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HomeMy WebLinkAbout116 BROOKLINE LN - Building Permits F CITY()PASTA MESA <4011 BUILDING DIVISION Y y ,� DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER b. MI I PERMIT B06-00981 4tbfrmoRmso" (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ce{rpLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 116 BROOKLINE LN Status: ISSUED Suite: Applied: 06/19/2006 Vicinity: BEDROOM AND KITCHEN Issued: 06/19/2006 Primary Occ: R3 Type of Construction: V-N Parcel Number: 41916345 Zoning: Applicant: STEVEN JANOSIK Address: 1621 EST ANDREW PL Phone: 714-259-5120 ISSUED BY: SANTA ANA,CA Zip: 92705 CDL D6923436 Owner: MONTGOMERY, KEVIN PAUL Address 247 S HARTNETT AVE Phone: 714-557-1984 FERGUSON,MO Zip: 63135-2103 Contractor: DIAL ONE WINDOW REPLACEMENT SPECIALISTS Address: 1621 E ST ANDREW PL Phone: 714-259-5120 SANTA ANA,CA Zip: 92705 License: 523043 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT RETROFIT 2 WINDOW LIKE FOR LIKE W/VINYL WINDOWS(KITCHEN AND MASTER BED)FOR SFD.WINDOWS TO MEET 1997 UBC EGRESS REQUIREMENTS. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,000.00 Permit: $38.75 Claim Valuation: $1,000.00 SMIP Res: $0.50 SMIP Com: $0.00 Other $0.00 Inspection: $0.00 Total: $39.25 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(JQ0) DECLARATIONS • - ' : x. WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ''` 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.I_nlsur�ance carrier and policy number are: /' (D Carder: .5 c(q R e 1�7F / 1 Policy Number: e 1 10 O 6 (This section need not be completed it the permit is valued at one hundred dollars($100)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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr�vi ions. Applicant Signature: _-_i rO 1 • : I Date: lea — r 9 _Q c° WARNING:FAILURE TO SECURE WORKERS' NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100.000).IN ADDITI•�RTT• - E COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business ani Professions Code,and my license is in full force and effect.Lic.• rj 7 �Q 1.-3 Class N ,lF.l1 Y-r--e—`KJ ConlractoYs Signature: � �, . . �„r . Date: ex, — t 9 _ b Co 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 end 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.). ❑ I 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 flee(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 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 0 N (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 en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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 0 No (If'yes',the facility must meet the requirement of Sections 25534 end 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? 0 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 property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sig r Of Legal• r(s) De An r u razed A.. n Date CODE• INSPECTION TYPE PATE INTITIALS CODE r fNSPECTIDN TYPE PAM INmULS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall • 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval � /�/� 203 Final Signm 222 Final Site X71—` 204 Final Demolition 250 Final Building/Occupancy JOB SITE l ( to ER00%CL% $E ZIP CODE Iii 2,4% 4 W � I ENTRY KIT Tz1 c7 j --i 2 ± DN_:` / 0w cc 0 I MBED UP 0 co / 10'— r- u1 o —41 SECOND FLOOR - � I4' 0 V P/L------Jr--- _._ • Window&Door Replacement A In the space provided, sketch a floor plan indicating all adjacent -NO. ROOM EXISTING WINDOW / DOOR NEW WINDOW / DOOR i roams and their square footages, existing windows and doors, SIZE/ TYPE SIZE / TYPE locations of window and door replacements. a All windows must meet UBC Sect 2406 for Safety Gazing, The 1 KIT 45 X 31 ALUM XO WINDOW 45 X 31 VINYL XO WINDOW tJowng locations require safety glazing(tempered orlaminated)to 2 MBED 93 X 43 ALUM XOX WINDOW 93 X 43 VINYL XOX WINDOW 1:1:1 be etch marked: SASHES ARE EQUAL ON XOX TO MEET EGRESS 1. mass in daps 2. Glass in windows within 24"from doors and less than 604 high Owner KEVIN MONTGOMERY Contractor Address 3. Glazing wither 5 feet tan pod or spa 4. Glazing in