HomeMy WebLinkAbout3079 ROANOKE LN - Building Permits CITY OF COSTA MESA •
BUILDING DIVISION PERMIT NUMB R
1.1 DEVELOPMENT SERVICES DEPARTMENT
PERMIT
fi, 0-00437
•
(714)754-5273 • Fax(714)754-4656 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3079 ROANOKE LN Status: ISSUED
Suite: Applied: 04/05/2000
Vicinity: HOUSE&ATTACHED GARAGE Issued: 04/05/2000
Parcel Number: 14151213 Zoning: R1 R1
Applicant: JEWELL, TODD R. ISSUED BY:
Address: 23532 EL TORO RD#21
Phone: (800)499-1340
LAKE FOREST, CA Zip: 92630
Owner: WILLS, JOHN & LEEZA
Address 3079 ROANOKE LN
Phone: (714)662-0646
COSTA MESA,CA Zip: 92626
Contractor BIENEK ROOFING
Address: 23532 EL TORO RD#21
Phone: (800)499-1340
LAKE FOREST,CA
Zip: 92630 License: 651509
Arch : - Eng:
Address: Address:
Phone: Phone:
Zip: - License: License:
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(30 SQ).TEAR OFF EXISTING SHAKE ROOFING
&RESHEATH WITH 1/2"OSB PLYWOOD. INSTALL 1 LAYER OF 30#FELT UNDERLAYMENT&REROOF WITH"ELK
SABLEWOOD"40 YEAR COMPOSITION SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $6,000.00
Permit: $125.25 Claim Valuation: $6,000.00
SMIP Res: $0.60 •
SMIP Com: $0.00
Other $0.00
Inspection: $0.00
•
Total: $125.85
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 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 nobcommenced 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
DEC&ARATIONS I '
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
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 permit is issued.
My workers'Cofl,�'l pensation Insurance carrier and policy number are: .
Carrier Vill A/ ,11/1-- Policy Number C - 0 2-507k3
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Calif ia,and a ree that it I o Id become su ject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro ' ns. /J l i y r 3— 0
Applicant Signature: / o`` Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATIO VEPAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS($100,000),IN ADDITION TO THE COS OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provislo s of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Prof sions Code,and my license is in full
force and effect Lic. 5 1 /� Class#
Contractors Signature: 0 Date: O O
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business end 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 properly, 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.).
O 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 Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)Leet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
O As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? 0 Yes LJ 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 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
-7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No
B (If Nes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
r-------'//'' Siggature gal Ownere
Owner(s) 1 — S — 0 d
And/Or� Aut zed Applicant Date
g0DE S INSPECTION TYPE PATE INTf11ALS CODES INSPECTION TYPE DATE INTITIAL5
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 298 Final Plumbing
200 Final Re-Roof t—t if—a° � 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446-46
O B CITY OF COSTA MESA
4 BUILDING DIVISION �i
f til:..� DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
t;I ��•n4,- I
oOPP4I
• PERMIT M 05-00683
eF
(714)754.5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
MECHANICAL PERMIT
Job Address: 3079 ROANOKE LN Status: ISSUED
Suite No Applied: 11/30/2005
Issued: 11/30/2005
Vicinity: HALLWAY CLOSET
Parcel Number: 14151213 4111 /
ISSUED BY: ..z A
Applicant: MOLINA, AL
Address: 8 FALLBROOK , , /
' •4 •Phone: 949-552-5612
IRVINE,CA - -Zip: 92604
Owner: WILLS, JOHN L JR
Address: 3079 ROANOKE LN -
' •
Phone'- -
COSTA MESA,CA - ' ' .-- Zip: 92626-3019 -
Contractor: WEST COAST-HEATING AND AC
Address: 8 FALLBROOK • '
Phone: "926-552-5612
IRVINE;CA Zip: '92604
License:814471
-
SCOPE OF PERMIT .
CHANGE-OUT OF A.FAU.(90,000 BTU)IN THE CLOSET OF AN EXISTING SFD.
