HomeMy WebLinkAbout958 CHEYENNE ST - Building PermitsPFUJECTPDOflESS: 9r�H CxEY�,NiJE .Cil
OWNEF'S NAME: NGUYEN, TUAN V
nooxess: NGUYEN, SIM
958 CHBYENNE ST
� COS'TA ME5A,CA 92626
AXCHIENGINEEN:
aooaess:
flEG.NO.:
UNIT:
uxir:
�
PENMITTEE: lUAN V NG[1YEN ( 714 ) 89'7-4997
aooness: g�g CHEYENNE ST
CUSTA MESA CA 92626
UCENSEO CONTHACTOB OECIANATION: I �ere�y al6rm �ha� I am licensetl untler pmvisions o� C�ap�er 9(commencing with Section
7000� ol Division 3 of Ihe Business antl Professions CoJe, antl my license is in full �orce and eflect.
CITY LIC.: STATE LIC.: CIASS:
Oate: Signa�ure:
WOBKEHS' COMPENSpTION OECLABRTION: I nereby aflirm �ha� I have a cenilicate oi consent m sel4insure or a certificate of workers'
ComDensalion Insurance. or a certifietl capy Ihereot (Seclion 3800, Lab. C�.
POLICY NO.: EXP. �RTE:
� COMPPNY:
❑ Ceridietl copy is here�y �umishea. ❑ Cetlifie0 copY is filetl with t�e ciry Builtling Oivision.
��
Date'. Applicam'.
EXEMPTIONFflOMWOflKEflS'COMPENSA710NOEClAHpTION: (Thisseciionneednolbecomple�eaiflAepermi�islaronehuntlre0�51W�orlesS).
I cetlity iha� in Ne pedormance o� Ihe work �or whicA �his permi� i5 issued. I shall no� employ any person in any manner so as �o become
sublecl �o ie W rkerY �ompensation LawS ol Califomia. �♦ � _� /
'IJ ll/� � /
�ate'. �' Signature� �"`T � A^'
NOTIC : II. aller making Ihis aeclara�ion. you 5houlA becom��o the Workers' Compensa�ion pmvisions o� �he La6or
Cotle, you must fonhwith camply with such pmvisions or inis permit�shall be OeemeO revoke0.
CONSTqUCTION LENOING AGENCY: I hereby alfirm that there is a construction lending agency lar Ihe Dedormance ol ine work for
wnich �his permn is issueQ�Sec(on 3097, Civ. C�. (,j
LENOEN:
ROOflE55:
OWNEfl BUILUEfl OECLAHPTION: I hereby ailirm Ihal I am exempl Irom t�e Contracbrs' State License Law �or ihe following reason
(Sec�ion 7031.5 Business antl Prolessional CoOe'. Nny ciry o� counry whic� requires a pe�mi� lo cons�mct, alter, impmve, tlemolish, or
repai� any s�mcWre. pnor ro i�s issuance, also requires Ihe apDlicani lor such permi� �o �ile a signetl sta�emeni �ha� helshe is Iicense0
pursuant lo the pmvisions ol Ihe Contmctors' Slale License Law (Chap�er 9(commencing wilh Section 7000) of Uivision 3 of Ihe Business
ana Pmfessians Cotle) or Ihai �e/s�e is exempi Iherefmm anA Ihe basis lor Ihe allegetl exemp�ion. Any violation ol Seclion 7031.5 by
any aDPlicant far a permii su�lecls Ihe applicanl Io a civil penaliy oi not more ihan live hundretl tlollars ($500�.
, as owner ol the pmpetly or my employees wilh wages as [heir sole compensa�ion, will tlo ihe work, and �he
❑ slmcture is not imenaetl or ofleretl �or saie (Semion 7044. Business and Professlonal Catle: The ConVacmrs' S�a�e License Law
AoeS nol appty t0 an owner ot a pmperly who Guilds or im0�ove5 �hereon, an0 wh0 doe5 Suth wOtk himSelVhersel� or through
his or her own employees, proviaetl tha� such impmvements are nat in�ended o� o�fereU �o� sale. II, however Ihe builtling or
impmvement is sold wilhin one year ol comple�ioq the awner will have Ihe burden o� pmving he/she Oid not 6ui10 0� impwve
, for (he purpose of sale�.
