HomeMy WebLinkAbout1119 CHARLESTON ST - Building Permits(714) 754-5273 • Fax (714) 754-4856
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address: 1119 CHARLESTON ST
Suite:
Vicinity:
Parcel Nunmber: 14169210
BUILDING PERMIT
Zoning: R1
R1
Applicant:
CLOUD, DANIAL H
Address:
CLOUD, KATHLEEN S
COSTA MESA,CA
Phone:
1119 CHARLESTON ST
Zip:' 92626
Owner:
CLOUD, DANIAL H
Address
CLOUD, KATHLEEN S
,
COSTA MESA,CA
Phone:
1119. CHARLESTON ST''.
Zip: 92626,.
Contractor
Address:
Phone:
Zip:
License:.
Arch / Eng
Address:
- -
- --
r' ,yPfione;
'
License:
P IPAR
M ER
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 07/15/1998
Issued: 07/15/1998
SCOPE OF PERMIT
r 59 LIN. FT OF 6 FT HIGH BLOCK WALL, 25 LINEAL FEET OF 4.1/2 FOOT HIGH BLOCK WALL, 17
i 1/2 LINEAL FEET OF 2.1/2 FT HIGH BLOCK WALL ON THE SIDE PROPERTY LINE
FEE SUMMARY
Plan Check: $26.16 -- Calc Valuation: $1,200.00
Permit: $40.25 _ _ Claimed Valuation: $1,200.00
..SMIP Res: $0.50 �� t
SMIP Com: $0.00
Other: $0.00 _ - —
-
Inspection:. $0.00
,Total:' $66.91,
SETBACKS
MAIN STRUCTURE Front 0-0 " ` Rea r"00. 0,
ACCESSORY Front "0-0 Rear- 0-0
PARKING Existing: 0 Required: 0
NOTES:
PLANNING & ZONING
Left . 0-0 - Right '0- 0
Left 0-0 Right 0-0
Proposed: 0
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
G
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.
❑ 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 issued.
My workers' compensation Insurance carrier and policy number are:
Carder: Policy Number.
(TMs sactlon need not be completed I/ the permit is valued of one hundred dollars ($100) or less.)
I certify, that In the do c 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 Is o Cal an agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with thes pr vis d'
plicant Signature: Date: D"
WARNING: FAILURE TO SECURE WORKERS' MPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed ndce� o its of spier 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full
forand effect. Lir M a Class k
Contractor's Signa re: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there Is a construction lending agency for the performance of the work for which this perrnit is Issued. (Sec. 3097, Civil Cade).
Lender's Name: Lender's Address:
Signature: Date:
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($SOO).):
❑ 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.).
❑ I, as owner o1 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 ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
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, Art 2, Sec.
341, Title 6, 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 2DO 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 Costs 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 01 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 If en RMPP Is presently requlretl, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
....................................................................................................................................................................................................................................................................................
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plicatlon appermlt for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residemal building permits).
....................................................................................................................................................................................................................................................................................
8 Will any pert 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 proscribed by California Health and Safety Code Section 42303 been made ❑Yes ❑ No
....................................................................................................................................................................................................................................................................................
8 (If yes', attach Cortificale of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is coram. 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 slate that the Information given is
correct. I ree 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 -d scI'i ed property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
toe Of Legal Clwner(s) Date
Jn)Mr Authorized Applicant Date
QQR t. INSPECTION TYPE PATE INTIRALs CODE INSPECTIONTYPE lim INTRIALj
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 206 Final Plumbing
200 Final Re -Roof -7 210 Final Electrical
201 Final Block/Retaining Wall /'l' 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
2446.46
612?
