HomeMy WebLinkAbout3042 CLUB HOUSE RD - Building Permits�
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PXOJECT�MADflE55: 3O3H CLUB HOUSE RD
� OWNEfl'SNAMF: VAN HORN, PETRONELLA TR
nooness: 3038 CLUHHOUSE RD
COSTA MESA,CA 92626
RflCHIENGINEEH:
AODflESS:
flEG.NO.:
UNIT:
UNIT:
PEpmiTTEE: pETERSON ROOFING ( 719 ) 979-7111
aoosess: 3006 ENTERPRISE
COSTA MESA CA 92628
LICENSEO CONTFACTOP OECLABATION: I hereby a�firm Ihai I am hcense� under pmvisions of Chap�er 9(commencing wiih Seclion
7000) o� Oimsion 3 al ihe Business and Prolessions Cotle. and my license is in tull lorce antl eflecl.
ciTruc.: 095945 STpTELIC.:6O-�87z uss: C-3
Date: e«— � Signature� _ _
WOflKEBS' COMPENSRTION OELL4flFTI0N: I �ereby a�hrm tha� I ve a cenificate ot consent to seu�insure or a cemiicate ol workers'
CompenSalion Insurance. or a certifietl copy Ihereof (Sec�ion 3800, Lab. C).
raucvxo.: NC3501565 E%P.OAiE: O3�ZOI9S
comvnxr: REPUBLIC
I � Certihed copy is here�y lumis�ed. � Cehified copy is �iletl wilh �he ciry Building Division.
�ate: � O � � � PpplicanL �/�
EXEMPTIONFAOMWONREBS'COMPENSATIONOELUflRTION: �Thi55eclionneeOnolbewmpleletli�thepermilislaranehunAred�5100�or1e55�.
I cenily Ihal in the peAormance o� the work for which Ihis permit is issued, I shall nol employ any person in any manner so as �o become
sublecl ta ihe Workers' Compensalion Laws o� Cab�omia.
Oa�e'. SignaWre:
NOTICE: I�. a�ter making this Oedaralion, you shoultl become sublec� �o Ihe WorkerY Compensalion pwvisions ol the Labor
Cotle. yau must lotlhwil� comDly wi�h such pmvisions or Ihis permi� shall De OeemeO revoketl.
CONSiXUCTION LENOING AGENCv: I hereby ailirm ihat ihere is a consimction lentling agency lor Ihe Dedormance of tne work far
which Ihis permit is i<sued (Section 3097. Civ. C�.
LENOEN:
RODflESS:
OWNEfl BUIL�Efl OECLABpTION: I hereby affirm Iha1 I am exemp� Imm Ihe Comrac�ori S�ale License law lor the following reason
(Sec�ion 703L5 Business antl Pmiessional CoOe: Any ci�y oi counly w�ich requires a permit �o canstmci. alter. impmve. demolish, or
repair any simcture, Onor lo its issuance. also requires ��e applicani for sucA permi� to lile a signetl statemen� iha� he/she is licensetl
pursuam m �ne provisions of Ihe ConVacmrs� Sta�e License law (Chap�er 9(commencing with Seclion 7000) of Division 3 0� �he Business
and Pro�essians CaOe) or Ihat he/she is exemp� Ihereimm and I�e basis lor Ihe alleged exemption. Fny violation ot Sectian 7031.5 by
any apPlicant �or a permi� sublecis �he applican� lo a civil penalry o� not more ��an �ive �undretl dollars (8500�.
I, as awner o� �he pmperty or my employees wi�� wages as �heir sole compen5ation, will Ao Ihe work. and Ihe
❑ simcWre is na� intentletl or olteretl for 5ale (Section 7044, Busness and Pmlessional Cotle: The ConVaciors' Sia�e License Law
tloes not apply to an owner o� a pmpeny wha build5 or impmves Iherean, antl wha tloes suc� work himsel�/hersel� ar Ihmugh
his ar her own employees, pmvidee �ha� such impmvemen�s are nol intenOeU or o�fered lor sale. If, however the building or
impmvemen� is sola within one year of completion. �he owner vnll have ��e bur0en of proving he/she tlid nol builtl or impmve
for Ihe purpose oi sale�.
