HomeMy WebLinkAbout490 CABRILLO ST - Building PermitsPHOJECTRDOPE55: t� JO CABRILLO ST
awNen�sxaMe: ANTONINI, DAVID M
! aooeess: ANTONINI, SUSAN F
490 CABRILLO ST
COSTA MESA,CA
548-2850
ppCH1ENCINEEfl:
aooeess:
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UNIT:
92627
xEc.No.:
uxiT:
PENMITTEE: WEYBURN ENNS (714)786-4045
aooness: 3591 FENN ST
IRVINE CA 92714
UCENSEO CONTBACTON OECLABATIoN: I hereby allirm �ha� I am licensed untler O�ovisions ol Chap�er 9(commencing wi�h Sec�ion
7000� a� Division 3 o�l�e Business and Pmfessions Cotle. and my IicenSe is in �ulllorce and eilecl.
CITY LIC.: STATE LIt.: CLASS:
Da�e:.�,�J O.�_ % SignaWre:
WOPRENS' COMPENSA710N oECLAXATION: I here6y allirm Inal I nave a cenilicate ol cansent to selbinsure or a ceniticate af woBers'
Compensation Insurance. or a cerniietl copy thereof (5ection 3800. Lab. CI.
POLICY NO.: E%P. OATE:
COMPANV:
❑ Cendie0 cooY is nere�y furnishe0. ❑ Certiliea coDY is filetl wiln tAe cily Builtling Division.
Date: pOV�icant:
E%EMPfIONFXOMWOfl¢Efl5'COMPENSATIONOECUflATION: RhisSec', ne noi ewmpletediitAepermtislaonehmqrea�St00�aless�.
'<erlily Ihal in Ih¢ p¢dormance 0� lhe work �or w�iCh this permi� is � ae Cl sh�l nOl ¢mploy an per5o � any manner 50 as lo betame
hjecl to t�e Workers' ComOensation Laws oi Calilomia. /
Date: �•R-G � � Q �% Signaiure:
NOTICE: II. alter making �his declara�ion. you 5hou10 become bleci lo Ihe Workers' omDensa�ion pmvisians of Ihe Labor
Catle. you mus� Iorihwit� tomply wiN Suth O�ovisions or 5 Oermi� shall �e Ueemed revoketl.
CONSTBUCTIDN LENOINC AGENCY: I hereby afiirm thal t e is a consimc�ion lending agency br Ihe pedormance ol �he work �ar
whic� ��is permii is issuetl (Sec�ion 3097. Civ. C�.
LENUEH:
PDUPESS:
OWNEfl BUILOEB OECLANpTION: I hereby allirm Ihat I am exempt trom �he Coniractors' Slate License Law for Ihe followinB reason
(Sec�ion 7031.5 Business an0 Professional Cade: My city of wunty w�ic� ropui2s a permit to constmct, alter, im0�ove, Aemoli5�. or
repair any slmcture. prior lo iis issuance, also reQuires Ihe ap0lican� lor SucM1 Oermil to bie a signed slaiement t�at he/she is Iicen5e0
pursuani to I�e O�avisions ol lhe Caniractors' Stale License Law (ChaD�er 9(commencing with S¢ctmn 7qp) oi OiviLon 3 oi the Busines5
and Prolessions Coae) or Ihal he/s�e is exempi iherelwm ana Ihe Uasis lor I�e allepe0 evempiion. Fny holation ol Seciion 7031.5 Oy
any aOVliunl tor a permi� subjecls t�e aDPlicant lo a civil penally oi no� rtwre Ihan five �untlr¢tl tlollars (E500).
I, as awner ol ��e pmpetly a� my employees with wages as �heir sale campensation, will Oa lhe work, an0 I�e
Q slmciureis nolinlena¢d aroffered brsale(S¢c0on 7044. Bu9ness anG Pmie55ianalCoOe: The Conlraciars'Sia�e License Law
aoes nol apDty Io an owner ol a pmperiy w�o �uilds or im0�ove5 Ihereon, ana w�o Ooes su[h work himselflhersell or ��muq�
�is or �er own emD�oYees. pmviEea ihat suc� imD�ovemenls are nat intentled or aifere0 tor sale. 11, however Ne Uuiltlinp or
impwvemeni is 5010 wilhin one year o� compleiion, ihe owner will �ave the EurGen of Droving �e/she tli� noi build or improve
for Ihe purpose of Shcel.
