HomeMy WebLinkAbout965 AZALEA DR - Building Permits�I
QIECTROOXESS: )EJS AZALEA DR
OWNEP'SNRME: KELLY JOYCE J
aoonEss: �q Z 1 �OPPY ST
CORGrIA, CA
714) 444-9736
ANCHIENGINEEH:
ADDflE55:
UNIT:
9i7i9
wec.xo.:
UNIT:
PENMITTEE: LEWIS & SONS CC>NSTRUCTION ( 719 } 533-99UU
aooness: qzq N JANSSAV
ANAHEIM CA 92$OS
LICENSEO CONiNACTOfl OECLARpT�ON: I here0y affirm �ha� I am licensed under prOvisions of Chapter 9(commencing wit� $ection
7004) ot Dimsian 3 n� �he BuSiPess and Pwfessions Cotle, antl my license is in Iu0 �orce and ei(ec�.
cirruc.: sTareuc.:q16525 cuss: C-39 EXP:
,� %-/9- 9y SiAnature: ��^--�
WONKENS' COMPENSpTION oEClANA7lON: I hereby attirm inat I have a ceniticate of consent m self-insure ar a cenificate o� woMers'
Compensalion Insurance. or a Getlilie0 coDY �hereot (Sedion 3800. Lab. C1.
POLICY NO.: EXP. UATE:
camrnNr:
❑ Cetlitietl [o0Y is �e�eby Wrnished. ❑ Cehifietl copy is IileU with �he ciry BuilOing Divisian.
Dale: FPplican�:
EXEMPTIONfBOMWOBNENS'COMPENSI1710NOECLANRTIUN: (Thissectionnee0no7hewmplete0iitheDermitisforonehundreG(3100)arless�.
I certity Ihal in Ihe pedormance o� �he work for whiCh this permit is issued, I S�all no� employ any pefsOn in any manner 5o a5 b b¢come
subject lo Ihe WoBeK Compensact.i�on Laws of Calibmia. —y���/J
� 7��8�/ SignaNre: ��'4�
aTICE II. atter making tnis declaration, you shoWG become subiect to ihe WorNers' ComOensation pmvisions af [he La6ar
Cotle. you mus� fotlhwi�h comply with such provisions or this Dermit shatl �e tleemetl revakeA.
CONSTBUCTION LEN�ING ACENCY: I hereEy atlirm ihal there is a canstmction lending agency for �he performance of tne xrork for
which �his permit is issuetl �Sec�ion 3W7. Civ. C�.
LEN�EN:
ROOflESS:
OWNEfl BUIL�Efl UECLAflAT10N: I here6y affirm t�at I am exempt fmm ihe Contranors State License Law far the following reason
�Section 7031.5 Business and Professional Cotle: Any city oi counry which requires a permit ro constmct, alter, improve, tlemolis�, ar
repair any stmcWre, ptlor to its issuance, also requires the applicant for such Dermit ro file a signetl statement ihat �e/s�e is licensed
pursuam to ihe pwvisions of tne Contracrors' State License Law (Chapter 9(commencing with Sectian 70W) oi Divisian 3 of the Business
antl Pmiessions Code� or Ihat he/she is exempt �herefrom and ihe hasis lor Ihe alleged exemD�ion. Any viola[ion oi Section 7U31.5 6y
any applicam lor a permit subjecis tne applicant to a civil penalty of not more ihan five Auntlred dollars (�`�).
I. as owner of Ihe p�oPeny or my employees with wages as iheir sole compensation, will tla Ihe work, an0 Ihe
❑ sirucNre is not intended or oiferetl for sale (Section 704d, Business and Pmiessional Code: The Coniractors' State License Law
tloes nol apply to an owner oi a pm0erty who 6uiltls or impmves thereon, and who tloes suc� work himself/hersetl or IhrouAh
his or Aer own employees, pmvideC that such improvemenis are not inten0e0 ar oflered for sale. If, however Ihe builtling or
impmvement is saltl withm one year of completion. Ihe owner will have ihe bur0en al pmving he/she tlitl not Ouiltl or impmve
for Ihe purpose of sale).
� I. as owner al the pmpeRY. am excWsively coniracting with licensetl contractors to construct the D�oject (Section 704d, Business
❑ antl Professions Cotle: The Contractars' State License Law tloes not apply to an owner of pmOeM who bwlds ar impmves thereon
antl who conlracts br such prolects with a contractor�s� license pursuanl ta Ihe Caniractors' State Lkense Law�. I am aware
Nai pmof al their WorNer's Compensation insurance shoultl be provided to me.
� I am exempt untler Sec�iore 9. 8 P. C.
tor Ihis reason:
�aie: Ownec
I tlo hereDy cenify ��at I am awa�e ol antl understand t�e repuirements oi Califomia HealtA antl Sa�ery Cotle Sections 25505, 25533, and
25534 antl that I or any IUNre builaing occupant will/witl no� (circle one) neetl to comDN with said state cotles antl the requirements for a
permit lor constmction or moailication imm the Fir Oualiry Management Oistric�. Pesitlential constmction apD�iw[ions are eKemO� f�am
mese pmvlsfaos.
