HomeMy WebLinkAbout486 SHADY DR - Building Permits�
CITY OF COSTA MESA
.
�""'FS,, BUILDING DIVISION
F . � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Faz (714) 754-4856 • v+ww.ci.wsta-mesa.ca.us
� ` FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: BX10-00239
PERMIT TYPE B MISC STATUS: ISSUED
APN: 11737252 .r DATE ISSUED: 10/26/2010
Zoning: , ISSUED BY: RMD
JOB ADDRESS: i486ESHADY'.DR GM°� Suite/Unit:
Viciniry: EXTERIOR �' Primary Occ Const Type :?9
SQ. FT: 0 Valuation: 55,000.00
SCOPE OF WORK:
INSTALLATION OF NEW SIDING (ICC# 2588) AND NEW OUTLET AT FRONT OF HOUSE AND RESTUCCO AT REAR OF HOUSE.
OWNER: FARR, GARY M
City/State: COSTA MESA, CA
Phone: 949-646-5721
APPLICANT: JACKIE, FARR
City/Slate:
Phone: 949-646-5721
Address:
City/State:
Zip Code:
ARCHITECT:
Phone
ENGINEER:
Phone
OWNER-BUILDER
FEE SUMMARY
Building Plan Check:
Building Permit:
Electrical Permit:
SMIP Residential
SMIP Commercial
Bldg Std Admin Fund
Address:: 486 SHADY DR
Zip Code: 92627
Address:
Zip Code:
License No. 000000
Phone Cell:
License No.
License Na.
$0.00
$111.25
$24.50
$0.50
$0.00
$1.00
Unit
Unit:
UniC
TOTAL FEES $137.25
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3N8/2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru �:00 pm. Satrudays -9:00 am Ihru 6:00 pm. Prohibited all hours - Sundays and the (ollowing Federal Holidays:
NO710E: The work authorized by mis permi! shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approvai must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
OUEt. INSPEC110NTYPE ORTE IN7O1nL5 CODE1 INSPECTIONttPE �ATE IN717IAL5
1616 Fixed System Final Fire Prevention 206 Final Mechaniral
1266 Pool Spa Final 208 Final Plum6ing n
200 Final Re-Root 210 Final Electrical � y'—�Q —�� �O bv �
201 Final8locWRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Site � ^
jC �F�if/-i� iQA c cb�i
204 Final Demolition 250 Fina� Building/Occupancy ___�
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalty of perjury one of the (ollowing declarations:
❑ I have antl will mgintain a certifiwte of consenl to self-Insure•for v✓orkers'
compensation, as providetl for by section 3700 of the Labor Code, for Ihe
pertormance of Ihe work (or which this permit is issuetl.
❑ I have and will maintain vrorkers' compensation insurance, as required by
sectbn 3700 0l the Labor Code, /w Ihe peAortnance of Ihe vrork !w which this
pertnit is issued. My wprkers' compensation Insurance carrier and policy
number are:
Carrier:
(This settion need rrot �e completed n�ne pe.mrt k valued a� one hundretl tla�ars (Stoo) w less.)
�Polic Number:
t certi(y that in the peRormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to Ihe vrorkers' comppnsation laws of Califomia, antl agree Ihat if I should
beto e subject to the workers' compensalion provisions of Section 3700 ot
t la or Code shall forthwit omply with ihese provisio s.
� _ Dz - �
MP�nYs'Si9nalu�e .`Dete�
RNING: FAI�URE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUT AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aff rm �hat I am licensetl under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of lhe Business antl Professions Code, and
my license is in tull force and effect.
Lia # Class #
Comrac�ors Signawre Da�e
CONSTRUCTION LENOING AGENCY:
❑ I hereby aKrtn that there is a construction lending agency for the
peAormance of Ihe worlc for which [his pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Date
OWNER-BUILDER DECIARATIONS:
I hereby aKrm that untler penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (of lhe (011owing rea50n (Sec. 7031.5,
Business and Pmfessions Code: Any ciry or counry which requlres a permi� to
construcl, alter, improve, demolish, or repair any simcWre, prior to its
issuance, also requires the aDP�icant for such permit to file a signed statement
that he or she is licensed pursuant to the pmvisions of the Contractors
License Law (Chapter g(commencing with Seclion 7000) of Division 3 of the
Business and Professions Code) or ihat he or she is ezempt Ihere(rom and
the basis for the allec�ed ezemption. Any violation o( Seclion 7031.5 by any
applicant (or a permil subjects the applicant to a civil penalty of not more than
five hundred dollare ($500�.):
�0 I, as ovmer of the property. or my employees with wages as their sole
com`pensalion, WILL DO THE WORK, and the structure is nol intentletl or
oflered for sale (Sec. 7044, Business and Professions Code: The Contrectors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himself or herself or Ihmugh his or her own
employees, provided that such impmvements are not intentletl or oflered for
sale. If, however, thn, building or improvement is sold wilhin one year of
completioq the owner-builder vnll have the burden ol proving that he or she
did not build or improve for purpose of sale.).
❑ 1, as owner ol the property, am EXCWSIVELY CON7RAC71NG WITH
LICENSED CONTRACTORS ro consiruct the project (Sec. 7044, Business and
Pro(essbns Code: The contractors License Law dces not appty ro an ovmer of
property who builds or improves thereon, and who contracts (or such project with
a contracta(s) license pursuant ro the Cont2ctors License Laws.).
❑ I am exempt unqer sec.
Business and Professions Code (or Ihis reason:
� 2!v
9aatur ' ' Da1e?
5]-46(3/0])
Ovmer ID verified by driver s lict. .. "�Yes ❑ No
�rivers:License No. Exp� %/�
Verifcation of Ovmership oy (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certi(y ihat no excavalion (rve (5) or more feet in depth iMo which a
person is required to descend, will be made in conneclion wilb �wrk autha'rzed
by Ihis pertnit, and that no builtling stNCWre, scaFfdding, falsev.ork, a demolition
or dismantling �hereo(, will be more than thirty-sia (36) feet high. (Chap. 32, Gry
2, Art 2, Sec. 341, Ttle 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone �0 do work which would
require a permit from the Division of Intlustrial Safety, as noted above. unless
such person has a permit to tlo such work fmm the division.
Applicanfs SignaWre Dale
Division of Indusirial Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the appticant or present or fuWre building occupant need to 61e antl
certify a Business Plan for emergency response lo release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Seclion 25505 of the Califomia Health antl Safely Code requires, with some
exceptions, ihat a Business Plan be fled with the Costa Mesa Fire
Department by every business whiCh has at any one �ime during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume ot 55 gallons, or 200 cubic feet of compressetl gas
at standard temperatwe antl pressure�.
2. Does or will the applicant or present or (uture builtling occupant need to file
a registration form (or acutely hazartlous materials? ❑ Yes ❑ No
(Section 25533 0( the Califomia Health and Salety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantity of acutely
hazartlous materials equal lo or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cuhic feet o( compressed gas at standard
[empera�ure and pressure).
3. Does or will Ihe applicant or present or fuWre building occupanl need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Cotle provitles that the
Costa Mesa Fire Department may require the preparation, certifcation and
fling with the Fire Department of an RMPP Dy 6usinesses which are required
lo register acutely hazardous matenals with the Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of ihe Califomia
Health and Safery Cotle been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre building occupant require tor
the work which is the subjecl of this application a pefmit for such cOnsWction
or modifcation from the Soulh CoaSt Air Quaiiry Management Distnct or trom
any other air polNtion control tlistnct or agencyT ❑ Yes ❑ No
(Section 658502 ot the Califomia Govemment Code requires that the requested
information be fumished on applications fa ran-residential building pertnits).
6. Will any part of Ihe faciliry to be constructetl under this permit be vrilhin
7000 feet �rom the outer hountlaries of a school? ❑ Yes ❑ No
pf'yes", ihe facility must meet the requirement of Sections 25534 antl 42303
ol lhe California Health and Safery Code).
