,.rtS&gnbAre Date � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force �and effect. LID. # % i Z/1"/JrT Class # �i Contractor's ST ature -Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Date OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 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 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 property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 3057 4613107 Owner ID verified by driver s I�. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property taxbill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition ordismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applicant's Signature Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. �-$" or Legal O aria) Dale /u/ `51 - And/or Authorized nt "�- Date 3J -n9 Date (714) 754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us I nvn UhWtz, cva IA mean, �A ezazo BUILDING PERMIT Job Address: 1812 ALASKA AV Suite: Vicinity: RIGHT SIDE YARD Parcel Number: 13958109 Zoning: Applicant: BANTEL, MICHAEL K Address: 1812 ALASKA Phone: 714-751-3887 COSTA MESA, CA Zip: 92626-2009 Owner: BANTEL, MICHAEL K Address 1812 ALASKA Phone: COSTA MESA, CA Zip: 92626-2009 Contractor: OWNER -BUILDER Address: Phone: Zip: License: 000000 Arch Eng: Address: Address: ISSUED BY: Status: ISSUED Applied: 01/22/2003 Issued: 01/22/2003 Phone: Phone: Zip: License: License: SCOPE OF PERMIT DEMOLITION OFA POOL (APPROX 270 SF) AT THE RIGHT SIDE OF AN EXISTING SFD. ADJOINING SPA TO REMAIN AND THE WALL BETWEEN THE POOL AND SPA TO BE BUILT UP 1"AND WITH COPING AN ADDITIONAL 4" WILL BE ADDED. COPING AND BOND BEAM AROUND THE POOL TO REMAIN, BECAUSE PROPERTY OWNER MAY RECONSTRUCT POOL AT A LATER DATE. CLASS 2 AGGREGATE BASE WILL BE USED TO FILL POOL TO ABOUT 1 TO 1-1/2 FT OF GRADE. Total: $69.75 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244646 (SM) FEESUMMARY Plan Check: $0.00 Calc Valuation: 82,000.00 Permit: $69.25 Claim Valuation: 82,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $69.75 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244646 (SM) Ir, _, DECLARATIONS WORKERS' CQMPENSATION DECLARATION: ' I hereby affirm under penAy of perjury one of the following declarations: ^ ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Carder: Policy Number: (This section need not be completedif the permit is valued at one hundred doilam ($100) or less.) ❑ 1 certify that in the performance 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 that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. # Class # Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Cotle), Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 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 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 property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a coniractor(s) license pursuant to the Contractors License Laws.). ❑I am exempt under sec. Business and Professions Code for this reason: Signature: Date: lin ZZf?Gt7 Z Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. . Expires: 3— 20 — 06 Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec, 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ NO (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight o1 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 2 Dces or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ..........................................................................................................................I............................................................................................................................................................................................................................. 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ....................................................................................................................................................................................................................................................................................... ............................................................................................