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Home My WebLink About2239 REPUBLIC AVE - Building Permits • CITY OF COSTA MESA ocni F�, DUILbING DIVISION ,t re. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us °IFOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: B11-00156 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42238303 DATE ISSUED: 05/1612011 ISSUED BY: KJB JOB ADDRESS: 239°REPUBL'LI IC AV-OM Suite/Unit: Vicinity: 11r� Squares: 1300 Valuation: $5,700.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF. REPAIR/REPLACE SHEATING AS NECESSARY.COVER WITH 30 YEAR COMP SHINGLE. ROOF PITCH IS 3:12,APPROX 1300 SQ FT. INCLUDES ATTACHED GARAGE.REF: E11- NOTE:RESIDENTIAL. RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: HOPE,THOMAS A Address: 10102 CUTTY SARK DR Unit: PHONE: City/State/Zip: HUNTINGTON BEACH,CA APPLICANT: SINGER CONSTRUCTION Address: 17762 LEWIS LN Unit: : PHONE: 714-504-5028 City/State/Zip: HUNTINGTON BEACH,CA CONTRACTOR: SINGER CONSTRUCTION License No. 918040 Address: 17762 LEWIS LNUnit: PHONE: 714-504-5028 City/State/Zip: HUNTINGTON BEACH,CA 92647 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $125.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 • TOTAL FEES $126.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: 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 approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODER. INSPECTION TYPE DATE INITnALS CODER INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention • 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof X 61"). —i) E ' 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 • WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive..license. ❑Yes 0 No • I hereby affirm under penalty of perjury one of the following declarations: Drivericense to. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this'permit is issued. ❑ I have and will maintain workers'compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: , or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp d (Thaseun need not becompleledd the Dermas valued at one hundred dollars(3t00)or less2,Art 2Sec.341,Title 8,Califomia Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless issued, I shall not ejfoy any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' co,••ensation laws of California, and agree that if I should becom- •ject , the workers' compensation provisions of Section 3700 of the c bor •ode shall forthwith comply with these provisio Applicant's Signature Date Division of Industrial Safety Permit Number: flitraltaltr /%rplira • ipaature 41 " HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARN G: AILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UN • JFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENAL S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS • CLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am li -ns-d under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of IT isio• 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full for - a • effect. a registration form for acutely hazardous materials? ❑Yes 0 No `LiD-8� — y, (Section 25533 of the California Health and Safety Code, with some di�I exceptions, requires registration with the Costa Mesa Fire Department by /� , r each business which at any one time has on hand a quantity of acutely A�, at re Err. 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 CONSTR.'CTION NDING AGENCY: temperature and pressure). ❑ I hereby a rm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of -work for which this permit is issued. (Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). • completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.), information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is orrect. I agree to comply with all state laws and city ordinances relating t• bu'ding construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa es: to enter upon the above-described property for inspection purpose-. I .