7. I( a permil from the South Coast Air �ualiry Management DisMct or olher
air pollution conirol district or agency is required (or the work which is lhe
subject o! this application, have all of the disclosures prescnbetl by Califomia
Health and Safely Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air polWtion
control oKcer).
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
ciry ordinances regarding Hazardous Materials antl Emissions.
Signature Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
ceAify under penalty of perjury that I have read this application antl state that
the information given is correct. I agree to comply with all state laws and ciry
ordinances relating ro building construction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the above-Uescribed property for
ins ion urpose . I agree not to occupy or allow occupancy of any building
a thorize y thi ermi until f�nspection. / L2 p/�
/A /�G
L�C_.
9lgnat�ure_Of Legal Owner(s) Dai. e--.�
Analor ANM1onzeE Ap0licanl Dd�
ICC-ES Evaluation Report ESR-2588
Issued June 1, 2009
This repoR is subject to re-examination in two years.
www.icc-es.orp �(800) 423-6587 �(562) 699-0543 A Subsidiary o/the Intemational Code Council�
DIVISION: 07—THERMAL AND MOISTURE PROTECTION
Section: 07460—Sid ing
REPORT HOLDER:
COLLINS PRODUCTS, LLC
6410 HIGHWAY 66
KLAMATH FALLS, OREGON 97601
(503)471-2239
www.collinswood.com
dbarnes(a�collinsco.com
EVALUATION SUBJECT:
TRUWOOD� SIDING PRODUCTS
1.0 EVALUATION SCOPE
Compliance with the following codes:
■ 2006 /nternational8uilding Code� (IBC)
• 2006 /nfernationa/ Residentia/ Code QRC)
■ Other Codes (see Section 8.0)
Properties evaluated:
■ Exterior wall covering
■ Wall bracing
2.0 USES
TruWood� lap and panel sidings are used as exterior wall
covering materials (or buildings permitted to be of Type
V-B construction and (or strudures construded in
accordance with the IRC. The hardboard sidings comply
with IBC Sections 1404.3.2 and 2303.1.6 and IRC Table
R703.4. The panel siding is also used for conventional
light-(rame wood construction as braced wall panels within
designated breced wall lines as defined in IBC Sedion
2308.3 and IRC Section R602.10.1, and as str�dural
sheathing tor continuously sheathed braced walls in
accordance with IRC Sedion R602.10.5.
3.0 DESCRIPTION
TruWood�siding is a fibrous-felted hardboard panel made
from wood fiber that is consolidated under heat and
pressure to a uniform density. The product is manufactured
in �/�e-inch (0.400 inch actual) and '/r�nch (0.490 inch
actual) thicknesses and has a factory-applied primer on
one face. The product is produced in lap siding and panel
configurations having a variety of smooth or embossed
surface pattems. TruWood� lap siding products are
machined to a variely of groove patterns, lengths (renging
from 48 inches to 192 inches) and widlhs (ranging from 6
inches to 16 inches). TruWood� panel siding products are
machined to a variety of groove pattems, lengths (renging
from 48 inches to 192 inches) and widths (ranging from 47
inches to 50 inches). TruWood� siding complies with
ANSI/AHA A135.6.
Lap siding is available wilh square or beveled edges, or
with a self-aligning feature on the back of each piece to
allow for alignment of subsequent courses. Premium lap
siding has horizontal shiplap joints. Sure Lock Lap Siding
with Concealed Nailing System has tongue-andyroove
joints on each piece. Panel siding is available with squared
edges on all four edges or with square horizontal edges
and shiplap vertical edges.
4.0 DESIGN AND INSTALLATION
4.1 General:
Installation of TruWood� siding must comply with this
report and the manufacturers published installation
instrudions. The manufaclurers published installation
instructions must be available at the jobsite at all times
during installation.
Except where otherwise noted in this report, installation
must wmply with IBC Table 2308.9.3(5) or IRC Table
R703.4, as applicable. A water-resistive barrier in
accordance with IBC Section 1403.2 or IRC Sedion
R703.2 musl be applied directly beneath the siding.
Vertiral butt joints of the siding must occur over
framing members. A�/�e-inch (4.8 mm) gap must be
provided at all joints and around all openings. Gaps and
vertical end joints must be caulked with an approved
sealant. A minimum 6-inch (152 mm) Gearance is required
from the bottom of lhe siding to adjacent grade. Siding
must not be in direct contact wilh concrete. All exterior
openings must be tlashed in accordance with the
applicable code. Fasteners used to attach the siding
materiai to pressure-preservative-treated wood must be
zino-coated in accordance with ASTM A 153.
4.2 Lap Siding:
All siding courses must be lapped a minimum of 1 inch
(25.4 mm) unless self-aligning or tongue-andyroove joints
are provided on the siding. Sixteen-inch-wide (406 mm)
Premium lap siding requires three nails per lap siding
board on all studs. Successive boards are nailed °/e to �/a
inch (15.9 to 19.1 mm) up from the dnp edge and in the
center of the board. Sure Lock lap siding is nailed on the
scnbed top edge and locked into the siding piece below it.
4.3 Panel Siding:
VeRical edges of siding with shiplap edges must occur
over framing. Vertical edges of square ed9ed siding must
occur over framing and should be covered with batten
strips.
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i end�rz�emem r�the .vuhjea f ihr rcpnr or � rrrummerWa�ion f r iu me. TM1ere ia re.�armnry by lCClsvuhm�iun Servioe. lnc.. eipreri nr impbed. ar �� �
m any finAing ar nther mavn in ihl.r reprn. or m m uny yrcduai caverrdDy ihe reporl. m� y�_
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ESR-2588 I Most Widely Accepted and Trusted Page 2 of 2
4.4 Panel Siding Used as Wall Brecing:
TruWood° panel siding vnth a minimum 48-inch (1219 mm)
width as described in this report may be used as wall
brecing in accordance with method number 8 in IBC
Section 2308.9.3 and IRC Section R602.10.3.
4.5 Design:
The siding products are limited to use on structures o(
conventional light-frame wood construction under the IBC
in areas where wind speeds (three-second gust) do nol
exceed 100 miles per hour (80 miles per hour fastest mile).
In areas utilizing the IRC, the siding products are limited to
use on structures in areas where wind speeds (three-
second gust) are less than 110 miles per hour (90 miles
per hour fastest mile). The panel siding products are
limited to use in Seismic Design Categories A, B or C,
when they are used to resist seismic loads.
4.6 Finishing:
The primed siding must be Geaned, dried and finish-
painted in accordance with the manufacturers published
installation instrudions.
5.0 CONDITIONS OF USE
The TruWood° siding products described in this report
comply with, or are suitable aliematives to what is
specified in, those codes listed in Sedion 1.0 of this report,
subject to the following conditions:
5.1
5.2
Installation must comply with this report, the
manufacturer's published insiallation instrudions and
the applicable code. In the event of a conflict between
the manufacturers published installation instrudions
and this report, this report govems.
All windows, doors and other exterior openings must
be flashed in accordance with the applicable code.
Honzontal joints between siding panels must be
flashed and sealed in accordance with the
manufacturefs instrudions.
5.3 The siding products are limited to use on structures
as described in Section 4.5.
5.4 The sidings must be installed over a water-resistive
barrier in accordance with the applicable code.
5.5
5.6
Truwood� siding panels used to meet the bracing
requirements of inethod number 8 in IBC Section
2308.9.3 and IRC Sedion R602.70.3 must comply
with Section 4.4.
TruWood� siding products are produced in Klamath
Falls, Oregon, under a quality control program with
inspedions by the Composite Panel Association (AA-
614).
6.0 EVIDENCE SUBMITTED
6.1 Manufacturer's published installation instructions and
product literature.
6.2 Reports of tests in accordance with ANSI/AHA A
135.6.
