HomeMy WebLinkAbout116 CLEARBROOK LN - Building Permits I
CITY OF COSTA MESA ,,.c•.,•1;:;.;a• z:y9i
.�s , BUILDING DIVISION .:__ _. -..
:9-ell 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www,ci.costa-mesa.ca.us
k. FOR INSPECTIONS CALL:(714)754-5626
eft
"'"° "`° PERMIT NUMBER: B10-00228
PERMIT TYPE B_ROOF2 STATUS: ISSUED •
APN: 41914108 DATE ISSUED: 08103/2010
. - ISSUED BY: CAC
JOB ADDRESS: 116 CLEARBROOK LN CM Suite/Unit:.
Vicinity: • „ - - _ �
.
Squares: 4000 . Valuation: $8,500.00
SCOPE OF WORK: TEAR OFF 4 PLY BUR 1 PLY#25 LB BASE 2PLY#11 FIBERGLASS 1 PLY ENERGY SHEET. REPLACE ^'\
SHEATHING AS NECESSARY FOR A TRIPLEX ,
OWNER: ENGELMANN,TERESA TR Address: 353 S CALIFORNIA ST Unit:
PHONE: 714-538-3369 City/State/Zip: ORANGE,CA •
APPLICANT: JOHN DAVIDO Address: 7068 VIEW POINT LN Unit: :
PHONE: 714-791-6369 City/State/Zip: ANAHEIM, CA ;N nrs p
CONTRACTOR: 5 STAR ROOFING x •- ` License No. ,...825383 '
Address: 7068 VIEW POINT LNUnit: PHONE: 714-791-6369 .
City/State/Zip: ANAHEIM;CA 92807 'i - ' -• -CELL: - :T —
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $167.25 •
Reinspection Fee: $0.00 - - ' ,
Bldg Std Admin Fund $1.00
Unit:
TOTAL FEES $168.25 •
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 holidays
New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No.92-28,§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 expiration of this permit.
CODE#. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final ( 208 Final Plumbing
200 Final Re-Roof t/ (�fl'13/I t] 12. 3.-- 210 Final Electrical ,
201 Final Block/Retaining Wall 212 Final Fire Prevention _..._..........._._.___._
i
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
L.` 204 .Final Demolition -- 250 Final Building/Occupancy
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: f
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or dee'd):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain workers'compensation insurance,as required by
s tion 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
num er e: person is required to descend,will be made in connection with work authorized
�Sra rC Fu N by this permit,and that no building structure,scaffolding,falsework,a demolition
,Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap. 3.2,Grp
as-.'•• eed not be completed she permit is valued t one hundred dollars($100)or less) 2,Art 2,Sec.341,Title S,Califomia Administrative Code).
P 7i3 - Co'b y�z
❑ As owner-builder, I will not employ anyone to do work which would
■ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to thework- ' compensation laws of California, and agree that if I should
become ������.JJJ•ect to the workers' compensation provisions of Section 3700 of - Applicant'sSignature Date
theode,I shall forthwith comply with these provisions.
-3-2-0/O Division of Industrial Safety Permit Number:
� Apar Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
• ARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for,emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons. or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. 4 a registration form for acutely hazardous materials? 0 Yes El No
Lic.# •at s 38-3 -Gta$s>x �/ (Section 25533 of the California Health and Safety Code, with some
/ exceptions, requires registration with the Costa Mesa Fire Department by� each business which at any one time has on hand a quantity of acutely
o(a°mr'ssi t= hazardous materials equal to or greater than a weight of 500 pounds. or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CON' RUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required. has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors •subject of this application. have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safely Code Section 42303 been made? ❑Yes ❑ No
thereon,and who does such work himself or herself or through his or her own 8 (If"yes",attach certificate of compliance from the appropriate air pollution
employees. provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the properly. am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and _
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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
authorized by this .-rmit until final inspection.
