HomeMy WebLinkAbout2238 CATHERINE PL - Building PermitsCITY OF COSTA MESA
� T E BUILDING DIVISION
>�� 77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • w�wi.ci.costa-mesa.ca.us
���m fi FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: BC09-00186
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: GRN2_RES DATE ISSUED: 06126/2009
ISSUED BY: BJK
,106 ADDRESS: 2238 CA7HERINE PL CM
APN: 42607208
Vicinity: SW ROOF
Const Type: V-B SQ. FT:
Zoning: , ,
Suite/Unit:
Primary Occ: R-3
Valuation: $10,000.00
SCOPE OF WORK: INSTALLATION OF A 10 PANEL PHOTOVOLTAIC SYSTEM ON THE SOUTHW EST ROOF OF AN EXISTING
2-STORY SFD. ELEC.
S0�,4R PANELS ARE FLUSH WITH THE ROOF AND DO NOT EXTEND OR RETRACT.
OWNER: MIYAZAWA, EUGENE T
Phone:
APPLICANT: HARRIS, MIKE
Phone: 774•315-9830
Address: 2238 CATHERINE PL
City/State/Zip: COSTA MESA, CA
Address:
City/SWte/zZip:
coNTRAC70R: STOUT AND BURG ELECTRIC INC. License No. 826780
Phone: 714-544-5066 Address: 15052 RED HILL AVUnit:
Cell: Ciry/State: TUSTIN, CA
ARCHITECT:
ENGINEER:
COMBINATION PERMIT F�E SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees: ,
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
••Refer to tee recelpts for all fees paid for proJecl
License No.
License No.
$117.81.
$181.25
$92.60
$0.00
$0.00
$1.00
$0.00
$1.00
$393.66
:s��
-,,`�''$�
�'�,
.� ;X _
Unit:
Unit: :
SUITE C
ZipCode 92780
PHONE:
PHONE:
NO710E: The work aulhorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order �or the work authorized under Ihis 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 o( this permit.
LOOE 1. INSPELPONTYPE
1816 Fixed System Final Fire Preventipn
t26fi Po01 Spa Final
200 FinalRe-Rool
ZOt Final Blotk/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 i Final Demolition
OpT INTRIALS COOEf INSPECiIONTYPE
206 Final Mechaniral
208 Final Plumbing
270 Final Electncal
212 Final Fire Prevention
220 FinalPianningApproval
222
250
Final Sile
Final BuildinglOcCupancy
DATE NTII PRLS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penal�y oi perjury one of the /ollowing declarations:
❑ I have and will maintain a certificate of cOnsen� to self-Insure (or workers'
compensation, as provided !or by section 3700 of the Labor Code, for the
performance o( the vrork for which this permit is issued.
I have and will maintain wnrkers' compensation insurance, as requiretl by
ection 3700 of the Labor Code, (or the perfwmance of Ihe work for which this
pertnit is issue My workers' compensatior� Insurance carner and policy
numberare: / /��
Cartier� S �i � L-O
(TM1is sedqn need ��!�;�mm etl A penn s valuT��a�t on�e'n1un0 Wllars (S/00J a less )
Policy Number: �d �l I�'�—(T I f�
❑ I certify that in the peAormance o/ the work for which this permit is
i s d, I shall not employ any person in any rt�anner so as to 6ecome subject
� � vrorkers' compensa�ion laws o/ Cali(olnia, and apree I at if I should
be o subject to the vrorkers' compensation provisio of S ction 3700 of
the Code, I 5 all (orthwith comply with [Bese provi ons.
�� 8
AO b 's Sipnawre Dat , �
WARNING: I RE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF C�MPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LP,BOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION;
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
wi h Seclion 7000) o! Division 3 of the Business and Professions Code, antl
m ic se i/sJin/ (u�ll7(oroe and effect.
