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HomeMy WebLinkAbout335 BOWLING GREEN DR - Building PermitsJob Address: 335 BOWLING GREEN DR SWte No Vicinity: Parcel Nunmber: 14138303 npplicant: LITTLEFIELD, SCOTT Address: 24707 SAN FERNANDO RD - � " - �. . - , - .. ' � � . .-� ,,i.�-"- �- . : �J,, � . Phone: 888-611-4328 - -- SANTA CLARITA, CA� �_ - , � �� � � Zip: 91321 � . owner: MORITZ, LEE GENE TR - -.� Address s 335BOWLINGGREENDR':�- _'-�,.- - --. � �� , „ , � � � - � . . Pfione: - .. �,; �, COSTA MESA; CA,,--;���-�.-� Zip: 92626-6106 ^� i ' �' Cantractor: AFFORDABLE WATER HEATERS AND PLUMBING � Addressi 24707 SAN�FERNANDO RD � " � . . � Phone: f�661-259-7131 SANTACLARITA,CA � 2ip: 91321 � . , . - � . '�License: � 627368 " � � - - " SCOPE OF PERMIT WATER HEATER CHANGE OUT Status: ISSUED Applied: 03/13/2007 Issued: 03/13/2007 �/ � /1 ISSUED BY: .�� � �-%�� � �� �� � ; . � - � ,. � , � � �. , FEE SUMMARY � , AMT �,� . �:• -� . �. . _ . . _ �.'AMT � �,� -. � AMT QTY ISSUEFEE $23.50 LaundryTub/.Washer'_ _,��$0.00.',�"0._ _„' �SumpPump , � i $0.00 �0 BackFlow irrigation $0.00 0 � Landscape Irrigation - � $0.00 0 � - - Swimming Pool � .'. $0.00 0 BackOow Preventer $0.00 0� P-Trep $0.00 0� � Trap Primer � . $0.00 �0� Bathtub $0.00 0 Pressure Regulator $0;00 ,0 _ Urinal f_, r $0.00 0 Clarifier Syslem $0.00 0 � � �� . Process�Piping-(per,10 ft) �� ,$0.00 � :��0 � ;' �-� Vacuum Brkr Bkflow(1-4) ;_ �$0.00 "0 Conned pce,Soda,etc) $0.00 0 �- - ----Receptors = _ - - � � $0.00 i �0� � -- � `, Vacuum Brkr Bkflow(5+) � _ $0.00 � ; � 0 DentalUnits $0.00 0 � �� � SepticTank ��' � � --$0.00 - 0' - � ---'� WashBasin ",� ' $0.00, �� 0 Dishwasher � $0.00 0 SewerCapforDemo $0.00 � 0 � WashBasinSef%;' - ���$0.00��� �0 Drein, Floor $0.00 0 Sewer Connect �$0.00, - 0 � Waste and Vent §ystem � $0.00 0 Drain, Rainwater . $0.00 0� Sewer Private Line .` $0.00 �.' 0 Water Closet (Toileq $0.00 ' 0 Drain,Roof $0.00 0 Shower $0.00 0 WaterHeater/vent., �$12.30. 1 DrinkingFountain ,' $0.00 0 Sink, bar . . $0.00 0 Water Piping (Inst or Rep.) -$0.00� 0 Expansion Tank $0.00 0 Sink, commercial � ���: $0.00 0 Water Re-pipe . -� $0:00 0 GasEaAhquakeValve $0.00 0 Sink,�Floor � � ` � �•$0.00,.- 0 WaterService � : $0.00 0 Gas (1-0 outlets) $0.00 � 0 . Sink;�kitchen $0.00 �,,�;0. _,. �.. _ Watei $oftener . ,-� , $0.00 0 Gas(Over4outlets) $0.00 ' �0 �-"�:.� 'Sink,service/mop �� � �$0.00� -� 0 �; ��'�:ti��: OTHER� � _ ,� $0.00 Gas Repipe 50.00 . 0 Spa (private)�. � . � $0.00 0 ' VIOLATION, , �- � �$0.00 Gas Service � � `. � $0.00 ' 0 Spa (putilic),' � '/ $0.00 = 0 - °PL�AN.CHECK . - f $0.00 Interceptors (Grease, Oilj � $0.00 0 � _ '- � � _ � ' " � '�'�REINSPECTION ; ��� % $0.00 0 Interceptors (Sand Auto ) $0.00 � �0� , . . � - • ' � .� �� � - � � % � . - � `�, . � - � TOTAL-CAL�CULATED�FEES: $35.80 - , , _, - - . _. .� . - _� � ,, � COMMENTS / SPECIAL,CONDI'f'IONS _ , � . � � � . . „ ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 9248, § 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 tor a period of 780 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 Inspectlona and final epproval must be obtained. Failure to obtain inspections and (inal approval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (774) 7545626 xaasas �wool WORKERS'COMPENSAnON DECLARAnON: - ' I hereby aHirm untler penalry of perjury one of the tollowing declarations: . ❑ I heve end will meintain e certificate of consent ta setl-Insure for workers' compensetlon, es Drovitled for by section 3700 af Ihe Lebor Code, tor the performence ot the work tor which this permit is issuetl. � I have ena will meimain workere' compensation insu�ance, as required by sec[ion 3700 of the Lebor Code, for t�e pertortnance of Ihe work for which ihis pertnit Is issuetl. �--�My workers' compenselian I surance cerrier and policy number are: � /�� rf � "C e ��G ���''�"� Policy.Number. � b�6 Q!