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HomeMy WebLinkAbout2538 COLUMBIA DR - Building Permits� . � CITY OF COSTA MESA � BlIILDING D►VISION � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(7'14) 754-5273 • Fax Q14) 754-4856 • wwv+,ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 APN: 41913103 JOB ADDRESS: 2538 COLUMBIA DR CM Vicinity: � Squares: 2600 > PERMIT NUMBER: B10-00099 STATUS: ISSUED DATE ISSUED: 04119/2010 ISSUED BY: KJB Suite/Unit: .. � � � ' Valuation: � � $6,925.00 SCOPE OF WORK: �TEAR OFF EXISTING ROOF COVER, COVER WITH 30 LB FELT AND NEW 30 YR COMP SHINGLES. ROOF PITCH IS 3:12. INCLUDES ATTACHED GARAGE. OWNER: PANONCIALMAN, MARK � Address: 2538 COLUMBIA DR � - -�� Unit: PHONE: - City/State/Zip: COSTA MESA, CA APPLICANT: MARTIN ARROSAGARAY PHONE: 714-556-8867 Address: 2508 BOWDOIN PL City/State/Zip: COSTA MESA, CA CONTRACTOR: MARTIN ARROSAGARAYS ALL SEASONS ROOFING License No. 622480 Address: 2508 BOWDOIN PLUnit: PHONE: 714-556-8867 Ciry/State/Zip: COS7A MESA, CA 92626 �- ' ��"`' CELL: ARCHITECT: ENGINEER: FEE SUMMAI2Y Reroof Plan Check: $0.00 Reroof Permit Fee: $13925 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 License No. License No. PHONE: PHONE: Unit: : 4L FEES $140.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thankspivinq Dav and Christmas Dav NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No, g2-28, § 1, 1241-92) 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 fnal approval will resWl in the expiretion of this permit. COOE t. INSPEC710NTVPE �ATE IN1111AL5 COOEN MSPECTONTYPE OATE INi1T1ALS ifi16 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ���{.��/���� � ,,� �•,� 208 Final Plumbing 20o Final Re-Roof �Q (_� �+ �` 210 Final Electrical 201 Final Block/Retainin9 Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Appmval 203 Final Sign 222 Final Site 204 Final Demolition ` 250 Final Building/Occupancy • WORKERS4COMPErySATION DECLARATION: I hereby affirm under penally o( perjury one of the (ollowing tleclarations: ❑ I have and vrill maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Cotle, for the performance o( the work for which Ihis permit is issued. ❑ I have and will maintain workers' compensation insurence, as required by sectbn 3700 of the Labor Code, for the pertormance of [he work fw which [his permit is issued. My workers' compensation Insurance carner and policy numberare: � / � �� Cartier. •�'� (This sepqn need nol �e mmplefe0 �d jI�e permrt is valued �ne nunered ddlars (S�OOJ oness J Policy Number: /�S o �� D ❑ I certify Ihat in the pertormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subjecl to the workers' compensation laws ot Califomia, and agree that if I should become subject ro the rkers' compensalion provisions of Section 3700 of the 6r Co , I sha o hwith comply with [hese provisio� I � AppliwnCs Signawre Da�e WARNING FAILURE TO SECURE KERS' COMPENSATION COVER4GE IS UNLAWFUL AND SHALI S ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5700,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn that 1 am licensetl under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle, and my license is �in f)ull forc d eRect. Lic. # d'>' Ll � Class # � —� Co ractor's Signalure ' Da�e ��) CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn that there is a constructbn lending agency tor the perfwmance o( Ihe �+ork for which Ihis permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Atltlress: