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Home My WebLink About1013 DAMASCUS CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIH UHI Vt, UUJ I A Mt,A, UA UZbZb PLUMBING PERMIT Job Address: 1013 DAMASCUS Cl Status: ISSUED Suite No Applied: 04/02/2001 Issued: 04/02/2001 Vicinity: ISSUED BY: Parcel Nunmber: 41237136 Applicant: GLOVER, LORIE Address: 2737 S CRODDY STE D Phone: (714) 241-1414 SANTA ANA, CA Zip: 92704 Owner: STIMSON, KENT D Address 1013 DAMASCUS CIR Phone: COSTA MESA, CA Zip: 92626 Contractor: COAST ROOTER PLUMING HEATING & AIR CONDITIONING Address: 2737 S CRODDY STE D Phone: (714)241-1414 - SANTA ANA, CA Zip: 92704 License: 529127 Arch / Eng Address: - .. Phone: Zip: License: - _ J - SCOPE OF PERMIT - 1 WATER HEATER CHANGE -OUT FEE SUMMARY - - AMT ' QTY_ -. AMT QTY y _- ,, = '� AMT QTY ISSUE FEE' $23.50" - .'Laundry Tub / Washer " _$0.00 0 "' Sump Pump �' ,,x$0.00 0 Backflow irrigation $0.00 0= Landscape Irrigation„ $0.00 0 = Swimming Pool ' /$0.00 0 Backflow Preventer ` $000;- 0 P -Trap - -- $0.00- 0 -/ Trap Primed' $0.00 0 Bathtub ', �'.-� $000 j 0 'Pressure Regulator- $0.00 0 �/� Unnal� A $0.00 0 Clarifier System 110.00 1 ' 0 - Process Piping (per 10 ft) $0.00 ' 0 - 'Vacuum-Brkr Bkflow(4-4) $0.00 0 Connect(Ice,Soda,etc) ,$0.00 0 Receptors -$0.00 0 �, Vacuum Br1kr-Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 ', `Wash Basin; � $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo. $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 - Sewer Connect $0.00 0 ,-Waste-and Vent System $0.00 0 Drain, Rainwater $0.00 0 - Sewer Private Line $0.00 0 -, Water Closet (Toilet) $0.00 0 Drain, Roof $0.00 0 - _ Shower $0.00 0 Water Heater / vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar $0.00 " 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial .$0.00 0 Water Re -pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas (1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors (Sand Auto ) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration.of this permit. FOR INSPECTIONS CALL: (714) 754.5626 244646 (6/00) 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 workers' com enation Insurance artier and policy number are: Carder: CIP 4j4A Policy Number: ��O)(o r�-,�1)^b (This section need not be completed it the permit is valued at one hundred dollars ($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 provisions s6l�i� i Applicant Signature_ Dete: y ^ M=� 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 DOLIARE ($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 underrovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business anQfessions Code, and my license is in full force and effect. Lic. # S� Contractoes Signature Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirn 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 pernit 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) of 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).): ❑ 1, 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. It, 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 Cade: 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed). DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more 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 o.. the California Health and Safety Code been fully complied with? ❑Yes ❑ No ...................................ill t.......ap......................................................... ildi..................................................................................................................................................................................................... difi................ 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of ? a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes LJ No (Section 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 rrust 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 ................................at-t.c-h-....................................