HomeMy WebLinkAbout136 CECIL PL - Building Permits '0 ,y:'�-�` ,, CITY OF COSTA MESA t
Y`;r '1, BUILDING DIVISION PERMIT NUMBER 1�
�. DEVELOPMENT SERVICES DEPARTMENT
PERMIT
99-00658
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 136 CECIL PL Status: ISSUED
' Suite No Applied: 07/15/1999
Vicinity: FRONT YARD AREA Issued: 07/15/1999
Parcel Nunmber: 42605312 ., 7/�
ISSUED BY: / O7
Applicant: BULLARD, RICHARD P; , , - ' - - - -
Address: 136 CECIL PL , ;/; 't -
• Phone:
COSTAMESA;CA Zip: 92627
i ,
Owner:�t ,BULLARD, RICHARD-P- =
Address j j 136 CECIL PL, -
-
Ail/ N / / //:f Phone: (949)722-6151 _ ,<',•-\
/,% COSTA MESA;CA Zip: 92627 N
. / //2,/
Contractor: fN _h`
Address:- -
- Phone: - -�
„ /" r Zip: - -
•r License: -
s A\ /= -. SCOPE OF PERMIT /\ ,
‘�( / INSTALL NEW 2 OUTLETS,200 AMP ELECTRICAL METER&HARDWIRE FOR NEW ABOVE GROUND SPA.
/ MIN.5'0"HIGH FENCE IS EXISTING
_
FEE SUMMARY •" ;, -
\,
, Quantity - " .• - Quantity i
'ISSUE FEE. • $22.00 - - -- Temp Dist System/Lighting $0.00 0 --
.Temp service test•A $0.00 Busway/100 ft. $0.00 0 - , A /
Res.a/c package $0.00 , • Standing Section $0.00 0" c i
New Res(1-2 units) • \.., $0.00 / 0 Misc Electrical Equipment • $0.00 ,0- • ‘ i
New Res(34,-units), `° $0.00 0 • - Transformers up to 1 kva/kw ' $0.00 e 0 - , ;
Pool/Spa Vv .- '\ $0.00 0 up to 10 kva/kw $0.00 - 0 _
Lighting•Fixts'., ; .,$0.00 0 . . up to 50 kva/kw $0.00 ' " 0
Recepf Outlets ;' $2.00 2 up to 100 kva/kw _ $0.00; 0 -
Switches. '.A '\$0.00 0 - - over 100 kva/kw . . ,$0.00- 0
Non Res Appi y $0.00 -- . -0 - - Low Voltage Equipment - $0.00 0 '
Res Appl V',�„ ,/,' . $0.00 0" - Low Volt Wring System/Ckt - $0.00 - ' 0 ' •
Service to 200a/-A //,',/ $27.25' 1 . ' Misc.Conduit - - -$16.25 ; 1 ' i
Service to 1000a N'•', <; '$0.00 0 - Misc.Conductor - $0.00 , 0 /
Service over 1000a, - y, . $0.00- ' 0 - _ Circus(gen or ride) $0.00 - 0' ,7
Motors to 1 hp V- $0.00 ' 0 Circus(mech ride or lights) $0.00 ,- 0 /
Motors to 10hp , $0.00 0" _ Christmas Tree Stand $0.00. , 0
Motors to 50hp - $0.00 - 0 Fireworks Stand ' - $0.00' 0
Motors to 100hp N $0.00 0 Other Electrical.Fee $0.00
Motors over 100hp $0.00 0 " -
Communication drops $0.00 0 - Investigation Fee , ' $0.00
Sub panel to 200a $0.00 0 . Plan Check Fee " $0.00
Pole Light Pkg $0.00 0 • ' ' ' Reinspection Fee $0.00
Sign Circuits $0.00 0 -
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $67.50
Intermed Pole $0.00 0
• COMMENTS/SPECIAL CONDITIONS
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 permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
•
INSPECTIONS: In order for the work authorized under this permit to be considered(legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS
•
WORKERS'COMPENSATION DECLARATION:
�I hereby affirm under penalty of perjury one of the following declarations:
❑ I hive 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: Policy Number:
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: 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 DOLLARE(S100.000),IN ADDrI1ON 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 my license is In full
force and effect.Lic.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code).
