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Home My WebLink About1274 BELFAST AVE - Building Permits • /' I r 4`Ogtn F 9 CITY OF COSTA MESA • BUILDING DIVISION >• v,,, "4+ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4t els � PERMIT r ✓B01-00395 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1274 BELFAST AV Status: ISSUED Suite: Applied: 03/27/2001 Vicinity: HOUSE&ATTACHED GARAGE Issued: 03/27/2001 Parcel Number 14104106 Zoning: R1 R1 Applicant: MOSELY, ROBERT - - ISSUED BY: Address: 2626 NEWPORT BL is"�' - _ t . -----7-•,2•'.. - - Phone: (949)548-1645 COSTA MESA„;CA_'- Zip: 92627 ' ' ,%,,' i i . G ' , . Owner RAY RALPH 8 LESLIE - `� - �' �� Address 1274 BELFASYAVE _ _ •” - -. a. , � r,41i \. \. Phone � � / OSTA MESA,CA - Zip: 92626 N. ',/ \/ v Contractor: PETRONELIL'A'ROOFING / ''� �Addr'ess:7 2626 NEWPORT BL A �, 1/ //fl �/1;/ Phone:`2(949)548-1645 ` :'\\A 1,1+ � v-.COSTA MESA,CA 4 �V\.��A v��-� // , Zip t f 92627/ ..'License: =460707 • • �� .t� l�V/ !Ut/ _ i6AV \ J \ ' vArch ---) I fl f,' — _ '�i - Eng:. 4.0,A .,-".— `A V1 Address: I/ 2 - - Address: 4 '\ 1� f.r -: .ti DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have end 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 Code,for the performance of the work for which this permit is issued, �My workers'compensation Insurance carrier and policy number are: /459 Policy Number` T' jf -(Tfiis section need not be completed li the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the perto an a work for which tit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws o alifor , d agree th.t if I sh• • •ecome subject to the workers'compensation provisions of Secti 3700 qi the Labor Code,I shall forthwith comply with these vi 'o -Applicant Signature:, - Date: .9 2-? C) 'WARNING:FAILURE T 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 undgr provisions o Chapter 9(commencing with Section 7000)of Division 3 01 the Business andprofessions Code,and my license is in full force and effect,Lir c.x -i �Sro7o Class•a—r " 7///moi Contractor's.Signature_ . - • ,Date:--3 7/V 1 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: 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 contractor(s) license pursuant to the Contractors License Laws.). ❑ am exempt under sec. Business and Professions Code for this reason: Signature: . Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: 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,Califomia 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 tile and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 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? 0 Yes 0 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 aPPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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? 0 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 0 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 props/•r inspection purpos.s.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ign.f'.:e Of ej • ner(s) le • •nd/Or Authh rizeMl Date • - - CODE• INSPECTION TYPE, INTRIAL$ GOOF/ INSPECTION TYPE IHTRIAI4 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 .Final Plumbing 200 Final Re-Roof y-"l/"O/ 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 _ • • T u , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7309 10/ 1403 I / •. -CITY OF-COSTA MESA. - . - " '-- - - - P�E�MAIT NO - ' "TRACT NO. ' - - LOT NO. - , - . BLDG:NO.