HomeMy WebLinkAbout1589 CORSICA PL - Building Permits 1110
CITY OF COSTA MESA lb
,____ BUILDING DIVISION PERMIT NUMBER
' DEVELOPMENT SERVICES DEPARTMENT
.4. fn. . PERMIT
'mss P99-00204
•
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1589 CORSICA PL Status: ISSUED
Suite No Applied: 03/31/1999
Issued: 03/31/1999
Vicinity:
Parcel Nunmber: 13919213 ISSUED BY:
Applicant: NOCK, RON
Address: 11612 KNOTT ST
Phone: 714 895-1246
GARDEN GROVE,CA Zip: 92841
Owner: RIVERA, JAMES B
Address 1589 CORSICA PL
Phone:
COSTA MESA,CA Zip: 92626
Contractor NOCK PLUMBING
Address: 11612 KNOTT ST •
Phone: 714 895-1246
GARDEN GROVE,CA Zip: 92841
License: 707775 ', E 1
EXPZ
Arch I Eng: p C�„�u
Address: O •
Y"^ Ut
Phone: DATE 1 I 'Ur
Zip: N O
License:
SCOPE OF PERMIT
WATER HEATER.
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $11.00 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00. 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $33.00
COMMENTS/SPECIAL CONDITIONS
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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
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.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS .J i
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
w9rk for which this permit is issued.
G]/f have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued.
My workers'compensation lnsur nce carrier and policyy number are:
Carrier: �F7/1..t— Policy Number: D ( 3 L- .(�Z
(This section need not be completed the permit Is valued et one hundred dollars($100)or less.)
❑ 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 become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions S C
Applicant Signature: `c��--t Date: ^ T
r 2-
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 DOLLARE($100.000).IN ADBmON TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Cede,and my license is in full
force and effect.Lic.N Class N
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,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 is licensed pursuant 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 and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fore permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,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 owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 704.4, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more.feel in depth Into which a person is required to descend,will be made In connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative 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 from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California 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 time during a reported year a quantity of 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 temperature and pressure).
__...._rmoraueyhazardo0
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No
(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 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 temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the 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.
.._ . ._._fu..._.o...pli_d. . .
4 If an RMPP is presently required,has Section 25534 of the California Health and SafetyCode been fully complletl with? ❑Ves ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akEermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65R50.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If"yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I 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. .
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of 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 permit until final inspection.
Signature Of Legal Owner(s) DateAn. :r Authorized Appll Date
BODES INSPECTION TYPE gdIF IMMO CODE INSPECTION TYPE PATE UfflilhLS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing _Qa?-Qye, tiLaV
•
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Flre Place 220 Final Planning Approval
203 Final Sign 222 Final Site
•
204 Final Demolition 250 Final Building/Occupancy ,
2446-46
jwEcTADDAEsS: 1589 CORSICA PL CITY OF COSTA MESA — BUILDING PERMIT "' ••^ ^roti+^ r
UNIT: • —^•• ••— • -- -
OWNERSNAME:RIVERA JAMES B
1589 CORSICA PL Iq PERMIT NO: B 061816 PLAN CHECK NO: N ^—^T": "; 'TYP ': ^'
ADORESS:COSTA MESA,CA 92626 •
CONSTRUCTION TYPE: V—N PERMIT TYPE: STRPURPOSE: ALT
1 545-0623 r
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT—REROOF W/ COMP SQQ�T: 4, 800 •
ADDRESS: UNIT: CLAIM VALUE: .4 , 800, 00 CALC—VALUE: 4 , 800. 00 GROUP 0 C: R-3 /
WEST VALLEY ROOFING ( 909) 674-0159
PERMITTEE:
ADDRESS:LAKE
AVOCADO WY COMMENTS : SMOKE DETECTORS REQUIRED
LAKE ELSINORE CA 92530 9t*******************************+E*+EeE#at+E*+E******4(** E**x-*ac****+c** (***** *****#K x•
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under pravisi I Chapter 9(c/ommenny�.04nnnnl g with Section Z O N I N G REQUIREMENTS
7000)of Division 3 of the Business and ProlAsi9pt 9)14in licens is in`I for n effect. S E T B A C K S
/ITY LIC.: �,,'F G�ST�ATTE LIC.:: LASS:/ MAIN BUILD NG ACCESSO ' BUILDING
Dale:_[ y ` _//-- Signature/// v� _ L �L4-�— FRNT: FT IN REAR FT IN FRNT: FT IN R FT IN
• WORKERS' OMCENSATION.DECLARATION: Ihereby affirm that Ihave acectilfiy�glLggsegttosell-insure or acendicateofWorkers' LEFT; FT IN RGHT: FT IN LEFT: FT IN RGH FT IN
Compensation Mixinte&i=Diked copy thereat(Section 3800.Lab[Ctl/ 4 /7 Y .�`
POLICYNO.:STATE EXP.DATE: PARKING REQ: PROV: PARCEL : 13919213 ZNE: REF NO:
m
COMPANY: X PLANNING N TES>
4 1 Certified cop. s hereby fu aped. ❑ Certified copy i e' •.th city Buildi : r on. >
.. I j(***********if*****Y-*******3E*7E******1EiE**iE********fE*iE***i(************iE#******#***
Date: AP - I. Applicant' - � /i DEVELOPMENT SERVICES REQUIREMENTS
ETEMPTIO'FROM WOO RS'COMPENSATION DECLARATION: (This section need not be completed if the pent is for ore hod:Iced(5100)or less).