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this /-17 day of
by and between
hereinafter referred to as "LANDOWNER," and
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between
of Adjoining Properties)
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book _L , Page ,Eof Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach M LQ9✓�rL
-_/_�_ �
�LFv3/.
phO_
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
(S g n at u re)'"�4GQl
k4AJ4JE-A/ 11/_Ec01 Y—L-/V
Name (Typed or Printed)
,11,?3 - 19 RZEsTon/ sT,
(Address)
(os TA NILS4f �A 9aEo X
t9M46
ADJACENT PROPERTY OWNER
(Signature)
Name (Typed or Printed)
NOTARIZATION REQUIREDDI
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of _
County of
No. 5907
On S before me,('A,1
61 V DATE NAME, TITLE OF OFFICER -E.G.,'A EDGE, NOTARY UBuc-
personally appeared /t� � % znwQ
E(S) OF SIGNERS)
❑ personally known to me - OR -proved to me on the basis of satisfactory evidence
to be the person(4,whose name(s) is/ar-e-
subscribed to the within instrument and ac-
knowledged to me that he/she/they executed
the same in his/her/their- authorized
CHEIM RAE HELWIG capacity(imes)r-and that by h+s/her/their-
CommissionS 1182626 signature(s. on the instrument the persons,
Notary Public - Col;fomp
Orange County - or the entity upon behalf of which the
My Comm.Expi/es Jun 3,2002 1 person (s�,acted, executed the instrument.
WITNESS my hand and official seal.
C-4,4_,eel zfeTS "17-
,r
SIGNATURE OF AOTARY
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could prevent
fraudulent reattachment of this form.
CAPACITY CLAIMED BY SIGNER
❑ INDIVIDUAL
❑ CORPORATE OFFICER
TITLE(S)
❑ PARTNER(S) ❑ LIMITED
❑ GENERAL
❑ ATTORNEY-IN-FACT
❑ TRUSTEE(S)
❑ GUARDIAN/CONSERVATOR
❑ OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON(S) OR ENTITY(IES)
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
01993 NATIONAL NOTARY ASSOCIATION - 6236 Remmet Ave., P.O. Box 7164 - Canoga Park, CA 91309-7184
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this day of
/—
/99�, by and between __�Fi C—Lw i)
hereinafter referred to as "LANDOWNER," and
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between
(Address of Adjoining Properties)
ST_
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LA ER
(Signal
DANNY H. CLOUD
Name (Typed or Printed)
ADJACENT PROPERTY OWNER
(Signature)
Name (Typed or Printed)
1119 CHARLESTON ST., COSTA MESA, CA 92626
(Address)
190646
(Address) '
NOTARIZATION REQUIRED
A
AME_RI�
�9
)
STATE OF CALIFORNIA )ss.
COUNTY OF ORANGE }
On JULY 15, 1998 , before me, CAROL
personally appeared
DANNY H. CLOUD
personally known to me
(or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signatures) on the instrument the
person(s) or the entity upon behalf of which the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signature
C CAROL S. V:OTA9�USt-CC'tFoT;
Camra M707
_ G. g ORANGE COOComm. E.p. Sept.99
(This area for official notarial seal)
Title of Document PARTY WALL AGREEMENT
Date of Document JULY 15, 1998 No. of Pages 1
Other signatures not acknowledged none
3008 (1194) (General)
First American Title Insurance Company
APPROVED
CITY OF COSTA MESA
BJ&//�� PLANNING DIV.
T_TO BLDG. DEPT. R'.
L,)c-�
P
5q
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Cement Coping Optional --
Channel Block With 1-3/856
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8" 0 at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8-0 at 32" O.C.
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-15-39
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURALGRADE
TWO 3/8"4 BARS
CONTINUOUS TOP
& BOTTOM
HOR17—STEEL MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION.
TYPICAL 611 CONCRETE BLOCK FENCE
w
I DnI�
-►i
WIDTH
SEEp SEE CH[
99 BELOW
o L
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR:
One Part Plastic Cement, and
. . . . . .14" . . .
Three Parts Sand
GROUT:
One Part Cement Three and
.10°
One Half Parts Sand
COPING:
One Part Cement, Three
.20" . . . . .
Parts Sand
CONCRETE:
Well Mixed 1:2-1/2:3-1/2
14'
Max. of 7-1/2 Gallons of
Water Per Sack of Cement
GROUT MAY BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H OF EARTHTCOTH
1/3 THE HEIGTH OF FENCE
BLOW BOTTOM OF FOOTING
WIDTH
.14' . .
