HomeMy WebLinkAbout3210 COLORADO PL - Building Permits� CITY OF COSTA MESA �
B!/ILD/NG DIV/S/ON
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B10-00030
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 13908603 DATE ISSUED: 02/01I2010
- - _ _ ISSUED BY: RMD
JOB ADDRESS: 3210 COLORADO.Pt CM ' !' Suite/Unit:. �.
Vicinity: HOUSE AND GARAGE ROOF
Squares: 2700 . - , - � � - � �� �, � Valuation: , " '', $7-,000.00
SCOPE OF WORK: TEAR OFF (E) ROOF NIATERIALS, INSTALL 1 LAYER OF 30# FELT ON•A 4:12 PITCHED ROOF AND REROOF
WITH 30 YEAR COMp SHINGLE:ON AN ATTACHED HOUSE AND GARAGE. REPAIR AND REPLACE SHEATHING AS
NEEDED. . �. ` . � �
OWNER: FORRESTERGR4HAMB �:� " , " Address: 3210�COLORADO.PL . �. � Unit:
PHONE: 949-244-0983 � � - ��� - Qity/State/Zip: COSTA MESA, CA � � �- -
APPLICANT: MARK AMAR4L . �"- Address: 9902 KINGS CANYON - Unit: :
PHONE: 714-719-0032'� � - . � . ; City/State/Zip: HUNTINGTONBEACH,CA�- - -
CONTRACTOR: MARKAMARACROOFWG. � � � . �� License�No.:��-�696775
Address: 9902 KINGS CANYONUnit � . � � ��- � PHONE: � -. - - . 714•719-0032
City/State/Zip: HUNTINGTON BEACH,�CA - - � � � � 92646 CELL: � � �
714-9603032 . . . . ... - .. � . ' - . ' . . .
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check;
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALFEES
License No. '
� . - � License.No. `� ' � �
_, : ' �. . � _ _. k_;� -. - . � .. � .
` .$o.00 . _ ,
$13925` : .
$0.00- .. . - ...
$1.00 .� � . . , - - .
�
5140.25 - � -
PHONE:
PHONE:
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and relatetl
regulations. (Ord. No. g2-28, § 1, 12-21-92) ,
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 expiralion of this permit.
CO�Etl. INSPECTIONTYPE OAT� INPTAI CODE1 INSPEC710NTYPE OpTE IN7171A�
ifit6 Fized System Final Fire Prevenlion 206 Final Mechanical
7266 Pool Spa Fina� A'` 208 Final Plumbing
200 Final Re-Roof — � � N� 210 Final Electncal
201 Final 81ock1Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire place 220 Final Planning Approval
203 Final Sign 222 Final Site
20a Final Demolition 250 Final Building/Occupancy
• �
WORKERS' COMPENSA710N DECLARATION:
I hereby affrm under penalty of perjury one o! the following declarations:
❑ I have and will maintain a certificate of consent to sel(-Insure for workers'
compensation, as provitletl for by,section 3700 of the Labor Code, for the
performance of Ihe work for which this permit is issued. �
❑ I have and will maintain vrorkers' compensalion insu2nce, as 2quired by
sectbn 3700 of the Labor Code, for the perfortnance of the vrork for which this
permit is issued. My workers' compensa[ion Insurance wrrier and policy
number are: �� �� � n
Cacrier. , a�
s seclqn neetl nol be mmpleted dthe peimrt is valvetl a( one huntlred tlollars (5100) a less.)
��Y �: � l 3— ODon �8 1
I certify tha[ in the pertormance of the work tor which this pertnil is
issued, I shall not employ any person in any manner so as [o become subject
to the workers' compensation laws of California, and agree [hat if I should
become subject to the vrorkers' c pensation provisions of Section 3700 of
the Labo Co „ I I forthwilh c ply with these provisions.
a -� �o
A �IicanCs�g aNre
WARNING: FAILURE 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 COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license/�is in full force antl effect.
jci• f0 7 7 •lass � � �
a-� -ia
� p�G'IfJoie'SgnaWre �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aftirm that there is a wns�ruction lending agency for the
pertormance of the work fa which Ihis permit is issued. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
SignaWre
OW NER-BUILDER DECLARATIONS:
I hereDy aKrm Ihat under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for [he follovnng reason (Sec. 7031.5,
Business and Pmfessions Code: Any city or county which requires a permi[ ro
construcl, alter, improve, demolish, or repair any stmcWre, prior lo its
issuance, also requires the applicant for such permit to file a signed stalement
that he or she is licensed pursuaM to lhe provisions of [he Contracrors
License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the
Business and Pm(essions Cotle) or Iha[ he or she is exempt there(mm and
the basis for ihe alleged exemption. Any violation of Section 703L5 by any
applicant for a permit subjects the applicanl [o a civil penalry of not more than
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the slructure is not intended or
offered tor sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himself or herselt or Ihrough his or her own
employees, provided thal such impmvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the ownervbuilder will have the burden of pmving that he or she
did not build or improve tor purpose of sale.).