Lic- ' o�(Q ( Class.#
�
b tr coY SignaWre Daie -
CONSTRUC 10 LENDING AGENCY:
❑ I hereby affirtn that there is a constn�clan lending agency for Ihe
pedortnance of the v.ork fa which this pertnit is issued (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
SignaWre
OWNER-BUILDER DECLARATIONS: y�`�j'�j � � �,}, '�
I hereby aKrm Ihal Under penaltya6Rperju_rygNat�I�am.EXEMPT FROM THE
CONTRACTORS LICENSE LT�AW Or lh�f0�l wain,g;rea5on (Sec. 7031.5,
Business and Profeasion�Code n t o�ty which requires a permit to
constmcl, aller, imp�ove,7tl moli h, repair any structure, prior to its
issuan��o requides Ihe a�li or such permit to file a signed statement
Ihal h or 5he i5 li�rjsed pursuant lo the provision5 Of the Con[ractors
License Law�( hapter 9(commencing with Section 7000) o! Division 3 of the
Busines d rofessions Code) or that he or she is exempt therefrom and
Ihe basi for Ihe allegetl exemplion. Any viola�ion of Section 7031.5 by any
applicant for a permit subjects the applicant lo a civil penalty o( not more than
fve huntlretl tlollars ($500).):
❑ I, as owner of the pmperty, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the sWcture 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 hCrself or through his or her ovm
employees, pmvided that such improvements are not imendetl or of(ered for
sale. If, however, the building or improvement is sold within one year of
completioq the ovmer-builtler will have the bwden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as ovmer of the property, am EXCLU5IVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the ploject (Sec. 7044, Business and
Professions Cotle: T�e contractors License Law dces not apply to an amer of
property who builds or improves thereon, and wt+o contracls tor such project vnth
a contractor(s) license pursuant to the ConUactas license Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
SlgnaWre Date
309-46 �3/0])
Owner ID verifed by tlriver's license. ❑ Yes ❑ No
Driver's License No. Ezpires:
Verification of Ownership by (rype of tlocument, i.e. - propeny tax bill or tlee0):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certrfy that no excavation (rve (5) w more feet in depM into which a
person is required ro descend, will be made in connection vnth work authorizetl
by Ihis pertni�, and that no building sWCNre, scaffd0ing, falsexvrk, or demolition
or dismantling Nereof, will 6e more than �hirty-sia (36) feet high. (Chap. 32, Grp
2. Art 2, Sec. 341, Trtle 8, Califomia Administ2tive Code).
� As ovmer-builder, I will not employ anyone to do work which would
require a permit tmm Ihe Division of Industrial Safety, as noletl above, unless
such person has a permit to tlo such work from the division.
Appli W nfs SignaNre
Division of Industrial Safety Permil 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 threatene0
release o( a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Calilomia Health and Safery Code requires, with some
exceptions, that a Business Plan be filed with the Cos[a Mesa Fire
Department by every business which has at any one time dunng a reported
year a quantity of hazardous materials equal to or grea[er than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
aI standartl temperature antl pressure).
2. Does or will the applicant or preseM or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Seclion 25533 of Ihe Calilomia Heallh and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Departmenl by
each business which at any one time has on hand a quan[ity o( acutely
hazardous matenals equal to or greater than a weigh[ of 500 pountls, or a
volume ot 55 galbns, or 200 cubic teet ot compressed gas al 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 0! lhe Califomia Health antl Safety Code provides that Ne
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Depariment of an RMPP by businesses which are required
to register acutely hazardous matenals with the Fire Department.
4. If an RMPP is presently required, has Sec[ion 25534 of [he Cali(ornia
Health and Sa(e[y Code been fully complied with? ❑ Yes ❑ No
5. Does or vnll the applicanl or preseM or fuWre building xcupant require for
lhe work which i5 Ihe subject of this application a permit for such constmction
or modi�wtion from the South Coast Air Quality Management DisMct or from
any other air pollution control disirict or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Cotle requires that the 2ques�ed
in(ortnalion be (umished on applications (or non-residential building permits).
6. Will any part of lhe tacilily lo be consWcted under this pertnit be within
1000 (eet (rom the outer bountlaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safery Cotle).
7. If a permit from the South Coast Air Quality Management District or other
air polNtion control dislrict or agency is required for [he vrork which is the
subjecl o( this application, have all o( the disclosures prescribed by Califomia
Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No
8. Qf "yes", attach certificate of compliance fmm the appropriate air polNtion
control officer).
CERTIFICATE OF COMPLIANCE: I certify ihat under penalty of perjury the
information given above is correct. I aqree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
S�gnaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I
certify untler penalty of perjury that I have read this application and state that
t�e intormation given is correct I agree ro comply vrith all state laws and city
ordinances relating to building construction, antl authorize represematives ot
the Cityyy of Costa Mesa ro enter upon the abovedescribed property for
ins cu� purposes. I agree not to occupy or allow occupancy of any huilding
auth by ihis permit until final inspection.
ature ol ai wner(s) Da�e
• �Q Nonze �1nPicani oa�e
(71a) �54-52�3 • Fax (714) 754-ae56 • www.ci.costa-mesaELECTRICAL PERMIT �� FAIR DRIVE, GOS IA Mt5A, GA a2ti16
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
2238 CATHERINE PL
42607208
MIYAZAWA, EUGENE T
2238 CATHERINE PL
COSTA MESA, CA
owner: MIYAZAWA, EUGENE T
Address 1793 ORIOLE DR
Contrector.