1 INST FAU< 100K BTU ..
NO OTHER WORK AUTHORIZED WITH THIS PERMIT.
' FEE SUMMARY .
•
Quantity - .Quantity
ISSUE FEE• , . $23.50 . Repair/Alt Absorbtion Unit , - $0.00 '0 ,
Inst FAU<100 k BTU $14.80 1 , .- Repair/Alt Refrigeration Unit $0.00 0
Inst FAU>100k BTU $0.00 0 --•.. `. _x-Ventillation System „ $0.00 , 0
Repair/Alt Cooling/Heat" . $0.00 0 Evaporative Cooler - $0.00 ' 0'
Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.09 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0
Factory Fireplace $0.00 0 •-- 3 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 ,-- . --15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00 0 _ 30 To50 hp/1,750 k BTU $0.00' 0
Vent Fan/Single Duct $0.00: , 0 . . - Over 50 hp/Over 1,750 BTU . ' ' $0.00 0
Appliance $0:00 - • 0 Boilers
Fire Dampers $0.00 0 . Up to 3 hp $0.00 0
Smoke Dampers $0.00 . 0 . 3.To 15 hp ." $0.00 0
Inst or Relocate Appl Vent $0.00 0 - 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 0 '30 to 50 hp_-d - $0.00 0
Air Handlers> 10000cfm .. $0.00, '-_0 ..i-Over50"hp $0.00 0
Floor Furnace . • $0.00 0 OtherMechanical Fee . .
Floor or Suspend Heater $0.00 0 _ ..,.Investigation Fee $0.00
$0.00
,Reinspection Fee $0.00
--=TOTAL CALCULATED FEES $3830
COMMENTS/SPECIAL CONDITIONS
•
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
2446-4e(&OO)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: .
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure fol'workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is Issued.
Jj I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued.
My workers' mpensation Insu nce carrier and policy number are:
-Carrier--'"tme .rrir ra i-t,v0/ Policy.Number: /7407o.e-2D/�s
-(This'section need not be completed if the permit Is valued at one hundred dollars($100)or less.) C
❑ 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 nd 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 pr io
ApplicaM.Slgnatum i-"'^"" CDate -A/I- — OS
WARNING:FAILURE T SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT MI EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S 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 an Professions Code,and my license is in full
force and efect:VC:# - . (Class/ G'
ir
Conhactors.Signaturre: Dateh 3p-t/I— ' D
1 —J r I. z Y
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is llcengQd 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 nbt more than five hundred dollars($500).):
❑ 7 a4 ,owneriof s the property,ibns ode: ee With wages as their sole not apply WILL DO THE r WORK,and the structure to not intendeder , offeredwo for sale(Sec.
7044,Business and P,(STessions 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 trough 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.). •
y
❑ I,as ownerjof.
the tors License
EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to andk?the project(Sec.7044,Business and Professions
Ste:The contractors License Law does not apply to an owner of property who builds or improves thereon, who contracts for such project with a contractor(s)
lime pursuant to the Contractors License Laws.).
