HomeMy WebLinkAbout178 BRANDYWYNE TERR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.811111-DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 178 BRANDYWYNE TR
Suite:
Vicinity: ROOF
Primary Dec: R Type of Construction: V -N
Parcel Number: TPNO06023 Zoning:
Applicant: JOEL ISFELD
Address: 8941 MINT AVENUE
WESTMINSTER, CA
Owner: BRANDYWYNE HOA
Address 182 BRANDYWYNE TR
COSTA MESA, CA
Contractor: CALIFORNIA ROOF LIFE CO INC
Address: 8941 MINT AVENUE
WESTMINSTER, CA
Zip: 92683
Arch :
Address:
Phone:
Phone: 714-847-7663
Zip: 92683
Phone: 949-548-3198
Zip: 92627
Phone: 714-847-7663
License: 509623
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 05/26/2006
Issued: 05/26/2006
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 7/16 OSB, 50 YEAR G.A.F., GRAND SEQUOIA COMPOSITION SHINGLES OVER 1 LAYER OF 15# FELT. 38
SQUARES. UNITS 178-182,
Plan Check:
$0.00
Permit:
$44.85
SMIP Res:
$0.50
SMTP Com:
$0.00
Other:
$0.00
Inspection:
$0.00
Total:
$45.35
SETBACKS
MAIN STRUCTURE
Front 0-0
ACCESSORY
Front 0-0
PARKING
Existing: 0
FEE SUMMARY
PLANNING & ZONING
Rear 0-0 Left 0-0
Rear 0.0 Left 0-0
Required: 0 Proposed: 0
Calc Valuation: $1,200.00
Claim Valuation: $1,200.00
Right
Right
UIiO
me
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California 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
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
wao-co law
DECLARATIONS
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.
Ly 1 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' wm�pens�atian Insurance carder and policy number are:
Carrier: 16+` " ' c- /-�%GN%% Policy Number: _7&3; %%g- 2000
(This section need not be completed it the permit is valued of one hundred dollars ($100) or less.)
❑ 1 certity 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 shell forthwith
comply with these provisi
Applicant Signature: Date:
WARNING: FAILURE TO RK ON COVERAGE IS UNLAWFUL AND SHAH SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE IS ),INA TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECrON 306 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 and Professions Code, and my license Is In full
force and effect. Lic. a S G Z Class s C ✓? 4
Contractors Signature: Date:
CONSTRUCTION LENDING
❑ 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).
Lenders Name: Lender's Address:
Signature: Data:
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 and 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 Cade) 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.).
❑ 1, 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 contrector(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or dead):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certify that no excavation five (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, All 2, Sec.
341, Tide 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? ❑ Yes ❑ 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? ❑ Yes ❑ 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 ❑ No
(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 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
...........................................................................................................................................................................................................................................................................................................................-...............................................................
5 Does or w111 the applicant or present or future building occupant require for the work which is the subject of this a plication a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 8 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
........................... ............................................................................. ..................... ................. .............I.. .... ................... .........................................I......................... .I........................................................................................
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 stale 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.
e Of at r(s) Date
s``ati
n Date
;&IR i INSPdCPCrN TYPE gLU 1MMALi S9PEI INSPECTION TYPE QejE Imo$
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
2D2 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
BRANDY YNE HOMEOWNERS A' OCIATION
182 Biandywyne Terrace, Costa Mesa, CA 92627
May 15, 2006
City of Costa Mesa
77 Fair Drive
Costa Mesa, CA 92626
Subject Brandywyne Homeowners Association
178-199 Brandywyne Terrace
Costa Mesa, CA 92627
To Whom It May Concern:
This letter is to advise you that we have selected Roof Life Company as the
contractor to re -roof the six buildings that comprise our complex.
Please accept this letter as authorization for Mr. Larry Hartley or any other
representative of Roof Life Company to obtain the permits necessary to go forward
with this re -roofing project.