•ree not to occupy or allow occupancy of any building authorized by thi •-r• it until final inspection. ff.,re of Legal Owneds) Date Signature Date 3057.46(3107) .. .ixe Bram C05tE� Prescriptive Certificate of Compliance: Residential CF-1R-ALT Residential Alterations (Page 1 of 5) . Project Name: �_-�U -' Climate Zone f! i #of Storiek 72 �y 1'—e- TgLIL IVe yr Q !til bD/c General Information Site Address: 2_23C7 'eT U.Ll L Enforcement Agency: Date: 4,A-4/ Building Type'Single Family 0 Multi Family Circle the Front Orientation:N, E,S. W,or degrees UY' Conditioned Floor Area(CFA): Project Type: 0 Alterations 0 Envelope ElFenestration ;roof 0 HVAC Replacement or Chance Out ❑ Duct Replacement 0 Water Heater NOTE: This form is not to be used.for Newly Constructed Buildings or Additions • Laudation Values For Opaque Surfaces(for Furring use the Mass and Furring Strips Construction table below) Assembly Alteration 0 Opening of framed cavity alone-Alterations that involve the opening of the framed cavity of wall, ceiling, or floor must install the mandatory minimum insulation value per,¢150,for the altered assembly. Fill m Columns A-C and enter mandatory insulation value in Column H. 0 Replacement of entire assembly-Replacement of an entire wall, ceiling,or floor assembly requires the installation of Component Package-D insulation values in Table 151-C. Fill in Columns A-J. . CI a.ue Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. -A B C D - E • J Pro nosed see Nate Standard I Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed . Tag/ Assembly Name Material Spacing, U- i 1A4 Table Cavity insulation Assembly Assembly . IDt or Tye' and Size' or Other' factor' I, Number' R-value R-Value' Cell Values ' U-factors Note'For furred assemblies,accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and I Furring Consrrvction table below. '' 1.For Tag/JD indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors, Slabs, Crawl Space,Doors and etc...Indicate the Frame type and Size:For Wood, Metal, Metal Buildings, Mass, enter 2x4,2x6, or etc.,.see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"0C;or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel,Logs,Straw Bale Panel and etc.... . 4.Based on the Climate Zone;enter the Standard U-factor from Table 151-B, C or D for each different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. 6. Enter the R-value that is being installed in the wall cavity or between the framing;otherwise, enter "0". 7. Enter the Continuous Insulation R-value for the proposed assembly;otherwise, enter "0". 8.Enter the raw and column of the Ufactor value based on Column F Table Number and enter the Assembly U-factor in Column J 9.The Proposed Assembly U factor, Column.1, mus!be equal to or less than the Standard U-factor in Column E to comply. Furring Strips Construction Table for Mass Walls Only A 73 C D E F C H I J K L M Proposed Properties of Masonry and Concrete Added Interior or Exterior Insulation • Walls From Reference in Furring Space from Reference . mint Appendix Table 4.3.5,4.3.6.4.3.7Joint Appendix Table 4.3.13 Vu i Ts V c ,_ .; Y o - U b. 8LE; " cL Assembly <-v n o 'R �' c a,"= o e e Final v ' Mass Name or JA4 Table - g; v v = w w o 't m R ? u Assembly Thickness' Type' Number' < ry 4 = m Z' i 3 c'. N c i C U-factore'" Comment P J I I i 1 Registration Number: Registration Date/Time: HERS Provider; 2008 Residential Compliance Forms August 2009 Prescriptive Certificate of Compliance: Residential CF-1R-ALT Residential Alterations (Page 3 of 5) Project Name: Climate Zone If #of Stories , s ROOFING PRODUCTS(COOL ROOFS)§151(/)12 When the area of exterior roof surface to be replaced exceeds more than 50%of the existing roof area, or more than 1,000 ft', whichever is less, the new roofing area must meet the roofing product"Cool Roof'requirements of§152(b)111i, 152(b)1Hii,or 