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Home My WebLink About3158 CORK LN - Building PermitsCITY OF COSTA MESA B!/ILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 PERMIT NUMBER: BC08-00386 PERMIT TYPE: B COMBO STATUS: ISSUED Sub Type: POOLSPA DATE ISSUED: 08/14/2008 - ISSUED BY: RMD �oe a,DDREss: 3158 CORK LN CM <t � `{ Suite/Unit:... APN: 14763401 '-ZOning R1 '�..� z �` Vicinity: Gonst Type: SCOPE OF WORK: CON BTU, 1 ELECTRICAL PO OWNER: ALVIS, JAlR Phone: 714360-013 APPLICANT: ELLISON, P+� Phone: 949-683-986� CONTRACTOR: SWAN Phone: 949-859-8466 Cell: ARCHITECT: ENGINEER: AARON =.r. J - ' _ _ . �'- ` - �' � Primary Occ: POOL: . + SQ:_FT '' 0 ,,' ,:: Veluation: $4Q000.00 f-'��i�: :-r' �. _-d. STRUCTION OF,Q:420 SF IN-GROUND GUNITE POOL AND SPA (SW-07-0348) WITH 1 FAU > 100 K OUSPA;1 PLUMBING FOR POOLAND SPA. ''`"' � . - 'r't � � 1:.•�.'. r --.:? r ' .. O � , Address 3158 CORK LN i , =� � "=�t �, Unit: 3�( �� ; City/State/Lp _.COSTAMESA,CA ��r i�.'s e�,j q' a -..�. . .... . � , . � i AUL y' � p _ = Address: � ' �__ �F _ *'�� Unit: . ! 4 � �4; ,. '.�_ City/State/zZip: ' � , �r_�._. , .. : � _. . � �� -�', ; ,. ,. , .. , .. -. . 4 . o. . . POOLS OF SOUTHERN CACIFORNIA � �: � � License No.. 440333 . _ , : �,� �� Address:� 24512 BRIDGER.RDUnit: � � '� City/S1afe: LAKE FOREST, CA � -- `%-�.ZipCotle 92630 � .- . `�� -License No. ,�:�-.- - � - � - :� PHONE `��' OWEN P E;� License No.58876 �-' - +:PHONE'>i� ri � , ERMIT�FEE�SUMMARY � - � � � Building Plan Check: ;, ;; _ $353.11 � ". : , Building Fees: $543 25 '' ` Electrical Fees: ��-�� $73:00 � - � � � . � - . Mechanical Fees: � $41.50 - � - . � Plumbing Fees: : $114.50 - - - SMIP Residential: � $0.00 " - -;;�,'.' SMIP CommerciaC ?. $8`40' � :. TOTAL FEES: $1;133.76 ` ,. �.,. "Refer to (ee receipts tor all te¢s paid br projact ..- ` - _= NOTICE: The work authorized by this permit shall comply with all applicable handicap access repuirements under California statutes and related r�gulations. (Ord. No. 92-28, § 1, 12-21-92) �XPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSAECTIONS: In ader fa the work authorized under this permit to be considered legal, such work must wmply with all applicable codes, and all required inspections and Fnal approval musl be obtained. Failure to oblain inspections and final approval will resull in the expiration of this permit. � DEi. INSPECTIONTYPE OATE INTITIALS COOE� INSPECTIONTYPE U-� � IN70UL5 1616 Fixed System Final Fire Preve�tion 206 Final Mechanical i%.� 1�66 Pool Spa Final . �� 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical M�1_ z07 Fioal Block/Retaioing Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 204 Final Sign Final Demolilion 222 Final Site 250 FinalBuilding/Occupancy WORKERS COMPENSATION DECLARA I fiereby affilm �nder penalty ot peryury one o� �ne following declarations: ❑ I have and vrill maintain a certifcate of consent to self-Insure for vrorkers' compensation, as provided for by section 3700 of the Labor Code, for the peAoRnance of Ihe aork (or which ihis pertnit is issued. ave and vrill maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Code, for [he pertwmance of lhe�work for which this pertnit is issued. My v,orkers' wmpensalion Insurance cartier and policy number are:,�A �Carrier /Y1 AJ �STI � / ti/ S C—� � (Thissedionneedrpl0edmplefeCdllrepeimlavaluetlafinenurrtliM�llars(St001wless.J Policy,Number: ��07 �3 g�2�2 ❑ I certily that in the pertormance of the vrork for which this pertnil is issued, I shall not employ any person in any manner so as to become subject to ihe workers' compensation laws o( Califomia, and agree that if I should bewme subject to t rk wmpensation provisions of Section 3700 ot the La � AEiT or �h comply vnth these provisiqns y p, � �� V ApplifaN'sSignaWre . Ddte WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirtn that I am licensed untler provisions of Chapter 9(wmmencing with Section 7000) of Division 3 of the Business antl Professions Code, and my license �is /in�f�ull f2orc-ze antl effect. Lic. # T`r��7✓ 3 -- qass # G�� ¢ v� ranor'sSigriaWre _ Date CONSTRUCTION LENDING AGENCY: ❑ I hereby aHUm that there is a consiructbn lentling agency for the peAormance of ihe vqrk for wfiich this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Sip�uWre Da�e OWNER•BUILDER DECLARATIONS: I hereby aKrm that under penalty of perjury that I am EXEMPT PROM THE CONTRACTORS LICENSE LAW for lhe follovnng reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a permit to construcl, alter, improve. demolish, or repair any structure, prior to ils issuance, also requires the applicant for such permil to file a signed statement Ihat he or she is licensetl pursuant to the provisions of lhe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle) or that he or she is exempt therefrom and the basis for the alleged ezemption. Any violalion Of Section 7031.5 by any applicant for a permit subjects lhe applicant to a civil penalty of not more [han five huntlretl dollars ($500).): ❑ I, as owner of the propeRy, or my employees with vrages as their sole compensation, WILL DO THE WORK, and the structure is no[ in[ended or oflered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves ihereon, antl who dces such vrork himself or herself or through his or her ovm employees, pmvided that such improvements are not intended or offeretl for sale. If, however, the building or improvement is sold within one year of wmpletion, the ovmer-builder will have the burden of provinq that he or she did not builtl or improve for purpose of sale.). ❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS ro construct the project (Sec. 7044, Business and Pro�essbns Code: The contractars License Law dces not apply to an owner o( properry vmo builas or improves thereon, and who contracts fw such prqect with a cont2cta(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. � Business and Professions Code for this reason: JOS]-G6 (YW) Ovmer ID venfied t ir's lice� ,] Yes ❑ No Driver's LicenSe No. Expire5: Verification of Ownership by (rype o( document, i.e. - propert4 tax bilfor d�ad): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify tha[ no excavation frve (5) or more feel in tlepth into wfiich a person is required to tlescend, will be matle in connection with v.ork authorizetl by [his pertnit, antl that no building sWcture, scaffdding, false�wrk, ar demolition or tlismantling thereo(, will be more than thirty-si�c (36) feet high. (Chap. 3.2, Grp 2, M 2, Sec. 341, Title 8, Cali(wnia Adminis[rative Cotle). ❑ As owneo-builder, I will not employ anyone to tlo vrork which vroultl require a pertnit from the Division of Industrial Safery, as noted above, unless such person has a permit to do such vrork from [he division. Applicanfs SignaWre Da�e Division of Industrial Safety Permil Number _._ _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to fle and certify a Business Plan for emergency response to release or lhreatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, with some exceptions, lhal a Business Plan be fled wilh Ihe Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous matenals equal [o or greater than a weight of 500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressetl gas at stantlartl temperaNre and pressure). 2. Does or will the applicant or preseN or �uture building occupant need to file a regisiralion fortn for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of [he Califomia Heallh and Safety Code, wit� some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one lime has on hand a quantiry of acutely hazardous matenals equal ro or greater than a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas al standard temperature and pressure�. 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management antl Prevention Program tor acutely hazardous materials)? ❑ Yes ❑ No (Sec[ion 25534 of Ihe Cali(omia Heall� and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP Dy businesses which are required to register acutely hazardous materials v+i[h the Fire Department. 4. If an RMPP is presenlly required, has Section 25534 of ihe Cali(omia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicanl or present or (uWre building occupant require for tne work wnicn is me subject ot this application a permit for such conswction of modifiCa�ion frOm the South CoaSt Air Quality Managemenl DIStriCI Of ffom any other air pollution wntrol district or agency? ❑ Yes ❑ No (Sec[bn 65850.2 of the CalAwnia Govemment Code requires ihat the requested infwmation be fumished on applications for rron-re5idential building permits). 