HomeMy WebLinkAbout3036 CLUB HOUSE RD - Building Permits�
7
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PflOJECTA�OflESS: 3OBG CLUH HOUSE RD
owNEn s iame COL EMAN DAN I EL B
�, nooness: 3280 DO�,ONITA AVE
HACIENDA HEIGHTS.CA 91745
AFCMIENGINEEfl:
FDOflESS:
flEG.NO.:
UNIT:
UNIT:
PEpminEE. PETEkSON ROOFING ( 719 ) 979-7111
aoonEss: 30G'0j'p6, ENTjEyRPRISE (� p
LICENSED CONTBACTOB D7CLIBATIONM�eCreb-y aifirm Ihat I am licensetl under pr�ovisios ofC�pYer 9(commencing wilh $ection
7000� ot Division 3 0� t�e Business ane Professions Catle. and my license is in �ull �orce and eilec�.
ciTvuc.: 095445 STqTELIC.:6O-�H-�2 c�ass: _
�ate: _��_- G_y SignaWre'. �_� ..-P
WOflNEPS' COMPENSATION OECNPIITION: I hereby a��irm Iha� }Tave a cerlilica�e oi consent �o sell-insure or a ceni�icate o� Workers'
Compensation Insurance. or a cerllliea cnpy thereoi (Section 3800. Lab. C).
roucvNo.: NC3501565 E%P.OATE: 03/2O/9S
comraNr: REPUBLIC
� Certilietl copY is �ereby fumis�ed. � Cerii�ied coDY is file0 with Ihe ciry Builtling Divisian.
Oate: S"g� �U qpplicanl: �'�ay ��
E%EMPTIONFROMWOBNEBS'fAMPEN5ATI0N0ECLFNATION: ��SSec�ionneeUnalbecomple�etlitthepermiti5foronehunOreA�5100�or1e55).
I ceNly Ihat in I�e petlormance of �he work tor which this permit is issuetl, I shall not employ any De�son in any manner so as �o become
su�lea� io the VJarMers' Compensalion Laws ot Calilomia.
�ate'. Signamre:
NOTICE: Ii. a�ter making this tleclaration, you s�ould become su�lecl to Ihe Workers' Compensalion provisions o� lhe Labor
CoOe. you muSl �ort�with comply with such pwvisons or Ihis permi� shall be tleemea revokeU.
CONSTBUCTION LENOING aGENCY: I hereby aHirm that ihere is a constmc�ion leneing agency lor the pedormance o1 ihe work for
which IhiS pPrmil IS i55uEtl (S¢C�iOn 3097. Civ. C�.
LENOEfl:
A�OFE55:
OWNEP BUILOEB OECIAXpTION: I M1ere�y atlirm t�at I am exempl tmm Ihe ConUadors' Slaie License Law �or �he lollowing reason
(Sec�ion 709L5 Business ana Pmiessional Coae: Nny ci�y of caunry which requires a permi� to conSlmcL alter, improve, Oemolish, or
repair any Slmcime. prior lo its issuance, also requires Ihe applicant �or such permil to file a 5igneU slatemen� that he/she is licensed
pursuant io �he O�ovisons o� the Cantracmrs' Sia�e License Law (C�aO�er 9(commencing wi�� Section 7000) ol Division 3 oi I�e Business
antl Pmfessions Code� or �ha� helshe is exemp� thereham and the basis tar �he alleged exempiion. Any vioiation o� Sec�ian 7031.5 �y
any applicani lor a De�mi� subjecis Ihe applicanl ro a civil penalty af na� more Nan five �untlre0 tlollars ($500�.
I, as awner of Ihe pmpehy or my employees with wages as �heir so@ compensation, wiu Uo ine work, and t�e
❑ stmcmre is not intende0 or offerea for sale (Section 7044. 6usiness and Pmiessional Code: The Conlractors' State License Law
tloes nol apply lo an owner oi a pmperiy who builtls or improves ihereon, and who does such work himseli/herself o� ��mugh
his ar her own employees. pmvitletl �ha� such improvemenis are not intenaetl or offeretl for sale. II, however Ihe 6uiltling or
impmvement is soltl wilhin one year ol complelion, �he owner will �ave the buraen o� pmving he/she Oid no� 6uiltl or improve
tor Ihe purpose oi sale�.
