HomeMy WebLinkAbout179 BRANDYWYNE TERR - Building Permits t` 9 CITY OF.COSTA MESA
BUIEDING DIVISION
> -sr DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER
Ft .. . t
yPERMIT 06-00818
Itlzbentano#4.
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa3DING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 179 BRANDYWYNETR Status: ISSUED
Suite: Applied: 05/26/2006
Vicinity: ROOF Issued: 05/26/2006
Primary Occ: R Type of Construction: V-N
Parcel Number: 43946396^r_ Zoning:
Applicant: JOEL ISFELD
Address: 8941 MINT AVENUE
Phone: 714-847-7663 ISSUED BY:
WESTMINSTER,CA Zip: 92683
Owner: yJ—yam QOV ski\S
Address 179 BRANDYWYNE TER
Phone:
COSTA MESA,CA Zip: 92627-1577
Contractor: CALIFORNIA ROOF LIFE CO INC
Address: 8941 MINT AVENUE
Phone: 714-847-7663
WESTMINSTER,CA
Zip: 92683 License: 509623
Arch : Eng:
Address: Address:
Phone: 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 1514 FELT.38
SQUARES.UNITS 179-183.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: 51,200.00
Permit: $44.85 Claim Valuation: 51,200.00
SMIP Res: $0.50
SMIP Com: $0.00
Other $0.00
Inspection: $0.00
Total: $45.35
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
•
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work Is suspended or abandoned
for 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
2448.46(age)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
•
I hereby affirm under penalty of perjury one of the following declarations:
O 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.
jEr I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is I•cned.
My workers'compensation Insurance carrier and policy number are:
Carrier: $7-77frEPolicy Number: /76 3999 - 2i70/o
(This section need not be completed if the permit Is valued at one hundred dollars($100)or less,)
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith
comply with these provis•A:or
Applicant Signature: l Date: Sr—•26 -OG
WARNING:FAILURE TO SElc' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOUARE(SI••...• • ION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST, D ATTORNEY'S FEES.
' AN
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-09 F Z 3 Class N G 39
Contractor's Signature: Date: J"'26 ' 04
CONSTRUCTION LENDING ENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business 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 Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fore 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.).
O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O I 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,Art 2,Sec.
341,Title B,California Administrative Code).
O As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑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.
_.._ ..._ _..___...._ll
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Ves ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LI No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 pemlit 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
B (If yes•,attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is
correct. I agree to comply with all slate 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.
SI•• • re Of Legal bwn r(s Date
7f - 7-0?6 -se,
!- .Or Au nz p Date
CODE r . ' ql•, . - B.11 MALI POE( INSPECTION TYPE 2SIE MA45
Or
1616 Fixed S - rn Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 'T 7 �� 208 Final Plumbing
200 Final Re-Roof 1 '7 -af f//•w� 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
•
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
r
ADDRESS OR BUILDING: 1.79 BRANDYWYNE TR UMT: CITY OF COSTA MESA — BUILDING PERMIT
CWNERSNAME IFKNOWN: MORIN, DUANE / PERM NO: P 074118
ADDREss: 179 BRANDYWYNE TR ISS
PERMIT NO: P 074118 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA, CA 92626 722-0940
APPL.MMUNG ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: REP
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : CHANGE OUT WATER HEATER SQ FT :
ARCH.OR END'S ADDRESS: WIT:
CLAIM VALUE: CALC—VALUE : GROUP OCC : R-3 /
cONTRAcr0WsNAME: NOCK PLUMBING ( 714 ) 895-1246
CCNTRACTDR'SMMUNG 11610 SEABOARD CIR COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT
ADDRESS: STANTON CA uC.NO.: 511971 EE'***************************************************HElE-lEif1E1E1EiFlEiElfiF+EififjEiEHE3EiEEEiflElf***
90680 WIT: Z ON ING R EQU IR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby elfin under penalty c4 perjury that I am licensed under provisions of Chapter 9 SETBACK S
(commenting with Section 7000)of Division 3 d the Business and Professions Code,and my license is in full force and Ow I.