6. Will any part o( Ihe faciliry ro be consWcled untler this permit be within 1000 feet lrom the outer boundaries of a school? ❑ Yes ❑ No Qf'yes", the facility must meet the requirement of Sections 25534 antl 42303 ot the Califomia Heal[h and Sa(ety Code). 7. If a pertnit lrom ihe South Coast Air �uality Management Districl or olher air pollution control districl or agency is requiretl for the work which is the subject of lhis application, have all of the disclosures prescribetl by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", a[tach certificate of wmpliance from the appropriate air pollution conlrol oKcer). CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury Ihe information jiven above is correct I agree to comply with all sWte lavrs antl city ordinances regarding Hazardous Materials antl Emissions. - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I certi�y under penalry of perjury that I have read Ihis application and sWte that the information given is correct. I agree ro comply with all state laws and city ordinances relating ro building construction, and authonze representatives of ihe City of Costa Mesa to enter upon the abovetlescdbetl property for inspection purposes. I agree not to occupy or allow occupancy ot any building authorized by Ihis pertnit until final inspection. Si nature f eg er(s) �Ox e � �� 8 A V Mzetl APO��n� _� ale r r . . � � � �✓�04� �� e��idl."otiL POOL AND SPA,REQUIREMENTS The following information is required in a dear and legible manner. All information shall be complete and on the plans. Four sets of plans showing all of the following with measurements shown from property lines, buildings, patio covers or other structures. 1. Name, address, phone number of owner. 2. Name, address, phone number, type of license of any contractors or subcontractors. 3. Pool ancUor spa ]ocation. 4. Equipment location. 5. Gas and electrical meter locations. 6. Overhead service lines and serving pole location. 7. Type of gas and electrical conduits to be used. 8. Size of main electdcal service (if less than 100 AMP, service is probably inadequate and will have to be upgraded to minimum City requirements.) 9. Rating (horsepower, voltage, amps) of all electrical equipment. 10. BTU rating of gas heatec I 1. Distance and size of gas line. 12. . All electrical outlets within 15 i. of pool/spa. 13. Capacity of spa (spas only). 14. Handrails; ladders, slides and diving boards (if any). 15. Location and details of solar panels (if any). 16. Location of doors and windows within 5 ft. of pooVspa. 17. The type of constructioo-gunite, poured concrete, prefabricated fiberglass or other. 18. � The pool dimensions, including the depth and adequate cross-sections drawn to scale. 19. Computations, stress diagrams and other data sufficient to show the correctness of plans; including reinforcing steel schedule and details. 20. A statement by the applicant conceming [he anticipated nature of the soil under and around Ihe pool structure (expansive, moderately expansive, non-expansive). (A soils report may be required by Building Division prior to permit issuance.) 21. The Engineer's wet ink signature is required on pool plans and calcutations. 22. All semi-private pools and spas shall conform to Califomia Adminis[rative Code Tide 24 handicapped requirements (hotels, motels, recreation areas for lease to public or publicly funded projects). 23, Where a permanently installed pool is constructed, at least one 120 volt receptacle shall be installed a minimum of 10 feet and not more than 15 feet from the inside wall of the pool and shall be protected by a ground fault circuit interrupter. 24. Indoor ins[allation of spas and ho[ tubs, receptacles shall not be closer than five (5) feet ro spa/tub. 25. Receptacles located within twenty (20) feet of a spa or hot tub shall be G.F.C.I. 26. Receptacles for spa/hot tub motors shall be G.F.C.I. protected. 27. Comply with Costa Mesa City ordinance 93-12 requiring protective barriers, fencing and/or enclosures. to79-06 (REv. t0�o9) GENERAL REQUIREMENTS 1. If capacity is 750ga1. Or more, backwash and p-trap shall be installed. 2. All P traps s6all tie in at lower terminus of house drain. ' 3. If permanent fil] line is not installed, nearest hose bib shall have an anti-siphon valve. 4. All PVC shall be 18 inches underground. 