Date OWNER•BUILDER DECLARATIONS: I hereby aKrm Ihat under penally of perjury [hat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sea 7031.5, Business and Professions Code: Any city or county which requires a permit to construc[, alier, improve, demolish, or repair any stmcture, pnor ro its issuance, also requires the applicant for such permil to file a signed statemenl that he or she is licensed pursuanl 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 antl the basis (or lhe alleged exemplion. Any violation ot Section 7031.5 by any applicant for a pertnit subjects ihe applicant ro a civil penalty of not more than five hundred dollars ($500).�: ❑ I, as owner ot the pmperty, 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 ovmer of property who builds or improves thereon, and who does such vrork himself or herself or throuqh his or her own employees, provided Ihat such improvements are not intended or oHered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving [hat he or she did not build or improve for purpose of sale.). ❑ I, as owner ot Ihe property, am El(CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Professions Code: The contractors License Law dces not apply to an ovmer of property who builds or improves Ihereon, and who contracts for such projea vnth a contrecta(s) license pursuant to the Contraclors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Owner ID verified by drive• nse. ❑ Yes ❑ No Driver'S LiCense Na Expires: Verifcation of Ownership by (type of document, i.e� - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation (rve (5) or more (eet in deplh inro which a person is requiretl to tlescen4 will be matle in connection vnth work authorized by Ihis pertnit, and Ihat no building structure, scaffdtling, (alsework, a demolition or dismantling thereof, will be more than Ihirty-s�c (36) /eet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Calitomia Atlminist2tive Code). ❑ As owner-builder, I vrill not employ anyone to do work which woultl require a permit from Ihe Division of Intlustrial Sa(ety, as noted above, unless such person has a permit to do such work from the division. AOPlifanl'S SignaWre Division of Induslrial Safe[y Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupanl need to fle and certify a Business Plan for emergency response to release or threatenetl release o( a hazardous material? ❑ Yes � No (Section 25505 of the Califomia 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 [ime during a reportetl year a quantity of hazardous materials equal to or grealer tnan a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperaNre and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form (or acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Calitornia Health and Safe[y Code, wiih some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of awlely hazardous materials equal to or greater than a vreigM of 500 pounds, or a volume ot 55 gallons, or 200 cubic feet of compressed gas at standartl temperature and pressure). 3. Does or will Ihe applicant or present or fuWre building occupant need �o prepare an RMPP (Risk Management and Prevention Program for acu�ely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Cali(omia Health and Safety Code provitles ihat the CoSla MeSa Fire oepartment may require me preparation, certifcation antl fling wi[h the Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials with the Fire Department. 