. . . . . .14" . . .
12". .
THICKNESS
.10.
.10°
8"
DEPTH OF EARTHTOOTH
24"
.20" . . . . .
. . . . . 16"
SPACING OF EARTHTOOTH.
12'
14'
. . . . . 16'.
City of Costa Mesa, California
Building Department
h:EV1hED NOV. BZ
SCALE' 1/2to= I'
12"
8"
12"
16'
MDRE330FOUtLDWG: 1119 CHARLESTON ST UMT:
SPRAKER MARK L FLOOD: X 47
1119 CHARLESTON ST
COSTA MESA,CA 92626
549-2580
APPL. MAILM ADDRESS:
ARCNRECT OR ENI3 iEFA:
AROlt OR ENG'S ADDIIEM:
UCN0:
UMT:
cwmAcmn9NAw-' WEST COAST ROOFING/CHICK (714)567-9448
cOmAcfOR9MALRO 16822 BLANTON
ADDREm HUNTINGTON BEACH CA ucr - 707696
92649 UMr: A
LICENSED CONTRACTORS DECLARATION: I hereby affirm under thereat, d perjury thel I Are Icemed under Prwiacns d Chapter 9
(commamiag wish S dtion 7000) d Division 3 of the Bugmss end Professions Code, end my trona a In full lass end effect.
OfLIC. NO.:068446 uc.Cues: C 39 LiC7rA 96 EXP: 09/97
Dale. It I .L �56 Connector: II
,J�1
OWNER BUILDER DECLARATION: I hereby affirm under Mnaky of perjury No I are exempt Iron the Conlrmors Licenee Lew lor the
folcwn0 reason (Seolion 7031.5 Business and Professions Coda: Any city or county which require, a permit to coratruot, err, Mproes,
demolish, or repair any structure. prior to its Isvuance. abo requires she applicant Im such permit to fib a signed statement Due M or she
s licensed Punaenl to the aovislone of Ne Contractors Lioenae Lew (Chapter 9 (commepyag with Section 7000) of Dention 3 of the
Busirren end Professions Code) or that M or she is exempt thaeMm and IM haus for Na staged aamplion. Arty vidtlion of Soren
7°31.5 by any applicant for a permit subpcte the applicant to a cat perafty of not mise then Ma hundred dollars (55001).
❑ I, as owner of the propery or my employees wuh wages As their site mmpersomon, will do the work, and the mumuse in m Intended
or offeree her Axis (Senior 7044, Business; and Pmlessic rut Code: TM Contractor I.bnes law dose not apply to an owed popery
Mho build. or in, mvu Maroon, end wed does ouch work Iimsel or heroM or thrmgh M or her own employese. proAded thel such
imlxm+nona ere no, intruded or offered for eels. 1. however, the building or kngovpnM g sold within one year of completion. Me
.4,uilder will have he buNen d provug he or she did not build or en,sme, I. the pontoons d ala).
❑ I, M owner d the pop". sm ucknively commdlg Must licensed ompeclore to eonmera the pajen (Section 7044, Business And
Professions Coda: The CaHredwe license Law does no, apply to an awe of Property, wed builds or impwa Manson and wed
contracts for suds projects rush a cantrmods) Icensed ptnueM to Me CoMredae Licem , Law).
❑ I Am exempt under Section: B. & P.C., for this ruson:
Date: Owner:
I & hereby candy Nal I ant nwera d end underoMrd ted rommen me of CaBomda 1Neah and Safety Code Servs:t55o5. P•v.533, end
25534,
And del I er any Inure Wild W occupant will I will m (drab one) used to campy M,h said Bele codes end the requirements for
a perms for comWction or modification Imnled Akelty .rest Dished. ReeNaphad wWngen appirmbro aer exempt from these
pmeteon..
WORKER'S COMPENSATION DECLARATION: I hereby affirm oder perdxiy of perjury oro of the following decimations:
❑ 1 hive and willetaiman a can host. of portent to satinguro for Morkmi conq ansmcn. As prmaded for by Sadiron 3700ofthe Lebor
Code, for the pedustrame of the work for which this perms la issued.