I, as ownei o� Ihe pmperry, am ezclusively conVaming wiih licensed comracmrs �o conslmc� �he pmlecl (Sec�ion 7044, Business
❑ and Pw�essions CoOe: T�e ConVaciors' Sta�e I.icen5e Law Ooes nat apply Io an ovmer o� pmperty who Oui105 or improves ��ereon
ana w�o conlrBcis for suc� pm�ecis wilh a coniraclor�s�license pur5uanilo Ihe Can�rac rs' Slaie License Law�. I am aware
I�at O�oof ol Iheir Worker'S Compensalion insurance shoultl De O�ovitletl to me.
� I am exempi under Secbon�. B. 8 P. C. /
lopr �mis reasort. G �
Uate: /�1 O—[' 7� L 3 Owner
I tlo �ere�y certily I�at I am aware ol an0 untlerstantl I�e re0uirement5 0l Califom eal�� an0 Salety Cotle Seclions 255Q5. 25533. ane
2553a and Ina� I or any iWure Duiltling occupam will/will no� (circle one) neeU to mpty vnih saia sia�e codes an0 I�e reQuiremenis lor a
permil lor con5imclion or moOJication imm the Ai� Ouality Managemeni DiStriCL Hesitlen�ial [ons�mction apPlicalions a�e exempt irOm
Ihese provisions.
Dale: ADDlicant: _
I here0y Cetldy Iha� I �ave reatl I�is aDPlita�ion antl S�ale ��ai l�e
OrOinance5 and Slale laws relaling m �uiltlmg conSlmtiion and herel
pioOenY �orinspetlion purposes.
ip
Date: `'Q= 7 d -�_ Signature:
�nvefs license or Social Securi�y a:
is cor2cl 1 agree lo compry vn�� all ciry and couniy
nlatives of �Ais ciN IOSnier uoon ihe abOve�menlionea
t6aba6 Whne—Bwltling: Green—Cotle Eniarcemem; Canary—Appl�canl; Plnk—Revenue: Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 065234
PERMIT NO: H 065234 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRZPTION ; INSTALL 2 SKYLIGHTS, ICBO#2469 SQ FT: 800
CLAIM VALUE: 800.00 CALC—VALUE: $00.00 GROUP OCC: R-3 /M-1
COMMENTS: INSTALL 2 SKYLIGHTS W/LIGHT SAAFTS
**�c�c��r*x�*��**�r**�«*u�*�r��t**u�**�**x*�-**�***x**�**�*****t���****+�*******�*�r******��#
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 HUILDZNG ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT ZN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGFIT: FT ZN
PARKING REQ: PROV: PARCEL: 11737248 ZNE: REF NO:
PLANNING NOTES> -
>
ik iE ik ff iF if iF if iE iF iE i! iE i(-7f !E 7f if l�Y� if if iE i! if iElk jf fk iE IF # ih 1E 1E iM1 it iE iE if iF if if 1f iE fE iE 1f Yr jE iE iE fF if 1f IE if iE if iF 1t �E iE fE # iE if i(� �iF iF ih iE iE iM1 if if *##
D E V E L 0 9 M E N T S E R V Z C E S R E Q 0 I R E M E N T S
ZONING APPROVED BY,,' • DATE: •
HUILDING APPROC�ED &,Y : DATE:
APPLICATION ISSUED HY: � DATE:'�Z L1
�EiElfilffiFlFiElFitlElEklFlfiElEiEi�lFiEi(� �Fif���iflf%ififiFiFiFiF1Ei��� k�1Eif�iFiF{E
it it iF k�1E iF �)E if * it iE',f iE it k if if 1F i! iE if i! iE if 1E iE iE iE iE iE iF iE if �lf if iE i4 if if it it % if fE if it iE %3E iE if if if 3E iE 7t iE 3E if� iE iE iF iP iR Y.-iE iE jf aF iF iE 9f� # if #- # af jr #
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADING
PERMIT 21.00 .50
SMIP/NON=RES
PLAN '
