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Home My WebLink About456 CAMBRIDGE CIR - Building PermitsSee 435 Ogle Cir. for permit for Retaining Wall ' y��' ;�i PERMIT TYPE • CITY OF COSTA MESA � BUILD/NG DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv�rw.ci.wsta-mesa.ca.us FOR INSPECTIONS CALI: (714) 754-5626 PERMIT NUMBE 607-00928 JOB ADDRESS Vicinity: ROOF Squares: 2600 B_ROOf� , � STATUS: '�ISSUED . '� DATE ISSUED: 09/11/2007 *� '--.'ISSUED BY: SOK 456 CAMBRIDGE CI CM `.,' Suite/Unrt - ,,. ' . '� r � . . . < � �__� . 's� - - �Valuation � _ ,� $5;400.00 � 1:.': ,/ y SCOPE OF WORK: TEAR OFF`EXISTING ROOF.�INSTALL 7/16" OSB, 7 LAYER OF 30# FELT,�OWENS CORNING, 40 YEAR COMPOSITION SHINGLES FOR S.F:D. 2 600-5".F. WCLUDES ATTACHED GARAGE. - J* ,., OWNER: TEEGARDIN MARY M�TR�s� -_ � Address: �. � 456 CAMBRIDGE CIR � Unit: PHONE: ;'�� - ; � _ : � Ciry/State/Zip: COSTA`MESA; CA . t - APPLICANT: FERGUSON LEWIS ��"- �- Address: 1216N�HANCOCK"-'., PHONE: 714-777-4040". . � City/State/Zip: ANAHEIM, CA ��- - - .. , �, ; ., . , . . . . � �. ..' . ',.' CONTRACTOR: MC CORMACK ROOFING -�� - : �� - - - � `: ��'- - � : � License No. � �- 643700 �: Address: 1216 N HANCOCKUnit -� � � - _ " . . - . SUITE 107 .° � � PHONE: �', 7t4-777-4040 City/State/Zip: ANAHEIM, CA � � _ � �� 92807 � . � " � �. CELL:� � �� '` • ' ARCHITECT: � � � � � �- � License No. � � A; ENGINEER: �� ' License No. � ` -�- - .� PHONE� ; ' � PNONE:' FEE SUMMARY Reroof Plan Check: � ; . $0:00.,,, � . , - Reroof Permit Fee: -$12525`, -� �,-��:�_ - � 'r� - � - Reinspection Fee: $0 00 � , - TOTAL FEES $125 25 ' ' ` � -, ' ' i Unit; :SUITE 107 ' ' x: NOTICE: The work authonzed by this permil shall comply with all applicable handicap access requirements under Califomia 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 wdes, 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. GOUE R. INSPEL710N TYPE 1816 Fixed Syslem Final FiB Preven�ion 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 204 Final Sign Final Demolition ..� " DATE INTn��s �j ZS-�7 � CODEI INSPECTIONiYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 220 222 250 Finai Fire Prevention Final Planning ApprOval Final Site FinalBuilding/Occupancy DRTE IN1111AL5 WORKERS' COMPENSATION DECLARATION� � � � .'-' I hereby affirm under penalty of perjury one of the o lowing tleclarations: - ❑ I have and will maintain a certificate ot consent to selt-Insure tor workers' compensation, as provitled for by section 3700 of lhe Labor Code, for-Ihe perfor ance of the work (or which Ihis permit is issued. � ave and will maintain workers' compensation insurance, as required by section 3700 of lhe Labor Code, for Ihe peAormance of the work for which this pertnit is issued. My workers' compensation Insurance carrier and policy . number are: �� / • ame ` �/7 J G �':�t A.97J ' . _ (T�rsSetlionneetlrrolhemnpletetlAlhe1p,erm/�d'a�vIaluetlafonehuntlretlOWlars(Sf00Jo�lesSJ o icy Number — 1 g� 1 I 7 3 ❑ I cehi(y that in the pertormance of the work for which this perm(1 is issued, I shall not employ any person in any manner so as to become subject to [he woMers' compensation laws of Califomia, and agree that if I should become subjecl to lhe workers' compensation pmvisions of Section 3700 ot lbe Labor I shaU f hw�y compty vnib ihese provisions. �. --�s.�.�-�----.�ca9//I/07 � Appliwms5ignawre 05te.' i��y c.. WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I$ 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, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrm that I am licensed under provisions of Chapter 9(commencing With Section 700D) of Division 3 of the Business and Professions Cotle, and r�y license is in full force and eflect. �—.-,/1 �_.:4ic. # � �3 �a� 'Class # _ �- ! `� � � .s.� _ -- _ // O� 'E'anVact s ig � ,� '...