If you have any questions or need further information, please call me at 949-548-
3198.
Thank you.
Sincerely,
BRANDYWYNE�HOMEOWNERS ASSOCIATION
Dee Storme
Treasurer
.��
Applicant to fill in all spaces except those within Heavy border lines and sign all appropriate declarations.
u.Jl
Off""IMSTA MESS�A CONSTRUCTION PERMIT
Project Address _L�. L2_
Applicarl Mailing Address y
Owner's Named r�/�pa�i�n�� T c/mplv^rN Pho
Address �7p3i�11/VN�. TE:C/r eat m'si -
Arch/Eng. License No.
Address
Contractor's Nam - Phone
Address (mailing)
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I arty licensed under provisions of Charter 9 (commencing
with section 7000) of Division 3 of the Business and Professions Code, and .
my license is in full force and effect.
License Class License No.
Date Signature
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section
3800, Lab. C.)
Policy No. Company
8 Certified copy is hereby furnished.
Certified Copy is filed with the city Buifding Division.
be Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION.
'(Thlsseclion need not be completed if the permit is for one hundred ($100) Or
less).
1 certify that in the performance of the work for which this permit is
i ued, I
shall not employ any person in any manner so as to bec me subje to the
WOrke,d/Date W.C. Laws of Califo i
Signature
NOTICE: It. after making this cie Claration, you shouldbecorA Subject to the
Workers' Compensation provisions Of the Labor 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 which this permit is issued (Section 3097 Civ. C.)
Lender's Name
Lender's Address
OWNER BUILDER DECLARATION
1 hereby affirm that 1am exempt from the Contractor's License Law for the
following reason (Section 7031.5 Business and Professional 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/She is licensed pursuant to the provisions of
�he Contractor's License Law (Chapter 9 (commencing with Section 7000) of
.Division 3 of the Business and Professions Code) or that he/She is exempt
therefrom and thebasis for the alleged exemption. Any violation of Section
7031.5 by any applicant for a permit subjects the applicant to.a civil
walty of not more than five hundred dollars ($500).
Nu 1, as owner of the property
eanpenealien, will do the work, and the structure is not Intended or offered
for sale (Section 7044, Business and Professional Code: The Contractor's
License Law 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 improvemen Lis sold within one year of com-
pletion, the owner will have the burden Of proving he/she did not build or im-
prove efor the purpose of Sale).
I.
aS owner Of the property, am exclusively contracting with licensed con-
tractors to construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who
builds or Improves thereon, and who contracts for Such projects with a con-
tractors) license pursuant to the Contractor's License La W). Iam aware that
proof of their Worker's Compensation insurance Should be provided to me.
❑1 am exempt under SCCtion& P, this reason
Date Owner
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 lawsrelating to building construction, and hereby authorize repro-
sentatives of this city to en r upon he above-mentioned property for
inspection r ses.• �y
Signature is- / Date, O tom_
I Drivers' License or SS $ /
CMF 0865-46, rev. 10/84
aag3s
Showers
C)-
I_.
v u
TYPE OF CONSTRUCTION U NEW LJ ADD LJ ALTERATION U REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHEfiI
��//
DESCRIPTION OF WORK/USE OF BLDG. ` P/ J�4—in f A-'
U
A.P. # G
S
Main Buildi
TYPE OF PERMIT LJ GRADING LJ FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICALR
❑ OTHER
E
T
A
Front
Rear
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
CONSTRUCTION TYPE VALUATION $
ZONE GRADING CU.YDS. ACRES
C
K
S
Right
t
ping. Ref. #
Remarks: /17 l x.e. /)1117- _P AdI It;, Ad.Q -
Planning Notes:
EES
37:
Zone RGL
Accessory Building:
Z
0 '.
N
1
N
G
R
Parking Req,/Provided E
0
M
T
S
Bar Sink
Showers
v u
ELECTRICAL V FEES
Backflow Preventer
Service Sink
Automatic Washer
Construction Pole Sub.