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID �- DUE
TOTALS----> 21.50 0.00 0.00 21.50 21.50 .00
REVENUE DZC�ISION TOTALS--> COLLECTED: 21.50 OVER/SHORT: .00
HLDG PMT PLtIMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG gLAN—CHECK
21,00 .50
!F �f !f iE iE 1t ih iE iE iE iE iE �E 9f �! 1k if !f iE 1E fE iF iE iE �f �E i! iE 1F if iE iE iE iF 1P if if iE 1ElF if if !f if fE iE if �f iF 1E iE df �E 1F 1f iF jf jE 1F iE if iF �t ff �f jE ff !F �F 1E 9E if 9f �F if 1t 1E iF 9E
I N D I V I P 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 2 O N UNIT COST •'TOTAL COST
SFR 800 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 800.00
END OF FEES
l
�S 001`i39?-0�1`i9fld T CaT 21,�0
CATE: 12�07/93 TI�'IEe 14:3d
CONSTRUCTIOv AZ�PLANNING
APPROVALS Permit �
1. Temporary Electncal Service o� Pole ,
2. Sod Pipe�Undrgrnd. � ��
3. EieMrical Condu�t UUiity-Undrgmd. ��.
4. Electrical Condurt�Undrgmd.
5. Steel Reinforcement
6. Electrical UFEF Grnd
7. Footings
8. Foundation
°. 14ater Pipe-Undr9rnd,
70. Structwal Floor System
17. Proper;y Sei:er Line & Heuse Connection
72. Se:�er Cap
73. Roof Or;�ns
14. Roug� Piumuing
75. Rough EiectricabCondwt
16. Rough Electric W�ring
17. Ra�gh Wiring Siyn
18. Rough Eleetriql-T Bar CeJing
19. Rough Heaung & A�r Cord�Lon,ng
20. Pough Factory F�replace
21. Ducts, in Structu�e
22. D�cts, Vontilatinr�
23. Gas Pipe�Rouqh & Test
24. ftoaf Fram:ng
25. fioof Sheathing
26. T�Bv Cedmg ISvuctwa�l & ocoat
27. Frame and Flashi�9 !j
28. Lathing & Siding
29. Insulation
30. Drywall Nail,ng
37. Plastc. Bro�vn Coat
32. Electncal Po�roer Ueter-F�rui
33. Finai Electnc
34. F;n�l Heating & Ai� Cond�tion-nn �
35. Final Gas PiFa-7est
36. Hootl or Caropy
37. F�nai Fsctory P�rep�ace
38. F�nal Plumbing
39. Water Service�Final
40. Gas Service�F�na�
41. Solar pomesticFinai
42. Backfiow Preventer
43. Backflow Irngat�on
44. Landscape hnpation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE 8, BUILDING Ve
48. FINAL PLAI�fvI��G
49. Elec:ric Relexse to Edison
50. Gas Release to 5outhern California Gas Cv
51. CERTIFICATE OP OCCUPANCY
No. Date
POOL & SPA
Date I�spector AppROVALS Permii �k Date
52. Paol & Equlpment LocaUon •
53. Steel Reinforcemeni '
54. Forms
55 Electrical Bonding
56. Rough Piumbinq & Pressure Test
57. APPROVAL TO COVER�GUNiTE
58. Electncal Condwt�Undrgrntl.
• 59. Gas Pipe, O Undrgmd., Test
� 60. Backwaih L����es, P�T�ap,'J Undrq�nd. _
67. APPROVAL TO DECK
- 62. B6e1<s'rnsh'S Ree2p,crFi:�ai
63. Heater & Vent-Fina'� I
64. Piumbing Syttem � F��al .
65. ElectricaLF�nal
66. Solar SYstem-Final
67. Fencing & Access Approvai
68. APPROVED FOfi P�ASTERING
69. POOL/SPASYSTEtUSFINAL '
FIRE DEPT. REQUIREMENT
APPROVALS Per��it-,r`
70. Undergraund Hydro
77. Product P�pin9 O Gas �' Oii �
72. Underqro�.�d F;�s'�i
73. Uncergrno.S:nrcccTank �Gas :'U � I
74. Overl:�acJ Hyarc
75. Dry Chemicai
�^q 3 �Lv� 76. Dry Standpio?