� Date"•� � CONSTRUCTION LENDING AGENCY: ❑ 1 herehy aKrtn that ihere is a consWctbn lentling agency for the performance of the wvrk for wfiich this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Adtlress: Date OWNER-BUILDER DECLARATIONS: � hereby affirm that untler penally of pe�jury that I am EXEMP7 FROM THE CON7RACTORS LICENSE LAW (or the following reason (Sec. 7031.5, 9usiness and Professions Cotle: Any.ci�y or county which requires a permit to constmct, al[er, improve, demolish, or repair any stmcture, pnor to its issuance, also requires the applicant for such permil to fle a signed statement that he or she is licensetl pursuant to the provisions of the Contractors license Law (Chapter 9(commencing with Sec[ion 7000) of Division 3 of [he 9usine55 antl Pro(essions Code) or thal he or she is exempt lhere(rom an0 �he basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pe�m'rt subjects the applicant to a civil penalry of not more than five hundred tlollars ($500).): [] I, as owner of the property, or my employees with wages as Iheir sole Compensation, WILL DO 7HE WORK, and the strucWre is not intended or oflered tor sale (Sec. 7044, Business and Professions Ccde: 7he Contracto�s �icense Law does not apply to an ovmer of property who builds or improves lhereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or oNered for Sale. If, however, the building or improvement is sold.within one,year of Completion, the ovmer-buiider will have the burden of proving that he or she tlid not build or improve for purpose of sale.). ,, ,, , � ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTWG WITH LICENSED CONTRACTORS to construct fhe project (Sec. 7044, Business and Professbns Code: The contractors License Law dces not appty to an owner of property who builds or improves thereon, and who contracts (or such project wilh 8 contractw(s) license pursuant to the Contractors License Laws.). � I am exempt under sec. Business and Pro(essions Cotle for this reason: 305]-66(3I0]) Ovntei ID verified by driv�se. ❑ Yes ❑ No Driver's License,No. Expires: � � � Verifcation of Ownership by (type of documenl, i.e. - property tax bill�or tleed�: DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: �'"� ❑ I hereby certAy that no excavation frve (5) or more feet in deplh into which a person is required to descend, will be made in connection with vrork authonzetl by this pelmit, and lhat rro building structure, scaffWdirg, falsewnrk, or demolition or dismantling thereof, will be more than lhirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As ovmer-builder, I vnll not employ anyone to tlo work which would require a permit (rom lhe Division of Indusinaf Safety, as noted above, uniess such person has a permit to do such work (rom the tlivision. Appliw^I's SignaWre Dale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to fle 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, wilh some exceptions, thal a Business Plan be filetl with Ihe Cos[a Mesa Fire Department by every business which has at any one time tluiing a reportetl year a quantity of hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 9allons, or 200 cubic feet of compressed gas at standartl temperature and pressure). 2. Does or will the applicant or presenl or fulure buitding occupani need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Califomia Heal[h and Safety Code, with some exceptions, requires registration with lhe Costa Mesa Fire Depatlment by eacb business which at any one time has on Aand a quantity o( awlely hazardous materials equal to or greater [han a weight o( 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard lemperature and pressure). 3. Does or will the applicant or present or fuNre builtling occupant need to prepare an RMPP (RiSk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of ihe Cali(omia Health and Safety Cotle 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 lo register acutely hazardous ma[erials with the Fire Department. 4. If an RMPP is presently requiretl, has Section 25534 of the California Health and Safety Code been (ully complied with? ❑ Yes ❑ No 5. Does or wi71 the applicant or present or future building occupant require !or the work which is the subject of this aDPlication a permit for such consiruclion or modifca�ion (rom [he Soulh Coast Air �uality Management District or trom any other air pollution control disMct or agency? ❑ Yes ❑ No �Section 658502 otlbe Califania Govemment Code requires that the requested infortnation be fumished on applications for nornresitlential huilding permits�. 6. Will any part of the facility to be conslructed under this permit 6e within 1000 fee[ from [he outer boundaries of a school? ❑ Ves ❑ No Qf "yes", the tacility must meet the requirement o( Sections 25534 and 42303 of ihe Califomia Health antl Safery Code). 