- - -- 'l ---- -- -- r - • CONS'i1Fi1CTlOf1(PERMIT / lt'9.//r1 . ' Project Addre•ss . ?y -, -IST - _TYPE OF CONSTRUCTION : ' LI NEW • ADD LI,ALTERATION- LI,REPAIR' • Applicants Mailing Address. ;1IA 2 ' 0 ' .. - • ' CI CONVERSION TO DEMOLISH 0 OTHER - ' „ A,p.'# '- ^ :Zone ^ Ill. ",, �,/ ,/ 'DESCRIPTION OF WORK • • Owner s Name ///r�'/2�h',_A(�. /TIy"�!' �1.c.c+Rhone --(/-?Al ' c S- : S Main Building:, '- - Accessory Building:. I Z Add • ress 427 'C#%�� / - t • O P , „ 1 a _TYPE SOF PERMIT 1 ❑ GRADING• ❑ FOUNDATION ❑ STRUCTURAL T Front _ - •_ J __ I` N . Address, Arch/Eng •- - I -- License No, . CI TENANT CI ELECTRICAL 111 PLUMBING ❑.MECHANICAL B. :Rear. • ' I i • I Address I f 1 ❑"OTHER . .• __ . . I r ,. , A .. N : Contractor's Name ®/�°•' I ' 'Phone I - - PROJECT DESCRIPTION SQ. FT. - • OCCUPANCY C Riglit ' - , i y ,. G ' • • K Left R Address(mailing} - ! ^ - I - CONSTRUCTION TYPE 1 • VALUATION$ S. . • - - -. . -- E ZONE ' GRADING CU.YDS. ° • ACRES Plug, Ref.4 c •• Park.'Fees $1 1 0 ._ City License No. _ , _, . _ U LICENSED CONTRACTOR DECLARATION - Remarks ' • - Parking Req./Provided i _ 1 1. I hereby,affirm that l;am licensed under provisions of Charter'9 (commencing - • R with/section 7000) of Division 3 of the Business and Professions Code, and I • - Use of Building: I 1 - _ E my license is in full force and-effect. 1 I I - , License Class = I License No.• I I ; PLUMBING• 1 ' FEES Planning Notes: - - -- M : Date•' 1 Signature ' - . .. , E •- ; •Bar Sink Showers i I N COMPENSATION.DECLARATION ; r - • • T . 'hereby affirm that I have a certificate of consent to self insure or a certificate 1 ' Backflow Preventer ' Service Sink • ' - S ''1.;"..4f'Workers' Compensation Insurance;-or--a-certified.copy thereof (Section- - .. ' -- - - - - - 3a00, Lab. CJ I f • Backflow Irrigation ,4': ,.i Sewer Cap • ' � -_ '•t ELECTRICAL FEES • Policy No. I ' • I Company I - • - �4. . _ - RCertified copy is hereby furn ishetl. Bathtubs . J".'' ' 1 Sewer Connection - . •Automatic Washer , • Transformer 0 15:50 KW Certified copy is filed with the city Building Division. i 1 'I - : �,y, ._ . t Clarifiers c. - 0 50'+ KW Date Applicant +.. Solar Collectors . , , ' ConstructionPole'Sub. , • EXEMPTIONIFROM WORKERS'COMPENSATION•DECLARATION - Dishwasher -- _ - Solar Piping (This section need not be completed if the permit is for one hundred ($100) or x, - Cooking Unit '---" "- - Meter- ❑upt0 100 amps - - --- less). ._ r ~1 - - - I certifythat in thepermit ' DrinkingFountains ,e, ,. amps , performance. ersoInany the work for as to thisasubject is t to the I - Solar Tank . 'Dishwasher .Meter Clover 100 .$hath not employ any. In manner so as to become subject to the - _ Workery.Compe sa i Laws of Calif - ia. , ! Floor Drains /1, -�r 1 Swimming Pool w/Spa Dryers ❑Gas ❑Electric ;Sub Panel , Date/L]-/ ki Signat tire�'�Q<-1 become --e./� — - - ' NOTICE:If,after making this declaration.You should becomes bject to the • Floor Sinks 1,r ;, Urinal : Fan Motors ❑0-1 HP ❑1''A-- • Workers'7CompensatIon' provisions of the' Labor Code, you must forthwith-` - -- - - - -- - - • - comply ;with such provisions or this•permit;shall ,be deemed revoked., ., Gas Service ' :Outlets• , . Water Closet '• F:A.U. ' ' 'Inc.Solar;09-15 HP ❑16-15+ • ' CONSTRUCTION.LENDING AGENCY ' - . ' - - • - IHereby affirm that there is a construction'lending agency for the performance Interceptors,' Water Heater. '- Fixtures�•` , I Microwave i - of the 'work for which this permit is Issued. (Section 3097 Civ. C.) - -- '- Lender s Name- - o _ _- - Kitchen Sink:_ -Water Service - - - i Lender's Atldress• r - - i' i - - 1 - • bevice Boxes •Pole!Light 1 . 