Vsture of Legal Owner(s) Date
Signature Date
3057-46(3/07) ���/
/A 0/or • °rued Ap•li Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . •
•
' CITYOFCOSTA MESA•--1 —. - - ^ ' PEWIT- PEIT N31. •TRACI-NO. LOT NO.- -• • BLDG.NO. " 1. _ 4585-"1,2/24/84 Sat/C'- 'T
: CONSTRUCTION PERMIT r I • .', C I . 11 i (I 17--1 ' ; :'
r •
-� p I 1 I i
• Pr'o)ect Address_ •� s �'�'/& •t •�� -TYPE OF CONSTRUCTION , '❑ NEW Li' ADD LIrq LTERATION •LJ REPAIR' - - - • • l •
• Applicant's Mailing Ad• ess• �•ii�� /�� �'l CONVERSION `❑ DEMOLISH ❑ OTHER' - I (Zone r
AP.#
Ire / 'DESCRIPTION OF WORK
u' Owner's Name A - '�� ' a hone . iQ7�jF _ , I . _ .. - S Main Building: u Accessory Building 7 1.- Z i
M
f = / • Q 1
W Address' � HT1 7 Li GRADING` FOUN DATIONI ❑ ST RUCT_V RAI: T :Front ' • i , - . I N
- TYPE OF PERMIT ,
•
'- Arch/Engt' _ r License No, ..❑D TENANT ❑ ELECTRICAL' PLUMBING ❑ MECHANICAL. . ' B Rear a• ' i . ,i 0 `- I I
A-ddress - r t ❑ :OTHER I • - I A . _ N
M1 - ` j , C Right ^t - 1 ,_ - G
' Contractor's Natty' •/.r•et . •/ if i�z Ph 4'3(' -00- PROJECT-DESCRIPTION, SQ:FT ' � ' - ,OCCUPANCY K - - I F f _ R
•
. Address(mailing) ,Ir / a eta •• _oft/A 4, ! - "CO N ST RUCTION.TYPE
t _VALUATION$ S Left _ ,r �.'"' E 4
6 p. ZONE ' '- ' • GRADING CU.YDS: I 'ACRES Park.lFees $1
City Eicense No. . I ' .CJ.- 3ff ' -- ' I i r _ Ping. Ref.# I , -
LICENSED CONTRACTOR DECLARATION I Remarks: _ •- 1 ' ' _ Park ing Req./Provided p - U
I herebylaffirm that I am licensed under provisions of Charter 9 (commencing '- • ' '' - I '
with section 7000) of, Division 3 of the Business and Professions Code,Qand ; I i i, - • f • 1 r t i t Use of Building: , - , E
my license-is In full f•rce . •I-ffect. { I i, p - . -- - _ , _
;License' las - ? 'cen e N ��'�8�O�,e ! • , ' , • ' -PLUMBING r, . r • ' I 'I FEES 'Planning'Notes: j 1. I • ��! M !
ate ' - --4 Signature • Obi 4.�_ 'lLrof/re i i , _ ._ ,.: E
�� r { Bar Sink i .Showers « i N
y 'ORKERS•COMPENSATION DEC - ON ! - t I T
I hereby affirm that I have a certific.to o consent to self-insure o a certificate Backflow Preventer i Service S•ink y� _!— ' •I • f . t- ' S '
of Workers' Compensation Insurance, ore' certifle c py•thereof ( ct on '� - -- '- — - - .,
3800, Lab. C. i I • •
I
ai t1 „�l 71./ • //n.LO� G/ iY� backflow Irrgation Sewer Cap i • I 'I 'ELECTRICAL ;FEES 1