� - '(lhis section need not be comp/eted i( fhe pemrit is velued ef one hundred dollers ($100) or less.) -:_ �1 ❑ I certity that in the pertormence of the work for which Ihis pertnil is issued, 1 shall not employ any person In any manner so as to become subject to ihe workers' compensation lews of Califomia, en0 agree that Ii I should become subject to Ihe workers' compensetion provisions of Section 3700 of the Laboi Code, I shall fotlhwith comply with these pravisiens. ) Applicant SigneW�re: /� �.�'-� � r--Date: �� I 3� 0�% i � - -" �-+ WARNINO: FAILURE TO SEC E WORKERS' CAMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUBIECr.AN EMPLOYER TO CRIMINAL PENALTIES ANO CIVIL FINES UP TO ONE HUNDRED :TNOUSANO DOLLARE ($100,000), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIpJ 37060F THE LABOR CODE, IMEREST, ANO ATTOFNEV'S FEES. LICENSED CONTRACTORS DECLARATON: I hereby aHirm Ihat I em licensed under provisions of Chapter 9(commenr.ing with Section 7000) of Division 3 of.ihe Business and Professions Cotle, and my license is In tull torce and eNecL'Cic. # CClass a � 3 6 ComrectorsSignaWre: i�JZT/' Date: 3—�T-07 `/ Y ♦ CONSTHUCTION LENDING AGENCY: -�-J ❑� I hereby aHirtn that there is a consiruction lending a9ency tor Ihe Dertormance of ihe work tor which ihis permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: Signalure: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm Ihat untler penelty of per�ury that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professions Code: Any city or counry which requires e permit to construct, elter, improve, demolish, or repair any siructure, prior to its issuance, also requires ihe applicant tor such pertnit to file e signed statement that ha or she is licensed purouant to ihe provisions of the Contractors License Ww (Chepter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that ha or she is e:empt iherefiom and ihe basis for the allegatl exemption. Any violetion of Section 7031.5 by any epplicant for e pertnit subjects the applicanl to a civil penalry ot not more ihen five hundred tlollars ($500).): � ❑ I, as owner oi Ihe properry, or my employees with wages es iheir sole compensation, WILL DO THE WORK, and Ihe structure is not intended or ottered ior sale (Sec. 7044, Business and Protessions Code: The Contractors Licanse Law does not apply to an owne� ot property who builtls or improves ihereon, and who does such work himsetl or herself or Ihrough his or her own employees, provitletl ihat such improvements ere not intendetl or oHered for sale. If, however, the building or Improvement is sold within ona year of completioq the owner-builder will have the burden of proving ihat he or she did not build or improve for purpose of sale.). • ❑ I, as owner of t�e propeny, am E%CWSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions Code: The comrectors Llcense Lew tloes not apply to en owner of propeny who builds or Improves ihereon, end who contrects for such pmject with a comractor(s) license pursuant to tha Contractors License Laws.). ❑ I em ezempt under sec. Business antl Protessions Code tor ihis reason: SignaWre: Date: Owner ID verified by drivers licanse. ❑ Ves 0 No Dnvefs License No. Venfication of Ownership by (rype of tlocument, i.e. - property tax 6ill or tleed): DIVISION OF INDUS7FIAL SAFETV PERMITCERTIFICATION: Expiras: ❑ I hereby certify that no excavation five (5) or more feet in tlep�h into which a person is required to tlescentl, will be made in connection with work euthonzed by this permit, and tha� no builtling simcNre, scaflolding, falsework, or tlemolition or dismantling thereof, will be more ihen ihirry-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tule B, Califomia Atlministrativa Cotle). ❑ As ownervhuilder, I will not employ anyone to do work which