1 Lavatories' •- - - r, i - ,y 9 OWNER BUILDER DECLARATION • ,; Outlets Range • I hereby affirm that I am exempttfrom the Contractor's License Law for , — - - V following reason.(Section-7031.6,Business and Professional Code: Any city or P Trap t •- . ; 1 $'.ditches Sign_ _ • county which requires a p issuance, o construct,alter,improve,demolish or repair ' • - any structure; prior to its issuance,also requires the applicant for such permit Roof Drains - I - _ 1- Garba'ge-Disposal $tarid ing Sections i to file a ractotl statement that he/she is licensed pursuant to provisions of - _ - . . : - ' ;the Contractor's-Licepsi Law (Chapter 9 (commencing with Section 7000) of - 1 , i _ - - Generate r'❑0.5 KW CI -15 KW Trash Compactor Division 3.of the-Business and Professions Coie),or that he/she-is exempt - 1 P ':there.5 byand the plica basis-for the alleged exemption. heAny,violation of Section ' . , • • I _-.:7031•-5 by any applicant for: a permit, subjects the.applicant to a' civil ' " . - ,3 • 1• - ' enalty of not more than five hundred dollars($500).: 1 - , '. Reinspection-Fee.- I $25' Issue Fee .- -' $ ' ' 1,'asI owner of the,property aor:'my employees:with' wages'as their sole ; Reinspection Fee , $25 j Issue Fee' 1 - , $'3 compensation, will do the work;antl the structure.is not Intended or offered ' --- I • I i ' ! I -MECHANICAL t - FEES for sale'(Section 4044, Business and Professional-Code: The Contractor's I - - ' PUBLIC'SERVICES REQUIREMENTS: '1 ' . License Law does not apply.to an owner of a property who-builds or improves • ' Boiler - Hood or' Type I ' 0 - thereon, and•who'does such work himself/herself'or through his or her own -' 1 r Zoning:Approved By - - Date • employees, provided that such:Improvements are not intended or offered for : i • Canopy : Type II ❑ ' _ sale. If, however, the building or improvement is'sold within one year of com- ' Duct- Under Ground - i 1 - _ Application Approved By Date ' pletlon, the Owner will hale-the burden of proving he/she did not build or im- ' — C-1/9/3 ^/� [ r•�JJ Urove for the purpose of sale). ' 1 ; Duct-Structural : Refrigeration System Application Issued By —�'`� Date '! %� rry I, as owner of the property,am exclusively contracting with licensed con- , ( ❑4,100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: : / Duct- in .�. , ` "' .SUMMARY OF FEES ' - The Contractor's License Law does not apply_to an owner_jects petty who.: .. . . . .. _ 1. ._ _ - 1 builds or improves here n,;and who contracts for such projects with a con- .., Exhaust System ❑ Multiple❑; System Repair/Alteration - 'BUILDING PERMIT $ ' SMIP. • $ • tractor(s) license pursuant to;the Contractors License Law). -- •"PLAN CHECK $ • _ PERMIT.' i ' 0 - exempt under SectloI B.& P.C.for this reason ./ Firepl/Fact.Bit. ICBG#/�{�/, 1 PLUMBING $ . ISSUANCE I $ , Date./. . " ' ) Owner - '- - f. a, A__„..... a. Heating System&Ducting ' 1 I - _ PLAN CHECK $ ENERGYP.C. $ ' I hereby certify that 1 have read this application and state that the above ❑O-100,000 BTU 0100,000 BTL I .6-?. GRADING $ 'Information is correct: I agree'to-comply with all city-and county ordinances- - - " ' '- - - -- - - - ' - - -- -. - ELECTRICAL ' $ I • and-state laws relating to building construction,and,hereby authorize repre- : I ; .P,LAN CHECK • $ • : MICROFILM • $ - sentatives of-this city to enter, upon the ab ve-mentioned :property .for : ,.i Inspection purposesy� ,f /'9, �I /'�� • -' - 1• -MECHANICAL . $ �' , • TOTAL FEE $ - / 7, 76 • 'Sign•ature A CIO// ' 1-41 4-?