77. FIXED SYSTEf:^. F;NAL
78. FIRE PREV. FINAL
HEALTH DEP7. REQUIREMENT
-`t 3
79. FINAL INSPECTICN
80. FOOD CERTIFICATE ISSUED
Notes:
S
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I IInspector �
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�c nrlo i`(' CpRR1ED pqDMnN
%:.:;? 4.EHAi1G��S g�'� �R OF ANY OTHEA
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'� APPROVED
�� ��
� �itv of Costa Mesa Building Dept.
�Y DATE 19
�� -- —
�'•� �%t�?F PL:JdS �1UST E[ 0�1 ,;0`) A? ALL TiIJ��S �dAKE
Iv�) CiU. Y,�[_.. 149'TFlOUi i�' a� , a�r,�,i_ r;F CEPT.
I?V�� IS.`:UA^C` OR GRANTI•,: � .. �'�i ..• „'':��OVAL OF
� Pi.;N:; Afd'J [�':.. .FK:ATh^,i15 :' � '.. . - .' t..:'••• � iI_'O HF A
� nG{:`cll- pCp p: GN APFnr,�.; . . _ f ANY Of
� ��c_,;�,•.I�:.')��:]?f �H7S.. . - ,ti'OGIVE
. �.��::Ll,le;,� . . '.l;,-�F"fN15
j „� . !'��:U I nf +„LIII f. [J( .� i.. .iJ , ..n -,. •-.. :ri)ri�C O��E
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i9..�'!y:.;n:�..J. r:Fh fn:��,',., ❑ � , •:_nN�ltO
n:t�C!FiJAI'10^" , dl `J01 NF�1.';? �����' s: •_���. rricin�
�,�y. pNii!d cAFTERfiE fliiHcCOits'v`^"..,•�GFERRORSIN
^�„ ., PLANS AND ,�LATIO� ' � i FC?.1 PftEVENiING
r BUiLMr:(yOFEFil�TIONS B� AIED oN TrtEREUiJDEA WNEN
II:Jf✓�TION OF T" E OP ANV OTHER ORDINANCE OF
����� . _
/�Ii�� .
ALL-PURPOSE ACKNOWLEDGMENT
StatB Of California �
County of Orange
On 12-3-93 before me, Sandra Ruiz
DATE NAME, TRLE OF OFFICER - E.G..'JANE OpE. NOTARY PUBLIC'
personally appeared David M. Anconini
� personally known to me - OR -❑ proved to me on the basis of satisfactory evidence
to be the person(3�) whose name(1F) is/s�
subscribed to the within instrument and ac-
knowledged to me that hefpqe/,f6tay executed
the same in his/�afG�sr authorized
r.,�,,, SANDRARUIZ capacity(ies�, and that by his/f�$aHi�sr
COMM. k977E�62 � signature(s) on the instrument the person(s),
¢ • � NOiAiii PUBUC - GIIFOFBIN x
a=. �� qU,yGECCVNtr t or the entity upon behalf of which the
� �l�^ ��m"•� �� 1 person(� acted, executed the instrument.
�..�.....-...,...___ .------...
THIS CERTIFICATE MUST BE ATTACHED TO
THE DOCUMENT DESCRIBED AT RIGHT:
Though �he tlata requested here is not required by law,
i� could prevent fraudulent reanachment of this form.
WITNESS my hand and official seal.
C �``SN �F. `\l.uh
SIGNATURE OF NOT V
OPTIONAL SECTION
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
SIGNER(S) OTHER THAN NAMED
No.5193
� OPTIONAL SECTION �
CAPACITY CLAIMED BY SIGNER
Though statute does nm require the Notary to
fill in ihe tlata Delow, tloing so may prove
invaluable to persons reying on the daument.