-pli...........-fro....................................................11ut................trol..............r) ................... 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. SigDatu I Legal Owners) Date And/Or Authorized Applicant Date CODE x. INSPECTION TYPEpA�.F.' INTMAL$ CODE r INSPECTION TYPE DATE A 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing GJ 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 2134 Final Demolition 250 Final Building/Occupancy PROJECT ADDRESS: AME 1013 DAMASCUS CI OWNER'S NAME: STIMSON, KENT D ADDRESS: STIMSON VIVIAN N 1013 DAMASCUS CIR COSTA MESA FCA ARCHIENGINEER: ( 714 ) 751-8008 ADDRESS: UNIT: 92626 REG.NO.: UNIT: PERMITTEE: PRIORITY ROOFING (714)837-8061 ADDRESs:22982 DUNE MEAR LAKE FOREST CA 929 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions o aper 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC. :6 4 19 3 8 CLASS: C-3 Date. J0 —zit—AO Signature: _ p �- WORKERS' COMPENSATION DECLARATION: I hereby at that l have a certifjc I co nl to self insure or a ce - cats of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab, Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Carried copy is filed with the city Building Division Dale ('Applicant.. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for One hundred ($1W) or less(. I certify that In the performance of the work for which this permit is issued. I shall not employ any person in any mi so as to became subject to the Workers' Compensation Laws of California �� Date: i6—`C`—% '� 9Zl Signature: eL NOTICE: II, after making this declaration, you should become sublet[ to t kWorke 'Compensation provi s the Lobar Code. you must forthwith comply with such provisions or this permit shall bZAeeme revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ, C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to tile a signed statement that helshe is licensed pursuant 10 the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helms 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 am layers with wages as their Sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7W4, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered tot sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusive[p contracting with licensed contractors to construct the project (Section 7044. Business Eland Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractogs) license pursuant to the Contractors' State License Law). I am aware that most of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. & P. C. for this reason'. Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Cade Sections 25505, 25533, and 25534 and that I or any future building occupant wilVwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date. Applicant: I hereby certify that I have read this application and stale that the above information is correct. l agree to comply with all city and county ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon tl above-mentioned Pmorally for inspection purposes. Dale9"2, Signature: Driver's License or Social Security a: 1641 46 While—Building: Green—Code Enforcement: Canary—AOPlieari Pink—Revenoel Goldenrod—Assessor PLANNING N TES> 4E 4E 4t 4F iE 1E 4E 4E k 4E 4f 4t 4E 164E 4E k iE k iE iE 4E iE 4E 4E iE 4E 4E 4E iE st 4E 4E 4E ik 4E iE iE 4t 4t k 4E # iE 404E * if 4E iE iE iF iE it * * 4E 4E 4t iE iE 4E 4E 4E it iE 4E 4F iE`lE4E iF 4F 4E 4F iE 4E 4E _� 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 NT- S ZONING APPROVED BY DATE; v, BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY: DATE; ro ZY 4f 4f 4f 4F 4E 4Fk 4E 4E 4F 4Ek lE iE iE k4E if if k4E iE iE 4E 4E iE 4EATE: 4F 4E iE 4E*fF if 4E if 4E 4E 4E 4E 4E ik 4E iE**4F 4E if*aE 4E 4E 4E 4E iE 4F iE iE 4E 4E 1E iE iE 4F 4E 4F 4E* 4E 4F 4F ♦f iE iE iE k4E