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 become ZONING APPROVED• B Y DATE: -
subject to the Workers'Compensation Laws of California.
Date: Signature: BUILDING APPROVED BY : DATE: Y
NOTICE:II,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor _'J/I
Code.you must forthwith comply with such provisions or this permit than be deemed revoked. APPLICATION ISSUED BY: Sr DATE: Ot�- o�'�
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for Ihe performance of the work for ********************** - Rx ." " " " " ' " it itx.- ********** Z ' **
which this permit is issued(Section 3097,Civ.C). ********************* . ******rt*******************************b,.****#)ti;**
AUNDER: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y
SS
BLDG PMT PLUMBING ELE' TRIC MECHANIC FIRE SMIP/RES' GRADING
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason p ERM I T 72 . 0050
,
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or
repair any structure,prior to its issuance,also requires the applicant for such permit to life a signed statement that he/she is licensed PLAN SM I P/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE • r
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID I DUE
I. as owner of the properly or my employees with wages as their sole compensation, win do the work, and the TOTALS----> 72 . 50 0 . 00 0 . 00 72 . 50 72 . 50 • 00
❑ structure is not intended or ollered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through 7 T J /
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or
REVENUE UE D It I S ION TOTALS--> COLLECTED; 72, 50 OVER/SHORT• 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG 72 PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING-PLAN—CHECK
for the purpose of sale).
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: TheContractors'State License Law does not apply to an owner ofpropeny who builds or improves thereon *********************************************************************y.x******it*
and who contracts for such projects with a contractor(s)license pursuant to the ContractorsState License Law).I am aware INDIVIDUAL F E E BREAKDOWN
that proof o1 their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: R.a P.C. TYPE QTY DESCRIPTIO N UNIT COST >TOTAL COST
tar this reason:
Date. owner: SFR 4800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 ' 4 , 800 , 00
I do hereby cenily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any luture building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt Iron
these provisions.
Date: Applicant: CTOR /
I hereby certify that I have read this application and state that the above information is corre I agree to comply with al ity and county SMOKE
D ETE
ordinances and state laws relating to building construction and her thorae represenat ' of his thy to enter trove mentioned C
property for mspr don purpose . E J
V ;24)
11:30
1641-46 White—Building:Green—Code Entorcoment:Canary—ApphcanC Pink—Revenue:Goldenrod—Assessor
lCONSTRUCTION AND PLANNING POOL 'A
Date Inspire-40r Dtte Inspector
APPROVALS Permit ;`- APPROVALS Permit
'I mporary Electric] $er:'ct•urPok• -17- . 52. Pool & Equ;molt I n.t c r i
2. Esti Pip-thither-It
-1 _- I 53. Steal Rainf ore' r-
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t t. td drgrn7 P 1 I 54. Forms I
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7 Foot^_s ' 53 Eleebical Co^_ur •_^d - _ I
d. Fopnant.on _i___.
--- 59. Gas Pipe, lieu - c . -- -• - - - - - ,------
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9 ....,,ter P,pe L'r - E1 3ucia•.vash L., c. P ' c t
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1?. � 63. Hatter & Vent-fire
13 Ruin Ji.:.:, 64. Plumoing System - F,.•. ! {
14. Ro,.7'' P ,:rn.:',;--- ----- -----I- - ---I 65. Electricai-F.nal
_ - - - - - -- = I E-
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15. Hough E ectr,co'-Gnnduir I �66. Sola: Svstar. l" n.
