HomeMy WebLinkAbout142 BROOKLINE LN - Building Permits PROJECTADORESS: 142 BROOKLINE LN UNIL CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 069618
OWNERS NAME: SHERRILL ROBERTA J
ADDREss: 142 BROOKLINE LN PERMIT NO: B 069618 PLAN CHECK NO; N GOVT; N SUPP: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
ARCHIENGINEER: REGAL: JOB DESCRIPTION : T/O RESTH & REROOF W/COPM 6 HOT MOP SQ FT: 2, 508
ADDRESS: UNIT:
CLAIM VALUE: 2 , 508 . 00 CALC-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 *************************************************************.r**** ***TH********
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 etlect. SETBACKS
clTYLlC.: 059377STATELIC.: 402536 cuss: C 39 EXP: 10/95
Date:ibIal4U signature: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT : FT IN REAR; FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
Compensation lesuraxe2rtataditied copy thereof(Section 3880,Lab.0 5/1 9/9 5
POLICY NO.: JAIG O 0.7 EXP.DATE:
PARKING REQ: PROV: PARCEL : 41916354 ZNE; REF NO:
COMPANY: d�(( PLANNING NOTES>
El Certified copy is h rebynfurnished. LJ Certified copy is filed with the city Building Division. >
Date- I D' G1 Applicant: DEVELOPMENT SERVICES REQUIREMENTS
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is Ior one hundred(SIP or less).
I certify that in the performance al 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:It.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor - - _
Code.you must forthwith complywith such provisions or this permit shall be deemed revoked. p
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction fending agency for the performance of the work for APPLICATION ISSUED B Y : * DATE: /D c ? "/5L.
which this permit is issued(Section 3097,Civ.C). ************************* * **************************************** ***TF**
LENDER: ************************ ****************************************************
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I herebyaffirm that l 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 54 , 00 5 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 SM I P/NON-RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Cade)or that he/sne is exempt therefrom and the basis for the alleged exemption.Any violation of 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(55W).
I. as owner of the property 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————> 54 , 50 0 , 0 0 0 , 00 5 4 , 5 0 54 . 50 , 0 0
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.IL 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 purpose of sale).
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 , 00 , SO
❑ and Professions Code: The Contractors'State License Law does not amity to an owner of property who builds or improves thereon ******,***************,******,k*,****,*,****,*****************************************
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FE E BREAKDOWN
❑ I am exempt under Section: B.&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
I do hereby certily 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 certify that I have read this application and state that the above information is correct.I agree to comply with all qty and county
ordinances and state laws relating to building construction and he by authorize representatives of this city to enter upon the above-mentioned
Property lot inspect owes.
Date: 10/
Uly Signature: 01 00170726-00170727 TOT r.4-.?:Oniver's License or Social Security n: DATE: 10/28/94 TINE: 13:33
1641-46 White—Gooding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING PUOL & 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. 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, 0 Undrgrnd-, Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, ❑ 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. 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
20.1 Rough Factory Fireplace - - tAPPROVALS - t. Permit #
21. Ducts, in Structu}e. . - - - 70. Underground Hydro
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 14'5 l� 646/-- - 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 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• •
36. Hood or Canopy .i :
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 a_7...15-
48. FINAL PLANNING
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
vnnILIC SAN VISTA BUILDING COMPANY OAIC 10-4-67
JOB ADDRESS 142 Brookline Lane BUILDING PERMIT NO. 27647
GENERAL CONTRACTOR Same DESCRIPTION of WORK Residence W/Att. Garage
AP No. LOT 75 TRACT 160 FIRE ZONE VALUE $ 18,114.00
INSPECTIONS Signature Date GROUP I & J TYPE ZONE R-3
SOIL 4.9.4-s- '— '"" SUBCONTRACTOR I PERMITS ISSOED
GAS Date Number j Signatu._
WATER('4 Aic_n_e7 A, lumbing�)A' �4/
ROUGH PcUMBING y1 � /Y 21 LASLISIFU.eLtw,1,4., /0-i5---6/7 ,O 7„2!x/ .sGTt
PROP. SWR. LINE❑ HOUSE CON. LLY 44/-5" l• -6-6-) (((///
• SPRINKLING SYSTEM
MISCELLANEOUS '^ '
ROUGH HEATING AND AIR CONDITIONING ,�/ydS I ,' -67
TEMPORARY SERVICE OR POLE I_ -
UNDERGROUND O POWER 0
ROUGH WIRING � 4c._ / Heatin and VentTRENCHES Q/FORMS ❑ STEEL REINF. • ,( ey.4,-,, 'A'/�/,, i/,eG7 �y//FLOOR SYSTEM )cL e iili f G / ,
BOND BEAM n STEEL REINFORCE n
SHEATHING C '1 7
FRAME AND FLASHING____ +[_
LATHING — IN OUT Mr C. ( /c/ 7
PLASTER, BROWN COAT / C6
STRUCTURAL,ING, FINAL //�, F // ( 2X�
HEATING, VENT., REFRIG. AND A.C., FINAL44 -6 �( / I;I-47T /
PLUMBING. FINAL AND GAS TEST n ,S' ./ � S {
ELECTRIC, FINAL C. ..of Ilf I{tl
BUILDING. FINAL it 77 C q (,
27647
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1290 COSTA MESA, CALIFORNIA 92620
For Applicant to Fill In Completely
TYPE OR PRINT
m COSTA MESA, CALIFORNIA Y
PflIl1 '._,:ply C
act—u-6iC1;,,00 121.• .. ::...
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
mme— NO. PI
® DESCRIPTION OF WORK 0
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PLY WITH ALL CITY DINANCAS AND RATS LAWS RZOUNTNS
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