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ....................................................................................................................................................................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Splice a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........................... ..................... ...................... .................... I ....................... ...... ..................... ........I........................................................................................................................................................................ 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and . Safety Code). ..... ....................................................................... .................. ................................................................................................................................................................................................................................ 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .............................................. ............... ...................... ...................... ....................................................... ................................................... ....................................... ... .............. ......................................... -........... ........................................................... 8 (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property`r»nspection pur o I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Je4n gnelnra Legal Owners) Dat And/Or Authorized Applicant Date CODE 0. INSPECTION TYPE DATE INTRIALS COGEN INSPECTION TYPE BATE INTITALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 200 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy August 29, 2003 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION NOTICE OF PERMIT EXPIRATION Michael & Tracy Bantel 1812 Alaska Ave Costa Mesa, CA 92626-2009 PERMIT NUMBER (S): FOR: PROJECT ADDRESS: B03-00100 Demolition of Pool 1812 Alaska Av., Costa Mesa Our records indicate the above listed permit(s) were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project and additional fees may be required to finalize expired permits. According to our records, the permit(s) listed above have not had an inspection for a period exceeding 180 days. If you have a signed inspection card indicating an inspection was conducted within 180 days from the date of this letter, please contact this office so we may correct our records. A time extension may be granted if you intend to commence work and complete the project. Requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you need to request an inspection please call our Inspection Request Line at 714.754.5626. If you do not contact this office within 10 days, your permits will expire on September 17, 2003. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, Vne Weidenkeller Office Specialist II Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Division (714) 754-5245 FAX (714) 754-4856 • TDD (714) 754-5244 • �.ci.cosla-mesa.ca.us M+ PRNECT ADDRESS: 1812 ALASKA AV -161111 NAME: PAAKHURST, JOSEPH C ADDRESS: PARKHURS T CLAIRE E 1312 ALASKA AVE COSTA MESA,CA 92626 AflCNIENGINEER: 549-2092 flEG.NO.: ADDRESS: UNIT: UNIT: PERMITTEE: JOSEPH C. PARKHURST (714)549-2092 ADDRESS: 1812 ALASKA AV COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LI C.: STATE LIC.: CLASS: Dae: Signature: NORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure of a certificate of Workers' Ybmpensation Insurance. or a certified copy thereof (Section 3800. Lab. C) 'OLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division, Date. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thissedion need not be completed if the permit isforone hundred ($100) or les s). I Certify that In the performance 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 WorkersCompensation Laws of California. Date: Signature: NOTICE: It. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. 