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1G. Rough Electric 1'd•nng I I 67 Fencing & Acc^sr. An;' c I - -
17. Rouyn C. 1 S,gr ' 63. APPROVED FOR PL 's3: 1 ,4:..,..1 •
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CLRIiFICA:E OF CCCUPANCY
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::\N' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
F COSTA MESAOCONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. i
•
, Project Address' 15V� GOCZSIcA F-- / ' ��398' - ar 85 0 7/01/06 IMO TL
Applicant's Mailing Address /St 1 CJ9�SICQ P1 ' 2 TYPE OF CONSTRUCTION U NEW LI ADD ❑ ALTERATION LI REPAIR
T4 We IR ( 1/Ck-k{ Phone s��'Oo+s�
411 CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name DESCRIPTION OF WORK/USE OF BLDG. '
Address St 1"----e_ 411...S. An(00 V t' S Main Building: Accessory Building: •
Arch/Eng. License No. TYPE OF PERMIT 0 GRADING LI FOUNDATION 0 STRUCTURAL T Front• D
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 8 N
Address ❑ OTHER ' A Rear
Contractor's Name 0��'e it _ sL V Phone • PROJECT DESCRIPTION •SQ. FT. OCCUPANCY K Right G
Address(mailing) : - CON ST RUCTION TYPE VALUATIONS $ Left
City License NO.. , ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION • Ping. Ref.# • Parking Req./Provided E
1 hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: - a Q
Planning Notes:
with section 7000) of Division 3 of the Business and Professions Code, and M
my license is in full force and effect. - • • T
•
License Class License No. S
Date Signature PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL . FEES
f Workers' Compensation Insurance, or a certified copy thereof (Section • -
£00, Lab. C.) Backflow Preventer Service Sink • Automatic Washer Transformer 0 15-50 KW '
Policy No. • Company Backflow Irrigation Sewer Cap' - 0 50+ KW
8 Certified copy is hereby furnished. Construction Pole Sub.
Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit • Meter ❑up to 100 amps
Date Applicant ,
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers y Solar Collectors Dishwasher / Meter LJOver 100 amps 7 50
(Thissection need not be completed it the permit is for one hundred($100)Or - '
less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel
I certify that in the performance of the work for which •.,. mit is issued, I
shall not employ any person in any manner so as to subject to te - Drinking,Fountains Solar Tank Fan
Workers' Comp p9ttsjiop Laws of Califon - Motors 00-1 HP 011/2-8
Date /// L., Signature �/ .. ..� Floor Drains - Swimming Pool w/Spa —• F.A.U.NOTICE: If,after making this declaration, you should become subject to the Inc.Solar 09-15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole
I hereby affirm that there is a construction lending agency for the performance - Light .
of the work for which this permit. is issued (Section 3097 Civ. C.) Interceptors "
Lender's Name I Water Heater Outlets Range •
Lender's Address Kitchen Sink .- Water Service Switches '
OWNER BUILDER DECLARATION Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposalg
following reason (Section 7031.5 Business and Professional Code: Any city or Standin Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTrays
• any structure, prior to its issuance, also requires the applicant for such permit y Generator ❑0.5 KW ❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt - - - -
'herefrom and the basis for the alleged exemption. Any violation of Section
031.5 by any applicant for a permit subjects the applicant to a civil .
,enalty of not more than five hundred dollars($500).
❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work, and the structure is not Intended or offered - Reinspection Fee $15 Issue Fee . $ 3
for sale (Secion 7044, Business and Professional Code: The Contractor's MECHANICAL
License Law does not apply to an owner of a property who builds or Improves _ _ — ___ la -FEES_
thereon, and who does such work himself/herself or through his or her own - - . DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements aro not Intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
•
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground _ Building Approved By Date -
rove for the purpose of sale). 7—/— b
I,as owner of the.property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By • Date
rectors to construct the project (Section 7044,Businessess and Professions Code:
The Contractor's•License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTUSUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con- ,
tractor($) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
' ❑ 1 am exempt under Section P.C.for this reason 1 Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $
Date _771./5-4:2— 'owner Heating System& Ducting Registers • _ PLAN CHECK 25% $ n ENERGY P.C. $
•I hereby certify-that I have read this application and state that the above - ' 00-100,000 BTU 0100,000 BTL, ELECTRICAL $ IOrSp GRADING $
information is correct. I agree to comply with all city and county ordinances ,
and state laws relating to bu •ing construction, and hereby authorize repre- - MICROFILM '$ '
sentatives of th' city IS upon the above-mentioned prop.rty for PLAN CHECK 50% $ T
inspection pure. es. 'r11—/i„�. MECHANICAL $ TOTAL FEE $ IO'SO
• Signature �' J ,+- �'� Date
Drivers' License or S5$s " . Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ -C
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink - Accounting: Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL& SPA 0
Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit# o
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
'3. Electrical Conduit Utility-Undrgrnd. 54. Forms a
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. '?;, (>B� 1 -5 57. APPROVAL TO COVER-GUNITE _
7. Footings 58. Electrical Conduit-Undrgrnd. 52
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. 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. 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 Fireplace APPROVALS Permit# _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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 PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric /1-4'54b ( J Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test ^.Nx0
36. Hood or Canopy �J 1' w
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backf low Irrigation
• 44. Landscape Irrigation System
45. Sound Attenuation •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING •
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
All
No. Date
OWNER CGMESA, INC_ - DATE 5-].h-59
JOB ADDRESS 1589 Corsica Pl, BUILDING PERMIT NO. 931C
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 133715,00
AP. No. LOT 71 TRACT2822 FIRE ZONE DESCRIPTION OF WORK HeS.w/att.Garage
Ir'-_'SECTIONS 3-.,a." DATE I GROUP •
TYPE ZONE A 1
I. :rground Soil /y}/j U.G. Water/-S /s--/ PERMITS ISSUED
SUBCONTRACTOR
Underground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating /WS 7-/C- -e /z7i r G-9-Sf sc 9 o
Rough Plumbing 7-7579 /.. .,;(e-,(24,J .moi-cJ, , -C-47-6-% /9,7/6
Miscellaneous „ i
kw,Prop. Swr.Line Houi(Con. St. Swr. 7/'lq(<7 •Ail,:ba- l'kx%� Wt.z/L-ti f -A= .- -{—C-27 t
Sprinkling System Vl.
Heating, Final e s^(�t' 11
Plumbing Fixtures /// + 9-3 •• yr A.
Final Gas Test ' /n' r � I/s'' -/lam. } /
Construction Pole ' *At y
Underground Power 1
Rough Wiring 4%b. Z >RIvi�id/e/i.,..�P. c' 7-/-.SS 9s acJ
Trenches 1/Forms ✓ Steeteen-/,- (,/i/fl
Floor System '...•
Steel Reinforce Chimney Re-Rod
Bond Beam '
Sheathing
I c and Flashing 0'14- 7^14^��
L._._.mg, In 4.--- Out field 7-9f -r '
Plaster, brown coat #7 k-91--
Plumbing Fixtures, Finalo--9-sr,
14'
Electric Fixtures, Final7 . 47.,
Building, Final // /r I VW
OCCUPANCY '
Form 210-3M-4-59 9310
.
Ir .7* 9310
•
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA, CALIFORNIA
CITY OF COSTA MESA
FOR APPLICANT TO HU IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
ADD
BUILDING 1589 Corsica Pl.
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
I RECEIPT NO. "IT NO.
OWNER Comesa. Inc.
MAIL 419 E. 17th th St. RE EIVEQ BY DATE RECEIVED_„
/DATE ISSUED
ADDRESS 3-13 t�-`3 J 1 J '/v
CITY Costa Mesa TNO.LI81159 A ESS
G
ARCHITECT Carlson & LIC. COSTA MESA, CALIFORNIA
OF ,INFER Middlebiwk NO.
FIRE VE
31
ADDRESS Garden Grove ZONE'/ /7 ///y
CONTRACTORikS & GOlegrOVe, In¢rLIC.NO 167293 BBVPROVED 7 DATE 'S y J /
ADDRESS 419 E• 17th St. , Costa Mesa ZONING
LEGALI LOT I I }&'J2 ZONE NO.OF USE OF NEW/ge
DESCRIPTION NO. 71 BLOCK T q11:9 ( PLANS �I BUILDING
A.P.NO. APBYP////E� el) rGATE ✓ V `S/?
SIZE 60 x 104 NO.OF SLOGS. YARDS ' (i'�SrVES /
OF LOT NOW ON LOT none REQUIRED ALLOWED
USE OF none (CENTER LINE ST.)
EXISTING BLDG. FRONT L7�FT, IN,
SETBACK LINE FROM
CENTER OF STREET 55i . . REAR YARD 29' R.SIDE SFT. IN.
SIDE YARD I LEFT 51 I RIGHT 5? L.SIDE IN.
DESCRIPTION OF WORK /J
X REAR a 2--/ FT. IN.
NE' I X ALTERATION I I ADDITION I
REPAIR I II MOVING DEMOLISH S -
IZE NG 1365 ROOMS 6 STORIES 1
SIZE
EXTERIOR WALL Stucco I ROOF Shingle
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
Single family 'dwelling with
attached double garage
Plan 110BR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. �i /` VALUATION
SIGNATURE OF'C��D I�/�. r PERMIT FEE $ 32.00
PERMITTEE �/ Y-N�
13,715. PLAN CHECK $ 16.00
RIZED AGENT Dike & Co egrove., Inc. TOTAL FEE $ 48.00
JOB ADDRESS 1589 Corsica Place BUILDING PERMIT NO. 25777
GENERAL CONTRACTOR R':..M. Wilson DESCRIPTION OF WORK Pat.CVr.W�scr.encl.
