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Home My WebLink About1115 RIDGECREST CIR - Building Permits 4O•'�y„ CITY OF COSTA MESA BUILDING DIVISION ) •j ,1 DEVELOPMEI4i SERVICES DEPARTMENT PER NUMBER 4PERMIT 05-01486 � (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.SIIHLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1115 RIDGECREST CI Status: ISSUED Suite: Applied: 09/01/2005 Vicinity: ROOF Issued: 09/01/2005 Primary Occ: R1 Type of Construction: V-N Parcel Number: 42203129 Zoning: Applicant: KATIE YOUNG Address: 1015 E CHESTNUT Phone: (714)953-5444 ISSUED BY: Yl� SANTA ANA,CA Zip: 92701 Owner STEWARD, CHRIS Address 1115 RIDGECREST CIR � � 4 x COSTA MESA,CA - m` Zip 92627-3977 45 t Contractor: YOUNGS(ROOFING=CO INC Address: 1015 E CHESTNUT, <J.,/c/ -_ % - Phone: (714)953-5444, SANTA ANA;CA Zip: 92701 ' - License: 568560 Arch* «, Eng: Address: 2 Address: p Phone. tg; . I B'' � Phone -_, - 14u • SCOPE OF PERMIT T/O EXISTING SHAKE ROOF ANDINSTALL OSB FELT AND 30 YEAR COMP SHINGLES.APPROX 2 000 SQUARE FEET REPAIR AND REPLACE SHEATHING AS NEEDED FEE SUMMARY <- " a p Plan Check: $01130,';',A, c• . ' _ ' ` ; Calc Valuation:; ,$4,000.00 . Permit 597.25' Claim Valuation: $4,000.00 •SMIP Res: $0:50, . SMIP Corn: ;$0.90:. - - =k Other _$0.00- A Inspection:` $0 00 , K, • *>� Total A $97 75 4'' _ PLANNING'S,ZONING -,S- SETBACKS ': iGee $ ' MAIN STRUCTURE Front 0 0r ' • ••• Rear ''0 0 ' - Left 0-0 ~M Right ' 0-0 4 rr • ACCESSORY _Front 0-0. = Rear 0 0) 0 0 Right 0 0..," PARKING Existing: 0 Required 0 Proposed ,s 0 • , 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: 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 2446-46(NW) DECLARATIONS' ( ) n 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,gs provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit Is issued. 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 workko compensation surance ca er and policy number are: �7 � Carter 7/� � cPolicy.Number,"7 U /() -/7��\ 1(Thls ssection need not be comp eted if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro// ons. / Applicant Signature: Date: ////U car___ WARNING-FAILURE TO SECURE WO ERS'COMPENS ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,0c0).IN A DrnON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full r"e r,a- C Contractors cgna a '� �` e C! ates-p• !� a / TContractors Signatuu i Dete:?' Cj ,"D —27 CONSTRUCTION LENDING AGENCY: 1 ❑ 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). Lenders 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 property 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 feel 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? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 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 a_aPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DU Yes D No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑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 Yes 0 No. 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE 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 Owner(s) VI /O `D -d fAnd/Or-A gl.orized-Applicant r—Date - / CODE# INSPECTWK TYPE PAIS INTIRAL£ CODE# INSPECRONTYPE PATE MALE 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof `D/2-or &u'" 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 • CITY OF COSTA MESA REQUEST FOR OCCUPANCY ? TRACT NO. s9/s- DATE 4-lpl - .' . IAT NO. • /4 ADDRESS ///-5- n�o&csr Cit'Lr The developer of the above entitled tract desires to sell the above set . • , forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) f i (woe or were) advised that this tract has . ' not been given final inspection nor has it been