6.3 Reports of racking resistance tests in accordance with
ASTM E 72, following the procedures in Sedion 4.1 of
AC269, dated June 2007.
6.4 Quality control documentation.
7.0 IDENTIFICATION
Each package containing the TruWood� siding produds
described in this report is identifed by a stamp bearing the
manufadurers name (Collins Products, LLC), the product
name, the address of the manufacturing plant, the name or
UademaB of the inspection agency (Composite Panel
Association), the date of manufacture and the evaluation
report number (ESR-2588). Additionally, each package
must bear a note indicating conformance to ANSI/AHA
A135.6.
8.0 OTHER CODES
8.1 Evalualion Scope:
The products in lhis report were also evaluated for
wmpliance wryth the requirements of the 1997 Uni/orm
Building Code (UBC).
8.2 Uses:
See Section 2.0, except TruWood° siding is for buildings
permitted to be of Type V-N construction. Use of the
shiplap panels for shear resistance is as noted in Section
8.4.
8.3 Description:
See Section 3.0.
8.4 Installation and Design:
See Section 4.0, except for the following:
TruWood° panel siding with a minimum 48-inch (1219 mm)
widlh as described in this report may be used as wall
bracing in accordance with method number 8 in UBC
Section 2320.11.3. TruWood� siding products are limited
to use on structures o( conventional light-frame wood
construclion in areas where the basic wind speed ((astest
mile) does not exceed 80 miles per hour (761 km/h). When
TruWood� Shiplap Panel siding is installed in accordance
with UBC Section 2310.6 and Table 23-II-C, the allowable
racking shear design values must be as given in Table 1.
8.5 Conditions of Use:
See Section 5.0, except for the following:
Truwood� siding panels used to meet the bracing
requirements of inethotl number 8 in UBC Section
2320.11.3 musl comply with Section 8.4.
8.6 Evidence Submitted:
See Section 6.0.
8.7 Identification:
See Sedion 7.0.
TABLE 1-TRUWOOD� SHIPLAP PANEL SIDINCTALLOWABLE RACKING SHEAR DESIGN LOADS
PANEL THICKNESS
For SI: 1 inch = 25.4 mm, 1 Ib./ft. = 14.59 N/m.
'Values obtained on aged samples at'/e-inU defleaion.
DESIGN LOAD
155
202
CITY OF COSTA MESA PLANNING DEPARTTfENT
A. P. No. U-372-:'[ �
Bldg. Permit No. a
Project Address
Owner's Name
1U°� 20-7lcnsc001865�o*a*=2�.,^.0
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
r^�, ,�'yC�Y '�f:IYC. CO�T� h'��A, CP.l1f0{{.Ih
!;t�it�' .�. rt�Rf:
Bachelor or 1- Bedroom Units � @$25.00 =
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
S - or more Units @ $75.00 =
Total Fee
Total niunber of Dwelling Units 1
Planning Department Approval Date i�-20-71 Park Area No. :'
r-
By :i.L.v. dh Applicant's Signature
. . !'t �
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P.00licant to till in all spaces ezcept lhose wilhin neavY borGer Iinei antl si9n all appropriate tleclarations.
CIY�F G�F COSTA NFESPI C�NS TRU� CTIONLP�ER,MIT MIT NO.O � �R rt. _LO�Nf'i,f. UNIT NO. �
nx� iu
ProjectAUd��P,�s,/S��% ✓ftif•���j � „ �� 7811 10/21/87 �'loLt9
ApplicAni'sFilailingAddress TYPEOF�CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTH � q.p.# �. � �Z Zone +
U'w'ner'sName � F Phond%�l/e'��� DES RIPTIO OFWORK/US OFBLDG. ��Q2 qaro'qQ- Z
Address /� � �-t- / ���- S Main Building: Accessory Building:
Arch/Eng. t S Y/ S ��lt License No. _� TYP�F PERMI�DING FOUNDATION STRUCTURAL T Front. I i ✓ � \ �'.�r O
Addres5 t � 7Y8� ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANIGAL gA RQ� �' N
❑ OTHER
Contractor's Nam Phone pROJECT DESCRIPTION 5o. FT, oCCva.aNCv � C Right ^� N
Address (mailing) � - ' � � / �1 pp K � , G
' CONSTRVCTION TVPE � VALUATION S.J�y �� K��� S Left R
CityLiCenSeNo. ZONE GRADINGCU.VDS. ACRES
• Pin9. Ref. # - '� � � � s Parking.Req./Provid y/ ZQ $� Q
LICENSED CONTRACTOR DECLA0.ATION
I bereby aftirm [M1at I am liconsetl unticr provislons of Charter 9(commencing ftemarkz: �g� Planning Notes: ��, �� M
with sec[ion ]000) of Division 3 ot ihc Business antl Professions Cotle, antl �-�/
my license is in (ull brce ana ettecL ' . f«y� �s,'l'dU^ �Gi T
License Clazs Llcense No. � // S
Date Signature PLUMBING FEES ���C� �ti %.Z�:o•�Q
WORKERS' COMPENSATION DECLARATION Be/.Sink ShOw¢�5 ' ELECTRICAL FEES
I hereby atfirm that I have a certificate of ConSent [o sel(-insure or a cortificate
ot Workers' Compensation Insurance, or a certl(ietl <opy thereoi (Section � gackflow PRventer Service Sink
3800, Lab. C.) Automatic Washer Transformer ❑ 15-50 KW
PolicyNo. Comoany � Backflowlirigation SewerCap ConstructionPoleSub. ❑50+KW
eCertifietl copy is hereby fumishetl. � .
Certifietl copy is filed with the <ity Builtlin9 Divlsion. Bathtubs`� Sewer Connection Cooking Unit Meter �up to 100 amps
Date APPlicant -
EXEMVTION FROM WORKERS' COMPENSATION DECLARATION � Cl2!-if1¢�5 $Oldf COIIECtO�S Di5hwd5h¢/ M22¢� OOv¢� 1008Tp5
(Tniszection neetl no[ be campletetl i1 Ihe permi[ I5 for one huntlretl ($100) or
less). - Dishwasher Solar Piping Dryers ❑Gas ❑Electtic � Sub anel
I certify Ihat in the per(o�mance of the work fo� wM1icM1 thls pe�m�t is i55uetl, I� �
shau not employ any person in any m�nner so as to becoi e subject to the Drinkin9 Fountains Solar Tank Fan otors DO-1 HP �1 X- 8
Workers' ComDenSation Laws of Califor la. . '
Date 1A.1Js.X15ignature � �' � . Floor Drains 5 imming Pool wlSpa F.A.U. Inc Solar �9-15 HP 016�15+
NOTIC�'� If �after mat inq tnis tleclaration, ou s oultl beco e sub ect to the —
Workers' Compensation provisions of [he Labd COGe, you must forthwith FloorSinks Ur'inal Fixtures �
mmply with such.provisions o� this permlt shall be tleemed revokea. � Microwave
CONSTRUCTION LENDING AGENCV GasService Outl¢[5 �i .Water.Closet Device8oxes
I hereby affirm fhat lheie'is a constru<tiOn lentling aqency (or the perto�mance POI¢ LieJh�
ot tna work for whith thls permil is Issuetl (Section 309] Civ. CJ InterceptOrs Water Heater Outlets Range
Lenaer's Name
Lentler's Aatlress � Kitchen Sink � Wa[er Service � � Swi[ches � Sign
OWNER BUILDEH f�ECLARATION .