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (7-2 units)
New Res (3+units)
Pool / Spa
Lighting Fizts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
COSTA MESA, CA
Phone: 949-515-8696
Zip: 92626
Phone:
Zip: 92626
Phone:
Zip:
License:
ISSUED BY:
Status: ISSUED
Applied: 10/20/2000
Issued: 10/20/2000
SCOPE OF PERMIT
LEGALIZE - UPGRADE RESIDENTIAL SERVICE TO 200 AMP. INSTALL MISC. CONDUIT AND ONE 50
AMP GFI IN ELECTRICAL PANEL FOR SPA. -
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$30.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
._._._.......up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System ! Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$1820 1
$o.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$1820 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E90.40
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
2446d6 (N00)
WORKERS' COMPENSATON DECLARATION: ,,,�' � ��
I hereby aFfirm under penalry oF perjury one of the following declarations: '
❑ I have end wilt maintain e certificate of consent to sel(-Insure for workers' compensation, es provided for by section 3700 of the La6or Code, for tha peAormance ot the
work for which this Oermit is issuad.
❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the pedormance of ihe work for which this permit is issued.
My workers' compensation Insurance carrier antl policy number are:
Carner: Policy Number:
(Triis section neetl nof be cromp/eted i/ the permit is valued a( one hundred Uollers ($100) or less.)
❑ I certity ihet in ihe peAormance of the work for which this permit is issued, I shall not employ eny person in any manner so as m become subject to the workere'
compensatlon laws of Calitornie, end egree that ii I should become sub�act to tha workers' compensation provisions of Section 3700 of the Labor Cotle, I shall forthwith
comply with these pravisions.
Applicent Signature: Date:
WAPNING FAILURE TO SECURE WORKERS' COMPENSATIIXJ COVERAGE IS UNIAWFUL ANO SHALL SUBJECi AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED
THOUSAND DOLLARE (5100,000). IN AODRION TO iHE CQ57 OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3IO60F THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I here6y aHirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) oi Division 3 of Ihe Business and Professions Code, antl my license is in full
force and ettecl Lic. # Class #
Contraaors Signeture: Date:
CONSTRUCTION LENDING AGENCY:
i
❑ I hereby aflirm that ihere is a consimction lentling agency for the performance ot the work tor which this permit is issued. (Sec. 3097, Civil Code).
i
Lenders Name: Lendefs Adtlress:
Signalure:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aHirtn that under penelty of perjury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the toilowing reason (Sec. 7037.5, Business entl Professions
Code: Any city or county which requires e permit m constmct, alter, improve, tlemolish, or repair any stmcture, prior to its issuance, also requires Ihe applicant for such permit
to file a signed statement Ihat he or she Is licensetl pursuant to the provisions of the Contracbrs license Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Coda) or that he or she is exempt t�erefrom and ihe besis for the alleged e:emption. Any violation of Section 7031.5 by any applicent for a permit
subjects the applicant to a civil penally of not more than five hundrea dollars ($500).):
❑ I, as owner of the properry, or my amployees with wages as their sole compensation, WILL DO 7HE WORK, antl ihe structure is not intentletl or oflered for sala (Sec.
7044, Business and Protessions Cotle: The Con�racbrs License Law does not apply to an owner ot property who builds or improves thereon, and who does such work
himself or herselt or through his or her own employees, provided that such improvements are not intendetl or oNeretl for sale. If, however, the building or improvement is
///jjj sold wiMin ona year of completion, the owner-builder will heve Ihe burden o� proving that he or she did not build or improve tor purpose ot sale.).
❑ I, as owner of the property, am EXLLUSIVELV CONTRACTING W17H LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions
\ Code: The comrectors License Law poes not appty to en owner oi propeny who builtls or impmves thereon, end who coniracts tor such project with e contractor(s)
license puys�ent to the Comractors lLcense Laws.).
I��
Owner ID verified by dnver's
Verification of Ownership by
Business and Professions Code for this reason:
❑ No Driver's License No.
property tax 6ill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTiFICATON:
❑ 1 hereby cetlify that no excavation five (5) or more teet in dep�h into which a person is required to descend, will be ma0e in connaction with work authorized by this
pertnit, and ihat no building siructure, scattolding, falsework, or demolition or tlismantling ihereof, will be more than ihirry-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle 8, Califomia Administrative Code).
❑ As owner-builder, I wiil not employ anyone m tlo work w�ich would require a permit irom ihe Division of Intlusirial Safery, es noted above, unless such person has a
pertnit to do such work trom the division.
SignaWre: Date:
Division of Industrial Safery Permit Number:
CERTIFI ATE OF COMPLIANCE AND AUh10R1�710N OF ENTFiY: I cenity under penal�y ot perjury ihat I have read Ihis application and stale ihat the information given is
corr . I ee to omptyyyith II stete laws and ci y ordinences rela�ing to Duilding construction, and authonze representatives of the Ciry of Cos�a Mesa lo enter upon ihe
ebo C�rscri oparBj fd�in ection p oses. I a ree t to occupy or allow occupancy of any building authonzed by t's p' i� until fin I inspection.