would reQuire a pertnit from the Division of Intlusiriel Sefery, es noted above, unless such person has e permi� lo do suCh work trom the diNsion. � Signelure: Date: Division of Intlusirial Safery Pertnit Number: CERTFICATE OF COMPLIANCE AND AIJfHORIZA710N OF ENiRY: I certity under penalty of perjury that I heve read this application and state that ihe iniormation qiven is correct I agree to wmply with all s�ate laws end city ordinences relating to building cons�ruction, and authorize representaiives oi ihe City at Costa Mesa to enter upon ihe above-described property for inspection purposes. I egree not to occupy or allow occupancy of eny building authonzed by this permit until (nal inspection. Signature Of Legal O ner(s) Date ---.... cc�s-� 3—� 3 -o �—, And/OrAuth 'Applicant ^ — ` Date CODE t. INSPECTIONTYPE , 7616 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Final R8-R0o1 201 Finel Block/Retaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolilian �j� IN CODE� INSPELTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Finel Fire Prevention 220 Final Planning Approval 222 250 Final Site Final BuiltlincyOccupancy uerF uuma�i -3�07 � PflOJEC1P00flESS: 33J EOWLING GREEN DR OWi�EH�NAME: MORITZ LEE G ; Aoos[ss: 335 BOiJLING GREEN DR t COSTA MESA,CA °2626 PFCHIENGINEEB: AUOFESS: FlEG.NO.: UNIT: UNIT: PEflMITTEE: LEE ROOFING (714)642-7223 nooxEss: 1653 SUPERIOR COSTA MESA CA 92627 LICENSEU CONTNpCTOq DECLABATION: I hereby affirm Iha� I am licensetl untler provisions of Chapter 9(cammencing with Section 70001 of Orvision 3 0� ihe Business and Professions Code. antl my license is in �ull lorce and eftect. a 0287 1 sTpTEuc.:3496RF u�s 39 ate. a�y`"J� Signature:� WO flS' GOMP SATIUN OECLABATION: I hereby a�firm �ha� IA ve a cetlifica�e oi consent to selGinsure or a ceRificaie o� Workers' pensation Insurance, or a cer�ifieA copy ihereo� (Sec�ion 3806, Lab. C�. �Poucrxo.: 1300948-99 E%P.OATE: 06�3OI9S COMPANY: STATE FUND ❑ Certdied coDY is hereby fumishe0. � Ce�ilied copy is tiletl wii(h'�the ciry Builtling Division. ��ate NpDlicanL �F "L d[f4 A iL3 E PTION HOM1 WOBNEBS'LOMPENSATIONOECIAflRTION: Qhi55ec1ionneeAno� ecompl il�hepermilis�aronehuntlretl�5100�orless). cetlity ihat in Ihe pedormance af �he work for w�ic� Ihis Oermii is issuetl, I 5hail no� em0loy any person in any manner 5o a5 io become subleq to Ne VJorkers' Compensalion Laws ol Calibmia. �aie: SignaWre'. NOTICE: If, al�er making �his tleclaration, you shoultl become subled m the Workers' Compensa�ion pmvisions o� the Labar COde. you mus� forthwith tompty with Such pmvisions ar t�is permii 5hall 6e deeme0 revoked. CON5T8UCTION LENOING AGENCY: I hereby allirm ihat there is a canstmction lentling agency for the Oedarmance af t�e work tor which ihis Dermit is i=sue0 �Seciion 3U97, Civ. C). LENOEP: nooness: m PERMIT Nc�: B CITY OF COSTA MESA — BUILDIDIG FERWIT 067986 PLAN CHECK NO: N PERM NO; B D67486 GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : T/OFF AOCK ROOF & REROOF W/COMP. SQ FT: 5,000 CLAIM VALUE: 5,060,00 CALC—VALUE; 5,000.00 GP.OUP OCC: R-3 / COb]MENTS: SMOKE DETECTOR REQUIRED PRIOR TO A FINAL **+��r�**+�*�x��*****���t*;�****��c+�*+�*****�*********+t���****�x�**�+�*u**x***�:+�**<*+�**� 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 BUILDIP7G --------- FRNT; FT IN REAP.: FT IN FRNT: FT IPJ P,EAR: FT IN LEFT: FT IN RC.HT; FT ZN LEFT: FT IN RGHT; FT IN PARKING REQ: PROL': PARCEL: 14138303 ZNE: REF NO: PLANNING NOTES> .