Policy No. (i!/l/W/'Y Compan 1�{/TI r ( Lt I _ -
8 Certified opy hereby furnished., Bathtubs Sewer Connection Automatic Washer !Transformer 0 1550 KWI.
Cert f' tl y tl with the city I -
Date ) Applicant iVit- r./ Clarifiers I• Solar Collectors , • - 'Construction Pole Sub I ❑ 50�+KW I •
-
• -EXEMPT NIP OM WORKES'CO ATION DEC LA RATIO •- ) "' - Dishwasher - 1 • - Solar Piping• -'' ' -- :Cookin Unit - - , -' t- ;Meter'Ou -to 100 amps-- r ,
This section need not be completed if he.permit is for one hundre 100 or 1 9 ,'1 p p;
less): DrinkingFountains • 1i
I certify that'in the performance of the work for which this per u is Issued, I i Solar Tank •, , Dlehwa5her •I ,n I 'Meter Dover 100 amps I
shall:not employ any person in any manner sous to become subject to the - 1 - '
Workers'.compensations Laws of California. I Floor Drains: Swimming Pool w/Spa '! j Dryers ❑Gas! ❑Electric :Sub Panel : ! 1 i
Date ' Signature - - '
NOTICE: If,'af ter making this declaration,you should become subject to the Floor Sinks . i Urinal • .Fan ' i I
Workers''Compensation provisions of-the Labor Code, you'must forthwith' - ' - ' • - - - • - _ """ - -- - - - - - - - -- ,Motors OO 1 HP 01/_'8
comply .with, such provisions or this permit shall be'deemed revoked. ' Gas Service. ' Outlets' • :Water Closet: • ' I - , - ! '
CONSTRUCTION!LE NDING 4qG ENCY • ` - " * ; 06,/
F.A U. 'Inc.Solar 09-15 HP ❑16-15+
hereby affirm that there is a construction lending agency for the performance Interceptors, •
r ._ .. ......... .. ..... ..
Heater • , VU Fixtures , MicrowaV1of the work for, which• this permit'is-issuetl (Section •3097 Civ C.)• • - - i 4 •Lender's Name : 1 KitchenSink r•' Water Service •:, r; _ _ - Device Boxes = Pole LightLender'sAddress - _ - I , •
-
OWNERBUILDERDECLARATION • r. Lavatories '' ,•`• 7 - )I w i -• Outlets ;Range1 hereby areasonthat I am-e0empt from ssan ntractor's-Llcense Law for the following reasop-(Section 7031'.to conness antl Professional!Code: Any city or: • - P-Trap L , , - - II Switches - ;Sign 1county which requires a permit to construct,altarimprove, tdemolishiorrepair ; , - _ , 'ny structure; prior to its Issuane/she is requires purepplicant for such permit - Roof'Drams' _ z."1 ' i' - '' Garbage Disposal - 1 Standing Sections l
b file assigned statement that he/she is licensed pursuant to the provisions of T`he Contractorthe'Bnsi Law(Chapter 9 (commencing with Se/she:7000) of I ' _ Generator❑0-5 KW 05-15 KW•there rom of tM1e•Business and Professions ption or that he/She'-if exempt - ., i ' Tfaeh Compactor , ,therefrom and the basis for the alleged exemption, heAny;violationicant of Section -7031.5 by:any-applicant for: a permit subjects Ithe applicant 'to a civil I 1- 1 ' - - , ri I I !�nalty of not more than five hundred dollars($500).. , . ':Rinspection Fee f I .$250 'i,• • I Issue Fee_ J I • _ $,3 - -
I, aslowner of the:pro petty or,-my.employees with wages,as their sole _ , Reinspection Fee $25 Issue Feel ! ( $ 3 !
compensation, will'do the work,and the structure is not Intended or offered ' ', 1 I-- - . . . MECHANICAL s 1 FEES
tor sale,(Section 7044, Business and, Professional Code: The..Contractor's PUBLIC SERVICES REQUIREMENTS: - •
License Law does not apply to_anfowner of a property.who•builds or improves . - 0 I ' ,
thereon, and who does such work himself/herself or through his or her own Zoning Approved By "' ' Date ' '
employees, provided that such Improvements are not Intended or offered dor I -
sale. If, however, the building or improvement is'sold within one year of com- • • • - Application Approved By • Date - li,
pletlon, the owneriwill have the burden of proving he/she did not build or im- d -
�rove for the purpose of sale), f t _ • e • Application Issued'By v-y " ' Date 12'�
LJ I,as owner of the property, am exclusively contracting,with licensed con- 00-100,000• e0100;000 ' . I .
tractors to construct the project (Section 7044,Business anProfessions Code: - • , , iSUMMARY OF FEES • •
The:Contractor's License-Law does.not apply to-an.owner-of property who- • ,• $
builds or improves thereon, and who contracts for such projects with a con- I ': ■ BUILDING PERMIT I $ ' , SMIP,
tractor(s) license pursuant to;the Contractor's License Law). r .
