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HomeMy WebLinkAbout1109 DANA DR - Building PermitsCITY OF COSTA MESA BUILDING DIVISION iA$ 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 - Fax (714) 754-4856 • www.ci.costa-mesa.ca.us v FOR INSPECTIONS CALL: (714) 754.5626 PERMIT NUMBER: B09-00136 PERMIT TYPE B ROOF2 STATUS:. ISSUED APN: 41207421 DATE ISSUED: 07127/2009 ISSUED BY: BJK JOB ADDRESS: 1109 DANA DR CM Suite/Unit: Vicinity: Squares: 500 Valuation: $4,000.00 SCOPE OF WORK: REMOVE/REPLACE SIDING (ICC #ER1410) AT AN EXISTING SFD. 1 LAYER 40# LATHE, METAL EDGING AND SBS ASPHALT SIDING. 500 SO FT OWNER: HIRATA, DANIEL J Address: 1109 DANA DR Unit: PHONE: City/State/Zip: COSTA MESA, CA APPLICANT: SHUR, TIM Address: 344 ROOSEVELT AV Unit: PHONE: 805-647-2813 City/State/Zip: VENTURA,.CA CONTRACTOR: SHUR ROOFING COMPANY License No. 386491 Address: 344 ROOSEVELT AVUnit: PHONE: .805-647-2813 City/State/Zip: VENTURA, CA 93003 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $97.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $98.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9228, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE i. INSPECTION TYPE DATE INTMALS CODEC INSPECTION TYPE DATE INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Slock/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site S1 �J' ` n 1c OW�} 204 Final Demolition 250 Final Building/Occupancy l� tid�ZS •TI9 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 work for which this permit is issued. I 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 Insurance carrier and policy number are: Carrier 57-,-11Fe-ti0 (This section need not be completed tl the permR is valued atone hundred Collars (8100) w less) Policy Number: CP 3 a ❑ 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 L shall forthwith comply with these provisions. Applimnt'sSignature Date � 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 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 affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and 2_ Does or will the applicant or present or future building occupant need to file my license is in full force and effect. q a registration form for acutely hazardous materials? El Yes El No LiC # _> 3 9 l ! f Class (Section 25533 of the California Health and Safety Code, with some /'� / q exceptions, requires registration with the Costa Mesa Fire Department by Int l� 7 Z_7/C) / each business which at any one time has on hand a quantity of acutely Cpmraadr s'Signawre 'Datehazardous 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ 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). Lender's Name: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. �:.Tkes. Verification of Ownership by (type of document, i.e. - progeny tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet 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. Applicant's Signature Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be fled 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). Lender's 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 for a 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. 7044, 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: 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. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ 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 ❑ 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 orie al Ownegs) �f Date p� 30576 (3/07) Signature Date (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Job Address: 1109 DANA DR Suite: Vicinity: RESIDENCE & ATTACHED GARAGE. PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/13/1999 Issued: 04/1311999 ParcelNunmber: 41207421 Zoning: R1 R1 ISSUED BY: Applicant: SHUR, TRACEY Address: 2307 VAIL AVE Phone: 310-370-0703 REDONDO BEACH, CA Zip: 90278 Owner: HIRATA, DANIEL J Address 1109 DANA DR Phone: COSTA MESA, CA Zip: 92626 Contractor: SHUR ROOFING COMPANY Address: 2307 VAIL AVE Phone: 310-370-0703 REDONDO BEACH, CA Zip: 90278 License: 386491 Arch : Eng: Address: Address: Phone: Phone: Zip License: Zip: License: SCOPE OF PERMIT REROOF: T/O EXISTING ROOF TO SHTG; RESHEATH WITH 1/2" CDX PLYWOOD. REROOF WITH PROTEX SHAKE/SHINGLE. 