5. Pressure test shall be required on entire system (35 P.S.I air test or water fill) prior to back fill. 6. PVC gas lines shall be tested at 60 P.S.I. Z Pressure test required on entire system (35 P.S.I. air test or water fill) prior to back fill. 8. Overhead Edison drops shall be installed per NEC 680-8. 9. Clarification or additional informa[ion may be obtained by telephone: (714) 754-5273, be[ween 8:00 a.m. and 4:30 p.m. REQUIRED SETBBACKS Pool Heater vent outlet as per UMC 806.7: 1. 4ft from property line. 2. 4ft from doors/windows. 3. 4ft from attic vent. Pool/Spas: Above-ground pools and spas shall not be located in the required front yard setback from a public street and are subject to 5 foot and ] 0 foot yard setbacks for main structures. Any deck that is raised higher than 6 inches above grade, will also be subject to the 5 foot and 10 foot yard setbacks requirements. Please consult with Planning Division regarding any in-ground pool and/or spa that are proposed to be located in the front yard. 1. Overhead Edison drops shall be installed per NEC 680-8. 2. It shall be unlawful for any person to instail, remove, alter, repair or replace any plumbing, gas or drainage piping or any fixture, swimming pool heater or treating equipment in a building or premises without first obtaining a permit to such work from the Building Division. 3. Clarification or additional information may be obtained by telephone (714) 754-5273, between 8:00 am and 430 pm. 1039-46 (REV.10/09) 0 1 Q OS/07/08 16L24 FAX 5627951117 � CDFA/RIFA f�001/0� �..._ �� oT_i vmri�q �i�rv� VVLJ CAFA/R1k+A NO • ��Q P, � ' ' � �� W � � 1 ��01 . , � �r�� bv � �.6 Coope�raiive Red Imported Fire Ant (RIFA) Pxoject Address: Red inaported 5re ant Agreement No. � r I Name of Company Contact Pezson: Noti�icatioaa of Tntent to Move Soil From or within Qnarantined Areas of i0range, Ri�verside, and I.,os Ar�geles Counties California pepartmeut of Food and Agriculfure, RIFA. Pxogram PO Box ZOY'7 T.os Alamitos, CA 90720 Phone: 562-795�1100, �'A.X 562-795-1i17 coxnpiianco Approval: Tssvang Agency: City/Co'unty Address:��S� Ol ��IALl�.•'ty_ �,��q�j�7o Te1e hone: �'� • Fax: ( �� • {/� �,'� Excavadon tion: ,�` V �� '�'B'" -1�� G1-=J---.f '! �1(�l �,� � 4 `J'U ��Q'�' k. �.t� � wcres: .. � VV V' �a�a� Destina ' n Loc don: , ,,,_ "' �. !.-� i i L\ 2 t � n� t� i��i Estimated Quantity of Soil (Cubic Yards): Anticipated Date of Tvioveimexit: LTrgemcq I,e for 7mmecliate Ins�ection and Release**: [Circle OneJ Fztgh m�ea�um z,ow 70 �CAMPLETEti 8Y RIFA PROJ�CT REGULATORY OF�IGIAL ONI.Y: o� soil xs peTznittad ❑ Iiold movamez�,t until sitn checked - W� WILL CAI,L AS 500N AS �OSSIBLE TO SCHF,DULE INSPECTION b.ATE AND TIIv�F_ , Date Tnppcd: # of Traps: Acres: Date Picked �1p: PDR #: Cotnmcnts: Trapped by: ❑ Soil Ivlovemant soil is strzctlyprohzbited for ffi0�o11oWing reasoixs: Nameo£RLFA Signature: _ Officxal: iJate; �`TB is Thomas �xotl�ers xnap page and gid infoxmation xrnp �om, Cn-1 Rov;sea sn voa *"Please aJlow 3� wo�JanB days for 3nspectioa (Mon — Thu) Califonaia Departznent o� Food aad AgriculNie — RII+A Program PO Box Z017 Loe F.lamitos, CA 90720 OS/OB/OB WED 09:20 [TX/RR NO 9204] (714) 754-5273 • Fax (714) 754-4856 • Www.Ci.CoS�e-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 lob Address: 3158 CORK LN Suite No Vicinity: Parcel Nunmber: 14763401 Applicant: NOCK PLUMBING Address: 11612 KNOTT ST SUITE-217 � GARDEN GROVE, CA Owner: -ALVIS, JAIRO � _ Address .3158 CORK LN- COSTA MESA, CA Contractor: . NOCK PLUMBING Address: 11612 KNOTT ST � � . SUITE 217 GARDEN GROVE, CA Arch / Eng : Address: ISSUE FEE BackFlow irrigation BackFlow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve PLUMBING PERMIT Bhone: (714) 8951246 Zip: 92841 Phane: 714-360-0133 Zip: 92626-2607 Phone: (714)895-�246 Zip: 92841 License: 707775 Phone: Zip: "License: SCOPE OF PERMIT WATER HEATER CHANGE OUT. - AMT 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 J Status: ISSUED Applied: 02/02/2004 Issued: 02/OZ2004 ISSUED BY: -FEE�SUMMARY_ . QTY - AMT�:�QTY " � AMT Laundry Tub / Washer � $0.00 � 0 _ _�• Sump Pump - $0.00 0 `- ' ` 'Landscape Irrigation $0.00 0 � Swimming Pool $0.00 0 . P-Trap $0.00 0 Trap Primer $0.00 0 � Pressure Regulator $0.00 0 � Unnal $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr BkFlow(t-4) $0.00 