kiE lF iEk 4E iE iE 4E♦E 4E 4E 4E 4F 4F k4E 4E'4E 4E 4F iE 4E 4E 4E 4t iF iE LEGALIZATION:N F E E S U M M A R Y STRUCTURALtSEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 126,00 1,08 PLAN SMIP/NON-RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 127,08 0,00 0,00 127,08 127.08 .00 11 REVENUE DIVISION TOTALS--> COLLECTED; 127,08 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 126,00 1.08 iE 4f 4E 4E 4f k 4E 4E it 4E 4E fF it 4E iF 4E 4E 4E 4E k 4E iF 4E iE 4E 4E 4E * 4E iE k 4E iE 4E iE 4E 4E 4E 4E 4E NiE 4E iE k iE k 4E 4E 4E 4E k iE 4E iE4f it 4E 4E iE iE 4E * 4E 4E iE 4F iF iE 4f 4f 4E it iE 4E IE iE iE ♦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 S C R I P T I O N, UNIT COST TOTAL COST SFR 10750 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 10,750.00 END 'OF FEES 01 00141795-00141796 T O T 127.08 DATE: 06/28/93 TIME: 09:39 CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 062770 PERMIT NO: B 062770 PLAN CHECK NO; N GOVT; N SUPP; N CONSTRUCTION TYPE; 5-N PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION ; T/O EXISTING SHAKES S APPLY "CAL -CLAY" SQ FT; 10,750 CLAIM VALUE; 10,750.00 CALC-VALUE; 10,750.00 GROUP OCC; R-3 /M-1 COMMENTS: SMOK DETEC'S REVD PER THE '91 ED, OF UBC / RE: ICBG# 2882 A 1 4E it 4t 4tiE 4E 4E 4t 4f 4E 4E 4E>E *4EiE**4E lE k4E iE 4E 4E 4E 4E if iE 4f iE iE 1E 4E 4F iEiE 4E iE if iE iE 4E iE iE iE 4E 4E 4F 4E 4E iE iE iE iE4E 4F 4E iE 4t iE 4E 4E iE iEk iE iE j�k �±r�£$1 ' �� Z O N I E M E N T N GS E R T E B Q A U C I K R S sMOK S ISoED ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDINFIE-W-- L� 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 REQ; PROV: PARCEL; 41237136 ZNE: REF NO; PLANNING N TES> 4E 4E 4t 4F iE 1E 4E 4E k 4E 4f 4t 4E 164E 4E k iE k iE iE 4E iE 4E 4E iE 4E 4E 4E iE st 4E 4E 4E ik 4E iE iE 4t 4t k 4E # iE 404E * if 4E iE iE iF iE it * * 4E 4E 4t iE iE 4E 4E 4E it iE 4E 4F iE`lE4E iF 4F 4E 4F iE 4E 4E _� 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 NT- S ZONING APPROVED BY DATE; v, BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY: DATE; ro ZY 4f 4f 4f 4F 4E 4Fk 4E 4E 4F 4Ek lE iE iE k4E if if k4E iE iE 4E 4E iE 4EATE: 4F 4E iE 4E*fF if 4E if 4E 4E 4E 4E 4E ik 4E iE**4F 4E if*aE 4E 4E 4E 4E iE 4F iE iE 4E 4E 1E iE iE 4F 4E 4F 4E* 4E 4F 4F ♦f iE iE iE k4E kiE lF iEk 4E iE iE 4E♦E 4E 4E 4E 4F 4F k4E 4E'4E 4E 4F iE 4E 4E 4E 4t iF iE LEGALIZATION:N F E E S U M M A R Y STRUCTURALtSEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 126,00 1,08 PLAN SMIP/NON-RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 127,08 0,00 0,00 127,08 127.08 .00 11 REVENUE DIVISION TOTALS--> COLLECTED; 127,08 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 126,00 1.08 iE 4f 4E 4E 4f k 4E 4E it 4E 4E fF it 4E iF 4E 4E 4E 4E k 4E iF 4E iE 4E 4E 4E * 4E iE k 4E iE 4E iE 4E 4E 4E 4E 4E NiE 4E iE k iE k 4E 4E 4E 4E k iE 4E iE4f it 4E 4E iE iE 4E * 4E 4E iE 4F iF iE 4f 4f 4E it iE 4E IE iE iE ♦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 S C R I P T I O N, UNIT COST TOTAL COST SFR 10750 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 10,750.00 END 'OF FEES 01 00141795-00141796 T O T 127.08 DATE: 06/28/93 TIME: 09:39 CONSTRUCTION AND PLANNING . APPROVALS Permit :hs Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 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 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15, Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Per mit# 20. Rough Factory Fireplace _ 21. Ducts, 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. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 6(/- 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat U ' 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Sidings 77. FIXED SYSTEM FINAL 29. Insulation I 78. FIRE PREV. FINAL 30. Drywall Nailing I ! HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 1 .