5 < � Or' �-�2�� /�%`/� %
Y i i r��a�i� a nu a i nwnnrra� ! � Date •
FOOE �. INSPECTIONTYPE
1676 Fixetl Sys�em Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
Applicam
Q�g �$
COOE� INSPECTIONTYGE
206 Final Mechanical
20B Finel Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Slte
250 Final Building/Occupancy
Dale
O�rE U+�u�s
.f ri'i il/
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 2238 CATHERINE PL
Suite No
Vicinity:
Parcel Nunmber: 42607208
Applicant ANTHONY PASTORELLO
Address: 9852 W KATELLA AV
STE 301 Phone: 714-996-4701
ANAHEIM, CA Zip: 92804
Owner: MIYAZAWA, EUGENE T
Address 2238 CATHERINE PL
Phone:
COSTA MESA, CA Zip: 92627-1815
Contractor: R A PLUMBING & DRAIN CLEARING
Address:
Arch / Eng :
Address:
ISSUE FEE
BackFlow irrigation
Backtlow Preventer
Bathtub
Clarifer System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Dnnking Fountain
Ezpansion Tank
Gas Earthquake Valve
9852 W KATELLA AV
STE 301
ANAHEIM, CA
Phone: 714-996-4701
Zip: 92804
License: 537784
Phone:
Zip:
License:
SCOPE OF PERMIT
ADD 3/4 UNDERGROUND GAS LINE FROM METER TO GARAGE.
AMT
$23.50
$0.00
50.00
$0.00
$0.00
$0.00
$O.Oo
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
aTY
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Status: ISSUED
Applied: 11/19/2003
Issued: 11/19/2003
ISSUED BY: �
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Wasle and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
water Service
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: � This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must compy with all applicable codes, end all
requlred inapectlone and iinal approval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of this permlt.
FOR INSPECTIONS CALL: (714) 7545626
zaaa-ae I�oo�
WORKERS' COMPENSA710N DECLARATtON: �
I hereby aHirm untler penelty of perjury one ot the following tleclaretions:
❑ I have end will maintain e certificata ot consent to selFinsure br workers' compensetion, es providad for 6y saction 3700 0/ the Labor Cotle, tor the pertormance of Ihe
�work tor which this pertnit i5 issued.
I have end will maintain workers' compensetion insurance, as requiretl Dy section 3700 of ihe Labor Code, for ��e Dedormance of Ihe work for which Nis permit is issuetl.
My wo e{s' w�m �s�a�ti�on� I surance ca�r ier a pollcy umber ere: ^h� �^^' ����
Carrier. l� " I.Aljl����%� �� �f �—, PolicyNumber. (JV VC/
(lhis section ne�ofbe comp/efed ll fhe perm(� I5 ve ued a( one hundred dollero ($ f00) or /ess.)
❑ I ceniry met in me pertormance ot tne work t r hith ihi ertnit is issuad, I shall not employ eny person in any menner so es to becoma suDjaa to the workers'
compensation laws ol C�mia, antl e rea t if I shoul becnme subJ _ o ihe workers' compensetlon provisions of Saqi n 370 of the Labor Code, I shall fort�wii�
comply wit� t�ese pm ' ion .
Applicem Signeture: Dete: 6
WARNING FAILURE TO SECURE WORKERS' COM E ATION COVERAGE IS UMAWFUL AND SMr1LL SUBJECT AN EMPLOVER TO CRIMI L PENA TES PND CML FlNES UP TOONE MUNDRED
TLKKISAN�DOLURE(E100,ODO�.INADDIPONTOTHE OFCOMPENSATION,DMUGESASPROVIDEDFOfiINSECTiON31480FTHE BORCOOE,INTEREST,ANDATTORNE`fSFEES.
LICENSED CONTRACTORS DECLARATON:
I herehy eHirm Ihat I em licensed under rovision ot Chepte ommencing with Section 7000) of Division 3 of ihe Business en� Prolgs�si ns Code, end my license is in full
force and ettect Lic. a Class N 3
Cantractar's Signeture: Dete:
CONSTRUCTION LENUING AGENCY:
❑ I hereby eflirm that thera is a canstruction lending egency tor Ihe peAortnance ol iha work lar which this permit is issued. (Sec. 3097, Civil Cade).