❑ I, as ovmer of ihe property, am EXCLUSIVELY CONTRAC7ING WI7H
LICENSED CONTRAC70RS lo construct the pmject (Sec. 7044, 8usiness and
Professions Code: The contractas License Law dces not apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant ro the Contractore License Laws.).
❑ I am exempt untler sec.
Business and Professions Code for this reason:
SignaWre
305]-68(3I0])
Owner ID verifetl by driver� se. ❑ Ves ❑ No
Dnver's License No. Expires:
Verifcation of Ownership by pype of tlocument, i.e. - property lax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify ihat no excavation frve (5) or more feet in depth into which a
person is required to descend, will be made in connection with vrork authorized
by this pertnit, and that no building structure, scaffolding, falsewnrk, or demolition
or tlismantling thereo(, will be more Ihan ihirty-six (36) (eet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Ttle 8, Califomia Atlministrative 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 fmm [he division.
Applicanfs SignaWre Dale
Division of Industrial Safety Permi[ Numher:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future builtling occupant need to fle antl
certify a Business Plan for emergency response to release or threa[ened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health antl Safery Code requires, with some
exceptions, that a Business Plan be fled 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 ro or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic (eet o( compressed gas
at standard temperaWre and pressure).
2. Does or will the applicant or present or future builtling occupant need to fle
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Healih antl Safety Code, with some
exceptions, requires regisUation with the Costa Mesa Fire Deparlmen[ hy
each business which at any one lime 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 teet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or fuWre building occupant need to
prepare an RMPP (Risk Management and Prevention Program for awtely
hazardous materials�? ❑ Yes ❑ No
(Section 25534 0( �he Califomia Heal�h and Safety Code provitles that Ihe
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 an RMPP is presently required, has Section 25534 ot lhe California
Health and Safety Code been fully complietl wilh? ❑ Yes ❑ No
5. Does or will the applicant or present or (uture building occupant require fOr
lhe wofk which is lhe 5ubjeCt of lhi5 appliCalion a permit for such conslruction
or modification fmm the South Coast Air �uality Managemen[ Dis[ric� or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requested
information be fumishetl on applications fa noo-residential builtling pertnits).
6. Will any part ot Ihe facility to be constructetl untler this permit be within
1000 feet from [he outer boundaries of a school? ❑ Ves ❑ No
Q!'yes", the tacility must meet Ihe requiremen[ of Sec[ions 25534 and 42303
of the Cali(omia Heal[h and Safety Code).
7. If a permit from Ihe South Coast Air Quality Management District or other
air pollulion conhol district or agency is required for the work which is the
subject o( Ihis application, have all o� Ihe disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: 1 certify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1
certify under penalty of perjury that I have read this application and state that
the information given is correcl. I agree to comply with all state laws and city
ordinances relating to building consiruction, and authorize representatives of
ihe City of Costa Mesa to enter upon the above-tlescnbetl propeny for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
Siqn o galOwn Date
� � �O
��nOfo-;^�'�:�^y i�tl ../Cppl¢am W
PresoripYive Certificate of Co�.
2e.iirlkntial Alteratio�as
Prujucf Name:
ancc: i2esidenti�l
1_
ClimaCe "Lonc #
1 of
T
General !n(arnuition
Site Address: 3. O I OrQ J_ Gnf'orcemeN Agency: ll:rte: ^ 1.� l
\ qCJ
6uilding Type�Single �amily ❑ Multi Family Circle the Front Orieniatian: N, E, S, W, ar degrees
Projec� Type: ❑ Alterations O 8nvelope O Penestration 2oof O FNAC
Conditioned floor Area (CFA): ��� Re lacemem or Chanqe Out ❑ Duct Re laeemen� ❑ Waier Heater
NOTE: Thi.v Jbrm i.e �in! !o Ge used %nr Ne�vlp Gnrtstr�iefcd Uuilrlings or Additians .
- b�sulutim� Vnlue.+' Fnr Opaquc Sur/i�ces (Jm� Fw'ring use the MAss nnd Fvrrirtg S'n'ips' Cons�rucfiorr �ubfe belowJ �
Assem6ly Alteration
❑ Opening oi'frUmud caviy� nlone—.4/teratimts� Ihnl Lrvolna 1he apeni�ag oflhefi-mrre�/cnvily afn wall, ceili�og, arJloar miis7 u�s1n!/ the
wandainrr mittimum insu/u�im� vnln�c per,¢150 far �he aLered assemh(p. Fil! irv Colunans d—C and enter mandator�� insulat7wi value i�� Column H.