Lender's Name: 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
sub�l the applicant to a civil penalty of not more than five hundred dollars($500).):
IB' 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 forsuch project with a contractor(s)
license pa a t to the Contractors Lice Laws.).
❑ I am ex-1,Tt u/der se
Date: l -lc--Ck9
Owner ID verified by driver's license. 0 Yes 0 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:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the Califomia 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? 0 Yes 0 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 akermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U 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? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANC AND A ORATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
corr I a ee to ply all state ws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
ab v de ribed rty spectio urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection.
di a 7-IC-99
Signature Of Legal Owner(s) Date
And/Or Authorized Applicant Date
CODE it INSPECTION TYPE DATE MALS CODFF INSPECTION TYPE DATE INTITIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical '
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical - '9 i'9-77 7 In
201 Final Block/Retaining Wall 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
2446-46
.
j
ADDRESS OF BUILDING: 136 CECIL PL - UHF 201 CITY OF CO\ 1 MESA - BUILDING PERMIT TER;I i;0; Z. .,-i-�.
OWNERS NAME IF KNOWN: BULLARD, RICK
ADBREss: 136 CECIL PL _ FERMIT NO: E 071311 PLAN CHECK NO: N :.,--:: . .. .::i I . ..
COSTA MESA, CA 92627
722-6151 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ALT
APPL.MAILING ADDRESS
JOk DESCRIPTION : REMOVE & ENLARGE 2ND FL DECK SQ FT:
ARCNNECTOREI fi: JAY CROWFORD uexG: C9001 1
ARCN OR END'S ADDRESS: 6 MORGAN EMT: 100 CLAIM VALUE; CALL-VALUE: GROUP OCC: R-1 /
IRVINE CA 92718
CONTRACTOR'S NAME, COMMENTS : REF: B-70197 1
COMPACTOR'S YNI0i0 444414444444E 444***** 4443444*4344344 i4**1E44444444444E*344443444433 if 44-144444*344444444444i444*44.
ADDRESS UR.NO.: Z O N I N G REQUIREMENTS
WIT: SETBACKS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I ern licensed under provisions of Chapter 9
(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full forcead erect. MAIN BUILDING ACCESSORY BUILDING
CRY LIC.NO.: LIC.CLASS: LIC.NO.: EXP ; FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
/.!t Contractor:
'At
re r ER BUILDER DECLARATION:I hereby affirm under penehy of perjury that I am exempt from the Contractors Lienee Lew for the PARKING REQ• P RO V: PARCEL : 42605312 Z N E: REF NO:
ir',allowingsmcreason(Section 7031.5 Business and Professions Code:Any oily a county which require.a p sig tat COnStn nt alter.improve. PLANNING NOTES>
r,Wsm or repair any structure,prior to is issuance,also requires the applicant for such permit to file a signed statement that he a she
licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commencing with Section 7000)d Division 3 d the >
^�Busineess and Professions Code[or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 4444444444444444444444444444444444x444444444 u444444441444444444444444444444444444
7031.5 by any applicant for a permit subjects the applicant toe wit penalty of nig more than fire hundred dollen(95000.- DEVELOPMENT S E-R V IC ES REQUIREMEN TS
EI I.an owner of the properly or my employees with wages in Ihek Bole compensation.will do the work,and the sbuctwe is not intended
or offered ler sale(Section 7044,Business and Professions Code:The Contractors license Law does not apply loan owner of property 7 +�
who bolds or improves thereon.and who does such work himself CC herself or through his Z or her employees,provided that snob ONING APPROVED BY DATE;
improvements era not intended or offered for sale.If,however.the building or improvement S sold within one year of completion,the `
owr«.widerwiI have the burden of proving hen she did mol wild or improve for the purposed sale). BUILDING APPROVED BY : DATE: _
o Las owner d the property.am exdusirety contracting with licensed contractors to construct the project(Section 7044,"minces and
Profession Code:The Contractors License Law does not apply to an owner d property who wilds or improves thereon and who
contracts for such projects with a contractor(s)licensed pursuant !!/RR ram Law /�/1 APPLICATION ISSUED B Y : ( ' DATE: ,
❑ exaammq undo jeclbn B. vim':e^ la Sx ext.
