HomeMy WebLinkAbout2037 BALEARIC DR - Building Permits�
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PflOJECTAUONESS: zO3% BALEARIC DR
owxensxame CARPENTER FRANK C JR
RDOXE55: zO3% BALE�RIC DR
COSTA MESA,CA 92626
APCMIENGINEEfl: � 7 1 4� S 4 9— 2 4 4 S qEG.NO.:
RDOflESS:
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PE"MiTTEE: CALIFORNIA ROOF LIEE ( 714 ) 847-7663
aoonEss: 16462 GOTHARD L
HUNTINGTQN BEACH CA 92697
UCENSED CONTBACiOfl OELLAf1ATI0N: I hereby aifirm Ihat I am Iicen5e0 under provisions of ChaD�e� 9(commencing wi�h Sec�ion
7000) ol Oivision 3 0l Ihe Business ana Pmlessions Gotle, an0 my license is in lull lorce ana eHect.
ciTvuc.:042245 sTareuc:509623(v'� ��ssi(:—�3� [n ,
Daie: � ` � � —� Z Signamre: __t--O��u � �� ��- _�..�(a•�
WOHREBS' COMPENSRTION OEClABF710N: I hereby aifirm that I have a certifica�e oi consent to self-insure or a�cenitica�e o� Workers'
Compensation Insurance, or a cenilied coOY ��e�eol (Sec�ion 3800. Lab. q.
roucvxo.: 1021135-92 E%P.OATE: OGIOZI93
cornraxr: STATE FUND
❑ Ceaifietl copy is hereby lumishetl. [x Certified coOY is �ile0 wi�h �he ciry Bu(iltling Oivi ion.
Date: �`� � � � � � Applicant: � J
E%EMPTION FflOM WOBKEPS' COMPENSATION OECIAIiATION: QhiS Sxlian neeU no� be comple�eG i� ihe permit is for ne hunUretl (5100) or les5�.
I cerlity Ihat in �he petlormanCe oi I�e work br whic� �hi5 permit is i55ue41 Shall nof emDlOy any p¢f5on in any manner sa as Io became
subjec� �o the Workers' ComDensation Laws af Califomia.
Date�, SignaWre:
NOTICE: I�, afier making ihis tleclaralion, you shoultl become subjec� �o lhe Workers' Compensalion pmvisions of �he LaDor
Cotle, you must lorihwilh comply with such O�ovisions or Ihis permit shall be aeemea revoke0.
CONSTPOCTION LENOING pGENCY: I here�y affirm tha� there is a constmc�ion lending agency �or the pedormance oi Ue work for
which Ihis permi� is issuetl (Section 3097. Civ. C�.
LENOEfl:
I ADOflESS:
OWNEB BIIILOEP UECLABRTION: I hereby a��irm ihat I am exempt fmm ��e Contractors' Siate License Law lor Ihe following reason
(Seclion 703L5 Business anA Prolessional Cotle: Fny ci�y of counry w�ich reQuires a De�mil to consimct, ai�er, imDmve, Oemolis�, or
repair any slmciure. prior lo i�s issuance, also reQwres Ihe apPlicant for such permi� �o file a signe0 statemen� that he/she is licensed
pursuam lo ihe pmvisions of ��e ConVacmrs' Slate License Law �Chapter 9(cammencing wiN Sec�ion 10W) o� Division 3 of �he Business
antl Pmfessions Code) or Ihal �e/she is exempt �here�mm and Ihe basis lor the allegetl exemD�ion. Any violation of Section 7031.5 6y
any applicant for a permit su�iecls ihe apolicant lo a civil penalty of not more ihan tive hunOreU dollars ($500�.
I, as owner of �he pmDerty or my employees wilh wages as their sale compensation, will Ao ihe work, and �Ae
❑ s�mmure is nol intentletl or ofteretl �or sale (Sec�ion 704A, Business antl Protessional Code: The Contrac�ors' Siate License Law
tloes no� aODly �o an owner of a D�oDerty who builtls or impmves ��erean, antl who tloe5 such wark himsel//hersell or ��mugh
his or �er own emplayees, provide0 t�at such impravemeni5 are not in�entletl or oflerea for sale. I�. however �he builaing or
impmvement is solE within one year o� completion. Ihe owner will have Ihe burtlen o� pmving he/she Ui0 nol build or improve
lor Ine purpose ol sale).
I, as owner of ihe pmpetly, am eKCWsively contrac�ing with licensed conlraclors to con5imc� �he pmled (Section 7044, Business
❑ and Pmfessions COUe: The Contractors' Slate License Law tloes not ap01y to an owner ol pmpeM who hmlds or imD�oves Ihereon
antl who comracts for such pmiems wit� a contrac�or(s) license pursuant to tAe Coniractors' State License Law�. I am aware
thal pmo� o� Iheir Worker'S Compensa�ion insurance shoultl be pmvitletl to me.
� I am exem0� untler Sec�ion: B. 8 P. C.
br Ihis reason:
Daie'. Owner.