accepted by the City of Costa Mesa as havingcomplied with the conditions of approval which 'were imposed by the City • ' • ' %rat the time the final tract map was approved. The City assumes no liability for the enforcement of 'the conditions I I necessary for approval other than those conditions protected by surety bond. ` The undersigned agrees to indemnify and. hold the City harmless from ', y"`.' any claim resulting in damage or personal injury to the undersigned by reason. of the aforementioned uncompleted condition. B ., //), —Thar, ,ser RECEIVED • CITY OF COSTA MESA BY : A/ a • pi,^ !6!I;;" )"PT. reveloper and or auth• ed • rept', t- iv- APR 12 1977 ' �- 1" 71819110111112111213141516 ! • Applicant to fill in all spaces except those within heavy border lines and.sign all appropriate declarations. I^- . • CITY OF CQSTA-NIESA� .CONSITRUCTION PERMIT P MIT NO. TRACT NO. LOT NO. UNIT NO. . Project Address /rah #Z;e� e rj/r.5/ r f .� �•` -2•Z 2S7 9J / jn • • - I 6696• _ II/0'2/86 '`I^5 0,:;.2 . TL Applicant's Mailing Addres•s 6� (f.:.l L - u. TYPE OF CONSTRUCTION L( NEW L.-1 ADO L(ALTERATION U REPAIR -- • - T� �: `/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - • A P #: - - Zone '/� Owners Name t t. if tz u J� Phone 771^417.7 • • DESCH IPTION OF WORK/USE OF BLDG. Address • _ e _ A . a — . EP, S/QQJ Q 4/V. , '. _ - S Main Building: - Accessory Building: _ - - Z Arch/Eng. - - License No. ' TYPE OF PERMIT S GRADING 'IN FOUNDATION �2 STRUCTURAL - ' T Front Qqt'• , - _ - O Address • - • • ❑ TENANT L ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear OV l f - • N J I j e'Ys c��y� • �j -` Contractor's NamnJ�/Yr/v i1 'e—•SA,y:. Phone d/J /71S OTHER In O - OCCUPANCYK-3 C Right , ' N • PROJECT DESCRIPTION SQ. F7.' / Q Address(mailing) 6770 U %,•a �7•+ e-t:n,a,• 'Sr,'4_�v7 e-4/ VALUATION$OCCUPANCY R g Left IMEIIIIIII R �q J,{ CONSTRUCTION TYPE City License No. �./ Of IIIJJJ 000ll1��i ZONE GRADING CU.YDS. ACRES pin Ref. # :�. - E LICENSED CONTRACTOR DECLARATION - - g. fa I hereby affirm Mat I am licensed under provisions of Charter 9 (commencing Remarks: . Planning Notes:.': - N7 with section 7000) of Division '3 of the Business and Professions Code, and - - T my license is in full hate and effect. ' �� /-`• ,� O/ .- • .•• = 1 • S License Cla s S I -Linse • o. 951 C.• a(G • . Date •. -- •i^ Signature ? - '�. r i PLUMBING FEES IRKERS'COMPENSATION DECLARATION ) Bar$ink • Showers reby affirm that I have a certificate of consent to self-insure,.or a certificate ' ELECTRICAL ' ' .FEES Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer • Service Sink - 3800, Lab- C.) - - - - --• • Automatic Washer - - Transformer ❑r 15-50.KW Policy No. Company Backflow Irrigation Sewer Cap r, ''".f' ® Construction Pole Sub.. - ❑ 50+-KW ECertified.copy is hereby furnished. �� - + Certified copy is filed with the city Building Division. • Bathtubs Sewer Connection'.':'-- / Cooking Unit Meter ❑up to 100 amps • Date Applicant r EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ®Clarifiers Solar DOII¢C10f5 ®, Dishwasher . Meter (Dover 100 amps - (This section need not be completed if the permit Is for one hundred ($100) or - less). Dishwasher • , ■ Solar.Piping •- !r • ®. Dryers ❑Gas ❑Electric - Sub Panel . 