7. If a permit trom the South Coast Air �uality Management District or other air pollution control district or agency is required for the vrork which is the subject o� lhis application, have all ot the disclosures prescirbed by Califom'ia Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropriate air pollution control offcer). ' CERTIFICATE OF COMPLIAMCE: I certify tha[ under penalry of perjury the informalion given a6ove is wrrect 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 correcL I agree to compty 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-descnbed property for inspeclion purposes. I agree not to occupy or allow occupancy of any building authorized by this permit un[il Lnal inspection. - ignaWreof al �er(s) Oa�e ' ,,,D_��//l0 7 � Antll�p ni '?�' Oa�e- a i (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 456 CAMBRIDGE CI Suite No Vicinity: Parcel Nunmber: 42515319 Applicant CULLIGAN WATER Address: 502 S LYON ST SANTA ANA, CA Owner: TEEGARDIN, MARY M TR Address 456 CAMBRIDGE CIR COSTA MESA, CA Contractor: CULLIGAN WATER Address: 502 5 LYON ST Arch / Eng : Address: ISSUE FEE Backflow irtigation BackFlow Preventer Balhtub Clarifler System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve SANTA ANA, CA INSTALL WATER SOFTNER. AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 PLUMBING PERMIT Phone: 714-750-2233 Zip: 92701 Phone: Zip: 92627 Phone: 714-750-2233 Zip: 92701 License: 663091 Phone: Zip: License: SCOPE OF PERMIT QTY �- � - - � Laundry Tub / Washer � 0 � Landscape Irrigation 0 P-Trap 0 ; Pressure Regulator 0 � Process Piping (per 10 ft) 0 ' . � Receptors - 0 Septic Tank 0�� Sewer Cap for Demo 0 ' Sewer Connect ' � 0 � SewerPrivate�Line 0 Shower � �, 0 � Sink, bar _ , 0 � Sink, commercial - - � 0 Sink, Floor �Y, AMT ��.QTY $0.00 0 � - � � $0.00 0 $0:00 0 $0.00 0 - - $0.00 0 $0.00 0 $0.00 0 . $0.00 0 ' $0.00 0 $0.00 � ,0 " , $0.00 0_-�.-� $0.00, r, - 0 • : . . $0:00. 0 $0.00 0 Status: ISSUED Applied: 12/06/2004 Issued: 12/10/2004 ISSUED BY: SumpPump � � Swimming Pool �TrapPrimer, � UrinaF - Nacuum-Brkr BkFlow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin '" - Wash Basin Set Waste and Vent System �� Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 abandonad for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeotlons and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 , zaas-as �eroo� a WORKERS'COMPENSAnON DECLARATON: — I hereby eftirtn untler penalty of perjury one oF the followinq tlecleretions: ❑ I heve end will maintaln a cenificate oi consent to selt-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the pertormance of Ihe work for which this parmit is issueG. ;� I �ave and wiil maintain workers' compensetion insurance, es required by section 3700 of ihe Labor Cotle, tor ihe pertormance oi the work for which this pertnit Is iuuetl. My workers' compen ation Insurance car�ler antl policy number are: ��:'�uNiL� hme.rzr�A� tN; �_o P cyNu_�bJr:Gt/C 3%4U `�S(ao0 �(7his sectlon need not be com0�eted il fhe permit Is velued et one hundred dollars ($100) ar less.) ❑ I cenity Ihat in the performance ot ihe work for which ihis pertnit is issued, I shall not employ any person in any mannar so as to become subject to ihe workers' compensetion laws ot Celifomia, antl egree th t if I shoultl ecome subject to iha workers' compensation provislons of Section 3700 of t�e Labor Code, I shall torihwith comply with th rovisions. �/ MFP�OtSI,�: _�,�.Da�e: � I D /U T' WPPMNG: FAILURE TO CURE WORKERS' COMPENSATION CqVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPCOVER TO CRIMINAL NALTIES AND CIVIL FlNES UP TOONE HUNDRED hKK15ANDDOLLAHE( 00,000),INADDITIONTOTHECOSTOFCOMPENSATION,DAMAGESASPFiOVIDEDFORINSECTION3]O60FTHELABOqCADE,IMEREST,ANOATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I �ereby afl�t,h�et I em lice7�ed under provisions of Chapter 9(commencing with Section 7 00 of �ivision 3 of ihe Business end P lessions Cotle, end my license Is in full lorce and�eHec�7.j�c. a O �# �' S� Cont�act�rs;�9naWre: �,�BaJ_�//n ��/ CONSTRUCTION LENDING AGENCV: ❑ I �ereDy aNirtn that there is a consiruction lendinq agency for Ihe peAormance oi the work for which this permit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lenders Adtlress: Signature: OWNER-BUILDER DELLARATIONS: Date: I hereby aHirtn that under penalty of perjury tha� I am EXEMPT FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7037.5, Business entl Protessions Code: Any city or counry which requires a permit to construct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is Ilcensed pursuant to the provisions of the Contractors License Lew (Chapter 9(commencing with