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Home My WebLink About950 SERRA WAY - Building Permits • "----7 M s, CITY OF COSTA MESA r W4t BUILDING DIVISION PGl< 1-t DEVELOPMENT SERVICES DEPARTMENT 4• PERMIT PERMIT NUMBER °"P P98-00842 ,/ (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 950 SERRA WY Status: ISSUED Suite NoApplied: 11/10/1998 • Issued: 11/10/1998 Vicinity: Parcel Nunmber: 14155205 Applicant: RON Address: C/O NOCK PLUMBING Phone: 714-895-1246 Zip: Owner: COULSON, HEIDI Address %COULSON,JAMES A TR COSTA MESA,CA Phone: 950 SERRA WAY Zip: 92626 Contractor NOCK PLUMBING Address: 11612 KNOTT ST Phone: 714 895-1246 GARDEN GROVE,CA Zip: 92841 License: 707775 Arch l Eng: Address: • Phone: Zip: License: SCOPE OF PERMIT ' DISHWASHER CHANGE-OUT FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 , Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $8.75 1 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 $0.00 0 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: $30.75 COMMENTS/SPECIAL CONDITIONS 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 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 w rk 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 carder and policy number are: ''11 _ Cartier: /OWL` r ( Policy Number:Nv�^4 7/q 3 V 40 L (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 theseprovision • 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 DOU.ARE($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 u,ndo1 p, vi ons of Cha $z 9(commencing with Section 7000)of Division 3 of the Business and Professp) rs Code,end my license is in full force and effect.Lic.p ! 7 7 7 5 Class a C."% & Contractor's Signature: 7�9 --��-1 _ Date: // ' / L- >7 CONSTRUCTION LENDING AGENCY: C_ ❑ 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 subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 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? 0 Yes 0 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? 0 Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? O Yes ❑No (Section 65850.2 of the Califomia 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 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? 0 es ❑No 8 (II yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owners Date And/Or Authorized Applicant Date CODE! IN$PFrTIONTYPF gait =ALS CODE! INSPFm1nN TYPE DATE lNBUALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ia-a l -9$ 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 _ 204 Final Demolition 250 Final Building/Occupancy 2446-46 5 fz3 Applicant to fill in all spaces except those within heavy border r lines and sign all appropriate declarations. • CITY OF COSTA MESA i P IT NO. • TRACT NO. LOT NO. ' BLDG.NO. CONSTRUCTION PERMIT — /3'28 Z LI aQ• {�.s/ („Q •. (1113 5/r'• '�04 e„J TI Applicant's Mailing Address ', ” .. 14-4- YYk La sCy a • TYPE OF CONSTRUCTION U NEW Ll'ADD U ALTERATION U REPAIR . Project Address- Sn Ns R - I r ❑ CONVERSION ❑ DEMOLISH ❑ 0 H_E�} - - ��I r It1 COLA 15 611 Phonee�N-9J 17 DESCRIPTION OF WORK 4I U Nf. t-'•O c'wde'✓ Owner's Name ' � f/ / 3.-"S-,2 ZONING REGULATIONS I Address 17n4^, • - TYPE OF PERMIT U GRADING U FOUNDATION tJ STRUCTURAL A.P.1Y IejI (•-' - .5 ZONE '/`.<j Arch/Eng. 'Th License No. 0 TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL -"• BUILDING •1 PLNG. REF. Address„ /�.at"- ❑,OTHER eprw nrr its GT VI ti� TO BUILDING �1_��1/' //• 71c'6G6G PRaIECT DESCRIPTION SQ.F7. � XZy ��T'J PROPERTY LINE ft71 atD REAR YARD(TO P/L)75 enontiew Contractor's Name ?kepi Sas. Ps D honeOCCUPANCY - - f/ 5 J/yp LEFT SIDE YARD / RIGHT SIDE YARD Address(Mailing) (["�� '�7i �7 L �Pd' xs'✓q pt+(• CONSTRUCTION TYPE y VALUATIONS ��Q �� ZONE •4- i ' GRADING CU.YDS. ACREc PKG.SPACE REQ. ..--- 1 PROVIDED — • License No. - LICENSED CONTRACTOR DECLARATION ' ' Remarks: ' STREET WIDTH ---- PARK FEE$ I hereby affirm that lam licensed under provisions of Charter 9 (commencing - -• - - - with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: . ' I my license is In full force and effect. ��sst 2 9 ZZZ t ' License Cla-ss �'- r.