Lenders Name: Lentlefs Atltlress:
Signature:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby eflirtn that untler penalry ot perjury that 1 em EXEMPT FROM THE CONTNACTORS LICENSE LAW lor the following reasoo (Sec. 7031.5, Business end Protessions
Code: Any ciry or counry which requires e permit to canstruct, alter, improve, demolish, or repair eny simcture, prior to its Issuence, also requires Ihe epplicen( br such permit
to file e signetl statement ihat he ar she is licgnsed pursuant to ihe provisions oi the Conirectors License Lew (Chapter 9(commendng with Sectlon 7000) oi Dlvlsion 3 ot t�e
Business end Professions Code) or that he or she is exempt therefrom antl the besls for the allegetl enemption. Any violetion of Sectlon 7031.5 by any ap0�icant tor e pertnit
subjecis Ihe epplicant 10 a clvil penalry of not more then tive huntlred dollers ($500).):
L7 1, as owner of the properry, o� my employees with wages es their sWe compensatbn, WILL DO THE WORK, and the siructure 75 rrot intended or oNeretl for sale (Sec.
7044, Business antl Professions Code: 7he Contractors License Lew dces not apply to an owner of property who Duilds or improves thereon, and who does such work
himself or herself or �hmugh his or her own employees, provided that such improvemems are not intended or oHered for sale. If, however, the building Or improvemeni is
sold within one year of completion, the pwner-6uilder wiil have.ihe burden ol proving that he or she did not build or improve for purpose oi sale.). '
❑ I, as owner of the property, am EXCLU$IVELV CONTRACTNG WITH LICENSED CONTRACTORS to constmct the project (Sec. 7040, eusiness antl Protessions
Code: The conirectors License Ww does not appty to an owner oi pmperty who builtls or impmvas thareon, and who contrecis for such pmlect with a contractor(s)
license pursuant to the Conlradors License Laws.).
❑ I am exempt under sec. Business antl Professions Cotle for i�is reason:
Signature: Date:
Owner ID veniiea by dnveYs license. ❑ Ves ❑ No Dnvefs License No. Expires:
Verification oi Ownership by (type of document, i.e. - properry te�c bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERM17 CERTIFICATON:
❑ 1 hereby certity thai no excava�ion live ($) or more teet in depth Imo which e person is required to tlescend, will be made in connection with work eui�onzed by this
pertnit, antl thai no building structure, sCaftolding, talsework, or tlemolition or tlismantling Ihereof, will be more ihan thlrty-slx (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec.
341, Tltle B, Califomia Administrative COtle).
❑ As owner-builtler, I will not employ enyone to tlo work which would require e pertnit from lhe Division ol Intlustnal Sefery, es noted ebove, unleu such Derson has e
pertnit to do such work irom the diNsion.
Signature: Date:
Division of Intlustnel Satery Permit Number:
CERTIFICA7E OF COMPIJANCE AND AUTHORVA710N OF EMRY: I cenify under penalty of perjury that I have read this epplication and stale ihat the information given is
correcL I egree to comply with all stete lews enC ciry ordinances relating to building consWction, and euthonze representutives of the Ciry ot Costa Mesa ro emer upon the
ebova-descnbed properry tor inspection uryoses. I egree na to occupy or ellow occupency ol eny building authonzed by Ihis Oermit until (inel inspection.
COUE A. INSPECTIONTYVE / QejF INTIfIRLS
1616 Fixed System Final Fire Prevention
1266
200
201
202
203
Paol Spe Final
Flnel Re-Root
Finel Blxk/Reteining Well
Final Faciory Fira Place
Finel Sign
204 Final Demdition
/ � / � �a✓�
Daie
Q,QQ�( INSPECTIONTYPE
206 Finel MeChanlcal
208 Finel Plumhinp
210 Finel Elaclricel
212 Pinel Flre Prevention
220
222
250
Final Plenning Approval
Final Site
Final Building/Occupency
PAg 1ti�L5
!/-.'i'/-03 eg /�
�reaii!I�eooeesa: zz38 CA:HERINE PL
OWNEfl'SN�ME: EUGENE MIYAZAWA
aooness: 1793 ORZOLE
CM CA 92627
RNCNIENGINEER:
�DDflES3:
, ys ��R:
HEG.NO.:
UNR:
PEXMITTFE: SANDKAMP ROOFING ( 714 ) 557-3666
�oo��: 3130 GRISET PL
SANTA ANA CA 92704
IItENSED COMML70B OECUM710N: I �eaCy affirm ttut I am ticense0 unGer D�odsims of Clapter 9(commencin0 �+t� SecUon
7000) ot OMvon 3 0l Na BusNess m0 Professions COGe, aM rtry 6unu is In hA lorce aM ettttt.
cmuc.: 04164o3 sTereuc.:362896 �u� C-39
Date: � Z — l � SlpnaNra:
WOPNFfl3' COMPENSRTION DECIAMTION: I �ereCy atlirm that l ave a certiliwte ot co�e setbinsure ' cate o1 Workers'
Compensatbn Insurance or a c niliW mpy Urereol (Sectlon 3800. LaU. CI.
