HomeMy WebLinkAbout271 ROCHESTER ST - Building Permits r '.
CITY OF COSTA MESA .
, s'=''r.; BUILDING DIVISION
p?2 �� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 ; www.ci.costa-mesa.ca.us
4 aura FOR INSPECTIONS CALL:(714)754-5626 •
PERMIT NUMBER. B08-00193
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 42546214 DATE ISSUED: 07/01/2008
ISSUED BY: YH
JOB ADDRESS: 271 ROCHESTER ST CM Suite/Unit:
Vicinity:
Squares: 0 Valuation: $15,814.00
SCOPE OF WORK: REROOF:T/O EXISTING 2 LAYERS OF ROOFING,REPLACE SHTG AS NEEDED, INSTALL 2 LAYERS OF 154$
FELT AND 28 SQR'S OF 30 YR.GAF COMP.SHINGLES ON 3:12 PITCH ROOF.
OWNER: MILLER, MAURINE CALDWELL Address: TR Unit: COSTA
MESA,CA
PHONE: City/State/Zip: 271 ROCHESTER ST .
APPLICANT: MILLER,DAVID Address: 2870 CHIOS RD Unit:0193
PHONE: 949-631-1924 City/State/Zip: COSTA MESA,CA • -1.,
CONTRACTOR: ORANGE COAST ROOFING License No. 434674
Address: 2870 CHIOS RDUnit: PHONE: 949-631-1924
City/State/Zip: COSTA MESA,CA 92627 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: - License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00 '
Reroof Permit Fee: $265.25 •
Reinspection Fee: $0.00
TOTAL FEES $265.25 ,
..,;,! . n3
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.
gODE A INSPECION TYPe all JN1IM44 CODE INSPECTON TYPE 21F IN1111AtS
1616 Fixed System Final Fire Prevention 206 Final Mechanical •
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 Sitee
204 Final Demolition 250 Final Building/Occupancy P7,41.' . U'
t
WORKERS'COMPENSATION DECLARATION: OwnerlD-verified by driv icense. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
0 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
perfarmance 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 0 t 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
i/ aeby this permit,and that no building structure,scaffdding,falsework,a demolition
Carrier. or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp
(This seUlonn not ted ldro pe mu a yak ed at oneonhundred doIarsfSIOOIar less.) 2,An 2.Sec.341.Title B.California Administrative Code).
PolicyNuriber: .6 00 9 6.9 -a0 a s
❑ 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 employ 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' compensation laws of Califo • , and agree that if I should
become subj ct to th work^rs'compensatio provisions of Section 3700 of
c Applicant's Signature Dale
the Labor o e.I shat forthwith co ly with t se provisions.
A /7 /_p - Division of Industrial Safety Permit Number:
A s lgnature DaleHAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the Califomia Health and Safely 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 DECLARATI,i N: 500 pounds.or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm Ih. I am licensed under pr.}isions of Chapter 9(commencing at standard temperature and pressure).
with Sec len 700.1 of Division 3 of the B chess and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my licen i in fu orc/e .ntl effect. 5 a registration form for acutely hazardous materials? ❑Yes 0 No
_tic:#— 1j/ 3+1 tP \ Class# • C 3— (Section 25533 of the Califomia Health and Safety Code, with some
I ��� /)— ,ds. exceptions, requires registration with the Costa Mesa Fire Department by
.L , each business which at any one lime has on hand a quantity of acutely
V 7.47.41•'s Sig . e W Date,. 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm 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 the 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
Signature Dale to register acutely hazardous materials with the Fire Department.
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 0 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? ❑Yes 0 No
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 (Section 65850.2 of the Califomia Govemment Code requires that the requested
information be furnished on applications for
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the non-residential building permits).
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? ❑Yes ❑No
thereon,and who tloessuch 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
city ordinances regarding Hazardous Materials and Emissions. •
❑ 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 Signature Dale
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 1 have read this application and state that
DII
exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building conslru ion,and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter u."n the above-described property for
inspection purp•ses. I agree not to oc/py or allow occupancy of any building
authori ed by I s permit until final ins.-ction.