� INDIVIDUAL
� CORPORATE OFFICER(S)
� PARTNEFi(S) � LIMITED
� GENERAL
� ATTORNEY-IN-FACT
� TRUSTEE(S)
� GUARDIAN/CONSERVATOR
� OTHER:
SIGNER IS REPRESENTING:
NAME OF PERSON�S) OR ENTITV(IES)
DATE OF DOCUMENT
07993 NATIONAL NOTAFY ASSOCIATION • 8236 Remmet Ave., P.O. Box 7184 • Canoga Park, CA 97309-77Ba
DECLARATION OF AUTHORITY �
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
y9D c,0 BQ f�-G o
Street Address
Bldg. Permit #
This Permit #
AP Number
1. I(we), �a.�ncl M•�tuvt i n � , dedare that I am the Owner of Title
of the above referenced real property, and that I(we) hereby authorize:
��' Y(j (J R N � L'`NN S 7`d� - y o Y,S
Name Telephone No.
3s 9 i r=,c= /y�! s i
� Sireet Address .
to obtain permits in my behalf, as owner/builder, for a S �S %� �-- � G" NTS
af the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I(we) shall im-
mediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties as a result of work authorized
by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
Executed this 3� day of��'CMb� 1g Q3 , at ��°uwt , California.
� ��w,d M . �+�.�„�� �a-13143
Y
Printed Name Date
NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides
fOr limited power of attorney to secure this permit in any behalf.
NOTARIZATION REQUIRED
OP9�a6 (Fev. 7J91)
�
�
/
�
PHOJECiqDOHESS: �tjO CABRILLO ST
,.owNenseame:ANTONINI, DAVID M
aooness:ANTONINI, SUSAN F
�. 490 CABRILLO ST
COSTA MESA,CA 92627
PflCMIENGINEEX: S 4 S— Z B S O NEG.NO.:
ADONE55:
uxir:
UNIT:
renmince: ALCANTRA ROOFING ( 714 ) 837-5376
A�DNESS: 2q-�81 WINTERWOOD DEi
LAKE FQREST CA 92fi90
IICENSEO CONTFNCTOfl OECIABATION: I �ere�y affirm Ihal I am IicenSeA un0er pmvismns of Chapler 9(commencing wiih Sec�ion
7000� ol Divisi n 9 I usi s antl Pm�essions Code, and my license is in lull �orce antl e��ect.
cirr uc.: ��kATE LIC.:S i 4 Z 8 z c�as��'
oa�e: �Z � �j 9gnature: _� L~
WOHREflS' COMPENSATION OECLRflATION: I �ereby aflirm Ihai I have a cetlilicale ol consen� Io selbinsure or a certifica�e a� Workers'
Compensa�ion Insurance, or a certi�ied copy �hereo� (Sec�ion 3800. Lab. C).
POLICY NO.: E%P. DAiE:
COMPRNY:
❑ Cetlilied copY is hereby fumished. ❑ Cetlified coOY is �iled wi�h IAe cily Builtling Oivision.
�ale'. ApplicanC
E%EMPTIONFROMWOflREflS'COMPENSATIUNOECLANATION: Qhi5seclionnee0nolbewmpleleGdlhe rmili5laronehuntlrea�511p�arle55).
I cerlily I�at in t�e pedormance oi �he work �or which �his permit is iysyYA. I s�all nol employ any son in any m_a�ner so as to became
sublect lo ihe W rker ' Compensation Laws ol Cah�omia. // � � ��
/2 / i°J � �
�ale: $igna�ure: « �✓� G� (,
NOTICE: II, ailer making �his tleclaralion, you shoula b ome subjecl �o the Workers' Compensa�ion pmvisions of lhe labor
CoEe. you must forihwith comply with such pmvisions or ��is Oarmit S�all Ue Ueemed revoked.
WNSTBUCTION LENOING AGENCY: I hereby a�firm that ��ere is a consimction lending agency for the peAarmance of ihe work lor
which Ihis permil is issuea (Sectian 3097. Civ. C�.