I Uo hereby ceNty �hal l am aware ol and underslantl the requiremenis o� Cahbmia Heal�h an0 Safe�y Cotle Sec�ions 2550.5. 25533, antl
25534 antl �hai I or any Iuiure builtling occupant will/will not (circle one) need lo comply with saitl state co0e5 anA [he requirements for a
permit tor conslmciion or modificalion �mm �he Air Oualily Managemenl DistricL Fesitlen�ial canstmc�ion aDPlicaiions are exemp� �mm
t�ese D�ovisions.
Dale: Applicanl:
I hereby cerlity that I have reae Ihis applicaiian and S�aV
oitlinances antl Slalelawsrelating�o OuilAing cons�mction
pmpeny for inspectian vurvoses.
�ate: � � � � ( � $ignature:
oriver's �icense or Sociai Secwity
is correcL I agree to compty with all city antl county
naiives of this ciry to enter upon the above-mentioned
�
t6at�a6 W�ae—Builtl'ma; Green—Cotle Enlorcemenl'. Canarv—Aoohcan�; Pink—Revenue; oltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 05781_
PERMIT NO: B 057819 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: 5—N PfiRMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION ; T/O, RESHEATH W/1/2"CDX,APPLY"EAGLELITE" SQ FT; 10,850
CLAIM VALUE; 10,850,00 CALC—VALUE: 10,850.00 GROUP OCC: R-3 /M-1
COMMENTS• SMOKE DETECTOR(S) RE�IUIRED IN HOME, ������
*�*�*���**�****���*��*�*������ ��������*����*��***��*������ � T*a
2 O N I N GS ERTEBQAUCIKRSE M E N T S R�QUIRED
------------ MAIN HUILDING ---------- --------- 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
PARRING RE • PROV; PARCEL: 13945909 ZNE; REF NO: �
PLANNING N�TES>
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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 5
f _
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE; '�
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LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 126,00 1.09
PLAN . '
ISSUE FEE �
BUILDING—DIV—> PERMIT ISSUE PL�AN—CHECK TOTAL PAID DUE
TOTALS----> 127.09 0,00 0,00 127,09 127,09 .00
� .
REVENUE DIVISION TOTALS--> COLLECTED: 127.09 OVER/SHORT; ,00
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
126,00 "'% 1,09
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if iE if iE iE ik iE iF fk iE �F iF iF iE 3F iE ik if 1E iE 1E 1E iE 1E k 1E 1E iE iE ik iE �lE iE iFiF if 1E if �E �lE iE if if jf iF jF 3f if iE iE iE k if if iF iE if�±f aE iE iE if if if iE �E iF iE 1E 1E iE iE if iEjE iE jE 1E IE
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
SFR 10850 REROOF BY VALUE RESIDENTIAL NOZONE 1,00
END OF FEES
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TOTAL COST
10,850,00
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CONSTRUCTION AND PLANNING . POO� b SPA
APPROVAIS Permit # Date Inspector APPROVALS Permit # Daie Inspector
1. Temporary Electrical Service or Pole � �52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. - - 53. Steel Reinforcement
3. Electriwl Conduit UtilitY�Undrgrnd. ' 54. Forms
4. Electrical ConduibUndrgrnd. 55. Electricai Bonding
' 5. �tgel ReinforCement 56. Rough Plumbing & Pressure Test �
6� Electricai UFER Grnd. 57. APPROVAL TO COVER-GUNITE
"'7. Footings � 58. Electrical Conduit-Undrgmd. �
�
8. Poundation ,� 59. Gas Pipe, d Undrgrnd., Tesi �
9. Water Pipe-Undrgmd. - 60. Backwash Lines, P-Trap, � Undrgrnd. .
10. Structural Floor System � � 61. APPROVAL TO DECK �
i t. Property Sewer Line & House Co�oection _ 62. Backwash & Receptor-Final
12. Se�ver Cap : � 63. Heater & Vent-Final
13. Roof D�ains � _ 64. Plumbing System - Final
14. Rough Plumbing � � 65. Electrical-Finai _
15. Rough Electrical-Conduit ' -• 66. Solar System-Finai .
16. Rough Electric Wiring 67. Fencing & Access ApProval
t7. Rough Wiring Sign 68. APPFOVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heati�g & Air Conditioning FIRE DEPT. REQU4REMENT
