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HomeMy WebLinkAbout167 BUOY ST - Building Permits ,\ rHa�l:c�LDDREss: 167 BUOY ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: EMP 049152 r Dt.7mmsE: LEO JARZOMB/KATHY HILTS ADDRESS: 167 BUOY ST PERMIT NO: EMP 049152 PLAN CHECK NO: N GOVT: N SUPP : N' COSTA MESA • . . CA 92627 CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELE MEC PLU . PURPOSE: 0TH (714 ) 548-5866 .ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : £LEC. ,MECH. & PLMB . FOR SFD ADDITIONS SQ' FT:• ADDRESS: - UNIT: PERMDTEE: KATHY' HILTS • ( 714 ) 548-5866 CLAIM VALUE: CALC-VALUE: "`\ 'GROUP OCC: R-3 ' I- ADOREss: • 167 BUOY ST COMMENTS: B-48681 • • COSTA MESA CA 92627 x* t** E **** rx** r**� � � *S **SS � *S *� **+ � ***4******� * Et*S ******S * * ErS ******+ + r� E+ * 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. SETBACK S . CITY UC.: STATE UC.: CUSS: - Date: signature: MAIN BUILDING ACCESSORY BUILDING •` FRNT: FT IN REAR:WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' ' FT IN FRNT: FT IN REAR: , FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT, IN RGHT: 1"'I• IN• POLICY NO.: EXP.DATE: - 'OMPANY: • • PARKING REQ; PROV: PARCEL: 42619203 ZNE: REF NO: , r Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. . PLANNING NOTES> :,-1. ..• a • yv[} • Dale: - Applicant. ., r,*.**************ip*******,*********)L••*iL*dti(4*********.**********************-********* EXEMPTION PROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed N the permit is for one hundred(IWO)or less). D E V E`=L O P M-'E N T ,%". S; E FR V-/ I C E S t ,R E Q U I R E M E N I' S I certify that in the performance of the work for which this permit is issued,I shall not employ any person inlay manner so as to become L-' ,� subject to the W dors'C pensation Laws of California. �/ r ''ZONING APPROVED::BY •�' 1/' 1. ',•' P'•` DATE Date: - 9>.2Vel 0 Signature: /'� ✓ it) •• . NOTICE:If,after making this declaration,you should become subject a Workers'Compensation provisions of •the Labor •BUILDING APPROVED BY -. ..-.0 . s'":.. %-, DATE: Code,you must forthwith comply with such provisions or this permit all be deemed revoked. '°.). i:' ,s, �� :C. -4- C ✓ • q1 Z CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for .,APPLICATION ISSUED BY.--: . , .•'% % ' }/�,[/�1 , ..r+ DATE: l / ��9 which this permit is issued(Section 3097,Civ.C). - ****************************************^��"'•*�****************************iF iE�F* LENDER: • ******************************************************************************* ADDRESS: LEGALIZATION:N F E EI5' SUMMA R Y STRUCTURAL SEGMENT:N ti OWNER BUILDER DECLARATION: Ihereby affirm 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: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 19 .00 -c,43 . 25 •i 9 .00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25%5% 1 5 0% - 25% S M 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 - r, and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN ., .�" any applicant for a permit subjects to a pliant to a civil_penalty of not more than five hundred dollars($503). ISSUE FEE 3 . 00 ' 15 . 00 1 5 .00 • BUILDING-DIV-> PERMIT ISSUE ''?PL'AN-CHECK TOTAL PAID DUE 1, as owner of the prop¢ ' , wit do the work, and the " structure is not intended or offered for sale( coon 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> .71 . 2 5 3 3 .0 0 ; !,:.,1 ,- 0 . 0 0 '4 . 104 , 25 104 . 25 . 00 , does not apply to an owner of a properly who builds or improves thereon,and who does such work himseffPoerself or through1 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:' - 104 . 