-L_a/v Date C/j . ' 1 - $ - Drivers' License or, S - i Reinspection Fee • $25, Issue Fee $ 3 • PLAN CHECK . CMF 0665-46 rev. 7/83 '- White-Building:Canary Y-Applicant;Pink-'Accounting;Goldenrod -Assessor- - - -- ,_ ` • / CONSTRUCTION AND PLANNING p� 2 - • - POG`c=Si�SPA -'rAPPROVALS.- Permit NE-9110 - Date Inspector. APPROVALS Permit# Date Inspector 1 it. Temporary ElectricalService or.Pole. , 52. Pool & Equipment Location ' 2. :Soil Pipe-Undrgrnd. - • 53.•Steel Reinforcement " • 3.Sectrical Conduit UtilitY-Undrg}nd. - - - , - 54. Forms - ' , . 74. F�lectrical Conduit;Undrgrnd. _ 55. Electrical Bonding. •5. Steel Reinforcement ' - • - 56.-Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. •• ' " ' 57. APPROVALTO.COVER-GUNITE 7..Footings • 58.•Electrical Conduit-Undrgrnd. , 8. Foundation • ' . • 59. Gas Pipe,'0-Undrgrnd.,Test - . 9.t 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 15t Rough Electrical-Conduit- - I 66. Solar System-Final • ' • 16. Rough Electric Wiring lOird� 3 �_ 67. Fencing& Access Approval ' " • 17. •Rough Wiring Sign . 68. APPROVED FOR PLASTERING ' 18. Rough Electrical-T B'ar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating &•-Air Conditioning aka) /A ' FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace r.- , 2/43 //']rT��' APPROVALS Permit# - - 21. Ducts, in Structure 'f , !+� a ! Af7�.�' 70. Underground Hydro 22: Ducts', Ventilating 67/6(M �Jt 71. Product Piping 0Gas 0 Oil • - ,e23'. Gas Pipe.Rough & Test 72. Underground Flush - /24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil . • .�i25. Roof Sheathing . _ • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat • . 75. Dry Chemical 27: •Frame and Flashing . 76. Dry Standpipe • • 28. Lathing &,Siding' 77. FIXED SYSTEM FINAL 29: Insulation - 78. FIRE PREV. FINAL ' 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . ' , 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' - - ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric - - s/,„Mk. C C Notes: . s/• 34. Final Heating & Air Conditioning -Oil cls 0-1, a-0 - 35. Final Gas Pipe-test- • ' . , /2757-€3 coot, -.4 • 36. Hood or Canopy - 37. Final Factory Fireplace ' ; 38. Final Plumbing ' sl1&f '( LID 39. Water Service-Final ' - • - 40. Gas Service:Final 41. Solar Domestic-Final - 42. Backflow Preventer 43. Backflow Irrigation '4 • . , ' 44. ,Landscape Irrigation System • 45. Sound Attenuation ` • - 4 • 46. Handicap Regulations . . . • - • 47. FINAL STRUCTURE & BUILDING i • . , _ . ' • • 48. Special'Requirements Completed 49. Electric Release to Edison - - - • - • ,- - - - , 50. Gas Release to Southern California Gas Co - • 51. CERTIFICATE OF. OCCUPANCY . . ' No. Date - - - 4L59 8/E4ILJ I o/' i� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - f CITY OFCOSTA NtESA i— • • ----,•--17:-(- 7 1 - PEWIT NO. -- :TRACT NO LOT NO. •BLDG.NO. I t.. . - '--- --- r �{ • _ - s i CONSTRUCTION PERMIT. I°. 1- 1 � ' �4 13 ` • 'Lfi'7` i ``. ' 147 • a ! { Applicant's Mailing Address' /- - 'tee�- i'S • ' TYPE OF CONSTRUCTION '- . ❑.NEW ADD C/A LTERATION%U REPAIR g ,.. 1 ! 1 r"' 1 '� I ' r t .,t I 1 Project Address. MI'&7 yy,i'�?