>/ / License No. - PLUMBING , . . 'rI^ Date --//j j Signature /�r(f a=tlsl�•0A-C Bar Sink • Sewer Cap ELECTRICAL ]'J WORKERS'COMPENSATION DECLARATION - - - - ' ((LLvv I hereby affirm that I have a certificate of consent to self-insure or a certificate_ : Backflow Preventer Sewer Connection Automatic Washer Meter Dover 100 amps. of workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.A. Backf low Irrigation Solar Collectors_ Construction Pole Sub Panel (.0 Policy No- -3 0/ / Lay Company 0-� - Cooking Unit . Sub Pole \ 8 Certified copy is hereby furnished. ! Bathtubs Solar Piping _ Certified copy Is tiled with the city Building Division. Dishwasher Motors ❑0-1 HP ❑1%s$ I Date Applicant - Clarifiers • Solar Tank I� EXEMPTION FROM WORKERS'COMPENSATION DECLARATION . Dryers ❑Gas ❑Electric Inc.Solar 09-15 HP 016-15+ \\v (This section need not be completed if the permit Is for one hundred($100)or I Dishwasher Swimming Pool w/Spa less). Fan Microwave I certify-that in the performance of the work for which this permit is Issued I Drinking Fountains Urinal • shall,not employ any person In any manner so as to become subject to the - - - - - F.A.U. • Pole Light Workers'.Compensation Laws of California. ' Floor Drains Water Closet - Date - Signature - Fixtures I NOTICE:If,-after making-this declaration,you should become subject to the - - Fldor-Sinks - - - - Water Heater Range -- - . Workers' Compensation provisions of the Labor Code, you.must forthwith - , comply with, such provisions or this,;permit shall be deemed revoked:, Gas Service ' Outlets Water Service • Device Boxes Sign 'CONSTRUCTION'LENDING AGENCY - - • - - - _-- - Outlets Thereby affirm that there Is a construction lending agency for the performance Interceptors Standing Sections of the work for which this• permit is issued (Section 3097 Civ. C.) Switches Lender's Name. /////t )1 _ • Kitchen Sink .. 'Trash Compactor Lender's Address u�ti.1C " - - - - - t OWNER BUILDER DECLARATION - Lavatories - • Garbage Disposal I hereby affirm that I am exempt from the Contractor's,Llcense Law for the --- - , Generator 00.5 KW 05-15 KW ' ' following reason.(Sectlon 7031.5 Business and Professional Code: Any city or P—Trap ' , , . _ • - _ , 'county which requires a permit to construct,altar,improve,demolish or,repair - Transformer ❑15.50 KW ' 'any structure, prior to Its Issuance,also requires the applicant for such permit Roof Drains' - to file a signed statement that he/she is licensed pursuant to the provisions of ; _ - ' 050+KW • the Contractor's License Law,(Chapter 9(commencing with Section 7000)of Reinspection Fee $15 Division 3 of the Business and Professions Code) or that he she Is exempt Showers I - ' Reinspection Fee $15 - therefrom and the,basis for the alleged exemption. Any violation of Section --- - - - -- - - - Meter ❑up to 100 amps Issue Fee $ 3 7031.5 by any applicant for a'permit' subjects the applicant to a civil enalty of not more than five hundred dollars($500). , Zoning Approved By D/Cr.- Kisdc Date '---a/_, • Service Sink Issue Fee $ 3 I, as owner of the property or my erilployees with wages as their sole _ MECHANICAL compensation will do the work',and the structure is not intended or offered 1 . Application Approved By //� Date / •/ for sale.(Section 7044, Business,arid:Professional Code: The Contractor's - 1 ' \VVV{es(,..