CITYLIc.NO.: 0503^86 uC.CLASS: C-36 uc.,NO, 511971 EXP : 02 /96 MAIN BUILDING ACCESSORY BUILDING
FRNT:
FT
IN REAR:
FT
IN
FRNT:
FT
IN REAR:
FT
IN
Date:
4//�/ g S cowndo 'V�CSC- Pl_UIYI6/J0e LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the
flowing reason(Section 7031.5Business and Professions Code:Any city orccumy Mich require*spencer t000mtsd.alter,improve, PARKING REQ: PROV: PARCEL : 43926306 ZNE: REF NO:
emolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES>
a licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Dir'icn 3 of the
Business and Professions Code)or that he or the is exempt therefrom and the basis for the alleged exemption.My violation of Section >
7035.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($500)). ***************************************************************iE*************3E*
❑ I,as owner of the property or my employees wish wages as theiade compensation.wil do the wore and the structure is not intended DEVELOPMENT SERV ICES REQUIREMENT S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not appty to en ownerof properly
who blda or inproves thereon,end who does such work Nmsef or herself or through he or her own employees,provided that such
improvements era it intended or offered foe sale.I,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE:
owner'builder will have the burden d proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the properly,em exclusively contractile with licensed contractors to construct the props(Section 7044.Business and BUILDING APPROVED BY : DATE:
Professions Code:The Coot License Law does not apply to an owner of properly who builds or improves thereon end who
contracts for such projects with a contractor(s)framed pursuant to the Contractors License Law).
❑ lamexempt under Section: B.&P.C_for this reason: APPLICATION ISSUED BY: S DATE: 9'l "95-
*******************************************************************************
Date: Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,end
25534,and that)or any future building omgfl will/wil not(circle°nlneed to comply with saddete codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modRWionfromthe AirralWy anepemeM Didd esi eMW construction eppications are exempt from these PERMIT 7,00
provisions.
Date: 96r/�-1, s Aodioer: 258 SMIP/NON—RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally d pedury one of the(diming declarations: ISSUE FEE 20 . 00
❑ IhaveandwilmainteinacerMitedmmennoeeMrnsurefrworkes'compensation,esprovSection BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code.for Ihe performance the.wanklr withthis permit eissued. TOTALS----> 7 . 00 20 . 00 0 . 00 27 . 00 27 . 00 . 00
I have and MI maintain workers'compensation Insurance,es required by Sedion 3700 of the Labor Code.for the performance of the
work for which this permit is issued.My workers'compensation ra
ation insurance pier and policy number are:
Carrier: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 27 . 00 OVER/SHORT: . 00
Policy Number: NWCA211J1U0 09/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed/the penal s for one hundred dollars/5100)ov Mn) 27 . 00
❑ I turfy Mat 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 wo 'compensation laws of California. . shoo. .... a subject to IM workers' *******************************************************************************
compensation p/e/veia" Bion 314604 me labor Cove,I shell ''S'compl''with '' INDIVIDUAL , FEE BREAKDOWN
Date: t9/ • { S Applicant: .--
res_
Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTI ,O N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(slog000).In addition to Me cost of compensation,damages as provided for In
Section 3706ofthe Labor Code,intrest,and attor '
attorney's PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00
• CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance d the work for which this period is issued(Section 3097.CN.C).
LENDER'S NAME:
LENDER'S ADDRESS: XPI^4 p� '
I certify Wel I have read this application and date that the above information is correct.I agree to comply with all city and county ordinances ,
NT
and state lace raiding to building construction and representativesthishereby authorize citym
to anter upon the abovementioned properly
brirapedionpumcees. RON NOCK D��'a' _ �tlL-g_lL_' uhf 0,1„Q,,. ..9:..".' T0 0— •:-7 :,-.
t Print Name � ^ 4F�TL: /L." `. ,,:'j
Date: q /
Signature of Owner/AgentiAp -- L/Contractor
(5151'46.WP) White-Buidig d Safely:Green-Fir;Canary-Appicant;Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement •
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
i
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
1
11. Property Sewer Line& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit - 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING . .
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing- 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding . 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE 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: (0_-2-3-Sir NO AntiLS3't
34. Final Heating & Air Conditioning /'yfa(t c- 40,
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. FINAL PLANNING ,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
ADDRESS OF BUILDING: 179 BRANDYWYNE TR UNT: CITY OF COSTA MESA - BUILDING PERMIT
OANERS NAME IF KNOWN: MAHAR, DEANNA PERM NO: P 083017
ADDRESS: 179 BRANDYWYNE TR
•
COSTA MESA,CA 92626 PERMIT NO: P 083017 PLAN CHECK NO: N GOVT : N SUPP: N
631-0394
APDL.UMUNG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE : REP
ARCHITECT OR ENGINEER: UC No.: JOB DESCRIPTION : INSTALL DISHWASHER SQ FT:
ARCH OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
CONTRAOTORSNAwE: NOCK PLUMBING ( 714 ) 895-1246
Ca+mAcrowswAllwG 11612 KNOTT ST COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT
ADDRESS: GARDEN GROVE CA ucNO.: 707775 +ESE*at****riE**+E+E+t-******* -** -iEarstft****+E+L-**+t** -+E***+E+E*at*************stir-*+car*** -*stat*itaE*
92841 uNT: 17 Z ONING REQUIREMENTS
UCENSED CONTRACTORS DECLARATION:I hereby affirm)under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect.
CITY lie.NO.: 05 8 UC.CLASS: C-36 uc.NO.; 777 EXP: 02 /98 MAIN BUILDING ACCESSORY BUILDING
G 7 r �_
FRN : FTIN REAR: FT IN FRNT: FT IN REAR: FT IN
Dale: y / / Contract 2"..e4 LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DELLA ATION:I.ireby affirm under penally of penury that I am exempt from the ConN°cton �_
following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to construct,alter,improve, PARKING REQ: PRO V: PARCEL : 43926306 Z N E: REF NO:
demolish,or repair any structure.prior to its issuance,also requires tha applicant for such pe°ni to fib a signed statement that he or she
is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)d Division 3 of the PLANNING NOTES>
Business and Professions Cab(or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section >
7031.5 by any applicant fora permn°ubHcts the applicant to a civil penalty of not more thanlive hundred dollars MOON. ******************************************at************************************
❑ I.as ovewr of the property or my employees with wages as their sole compensation,will do the work,and the structure is nol wended DEVELOPMENT SERVICES - REQUIREMENTS
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not appfyto an bwner0I popery
who builds or improves thereat and who does such work himself Cr hersel or through he or her own employees,provided that such
improvements are not intended or offered for sale.n.however.the building or improvement is sold within one year of completion,the ZONING APPROVED BY % DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose d sale).
❑ I,as oWner of the Professions Code:The°fO° Contractors La»rmeiat w'does nnootlicensed t apply to`ontractorsn owner of pr�°n°tlwro binds°«�nwroves t01h.Business and
irreon and wise BUILDING APPROVED BY DATE:
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ Iamexempt under Section: B.ApC.,for this reason: APPLICATION ISSUED BY: DATE: P-23/ -1
**
******************************************** ******************** *** * ***
Date: O°°B LEGALIZATION:N F E E S U M M A' R Y STRUCTURAL SEGMENT:N
I do hereby certify that Ian aware of and understand the requirements of California Health and Safety Code Sections 25505,pas'3,and
25534.end the I or any future building nmpent will/wit nok(circle one)need to comply with said state codes and the requirements for
e permit for construction«modification from the Air Duality Management District.Residentidmatrudion appicatiosaxe exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 8 . 75
Date: Applcam: 2 5% SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION;1 hereby affirm under penalty of perjury oneof the following declarations: PLAN
ISSUE FEE 22 . 00
❑ Ihave and will maintain a certificate of consent to self-baure f« compensation.es provided for by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,for the performance of the work for ivNch this permit is Sued.