Signature Date g�, ' 0�l i _o r-
305746 t3/07) If ' for Authonz.•Apr.77 .- Dale
PROJECT ADDRESS: 271 ROCHESTER ST .. UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 062338
OWNER'S NAME: MAURINE' C
ADDREss: 271 ROCHESTER ST PERMIT NO; M 062338 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: PERMIT TYPE; MEC PURPOSE: OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; REPLACE 75• 000 BTU FAU SQFT;
ADDRESS: UNIT:
CLAIM VALUE; CALC—VALUE: GROUP OCC; /
PERMITTEE:SOCO AIR CONDITIONING ( 714 )944-1340
ADDRESS: 6892 CARNELIAN COMMENTS: *
ALTA LOMA CA 91701 ****************;E**************************************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
70001 of Division 3 of the Business and Professions Code. and my license is in full force and effect. SETBACKS
CITY LIC.:057543 STATE LIC.:3 3 3 2 3 9 CLASS:C2
r— Date:LS --at•1-53 Signature:_ 7 a/tee MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.:0729688-93 EXP.DATE: 02/10/94
COMPANY:STATE FUND PARKING REQ• PROV: PARCEL: 42546214 ZNE: REF NO:
Certified copy is hereby furnished. kg Certified copy is�filed with
+the
city Building Division. PLANNING NOTES>
Date S 1/4.. 4.3 Applicant' L('/ e a >
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to to the Workers Compensation Laws of California. ZONING APPROVED BY
DATE:
Date: Signature: -
NOTICE:If.alter making this declaration.you should become subject to the Workers'Compensation provisions at the Labor BUILDING APPROVED BY ; DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �//
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; �I DATE; X25�`�?
which this permit is issued(Section 3097.Civ.Ci. **************************.. **,* **, w**** *.*,* *** **************** *******4r
LENDER: *********************************************** ******************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC F IRE SM I P/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 9,00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed p
pursuant to the provisions o1 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMI P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15.00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9 .00 15 . 00 0. 00 24 . 00 24 . 00 .00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED• 24 . 00 OVER/SHORT. 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 7---... 2 4 . 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors Stale License Law).l am aware ******************************.****{f**********,**,**.)t******.k.*******..***.*****..***.***.*.
that proof of their Worker's Compensation insurance should be provided to me.
•
❑ , lam exempt under Section: B.S P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE DESCRIPTION•
O N UNIT COST TOTAL COST
Date: owner: MEC 1 INST FORC—AIR/GRAN FURN <= 100 K BTU 9 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 9 00
25534 and that I or any mlure 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 Duality Management District.Residential construction applications are exempt from
these provisions '
•N
Date: Applicant: '
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes. �J `�
-- Dale.• 5 ' V 9 7 Signature: !{/".9 e�74 — 01 00139795-00139795 TOT 24.00
DATE: 05/25/93 TIME: 13:32
Driver's License or Social Security'
164146 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
1
CONSTRUCTION AND PLANNING POC SPA
APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Servcce or Pote,,r 52. Pool & Equipment Location
2. Soil Pipe-Undrgrndy ': r i;.` 53. Steel Reinforcement I
3.• Electrical Condua-Jtt hty-Undrgrndy 54. Forms I i
4. Electrical Condua-Undrgrnd. - 55. Electrical Bonding •
5. Steel Reinforcerner+. 56. Rough Plumbing & Pressure Test -
'6.'•Kctrical OF ER .5rnd - 57. APPROVAL TO COVER-GUNITE !
7. frgotings _ - 58. Electrical Conduit-Undrgrnd. � j
8. 'Foundation 59. Gas Pipe, Undrgrrid., Test
9. Water Pipe-Undfgrnd. 60. Backwash Lines, P-Trap, 0 Undrornd
10. Structural Floot System 61. APPROVAL TO DECK I
11. Property Sewer Li .& HoyseConnection ' ?
� 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final • !