4. I( an RMPP is presently requiretl, has Section 25534 of ihe Calitornia Heal[h antl Safety Cotle been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is [he subject of [his apDlication a permit for such constmclion or modifcati0n from the South Coast Air Quality Management District or from any other air pollution contml disMct or agency? ❑ Yes ❑ No (Sectbn 658502 of the Califomia Govemment Code requires that the requested information be tumished on applications fa non-residential building permits). 6. Will any parl of the faciliry to be constructed under this pertnit be within 1000 fee[ from the outer boundaries of a school? ❑ Yes ❑ No (If'yes", the facili[y must meet the requirement of Sections 25534 and 42303 of the CaliFomia Health and Safery Code). 7. If a permit from the South Coast Air �uality Management Dislrict or other air pollution conhol district or agency is required for lhe work which is the subject of this application, have all of the disclosures prescribetl by California Health and Safery Code Section 42303 been made? ❑ Yes ❑ No 8. pf yes", attach certificate of compliance from the appmpriate air pollution control offcer�. CERTIFICATE OF COMPLIANCE: I ceAify that under penalty ot perjury Ihe information given above is correcL I agree to comply with all state laws antl city ordinances regarding Hazardous Matenals and Emissions. Si9nalure Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penal�y of perjury Ihat 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 construction, and authorize representatives o( the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl by this permil until fnal inspection. ��/���///_n/ igna re iLegalOwner�s� -� Oale Signamre �ate ��'� l �._� J 305]-a6(3ro)) qna/orAumonzedAOGli t Da�e Prescriptive CerCificate uf' Re.ridentia! ,9 L[eratians 1'ro,jecl�'�mc: L � .� Climate'Lune q CF �! of 1 of'S) Genernl ]nfnrmt�tiun � � � Si1eAdAress: � —30 �'QIt�M /Y'i I EnforcemenlAgeuc)': ( llate: � ./ Building Type ingle P�mily ❑ Multi �amily � Circle lhe Pronl Orienm�ion: N, E, S, W, or degrees Cunditioned PloorArca (CPA): - 1'roject 7'ype: ❑ Alterations ❑ Envelope O Fenesvation koof � H1�AC Reufacement or Chanec Out ❑ Ducl Re>lucement � Watei Healer NOTE: ThisJnr•ur is nn<<o ha ua�cr! J'or Ne�vlo Cnnstructed 1luilrlings nr�JAditinns - Irr.tulntin�i VnLias Fnr Opnquc Snr�irex ((m' Furruao u.m Ilie Mass unJFcn�rinb Slryzc Cmi.rb'uction �able be(mvl Assem6ly Alter�itinn ❑ Opening of O�amed caviq� nlone-Alrera�ionr dem invo/re Uie opening ojd�cfi'anreJc[rvi17, oju w�ll, ccrling, orjloa� uiusl brsral/ �he mm�dcuorp nvininaim� insadutimi rnlaie per ,¢I50 �m� Ihe nl�ere�( assembl��. Till in Cohnnns d-C nnd enier maudniorp in,suln�io�v value in Colurnn H. ❑ Repl.icemenl of entire :�ssembll'-Replocemen� o/'cm emire mn(l, ceili�te, a�floor aa�senablp regvires Ihe ins�ul(ation qfComponeni Pnclm,�e-D in.rufntion values inTnble I51-G Fi]] fn Calvmns A-J. Su�•f'ace lletails ror ti�e fun�ed Tag/ I Assembly l�ame ID� orType� Noic: For Framing Material of Mass Thiclmess, Sp�cing, or Other� Walls see Purrinq Strips Cnnstruction Table below. C � p � R � G H � . � _... ._ . . . �, . .. [;mdm'd Values Fran 7A4 Table Frumed Continuous JA4 Proposed U- JA4'I'able Caviry Insulation Assembly Assembly factor" Number' R-value� R-Value� CeII Valuea U-factorv see Pnge J44-3 and Equation 4-1. For cale�daiing fimred wolls use d�e 1. For Tng/1D u�dicn�e the ideia7i/ica�im� nanve tha! mn�ches Uve 6uilding plans. 