•, f 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test I I I ! Nc ! i C?u-- 36. Hood or Canopy i 37. Final Factory Fireplace I I 38. Final Plumbing 39. Water Service -Final I 40. Gas Service -Final 47. Solar Domestic -Final , 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation `M- 46. Handicap Regulations'=' __ _t I - 47. FINAL STRUCTURE'& BUILDING 48. FINAL PLANNING" 49. Electric Release to [;�fisan - i "-i 50. Gas Release to Southern California Gas Cc I I 51. CERTIFICATE OF OCCUPANCY No. Date JUIN Gb "b.i JTJ:LL I . m ICBG Evaluation Service, Inc. A subsidiary corporation of the International Conference of Building Officials EVALUATION REPORT Recon at z6az Copyright e 1993 u280 Evaluation Servicc, Inc. fei)luary, 1993 Filing Category: ROOF COVERING AND ROOF BECK CONSTRUCTION—Roof Covering (202) CAL -SHAKE, CAL -SLATE AND CAL -CLAY ROOFING PRODUCTS CAL -SHAKE, INC. 5355 NORTH VINCENT AVENUE IRWINDALE, CALIFORNIA 91706 I. Subject: Cal -Shake, Cal -Slate and Cal -Clay Roofing Products fl. Description: A. General: The roofing products are composed of one part portland cementto six parts of dry lightweight aggregate. The result- ing products have the capability of being nailed or sawn similar to wood. Color is obtained by mineral oxides. All products are 12 inches wide, 22 inches long and are nominally 1/e inch thick. Both Cal -Slate and Cal -Clay have rustic units 6 inches wide while Cal -Shake has rustic units 5, 7110 and 11 inches wide. Each product has its own unique exposure detail pressed onto the lovler 10 inches of the butt end. The installed weight of each product is approximately 5.6 pounds per square foot. The products are considered noncombustible material complying with Section 415 of the Uniform Building Code. A thermal resistance value (R) of 2.4 hourfl2-°F/Btu is assigned to the roofing system when installed with a Type 30 asphalt -saturated felt inter- layment on minimum 1/2 -'inch -thick plywood sheathing complying with the code. B. installation: Cant strips of redwood, cedar or Douglas fir are nailed along the eave line as indicated in Figure No. 4 to provide required support for the starter course, 1f the fascia is elevated t0 provide proper support, cant strips are not required. Cant strips can be installed either beneath or on the felt. Thirteen -inch -long starter units typically overhang the eave from 1 to 2 inches. The first Course of field units are then installed on the starter units so that the units are doubled at the eaveline. For the remainder of the courses, the spacing and sidelap are similar to that required for wood shakes, as described in Chapter 32 of the code. Hip and ridge pieces are supplied as 12 -inch by 22 -inch field units with mesh reinforcement and a center line inscribed for scoring and bending to conform with the root pitch. All valleys must be flashed as specified for wood shakes in Chapter 32 of the code. Each unit, including hips and ridges. Is fastened to the roof with two cor- rosion -resistant nails of at least No. 13 gauge, or two corrosion -resistant No. 16 gauge staples with a t/ta-inch crown width. Fasteners are installed between 1/2 to 11/2 inches above the overlap point and must be long enough to penetrate the sheathing 3/4 inch or its full thickness, whichever is less. See Figures Nos. t through 3 for further details. Both solid and spaced sheathing may be used in accordance with Chap- ter 32, Table 32-8.2 of the code. in either case, the installation is recog- nized as a Class A fire -retardant roofing system. Underlayment may also be required depending on the roof pitch. C. Underlayment: Installation shall be as follows: 1. Under 3:12 Roof Pitch: The products are not designed for roof slopes less than 3:12. They may be installed for decorative purposes on these slopes when installed on solid sheathing as set forth above, covered with a Complete built-up roofing system installed in accordance with Chapter 32 of me code and specifically approved by the local building offi- cial, 2. 