Section 7000) of DlNslon 3 of the Business end Professions Code) or that he or she is exempt Ihereirom antl Ihe basis tor ��e alle9ed e:emption. Any violation of Section 7031.5 by eny flpplicant for e permit sublacts the applicant to e civil penalry ot not more than tive huntlretl tlollars ($500).): ❑ I, es owner ot ihe property, or my employees with weges as thelr sole compensetion, WILL DO THE WORK, end the structure Is not intendetl or oHered tor sale (Sec. 7044, Business antl Professions Code: The Contractors License Law tices not epply to an owner ot property who 6uilds or improves ihereon, and who tloes such work �imself or herself or through his or her own employaes, providetl ihat such improvements are not in�ended or oHered tor sale. I(, however, t�e building or improvement Is sold within one year ot completion, the owner-builder will have ihe burden of proving thal he or she tlitl no� build or imD�ova for purpose ot sale.). ' ❑ I, as owner of the properry, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construtt ihe project (Sec. 7044, Business antl Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, antl who contrects for such projea with a coniractor(s) license pursuant to the Contractors License Laws.). ❑ I am ezempt under sec. Siqnature: Owner ID ventietl by tlnvers license. ❑ Ye5 ❑ No Business and Protessions Code tor this reason: Verificetion of Ownership by (typa af documem, i.e. - property ta: bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Dnvers License No. D9fe: Eapires: ❑ I hereby certiy that no excavatlon tive (5) or more teet in dep�h into which a person is requiretl to tlescend, will be made in connection wi�h work authorized by this permii, end that no building siructure, swNolding, talsework, or tlemolition or dismantling �hereot, will be more �han Ihirty-sla (36) fael high. (Chap. 32, Grp 2, Ar12, Sec. 341, Ttle B, Califomla Atlministrative Cotla). � ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Intlustnal Safety, as noted above, unless such person has e pertnit ta do such work from the division. Signature: Date: Division of Indusinal Safery Permil Number: CERTIFlCATE OF COMPLIANCE AND AUh10RIZA710N OF ENTAV: I certity under penalty of perjury Iha� I have reed ihis epplicalion and stata ihat iha Information given is correct I egree to comply with all state laws end ciry ortlinances relating to builtling consWctioq and euthonze representatives ot the Ciry ot Costa Mesa to enter upon the abova-described property tor inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until finel inspection. CODE I, INSPECTIONTYPE Ifi16 Flxetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roaf 201 Final8lock/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition Date t �/�/o � Date Q/y¢ � j�QP� INSVECTIONTYVE 206 Final Mechanical 208 Final Plumbin9 270 Final Electrical 212 Final Fire Prevention 220 222 250 Final Planning Approval Final Si�e Final Building/Occupancy PAg INI!➢eL$ � 6� . . AO licant to till in all CiTv OF eOSTA. E a_ CONST.RUCTION PERMIT Project Address �� - Applicant's Mailing'Address Owner's Name� Phone � Address Arch/Eng. License Na. Address Contractor's Nam �j � Phone a-��n Addresslma'I'nnl �b13 ��.i. '�C_�l YL� Ciry Licencr No �3 LICENSED CONTRACTOR DECLARATION I hereby at(irm that I am licensetl untle� provision5 of Charter 9(commencin9 with section ]000) of Divlsion 3 of the Bu5ine55 antl Protessions Cotle, antl Ty �ICElISE IS I!1 WI I 2 dOtl 2flEC[. . � ' Licen Class - Li ns yo.� �lf�l�Z Da[e��-� � 5�9 t ��L-��A^�•C WORKERS' COMPENSATION DECLARATION - 1 hereby aftirm�tM1at I nave a ceriificate ot mn5ent to selbinzure o� a certificate of Wo�ke�s' Compensation Insurance, or a 'fietl coOY the�eof (Section 3800, Lab. Cr�y�' y' IGI'� Policy No, v, n� 7 Company �� ❑ Certitietl copy is hereby furnished. . ', �CertitJ� c�yy,ls etl with the city Bui}� Div sio n Date �'/�U�-eY� qpplicant /� ��.�D f/��!