Transformer ❑ 15-50 KW
❑ 50+KIN
Backflow Irrigation Sewer Cap
Bathtubs
Sewer Connection
Cooking Unit
Meter ❑up to 100 amps
Clarifiers
Solar Collectors.
Dishwasher
Meter ❑over 100 amps
Dishwasher
Solar Piping
Dryers ❑Gas ❑Electric
Sub Panel
Drinking Fountains
Solar Tank
Fan
Motors ❑0-1 HP 0 h - B
Floor Drains
6 1 ii g Pam' W/Spa
F.A.U.
Inc. Solar 09.15 HP 1316-15+
Floor Sinks
Urinal
Fixtures
Microwave
Gas Service Outlets
Water Closet
Device Boxes
Pole Light
Interceptors -
-Water Heater
Outlets
Range
Kitchen Sink
Water Service
Switches
Sign
Lavatories
Auto -Wash
Garbage Disposal
; Standing Sections
P -Trap
Laundry Trays
Generator 00-5 KW 05-15 KW Trash Compactor
Roof Drains
Reinspection Fee
$15
Issue Fee
$ 3
Reinspection Fee
1 $15 1 Issue Fee $ 3
MECHANICAL
FEES
DEVELOPMENT SERVICES REQUIREM NTS'
/) I -I
Approved By `-.- �/ _Date L..l
Building Approved By O Date -W
Application Issued By Date oi�r�-8�i+
Boiler
Hood or Type ❑
Canopy Type It El
Duct - Under Ground
Duct - Structural
Refrigeration System
❑0.100,000 BTU 0100,000 BTU
Duct - Ventilating
BUILDING PERMIT
PLAN CHECK
PLUMBING
PLAN CHECK 25%
ELECTRICAL
PLAN CHECK 50%
MECHANICAL
PLAN CHECK 25%
\SUMMARY OF FEES
\ SMIP $
$ _ PERMITISSUANCE$
$
$ ENERGY P.C. $
$ '`GRADING $
$ MICROFILM $ �y� �(�
$ TOTALFEE $ 0Y-Uli
$
Exhaust System ❑ Multiple ❑
System Repair/Alteration
Firepl/Fact. Bit. ICBG#
Fire Dampers
Heating System & Ducting
00-700,000 BTU 0100,OOOBTL
Registers
Reinspection Fee
$15
Issue Fee
$ 3
White - Building; Canary - Ap PIICdnt; Pink - Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING
APPROVALS Permit#
Date
Inspector
PL & SPA
APPROVALS Permit#
Date
Inspector
I: 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 LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, 0 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
t�
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit#
1,20. Rough Factory Fireplace
.21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas 0Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank 0 Gas 0Oil
25. Roof Sheathing
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical
27. Frame and Flashing
1
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREV. 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: r2 -Z 7- 6-4 - C Fj:P " c veo . G/E.A
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic -Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
/
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
1 J FgNC
PAT/ o
r-iaRE GLASS I C
SPA �
LL
i C
y i !J EEA i b
C4 a —�
i I
IJ . O I p��nP moray I
sun�r�G T llo I/
pool Two 10A 0,6010 TE,O
c/RCuIiS Aloe POMP
--� 0 N 0 Fr S w I 1 cN /IQ V - 6 HPIPS
GAS LINE /S
HO I SPA CAP 1TvMR- ® %tE i9°
rcecTalo L coQTYTQF 0 Tiklk;7N.10r GAS
Q
Akf y.2 1x (e3-fkctrical ' oC. 4i1NE
L -V lV - Tf L' Chanlcc Saction
j� Plumbing ectlon
uur"C�1 g Division
F Approved.......(/.-....
Dote.