I hereby aftirm that 1 Am exempt trom the Conlractor's �icense Law for the Lavamries ' � Auto-Wash Garbage Dispoul $canding Sections
following reason (S¢ctian ]031.5 Busine55 antl Professional Cotle: Any.city or '
munty which requires'S pe�mit to Construct, alter, improvo, tlemolish or repai� P—T�dp � ''��' �! Ldund� Trd 5
any struclure, prlo{1o'it5 is5uance, also requires the applicant for such permit - Y � G¢�¢tdt0� �0�5 KW 05-15 KW STrash Compactor
to file a SlgneC s[atement that he/she is licensetl pursuant to tM1e provisions of R001 DfdinS
the Contractor's Licanse Law (Chapter 9(commfncin9 wlth $ection 7000) of �
Division 3 ot the Business antl Professioni CotlC) o� that he/she is exempt
theretrom antl the basii for Ihe allegetl ex¢mpllon. Any vloldtion ot $ection
]031.5 by any applicant to� a permit subjects IhG applicant to a tivil
e Ity of not more than (ive huntlretl Oollars (E500).
I as owner of tne proverty or my employees witn wages as their sole Reinspection Fee $75 ISSue Fee $ 3 -
o pen5ation, will Eo tha work, antl lhe struclure i5 not inlentletl or offeretl ReinSpettiOn F82 $15 ISSUB F¢0 $ 3
tor sale (Section 7044, Businezs antl Pro(essional Cotle: The Contractor's MECHANICAL FEES
License Law tlOes nol appty [o an owner O! a properry wno bullCs or impmves '
thereon, antl who tloes sucn work himself/herseH or tnrou9h his or her own � DEVELOPMENT SERVIC S�i ji, €AUI TS:
employee5, provitletl that such improvemen[5 a�e not in[entl¢tl o� offeretl for BOiIE/ . HOOd Of TypC I ❑ . ji��� �0��
sale. Ii, howeveq the builtlin9 or improvement is soltl withln one year ot com- '�C2nopy Type II ❑ ZOnmg Appraved By Data
pletion, the owno� will have the burtlen Ot Proving he/She tlitl not bulltl or im- DuCt - Under Ground BUilding ApprovEd By Date �d `�-� g7
prOve for tbe pur0�se ot sale). �. •
�XI I, as owner of the oroperty, am exclusively contractln9 witn licensetl com Duc[ - Svuctural Refrigeration System Appliption Issued 6y ^ Date__(R —;�Lt.S{'�7
R�2cto�s to construct the project (Section 7044, BuSinezS antl Profession5 Cotle:
The Contractor's License Law tloes not appiy to an owner oi property who Duct - Ventilatin9 ❑0-100,0008TU ❑100,000 BTU ,
builtls or improves thereon, ana who conVacts lor such projects with a mn- SUMMARV OF EES /`�
tractor(s1 iicense pursuant ro the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System pair/Alteration ' BUILDING PERMIT $ t�Q�.�Y% SMIP $ • Y�
proof O( meir Worker's Compensation insurance shoultl be pwviaetl to me. PLAN CHECK $ PERMIT �
❑ I am exempt untler Section B. 8 P. C. (or this reason Firepl/FacL BIL ICBO # Fir ampers PLUMBING $ ISSUANCE $
Date owner Heating System & Ducting egisters p�,qN CHECK 25% $ ENERGV P.C. $
I hereby certify that I have reatl thiz applicatlon antl state tnat the above ❑0-100,0008TU �100,000BT GRADING 5
info�mation is conect. I agree to comply with all tlty antl county ortlinances ELECTRICAL $
antl state laws relatin9 io builtlin9 �onsVuction, antl hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city lo en r upon the abOve-men[fOnetl Oroperty for �
inspettlon purp ses. y� ��. MECHANICAL $ TOTAL FEE $
Signature /i Daie� Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
D�ive�s' Licenze O� -
�� CMF 0865-46, rev. ]0/84 White - Bulltlin9: Canary - Applicanp Pink - Accountinq; Goltlenrotl - qssessor
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Date Inspector qPPROVALS Permit # � Date Inspector
1. Temporery Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,
3. Electrical Conduit Utility-Undrqrnd. 54. Forms • �-;i
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � '
5. Steel Reinfarcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings ^J�� �. 58. Electrical Conduit-Undrgrnd.
8. Foundation . } � 1 59. Gas Pipe, O Undrgrnd.,.Test �
�
9. Water Pipe-Unilrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor Sysiem ' 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 .
79. 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 O Gas ❑�Oil ,
23. Gas Pipe-Rough & Test 72. Underground Flush '" i�' �
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil '
25. Roof Sheathing /� 74. Overhead Hydro � � -
26. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical '
27. Frame and Flashin9 �(� ] y 76. Dry Standpipe • ,
28. Lathing & Siding L�7 77. FIXED SYSTEM FINAL • ' �� t` '
(�
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 80. FOOD CE I G T ISSUED r
33. Final Electric Z/ Notes: � �,/OJ.'✓ � d�,c �,w�,��w
34. Final Heating & Air Conditioning . �/Q L i/� �;.
v
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 pomesticFinal � -
42. Backflow Preventer ' •
43. Backflow Irrigation , ' , � .
i � .
44. Landscape Irrigation System
45. Sound Attenuation � •
I :
' 46. Handicap Regulations
47. FINALSTRUCTURE&BUILD�NG Y • � � ,
48. Special Requirements Completed ' � �- �
49.�Electric Releaseto Edison ' �- ! �
�
50. Gas Release to Southern California Gas Co � . �.�
51. CERTIFICATE OF OCCUPANCY, ,-
� No. ' Date �� ' � ' � � �
Applicant to fill in all sDaces except t�ose within Iteavy bortler lines an0 sign all appropriate Ceclarations.
cifiv dF COSTA ME a C4NSTRUCTION PERMIT PERMIT NO. ` r a T LOT N urvir No. 0479 I I/30/87 39028 zi
Project Adnr�ss �p �O� ��
Applicant�s�ailing Addf2s5 _� M E TVPE OF CONSTRUCTION NEW ADD ALTERATIO � REPAIR
dwnef'SName ' PhOne_��(.-C��� � CONVERSION ❑ DEMOLISH ❑ OTHER �� -5 n q,p,# � � 'Z�. �`2 Zone
� D CRIP ION OF WORK/USE F BLDG.
Address A - S Main Building: .Accessory Building:
� ��-S' 7< / —�/i� �• �.,�a' /ot ) / E z
Arch/Eng. ' � License No. TVPE OF PERMIT�DirvG LJ FOUNDATION TRUCTURAL T Front �2 O
Add�255 —- - ❑ TENANT ❑ E CTRICAL ❑ PLUMBING ❑ MECHANICAL e Rear � N
Contractor'sName— (� _Phone 5✓���° � oTHER ��'�,�a�/[JS'¢ % 6X/�y'�,� //�O� P` I
.0 ♦
Address Imailin9) PROJECT DESCRIPTION $Q. FL �d,S � OCCUPANC�'/�� K Re9L� � G
City LicenSe NO. CONSTRUCTION TVPE VALUATION S� �—� S ' p
Z E RADING CU.vDS. ACRES Ping. Ref. # g Parking Req./Provided Q
LICENSED CONTRACTOR DECLARATION
I M1ereby aHi�m tha[ I am licensetl untler provisions of CM1arter 9(commencing Remarks: PldOning NOt¢5: M
with sectlon ]000) of Division 3 Ot tM1e Business antl Professions Cotle, antl S� C
my license is in full force antl efie�t. 9�1/ T
LicenseClass Licenservo. ek� ' We� �'� ' VG �P� S
oate Si9nature PLUMBING � FEES
WORKERS' COMPENSATION DECLARATION Bd/ Sink ShOW¢�5 ELECTRICAL FEES
I hereby affirm that �1 M1ave a certificate of consent to zelf-insure o� a certificate
ot Workers' Compensation Insurance, or a certifietl copy the�eof (Section -
3Boo, �ab. GJ Backflow Preventer Service Sink Automatic Washer - Transformer �❑ 15-50 KW
Policy No. Company Backflow Irrigation Sewer Ca ❑ 50+KW .