31 SQUARES. ICBO #ER -5492 (5.8# SQ FT). FEE SUMMARY Plan Check: $0.00 Calc Valuation: $12,000.00 Permit: $187.25 Claim Valuation: $12,000.00 SMTP Res: $1.20 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $188.45 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 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) 7545626 DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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 work for which this permit Is issued. [� I 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 work8rs'{�p mpens tion Insurance carder and policy number are: Carrier: �Srt�7P �U/'Y� Policy Number: (This section need not be completed if the permit is valued at one hundred dpllars ($100) or less.) ❑ 1 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 p visions. Applicant Signatur . Date: WARNING: FAILURE TO SECURE WORKE(1 COMPENSATION COVERAGE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDTI N 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 affirm that I am licensed un r pi.si sof Chapter 9 (commencing with Section 7000) of Division 3 of the Business��nd Professions Code, and my license is in full force and effect. Lic. M V Class Contractors Signatur Date:/ CONSTRUCTION LENDING AGENCY: ❑ 1 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 em 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 for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).): ❑ 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. 7144, 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. 7044, 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 contractors) 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. ❑ Yes ❑ 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: ❑ 1 hereby certify that no excavation five (5) or more feet 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: 1 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? ❑ Yes ❑ 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). 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. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a parmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ 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 ❑ 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. ignatu f egal Owner(s) to And/Or Authorized Applicant Date CODE I, INSPECTION TYPE DATE 7LDmALs CODE I INSPECTION TYPE p INTITALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof If -1 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2""6 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. (CITY OF COSTA MESA PE MIT NO. TRACT O. LOT NO. BLDG. NO. 'CONSTRUCTION PERMIT ► -22oC- Address 114 ,&Lrla wive, Arch/Eng. License No. Address Contractorml- IhV I AfP�[xY?YS h/. Phor Address 10 I 14:. T)Tf T v�. .ICENSI5D CONTf2ACTOR DECLARATION T- hereby affirm that I am licensed under provisions of C nen ting with -section 7000) of Division 3 of the Tofessions Code, I nd IIc5nse is In full rcj n s / Lc eN PIMP,e Signatuj -1 )- NORKE S' C ENSATION DE AR ATION - hereby affirm that I have a Certificate of consent o :ertificate of Workers' Compensation Insurance. or\ TYPE OF COrTRUCTION L= - ❑ NEW VADD I] ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER 11 DESCRIPTION OF WORK TYPE OF El93-`FOUNDATION PERMIT1J �'. - X / GRADING " STRUCTURAL "- ❑ TENANT�I] ELECTRICAL ❑PLUMBING -❑MECHANIC 9 (Com - ass and ❑ OTHER fgct. PROJECT DESCRIPTIO /(1_Jn7rlt SQ. FT. Sgt i (Sr¢ or a OCC UPANCYXa-CONSTRUCTION TYPE ad C py VALUATION ONE I/ GRADING CU..VOS. ACRES L'7 Certified copy is hereby furnished. -- - REMARKS: - ❑ Certified copy Is filed with the city Building Division. v rp Lender's Address EXEMPTION FROM WORKERS' COMPENSATION DECLARATION OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for / (This section need not be completed if the permit Is for one hundred the following reason (Section 7031.5 Business and'ProfeSSlons"Cotle:- Any city or county which requires a permit t0 construct, alter, WATER SERVICE ALTERATION ($1001 Or Ieas1. GAS