> . iE fE 1f iE # iE?' if if # if ihlt-i� * 1F?E i: if �k if it iF+f ?F iE !E if iE jE 3E if !E i(-�lE if if iE it if iF iE±F �lE K iF 14 3E �f �IE it if i(� iE iE iE #'- iE if il-iE iF iF iE fi� 1t ic if ticl� iE iE iE ar-±E �IF #-�1E iE D E C' E. L O P M E N T S E R V I C E S R E Q U I R E P5 E N T S ZONING APPROVEP BY __:,__�r e_s�T_EC�TUK DATE: BUILDIA7G APPROC'ED BY ; J���`""' �_ r��_� DATE: �//�/ _� APPLICATION ISSUED HY: DATE: b/ Z/ t� �)f'if 1k if')E iE iE iE iE'lE iF iE if iE if iE * iE 1f')E iE 1h�iFSF ��' E t'' C 'F i4 iF af if ?E 1F'� if 1E?f�i`e/rF�e ic �iZi('-1F � iE iE 9K iE iE i' 1F iE if 1E iE if if iE jf iE 1F �f iE iE af fR iE �E iE iF iF iE M 9f 9f if �lE 9E iE iE iF if iF aE iF if af aF'T.1F>E � 9E iE if if if iE � if iE x i: iE iE if iE iE iP jf -1E 3E j� * �f iP � iE � 14 iP 3!- LEGALIZATION:N F E E S 0 M M A R Y STP.IICTUP.AL SEGMENT:Y OWNEflBUIlOEflOECLFHATION: Ihere6yafiirmlhallamexempl�romtheConiracbrs'SIa�eLicenseLaw�orthe�ollowingreason BLDG PMT FLUMHING ELECTP.IC MECHAh1ZC FIRE $MIP/FZES CiP.ADING (Sec�ion 7031.5 Business antl Pwfessional Cotle: Any ciry o� county whic� reqwres a Dermi� to cons�mct, al�er, improve. tlemolish, or p ERM I T % z, � Q , 5 Q repair any slmciure. Drior Io i�s issuance. also requires �he applicani for such permil to �ile a signetl s�a�emeni �ha� he/she is Iicen5e0 SM I P/ NON—RES pursuant to Ihe pmvisions a� the Comracmrs' Sia�e License Law (C�apter 9(commencinA wi�� $ection 70W) of Oivision 3 of Ihe Business and Pmfessians Code) or thal he/sne is exempl Iherelrom an0 Ihe basis for �he allegetl exemp�ion. Any viola�ion of Sec�ion 7031.5 by P LAN any applican� lor a permi� su61ec�5 ��e applican� Io a civil penalry of not more than �ive hundred dollars (5500). j$$[JE FEE i. as owner o� ine ompeny or my empioyees wiih wages as tneir saie compensation, will ao me work, antl me BUILLIING—DIL�—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ stmcture is nol intendee or oaere0 far sale Isecuon 70aa, Business an0 Pmfessionat Cotle: The Comracmrs State License Law TOTAL S----> 7 2, 5 0 0. 0 0 Q, 0 Q 7 2, 5 0 % 2. S � . 0 0 does no� apply �o an owner o� a pmpeny who builds or improves Ihereon, and who tloes such work himself/hersel� or ihmugh his or her own employees. pmvitletl that such impmvements are not intentled or ofiered for sale. Ii, however the building or improvement is soltl within one year o� compleiion, �he owner will have �he burden ot proving he/she tlid not builtl or impmve REV ENUE D IL,TIS ION TOTAL$--> COLLECTED : 7 2. 50 O�'ER: SHORT : , � � mrineourPoseorsaieJ. BLL�G PMT PLUMBING ELECTRIC MECHANIC FIRE SMIF/TOT GRADING PLAN—CHECK I, as owner ol Ihe pmperiy. am ¢xclusively conirac�ing wiih Iicense0 contrac�ars lo constmct the pmlect (Section 704A, Business 7�. � � , 5 � ❑ antl Pmlessi0n5 Code: T�e COnVati0r5' S�aie License Law Ooes no� apply �o an owner ol property w�o bwlds nr impmves the�ean antlwAocomradsforsuchprolectswiNacomracmr(s)Iicensepursuan�toNeContrac�ori $�diELILCtISELdW),Idrt12Wd!¢ *j(�*{fi(�filfih?I�iF1EiEiffFik')E�itiE��7kiF#'�jFiE#jfli�lfiEiflEi(�1Fi1��1FiE'f.N-ififiE�f!fiL;ejF1f�1E�)F1f!(�i(�iEjf{E'k{E{Fi(�iEiEjL*jfiFt#jFiE{Fy�jl�i�-*}j(-** mat prooi o� meir Worker's Compensaoon msurance should be pmvitle0 �o me. j N D I V I D U A L F E E B R E A K U O W N � I am exempt untler Section: 8. 8 P. C. mr mis reasore T Y P E Da�e: Ownec $ FR I Uo hereby cenify that I am aware oi antl untlerstand ihe requiremenis of California Healt� and Safery CoOe Sections 25505, 25533, and 2553< antl t�at I or any fuWre Duiltling accupanl will/will no� (circle ane) neea ta comply wi�h said sta�e cotles antl ihe requi�emen�s �or a permit torconslruction or motlifica�ion hom the Air �uality Managemenl �i5inc�. flesitlential con5[mciion aOD�ication5 are exem0� «om Ih¢5¢ provisi0n5. Oa�e: NpplicanC I �ere�y cerlilylhat I have reatl Ihis applica�ian antl s�aie Ihai Ihe above in�ormalion is correcL I agree�o comply wi�h all ci�y and coun�y ortlinances antl s�ate laws relaiing �o builtling conslmction antl hereby authorize repres �ives o� �his ciry ro en�er upon �he ahove-men�ioned p� for inspection pu�pases. _ � / �ver's l�ense�6r Sociai Secmity p: — �6ai�a5 Wnne—Bulitling, Green—Cotle Enlorcement: Pmk—Revenue', Galtlenmtl—Assessor QTY SQ00 P E S C R I P T I O N REROOF BY VALUE RESIDENTIAL N020N£ END OF FEES UNIT Ct�ST TOTAL COST 1.00 5,000.00 �1 001;1803-00]6lE04 T�] T 72.;4 DATE: DS/07/94 TICiE: D4:12 1 - . � PC,.. � & SPA C�NSTRUCTION AND PLANNING - �� r'LPPROVALS Permit#'r � Oate tnspecior pppROVALS Permit # Date Inspector . � 7. Temporary Electrical Service or Pote 52. Pool & Equ:pment Location 2. $pii Pipe�Undrgmd. 