I PLAN CHECK $ l • PERMIT
❑•1 am exempt under Section e.& P.C.for this reason e - -' �.'! r 'ISSUANCE $
- - , , PLUMBING • : $ -
Dat •
e ' Owner• ) • PLAN CHECK ! $ ENERGY P.C. r $
1 hereby certify that 1 have read this application and state that the above ■r 11 111 : 0100,000. : GRADING $ - ' •
information Is correct:"Pagree-to comply with all city andicounty ordinances', ELECTRICAL . • $ ' !
and.state'laws elating'to bu'Iding construction, and hereby authorize repre- PLAN CHECK $ - I MICROFILM Si. I
sentatives of: is,city to = ter: upon : above-mentioned ,property for
inspection p r •s:., I ! �.7 v MECHANICAL $ I TOTAL FEE
Signature ese or //-7 / '41 - • •
CMF-0865-46 rev. 7/83'- White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor -- - . . . - - __ _ - - - _ _ __
` ...r R-. ♦ w - h r - r ...
• - CONSTRUCTION AND PLANNING _ ., & SPA
. APPROVALS -Permit# ' Date Inspector •'APPROVALS Permit#- : - - Date Inspector.
- -1. Temporary Electrical Service•or Pole - . 52. Pool,& Equipment Location - , - -
2: Soil Pipe-Undrgrnd. • r - 53. Steel Reinforcement • -
,
3. Electrical Conduit Utility-Undrgrnd. - 54.• Forms - . - .
. 4. Electrical.Conduit-Urdrgrnd. 55: Electrical Bonding' '. ,
.15.E Steel Reinforcement : - - - _ 56. ••Rough.P.lumbing-& Pressure Test'•.
6. Electrical:UFERGrnd: . , ' 57. APPROVAL TO COVER-GUNITE
7.• Footings; _ - , ' 58. Electrical-Conduit-Undrgrnd.
8.' Foundation •' �. s - 59.'Gas Pipe;-D Undrgrnd., Test ' , , - -• r
9..Water Pipe-Undrgrndt• - 4. '60.`Backwash Lines, P-Trap, 0 Undrgrnd. -.
t Structural Floor System' - , ' ,q _ . -
10 61.'APPROVAL TO DECK - - - , - - - : ' -
111 Property Sewer Line & House Connection - . 62. Backwash & Receptor-Final • •
12: Sewer Cap "° 63.' Heater & Vent-Final
13. Roof Drains ' . ' - ' -,�,.• '
64. Plumbing System - Final • • -
14. Rough Plumbing'. ; - 65. Electrical-Final • '
. 15.-Rough Electrical-Conduit - - - 66. Solar System-Final - , ' • - - .
16. Rough Electric Wiring . - •. 67. Fen •
cing &Access Approval - • •
_ 17. Rough Wiring Sign- - 68. ,APPROVED'FOR PLASTERING , •
18: Rough Electrical-T Bar Ceiling .- 69. POOL/SPA SYSTEMS FINAL -
19. Rough Heating & Air-ConditioningFIRE DEPT. REQUIREMENT '
•
20. Rough Factory Fireplace APPROVALS ` Permit#
21. Ducts, in Structure - , ' 70. Underground Hydro -
22. Ducts, Ventilating i 71. Product Piping'D Gas 0 Oil
23. Gas Pipe-Rough & Test, - - 72. Underground Flush
24. Roof Framing ••• . 73. Undergrnd.Storage Tank 0 Gas 0 Oil • •
25. Roof Sheathing 74. Overhead Hydro '
, 26. T-Bar•Ceiling (Structural) & Monocoat - _ 75. Dry Chemical -
27. Frame and Flashing- 76. Dry Standpipe .
' ' 28. Lathing& Siding , ' 77. FIXED SYSTEM FINAL .