I, as owner ol Ihe pmperty, am exclusiveiy contracting wi�h IicenSeU can�rac�ors �o cons�mc� Ihe D�ole�� (Sec�ion 7044, Business
�❑ antl Professions Cotle: The Conlraclors' S�a�e License Law tloes no� apP�Y �o an owner oi Omperty who Uuiltls or impmves �hereon
' an� w�o comrac�s for such pmlecis wil� a con�ractoqs) license pursuam m ihe Contracmrs' State License Law�.l am aware
Ihat prool ol Iheir Worker's Campensation insurance s�oNa be pmvitletl lo me.
��. � am exemPt uneer 5emion�B P% � 4 4 d� " P� ��
for Inrs rea�°n BY Q �
Oale: ��/Z"/ � 7 Owne� � /'^7�
I tlo hereby cen�ty �hal I am aware ol and untle�51an0 the requirements oi California Healih and Salery Code Seciions 25505. 25533, and
25534 and �ha� I or any fuWre building occupant will/will not (circle one) neetl to camply wilh 5ai0 s�ate cotles antl Ihe requiremen�s �or a
permil lor consimction or mo0ifica�ion Imm Ihe Air Ouab�y Managemenl �iStncL Fesiden�ial constmc�ian applications are e�empt Imm
Ihese pmvisions.
Date'. Appl7canL
I hereby wriify I�al I �ave reatl��is apPlica�ion antl staie�hatlhe above intorma�ion is wrrecL I ag�ee lo comply with allciry antl couniy
orainancesan�statelawsrelaling�obuildingcons�mc�ionantl�er yauthonzerepresentativeso�ihiscirytoenteruponl�eabove�men�ionetl
pm0etly for i spec�i purposes. /_
� �I / � � . .
�a1e: 2- Signalure: �� �Y`�i /AC�/�
Oriver s Lcense or Social Security
ApPllcanl; Pink—Revenue: Gottlenrotl—Assessor
CITY OF COSTA MESA — BU3liDTNG FERMIT PERM NO; B 061596
PBRMIT NO; H 061596 FLAN CHECK NO: N GOVT: N SUPP; N
CONS1'RUCTION TYPE: 5—N PERMIT TYPE; STk PURPOSE; ALT
JOB DESCRIPTION : T/O EXIS'FING ROOF 6 APPLY NEW ASPH.COMPO SQ FT: 3,UOU
CLAIM VALUE: 3,000.00 CALC—VALUE: 3,000.00 GROUP OCC: R-3 /N,-1
COMMENTS: SMOKE DETECTORS REI�UIRED PER THE 7 591 c^DITION flF ���a�� DET�C�O�R
*�t,r�t�rtrt���k**�*�t�rt-��x�rt****����-x� ���,r��x��t±�i�*�c�x�x�*�t**�t�t�rx��t�f�t�t�*#��x*� f , tt�� t���� �.• �c.