1 certify that in the performance of the work for "ch this pe it is issued,I .. shall not employ any person in any . er s. as . beczsubjec . he Drinking Fountains II Solar Tank J , , ■ Fan . Worker mp n ti n Laws of Calif. .i.. - Motors❑0-1 HP ❑fiA-8 XDate Signature Floor Drains Swimming• Pool w/Spa NOTIC : If fte making this declaration, you show Al. re subject to the p F'A'U' Ine.Solar 09-15 HP 016-15+ Workers' C mpensation provisions of the Labor Code, you must forthwith .Floor Sinks - I. Urinal 11 comply Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave0 • CONSTRUCTION LENDING• AGENCY - • i Gas Service Outlets Water Closet' , Device Boxes I hereby affirm that there is a construction lending agency for the performance; Pole Light of the work for which 'this permit is issued (Section 3097 Civ. C.) ' Lentler's Name f 'O�r + Interceptors _ `Water Heater �® Outlets' Range O • Lender's Address ,V C .Kitchen Sink ■ -Water Service ■ Switches Sign . 0 OWNER-BUILDER DECLARATION ' ' ,. - • hereby affirm that I am exempt from the Contractor's License Law for the Lavatories IIIAuto-Wash S� Garbage Disposal ;Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any city.or county which requires a permit to construct -alter,improve,demolish or repair P-Trap - Laundry Trays Generator ❑0-5 KW ❑5-15 KW Trash Compactor any structure, prior to its issuance, also-requires the applicant for such permit - • .. to file a r signedr statement that hapte is licensed pursuant to eceon 7 00) of Roof Drains • ' E5-15. ' °,.he Contractor's License Law(Chapter 9(commencing with Section is of 11-18ivision,3 of the Business and Professions Code) or that he/she is exempt %17rom and the basis for the alleged exemption. Any violation of Section . O31. %031.5 by •any applicant for a permit subjects the applicant to a civil aenalty of not more than five hundred dollars($500). TI I, as owner of the property or my-employees with. wages as their sole . Issue Fee i $ 3 compensation, will do the work,and the structure is not intended or offered . Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and'Professional Code: The Contractor's MECHANICAL FEES • 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 : .. DEVELOPMENT SERVICES REQUIREMENTS• employees, provided that such improvements are not intended or offered for MI Hood or Type I ❑ , 12 .,d 3. .♦ , sale. It, however, the building or Improvement Is sold within one year of corn: Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground• Building Approved By Date rove for the purpose of sale). iiiii I, as owner of the property,'am exclusively contracting with licensed con- Duct-Structural • I 1 Refrigeration System Application Issued By Date__ //2/ _ tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES ' builds or improves thereon, and who contracts for such projects with a con- tractors) license,pursuarit to the Contractor's License Law). I am aware thatBUILDING PERMIT $ ..5-64Z) ' SMIP $ t .So proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple❑' System Repair/Alteration PLAN CHECK $- .?C-72- PERMIT.. ❑ I am exempt under Section B.& P.C.for this reason 5 Firepl/Fact.Bit. ICBG# III Fire Dampers PLUMBING $ ISSUANCE $ • - ' HeatingDucting RegistersPLAN CHECK 25% $ ENERGY P.C. $ ' Date Owner System& -I hereby certify that I have read this application and state that the above • - 0o-100,000 BTU 0100,00087 - ELECTRICAL $' 3 aO ' GRADING . $' information is correct: I agree to comply with all city and county ordinances ' and state laws relating to building construction,and hereby authorize casae-, PLAN CHECK 50% $' 0r Ii 0 , MICROFILM $ sentatives othis • o. ante upo he above-mentioned property for, , inspection�r�°se I MECHANICAL' $ - - • TOTAL FEE $ 97Z ' - Signature 4/01 � .•�-' Date /2-23-5(C / Drivers' License or SS 9f / - Reinspection Fee • $15 Issue Fee $ 3, PLAN CHECK 25% $ CMF 0865-46,rev.10/84 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING PC &SPA . APPROVALS . Permit# Date Inspector APPROVALS Permit# Date Inspector ' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location !2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - _ 3. Electrical Conduit Utility-Undrgrnd. ' r 54. Forms: -1 . 