Windows at shower or bathtub and stair landings less Address 116 BROOKLINE 1621 E. St. Andrew Place than 60'above surface City,Zip COSTA MESA, 92626 Santa Ana, 92705 C. NI construction shall complywith the 2001 Catania Building Code Phone 714-557-1984 714-259-5120 All windows are rated with 201bs/sf of wind load Prepared By: Steve Janosik M windows must meet UBC Sec 1203 for Ught end Ventilation AO replacement windows and glass doors must comply with the Cafitmda Energy Code,with a factor 0.67 and SHGC 0.40 All New Windows and Doors Have Dual Glaze, Low— E Glass D. Roans that can be used for sleeping purposes: Unless Otherwise Stated • Smoke alarms per UBC 310.9 LEGEND • At least one Window or door opening directly tothe exterior and XX Slider— Slider AWN Awning Window the window must meet Ina following criteria: XO Slider— Fixed DH Double Hung Window Min.net dear area:'5.7 sq.ft. Mir net dear height 24' Max.sllhdght 44' Min.nddear wtdth: 20' GW Garden Window 514 Single Hung Window E. Replacement windows that atter the existing moisture banter must CST Casement RBA Renewal By Andersen provide the following: PIX Picture Window AND Andersen Vinyl Clad Patio Door , Moist-stop flashing around windows and doors. Bilchuthane at vertical to horizontal Intersections.Exterior stucco per UBC Chap.25 JOB: 17 8 2 7 m b with 60 min.building paper. Separate inspections for each phase of stucco construction:scratch,brown and cola.Two layers of Grade D paper at an exterior wags with wood base sheathing and stucco covering per UBC 2506,4. Provide 4'and T dearance from weep sated to grade and paved surface respectively per UBC 2506.5. F. Doors that swing outward must open over a l ndng thatmom is not moSCOPE OF WORK: than P lower than the interior finished flop level-The Ia nd-ag must RETROFIT 2 WINDOWS WITH VINYL WINDOWS OF LIKESIZE be as wide as the door(s)and extend outa minimum of 3 feet. NO OPENING MODIFICATIONS NO HEADER CHANGES Dial . 1"; L______ o, ee o uuu. Spectrum e n e� / . 1 n erg® dal Windows&Doors Window . . ., ,...:: Energy Efficient Windows&Doors .? t P7C4±ECTADDRESS: 116 BROOKLINE LN UNIT: - ' CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 051291 OWNER'S NAME: NELAN, JAMES P ADDRESS: NELAN, ROSA G PERMIT NO: B 051291 PLAN CHECK NO: N GOVT: N SUPP: N 116 BROOKLINE LN COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: REP ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : REPAIR FIRE DAMAGED GARAGE ROOF SQ FT: 2, 000 ADDRESS: UNIT: CLAIM .VALUE: 2, 000 , 00 CALC-VALUE; 2, 000 , 00 GROUP OCC: M-1 / PERMITTEE: ROBERT' S CONSTRUCTION ( 714 ) 537-7200 - ADDRESS: 11781 CARDINAL CR COMMENTS; SMOKE DETECTOR(S) REQUIRED IN HOME, GARDEN GROVE CA 92643 #*******#*#**##**#*##**#***### ******#####**4*###*#*********#*#*##****##******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY UD.: 024507 STATE LlC.:389991 CLASS: B Date 3—Lk—�, signawre _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirI have certificate f consent to self-insure or a ceniticate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN firm Compensation insurance or a certified copy thereof/Seat BOO. Lab.C)• LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PDLICYNO.: 766893- 90 KP.DATE: 07/01 /91 COMPANY: STATE FUND PARKING REQ• PROV: PARCEL: 41916345 ZNE: REF NO: ❑ Certified copy is hereby furnished. ® Certified copy is filed wi the city Building 9----- >g ' ' • _ PLANNING NOTES> Dale: � � Applicant: #**####********##*#####*****######*##**###******##********#*#ah#*****}****#****# EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (T' section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N'-T S I certify that in the penormance of the work for which this per it is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY . DATE: Date: Signature: BUILDING APPROVED BY NOTICE:IL after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor :" - i DATE: - ___—_ Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY: I hereby affirm That there is a construction lending agency for the performance of'the work for APPLICATION ISSUED BY• ,C.