-5 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This zection neetl not be [ompletetl if the permit is fo� one huntlretl ($300) or less) J 1 certity lhat in the pe�formance of the wo�k to� wM1ich this perm�t is issuetl, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws bf California. Date Signature NOTICE: If, afte� making this tlecla�ation; you shoultl become subject to Ihe Workers' Compensation provisions of tne Labor Cotle, you must forthwitn cOmply wilh such provi5ion5 or this permit shall be tleemetl revoketl. CON5T0.UCTION LENDING AGENCV . � I herety aftirm that there is a mnstruction lentling agenq fo� the pe�fo�mance ot the wo�k tor which [his permit is issuetl (Sectian 309 � Civ. C.) Lentler's Name Lentler's Atltlress - OWNER BUILDER'DECLARATION �` I hereby affirm that I am exempt trom the Cont�acto�'s Llcense Law for the followinq reason (Section �031.5 Businessantl Professional Cotle"Any city or county which requires a permit to construct, alter, improve, tlemolish or repair any Structure, prior to its issuance, also requires the aOP�icant for such permlt t0 file a signetl statement that he/she is licPnsetl pursuan[ to the�provisions ot the Conbacto�'S LicenSe Law (ChaD�e� 9(commentinq witM1 Section ]000) of Division 3 o{the Business antl Professions Cdtle) or that he/she is exempt tM1erefrom antl the basis fo� the allegetl exemptiOn. Any violation of Section ]031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five huntlretl tlollars ($500). ❑ I, as owner o( the property or my employees wi[h waqes as their sole mmpensation, will tlo the work, antl the 5tructure is not intentletl or offeretl for..sale (Section 7044, Business antl Professional Cotle: The'Contractor'S License Law tloes not apply to an owner of a properry who builtls or improves thereon. antl who tloes such work himselt/herself or through his or her own employees, provitletl that such improvements are not intendetl or oftered tor sdleJlf, however,�the builtling or improvement is soltl within one year of com- pletion, the owner will have the buraen ot proving he/she tlitl mt builtl or im- prove tor the purpo5e ot sale). ❑ I, as owner of the property, am exclusively contractinq with licensedcon- iractorsto mnstruct the project (Section 7044, Bu5ine55 antl Professions Code: The ConVactor's License Law tloes not apply to an owner oi pwperty wno builtls Or impfOves Lh¢I¢On� antl wh0 COOtldci5 fOf SUCh plOj¢Ct5 with d COO- tractor(z) imense �pursuant to tne ConVactor's �icense Law). I am aware that proof of t�eir Worker's Compen5ation insurance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for tnis reason P except those within heavy bor0¢r lines antl si9n all apprap�iale Eeclaralions. PER - NO. ' I nHc I rvu. LU I NO., UNIT NU. • �57�� TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR. ❑ CONVERSION ❑ DEMOLISH O OTHER ' � � OESCRIPTIONOF WORK/USEOF BLDG. � TVPEOFPERMIT ❑ GRA�ING ❑ FOUNDATION STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' O OTHER � .. � .. . _ PROJECT DESCRIPTION 5c1. FT. � oCCuaaNCv CONSTRUCTION TYPE VALUATION S ZONE 'GRADINGCU.YDS. ACRES Remarks: Bar Sink Backflow Preventer � � Backflow Irrigation' Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Kitchen Sink Lavatories Roof Drains Showers , Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping, Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash . A.P. # 5 Main Building: E T Front A Rear C Right g Left ' Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub.� Cookin9 Unit� � Dishwasher ' Dryers ❑Gas ❑Electric Fan F.A.U. ' Fixtures � Device Boxes Outlets - Switches � • Garbage Oisposal � � Generator �0.5 KW �5-15 Reinspection Fee � $15 � I Issue Fee � I $ 3 I: Boiter Duct- Under Ground Duct - Strucmral Duct-Ventilating � Exhaust System � Multiple Firepl/Fact. Blt. ICBO # Date owner Heating System & Ducting I hereby certify that I have reatl this application antl state that tne above ❑p100,000 BTU �100,OOOBI information is mrrecL I agree to comply with all city antl county ortlinan<es antl 5[ate laws relating to 4uiltling construction, antl he�eby authorize �epre- sentatives of tnis cit t' t r upon the above-mentionetl pwperty for_ . Inspection pur d. � ' Signature t Dat -�9-/y-� Drivers' License or 55 � - Reinspec[ion Fee $15 CMF 0865-4fi, rev. 30/84 White - Builtling; Canary - Appli<ant; Pink - Accounting; Goltlenrotl - Assessor Hood or TYPeI ❑ Canopy Type I I ❑ flefrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers . Issue Fee $ 3 Zone . Accessory Buildin9:. ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps � Meter ❑over.100 amps " . Sub Panel � Motors �0-1 HP 01 %- 8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Light Si9n Standing Sections Trash Compactor � I Rainspection Fee !