i444 44*4+***444E*ivx4in*i4**e-444+414#x**i44444**-1#if#**44 4V i4*-1tr+44
i4 44***if,*
**ifs4144*44G*44**44#'+fi4 i4*df 4nif
�. (//�� IrJI /U(' 444444441444444E*144E 44f 4414 i4+t i4 if r144f 144E if iF 44 4E 1414 if 1444 iEaE 444444#1'4f ac 14444444 Y44V i4 i4+F 44 i44f 4414 x4144(-44 i4-1F i44444M4Y +444 uf.4E i4 air 44 i44r.
°w a` '� 60� LEGALIZATION:N F E E% . S U. M M A R Y STRUCTURAL SEGMENT: N
«hereby certify that I em aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534,and that l or any future wilding occupant will/will not(circle one)need to comply with said Sate codes endtheiequirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modification from the Ar uIt3 Management District.Residential construction applications ere'exemq from these PERMIT 5 , 25
provisions.
Dae: Applicant: 50 o SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: ISSUE FEE 15 . 00
❑ Ihave and veil maintain a certificate of consent to self-insure for workers'compensation,as provided for by Semon 3700 of the labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,for the performance dthe work for wham this pemm Tissued. TOTALS----> 5 , 25 15 , 00 0 . 00 20 . 25 20 , 25 . 00
❑ I have and wit maintain workers'compensation isuraroe,es required by Section 3700 of the Labor Code,for the performance of the
wakf«whim this pamileisued.Myw« a compensationkarinsurance carrier and policy number are:
REVENUE DIVISION TOTALS--> COLLECTED: 20 ^ 25 OVER/SHORT: . 00
Pony:
Polity Numlar. - - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
cods ion need not be completed the penny is ser one hundred dollen/sl0o/aiss.l 20 . 25
I amity that in the performance d the work for which this permit is issued, Mall not employ any .. ..: '.any so as to
become subject to workers'compensation laws dCelRani • that'� should .:..� the workers' 444***** 41E*44444i444444E4444*441444N4444****if#34-***4r444E4444 44444444*A(441444144414*i444*****44i444xi4 a444444E4444444G4i44F44
coon ger d Section 3700 d the labor Code.h h ' comply . . ..; Z N D I L7 I D U A L F E E B R E A K D O Id TI
�2�s Applkgela nl
Imp: Munro WO wodrsro'rorrperuedon u:overegsb unlawful,and cshell art of
employer eMM.providedf and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines Ip to ole hundred thousand dollen(5104000).M addition to the cwf of compensation&Mare as provided for In
Secdon3706oftheLaborCodeInterest,endatromaySfees. ELE 3 FIXTURES, LIGHTING 1 ST 20 EA. . 75 2 . 25
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there i a conatmdion lending agency for the ELE 3 RECEPT/OUTLET 1 ST 20 EA. . 75 2 . 25
performance of the work for which this permit iissued(Section 3097.CW.C). ELE 1 RECEPT/SWITCH 1 ST 20 EA. . 75 . 75
LENDER'S NAME: END OF FEES
LENDER'S ADDRESS:
I certify that I have read this application and stale that the above information is coned.I agree to comply with all thy and county ordinances
and state laws relating to building construction and hereby authorize representatives d this city to enter upon the above•mmined property
for"salon
Ail^'2 J:Nom, 01 00177452-9151177453 '1"5a 2
ic
6 % � DATE; 02/ZSl xn TItlE: 13:3Q 20.9� .!.."'', •WAppicant/Cantrmor Dalt
(5151-46.WP) Whhe-Building 8 Safety:Green-Ie:Caary-Appian:Pink-Revenue:Goldenrod-Assessor
PO1 I SPA
CONSTRUCTION AND PLANNING ' - •
Date Inspector ' i Date- . Inspector
APPROVALS Permit # '• APPROVALS Permit#
i
1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location.' -
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement t
•
3. EIectrical Conduit Utility-Undrgrnd. • 54. Forms I 1
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
1 - .