3:12 to less than 4:12 Root Pitch: The products may be installed at this slope on solid sheathing with a Type 15 felt underlayment with the approval of the local building official. A Type 30 fell interlayment. is also required as described in Item No. 3. 3. 4:12 to and including 12:12 Roof Pilch: The product, may be installed on spaced or solid sheathing with minimum 18 -inch -wide Type 3o telt interlayed between courses so that no felt is exposed directly to the weather. See Figures Nos. 5 through a for further details. In areas subject to wind -driven snow, solid sheathing is necessary with shakes applied over minimum Type 15 felt underlayment in addition to the interlayment. 4. Greater than 12:12 Root Pitch: Products maybe installed on spaced or solid sheathing with felt installed as set forth in Item No. 3 above. For mansard roof applications, flashing is required at the top of the mansard sections. 5. Reroofing: Where the existing roof is smooth and uniform, such as with composition or wood shingles, and the existing framing sufficient for the increased load, the roof product may be applied overthe existing roof- ing as set forth in paragraph 11 C 3 of this report. For decorative purposes, an "L" metal strip is Installed overthe cant strip and existing roofing along the eave line and similarly along the rake line. Reroofing applications require prior approval by the local building official. D. identification: The product name is imprinted on each field unit. Packaging bears the name of the quality control agency Ramtech Labora- tories. Inc. (NEROA-293), name and address of the manufactum r and the evaluation report number. 111, Evidence Submitted: Data in accordance with the ICBG ES Accep- tance Criteria for Special Roofing Systems, dated July, 1992. 1992 Supplement to the U.B.C.: This report is unaffected by the supple- ment. Findings IV. Findings: That Cal -Shake, Inc. lightweight root products are a Class A roof covering complying with the 1991 Uniform Building Code, subject to the following: 1. Products are fabricated, identified and installed in accordance with this report and the manufacturer's Instructions. 2. Products may be installed on roofs up 1040 feet high in Exposure B areas subject to basic wind speeds up to 80 miles per hour. 3. Units are manufactured at the Cal -Shake, Inc., Irwindale, California, manufacturing facility with follow-up inspections by Ramtech Laboratories, Inc. (NEROA-293). This report is subject to re-examination in two years. Evaluation reports o17c10 Evaluation .Se"fre,Inc.,aft issued solely toprovideinformation to CW vA members of1C'BO, utilizing the code upon which the report is based. Evaluation repons pre nutto be cunstrutd as representing aesthetics orany otherattributes not spec[Twlly addressed noras an endorsement ur recommen- darion for use of the subject report. This report is based upon independent tests or other technical data submiaed by the applicant. The ICBO Evaluation Service, Inc., technical sluff has reviewed the rem rrsutts and/or othtrdata, but does no! possrss tenjacirities to snake an independent ver/fieation. There is no warrantyby 1010 Evaluation Service, Inc., express or imptird, as to any "Finding"orother matterfn the report oras to anyproduct coveredby the report. This discWrmer includes, but is nut limiltd to, merchantability. Page 1 of 2 JUN 28 193 09:21 TO: FROM TIME: M«1acu,c 9-.R5A.H. FACHMEX NUMBER OF PAGES INCLUDING COVER: 3. P.1/3 CAL -SHAKE, INC. 5355 N. VINCENT AVE. P.O. BOX 2265 IRWINDALE, CA 91706 (818) 969-3451 (818) 969-7520 FAX G SUN 23 '93 09:23 Page 2 of 2 5mpelt, tlp. Nallinp Fasten at naRng Orb area R FaatenNgN Cut nae standard field unit J& Faseta -�A>7 su dam flew unit FIGURE NO.5 EAVE DETAIL FIGURE NQ t STANDARD FIELD