- i
20. Rough Factor4 Fireplace � _ � APPROVALS .Permit #
21. Ducts, in Structure ' � ` � '
70. Underground Hydro
22. Ducts, Ventil5ting � ' . 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Tes[ 72. Underground Flusti= �
24. Roof Framing • ' �� 73. Undergrnd. Srorage-Tank O Gas ❑ Oil
25. Roof Sheathing � � �j �'� �- 74,�pverhead HYdro . � ' `
26. T-Bar Ceiling (Strucwral� & Monowat 75.� Dry Chemical �
27. Frame and Flashing 76. DrY Stand'pipe -
28:'Lathing & Siding .` . 77. FIXED SYSTEMaFiNAL
-29. Insulation 78. FIRE PREV. FINAL �
30. Drywall Nalling � HEALTH�DEPT. REQUIREMEN7
� 31. Plaster Brown Coat � 79. FINAL INSPECTION �
32.-Electrical Power Meter�Finai � - 80. FOOD CFqTIPI�ATE ISSUED
33. Finai Electric ' ' ' ' NoYes: ,5��_I /OJ/ ' .U/��!/r��
�_�r.� `F�„
34. Final Heating & Air Conditioning a� , , .
35. Final Gas Pipe-Test - � -
i
36. Hood or CanoPY � �
37. Final Factory Fireptace � ' � � ' ' '
38. Final Plumbing •
39. Water Service�Final i .
40. Gas Service-Final . ,.. - ,
41. Solar pomestic-Final .
42, Backflow Pre�enter
43. Batkflow Irrigation - .
44. LandscaDe tr�igation 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. CERTIFICA7EOFOCCUPANCY
No. Date
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ICBO Evaluation Service, Inc.
�O� ,asubsidiarycorpor,rionolche Internationa� Conference
IM
EVALUATION REPORT
Coppight �c 199U ICBO Evaluation Servite, In<.
Filing Category: ROOF COVERING AND ROOF DECK CONSTRUCTION—Rooi Covering (202)
EAGLE AND EAGLELITE CONCRETE ROOFING TILES
EAGLE ROOF�NG PRODUCTS
3546 NORTH RIVERSIDE AVENUE
RIIILTO, CALIFORNIA 92376
I. SubjecC Eagle and Eaglelite Concrete Roofing Tiles.
II. Description: A. General: t Eagle conventionai weigM concrete rooi-
ing tiles are protluced in high profile (Capistrano), low profile (Malibu),
and flat profile styles with either smooth (Bel Air), orteztured (Ponderosa)
surfaces, Ridge and rake Irim units are produced to match each product.
The tiles are composed of portland cement, sand, and proprielary addi-
tives. Mineral coloring oxides are atlded or are mixed with ponland ce-
ment and water tor surface application follo�ving e#rusion. Units are
cured under controlled temperature and humidiry conditions. Tiles are 17
inches long, 12�/e inches v�ide, antl nominally'/a inch thick. They are man-
ufacNretl in either tlat or profile style with 3/,-inch interlocking sidelaps
designed ro resist surface water penetration and maintain proper align-
mem. All tiles have continuous protrutling heatl lugs on the undersitle,
which provide meclianical attachment over wootlen or metal battens, or
provide a stable foundation for nail attachment to solitl decking. Two nail
holes are providetl in each tile for use where half tiles are needed. Approxi-
mate installed dry weights with 3-inch head laps are 9.5 psf for Capistrano
tiles. 9.5 pst for Malibu tiles and 10.0 pst for Ponderosa and Bel Air tiles.
2. Eaglelite`"" Tiles are produced in the same size, manner and shapes
as conventional weight field tile except for substitution of IightweigM ag-
gregates and additives for sand. Approximate instal�etl dry weights with
3-inch head laps are 6 5 psf for CaDistrano til�, 6.0 psf for Malibu tiles
and 7.0 psf for Ponderosa and Bel Au hles.
B.Installation: t. Sheathing: Soho sheathing of nominal 1-inch boards
or minimum 4Z inch-thick plywood is installed in accordance with the
code.
2. Roof Pitch: See Tahle No. L Where roof pitch is between 2'/Z:12 and
4:12, an approved built-up rooi is installed ovar solitl decking in com-
pliance with Table No. 32-D-1 of the cotle. Vertical nominal i by 2-inch
wood battens are then nailed over the built-up roofing at a maximum 24
inches on center into ratters with subsequem hot mopping of the entire
rooi. Horizontal nominal 1 by 2-inch wood batlens are then nailed to the
venical battens at propzr coursing not exceetling 14 inches on center.
Nose end of tiles installed on pitches exceeding 18:72 are securetl wiih a
clip or approved adhesive. .
On roof slopes 4:72 to 21:12, installation must comply with Table No.
I and Table No. 32-0-2 of ihe cotle. Tiles are not permitted on slopes ex-
ceeding 21:12.
3. UnderiaymenC One layer ot minimum Type 30 asphalt-saturated or-
ganic felt, meeting U.B.C. Standard No. 32-1, is carried over or under hip
and ritlge nailer boards antl laced ihrough valleys. _
4. Battens: Where the roof pitch exceeds 7:12 or whe�e specitied at low-
er pitches, nominal 1 by 2-inch wood batten strips are nailed or stapled
of Building Officials
Report No. 4660
December, 1990
to decking on 24-inch centers, allo�ving a'/Z inch separation at �atten
ends. If battens exceeding 48 inches are used, 2-inch square shims cut
from asphalt shingles shall he placetl between 6attens and ihe deck every
48 inches prior to nailing to provide drainage 6eneath the battens. Hori-
zontal batten placement shall not exceed 14 inches on center.
