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Home My WebLink About110 BROOKLINE LN - Building PermitsPROJECT ADDRESS: 1 1 0 B ROOKL I N E LN UNIT: OWNER'S NAME: ARNOLD HARRY E TR ADDRESS: 22792 LOMINITA RD 4 LAGUNA NIGUEL,CA 92677 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: STOUT ROOFING INC (310)923-6775 ADDRESS: P O BOX 4309 DOWNEY CA 90241 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITYUC.: 0591,147 59 7 STATELIC.: 402536, CLASS: C 39 EXP: 10/95 Dale' _LD�y Signature: — _ WORKERS'C MPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self -insure or a certificate of Workers' Compensation IgSUWtIGe2oL.a pgtl�5ed copy thereof (Section 3800. Lab. 5 / 19 / 9 S POLICY NO.: ] tl L b 7 7 EXP. DATE: COMPANY: AIG �/ ElCertibed copy is hereby furnished. LT Certified copy yiiiss/filed with the city Building Civilian. Dale:� 1'h�J��L�o Applicant: !:X / I EXEMPTION FiROM W BEERS' COMPENSATION DECLARATION: (This section need not be completed if gM permit is lair one hundred (5100) or less). I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or INS permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency tar the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06961 PERMIT NO: B 069613 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE: ALT JOB DESCRIPTION ; T/O RESTH & REROOF W/COPM S HOT MOP SQ FT: 2,508 CLAIM VALUE: 2,508,00 CALL—VALUE: 2,508,00 GROUP OCC: R-1 / COMMENTS: REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REgUIRED xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxxxx Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 41916342 ZNE: REF NO: PLANNING N TES> > xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx.nExxxxxxxxxx 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 S ZONING APPROVED BY DATE: r BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: xx xxxxxxxxxxxxxxxxxxxxiF3FiF3FiFTFTFiire die—'iFiF'iF';F'iF �r�iFiFiixxxxxxxxxx xx xxil lFx xlFx xie 9f xiexxxaFxxxxlEx ie ilxxxiE rex f ix xie afxxx xxxxxxxxxx xxxxxxxxxxxxxxxxxxxxxxxxxx xxx LEGALIZATION:N F`F/E S U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby alirm that l am exempt from the Contractors'State License Law for the following reason BLD PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESO GRADING (Section 7031.5 Business and Professional Code: Any city o1 county which requires a permit to construct, alter, improve, demolish, or PERMIT 54P00 repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that helShe is licensed SM I P / NON —RES pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business PLAN and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law TOTALS ----> 54.50 0•00 0.00 5 4 .50 54.50 .00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. ll, however the building or REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: 00 Improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the pumope of sale)- 54 .00 .50 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and ProleStions Code: The Centractors Stale License Law does not apply o an Owner of proper)y wto builds w improves thereon and who contracts for such projects with a contractogs) license pursuant to the Contractors State License Law),I am aware that proof of their Worker s Compensation insurance should be provided to me. ❑ I am exempt under Section: 8. 8 P. C. for this reason: xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx I N D I V I D U A L F E E B R E A K D O W N TYPE Date. Owner:I SFR J do hereby eenily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that for any luture building occupant will/will not (circle one)need to comply with Said state codes and the requirements tors permit lar construction or modification Irom the Air uahty Management District. Residential construction applications are exempt Irom these provisions. Date' Applicant: I hereby eerily that I have read this application and state that the above information 6 correct. I agree to comply with all city and county ordinances and state laws relating to building conshudian and hereby adhodle representatives of itis 6ty to enter upon the above-mentioned property for insidecinin Purposes. Date' �ociSignature: —/ Drover's License or Sal Security 4: 164646 White—Biutdmg; Green—Code EnterCernent: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor QTY D E S C R I P T I O N 2508 REROOF BY VALUE RESIDENTIAL NOZONE END OF FEES UNIT COST TOTAL COST 1,00 2,508,00 Oi 00170708-00170709 Tl -.)T DATE: 10/28/94 TIME: 13:34 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POL, & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utifty-Undrgrnd. 54. Forms 4..Electrical Conduit -Undrgrno. 55. Electrical Bonding 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test • 6:;'Electrical LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit Undrgrnd. . 8.'foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P Trap, 0 Ucdrgrnd. 