LENOEfl:
AOUPESS:
OWNEX BUILDEH DECLABATION: I hereby affirm Iha� I am exempt imm the ConVacmrs' State License Law tar the �ollowing reason
�Seciion 7031.5 eusiness antl Professianal Cotle: Any ciry o� counry which requires a permit �o conSVucL alter, improve, tlemolish, or
repair any slmcture, pnar �o ils issuance. also requires �he applican� lor such permil �o file a signetl 5�a�emeni [hat he/she is licensetl
pursuant m the pmvisions o� ��e Comracmrs' S�a�e License Law (Chapter 9(commencing with Sec�ion 70W) of �ivisian 3 o� �he Business
antl Pmiessions Cotle) or I�ai he/she is exempi Iheretmm and �he basis lor �he alleA¢0 exemption. Any violation oi Sec�ion 7031.5 by
any apDlicant lor a permit su�lects ��e applican� ro a civil penalty o� nai mare ��an five huntlred dollars ($SW�.
I, as owner ol the Dmperty or my employees wi�h wages as Iheir sole compensa�ion, will tlo the work, and lhe
❑ slmcture is not imentlea or ollerea �or sale (Section 7044, Business and Prolessional Code: The Con�ractors' S�ate License Law
Ooes no� apDly to an owner of a property wha builAs or impmve5 Nereon, antl who tloes such work himsell/herself or ihmugh
his or her own employees, pmvi0etl t�at such improvements are not in�entletl or oflered �or sale. If, however the builtling ar
imDmvement is soltl wi�hin one year o� completion, Ihe owner vnll M1av¢ Ihe Ourtlen o� pmving Ae/she Ai0 no� 6ui10 or impmve
lor I�e Ourpose ol sale).
I, as owner ol ihe pmDe�Y. am eKclusivety contracting wiih licensetl tonVaciors lo conslmct ��e prolect (Section 7044. Business
❑ antl Pmie55ions CoOe: The Contrac�ors' Siate License Law Ooes no� apply la an owner oi Dmpehy who Ouilds or improves ��e2on
an0 w�o conlrac�s lor suc� pmlecis wi�A a comractor(5) license pursuanl Io Ilie Conuactors' State License law). I am aware
ihai Dmof ol ��eir Worker's Compensalmn insurance should be pmvidetl to me.
� I am exempl unAer Section: B. 8 P. C.
lor Inis reason:
Oate: Owner
I tlo hereby certlly iM1at I am aware oi end unAerstantl the requirements ol Celifomia Heal(h an0 Sa�ery Cotle Sec�ions 25505. 25533, and
25534 an4 ihal I or any lu�ure builtling occupan� willlwill nal (circle one) neetl �a comply wi�� saitl state codes antl ��e requirements for a
permil foi canslmciion or modilicalian trom ihe Air Oualily Managemen� OiSVic�. Resitlential canstmc�ion applications are exemp� �mm
Ihese provlsions.
Date: Applmant
I hereby cer�ily Ihal I have read Ihis ap0lmatmn antl s�ate Ihat �he a�ove iniormaiion is correc�. I agree �o compty wit� all ciry and counry
artlinances antl 9ale laws relating to builaing coretmc�ion and here6y a horize represematives of �hi ity Io enier u on ��e above-memioned
proper�y �orinspeti0n purposes.
Da�e: � � � � 3 Signature: � � � ���
Driver'S License or Social Securily n:
t64L46 WM1ne—Boilding; Gieen—Gotle Enlorcement; Canary—Applicanl; Pink—Revenue: Goldenrotl—Assessor
CITY OF COSTA N1ESA — BUILDING PERMIT
PERMIT NO: B 065144 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: STR
PERM NO; B 065194
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION ; T/OFF SHEATH S REROOF W/COMP SHINGLES SQ FT: 5,500
CLAIM VALUE: S,SU0.00 CALC—VALUE: 5,500.00 GROUP OCC: R-3 /M-1
COMMENTS: REROOF 2800SF RESID & GARAGE W/COMP. SMOKE DET�C:TORS Qwn"R-•.a�
����*�*�.�*��*�*����*��*�,�*****���������**��.��;���.***���**:�,����i�*�;�����LTOR