P No. 139-192 13 LOT TRACT FIRE LONE VALUE $ 941.00
1. ECTION5 Signature Date GROUP J TYPE IV ZONE R-1
SoilPERMITS ISSUED
I
L,Gas SUBCONTRACTOR Date I Number I Signature
Water Plumbing
Rough Plumbing
Prop. Swr. Line 0 House Con.0
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0 ,
Rough Wiring Heating and Vent.
Trenches 0 Forms 0 Steel Reinf. 0
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing .
Lathing—In IJ Out❑
P1?�,`� ter, Brown Coat
,"cural, Final Electric
Ile-thing, Vent., Refrig. and A.C., Final
Plumbing, Final and Gas Test ❑
Electric, Final
Building, Final ata if5•/i.,:
25 777 CITY OF C STA MFS
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 02020 - n
JUN 9 1966
For Applicant to Fill In Completely APPLICATION FOR PE
TYPE OR PRINT
11,
1 ,rit, Only
A
ADO ESS /SGly g•I �j
O / VO YS/GCL p/'
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA
OWNER EEC[ [DSY DA�R[6VBD-6 ,T[1[[U[��
d Condo Ry (/� jT7AyL/Y4
/ BUILDING
MAIL //'' ADDRB$S '
ADDRESS N_ '� (/
FIRE
CITY 0(/�'q /✓"�6i NOL����/`�/ ZONE TYP GROUP /
APPROVED i/C!//t. /
IFFNITBGT y,�/ L TOL BY' DATE / /
NGIN88R '.. ( >'l/4/�/r T11
///.��� yp^l//���� ZONING 0-4.1 -(111.�
JREQs ///)//////o.�I(f/��YI*o •^'•r
Z°1 ---1
NO.OP USE OF NEW
CONTRACTOR ///L/-�J/// S6 I Iiv^IG^- LSOAL
�/-y �l / I PUIU BDILDINYI j ,T,w... --10#
ADDR /6 I V D 0/ O'�[GI 4 sAi CI DESCRIPTION
r 7/ rl-gv•. �2r2...12-1-
A.
[- --
DESCRITON
CITY �// q/�Q� A.P.NO. ' > �`f 3
ISI .TNG. I S 5—Zv6 tip I ^c.IU D _ Sr TO SIDE&REAR p.L•OVERHANGNOTE: NO EAVE SHALL BE LESS THAN
SIZE I NO.OF BLDCS. ALLEAVES
OWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
BE OP / YARDS APPROVED YARDS APPROVED
U
USE OP BLDG. MAIN BUILDING ACCESSORY BUILDING
(FROM C/L R1`ET) 1
SETBACK LIN[PROM i'A
CENTER OP STREET REAR YARD FRONT 35--FT.----
�1r FT. -
SIDE YARD I LEFT I RIGHT
R.BIDE J" Fr.� FT.
DESCRIPTION OF WORKS L.SDR FT.' PT.
' ALTERATION ADDITION NREAR .2/ FT. FT.
DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN BLDOS. ACCESS.BLDGS.
BUILDING NO.OF VAR.# DATE
SIZE ROOMS STORIES C.U.P.# rr ` APPROVED
EXTERIOR WALL ROOF APPROV ' �/\/'I w...'^',,1 /- / /'
COVERING I COVERING PT L�-Y(Ae I DATE lo-C9 -(� 6
US/�y��pyFB ILDDII/NSG AND�y �W/OOORK TO BE PERFORMED I ) d
IIIdi
en
SQ.IT.
I HERESYAT EDA APPLICATIONT.I NAVE READ THIS APPLICATION
TIM AMOUNT SHOWN UNDER VALUATION IS FOR THE C
THAT
T
AND STATE THAT THE A.- .UI CORRECT AND AGREE TO COY. PURPOSE OF t[TABLISNINO A PERMIT FEB ONLY. a
PLY WITH ALL CITY 0 PA AND ST LAWS REGULATING
BUILDING CONSTRU •N. VALUATION - D
SIGNATURE OF • ////I ' L//'�Il V•✓ O� PERMIT FEE
PERMITTBF ! i?1,.//
. PLAN CHECK S /` r wAUTHORIZED AGENT _ TOTAL PEE $ 1/d