53. Steei Reiniorcement � ; 3. Electrical Conduit U[ility-Undrgrnd. � 54. Forms 4. Electrical Condu(t�Undrg:nd. 55. Eiectrica( Bonding � 5. Steei Reinforcement 56. Hough Ptum6ing & Pressure l"est 6. E�ectrical UFER Grnd. 57. APPflOVAL TO COVcR-GUNITE 7. Footings 58. Electricai Ccnciuit�Undrgrnd. ' � 8. Foundacion ' 59. Gas Pipe, C Undrgrnd., Tese � 9. Water Pipe-Undrgrnd. 60. Eackwash Lir.es, PTrap, C1 Ur,drgmd. 70. Structural Floor System ,, 61. APPROVAL TO DECK � 1 �. PrOPerty Sewer Line & House Connection , ` 62. Backwash & ReceptorFinal 12. Sewer Cap � .,< � 63. Heater & Vent�Final 13. Roof Dreins - 64. Plumbi�g System - Finai ' 74. Rough Plumbin9 � 65. Electrica6Fir,al 15. Rough Eiectrical-Condu;t 66. Soiar System-Final 16. Rough Electric Wiring 67. Fencin9 & Rccess AnVrovai 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Cei�ing 69. POOL/SPA SYS7EP,15 FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, NEQUIREMENT 20. Rou9h Factory Fireplace APPROVALS Permit � 27. Duc.s, in Structure 70. Under9round Hydro 22. Ducts, Ventilating 71. Pcaduct Pipiag C7Gaz �011 23. Gas Plpe�ftough & Test 72. Underground Fiush 24. Roof Framing 73. Undergrnd. Stora9e 7ank � Gas � Oil 25. floQz Sheathing („J�y�f1� �,C 74. Overhead F?vdro 7 /�" 26. 7-Bar Ceiling IStructuralY & Monocoat 75. Dry Chemical ' 27. Frame and Flashing 76. Dry Standp;oe 28. Lathing & Siding 77. FIXED SYSTEM FI�VAL ' 29. InSulation 78. FIRE PREV. FINAL �� 30. Drysvall Nailing HEALTH DEPT. REQUIREMENT � �- -31. Plaster Brown Coat .- �9. PINAL INSPECTION � 31 2. Elactrical Po�ro�zr MeterPinal (f � 80. FOOD CERiIF�CATc iSSUED 33. Fina� Electric • '� `A•= -, Notes: 34. Fir+a! Heating & Air Conditioning � !'• 35. Final Gas PiDe-Test (-f _.f 36. Hood or CanopY �, 37. Final Factory �ireplace .� ' �-�� ---- -�--- 38. Final Plumbing � ' r` 39. Water Service-Pinat ��-` ` 40. Gas Service-Final 41. Soiar pomestirFinal 42, BaCkflow Preventer � 43. Backflow Irrigation . 44. �andscape Irriqation System � � 45. Sound Attenuation 46. HandicapRegulations - �- 47. FINAL STRUC7URE & BUILDING �.LjC,c �� � 48. FINAL PLANNING , � 49. Electric Release to Edison � 50. Gas Retease to Southern Catitornia Gas Cn ' 51�. CERTIFICATE OF QCCUPANCY No. Date PflOJECTFU�flESS: 33S BOWLING GREEN DR OWNEfl'SNRME: MORITZ LEE G aooRess: 335 HO{M1TLING GREEN DR COSTA MESA,CA 92626 AHCHIENGINEEH: pooness: flEG.NO.: UNIT: uxir: PEflMITTEE: NOCK PLUMHING (719)t�95-1246 nooxess: 11510 SEAHOARD CIR - STANTON CA 90680 LICENSEO CONTpACTOB OECLABA710N: I herehy a�firm that I am licensetl under pmvisions ot ChaD�er 9(commencing wi�h Sec[ion ]000� ul �iv��sian 3 0l Ine Business an0 Pmlessions Cutle, and my license is in WII �arce antl eliect. ciTvuc.: 05038 srnreuc.:511971 ciass: C-36�EX�2/95 IDaie: � � SignaNre � WOHREflS' COMPENSpTION OECLAPATION: I here6y aifirm Ihat I have a cenitica�e of consen� �o sel4insure or a cehificate oi Workers' I' Compensation Insurance or a cerafietl copy ihereof (Section 3800, Lab C. �voucveo.: 116"7992-94 EXP.011TE: �3/OlI9S comraxv: STATE ❑ Certifietl co y is hereby lumished. Q Cetlified copy is hle �he ci�y Buil � Division. oate'. � � L Applicant: ��y � E%EMPTION FHOM WOPREflS' COMPENSFTION DECLABATION: Qhis sec�ion neetl noI be cample�ea if the permit is �or one hundrea (51W) or less�. I cetlify NaI in �he pedormance ai �he work for which ihis permit is issued, I shall no� employ any person in