25 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 ,for the purpose of sale). 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 22 •005 B . 2 5 2 4; 0 0 - ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon -1 ' and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware ********************************************_***************************•******** that proof of their Worker's Compensation insurance should be provided to me. ' - INDIVIDUAL'? FEE BREAKDOWN ❑ l am exempt under Section: • B.8 P.C. .1 r is reason: TYPE QTY DESCRIPTIO' N • UNIT COST TOTAL COSTfo 9/75/A 0 • Owner. ,�� "at,Date: 11//OO�� ELE 10 FIXTURES, LIGHTING 1ST 20 EA. .75 7 . 50 I do hereby Certify that I am aware of and understand the requirements of California Health Safety Code Sections 25505,25533.and ELE 10 R EC EP T/OUTLET 4:: 1-' ST 2 0 EA. .75 . 7 . 50 25534 and that I or any future building occupant w11/will not(circle one)need to comply with said state codes and the requirements for a ELE S RECEPT/SWITCH '-. 1 ST 20 EA. 75 3 . 75 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from 1 mese provisions. . ELE • 2 RES APPLIANCE NOT OVER 1 . 0 HP 3 .00 6 . 00 ELE 1 SERVICES BELOW 600 V & BELOW 201 'AMP 18 . 50 18 . 50 Date:' • Applicant: MEC 1 INST FORC-AIR/GRAV FURN <= _100 K BTU 9 .00 9 . 00 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 PLU 1 LAUNDRY TUB OR WASHER 2 .00 2 . 00 ordinances and state laws relating to building construction and hereby authorize representatives otthis city to enter upon the above-mentioned PLU 1 SHOWER • • i 2 .00 2 . 00 property for inspection urposes. PLU 2 WASH BASIN 2 .00 4 . 00 (�/ys190 PLU 1 WATER CLOSET (TOILET) - 2 .00 2 .00 Date: Signature. PLU 1 WATER HEATER AND/OR VENT 01 �L2,.0i0.w_(,r c,;_. 2 , 0p Driver's License or,Social Security x: ' U �J�� o T .. • &�- - ter>L� 26, f?'T ' - DATE! 07;'2s/5C 1�:E: 1641 4N White-Building:Green-Code Enforcement:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor 9 22/9.3 ( . T - • __ . . _ . . _ `'CONSTRUCTION AND PLANNING - FID'. „ SPA .e Date Inspector Date _ Inspector APPROVALS Permit# - APPROVALS Permit# t P 1. Temporary Electrical Service or Pole 52. Pool &,Equipment Location '"; .e .. •-2._,gioi1.P-ipe-Undtgrnch 53. Steel Reinforcement - -- ./ . -" LT 3:-Electtcal ConECul7.`C'ltility-Undrgrnd. 54. Forms ' ' " • rrf -:,/4-G,�•Ele�tnical Conduit-Undrgrnd. 55. Electrical Bonding - . - . f5?"See1°Reinforc''p�}iern 56. Rough Plumbing & Pressure Test . L • .:;,gem cal UFETFI7OrSd. 57. APPROVAL TO COVER-GUNITE s„ • - '7. Footings - 58. Electrical Conduit-Undrgrnd. - u c 8. Foundation - .' ° 59. Gas Pipe, 0 Undrgrnd.,Test , j y Zya e ..VROR DORESS: UNIT: • '!!OWNER'S NAME: - ' . , ..i. , ADDRESS: PERMIT NO: EMP 049152 PLAN CHECK NO: 05891-90 N PAGE: 2 .. I - - iH#9L463EMiF;IkifltiFiFikiklkififaF+E****3Fik****jl•ik3F****if#iffkif3taFdE****lF********ifif•iEitiEiFiEitkikltifif• ifiF#�tiF***** . cx/ENGINFEN: ` -REO.x.. TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ADDRESS: UNIT: " • PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS - 2 .00 ' - 2 . 00 • RMITTEE: PLU 1 SEWER, CONNECTION TO BUILDING EACH 5:00 5 . 