/ S� /� `/ - El CONVERSION •❑ DEMOL/A�S�y/1A THF1R i - � '. _r. i • _ I i Owner's Names4••G'/�e�' ///'IC it -PK.PhonsCai g'/4 • 'DESCRIPTION OF WORK b-Vd ee}}pp •Sr�irq ',�✓ ' - M,- •)--es _ I � /� FM _ _ - - = - ' - ' --I V I = 1 = - ZONING REGULATIONS - I Address ''�a2� CJ e'�/ /7 - • " - _ ,• 644 T•OCp . (�•( 'C-74 I J, i r,., • x I4. I I - - • I f 'TVPEOFPERMIT'. UIGRADING"❑ FOUNDATION STRUCTURAL C A P!'gW414I , 'ZONE fj �- • Arch/Eng: b - - License No , 1 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL . 1 ' ' 1 /..-„„6BUIL !NG - r ( - { ! I Jr-- -. - 4 x • c <PLNG. REF.,,Jk t f ' " . I Ck Cn- .j-T 1 e- Address >'❑ OTHER w - TO'BUILDING - I. (1 • 1 i - i - - - - .31 PROPERTY LINE Mfr•+ REAR YARD(TO P/L) VII n I' Contractor's Name d/- S -Phone P PROJECT DESCRIPTION' SQ:FT.• •- • ' /OCCUPANCY I r s 1 "(� • • Address Imailin 1 t • 1O • ' • I'• I CONSTRUCTION TVPF�-1Z_N VALUATION$ I7 'C>7'r ;/•0/' 'L'EFT SIDE YARD-4 - 6 I '- 1 RIGHT SIDE YARD. � a A > I 1 g - f -- ' ' ' • i I ` - • i • ZONE ' I t- I • GRADING CU.YDS: - ACRE I t ' PKG.SPACE.REQ. /. ' PROVIDED 1 •-: I License No ; , J. . - - .� • I - i LICENSED CONTRACTOR DECLARATION i • I 1 ,Remarks: �G, '4,, v_s,S'- 4 ;J'7_�'e ed. y_ - STREET WIDTH I I I ' ;PARK FEE,$ ; - ' I'herebyjaffirm that i'am licensed under provisions of Chartert9 (commencing ��((( r - - • ' with sectIon 7000) of Division 3'.of the Business and Professions Code, and. Pe.. $F ¢•cd,6 I 1 - I i V ! i ' I , SPECIAL CONDITIONS: I I I 1 1 C7 ,1 my license is in full force and effect. i ; I . ' • i , License Class' ' License No. ' : . i 1 • 1 1 PLUMBING 1 .t ! • ! , ! • I I l I I 1 ! Date - I I Signature • t• , - i - '1, • - - • Bar Sink 1 Sewer Cap' ..''' i _ ELECT ICA 1 . WORKERS'COMPENSATION DECLARATION i '' , -1 - I ' I - -. 1 • 'hereby,afflrm that l.have a certificateof consentto self-Insure ora certificate y..- • Backflow Preventer - - - — ' '-Sewer Connection/- -t - _ ___ Autorhat;c Washer ,y, - ,_ - 'Meter ❑over 100 amps i ' ' Workers' Compensation Insurance,.or a certified-copy thereof (Section - ' r , _ ' t • X800, Lab. C:) ` .,• t , I Construction PoleSub Panel' t i 1 • - ; • ' Backflow Irrigation Solar•Collectors I I - J' Policy No. 1 • ' Com Pant •! /• , 1 I 1- Bathtub's ' Solar'Pi m - - i ,I •1 • Cooking Unit,! 1 • I Sub Pole ; j • i i •' Certified copy is hereby furnished. I ' r P g I • •1 9 Certified copy is filed with the city Building Division. , I Dishwasher:, ' I' Motors ❑0-1 HP ❑1%-8 l t 1 Date • ' 1 • Applicant - I. • I I 1 Clarifiers ; ' Solar Tank ' - I 1 I i_EXEMPTIO ROM WORKERS'COMPENSATION DEC LAR ATIO f•! - Dryers ❑Gaej❑Electric • -T ,Inc Solar•❑9,15 HP ❑16-15+ ' (This section need not be completed tf.the permit is for:one hundred ($100)or Dishwasher i ' I Swimming Pool vi/Spa ; + i 1 less)- ! i i i i �", ....' ! - i 1 — - ,, I y, ' Fan; I Microwave . I ! T 1•.1 certify that in the performance of the work for which this permit is issued I 1 , Drinking Fountains Urinals I 1 ' shah not employ any person In any,manner so as to become subject to.the - - F.A.U. ' ' -I I • - 1 Works ' cgfnye :font Laws of Califo niap � /� � � , / a : Floor Drainsi i ' Water Closetl ., t +'J •- • 'j -S l , i (Pole Light 1 , ; Date90/�'•fif aft Signature 7',/tH LCQ /JAG ect to the - -NOTICE:If,-aftersation4hissions ofIon;you-snouldf become subjeorthwihe- Floor-Sinks-,-- - - ,---'--- •Water Heaton•- _--',Fixtures - t _1 j 'Range ; i ;; ! ! Workers'-Compensation provisions the Labor, e dee ust.fortherlth 1 I,,. f.