10. Structural Floor System 61, APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing - 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1S. Rough Electrical -T Bar Ceding 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REOUIREMENT .APPROVALS Permit# 20. Rough Factory Fireplace 21.-Ducts,in. Structure, 70. Underground Hy6ro 22. Ducts, Ventilating. 71. Product Piping'IG:s ❑OSI 23. Gas Pipe -Rough & Test. 72. Underground Flush 24. Roof Framing .. 73. Undergrnd. Storage Tank C Gas E] 0.: 25. Roof Sheathing "3 r30 -q ��6t 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing t ,- 76. Dry Standpipe 28, Lathing Si Siding 77. FIXED SYSTEM FINAL 29. Insulation 76. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. ElectricaIPower Meter -Final. 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & A'a.Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace' '- 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final• 42. Backflow Preventer , 43. Backflow Irrigation 44. Landscape Irrigation System. - 45. Sound Attenuation L • 46. Handicap,Regplations 47. FINAL STRUCTURE & BUILDING &a4/ 48. FINAL PLANNING'. 49. Electric Release to Edison - - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date \J OWNER JOB AC GENER AP No., 1411 Barbara lokline GAS WATER ROUGH PLUMBING PROP. SWR. LING ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING TRENCHES ❑ FORMS ❑ STEEL REINF. ❑ FLOOR SYSTEM BOND BEAM STEEL REINFORCE ❑ SHEATHING FRAME AND FLASHING LATHING - IN OUT ❑ PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING. FINAL AND GAS TEST I -I fdF DATE SUBCONTRACTOR RMIT W 1 35410 Z WW Z Z_Q ON a0 JW JN Q W M J (D JQ U� Za WCr M W w JO M JM WW Q _ Z_ 1 - WO W M 70 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Pnln CEP 18-72cf;st00 623 *****7.05 AP LI ATION FOR BUILDING PERMIT For Applicant to Fill in CompleIle RE EI ED V TE CEIVED C O TE I S D _ _ tl BUILDING ADDRESS t/ P RMlj f1()11 OWNER A,P.NO. J/{ MAIL BUILDING /,,,, //�i D ADDRESS ADDRESS' reVILLIr/6 4/U TRACTS/4L) LOT S BLOCKCITY CONSTRUCTILENDER mavpBRANCH//OWNER Q L 15ta0 66Q - ADDRESS VALUE VARCHITECT S �0 L'.r�-/ 5OR ENGINEER i . FIRE V ADDRESS ZONE TYPE GROUP APPRO E r• '1 ,_ L 8 CONTRACTOR v By DATE ADDRESS ZON NO. OF USE OF NOV10 TEL. TE — PLANS BUILDING CITY Url'JoF STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) SIZEO NO.OF BLOGS. ' OF LOT o2D NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT FTJ SIZE OF NO. OF ff NEW BLDG. ROOMS 1 STORIES i L. SIDE FT. FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. 1 t\ VAR.* DATE C.U.P. 4W APPROVED I APPROVED&Apo _49 h DATE / I hereby acknowledge that 1 have read this application and state that the above Information Is correct and agree to comply with s all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of T the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. the Stateof California Business and Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION and Professions Cotle, Division 3, Chapter 9. PERMIT FEE $ Signature of `�/I ��'��///rrr ' Permittee '.a� /� /e_ A o -K VA2 $ /ifif / t/ PLAN CHECK $ Authorized Agent TOTAL FEE $ OWNER JOB ADDRESS AP No. LOT 5 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK res watt ge_ INSPECTIONS Signature DATE GROUP MJ TYPE V ZONE Soil Gas _— SUBCONTRACTOR PERMITS ISSUED NUMBER DATE Water YS _ Rough Cord. Reffig. f] Air Cond. Rough Heating Rough Plumbing-/— ,9,j Miscellaneous Prop. Swr. Line ❑ House Con. St. Swr. ❑ _ _ q 1993 Sprinkling System Construction Pole Underground ❑ Power r] 1 Rough Wiring�e77e- Trenches ❑ Forms O Steel Reinf. ❑ Ic Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing r: Frame and Flashing Lathing — In . Out n Plaster, brown coat 11 Refrig. ❑ Air Con. C] Final l Heating, Final Plumbing Fixtures, Final - Final Gas Test %- d Electric Fixtures, Final - Building, Final ' /-S- OCCUPANCY „�, ?_2!66 C STA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX ]1] COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING .ADDRESS 110 Brookline Lane COSTA MESA. CALIFORNIA OWNER San Vista Building Co. MAIL - 1166 E. 58th Street USE OF FEE RECEIVED m'710 lld9 FINANCE DEPT. APPIQ}tirT4 101 B6&TAEdW BUILDING For Office Use Only RECEIPT NO. ln'"PaiVA O. APPROVED R RaF pond Levans rTr _OR 37010 BY DATE ZONING 3432 Via Oporto, Ne ort Beach ZO NO. OF D6E OF NE PLANS BUILDING Lo R San Vista Building CO. 1166 E. 58th Street `EDA`- DESCRIPTION NO. OF BLOOS. EIIBACR LAVH FRUM CENTER OF STREET 13' REAR YARD 61DE YARDI LEFT O I RIGHT 0 DESCRIPTION OF WORK NG n U,L,2 /r i a v / ROOM9 BTORIHB 2 OR NG Stu StuCCOI ROOF COVERING Shingle I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE TN ABOVE IS CORRECT AND AGREE TO COM. PLY WITH ALL CITY ROMANCKS AND STATE LAWS REGULATING BUILDING CON TPU ON. A. P. NO. NOTE: NO HAVE OVERHANG SHALL BEL 95 THAN 90' TO SIDE a REAR P. L. EAVES ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BU ILDING(� (FROM C/L,STREET) BET. BET. MAIN Q 78. ACCESS. BLDGS. DATE 5 ' (� APPROVED 60. THE AMOUNT SHO N UNDER VALUATION IS FO p THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O VALUATION m PERMIT FEE $ N i $ / (/� // ✓�� A C E / a