.29: Insulation. - - 78. FIRE PREV. FINAL
- 30. Drywall Nailing HEALTH DEPT. REQUIREMENT
' 31. Plaster Brown Coat . ' . 79. FINAL:INSPECTION
• .
i
32. Electrical Power Meter-Final80: FOOD CERTIFICATE ISSUED ,
33. Final Electric Notes: � .
34. Final-Heating & Air Conditioning • ' , -' , ' -
35. Final Gas Pipe-Test - - -
36. Hood or,Canopy - .
37. Final:Factory Fireplace
•
38. Final Plumbing /2/001('Y (i . -
39. Water Service-Final
40. Gas Service-Final • .• '
41. SOlar Domestic-Final , • - _ - - . 'r .
42. Backflow Preventer 0 t' l - ..
43. Backflow Irrigation . - _ , - i 1 .
44. ,Landscape Irrigation System.
45. Sound Attenuation • , . •
46. Handicap Regulations- ' ' - _ i.. •
47. FINAL STRUCTURE & BUILDING ? , i ' ' ,
•
48. Special Requirements Completed - i $ , 4
, '
49. Electric:Release to Edison . ' •
50. Gas ReleasertosSouthern California1GasCo I ' • , .
•
51. CERTIFICATE OF OCCUPANCY . • . '
1 '
No. ' - '• - 1 Date
ADDRESS OFSUILDEC: 116 CLEARBROOK LN UMT: CITY OF COSTA MESA - BUILDING PERMIT
ImirstomEwmovikENGELMANN, TERESA TR PERM NO: B 082055
ADDRESs: 1324 E PAM AVE
ORANGE,CA 92666 PERMIT NO: B 082055 PLAN CHECK NO: N GOVT : N SUPP : N
548-3369
PPL.MAIING ADORES& CONSTRUCTION TYPE: PERMIT TYPE: STA PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/O & REROOF W/BUILT-UP SQ FT: 4 , 700
ARCH.OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: 4 , 700 . 00 . CALC-VALUE: 4, 700 . 00 GROUP OCC ; R-1 /
CONDUCTOR'SNAM: CHRISTOPHER ROOFING CO. ( 714 ) 839-6088
CaNIRACTORS MAILING 915 W COLLINS COMMENTS : REROOF 3400SF APARTMENT BUILDING W/BUILT-UP
ADDRESS:ORANGE CA ue.NO.: 624118 +H*ib*rH*TrsHSE*SEitSESriE+E********+E+t*+ESB+b+E**SE**SH*+b+b+E*** iEitit+E+A+EiE* *iEit*+Ex*SESE+A****SH**SE*x*****
92667 WMT: ZONING R EQU IR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby atm under panty of perjury that I am licensed under provisions of Chapter 9 S E T B ACK S
(commenting with Section 7000)of Division 3 of the Business and Professions Code,end my license is in lullforceand effect.
CITY uc.NO.:056562 UC.CLASS: C_39 sec. o.: 62 1' "r`EXP: 00/00 MAIN BUILDING ACCESSORY BUILDING
__ N. Date: 3-/7-99 convaaor. �^''�v�-'_� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the
following reason(Section 7031.5 Busies and Professions Code:Any coy or county which reqdrea a permit m construct,eller,improve, PARKING REQ: PRO V: PARCEL: 41914108 Z N E: REF NO:
demolish,or repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she
S licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NU TES.>:
Business end Professions Code]or that he or she S exempt therefrom and the basis for the alleged exemption.My vitiation of Section >
7031.5 by any applicant for a permit stibjecls the applicant to a evil penalty of not more than lee hundred dollars 155001). *******************************************************************************
❑ I,as owner of the property or my employees with wages as their sole compensation,will do the work.and the stmcture is not intended D E V E :L O P M E N T SERVICES REQUIREMENT S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License law does not apply to an owner of propend
who builds or improves thereon,and Ma does such wok himself or herself Of through he or her own employees,provided that such • 0...-
improvements
ate not intended Or offered for Sale.If,however.Ihebuilding«improvement issold within one yearofcompleton,the ZONING APPROVEBY •. DATE:
owner-builder will have the burden d proving he or she did rel build or improve for the purpose of sale).