-v - Device Boxes ' comply with such provisions. or:this,permitshall- l be ideemeda revoked7.: t , Gas Servicer - •Outlets ' - - Mater,Service ' ,. - ll ' Sign ; •j CONSTRUirmtha LENS: NG AGENCY 1 -.' , 1 I hereby affirm that there Is a'construmit iso issue (Section Ir the.performanc' Interceptors '• •L :•, ,'y I • i Outlets } 1 1 g � -I l I of the work for. wixicp• UAL.permit is•'isseed •(Section :3097: Civ: C.1: _ 1 r ' I 1 ..1 1 I •`� J' 'r- 'r - G!• 'standing Sections i t , Lender's; Nam/er• A/OAJ ' M f; q i s- i - Switches•; ' I Kr4chen;Sink i 7 ? i ITrasfi Compactor j .I .� • Lender's Address i ; ' • ' f 1 1 r .) , - fl ' c i t I I "1 T Garbage Dis osal .1 i - : 1 .l I OWNERIBUILDER DECLARATION' : - • t.' 1 I j •Lava...... . I n P I .) a 1 , f„ ( *; ' J-' g p , e ' ,,I herebylaffirm that I am'exemptifroni thelConttadtor's,License law for the- - - ' Generator,❑0?5 KW 05-15 KW i i ' ' following reason,(SectIont7031:5 Business and Professional Code: Any city or Pe-1 rap, , •• - ! 3 , 5. . , y:, t. ,! ! I 1' I 1 I'county which'requires a permit'to construct',alter,improve'demolish or repair Transformer ❑i5-50 KW any structure, prior to Its issuance,lalso requires thea applicant:for such permit, I Roof Drains - , -r T;, I •"•"I M , I, - „r1" `'! 1 f I to file,a signed statement-that he/she is licensed pursuant to thelprovisions of - - - 1 ,❑50+KW: ' ' the Contractor's;License Lawl(Chapter 9(commencingjwith•Section,7000)of ! ,„ , 1 ii-:' - ) , , ,. - 7F: t = - I I IReinspeetien Fee i ) $15' i ,lvision'3 o5 the,'Business'and:Professions;Code)"orl that)he she-is exempt + ' Showers •-rt Y ,1 •,_ .�. • Reinspection Fee 14 ,-$15 - • • _ - I / _ I " ' " I • Meter ❑up to 100/amps ' { , 'Issue Fee' I • $.3. { •reirom and the basis for the alleged exemption:Any-violation-oP Section ' - - I ` ' _ - 31.5 by.'any applicant for.,a.permit-subjects:the'applicant to az civil 1 Service Sinkl TI I Issue Fee $ 3 - rr1 -+ - -to moi. natty of:Owner r of than five rty o Collars($500). T '( - ( I _.-• Zoning pppr0ved By d 'Date lig I,-as:Owner of the:property or.my employees with, ntend•as their sole ; i I • i for sale tion; wilCdo the work,and the structure'is not intended or offered MECHANICAL' I *•• Application Approved By - I I fDate SIT, �g . for sale Section 7044, Business and I Professional Code:'The.Contractor's �- - - of ger - t :Kr - I ,i License Law does not apply loan owner of a property who builds or improves : ' - Refrigeration System ' I /I,v: -'/ , i thereon„and who doesssuch work himself/herself or through his or her own ! Boiler:, -- ; - • -{ Application Issued By !-y Date I%T • • . employees, provided that such-improvements are•nbt'intended or offered for I i ❑0-100 OO BTU ❑100,000 BTU• - -/I• - ! • sale, If, however, the buildingor-improvement rovement is sold within one yearlof com- Duct-Under Ground , A -I i P i - i SUMMARY OF FEES'' pletion, the ownertwill have the burden of proving he/she did not build or im- I • ' , : ::• _rove for the purpose pf sale: ' r! •I Duct Structural ' I System Repair/Alteration I' ' y1 - BUILDING PERMIT C / , I U r )., 1 - '1 t I 1 i $, �17i�J� ( SMIP $•.f [ •IZ I I,as owner of the property,am exclusively contracting with licensed con-"'I - ' i 1 _tractors to construct thesproject • -7 •Contractors not apply to an,owner of property who' 1 • , , ,I - ' 1 'I .1 ISSUANCE I ' $ , 1 1 ' ' j builds or improves.thereon;and Who contracts-for such projects with a con- i ' Exhaust System ❑ Multiple❑; ! ' ' PLUMBING $' I I - I tractor(s) license pursuant to the Contractor's License;Law): I - - I f ' 1 $• ; •I I' I GRADING _1 • i $ { , D lam exempt under Sectio' B.