HomeMy WebLinkAbout3249 DAKOTA AVE - Building PermitsTUSTIN, CA
Owner: URAGAMI, ROBERT K TR
Address 3249DAKOTAAVE � �
COSTA MESA, CA .
Contractor. MC CORMACK ROOFING
AddreSs: 4091 E LA PALMA �, �
SUITE D
ANAHEIM,CA
Zip: 92807
Arch :
Address:
Phone:
� Zip: 92705
- , ' '..�' "
Phone:
Zip: 92626
Phone: 714-630-5543
License: 643700
- • . � :Eng-_"--•.— ' -_
Address:
Phone:
2ip: � License: - License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 1 LAYER OF 30tF FELT, 40 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS
NEEDED. 28 SQUARES.
FEE SUMMARY
Plan Check: $0.00
Permit: $125.25
SMIP Res: $0.54
SMIP Com: $0.00
Oth�r: $0.00
Inspection: $0.00
Total: 5125.79
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Fronl 0-0
ACCESSORY Front 0- 0
PARKING Existin : 0
Rear 0. 0
Rear 0-0
Reouired: 0
Lek 0• 0
Left 0- 0
Pr000sed: 0
Calc Valuation: 35,noo.00
Claim Valuation: $s,aoo.00
Right a a
Right 0• 0
.�Y� .,�"�' . _ __.
-• —,- � .__.*•_ --,.. —._- --
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within'i80�days, or if work is suspended or abandonad
tor a period of 180 days. ,__Y . ��. � ,,,, , _.
INSPECTIONS: In order for the wark authorized under this permlt to.be considered legal, such work must compty with all eppiicabte codes, and ell
requlred Inepectiqna�and final epproval.must be obtained. FaiWre lo obtain inspectlons and flnal approval will�result in the ezpiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545826
2abae la�ool
WOflKERS' COMPENSAnON DECLAFiAnON: '
I hereby eHirm untler penalry of perjury one of Na fdlowing dedaretions: , �� - , .
❑ I �eve end wlll maintain a certiticata ot consent to self-Insure tor workers' compensation. as DroWdetl br 6y section 3700 of the Lebor Cotle, br Ihe peAortnance ol the
work.br which ihis pertnii Is issued.
� r-r—'.
yr�l have tl wlll malntain woAcers'c� pensatlon Insurance, as required by sectlon 3700 of ihe Lebor CaAe, for Na perfortnance af t�e work br whlch NI pertnit is issuetl.
My w k rs' co e�¢?tion Insurar9e e rder�n) pol' num0er ere:/I (�/� }� �
,Carner: . 1�'�.1 4r\ � � )YU� `C Poiicy,N�mEer:I���"4��
(Tbls secNon need nOf bB Comp/eted il ( e perm�t �5 va/ued f�o�dollers (5100) Or /ess.) �i"'�"
❑ I cenity thet In ihe pedo nce ot Ihe work tor whiGi this pednli Is issued, I shell not employ any pereon in eny manner so es to become sub�ect to the workers'
compensetlon la ol C li mia, iW agree � e'I 1 should become subject m the workers' compensatlon pmvisions ot Se`tlqqq��� 3700 o the Lebor Code, I shali foMwlth
camply with e roW o s. � 1 1�'�, '
�Ap��aMSiqnatur � � ate:. 1 � �
'WARMNG: FAILUR O SE E WORI�RS' OOMGENSATION COV G IS UN WFUL ANO SHALL SU6IECT AN EMPCOYER TO CRIMINAL PE TIES CML FlNES UP TO ONE HUNORED
TlIOUSAND DOLLA (5100, � IN rtDqTION TOTHE W5T OF EN TION, AAINGES 0.5 PROVIOED FOR IN SECTION 3lOB OF iME LABOR CODE, IMEREST, M'D ATTORNEYS FEES.
LICENSED CONTR
I here�y aHirtn that I
CONSTRUC710N Li
❑ I hereby affirtn
Lentler's Neme:
Signature: _
CLARATON: '
1 Chepter 9(cammencinq with Sectlon 7000) of DiNsion 3 0l Ihe Busin Iessio Coae, antl my license is in tull
C'Gfasa.K"" - �
Lr—�Dete:-- �
ENCW. �
e construction lending egency br ormance of 1he work tor which lhis pertnit is issued. (Sec. 3097, CiNI Cotle).