❑ 1,as owner of the properly.am exclusively oonn°dirg with licensed contractors to con*uct the prajed(Section 7044.Business and
Professions Code:The Contractors License Law does not apply to en owner of progeny Mn builds Or improves Iherecn and who BUILDING APPROVED BY : DATE:
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ lamexempl under Section: B.SP.C.,for this reason: APPLICATION ISSUED BY. DATE: 31
CI(Ai
IL
********************** ************************* ***************4*************
Date: Oer
LEGALIZATION;N ' F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby cants that I am aware of and understand the requirements of Calaomie Health and Safely Code Sections 25505,25533.and
25534.and that I or any Mare building occupant will/we not(drab one)need to comply with said stale codes and the requirements for
a permit for constructonor modiRmlion from the Ai u�Teiy1.Tenagemenl District.Residential construction appfrmionsare exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 99 . 75 . 50
Date: Applicant: I S M I P/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjuy one of the following declarations: ISSUE FEE
❑ Ihave and wlmaintain acerMrmeoconsent tosell-insure for workers'compensation.esprovided for bySedion370of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code, am.work f«M:nmi.pem4bissued.
TOTALS----> 100 . 25 0 . 00 0 . 00 100 , 25 100 . 25 . 00
o I have and ell maintain workers'compensation insurance,as required by Section 3700 of die Leber Code,for the performance of the
work for which this permit is issued.My workers'compensation insurance carder and policy number are:
Caner: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 100 . 25 OVER/SHORT: . 00
Policy Number. 285-971'1N] T00625 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed a the permit is for one hundred dollars 15/O01 or foes.) 99 . 75 . 50
❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to
"Aare 10 *******************************************************************************
!!!
compensationprovisionsof Beaioe 3700 of the Labor Code.I hwth'those provisions. I N D I VI D U A L F E E B R E A K D O W N
Date: len-97 Applicant: 4rsMs+�
Warning:Failure to secure waren'compenntion coverage la unlawful,and shall subject an employer to criminal penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(5100,000),In addition to the cwt of compensation,damages as provided for In
Section 3706of the Labor Cods,Intermit.and atfornsy.fees. SFR 4700 . REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 700 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending army for the END OF FEES
pertonnance of the work for which this permit is issued(Section 3097.CM.C).
LENDERS NAME:
LENDER'S ADDRESS:
I certify that I have read this application and stale that the above information is coned,I agree to comply with all city and county ordinances
and stale laws relating to buildup construction end hereby authorize representatives of this city to enter upon the above-mentioned property EXPIRED for inspection purposes.
FRED FARMER `` p 83-17-1997/11:16 AN/5100.25
Print Name DATE 1 D R1:60 1-0003487
3 ^7 7 �'— PERMITe082055
�� Done: -,7—I
Signet OwnerT rAAgei plicam onlractor --
•
i (5151.46.WP) White-Building 3 Safety:Green-Al:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
f, - . -, .
-
CONSTRUCTION AND PLANNING f t''OL & SPA
APPROVALS Permit# Date Inspector APPROVALS . Permit # Date Inspector
1. Temporary Electrical Service or Pole - . 52: Pool & Equipment Locatiori-' - ,
2. Soil Pipe-Undrgrnd. ' ' ' 53. Steel Reinforcement '
•
_3. Electrical Conduit Utility-Unctrgrrtd. _ 54; Forms '
• `;..4: Electrical Condutt_Uridrgrnd. - 55. Electrical Bonding - - ._
.�.�. - .
;5.'Steel Reinforcement 56. Rough Plumbing & Pressure Test • .