¢aucvxo.: W04b00�9 exr.o�Te: 04/10/31
{�MPANY: CA COMP INS CO
J CertifieO apy 5 �ereEy Iumistie0. � CeniliM copy'n fileO wi[ �/ BWGinq Divisi
Date: �� Z— 9 0 MDlican'
IXEMPIION FHOM WOHKFIIE' COMPENSITION OECIAMTION: (fli5 sttuon reN not De mmple[eG if errtii 61eww.�un 0 �3100) a less�.
� ceniy that In Ne penormanca of tlre work tw wlurli tNs perMt "a issueU, i snatl mt em0�' N7 erson in any manner w as to become
suhlect ro IAe Worken' ComDensation Laws ai Calitartua.
Date: SiO�a�ua:
'. NOTICE: II, aller maldn0 ��ro��. You SAONE haome suOjM ro t�e Workeri ComDe��n D��ons of Ue �abor
' CaAe, you must IonAwit� campy wltA suc� Drovivons or ihis Dermii sAall Ca deemea revoked.
CONSTPUCTION 1FN01N0 �GENCY: I AereEy aKrm ttat thea k a wnsiruction Imdinp a0ency for tAe Derlormance ot Ihe wark lor
wnich tAis Dermil is IssueE (Sectlon 3097. Gv. CI.
LENOER:
RODflES&:
OWNEP BUILDEN DECUILITION: I AereCy atlirm t�at I am exempt tmm I�e Contractors' Stare License Law tar ihe tollowinp reason
(Section 7031.5 Business anA Gro'esslonal COGe: My dry al counry wNc� reQuirn a permil to comiruct, al[er, Improv4 Eemolh�, ar
repair any stmcture, pdor to Ils issuance, atso reyulres I�e apDlicant lor wc� Dermit to lile a slOneE statement that �e/she Is IlcensoU
pursuant to t�a DroNslons al tAe Controcrors' Sute Llanse Law (Clupter 9(mmmeircinp wit� Smtlon 70W) ol Division 3 0l �Ae Busineu
and Pmfeulons Coda) or l�at MISM Is exempt Nerelmm an0 t�e Oas'a for tAe allepeA eaemD��� �Y hoWtlon ol Sectlon 7031.5 Ey
any aDPlicam lor a DarMt suojecls the �OW��� ro a civll penalry al ret mom tAan iive �urMreE Edlars (5500�.
I, as owner oi IAe properry or my emWq2as wlt� v.ayes az t�eir sole wmpensatlon, wi0 Oo ina wark, aM tAe
❑ simctum rs not intenEeE ar offere0 for sale (Sectlon 70G/. Buvnesz and Professional COEe: The ConVactors' Stata Ucense Law
aoes nol aODN �o an wmer ol a properry wtp OWIQS or im0�wes tAereon, aiM wAo dces wU work �imsell/Icersell or tnroup�
N5 or her own empbyecs, yovlEeA Nat suc0 improvemenis are nol intenACE o� otler¢d lor sale. It, Mwever t�e Ouildinp or
improvement is sdE wit�in qre year oi mmDktian, tAe owner w01 Aave Ne EurEen at provinp tWslie diE not Cui10 ar ImO��'e
for IAe ourpose ol sale).
I, as owner al t�e Droperry am exGusheIy [onlncWp vnth Ikense0 contraclors lo constmct Ne O��ect (Sectlon 7014, Business
❑ a�q Protts9au CoOe: The CanUactors' State Lkmse Uw Eces not appry to am m�w of prope�ty xin MdOs m imProves Nereon
anO wtw contncis lor wch D��I�� 4N a conVapor(s) Ikense Oursuant la tM Contractors' Sum License Law). I am aware
Wt praal al Ilieir WorFer's Compensztbn 4minxe slaulO De 0��� to me.
,� I am eaemD� ���� B. 8 P. C.
', lor Nis reasan:
Date: Ovmer.
I Eo MreOy certiry Wt I am aware ol anE untlersWN Ne repuirements ol Calilomia HealU an0 Salery CoEe Sectlons 25505. 2553J, an0
2553< aM that I ar any M1rture OuiWiny oav0�� wiNn7n not (drde one) MN ro comqy xiN saiE sute caEes an0 Ne reyu'vemenis lor a
permit for consvuction or moEillutim Irom tM Ni�ManaOemenl DisVict. HesiOential wiSWttion apWiwtions aa exemD� ��om
IAese O�ans.