& P.C.for this reason I Firepl/Fact.Blt. ICBG* j ,1 i �' PLAN CHECK I ,I , $• ' Date 5� Owner'., ...if . i. f /% 1 Heating:System&Ducting j j ! I , I I $ I 1 MICROFILM $. 1 • I. -i hereby, certify-that-lthave read thin application-and•state-that the above-_l. - ❑0-100,000`BTU-0100,000BTL - - q :PLAN CHECK, $ , i Information is correct. I agree to comply with all city-and county ordinances - - t i i I _ . %i -j ' . TOTAL'FEE1 • $"-• • and"state laws relatingto buildingconstruction,'and herebyauthorize re re- - . . MECHANICAL $ ; 1 j e e Y' p Pr Per Y repre- Hood or Type ❑' q i , , 1 sentatives of'this cit ,to 'enter;u on-the above-mentioned I Reinspection Fee ';x$15 1 I LESS ' • i - `Inspection purpos I ' • t ' I Canopy: Te ADVANCED'PC ' $ �yJ I PY' Ype II ❑' ' I 'PLAN CHECK i $ I 510Mo--re � (' .Orn' e.cir.7� I bete .(YT/c+� I ' Registers { 1 1 ' Issue Fee - '$ 3 1 I , f l f i , I 'i 7 j 1 • • IDr,tiers' License or55# ` I - • • I , - 1 i ._ , I .; FINAL FEE) ; $•1 /Z".7C i I CMF 0865-46 rev.12/82 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod -Assessor if - • CQNSTRUCTION AND.PLANNING • POOL A Date Inspector Date Insiiecio3 ',APPROVALS Permit# APPROVALS Permit# - 1, Temporary Electrical Service or Pole 52. Pool & •Equipment Location - - • j2. .Soil Pipe-Undrgrnd. - 53. Steel Reinforcement -• . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - _- ' 4. Electrical Conduit-Undrgrnd. • , 55: Electrical Bonding , • '5;,Steel Reinforcement - _ S6. Rough Plumbing& Pressure Test - -- • 6. Electrical UFER Grnd. _ksS ,,..t 0.3 . . 57. APPROVAL TO COVER-GUNITE 7. Footings -' 1)5 : .1„1.91 58. Electrical Conduit-Undrornd. • . 8. Foundation - ,59. Gas Pipe, 0 Undrgrnd. Test : - •' . - 9.•Watei 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: Soler System-Final . - - - ••16.,Rough Electric Wiring - 671. Fencing 8i Access Approval . - - ' 17. Rough Wiring Sign - - 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69: POOL/SPA SYSTEMS FINAL : • ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.-Rough Factory Fireplace - APPROVALS Permit# - 21.'Ducts, in Structure 70. Underground Hydro - . - 22.,Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil . .23.'Gas.Pipe-Rough &Test .72. Underground Flush 241 Roof Framing 73. Undergrnd.Storage Tank 0 Gas. 0.Oil . , 25. Roof Sheathing . • >5 t-o cA 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural);& Monocoat _ - - 75. Dry Chemical - • . 27: Frame and Flashing 4 5 ip/244..376. 'Dry"Standpipe - 28. Lathing& Siding , - b,-.5 if cf/ 77. FIXED SYSTEM FINAL. , . 29. Insulation b.-, 0/2¢/ :78: FIRE PR EV. FINAL - 30. Drywall Nailing bS biat -Notes: .44 E C4 � -1---::re� � �,�` 31. Plaster-Brown Coal - 13 �' 9, .t' fa•':': 32. Electrical Power Meter-Final - . - ,1 • 33. Final Electric - ' ry dc/ ' - - Witele- G.4)._ . 34. Final Heating & Air Conditioning - . 35. Final Gas Pipe-Test - . - - . - . . r 36. Hood or Canopy - ' - . . ' ' . 37: Final Factory Fireplace 0610 5- cc-""7 , 38. Final Plumbing • , , ' - - - - . 