APROVED THE ISSUANCE OF A PE9MIT BASED UP0 PLANS IIJ
{ e�iw �y����T. Sl n1 PKI NS SPECIFICATILNS SHALL NOi PR_V:.NI THE OL':LGI IG .FF
OF CO{J�A MC�w I FROM THEREAFTER REQO. N7UTHL CCCRECT-J, I rt
KANNINGDBT• %8' /�eAIVOYWYNt r6^�K IN SAID PLANS AND SPEC ICA'ACHS OR FROM f:;L.-WING
ilR1EtT TO ' DEQ RfO. C Q S f R /h C+S! I CA, W 6 d7 1 BUILDING OPERATIONS GER ' CARRIED LN i..ER_„,.DER WHEN
1 � L , �Gj . W IN VIOLATION OF TH.S CL' : OR OF ANY .. mER ORDINANCE
O/ E)bATE6` I H: -7 / y - 6s0-saa 7 � OF THE CITY. O=
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CITY OF COSTA MESA
PARK FEES
Fee Payment Receipt
N° 555
Project Address l��5' ;fd X99 UI'4&L4/"` �G/`IY.GP_
A.P. Number % �Q —mss/ a;l Park Area :96f 3
Building Permit Number Q 7A 34, la a5-'
Owner's Name _
Mailing Address_
FEE:
Single Family '
Number of Units
2 -Bedrooms or Less
@
$ 861.76 =
3 -Bedrooms
@
1,205.67 =
4 -Bedrooms
@
1,545.62 =
5 -Bedrooms+
@
1,810.50 =
Multiple Family "
Bachelor or Studio
@
474.37 =
1 -Bedroom
@
573.18 =
2 -Bedroom
_ 112- @
881.51 = 12,
3 -Bedrooms+
@
1,392.72 =
c p 43. Total Fee
Planning Department Approval Date / ' ) /p By �t�:%/Q
Applicant's Signature „
• City Ordinance 72-44 • • City Ordinance 72.45 -.,/City Resolution 78-116
CMF 0174-32 Rev. 1/79 White—Planning; Canary—Pianning; pink—Finance; Goldenrod—Applicant
costa mesa
CITY OF COSTA MESA
PARK FEES
Fee Payment Receipt M 704
Project Address/79;—/f9
Number of Units
Rra���a�.'.v�_
2 -Bedrooms or Less
A.P. Number // 9
— 0, 1—/
— e4/ Park Area #�'3
@
Building Permit Number
Zi763
G 4`0 Z5
1,545.62 =
Owner's Name
Mailing Address
7995 12/06/79 3478.70 TL
FEE: Single Family "
Number of Units
2 -Bedrooms or Less
@
$ 861.76 =
3 -Bedrooms
@
1,205.67 =
4 -Bedrooms
@
1,545.62 =
5 -Bedrooms +
@
1,810.50 =
Multiple Family **
Bachelor or Studio
@
474.37 =
1 -Bedroom
@
573.18 =
2 -Bedrooms
@
881.51
3 -Bedrooms+
@
1,229.38
3 -z'_7
Total Fee "**
Planning Department Approval Date,/2-5-
at — By
Applicant's Signa
TI
*
City Ordinance 72-44 *+ City Ordinance 72-4 *** City Resolution 78-116
CMF 0174.32 Rev. 6/79 white—Planning; Canary—Planning; Pink—Finance; Goldenrod—Applicant
a
3
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
f,taa a]nai70 I i„1
fr.
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APPLICATION FOR'STRUCTURAL PERMIT''
For Applicant to Fill in Completely — Use Ink y
RECEIVED BV DATE
RECEIVED DATE ISSUED
/ PERMIT NO.
BUILDING /.l
ADDRESS F•� FFF
/Ny
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OWNER ��
A.P. NO.
MAILQ.� �j,,�
ADDRESSX%G-iae� AX& M 4”
BUILDING
/+DDRES
TRACT
LOT BLOCK
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CITY RUI/f/CJ CA. S NOLo�3G�'0'
LLEENDElR1CTION G I% C L .Mr
I ADD
ALTER
REPAIR MOVING QFMOl ISH
BRANCH O E
OWNER
C
ADDRESS
FIRE
'ZONE
VALUES
PE GROUP':'
ARCHITECT TEL p
OR ENGINEE&,W;iz 0.