❑ I have end coil meierec woMere' pompemation inaronca, as resumed by Section 3700 of IM Labor Code, fp the Perorndudu of the
corm for which This permit is Hued. My waken' compengetion insurance certier end poky ramber era:
Cerner:
Policy Number:
(Thin sermon need no be completed it ted prumR is for one hundred unites /drool or hour)
❑ 1 omty that in the performance d ted work fru Much this pem'n is issued, I shall nit employ any person in any manner eo asto
become subjeof to the workers' compensation laws of CxidomiA ggqrrrddd roc iho it ahWid became abjed to IM Modus'
nompona i'oyn p Maiom d Smipn 3700 d the Labor Code. eMW�hwsply trow3pro+muu.
Dos: I {,L i6 APgiram:
Wmele,y. F.111 M Al. wmlrmi conpensedon cuveregs le unbwdu( end slops ereylect an employer ro pdminel'meld" and
.1sul Suss w m one hundred fMuurd dollen ($109000A M edd/pon Is the coat of rompenaflort dantpes as pmvldm roc In
Secdcn 3705 of the Labor Code, InMsel, end mssmey'a lea.
CONSTRUCTION LENDING AGENCY: 1 hereby Affirm under perWy d P-mY thed there b e aorWrmion Wrdrg e9eney for the
perform. d the work for Mhich ted perm, u sassed (Bmion 3097. civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I canny the, I haw reed No appticauon end gets Ther the above infatuation is coned. l apse to comply with al ay add county ordinances
end gate lam reins g b butdsg construction end hereby arborize repraeraada'a d this dy to sour upon Me xiAo e-nd.ntion.d property
for nspedion purposes.
MARK CHICK
Pr{(• Date:
Signalof w AppkcaAVCcMmcIor
(515P46.WP) WhM-Duild'vg 8 Safety; Grseo-Fle; CAwy-Appleent; Pink-Reanoo; Goldenrod-Asauor
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 080559
CONSTRUCTION TYPE:
PLAN CHECK NO: N
PERMIT TYPE: STR
PERM NO: B 080559
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : T/OFF SHEATH & REROOF W/ASPHALT SHINGLES SQ FT: 5,000
CLAIM VALUE: 5,000.00 CALC-VALUE: 5,000.00 GROUP OCC: R-3 /
COMMENTS: REROOF 2400SF RESIDENCE W/COMP, SMOKE DETECTORS REQ
+3��PER
[994UBCC
E*x** ** *all** *r*# *Z OMEN I N*GS ERI EHQAUCIKRSE MifEafNiET*S�71VI®�KE DETECTORTry
------------ MAIN BUILDING ---------- --------- ACCESSORY BUif&ckjQU.li9E61---
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 14169210 ZNE: REF NO:_
PLANNING NOTES>
>
if * ill ill ill if if * * ill dE Sf dE ff iF ill dE fE ifirk ill ill fE it dE it 1E lE if if ie iF * ill ill if if Ih 1E ill dF ill ill ill dF dE ie * ill i! if db if if If 4 dk * jE ill N -if * fE ill * ill iF'iE ill k irk if ill ill ill 1E ill If
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY DATE: _T
APPLICATION ISSUED BY: DATE: Q;ii a
iE��f-�i*+t air �r��f it it it it it ic-it io- fEit it it + *+�**�t�at-ill*ic;F;FiF3F�E+r
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 99.75 ,50
SMIP/NON-RES
PLAN
ISSUE FEF.