� 2Z �' License Law does not apply to an owner of a property who builds or improves Boiler - Refrigeration System thereon, and who'does such work himself/herself or through his or her own I t Application Issued By Date emploees, provided that such improvements are not Intended or offered for Duct-Under Ground ❑0-100,000 BTU ❑100,000 BTU sale- if, however, the building or improvement is sold within one year of com- SUMMARY OF FEES pletion, the owner-will have the burden of proving he/she did not build or Im- , Drove for the purpose of sale). i ( ' Duct-Structural System Repair/Alteration ,BUILDING PERMIT $ 2,4to $MIP , $ 0'`rO I LJ 1,as owner of the property, am exclusively contracting with licensed con- ' • - - - tractorsto construct the project (Section 7044,Business and.Professlons Code: Duct-Ventilating .._ _ ' . PLAN CHECK $ / • 70 PERMIT The Contractor's License Law does not apply to an owner of property who ISSUANCE $ '• builds or improves thereon, and who contracts for such projects with a con- I Exhaust System 0 Multiple 0 PLUMBING $ . tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ GRADING • $ ' ❑1 am exempt under Section B.6 P.C.for this reason Firepl/Fact.BIL ICBG'' t , Date ' Owner - Heating System&Ducting ELECTRICAL I $• I $ - I hereby certify that I have read-this application and-state that the above - 00-100,000 BTU 0100,000BTU - - - - 'PLAN CHECK' $ MICROFILM $ information is correct. I agree to comply with all city and county ordinances TOTAL FEE $ and-state laws relating to building construction,and hereby authorize repre- MECHANICAL $ sentatives of 1 is'city to enter.upon the above-mentioned pr rty for Hood or Type 1 ❑ • Reinspection Fee', $15 : LESS inspection our os ss, /� / 11 n I Canopy Type II ❑ - , . PLAN CHECK; $; I ADVANCED PC - $ . 3('� • Signature AO,,/�i'IV �bfti I. Date • ' - / • Registers . Issue Fee $ 3 i DriJers'License or SS ��^ /7-' j FINAL FEE' $ - CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor . . C tCONg:r UCTION,AND_PLANNING - - -- = ' _ _' - - ; POOL-&SPA -- -• - ' - Date•, ;Inspector • Date Inspector . _APPROVALS , Permit:4- • - APPROVALS'--- Permit# " ' ! 1. T- • empor'ary iElectrical Service 6r ;• Pole . - __ - 52.--: Pool &•_ quipmet Location En - _ - _ 2! Sail Pipe-Undrgrndra 3 ,! ;., 53, Steel Reinforcement - - - - - 3, Electrical Conduit utility-Undrgrnd- ' _ 54: Forms :' '_ . ' - " "? 4: Electrical Conduit-Uridrgrneg _ _ - • '55. Electrical Bonding • 5: Steel Reinforcement • .4".;, •, t,- _ L. r , , - 56_ Rough Plumbing,& Pressure Test - " 6: (Electricalq '7.UFER Grnd,I , '- ' 57: APPROVAL'TOCOVER-GUNITE : 7, Footin - ' ,g9 4 °1• _:_ '58'. •EledtricaP Coriduit•Undrornr{,. • ': 8. Foundation 1 ; ' _ - t 59- Gas Pipe,O;Undrg• rnd.,Test - 'l ' 9. Water Pipe-Undrgr . ;nd - -60. Backwash Lines, P•Trap, 0 Undrgrnd. " 10. Structural Floor System oI ig , 61. APPROVAL TO DECK • 11. Property Sewer Line &'House Connection _ r ' 462. .Backwash•&_Receptor-Final ' ' - - 12. Sewer Cap - = 63. Heater &Vent-Final • - 13. Roof,Drains • ! ,' : X64. Plumbing:System -Final , - : 14. Rough Plumbing i - ' • ``_' - '65. Electrical-Final - _ - r -15:',Rough'ElectricaRConduit • - ` .- - -- -1 -- - -;-"",66. Solar SYstern=Final-- - - - - - - ' - , '16.•'Rough Electric Wiring, - ; I - :• _ ---:.- • I 677 Fencing&Access Approval "" - 'l - - " - _ - 17. Rough:Wiring:Sign,• `; I ' i i , , , i _ _ _ 68. APPROVED FOR PLASTERING • ` 18.-'Rough Electrical-T;Ba Ceiling ' ; ;I r ' I I 69 POOL/SPA SYSTEMS•FINAL 'I 19. ;Rough_Heating& Air Conditioning • - I _ FIRE DEPT-;REQUIREMENT - ' ` = •' 20. I,Rough.Factory Fireplace 1 I, , • I ! APPROVALS Permit# ' 211bucts,7in Structure.; I .70.' Underground Hydro .• r • ' ,'-22- 'Ducts;Ventilating 7 • r: I •I ' I ' 71,; Product Piping 0 Gas 0 Oil • I f 23. Gas Pipe-Rough& Tkst i 72.' Underground Flush • ,-24.,Roof Framing . ,11 ! ;:,� , f 73.1 Undergrnd.Storage Tank 0 Gas ❑Oil ' 25:_Roof Sheathing i I = ! : _- ' ' ..:• 74. Overhead Hydro 26. ii-Bar Ceiling (Structural) & Monocoat- ' I _: ' , ;75.' Dry Chemical I c • ''27:.Frame and'Flashi.ng! -- i � *�/8/V( J 5 76- Dry Standpipe 28. Lathing& Siding. - i ; 9 9 I ;� I 77., FIXED SYSTEM FINAL s 29. Insulation - I o '4r• .r, I , '78: FIRE PREV. FINAL , .'30. 'Drywall Nailing , , ,-1 • . I. • + , l ' ' : Notes: i , I 31. Plaster Brown Coat .' r' ; ' 32. Electrical Power Meter-Final ' ' ` i I - •• • 33. Final Electric - __ I I' - _. . _ I J. I -1. '_ I I_. i. . 