ADDRESS Qe �I..`0 CA/ISS
CONTRACTOR o:!%v w
APPROVED
BY Zd
DATE
ADDRESS ylw
TEL.
CITU R NO. �%
ZON
NO OF
A
PL1�
USE OF
Z BUILDING NEW
STATE CITU
YARDS APPROVED YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE /�
OF LOT P. �• //•
NO. OF BLOCwS
NOW ON LOT -O�
(FROM C/ EET)
O T
L,
FT.
F
USE OF
EXISTING BLDG ll*%
Separate permits are required for
e.SIP9 FI.
FT.
REAR
FT.
electric, plumbing and heating work.
LU
LOIN ASND WORK TOiBi ERFM�Ll
DISTA
MAIN NST
BET MAIN &
ACCESS BLOCS.
VAR.* DATE
C.U.P. R-IoK APPROVED9114126
APPROVE 14,
/ DATE , _, 7 9
H
F 1 FATF
I hereby acknowledge that 1 have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person In violation of a workman's compensation laws of
.26 no SO, FT.
z Q
the State of C011/ofnie.
I hereby certify that I y licensed as ntractor under
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of Calllornla u n nd Profn s Coda, Division 3,
Chapter 9, antl roar h e are ull force and effect, or I
THE PURPOSE OF ESTABLISHING
A PERMIT FEE ONLY:
em exempt from rho r al a State of California Business
eno Professions Cotle, i , Chapter 9.
VALUATION
PERMIT FEE $
y
PLAN CHECK S/7,0.
Signature o1
Permittee
S r/
TAX S 4.11,0
Authorized Apa � �
/y�.�.a�,/a/�
dip V
TOTAL PAID 5/
fr.
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COSTA IMXE,Zoo BUILDING-SAFETY
MESA, CALIDEPARTMENT
9 626 APPLICATION F Till �, YW PERMI 63 00
For Applicant to Fill in Completely — Use Ink Only
RECEIVED BYPERMIT ,
(� L/
BUILDING 9
ADDRESS Lot 12 Brandowune Terrace
A.P. NO.
OWNER ORADDRESS
TENANT Yellow Brick Road Building Co.
8
UNIT OR
SPACE NO.
MAILING
ADDREss2082 Business Center Drive, #145
TR.NO.
LOT
BLK.
TEL.
CITY Irvine No.833-8638
NEW
ADD
ALTER REPAIR MOVING
DEMOLISH
CONSTRUCTION
LENDER Republic Federal Savings
BRANCH Orange Branch
OWNE
1.41U T
ADDRESS 1745 Orangewood, Orange, 92668
VALUE
USE S
ARCHITECT Environmental TEL
OR ENGINEER
ZONE
TYPE GROUP
ADDRESS 666 Baker St, #267, Costa Mesa
CONTRACTOR Owner Builder
APPROVED
BY DATE
ADDREsS2082 Business Center Dr. #145
TEL.
CITY Irvine NO. 833-8638
STATE CITY
LIC. NO. N.A. LC. NO. 19429
APPROVED SETBACKS
SIZE
OF LOT 2,500 sq. ft.
NO. OF BLDGS.
NOW ON LOT O
(FROM C/L STREET)
FRONT FT. '
USE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
L. SIDE FT.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
Residential — New Construction
DATE
APPROVED
APPROVED
RY
DATE
I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or I
am exempt from the provisions of the State of California Business
and Professions Cotl1ee,,, Division 3, Ch ter 9.
Signature of -',�'
Permittee
or
Authorized Agent Date -79%-47
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
VALUATION
$
PERMIT FEE 30
S
PLAN CHECK S
TAX E
TOTAL PAID E 60