I. as awner a� �he propetly, am eKclusively con�racting wilh licensetl conVactars to conslmct �he pmlec� �Seciion 70d4, Business
❑ antl Pm�essions Goee: T�e Conlrac�ors' Slaie License Law tloes not apply �o an owner o� pmpetly w�o builtls or impmves ��ereon
and who convacis br such pralec�s wi�h a caniracbqs) license pur5uan�io Ihe Conimctors' S�ate License Law�. I am aware
Ihal pmof o� Iheir Worker'S Compensa�ian insurance 5houlA be pwvi0ed lo me.
� I am exempl untler Sec�ian'. B. 8 P. C.
�or Ihis reasan:
�a�e: Pwner
I Oo here�y cetlity Nal I am aware ai anA understantl �he requiremen�s o� Califomia Heallh antl Sa�e�y Cotle Sec�ions 25505, 25533, and
2559d and �hat I or any fuWre builtlmg occupant willlwill no� (cirde one) neetl lo comply wilh saitl slale codes an� �he requiremenls for a
permit for consimdion or modificahon �rom the Air �ualiry Managemenl �isiricL Residen�ial cons�mction applica�ions are exemp� �mm
IheS¢ prOvisions.
Oate: ApplicanL
I I Aere�y certifylha� I havereatl��is applicalion ana 51aie I�atihe above inlormaiion is correcL lagree ta comply with allci�y and couniy
oremances antl 9a1e laws relalinq �o bwltlmg cons�mction antl hereby au�horize represen�atives ol Ihis ciry ro en�er upon Ihe above-menlioneU
pmpeny lorinsppec�iofn purposes.
�ate: S� O J'/ �/ Signamre:
�riverS License or Social Secumy <: �
tfi41�d6 Whne—Builtlmgl Green—Cotle Enfor<emenL Canary—Appllcan�: Pink—Revenue; Goldenrotl—Assassor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO; B 067097 PLAN CFIECK NO: N
CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR
PERM NO: B 067097
GOVT: N SUPP: N
PURPOSE: OTH
JOH DE5CRIPTION ; REMOVE BUR & REPLACE W/BUR SQ FT: 1,786
CLAIM VALUE: 1,786.00 CALC—VALUE; 1,786.00 GROUP OCC: R-3 /
COMMENTS; SMOKE DETECTORS REQUZRED PER 91 UBC
�c�***�*�r***�***+�**�***x��c*�***�*****�c*****x�*��c*��c**���+��*���x+�*s*****���c�**� **
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCES50RY BUILDING ---------
FRNT: FT IN REAA: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL; 13951523 ZNE; REF NO;
PLANNING NOTES> �•_�
..i ,
x�**�+�+�*x***�*x��*�x���+��r���*�*���**+��**x�*�**�*+r****�x����*�**�*�*������r*���****
D E V E•�L O P M E N T S E R V I C E S R E Q 0 I R£ M E N'T S
ir
ZONING APPROVED BY DATE: Y
BUILDING APPROUED BY : DATE: !j'
i;.