5. Eaue: Metal eave closure strips must be installed when using Eagle
Capisirano tiles. Eave riser sirips of wood or metai must be instalied at
eaves when using Eaqle Bel Air, Malibu or Pontlerosa Tile Eave closures
and/or eave risers elevate eave tiles to the proper heigM. block wind. fire,
snow, vermin, or birds, and allow drainage of moisture accumufated be-
neath ihe tiles to escape ihrough weep holes in metal or slots in wood.
6. Fastening: Tiles are attached in accordance with Table No. I. All tile
nails are minimum No. 17 gauge corrosiomresistant steel having a mini-
mum 5/�fi inch heatl and sufficient length to penetrate 3/a inch into iraming
battens or through the thickness of the sheathing, wh ichever is less. Naile r
boartls ot suflicient height to adequately support hip or ridge tiles are
nailed imo (raming every 48 inches with 20-penny steei nails or secured
using galvanizetl steel strappinq or special gaWanizetl steel attachment
devices at 48 inches on centec Each Eaglelite Tile must be attached in ac-
cordance with Chapter 32 of the Uniform Building Cotle.
7. Trim Tile: Each hip or ridqe tile is secured ro nailer bwrds with one
nail at the head end and a dab of rooters mastic or other perman?nt adhe-
sive placed over the nailing area to secure succeetling tile. As an aesthetic
option,mortar may be used at hip and ridge ends or to fill open areas be-
neath hip or ridge trim. All rake tiles are attachetl with tvro nails into ihe
barge board.
8. Flashings: Valley metal shoultl be copper or minimum No. 28 gauge
galvanized steel formed with a 1-inch-high splash diverter in the center
and both longitutlinal edges Wrned inward approximateiy '/r inch at
30-degree angles. Succeeding valley metal sections shoultl overlap a
minimum of 4 inches and be attached with clips or nails bent over the
edges—not penetrating the metal. All exposed tieltl- or root-to-wall flash-
ing for Eaqle Capistrano orMalibu Tiles must be malleable metaL Standard
galvanized iron flashings may be used with Eagle Ponderosa or Bel Air
Tiles. In all cases, tlouble flashing of pipe or vent penetration is required.
9. Re-rooling Eagle Tiles provide a Class A roo( when installed over ex-
istingasphaitshingleroofs Ezisting(ramingmustbeadequateforthead-
ditional load. The existing rootshoultl be inspectetl in accordance with Ap-
pendix Chapter 32 ot the cotle. When re=rootinq wood shake roofs.
existing sh;kes must be removed and tile installed as with neve construc-
tion.
10. Broken Tile ReplacemenC The broken tile is first removed. It bat-
tens were used originally, existing nails, if any, are cut and new tile in-
serted. It no banens were used. 6-inch by 6-inch by'/z-inch plywood piece
is nailed to the tleck to acf as a batten. The new tile is then insertetl.
71. Special Enuiranments Conditions: a In areas subject to eave ice
build-up, underlayment as required in �able No. 32-D-2 ot the code is ini-
tially applied. Nominal 1 by 4-inch wootl strips vertically over rafters (max-
/i rofualiun repurn nf /CHO F.buhmtion .Sen�i��et /nr.. arr is �ued so(elr lu procide informalinn !n C(aes A membrrs nf ICBO. ulilijng fhr rndr upmr x�liirh rhr repor!
i� h¢�ed. /i ralua(iun rrporl� am nn! lo Ae <�an vin�ed a� repreorn(ing aeslhr(ies or anp nther al/rihules nol sperificallp add�essed nor as an rndunrmrr�l or re��nmmen-
datinn far me uf Ihe ruAjrcl rrparl.
7'hi� repurl i� hn.�rd upnn indrprndrn( Irefc nr nlher Iethniral dam suAmitted 6y thr opplir'onL Thr /CRO 6�calmfinn Serrice, Inc, (eehnical+laf/ha� n•rirw�rd U�r
le�l rr�ull� andlnr mhvr daia. hu/ durs nu( pus �rn !eN faci(ilirc (n makr an independem rrrifira(inn. There ic no warranp' b�� /CBO 61'a(uariun Srn�i� r. lne. erprr ��
urimp(ird.a�luum�.•Finding"uru(herma!lrrintherepnrinrarinam•pmduelroreredbclherrpun.Thisdis�laimerinrludes.Au�isnoNimirrAru.mrrdmnmhififr. �.
Page 7 of C
Page 2 of 4 Report No. 4660
imum 24 inch cenlers) and nominal t by 4-inch strips horizontally at prop-
er course intervak ar? th=q nailetl. A�I tiles are nailed with hot-dipped
galvanized nails.
b. In areas where winds ezceeding 100 mph ezist directia ns in 7able No.
I are followed. Additionally, ciips or approved adhesive are usetl to stabi-
lize noses ot all tiles.