39. Water Service-Final.. ' - - - ' 40. Gas Service-Fir-1617...r. - - - - 41. Solar Domestic-Final ' 42. Backflow Preventer. .,• : 43. Backflow Irrigation . - . _ - , 44. Landscape Irrigation System - - - -- - . . •, ' 45. Sound Attenuation ' • - - - - - - 46. Handicap Regulations • • - - ' 47/FINAL STRUCTURE & BUILDING'_ • -s/c/ CpA- - 48. Special Requirements/Completed / - • . -, 49. Electric Release-to-Edison ' • 50. Gas Release to Southern California Gas Co - , - ,, - ,, 51. CERTIFICATE.OF OCCUPANCY .• . - -! No • Date _ - N. . 1274 Belfast Costa Mesa , Calif . May 18 , 1984 City of Costa Mesa Building Safety Division Fair Drive , Costa Mesa Building Inspector The room addition located at 1274 Belfast (Permit No . B8483) has met the drainage specifications as required by the City of Costa Mesa : 5 ft . from the house at a 2% grade and draining 1% thereafter to an approved receptor . Michael Milchiker Owner-Builder ` ..� '1 MJ f-q lry�� 1 COSTA MESA 'BUILDING DEPARTMENT P.0. BOX 317 �..,,.`�a COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDIN1274 Belfast Avenue • BUILDING ADDRES COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. 1`£R RT OWNER COLLEGE MESA COMPANY, 6 ,'� 'q 1 RECEIVED BY DATE DREECEIVED ,.DATE ISSUED MAIL ADDRESS P. O. Box 2277, Brookhurst Station v , f S`r 8 195t CITY Anaheim TNo: KE 3-3161 ADDRESS ARCHITECT Bulot, Quigley LIC. COSTA MESA. CALIFORNIA OR ENGINEER and Clark NO. RR 7191 ADDRESS 1102 W. 17th St. , Santa Ana FIRE' ZONE ZONE NO.OF TYPE GROU C CONTRACTORIThe Half CompanyCITY `Nig: 7350 - �.J PLANS C ADDRESY777/ W. Lincoln Anahein1,Eo: KE 3-3161 AAPPROVED// DATE LEGALCORRECTIONS DESCRIPTION LOOT 147 BLOCK TRACT 2671 Plan 3-A . A.P.NO. ' SIZENO.OF BLDG$ OF LOT 65 X 100 NOW ON LOT None USE OF l EXISTING BLDG. SETBACK LINE FROM CENTER OF STREET 501 REAR YARD 311 — SIDE YARD 1 RIGHT 91 - LEFT 81 , DESCRIPTION OF WORK NEW X ALTERATION ADDITION REPAIR MOVING DEMOLISH BUILDING 1222 -Gar. ROOF 5 1 1 ROOMSOFSTORIES EXTERIOR WALLstucco ROOF COVERING COVERING Compo USE OF NEW BUILDING Single dwelling w/att. garage • I HEREBY ACKNOWLEDGE'THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC• TION. COL GE MESA COMPANY VALUATION SIGNATURE O�Bv:rle Hale Company,Gen.Partn PERMIT FEE 30.00 PERMITTEE ��12,599 PLAN CHECK 5 15•DO ��7�� BMF AUTHOR' EE �f ��(�� 7 TOTAL FEES 4S. 00 OWNER COLLEGE MESA COMPANY DATE 9/8/58 • JOB ADDRESS 1274 Belfast Avenue • BUILDING PERMIT NO. 7546 GENERAL CONTRACTOR The Hale Company VALUE $ 12,599 AP. No. . LOT 147 TRACT 2671FIRE ZONE DESCRIPTION OF WORK Single dwelling w/att.oar. GROUP TYPE ZONE PLAN NO. INSPECTIONS - . DATE SUBCONTRACTOR PERMITS ISSUED _ DATE NUMBER Trenches Forms Steel ��fjf /43is . Floor System �j� /0 - 2,- Steel Reinforce Chimney Re-Rod Bond Beam w,a fi A3.-A-w�W' AC . Frame and Flashing a-6--L, -it -r -:.01' Lathing, In Out 4--5--k ) -,2y. yY Plaster, brown coat go/t ik ./ ? ..4 y • Underground soil/14-/S' W/G Pipe Testyj/( ,o-771- ' Top Out /0 175Y Furnace /-. iV i.2--i5' $' �_ �' tN(� Gas Vents �7 C&S- E' W-.1 ) I\ Rough Plumbing LW/Q-..5-Si $�P 2 9 195$ i Cesspool Septic T nk r �, f' I Prop. Swr. Hous e. St. Swr. I'l.(f uI c - 07-C '�' �� I 1.1 cis-- I S``1 —� • f t Sprinkling System - Heating Final 1-er 2.-4-W �(y Plumbing Fixtures, Final 1/j.as, ' -r-'t>JJ .d Final Gas Test t 6211-M r>,G-Sg � 1 Construction Pole - i Underground Power /� � � � 6 Rough Wiring PI- 11 ..),../$ .ib'- C[V( t/�-tom„ . /- —,t�Sal 7 6 -f.} t!Qj I Fixtures, Final FF}T J _/y-17 • OCCUPANCY 7=F! 9,_%7•-i1 Form 210-5M-1-57