8 Certifietl copy is hereby furnishetl. P Construction Pole Sub. '
Certitietl copy is filetl with the city Builtlin9 Dlvision. Bathtubs Sewer Connection Cooking Unit_ , Meter ❑up to 700 amps
Date Applicant �
EXEMPTIONFROMWORKERS'�OMPENSATIONDECLARATION Clarifiers . SolarCollecrors . Dishwasher � Meter ❑OVEf1002mps
(Thissection neetl nat be completetl if the permit is for one hunCretl (5300) or
less). ' Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electtic Sub Panel
I ce�tify Ihat in the per(ormance pf the work (or whiCh th'�t p¢rm�t is issuetl I -
shall not employ any person in any ma ner so as to be ome subject to the Drinking Fountains Solar Tank Fan Motors �0.1 HP 01'/=- 8 -
Workers' Compensati n Laws of Califor ' h ' � �
Date Si9nat�re Floor Dreins Swimmin Pool w/S a '
NOTIC : If, fter making this deCla�ation, you houltl become subject to Ihe _ 9 P F.A.U. Inc Sold/ �9J5 HP �i6-75+
Wofkels' Compen5ation provisiohs of the Ldb f Cotle, you muzt forthwi[h FIOOfSinkS Ulifldl Fiz[ufES MiGfowdv¢
mmply with such provisions Or tM1iS permit Shall be tleemed revoketl.
CONSTRUCTION �ENDING AGENCV GaSServiCe OuUeiS WaterCloSet DeviteBoxes PbleLi ht
I bereby affirm tM1at the�e is a conEtvuctlon lentling aqenry fo� the per/orm�n�¢ 9
of the work for �which this permit is issuetl (Sectlon 3097 Civ. CJ '�
l.entler's Name "' ^ Interceptors Water Heater Outlets 'qange '
Lentler's Atltlress � . Kitchen Sink Water Service Switches Sign �
OWNER BUILDER dECLARATION -
I hereby aHirm thaFl am exemp� from Ihe Contractor's License Law for the Lavaro�ies Auto-WaSh Garbage Disposal , Standing Sections
following reason (Section 7031.3 Business antl Professional Cotle: Any city or
county which requires a permit to construct, alter, improve, demolish or repair P—Trap Laundry Trays Generator OO-5 KW 05-15 KW Trash Compacto�
any structure, p�io� to� its isSuanCe, also requires the applicant for such permit
to fiie a si9netl StdtEment Ihat hp�ghe is licensetl pursuant to the provisions o� ROOf D�dinS � �
the Contractor's License�Law (CM1apter 9(commencinq with Section �000) of
Division 3 of tbe Business antl Professions Cotle) or that ne/sne is exempt .
tM1erefrom antl tbe basis for the allegetl exemption. Any violation of Section
]031.5 by any applicant for d permi[ subjects the applicaN to a civil
alty of not more than five huntlretl tlollars ($500). $ 3 - �
I as owne� o( the properry or my employee5 with wages as their sole ReipSpBction F¢e Q75 IsSu¢ Fee
c pensation, will tlo the work, antl the structure is not intentlea or offeretl Reinspection Fee $15 Issue Fee $ 3
for sale (Section 7044, Business antl Protessional Cotle: The Contractor's MECHANICAL FEES
License l.aw tloes not apply to aq p�yner of a property who builtls or improves
thereon, antl wno tloes such work himselt/herself or through his or her own DEVELOPMENT SERVICES REQUIR�MENTS:
emDloyee5, provitled that such iry�pvovements are not intentletl or otfevetl for BOiIE� HOOd O� Typ¢ I ❑
Shc¢. If, hoWeveq the builtling or improvemenf is Soltl within one year of com- C3nOpy TypC I I ❑ ZOning App�ov¢d By Ddt¢
pleHOq tbe owne� wlll have the bu�Gen of proving M1e/s�e tlltl not bwltl or im- DuCt - Unde� G�Ound
nr ve tor tne purpose ot sale). Buildin9 Approved By Date
I, as owner of the property, am exclusively con[racting wim licensetl con- Duct- Structural Refrigeration SyStCm Application Issued By - Dat b
tor5td construct the proje<t (SeCtion 7044, Business antl ProteSsions Cotle:
Th Contractor's License Law does nol apply to an owner oi property who Duct - Ventilating ❑0-100,000 BTU ❑700,000 BTU SUMMARY F F S �
builds or iTproves Ihereon, antl who contracts for such p�ojects witM1 a con- -
tractor(sI ucense pursuant to the Contractor's License Law). I am aware that - BUILDING PERMIT $ 2-3' SMIP � $
proof O( thev Worker's Compeqsation insurance shoultl be provitletl to me.
Exhaust System ❑ MWtiple ❑ System Repair/Alteration pLAN CHECK $��� PERMIT
❑ i am exempt untler Section B. & P. C. Por this reason Firepl/Fact. BIL ICBO # Fire Dampers PLUMBING $ ISSUANCE S
Date Owner Heating System & Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have reatl this appliwtion antl state that me above ❑0-100,000 BTU �100,OOOBT GRADING $
informalion is mrrecL I agree to comply wi[h all city antl Countyordinantes ELECTRICAL $
antl state laws relating to builtliqg construction, and hereby aurnorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives oi t is city to enter upon the above-mentionrtl property fo�
inspection purp' es. C MECHANICAL $ TOTAL FEE $�
5ignature ,_ Daie�!,��_p.� peinspeMion Fee $15 { Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or 5 � �
',MF OB65-46, rev. 10/B4 White -�uiltling; Canary - qpplicant; Pink - Accopntin9: GOltlenrotl - Acsossor , _ �
CONSTRUfT10N AND PL.ANNING POOL & SPA .
APPROVALS Permit #�� Date Inspector AppROVALS Permit # Date Inspector i
�
7. Temporary Electrical Serv�ce�or Pole ' 52. Pool & Equipment Location �'�
. 2. Soil Pipe-Undrgrnd. �.� 53. Steel Reinforcement .
3. Electrical Conduit Utility-Undrgmd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - I
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test , ,
6� Electrical UFER Gmd. �- d'�, 57. APPROVAL TO COVER-GUNITE
7. Footings ' 58. Electrical Conduit-Undrgrnd. �
8. Foundation ` � 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgmd; _ 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK .� ,
17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � . •
72. Sewer Cap � 63. Heater & Vent-Final
13. Roof Drains ' � 64. Plumbing System - Final ;
14. Rough Ptumbing 65. Electrical-Final :'• ` . �
75. Rough Electrical-Conduii 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 Heaiing & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #� '
21. Ducts, in Structure • 70. Underground Hydro " '
22.Ducts,Ventilating 71.ProductPiping�Gas OOiI �
23. Gas Pipe-Rough & Test _ 72. Underground Flush ' ;y
24. Roof Framing ' _ 73. Undergrnd. Storage Tank ��Gas ❑ Oil -
25: Roof Sheathing - `�� 74. Overhead Hydro •• � . '"
26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemical r,,
I 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 No es: � � • �
34. Final �Heating & Air Conditioning , �
35. Final Gas Pipe-Test .- S�
36. Hood or Canopy
37. Final Factory Fireplace �
38: Final Plumbing . - � �
39. Water Service-Final ��
40. Gas Service-Final - �
� 41. Solar pomestio-Final . � � .