Lenders ACdress:
Da�e:
OWNER-BUILDER DECLARA710NS:
I hereDy efllrm t�el untler penalry ot perjury Ihat I em E%EMP7 FROM T}tE CONTRAC70RS LICENSE LAW for Ihe following reeson (Sec. 7031.5. Business antl Pratessions
CoOe: Any city or counry which requires e pertnit to construci, alter, improve, demolish, or repair eny strucWre, pnor to its issuance, elso requlres the applicant for such pertnit
to file a signetl statement ihat he or she is licensetl pursuant to t�e provislons of Ihe ContreMors License Law (Chepter 9(cammencing wlih Section 7000) of Division 3 0l the
Business end Professlons Codej or that he or she Is e:empt therefrom and the basis for Ihe elleged eaemption. Any violation of Section 7031.5 by eny applicam tor e pertnit
su6jects 1he applicent to e civil penalry al not more than IWe hundred dollars (5500).):
❑ I, as awner of the properry, or my employees with weges as t�eir sole compensatlon, WILL DO THE WORK, anC the siructure Is not Intentletl or oMeretl for sale (Sec.
7044, Business en0 Professions Cotle: The Conirectors Llcense Law does not apply to en ownor of property who builds or improves lherean, and who does such work
himself or �erself or through his or her own employees, pravided that such improvements ere not intended or oHered for sale. If, however, Ne builtling or improvement is
soltl wit�in one year of comple�ion, the ownerbuiltler will �ave the burden ot proving tha� ho or she did not builtl or improve for purpase af sale.). �
❑ I, as owner of the properry, am EXCLUSIVELY COMAACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7046, Business ana Protessions
Cotla: The coniractors Licensa Law tloes not eppty to en ownar oi property who builds or Improves thereon, and who coniracts lor such pro�ea with a contrenor(s)
license pursuant to the Comractors License Lews.).
❑ I am exempt under sec.
SigneWre:
Owner ID venfieA by UnveYs licensa. ❑ Ves ❑ No
Business and Professions Code lar Ihis reason:
Venlication of Ownership by (rype of documeni, i.e. � property ta: �ill ar tleetl):
Drivers License No.
Dale:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICAiION:
❑ I hereby certlty ihet no excavatlon Ilve (5) or more leet In tlepth into which a person Is required to tlescend, wlll be mede in connection with work euthorized by this
permit, and Nat no builtling sirucWre, scalloltling, lelsework, or tlemolition or tlismantling thereol, will be more ihan ihirty-six (38) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Celifomia AdminislraWe Cade).
❑ As owner-builder, I wlll not employ enyone to do work which would require e pertnit irom Ihe Divislon of Indus�nal Sefety, es noted ebova, unleu such pereon hes e
permlt to tlo suc� work tmm the divlsion,
Siqnature: Date:
Divislon ol InAustrial Sefery Pertnit Number:
CER7IFlCATE OF COMPLIANCE AND AUTHOFiRJ1TI0N OF ENTFiY: I cenity unUer penalty of perjury that I have reatl t�is aDPliwtion entl stete thaf tha information given is
wrrect. I egree to compty with all state laws end Ury ortlinances relating to buil0ing construction, and eulhodze representatives of ihe City ol CoSta Masa to enter upon Ihe
ebove-descnbetl property tor inspection purposes. I agree not lo acupy or ellow occupancy ol eny building euthonzed by Ihis permit until linal inspection.
OE I, SPECTONT'PE ' "' '
16 xed System Final Fire Preventlon
1268 Pool Spa Finel
200 Final Re•Foot
201 Final Block/Retaining Well
202 ' Final Factary Fire Place
203 FinalSign
pp4 FinalOemolilion
��
�
��.1 JIII_
���_ uG I
_ ,
y� � �� � V\�
—� �d ate....,.
GOpE1 INSPEC710NTYPE ' • � `Q�¢, �$
208 Finel Mechanicel �
20B Finel Plumbing '
210 Finel Electrical '
212 Final Fire Preventlon
220 � '� Final Planning Approval
222 Final Site �
250 Final Building/Occupancy
PNOJECT qDOHESS: 3 2 Q
OWNEfl'S NRME: URAG
�q,sess: URAG
` 3299
, COST
�. 545-
AflCHIENGINEEH: LAND
aoosess: 12 0 6
AKOTA AV
, ROB RT KATSUMI
RUM
i{OTA AVE
ESA,CA 92626
K ENGINEERING
ALLEY VIEW ST
UNIT:
qEG.NO.: CQ
uNiT: 2 37
�t PERMITTEE: WILLECONS�TRUCTION CA 907(213)634-8729
PDDflESS: ZOZZ SILVA ST
LAKEWOOD CA 90712
LICENSEO CONTPALTOB OECIANATION: I here6y aflirm Ihal I am licensed un0er provisions al Chap�er 9(commencing wil� Sec�ion
7000� ol Oivision 3 0l the Business antl Pmlessions CoOe. antl my license is in full lorce tl eifect.
c�.r uc.: 0517u43 ps�T'aT'e uc.:506599 — cuss:
Da1e: � �="l —� Signam�e: _ 1
WONRENS' COMPENSATION OECLAflATION: I A¢r¢�y alli rt ai I � a /cr�etlilicate of consen� to SelFinsure ar a ceriilicate oi Workers'
Compensaiion�,�r�yco of A�Q;�e� ;yOY �e11"ol (Sec��E%P. ORTEab. V�9 � O 1/ 91
POLICYNO.: WYy 9Zf � •�
comranr: FREMONT ,Y
❑ Cetlili¢a [opy is �ere�y fumi5�e0. Ln C¢rii�i¢4 CaOY i- wi�� Ih¢ ly Pyr%ing Oihsion.
oare: l 2— y�� noai�c r' -- , r��
�
EXEMPTIONFNOMWOFNENS'COMPENSPTIONOELNPATION: �This etUonneeAnolbemmpl¢feCi�IhepermAiS�aronehunCr¢0�E11p�orle55).