'jail-exempt
❑ under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. Ates 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,es 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? ❑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 then a weight of 500 pounds,ora 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 ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 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 0 No
(If yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
�� ature eget Owner(s) 3 Date
// r�- OS
AndtO>1.,&At,onzed.4mic En p,' ;_ Date /o.T%TE�/ 1/(��/gym/(����`'�
61St Sys TYPUM RITmAL$ 206 INSPEFinal Mechanical --' (/ f/
1616 Fixed System Final Fire Prevention 206 Final Mechanical l
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Root 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
•
OWNER NORTHGATE DATE JUL 5 1963
JOB ADDRESS 3079 Roanoke Lane BUILDING PERMIT NO. 19999
GENERAL CONTRACTOR Bonser Construction, Inc. VALUE $ 13,538.00
AP No. LOT 28 TRACT 14891E FIRE ZONE DESCRIPTION OF WORKSng.Fam.DW" ''al
INSPECTIONS ASignature DATE GROUP I & J TYPE V ZONE RL ,pT,
Soil _ • T_ 49-ht. 3 PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
WaterkN/Nffz4Q
Rough om. Refrig. 0 Air Cond. :0
Rough Heatingi. ( .5-/y--13c�y/ `�-� JU �ratil z -
Rough Plumbing �J. SI'0,4-•G� 7` JUL 2 "t
Miscellaneous "
Prop. Swr. Line D'House Con. 'St. Swr. 0 �- Q-4- 4 ? (2 (P9-+ ,..p.„. .AUG 8 m59 IV" I
Sprinkling System /d 9-iG,3, .,e, ,/ : AUG 1 t 19; .4041,�� I,:
Construction Pole _ , V
Underground 0 Power ,0 �y` to
RghouWiring Raj 3x.-to -792-/3. /C-a--0 .4,--/s-- H -, 20- o —
Trenches V:1-.- Forms g.---Steel Reinf-e— �13/ 7 Zz
Floor System /f" -7-gs-- -
Bond Beam 0 Steel Reinforce 0
Sheathing a&, 2/1,--.3
Frame and Flashing
Lathing— In,Z4--- Out-. �✓j�,f L '
Plaster, brown coat d2 -
J/C'2
Refrig. 0 Air Con. 0 Final
Heating, Final 4j*.s 0 X142
Plumbing Fixtures, Final 1.-?.------ /D-9 .0'7
Final Gas Test /.31-,L •,_ ,L 3
Electric Fixtures, Final
Building, Final rd'Xi Ce,
OCCUPANCY - ,
Form BU4-5M-3-63—S-B P
r.
19999 FEE
(J / (�
COSTA MESA BUILDING-SAFETY DEPARTMENT I C I\ lei iY E J
P.O.BOX 317 COSTA MESA,CALIFORNIA
JUN 2 0 it3e3
For Applierrnt to Fill In Completely Al�tyjlP",c!f3''13&4 OfE RTPERMIT
i't
TYPE
/ OR PRINT 1j.8914-2889l4-28 C1F
rorQO Ce Qi?g,Ay
ADDRESS _Jc I ) "2onkl3 J4( F AVE
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA Igggg
R[CEIVGPSY �TE ty�[D3 DATE ISSUED
���
3 nn
OWNER NORTHGATE
MAIL BUILDING
ADDRESS 133141 Golden West ADDRESS /
FIRE
I,1A�'
CITY WestminsterCal_ rNiO..'897-78211 ZONE TYPE V GROUP��'t-
APPROVED ��V
�
ARCHITECT TEL. BY DATE
OR ENGINEER C. Hiller N0.535-2007
I, ZONING �� Dom\
ADDRESS Box 11, Anaheim, Cal. >:dN NO.O USE OPtt��N ""�J�
� ' I PIANS�j I gU1LDy+�� /V('rV}-
CONTRACTOR Bonser Cons tr. Inc. / ^y/ /•. `` �T'1I (�
l LEGAL LD I _ - -t "R ( & c/
ADDRESS 133!4]. Golden West DESCRIPTION l (�
1
CITY Westminster, Cal, A.P.NO.-:-C3-'
p NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
LIC.rNO. 2150149 O • 897-7824 30'TO SIDE @ REAR P.L.
SIZE 60 x 100plus EAVES
OF LOT I NO.OPBLOTS. G ALLOWED (U.R.C.REQUIREMENT)
NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. a
(FROM C/L STREET +T r
SETBACK LINE FROM FRONT �'ter: F ±FT.
CENTER OP STREET 401 plus REAR YARD 101 '(
SIDE YARD I LEFT 201plus I RIGHT 5t R.BIDE FT. FT'
DESCRIPTION OF WORK FT.
•- gr FT.
NEW x ALTERATION ADDITION
DISTANCE BET. BET.MAIN B
MAIN BLOCS. ACCESS.BLDOS.