42. Backflow Preventer •� � • � •
43. Backflow Irrigation � : ,� �
� 44. Landscape Irrigation SYsiem � . �
-45. Sound Attenuation �� � 1 �
46. Handicap Regulations . _ � ,
"47. FINAI STRUCTURE & BUILDING / � � ' ,
v
48. Special Requirements Completed - , "
i - -
49. Electric Release to Edison� !��,
50. Gas Release to Southem Califomia Gas Co � , ;� ,
51. CERTIFICATE OF,OCCUPANCY ' � '
No. ';Date - � � �
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fi '� +� �_� 'f* �� :^ . . Applicant m tiu in al1 sDacez exce0t those within hcavy Doraer Iines ana sign all approprlate tleclaratYons. ^,
PERMIT NO — TRACT O. LOT NO. UNIT NU. /
CI7Y oF COSTA MES /�C/O�NSTRUt�CTION PERMIT �8 y �� 8 (/��� 3 r% 9273 I I/09/87 4�07� �T
Pioject Address � Y'l l7 S Il Q�� � R. Y/
AppiicanYs Mailing Address SAM F TVPE OF CONSTRUCTION NEW .4DD ALTERATION REPAIR ^
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# r Zone
��Owner's Name � Phone�2�i2�2� DESCRIPTION OF WORKNSE OF BLDG. �
Address —�' � F � S Main ui ' g� Accessory Building:
Arch/Eng. License No. TVPE OF PERMIT GRADING+[7 FOUNDATION STRVCTURAL T FrOnt p
Address - ❑ TENANT �ELECTRICAL �J PLUMBING ❑ MECHANICAL A Rear N
�� � OTHER �`
Contractor's Name p�� F Q Phone C Right N
Addressimailing) i`.p/� PROJECTDESCRIPTION S4.F OCCUPqrvcV K G
---���Y"{"�— �CONSTRUCTIONTVPE VALVATION$ S Left R
City Lic¢nse NO. _ ZONE GRADING CU. VDS. ACRES
IICENSED CONTRACTOR DECLARATION - PIOg. Ref. $` ✓ Pa�king Req./Provid2d � E
Q
I her¢by atfi�m tnal I arq licensetl untle� provisions ot Charter 9(commencin9 Remarks: Planning Notes: M
wi[b section ]000) of qivision 3 of tbe Business antl Protessions Cotle, antl T
my Iicense is in tW1 torce antl eHect. ,� ' - � 3O 7 S
License Class LicenSe No.
Date Signature PLUMBING FEES
WORKERS' COMPENSATION OECLARATION Bdr Sink ShOw¢r5 2 o ELECTRICAL FEES
I hereby affirm [hat I have a certificate of consent to self-Insu�e or a certlflcate
of Workers' Compensation Insurance, o� a certifietl copy the�eof (Section 63ckfIOW P�2v¢nt¢f 52rviC¢Sink
3800, l.ab. G.) . Automatic Washer Trensformer ❑ 15-50 KW
Policy No. Company ��' Backtlow Irrigation $ewer Cap Construction PoleSub. ❑ 50+ KW
8 Certifietl copy is hereby fvmisM1etl. .
Certifietl copy is filetl wirn the city Builtling Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up ro 100 amps
Oa[e Applicant -
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - Cldflfi¢�s Sola� COII¢Ct0�5 Di5hWd5hE� M¢tE! ❑Ov¢� 1002n1p5
(This se<tion neetl not be completetl if the permit is for one huntlretl ($100) or '
iess). Dishwasher Solar Piping Dryers ❑Gas ❑Electric � Suh Panel f S
I certify thai in the Derfprmance ot the work for which this perm�t is issuetl, 1
shall not em loy any pkrson in any manner so as to be om subje<t to the � Drinking Fountains Solar Tank Fan Motors �0-1 HP �7 %- 8 "
Workers s�jey �aws of Califor/�ia. /y� .
Date SL�_Si9nature 7"Li •//l �J Floor Drains Swimming Pool w/Spa p F.A.U. -
�.a�b ` InaSolar �9-15 HP 016-75+
NOTICE fte� makin9 this tleclarat�on, yo shoultl bpcome subject to th¢ —
Worke�s' Compensalion O�ovision5 of the Labor Cotle, you must torthwith FIOOf SiOkS Urinai ' 2
COmply with such p�oyi5ion5 or this permit shall be tleemeC��/evoketl. OQ � FixtU�¢5 Mic�owave
CONSTRUCTION LENbING AGENCV � ` G95 $¢�ViC2 �uLICLS Wdt2� CIOs¢t 2 Device Boxes Pole Light
I hereby affirm that thers is a construction ienaing agency tor the performance `
of [he work for whiCM1 tnis permit is issuetl (Section 309]' Civ. C.) Int¢!c¢ tOrs Wdt¢r Hedt¢r
Lentler•s Name '.� P 2 /` Outlets Ran9e 2
Lentler's Aedress Kimhen Sink Water Service 2 Q 3 Swi4hes g�9� D
OWNER BUILDEN �ECLARATION �Ij
I hereby aHirm that 1 am ezempt irom the Contractor's License Law for the Lavatories Auto-Wash Garhage Disposal Sianding Sections
followin9 reason (Sectlon 7031.5 Business antl Professional Cotlei Any city or •
county which requires a permit m construct, alter, improve, demolish or repair P—Trap Laundry Trays (�ti . Generemr �0-5 KW 05-15 KW
any sVucture, prio� to its i55uance, also �equire5 the appliCant focsuch pe�mit T�dSh COTpactO�
to tile a signetl statemeqt that he/she is licensetl pu�suan[ to the,provisions ot ROOf D�dins
the Contractor's�License �aw (GM1apter 9(commencinq with Section 7000) of �
Division 3 of the Busiqess antl Professions Cotle) or that he/she is exempt
tnerefrom antl the basiy to� the allegetl exemption. Any violation ot Section
]031.5 by any ap0licdnt tor a permit subjects fhe applicant to a civil
�Q.¢nal[y of not more thary five huntlre0 tlollars (5500).
`� I, as owner of the Oroperty or my employees with wa9es as their sole ReinSpection Fee $15 IRue Fee $ 3
��'dTnoensation, wiu ao the work, antl Ihe structure is not intentletl or otferetl Reinspectian Fee $15 Issue Fee $ 3
for sale (Section 7044, Business antl Pro(essional Cotle: The Contracmr's MECHANICAL FEES
License law tloes not a�ply to an owner of a property wno builtls or improves
thereon, antl who tloes sucn work himself/herselt or tnrough his or her own Hood or T DEVELOPMENT $ERVICES REQUIREMENTS:
employees, provitletl tM1d[ such improvements are not intentletl or offeretl for BOiI¢� ype I ❑
sale. It, howeveq the b��itling or improvement is soltl within one year of com- Canopy Type I I ❑ Zoning Approved By Date
vletion, the owner will have tne burtlen of proving he/she tliC not builtl or im- Duct - Under Ground guilding ApproV¢d By Date
p ve for the pur0ose of sale). ' �� �
I, as owner oi lhe prooerty, am extlusively contra<tin9 with licensetl con- Ducl - Structural Refrigeration System Appliwtion Issued By Dat
tr ctOrs to construct tbe project (Sec[ion ]044, Business and Professions Cotle:
The Contracmr's License Law tloes not appty to an owner ot property who �uct - Ventilating ❑0.100,000 BTU ❑100,000 BTU SUMMARV OF FEES
builtls or improves thereon, antl who confracts for sucp projects with a con- _
tractor(s) iicense pursuant ro the Contractor's License Law). I am aware that ExhaustSystem ❑ MWtiple ❑ System Repair/Altera[ion BUILDWG PERMIT $ - SMIP $
proof of their Worker'S Compensation insurance shoultl be provitletl to me. � _ PLAN CHECK $ PERMIT
.L7 I am exempt untler 5ection e.�& P. C. tor this reason Firepl/Fact. BIt. ICBO �`- Fire Dampers PLUMBING $ l � �SSUANCE $
Date � owner " Heatin9 System & Ducting Registers P�qN CHECK 25% $ � �d ENERG�' P.C. $
� hereby certi y that � have read this appi ation antl state that the above ❑0.100,OOOBTU �t00,0006T ELECTRICAL $ �2.tQ� GRADING $
intormation is correcL I agree to comply with all city antl county orainances
antl state laws relating (o builtlir�g construction, antl hereby authorize repre- . PLAN CHECK 50% $ �•�0 MICROFILM $
zen[a[iv¢5 of tljs city [q entQq u on Ihe above-mentionetl property to� /�
inspection purp . A_ � Date_�1; /o /D7 MECHANICAL $ `T0.�0
Signature ��^
—�` � / f (iainspection Fee $15 ' Issue Fee '$ 3 PLAN CHECK 25% $
CMF 0865-46, rev. 10/84 WM1ite - Builtling; Canary - Appllcant; Pink - Accounting: Goltlenrotl - Assessor
\1
.CONSTRUCTION AND�PLANNING � � . POOL & SPA �
�APPROVALS Permit# Date Inspector AppROVALS Permit# Date I�spector
1.�Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. q�e �y"/` `� 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-Undrgmd. . �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ����f� , 60. Backwash Lines, P-Trap, 0 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 Plumbin9 /� �� �� 65. Electrical-Final � •
75. Rough Electriral-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. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts,Ventilating 71. ProductPiping�Gas ❑Oil ,,.