SERVICE OVTLETS - _ I Cert fy that p the performance ce Of the wor k.for which this.per mit Is issued, 1 shall not employ any person in any manner so as to become PLU ING PLAN CHECK subject [o the Workers' Compensation Laws of California. BATHTUBS -, SHOWERS Date Signature _TOILETS URINALS - NOTICE: It after making this declaration, you should become'subjecl to the Workers' Compensation provisions of the Labor Code, you must forthwith comply wlin such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS revoked. . - - .. - -- -- . . CONSTRUCTION LENDING AGENCY KIT.SINKS --DISHWASHERS- SERVICE SINKS - - .SUMPS - - - 1 hereby affirm that there is a construction lending agency for the per. formance of the work for which this permit is issued (Section 3097 CI C) ' Lender's. Name FLOOR SINKS FLOOR DRAINS Lender's Address DRINKING FOUNTAINS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS -CLARIFIERS --SWIMMING POOL-PTRAP' - the following reason (Section 7031.5 Business and'ProfeSSlons"Cotle:- Any city or county which requires a permit t0 construct, alter, WATER SERVICE ALTERATION Improve, demolish or repair any structure, prior to its Issuance; also re. quires the apt licant for, such permit to file a signed statement that he GAS SERVICE OVTLETS - Is Ii tensed pursuant to the provisions of the -Contractor's -LicenseLaw (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - - BTU OUTPUT t Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS -' any applicant for a permit subjects the 'applicant to -a civil' penalty of ,not more than five hundred dollars ($500). •PLAN CHECK El I, as owner of the property, or my employees with wages as their SOLAR TANK `-- COLLECTORS-- - - sole Compensation, will do the work, and.the structure is.not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. Contractor's License Law does not apply to-an.owner of a property _ _ ISSUE FEE I' who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not GRADING $ MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the.owner will have the. burden SVSTEM 0-1:000 BTU ' --HND DUCTING' `0 - - 100,000+BTU of proving he did not build or improve for the purpose of sale). El00HEATING I,'as owner"of-the property, am exclusively- contracting with licensed contractors to construct the project (Section 7044, Business and Professions Cotle: The Contractor's' License Law does not apply to REFRIGERATION 0-100,000 BTU an owner of property who builds or Improves thereon, and who con- tracts from Such projects with a-contractor(s)-licesned pursuant to theContractor's License Law). SYSTEM - -- - -- 100,000 +BTU ❑_ 1 am exempt under Section B. & P. C. for this reason - - -- - BOILERS BTU Date' Owner -- - SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application and state that the above EXHAUST SYSTEM_ MULTIPLE Information is correct. I agree comply with all city and county _ Ordln a n ccs a state laws rela n to post r uction, and here by au horiae representati a of this city a ter upon .the above) tioned property t i pe on pLL ses. Signature / .I are Drivers' Licen r SS YR ) ISSUE FEE - - - -- CMF 0865.46 White -Building; Caeary-Applicant; Pink -Accounting; Goldenrod -Assessor 0143 1/04/82 64.02 TL' - ZONING REGULATIONS KW_ I KW A.P. rl 7 - 0.1 HP 10-50 HP_. ZONE _ PLNT,,G-• - FIXTURES gRLEIF. p� SETBACK C ST PRIJPEIRTV INE SWITCHES VA R11 _ 41 fl'�7RIEI FG - - SIDE HTA i p - -POLE LIGHTS- REAR YARD (TO P/L) G - --'' ,PKG.SPACEREQ. PROVIDED ' •PLAN CHECK STREET WIDTH - PARK -FEE E - - PERMIT SPECIA6 CONDITIONS: / O _T u) /l � X /S' lei .ELECTRICAL 'PLAN CHECK OR GENERATER TR ANSFORM - ,APPLIANCE '-10-50 0-1'KW_1-30 KW -50 KW_ I KW MOTORS '(INC. SOLAR) _ 0.1 HP 10-50 HP_. 1-10 HP _ 50 -+-HP - FIXTURES OUTLETS' SWITCHES - GAS TUBE SIGNS - - $J. O - -POLE LIGHTS- - --'' •PLAN CHECK $ R.%`C 02 .PANELS- -MAIN - - SERVICE - - AMP - " ISSUE FEE - - •' - - APPLICATION APPROVED BY - DATE/ SUMMARY OF FEES -BUILDING - 'PERMIT $J. O SMI P.,. ,$ _yr 1 n •PLAN CHECK $ R.