❑ Replacemen[ uf entire asxemblp—Replocemem oJ'un emire wnl(, ceilino, a� floor' ossembfp requires (he instu!lutinn ofCornyonem
PuckttRe- D insidntion values in Tnhle ISl-C. Fill in Columns A—J.
ue Surt'uce Detaiis For tl�e furred
Framing
7ag/ Assembty Name Material
ID� orTvne� andSize'
:d nf Mass Walls sec I�urrin� Strips Cunstrimtion Tab�,
D C � F G H
Thickness, �
Spacii�g, U-
or Other3 factor°
Insulalian 2-vafue, see Pnge
JA4 Table I Cavity
Number' R-v11ue�
Equotiwi 4-1.
Insulation
J
Assembly � Assembly
:elt Values U-facmrv
use the Mass ond
]. For Tng/!D ittdicate tive identiJic4�ion name thal ntntches the builcling plans.
2. /ndicate �he Assemhlt� Nume ar type: 2oo(/Ceifing, Walls, Floors, SfaGs, Craw! Spuce, Doors artd etc...Indicate !he Frame type and Size: For
I�Vood, Metal, Me�a! &�ildirtgs, Mass, enter 2s9, 2x6, or e�c... see JA4 for other possi6le,frame tyYe assemblies.
3. Enter the thiclmess for mass in inches or Spacino benveen jraming members enler; 76 "or 24 "OC; or Otherfor a!( odier assemblp description
such as Concrete Smrdwich Panel, Spandre! Panel, Logs, Straw Bale Pane! and em.._ .
4 Bnsed on Ihe Climate Zone; en�er the Slandard U facla� fi�om Ta61e 151-8, C w' D for each dtfferent asseinbl�� Name a• type. �
S. Enter the Table irarrrGer that closelv re,renables dte proposed asa'enably.
6. Gn�er tlie R-raluc /hat is' beirag insdull�ed in (he wa(( caviq� nr 6etmee» dae f�onting; od�erwise, enler' "0 ".
7. Lnter tlie Cailiuuous Insrdotian R-vnlue jor the praposed nsse�ubl7'; nlhenvise, emer "0".
8. Enler Ihe rom and cnlunm ojlhe U-(ac�or nalue based ar Colurttn F Tuble Number and enter (he Assembfp U factor' in Cofumn J
9. The Propnserl Assembly U factor, Colunm J, musr Ge egual �o or les5�7hkn Uie S[aidard U-factor in CoArmn E�o compl�t -� �
�un'ing Strips Constniction Table for Mass Walls Onlv
A i3 C D C F G A I J IC L M
Proposed Pruperties of Masonr)' �nd Concre[e Added Interior or �xterior L�sul:�timi
Walfs Frum Ref'erence in F'urring Sp:�ce 1'rom Referencc
Jninl A� iendix'1'able 4.3.5, 4.3.(. 4.3.7 Join� A>>endiz Table 4.3.13
- v N N T -
V J ,_ �j Y - V
u� u p V dG � w
Asscmhly �.e � o o.� F- F- o a�'v 2'� .� v Final
Mass Name or )A4'I�able .1 _ v v� q- � o t� a� " � ASSeml7�y '
'�I�ickness� 9� �c' Num6cr' �-1° — � u= �. � G w c ¢'� t�i� � �1-{�aClol'�'� Cortullenl
I _ � � _
II
I � I I
Regi�xiro�imi Nurnber: 2eRisiratio�� DutelTinre: HE2S Po�ovider':
200d' Residenlial Cn�nplicuace Fnrms �Izrgus! 2009
Certificatc uf' Co..
A[teralinns
Residential
ROO�ING PRODUCTS (COOL ROOFS) §I57(�12
GYhe» Ihe uren �f u�reriiu ranJ'snrjace m/�e repluced ecceeJs uiore than
less, fHe neru roofing nren ��mst niee� Uie rnnfi�ig product "Cord
ma :Zene #
eeisting roojnren, nr more Niun 1,000
or
CF
3 of'
rvkichever is
Check upplicnble rdternnlive or ezcepfian belmo fYhe roojulterution is exempt fi�om �he roofing produc� "Cool XooJ"' reguirements. Na�e: /f uny
one ojrhe uAernutives or escep�ion beloH� i.s checked, ihe Rged Solur ReJlecmnce and Thermal Emiltonce requiremenrs jor roofing products in
,�/ 18(iJ are not npplicublc. Do no�Ji!/ table 6elow.
❑ Cool Roofs Not Required in Climale Zones I-12, 14, and 1( with a Low Sloped. Less or 2:12 pitch. "
�C;ool Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped 2oofs (pitch greater than 2:12) aud product unit weight less
than 516/ft�.