$15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Aoolifatian Issued Bv FEES $ 3 Z O N I N G R E Q M - SUMMAHV OF FEES � . BUILDING PERMIT $ SMIP $ PLAN CHECK $ � PERMIT � � .. PLUMBING $ �� ISSUANCE $. PLAN-CHECK 25% $ ENERGY P.C. $ ELECTRICAL $. � GRADING $� PLAN CHECK 50% $ - MICROFILM $ � MECHANICAL $ TOTALFEE $ •oi� D , PLAN CHECK 25% $ � ' ��i CONSTRUCTION AND.PLANNING � POOL & Si - . - � L...a Inspector � Date Inspector APPROVALS Permit.# APPROVALS Permit# � 1. Temporary Electrica�8er'v'ice or Pole 52. Pool & Equipment Location� � 2. Soil Pipe-Undrgmd. '� 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings � � 58. Electrical Conduit-Undrgrnd: �,�� -, 8. Foundation} - � � 59. Gas Pipe, O Undrgmd., Test; ~ : ,--� e • � 9. Water�Pip rUndrgrnd � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK t_' ;11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final!? .J 12. Sewer Cap 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System - Final . "F,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 . , �7 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS . Permit # 21. Ducts, in Structure 70. Undergiound Hydro ' 22. Ducts, Ventilating . � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil . 25; Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & MonocoatT 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding . 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat 79. FINAL INSPECTION � �� 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � �� 33: Final Electric Notes: C�� .34. Final Heating & Air Conditioning �� 35. Final Gas Pipe-Test 36. Hood or Canopy _ ..� 37.` Final Factory Fireplace . '- � � � j': 3S..Final Plumbing 2/ � L�Q �� '. A� 39» Water Service-Final � � = i 40. Gas Service-Final . . , - � _ 1�41. Solar pomestic-Final ' � . ' , . ' � . , a., ;42. Backflow Preventer _ . -- , , . � _ �- �43. Backflow Irrigation . � ' _ ' � `��} n�y . ,r44. tandscape Irrigation System � ' " , � � ,� _ _ �45: Sound Attenuation ' • � � ^=� i �� 46. Handicap Regulations . • �� i v 47�. FINALSTRUCTURE&BUILDING - � '- ' - � ('j), �. � 48. Special Requirements Completed , ' �`- � � ` .-� . 49 Electric Release to Edison - z . _ 50. Gas Release to Southem California Gas Co _ �� - �� , 51. CERTIFICATE OF OCCUPANCY � - � � • ' No. Date � , ` .. � \ � �. P.opi�cant to fiu in all sDacez within heavy Coraer lines antl s�yn an appropriale tleclarations. � %B%2 9/ I 7/Q2 TRACT NO. LOT NO. BL�G. NO. SaDO TL CITY OF COSTA MESA PeqJpIT NO � � � � - - • CONSTRUCTION PERMIT /��^ • �- - Project Address �7 � C TYPE OF CONSTRUCTION � .. _ _ . _ , , _ , � • ' OWnef _ <�^fy�y �� ` Phon� �.,�G/Z ❑ NEW ❑ AOD ❑ ALTERATION ' � - � ' _ � -- Addfess 'q'- - ❑REPAIR ❑CONVERSION ❑DEMOLISH . _ _ - � Arch/Eng. License No. . ❑ OTHER � � ZONING REGULATIONS � DESCRIPTION OF WORK - � A'P' � • � Addre55-' ' � -- , t' ZONE � -� PLNG..REF. � �• ' -' : Contractor%j�-�p., �: .h . _,�^. Phone" - Q ^) .TVPE OF PERMIT • � ' ' � - � � " � ""` ��pPU ��p ING - ' :SETBACK C L T. ERTV LINE ' ' Address � " J• /' � /n�. �J ` .D.GRADING...,❑ FOUNDATION '❑ STRVGTURAL ' �I�J�.YqRD "" - - ', i � i . �/ LICENSED' CONTRACTOR DECLARATION - � - � � � � �0 TENANT O ELECTRICAL �L�4PLUMBING-OMECHANICA gIOE VA - � � � ^ � - - - -- �1 hereby afilrm th:.t I am licensetl �untler provisions of Charter 9 (wm- ' • • � � .. - RIGHT. - � � ,mencing with section ]000) oT' Division 3 of the Business antl� �� OTHER -�-=�� - - _ � �Professions Cotle, �ar�.f my license is in full (orte antl �effecL - � - REAR VARD (TO P/y ,.�; •,� � "" .L' ? � - , - �/?�„��- 'PROJECTDESCRIPTION ', . .. ..' i ' ... - . . '^' Litense�i Class �// Lmense No, ,�„ . . ' PKG.-SPACE REQ. , PROVIDED . ;Date `�'a''�:L- 'S9n5tuie 2"etA� �-r '�. -�.n..l._ SQ.-FT" ' ' � : ', . _ , _ _... . , __ ' � STREET WI�TH PARYC FEE y� n - �� ' 'WORKERS' COMPENSATION DECLARATION � OCCUPANCV_CONSTRUCTION TYPE! l � - - . 1 ZONING�AP7ROVED BV � . DATE ' - - ,I hereby affirm that I have a certificate of consent to self-insure or a.�VA�VATION' a'� ZONE �� ,certifiwte oYWorkers' Compensation Inzurance, or a certlfie0-copy - --� -� � �� i . . . .. . _ '� _ .• .. SPECIAL CONDITIONS: 1 �Policy Nm �b. C) � � �.GRADING�CU. YDS. '� ACRES ' . �..7'r� ^� 'f thereof (Section 3g 00 ' ' O'.CF!1./) � ComPanY��C>A✓!�G •.T.dS _. . . ..' " �- _ .'. ' .. "__..___.. _ �., .'_ ' �❑ ettlfietl copy is her¢Gy fumishetl. -. - _ . .. . , � REMARKS: " - - - . _ _ � ertifietl copy Is filetl wi[h [he city Builtling Division. ,_ , ' ' � � , ' 7. � � � .�� , � ��kMPTION FROM WORKERS' COMPENSATION DECLARATION ' � - " ' ' ' � "'"' ^ ' • y, Section neetl not be Cample{ed if the permit i5 tor one huntlretl -'� � 4N'b)OIIC55). 