any manner so as to become sublec� lo ihe Workers' Compensation Laws ot Cali�omia. Oate: Signa�ure: � NOTICE: II, ailer making this tleclara�ion, you shaultl 6ecome sublect �o Ihe Wo�ke�s' Compensation provisions of �he Labor COUe. you mus� �onhwith comply with such pmvision5 or Ihis Dermii shall be Oeemetl revoked. CONSTflUCTION LENUING NGENCY: I hereby a�hrm tha� there is a constmction lentling agency for the peAormance oi the work tor which �his permil is issuetl (Section 3097. Civ. C). LENOEfl: FDOPESS: OWNEF BUILOEN DECLABpTION: I hereby affirm ihat I am exempt irom the Contractors' Sta[e License Law for ihe following reason (Section 703L5 Business antl Pmiessional Cotle: Any ciry of coun�y which requires a permit lo cons�mct, alter, improve, tlemolish, or repair any 5imciure. prior to its issuance. alsa repuires ihe applicant �or such permit �o tile a signed s�a�emen� Ihat helshe is licensed pursuam �o Ihe pmvisions of Ihe CONractors' S�a�e License Law (ChaD�er 9(commencing with Section 7000) of �ivision 3 0� Ihe Business antl Pmlession5 Cotle) or Ihal he/she is exemp� therefmm antl the �asis for �he alleged exemption. Any violation o� Seciion 7031.5 by any applican� �or a permit sublects �he applican� �o a civil penalry o� no� more Ihan five huntl�e0 tlolla�s ($500). I, as owner ol Ihe propetly or my employees wiih wages as �heir sole compensa�ion, will tlo ihe work, antl the ❑ simctureis notinlentletl orofieretl forsale(Section 7044, Busmess and PmfessianalCode: The Coniractors' State License Law Ooes not apply to an owner of a pmpeny who butltls or improves ihereon, antl who tloes such work himseli/hersel( or thmugh his or her own employees, pmvided Ihat such impmvements are not inten0ed or offeretl for sale. If, however ihe builaing or impmvemeni is sald wi�hin one year of wmpletion, �he owner will have �he 6urtlen of pwving he/s�e tlid no� build or impmve �or Ihe purpase a� sale�. I, as owner of �he pwpetly, am excWsivery cantrac�ing wi�h licensed conVac�or5 io cons�mc� Ihe pmlect (Sec�ian 7044. Business ❑ and Pmtessions CoOe. The Conirac�ors' State License Law tloes not apply m an owner of pmperty who huilds or improves �hereon and who coNracts for such pmlecls wi�h a controcioqs) license pursuant ta �he ConVactors' S�ate License Law�. I am aware ��al pma� of Iheir Worker's Compensa�ion insurance shoul0 be provide0 m me. � I am exempt unUer Section'. B. 8 P. C. for this reason: Oaie: Owner: I do hereby cerlify Iha� I am aware of antl untlerstantl �he reduirements of Cali�omia Heal�h an0 Safe�y Code Sections 25505, 25533, antl 25534 antl thai I or any WNre building occupant willlwlll nol (circle one) need to comply wlth saltl sta�e codes and �he requirements for a permit lor cons�mc�ion or motlihcation �mm the Air �ualiry Managemen� DiS��icL Re5i0en�ial construc[ion applica�ions are exemp� twm thESC O�Ovi5i0�5. Dale'. ApPlicant. I here0y cer�ify �hai I have read Ihis applica�ion antl s�ate tha� ihe a�ave information is correcL I agree lo compty with all ciry antl counry ortlinances antl stale laws relating Ia builtling cons�mction antl her Ihoriie representatives of this ciry ro enter upon the above-men�ionetl property �or'mspet�Ion purp es. / �ate: SignaNre'. _. � Driver's �icense or Soaal Securny a: 164L46 W11ile-6utltlingl Gr¢¢n—COtl¢ En�orcemen�; Canary—Applican�; Pink—RevBnuB; GOItlBnrOtl—ASSBSSor CITY OF COSTA MESA — HUILDING PERMIT PERM NO; P 069870 PERMIT NO: P 068870 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION : DISHWASHER REPAIR—C/O SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WpRK AUTHORIZED BY THIS PERMIT *x*+��*****�***********�r***********�****+�**********�r+�*�*��**�c**�c �c�r*�******+�***** Z O N I N G A E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- 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: PROt�: PARCEL: 