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test rs
6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation i 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. I 60. Backwash Lines. P-Trap,tI'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 I 65. Electrical-Final
15. Rough Electrical-Conduit ' • 6r' olar System-Final •
16. Rough Electric Wiring - 13/ !16' _-� 7. r ncing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough&Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric 6; Notes:
34. Final Heating & Air Conditioning ////
35. Final Gas Pipe-Test
36. Hood or Canopy
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
1 44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING .
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�PflO OWNER'S
NAME: 136 CECIL PL UNIT: 201 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 07019 ,
OWNFgsNAMF: BULLARD RICK
ADDRESS: 136 CECIL PL PERMIT NO; B 070197 ✓PLAN CHECK NO: 04382-94 L GOVT: N SUPP ; N
COSTA MESA, CA 92627
CONSTRUCTION TYPE; PERMIT TYPE; STR PURPOSE; ALT
722-6151
gFC.NO.:
ARCH/RNOOflES$:GINEER:
JAY CRMOWFORD ORGAN C9UNA:1100 JOB DESCRIPTION : REMOVE D ENLARGE 2ND FL DECK SQ FT: 196
IRVINE CA 92718 CLAIM VALUE; 2, 500 . 00 CALC—VALUE; 2, 900 , 80 GROUP OCC: R-1
PERMITTEE: RICK BULLARD ( 714 ) 722-6151 •
ADDRESS: 136 CECIL PL 201 COMMENTS; 196SF DECK AT ENTRY OF UNIT
CLICENSED CONTRACTOR OECLAAATION: I hereby affirm thallam licensed under rA 92ns Cliapler9(commencinp with Section *******************************************************************************
7000)of Division 3 of the Business and Professions Code.and my license is in full force and MGM. ZONING REQUIREMENT S
CITY LIC.: STATE LIC.: CUSS: EXP : S E T B ACK S
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT; 34 FT 6 IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,lab.C). LEFT; 31 FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV; PARCEL ; 42605312 ZNE; R2 REF NO:
J Certified copy is hereby fumisbed. 0 Cethfied copy is fifed with the city Bufthng Division. PLANNING NOTES> REMOVE 2ND FLOOR DECK; REPLACE D EXTEND DECK APPROX . 19 SF,
> EX . STAIRS TO DECK TO REMAIN. DECK SERVES UPSTRS FRONT UNIT ,
Dalt: Applicant: *******************************************************************************
Ecenify ON FROM WORKERS'COMPENSATION the workf OECLA h this p mit n no�completed the an one m nner so($100 a to m). D EVEL OP MEN T S ER V ICES R EQU IR E M E f; ' T S
certity that in the performance of the for which this perms ed Shag not emDl Derso any manner so as to become
subject to the Workers'Compensation Laws of Catifomia.
L z, �� ZONING APPROVED BY DATE;
Da :1ZrZ.0 S-9 Signature:
NOTICE:If,after making this declaration.you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY
which this permit is issued(Section 3097,Civ.C). DATE;
********************************************************************-******SF****
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E S U M• M A R Y STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I herebyaffirm that I am exempt from the Contractors State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,atter,improve,demolish,or P ERM I T 54 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed . 50
Pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 35 . 10
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE •
•
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
C,X structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 54 , 50 0 . 0 0 35 :10 8 9 . 6 8 9 . 6 0
dnes not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or throughs/ . 00
his or her own employees.provided that such improvements are not intended or offered for sale. II, however the building or V
improvement is sold within one year of completion,the owner wit have the burden of proving he/she did not build or Improve REVENUE DIVISION TOTALS--> COLLECTED ; • 89 . 60 OVER/SHORT• 00
for the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 , 00 . 50 35 . 10
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or Improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'state License Law).l am aware .µ*.*.**.µ*.*****.*,********,*,**,*,µ* µ****, ******,*,w,µ**,**,*,N************X,***********4******
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.8 P.C. IND I V I DUAL F E E BREAKDOWN
for this reason: • Q//^,�/��,/{ TYPE QTY DESCR IP T IO N UNIT COST TOTAL COST
•hx DEC— S,qy Owner:121 w ..
ereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 196 RES—BALCONY, EXTERIOR STAIRWAY 14 . 80 2 , 900 . 80
25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification hum the Air Duality Management District.Residential construction applications are exempt from
these provisions.
• I hte Applicant'
I hereby sd that I slttl this ingtion and stateothat the above informationiseof I agree to comply with all city and county 7
ordinances and state laws relating to building construction and here •autinn�e representatives of dry to ent upon the abovnmentionco
Property for inspection purposes. - 01 DD12838-00172840 T:0T
OGO29.
•
1_I' G(. t DATE; 22/05/74 •0J
/,pial/l''��___ S��y� Signature: i111E: I4•
'erwen 7 4 S 4 S
1641.46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
POt- t SPA
CONSTRUCTION AND PLANNING
Date 'Inspector Date Inspector
` APPROVALS Permit# ',7 p APPROVALS Permit
n
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 UF ER Grnd. 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, 0 Undrgrnd. •
10. Structural Floor System i 61. APPROVAL TO DECK •
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains ' 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final '\
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 0,1
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing G Q/ HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD/CERTIFICAT SSUED
33. Final Electric Notes: z/Zg�s �� U sotr
34. Final Heating & Air Conditioning !
35. Final Gas Pipe-Test �� // ,/
36. Hood or Canopy 1/f_ Ca��a_1% Ale;
37. Final Factory Fireplace L'
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final -
O
41. Solar Domestic-Final •
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations -.
47. FINAL STRUCTURE & BUILDING 01W57;
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
`•4 38720 �� �I , ,onz,sl :: :. . a3. ai -
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LI TION FOR BUILDING PERMIT
For A``//pplicant^^to Fill in Completely/ 7elQ V ^DJATEE RECEIVED DATE ISSUED
/-'
BUILDING I Ji e I / eta. /�" L'�� /��O'�/-7
ADDRESS �7
/� / P, 'MIT O.
OWNER r A.P.NO. • -dy3 - /O
�� i'. it/•
MAILAODRE S BUILDING /7 ' GECf[. r4cc
Z
ADDRESS :Ped.47 �j ^'/dU CITY 'LL La /t jNOL Sy�'o / TRACT II9 LOT ail BLOCK
Z
Z< a NEW , ADD ALTER REPAIR MOVING OFMOLLSH
CONSTRUCTION( ( /
O LENDER -/
CL 03
J BRANCH /• t , ` ^(.�
JN 1< LB OWNER I Q 111.4?-14 syr
m J ADDRESS / �I / t VALUE �7�Q,�tl'O
J m ARCHITECT f TEL. Ulf s es. W/ $ .72jg
y OP ENGINEER NO
WFIRE
K ADDRESS ZONE
atiE
� GROUP 1443
a. LU I
0.4.///h ,JZ/ y BVPROVEO DATE /-0%20?-25.---
_���S�` (V_,
Luz CONTRACTOR
mZ
Jcc ADDRESS /
/ ' / TEL. 11� ZO NO.OF USE OF NE / 'l.
ZFCITY t i r �i-r r/ r NO. cu la_ - PLANS � "BUILDIN / -j / . / /'(Y0
0 STATE CITY YARDS APPROVED YARDS AP-ROVED / r 11
wCC LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING J
_0 SIZE (� / NO.OF BLDGS (FROM C/L STR E /y / /L jj
OF LOT �y-r3 s,�/t/0 NOW ON LOT FRONT 5'T9 ee.atl F4-. tace-
USE OF TTT N
EXISTING BLDG. B.—SIDE ,5T. FT. I
H SIZE OF A5'L y
NO.OF ` �j
ZZ NEW BLDG. 7 3 7 ROOMS / STONES 't L.SIDE /J iFT.>._2 FT.