REPAIR MOVING DEMOLISH
BUILDING NO OF DATE
SIZE 51 x 501 ROOMS 6 STORIES 1 c.U.P. • APPROVED / /
EXTERIOR WALL,, ROOF APPRO ��'_, (•'/ 0,r6 2
COVERING SY.urr.n I COVERING shingle BY E'�'�'1'\ DATE l� J
USE OF BUILDING AND WORK TO BE PERFORMED
Single family Watt garage
#/yap'"
.3• CH al D/ o
_ /0S3 SQ.FT.
I HEREBY ACKNOW - , TH - ' -HAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATI •IS FOR THE
AND STATE THA HE A-• ORRE AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. 0
PLY WITH AL CITY OR, ` D ST TM LAWS REGULATING VALUATION
BUILDING CO'STRUCTI•i Q' A-/� N
SIGNATU-+ OF PERMIT FEE $ G•I/V j
PERMITTE: - .GL) p� G
r/ n 4
AUTHORIZED AGENT TOTAL FEE $ /pL+
Thu" `L" HARBECK, William in u io
1013 ADDRESS 3079 Roanoke Lane BUILDING PERMIT NO. 41957
GENERAL CONTRACTOR Bwner/Bldr. DESCRIPTION of WORK Bdrm.' Bath S. Home Worksho__
SAP No. 141-512-13 LOT 28 TRACT 4894 FIRE ZONE VALUE $ 13.420.00
INSPECTIONS Siynature Date TYPE y GROUP I ZONE RI
SOIL ZyJ 5 `21 •1 SUBCONTRACTOR PERMITS ISS ED
GAS /� Date Number Signature
WATER fQ p Plumbing
ROUGH PLUMBING )TNL —(J a? 7_7 `fl - aJt-(y t . 5-I'j.-i. eh ^
PROP. SWR. LINE Q HOUSE CON. 0 I
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING (L0 1-cu .
TEMPORARY SERVICEr�-� OR POLE
LJ
UNDERGROUND POWER ❑ /
ROUGH WIRING / //�i��((..tt /to70- Heating and Vent.
TRENCHES S. FORMS ne STEEL REINF. [7 - 4--_2I_h �p�teas -aa-X, 2 f fl
FLOOR SYSTEM r-� L 5 5 As-� .. i. - r.. _ .. Lv -_; .Js or
BOND BEAM El STEEL REINFORCE ! 1 / ' r
SHEATHINGitAz L7--y-yg, 0., i iii erre_ (fin•/ PtJ
FRAME AND FLASHING^ ¢$.1.7 ,h `
LATHING — IN 1 I OUT`9{. .\\• G' �" w roil
PLASTER. BROWN COAT R tC- f z. V �.y.•�.r
STRUCTURAL, FINAL Elect n Ir
HEATING, VENT.. REFRIG. AND A.C., FINAL ^ Q4{y�a!•L- ya+. , 5-/tT 4Loi//f/ .
PLUMBING, FINAL AND GAS TEST I I<" NA 76
ELECTRIC, FINAL C /"J�-a1.9��^
BUILDING, FINAL `j 96
PAaL .tA.�„I 1.
i I 4. 1957 "AY 10-7600[5147na 75.1
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 /
A'.'LI el TI 9 N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
RE'EIV'Dr DATE RECEIVED D E V
ADDRESS ,3/0)79 �7/Z/aAIL)0 e.- LAlug
�'` I] % N��
OWNER //V�4 L-//7 /y"I �(TeIEK. A.P. DO. �J /�C , �1V
MAIL BUILDING ^107
ADDRESS Su�.lr4'l+� /� L r ADDRESS`-/1 [�/J ,Q
CITY 0051 /"1 �I� ESA NO. 10
J76Yj�� TRAC 9 7 LOTae BLOCK
CONSTRUCTION
ION A/�`-` NEW• -ADD ALTER REPAIR/ MOVING DFMOLISH
L
BRANCH /`l !\J�/� 1///9!SEEK .