?_6!. Electrical UFER Grnd. - - 57. APPROVAL TO COVE R-GUNITE
:, -7' Footings 58.. Electrical•Conduit-Undrgrnd. ('
z8, Foundation - - • 59: Gas Pipe, 0•Undrgrnd .,Test
''-'9. Water Pip¢-Undrgrnd.? 60. Backwash Lines, P:Trap;0 Und_rgrnd,
10. Structural Floor System - . 61. APPROVAL TODECK
11. Property Sewer Line,.& Housea9onnection • • 62,. Backwash &•Receptor-Final _ `
12.,Sewer Cap _ - •. ' 63. Heater & Vent-Final .•
r
•
13. Roof Drains 64. Plumbing System -Final _
14. Rough Plumbing •
. - 65. Electrical-Final . - -
15. Rough Electrical-Conduit _ - 66. Solar System-Final -
16. Rough Electric,Wiring , 67. Fencing & Access Approval . .
17. Rough Wiring Sign - - • 68. APPROVED FOR PLASTERING . . •
18. Rough Electrical T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL • '
19. Rough Heating & Air Conditioning - .. FIRE DEPT. REQUIREMENT
20. Rough Factory Fiieplace �„ ` r2 7 APPFOVALS,J Permit #
21.'Ducts,in-.Structure:: _ ' :- - T. 70.;Underground Hydro
22. Ducts, Ventilating'''- a. r "- ,. e 71 , Product;Piping alias 0 Oil
23. Gas P.ipe.Rough & Test _ -.c i r• �; • - 72. Underground Rush_-- • -
24. Roof Framing' I m r,;: 73 Undergrnd.Sto�arjeTad( OGas ❑Oil
25. Roof-Sheathing °.,- -igli r Overhead Hydro'
26. T-Bar Ceiling (Structural) & Monocoat NT
_ _ 75:t.Dry Chemical - ..
27. -Frame and Flashin_9,. ^c' .. - > •. 76. Dry StaUt ndpipe-4:-.
_
28. Lathing&Siding t' _ -• "= -. " " 77, FIXED-SYSTEM=FINAlL_ - -
29. Insulation c; _ - • • I 78. FIRE PREY. FINAL x w a -
• - 30. Drywall Mailing r ` i rREOUIEMENT
HEALTH DEPTR
•
31. Plaster BFown Coat - - -• . c 79. FINAL INSPECTION - _ i ;
32. Electrical Power MeterFinal -• "r 80: FOOD CERTIFICATE ISSUED . _-
-- 33. Final Electric - - t Notes: - -it, - t , Iny
34.-Final Heating.& Air Conditioni'ngt F .. A \� _)
35. Final Gas Pipe-Test Xi r '
36. Hood orcCanopY C-• = -• - ` 1' - r
` ' ..
37. Final'Factory Fireplace
38. Final Plumbing Z --
39. Water Service-Find- -' " _ �„I c
• ; 40. Gas Service-Final.;• - r �, t -.7L. c.: w
~
41. Solar Domestic-Final ;
- -
42. Backflow Preventers' ` :i r '_' •
_ r.
43. Backflow Irrigation, t c -
44. Landscape Irrigation System-"''. t- • t - C-
45.'Sound Attertuation; _ '•• • ,, r r c,;- r.L
46. Handicap,Regulation ss _
47.-FINAL STRUCTURE & BUELDING ' r r`` = ' . - -
48. FINAL PLANNING _- ` -•
49.'Electric Release to Edison R ' •
T
50. Gas•Release to Southern California Gas Co - - - •
. . - - c
51. CERTIFICATE OF OCCUPANCY - ` •
No Date
City of Costa Mesa
Building Safety Department CERTIFICATE OF OCCUPANCY N° 2190 C
•
P. 0. Box 317
Costa Mesa, California
The Building located at 116 Clearbrook Lane, Units A, B, C
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group IT P1 J Occupancy.