23. Gas Pipe-Rough & Test 72. Underground Flush .�
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing - _-- 76. Dry Standpipe - • ��T
28. Lathin & Sidin '�-� -'
9 9 77. FIXED SYSTEM FINAL • .. �y
29. Insulation 78. FIRE PREV. FINAL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
!
31. Plaster Brown Coat ti 79. FINAL INSPECTION � . ��
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ��'�
33. Final Electric Notes: � . � � ',� �S % �
34. Final Heating & Air Conditioning _ � � _ - ��
35. Final Gas Pipe-Test � �-�� "
36. Hood or Canopy
O�
37. Final Factory Fireplace �
38. Final P,lumbing Z _ �
39. Water.Service-Final � �
� '�
40. Gas Se�vice-Final ' "
� 41. Solar pomestic-Final � . ' .
� 42. Backflow Preventer .. y --
.�
43. Backflow Irrigation �• - �- �
Y
r 44�. Landscape Irrigation System - •
��45.'Sound Attenuation � • ,'
��46. HandicapRegulations ' � _•
47. FINAL STRUCTURE & BUILDING I
48: Special Requirements Completed
49. Electric Release to Edison '�"-'
r•
50. Gas Release to Southem Califomia Gas Co � '
51. CERTIFICATEOF�O.CCUPANCYr.- . �
No. � �� Date y � � �
CITY OF COSTA MESA PLANNING DEPARTMENT
A. P. No. _�-2-F�
Bldg. Permit No. I
Project Address
�ur, 2o-�t�M�°OOiaSs`i�*-��2;.^C
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
;;HkDY ORIVE, COSTA PtESA, CALIFORNIA
Owner's Name �.4RY .'�. FARR
Bachelor or 1- Bedroom Units
2 - Bedroom Units
3 - Bedroom Units
$25.00 =
@ $40.00 =
@ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00 =
Total Fee �,�5.U0
Total number of Dwelling Units 1
Planning Department Approval Date fl-?0-71 Park Area No. S
gy 4i.l.D. ati Applicant's Signature
LOT
INSPECTIONS
Final Gas
JENAIINGS. Lial Dee
SUBCONTRACTOR
•e 7-2l�-57
:DING PERMIT NO.
.uE S 600.00
:x Gara�e, ls x
N No. 5510
PERMITSISSI
DATE NUM
, ': � 5510 �p� „J
'' " L l,e.o f''',
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31�
COSTA MESA. CALIFORNIA
FOR APPLICANT TO FILL IN
6UILDING
ADDRE55
OWNER
ARCHITECT
OR ENGINEER
CONTRACTOR
�� S�i'd"di .�%�✓ 1 � e ,
%
COSTA MESA. CALIFORNIA
3) �Q ;je�nrr,r
�S •
.�'6 S%ady ,Orr rl
TEL.7 i
] �C�SIi NO.//I��
OESCRIpTION INO.�J:�J�
•S
A.P.NO. / I ��
S��E �� f X l
OF LOT
USE OF
E%ISTING BLDG. �
LIC.
NO.
'/ [�QTY LIC.
'LY NO.
TEL.
NO.
iLOCK � TRnC
� / NO. OF BLD�
NOW ON LOT
. FEE RECEIVED
FINANCE DEPT.
APPL�CYATFQN"TFdR"'PERM IT
BUILDING
FOR OFFICE USE ONLY
RECEIGT NO. PERMIT NO.
� ���
�ecEiveo er nnre nEceiv[o o�rc issueo
/�.t,/.n L,i� GL .� � �/� �7 GL��
% � BUILDINI�i
�l� ADDRE55
COSTA MESA. CALIFORNIA
FIRE
ZONE
sEianCrc �IrvE Faon � ! �
c[r+i[n oF srac[r� - R AR_ VARD n
/ /I �
SIDE VARD RIGHT �(Jl/�yLJL FT 3� 4���
DESCRI dN OF WORK
NEW ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BUILDING "- ✓ A il NO.OF
SIZE �. �� �i V � ROOMS STORIES
EXTERIOR WALLj� 7 � R�OF i C �
rrnvrvivr. /�{�/� INCO/ COVERING //)iY.. , J /i ��L
CORRECTIONS
T
TU
I MEREBY ACKNOWLE�GE TM4T I MPVE FE4O TMIS ippLlC>TION PNO
STATE TNAT THE ABOVE IS CONRECT RNp AGNEE TO COMPLY WITM 4LL
CITV OROIN4NCE5 iND $TATE L.�WS REGVL4TING BUILOING CONSTRVG-
T�o�. VAIUATI ON
�� •� � PERMiT FEE $
SIGNATURE OF /`����f�
PERMITTEE '—
� � % ) „� PIAN CHECK S
g G %
AUTHORIZED AGENT TOTAL FEE S
,_,OWNER FARR� (:ar
�JOB ADDRESS 486 Sha
GENERAL CONTRACTOR owner
APNo. 1- 2- 2 LOT Dor 11 TR
� �.INSPECTIONS Sii
�SOIL
G AS
W ATER
ROUGH PLUMBING
PROP. SWF. LINE � HOUSE CON. �
SPRINKLING SYSTEM
MISCELLANEOUS -
ROUGH HEAT�NG ANO AIR CONOITIONING
TEMPORARV SEftVICE OR PO4E
UNDERGROUND � POWER �
ROUGH WIRING
TRENCHES FORMS � SiEEL REINF. /
FLOOR SVSTpM �
BON� BEAM STEEL REINFORCE
SHEATHING
FRAME AND F�qSHING
IATMING - IN OUT
PLASTER,BqOWN COAT
STRUCTURAL, FINAI
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, RINAL ANO GAS TEST
ELECTRIC, FINAL
BUILDING, FINAL
DATE
-�SUBCONTRACTOR
T
, ` 3702b
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX1200 COSTAMESA,CALIFORNIA92626
For Applicant ro Fill in Completety
BUILDING
ADDRESS
OWNER R� M. A R
MAIL . � .. _. ....
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CONSTRUCTION
BRANCH
ADDRESS
ADOFESS
CONTRACTOR
ADDRESS
CITV
STATE
LIC. NO.
512E
OF LOT
USE OF
EXISTING BLDG.
S2E OF �,
USE OF BUILOING AND
TEL. ,
y No. (�46 �
�E R
. R NOL IgIG
NEf�
" TEL.
NO.
CITV
�IC. NO.
INO. OF BLDGS.
NOW ON l.OT
F_NCE
No. oF
ROOMS STORIES
ROOF
COVEPING
K TO BE PERFOFMED
dnn�-r�or�
I hereby acknowledpa that I heve reatl ffiis apP���aiion entl ste[e
thnt the ebove information is corract antl agrae to comply with
all lews re8�la[ing buildlnB consnvction, entl I shall mt employ
any pe�son in vlolation of the workman's compensaiiOn laws of
the State of California.