131 Roof Drains 64. Plumbing System - Final
14, Rough Plumbing 65. Electrical-Final
_r
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 -•
y FIRE DEPT. RYQUIREMENT
20, Rough Factoay Fireplace -_ :,t._= .� 0 .-.,, ' : ,PPR;OVALSj.^^Permit # , ,'-
21. Ducts, in Staticture - •- _ ' a X70tthder frotrit3 Hyro
22.,.Duas, ' ntitatin ' '- t
.go- __ y y •',:71. ProducT;# ping CJ di, LZ Oil
23�Gas-Pipe-Rti tgh & Test s - ' -4 - _72. Underground FIust' -
24: Roof Frainn§ ' - "", - _ ;'73�`7Undergrnd.Storag$"Tank L7 Gas Ud I !
25. Roof Sheathing - - . - - - •- •• ` 74;'Overhead Hydro`-: •
26,7T-Bay Ceiling (Structural) & Monocoat 1,--•"3/4 75[--Dry Chenucal - _ -'
27. Frame and Flashing '.r.,, i - - 76... -'Dry c ' - - _- -
- -. ' . ,.
28. Lathing-- Siding e •• _A�: • ^ s" Ti " '-' 77--.; FIXED SYSFEYI'•INALt. -
: , - ,
29. Insulation r - - - ,• ` 76i-FIRE PREY. FINAL - ' ': -
- t . , -
30. Dryv.all,Nailing . I • ;; IjEALTIthEP1. REQUIRtvIENT
31. Plaster & �y
on Coat= -. . a r i ' , 79.. FINAL Itt?°CTeN -
-4 i+ r i .-:-.. •• fY _
32:Electrical Po);ker MeterF�cal; _ - ( I " ; `B0;^FOOD CERTIFICATE ISSUED 4 [ 1
T il. ti .1. • -
33, Fina{ Electric. ;- Y , ,t . -1Ngies: S/tijt5 ?+y ; I3•ei0*o'. - CEO __--i
34. Fin51 Heatirl '& Att..; Cohdaiontng cAi ''-C ,Y Ti-" r `• -
35r final G@a Pia-Test; .•-+ .. -,
t �_• -.s' _i
36. Hood or Canopy 'a ' •• n • _
• ' >
. : • 'c_ t i r ... T a
37. Final Factory Fvelacer ' r• r ' ' •
i. g - 1
' - .I I : . - ---
38. Finbl Plumbing s. I ' r ' - ' ••I
ti. 4-
39. Water Service-Fina ..„ - • I ' it. ' `'`' '
' 40. Gas Service-Final ; .. -•- 10I l I. ' O r .-.'•, •
A •
41. Solar Domestic-Fidel•, ;11 • •r i, F- ! to •`` ---
+j tF. x •r 10 -1 r c
42.,backflow Preventer. • 1 I (±- •• / -" '
43. Backflow Hi-gallon gatio) % '
44. Landscape litigation Systertl'I.1+t •C • a• 12 _ •- , > r. 1 - . -
45.-Sound Attenhatioil , „ ,r -, :: �' '
1
46. Handicap Regulations - " I - • y •_ -_ !
47.`FINAL STRUCTURE & BUILDINGr ., ' i t .* - a' ,
48. FINIAL PLANNING . - . ' i •-i -
r i I f r� •
1 l
49.-Etectric Release to'Edison 1 •;• l.,' `. t'
50.-Gas:Release to Southern California Gas Co . I ,' * T • 1. • - •
r --
51.