Use of Building_
Legal Description 141-3b3-03
(See reverse side for Metes and Bounds)
Building Permit No. .22819 Electrical Permit No. P302 Plumbing Permit No. 1111.3.05
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments— 3 and/or guest rooms
ISSUED TO: Building Official
CLRARBROOK LANE CORPORATION
Date Iib 95, 3965
, This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Farm BU34—IM-11-63-5-B P
•
••.nor--• • 22819 • - FEE REcEivED
COSTA MESA BUILDING-SAFETY DEPARTMENT AUG 17 1964 •
P.O.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely . A$1116400 A WU IT
• , 111,g OR PRINT BUILDING .
BUILDING
_
, ‘ For Office Use Only
ADDRESS 2 I e., rosuy&uoielni.A.,-
k
RECEIPT NO. PE'22819
• COSTA.MESA, CALIFORNIA A,
_
?48 be or,1/4 1-441e* .RECEIV-ip 0E726 DATE ISSUED
CAA
OWNER Coepo R II 7/1 e 4/ / r AUG 9 1 1964
. BUILDING ,
MAIL
ADDRESS/Di/S- 071.AA,60Ree • ADDRESS •
• ' FIRE •Y-3 -
TEL. ' ZONETYPE Cr GROUP (4 Cr
CITY Me 101/12/R 7 L'e a c h N047i-1200 e
APPROVED
ARCHITECTi "i „ TEL. BY DATE
OR ENGINEERZ-iften-A/i b 5 , No.c.73:70/0 _
293a ,,/,, 14 n " , ZONING
g„ .
4.../10
ADDRESS i rimtv i v
Re a/frp 7tt
--geer- . . I NO.OF I all uS Ei LITT NNGEW ..__
PLANS
CONTRACTOR j.if A. e....envsr c....0. 84-7--
LEGAL 1-1) •rC 7
ADDRESS /64/ V" 3-/IAA ht5Re 12 DESCRIPTION
/ CII\
CITY,n8 WfoR 7 /3eAc h A.P.NO.
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. • '...3-)avo 30"TO SIDE&REAR P.L.
LIC.NO./c-7 41 s"- NO. &,_7
EAVES
SIZE ,-.1 j•• ,, ., I NO.OF BLOGISace ALLOWED (U.B.C.REQUIREMENT)
OF LOT/cs4 to SO Ys. CV NOW ON LOT li
' YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. .
(FROM C/L STREET) •
SETBACK LINE FROM 30rn FT. .
CENTER OF STREET REAR YARD Q.-0 FRONT -
i .•
SIDE YARD I LEFT to 1 I RIGHT /ICI/ R.SIDE ,6 F7. '
DESCRIPTION OF WORK L.SIDE /0 FT. .
NEW >7/C13AR S.--------- 6 ,
a-1-
ALTERATION ADDITION .
• — — —
DISTANCE BET. BET.MAIN& I.LI
.
MAIN BLDGS. ACCESS.SLOGS.
REPAIR MOVING DEMOLISH • CC
.5.
i VAR.# • DATE
BUILDING ., _,,, _, ,t10.OF •j•(...... .
SIZE /0/.-/ 7..3y...9 ROOMS / `) STORIES / C.U.P.# APPROVED i CY
i LU
EXTERIOR WALL 1 ROOF APPROVEty)AA
AMA DATE e-i\if-6-
COVERING ST&c c.,n COVERING PDC R _JIII.'BY t ....1
USE OF BUILDING AND W0VgsPERF2frI......YIED c------- V9\ Q . . • U.L---..j., ceTh <
• . • 444
•
ILI
-74-g '
/ ?Lie-K . ,Thwe J."- ;1 ig., _ . .
CL
14- 3 0 LO
CARAcrE il 7-fitr 4 e-/) ar.J97 7 723.1r 3d2oP v ce
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE i U.
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. 0
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION I ; 0
BUILDING CONSTRUCTION.
PERM'IT FEE $
SIGNATURE OF • 4.7[6-0
PERMITTEF ' ? .
LA EC
6 2_6/i C 0
• 0
AUTHORIZED AGENT R A 4.4„.„4 / i1
ara. TOTAL FEE $ i
• .
. .