0 Receptors $0.00 0. Vawum Brkr Bkflow(5+) $0.00 0 � Septic Tank $0.00 - 0 � Wash 8asin � $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set � $0.00 0 " Sewer Connect -, $0.00 0 Waste and Vent System $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0,- Shower , $0.00 0 Water Heater / vent $12.30 0 , Sink, bar $0.00 0 � Water Piping (Inst or Rep.) $0.00 0 Sink, commercial $0.00 �� 0 -� Water Re-pipe $0.00 0 Sink, Floor _ -$0.00 - 0 Water Service $0.00 aTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia 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 tor 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, end all requlred Inapectiona and final approval must be obtained. Failure to oblain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a48d8 (8/00) WORKERS'COMPENSAnON DECLARAnON: I hereby affirm under penalry oi peryury one of the following tleclarations: � I heve end willrr� mlaln a certificate of consent to self-Insure for workers' compensatloq�es provided for by section 3700 of the Lebor Code, lor lhe pertortnance of the w rk tor whith this pertni� is issued. hava entl will maintain workers' compensatlon Insurance, as required by section 3700 ot ihe Lebor Code, for t�e pedortnance of the work for which this pertnit is issued. My workers' compqssetlon InSurence wrder end policy number are: Certier: Policy Numbec (This secfion need not be campleted i! fhe permit is va/ued ef one hundred dollars ($100) or less.) ❑ I cenify that in the peAormance t�e wo i r which is pertnit is issuetl, I shall not employ any person in any manner so s to becoma subject lo the workars' compensatlon laws oi Califomi antl agr hat if I ould become sublect to the workers' compensation provisions of Se tion 3 00 1 the L bor Code, I shall fonhwith compy with thesa pmvisions. � o Applicant Signature: Date: WNflNINa: FAILURE TO SECURE W KERS' ENSATIqJ ERAGE IS UNLAWFUL AND SMALL SUflIEGT AN EMPLOYER TO CRIMINA PENALTIES AND CIVIL FINES UP TOONE HUNDRED TFIOUSANODOIJ.ARE(E100,OOO�.IN DITIIXJTOTHECOSTOFfAMPEN$ATION,�AMAGESPSPHOVI�EDWRINSECTION3]OBOFTHELABORCODE,INTEREST,MIDAT70RNEY'SFEES. LICENSED CONTRACTORS DECLAR TION: I hereDy aHirm Ihat I em licensed unde rovisi ns of Chap er (commencing with Section 7000) of Division 3 of the Business end Professions Code, entl my license is in full torce an0 ettect. Lia a Class # Contractors Slgnature: �ete: CONS7RUC710N LENDING AGENC : ❑ I hereby aMirtn ihat there is a consWction lending egency for Ihe peAortnance of Ihe work for which this pertnit is issued (Sec. 3097, Civil Code). Lenders Name: Lendets AdCress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn ihet under penalry of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business end Professions Cotla: Any ciry or counry whic� requires e permit to consiruct, alter, impmve, demolish, or repair eny stmcture, pnor to its issuance, also requires the applicant for such permit to tile e signeC statemem that he or she is licensed pursuant to Ihe provislons of the Contractors License Lew (Chapter 9(commencing with Section 7000) of Divislon 3 of the Busineu antl Professions Coda) or that he or she is exempt Nerefrom and the basis tor the allaged exemption. Any violation of Section 7031.5 by any applicant for e pertnit subjects tha applicant co e civil penalry oi not more than tive huntlretl dollars ($500).): ❑ I, as owner of t�e property, or my employees with wegas as their sole compensation, WI�L DO TTiE WORK, and ihe structure Is not intendetl or otteretl for sale (Sec. 7044, Business and Professions Code: Tha Con[ractors License Law dces not appty to an owner ot properry who builds or improves thereon, and who tloes such work himsefl or herselt or ihwugh his or her own employees, provided that such improvemenis ere not intended or ottered for sale. If, however, the builtling or Improvement is sold within one year of comD�etion, ihe owneo-builder will have the burden ot proving t�at he or she ditl not huild or improve tor purpose ot sale.). ' � I, as owner ol the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Cotle: The comractors License Law tloes not apply to an owner oi propeny who builds or improves thereon, and who contrecis tor suc� project wii� e contracror(s) license pursuant to the Contractors License Laws.). ❑ I em exempt