'L O N I N GS ER'TEBQATJCIKRSE: y E N T S R�Q�IRED
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING -------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT; ET IN RGHT; FT ZN LEFT; FT IN RGHT: FT IN
PARKING RE • PROV; PARCEL; 14172318 2NE; REF NO:
PLANIdING N TES>
�•
�x��x�*������r**��*-*�x-�**x*�t�x-�-x��������**�*��*�x+��x�xxx��x��+i��t**�r*��xx*���*�t�xx�-�r�
D E V�E 'L• O P M E N T S E A V I C E S k E� U I R E M B N<`f% S
�
'LONING APPROVEU'BY DATE; t�" '
BUILDING APPkOVEU BY ; _ DATE;
,, ? . —
APPLICATION ISSi��;D &Y;
IE iF jf if iEiE %� 1f %if # lE �E if� ja 3f iE N� iP �lE iE iE�3'F
iE it�rt lf IFif 3t M�iE-%� %�iE�if IE X�iE iE 3(�N� K� N�3f IE iE iE
LEGALIZATION�N
BLUG PM'l PLUMBING
PERNIT 54.00
PLAN
ISSCIE FEE
DATE; '
.+r k� i�- n ir :r ir i(��Eib*iFirAtjE�(�3(��n .�n� �x��-� �riffr
3f�F3fiEiFi4X�iE%3F1EiFiE-:., �EiEN�iE3i�jEX��%%�#3Ei6iFK�kX�3FiE��JtiE'kjEi6lfJF�7FifiEiFN�i(-iF�3Eil-3e
F E E 5 U M M A R Y STRiJCTURAL SEGNEN'T; Y
ELECPRIC MECHANZC FIRE SMIP/RES GRADING
.�0
SMIP/NOV—RES
HU3LDING—DIV—> PERMiT ISSUE PI,AN—CHECK TOTAL PAIP DUE
TOTALS----> 54,50 0,00 0,00 54.�0 59,50 ,00
REVENUE DIVISION T'OTALS--> COiLECTED; 54.50 OVER/SfiORT; ,00
` BLDG PMT PLUMBING ELECTRIC N�ECHRNSC cIRE SMIP/TOT GkADiNG PLAN—CHECH
54,�� ,5�
ii 1E IE iE �lE rt IF iF 1E 3E 3E iE N- iE 341f N� 74 3f M lE if % If iE if� 9h�lE it iE lE iF 3f iE iE-% iE ie �1F 349E 1F if 3E iF IF i(� IE 1f i(� �E �F ik iE 3k -%� �1f If 3F i4 if 1F 1E 1E%1f �l(-3F * 3F 3E !f� 94 # 1'r-1( iF iF iF
Z N U I V I D'J 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 TOTAI� COST
SFR 3000 REROOF BY VALiJE RESIDENTIAL NO'LONE
END OF FEES
1,00 3,OOO.UO
V
jC.'�L��1�...,' .._. , , . ,.
ICON,SiTRUCTION AND PLANNING - � POO� tL SPA �_ `
APPROVALS Pefmit# Date Inspector APPROVAIS Permit# Date Inspector
-i, Temporary EleGtrical Service orPole � _� 52.:Pool & Equipment location _ �
2. Soil Pipe-Undrgrnd. . 53..Steel Reinforcement ' �
3. Electrical Conduix Util.icy�Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding -
5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test
6. Electricai UFER Grnd. 57. APPROVAL�TO COVER�GUNITE
7. Footings . � 58. Electrical Conduit�Undrgmd.
8. Foundation �' 59. Gas Pipe, O Undrgrnd., Test �� � �
9. Water Pipe-Undrgrnd. • - _ ' 60. Backwash l.ines, P-Trap, Q Undrgrnd. ,_
10. 5tructural Floor System "- 61. APPROVAL TO DECK .. �
� 11. Property Sewer Line & House Connection , - 62. Backwash & ReceptorFinal _ '
12. Sewer Cap 63. Heater & Vent-Final - "
j 13. Roof Drains 64. Plumbing System - Finai . ,
74. Rouqh Plumbing 65. Electrical-Final - �
15. Rough Electrical-Conduit 66. Solar System-Finai
�. 16. Rough Electric Wiring � 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectricaLT Bar Ceiling 69. POOLISPA,SYSTEMS FINRL
79. Rough Heating & Air Conditioni�g- PIRE DEPT, REQUIREMEN7 �
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Str�cture 70. Undergroand Hydro.