1 .. ... . . q� .' � �I'EBrtify that in the performance of tne wotk for which this Dermit IS� �issuetl, I shall not employ any person In any manner so as to.bemme 7 P�LUMBING� ..� 7 PLAN CHECK ' �- ' ELECTRICAL � -- PLAN CHECK �- -- subject to the Workers'.Compensation Laws of California.. _ ' , _ , . �Date Siqnature BATHTUBS - SHOWERS � �- ' '� � �" ' i �NOTICE: If aiter making [his tleclaration, you shoultl becomeisu0ject .TOILETS•- , .. VRINACS - �" ' " ' ' �GENERATOR" p:l KW_�1-30 KW �� to the Workers' Compensatlon provisions ot [he labor Cotle, you mus£ � ' TRANSFORMER �- . � �.tOrthwith.comply with such provision5 or this permit shall be tleemetl LAVATORIES DOUBCE LAVS ' - ;APPLIANCE -' 30-50 KW_50 + KW {(, "' � ievoketl..._.: .. 1 . . ._ � ' ' - - . . .. ;CONSTRUCT,ION LENDING AGENCV � KIT. SINKS' �� ' DISHWASHERS' "- � ' 'MOTORS" `-^- ' 0-1 HP'=1-30'HP , �- -I hereby aifirm that there i5 a construction lentling,agency for the per- SERVIGE SINKS: "•', ��,SUMPS'-` - - -'�^- � ,(INC. SOLAR)- '� 10-50 NP_-50 � HP � - • -� �fo�mance Ot [he work for which this permit Is Issuetl'(Section+309] - �Clv. C.). ' ' " _ `� - 'y � ^' ' FLOOR SINKS�� F1.00R�DRAINS � - FI%TVRES — � OUTLETS SWITCHES ' "' �lenGer's�Name. ' ,.,. .. � .. +, . . . ., . . . '. _" " _" . _ ... .._ . _ ... .. -.. - .. � : - .__-_ �Lentler'sAtltlress DRINKINGfOUNTF11N5 �?j - - j ' ,GASTUBESIGNS'""- " ,- r � OWNER BUILDER DECLARATION'- - "' ' ' - � - � � � � -- 1 hereby af(irm that I am exempt from the Contractor's �icense Law for INTERCEPTORS� �� CLARIFIERS � �POIE LIGHTS" ' ' " , the (ollowing reason (Section �031.S�Businesrantl Profes5ionrCotle:� SWIMMING POOL " --PTRAP' '" ' "' "- � �� Any city or county which requires a permit to construct, alter, �POLES ' METER D SUB .. improve,-tlemolisM1 or-repair'any structure; prior to itz issuance, also re-- y.�qTER SERVICE �'� ALTERATION -� - �'�'PANELS ' � �' MAIN' . " SUB"' - - - � �quire5 the ap:licanl for such permit to file a signetl statement that �e ' . C islitensetl'pursuanYtothe�provisionsoft�e'Contractor'S'LicenseLaw GASSERVICE - � �OVTLETS ' � �SERVICE' � " -"" -" AMP' � � (Chapter 9(mmmencing wi[h Section ]000) of Division 3 of� the Business antl ProleSsions Cotle) or that he is exempt therefrom antl [he yyqTER HEATERS - -BTU OUTPUT �" � 6 ' ��. ,` �' � basis for the alle9etl exemption. Any violation of $ectlon 7031.5 by - any applirant for'a'permit subjecis the applicanYto a civil penalty SEWER CONNECTIONS� - ' ' - '- " ' " � ' -' - � � 'of not more Ihan five huntlred tlollars ($500)., �� ,� • i� i �� .�5s owner'of �the�property, or my employees witti wages as tneir � SOCAR TANK - ' COLCECTORS;`--` '�� (�`.. -,` ' , ' ^ " "•" ' - - �ompensation, will tlo.the work,.antl the,s[ructure is not intentletl �' 'ered for sale. (Section ]044, Business antl Aofessions Cotle: The SOLAR PIPING SYS. - � � � �ISSUE-FEE ' ' ' ' - ' ' " - - " ' ;actor's.License.Ldw tloes not apply to an owne� ot a Oroperty, ' w��o builtls or improves thereon, antl who tlOeS Such work himself or ISSUE FEE ��' � ' �1b .%�PPCICATION�APPROVED BV- -- DATE - throu9h his own employees, provitletl that sucM1 improvements are not iNentletl or offeretl tor sale. If, howeve�, [he builtling or improvemen[ MECHANICAL GLAN CHECK � is soltl witnin one year of�completion, the owner will have Ihe burtlen t. -' $UMMARY,OF FEES •,; of proving ne tlitl not build or improve for the purpose of -sale). ' BUILDING ' ' ' -- ' '' - � -- - - � � �� I, as owner of�"the property,�am-exclusively�mntracting with HEATINGSYSTEM 0-100,0008TU 'PERMIT - $ �'SMIP' ,$� �licensetl contractors to construct tne project Section 7044, Business AN� DUCTING - � . ''- - _ -- ( 300,000'+ gTU I PLAN CNECK $ PERMIT . antl Prote55ionrCotle: The Contractor's LicenSe Law�tloe5 not appry to � - -$�.. .-ISSUANCE �$ ' an owner of property who bulltls or improves thereon, antl who con- REFRIGERATION 0-100,000 BTU �PLUMBING %'� tracts from such projects-witn a-conbactor(s) licesnetl-pursuant�to• SVSTEM _. . ...GRADING .S ' �[he Contractor's License Law). / - 100,000 + BTU � PLAN�CHECK �S .. '� ;y, � I am exempt untler Section - B. & P. C. for this B��LERS BTV �' ELECTRICAL � E� �� $ - ,. rea5on' ' ' - - PLANCHECK $ ' MICROFILM'y SVSTEM REPAIR,ALTERATION �� Date ' Owner � � ' � TOTAL FEE $ �'� �° • 1 hereby certity [hat I have reatl this application antl State that the dbove EXHAUST SVSTEM MULTIPLE MECHANICAL § � � LESS�AD- ' • inPormation is mrrect. I aqree to compry with all tity antl county PLAN CHECVC �E VANCE PC $ J ' ' ortlinances antl state laws relatinq to COnStruction, antl hereby autM1orize - representatives of this city to enter upon the above mentionetl . - - property for i spection pu�poseys� - c 1 Si9nature ��/�/+� ��•/ �✓ + /��% � �• Date � 5 -FZ ' . . . FINAL FEE $ �/ • ` " orivers' License or 55 � � -�.