00 ••DREss: _ END OF FEES LICENSED CON ' CTOR DECLARATION: I hereby affirm that I am licensed under pr. ions of Chapter 9(commencing with Section ' 7000)of Division ' of the Business and Professions Code,and my license is in full I.ce and effect. , CITY LIC.: • _ STATE LIC.: CUSS: Date: • Signature: WORKERS'COMPENSATI I DECLARATION: I hereby affirm that I have a cer icate of consent to self-insure or a certificate of Workers' .o ' mpensation Insurance,o . certified copy thereof(Section 3800, Lab. . • LICY NO.i EXP.DATE: •OMPANY: I Certified copy is hereby fumi'•ed. ❑ Certified copy is filed th the city Building Division. • ,Date: Applicant: __ _. EXEMPTION FROM WORKERS'COMPENSATI I•DECLARATION: is section need not be completed if the permit is for one hundred($103)or less). I certify that in the performance of the work .r which this pe it is issued,I shall not employ any person in any manner so as to become . subject to the Workers'Compensation Laws 'f California. . Date: '- •natur: - • NOTICE:If,after making this declaration,yo s .uld become subject to the Workers'Compensation provisions of the Labor ' Code,you must forthwith comply with such p' isions or this permit shall be deemed revoked. , ,CONSTRUCTION LENDING AGENCY: I hereby a that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civ. r . LENDER: • ' • 'ADDRESS: --' • - . . .t '4 / • OWNER BUILDER DECLARATION: I he-by affirm that I am e . pt from the Contractors'State License Law for the following reason J ' (Section 7031.5 Business and Profess(. al Code: .Any city of co ty which requires a permit to construct,alter,improve,demolish,or - repair any structure,prior to its issu ce.also requires the applica for such permit to file a signed statement that he/she is licensed '-.' pursuant to the provisions of the Co actors'State License Law(Cha. 'r 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/ e is exempt therefrom and the ba for the alleged exemption.My violation of Section 7031.5 by � . any applicant far a permit subje - the applicant to a civil penalty of n. more than five hundred dollars($500). - .1 ' I, as owner at the roper), or my employees with wages . their sole compensation, will do the work, and the • S c- ) {i1 I ' ._J structure is not inten. .or offered for sale(Section 7044,Business a .Professional Code: The Contractors'State License Law . 7' .,, does not apply to a .weer of a property who builds or improves ther..n,and who does such work himself/herself or through r/• ' 71 ' -his or her own em'oyees,provided that such improvements are not i •nded or offered for sale. If,however the building ar I improvement is s..within one year of completion,the owner will have ' burden of proving he/she did not build or improve r c ,'- for the purpose . sale). 4 •.i I,as owner of e property,am exclusively contracting with licensed contractor to construct the project(Section 7044,Business ' ' .❑ and Profess).• Code: The Contractors'State License Law does not apply to an.. er of properly who builds or improves thereon r. -` and who cm racts for such projects vith a contractor(s)license pursuant to the ontractors'State License Law). I am aware . t tp ! , that proof• their Worker's Compensation insurance should be provided to me. ;f f) , '❑ I am exe.pt under Section: B.8 P.C. ^ for this eason: t: Date: ' _ Owner: st I do herebyerti that I ant aware of and understand the requirements of California Health and Safetyry , y ,.'e Sections 25505,equir25533,and 25534 an. hat I or any future building occupant will/will not(circle one)need to comply with said state c•.es and the requirements for a • •' 1 permit f. construction or modification from the Air Oualiry Management District.Residential constructio :pollutions are exempt from 'ihese•p+visions. F; Date' Applicant: - w I h' 'by certiy,that I have read this application and state that the above information Is correct.I agree to comply ith all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upo he above-mentioned - 1 •v X DUPL.. .Y_C-{ S E R(❑C ! F' ' •property for inspection purposes. . 