ZONING REQUTAEMENTS R�QUIRED
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSO:tY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGAT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 11737248 ZNE: REF NO:
I�LANNING NOTES?;
�
�r*�r*#�ru**��r�*x����**�r***x��r*��**�r*�r*x��r�r*****�+r+�*�r���**+r**�***u�**+���r�**********
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
ZONING APPROVED�BY DATE: .-
HUILDZNG APPROC'ED HY : DATE: '
APPLICATION ISSUED BY: DATE: IZ-I11��
iEifltififiFifiFjtiEiElEiE�#ifititiEiEifiE itfE%�ititlEik iF�1liER iFiriEitR 3fif i4 itiFi'iEic�lEiElFifiFiEitiE iR:� iF ih �Fif
�)f iE 3c if iE i(� �lf iE 1E iE if i4 jE 3f jE 9ElE # iE ih iE 3E 1E 1f iE 1f f! * fE iF �E iE �4 fE if iF # jf # jE iE if iF if �lf �1M1 iE if iE �1E if iE 94 9E 9F 1f� �1E �%- iE ib iP i: jF?E 1E �IF iE * af #!f if !f �F iF �E jf iE iE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUM&ING ELECTRIC MECHANIC FIRE SP1IP/RES GRADING
PERMIT 81.00 SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—� PERMIT ISSUE PLAN—rHECK TOTAL PAID DUE
TOTALS----> 81,55 0.00 O,DO 81,55 81.55 .00
REVENUE DIVISION TOTALS--> COLLECTELI; 81,55 OVER/SFIORT: ,00
BLDG PMT FLUMBING ELECTRIC MECI3ANIC FIRE SMIP/TOT GRADING PLAN—CHECK
81.00 .55
k�t k 1E fE 1t 1f iE iE 1! if iE iE 3ElE 9E 3k iE iE jE if if if 1E iE k iL if ff �f �f 3E iElt 1f iE if iF iE �k �f ff iE �c ii af iE 1E K fE if #�!t if if iF if iE it if iE iE iE iE #� 3f *?k j! �f iF iE iElf iF iE iF iF if
I N D I V I D U A L F E E B R E A Y. D O W N
TYFE QTY D E S C R I P T I O N U�lIT COST TOTAL COST
SFR 5500 RERC�OF HY VALUE RESIDENTIAL NOZONE 1,00 5,500,00
END OF FEES
�L �3!.5?J9'_0��.�'iG74 n°'.� S cl...
�.iTE: SZlOI/T3 T�IILS tD:aD
CONSTRUCTION ANO PLANNING
APPROVALS Permit#
7. Temporary Electncal Service or Pole
2. Soil Pipe-Undrgrntl.
3. Electrical Conduit Uttlity�Undrgmd.
--�`--
4. Electrical Conduit•Undryrnr,�,
5. Steei Reinforcemenc
6. Electrital UFER Gmd
7. Footings
8. Foundation
9. Water Pipe-Undrgrnd. �
10. Struetural Fioor System �
t t. PropertY Sewer �ine & House Connection
72. Sewer Cap .
13. Roof Drains
14. Rouqh Plumbing '
75. Rough Electrical-Conduit
16. Rough Electric Wiring
77. Rough 4N�ring Sign
18. Rough E�ectricai-T Sar Ceii�ng
79. Rough Heau�g & Air Conditioning
20. Rough Factory Firep:ace
21. Ducts, in Structure
22. Ducts, Ventifating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing /z
L
26. T•8ar Geiting (Struc.arat; & Mpnocoat
27. Frame 5nd Flashin9
28. Lathing & Sidinq
29. Insulation
30. Drywall Nailing
37. Piaster Brown Coat
32. Electricai ?ower Meter-F�nai
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Tert
36. Hood or Canopy
37. Final PSctory Pirepiace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final T
47. Solar pomestic-Pinal
42. Backflow Preventer
43. Backfiow Irrigation �
44. LandscaPe Irripatior.,Systam
' i
45. Sound Attenuatior., •� s � `
46. HandicaP Regulations +..,��-
4%. PINAL STRUCTURE F: +�JILDING �
?�
48. FINAL PLANNlN� ° �^
49. Eleciric Release ta E�is�n,
50. Gas Release to Sou:hern California Gas Q
a,
51. CERTIFICATE OFaCCUPANCY
Oate
Date
POOI & SPA
inspector �yppROVALS Permit,$
52. Pool & Equipment Locat�o�
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Piumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, O U�drgrnd., Test