I cetlity I�al in ihe pedormance of the work for w�ich t�is pem i rs issuetl, I shall no� employ any person in any manner so as to berome
Su�le�� �0 Ihe WOIkCR' COmp¢n5dli0n LawS o� Cdli�Ofnid. '
Oa1e: SignaWr¢:
NOTICE: II. aller making Ihis declaraiion, you should �ecom¢ sublect �o Ihe Warkers' Compensalion pmuisions ol Ihe Labor
CoEe. you musl Iotl�wii� COmply wilR Sut� pmvision5 Or Ihis permil 5�a11 be deemetl revoked.
CONSTflUCTION LENOING pGENCY: I hereby aflirm Ihat Ihei¢ is a conitNc�ion lentling aAency lor Ihe pertormance ol the work for
w�ic� ��is permi� is issuetl �Seclion 3097. Civ. C). ,.
lENOEN:
nooness:
OWNEP BUILOEN OECLABATION: I �ereby ailirm tnai I am evempt iwm ihe Contractors' Sta�e License Law for Ihe following reason
(Section 7031.5 Business antl Protessional Code: Any city ai couniy w�ich requires a Dermit to consimct, alier. improve, tlemolish, or
ie0aii any 5lmclure. prior Io ils issuance, also repuires Ihe applicanl for SucA permi� �o �il¢ a 5igneU s�a�ement Ihal h¢/she is licensed
oursuam w ��e pmvisions oi ihe Com�acmrs' Stale License Law (C�apter 9(commencing vn1A Section 7000) oi Division 3 al t�e Business
antl Piolessions CoOe) ai ��al �e/she is erempl Iherefmm anJ Ihe Oasis lor Ihe allegea exempiion. Any viola�ion ot Seclion 7031.5 Uy
any aD0licanl lor a permil su�jetls lhe ap0���ani �o a civil Denalty oi nol more than five hundreA tlollars (5500�.
I, as owner ol �he pmpeny ar my employees wilh wages as �heir Sole compensa�ion, will tlo the work, antl Ihe
❑ slmclme is not inlenaeC or oifere0 br sale (Section 70aa. Business an0 Pmfessional Cade: The Conlraclors' Sla1e License Law
tloes nol ap01y lo an owner o� a pmDetly who builtls or impmves �he�eon, an0 who does such work himselllhersell or ih�ouBh
his oi �er own employees. pmvitled ihat suc� improuemenls are nol intendetl or oflerea for sale. II, however tAe 6uilding or
impmvemenl ls sol� within ane year o� comploiion, Ihe owner will have Ihe burtlen of pmving he/sha tlld nol build or impmve
lor ine purpose ol sale).
I, as owner of ��e pmperry. am exclusively contracling wiih licensetl conVactors lo wnS�mcl the pmleci (Sec�ion 7044, Business
❑ an0 Prolessions Code: T�e Contraclors State License Law Qoes no� apply to an ovmer of Dwperiy w�a UmIAs or imprwes i�ereon
and w�o comrams for such pm�ecis with a comractoqs)license Dursuantio the Conlraclors' Sta�e License Law�. I am aware
I�al Orooi of iheir Worker'S Comp¢nsaiion insuran[e 5hou10 Oe O�a�itl¢tl �o me.
� i am exem0� untler Sec�ion: B. 8 P. C.
lot Inis iea50n:
Daie: Owner.
I tlo �ereby cendy ihat I am aware ai antl un4ers�anC ihe repuiremems ol Califomia Health and Safery CoOe Sections 25505, 25593, and
25534 anJ inat I or any IUWre Ouilding ocapant willlwill nol �circle one� need lo comply wit� said state cotles and t�e reQuiremen�s lor a
permil far consVuc�ion or modilica�ion Imm Ihe Air Ouali�y Managemenl DisVict. Fesidentiai wnslmc�ion aOPlicalions are exem0� ��om
Ihese pmvisions.