I. as owner o� �he pmperly, am exclusivety conVacting wiih licensed conlractors �o constmc� �he Omle�� (Seclion 704E, Business
❑ and Protessions Cotle: The Contractors' S�a�e License Law tloes nol apDty to an owner of OroDerty who builtls or impwves thereon
antl w�0 tOnlratis lor 5uth pmlett5 wrth a tonVatbr(S�license pursuant�o Ihe Con[raC�ors' Sta�e LiCense Law�. I am aware
Ihal pm01 0l Iheir Worker'S Compen5alion insurante s�auld �e pmvidetl to me.
� I am exempl un0er Sec�ion'. B. 8 P. C.
for this reasan:
Oale: Owner.
I do hereby ceNty Ihal I am aware ol antl untlerstana the repuirements oi Calilamia Heal�h and Salery CaOe Sec�ions 25505, 25533, antl
2553G antl Ihai I o� any Iwure Ouiltling occupan� will/will no� (cirde one) need lo comply wilh 5ai0 s�ale cotles ana the requiremen[s for a
permii lo� cons�mc�ion or moddication �mm I�e Nir Oualiiy Management DisVic�. Fesitleniial cons�mc�ion apPlica�ians are exemp� hom
these pmvismns.
�ale'. ApplicanP.
I �ereby cer�tlytha� I �ave rea0this applica�ion antl stale Iha� Ine above in�ormationis correct. I agreeio comply wi�h all cily and couniy
ordinances anA 9ate laws relating to bwiding conslmcimn and hereby aNhorize represenialives of Ihls cAy to en�er upon �he above�mentioned
prapeny lor mpspecfion yurposes.
�aie: �rO � 1 �'� SignaWre' � ��/i`�
Orive�S L¢ense oi Social Security a: ��
t6�1�46 �^/Me—Bwltling: Green—Cotle EnforcemenL Canary—ApplsanL Plnk—Revenue'. Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: H 067096 PLAN CHECK NO:
CONSTRUCTION TYPE: V-5 PERMIT TYPE; STR
JOB DESCRIPTION ; REMOVE BUR & REPLACE W/BUR
Cl
PERM NU; B 067096
GOVT: N SUPP: N
PURPOSE: OTA
SQ FT: 1,786
CLAIM VALUE; 1,786,00 CALC—VALUE: 1,786.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS RE�UIRED PER 91 UBC
iFiEiEiP1E1E�7f�1EiEiflFiFiflflFiFiEiEjEiElEiEjEiFfElF1EaE iEiEiEiEiE1EiElE1ElEifiEiEififikiFiE�E�(�iEfFiElkiRfflElEifiEiEffiElEiElFiEiEifiFifiEjEiFifififiEiEiE
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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
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: 13951529 ZNE: REF NO;
PLANNING NOTES> }•
,) , ,
iE iP iE iE iE iE iE if if iF iF iE iE iE if-1E if if if if jf iE iE iF if i! if iE it iE 1E k iE if if 1E iE k iE k iE iE 7f it if iE if if iE if jE %iE iE iE 1f M iE if if iE iE itlE jE iE iF 3f if"aE iE iE iE jF if iE if fE 1E
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
' �'� W
ZONING APPROVED BY DATE: i•
BUILDING APPROVED BY ; DATE: `�'�
APPLICATION ISSUED BY: DATE: '�c �
iFiEififjEiEiFiFiFik3EiF9E'1E�F3fiEjfiRiFiFif 1f9ffEifiEiGiEiEiEiE . iAiFiEiF
iE iE iE it if iE iE iF iE 9F iE 9t iE 9E iF #F *%iE it 1E 1E iE jE �f iE iE iE 1E iE iE iE if iE ik iE if iE iE iF aE iE if iE 14 if iE iE iF �F iE if if iE if iE �E 1E iE iE iE iF iE it if �E if iF iE iF 9E it if iE �F if if it 1f
LEGALIZATION:N F E E S U M M A A Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 41.00 50
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
PERMIT ISSUE PLAN—CHECK TOTAL
41.50 0.00 0.00 41.50
SMIP/NON—RES
PAID DUE
41,50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 41.50 OVER/SHORT: ,00
HLDG PMT PLUMBING ELECTRIC MECIiANIC FIRE SMIP/TOT GRADING PLAN—CHECK
41.00 ,SO
if iF 1E �f jE iF iE iF iE jf iE iF if if iE iF iE aE jE iE iE 14 iE if iE iE iF iElf �E iE if iE iE 1E!! iF 1Elf iE k iE K iE iF iF iE iF iF iE iE if M 1E iE iE i6 iF iE iE 9E fE if if if aE fE if it iE iE if if 1E iE iF M 9E iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY P E S C R I P T I O N UNIT COST TOTAL COST
SFR 1786 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 1,786.00
END OF FEES
01 �OS60�Z9—OD160230 T Q T 41.`0
OATEe O5/10/9< TIME� IS:27
�ONSTRUCTION AND PLANNING - .