1 I_1 0007O324-U30 132/6 T C.(x- 1•... ,Date: • Si nature: •' ORT:: 09 25 ' ^_' :it: Signature' ri.•y€9 TE� 1'�' Driver's License or Social Security N: .:f- ' 1641-46 White-Building;Green-Code Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor - '- i ' • CONSTRUCTION AND PLANNING - - K. Y SPA - - Date Inspector ' Date-' Inspector �` APPROVALS\erniit# ' - APPROVALS Permit # •' / '1. Temporary ElectricahSeevice or Pole 52. Pool & Equipment Location�/- 2. Soil Pipe-Undrgrnd. �� •- 53. Steel Reinforcement-' . 3. Electrical Conduit Utility-Undrgrnd - 54. Forms �� • i 4. Electrical Conduit-Undrgrnd. �� - 55. Electrical Bonding 5. Steel Reinforcement ' . • - X56 Rough Plumbing & Pressure Test ' 6..Electrical OF 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/ as Lines, P-Trap, 0 Undrgrnd. • • 10. Structural Floor System 7 - 61. APPROVAL TODECK , -11. Property Sewer Line &�ouse Connection 62. Backwash & Receptor-Fi al 12. Sewer Cap / . ' - 63. Heater & Vent-Final \ 13. Roof Drain • 64. Plumbing System - Final \ . 14. Roug,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 - ' 19dfio#gh �leat .&+ Air Conditioning FIRE DEPT. REQUIREMENT • 20`x3 our� gh cte\4ireplace APPROVALS Permit# s x m 21 'x;Dutts, in Structure 70. Underground Hydro + 22JDupts, Ventilating 71. Product Piping 0 Gas 0 Oil 0' 23'GaCPipRough & Test 72. Underground Flush •-i 24.eoaV f Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil C" * 25bRolf Sheathing 74. Overhead Hydro n 26;,r-4r Ceilin (efructural) & Monocoat 75. Dry Chemical • mt, ^�3 - 27A-FraThe a�d Wing 76. Dry Standpipe • 28. La ing Sing 77. FIXED SYSTEM FINAL 29. Instlation 0s: 78. FIRE PREY. FINAL *30. Dr vall Nailjcgi1 HEALTH DEPT. REQUIREMENT ,c cT 3.,, , 31. Plater 13rovRQtbat 79. FINAL INSPECTION 322JEle4trica}Pcwjg Meter-Final 80. FOOD CERTIFICATE ISSUED T ,r 33.' irr l ElQtric 8":,,r1, Notes:1 ip,2.,2 24,44, L,-AYZ, 4A7e4 W 34.t-fin l Hating,bjj r Conditioning /5.- ((_4Z obi - 1."6 FCTto*C 6Cotas x -v =,^ . 351rFin6l Gas Pifr9T wO t ht c..i atilt- o£, c.i.6 - al.-q3 36 Ho dor Ca 1R rj /fl 2 '. COr2.ert177d4.5 _Ca° • Sr= 37. FinI FactorgRreplace • 38.ein4l Plumb g 39,ciNater Service-Final . ^ n r e \. 40.`iGa0ervice-Firtal 41.dolar Dernestic-Final - -k K. 42.=Baettlot`vPreventer . . \ x \ 43. BackfloW,Irrigation . .,• r; eln .. 44. Latjdscae IFiiftion System" 45. Sound Attenuation - Y 46. Har Bicap Regulations I 47-<FINAL STRUCTURE & BUILDING 48.rflN&AL ELANNING 49. Electric Release to Edison 50.=GasRelease tdSouthern California Gas Co • 51. CERTIFI-CATE-OF OCCUPANCY No. Date PROJECTADORESS:- 167 BUOY ST UNIT: - CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 04868.1 • ch OWNER'SNAME: LEO JARZOMB /KATHY HILTS - - ' ADDRESS: 167 BUOY ST PERMIT NO: B 048681 PLAN CHECK NO: 04925-90 S GOVT : N SUPP : N • COSTA MESA . , • CA 92627 CONSTRUCTION TYPE; 5-N PERMIT TYPE: STR PURPOSE : ADD ( 714 ) 548-5866 'GRCHIENGINEER: REO.NO.: JOB DESCRIPTION : BEDROOM, BATH & LAUNDRYROOM ADDITIONS 'SQ FT : 466 ADDRESS: UNIT: CLAIM VALUE ; . CALC-VALUE; 32, 154 . 