Dale; Apnlicam',
1 �ereby cetldy ��at I �ave reaa Ihis applicalion antl slate �hal Ihe aGove inlormalion is cnrr¢cl. I agree to compty wiN all cily antl counly
ortlinances anJ slate laws relating lo bwltlmg conslmclmn antl �ere wlhorize rep sent+ es of �his city �o enier upon ��e abave�men�ionea
pmperiy lor inSpeCIlioln Durpo5e5
Date�J%--1—�0 Sigre�i�..__
Driver's �mense or Soc�ai Securny r:
t6a�-a6 Wbite—Butl�ing�, Geeen—Cotle Eniorcement: Canary—ApPI¢anl: Pink—Revenoe; Goltlenrotl—Assessor
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: BE
PERMIT NO: BE 050160 PLAN CHECK NO; 06567-90 L GOVT; N S PP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE STR PURPOSE: ADD
JOB DESCRIPTION ; 946SF RESID ADD, 242SF iST FL, 704SF 2ND SQ FT: 946
CLAIM VALUE: 37,000.00 CALC-VALUE; 65,279.00 GROUP OCC: R-3 /
COMMENTS: 704SF 2ND FL ADDITION
*+��r**�r���r�r�r***�r�***�**���x�*�r**+��e*��**�r*****�r**�*�r**���*�r�x �r**��r�*�****+�**�r**x-*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: 20 FT IN REAR; 46 FT IN FRNT; FT IN REAR; FT IN
LEFT; 3Z FT 6 IN RGHT; 10 FT IN LEFT; FT IN RGHT; FT IN
PARKING REp • PROV; PARCEL: 13906608 ZNE; R1 REF NO:
PLANNING N151'ES> PROPOSED 946 S�.FT. FIRST AND SECOND STORY ADDITION
> TO EXISTING S,
*�***x���***��r�*�e****�r�r***�r�r�r***i�**�*� *�*�*��r���r*+r*******�r*�*�r****x*�r��r****��r�**
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T S
ZONING APPROVED HY : �I DATE: / -
HUILDING APPROVED HY : � DATE:
APPLICATION ISSUED BY; DATE; /�-
*****�r�r�r*�******�r**�*x �r���***��* �r�
IFiFiEklflf�Elt�tlElf)fifMifiEiElFififiFiPkiFfEiElkilk�EiElE3fiFiElk iE iEklE*iF�l�F�flEfEiPiflfiElEififiEifiEiFiE1FlEifklk�lFiEiElE�F�EitiE�Eiti4iE
LEGALIZATION:N F"E E U M M A R Y STRUCTURAL SEGMENY';Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 486.50� 13.50 4.57
SOY SMIP/NON-RES
ISSUE FEE 316.23 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECR TOTAL PAID DUE
TOTALS----> 504.57 15.00 316.23 835,80 835.80 .00
REVENUE DIVISION TOTALS--> COLLECTED: 519,57 OVER/SAORT: ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECIi
486,50 28.50 4.57
iE aE �Elf !f 1E �If 1f if �F 1f if iEiFiE iEiE iE 1f �f �F if iF �E 1f iE 1E 1FIE 1E M Ik if M if 1f �F�f iE 3f if iE iE k 1f if IE if 1E iF iE iE if iE if if 3k IFif iEif 1E �F iE �)E if if �E jf iElE�lk �IE�EiF dE if �f �F
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 946 DWE-TYPE V-WOOD FRAME -GOOD 69.00 65,279.00
ELE 3 FIXTURES LIGHTING 1 ST 20 EA. .75 2,25
ELE 12 RECEPT/OGTLET 1 ST 20 EA, .75 9.00
ELE 3 RECEPT/SWITCH 1 ST 20 EA. .75 2,25
END OF FEES
V
a�. uno�s��.�-a�or�a�� �r��- =.4.:;
DATE� 12/�i/4il T.T.tiE: �]9:35
CONST�iOCTiC�I AND PLANNING POO� tL SPA
APVR'OVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. 1�emporary Electrical Servi6e or Pol� , 52. Pooi & Equipment Location
2. Soi�Pipe-Undrgrnd. � "'� `�� - 53. Steel Reinforcement �
�_�.-:.�. - �� _ C>'
..o� . �-...<,, i�
:.Efearical'CondWt.UUlity�Undrgrnd- -= - 54. Porms
%� 4iz Iecti�ahConduit-Undrgmd. � 55. Electrical Bonding '
� 5 �L
�: - � ,�:..:; �- . _! _qa 6wl!