C. Fire Retardancy: Eagle Rooting tile installations are recoqnized by
the code as Class A and have passed req uired tests to gain Class A recog ni-
tion when installed over existing asphalt shingles.
D. 1989 Supplement to ihe U.B.C.: This report is u:._ ;cted by ihe
Supplement.
E. tdentificatian: The name EAGLE and evaluation report nomber are
imprinted on each tile. A tag on shipping pallets list �he producing plant
location, product identification, antl quality control aqency (Ramtech Lab-
oratories NER-�A293),
III. Evidence Submitled: Resuits ot tests in accordance with ICBO ES
Acceptance Criteria tor Special Roofing Systems, tlatetl April, 1990 instal-
lation instruciions, and quality control manual. �
(
Findings
IV. Findings: That the Eaqle Concrete Rooting Tiles described in Ihis
reporl comply with the 1988 Unilorm Building Code as a Class A roof
covering, subject to the fallowing conditians:
1. They are manulactured, identitied and installed in accordance
with this report and the manufacturer's instructions.
2. They are manufactured at the Eagle Roofing P�oducts lacility lc
cated in Rialto, Calilornia.
3. The tiles are tor inslallation an roais with a maximum slope of
21:12.
This reporl is subject to re-examinatian in one year.
TABLE NO. F--INSTALLATION PROCEDURES FOR EAGLE AND EAGLELITE
CONCRETE INIERLOCKING ROOF TILE WITH ANCHOR LUGS. MA%IMUM WIND VELOCITY
UP T080 MPH'-ROOF HEIGHTS NOT E%CEEDING 40 FEET
FlELO TILE NRILING'!
NAILING FOR PERIMETEN
TILE RND TI�E ON
FOOF SLOVE SoliE Sneathine wim Bmtens So11E Sheel�inp wlt�ou� Bauem' GAMILEVEFED AREAS'
5:12 and below Nol reyuired E��ery �ile Every iile
Abo�e S:I? to Every iile Every tile Every �ilc
less Ihan I?:1? Every other row
12:12 ro 21:12 Every lile Eveq� tile Every tile
'In areas designaied by the building official as being suhjea w repeaied wind veiociiies in excesc ol 8U mph or where raif
heigh� exceeds 40 (eet above grade, all lilea shall be allached in uccordance with Chupler 32 0( Ihe Uni(ortn duilding
Code or as tie� tonh belou', whichever is more re�lric�ire:
a. The head� olall Iileti shall be nailed using onc naif.
b. The noaeti of nll eave coune �ile. shall bc I�s�ened x�i�h an approved dip or nail.
c All rake iilee ahall be nailed wiih Iwo nails.
d. The nose� of all ridge. hip and rake iilei shall be aet in a bead o( appmved roo6ng cemcm.
e Hip or ridge nailcr boaNti shall be �ecured lo r�d framing every 48 inchc. using ?O,penny nai6, mel:J �trapping ur
special purpose auachmem de��ices.
''For slopes exceeding 7:I2. baaens are mandainry.
�Perimeier nailing areas induUe �hree �ile coune�. bui na Ie�� �han 36 inches from ei�her �idt ol' hfp. and ridge. ur edge.
o(eavel and gable rakes. In special wind �rea� a+designaied by ihe building o0lcial. adJiiiowl (a��ening> may be re-
yuired.
�Eaeleliie�� Tiles musi he intlalled in accordancr wilh TaMe No. 32-D-'_ of Chaplcr 12 nl ihc l�ni�i�rm Huilding CoJe.
(Minimum. onr nail cach field lilc.)
Field and Trim Tile Specifications
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Page 3 of 4
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FLASHINGOETALLS C<VISTR4NOORMALIBU
Page4of4�
Application Details
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STEP1
Report No. 4660
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TYPICALNIPDETAILS BELRIRORGONDEROSA
STEV ] STEG J
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AVP��cant to fill in all spaees ex<ept t�ose within neavy eorEer lines antl sign all aDoropriate aeclarationz.
CITY OF COSTA MESA
CONSTRUCTION PERMIT
Project Address _ci(O'3 J�L+��� /r' �Fc' •
Applicant's Maili�n AId�dress
Own¢r i Nam¢ 4Q�`���/����� -- Phon �
Address �=' /—S.f7� �Q-�
Arch/Eng. License No,
Address �/
Contractor's Name �i•C' �V�kJ Phone �q5 /�'/
Addresslmailingl ���,S.�y�7b �iflllzn'✓ G�/R �T
City License Na .z�i,c�,2
LICENSED CONTRACTOR DECLARATION
I hereby atfirm that I am licensetl untl<r provislons of Chdr[e� 9(comm¢ncing
with section �000) oi Divislon 3 of the Business antl Professlons Cotle, and
my Iicense is in �ull t ce an tf ct. O
License ass � lme No.
oat�2.� Si9nature
�ORKERS• COMPENSATION DECLARATION
nereby atfi�m that I have a certiflcate of con5ent to Selt-insur¢ or a<evtifiCat¢
of Workers' Compensation Insu�ance, o� a certitietl copy thereot (Section
3800, Lab. C.)