�. -Ar.at • /_ i DATE; ei which this Permit is issued/Section 3097.Civ.C). ###################*##' "" • " ' #****####### # WWW** LENDER: ***********#lF#** -***********# *********** ******1(******************** E#******* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code' Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 45 . 00 . 50 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement That he/she is licensed ' SM pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business IP/NON-RES nd Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031,5 by PLAN ny applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and me BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 1044,Business and Professional Code: The Contractors'State License Law TOTALS----> 45 . 50 0. 00 0 , 00 45 , 50 45 . 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, If, however the building or REVENUE DIVISION TOTALS--> COLLECTED• 45. 50 OVER/SHORT• 00 improvement rptheepurrpose of sate). 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 I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 . 00 , 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with acantractor(s)license pursuant to the Contractors State License Law). l am aware ##*#**3%###############IF########*##########*#####"Y######!!*#MSE#######*##*####Y,### that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.g P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 . 00 2, 000 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Dale: Applicant- - / .. I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county �•// ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. Date:$_/_I-- 9/. Signature- Tom_ U'T OOOS'2 2E-0008232y T C' _j. Driver's License or Social Security e: 11,TE., 03/11/c i T::!1E: 11131 1641"46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor A/ ` [� CONSTRUCTION AND PLANNING POOL& SPA Date Inspector Date Inspector APPROVALS Permit# - APPROVALS Permit# 1. Temporary Electrical Service.or Pole • 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. .Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59. Gas Pipe, El Undrgrnd., Test 9. 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 I 12. Sewer Cap 63. Heater & Vent-Final . 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning .. FIRE DEPT. REQUIREMENT ' 20.,Rough Factory Fireplace i 1 _ 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- 24. Roof Framing j2--i( Q.- Ft 73.' Undergrnd.Storage Tank 0 Gas 0 Oil - 25. Roof Sheathing . ,-/L-2( 6Wt 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 PREY. FINAL 30. Drywall Nailing tc:K. . , HEALTH DEPT: REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final • - , 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' ' Notes: . - , 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 1(- F ,_'�l - F mit36. Hood or Canopy __ •Q,Gaji 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 .. . ' 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING 641/ 40,.'{- 48. FINAL PLANNING • • 49. Electric Release to Edison - 50. Gas,Release to Southern California Gas Co •• '51. CERTIFICATE OF OCCUPANCY . No Date BUILL .G AND SAFETY DIVISION - FIRE DAMAGE INSPECTION REPORT t s• (Required Prior To Permit Issuance) Address: • �1� setccf /i E- Unit: (c '' el Owner: /v' It• , d Owner's Address (if different from above): wE Au{. 11 /4 lr �c, r. io , S,., ( r. , r .r . (.0. 92 X72 Street City State O Structural permit required. © Repair or replace as necessary. El Plans required. Comments: / r yin i f r r r _ • NS. Electrical permit required. -Repair or replace as necessary. Comments: it c. CArt . or.,« ❑ Plumbing permit required. ❑ Repair or replace as necessary. Comments: O Mechanical permit required. 0 Repair or replace as necessary. Comments: • Inspector 1 Date Phone • 1612-46 Triplicate:Original-Owner;Hsow.Contrator; Pink-Building Division Imil PROJECT ADDRESS: 116 BROOKLINE LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069611 OWNER'S NAME: NELAN, JAMES P TR r i /,, ADDRESS: 706 AVENIDA COLUMBO SAN CLEMENTE,CA 92672 PERMIT NO: B 069611 PLAN CHECK NO: N GOVT: N SUPP : N CONSTRUCTION TYPE; V—N PERMIT TYPE: STA PURPOSE: ALT ARCNIENGINEER: REG.NO.: JOB DESCRIPTION : T/O RESTH & REROOF W/COPM & HOT MOP SQ FT: 2, 508 ADDRESS: UNIT: CLAIM VALUE: 2, 508 . 