OWNE 00
/. LIA AA!S EK
ADDRESS
,' I am VALUE
OARCHITECT R ENGINEER Or'V��� TEL. USE D,WI $ I L'✓
NO.
FIRE ROUP
ADDRESS ZONE VPE . - GROUP. .._
J, B APPROVED �(-76
CONTRACTOR G/ BY DATE /
ADDRESS
TEZON 0 NO.OF USE OF NE
CITY NOL PLANS BUILDINt/L 1 re /�/
F STATE CITY YARDS APPROVED YARDS APPRO '
g LIC.NO. / LIC.NO. MAIN BUILDING •
(FROM C/L$TRE ACCESSORY BUIL•
0. SIZE
LOT ��//JJElo NO.OF BLOCS. /
//W NOW ON LOT / FRONT FT. FT.
a USE OF / ,f/J
un EXISTING BLDG. J//JJ6LC .vl E s , - R,SLOE eiea FT.
Col
sm Separate permits are required for . L.SIDE ST. FT.
C electric,plumbing and heating work. REAR P/FT/}J/ti FT.
W USE OF BUILDING AND WORK TO BE PERFORMED
F DISTANCE BET. BET.MAIN&
Q MAIN BLOCS. ACCESS SLOGS.
aADD R, bre{ ' NOME VAR.* DATE
/�'/` ,. / p R �/ 4/160, C.U.P.#I+ / / //�j �AP�PROVED
.rl �D/�vS.�r,O/' V ��YO�'�' TRVAPPROVEq/Jri V./L \�!ATE �6 �fp M
CC vCL
�,
A.
0 I hereby acknowledge that I have read this application and state in
X that the above information Is correct and agree to comply with w 71
0., all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of a
W the State of California.I '''}/' //�/ /T /�
I hereby certify that I am properly licensed as a contractor under
jet SQ. FT. �/ �t-� 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: \V^,
am exempt from the pro s of the State o California Busi ss y
VALUATION PERMIT FEE 5
and Professions C de, visio 3,Chapter n
/� /jr
PLAN CHECK 7: / 0
signature ot�'�= �% GZ=. 01 - /I ')"-e o
Permittee CC..GG /� -S/ / a-
�) TAX E
N� U
Authorized Agent / TOTAL PAID g
•
I/ f/ 7c7
'AY 11-76PAl°00 520 0***=51.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP LI A ON FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
REC I ED Y DATE RECEIVED DATE ISSUED
BUILDING y/ ^'J
ADDRESS�01 1 c l,C/ .5=ii X
�ILLL AR/3 ECL PERMIT NO.
OWNER � A.P.A.P,NO. ,
BUILDING pA Nn(F La'
AMAIL DDRESS ADDRESS,30 71 /C
TEL.
CITY NO. TRACT I LOT BLOCK
CONSTRUCTION NEW ADD ALTER I REPAIR MOVING f1FMOI ISH
LENDER `,Y`/ I'{
BRANCH // // A
OWNER 1 A2136z k
ADDRESS 9,I{ BP
q1- {R(��ALOE
ARCHITECT TEL. USE /40 7JPRn1 4 81a $
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPE GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS
TEL. ZONE INO:OF USE OF NEW
CITY NO. PLANS BUILDING
F STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLOCS. (FROM C/L STREET)
B.. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
cn EXISTING BLOC. R.SIDE FT. FT.
to
F Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work.
LMzi REAR FT. FT.
USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
QMAIN SLOGS. ACCESS.BLOCS.
VAR.* DATE
', C.U.P.# APPROVED
a —
APPROVED
} BY DATE
CL
W
Q I hereby acknowledge that I have read this application and state
N
h.
X that the above Information Is correct and agree to comply with
O. of
all laws regulating building construction, and I shall not employ
'
Z any person in violation of the workman's compensation laws of c`
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT. 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 n
and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ .S7r �Td N
/
PLAN CHECK $ en
Signature of 0
Permittee S TAX $ LL
2
U
Authorized Agent ` TOTAL PAID $ 5 ; ia
`