152(b)IHiii. Check applicable alternative or exception below ifthe roof alteration is exempt from the roofing product "Cool Roof'requirements.Note:If any one of the alternatives or exception below is checked, the Aged Solar Reflectance and Thermal Eminence requirements for roofing products in §11 i)are not applicable. Do not fill table below. ❑ ool Roofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. of Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less an 5Ib/112. Alternatives to§152(b)IHi and§152(b)Hii,Steep-slope roof(pitch>2:12) ❑ Insulation with a thermal resistance of at least 0.85 hr112.°F/Btu or at least a 3/4 inch air-space is added to the roof deck over an attic;or O Existing ducts in the attic are insulated and sealed according to§151(f)10;or .❑ In climate zones 10, 12 and 13,with 1 112:of free ventilation area of attic ventilation for every 150 R of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or D Building has radiant barrier in the attic meeting the requirements of§151(02;or ❑ Building has no ducts in the attic;or ❑ In climate zones 10, 11, 13 and 14,R-3 or greater roof deck insulation above vented attic. Exception to§152(b)IHiii,Low-slope roof(pitch<2:12) O Building has no ducts in the attic. Other Exceptions 0 Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. 0 Roof constructions that have thermal mass over the roof membrane with at least 25 lb/ft2 is exempt from the below Cool Roof criteria. - Note:If no CRRC-I label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, Check the applicable box below if Exempt from the Roofing Products"Cool Roof"Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Number < 2:12 >2:12 < 5Ib/ft2 > 5Ib/ft2 Type2 Reflectance3 4 Emittance SRI5 ❑ ❑ ❑ ❑ ❑4 ❑ • ❑ 0 0 04 — ❑ ❑ ❑ ❑ ❑a ❑ ❑ 0 0 ❑° ❑ ❑ ❑ 0 ❑4 I. The CRRC Product ID Number can be obtained from the Cool Roof Rating Council's Rated Product Directory at www.coolrolr.org/products/search.php 2.Indicate the type of product is being used for the rooftop,i.e.single-ply roof asphalt roof metal roof etc. 3. If the Aged Reflectance is not available in.the Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the sante directory and use the equation(0.2+0.70rnitiut—0.2)to obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4.Check box if the Aged Refectarce is a calculated value using the equation above. 5. Calculate the SRI value by using the SRI- Worksheet at hap:/Avww.energreca.gov/itle24/and enter the resulting value in the SRI Column above and attach atopy of the SRI- Worksheet to the CF-1R. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage recommended by the coatings manufacturer and meet minimum performance requirements listed in§1180)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating 0 Cement-Based Roof Coating 0 Other Registration Number: Registration Date/Time: HERS Provider: • 2008 Residential Compliance Forms August 2009 • Prescriptive Certificate of Compliance: Residential CF-IR-ALT Residential Alterations • (Page 5 of 5) Project Name: Climate Zone g ( t of Stories • HERS VERIFICATION SUMMARY The enfor-cenhent agency should par special cmention to the HERS Measures specified in this checklist below. A completed and signed CF-41(Form for all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HERS verification is required for this measure. ❑ YES ❑NO YES:In Climate Zones 2 and 9-16,if more than 40 linen feet of new or replacement ducts are installed in unconditioned space,the ducts are to be sealed per§152(b)1Dii and the newly installed ducts are to be insulated per §151(1)10. ❑ EXCEPTION: Existing duct systems that are extended, which are constructed,insulated or sealed with asbestos. ❑YES ❑ NO YES.In Climate Zones 2 and 9-16, if the existing space-conditioning system (HVAC equipment and ducting)is replaced,the ducts are to be sealed per§152(b)1Di. • ❑ YES 0 NO YES:In Climate Zones 2 and 