Alterns�tives to §152(b)1Hi nnd §152{b)Hii, Steep-slope roof (pilch > 2:12)
❑ Insulation with a themial resistance of at least 0.85 hr� °F/Bhi or at least a 3/4 inch airvspace is added to the roof deck
over an attic; or
❑ Existing ducts in the attic are insutated and sealed accorcling to §151(�10; or
❑ In climate zones 10, 12 and l3, with I ft� of fiee ventilation area of attic ventilation for evety 150 ftz of attic floor area, and
wherc at least 30 percent of the free ventilation area is within 2 feet vertical distance oPihe roof ridge; or
❑ Building has at least R-30 ceiling insulation; or -
❑ Building has radianl barrier in the attic meeting the requirements of §151(�2; or
❑ Building has no ducts in the attic, or
❑ In climate zones 10, I 1, 13 and 14, R-3 or orea[er roof deck insulation above vented altic.
Exception to §I52(b)1Hiii, Low-slape roof (piicl� <2:12)
❑ Buildine has no ducts in fhe a[tic.
Other Exceptions - �
❑ Roofing area covered by 6uilding integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Root'criteria.
❑ Roof constructions that have thermal mass over the roof inembrane with at least ZS I6/ft is exemot from the below Coof Roof criteria.
Notc If no
box
CRRC Product ID Num6er�
ice method cannot be used, use the Performance Approach m show compliance, otherwise,
the 2oofine Products "Cool Roof' ReaairemenC
RoofSlope Product Weigh
2:12 > 2:12 < 5�16/ftZ > �Slb�
❑ ❑ LJ I L-1
�
�
0
�
�❑
G
�
0
G
C
C
�
0
G
�
0
Aged Solar � Thertnal
O°
❑4
�4
The CRRC Producl lD Number cmr Ge oGlnineAfi'om Ihe Cool Roaf fto(ing Council's RaredPrnd��c� Directory at �ow�r.coolrnoLr.are/nroducis/march n
Indicare the rype ofproducl ia� bcing used for tlie rooj�op, i.e. single-p(y roof, osphall ronf, mem! roof, elc.
/f(he Aged HeJlecim�ce ix no! �vnilnG/e in.lhe Coo/ Boofftoling Cowici('s Ra(edProdim! Direclory lhen use Ihelniliul Reflecmnce vu/ue j'om !he anme
directnr�� ond use Ilm ey�m(ion (02+p.7(Pini�inl— n.2J (a oGlain n cnlculated aged vahre. Where p i.s Ihelniliql Solnr ReJ7ectanm. '
Check bo.r if'lhe dged ReJlecmnm is a en/adaled oulue using Ihe eqimtian nbove.
Calcu(ate U�e SRI vuh�e !m using dre SRl- Work.cheei ni httn'�/�v�v�r enerm� cn eovpitle24/and enmrlhe resuhing vnG�e in tAe SR! Cohnmi nbove nnd artuch acop�+of
�he SRI- INm�ksheel to the G•'-1 R.
� apply Liquid rield Applied Coatings, the co�ting must be applied across the entire roof surface and meet the dry mil tliickness or coverage
�ommended by the coatings manufacmrer and meet minimum performance requirements listed in §I 18(i)4. Select the applicable coatin�:
Aluminwn-PigmentedAsphult RooFCoating
Cemen[-Based Rwf Coating �LJ 0[her
Regiso�n�ion Number: Regislru�ion Da�e/Tirne: HERS Prorider:
2008 Residentiul Compliance Fonns �
Augusl 2009
Certiilca�.eui�Cumpliance: Residential
Projecl Name:
�
cr-� a_AL•r
iPx�e � ul� ��
% _ � n of tor es
ir�
HP'-.RS VLR7F] CAT101� JUMMAR)' T6e enjorcemen� ngenqrsl�o�dc] yar s,neclal anention in !hc HLRS Mcasure.s a've_^i)ied in diis
cl�ecldisi belnw. A camyleied and siorvvd CF-41t Farm for a7! Oae maaa�nire.r s,uecijied shcil] Ge subnvflied vo the uui]dfttg inspeclor before jinal
ine�nectian.
Dllci Sealip�e b i�051in� HL2Snerijica�ion i,v rayuireclJorthis meo��zur.
❑ TGS ❑ NO 1'GS:ln Climate Zones:' and 9-16, 3f more than 4G hne�� ieet ofnew or replucement ducts are m�tEilled in uncondrtioned
spbee, the ducts are to be setiled ner � I S2(b)1Dii aud [he newly instaifed ducts arc to ue insula�ed per §'] 5J (i110.