r 5:- SteeljReinCqrceri+ent- � 56. Rough Plumbing & Pressure Test
�_ 6:�lElectric5l�UF:ER �nd. �• 57. APPROVAL TO COVER•GUNITE
'�'- r -n- ..r.�
17�'Fo4oting5�'`�"'' � �1�� Q� 58. Electrical Conduit-Undrgmd. . -
:>8•, Founda[ion� i- � � Z:`r-Q �' pt�- 59. Gas Pipe, O Undrgrnd., Test �
,..n
9. Water Pi�e%Undigrnd. . 6�. 8ackwash Li�et, P-Trap, � Undrgrnd.
.�. .,
10'�. Structural'Floor System �:. 67. APPROVAL TO DECK
1�1�; Prop�rty Sew'ir Lin�& Ho�e Conn'ection ^ 62. Backwash & Receptor-Final �
12. Sewer Cap � �, ��� a 63. Heater & Vent-Final
13. Roof Drains�� 64. Plumbing System - Final
14. Rough Ptumfiing `� 65. Electrical-Finai
15. Fiough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electric W�ring 67. Fencing & Access Approval
17. Rough Wir,ing Sign 68. APPROVED FOF PLASTERING
18. Rough Electrical�T Bar Ceilin9 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- ' _ ' ' ' _.A:-' , r....�.
20.'Rough Factoyy FKeplace � ���'' �x �- = - i'- • .qppR�VAL•5�=:-Permit # �� -
i �J ?.'� I�L� U'�•• .;i - --• r� J G.��I i 0..^•"r :
� �� > .c - ' � . i� .c �.
21. Ducts, in-Structur;e a � •. .• ' ,�: � � :70. Underground:Hy�ro ��
22. Ducts, Ventilating:, -- - `r = �r �.":r77 producf`,Pi°ping OY'ias OQiI
23.`;Gas Pipe�Rough & �est � "��' � ' . ;r J �z; •7? � 72. UndergroLLnd Flush�cc �•
24.'floot Framing� �=k � : �.- ^ - ;� �, r' ' `,73.=Undergrnd'Storag"�7enk OGas OOfI`� � -
`: Y �' � N 'l � i � ` ` �J 6 y. . .i
25. Roo,L Sheathing r * = n - •> ��74. ;Qverhead Hydro_ � ` ,.,
26�T-Bar Ceiling (St��ucturall &'Monocoat �r� ^' _ � �' � 75?pfy Chemical - .0 � .' �T�, T r
27:"FrameandF�ashing;� ''.�_, ' _ „ ,,.4''" 76'JDiySiandpipe � '`_'1'�
� ��
� � :..- - ' � -
,`-26.'Lathing&Siding�r;: :.(;z r:o..-> • �i -��* 77.YFIXEDSYS�EM-F�NAL' ?T� �..
}29. Insulation " _ K � �� �� �� ' - . ' - � �� �'f x'� 7gy FIRE PREV`FINRL �r _ .. l ��; �
��30. DrywallNailing r� ���i-� .+" -' � ' •� 1'a ". \. HEALTH^DEPTtREQU1REMENT
}37. Plaster Bcown CAatz i ,.,,. .�y`� "`-I . � �� '_ ,.79."FINAL INSRECTION; 'x' � ' '
' �, >� � �. - �. �, = -�-
32.-Electrical;Power �Metef,;Final, • ._ I ! �, _ �, . � O.:�FOOD CERTIFICATE ISSUED . �
..33�Fina1 Electric F .,� � ,y I �� 'N tes:. � � � ��' _
;. � .' � . . . . . . � - � ..-.. � . � _
•34.-FinelHeating_&Air;�Co'nditionir�gc ��m • . �zu.�� . ��,�, . � . _
� �' _ r
35. �Final Gag PiPe-Testv ;.X I . � r ;. � , - ��`" _ _ " .r -
r� �r. o �,
,y36�Hood or`CanoPY � - � ^. �; . �. n ,��j
-37.-Final Factory Fireplace =="� :�=: . . , ', e w. :: • c�oe:-*
r. o e e I �° r. y ;z: c_
�`38..Fina1, Plpmbing > � � .. .. �c,� • i f � \ r-- .r �
�
. 39. �Water Service�Final� ,y. � 1 _ • v � � � :K r , � � �' • x �
r ••Y, T1
�40: Gas�Seryice�Final ° ,; �r,,r.r .� - � �r, � �. . � �. � `.
t '
�.41:<Solar pomesiioFinal 5 ••n. - I { � -".h : �
+ .r - 1.
42. Backflow Preventec; � ''' '�� "' ; � � `-",� ; - - .'
L C I rr > .0 >•_ _ .
43. Backtlow Irrigation- v �:` � � * ` ''= -� � _ �
� « � n; i` -
a' s � ..�i. . :r
�44. LandscapelrrigationSystem;,;.'�' . , - - -. �.'.� ti • .. -' �1 er_ _•�
• 45 ::Sound Attenuauon - •r • ' � ' • ' -
r n . . �
�46: Handicap;Regulations '- ``-' �' '`� . . ... ' ���: ",:� - _ .,
47. FINAL STRUC7URE & BUIiDING ^ � �h � � ;�;:�;� " '
( . T° �i' �,
'48;.FINAL PLANNING . � : ``. ��� 1' .
, r .
49 :Elecfric Release to Edison , �, � : � ' • , „ �i^ _ • � .