9-16,if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,or the furnace heat exchanger)the ducts are to be sealed per§152(b)IE. ❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS • verification in accordance with procedures in the Reference Residential Appendix RA3. ❑ EXCEPTION: Duct systems with less than 41)linear feet in unconditioned space.. - . ❑ EXCEPTION: Existing duet systems constructed,insulated or sealed with asbestos. Refrigerant Charge - Split System HERS verification is requiredfor this measure. ❑YES 0 NO YES:In Climate Zones 2 and 8-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge measurement shall be verified per§I 52(01F. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150(o)do not apply to existing residential homes. . Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. - ❑ YES ❑NO YES:In Climate Zones 10 through 15.when the existing space-conditioning system(HVAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified per§152(b))Ci to meet the requirements of§151(f)7B. Documentation Author's Declaration Statement • I certify that this Certificate of Compliance documentation is accurate and corn'let• Name: SignaturC (!tt rvs3 Ste, - i Company: Date: Se -xt ST 20Uh D'.1 6-16A Address: If Applicable0 or CI CEPS r X62_ S L-7'-' - (Certification p): City/State/Zip: A Phone: -L :4CDNc,T•Pril _ Y 5---o 4 Responsible Building Designer's Declaration Statement • 1 am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • 1 certify that the energy features and performance specifications for the building design identified on this Certificate of Compliance conform to the requirements of Title 24,Parts 1 and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance arc consistent with the information provided to document this building design on the other applicable compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. Nam c: Signature: Company: Date: • Address'. •- License: CindState/Zip, Phone: For assistance or yuestimtc regarding the Energy Standards, contact the Energy Hotline at:7-800-772-3300. Registration 1Juntbec Registration Dote/Time: HERS Provider- 2008 Residential Compliance Forts August 2009 PROJECT ADDRESS: 2239 REPUBLIC AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 04 ?/3 OWNER'S NAME: THOMAS HOPE ADORE;s: 2239 REPUBLIC AVE PERMIT NO: ' 13 049923 PLAN CHECK NO: NGOVt :' N SUPP: .,_ COSTA MESA • • • - CA 92627 CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: ALT 714 650-2692 • ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : -REROOF FLAT HOT MOP SQ FT: 2, 250 ADDRESS:_ UNIT: CLAIM VALUE: 2, 250 . 00 CALC—VALUE: , ' 2, 250 . 00 GROUP OCC: R-3 / PERMITTEE: WESTERN SIERRA ( 714) 529-1019 ADDRESS: 450 APOLLO • D COMMENTS: SMOKE DETECTOR REQUIRED IN HOME ' r BREA CA 92621 *************************** *>tTr�P�6Ar**�6�6****�t*** T6*�6**** •*�r**+Bit*�F*x>E�r***********16 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q U • I R E M E - N T S 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect • SETBACKS CITY tic.: 039991 STATE LIC.:49259 cum: C 9 • l Date'.—ii — 17 L` ` FT MAIN BUILDING ACCESSORY BUILDING —p0 Signature:__ — — FRNT: IN REAR: FT IN • FRNT: FT IN REAR: - FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ' IN,. Compensation bsIrvie p 1cgset eppA thereof(Section 3800.Lab. 64/01 /91 POLICY NO.: ESP.DATE: (� + COMPANY: SUP, NATIONAL,yyPARKING RE(Q PROV: • • PARCEL: 00000000' ZNE: , REF NO: ❑ Certified copy is hereby furnished. L"J Certified co is filed with the city'Building Di a PLANNING NOTES> 412.2-38303 , 11 �/�1 JJ > Date' /� : l 4Q ******************************************************************************* Y=_�� Applicant D E V E L O P• M E N T SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($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. - ZONING APPROVED BY DATE: _ . Dale: signature: BUILDING APPROVED ,BY NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE': Code.you must DING G comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED B Y: • i DATE• / . ,/ J CONSTRUCTION LENDING AGENCY: I hereby affirm that there isaconstruction lending agency for the performance of the work for *************,************ * ** * * ** **********************• - • • • . • ** • which this permit is issued(Section 3097.Civ.C). LENDER: • *************'*********************** **.' ***************************#********** ADDRESS: ' LEGALIZATION:N • F E• E- SUMMARY - STRUCTURAL SEGMENT:Y' OWNER BUILDER DECLARATION: hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE ' SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5 4 . 00 • 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 _ ' SMIP/NON—RES pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business - PLAN • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by i any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE BUILDING DIV > PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 54 . 50 0 . 00 0 . 00 54 . 50 54 . 50 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Cade: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ' his or her own employees, provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> • COLLECTED : 54 . 50 OVER/SHORT: ,00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT ' GRADING PLAN—CHECK for the purpose of sale)- ji54 . 00 i . 50 I.as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business - • - 1 • ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of propentywhabuildsorimprovesthereon *,****,**,*,*,*.*jf.*,****,*****.,**.*.*,.*,.*,*,*,*..*.*.*.*.*,.**..*.*,*,*.**,.**.**.*.****.*.*.*.*.*.**y.***..*.*..**.*.*v.*.*{j.*.{(.'*,*.,)i,.* and who contracts for such protects with a contractnr(s)license pursuant to the Contractors'State License Law).I am aware mat proof of their Worker's Compensation insurance should be provided to me. . INDIVIDUAL F E E B ,REAKDOWN , ❑ I am exempt under Section: B.8 P.C. for this reason: ' • -TYPE QTY ' DESCRIPTIO N UNIT COST TOTAL COST Date. Owner: SFR 2250 REROOF BY VALUE RESIDENIAL NOZONE 1 . 00 ' 2, 250 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Cade Sections 25505,25533,and END OF FEES , 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a • • ' permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from • these provisions. . Date: Applicant: 1 , • 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 `t� ordinances and state laws relating to building construction and hereby authorize representatives of this icy enter upon the above-mentioned • - \`�`\ property for inspection purposes.� � (\�� /\X1' (' 1/\y\'� Y•'‘ \ ' Date:4/�L_ 40 Signature: 0 L7-�L�, ti- �?: i.El;l?4157' '�J0' :)C15536R8DATE: 11/74.'70 'Tt.1' i-Driver's License or Social Security#: -+ Ne 1641-46 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# late Inspector APPROVALS Permit Date Inspector i • 1. Temporary'Electrical Service Pole 1 `or 52. Pool & Equipment Location t ,- 2. Soil Pipe-Undrgrnd. �_ .c ,r 53. Steel Reinforcement' ..3. Electrical Conduit Utility-Undrgrnd. - I 54. Forms I r • 4 U Electrical Conduit- ndrgrnd 1 1 55. Electrical Bonding !i rr 15.`Steel'Reinforcement • = ' 56. Rough Plumbing & Pressure Test . .--6h Electrical LIFER Grnd. _ 57. APPROVAL TO COVER-GUNITE 7i. 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 ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection • 62. Backwash & Receptor-Final • 12. Sewer Cap _ - 63. Heater & Vent-Final 13. Roof Drains c - • 64. Plumbing System - Final 14. Rough Plumbing - - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring.Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT C rr ' . '2 ;c 20r Rough Factory Fireplace . ';:lr • . - ,'APPROVALS- 'C- Permit # -• _ - 21;'. Ducts, in Stiucture . ,. T - f _ : 70. Unde7ground Hydro T. 22. Ducts, Ventilating. . ' ' 71. Product,Piping Cites DOiI 23.,Gas PipetRough &,Test 1 ' „ , , " ' I .