34. Final Heating&;Air Conditioning I ' , 35. FinalGasPipe-Test i- '` 1, ' • r - i` ' I I` - - • 36. Hood or Copy:- • ' I , I I 37. Final Factory fireplace - i s rr - • I - - 38, Final Plumbing I I , _ I _ " - 39. WaterService-Final ' I , • l 40. Gas Service-.Final ' I . I ' '- I 1 - I i I , I i - . . 41. Solar Domestic-Final I ! •- - i 42, Backflow Preventer j ,,, . • ' 1 - 43. Backflow Irrigation ;' _ _ ! - _ - 44- Landscape Irrigation.System - - , : • 45, Sound 'Attenuation I. ° ,, _ ..• 46. Handicap Regulations I, , I � .' ! ' • ! t- ' -! , '. a - - 47- FINAL STRUCTURE & BUILDING ' . G /3/ 4i -A S • I 1 ' :t: ' !1 48. Special Requirements Completed I i ; 49. Electric Release.to Edison, ' _ _h_ ; 1 „ !•, ;I 50. Gas Release to Southern California Gas Co , ( ' i , ' ; _ 51. CERTIF ,OF OCCUPANCY _ _ -_:- _- '_ 'r' 4 Noi �CA,TE •, Date 1 � T � .1i i PBOJECT11eesEst 0 SERRA WY UNIT: 950 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062885 \ OWNER'S NAME: GUERRERO, JESUS M , a00BEss: %000LSON JAMES A TR PERMIT NO: B 062885 PLAN CHECK NO: N GOVT: N SUPP; N 950 SERRA WAY COSTA MESA, CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT I ARCH/ENGINEER: NEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION ; T/O WD SHKS,RESHEATH W1 /2"CDX APPLY COMP SQ FT: 4 , 833 PERMITTEE: CLAIM VALUE: 4 , 833 . 00 CALL—VALUE: 4, 833 , 00 GROUP OCC; R-3 /M—i ADDRESS:BEST ROOFING ( 714 ) 557-4040 670 W 17TH; ST 37 COMMENTS. SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC, COSTA MESA CA 92627 ****�E+ **4*�E+r�E* *** *****� *** **********�k�r�t�r�p******** *******gip*,F*�E> 4**BETE***** ** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions o apter 9(commencing with Section ZONING R EQU IR EMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and:effect. CITY LIC.: STATE LIC.' C S E T B A C K S 050047 570720 39 Date•7 •6, • c4? Signature:_ — MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm t at l have a certilica a of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.:1 1 3 7 5 1 2—9 3 EXP.DATE: 06/01 /94 COMPANY:STATE FUNDn PARKING REQ: PROV; PARCEL: 14155205 ZNE; REF NO: ❑ Certified copy is hereby furnished. P5' Certified copy is tiled with the ci Building Division. PLANNING NOTES> • — Dale: / > , 7 �'-11/�� Applicant: T/ .17`✓>'\ ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($1iXf)or less). DEVELOPMENT SERVICES REQUIREMENTS 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. ZONING APPROVED BY • Date: Signature: DATE; 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. r CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; 1��I bE DATE• 6 which this permit is issued(Section 3097.Civ.C). ***.***.**..**.***.**.*.*.*.**.*.T{.****.*9F3f* iE iF Y(**** *•1E iF iE 3f*if *********iF**-. . . . • ** LENDER: • ***********. t*********************************** ***************************** • ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES c GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 72 , 00 i 50 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 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 • any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE ' • I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 72 . 50 50 0, 0 0 / 0 . 00 72 , 50 72 . 50 . 00 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 completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 72 . 50 OVER/SHORT: . 00 tot the purpose of sale). 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 72 . 00 , . 50 ❑ 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).I am aware **,**,***,**,*,***,*,*******,**********************************_************************ that proof of their Worker's Compensation insurance should be provided to me. , ❑ I am exempt under Section: B.8 P.C. I N D I V I D U A L1 FEE BREAKDOWN • Mr this reason: TYPE QTY D E S C R I P T I O'N UNIT COST TOTAL COST Date: Owner: I do hereby certify that am aware of and understand the requirements of California Health Safely Code Sections 25505,25533,and SFR 4833 REROOF BY VALUE RESIDENT IAL NOZONE 1 , 0 0 4 , 833 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with sai codes and the requirements for a . END OF FE S permit for construction or modification from the Air Ouality Management District.Residential construcbote'ufications are exempt from ./ i these provisions. - • Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county -/ ordinances and state laws relating to building construction and hereby author'a representatives of this city to enter upon the above-mentioned - • property for inspection purposes. "--_OaleI '6 ' 977 signature !