=50. SGas jielease to Southem Califncnia-Gas Co x ' ?� � ' -�; ; ;� `= _ . �, ;, . . .'
_`51. CER7IFICATE OF`OCCUPANCY . . y ." ; ti '� � = - - ^
No, Date
PHOJECT RDUflE55:
OWNEH'S NRME:
Aqj7flESS:
•
• : .
, RO�ERT KATSDMI
A MESA,CA 92626
UNIT:
RPCNIENGINEEH: LANDMARIC ENGI1vEERING NEG.NO.: CO
noowcss: 12062 VALLEY VIEW ST u"�T 237
GARDEN GROVE CA 90712
PEflMITTEE: yjILL CONSTRUCTION i213)634-8729
aoosess: zaZ� gILVA 5T
LAKEWOUD CA 90712
IICEN5E0 CONTHACTOfl OECLPFATIaN: I �ereby aifirm thai I am licensetl untler provisions � Chap�er 9(cammencing wiih Section
7000� of Division 3 oi 1�e Business ano Proiessions Code. anU cense is in lullforce a efiect.
cirr u�c.: 0 S� �1j7�4 q3 sTnrE uc.: 5 0 6 5 9 � cuss��
�ate: _��__-/_—�! Signam . ,�
WOBKEflS' COMPENSATION OECLAflATION: I he y a�hr th �ave a certilicale o� consen� �o sel4msure or a ceriificate o� Workers'
Compensalion n ra c or ie py e 7(Sectio 00. Lab. )
roucvxo.:���$b4�����—�L E%P.ORTE: 9�OSI9I
comvaNv: FREMONT
❑ Cetlilied copy is hereby Iumishe0. � Cehilied copy is � 9 wiih ��e city BuilOing Oivlsian.
Oate'.�y=��__ Applicant
E%EMPTION FROM WOflRFflS' COMVENSATION OECLAH ON: (i 55etlion nee0 noi be tamp¢Ietl it Ne permi� is �ar ane hundred ($100) or 1e55).
I certify Ihat in Ihe performance oi �he work lor whi �his per t is' suea, I shall no� employ any person in any manner so as to become
subleci to Ihe Warkers Compensaiion Laws oi Ca omia.
Date: SignaWre:
NOTICE: If. a�ter making ihis Declaration, you shoultl become 5ublecl to Ihe Workers' Compensa�ion pmvisions o� �he Labor
Cotle. you musl �ort�viiih comply wiih suc� pmvisions or Ihis permit s�all be Oeemee revoked.
CONSTflUCTION LENUING RGENLY: I hereby aliirm Iha� there is a consimttion lending agency Ior �he pertormance ol �he wark tor
whic� IAis permi� is issuetl (Seclion 3097. Civ. C�.
LENOEH:
PODFE55:
OWNEP BUILDER OECL!'BATION: I hereby a�lirm Iha� I am exemp� imm Ihe ConVac�ors Sta�e License Law lor Ihe following reason
(Seciian 7031.5 Business antl Pmiessional Code: Fny tiry o� caunry which requires a permit �o cons�mc�, aller, im0�o�e. Oemolish, or
repair any Slmclure. prior �o i�s issuance, also requires Ihe app6cant �or such pErmii to file a signed s�atemen� ��at he/she is licensed
pursuanl to Ihe pmvisions of Ihe Con�mctors' S�ale License Law (Chapler 9(commencing with Section 7000) o� Division 3 of Ihe Business
anU Pmlessions CoOe) or �hai �e/she is eKempi Iherefrom antl Ihe basis tor I�e alleged exemp�ion. pny viola�ion o� Seciion 7031.5 by
any apDlican� lor a perm�t su�lecis ihe ap0licanllo a civil penalry o� noi more ihan live hunOred tlollars (E500).
I. as oviner ol the pmpetly or my employees with wage5 as Iheir sole compensa�ion, will tlo �he work. and �he
❑ 5�mctureis noiinlentletl oro��ered lorsale (Seclion 7044, Business antl Pm�essionalCode: The Con�ractors' S�aie License Law
tloes not apply to an owner ol a pmpeny who huilds or improves ihereon, antl who does such work himsell/herself or t�mugh
his or her own employees, provi0e4 tha� such imvmvements are nol inlendetl or oiferetl for sale. Ii, however ihe 6uilaing or
improvemen� is sald wilhin one year ol complelion, the owner will have �he bur0en of pmving he/she Oitl not 6uild or impmve
Inr Ihe purpose a� sale�.
I,as ownerof�he property,am exclusively conVac�ing withl¢ensetl contractorsto constmcl�he pmject�Section 7044, Business
❑ antl Pmlessions Code: The Coniractors' S�ale License Law tlaes no� apply Ia an awner of pmpetly who builds or impmves thereon
antl who cantrac�s lor such pmjec�s with a conVacior(5)license pursuanl�o �he Contrac�ors' S�a�e License Law�. I am aware
Ihal pmof o� their Workefs Compen5aiion insurance shoula be pmvidetl �o me.