.IJ �XCG7''f70�': Lxisfing ductsystems timl are extended, which iire cousreucied, insul�ted ur-senled wiCh usbesms.
❑ P�S ❑ NO YGS�. ]n Climate Zoues 2 and 9-]G, if the exis[in� spact-conditio�iiue srstem (HVAC equipment and ductingj is replaced, the
ducts are to be sealed oer §] �2(bp Di.
�J YES ❑ NO l'L^5: ]n Climate Zones' aod JJ 6, if [iie existing HVAC equipment is replaced �(ineluding the replacement of thu eiir handler,
ou[door eondensing �mii of n split system, cooling or neating coil, or the furnace lieat excnange�) the ducts �re tu be
sealed per §152(bpE.
❑�XC�PTION: Duct systems tiiat are ducumented io have lreen previoush• se:ded conSirmed through HLRS
veri�ca[iou in acco+�dance witlt prucedures in the Referencc Residential Appendis 3tA3.
� ❑� CXC�PT10�: lluc[ systems with�less [hnn 4U line�r feet in wicondi[ioned synce. ... ..
❑ EXCL,PT]ON: �zistin� duct s�B[ems cunstructed. insulated or sealed with asbestu5.
F:0filperdRf Ch3ivE - SFl]lf S}'S[elil HERS verificatim� is regi�iret%jor Ihi,s naea.n.n�a.
❑ 1'�S ❑ NO YES: ln Climate Zones 2 and S-li, wi�en the exis[ing HVAC equinment is replaced (includin� the replacement of the air
handler, on[door co�densing unit of a snlit sysiem A/C or l�eat pump, cooling o� hea[iog coil, or tne fumaee hea!
excnaneeri e cefrieecan� charee measuremen� shall be veri5ed oe; (] 52(611F.
Cenn•a] Fan Inteeraied (CFI) Veniilation System and Fan WaY Draw
The ventilation rem�irements of b150(ol do no? aoolv tn existine residential homes.
Ducxed Split Syscems - 9ir Conditioners and Heat Pumps: Airflow HcRS verii�carion is reguired jor tiris measu�c.
❑ 1'ES ❑ NO YL+S: In Climate Zones ] 0 Tnrou�h I5, wiien the existing space-conditionine system (HVAC equipment and ductai�) is
replaced. the airfiow and ian watt draw si�all be verified ne� � 152(61] Ci Lo mee� thu renuirements of C� 151(fl7B.
• I certifv that
Nam::
�a��
Comnany:�
�
Address: ��
O
City/5tate/Zip�.� �
��
and
Date:
If� Applicable O CEA or i7 CEYE
(CerLification �!):
s6as Cl . 4-� :' l Cl _ <!X CO`YLO I //Y —!/ !^�a c70L
ReSponsible Ruildin�� Desi��ner's Declaratiou Siatemcni
^ 1 am elipible under Divislon 3 oflhe C�lifornia Business emd Professions Code to acc�pu�esponsibilih� for th� bulldino d�sl�n identified mi
tiiis Certificate of Compli[mc��.
•] ccrtif}� thni th^ cacigy fetnure.e aud perl�ormanee sq�eciGca�ion� for thc buildi��� desi�u iden�ife�l on this Ce�tifcat� of Compli�nce eoni'orm
tu tiie iequircments of'Title 24, 7'utts- I Eind G of the Califomia Code of Regulations.
• Tha 6uildin� design 1'e[nures ldenti6cd on tius Certificatc o1'Compliance ara consislen� with Lhc infnrmntion provid�d tn documem this
huildii�� desien on tn: otfiei eppli;:oble compli�nc�.:� iorm:, warl:sfiects, calculatians, plans and spcci(me�ions subnulmd �a ti�c enforcement
ueenc�� foi anorov�l wlth this lmildin�� nennii anolication.
n��imc.
Cumuam
Addres�
C i r,�l8tate/7 io:
Sign�ture:
f�i�one:
Far a,s.rr,st¢ucc m� t/u�ts'timi:: regrtrdi7+g i1:c ii+mo r Sunxl�o�dt, coinac7 tlir Erae��o �=i-latliizc «t: 7-b'f/D-7i7-i300.
Icegisu�aiinn l��wnber: Kegr�rva�ion Late/Tfmc: Ht;l',i Fro»ine+-
3008 Rc.rtder�iial Com��(im�ce Fonrvs
Au��u.si 30b9
� .
COSTA MESA BUILDING—SAFETY OEPANTMENT
' , P. 0. BOX 1200
Costa Mesa, California
C�1p(� ..�L.ii/ll��lA.i Zljl Cod�
i�
Swts licens� No.3(o (o O// C�°u• C S.