APPROVALS Permit # Date
i•
'��7. Temporary� Electrical Service oY Pole
2. Soil Pipe�Undrgrnd. - � -
3. Electrical Conduit Utiliry-Undrgrnd.
4. Electrical ConduiT-Undr9rnd.
5. Stee4 Reinforcement
6. Electrical UFER Grnd. -
7., footings
�8, Foundat�on
9. Wate: Pipe-Undrgmd. r
iQ. Structurel Floor Shsiem _ -'� _ .-.,. ., ,
11. Property Sewer Line & House Connection �
12. Sewer Cap ' �
13. Roof Drains � �
14. Rough Plumbing
15. Ro�gh Electrical•Conduit
i6. RoughElectricWiring
77. Rough Wiring Sign
18. Rough Electricai-T Bar Ceil�n9
79. Rough Heating & Air Conditioning �
20. Ro�gh Factory Fireplace '
21. Ducts, irrSiructure• �
22. Ducts, Ventila(ing' ,
23. Gas Pipe•Rough & Test �
24. Roof Framing . ��
25. Roof Sheathing S���Y
7
26. T-Bar Ceiling (Structural� & R9pnocoat
27. Frame and Flashing . '
28. �athing & Siding •. " . .
29. Insulation � � '.,. �
30. Orywail Nailing
31 . Piaster Brown Coat' . � �
32. Electrical Power Meterfinai "
33. Final Electric .
34. Final Heating & Air Cond�tioning
35. Fina� Gas Pipe�Test . ,
36. Hood or Canopy .
�7. Final�Factory Firepl2ce'
38. Final PIum6(ag . � .
39. Water Service�Finei �
40, Gas Service-Final .
41. Solar pomestic-Pinal "
42. Backtlow Preventer ,
43. Backffow Irrigation
44. la�dscape Irrigation Sysrem
45. Sbund Attenuation
46. Handicap Regulations
47. FINAI STRUCTURE & 6Ut�DING r j�_ct�
48. FINAI PLANNING
. 49. Electric Release to Edison
50. Gas Release to Southern Catifornia Gas Co
PO(. . SPA
inspector qppROVALS Permit # Date Inspector
� 52. Pool & Equipmznt Location
53. Steel Reinforcement
54. Forms
55. Electrfcai Bonding
56. Rough Plumhing & Pressure Tes,
57. APPROVAL TO COVER-Gi1NITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Te:t
� 60. Backwash Lines, P-Trap, Cl Undrgrnd.
�-
67. APPRQ��AL TO DECK -
62. Backwash & Receptor-Final
63. Heater & Vent-Final �
64. P!umbing System - Fina;
65. Electrical•Final
66. Solar System-Finai
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. P06L/SPASYSTEti"SFINAL
FIRE DEPT. REQUIREMENT
APPRdVALS Permit �
70. Urxderground Hydro .
71. Pro�uct Pip'sny �Ga's C7. Oii
' - 72. UndergrourM.Fiush - . � , �
�. 73. CJndergmd. Storage �Tank O Gas ❑ Oil
74. , Ouerhead Hydro
� 75. -pry Chemical � �
. , , 76."Dry Standpipe �
" "' ' �7.'FIXED SYSTEM F(NAL �
76. FIRE PREV. FINAE. �
HEALTH DEPT. RE�UIREMENT
• � 79. FINAL INSfiECTIJN -
' 80. FOOD CEftTIFiCATE ISSUED
Notes:
G u-bF
Date ' ! �
s
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. ,�^� � PEV. , '.