under sec. Business and Professions Code tor this reason: Signature: Data: Owner ID venfied by tlrivefs license. ❑ Yes ❑ No Driver's License No. Expires: Vedfication ot Ownership by (type at tlwument, i.e. - property taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity iha� no excavetion five (5) or more feet in tlepth into which e pereon is required to tlescend, will be made in connection with work authonzed by Ihis permil, end that no building structure, scaHolding, talsework, or demolition or dismantling thereot, will be more than thirry�six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Callfomla ACministrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which woula require a pertnit from the Division of Industriel Sefery, as notetl ebove, unless such person hes e permit to tlo such work from the division. SignaNre: Date: Division of Industnal Safety Pertnit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORVJITION OF EMRY: I certify under penalry of perjury that I have read this appliwtion and state thet ihe infortnation given is correct. I egree lo comply with ell siate laws end ciry ordinances relating to building consiruction, and auihonze represeniatives of Ihe Ciry of Cos�a Mesa to anter upon Ihe ebove-descnbed property for inspection purpases. I agree not to occupy or�ellaw occupancy of eny building euthorized by this pertnit until tinal inspection. CODE �, INSPECTIONTYPE �l Qajf, 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Rooi 201 Finel BIocWRetelning Wall 202 � Final Fectory Fire Place 203 FinelSign 204 Final Demolition �� CQOE� INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Electncel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy BAg II�LS 3•l5-0`l � � � '0°"�0F81i10P� 3158 CORK LN u"T: avr+Eas""°EiFa�°^'":KAMMERER, LAURA K TR FLOOD: X 46 �D�� 3158 CORK LN COSTA MESA,CA 92626 557-5440 �iNPL.IW lIIlG �OONE55: uc. ra.: uxr: �+�T�� HALBOA ROOFING (714)631-5081 caNm�crarsMuuxo 600 CLIFF DR �ou�ss: N. B. CA uc. xo.: 714 7 2 9 92663 uxr: LICENSED COMNRCTOHS DECLANATION: I hamby eflim under pemXy of popury ihet I em I'reneed uMer povieiom ol Chepter 9 (commeruiip xn� Sxtian ]W0) d Diwun 3 d Ne Buaneu eM PNm ' Code. enE nY lioeiue b in full brce vM eHeq. rua p cmuc.No.:0/j6804/�w9 uc.cuss:C-39 uc.No.: 14 29(/�}�/�JE,/]}('P: 08/97 Dete: �/ I �/—L � Conl�eaor: �J`I OW NEN BUILDEfl DECLAflATION: I hereby elfirm uMx panely d perjury iMt I em axemq ham IM CaNreuae licenae Lew la Ne folbwmB reeeon (Sedion )031.5 Buaneaa eM Proleaeiom Cade: Fny cIy a munry whid� reyuirae e permil b mnabuct, allm, imqove. Eemd'eh, a repei arry etrucWn, pia io na us�wra, e6o requirec tha epplirent ta euch pa�mu �olJs e ap�d e�etement Mm he a ehe c licenaed punuent lo Ihe proviaiona d tln Cantreqan Lirnme law �Chypm e(commenwp xnh Sedion ]000� d Divwion J d iha Buainaw enE Professione Code� or thet M or she is azemq IMrNmm end the bnu lor ihe ellegeE exemqion. My videton M 6wion ]W 1.5 by anY eDd�� la e permil wbpds Iha epplicen� �o a dvil paneMy d nd more Ihen INe huiMred tlolW �SSOOj). . � I.evmmardthepapaMamY�Noi�=�hwapeaavlheiedecamperuelbn.willAothev.ork.eMlMahw.YuroeMinteMeE a dtared Irn aeb (Seelion 101a, Buaern end VMeauana Coda: The Comreqore Linrue law doea rwt eppty�o en oxnxd poperry who Wlds ar inD��'ee �herean. enE Ma droe such wwk NmeaM a Mnell or IMouBh h6 a Mr own empbyeae, prwiEed ihet euch impovemxJa ere nol inteMad a Waed la seb. H, hows.er, �Ir Witli�p a'vnpwemeM io edd wilhin me year d mmpbtion, tha owiror�WiNm xill heve tM W rCen d po.•iig M w sM Ek mt W ik a improve lar Ihe WNo+e d aeb�. � I. es ow�e� M IM D�VeM. � exduSiveFy conlredirq wilh licenaed conVeclwe lo condrW Ihe pml� (Sepion'100d. Bu+in�e erd PMesabru Coda: The Canirmas licanx lew doo ria epply m en ow�wr d propeny who buitle « imqwx tMraon vd xM canvecia ln witl� w4�a wil� e wnirmMs) IcmmE Wnuan� �o iM Coniredas Lice�ca lawl. � I em a�ampt mEer Saciion: B, fi P.C., br ihia reemn: o�a: o.,�.: � eo nereM ceniy �nm � em eware w ad uMaisieiw ine r«�wremenn m celaan,u Heenn end selery cod. seaions zssos, zssa�, eiw �. 25530. eM Nel I a anY Mure buikinp oeeupent xill / wil nd (aeeb me) neeE b wmpy wIh sek &ele mdm eM iM repuiremend br � epe�m�f«cauuuctianamoCificmionhantMAi u3eTi�erepemenlDipr'uf.RaeidmimlmfmwionappireiiwneraevemplromN»e yrovislons. o�e: nod�n: WORKER'S COMPENS�TION OECLAN�TION: I MreEy etfi�m undx pareM1y d pa�ury wr d tha Idlarrirq dederaiiom: ❑ inere.