City License No. 'Tel. No� (�.2
JUMBER TYPE OF FIX'IURE OR ITEM FEE
Bar
Kitchen
ureine
Yiping Alteration
low I'reven�er
SO���klrrs (Res or
rty Sewer ... Feet
Pipinµ
ool. Seotic Tank
'I'O'CAI. FF.E I � I � �
:; 4�iHl li.1/Ib/79 G.O;: �l.
�C
pp PERMIT NO.
TMC! HO.� RECO. BY �7 �� �� �'
LOT NO. OAT6 88U60
BUILDING USE �O �� Z
Building
Address
Owner
, �
City �A� rt�` `� '`� .� Tel. No
I hereby acknowledge tlut I�have read this application and
stale thal ihe abovt is cotPect and agree to comply wilh all
City Ordinancls and SWte laws regulating plumbing.
1 certify�that 1-possev ihe above valid Slate ot California clasai-
ficalion or�,l am the legal owne� of Ihe residential property dr
scdbed� abo've.
1 cerHfy Iha[ 1 have obtained a permit from the State Diviaion Of
Industrial Satety forexc�vations,other Ihan swimming pools, five
ke[ deep or deep nd inlo which a person is requirtd to� de% end.
SiBnature o � // �D/�t / �„
Permittee � 1_ �5 - �L� ff�_
aPPRova�s
SL�E
CMF 0<5f1-66 B�Q• ��T N0. I H `�� 1
Lot 9.1 r ' _
. _ ���2��
COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA, CALIRORNIA
For Applieanf to Fill In Completely
� TYPE OR PRINT
ADDRE6S 3210 Colorado Place
� COSTA MESA. CALIFORNIA .
OWNER Kenkol Construction Co.
ADDRESS 1555 Placentia Avenue
TEL. MI
an t• eaCh - No.
ARCHITECT TEL. �
��� ���� �ti���� � ,
�-�. 5- i3-c�o;..
�I�i�t��E �E�lto
�i1V Qf Gtk�� ��
APPLICATION FOR PERMIT ±
� BUILDING
For Office Use Only
RECHIPT NO. A �'gERMIT�_I�O�
1� V lJ�j
�d]' (�a/R9��v � r�AYEi au"i�sn
��'J'
G
ADDRESS 1555• Placentia Avenue ZONING
t Beach IONE NO.OF U8E OF NEW
c�n NE'w Ox � I r�,He �-eui�niNc _ ,
LIC.TNO. S NO. MI 6-3227 �E°�� ��
�ESCFIPTION
SIZE I r+o. oF Btnee. O
OF LOT rvoW oN. �or A. P. NO.
USE OF YARDS EVES
EXISTWG BLDG. APPROVED ALLOWED
96lBACK L�N6 PROM � , r�C � IGENTER LINE BTJ
c2M6n On siRsei REAR YARD a� FRONT T. IN.
BIDE YARO I LEFT � t� I RIGHT `' R. SIDE FT. IN.
DESCRIPTION OF WORK -
L. SIDE FT. IN.
NEW �I X II A4TERATION I II �1DDITION I REAR 4` �T. IN.
REPAIR " I�"IIMOVING I IIDEMOLISH I BYPROVED�U' �` �r DATE ��a'-{O�
$B = LDING 159•7 � 5.�.+f ROOMS v STORIES �
1
EXTERIOR WALL S'ti1CC�xooFROCk '' 7. �'�
GOVERING COVERING
USE OF 6UILDING,AND WORK TO BE PERFORME�
'd nce and
Attached Garage Plan 2-B �30 � �
I HERE9Y AGKNOWLEDGE TXAT � HAVE READ THI6 APPLIGTION THE AMOUNT BXOWN UNDER VqLUAiION 16 FOR TX¢
/.NO eTATE THAT THE A6GVE 13 CORPEGT ANO AGREE TO COM-
PURP09E OF, ESTABLIBHING A PERMIi FEE ONLY.
PLY WITH ALl GITY ORDINANGE6 AND BTATE LAWB PEOULATING
BUILo1Nc CON9TRUGTION. VALUATION /
81GNATURE OF PERMIT FEE $ �b —
PERMI7TE -- /'/ p m
' �/� $ / (� �S �� PLAN CHECK $ � 0 �
AUTHORRED AG T / �'�' � � "'nVtiry / ' 2
TOTAL FEE �S~ � �
6
� ,
-,` COSTA MESA BUILDINO—SAFETY OEPAHTMENT
' P.O. BOX 1200
Coita Mesa, Califamia
cm
MO. �i�M
Owellinp. Sq. F�.
Garage, Sq, Ft.