1'l Ihave and wilmaintain worker'compensation insurance,es required bySection 3700of the Labor Code.for the performance oftM TOTALS----> 8 , 75 22 , 00 0 . 00 30 , 75 30 . 75 . 00
7C work for which this permit is issued.My workers'compensation insurance miner and policy number are:
Carrier: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 30 , 75 OVER/SHORT: . 00
Policy Number. Nut^ 37114101 09/01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed I the panne is for one hundred dollars 151001 or less.) 30 , 75
❑ I meth that in the performance of the work for which this permit is issued,I shell not employ any person in any manner so as to
become suIbjectovo the pomponr°te laws of California,end :.ree t.:i shouldbecmr subject to theµotere' ***************************************************************
****************
7— 7sw °° lC°°°'t shall corn. provisions. INDIVIDUAL FEE BREAKDOWN
Date: *Pelican:
Warning:Failure to secure work compensation covetous Is unlawful,and shell reject an employer nctnt,el,,.-•• TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars 0104000),In addition to the cost of compensation,ds -• ' r provided for/n
Section 3706 of the Labor Code,Intres',and afbrnqw.'fPLU ]. DISHWASHER 8 , 75 8 , 75
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of Panay that then is a construction larding agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C).
LENDER'S NAME
LENDER'S ADDRESS:
I certify that I have reed this application and stale that the above information is correct I agree to comply with all any and county ordinances
and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property
or inspection purposes. RON NOCK CCS-0-1397/1Q:53 An/i3Q.7a
Prim Name SCATA:ul-02-7422
imilIKDale: �CLL l��G /"� �°Eki'4YT,0L31Y7
Sgl7 as of Owner/Agentlt.pli : onlndor
(5151d6.WP) White-Buildup&Safely;Green-Ala:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POuL & SPA
APPROVALS Permit#
Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2, Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER 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, O Undrgrnd,
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer CaP • 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65- Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas G Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73- Undergrnd.Storage Tank ❑Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe -
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace L
38. Final Plumbing /(//q,/`j7 d''
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. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
'.. COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FQ�7pY$TR PERMIT.
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 �"'r "�c„ /' e63•00 Tt.`
RECEIVED BY PERMIT , / / ^
For Applicant to Fill in Completely- Use Ink Only? �-F-71/1,+r�__S-
BUILDING
-
BUI LDING A.P.NO.
ADDRESS r,nt 7. Brandywyne Terrace ,
BUILDING '79 ,n))4,419(27,-1.-, A
OWNERORyellow Brick Road Building Co. UNIADDRESS pro
/ Llls//fX/
R
MAILING SPANO.C
ADDRESSSPACE
2082 Business Center Dr. , N1SS TR.NO. LOT BLK.
TEL.
CITY Irvine NO. 833-8638
CONSTRUCTION NEW I ADD ALTER REPAIR MOVING DEMOLISH
LENDER Republic Federal Savings & Lo .../
BRANCH Orange Branch / T
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alcK 3 —El/�
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ADDREssl745 Orangewood, Orange, Ca 92668 / ��! VALUE
ARCHITECT Environmental TEL USE E
OR ENGINEERStr,rtureS NO. 957-1811 _ 'MI
ADDRESS666 Baker, Costa Mesa, Ca #267 ZONE / PE GROUP
—
APPROVED "
CONTRACTOR 4p, -r Builder BY /ail DATE
ADDRESS2082 Business Center Dr. , #145
TEL.
CITY Irvine No.833-8638
f•' STATE CITY APPROVED SETBACKS
i—i�5+ LIC. NO. N/A LIC.No.19429
W SIZE NO.OF BLOCS. (FROM C/L STREET)
0. OF LOT 2,500 sq. ft. NOW ON LOT 0 FRONT FT.
Q USE OF
.N., EXISTING BLDG. R.SIDE FT.
La
F Separate permits are required for L.SIDE FT.