�ew�mew.un�rcmewow�im.w.wnm.�a.��o��.ow�deer«Msea�a�a�aoam.�.na CNB. IM IM D�01nlence W Ne �vo�k IIX MiCA �hrs pemiu o iauad. `[] � neve ane vrio meimein.on,,; canw�,smon wurence. e. rww.ee M saaian a�ao d ma lee« coa.. �« ma w�«me�,ce d m. n wuk lor whitli Nia pertnil u iseuad. MY wvken' c«npew�ion imurenca �a�ier eM pdicy numEar are: c�«: STATE FUND EXPIRES Poliry Number. Q]. � Q 1. � 9 8 (Tnu seaim neea rwr ae candbee r w w+�x is ror one nuneree edlas Isioo/ w bu.l . ❑ I cenh � in the periwmeMe d iM work la w1ic� t�n paimG ia bsueA. I ehell na emplq erry pe�ean in enY maruix eo av to berome subl� �e �he vrorkers' compeneeiion lewe W Celil ' d epree Ihel if I ehou becom 'q b �ha xorken' canP�vtion P�+iwu d Seeion 9]0o d ihe Lebor Code. I '• °" ' � oomPN xnh iMee m'' ' oa.� ' .�I�� noW�c Waminp: Fsllun b ucun worten'rompxwtlon coverep� Is unNwNl, andLWl �uD/�ct en wrployer ro erlMrW pwi�ltls� eM � clHl nnu w ro om hlnarM rlrouaiM eoll+n lst040WA M ME�tlon ro tM mr or rompwwtbn e+�p+ u pov/tlM ror In SscMon 8106 0l Me LMor COM, Infxssf, md ettomsy'� /w. CONSTflUC110N IENDING ROENCY: I hereby elfiim uiker peroXy M par'ryry ihm tMre ia e oonst�udan bMinp eparcy tor the �do�� a ine wax m...n�w ma a�� m a�•d (saa�, aw�. c:. c�. LENDEH'S NAME: LEN�Eq'3 ADDPE53: 1 cerlity Ihet I heve reeE I�is epdKd� � bde �MI ihe abova informetion is coneq. I pree to compy xnh ell ary eM couMy ardinenme eM etme lewe relatng io build'np wnsUuaion eed hereby euihor¢e repreeentalrvee W �hie dry lo emer upon IM ebova�mentionad pmpeM t«��o0emwr�.T1M WOODAF L � /� r A i Name . Dme: � I �� / SlpnaWre W Oxner/RBenVApplifanVConlretlor (5151de WP) Whne-Buildvq 8 Setety:OreerrFb; Cenery-Appirent: Pink-(ievenue; (3oldmro��emaea CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 082056 PLAN CHECK NO: N PERM NO: B Ot12056 GOVT: N SUPP: N CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/OFF SHEATH & REROOF W/COMP SHINGLES SQ FT: 4,250 CLAIM VALUE; 4,250,00 CALC-VALUE: 4,250.00 GROUP OCC: R-3 /U-1. COMMENTS: REROOF 2400SF RESIDENCE W/COMP. SMOKE DETECTORS REC� PER 94UBC *x�*iF�t+�*ie**��***�*at**��*x�*�t*te*�**��tat***�it**xit�**itx*�jt****� **�x*iFiF�it�x#��at�t�* Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE�• PROV; PARCEL: 14163401 ZNE: REF NO: PLANNING N TES> % �.�f� 1ElE 1E iE'lE if'IE'IE iE 1E 1E iE iE 3E 1E IE 1E 1E 1E if 1E 1E fE 1f 7E it 1k 1E IE iF if� if if ik 1f !f iE iE 1E iE 1ElElE 1E iE iE iE 1E 1E i(-if� 1E 1E iE 1E 1F'lE'lE'IE 1E 1E iE iE 1E')f 1E'lE iE 1E.iF�if !k 3E iE 1k if k!k iE 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: �� BUILDING APPROVEC� BY : APPLICATION ISSUED HY: !(� �E ik ik 1f� iElE if if if iE 1E itlElE iE jE 1E 1E 1FlE iEiFiF±FiF �f3F3F'iF'iF�fiF3F'if iF3FTf±F3f7F3F3FiF±E LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMHING ELECTRIC MECHANZC PERMIT 99.75 DATE: T�iFif iE iE iE 1E it iE if it iE�F�'iFi�"iFiFiFAFiE if STRUCTURAL SEGMENT:Y FIRE SMIP/R50 GRADING SMIP/NON-RES PLAN I55UE FEF. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 100.25 0,00 0.00 100.25 100,25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 100.25 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN-CHECK 99.75 .50 1E1f1E�ElE�EiE1EiFiEfFlEiFiF1F1E1ElElEikfflflEiE7l1E1E1EiElFiF1F1ElE1EiE1E1ElEiE1F1E1F1EfEiEiElFiFiE1ElEiE1E1E1EfFfE�EfE1EfE1E1E1E1EfE1ElFfEiE1E1EiEiEjFlFiEif I N D I V I D U A L F E E H R E A K D O W N TYP_E_ __QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 4250 REROOF BY VALUE RF.SIDENTIAL N07.ONE 1.00 4,250,00 END OF FEES 83-17-1997/11:46 pM/f1BA.25 PERMIT:T082056 CO��S�fION AND PL-ANNING . - . POOL & � � �8te Inspector� ' � Date Inspector APPROVALS Permit # � � APPROVALS Permit � 1. Temporary Elec[rical Service or Pole 52. Pool & Equipment Location � . , 2. Soii�Pipe-Undrgrnd. � � 53. Steet Reinforcement � . � ' ' �'3. �Electriral Conduit Utility�Undrgrnd. 54. Form's -�. . • . =�4. �Electrical Conduit:Undrgrnd. � . ' . . 