00 GROUP OCC ; R-3 . I' r t PERMITTEE: KATHY HILTS ( 714 ) 548-5866 ADDRESS: 167 BUOY ST • COMMENTS; SMOKE DETECTOR( S ) REQUIRED IN HOME. COSTA MESA . CA 92627 *arxr*+t**dt*******x *********iF******** Fit************+r******** **** ****+ yF******er**E , LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I . N G REQUIREMENTS .7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S • CITY LIC.: , STATE UC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING. FRNT; FT IN REAR: 10 FT IN FRNT: 1 FT IN REAR: • - FT • IN - 4RKERS.CDMPENMTIDNDECUON: Iherebyaffirmthatlhaveacertificateofconsenttose0-insureoracertificateofWorkers LEFT: 10 FT IN RGHT; 30 FT IN LEFT: FT IN RGHT; FT IN pensation Insurance,or a certified copy thereof(Section 3800,Lab.C). ICY NO.: EXP.DATE: . I • MPANY: PARKING REQ• 2 PROV; 2 PARCEL : 42619203 ZNE• : R1 REF NO:Certified copy is hereby furnished..El Certified copy is filed with the ciryBuilding Division. PLANNING NOTES> 466 SQ FT ADDIT, TO REAR OF EX. SF RES . (BDRM/BATH/LAUNDRY > OFF DEN/HALL-) . 375 SF REAR YD COVER OK; 340 SF PROPOSED . - - - Date: Applican• t: ************************k(-.*'*** *************************************** ********* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:• (This section need not be completed U the permit is for one hundred($100)or less). D E V E "L O P M' E S N-�T' S E R V I C E S R ,E Q U T A E M E N T S I certify that in the performance of the work for which this permit is issued,I shall not employ my person in any manner so as to become - �'' - n subject to the Workers'Compensation Laws of California. T�� . / ZONING APPROVED BY ;'�.'i :� �_ C�)1Rk- DATE; . ..t1-6-/--In Date: A /ems-/g D - r Signature: I i ' NOTICE:If,after making this declaration,you should'become subject he Workers'Compensation provisions of the Labor BUILDING APPROVED BY P : DATE:'- I Code,you must forthwith comply with such provisions orthiis permit all be deemed revoked. - ' - /• ; C' 'CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY:: i✓" '' . - DATE : C�'�_—Z• which this permit is issued(Section 3097,Civ.C). ***************************#*************** * **********************0*** **Lw* UNDER: ***********************.iE***'lfif************************************************** ADDRESS: LEGALIZATION:N ' - F E E - SUMMARY STRUCTURAL SEGMENT :Y ' • OWNER BUILDER DECLARATION: I hereby affirm 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: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT • • 304 . 00 . < 2 . 25 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 1 9'7 . 6 0 . ' ' and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ISSUE FEE _ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ,,,- BUILDING-DIV-> PERMIT ISSUE PLAN'CHEEK . TOTAL PAID DUE ' I, as owner of the property or my employees with wages as their sole compensation, will do the work, and,the TOTALS----> 306'. 25 0 , 00 197 , 60'' 503 . 85 503 . 85 ' . 00 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law • • does not apply to an owner of a property who builds or improves thereon,and who does such work himseff/hersell or.through his or her own employees, provided that such improvements are not intended or offered for sale.It,however the building or REVENUE DIVISION TOTALS--> COLLECTED• . 2 306 . 25 OVER/SHORT: - 00 improvement is sold within one year of completion,the owner wit 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). / 304 . 00 C Y. I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ' - . �,, 2 . 2 I CJ 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 a contractor(s)•Iicense pursuant to the Contractors'State License Law).I am aware ****************************'*'*'**'**'* **'*•*'*'**k!"*'*'*'*'*'**' **'***'**'*"**"'*'*'*'*'*'*'** **-'*'**'**'**'*' that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL '{F E E, BREAKDOWN • • 0 lam exempt under Section: B.8 P.C. , I for this reason: TYPE QTY DESCRIPTIO N'' • ''• UNIT COST : TOTAL COST Date: 9/?, /q? l/owner yIQXl1 [� l tY�(d I SFR 966 DWE TYPE V-WOOD FRAME; ` c -GOOD 69 . 