Fin1 20 Ovtlan, wch
� OudeU. A.dditional
Finf 70 Fiatorn, each
Fiaroro, Additional
Dryar
Fan
TEI, IJ�S'�(0-Z.
aASs. C S3
IACM 1�lS
f
O
Oven. Dometli< 1 . �
Fola Comrmnion�r '
Ranq�, Oomntic�
49H2 IU/16/79 12.c5 1�-
� ,
N° �
TRACi NO _ /{_(,�ra?(�
n REC'D BV _ ....F��� V V ' '
tOT NO..�_2__.
DA7E ISSUE
BUIIDING USE /O/j� p
6 l 7
COSTA MESA, GLIfORNIA
NE�NEST � y"`+ ��,':
CROSS Sf.
OWNER
000Eu3alo �=C�.cd—..,�
2� CITYe //l.(�'(�-� TEL. N��� r`7 �V
I HEYElY KKNOWLEDGE TNAT I NAVE AEAD THIS �PFtI.
CATIp1 AND STI.TE TNAT TNE ABOVE IS COR4ER IJJD AGREE
TO CdN➢IY WIiH All CIiY ORUINANCES AND STAif UWS YEC.
_ t. ULATING EIKTRIUL WIRING. `_
1 CE0.TIfY THA7 I POSSESS TNE AlOVF VAIiD STATE OF
UIIFORNIA CU�SSIFlUTION OR I AM iNE IEG�L ONTlE0. OF
iNE SINGLE fAMIIY pE51DENTIAI PROPERiY DESCRIlED AlOVE.
—_ SlpnoNn o� `1 • �
—YE�RMITTEF- :���
NO. � ti1M fACN FIlf
-SiQn'6i-irm�. 2.00
' � �__
Trans}orm�n �'ICW' .t:.
r
Gen�mta� KW ". _
.�e � _
� ,;:.
Mobn �Ses Schadvle� "' �B j
.j-� HV
H7 Sob�Tom) Fem - ,(3 e�'d �. C. /L ��/• �
HP APPROVALS
INSIlROt D�TE
Me�en, eo, iEMY. POIE � �
UNDEiGROUND CONUUIT � A A I��_�_�.����
Permil Fee 3� ROUGH I Cc I� T �� 1�� j
$u6-Tot01 fNf FIXTURFS I �
— POWER I I
Tmal fem �% �1�� UiLLITV CO. NOTIflED � I
L. L. FlNAL
CMF0313�46,rev.]/75 BIDG. PERMIT NO. � __
For jfemc nnf lic}oti ref>r tn Fee $[hcr{�iln
- - ->
` N1STA MESA BUILDING—SAFETT OHPARTMENT
, P.O. BOX 1200
Costa Mesa, Califamia
TL
tATE LICFNSE NO�[� ` Q /
ITV LICENSE NO.
ND. IIIM
Dw<Ilin9. Sq. Ft.
Garage, Sq. FI.
Firrt 20 Oulisn, wch
pullall, Addilional
Finl 20 Fiatmu, wch
Fiarure�, Additionol
Drye/
Fon
Heoter
Oven, Domaqic
Fole, Consrruclian.':
Reng�, Doma�lie
CUSS.
GCN
s
Htf
iRACi Nf.'�T-� � REC"D
lOT N0..�32
BUILDING USE
r l..�Z/��
WSTA MFSA, UUFONNU
DA7E ISSUED
/�`'�� � �� t �
CITY ` /I6C.QCA TEI. NO��
1 NE9EBY ACKNOWLEDGE TNAT 1 HAVE READ TNIS AVPII-
GTION AND ST�TE TNAi THE ABOVE IS CORAECT AND AGREE
TO COMPLY WITH All CIfY 00.U(NANCES ANU S�A�E lAWS QEG-
{,UUTINfi EIECTpIUI WINING.
;.�� I CERTI% TN�T I POSSESS TME AlOVE VAIID STATE Of
' GUFOYNIA Cl/SSIfIGTION O4 1 AM TME LEWL OWNER OF
..� � iME SINGIE FAMItY�fDENTIAI PROPFRTY DESCRIlEO MIOVF.
NO. " I7IM UCN
Sipn 6 1 Trom. 4.00
Tronaform�n 1(W
/!Et
:.. . �'____ .. , �+
,t
Gm�roton . '1(W ,�
.�. _. ,, ti _..- �. -� .
Moror� �Sea khadula�
.%� HP �,'-�T7��-�'_'Zf�� lll�.
Hp So6.Total Faa� "p N/J...— C. C-"/ I
HP APPROVALS
IWIlRO� D
Meten, w. TEMP. Pp�E �
UNDERGROUNO CONDUIT I �I�
Vermit Fee 3 00
ROWM
S�b.Totol Fs�t Fi�nURES � �
___ COWER � �
Total Feli � UTILITY CO. NOTIFlFO I I
FINAL
cMFo3i3oe,,e�.ii�s � � BLDG. PERMIT fd0. �'�
For item< nnt lisfe rr,fer in Fe= Sche ulr. _
i ,. . :r -• w , .