U EXTERIOR WALL._ ROOF ,,('s�•�r'}OJ( ,
COVERING Tf/r cM COVERING �T�� REAR ) _FT. FT.
J USE OF BUILDING AND WORK TO BE P RME DISTANCE BET. BET.MAIN&
1
o_ MAIN s. AMAIN BLDGS. ACCESS. BLDGS.
-/
Q // /7V VAR.+ DATE
a C.U.P.# APPROVED
1—
APPROVED /. 1 Az p� a
-7,c-
(.0
THY Ul/zHOLD FOR SPECIAI hereby acknowledge that I have read this application and state
D that the above Information is correct and agree to comply with IN*
CC all laws regulating building construction, and I shall not employ
H any person in violation of the workman's compensation laws of
CA the State of California. 1� ^/ Q '9
ZI hereby certify that I am properly licensed as a contractor under " ""'� SD. FT. �� / / O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUA ION IS FOR t
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2
am exempt from the provisions of th. ate of California Business VALUATION
and Professions Code, Division 3,C r 9. m
•otPERMIT FEE $ �z N
Signature of ;Ssi
/ /y/J al m
Permittee J f $ 51107)--- PLAN CHECK $ ` E
o
Authorized Agent s
TOTAL FEE $
w
`. _ PAI
sQo 28 _PAIL 790 :
J 37 :2U
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APP KION FOR BUILDING PERMIT
/ R C I DATE RECEIVED DATE ISSUED
BUILDING /`� /� /l_(// [/ /� �7 {7r�/'
ADDRESS (Q, ( e/ ( \IT .3- 7
'^/
PERMIT NO.
OWNER ,,,„L �SHA ✓c'. A.P.NO. C '--
/// BUILDING I
MAIL ADDRESS /
ADDRESS �E`�`
W W TEL. TRACT LOT BLOCK
I-Z. CITY NO.
ZQ CONSTRUCTION N_ EW _ ADD ALTER REPAIR JMOVINf: DFMnI ISH
- m LENDER \✓x/ Thew(
� zrl ./�-y� r
JO BRANCH (UL //ITVG/C
J� OWNER
ADDRESS
m J a PLe X �/ /y2 VALU$ .
m ARCHITECT TEL. S
J N OR ENGINEER NO '/ r
WQ ZONE I , TjYPE (/ GROUP/�H J
w ADDRESS FIRE �lzV/7t��/'lj '/� ^/L /�
J O CONTRACTOR 7.d - ym I `� BYPROVED DATE lI z-C/'/, 1�(\\�__\
m Z 777JJJJ \ V�
J¢ ADDRESS
W w TEL ZONE NO.OF USE OF NEW M`
O= CITY NO. PLANS BUILDING 1
ZI-
-O STATE CITY YARDS APPROVED YARDS APPROVED
LU
fn CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
7O SIZE NO.OF BLOGS. (FROM C/L STREET)
OF LOT NOW ON LOT FRONT FT. FT.
USE OF
EXISTING BLDG. R.SIDF FT. ET,
I- SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT.
✓ EXTERIOR WALL ROOF
COVERING COVERING REAR FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
d
a MAIN BLOCS. ACCESS.BLDGS.
Q VAR.* DATE
0
C.U.P.# APPROVED
F APPROVED
V7 ,_EY DATE 7/
OI hereby acknowledge that I have read this application and state �A �/
D that the above information is correct and agree to comply with ( r - 111
all laws regulating building construction, and I shall not employ
1- any person In violation of the workman's compensation laws of
N the State of California.
? I 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 is
Chapter 9, and that such licenses are in full force and affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: Q
am exempt from the provisions of the State of California Business
VALUATIONQ%)
and Professions Code,Division 3,Chapter 9. n
PERMIT FEE' $ /
Signature of
Permittee $ PLAN CHECK $ E
Authorized Agent /6�'Jj� •� LL
_ TOTAL FEE $// /