UNrr Stader unn Felt lapped over lip FIGURE N0, 7 MIP DETAIL 'J• r V FIGURE NO. 2 STARTER UNrr IS' len to prgAde 7 rwadLap Double at cave FIGURE NO. U VALLEY DETAIL P.3/3 Repert No'42882 / O• FIGURE Point FIGURE NO. 3 HIP AND RIDGE UNIT 0 Card grips standare Bab unn Starter unn Typical shako Proles at00 the save F ev� de.9 d µ top FIGURE NO. 4 Hip and rbpa unit FIGURE No, a RIDGE DETAIL TypiW YSBey Nin sWdard Bab unn Fan to lap ^valley to y Baddtq tMt to Bob Wilt ad" Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA �A/� 0 TRERMI[AS PERMIT NO. _ TRACT NO. - LOT NO. UNIT NO. 1111 Project Address O � r Applicant's Mailing Address G7 Owner's IN K. 5 hone Address ,1'217 Arch/Eng. _ Licen No. Address -- Contractor's Name Address (mailing) 10-76 City License No.9;K T T LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fuTrfe tl f } License Class License o Date Siq 1 ` WORKERS' COMPENSATI L RA 1 y4 I hereby affirm that I have a certificate of consent to self -insure or a certificate 1 of Workers' Compensation Insurance, or a certified Mpy thereof (Sect' n 3800, LaD. \ Policy No./%/D j ComPd C¢rtifiCtl co y is hereby furnished. Certife c is ' ed with [hC city ui on Divl i Date Applicant \ EXEMP I FRO M WO RKERS' C OM (This section neetl not De com plat o less). 1 certify that in the performance of the work for ch t perF.bect Ishall. not employ any person in any mannrsoas tob tot e Workers' Com pen satin n• Laws of California. . Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name_ Lender's Address 1 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt x therefrom and the basis for the alleged eam p[I on. Any violas ton of Section 7031.5 by any applicant for a. permit Subjects the applicant to a civil Finality 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 (Section 7044, Business and. Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through 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 com- pletion, the owner will have the burden of proving he/she did not build or im- 1��1rove for the purpose of sale). LJ I, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a can. tractor(s) license pursuant to the Contractor's License Law). Iam aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I•am exempt under Section B. & P. C. for this reason Date Owner _ I hereby certify_ that I have read this information is correct. I agree to comp and slate laws relating tq building con sentative oI'this enter. p inspectio rp9 Signature 1 Drivers' License or SS CMF 0865-46, rev. 10/84 White - Buildin TYPE OF CONSTRUCTION LJ NEW LJ ADD ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. LJ ALTERATION LJ REPAIR - A.P. 46 S Main Buildi TYPE OF PERMIT ❑GRADING 0 FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER ET B A Front Rear PROJECT DESCRIPTION SO. FT. OCCUPANCY CON STRUCTION TYPE VALUATION ZONE GRADING CU.YDS. ACRES - C $ Right Left Ping. Ref. # Remarks: $ GRADING Planning Notes: Sink Preventer _. Irrigation Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink - oof Drains Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash EES Reinspection Fee $15 Issue Fee $ 3 Duct- Under Ground Duct -Structural - Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICRO # Heating System Du ting / ❑0.100,000 BTU 100,000 BT Reinspection Fee .1 $15 Canary - Applicant: Pink - Accounting; Goldenrod - Assessor Hood or Type ❑ Canopy Type II ❑ Ki 1 igeration System . -100,000 BTU 0100,000BTU System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 I Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A:U. , Fixtures Device Boxes Outlets Switches Garbage Disposal Generator C0-5 KW C 2610 5/8/85 Zone Accessory Building: Parking Req./Provided ELECTRICAL ' Transformer ❑ 15-50 KW' ❑ 50+KW Meter ❑hp to 100 amps Meter ❑over 100 amps . Sub Panel Motors ❑ 0-1 HP ❑ 1 % - B Inc.Solar ❑9-15 HP 016-15+ Microwave - Pole Light Range