2. Indic��e the Assemblp Name a� ry�pe: Roof/Ceiling, Walls, F/oor's, S/abs, G-awl Space, Doors and e�c...lndicate !he Frame type and Size: For N�oocl, Metal, Metaf Buildings, Nlass, ere�er 2x4, 2z6, m� e�c... see JA4 fm" ofher possible f�Ame rype assembfies. 3. Emer fhe dviclmess (m� muss in inches or Syacino benveen fnming members enter; ] 6"or 24 "OC; or Other fa� alf odier assembl�� description such ns Cnncrete Sa+vdevich Panel, Spa�vdrel Panel, Logs, Sn�aH� Bale Panel aid etc.... . 4. Qnsed ai Uie Climale Zane; enler the S�andard U fac�w' fi'om Table /51-8, C w� D for euch difjeren! ussernGlp Name or 7��oe. S. Er��er d�e Tab1e rvumber tiva� closeli� resembles the propa.sed ossemblp. , 6. L'n�er !!m R-ralue iltn� is Leing instal[ed In !he wall cavi{p or Letween lleeT�onriirg; oUeenvise, enter "0 ". 7. L'nier Ihv Continuaus Lvsulalimi R-vnlue far tl�e/n�oposed qssernbl��; n(herwise, ei��er "0". B. En�e�� dre r�i+� m�d cn/wnn nf �he U-facloz nalue based a� GoGinm F TuGle Nuniber and emer the Assem67�� U-fac�a� in Calunm J 9. T/ie Prupnserl dssenrbh� U-fnc(ar, Colunv� J, nn�sl be eyual lo nr lesa� lhan U�e Slnndnrd U-facim' i�v Cnlazmn E(o complp. Furrin� Strips Construction Table for Mass Walls Only -� A B C ll C F G 1�1 1 J K L M Propnsed I'rnperfies uf N[nsonry ond Cmicrefe Added lnterinr ur L�xterior Insulntion VV:dls rrom Refermice in T�urring Sp:�ce frnm Reference . Joint A i�endix'fable 4.�.5.4.7.G. 4.3.7 3oinl A � iendiz'Cable 43.13 V c � J 1 v ' U o p � c.L � m w `o o U.. � v'., �i�78� Asscnibly � j G �.� F F= c �� _ c"� L J, p o �° A Assembl M��s's Name ar L\4 Table �= v � a E o. t!� R� �`u Y 'Phici<ness� T�c' Numbe� ��- �° w= � LL 6 u: rG �' u�i a 11-�eCtDt�'� ComnieN � � I I I I I I Regi.r�rn�inn Nwnher: 2e,�is�raiian Da�e/Time: HZRS' l'rovFder': 200d' Re.rrdeii�ia! Convplicuecn. Fnrm,r �tzrgers! 200y P ih oj ect Certiticate of Compliance: Residential Zunc # - cr-,x-.aLT (Pxge 3 ot' S) � # of 94�ries 1�`OOV ROORING PRODUCTS (COOL ROOFS),§ISI(n/2 IVhen the nren of rxterior rooJ'.r« rfnce (o be rep(need eeceed.c iuore than SO% njthe e.cisting rnof aren, or �uore lhue I,000 f�, IVIIIGIICVL'Y !S le.rs, Uia nern roofiug area un�sl mee( Uie rnnfing prndnc! "Cnn! Ron/" requireiuen(s of §152(b)1Hi, l52(b)ZHii, nr 152(b)1Hiii. Check npplicnble nller�iative a� e�ceptimi 6elmv iJ'rHe rnojulreratian is esemprfr�om �he roofingproducr "Cool2ooj" requiremems. Nate: /janv one oflhe uGcrnulives or' ezceplinn beloH� is' checked, the �Iged Sofur ReJlec(unce and Thermu! Gmittnnce reya�irements• fnr roo�ng prnducLs in ,�V !8(i) ure na npplicaGle. Do no� Jill table Gelnw. ❑ oi Roofs Not Required in Climnte Zones I-12, 14, und i( with a Low Sloped. Less or2:12 piech. ool Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs (pitch grenter than 2:12) and product unit weight less lhan Slb/ft'. Alternatives to §152(b)IHi a��d §152(6)Hii, Steep-slopc roof (pilclr> 2:12) ❑ Insula�ion with a thennnl resistanca oCa� Icast 0.85 hrdl��°F/[3tu or �itleast a 3/4 inch air-space is addcd [o the roof deck over an auic; or ❑ Existing ducts in Ihe attic ure insulated mid sealed according to §!51(t)10; or � �❑ In climate zones t Q 12 �nd 13, witli 1 fl of free ventilation area of attic ventilation for every l50 ttz of attic floor area, and where at least 30 percen[ af the free ventilation area is within 2 feet vertical distance of the roof