�ale: ppplicanC
i hereby cenity ihat I have reatl this application and state ihat ihe aUave information is correct. I aBree to comply with all ciry and counry
ortlinances ana slaie laws rela�ing �0 6uiltling cons�mc�ion an0 heBby auihonze represenla�ives oi �his cRy �o en�er upon �he above�men�ioned
�mpetly for inspection purpose5� �
e: �'�� — / �/ Signawre: / ��'� �
oriver's �icense or Socia� Securiry a:
16avn6 Whue—Builaing; Green—Cotle Enbrcemem; Canary—qpplicanl: P�^k—Revenue; GolGenrotl—Assessor
CITY OF COSTA MESA — SUILDINC FERt9IT PERi! NO: B 0681i8
PERMIT NO; B 068118 PLAN CHECK NO: N GOC'T: N SUPP: iJ
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: OTH
JOH DESCRZPTION ; T/OFF 6 REROOF Sd/LITTILE 5.8PSF SQ FT: 9,500
CLAIM C�ALUE: 9,500.00 CALC—VALUE: 9,500.00 GROUP OCC: R-3 /
COMMENTS: USE LITETILE CONC. ICBO # 2093
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Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSOR`L BUILDING ---------
FRNT; FT IN REAR;. FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
FARKING REQ: PROV: PARCEL; 41217333 ZNE: REF NO:
PLANNING NOTES>
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D E V E L O P M E PI T S E R V I C E S R E Q U I R E N E N+T S
ZONING APPROVED BY DATE: -
BUILDING APPROVED BY : LATE: �. �
APPLICATIC�N ISSUED BY: �Lly� DATE• '` y
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LEGALIZATION:N F E E S U M M A R Y ' STROCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FLAE SMIP/RES GRADING
PEAMIT 117.00 , .95
SMIP/NON—RE5
PLAN
ZSSUE FEE •
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL FAID DUE
TOTALS----> 117,95 0.00 0,00 1i7.95 117.95 .00
REVENUE DIVISION TOTALS--> COLLECTED: 117.95 O�'E&YSHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/T�T GRADING PLAN—CHECK
117.00 ;95„
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I N D I V I D U A L F E E B R E A K D O W PI
TYPE
SFR
QTY D E S C R I P T I O N
9500 REROOF BY VALUE RESIDENTZAL NOZONE
END OF FEES
S���E DET'ECTOR
f���t11RE�
. _ r,.,.
UNIT COST TOTAL CO5T
":1.00 9,SQ0,00
Q7 00264246—OD164247 T4 T 117.95
DATEe 07/18/44 7IME: 10=SS
_* .
CONSTRUCTION AND PL,qNNWG i� I POOL a. ePA ' ,
� APPROVALS Permit# Oate Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ,
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement
3. Elecvical Conduit Utility-Undrgrnd. ,i ,'i 54. Forms �
4. Electrical Conduit-Undrgmd. � '� 55. Electrical Bonding "
5. Steel Reintorcement �. � 56. Rough Plumbing & Prassure Test
6. Eiectrical UfER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings � 58. Electrical Conduit-Undrgmd.
S. Foundation ' ��' 59. Gas Pipe, O Undrgmd., Tesc �
9. Water Pipe-Undrgmd. �� � 60. Backwash Lines, P�Trap, C] Undrgmd.
70. Struciural Floor SYstem , �� 61. APPROVAL TO DECK
11. PropertY Sewer Line & House Cannection " I 62. Backwash & Receptor�Final
t2. Sewer Cap 63. Hea[er & Vent•Final
13. Foof Drains - e 64. Plumbing SYstem - Finai
14. Rough Plumbing � 65. Electrical-Final
15. Rough Elec;rical-Condult � � 66. Solar SYstem�Final
76. Rough Electric Wiring ' �� 67. Fencing & Access Appioval
77. Rough Wiring Siyn 1' 68. APPROVED FOR PLqSTERiNG
78. Rough Electrical-T Bar Ceiling �., 69. POOUSPA SYSTEPAS FINA�
19. flough Heating & Air Conditioning I FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � y APPROVALS Permit #
21. Ducts, in Structure '� 1� 70. Underground Hydro �
22. Ducts, Ventiiating 71. Product Piping .rJ Gas ❑ Oil
23. Gas Pipe-Rough & Tesi 1'i� 72. Underground Fiush
24. Roof Framin �
9 � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing ?��...R'� �QCv(� 74, Overhead Hydro