Daro: �1pWiwm:
I �ereEy cenity tAat I have rta0 U5 apD��� � s�ate Itut ��e aCova inlomution is artect. I a0ree ro comOh ��h all dry anE counry
orEinances anC sute laxs MatinO a�0 �V� ��«M � reP��� ol N's dry to enter upon the aDwamentqneE
propeM1y tar insD�on puryoses.
. Date: 7—�' Q d Spnawm: ���
onver's License ar Sacial Secudry x: �
18a1<B W�i�e—BuilEinBl Green—COCe Entorcamem; Canary—ApPliteni: Pink—Ravanue: GOIEenroO—Aasesaor
CITY OF COSTA MESA — HUILUZNG PEAMIT PERM NO; B 047987
PERMZT NO: B 097987 PLAN CIiECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERDtIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION : T/OFF AEROOF SQ FT: 3,250
CLAIM VALUE: 3,250.00 CALC—VALUE: 3,250.00 GROUP OCC: R-3 /
COMMENTS: T/OFF REROOF W/ FZBERGLASS SHINGLES
��r*�*******���#�***�**#+r�#�**�e�r*�*����*+���r�*�r*+�*�*****�r+�*��rx**�r��r*�r#��*���r***�#
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUZLDZNG ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 92607208 ZNE: REF NO:
PLANNING NdTES>
>
iE iE 3f it iF iE iE if iE iE if iE iE iE it'k iElF iE if if if ik �iE jf iE :k�'lE iE if'1E i't iF ik if �E if if jE iE #'lE if ?F?f iF if iE iE iE'k'.E iliE iE iE iE iE!( iE # if iE jE iE iE iE iE iE iE iF if� �E iE ik iE iE if iE
D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED HY .
HIIILDING APPROVED BY :
DATE:
DATE:
APPLICATION ISSUED BY: DATE: O%•O Z 90
'lfifif+F?tlfif�ltikflififilftiflflflflEitifiE�ilxxif l - �xr,.- .�r . ..��iFifiEiklEifikitiflEiEiF-iFlF�iFTr{tar�E
if if if 1f if iElE !f !F ff ff if !t !f !t iflf iF jt 1E'k iE k ik ikltlk �1! i! ih if it iE it if if if i! if i! # M.r it iE M ft iF if !! it if 1t if 1E 1F it if if ff iE iE if iE iElk it iE if iE if iE iE iE iE ib if if iE
LEGALIZATION:N F E E S U.9 M A R Y STAUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63.00 .50
" ' SMIP/NON—RES
PLAN , � .
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECI( ' TOTAL PAID DUE
TOTALS----> 63,50 0.00 •'0.00 63.50 63,50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 63,50 OVER/SHORT: 00
BLDG PMT PLUMBING EL£CTRIC MECHANIC FIR� SMIP/TOT GRADZNG PLAN—CHECK
63.00 .50
iE if if iE ih iF ik if ik it if if itlf if ik if if iE7f iF iF iE iE ik it iE ik it K!E ir'lE iE ik jE?f *�f iE iE if ik it j4 i! 1E if 1f if ik if it if if if iF iE it iF iF jF it if if iE it it if !E i4 iE iF iE iE 1EiE iE aE
I N D I V I D U A L• F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 3250 REROOF BY VALUE RESLDENZAL NOZONE 1.00 3,250.00
END OF FEES
d
I
C, fi0Cd4�2?—tLCo4�2.'+ Ti S17 c3,sC
DATE� 07/0?/90 TIIiE: OE:27
CONSTRUCTION AND PLANNING ' P�' '� SPA
pPPROVALS Permit # Date Intpector APPFOVALS Permit # Date Inspettor
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
Z, 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.
$. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�U�drgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor SYstem 61. APPR�VALTO DEGK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
��12. Sewer Cap 63. Heater & Vent-Final .
� 13. Roof Drains 64. Piumbing System � Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical•Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTER�NG
}g, Rougfi Efectrical-T Bar Ceiling 69. POOLJSPA�SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, in Struc[�re 70. Underground Hydro
22, pucts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe•flough & Tesc 72. Underground Flush
24, Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling IStructura�) & Monocoat 75. Dry Chemical
27, Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation � 7$, FIRE PREV. FINAL
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
35. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electriwl Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric Notes: �%,s��_Ko_[r ��`�_9�N-�-.