Standing Sections 5-15 KW 1 1 Trash Compactor 17.00 TL FEES Z O N 1 N G R E O M T S 1 Reinspection Fee 1 $15 1 1 Issue Fee 1 $ $ 1901 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By PLAN CHECK 25% $ SUMMARY OF FEES - BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT ' PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL . $ TOTAL FEE $ PLAN CHECK 25% $ CONSTRUCTION AND PLANNING . APPROVALS � Permit # • Date - Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pale ' 52. Pool & Equipment Location ' '2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3:'Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. -Electrical Conduit'-Undrgrnd. 55. Electrical Bonding '5: Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER.Grrid. 57. APPROVAL TO COVER-GUNITE 7. Footings `. - 58. Electrical Conduit-Undrgrnd. 8�Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. tO.'SVuctural Floor System 61 APPROVAL TO DECK 11. Property S2wer Line & House Connection 62. Backwash & Receptor -Final . 12. Sewer CaO 63. Heater &Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough 'Plumbing _ - 65. Electrical -Final 15. Rough Electrical -Conduit - 66. Solar System -Final - - 116. Rough Electric Wiring 67. -Fencing & Access Approval ' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING , 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts,, Ventilating' 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush I i 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil' 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding • 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30.. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat '79. FINAL INSPECTION 32: Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric . 311d5-.&tfo Notes: " 34. Final Heating & Air Conditioning (if;9 35. Final Gas Pipe -Test ' 36. Hood or Canbpy 37. Final Factory Fireplace 38. Final Plumbing - 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations _ 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison -- 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATEOF.000UPANCY No. Date PATIO COVER DETAIL 6/1/67 SPACING SIZE OVERHANG v' /� /%' RAFTERS: LF-�—' " �.� SLOPED FOR DRAIN Lrr�MAXIMUM %s TSPAN 4' o/t MAXIMU \-BEP E' 3/16X2° 1 I f _s r►a Z POST POST -BEAM CONNECTION Tle x 5 -Logs 32a/c Predrill Ledger Predrill Existing '/,-3 Deep JOIST HANGER or other approved methods of support • tie. ALL LUMBER DOUGLAS FIR CONSTRumolit' GRADE _ SHOW SIZE SHOW SPACING SHOW LOCATION ON REVERSE SIDE. 101, nArs -� SLOPE TO DRA04 DROP PATIO ...:3T THICK SLAB 1� PUDDLED SAND FILL itMo % Remove Gross And Weeds Down To Naturol Grade '_. 12� CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT POST ANCHOR _L ".a.� 7} GALLONS PER SACK CEMENT. For Pipe Post. Embed Provide 26 Go G.I. Flashing At Wood Floor Const. Pipe In Footing. Provide Flange Or Weld Plate Screwed Or Bolted To Frame. CMF 00012-46 (BU 40) 2 �CvIv CONTINUOUS LEDGER TYPICAL JOIST ANCHOR NOTE* USE REVERSE SIDE FOR PLOT PLAN. NO I R AFTER -CHA T NO -2 BE BUILT. FOR OPEN EGG CRATE ONLY. WIDER RAFTER FOR SOLID SHEATHING. ALUMINUM OR PLASTIC FOR SPACING ONLY. SHINGLES OR BUILT UP ROOF COVERING FOR PROPOSED OR FUTURE ROOFING. PATIO MAXIMUM SPAN SIZE SPACING MAXIMUM SPAN 17' 0" 2x6 12 % 15' 1" 16' 0" 2'x 6` 16'0/, 13' 3" 95' 0" 2'x6' 2401. 10' 11" 12' 0" 27x 4' 120/c 9' II" I1' 0" 2x4' Is°k B' B' 10' 0" 2'x 4' 240/. 