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 lot 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' Slate 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. prier to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business 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 (5500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (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 awn employees, provided that such improvements are not intended or offered for sale. It, 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 © and Professions Code: The Contractors' State License Law does not apply to an owner of propert9 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. I am exempt under Section: B. 8 P. C. far This reason: LZV -oar¢: ��'Owner' I do hereby certify that I am aware of and understand the requirements of California 1-ealth 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 state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date. Applicant: I hereby certify that I have read this application and stare that the above information is correct. I agree to Comply with all city and county ordinances and stare laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned property for Inspection purposes. � oat,: Or 3 I ! s.a Signature: A� ✓- — /�^ [Y,J I., Driver's License or Social Security v: 164146 While—Building', Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERM'T PERM NO: B 059789 PERMIT NO: B 059789 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE; STR PURPOSE; ALT JOB DESCRIPTION T/OFF RESHT, REROOF W/COMP SQ FT; 4,800 CLAIM VALUE; 4,800,00 CALC-VALUE: 4,800.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTOR RE?UIRED IN THE HOME 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 TN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REO• PROV: PARCEL: 13958109 ZNE: REF NO: PLANNING N TES> > D E V E L O P M E N T S E R V I C E S R E Q LJ I R E M E N Y S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE.- APPLICATION ATE;APPLICATION ISSUED BY: DATE: R'RXX7 777 -7 -fly RR fe LEGALIZATION:N F E E S U M N, A R Y STRUCTURAL, SEGMFNT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72,00 ,50 SMIP/NON-RES PLAN ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 72,50 0,00 0,00 72,50 72,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 72.50 OVER/SHORT;00 BLD72P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOO GRADING PLAN -CHECK I N D I V I D U A L F Z E B R E A K D O 9 N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 4800 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 4,.800,00 END OF FEES PA, CONSTRUCTION AND PLANNI1v­ APPROVALS Permit aW Date Inspector _)L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location�- v' 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. 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 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 22. Ducts, Ventilating 71. Product Piping OGas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas O 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 1 I 78. FIRE PREY. FINAL 30. Drywall Nailing I i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION 32. Electrical Power Meter -Final I I 'I 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test36. Hood Hood or Canopy l ---i Notes'. / u�wG P 7- y'b 0-"4 - 0 37. Final Factory Fireplace I 1 I 38. Final Plumbing l 39. Water Service -Final j 40. Gas Service -Final 41. Solar Domestic -Final i I 42. Backflow Preventer I I 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ��IL 48. FINAL PLANNING 49. Electric Release to Edison ll 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Mr. Joseph C. Parkhurst 1812 Alaska Street Costa Mesa, California Dear Sir: April 11, 1972 A building permit has be�asued to Madrid Custom Pools to construct a private swimming pool on your property. In order that yotiil� pool will be a safe one and for the purpose of advising you of yo responsibility regarding the require- ments of the Costa Mesa Municipal Code, we refer you to Section 8107, a copy of which is attached. This let directed to you in order that you will be aware of our ordinanc and can make a complete safety check of your pool area. Sincerely yours, RICHARD HANHART Building Safety Director RH:dh CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT N0. DATE L ^G LOT NO. ADDRESS 1,T12 �(!