00 32, 154_, 00 I I do hereby certify that I am aware of and understand the requirements of California Health and ry Code sections 25505,25533,and END--`,O F FEES 25534 and that I or any inure building occupant will/will not(circle Ona)need to comply with said state codes and the requirements for a - . ' _ll...clink 44 - I permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from •lr D o 0.F^"` ' these provisions. Y— ' • • Date: Applicant: ' / / 1 / S� ' C / '*DUPL T("7.4_9(rE FE,r7E I :7- • 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 `� \�r7C / i S !"i !j .ii �' . 31 (}OitbE074-OU' :0 S a_:7 • ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned /, (1F+TE: .03/2,901 FOE: 1G:56 property for inspection purposes. F Date: Li h.a-/'7 a /signature: / 7-fi1.0g / Driver's License or social Security x: G - eta_ `. d L�1 t+• r v _ -v ry �yy,'1r. ice`-r_r-�� 1 00:1 °,0 0 0,06E-4AD a 1:-.11- 1641-46 White—Building;Green—Code Enforcement;Canary—Applicant Pink—Revenue;Goldenrod—Assessor y y- . Q�1�� - '` �+ ,,,I ; DATE: �2l22,`n(i T E: .,. - ' I/ I CONSTAUCTKiN AND PLANN L & SPA - - APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1 Temporary Electrical Service or-Pole • -52.. Pool & Equipment Location ' •2. Soil Pipe-Undrgrnd. ' 9/ ."0)/}- 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. •YY _ 54. Forms 4. Electrical Conduit-Undrgrnd. 55.-Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. f 57. APPROVAL TO COVER-GUNITE 7. Footings 2 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 5d ' 59. Gas Pipe, O'Undrgrnd„Test 9. Water Pipe-Undrgrnd. 60.'Backwash Lines,.P-Trap, 0 Undrgrnd. 10. Structural Floor System .. -'4, 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 r 66.'Solar System-Final - I • . 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 • APPROVALS Permit #. - 21. Ducts,in Structure .. .70. Underground Hydro 22. Ducts, Ventilating - 71. Product'Piping 0 Gas 0 Oil ' r 23. Gas Pipe-Rough & Test ,• 72. Underground Flush': 24. Roof Framing - • 73. Undergrnd.Storage'Tank ❑Gas 0 Oiler' 25. Roof Sheathing • /}W' `p 74. Overhead Hydro ' - . 26. T-Bar Ceiling (Structural) & Monocoat- i 75. dry Chemical --C 27. Frame and Flashing Dry Standpipe . `i- ; 28. Lathing & Siding U ��9/ 77. FIXED SYSTEM FINAL •" 1-,•t •' 29. Insulation . (jif . - /78. FIRE PREY. FINAL . y :Jt 30. Drywall Nailing l _3o(-q3 (ti(�/ HEALTH DEPT. REQUIREMENT _ "�: ,• ;r! 31. Plaster Brown Coat' (p %,h•• 4K 79. FINAL INSPECTION i''sh r 32. Electrical Power Meter-Final �1` - -80. FOOD CERTIFICATE ISSUED { -"' _ 1• 33. Final Electric • Notes: -- ? S 34. Final Heating & Air Conditioning • ' ')A ( C�� f r�&- i :„35. Final Gas Pipe-Test _ 11� ` _ ' • 36. Hood or CanoPY3,AT- /n� /t`ftNyt 0f7r4 - . J t' 37. Final Factory Fireplace (!/ /`� - X•' 38. Final Plumbing 39. Water Service-Final ' ' ' 2. 40. Gas Service-Final % " -? r; j1 . - 41. Solar Domestic-Final - -, 42. Backflow Preventer - 43. Backflow Irrigation • • -.- 44. Landscape Irrigation System - :-` 45. Sound Attenuation • . ) 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING .Z1_4S‘wl�� 48. FINAL PLANNING 49. Electric Release to Edison • • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF,OCCUPANCY . No. -'+ t " 1 Date 110 S " uFsCITY OF COSTA MESA ,line4CALIFORNIA 926281200 PO. BOX 1200 O '4% ! . ,. o_ ,m lo. ire n .a DEVELOPMENT SERVICES DEPARTMENT J4. • QAC C_.