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement, 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grrid. • ,, . • 57. APPROVAL TO COVER-GUNITE ' 7. Footings; f/3 B C 58. Electrical Conduit-Undrgrnd. 8. Foundation S�A.(a /S� J 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 - - ,t2. 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: -Rou h Electric Wiringr 9 ' f+� ea CP 67. Fencing & Access Approval 17! Rough Wiring Sign I, 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# • 1 21. Ducts, in Structure 70. Underground Hydro - 22.pucts, Ventilating l: 71. Product Piping 0 Gas 0 Oil • 23."Gas Pipe-Rough & Test 72. Underground Flush , 24..Roof Framing 73. Undergrnd.Storage Tank O Gas ❑Oil 25. .Roof Sheathing 4s.-J j, D.3 . 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' ,'-27.,,Frame and Flashing 1/4-(25(8 (> ) 76. Dry Standpipe 28.;Lathing&;Siding { 77. FIXED SYSTEM FINAL - • - iI`4/ 410 ZS • 29. 'Insulationc. 7 S 78. FIRE PREY. FINAL o 30. Drywall Nailing iholoc.. 03 . . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' a40/Mit, 12) 79. FINAL INSPECTION , 32. Electrical Power Meter-Final -/ [ 80. FOOD CERTIFICATE ISSUED 33. Final Electric WA/1c. ,►S Ka._ Notes: :4%4 4 "Lk" 34. Final Heating & Air,Conditionirig _ .35. Final Gas Pipe-Test - - - 36. Hood or Canopy - - 37. Final Factory Fireplace • - - 38. Final Plumbing 39. Water Service-Final • r ' 40. Gas Service-Final . 41. Solar Domestic-Final - 42. Backflow.Preventer . - 43. Backflow Irrigation 44. .Landscape Irrigation System -. ' 45. Sound' Attenuation , 46. Handicap Regulations - 47- FINAL STRUCTURE& BUILDING l(/y(- p5 48. Special Requirements Completed - . J�( J 49. Electric Release to Edison _ - ' 50. Gas Release to Southern California Gas Co 1 , 51. CERTIFICATE OF OCCUPANCY ' No. ' - - Date - - 9_ , BOURDON & SONS LIC. NO. 459423 G 6770 VIA IRANA 714-995-4857 EL ^b STANTON, CA :90680 iAe 51(5 -1 Cive . Cees- Inas % c rain�ye_, AR_ rest- • 4ke sur('onck, aeea 65 177, idcrez (Veros cower e- Side ol --n-e, kUse aanA ;a1-0 le fee4 ha � _ (olty O 4/ / 52_ 7- Zh 7 /10,9g /// 5 GoSj� Wc5eak. „- ; - ' ' 4n72. . PAIL PP OO 875* n**78.16 • YD7Frn COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 _ APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only /- �p� N R EIV-• B DATE RECEIVED. DATE ISSUED BUILDING ADDRESS /IISRID( 6.-L-1C EST Teff— e... ....'.-.,. Ate/. -��/I'n ,/_^ 1: R ppp��I,/,/�/ OWNER pi'� Dae-6„zw c r LL A.P. NO.I�S(p( E2/,JJ,Z� D / MAILQQ , BUILDING /� `/(c ADDRESS0e E17 ruST• . ADDRESS/ll,c. RIS/ / CITY (. esr ,tV NOLg2 to TRACT 9q 5” LOT /4 BLOCK CONSTRUCTION EW ADD ALTER I REPAIR MOVING DFMOI ISH LENDER BRANCH . I OWNER ADDRESS / ARCHITECT '7�A 11� TEL�.,N g USE -l'�t7' (�/' tt. II [• $ 5r/ ✓s/' OR ENGINEER j/(!"j f{ NO'JT( 77 ` ,.rte FIRE / ADDRESS ZONE TY _. GROUPr C/ / APPROVED CONTRACTOFEJA-V ies 7" e / _ BY DATE ADDRESS/SO C, /7 —5T �q ^ TE i, /\ 1..� NO.OF USE OF NEW //,,yy CIT`a5`rq �,�5A Nr4L'42/p. PLANS� BUILDING/ , /(I'ar. !FJ . STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING IR SIZE NO.OF BLDGS. (FROM ClL,STgEFi7/ Q.. OF LOT NOW ON LOT FRONT t7LFT(T)/. FT. Q USE OF //� EXISTING BLDG. R SIDE FTg-'arty / f•-• Separate permits are required for i L.SIDE '/'FT. FT. electric,plumbing and heating work. W REAR 2?FT. FT. [,r USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q - ///J�/ 2 MAIN BLDGS.S.