�k98� 10/16/79 60,50 TL
' �� COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATIO OR STRUCTURAL PERMIT-' ;.�r .�,
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
REC PERMIT 1�iU 48963
For Applicant ro Fill in Completely — Use Ink Only ir
ADDRESS � 1 A.P. No. /3 9—oF16 — 03
BUILDING
OWNEROR A�DRE55 3��D
TENANT
UNIT OR
MAII_ING /h SPACENO.
ADDRE �/ '
TR.NO. LOT � /J/ BLK.
G- `'�, T�SI US7 ��
CIT N n
CAN5TRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH
LENDER �, !/
BRANCH
OWNER
ADDRESS y �y^ . I VALUE
ARCHITECT T�/� �� US'�^-' $ d�'
OR ENGINEER I� �� � Q
ADDRESS ����`I� �� ZONE •" I TYPE GROUP
rnn�Taerrn��... � � i � / ( �, B�PAOVED DATE '0%O/!7
ADDR O�/ (��C/J(�{,�/� f"�
CITV �o�r0'ZTOI
F STAT CITY APPROVEDSETBACKS
,G IIC. N. �� Q LIC. NO. '
� SIZE NO.OF BLOGS. (FROM C/LSTREET)
W
0+ OF LOT NOW ON LOT FRONT FT.
�/a USE OF
�-^ EXISTINGBLDG. S E FT.d
-�,
FSeparate permits are required for , �. sioe 3d Fr. d
� electric, plumbing and heating work: REAR FT. O
� USE OF BUILDING AND WOFK TO BE PERFORMED PLANNING ACTION
F
Q
/J DATE
Q IG(r��j(�(j61f�, B'Q�'C� APPflOVED
e;
} APPROVED �� /�— �a/,� �7 .
.d
�
W
oI hereby acknowletlga that I have reatl this application and state °�'
a! that the above information is correct and agree to comply wlth
d all laws reBulating builAing construction, and I shall not employ
z any pe�son in violation ot Me workman's compensation laws of v
-� ffie State of Celifomla. ' m
3 I hereby cerNfy thai 1 am properly licensetl as a contractor under SQ. FT. �`+
the State of Calitornia Business antl Protessions Cotle, Division 3, THE AMOUNT SHOWN UNDEF VA�UATION IS FOR ro
Chaptar 9, antl that such licenses are in full torce antl affect, or I TNE PURPOSE OF ESTABLISHING A PEFMIT F E ONLV: �
am exempt from the � visions ot the State ot California 8usiness a
VALUATION PERMIT FEE $
antl Professions Cotl , vision 3, Chapter 9. . ��� v�
� m
��' PLAN CHECK $ , mO "�
SiB�ature � / �
�q LL
Permitte L S v�'f� TAX $ �
i or p 2 • u
\ AuffiOrizetlAgant Date TOTALPAID $ '�
1
COST,A MES,S BUILDINO—SAFETY DEPAATMENT
P.O. BOX 1200
Costa Mesa, Cali}ornia
CONTRACTOR
Addross 7�
Cl� 1� �n� Zip Cop�-� &
Swts ucens� N�G (o O�/ Clau. �'_ S`
City License No. Tel. NQ$�%GLZ.7
JUMBER TYPE OF FIXTURE OR ITEM FEE
Bathtub
Leundry Tub or Tray
Automstic Weshing Machine
Shower
Sink, Bar
Sink, Kitchen
Wesh Basin (Lavatorv)
Noof Draina
Weter Wping Alteretion
Backflow Revrn�er
Lawn Sprinklers (Res or P
F400er[v Sewer ... Feet
�rorni, rzE I (n I O�
CMF 0450-4fi
� �,97i I O/�"J PERMIT.NU�• I I.
C/ r' -r�f�:�66
r'uc� n neco. er.,LL_ J
LOT NO DATE IB6U6D
BUILDING USE
Building �
Addrees �
Owner
Mail � %
Address �y ( �
�,�. ��i �. i 'Cel. �J ' ^gsOf
City
.
1 hereby acknowledge t}iat I�have read this application and
state ihat [he above is. correct and agree to comply with all
City Ordinancas and State Laws regulating plUmbing.
I cerfify,that 1`,pofsess the above valid S[ate of Califomia classi-
ficati6n out am Ihe legal owner of the residen[ial property de-
scribed "abo've.
I ccrHty Ihat 1 have obtained a permit from the Smte Division of
Industnal Safety forexcavations,other than swimming pools, five
feet deep or deepe� an o whic a pe�ia requ' ed t�
Signature oj
Permiftet .
BLDb. VERAUT