Policy No. Company
8 Certifietl Copy is heteby (u�nished.
Certifietl copy i5 (iletl with the city Builtling Divislon.
Date APplicant _
EXEMPTION FROM WORKERS• COMPENSATION DECLARATION
(This section neetl nat be completetl it the permit is for one M1untlretl ($100) ar
less).
I certify'that in the pertormance oi tne work for'which this permi{ is issuetl I
shall not employ ny pe�son in any manner s come ubject to t�e
Workers' m e Uq,pyaws of Califor i
Date Signature
NOTIC : Ifpaf er making this tlecla�ation, you shoultl b oi e Subject to [he
Workers' Compensation provisions of the Labor Cotle, yo must fortbwitn
comply wifM1 sucb,provi5ions or this petmlt snall be Ceemetl revoketl.
CONSTRUCTION LENDING AGENCV
1 hereby affirm that th¢re is a construction lentling a9ency (or the performance
ot tne .work for which this permif is 6suetl (Sectlon 3097 Civ. C.)
Lenaer's Name
Lentler's Atldress �
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt irom the Contractor'S License Law for Ih¢
followin9 reason (Section ]031.5 Business antl.Professional Cotle: Any city or
county which requires a permit to construct, alter, imOrove, tlemolish or repair
any St�uctu�e•, p�io� to Its i55uance, a15o rEquireS the applicant for Such permit
to tile a signetl statement that he/zne is licensetl pursuant to the provisions oi
'�e Contractor's License Law (Chapter 9(commencing with Section ]OOo) o(
vlsion 3 ot the Business antl Professions Cotle) or that he/she is exempt
aretrom antl the basis for the allegetl exemption. Any violation of SecHon
031.5 by any applicant for a, permit subjects the applicant to d civil
�enalty of no[ more than five huntlretl tlollars ($500�.
I, a5 owne� of the prOperty o� my em0�oyee5 with wages as their Sole
wmpensation, will tlo the work, antl the structure is mt intentletl or otferetl
for sale (Section 7044, Business antl Professional Cotle: The Contractor'S
License Law tloes not apply to an owner o( a p�ope�ty who builtls o� im0�oves
the�eon„ antl who.tloes such work himselt/M1erself or through his or her own
employees, provitled that su<h improvements are� not in[entletl or offeretl for
sale. IT, however, [he builtling or improvement is soltl wlthin one year of com-
pletion, the owner will have the burtlen of provin9 he/sne ditl not builtl or im-
��ove TOrthe pu�pose of sale).
1, as owner of the proDerty, am exclu5ively contracting with Iic¢nsetl con-
�, tractorstu mnstruct the project (Section 7044, Business antl Professions Cotla:
' The Contractor'S License Law does not apply to an Owne� ot prope�ty who
bulltls or improves thereon, antl who contracts tor such projects with a con-
iractor(s) license purzuant to the Contractor's License Law).
❑ I aT exempt untler Sectlon B. & P. C. (or thls reason
Date
Owner
above
TYPE OF CONSTRUCTION LJ NEW LJ ADD �ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK
�/
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5(2. FT. OCCUVANCv
, CONSTRUCTION TVPE VALUATION $
ZONE GRADINGCU.VDS. ACRES
Remarks:
8ar Sink
Backflow Preventer
Backflow Irrigation
�rinking Fountains
Floor Drains
FloorSinks -
u25 SC(VICC OULIELS
In[erceptors
Kitchen Sink
Lavatories '
P-Trap
Roof Drains . .
Reinspac[ion Fee $25
BOiI¢r
Duct - Under Ground
Duct-Strutturel �
Duct - Ventilating '
ExhaustSystem ❑ Multiple❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 0-100,000 BTU � 100,000 BT
Si9nature Date�L�< <+ I I
Drivers' Li se o 55 �
Reinspection Fea
CMF 0865-46 rev. 12/83 White - Builtling; Canary - APPlicant; Pink - Accounting; Goltlenrotl - Assessor
$25
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/$pa
Urinal
Water Closet
Water Heater
Water Service
Issue Fee
Hood or Type t � ❑
Canopy Type 11 ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
laue Fea
FEES
A.P. #
S Main Buildi
E
T Frant
B Rear
A
C Right
K �eft
s
Ping. Ref. #
Parking Req./Pn
Use of Building:
Planning Notes:
Automatic Washer�
Canstruction Pole Sub.
Cooking Unit
Dishwasher . '
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
��%f� :I�ri��.
I Zone
Accessory Building:
Park.Fees
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter LJup to 100 amps
Meter ❑overi00amps
Sub Panel� �
Morors �0-1 HP O1 %� 8 .