O electric,plumbing and heating work. REAR FT.
W,. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
Q
CI .
DATE
Q gesiainntia7 — Naw (inn StructiOn APPROVED
APPROVED
>, — ABY NATE
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I hereby acknowledge that I have read this application and state camt
(d that the above information is correct and agree to comply with
O. all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of a
= the State of California. m
3 I hereby certify that I am properly licensed as a contractor under SO. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: n
am exempt from the provisions of the State of California Business VALVATIONni
and Professions Code, Division 3, hapter 9. PERMIT FEE $ aT N
m
Signature of ------PLAN CHECK S o
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Permittee S r gL.
TAX $ 2
Authorized Agent Date 25-79 !7/ 2- v^VT U
TOTAL PAID E
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION A U �� ERMI'l 1�7�4'1cKTa
For Applicant to Fill in Completely— Use Ink Only -
RECEIVED BY �A'f$cElt{�ai . - _ ){(
, "'-✓-
BUILDING =I-"s'^ s s� ' ' /'
ADDRESS ... ' a /•.
/� naQO _ PERMIT NO.
OWNER aa.�� / /,mss,,�s� /�attg. Ca A.P. NO. ,'�/
MAIL a aS AlIYBSS GNY/71 . ae.#/i ADDRESS BUILDING 7 � I /s, �N.TEL ��
MADRESS ` 'I /
CITY7.1,42b/Mit. GR . 127/5 No..82-8638. TRACT/OQt LOT BLOCK
CONSTRUCTION /�� �s�.ss �s� NEy�yj��l ADD ALTER REPAIR MOVINfi DEMOLISH
LENDER �Qf�v,GSL�G � /lryV riti/I/ryso.J
BRANCH 0/2/9•4/!O6 /��
ADDRESS /7$5 4(2,4 NSaV .&,Omer—ONER VALUE
ARCHITECTIA, ozen �.`ZcNOL833-�63A USE $
OR ENGINES N. 4
t,.�'�.,a[�� OWL /s' �} �y FIRE
ADDRESSACS2 elacaSS OWL UW• 7,75 ZONE k
Y E GROUPccc///.,,������CONTRACTOR fyen thime,60.. BYPROVEDC DATES:Y- /
ADDRESS y�.� /
TEL. �s ZONE///� INO.OF (7 USE OF NEW
CITY /PM NO. #1//'f tsC. PLANS !, BUILDING
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING
(FROM C/L STREET) ACCESSORY BUILDING
04 SIZE 0. OF LOT /' P•40' NO.OF BLOTS � FRONT 2,3 FT.4' FT.
NOW ON LOT
Q USE OF
ca EXISTING BLDG. R.SIDE 3Y FT. FT.
CA ie.
2 Separate permits are required for L.SIDE I I FT. FT.
electric,plumbing and heating work.
W REAR c90 FT. FT. .
i.,, USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
MAIN SLOGS..
ACCESS.BLOCS.
RDATE
Q4/Z•rJe to�. rrn �atpt CUP ge 7QIZ54 APPROVE�W/ tI7
7 APPROVED
.4 R • - GO.+T'I l-ti DA�T,EitJ1sCL-tsstp L O
a
w
0 I hereby acknowledge that I have read this application and state tn
tn
N
04 that the above information Is correct end agree to comply with n
m
a• all laws regulating building construction, and I shall not employ
Z any person in violation of the workmen's compensation laws of m
SSSS the State of Californi. �}—' d'
I hereby certify the operly !Icon . as a contractor under �� e‘SQ. FT. �J ��At a
the State of Celifor s. and - .fessions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR w
Chapter 9, end the - .re in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from t S •of the State of California Business VALUATION PERMIT FEE $
and Professions Co•/-111s •• :,Chapter 9. u,
Signature of /���� I�/7� rn
PLAN CHECK $ /71'), 1Cr LL
Permittee `/J ' . - $ yP% TAX $ 1 r/ r`‘ u
Authorized • ••nt / I•
000 / TOTAL PAID $ v
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