APPLICATION IS�UED HY; DATE: � I�
iEififlliEiEffiE�lElE1EIEiFiEjffM1fEiEiE1EiF1E %iEiFlEHEiE1Elfifif F 3hif-
iE 1F %1E if 1E tE 1E if Yr if if !E iE iF �f jE 1E jE iE iE if iE if if ik 1E iF iE iE iE 1E 1E �E if �E 1f iE iE 3f iE iF ii iF 1k iE iE tE iE i(- ihlf 1E if it if iE �E fE iE fE 1E if iklE 1E 1E j! fE iE iE if if iFlE i4 fE iF 1F
LEGALIZATION;N F E E S U M M A R Y STAUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 41.00 50
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 41.50 0,00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
41.00
TOTAL
41.50
SMIP/NON—RES
PAID DUE
41.50 ,00
41.50 OVER/SHORT; ,00
FIRE SMIP/TOT GRADING PLAN—CAECK
.50
iE iElFlE 1E * iE 1Flf if if 3F iF 1E iE iE iF iE iE iE iE iE iE iE #� iE iE if jE iE iE ik 1E iE �7E 1F fE 1F 1E �E 1E iE if if iF iE i! iP iE 3E if iFlE iE iE iE if iE iE fE iF 1F iF if i! iF 1ElE 1E 1f iElE it aF iF iE jf if ik
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 1786 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 1,786,00
END OF FEES
Ol DU16Q227-0�16022E T O T 41.50
DATEa pg/10l94 T211E: 15:26
� CONSTRUCTION AND PLANN4NG� POOL & SPA �
APPROVALS Permit # - Date Inspector RPPROVRLS Permit # Date inspector
� t. Temporary Electrical Servicedr Pole 52.. Pool & Equipment location
2. Soil Pipe-Undr9rnd. � � : 53. Stee� Reinforcement . �.
3. Electricai Conduii Utility•Undrgrnd�. ' 54. Forms
4. Eiectrical Conduit•Undrgmd. � � 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -
6. Electrical UF6R Grnd. 57. APPROVAL TO COVER�GUNITE
• 7. Footings � � 58. Electrical Conduii�Undrgrnd.
8. Foundation � - 59. Gas Pipe, � Untlrgrnd., Test
9. Water Pi e�Undr rnd, '�� ; �
p 9 60. Backwash Lines, P�Trap, C: Undrgrnd.
10. Structurai Floor System 61. APPROVAL TO pECR
11. P�operty Sewer Line & House Connection � 62. Backwash & ReceptorFinal
12. Sewer Cap { , 63. Heater & Ven[-Finai
73. ftoof Drains ' � � 64. Plumbing SYs[em � Pinal
14. Rough Plumbing 65. Electrical�Final
75. Rough Electrica6Conduit , 66. Sotar System-Pinal �
16. Rough ElectriG W�ring � 67. Fe�cing & Access RpProval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar Ceilmg 69. POOL/SPA SYSTEMS FINAL � �
19. Rou9h Hzatinq & Air C,ondi:ioning FIRE DGPT. REQUIREMENT
20. Rough Facmry Fireplace - APPROVACS Permit # '
21. Duc[s, in StruGtur¢ . + � 70. Underground Hydro
22. Ducts, Ventilating - ' 71. Product Piping L�Gas t70ii
�
23. Gas Pipe�Rough &�7est � , 72. Underground Flush '
24. Roof Praming� � � � ' 73. Undergrnd; Slora�eTank OGas QOiI �
25. Roof Sheathing .�j�/Ql�i�,�"v : .74. Overhead HYdro � . . . , , . �
L
26. 7-Baz Ceilin9 IStrtteturaV} & Monocoat ' ' 75. Dry Chemicei ' _ ' �
27. Frame and F�ashing .. , 76. Dry Stanc�pipe � �
28. Lathing & Siding ' . • � r 77, -p�XED SYS7EM FINAL' �
29. Insulation ' '_ -" 78. FIRE PREV. FINA� �
30. Drywall Nailing �. � HEALTHDEPT,-REQUIREMENT '
� -- a
37. Plaster Brown Coat : . 79. FINA� INSPECTION '
32. Electrical Power 09eterF�nal • � 60. �FOOD CERTIFiCATE ISSUED
33. final Electric Notes:
�34. Final Heating & Aif Conditioning . ' �
35. Final Gas Pipe�Test � . , -!
36. Hood ar CanopY � � � . ' �
37. Final Factory Fireplace , � . �
, � � _
38. Pinal-Plumbing ' -
39. Water Service-Final ' .
..�.