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light
Range
Garbage Disposal Standing Sections
Generator �65 KW �5-75 KW Trash Compactor
O
N
I
N
G
R
E
U
U
I
R
E
E
$ 3
Reinspection Fee $25 �ssue Fee $ 3
FEES
PUBLICSERVICESREQUIREMENTS: �
Zoning Approved By Date
Building,Appmvetl By . � Date
Application luued By �� • � Dat�
. - SUMMARV OF FEES � �
. BUILDING PEFMIT $ SMIP $
PLAN CHECK $ PERMIT ��-
� PLUMBING $ � 6O ISSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTFICA� $ GRADING $ '
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �� �
$ 3 ' PIAN CHECK 25% $ � - �, . _
CONSTRUCTION AND PLANNING POO SPA - .. . - �
-APPROVALS Permit # Date Inspector p�ppROVALS �Permit # - �Date �� 'Inspecioi �
, �
1. Temporary Electrical Service or Pole,�� .. 52. Pool & Equipment Location . . -.,,
2. Soil Pipe-Undrgrnd. � ,�t 53. Steel Reinforcertient - _, - . � � -��� "
3.Electrita�I�Conduit.UtilitY-Undrgrnd:��'" � �'��% 54.Forms .- -._ - � '.1�:�.� y
�
�- 4, Electrical Conduit;Undeg"r�nd. - 55. Electrical Bonding � -_- `'i'4 i
5. SYeel Reinforcemerit• �" . � � . � 56. �Rough Plumbing & Pressure Test � - '%;/�"
6. �Electricel UFER Grnd.� 57. APPROVAL TO-COVER-GUNITE� -
7. Footings :� y•�, r� j,� 58. Electrical Conduit-Undrgrnd. - ' � �"�
/ i
S. Fiiund`atio'n' � ;•' � �
59. Gas Pipe, O Undrgrnd., Test ��
9. 1Neter Pipe-Undrgrnd. ��: . -�.i `60. Backwash Lines,�P-Trap, 0 Undrgrnd. � , ��-j
10. Structura6"Floor System �jr � ��� �; 61. APPROVAL TO`DECK . '
r.' �r
11. Property Sewer Line &�,House Connection f'� �62. Backwash & ReceptorFinal
12. Sewer�GapJ � . 63. Heater & Vent-Final _ , .%;;
�: .
13. Roof Qrains • ��� � 64. Plumbing System - Final � - - • +
14. Rough blumbing =, 65. Electrical-Final - � ' �.
- 15. Rough Electrical-Cond"uit � , 66. Solar SYstem=Final � ' ' � ` � - '
_r6. Rough Electric Wiring � - - '67. Fencing & Access Approval - , . � ' -"
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING ' �-
18. Rough E)ectrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL � �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT- � - � � '
' + �
20.\ Rough Factory Fireplace APPROVALS Permit # � �
�
2�: DuCts, in Structure J0. Underground Hydro � � � �
22. Ducts, Ventilating 71.� Product Piping O Gas ❑ Oil . , i.
23. Gas Pipe'Rough & Test �7�. Underground Flush • ; � v�
� 24. Roof Framing 73. Undergrnd. Storage Tank O 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 � j
31. Plaster Brown Coat 79. FINAL INSPECTION � �
�
32. Electrical Power Meter-Final $0. F000 CERTIFICATE ISSUED '�
i
. 33. Final Electric f�otes: � �
34. Final Heafing & Air Conditioning � � .'
35. Final Gas Pipe-Test _ . - - .
36. Hood or Canopy i -� ,� � -
37. Final Factory Fireplace � - � � � " -, ; . '
38. Final Plumbing � � - ! � . � � , � �
39. Water Service-Final • . - � -
40. Gas Service-Final � , ' � � ' '
41 . Solar pomesticFinal - - - � - - i� : i F; � � �
42. Backflow,Preventer ` � _ . �. � ' � ' � �
43. Backflow Irrigation � � . � � � r ' ,� � �
44. .Landscape Irrigation System � ' - � ' -
45. Sound Attenuation I � ' � _ - ° .
46. Handicap Regulations - - - � � - ' - _
� �
47. FINALSTRUCTURE&BUILDING � ' ' . � ��
48. Special Requirements Completed � • � " " ' ' ''
�
49. Electrie Release to Edison � � � � � - - - - ' � ' �
,i
50. Gas Release to Southern California Gas Co . �
51. CERTIFICATEOFOCCUPANCY . -- '. �- ' . . � , ,
No. Date _ .' .. . . ; . - . .. �
. �;t::_: isi is
��
COSTA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX 9/7 C08TA MH6A. CALIFORNIA
For Applicant to Fill In ComplQ ely
�l/j 3 � TYPE OR PRINT
BUILDING
ADDRESS P Q
COSTA MESA, CALIFORNIA
,fJ nG . . i .� � . l/
u
� 6ETBPCI(LINEF0.0M
re�.
unw�nu LO08.
t9
�EFT /� I RIGHT '
DESCRIPTION OF WORK
I HEREBY ACKNOWLEO�
AND 9TATE TH�T TXE .