22. Ducts, Ventilating 77. product Pipiny C7 Gas C Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing /���� 73. Undergmd. Storage Tank C� Gas L Oil
25. Roof Sheathing C//G/�? J4. Overhead Hydro
l% ( t
26. T•Bar Ceiling (Structurall & Monocoat � 75. Dry Chemicai
27. Frame a�d Flashing 76. Dry Standpipe
28. L.athing & Siding � � ?7. FIXED SYSTEM FiNAL
29. Insuiation I I I 78. FIRE PREV. FINAL
30. Drywafi Naiiing "� HEALTH DEPT. REQUIREPAENT
37. Piasrer Brown CAat � �� 79. FINAL INSPECTION
32. Electriral Power Meter-Final � .'� 80. FOOD CERT�FICATE ISSUED {
33. Finai Electric �
�'"�� Notes:
34. Finat Heating & Air Conditioning '��
35. Final Gas Pipe-Tesi I 1!;.' � �
� �..
36. Hood or Canopy �.�%� � ^'
37. Final Faciory Firep�ace � - -
38. Final Plumbing � � � �
39. Water Service�Fina�
40. Gas Service�Finai � � �
41. Solar pomesticFinai '
42. Backflow Preventer � � �
43. Backflow Irrigatiqn ;
44. Landscape Irripatior+SYstem
45. Sound Attenuati�tis � ,
46. Handicap AegulaUo65 ; ,- � ,
� 47. FINALSTRUCT.UREr$,$UILOING C��3� �
. �� �
48. FINALPLANNING '=. ( '
✓ :
49. Electric Release to Edis� ��,
50. Gas Release to $ouYherri,Califomia Gas Co �
51. CERTIFICATE Of OCCUPANCY •
No. Date
i' '.'v'b t'^s"�h-C}� .s•x. , ;. . . �fr . LyL�wt x�u.at ' ,. ,Sj.,1 .: �M.^, . . . . '
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x �,i
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{ ° "��. ,; Costa Mesa, Calif.
.�. `�..H . ...
x.4 '� � -n � , ' ' - . , . .. _
a , ', : . � January 31, 1968 �
. . " . ; i . � �'�--
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� �4� ` - The undersignedF�.°•.�.�./�P�/^ :�, purcheser of I,ot ;x �...., '_
�iF� �;� �a��..:` �, ' .. ' . � .. � . .� : � . � �..�.. � �. . . . ` � -_�.r.
' ''' Tract �5994 Count of Oran e st�etes that � he, is �n�illin� and �
�,�, .t� ..,, , �r . , y g , ,
� , t ?, , ' ' . ' . "" ` , ,
„ desirous of receiving irr�mediate possession of said property ,'`r , ,.
,,, �7:, M, � �
+'� f : � ,�� .' . ,
4�.t� r�, y;,He will not complain or,cause'ar�y action against the City of ,' ,;
, � , _ . �•s:
," ��',r -�� ' Costa Mesa; FHA or .'VA; 'or .Rancho Mesa Venture due to incomplete '
� �,,:�.s�'� r..:,n� � . '�. � ..
�;��n� %,�drive-way,.Strect� fencing, or any other items connected wi.th ��
'.N, � x,T.c� . � . ,.
,
F i �^" i1.> .'�_" i- . . �� ,. , . ., . . .
a
�� ' above residence, r ' '' " '
� �;,�::. ,.,; - .
� ; ,. ,-;:.:.
�,.. : �,, ••.
�':,;,=��y�' �ry' �,It. is;understood �that any items not comoleted at time of � '
, � aFr � � .. �� , . �. . . . . -
� ,.,
,:�` "F`'....^c-,:`possession will `be fini�hed according to VA/FHA s�ecilications "
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9 .� .� : ; . . . ' . ' . . ° ' `_. '
�s ', ,.� y� a`s soon as time and weather permit.'..;, ' • ."
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�"''�u;; � = Schmi�d DevelopmentL Co. ' ��+c.�G �� 1�< r�,�Sa.,,��La�� �,'/��.