ridge; or � ❑ Building has at least R-30 ceiling insulation; or " ❑ Building has radiant banier in the attic meeting the requirements of' § 151(t)2; or � Building has no ducts in the attic; or ❑ In climate zones 10, t l, l3 and 14, R3 or greater roof deck insulation above vented ahic. Lxceptian to §152(b)lAiii, Lnw-slope roof (pitcl� <2:12) ❑ Building has no ducts in the attic. � Other Exceptians � ❑ RooSing area covered by building integrated; phomvoltaic panels and solar thermai panels are exempt from the 6elow Cool Roof criteria. �� � Roof constmctions that have thermal mass over the roof inembrane wiih at least ZS I6/ft' is exempt from the below Cool Roof criteria. Note: If no CRRGI label is available, Check the aoalicable box below if pliance method cannot be used, use [he Performa Yom the Roofin Products "Cool Roof' Re uire¢ RoofSlope ProductWeight Product 2:12 > 2:12 < 516/ft� > SIb/fl2 TyPe� ❑ ❑ ❑ ❑ ��� ��� ��� ��� Approach to show complianc� Aged Solar Thermal Reflectance�'9 Emittano �4 TLe CRftC Producl ID Nmrtber cnn be oGlnined fr'orr� (hc Cool 2oof Raing Cmmcil's 2o1ed Producl Direclory al �vwm.cnolr'ooG�.ore/r�rnd�rcra'/sem�ch.� lndica�e Iha »ye aJyroAuG is being usedfarWe rnof lop, i.e .ring7e-yly ro�f, asphall roof, nie(al roof, e(c. . Ijtlrc: dged ife/lecimrce i.r rro� avnilnLle in.die Cno7 RoojRnling Cmnrcil'.s Ra�eAA�oduc! Direc�orp tl�en use U�e Ini�ia( ReJleciaice vnlue finru �he snure direclm�l� am( u.re Ilre equnlion (01+07((lin(Nnl— 01) (o obinin a calc�doted aged volae. Where p is tlic b�iliol Salm� /ieflecmnca. Clreck G2i' iJ dre d�ed Re/leclmrce i.r n calcrdu�er! vukre usr�rg /he equtniwi nlmvc. Colcidale die S2l value Li� ue'ing llie SRI- Worko'hee� nl htt�r// mn r ener'rr cn eon/lille24/tmd emar Ihe re.rid(ing ��alne in IHe SR[ CoLumr nLone mtU o�mch aco/>v q( dm SR/- Wnrkshee� in the CF-1/i. � apply Liquid rieid Applied Cuatings, the coating must be applied ticross the en�irc rouf suduce and meet thc dry mil thickness ar cover�ge commended by tl�c coatings manufacturer and meet minimum performanec requirements listed in § I 18(i)4. Select [he applicable coa[ing: Alumiiwm-Pigme�itedAsphai� RoofCouting Regi.slratia� NumGer: 200d' Reside���iul Campliunce Forms � Cemcnt-Based Roof Coating Date/Tiine: Other HL•RS R�orider: Augus�2009 ]'rescrintive CerYif7cate uf Comuli:uice: 12esidential Prujeef IVame: Cr-712-AL"T (P'x�e i oi' S1 , "Luncn � � i''ofSWfien' II�T:S V�RIk']CAT101� 5 UM➢1AP�i' TGe ei?fw�ccmeni ngenel'shoidcl ptm spec(cil aucmia� io dic HL'RS Iilensiu�er s7�ecfjiec! in [hisi cl�er.Idis� belm+�. �1 cnmplered und signed CF-4R Fonn (or cdl Ihe meaa�in'ea� speciliecl.sfiall Ge sui�minechu ifie bui(ding inspec�m- bejore li»o] vuL'lSBalillg&',ie5til2� NL7LSneri/icnlionrsrequiratlforlhdri»eciszu�e. ❑ 1'�S ❑ NO vP.S: !n Clima�e Zones ° and 9-16, if more thu�� 4l1 linem� fee� of new or replacemenl ducts xre ins�alled in unconditioned apnce, the duets tire to he seuled per y152(b)IDiI and the newly ius�ulled ducis Eire m be insulatecl per S�I il(1�)10, ❑ CXC�PTIO�': Lzisting ducr systems th:i� are extended, which ;ve cunsu'ucted, insul.ued ur scaled �rit6 asbesms. ❑ l'iS ❑ NO 1'LS: ln Climoie Zones 3 and 9-16, if the existinE space-coiidilioning system (HVAC equipmenl aud ductin�j is replaced, the d�cts are tu 6e sealed per (152(b)1Di. ❑ YES ❑ NO Y�S: In Climate Zones �' and JJ 6, if the ezisting HVAC equipmeni is repluced (including the replacemen� of' Ihe