00 CALL—VALUE: 2, 508 . 00 GROUP OCC: R-1 / PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775 ADDRESS: P 0 BOX 4309 COMMENTS- REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE, REQUIRED DOWNEY CA 90241 ********4*+t�r�r*�t*****kk�E*�r�r�L***�E*�r***�r�ryk�r*+r+k***�r**�E***+lye***�r�r**kr *4**+r+r**kr******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS cl3YUD.: 059377 STATEuc.: 402536 class: C 39 EXP: 10/95 Date: i 0 laf(1(4 14 Signature MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation lgsupnceocaP,Dified copy thereof(Section 3800,Lab.Ca.S/19/95 LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY NO.: 77 tlri 2269`tlJ EXP.DATE: COMPANY: AIG �yy PARKING REQ: PROV; PARCEL: 41916345 ZNE; REF NO: ❑ Certified copy is hereby furnished. LT Certified copy is tiled with the city Building DWision. PLANNING NOTES> '°Id'q� > • Date: Applicant- ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (his section need not be completed it the permit is for one hundred(5101)or less). D EVEL OP MEN T SERVICES R EQU IR EMEN TS 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, ZONING APPROVED BY •• DATE: Date: Signature: BUILDING APPROVED BY ; DATE: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. /D CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE: ` BP.which this permit is issued(Section 3097.Civ.C). ******'***'*'****************** * **********************************- - • * .7F*. LENDER: *************************** * *************************************** *** ***** ADDRESS: LEGALIZATION:N E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/REESS GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 5 4 , 0 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(55%). ISSUE FEE I. as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 5 4 , 5 0 0 , 00 0 , 00 54 . 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. If,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 kir the purpose of sale). I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 50 Elantl Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).I am aware '*****'**'*'**'*'*****'****'*********************************************************** that moot of their Workei s Compensation insurance should be provided to me, INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 2, 508 , 00 f do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby cermly that I have read this application and state that the above information is correct.1 agree to comply with all city and county ordinances and state taws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. l D c(q Signature: d Ale 01 00170702.00170703 T C7� c Date. _ TIn_: 13:33 ,t4,w0 Orwers License ei Sociat Security x: 164646 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor L CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3.-Electrical Conduit Utility-Undrgrnd•. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5.i8teel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. • 57, APPROVAL TO COVER-GUNITE 7. Footings58. Electrical Conduit.Undrgrnd. . 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9.•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 1 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.:Rough Factory FireplaceAPPROVALS Permit 21.'Ducts, in Structure ,; •. - . ' . 70. Underground Hydro J 22. Ducts, Ventilating .. ._ 71. Product Piping 0 Gas 0 Oil -, 23. Gas Pipe-Rough &'Test ' - „ 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing .3- 2 6444- _ 74. Overhead Hydro I 26..T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing . 76. Dry Standpipe - 28. Lathing& Siding „ - • 77.. FIXED SYSTEM FINAL 29. Insulatiop . • • '' _ 78. FIRE PREY. 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: 34. Final Heating& Air Conditioning ` _- - 35. fFinal Gas Pipe-Test i ' .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 . .i 45. Sound Attenuation .. ' 46. Handicap Regulations - . 