,40. Gas Service-Final . . - ' �
41. Solar pomestic-Final •
42. Backflow Preventer . - -- I
43. Backflow Irrigation , � . - ..-`�
44. Landscape Irri9ation System . . . � � � _ �
A5. Sound Attenuation • , �
46. Handicap Regu�ations . � �� � '- �
47. FINAL STRUCTURE & BUILDING S 3 �.�Y E�w.0 � ,
48. FINALPLANNING � . .
49. Electiic Release to Edison � � �
50. Gas Release to Southern California Gas Co .
51. CERTIPICATE OF OCCUPANCY
No. Date �
�I U.\_1�
� G ,.7 �35. 3U33 ;,
3041 �9 � � � REY. , ' �� , a. " m
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55 � � P�'�� � � S \� � � m
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� —• 3062 3060 3058 3056 3054 3052 3050 3042 30A0 3038 3036 3034 3032 3030 v �'^
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HOUSE ' ROAD
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JOB ADDRESS
INSPECTIONS
DESCRI�PTION OF WORK xeS.W
1'1RE 'LONE VALUE $
Date I GROUP I& J TYPE R
SUBCONTRACTOR � Date
raectnc
� � �
COSTA MESA BU1LbINGSAFEfY DEPARTMENT
- P.O. BOX 917 C09Tp M63A. CALIFORNIA
For Applicant to Ptll In Complalely
' TYPE OR PRINT
nooRess 3038 Club HouSe R08.d
COSTA MESA, CALIFORNIA .
OWNER Mesa Verde•Dev.Co. '
AD Rfiss 2850 � Mesa Verde Dr.
ARCHITECT E. KaltenbaCh TE�.5478046
OR ENGINEER NO.
wooaesslfi23 E. 17th Si;. S.A.
,.,,ure,,,T„o Sazae as owner
d USE
FEE RECEIVED
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMR
BUILDING
For ONice Use Only
� pece�nr rvo. � x
ev
DATEI88UEU
MAR 4 196.
ZONING
puns 2 I eu LOINO W eg�
r.ot 2� Tr. 4660
� ' NOTE: NOEAVEOVER
i81322 TEL. 30" TO SIDE @ REAR F
NO.
EAVES
25 X 7� I NO.ORE%.008. O ALLOWEG
NOW ON LAT
YARD3APPROVED
BLD6. --�'-��` MAIN BUILDIN6
f FROM GL SfREE�
NEFROM ' FRO T �� �. A
srrsecr REAR YARD /�
�I LEFT � RIGHT R.SIDE V FT.
DESCRIPTION OF WORK , �. sioe � Fr.
Ix II I II I .,�.e f� �.
I I MOVING � I� '- II DEMOLISH I MA NABLDG9�
�32 - VAR. JC
NO.OF 5 2
ROOMS BTORI64 C. U. P. JC .. 1
WALL I ROOF ' MPROVH� A
�ulns AIV� WORR i0 BE P6RFORMED
Res.w/att.Gar.
I XEREBY ACKNOWL2O08 TXAT 1 qpya READ TH�e APPLICATION
AND 6TAT2 THAT iX6 ABOV[ 19 CORRECT AND AOREB TO COM.
v�v wITH �LL CI qDINANCBB �qO GTATB L6W8 pHOULATINO
BUILOINO CONBT UCT ON. .
SIGNATURE OF ���1���
PERMITTE G(f
AUTHORIZEDA6ENT ' -� ,
none
AN6 SHALL BE LE59 THAN
YAROSAPPROVED
ACCESSORYBUILDIN6
DATB
t1UL'J 7'UK JNCI.I �iCCl1U1KCMCIV 1 J
See permit on Lo 1 Por conditions
�.25o SQ, �. a 460 0
THE AMOUNT HHOWN UN�ER VALUATION IB FOA THe F
PUHP09E OR 89TABL18HIN0 A pERMIT FEE ONLY.. p
VALUATIOfJ � % m
�/ PERMIT FEE $ �/ '�� j
$�'% D�/ PLAN CHECK S iiC� ��-7 (/ O
n — _ . ¢