�JO�ii (�fU2.. CA'/�/l The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he -she -they) (was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. !N chaser representati 1�1ender��� e 1411 Windemere Lane 1Twiaiaq Laboratories ,f ��«�==12 cagoTnia, J7u• PROJECT Swim Pool for JOSEPH G. PARKHURST P.O. BOX 41 A 3310 AIRROPT WAY .LONG BEACH. CALIF. 9080I A [213) 926-3355. (217) 676-2386 . X7141 U6.6432 ' JRANCH OFFICES ' TESTING 1 s1..D Na",n H,.P." s"..• N., D.-1— T.,3,,, Snr!, Pnn wWanln G})J3 Ill & $4 - Deep End: '955 Red.,d, A—, P.O. B., A7 IIIA) 913C.5 LI,., Be.ch. C.64. K1101 (213) 63441B6 may 3, 1972 Examination: SC72-2572 COMPRESSION TESTS ON GUN I TE CYLINDERS L. E. Sprague 1411 Windemere Lane Tustin,"California 92680 PROJECT Swim Pool for JOSEPH G. PARKHURST Permit# 34545 ADDRESS 1812 Alaska, Costa Mesa SAMPLE FROM Ill & $4 - Deep End: #2 & 15 - Shallow End #3 E N6 - Bond Beam ARCHITECT CONTRACTOR Madrid Custom Pools ENGINEER SUBCONTRACTOR , Grove Gunite " SPECIFIED MIX Gunite STRENGTH 1 2,000 psi " DATE CAST 4-26-72 SLUMP 511 E ° DATE TESTED 5-3-72 5-3-72 5-3-72 4 "HOLD" CYLINDER NO. 1 2 3 5 "HOLD" 6 "HOLD" COMPRESSION 7 Days 7 Days 7 Days TOTAL LOAD, LBS. 108,000 125,506 146,0oo POUNDS PER SQ. IN. 3,820 40835 5,180 SIZE: #1: 611 x 12-1/21' N2: 5-3/411 x 12-3/411 N3: 611 x 12-1/2" COMPLIANCE 7 -Day test complies i with specifications. MADE BY DELIVERED BY RECEIVED ON CYLINDERS L. E. Sprague LES 4-27-72 DISTRIBUTION: - BUILDING SAFETY DEPT L. EP Sprague - 2 Madrid Custom Pools J4AY 8 1972 Grove Gunite o5ta Mesa Bldg. Dept. ALL REPOPTS ARE 5V6✓ITTFD .5 TN!" CONIIOENTI.I ^RORCPTV CA CLIPNT6. AUTH0412ATIOH FOR 1U6LICA1101A Of OUR DEPORTS, CONCL U 610N5. OR E.- TPACTS 1N1. OR RiGARDING 1.1H I. RESEPVI:I ^t Yf Vy �.4 +P:T^EN APPROVAL AS A HUTVAt PROTECTION TO CLIENTS, THE RUSLIC AND OUR5ELVF5. 33012 INSPECTOR'S LABORATORY N ADDRES TELEPHONE JOB ADDRESS OWNER'S NAN WORK PERFOF BUILDING PE CITY OF COSTA MESA BUILDING SAFETY DEPARTMENT SPECIAL INSPECTOR NOTE: All special inspectors are to be registered with inspector's registrar at the office of the Building Safety Department. Inspectors shall furnish proof of affiliation with an ap- proved testing agency; or, a state -licensed architect or engineer; or he shall be in the direct hire, under state and federal pay- roll regulations, of the owner/developer of the proposed project. This proof shall be in the form of a signed letter from any one of the above three. REMARKS: /�C_wZ&LZ,4L B-1 i( 126 APR 24-69CNS�OO1320'TM ***137.25 to-.. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely R ECEI y,,Ep QV/ DAEC,-FIVEE ISSUED BUILDING 2 �,n / /O/' AD ORESS O;C!X PERMIT NO. OWNER Hermes Dev, Co.—A.P. NO. MAIL ADDRESS 1104 E. 17th Street BUILDING / ADDRESS W TRACT 612 LOT BLOCK [1 CITY nTEL.547-7044 ✓ ZZ Q CONSTRUCTION W AREPAIR O N LENDER am J Z) BRANCH 190 Broadway Ave. J to OWNER mJ ADDRESS San Diep:. C lifornia VALUE " J m Q ARCHITECT TEL. K Dorius 6 -1164 SJaw $ ZQ N FIRE -z- y W Q ADDRESS 2712 E Coast Hwy. Corona D. M. ZONE TYPE GROUP cL W APPROVED W Z CONTRACTORwner BV DATE J O S2 J (r ADDRESS W WI- TEL. 2 E NO. OFA USE OF NEV*"*" PLANS BUILDING Z= CITY NO. / ✓ _ 0 STATE CITY YARDS APPROVED YARDS APPROVED W W Q LIC. NO. 2 2 6o LIC. NO. MAIN BUILDING ACCESSORY BUILDING O SIZE NO.OF SLOGS. (FROM C/LSTR ET) OF LOT NOW ON LOT RONi FT. FT. USE OF EXISTING BLDG. R. SIDE FT. FT. H Z SIZE OFNO.OF NEW BLDG. I O 5 . ft ROOMS 7 STORIES 1 L. SIDE FT. FT. Q EXTERIOR WALL ROOF UOMPO Or wood 2 COVERING StUCCCOCOVERING REAR FT. '� FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & 1 a MAIN BLDGS. ACCESS. BLDGS. Q VAR. # / V DATE ` - 0 Residence w attached garage C.U.P.