I hereby ceiiity that 1 am properly licensetl as a contractor untler
Ne State ot Califomia Business antl Protessions Cotla, Divisicn 3,
Chapter 9, antl that zuch licanses are in tull force antl effec[, or I
am exempt from [he provisions ot the State oi California Business
antl Profezsions Cntle, Division 3, Chapter q
Sipnoxure of /'1)
'r
Pe�mittee
Au[horizetl Agent
� � � q t�a S
PA70 ,� �,.�+,��
llll19-73�,�SpO022 i 66.70
ION FOR BUILDING PERMIT
/+ _
7��5� PERMITNO.
6UILDING , l
ADORESS �{� �
ZONE� NO.OF
PLAN$
VARDS APPROV ED
I�
��
DISTANCE BET
MAIN BLDGS.
VAR. �k
C.U.P.�W
APPFOVED �,
0
BLOCK
VALUE
USE OF NEW � "' �
BUILDING ���7
VAflDSAPPROVED
ACCESSORV BUIIDING
BET. MAIN &
ACCESS. BLD
DATE
APPROVED
..,.+� �/�
THE AMOUNTSHOWN UNDER VA
TNE PUftPOSE OF ESTABLISHING A P
VALUATION
� PERMIT FEE !
S /� PLAN CHECK 9
W
e
0
IS FOR �
�ONLY: ¢
m
N
7
m
�!— E
' `a
LL
OWNER FARR, Gary M.. DATE $-20-71
JOB ADDRESS. Shady IIrive BUILDING PERMIT N0. �i545
'7,GENERAL CONTRACTOR Owner-Bldr. DESCRIPTIGN of WORK
�AP No. 117-372-52 LOT TRACT FIRE ZONE VALUE
INSPECTIONS Sionotui��e Date GROUP I TYPE
cnii TT/�
F3►I Z�P7: i i:7S�l ��l :7
GAS
WATER
ROUGH PLUMBING
PROP. SWR. LINE � HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING AND RIR CON�ITIONI�
TEMPORARV SERVICE OR POLE
UNDERGROOND � POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL F
FLOOR SYSTEM
BOND BEAM � STEEL REINFORCE
SHEATHING
FRAME ANO FLASHIN�
LATHING - IN OUT (L���
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. ANO A.C., F
PLUMBING, FINNL ANO GAS TEST rY�J'
ELECTRIC, FINAL
; . � " �� 33545
COSTA ME$A BUILDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA. CALIFOHNIA 9262fi
Z .
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Pair. .,, J„
?HC 2O'7' fr;5 OO1 H:'1 :... . �
FarApplicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
RECEIVEDBV DATERECEIVE DA EISSUED
ADDRE55 S ��� �^�9� �� � �d ��/
PE IT NO.
OWNER A.P. NO. I I�- 37 L' SZ �
MAIL ADDFE 5 �/8� S�NAt�`� D`'
ADDRE55
TEL. P• 6 S• pl7ZT/OA(
CITV No. gqE- �� TRACT LOT II B BLOCK
CONSTRUCr10N
LENDER �(
/�
BRANCH F/y P���
OWNER G�� N�• yp �y,�
ARCOH TECT TEL. 5�w' � V-!�+'^ LUS�/ �' \
OR ENGINEER
FIRE '
ADORESS L �- Sy�[F G ZONE TYPE GROUP �
G /� APPROVED . �I�j� �l
CONTRACTOR BV DATE
ADDRESS 20NE NO.OF USE OF NEW FA'H/Ly M
TEL. 2_ � P�p,� 2 BUILDING A'fN
CITY NO. EN t�T•
STATE CITV ��+RDS APPROVED VAROS APPROVED
LIC. NO. LIC. NO. MAIN BUILOING ACCESSORV BUILDING
SI2E i NO.OF BLDGS (FROM GL STREET)
OF lOT 7(� 1C ��p � NpWpN LOT ROM rrro FT.
USE OF
EXISTING BLOG. 1 y� �r T FT
S12E OF NO. OF
NEW BLOG. ROOM$ STORIE$ L. SIDE O FT. FT.
EXTERIOR WALL P ROOF C' 0 M
COVERING COVERING S REAR � FT. FT.
USE OF BU�LDING AND WORK TO BE PERFORMED DISTANCE BEf. BEf. MAIN &
MAIN BLDCv^. ACCFSS. BLDGS.
VAR.# DATE
IL CU C.U.P.�W APPROVED
ryDb !l� APPROVED L� � D , � I
D
Ew r 0 � �
I hereby acknowladBa t�et I have reotl th(s appliwxion end stata
ihat tho above ���ormation is corract and apree to comply wlth
ell laws re0ulnNng builtlinp comttuc[ion, ontl 1 shnll not amploy
any person in ��oletion oi the workman's compensation laws of
Me Sta[e of Caq�omie. �� y
I h¢�eby cer[ify [hot I am proporly lic¢nsetl as a con[rotto� untla� v SQ. FT.
tho State ot Cal�forn(a Buatness nntl Profazs(ons Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl tha[ 5uc� licenms nra in full force and attact, ar I THE PURPO6E OF ESTABLISHING A PERMIT FEE ONLV:
am oxempt irory� the prOvisions of Ma $mto o} California Busines4 w
antl Protesslona Cotlo, Oivision 3, Chapter VALUATION � C
/,.� FERMR FEE $ `� �
Sipnature ot �/L� � �j, g � p�qN CHECK 5 / � � �
Parmlttee �'�
Auihorized Apahi �" � � �7
TOTAI FEE g S/` � S�
SEP 5 7962
owNER JENNIN(
JOB ADDR�SS ;
nnTr 12-4-61
BUILDING PERMIT NO. l SQLFi _
GENEAAL CONTRACTOR p�,rner-builder VALUE $ 200.00
AP No.11%-371-22 LOT TRACT FIR� ZOIQE DBSCRIPTION OF WORK R210C.0X.gar.
INSPECTIONS
OCCUPANCY
Signature � DATE � GROUP .T TYPli �7 '/.ON�
SUBCONTRACTOR
� ; - A �ss���
G�OSTA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX 817 COSTA MEBA. CALIPORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT
BUILDING -
ADDRE68
COSTA MESA CALIFORNIA
/ . . .
OWNER F Dp¢ � �
mn�� .. . , n � / r� �
1 STATE TEL.
TEL.
NO. OP BLD09.
88TBAGK LINB PROM �
ceNTeR OP 64tE5i � G . REAR YARO �
I ' I !
81�E YARD LEFf RIGMT
DESCRIPTION OF WORK
OF
WALL
IILDING AND
FEE RECEIVED
DEC 4 1�61 �
�INANCE DEPT.
CITY Of COSTA MESA'G
APPLICATION FOR PERMI7
BUILDING
For Office Use Only
P[C61Pi NO. PBRMIT NO.
c�yeg )/�;-`i �1 C
� I /��e�l—C./I /'l �ssueg
L1
COSTA MESA.
FIRE
ZONING
ZONH NO. OP — I U86 OP NHW
�' I PLAN9 P�t BUILpINO
S �
L60AL `� I I � [�j y
D66CRIRION�[�'lfL-d�r �3
A.P.NO. II /' � �/'— �i
YARD6 � EVE6
APPROVED ALLOWED
(CGHSIR LIN6 8T.1 _ i, n 1
APPROVHD
-4-( !
I HEHEBY ACKNOWLEOGH THAT � MAVH M6AC TH�B .VVLIGTION TH6 AMOUNT BHOWN t1NDER VALUATION 16 F00. THE
ANO BTAT¢ THAT THE ABDVH �6 CORAGGT AND AGIiGH TO COM• pUPPOBQ OF [eT�9L�6H�No /. PERMIT FFP ONLY.
PLY WITH ALL CITY OPOINANGEB AND BTATe LAW6 ReOULATINO
Bu1lolNo coNeTxucrloN. VALUATION ��
SIGNATURE OF ��� ,(tiC� PERMIT FEE $ O` `
PERMITTE �
Y ,� � PLAN CHECK $ .� --
AUTHORIZED AGENT �
TOTAL FEE