BUILDING -DIV->
PERMIT
ISSUE
PLAN -CHECK
TOTAL PAID
DUE
TOTALS ---- >
100,25
0,00
0.00
100,25 100,25
.00
REVENUE DIVISION TOTALS-->
COLLECTED:
100,25 OVER/SHORT:
,00
BLDG PMT
PLUMBING ELECTRIC
MECHANIC
FIRE SMIP/TOT GRADING
PLAN -CHECK
99.75
,50
ill 3E ill 3E ill 1f if ill ii 1E ih 1F Ih ill ill ill ill if dE dE ill ill ill ill *ill
ill 1E ill ill ill ill
if ill ill ill iS 1E ill ill iF ill dE 3E ill
lF ff !E IE IE if ill ill * * ill if ill fE ill ill ill ill ill if if 9E fE ill ill dE ill ill ill 1E ill 1b ill ill
I N D I V
I D U
A L F E E
B R 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 5000
REROOF BY
VALUE
RESIDENTIAL
NOZONE 1,00
5,000,00
END OF FEES
01 00219716-00219717 TOT 100.25
DATE: 11/22/95 TIME: 10:50
.CONSTRUCTION AND PLANNING
e'kPi PROVALS Permit #
Date
Inspector
PC . SPA '
APPROVALS Permit #
Date
Inspector
,VI. 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.
i
B. Foundation
59, Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P-Trap, ❑ 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
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping ❑ Gas ❑ Oil
23. Gas Pipe-Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathingf
�,�p-��
&/4ice
�
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:
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. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
"?�3st
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 917 COSTA MESA, CALIFORNIA
SSSSSSSS
For Applicant to Fill In Completely
TYPE OR PRINT
BUILDING
ADDRESS
COSTA MESA, CALIFORNIA
FEE RECEIVED
i1AW 1 7 191.4
FINANCE DEPI.CV
p
APPLCTICN 9FEhSI
BUILDING
For Office Use Only
RECEIP1 NO.
Y DATE ..91 SO .DATE DATEISSUED
CiLg
11 V,
TEL.
APPROVED
BY DATE
ZONING
NOW ON LOT
YARDS APPROVED
YARDS APPROVED
ZOIL)
NO. OPS
UEEO N
ACCESSORY BUILDING
EXISTING BLDG.
S 4 r
c:
I
/
PLANS -/
I 111
EUIL
FRONT FT.
FT.
SIDEYARDI LEFT
I RIGI4T J
R. SIDE FT.
S
1)
l Q r yC'i
l
LEGAL
DESCRIPTION
rA-rA1
L. SIDE
1 `
A. P. NO.
�[
`
L1'y
O l
/ -I
TEL.NO. S J� _ Q /
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
90' TO SIDE B REAR P. L.
EAVES
REAR . - U -
sl<e O 1
O
I No. oP "LO S.—
ALLOWED
(U. B. C. REQUIREMENT)
OF LOT X `
NOW ON LOT
YARDS APPROVED
YARDS APPROVED
USE OF �.,�
MAIN BUILDING
ACCESSORY BUILDING
EXISTING BLDG.
(FROM REST)
SETBACK LINE FROM
ceNTER OF STREET O REAR YARD
FRONT FT.
FT.
SIDEYARDI LEFT
I RIGI4T J
R. SIDE FT.
FT.
/PT.
DESCRIPTION OF WORK
L. SIDE
FT.
NEW
�[
`
ALTERATION
ADDITION
REAR . - U -
FT.
DISTANCE BET.
BET. MAIN Q
REPAIR
MOVING
DEMOLISH
MAIN SLOGS.
ACCESS. LD S.
BUILDING y3 y NO. OF
VAR.#
DATE
SIZE ROOMS STORIES
G. U.P
APPROVED
EXTERIOR WALLROOF 1
COVERING C O COVERING P�1'� •Q
APPR
BY ti
DATE
USE OF B ILDINO ND WORK TO BE PERPORMED
L�S
-
/ -
I`y-
SO. FT. dO
REBY ACKNOWLEDGE THAT 1 8 READ THIS APPLICATION
THEAMOUNT SHOWN NDER VALUATION IB POR THE
STAT8 THAT O COq T AND AGREE TO CO..
PURPOSE OF ESTABLISHING A PERMIT FRE ONLY.
WITH AL TY ORD N AND ATE LAWS flEGULATING
VALUATION
DINGCPERMIT
FEENATUR
OPrE
LAUTHORIZED
�, o
/ a.,
AGENT
TOTAL FEE 5