7' 1" NOTE: FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO WALLS ARE TO BE BUILT. USE NO.2 CHART ONLY. WIDER RAFTER SIZE MAY BE INTERPOLATED FOR SPACING ONLY. FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO WALLS ARE TO BE BUILT SUBMIT COMPLF_TF HOUSE AND ADDITION PLANS COSTA MESA 77 FAIR DRIVE BUILDING DEPT. 834-5273 1 Q 4 /�%,Jjvs rsE E p e�O suil �.JOB �EPjNO CS M9Olt p 4.4 HANG `YOS DNCE OA CR " /R/SRA-444 PP TMEPERM/ SPlC/p " T.C OOD TkErfO? ��;Ti�•�S cF PEt'•;RVA4 lopIVE 0r, "F%,rC. qPPRO. , TRrw�fl4yV'Ol l'1F 1OuoN[ S$�NDErOfq 1py y, ,YQ' " _THEl4Z.41/0/,6o, NC OP R &qrD�Sp /yy� �7 ft U/1 ,1,x,4 fs 14 17 � Of TE � C' OE ��ryS eel, n/CM(, "ORrg/ 114j, "43'ft ,ppv� CpOE dq RAl�O r or ol/#. �h1pR 'Uij p f/, f �O414 t t "PRO j CRY OF COSTA MESA PLANNING DEPT, SUBJECT TO BLDG. DEPT. RM BY091e4L_ DAT 4. DIRECT() R OF PIANNINO I'? I 6; _i�. i l li�G Ili/' i ER DATE 7Ta AV N041 2 -170-i6 LOT TRACT FIRE ZONE VALUE $ Rnn_ nn INSPECTIONS Si nature Dat. TYPE v GROUP 7 ZONE 101L SUBCONTRACTOR IOAS Dat. Number Si nafor. 'WATER Plumbin ROUGH PLUMBING ADP. SWR. LINE HOUSE CON, SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER ROUGH WIRING ' Heatino and Vant. TRENCHES FORMS STEEL REINF. FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN D UT PLASTER. BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL COSTA MESA BUILDIN P.O. BOX 1200 COSTA For Applicant to Fill in Completely — Use Ink Only 6632 4/12/79.., B_. 50 T� APPLICATION FOR STRUCTURAL PERMIT ' �' t RECEIVED By .BUILDING ^ ��/` ADDRESS C $C. s= S A.P. NO. OWNER OR BUILDING ^^�'�� ADDRESS �Q � 3 yQMs1 cLS cu.S TENANT _/Y - UNIT OR MAILING / 1),4 IW ;bus C-a%�, ADDRESS / C v' �l SPACE NO. / TR.NO.QQ/ LOT RLK. �Q CITY. C laS A %f7 E j A NO. IaU ss NEW ADDALTER REPAIR MOVING DEMOLISH _ —LENDERr_Jj ' BRANCH ^ J/ ST1r'ts0.t/ OWNER /�, 4C/lir ADDRESS _ V UE ARCHITECT TEL. USE E OR ENGINEER ADDRESS '� ZONE R YPE GROUP CONTRACTOR ,QC I. wNC T Ary APPROVE 2 By DATE i`P ADDRESS Q EL.f3y CITY 611A/U (dA TNO.[`/ LIC. NO. �c .� O O d sSTATE' LIC VN D.`tl / APPROVED SETBACKS SIZE NO. OF SLOGS. (FROM C/L ST ETI OF LOT Q Q (fs NOW ON LOT OPfr USE OF BLDG. %D �+/ !. J/0EXISTING Separate permits are required for L. SIDE / FT. electric, plumbing and heating work: p O REAR p FT. USE OFF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION "9 /C%J APPROVED Aa ! v ('0 �^i / APPROVED s.. w 1e C DATIF 1 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. 17 1 hereby certify that I am properly licensed as a contractor under �•( SO. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E and Professions Cod Ision 3 Chapter 9 Signature of /'�I/ CHECK E Permittee I ''� T07—PLAN $ TAX E or _ ��1 7`�' Authorized Agent Date TOTAL PAID E t n>w OCT 21-77'001078* ***373.02 C115A 4793 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 API TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RE E E V GATE RECEIVED ��- D TE vISSUE �O�I' �� BUILDING ADDRESS OWNER FOI,ESC FAMILY TRUST A.P. NO. ' ,S� PERMIT NO. MAIL ADDRESS 2101 E. Fourth St., #100 BUILDING ADDRESS 1013 Damascus Circle clry Santa Ana, CA 92705 TEL'543-9471 TRACT 9901 LOT 34 BLOCK CONSTRUCTION LENDER U.C.B. W A A P BRANCH 1010 N- Main St. _ OWNER LC ADDRESS Santa Ana, CA 92704 t a VALUE (%A rid S �} FIRE ZONE 44 YPE� GROUP OR ENGINEER Hales -Langston NARCHITECTEL'547-0862 ADDRESS 777 S. Main #105, Qraaa 92668 CONTRACTOR FOle COnStrUCtion CO-, InC• BPPROVE DAT u• ADDRESS Same as above TEL. CITY NO. ZONER) /�, I NO.OF PLANS Z USE OF NEW BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE OF LOT NO.OF BLDGS, NOW ON LOT 0 (FROM C/ STREET) / FRONT FT. G FT. USE OF EXISTING BLDG. N/AR. SIDE FT. FT. Separate permits are required for L SIDE FT. FT. 2 REAR 2OFT. FT. electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. New Constriction, single family VAR.+ C.U.P.*+ DATE APPROVED detached, Plan 5, 5 bedrooms. APPRO D e H01 D FOR C A G tlnc I hereby acknowledge that 1 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. 1 hereby certify that I em properly licensed as a contractor under SO. FT. 658 . 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 I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business antl Professions Code, Iv Ion 3, Chep 9. VALUATION PERMIT FEE $ PLAN CHECK $ •fD Signature of 4- n ,S / TAX $ •�'1 Permittee $ r/�/�a � Author) t TOTAL PAID $271