/ . '� 01 . �% DATE: D7/06/93142272-00142273 03054 72.50 .. Driver's License or Social Security b: Applicant: ink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING • POOL & SPA APPROVALS Permit# , Date Inspector APPROVALS Permit # Date Inspector • 1 1. Temporary Electrical Service or Pole 52. Pool & Equipment-Location 1 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 LIFER 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 1 . 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 I 14. Rough Plumbing • 65. Electrical-Final 1` 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 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing / 73. Undergrnd,Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 1/7//�� 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat YYY 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe -28. Lathing & Siding • I I 77. FIXED SYSTEM FINAL 29. Insulation • 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - I .: 79. FINAL INSPECTION 32. Electrical Power Meter-Final • I - 80. FOOD CERTIFICATE ISSUED 33. Final Electric - � . �' Notes: /eacied 5��4,,g4 /, 34. Final Heating& Air Conditioning I ! � °I """" 35. Final Gas Pipe-Test I I 36. Hood or Canopy I i ; 37. Final Factory Fireplace : I 38. Final Plumbing 39. Water Service-Final j I 1 - 1 40. Gas Service-Final I I 41. Solar Domestic-Final I -I 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . 1 47. FINAL STRUCTURE & BUILDING /o-y_ I (o9-sc<� 5rt'tm leee 't e �a-'- 48. FINAL PLANNING i I �i�-✓T !�-- 4�- 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co I I • 51. CERTIFICATE OF OCCUPANCY No. _ Date T -49 1 286 Lot 60, Tract 4285, 4i O CEIVED 1✓ SEP 6. 1961 COSTA MESA BUILDING-SAFETY DEPARTMENT /a P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. For Applicant to Fill In Completely CITY OF COSTA MESA PP P Y APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 950 Serra Way COSTA MESA. CALIFORNIA For Office Use Only OWNER Mesa Del Mar Development RECEIPT NO. I -9PEEmttl3h Co.CO• -1La.72A MAIL R8L81V BY I DA RECEIV D DATE ISSUED ADDRESS 3800 E. Coast Highway p- / 6) CY Corona del Mar, Calif. ITNO. OR 3422C =Mg? ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER MaCCO Corporation NO. OR 3422c , _ FIRE / ADDRESS 3800 E. Coast Highway ZONE TYPE {� GROUP �1 CONTRACTOR Macco Corporation APPROVED DATE ADDRESS 3800 E. Coast Highway I ZONING CITY Corona del Mar, Calif. [ONEj I NO.DF /I BUI oP H—W]r L - Ci] / PLA NB v..1 /USEONG/ f l , 'p-/� LICNO. 98808-SB-1 TEL. OR 34220 LEGAL DESCRIPTION \ 1l�fF,) d_!f .6 `� SIZE I NO. OF BLDGB. OF LOT 7440 S F NOW ON LOT noA.P.NO. USE OF IYARDS EVES EXISTING BLDG. none APPROVED ALLOWED SETBACK UNE FROM , (CENTER LINE ST.) CENTER OF STREET 49 REAR YARD 21' FRONT 50 FT. ^ IN. SIDE YARD I LEFT 10' I RIGHT 81211 R.SIDE if FT. a IN. DESCRIPTION OF WORK L.SIDE /O FT. 1 IN. NEW I XX II ALTERATION I II ADDITION I REAR z'6 FT. — y IN. REPAIRI !l- / II MOVING I II DEMOLISH I BYPROVED /n�O J DATE O t-r/LI ( Pi SIZE DING 6119"x531 ROOMS 7 STORIES 1 EXTERIOR WALL • ROOF // COVERING stucco COVERINGWd/shingle Living area 1685 S F USE OF BUILDING AND WORK TO BE PERFORMED Single family residence Garage area Llio S F w/attached garage Covered porch, et.r. 68/s F I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IE CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. 1 N VALUATION �T MAI SPERTTEF OF D Ey Development Co. p PERMIT FEE $ -f r By $18,247.00 PLAN CHECK $ / 9- F AUTHORIZED AG 57.00 E TOTAL FEE $ 2