%`C 02 PERMIT ISSUANCE PLUMBING $ " GRADING $ PLAN CHECK E '- E, 1 ELECTRICAL $ - PL -AN -CHECK-$ - MICROFILM $ a� _ MECHANICAL $ - TOTAL FEE E PLAN CHECKS LESS AD. a VANCEPC-- ' _ FINAL FEE $ h 2 CONSTRUCTION AND PLANNING APPROVALS Permit # •� 2 o Date POOL & SPA InspectorgppROVALS Permit # -Date. , Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - - 2. SoilPipe-Undrgrn_ - _ 44. Steel Reinforcement - 3. Electrical Conduit Utility,Undrgrn _ _ 45. Forms 4.- - Electrical Conduit-Undrgrn _ 46. Electrical Bonding - 5. _Steel, Heinforce 47. Rough Plumbing & Pressure Test - . 6.. Electrical UFER Grn _ 48.' O ER -GUN ITE • APPROVAL TO COV 7.. _Footings _ _ _ 49. Electrical Conduit-Undr rn - .8. Foundation. 50. Gas Pipe, ❑ Undr rn, Test . 9. -Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ ndr rn - • •+� •• 10. --Structural Floor System 52. APPROVALTO DECK - - -• - -- 1. •_ Property Sewer Line SLHouse!Oonnection - 53. Backwash & Receptor -Final - -12. Street Sewer Connection _ - 54.- Heater & Vent -Final - 13. . Rough plumbing _ _ - _ - - -- - -- 14. Rough Electric -Conduit - 56.• - Electrical -Final 15. Rough Electric -Wiring - - - - - 57. Solar System -Final - 16. Rough Heating & Air Conditioning _. encing & Access Approval - 17. Ducts in Structure - APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe - Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing- Frame and Flashing -- _ �• NOTES: 23. Insulation - - 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat - V,",7. Electrical Power Meter -Final 8. FinaLElectric - 29. Final Heating & Air Conditioning - 30. - Final Gas Pipe -Test 31. Final Plumbing - -- 32s -Water Service -Final 33. • Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed -' .40.. Electric Release to Edison - - 41. Gas Release to Southern California Gas Co. - 42. - CERTIFICATE OF OCCUPANCY No.- Date .Y• 450i'71r COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING // r) ) ADDRESS `t f/�� _ f0_ GWNERProperties West Development Corp MAIL ADDRESS 508 29th Street CITY BRANCH TEL NO.I ARCHITECT OR ENGINEER Frank SF' filer No ' 673-095 ADDRESS 2240 Newport Blvd. , Newport Bch ADDRESS TEL. CITY NO. STATE CITY LIC. NO. LIC. NO. SIZE NO. OF SLOGS. OF LOT ApprnY hot x 90' NOW ON LOT USE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED #3 I hereby acknowledge that I heiVread this aj/plicetion and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that 1 am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I am ex ampt from the3vovisions of the State of California Business antl Professions Cope; Division 3, Chapter 9. Pormittee Agent 110V 10-77FAtBL00 561 *** 109.78 R54 APPLICATION FOR STRUCTURAL PERMIT RECEIVED BY DATE RECEIVED DATE ISSUED A. . NO. Z- 'OZ P X61 BUILDING ADDRESS TRACT 9860 LOT 53 BLOCK OWNERPropgrtiesDevelopment S Res. Atd. 'Gar. VALUE 61,100. RE DATE NO.OF w I USE OF YARDS OVED YARDS APPROVED MAIIN BUILRDING I ACCESSORY BUILDING VAR. N nrnf I! r cnr cnl iotD FIC,0 SQ. FT. 2295m N THE AMOUNT SHOWN UNDER VALUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE y n n PLAN CHECK $ n 0 $ 61,100. TAX $ 4.28 TOTALPAID $ /O -sem �a COSTA MESA BUILDING-SAPIETY DEPARTMENT PO BOX 1200 COSTA MESA CALIFORNIA 92626 c —� C:A ,00 506 �*-�*211.00 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RECEIVED BY I DATE RECEIVED DATE ISSUED BUILDING / / ADDRESS ( /i/ PERMIT NO. OWNER zdi A.P. NO. BUILDING /D _� A / MAIL 10/ ADDRESS / Q/J(fj(/ ADDRESS TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NEW ADO RP LENDER BRANCH OWNE ADDRESS V UE USEPUA. ARCHITECT TEL. OR ENGINEER FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO. OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZENO. OF BLOGS. IFROM C/L STREET) OF LOT NOW ON LOT ONT FT. FT. USE OF EXISTING BLDG. R. SIDE FT,FT Separate permits are required for L SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLOCS. ACCESS. BLOCS. VAR. %% DATE C.U.P.9P APPROVED APPROVED RY DATE I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. hereby certify that I em properly licensed as contractor under SO. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. VALUATION PERMIT FEE S PLAN CHECK $ Signature of y �/ �/�// / TAX $ Permittee��/iCC//%s+-[ %%%TTT �ili/''�'� $ // Authorized AO.nt L TOTAL PAID $.