• .;c0'. September 22, 1993 Katherine Hilts 167 Buoy Street Costa Mesa, CA 92627 RE: PERMITS B48681, EMP49152 167 BUOY STREET, COSTA MESA Dear Mrs. Hilts: I reviewed our records in response to your request for extension of the time limit for your permits. • The building permit B48681 was issued on August 22, 1990. The last recorded inspection took place on October 8, 1991. According to Section 303 (d) of the Uniform Building Code, this permit has expired. In order to renew action on a permit after expiration, you are required to pay a new full permit fee. Permit EMP49152 was issued on September 25, 1990. The last inspection on this permit was recorded on March 31, 1993 . The permit would expire on September 27, 1993 unless you request a new inspection in the interim. As you requested an extension of this permit prior to its expiration, an extension of 180 days is herewith granted. The final expiration date will be March 26, 1994 . If a new inspection occurs between now and March 26, 1994 , this date would be the starting point of another 180 day period during which your permit will be valid. Thank you for this opportunity to be of service. Sincerely, Cilir441-220 KLAUS STRASCHIL I G LL � KS/gz 'd'C W� 1 lNo 4 (167BU0Y.ST) C-15 312-09 CtieA 4AAA4S SZY S5en rk Oto r� d A,c,w.-n vii pillet--N C12,-1,-ii) bC� 3o3c4 �kv��-e ei„.„ cc. c I- 77 FAIR DRIVE Q.k -y_ 4 Building Division 714 754-5273 • 11�(.53 9 ( I Code Enforcement(714)7545623 • Plamm�q Division(714)754-5245 FAX (714)556-7508 Eon^ Y q iaZ a _ . CITY OF COSTA M 32. Electrical PowerFinal i BUILDING SAFETY DI VISI • ‘ 33. Final Electric POST IN CONSPICUOUS PLACE 34. Final Heating &Air Conditioning ON THE JOB 35. Final Gas Pipe-Test NOTICE 36. Hood or Canopy You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL 754-5627. 37. Final Factory Fireplace APPROVED PLANS SHALL BE ON JOB AT ALL TIMES. 38. Final Plumbing A. P. NO. DATE ISSUED .�> .� e� Ll 39. Water Service-Final TYPE GROUP PERMIT NO. 0 40. Gas Service-Final rO1/44 `�O(1'I 41. Solar Domestic-Final BUILDING ADDRESS 11 V)---1 c?'L4-c \ •1 CA 42. Backflow Preventer TRACT • LOT BLOCK 43. Backflow Irrigation r NEW IADD ALTER REPAIR MOVING DEMOLISH 44. Landscape Irrigation System' X 45. Sound Attenuation OWNER - • 46. Handicap Regulations USE 47. FINAL STRUCTURE & BUILDING A..Ct_ . ` c.-c.(. p . • 48. Special Requirements Completed POOL&SPA ' SETBACKS APPROVALS Permit# Front Yd. Side Yd. L R Rear 49. Pool & Equipment Location Side Yd. L R Rear 50. Steel Reinforcement CONSTRUCTION AND PLANNING 51. Forms APPROVALS Permit# Date Inspector 52. Electrical Bonding • 1. Temporary Electrical Service or Pole 53. Rough Plumbing&Pressure Test 2. Soil Pipe-Undrgrnd. fI -14 /91954. APPROVAL TO COVER-GUNITE 3. Electrical Conduit Utility-Undrgrnd. 55. Electrical Conduit-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 56. Gas Pipe, 0 Undrgrnd.,Test • 5. Steel Reinforcement 57. Backwash Lines, P-Trap, O Undrgrnd. 6. . Electrical UFER Grnd. 9bAlg 58. APPROVAL TO DECK 7. Footings �j�� 59. Backwash & Receptor-Final • 8. Foundation 60. Heater & Vent-Final 9. Water Pipe-Undrgrnd. 61. Plumbing System - Final 10. Structural Floor System 62. Electrical-Final 11. Property Sewer Line& House Connection 63. Solar System-Final 12. Sewer Cap 64. Fencing& Access Approval 13. Roof Drains �� ,,,;, APPROVED FOR PLASTERING 14. Rough Plumbing _ _ _ 1123h/ -�- P. .. _.66..POOL/SPA SYSTEMS FINAL '15. Sough Electrical-Conduit '-"•'r' 9 .. . .," ,_�aiA('+� sd1:1 .FIRE DEPT. REQUIREMENT 16. Rough Electric Wiring t©-r�jr 4 K t APPROVALS Permit#__ Yv _ J '7. Rough Wiring Sign i -` --"` 67. Unde4ground Hydro I 18. Rough Electrical-T Bar Ceiling I ) ' ` '" ._S',�'� 68. Produlct