34. Final Heating & Air Conditioning � /_�?.�/J
� l �o %�
35. Final Gas PiDe-Test
36. Hood or Canopy �
37. final Factory Fireplace
38. Final Plumbing � C4
39. Water Service�Final �,
40. Gas Service-Final
41. 5olar pomestic-Final �
42. Backflow Preventer
43. 6ackflow Irrigation
44. �andscape Irripation System
45. 5ound Atrenuation
46. Handicap Regulations
q7, FINAL STRUCTURE & BUILDING � zG�.ol (� /,v'
48. FINAL PLANNING
49. Electric Retease to Edison .�
50: Gas Release to Southern California Gas Co •'
51. GERTIFICATE OF OCCUPANCY
No. Date
U
OWNER PALUMFI()� TIIIIN DATE 9-Q2-58 _
JOB ADDRESS �z�H �atherine p18C� BU[LDING PERMIT NO. y6p(�
GENGRAL CONTRACTOR VAL
AP. No. LOT 16 TRACT 32 �IRE ZONE DESCRIPTION OF WORK edwood fence
GR011P TYPE ZONE PLAN NO. 7h 91,
INSPECTIONS I DATE I SUBCONTRACTOii I PERMITSISSUED
DATE NUMBER
mut
COSTA
MESA BUILDIPJG DEPARTk9ENT
P. 0. BOX 317
COSTA MESA CALIFORNIA
C•L. OF STREET
" �iPROP. LINE
� _ _ _ _ — T — _
I 10 FT. FOR 60 FT. STREET
�
�
�
�
�
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w �
rc �
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y I
O. �
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U � I�a
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F T. I ST.
LLEY OR
-�
r� I /
.
PROP LINE LL
--�--'--y----
C.L. OF STREE
b•,
i
i
L�L`I
� ~ �
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OZ� ��
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10 I
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40
N � FT
m �
� so i
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-' ------�
F
w
w
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F
N
LL
0
J
C)
S T.
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES------
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES
��p � � �7��� �
r � FOR APPLICANT /T�O FII.L IN
R_ � BUILDING ADDRESS ��_� � I..ATrft R iAl c
. �.. - C�ir�:iR'�f:7A:a1'I'liLIi7J
� a G .�
. . . !� . �..' �
City Lic. No. State Lic. No.
---- - �-- �J� .�-_-i /6 TGZ 3
Size of Lo G6 C L/`� No. �0 � � a!!�
i/
Setbacks: C/L Street �D � Rear�
��
Side Yard - Right � � � Left
Type of Fence l0 � L� D/�1 j�`y2 i�Zfb l,c/nob
I hereby acknowledge that I have read t4iis application and state
that the above is correct and agree to comply with all City Ord-
inances and State Laws regulating building construction.
FOR OFFICE USE ONLY
I Per
'7
Received by Date Received Dat�
��,�-� � � z- ._j f'
VALUATION
Permit Fee $_
$�� � � Plan Check $_
TOTAL FEE $_
USE REVERSE SIDE FOR DETAILS
0
rl'-ZI
609`7
•COSTA MESA BUILDING DEPARTMENT
/ P. O. BO% 31]
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
�s"s 2238 CATHERINE PLACE
COSTA MESA. CALIFORNIA
FABRE CONSTRUCTION CORP.
"'nooaess 3404 Via Lido
eosra � ���, I
';OV 19•57P�yEgp� �6Ba US.nn
APPLICATION FOR PERMIT
BUILDING ,
FOR OFFICE USE ONLY
c�rv Newport Beach rNo`:OR 3-1240 IqppRE55
OR P cJEE�aymond Levanas N�o,C. %�i% COSTA MESA. CALIFORNIA
AODRE55 3432 Via Oporto, N. B.
CONTRACTOR Lido ConstrucEi�bTiN�o: 75Z0
nooeess 3404 Via LidO
LEGnL LOT
DESCRIPTION NO. �� BL
A.P. NO.
FIRE �
N�: OR 3-1240IB�PROVED pqTE
�ro,..-r3242 CORRECTIONS
srze approx.83005(1.ft,I"o.oF��°°�.none
OF LOT now orv wi
USE OF —�
EXISTING BLDG.
sEie�en^ure FnoM 65� �3400� S
sioE vnRo
REAR VAR
5� 5'
RIGHT LEFT
DESCRIPTION OF WORK
NEW X qLTERATION AODiTION
REPAIR MOVING OEMOLISH
SIZIEDING 146� SQ.ft. ROOMS V STORIES 1
EXTERIOR WAILSLUCCO ROOF �
COVERING COVERING Rock
USE OF NEW Dwellino n / /�
BUILDING b ry�r �i �".
I MEREBV 4C1(NOWLEDGE tMPT I MPVE RERD THIS PPPLICFTION .�ND
ST/�TE TNAT iHE RBOVE IS CORRECT �NO iGREE TO COMGLY WITM AL�
CITY ORD�NPNCE$ AND STRTE lAWS REGVLRi1NG Bl11LOING CONSTPUC�
T���� /� n ) �(�J VPLUATION
SIGNATURE OF �� X_ /L f 1 I ..1 .. 1/
� � s/a 3o f�
,
AUTHORIZED AGENT
PERMIT FEE S
PLAN CNECN S
TOTAL FEE 5