� I am exempt under Section: B. 8 P. C.
lor Inis reasan_
Oale: Ownec
I tlo hereby cenily �hat I am aware ol antl understantl ihe requirements ol Calilamia Healt� and Safery Code Sections 25505, 25533, antl
2553a antl Ihat I or any fNure builtling occupanl willlwill no� (circle one) need Io comply wi�h saitl state cotles antl t�e requirements for a
permit for consimclian or modilication Irom �he Air �ualiry Management DiSVic�. Resitlential conSVuc�ion applications are exemp� �mm
�hese p�ovisions.
Dale'. ApplicanL
I hereby ceriify Ihat I have reatl this apPlicaiion and s�a�e ihat ihe a�ove informalion is c recL I agree �o comply wiih all ciry antl counry
ortlinances and slate laws relaiing Io builtling conslmc�ion and �ere author¢e i resent ives ol this city�o enter upon Ihe a6ove-mentioneU
pmpeny for inspectian ourposes. � /
/ �/
Daie: � — / �` �i SignaWr D
Driver's license or Social Searity p: [�]. . $ :
164P46 WOite—Bulltling: Green—Cotle Eniorcement Canary—Apphcanl' Pmk—Revenue: Golaenrod—Assessor
/
CITY OF COSTA NESA — HUILDING PERMIT PERN. NO; M 050606
PERMIT NO: M 050606 PLAN CHECK NO: N GOVT; N SIIPP: N
CONSTRUCTION TYPE; 5—N PERMTi TYPE; MEC FURPOSt: OTH
JOB DESCRIPTION ; 946SF RESID ADD, 2425F 1ST FL, 709SF 2ND 5(� FT:
CLAIM VALUE: CALC—VALUE; GROJP OCC: R-3 /
COMMENTS: RE: BE50160 PRIMARY BLDG. FERMIT,
*+�*�x *�*±c*x**�r�t�*���*#*�*�t**�r�����rt�****atx���� i�***�+t��t;r� u�����r*�*��*+ru �t�x�*;�u�*�,*�r*�
Z O N I N GS ERTEH�AJCIxRSE M E i3 T 5
------------ MAIt�1 HUILDING ---------- --------- ACCESSOkY BUILUING ---------
FRNT: FT IN REAR: FT SN FRNT; FT IN REAR; FT IIv'
LEFT: FT IN RGiiT; FT IN LEFT: FT IN RGHT: FT ZN
PARKING RE • PROV; PARCEL; 13906608 ZNE; REF NO:
PLANNI[JG N T'ES>
� •
jE 1F iE 3F iE if # iEiE �1F if �lE if iE-M� iE i41f iE iE �)f jE �!F if jf IF �lf if iF if iP 1f #�]! iElf 7f if iF?E �lf� �lE �If 7F if fE iE-lE 3f ik jf +E IE 3f 1E 1E iF 1F+.f *'h fF �E jE # 1E iF it ?F 1!� 3F iE iF 3E iF �➢(� �)F ib iF
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 E N T S
ZONTNG APPROVED BY , ATE:
BUILDING APPROVED BY ; " DATE;
APPLICATIUN ISSUED BY;�; •� DATE• — / `/;
iF3fif�7ElfiFiE3Eih-lEiEiE�t'iFiFiFifiEiEifiE�1F � it �� h 1f�?EifiEiE3EiEifiEiF 1 � leif
aF)EiFiffE�EiF3FifjEiEiE*i(�if3FiF36iEiEjFjEiF3fftjfiFif3F�)fif�fif3EiEiFiE iiEiF'� 3(�aEiEiS�ifi4iklEiEifiFiFiFjEfkiE3E3E3Fi€iElE�E3ElFiE3EifiFlEjFiEiEif3f�EiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 13,50
25: S@RIP/NON—kES
PLtW
ISSUE FEE 15.00
BUILDING—DIV-> PERMZT ISSUE 'PLAN—CHECK TOTAL PAID DUE
TOTALS----> 13,50 15.00 0.00 28,50 28,50 ,00
REVENUE DiVISION TOTALS--> COLLECTED• 2B,50 OVER/SiiURT: ,00
BLDG PMT PLUMBING nLECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
28.5�
IE �If iE I6 3e �If iE )F!E if iFlE iE �E �lf aE iE iE iE iE iE iE # 3P #F iE if if �)f iE ff iE if iE iEif iE if iE * iF 1E � iE 3E iE iE IE iE �E iE 3f �F ?f If 3F 1E iF if if 3E X jE #f 1c iF 1f IF �1F 3f !E �F iE #f if -7f ?E 1E?f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E 5 C R I P T I O N UNIT COST TOTAL COST
MEC 1 REPAIR/ALT HEAiING UNTT/SYS W/CNTLS 9.00 9,00
MEC 1 INST /REL APPL VENT NOT UNDER P�.RMIT 9.50 4,50
END OF FEES
9
Q� UJ'J[1Vi'�t'LuJ7(L]�f TS�� V �ej�l
CATE: tti; N,i9? TI�F: Gb':3�
CONSTRUCTION AND PLANNING- P� �' SPA