60. Backwash Lines, P�Trap, Cl. Undrgmd.
61. APPROVAL?0 DECK
62. Backwash & ReceptorPinal
63. Heater & Vent�Pinal
64. Plumbing SYstem - Final
65. Electrical-Final
66. So�ar SYstem-Final
67. Fencing & Access APProval
68. APPROVED FOR PLASTEPING
69. POOUSQASYS7EMSFINAI
FIRE DEFT. REQUIREMENT
APPROVALS Permit#
I 70. Underground HyCro
71. ProductPiping!�GaS ❑Oil
72. Underground Flush
73. Undergmd. S2orar,e Tank Q Gas ❑ Od
�(ty� 74. Overhead Hydr�
75. Dry Chemica�
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
NEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION �
80. FOOD CERTIFICATE ISSUED
Notes:
�w �
Date �Inspector
r'
�
,
1
i
CITY OF COSTA MESA
CALIFORNIA 9262&1200 P.O. 80% 1200
DEVELOPMENT SERVICES DEPARfMENT
September 19, 1994
Dear Costa Mesa Property Owner:
In reviewing past permits, we find that work has been done on your
property located at 490 Cabrillo Street, Permit No. B65144, for a
roofing permit. The permit is valid for 180 days from issuance or
your last inspection, per Section 303 (d) of the 1991 Uniform
Building Code. Should we not hear from you within 10 days, your
permit will expire as stated herein and additional fees will be
required to finalize the permit. Failure to final a Building
Permit could possibly impact the future sale of your property.
To activate the above permit, please follow these steps:
1. Telephone (714) 754-5626 or 754-5627.
2. Request an inspection; state address, permit number, and type
of inspection.
3. Be sure to have working smoke detector's as required per
Section 1210(a) of the 1991 Uniform Building Code.
4. Have an adult present at the property at the time of
inspection to provide us access.
Should you have any questions regarding this process, please
contact me at (714) 754-5273.
Thank you for your cooperation.
Sincerely,
anda Huapaya
Permit Processing Specialist
77 FAIR DRIVE
BuilEing Division (71a) 75a�5Z73 • CoCe Enforcemen� pla) 754�5623 • Planning DrviSion (714� 754.5245
FA% (7ta) SSF7508 • TDD (7/d) 75A�5244
. Losta Mesa Buildi Department
, " 111 EAST 20th aTREET
COSTA MESA� CALIFORNIA
FOR APPLICANT TO I+'II.L IN
Building �
Address �� % L�i�a�«a S%
Costa. Mesa, California
Nearest
Cross St. % P, f�/NF /1 YF.
Owner fj f %T GOHY,
nddress g i � YI' /5 �hf%
Tel.
Citv Li^.S i A /�%�EfA No.// !f/Ee
or
zw,yr"sr
No � �' I B�o�k
and Bounds)
City
of Lot 6�.+ /� �i � Now on Lot �
Setbaek Line from � Rear Vard 3!'
center oi 8treet � side vard f'
DESCRIPTION OF WORH
New I C ( Alteretion I I Addition
Repair I I Moving I I Demolish
Building No. ot
Size /srdO,fq %T Rooms � Stories �
Exterfor Wall ROM FOA �
Covering fTdLC'O I Covering jfjAhtt
Use of NeW _
I hereby acknowledge that I have read This Application
and state that the above is correct and agree to rnmply
with all City Ordinances and State Laws regulating
building canstruction.
Sfgnature of p /
Permiitee ���r %1'� e�^CIC-
^�� �
e����....�..a e„r. .�[�.,.._....A�hr �'I/__�
Valuation
s /Z 9So
rnou >na r_u 2u s-r,n
Fee
�
APP ts ON FOR Yl�'.KMI�
9 B ILD.LNG
FOR OFFICE USE ONLY
�_ Receipt No. � Permlt N
by
Costa Mesa, California
Nearest
Cross St.
Zone �/� No.oT � Type �, I
APPROVALS
�undatlon Location Inspector
Forms, Materlals,
Under-Pinning
�ame: Fire Stops,
Bond B
FINAL
I
I
�
2
D
' Show locatlon and distances irom
� property line and between buildings
;�:�R19-55PUd�sbnl7Ba �-::�*�3�.0�
--- . -• -` ,,:- -
. i .