14138303 ZNE: REF NO; PLANNING NOTES> ) �iE �E 3F iE �IE �E 1h iE iE �E )f 1E jElF if fElf if if 1f 1E iE �)E iE i! iE 1f i! iE iF # iE iE iF iE iE 1E iF iE iF if if if� if if ih 9ElE N- iF fE iF �lE �f �lE iF iE iF 1E 1E 1E iF if �1F 9F �F dF 3E if iE �lE jE iE iE iE iE iF �IE iE 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� ZONING APPROVEP BY �' DATE; BUILDING APPROVED HY ; �r'I DATE; APPLICATION ISSUED HY; - . � `"� DATE: � !FlE�1EiF9EfEjEfEiElfil�fEiFiF1FiE1EiEiEiEiE�1E F!E E.1E �- -i i E1E E F�k3k! F3E t E iE i�if9fifiE E!E !E!Elf7ElEfFiEiE3E9t iE �� 3EiF lfjEiE1ElEiEjElEiElEiE9E9F�IEjFiEiFiEiff6lfiEiEjfiEiEifiE E�lflEiE9FiEiPiFiFlEdEififiE9EiEjEiE#iEifdEiE�1lifjfifiElfitiFlEiF*iElEifjEifN-ifiE�eifib',�lE�flEiFlF LEGALIZATZON:N F E E ;S U M M A R Y STRUCTURAL SEGMENT;N HLDG PMT PLUMHI � ELECTRIC MECHANIC FIRE SMIF/RES GRADING PERMIT 7,00 _. 25� SMIP/NON—RES PLAN ' ISSUE FEE 20.00 — BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 7,00 20.00 0,00 27,00 27,Q0 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 27,00 /OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 5MIP/TOT GRADING PLAN—CHECK 2 % , 0 � iE'�E iE iE iF iE iE iE iE jF iE iF iE it'lE iE if iF iE iE iE it iE if �A if iE iE if iE iE iE iF ie� iE �lE iP.iF iElE i4 iE iE it iE iE iF k iE iE iE iF iE it iE it iE if iE iE iE iF iE iE �lY iE it �1! i4 if it if� iE iE if it i(� if iE I N D I V I D U A L ,F E E B R E A K D O W N TYPE QTY PLU 1 D E S C R I P T I O N DISHWASHER END.riOF FEES �/� UNIT COST TOTAL COST 7.00 7,00 V D1 �JO?67?35-1�01677sS T C17 27.OQ DA.TE: 09/la/94 TINE: t0.'0:, CONSTRUCTION AND PLANNING r_..L & SPA • qPPROVALS Permit # Date Inspector APPROVAIS Permit # Date Inspecror ' L Temporary Electrical Service or Pole - 52. Pool & Equipment Location � 2. Soil Pipe�Undrgrnd. 53. Steel fleinforcement 3. Electrical Conduit Utility�Undrgrnd. � 54. Forms 4. Elearical Condurt-Undrgmel. � 55. Electrical Bonding 5. S�ee! Reinforcemen[ 56. Rout�h Pium�ing & Nressure Test , � 6. �iectr�tai UFER Grnd. 57. APPROVFlL TO COVER�GUNIT[ ' 7. Footings 58. Electricai Conduit•Undrgrnd. � � 8. .Foundation ' 59. Gas Pipe, O Undre�md., Test � � li . 9. Niater PIpe�Undrgmd. � 60. Backwash Lines, P�Trap, C Undryrnd. 10. Struct�ral Floor SYsiem 61. APPROVAL TO DECK i t. Property Sewer Line & House Connection , 62. Backwash & Receptor�Final �� 72. Sewer Cap _ 63. Heater & VencFinal I 73. Roof Drains � 64. Piumbing System - final � t4. Ro�gh Plumbinq 65. Electrica6Final I 15. Rough Electrical-Conduit � 66. Solar SYstem-Final 16. Rough Electric Wiring 67. Fencin9 & Access Approval tl. Rough Wiring Siyn � 88. APPROVED FOR QLASTER4NG 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Roogh Neating & Air Conditioning PIRE DEPT, HEQUIREMENT t 20. ftough Factory Fireplace � � � ��; � APPROVAIS � Permit # 21. Ducts, in Structure � � • 70. Under9round Hydro 22. Ducts, Ventilating � 71. Product Piping O Gas D Oil 23. Gas Pipe�Rough & Tesi - 72. Underground Flush � 24, Roof Framing _ � � 73. Underyrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing . , . 74, Overhead Hydro 26. T�Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical � 27. Frame and Flashing - � . 76. Dry Standpipe I 28. Lathing & Siding . . � . � - 77. FIXED SYSTEM FINAL � � 78. �FIRE PflEV. PINA� � 29. I��sulation � 30. D�Y�vall Nailing � �-,-. � HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power MeterFinal .� 80. FOOD CERTIFICATE ISSUED 33. Finai Elec:ric � Notes: 34. Final Heating & Air Conditioning • µ�.- � lD^li��°1.1. �i.x Z 35. F�nal Gas Pipe•Test � � � i 36. Hood or Canopv ' � ' � • � 37. Final Factory Pireplace � - 38. final Plumbing 0 � 39, Water Service�Final . 40. Gas Szrvice-Final . ' . - 41. Sofar pomestic-Final j 42. Backflow Preventer , 43. B3ckflow Irrigation 44. Landscape Irripation System � 45. SOund Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDWG , , 4$. PINAL PLANNING �� , - 49: Electric Release to Edison � .