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I �,.REV.' . :
''��/ �' REV1�' 1 �����)
�U• CASA B�NITA 32�33 �
� ti. 291T�3Q r 3,.
� � M
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W
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� � 0" \� �� � � • ( a m
305� � � °i � l �.S a— - �
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� � '. V
V�2: M�� ' . ,_.,
- ` WADINO ,� . . � . u m
:fi' .. 4l ,So. _ ' (� $6.0�>
�� � I �-15� �l"'t rl .. � - - � o
� I 14 15 I6 �17 �IB � 19 � 20 r 21 22. , 23 , 24 � 25 � 26 � 27 �
'� ' � � CASA DEL AM160S'. I ' � � N a �
� �..� I m M
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a I _ -
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y. � .. , ' -- --
Q� _..._ ._... � . ,.,.. , , � i ---- u o
, G � B I B REV.I L REV. I B REV. I B 1 G G I" B� I " I ' I a _ a M
B NEV. C NEV. b NEV. B -G' d
—• 3062 3060 3058 3056 3054 3052 3050 3042 3040 3038 3036 3034 3032 3030 v „' "'
v g
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C6$TA MESA BUILDING-SAFETY DEPARTMENT
P. O. BO%b1] COBTA M86A. CALIFORNIA
Fo► Appllcanf to Fill In Complately
TYPE OR PRINT �
noo E'ss° 3036 Club House Raad
COSTA' MESA. CALIFORNIA
owNea Mesa Verde Dev.Co.
MAIL 2$50 Mesa Verde Dr.
ADDR6SS
��.�, C�ta Mesa' no
ORENGI fiR E. Kaltenbach NEu
ADDRE88 1823 F'. 17th St.
r.nruTwarmw SSNE 85 Owner�
STATE 181322
LIC. NO.
siZE 25 X 70
OFLOT
5� eerawcK un� rnou
T6L.
NO.
Ftt Ktc�iv�u
FEB 25 1965
-FINANCE DEPT.
CItY OF COSTA MESA
APPLICATION FOR PERMR
BUILDING
For Office Use Only
P6C[I V IjD BY
K�-
BUILDIN6
ADDRESS
5490395 =ONE
478046 BYPROVED
DAQ`T)6
v
DATE188UEO
R 4 i965
I & J
S.g.. • ZONINCi
ZON NO. OF I 116H OF NBW • �
R�} runa 2 em�oino gBTe.gE
8.
L80AL
oeacn�n�on L01', 24 TT'. 4660
w. P. no. none
NOTE: NO EAVE OVERHANO SMALL BE LESS THAN
NO. OF BLD08. Q '
EFT ' ' I R16HT
DESCRIPTION OF WORK ,
u
U86 OF BUII.DIRQ AND WORK TO BE PBRFORM6O.
Res.w�att.Gar.
1 HEREBY ACKNOWLeDUH TH�T 1 XAVB RP.�D TH�S APPL�CATION
AN� 6TATE THAT TXe �BOVe IB CORR6CT AND AOpEfi TO COM.
PLT WITX ALL y1'PY�ORD�NANCBB AND 8TAT6 LAWB HiOULATINO
BUILDINQ CON�TRUQ'ION. � � _
� AUTHORIZED A06NT
YARD3APPROVED
MAIN BUILDING
!OM C/L STREHT>
VAflD9APPROVE�
AGCESSORYBUILDING
VAR.�C DATE 1.
C. U. P. $R 317 APPROVED 11�16-64
AYPROV6 e i �^ ATE lJ��v'" ���
J
HOLD FOR SPECIA REQUIREMENTS
See permit on Lo no. 1 for cond.
15�9 �,. Fr. �'� m
TXE �MOUNT BHOWN UNDEH VALU�TION IB FOR TXH =
pUflPOSH OF 68TABLI6HINO A PERMIT FEe ONLY. �
VALUATION /// m
PERMIT FEE $ (�J (-% �
]
� 0
1 � (�J,�U..� � G
s =
�/�'/.— d
rors�wee S
JOB
or
UATE .
lE ZONE VAL�
GROUP I Rc J TYPE
SUBCONTRACTOR
PERMIT NO.