�J` ACCESS. BLOCS. �y t...0 agAn� m,0 tjz C4ATE y` C URP.a /57 7CAPPROVE[�„'s-/C / //yy�� "8_7g♦ >0 • A PROVE o...ye - DATF a :. HOLD FOR SPECIAL REQUIREMEN S w o. I hereby acknowledge that I have read this application and state O u, CL that the above information is correct and agree to comply with n m 0* all laws regulating Duilding construction, and I shall not employ Z any person in violation of the workman's compensation laws of m S the State of California. �� "/^ •'/ � w • I hereby certify that I am properly licensed as a contractor under SO. FT. ^ 'SG N the State of California Business and Professions Code, Division 3, - THE MOUNT SHOWN UND R VALUATION IS FOR ca DD Chapter 9, and that such licenses are in full force and effect,or I - THE URPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Busin ss , VALUATION PERMIT FEE e and Professions Code, Division 3, Chapter $ %�'�V' " n r #1 PLAN CHECK $ g:ce m / o Signature of 4 Permittee ,Q�� 71� $ r1 Aix TAX $ / LA'S`^ Authorized Agent ✓ ' TOTAL PAID $ ,i P ;�,7M /�`Is`. j PAW 1 �`�� )i&, 28-75C11$a :)292 r=rM 151.00 , l COSTA MESA BUILDING-SAFETY DEPARTMENT • P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 i■.TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only R E BY DATE RECEIVED DATE ISSUED ADDRESS BUILDING ��15 I IIIr1F CPE T GR OWNER A.P. NO. 0li. 7 MAIL BUILDINGDRS 1115 IDot'G 1 C ADDRESS ADDRESS TEL. TRACT I CITY NO. LOT BLOCK CONSTRUCTION • NEW (ADO ALTER REPAIR (MOVING DFMOLISH LENDER X. BRANCH • OWNER ADDRESS A-4WiA �s V�p,LI 0 ARCHITECT TEL. USE f a_ ......0 OR ENGINEER NO -" FIRE ADDRESS ZONE TYPE GROUP=4T APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW CITY NO. PLANS BUILDING .F. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING {r7 SIZE NO.OF BLDGS. (FROM C/L STREET) a. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF to •—• EXISTING BLDG. FL SIDE FT. FT, ca FSeparate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& <Q _MAIN BLDGS. ACCESS, BLDGS. VAR.# DATE •� C.U.P.# APPROVED Q _ APPROVED >. —BY 11,n W FC W • 0 I hereby acknowledge that I have read this application and state N N GS that the above information is correct and agree to comply with N LL all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of a y the State of California. oi FT. 3 I hereby certify that I am properly licensed as a contractor under SQ. w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY' am exempt from the provisions of the State of California Business et- and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE $ /5 / ' e M •PLAN CHECK $ mo Signature of 0 Permittee $...........e/K1 TAX $ 2 U Authorized Agent TOTAL PAID $ /57�Vet� N. • City of Costa Mesa INSULATION CERTIFICATION . Building Safety Division ///3 KGY,_-r Cac "are O/,-� , -Number and Street City • Coun� Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF �/ Material .� �.�/- % 9- J17 w�.,-�� Brand Name Thickness (inches) / Thermal Resistance (R Value) EXTERIOR WALL n Material .5-rt.-cc 0� // Brand Name Cite-+t)S eo-(t/)1,0j ler Thickness (inches) Thermal Resistance (R Value) / — /7 �1 • CEILING Batt or Blanket Type Brand Name Thickness (inches) R— 3 O Thermal Resistance (R Value) a — 30 Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb. Area Covered (ft2) Thermal Resistance (R Value) FLOOR,ELEVATED Material GOncr-e-l( Brand Name Thickness (inches) Thermal Resistance (R Value) • FLOOR,SLAB Material C-on c r-G // Brand Name Thickness (inches) r Thermal Resistance (R Value) Width (inches) /g �(/y/ FOUNDATION WALL Material Con ole. fr Brand Name Thickness (inches) /15"11/2/ Thermal Resistance (R Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). r./oma So. s !3G— GeneraLeuntractor(Builder) • License Number /////J Signature and Title Date �Al Suubb"Contractor(Insulation Applicator) License Number SignaturTitle- / Date CMF 1106-30