-- 50. Gas Release to Sou2hem Califomia Gas Cn - 5L CERTIFICATE OF OCCUPANCY No. Date � �� � 0 COSTA �MESA BUILDING DEPARTMENT P. 0. 80X 317 COSTA MESA CA�IFORNIA C•L. OF STREET " ��PROP. r 10 FT. FOR 60 FT. S � � � � � � �w � I � r- N I � I o. � �--: � m ��z ` U IN� F T. IW � oJ,. lo �a � _1iPROP. LI C.L. OF STRE i i LLEY QR NE =ET �[I2 FT. 61 �SOFT. S , 5 P OP, LINE\ nl r /' F � C, .ii au•� F- " �✓jUo � a V s m t�. "!_ � O .; , � m ¢�` ^� `- '4 _ U � � 3 U � a � � m I I � � � I � � -a-------� � � w w � f y � O J ti FT 60 FTj S MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------� MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES n � W � f-¢- � 0 U � 0 r f- U � � 5831 �� � FOR APPLICANT TO FII.L IN BUILDING' A/DDRESS ��3S �e[�/Iiti<•'- CRdEii/ Ri l/� Owner /7 •. 5� � ,���-� Maii Address ' �ii�i ✓G L City _��� ga[lIIiNG �iREcA/_ph. No.171a{��Q� _ Contractor � r �� Ph. No. � t'.z 9�:2 Address ����� �� �-&ti^k City Lic. No. • State Lia No. -------,-T�d-,-------------- Size of Lot E�G' X-�� AP No. �- — �- � SO' � . � Setbacks:'C/L Street� Rear // / i/ Side Yard - Right d Left (� Type of Fence �—���T� Q���l �' G'X �' � l �6' I hereby acknowledge that I have read this application and state that the above is correct and agree to comply with all City Ord- inances and State L s regulating b ilding construction. . Signature �,...'.�EG�" �l � ,i�i� , of Permittee FOR OFFICE USE ONLY ,.5-d�o S - Date Issued - 30 -� / I �-1' - VALUATION �' _ Permit Fee $ � � Plan Check $ ^' TOTAL FEE $ '� '— USE REVERSE SIDE FOR DETAILS OW NER COLLEGE-PARK -- - DATE 12-28-56 JOBADDRES`3� � �-$OWZ1riF Green Drive BUILDINGPERMITNO. #(11(�O GENERALCONTRACTOR Harbor COriSt, CO. VAWE $� ],Z.µOO.00 LOT ']1 BLOCK TRACT Q%Q(� $e5. W�Af,t, gar. GROUP T. L�:��T TYPE V ZONE �µ FIREDISTRIGT f1QQJy PERMITSISSUED INSPECTIONS DATE SUBCONTRACTOR I DATE NUMBER Footinq Trench � �� Foundation Forms and Grade to Rough Framin� 8� Plumbing, Rough to Slab Plum6ing, Rough Complete Temporary Pole Wiring, Rough S�. Septic Tank or Cesspool Lathing,ln Out ,Pfum6ing,Fin�al, Fixtures Com Plumbing, Fin,al Gas Test �S Wiring, Final _ Occupancy iORM 210 3M 10�•v5 � _ / r.-Je' Josta Mesa Bnilding Department P. O. Box 3! 7 � COSTA MESA, CALIFORNIA �'OR t�PPLICANT TO FILL IN Ing :se �j3rj BOIYLING GREEN DRI V Costa, Mesa, California Owner COLLEGE PARK N0. 2 Mail Address 2 � � 6 $O. MA I N ST. Tel. �ty $pNTA ANq, CoLIF. No. KI rchitect or Lic. ngineer No. Address City Lic Contractor�-{ARBOR CONST.CO No. �i Metes and Bounds) I� No. of Bldgs .ot 6LL X � �9 Nowon Lot N o. of Bldg. Families dion � � Addition 9 I I DemolisF No. of Rooms Stories Use of New Building RESIDENCE � ATTACHED of APPLICATION FOR PERMIT a�n� BUILDING ' FOR OFFICE USE ONLY Receipt No. Permit No. �/�O G Received by Date Rec'd. Date Issued — ��n 'Yn /2–.�7 <S� /� � �- S I hemby acknowledge that I have read this Applicatlon and state that the above is correM and agree to comply with all City Ordinances and State Laws regulating building construction. Signature of aerm�ttee HARBOR CONSTRUCTION C0. Authorized Agt ' Valuation PermitFee $ 3U "� Plan Check $ . /�— s 12,400. To�i — � Fea $ �� � �� �o�ss o. v. a s. Costa Mesa, California Nearest Cross St. APPROVALS Foundation Location Inspeetor Forms, Materials, Under-Pinning Frame: Fire Stops, � Bracing, Bolts Lath.int. Int Ext � Reintorced Dafe Date O r✓ � c -, PLOT PI.AN Show Ixatlon and dtatances from property tine and between builtlinpa �xi ` . � u. . .i 1 /_ . �v. . � . ' . . � � . . . _ —:\ OWNER INSPECTIONS Forms brown coat - DEC 31. 195i � DA.I.E 9-30-57 DI'1V8 MAR 7.�1958 BllILDING PERMYT N( lder VALUE $ 791.00 PIRE ZONE DESCitIPT10N OF WORK ConcPetB . TYPE ZONE DATE I SUBCONTRACTOR PLAN NO. PERMI _J