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� OWNER p�pp Mgl
� JOB ADDRE55 Cheqemle,_S
.� GENERAL CONTRACTOR OviIICT
AP No. l�i1-723-1a LOT
'� INSPECTIONS
S
SOIL
� GAS
� WATER
�1 ROUGH PLUMBING
PROP. SWR. LINE � HOUSE CON. �
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AryD AIR CON�ITIONING
TEMPORAftY SERVICE OR POLE
UNOERGROIIND � POWER �
0.0UGM WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SYSTEM '
BON� BENM � STEEL REINFORCE [�
SHEATHING
FRAME RNO FLASryING '
LATHING - IN OUi n
PLASTER,BROWN COAT
ST0.UCTl1RAL, FINqL
HEATING. VENT., REFRIG. ANO A.C., FINAL
PLUMBING, FINAL qN0 GAS TEST ❑
ElECT0.1C, FINAL
BUIL�ING, FINAL
DATE
SUBCONTRACTOR
�.
� y 4019�7
COSTA MESA BUILDING-SAFETV DEPAF
P,O. BOX 1200 COSTA MESA, CALIFORNIP
For Applicant to Fi7! in Completely
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ADDRE
OWNER
MAIL
CI7v
ADDRESS
ARCHITECT
ADDRE55
CONTRp.CTOR
ADDRESS
CITY
STATE
IIC. NO.
512E '
oF �07
USE Oi
EXISTING B�DG.
sizE oF ,.
WALL
USE OF
TEL.
TEL.
NO.
CITV
LIC. Np.
INO.O BLF�
NOW ON LOT
NO.OF
ROOMS STOI
ROOF
COVERING
K,TO eE PERFORMED
vatn
!111 —7_-7.5�ri,,,00 ?_35* �*A�-7.56
T�ON FOR BUILDING PERMIT
. D/ r �Ewi� D%7E �7 U
BUILDING
ADDRESS
VALUE
ED
— L�
�`�,�� NO.OFrj IUSEOFNE�r�
� i PIANS �� BUILDING � ��
VARDSAPPROVED VAflDSAPPROVED
MAIN BUILOING ACCESSORY BUILOING
REAR �
DI5TANCE BET
MAIN BLDGS.
VAR. �
1 hereby acknowledBe that 1 hava reatl thin appiication antl staie
that the above intormation is correct antl agree to comply with
all lews regulating buildinB construction, antl I shall not employ
any per5on in violetion af the workman's compensation laws ot
the State of Calitornie.
I hereby cartity thet I am Oroperly Iicensatl as a contractor untler Sn• F
the Stat2 ot California Businass entl Professions Cotle, Divisicn 3, THE AMOVNT:
Chapxer 9, antl thet such licenses are in full force antl effect, or I THE PVRPpSE O
am exerr�Pt from the provisions of ihe State of California Business VALUATION
antl Professions Code, DivisiOn 3, Chapte� j9�
Sipnatura%�yy�--v/ \�ri'�vLSt.w/� $ / / ,( /
Permlttee ff. /
� jA iv ti�
AuthoriTed Agent
BET.
ACCE
DATE
TOTAL FEE
� m
G
VALUATION IS FOR j
A PERMIT FEE ONLY: m
¢
m
E $ � �
]
m
K$ E
r7 °
LL
SWAN CONSTRUCTORS
BUII.DING
DESCRIPTION OF NORK �
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Date GAOUP J TYPE III
SUBCONTRACTOR I Datc
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COSTA MESA BUILDINCrSAFETY DEPARTMENT
P.O. BOX 1200 � COSTA ME8A� CALIFORNIA 92620
For AppllcanT fa Fifl In Campleroly
TYPE OR PRINT �
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DESCRIP7lON OF WORK
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APPLICATION fOR PERMR
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VALUATION � � � �
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TOTAL FEE $
,
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COSTA MESA BUILDING-SAFETY DEPARiMENT
P.O. BOX 73W � COSTA MESq� CALIFORNIA�Y262!
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� TH8 AMOUNT BXOWN UND6R VAWATON IH POp TH8 j
PUPPO88 OP 6BTABLIBHINO A PEflMIT PE6 ONLY. 5
VALUATION �
PERMIT FE6 �� � p
g� D 6 91 33- w
TOTAL FEE Y ���
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