+ �� APPROVED -�-� H APPROVED 4 L-46 Z 0 I hereby acknowledge that I have read this application and state HOLD FOR SPECIAL REQUIREWTT` that the above information is correct and agree to comply with cc all laws regulating building construction, and I shall not employ r any person in violation of the workman's compensation laws of /�, D the State of California.PP m o I hereby certify that I am properly licensed as a contractor under SO. FT. p� THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Professions Code, Division 3, C 9. VALUATION s PERMIT FEE $ i j �• Signature i/ U t/ Permittee 666 IE PLAN CHECK $ E Authorized Agent TOTAL FEE Sr%37,adJ o LL VnnIGR HERMES DMII)PMETU U/ IL 5-3 JOB ADDRESS IRIP Al..I,. 4:ran„a BUILDING PE AP No. LOT 45 FIRE ZONE VALUE $ 25,312.00 INSPECTIONS Si natVre to GROUP I & j TYPE 3r ZONE —1 _ SOIL - GAS SUBCONTRACTOR Date PERMITS ISS Number ED _ Si n� WATER (e ( lumbi ROUGH PLUMBING PROP. SWR. LINE HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING �E P Heatin an Vent. TRENCHES ® FORMS STEEL REINF. L] FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING / —(6—( FRAME AND FLASHING /�' LATHING— INS OUT i PLASTER, BROWN COAT STRUCTURAL, FINAL r' HEATING, VENT., REFRIG. AND A.C., F AL % Q PLUMBING, FINAL AND GAS TEST _ ELECTRIC, FINAL j (' BUILDING, FINAL SPECIAL REQUIREMENTS a' 7 34545 COSTA MESA BUILDING -SAFETY DEPARTMENT ? P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 F licant to Fill in Completely d J/ n C. �7 4 r �) S iY TEL. r�q� NO. 1(� ( - F z Q U_ J a a Q O In Z O F' U cc in in Z BRANCH ADDRESS ARCHITECT ADDRESS ^I GG(L/tlxv CJ ��J%,: CONTRACTOR L• Jy,H` /"v 45 ADDRESS �l'i"0 , t r / � CITY C.q [y� f TO OV -11 STATE rr,' LIC. NO. aG 9 J p !) / LIC. SIZE 0 [OF LOT 9O �� c 1 J. �J.OG 1NO NOW ON LO S FIRE ?ONE TYPE GROUP APPROVED BY / DATE 20 / NO. OF USE OF NEW O PLANSY BUILDING YARDS APPROVED YARDS APPRO ED MAIN BUILDING ACCESSORY BUILDI 1T! °'-577P 88 234- ****39.28 APPLICATION FOR BUILDING PERMIT RECEIVED BY Dp a DATE FT. ROOF X31 A.P. NO. s(j 7i COVERING REAR FT. BUILDING AD RES 18).1 r'd AND WORK TO BE PERFORMED It DISTANCE BET. BET. MAIN & MAIN SLOGS. LJ6TRiI CT OT �J VAR.. W A D A R C.U.P. APPROVED OWNER C• Or.l �/J/ APPROVED y �/p//—AL ( (]/I_;7 e- -. n VALUE FIRE ?ONE TYPE GROUP APPROVED BY / DATE 20 / NO. OF USE OF NEW O PLANSY BUILDING YARDS APPROVED YARDS APPRO ED MAIN BUILDING ACCESSORY BUILDI I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with . �-- all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. FAx 1 hereby certify that I am properly licensed as a contractor underFTHE,.Ir'FPOE T. o the State of California Business and Professions Code, Division 3, SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full farce and effect, or IF ESTABLISHING A PERMIT FEE ONLY:am exempt from the provisions of the State of California Businessantl Professions Code, Division 3, Chapter 9. /,mPERMITFEE $SignaturePermittee I_ Y/ l „/�¢�% PLAN CHECK $ �V f G E Authorized Agent ILL -) a TOTAL FEE $ + / IY/ 1T! NO. OF ROOMS STORIES L. SIDE FT. FT. ROOF COVERING REAR FT. FT. AND WORK TO BE PERFORMED It DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLOGS. �J VAR.. DATE a,QT C.U.P. APPROVED �/J/ APPROVED y �/p//—AL ( (]/I_;7 I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with . �-- all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. FAx 1 hereby certify that I am properly licensed as a contractor underFTHE,.Ir'FPOE T. o the State of California Business and Professions Code, Division 3, SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full farce and effect, or IF ESTABLISHING A PERMIT FEE ONLY:am exempt from the provisions of the State of California Businessantl Professions Code, Division 3, Chapter 9. /,mPERMITFEE $SignaturePermittee I_ Y/ l „/�¢�% PLAN CHECK $ �V f G E Authorized Agent ILL -) a TOTAL FEE $ + / IY/ OWNER PARKHURST Joseph C. DATE 4-6-72 JOB ADDRESS 1 J2 Alaska Street BUILDING,PERMIT NO. 3 545 F1 N ROUGH PLUMBING MISCELLANEOUS y ROUGH HEATING AND om Pools DESCRIPTION of WORK TRACT FIRE ZONE VALUE Signature Date 11GROUP J TYPE 41 SUBCONTRACTOR ROUGH WIRING Heatinq and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BONO BEAM ❑ STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN ❑ OUT ❑ PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND A.0 PLUMBING, FINAL AND GAS TEST FINAL FINAL