� . , 72. Underground Flush - _ 24: Roof Framing - - ' = _ - - • - 73� Undergrnd.Storage Tank;0 Gas 0 Oil - i. , r . 25. Roof Sheathing ';' '`- ' ` ,:' - _•:-14 s "74: Overhead Hydro-_ ., ; 26.-T-Bar Ceiling (Structural) &_Monocoat _ •'� ?:r ' 75T Dry Chemical - 27: Frame and Flashih9ju �. } 4, , 76ybry Standpipe ' .75,.; -. S ' a 28. Lathing& Siding ' .,, _ :C • • •• •••' ' 77: FIXED SYSTEM FINAL - •' '29. Insulation ' - • .. :, . ` `; - 78 FIRE PREV. FINAL . - ,r, ._ 30. Drywall Nailing • -•/4 _ HEALTH DEPT.,REQUIREMENT �� .�;r.'•,` 31. Plaster.Brown Cis-a(. .l' ;- .79. FINAL INSPECTION - - ' 32. Electrical PowerMeter-Final (/-moi.; 1 80: FOOD CERTIFICATE ISSUED 33._Final Electric r :/ Notes: _ ` ,;. 34. Final Heeti g& Air Conditioning "- _ 7-• _, - _ _ 35 'Final Gas Pipe-Test X - 1 C' ' _ - DIA if•/• r ^1/4- 36. Hood or Canopy -, r ,i. : - �,. _ _ . - 37- Filial Factory Fireplace, f ' ` 38. Final Plumbing ^, a .r d , - u• - 39. Water Service-Final $' ;I r • .. . - 'r . 40. Gas Service-Final , . , •, _. YI F ,, . .1 - 41. Solar Domestic-Final - •• - ' ,-"-I 42. Backflow Preventer i. l; ° 43. Backflow Irrigation • - :- f' . '' , 44. Landscape Irrigation System, �. . ,,. - c; - •;; c 457Sound Attenuation - r. 46., Handicap Re=gulations .. ,-• , . f,, .� _ _ ., `47. FINAL STRUCTURE & BUILDING �� 48: FIN-AL PLANNING .. til ' - i 49. Electric Release to.Edison i ! /t• - - 50. Gas Release to Southern California Gas Co i : " i j 1' _ = ' ` 51. CERTIFICATE OF OCCUPANCY -; r No. Date JOB ADDRESS 2239 Rapnhl i r Ave_ - ` -' - • BUILDING PERMIT NO. 5227 GENERAL CONTRACTOR Sarre Z Jan- Strt VALUE $ 9,876.00 cCr 3/-S 7 AP. No. LOT 72 TRACT 3185 FIRE ZONE DESCRIPTION OF WORK Res. P!/att gar GROUP I & J TYPE V ZONE Rh PLAN NO. 521 INSPECTIONS DATE PERMITS ISSUED : •. • - DATE NUMBER TrenchesnForms Steel ' Floor System Steel Reinforce / Chimney Re-Rod MINIMIll Bond-Beam /J'►fy/lnra� a Frame and Flashing atanWAWRES Lathing, In Out ,Zia OFferAll Plaster, brown coat W EJ O_7-j Underground soil - •• ai -,0-5 "Top Out Furnace J . MA-e- & e. > a m [ r i' 3 • 7 /OO 702, .-- Gas Gas Vents Rough Plumbing - "0-'9_40. ,lLv/t.ZrLC✓ 1&V q l 1c1 -/Oo 7d ✓ Cesspool Septic Tank r� ��/ Prop. Swr. Line House Con i�� BOUge r��T��ram�l�ea l� ern - itAa Sprinkling System - - re�) j -, 9-io- -c Heating Final J' o^2?-J7 - 4 Plumbin. Fixtures Final - his • ISTIMECII - • Final Gas Test /' Li {fs A'1R-r7 ® .1 '-"'' Construction 'ole - p Underground Power Si.-` „Wiring _ [ e FtIT[¢9r F=nal Waininnn ersoesea-PF _ , . _ n na f'. L.,-, 5219 - FEE RECEIVED COSTA MESA BUILDING DEPARTMENT • big-21 1957 A R. P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. FOR APPLICANT TO FILL IN APPLIc *IgIVrr'2084(1'P'ERMIT BUILDING n -1 A BUILDING ADDRESSpl J C-1�-c COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY ,` RECEIPT NO. � OWNER j 4-4) PEJ '' yy 227 RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS 9U11 A L L ite-rtd� /yup �J �/ 7h'�Ny 3 1 1957 TEL /y CITY Sx-C,--7 NO..zI /,„ BUILDIN / ADDRESS ARCHITECT - LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA . FIRE ADDRESSZONE / ZONE NO.OF TYPE GROUP CITY LIG. ..no/ PLANS CONTRACTOR _��rte Y/ �� D '� o TEL. APPROVED ADDRESS _-41--Tenn-/P ,, 'n- NO. BY DATE LEGAL LOT .KIn3I $S CORRECTIONS DESCRIPTION NO. /7-1/ BLOCK TRACT A.P. NO. • SIZENOF LOT ‘/3 X )13 v NOW OF !O. !SLOGS. a J USE OF L EXISTING BLDG. SETBACK LINE FROM -"-- i �� / CENTER OF STREET t d REAR YARD - ' ``_ SIDE YARD RIGHT J' LEFT 1/4/ DESCRIPTION OF WORK NEW' ✓ ALTERATION li ADDITION REPAIR � SIZEir NO.OF / I MOVING0 DEMOLISH UI SLDING / / / C w ROOMS . STORIES EXTERIOR WALL ROOF n �- I COVERING al.--t-0COVERING Arr--YV USE OF NEW ;�////�( ./�' n�1n' ., BUILDING U Yom✓-' ✓KG� . 4l/� � U , ip,,..„/ 2/—/ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC. I ^f TION. j 7) y � VALUATION PERMIT FEE $ OI` �i—� SIGNATURE OF PERMITTEE 9 -/'�J 76 — PLAN CHECK S "„.2_$ AUTHORIZED AGENT TOTAL FEE $ .36 --I ,pe