�-/.' /} �ISSUE FEE � � CMF 0865-46 Wnite�Builtlin9; Canary-Applicant; Pink-Accounting; Goltlenrod-Assessor ��, � l. � =/ ,�.-�� ,C.� Lr�i�J /� ' % � CONSTRUCTION AND PLANNIN POOL & SPA � � APPROVALS Permit # � �� Date Inspector qppROVALS Permit # � Date ' Inspector � t. Temporary Electrical Service or Pole 43. Pool & Equipment Location - -- �� - 2. Soil ipe-Undrgrn �� 44. Steel Reinforcement - - � 3. Electrical Conduit Utility-Undrgrn 45. Forms -- - 4. Electrical Conduit-Undrgm � . 46. Electrical Bonding -�- � tee ein orce 47. Rough Plumbin '& Pressure Test ' �" 6. Electrical UFER Grn " ' 48. APPROVAL TO COVER-GUNITE 7. Footings ' - �� 49. Electrical Conduit-Undr rn � • � ' � .8. Foundation;_ _ . ' � � � 50. �Gas Pipe,. ❑ Undr m; Test - � ' � 9. Watec Pipe-Undrgrn • � 51. Backwash Lines P-Tra '❑ ndr rn • ' 10. Structural Floor System 52. APPROVALTO DECK -' '- - ' " � 11. Property Sewer Line & House' Connection "� ' 53. . Backwash &� Rece tor-Final ' � � 12. .Stceet Sewer Connection � � �'� � '� � 54.- �Heater & VenbFinal � • 13. Rough plumbing - .- - - - ' -' . - -- ----. _ .. .. . _ . - . 14. Rough ElectrioConduif -- - - � -- -56.- -Electrical-Final- • � - 15. Rough plectric-Wiring � ' " � -�"� � �- � -- � 57. Solar SYstem-Final � � ' � "' 16: Rough Heating & Air Conditioning= � - � - • �encing & Access Approval ., , .17. Ducts, in Structure ' 9. APPROVED FOR PLASTERING ' 18.. .Ducts, Ventilating . .. _ . . ' _ ... . _ . _ . ..- . . . _ . 19. Gas Pipe-Rough &Tesf ' 60._ POOUSPA SYSTEMS FI.NAL • • • . 20. Roof,Framing_ . . . � . . � .. . . .. ' . - � . 21. Roof'Sheathin ' ' "' " ' � 1 '- . � .' "' � ' � � � . � � 22. Frame and Flashin - NOTES: � �e� � yx ' , 23: - Insulation ' � . � � � 24. Lathing &.Siding_ . .. ' � � � - - � - - 25.- .Drywall Nailing ' ' . ' . , , , ' . 26. Plaster Brown Coat - ' �� x ' - � � " " ' " ' • - � �, � - - 27. Electrical Power MeterFinal ' ' ' � � " .., r � � � - � � ' 28. �Final Electric � ' � � � � � � 29. _FinaG Heating & Air Conditioning ' - ' ' - � � - � � - "� , 30. Fina6Gas Pipe-Test ` � �' � ` � - - � - � 31. Final Plumbing $' � _ ' ' ' � - � " ' � 32. Water Service-Final - ' ' - ' ' � � 33. . Gas�Service-Final � � � " � 34. Solarpomestio-Final•'� �'� ' - ' � - ' � � � ' ' � � � 35. Lzndsca e S rinklin S stem _ � � - � ' � � - ! 36.' Sound qttenuation ' - � � ' - ' ' � � � � �• - 37. Handicap Regulations - � ' ' � �+ � ' ' ' - � � � � 38. FINAL STRUCTURE & BUILDING ' � � � �- - � � ' � 39. Special Requirements Completed � ' � ' �'- "� 40. Electric Release to Edison - ' � - - � � - � - � � �- 41. Gas Release to Southern California Gas Co�. � } � � a ` 42. CERTIFICATE OF OCCUPANCY _ i ' . . �. . No. � Date . � - -- - 1 I , . - 63�'� COSTA MESA BUILDING DEPARTMENT P. O. BOX 31] COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN nooRe�ss 456 Cambrid e St. COSTA MESA. CALIFORNIA OWNER Crown Homes, Inc. CtlJ.11 • TNO. ARCHITECT ' 4�� !V. LIC. r (' OR ENGINEERA�L, ldey & T�vy'jn'�� lO �� I nooRess 20i5 Net,rooT't Blvtl.. Costa Meqa C�]�IC�A[Q IEGAL LOT oesceipnor� NO. � 6LOCK TRACT 2 A.P. NO. ` $IZE G1 � X ryl• NO. OF BLOGS. TlOne OF LOT ��•L1, (w now ov Lor a� USE OF E%ISTiNG B�OG. - serencw �irve vAom c[Hr[R OF srAc[T � REAR YARD 24� O SIDE YARD RIGHT � n LEFT 5� Op � DESCRIPTION OF WORK NEW X ALTERATION ADDITION - REPAIR MOVING DEMOLISH BUILDI NO.OF � SIZE O ROOMS STORIES COVERINGC LL & S II ROOERING Sil<JAe BIJELDINGEWS1T1P19 C9RL11V LWEZZ1ilE ,-;�� c��v�� iL /S£5 J w Fi�!^,i�CE DEPT. eETy �G cos�.a r�ti_sn APPLICATION FOR PERMIT BUILDING FOR OFFICE USE OfVLY RECEIPT NO� PERMIT NO l�T FIRE ZONE COSTA MESA. CALIFORNIA CORRECTIONS / � / � � �-i� I NEREBY ACNNOWLEOGE TNAT I HAVE READ THIS APPLICATION ANO "� J STPTE THl�T THE TBOVE IS COflRECT AND 4GREE TO COMPLY WITH ALL �/ CITY OROINl�NCES AND $TI�TE LA�NS REGULATING OUIL�ING CONSTRUC T T�ON. /' / VALUATION SIGNATLiRE OF / w � _ _ /e✓ _ . _ L _ PERMIT FEE S I AUTHORIZED AGENT $ /�i ��0 I PIAN CHECK $ TOTAL FEE 5 d � O�� /6— �eMr .�;