Piping 0 Gas Oil 19. Rough Heating & Air Conditioning �I �j/ r1q3 (./fes 69. Undeiground Flush 20. Rough Factory Fireplace 1 ' -) _ 70. Undergrnd. Storage Tank 0 Gas 0 Oil 21. Ducts, in Structure 71. Overhead Hydro 22. Ducts, Ventilating 72. Dry Chemical 23. Gas Pipe-Rough & Test ,3/IC(3 Liu 73. Dry Standpipe 24. Roof Framin, •• 74. FIXED SYSTEM FINAL 25. Roof Sheathe g • dilltb (y-r-� 75. FIRE PR EV. FINAL 26. T-Bar Ceiling (Structural) & Monocoat .ram Notes: tin J� Q‘_ (A/P [n 27. Frame and Flashing ,C.c1\k r ;�1$ - n O 419444) 28. Lathing & Siding t"J�1 Oil 3 3J�1'.� Y r�/ 4.�F.re , f nista.._,,,r7 29. Insulation • Wa/n C €.4. DO GT'• I MSTALAat[IOH Freon% 30. . Dr •>q Nailing &4444&C P...•Ca 31. Plaster Brewn Coat - pep p (see reverse for additional notes) CMF 0559-46,rev. 12/82 {'� �J"-� OWNER SHERWOOD FOREST DEV. DATE 3_13-57 , JOB ADDRESS 167 Buoy-Street BUILDING PERMIT NO. #4670 GENERAL CONTRACTOR Lido Construction VALUE $ 12,301.4.00 LOT 11 BLOCK TRACT 3106 Res. w/att. gar. GROUP I & J TYPE V ZONE FIRE DISTRICT 4583 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED y ui3-2/-� DATE NUMBER Footing Trench E 7 Foundation Forms and Grade to Garage( � �CC Rough Framing .-_ F/F✓G eh 9 fi r Plumbing,Rough to Slab`tr-n C? 1-d-i_.3Y5 7/..I.j&-c- d- SOVt7J s3'/.3`,S 7 8' /7c) Plumbing, Rough Complete /y1 e3 t/,2-C2 LA// Temporary Pole Wiring, Rough APR 8 1957 VCS a-. Tar-- _JS;_S 7 9' a/ Heating, Rough 41C S VI-S-7 v.._.. I/ / �.-, a- 9- er 33 a__. Heating,Final e 5 5•a.0-s- y /� / b ewe HOUSP � ( Sewers St.l/Ni d- `� y .1.�`, 6), .X�c, dl -- -s if. f r Septic Tank or Cesspool ��/� Lathing, In Out Afl .—_ , - S-6 / _ Plastering .//€0". _8_ Y Plumbing,Final,Fixtures Completernj 6 r;4)67 Plumbing,Final Gas Test 1,..6- he...5 !j�2.0... cc /J7. /SF Wiring,Final ��2 LMAY 1 i 1957 VCB��cG- Occupancy ---‘17,e J'-a.n.,T) FORM 210 3M 10-05 4583 FEE RECEIVED ,� COSTA 'MESA BUILDING DEPARTMENT"` L I �� �+ P.O. BOX 317 - FINANCE DEPT.. COSTA MESA, CALIFORNIA CITY OF COSTA MESA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ABUILDING DDRESS I47 go .57 BUILDING COSTA MESA. CALIFORNIA ' FOR OFFICE USE ONLY /�� Wont) //�� L /�e� 1 /� l� RECEIPT NO. P M(y� p0 OWNERS/r4$Q WOOD / oII GST Dcv 'sly A�l.lT MAIL .e/ •'I� )) RECEIVED BY DATE FEC IVES. GATE ISSUED ADDRESS) 1,/ . _�AkrMrnFM ,.—ai •a - J ? "4RR 1 3 195 CITY nNANG /rl TNO.nt 0 r.alf� / BUILDING ADDRESS ARCHITECT RAVAail �,6vAn'Hs LICd, "7y7 OR ENGINEER //// L // NO COSTA MESA. CALIFORNIA ADDRESS 704 W. yi/F/rf/Lig, vP. FIRE ZONE' f� CITU LIC / ZONE PIOANSF TYPE GROUP CONTRACTOR Lin Ch/•�S� NO.I(pLiL ^ VA ADDRESSI141- ^�NCVid NO)CF ✓ iJ.S / B�PROVED DATE LEGAL LOT ) ) CORRECTIONS DESCRIPTION NO. I BLOCK TRACT)/ Co , A.P.NO. SIZE / Y I NO.OF BLOCS. OFFLOT X5. I 9 NOW ON LOT USE OF EXISTING BLDG. SETBACK LINE FROM 1,/o D - AP P " ®V E Y CENTER OF STREET REAR YARD 'I' CITY OF COSTA MESA SIDE YARD RIGHTS } LEFT Jp.} it-,! MPIG DEPT. • DESCRIPTION OF WORK SUBJECT TO BLDG. DEPT. REG. NEW ALTERATION ADDITION BY DAIS . REPAIR MOVING DEMOLISH PLAN T CH. UILDING/ ) NO.OF SIZEB / "J ROOMS Co STORIE7 S EXTERIOR WALL.,W COP ROOF aeon �lieRa COVERING c to CC U COVERING 5/,i.J ate USE OF NEW b 1, I g I- I J 16 a pr i i BUILDING kJ F /V ��`�✓ .•, I HEREBY ACKNO EDGE/IT I HAV$READ,ITHIS APPLICATION AND • STATE THAT THE DOVE.IS CORREC AND.AGREE TO COMPLY.WITH ALL CITY ORDINANC ,AD NN/DIUSTT.ATE LAW REGULATING�BUILDiNNG0-CyONSTRUC- SIGNATURE' O• ; � AM, ( A. VALUATION PERMIT FEE $ 3sC3 / ' $ / � � PLAN CHECK SAUTHORIZED AGENT ( JV // j4 --/' /dS TOTAL FEE S #41.3"-----` Verr co' - --