PLY WITH ALL CITY OQ
BUILDINOCONBTRO C
SIGNATURE OF
PERMITTE
AUTHORIZED AGENT
f I HAVE RHAO TMIB APPLIGTION
IB CbftRECT /1NO AOqEE TO COM-
'.EB AND eiAT6 IANfH RHOULATINO
_ � FIRE
FE� REC�l�IED
`��AAfl 2 2 1963
1� FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMR
BUILDING
For Office Use Only
pEC61pT rv0. � PEqNILNO..
oereiasueo
` / .
ZONING
ZON�NO.OP UBHOFNB
" � PLAN9 " BUILDIN n
'I� //�� �A
LEUAL '-'-�/� � \ 1. � L /I (�CIT � �
pEeCRIP'1'ION �ir � T U
A. P. NO. �
NOTE: NOEAV80VERHANGSHALLBELESSTMAN
80" TO SIDE B REAR P. L.
EAVES
ALLOWED (l1. B. C. RE�UIREMENT'
YARDSAPPROVEO YARDSAPPROVED
. MAIN BUILDING AGCESSORV BUILDIN6
VAR. #
�'a3�6so.�.
rHe AMOUNT eH
PURPO88 OP 68T1
VALUATION
$�yyis=
BET. MAIN @
ACCESS. BLI
DATE
yav �' �
0
uHoeR vw�uwrion �e voR rxs �
19HIN0 A PERMIT FEE ONLT. Q
7� 0
PHRMIT FEE $ n
0
/�/ m
PLAN CHECK S �" o
�/ LL
TOTAL FEE $ // / '�
OWNER PACESEITER WESP SOINT �TEI`1'1'ITRE DATE 3-22-63
JOB ADDRESS 2037 Balearic Drive BUILDING PERMIT NO. 1 11
GL�'NERAL CONTRACTOR pnA�-nc TanA Cmm�anv VALUE $ 2�i.11-15.00
AP No.
INSPECTIONS
OCCUPANCY
LOT �l� TRACT L.
� Signature
3 FIRE ZONE
DA'PE GROUP
DESCRIPTION OF WORK 2'0S Btt g8T
TYPE V 7.ONE
SUBCONTRACTOR
,� ' 2ieis
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 CDBTA MEBA. CALIFORNIA
For Applieanf to Fill In Complefely
TYPE OR PRINT
eui�oiN� .o- /�
ADDRESS ��J'% �- 1G I`
COSTA ME5A. CALIFORNIA
FEE RECEIVED
y�g 3 0 1964
fiNANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
ARCH�Teci �------Fe+=-- � COSTA MESA. CALIFORNIA �
OR ENGINEER NO.
�
FIRE " /
ADDRESS ___�_����-'-- ZONE TYPE � ROUP
CONTRACTOR AD l +-� � iLT l NS uLTIDAI BYPROVEO DATE
AODRESS }1 W -Sr ZONING
Z NO. OF I19E OF NE '
CITY S N A � I PIAN9 � B�IIIDINO
6TATE I 7EL. � 1 Q U8 G LeoA�
��c.No.pf 573b1 NO. DEBCRIPTION
$IZE 0_� p' ��yA/ I NO. OF BLDG9. t
OF LOT rvow ON LOT r p, p, NO. `� - -G
USE OF �•4 �-� ' YARDS EVES
EXISTING BLDG. ' APPROVEO ALLOWEo
BETBACK LINE FROM (CENiER LINE BTJ f�
CENTex On s'rttEET � -REAR Y7CRD-" FRONT FT. IN.
I i'�
SIDE YARD LEFT RIGHT R.SIDE �FT. IN.
DESCRIPTION OF WORK �. s�oE V F7. IN. �
NEW I/` IIALTERATIONI IIADDITION I REAR O FT. IN.
REPAIR I IIMOVING I II�EMOLISH I BY�'ROVED DTE �' O�Y�:
BUILOING N�. OF
SIZE ROOMS STORIES
EXTERIOR WALL IROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
�• 6� F�l� CMt anRT WhLL
y" 6' /��.' G r ��L
I HE0.EBY ACKNOWLEDGE THAT 1 HAVE READ TH�9 APPLIGTION THE AMOUNT eHOWN UNDER VALUATION 18 FOR THE
AND 6TATE THAT TH6 ABOVE IS CORREGT ANO AGREE TO GOM- pUFPOBE OF E9TABL18HING A vERMIT PEE ON�Y.
PLY WITH ALL CITY R�INANLE6 ANO Bl'ATE LAW9 REGULATINQ
BU��wa CONern ION. VALUATION
6IGNATURE OF �,�l PERMIT FEE $ S
PERM177EE "�' ��J�7 p
$�� V" -� PLAN CXECK j ��'
S
AUTHORIZED AGENT -
TOTAL FEE �� 4
JOB ADDRESS
2
�
a
Q
�
VALUE $ `�4'�
DESCItIPTION OF
SUBCONTRACTOR
mA��