APVF:OVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. �Cemporary Electrical Service or Pole : 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. ' � " 53. Steel Reinforcement
3. Electrical Conduit Utility-Uridrgrnd. '" 54. Forms
� 4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding •�
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �
' 7. Footings i 58. Electrical Conduit�Undrgrnd. �
8. F,oundation _ ' ' 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. '� . 60. Backwash Lines, P-Trap, O Undrgrnd. '���
�:
10. Structural Floor System ; 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection .; 62. Backwash & Receptor-Final . �
12. Sewer Cap . • 63. Heater & Vent-Final
73. 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 ApP�o�al �
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. Rouqh Factory Fireplace APPROVALS Permit #
21. Dutts, in Structure -' 70. Underground Hydro
22. Ducts, Ventilating .71. Product Piping O Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing •73. Undergrnd.StorageTank OGas OOiI �
25. Roof Sheathing ' � ,� 74. Qverhead Hydro
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � i i 77. FIXED SYSTEM FINAL
29. Insulation � �� � 78. FIRE PREV. FINAL
30. Drywall Nailing ' �' ��' HEALTH DEPT. REQUIREMENT
i ,.� .. i
31. Plaster Brown Coat, ' � i_' j 79: FINAL INSPECTION
32. Electrical Power Meter�Final � i��..� S0. FOOD CERTIFICATE ISSUED �
33. Final Electric � � j� ' Notes: �
_r- .
34. Final Heating & Air Conditioning ,��5 ey1 j �I�, � �
35. FinalGasPipe-Test' - ' /� ��1"' , '
A. . �A '
36. Hood or Canopy � :��` �� j'
37. Final Factory Fireplace i � �;� �
38. Final Plumbing � I � �1 �
39. Water Service�Final i '� ' '
I
40. Gas Service-Final ! ' I ,
41. Solar pomesticFinal � �
42. Backflow Preventer � �
43. Backflow Irrigation � '
44. Landscape Irripation System � .
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING � �� i
48. FINAL PLANNING � �" �
49. Electric Release to Edison � I"�
50. Gas Release to Southem California Gas Co � i C/,�
51. CERTIFICATE OF OCCUPANCY ,
No. Date
Lot 60
Tr 3722 12�� �
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. 807( 917 C08TA MEBA. CALIFORNIA
For Applieant fo Fill In Completely
TYPE OR PRINT
COSTA MESA, CALIFORNIA
0
TEL.
TEL.
SIZE G NO. OF BLDGB. O
OF LOT 1J SX1OO NOW ON LOT
6eio�GK LJN! PPOM SO � REAR YARD ZO �
C[NTBR OP BTREBT
SIDE VARD I LEFf J, I RIGHT IO j
I DESCRIPTION OF WORK -
EXTERIOR Wgt�J}�CCO I ROOF WOOa Jn1I1g�E $
COVERING COVERING
U9E OF BUILDING AND �MORK TO BEPERFORMED
Sin e r mil Re idence
and Attached Garage
Plan 6-B
I HeReBY ACKNOWLEDGB TMAT 1 HAV¢ READ TXIB MPLIGTION
AND BTATE TNAT TXE ABOVe 16 GORRECT AND AGNEH TO COM-
PLY WITH ALL QTY ORD�NANCEB AND�T ATE LAYl6 FiEGULATING
BUILDINO CONBTR�� N.�, / � „�
i'
SIGNATURE OF /i ��. � k p.�..� iry „n
� Al1THORiZED
FEE RECEI�lED
U �i3—�G—�
fINANC DEPT.
��PLIOAT�I,ON;�Qji ;,PERMIT
eua�iN�
For Office Use Only
REC8IPT NO. PlHMIT �
DATE
BUILDlNG
COSTA MESA. CALIFORNIA
FIRE
aoNiN�
ZONE I NO. OF I UBE OP NEW�
R�1 PLANB 2 BUILDINO j.T att
LEGAL
oescx�rrioH T.nt 60. TI'ACt i72'2
a. P. r,o. none
YARDS EVES
APPROVED ALLOWEO
(CCNTeR LINH BTJ _
APPROVED
TH¢ AMOUNT BXOWN UNOER VALUATION IB FON THE
PURP08E OP E9TpBL�BNING A PBRMIT pEE OXLY.
VALUATION /
$/� ��� j PERMIT FEE $ ��CJ'-'�'
� PLAN CHECK $ /Q �
"'"' _" .. � '���-