55. Electrical�Bonding ' �5. _Ste'el Reinforcement 56. Rough Plumbing & Pressure Test - , ; 6? Electrical UFER Grnd. 57. APPROVAL.TO COVER�GUNITE - r7 �• Footings � . � 58. Electrical Conduit-Undrgmd. � � �'8. Foundation . ' .. _ � � 59. Gas Pipe, G -Uradrgrnd.,�Test ' � 9. Water Pipe-Undrgrnd. == " , � �60. Backwash Lines, P--TraP, Cl Undrgmd. '10. Structurai Roor System � - ' �.61. APPROVAL TO DECK , � �� 17. �Property 5ewer �i�e & House Connection --� .62. Backwash & Receptor-Final • 72. Sewer Cap � " ', � 63. Heater & Veni�Final . 13. Roof Drains � 64. Plumbing System - Final. , 14. Rough Plumbing ' - � -65. ElectticaLFinal ' '15. Rough Electrical-Conduit . 66. Solar System-Finai 76. Rou9h Electric Wiriny ' _67. Fencing & Access Approval �� i�. RoughWiringSign � . �" � '68. APPROVEDPOR�PLASTERING - 18. Rough Electrical�T Bar Ceiling ' - _ 69. POOUSPA SYSTEMS�FINAL 19. Rough Heating &=Air Conditioning �- ' FIRE�DEPT. REQU�REMENT - � Y. i - � 20.'Rough Facto�y fir.eplace _ '�:4 � : ,y i APPROVALS-, • Permit # ` '� � 21.�Ducts,in Structure�� •� _ ` -�� ` 7p."Uadergroup'd H_ydro r � . ,. 22. Ducts, Ventilating:' : �- ,- _. - �' ` � 77. Product�Piping OGas OO�I 23. Gas Pipe•pou9h & Test - . .� � 72, Underground Flu"sh- - - 24. Rooi Framing : "" '_ `_ _ �- 73. Undergrnd.Stora�eTank �Gas ❑Oil 25. RooESh_eathing .- -�, r� �' � 74.'Overhead Hydro • 28. T-8ar Ceiling (St*ucturai) & Monocoat � � - C:'., 75. Dry Chemieai � M . ' r 27.-Frameand Flashing �- � �� -.� �� 76. �DryStandpiper��w � 28. Lattiing & Siding,_ : �y:� = `. � �. ..� .. _� 77. PIXED;SYSTEM'FINP�L . - y T 29. �nsWation � •� • � 78. FIRE PREV. FIN'AL � � � 30. Drywall Nailing � i ' � HEALTH DEPT: REQUIREMENT _ _ r _ 31. Plaster Brown Coat, - -. � ,r - 79. FINAL WSPECTION 32. "Electrical Power Meier�Finai '' " 80: FOOD CERTIFICATE I�SSUED �. � �� - .. . -..- ,� . .-� 33. Pinal Electric. � � Notes: •• - �. - 34. Finai Heat�ng�& Air�Coniiitionirig" , , -'' - ' � ' : - 35.�FinafGasP�PerTest. � ' . , � • „- � _ =' ,•� . ,- 36. Hood or. CanoPY . = ' - -. � .. = . , ' • 37. F.inal Factory Fireplace � _. �� '. '`' � _� � • 38. Final Plumbing "' - -T = - � - - -'_ ' 39. Water Service�Final � � ' , .i. � '` T ' `_�^- . 40. GasService-Final .,� - __ � - . ' _ - - � 41. Solar po{nesticFinal - ^ ' • ° , _ " _ J _ 42. Backflow Preventer - r. � • � - � . - - � 43. Backflow Irrigation � � �. ; ' - `' . � ,- � A4. Landscape IrriOation System' �- .- _ ' - - ' •" ` ` �' - � - - � r. < - � .� . ._ _ �- - - - - .i >� � 45.;Sound Attenuation'. _ ' ., '- ; � My� L ,. _ �'�� . -46. Handicap.Regulatfons - � �� c ,... s I � = ,. 47. fINAL S7RUCTURE & BUILDING - -- _ � �' Yj/,. �j� _ ', ^ " � 1�48.�INALP4ANNING � r. � - -� 49. -Electiic Relepse to Edison " . ' � � ' ' ' 50. Gas Release to Southern CaGfornia Gas Co i -. - � r ' - � 51. CERTIPICATE OF OCCUPANCY � . - ' - - No Date • owrrER HARBOR HALL OF FAME HOMES, INC. DATE NOV; 0 1962 dOB ADDRESS 3158 Cork Lane BUILDING P�RMIT NO. 18��+2 GENERAL CONTRACTOR Lifetime Residential Bld�. Corp. VALU� $ 17,415.00 AP No. LOT TRACT �35g PIRE 7,ONE DESCRIPTION OR WORK R25.W St't.gAx'. INSPECTIONS ISignaturel DATE GROUP Ig� TYPE \7 ZONE R-1 Soil /j� j�>� / PFR\1ITS ISSUEP n_,... —�f T SUBCONTFACTOR .�.,,,.,� ,....,,...�.. � OCCUPANCY — . o, i A�I�o ' � 18342 COSTA MESA BUILDING.SAFETY DEPARTMENT P. O. BOX 317 COBTA MESA. CALIFORNIA For Applicani fo Fill In Complefely TYPE OR PRINT BUILDING 3�SD �-FlrK � ADDRESS V COSTA MESA. CALIFORNIA TEL. ■ ARCHITEC7 ■ STATE FEE R!E'CE�tIVED�� Lot 92, Tract 43�� lan b00-B I� FINANCESDAPM �A APPLICATION F�YP�v1G� sua�iw� For Offiee Use Only RECEIM NO. P61iM1T q0.. . _ / BY I DATF)RHCHIVED. I. DATC 1880lD COSTA MESA. CALIFORNIA FIRE ZONE APPROVED ZONING ��A� /� ZONE,�J ' I puN9 � BOILO HO e��'-'��`�� t _ EIZG c , NO. OF BLDG9. OF LOT VO� '' Now oN �oT O q, p, NO. `iZ�✓--- U6E OF YARDS EVES EXI6TING BLOG. � NOIIE APPROVED ALLO BETBACK LINE FROM (CENTER LiNe 8TJ __.�_., _< .,_.._.._ Sn � e�. e .,. e..�n _ sn � -- --- � — ILEFT� l�j� �RIGHT 6� DESCRIPTION OF WORK EXTERIOR WALL ROOF COVERING plyater GOVERING $}�a�CP USE OF BUILDING AND WORK TO BE PERFORMED I HeREBY ACKNOWLE�pE T AT 1 XAVE READ TX18 APPLIGTION AN� BTATE TH�T THE ((��B IS CORRECT AN� AGREE TO COM- PLY WITH ALL CIiY pRp CE9 A� A�{L.�W9 AULATIN6 BUILOIN6 CONBTRU�I� . / � ■ AUTHORIZED AGENT R. SI�E `E' L. SIDE � J ' REAR 3 G `S APPROVED � /�/J � —//� ��U—�.�D`r THE AMOUNT 9HOW UNDER VALIIATION IS POR TN¢ PURP08E OP EBTpBLI6HINp p PERM�T FEE ONLY. VALUATION /� '7 PERMIT FEE $ �/ / �� y�y N $ �� S PLAN CHECK $ ��!/ / �^ � iOTAL FEE Sd u