air handler, ouldoor condensing unii of a split system, cooling or he�ting coil, or [he furnace heai exchanger) tlie ducts tu'e to be sealed per §]S2(b)lE. � ❑ L.XCI91'T10N: lluct sy,rtema fh�t are dueumenCed tu Ivrve been pruviously se�iled conf7rmetl Yhrnugh H�PS � � �verificatimi io accm�dance �vitL pcucedures in the Reference Residential Appenclis RA3. _ - �- ❑�XC�PTJO�: lluct svstems with less [h�n 4111inear teet in uncondiiioned space. � - . duct insulated or senletl with �2�fCleet'allf C�78CvE - Spllt $}Bt0R7 HL•2S veri/icnlion is regui+'ecf.fa'thi,s measin�c. ❑ Y�S ❑ N� YES ln Climate Zones 2 and S-I5, when the ezisting HVAC equipment is replaced (including the replacement of the air handier, outdoor condensing unit of a spiit system A/C ar heat pump, coaling ar heating coiL ar the himnce heat =xr.hanaeri a refrio=rant. r.harve measurement shall be verified oer i L`2(6)IF, Centra] Fao Integrated (CFI) Ventilation S��stem and Fan WaTt Draw The ventilation re�uirements of �] 50(0l do not applv to exiseinc residential homes. Ducted Spiit Spstems - Air Conditioners and Heat Pumps: Airflow HERS neri�ica�ia� is reguired (m-lhis mcasure. ❑ Y�S ❑ NO YES�. In Climate Zones 1 U throueh I5, when Ihe existing space-conditioning system (HVAC equinment and ductine) is - replaced. the airflow and fan watt draw shall be verified ner § 1;2(bl l Ci ro meet [he renuireinents of & I S I(;175. is accurnte and � �S � , G/�- Date: '�-' �-�9 I li Applicable � CEA or O CEPE (Certificatioii i!):. Phone: C7��)SS�n-8�� , Respunsible Building Designer's Declaration Statement - 0 7 um eligible undei Division 1 of the California Susiness and Professions Codc to accep� responsibility for the building design idenliGed on this CerliFic�te of Compliance. • 1 certifj• thai lhe energ>' features and performunec speciGcations fbr the buildiug design identiLed on this Cerlificate of Compliance couform tn thu ruquire�nents oi'Tilla 29, Yait:�, I�md G oi� thc Californiti Code of ]Zegulotions. . . • The building design fe�iun�e:; idemiLed on ipis Cerufieate of'Compliuncu ;u�e cunsisieni wilb �be inJnnnmiun prnvided �o dumnneni tbis buildmg dcsign on the other appllca6lu compliancc Ibrme, worl:shects. calcolations, pluns� tmd speeificatimis rcuhmiLicd tu ihe entoreemmu a�cncr for annrov�J with this buildin!.� nennii application. . � Address: Ciiy/SiaielZip: Date: Lic�nse: I'hone: Fnr a.s.si.vuuice nr quertirn�s re��nrrlin�� lhe Lnerbi' Strnu(«rd.r, cnntac! Ghe Ene�g�' Holline «t: 1-80(I-7i2-:i30(J. 7<agfsu'aiion hhinibcr: liegrsv�oiiorr Daie/7'imc: J-/EKS' Proi�fder: �n/IS n..,.;.l..nriul (�i»nnliinvrv. Fnrnxt' /�Uoz!.4'! �il(JJ OWNER S JOB ADDRESS AP No.141-401- INSPECTIONS SOIL GAS WATER ROUGH PLUMBING PFOP'. SWR. LINE I� �H .��1:7_��ll MISCELLANEOUS ROUGH HEATING ANO AIR CONDITION�NG TEMPORARV SERVICE OR POLE UNOERGROUN� � POWER � ROUGH WIRING TRENCHES I� FORMS I-I STEEL RE BON� BEAM �J STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING - IN n OUT � PLASTER, BROWN COAT STRUCTURAL. FINAL MEAT DATE BUILDING PERMIT N0. 3 < Patio Cover - Re VALUE $ 450.00 SUBCONTRACTOR �.a' : r • .