26. T�Bar Celing (Structuralj & Monocoat � �� 75. Dry Chemicai
27. Frame and flashing ' I 76. Dry Standpipe
28. Latfiing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing I HEALTH DEPT. REQUIREMENT -
31. Plaster Brown Coat � Y� 79. FINAL INSPECTION "
32. Electricai Power Meter-Final � 80. FOOD CERTIFICATE ISSUED •
33. Final Electric � . Notes: � ', � '' ��
34. Finai Heating & Air Contlitioning o . �-+�`Z ,o„_
35. Final Gas Pipe-Test ii -�1�
36. Hood or Canopy ° � 'F;
� _
37. Final Factory Firepiace 1 � - I
38. Final Plumbing ",-- �
�� ' x_ j
39. Water Service�Final ' ^ '
40. Gas Service-Finai �� '
41. Solar pomestiaFinal �i �,
42. Backtlow Prevenfer ' .
� Z �� •
43. Backflow �rrigation �� �
44. Landscape Irrigation System . �
i
45. Sound Attenuation '
46. Handicap Regulations � '
47. FINAL STRUCTURE & BUILDING Z` �"
48. FINAL PLANNING
49. Electric Release to Edison ' +
50. Gas Release to Southem �alifornia Gas Co w
51. CEflTIFiCATE OF OCCUPANCY j
No. Date
�b��J
COSTA MESA BUILDING-SAFETV DEPARTMENT
3O1 B P•O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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Fo� Applican[ to Fill in Completely
BUILDING / /�
ADDFiESS (Qo�
OWNER LARWIN SOUTHE CALIFORNIA, INC.
MAIL 16255 Ventura Bbvd.
ADDRE55
aTv Encino, Calif. rTioL986-8890
CONSTRUCiION
BRANCH
ADDflESS
ARCHITECT
Blvd.
CALIF. N�`273-4464
nooaess 9100 Wilshixe Blyd. B.H.
CONTRACTOR Larwin So. California, Inc.
ADDRESS 16255 Ventura Blvd.
CITV Endno, California No�' 986-8E
LIC.ivo. 191311 LICVNO. g��.
SI2E NO.OF BLDGS.
OF LOT (�2 X lO3 NOW ON LOT O
USE OF
EXIS7ING BLOG.
512E OF NO. OF
NEWBLDG. �.9H7 Sf ROOMS STORIES 1
COVERINGALLStuCCO COVOERING W�Od shinele
USE OF BUIL�ING AND WOFK TO BE PERFORMED
�9
I hereby acknowl¢dge that I have reatl this application antl state
that the above information is correct and agree to comply wiih
all laws reguletin8 builtling construction, antl I shall not employ
any person in violation ot the workman's compensation laws of
tha State of California.
I hereby certify thet I am properly licensetl as a contractor untler
the State ot California Business antl Professions Cotle, Divisicn 3,
Chapter 9, and that such licenses are in full force antl etfect, or I
am ezempt trom ttie provisions of the State of Celifornia eusiness
antl Protessions Cn�ie, Division 3, Chapter 9.
Signature
Pelmittee� ��� 71 T1nr.mc
Autharized Agent
lUL -5-73PA��OO 292� *** 173.40
[MSP
APPLICATION FOR BUILDING PERMIT
RECE VE BV D TE RECEIV D D TE ISSUE
n�-ad- -�
� ERMIT O.
A.P. NO. �"
ADORIE S / !O eJ � VLS
FIRE
ZONI
APPF
YAF
M<
flOM
#
CL(/GC.//Y/!'(l l "O "
YALUE
e, $
�
TVPE GROUP
r
DAT
NO,OF USEOFN
PLANS Z BUILDING �
iAPPROVED VARDS APPR VED
I BUILDING ACCESSORY BUILDI
L S�EET)
'� FT. FT.
SFT. FT.
S FT. FT.
i
— FT. FT.
BET. BET. MAIN &
HOLD FOR SPECIA E �
m
�
SQ. FT. O o
THE AMOUNT SHOWN UNDER VALUATION IS FOR �
THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: m
¢
VALVATION � `! � U-�D y
� PERMIT FEE $ � j
� /�7 m
$ � � PLAI�yC/HE�C�_K/� $ � E
i / L' V-i/ _ _ LL
Cl2. �F COSTA MESA REQUEST FOR OCCU, �,CY
7s:�� �
_�
TRACT N0.
TAT N0. ,S J�✓
ADDRESS ./ (� s_ j% z � / � �
DATE O �Z C ��
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
{he-'she-they) (was or were) 4 advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approva2 other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uncompleted condition.
!"'��I11ED
. RE�t.IVE��
�'?" � 'OSi,S ; iC3A
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��8�9;1ur�,:�,�, _ �2��a „��
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BY � '" �2 ' - �v / � �-t'/"�
�Purchaser �
� � / \�
._----
BY / L—�� ld-�Lv_c� //�'!��'�^'f-C�i� �
Aeveloper and/or authorized
representative
BY i2��i'f�r., l/. it�•-�.
Lender ;