47. FINAL STRUCTURE & BUILDING 4p'_7 I! 64„M_r 48. FINAL PLANNING - . • • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date NOW BUILL.NG AND SAFETY DIVISION FIRE DAMAGE INSPECTION REPORT / //�� (Required Prior To Permit Issuance) Address: 116 8k 00 //:, e Unit: C '1 dr- Owner: A,/ 'F /c f t Owner's Address (if different from above): �G6 .`� u{, i r �!i (c 4.. .. GO . j<., (A fd . - Ca. Street City State E Structural permit required. ® Repair or replace as necessary. ❑ Plans required. Comments: l' / 1/1r. i F Art- 71- ❑r Electrical permit required. Repair or replace as necessary. Comments: = r _ It ct r/rc . 04-f ❑ Plumbing permit required. ❑ Repair or replace as necessary. Comments: ❑ Mechanical permit required. ❑ Repair or replace as necessary. Comments: / 7C . 7-7 9/ 7P74-7-Y- J( / v Inspector i Date Phone 1672-46 Triplicate:Original-Owner;Yellow-Contrator; Pink-Building Division OWNER SAN VISTA BUILDING COMPANY DATE 6-1-64 JOB ADDRESS 116 Brookline Lane BUILDING PERMIT NO. 22169 GENERAL CONTRACTOR same VALUE $ 14,835.00 AP No. LOT 8 TRACT 5160 FIRE ZONE DESCRIPTION OF WORK res w/att gar INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R 3 Son SUBCONTRACTOR"ay ` PERMITS ISSUED Water /�-$' -� .5707a DATE NUMBER Rough Corn. frig.R Air Cond. 0 Rough Heating / �� ,� ®� , -�6-‘yl 3�l/ Rough Plumbing l % YH/�hi ni/-�!��/(/� /n-/-�o 3 3.3 �o �7 Miscellaneous / \ / Prop. Swr. Line❑ House Con. St. Swr. 0 s-," In s- /0-i,..0e- amirr.. IEC 9 issa 40607 Sprinkling System Construction Pole _ 'I Underground 0 Power S ii116y Rough Wiring /We ' .rriraMt_ . -27-4a 'rP..3aa.3 Trenches ❑ Forms 0 Steel Reinf. 0 / C g - t-�_ Floor System . S C Bond Beam 0 Steel Reinforce 0 Sheathing /�',de of 7:771-CF • Frame and Flashing // 9j e /1IVU Lathing — In,ft/Out ,a. 1/ e Plaster, brown coat (\ I Refrig. 0 Air Con. 0 Final !� 1\IIUV1c. Heating, Final ,` l[S' 1 UV L Plumbing Fixtures, Final /�S- Final Gas Test �s- G�lj � Electric Fixtures, Final /;_ //-S-G 4\ Building, Final )/•S-6y (— OCCUPANCY Form BU4-5M-3.63–S-B P HOLD FOR SPECIAL att IIREM1;Ni'S • 2216 FEE RECEIVED . ill COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 917 COSTA MESA,CALIFORNIA r(�''TTFINANCE DpEP t. 1 9 1 For Applicant to Fill In Completely APPLICATI& FCfKTPER)vBTA TYPE OR PRINT BUILDING BUILDING For Office Use Only ADDRESS 116 Brookline Lane RECEIPT NO. �J(Q ML]',f�O. COSTA MESA, CALIFORNIA ''//l1 r'.4-1'`j RECEI Y DATE RECEIVED DATE ISSUED OWNER San Vista Building Co. =/ _c/ JUN 1 1964 MAIL 1166 E. 58th Street ADo ESNSa ADDRESS FIRE TEL. ZONE TYPE 7 GROUP i.4--,\ CITY Los Angeles Ll, Calif NO. An 17787 , ARCHITECT TEL. APPROVED DATE OR ENGINEER Raymond Levanas NO. OR 37010 //'''��� ZONING \////////::::}}}11�yyyy��� ��.��`��`���n ADDRESS 3432 Via Ooort Qs Newport Beach Ion/Q-/� NO.OFE USE OF NE �L� tL/.� I FLANS I BUILDING.II CONTRACTOR San Vista Buildin- Co. Y� lII LEGAL ADDRESS 1166 E. 58th Street DESCRIPTION Tract) 5160�-J Lot 8 CITY Los Angeles 11, California A.P.No. ),UJ J / �� NOTE: NO EAVE OVERHANG SHALL BE LESS iAN LLIIIC.NO. 192782 N' AD 37187 90'TO SIDE a REAR P.L EAVES f SIZE I NO.OF BLDGB. ALLOWED (U.B.C.REQUIREMENT) OF LOT 20 41 ]Q NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING C EXISTING BLDG. None 1 T. - <FROM C/STo REET) / SETBACK LINE FROM 13' REAR YARD FRONT FFT. CENTER OF STREET �{) SIDE YARD I LEFT 0 I RIGHT 0 R.SIDE 0 PT. FT. �"� DESCRIPTION OF WORK L.SIDE Q FT. FT. C V NEW X ALTERATION ADDITION REAR FT. FT. Z DISTANCE BET. BET.MAIN a REPAIR MOVING //nnom� DEMOLISH MAIN BLDGS. ACCESS.BLDGS. // BUILDING/� NO.OF" � 3 C VAR.* t` (7 DATE �T {�j/� SIZE TOA k 3Z ROOMS S STORIES 2EXTERIOR C. P. ' / /' APPROVED ` / O COVERING COVERING Stucco I ROOF COVERING Shingle APBTS _• • - DATE ' .5- i/ 04 USE OF BUILDING AND WORK TO BE PERFORMED .) W7 Residence & - I t / J /3GQ.Fr. . yao e' N ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATS TN T H ABOVE IB CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. EO PLY WITH ALL CITY ROINANC88 ANO STATS LAWS REGULATING VALUATION q BUILDING CON U ON. PERMIT FEE : t, N c SIGNATURE OF //3.5--- , �J�J _ // D PERMITTEE it-C-� 6 /[J y.-J 4 — - :. C. .• a7 AUTHORIZfi AGE T // O J g� _ TOTAL FEE $