� 31 a24 COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. eOX 1200 COSTA MESA. CALIFORNIA 92626 Z . d U Z ZQ H � m J � J V1 Q W 0] J J m Q U � Z a W � aw W Z J Q m Z J � W w ❑ _ Z � w � N � �O PAICI J�4it"A'itie� wAR 7o-7n�MSn00 sb1 0 �.GO APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVE ev DATE RE EIVED . BUILDING " � �� e D�TNI3SU D D ADDFiESS � , N ^ � RMI NO. OWNER � A.P. NO. + 'i I BUILDING � � � � ���� MAIL /� ' ADORESS ADDFESS L�--o / TEL. TRACT LOT BLOCK CITV NO. CANSTRUC710N W ADD A P LENDEF � BRANCH OWNER ADDRESS �/�(7�� y// ,� VALUE J�+ ARCHITECT TEL S / (�W /// "" _ $ �i � OF ENGINEER N . FIRE ADDFESS 20NE TVPE GROUP APPROVED n CONTFACTOR ���.�, BV � DATE %9 / D AODRESS LLo 2��— TEL. ZON ^� NO.OF USE OF NEW. CITV NO. PLANS, BUILDIN . STATE . CITV �'ARDSAPPROVED VAFDSAPPROVED LIG NO. UC. NO. MAIN BUILDING ACCESSORY BVILDING SIZE NO.OF BLDGS. (FROM GL STRE T) � OF LOT NOW ON LOT RONT FT. USE OF � EXISTING BLDG. ' S FT FT SIZE OF NO. OF yT - NEWBLDG. ROOMS STORIES L.SIDE t7 FT. FT. EXTERIOR WALL ROOF / COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PEFFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLOGS. � � VAF. # DATE a�;�j .V(.N- � �...`�2/ C.U.P.#� APPROVED �I '77/' - APPROVED � / 9�/ I hereby acknowledBa that I have reetl this application antl state that the above information is correct antl agree io comply with all laws regulating builtling construction, and I shall not employ any person in violation of the workman's compensation laws of t�e State ot Calitornia. �^ � ° J � I hereby certity that I am properly licensetl as a convactor under SQ. FT. [ che State of Calitornia Business antl Professions Cotla, Oivisicn 3, THE AMOUNTSHOWN UNDEF VALUATION IS FOR Chapter-9, antl ffiat such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: a am eaempt trom the provisions of the State of California eusiness ,r a antl Protessions Cotla, Division 3, Chepter 9. VALUATION (� PERMIT FEE 5 J �\ � Signatute of � �jr./�__ /J � ,/ /�\ � Permittee /�f/ �� C_luic-e $�{�U� PLAN CHECK $ E � V � LL Authorized Agent TOTAL FEE $ �� COSTA B��J� MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA -,-. ,, � ._ � C e i._'U :.. li V i_ C ;;�-,� � � $-cj :-,-� FI(�r,;�CE DEPT. C1v ^ :a '.:' v.� "'�" . _ _QI. FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT AooR 'S5 2538 Colur:bia Drive B U I LD I N G ... COSTA Mesn. cnuFORrvin ' FOR OFFICE USE ONLY RECEIPT NO. PERMIT NO. OWNER Mesa' Highlands, Inc� r:� RECEI "D BY OnTE RECENED OA MAIL 1555 Placentia _ �r� ADDRE55 � �� � ' cirv Newport Beach� C81. � TNo: 2`fI Ei-3227 AooRe�ss ARCHITECT 98ID8 LIc. � COSTA MESA. CALIFORNIA OR ENGINEER � NO. FIRE ADD�RjE55'r jj /� LS/��le 20NE j\� W� y]0�� UOZi51i� V�. �,T� �,�. 12 7 IONE NO.OF TYPE GROUP _ PLRNS , ,' / CONTRACTOR � NO. V ADDRE55 'g�e TNO. `4�8 B P�—� DAT�� LEGAL LOT �/� 20 '9 �'�COO fZR�C. O�'J 'µ . �� OESCRIPTION NO. ��� BLOCK TRACT � w. �: i A,P. NO. �' y {'.� � ;M1 � { i �• ^ 4'" �;,-'. SIZE ry NO. OF e�ocs. � �' ' 1� � S C ��1-..' Lr OF LOT (O X�� ��Ow Orv LOT O �''F� �� USE OF � � E%�STING BLDG. � SETBRCK LINE FPOM C/� -- i��T�. cerviEw ov sie[ei N -� REAR YARD 1S i - P'� � SIDE YARD RIGHT lO LEFT lO DESCRIPTION OF WORK • NEW p ALTERATION AODITION REPAIR ' MOVING DEMOLISH ' BUILDING 15'77-. — 430 FOOMS V STORIES 1 SIZE EXTERIOR WALL ROOF L i COVERING BtuCCO COVERING yyOb�MO � USE OF NEW BUILDING Residence & att. araee Plan 2—E 1.HEREBY nCMNOWLE�GE THAT I X4VE' REPO THIS FPPLICPTION 4NO STATE TM4T THE ABOVE I$ CORPECT I�ND AGREE TO COMPLV WITM ALL purpose of establishing a permit fee oniy. CiTY ORDINANCES A STATE LnWS REGUL/�TING BUILUING CONSTR riorv. VALUATI ON SIGNATURE OF PERMIT FEE � 3S�QO PERMITTEE 15��'z�QO 17.SO PLAN CHECK $ � n AUTHORIZE� AGENT TOTAL FEE $ S<� SO SNf. C.