51. CERTIFICATE OF OCCUPANCY - •\:' • = r
No. Date
- - - - -Applicant to'fill:ro--ett,spaces except those within heavy border tines and sign all appropriate declarations. •
- -
I PER NO.- TRACT NO. LOT NO. UNIT NO. 6366 9/30/67 5p00 Ti
CITY OF COSTA IytF / C¢/hN�TRU�TIO_N PERMIT (�S (�
' Project Address fes( ► 1
Applicant's Mailin• Aid •ss �1�«ii�l - TYPE OF CONSTRUCTION U NEW U ADD H ALTERATION H REPAIR
�l& ' '• ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - q p # - I Zone
Owner's,Nar�g,I / _ .� -_ . Phon DESCRIPTION OF WORK/USE OF BLDG. '
Address' `' /f It a' J ` S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT El GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front • • 0
Address ❑ TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - , N
I ❑ OTHER B A Rear 1
Contractor's Name • -� Ph•ne C Right - N
.I�,mita PROJECT DESCRIPTION SQ. FT. _ OCCUPANCY K G
Address(mailing/ .•a d A I �� OA g I' CONSTRUCTION TYPE VALUATION $ S Left
City License No.o • ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E
D
I hereby affirm that licensed under provisions of er 9 (commencing Remarks: Planning Notes:
with section 7000) of Division 3 of the Business and Professions Code, and f JUL ) 1(1y� M
my license is in f for:;- :nd effect. ,' I t2ECEivED V 2 9 'IDD(, T
Licen rlas ' 7 .AP I Lit-me No le,'•i iii 'A i .i - . Ku:LIVED
LI\/En SEP 2 p S
Date .! III Signature ! ��_ .-jt -. ! PLUMBING FEES) 1`L\IG Y Ll p '��
•
WORK RS' •.OMPENSATION OECLA•ATION ( II
Bar Sink Showers
-ereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a certifie 'copy thereo (Section Backflow Preventer Service Sink •
-
.00, Lab. �j.��y��I Automatic Washer. Transformer 0 15-50 KW
Policy No- ltd+"l'I /3 Compan Backflow Irrigation Sewer Cap ' • j Construction Pole Sub. 0 50+ KW
��ertitied copy is hereby furnished.
(_ 5 V Ce t)'f�'�p¢de is filed with the city/��ilglpq 'Ankh_ Bathtubs Sewer Connection Cooking Unit - Meter ❑up to 100 amps
Date O)/I )/ Applicant `Z(NSA � p
•
EXE�PTIgTJ FROM WORKERS'COMPENSATION DECLARATION - - Clarifiers Solar Collectors • Dishwasher • Meter ❑over 100 amps - - • - - . .—
(This section need not be completed if the permit is for one hundred($100)or •
/1�,� a
less). Dishwasher yV Qf�yjY/v) Solar Piping —0`� Dryers ❑Gas ❑Electric Sub Panel
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 Drinking Fountain Solar Tank ' Fan Motors Do-i HP 01%-8
Workers' Compensation Laws of California. 1 ._
•
Date Signature Floor Drains • Swimming Pool w/Spa F.A.U.
'NOTICE: If,after making this declaration,you should become subject to the - - - - Inc.Solar ❑0-15 HP ❑16-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal -
comply with such provisions or this •permit shall be deemed revoked. - - Fixtures Microwave ,
CONSTRUCTION LENDING AGENCY - Gas Service 'Outlets Water Closet '
I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors' Water Heater Outlets Range
Lender's Name - -
Lender's Address Kitchen Sink - Water Service • ' Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am eXempt from the Contractor's License:Law for the Lavatories -Auto-Wash ' - Garbage Disposal '
following reason (Section 7031.5 Business and Professional Code: Any city or ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P=Trap _ Laundry Trays Generator ❑0-5 KW❑5-15 KW
'any structure, prior to its issuance, also requires the applicant for such permit - _ Trash Compactor
to file a signed statement.that he/she is licensed pursuant to the provisions of 'ROOF Drains -
the Contractor's License Law (Chapter 9 (commencing with Section 7000) of •_
-'ivision 3 of the Business and Professions Code) or that he/she is exempt - - -
erefrom and the basis for the alleged exemption.,Any violation of Section 's -
131.5 by any applicant for a permit subjects the applicant to a civil - - • - _
enalty of not more than five hundred dollars($500). _ 3
Reins Reinspection Fee $
-co I, as owner of the work, or my employees with wages as their sole : P $15 Issue Fee compensation, will do the work, and the structure isnot 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 . ' ' __ , e. _. -
thereon, and who docs such work himself/herself ohis or her own - Hood or Type 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are notf Intended
d or offered for Boiler
sale- If, however, the building or improvement is sold within one year of com- - Canopy Type II 0 Zoning Approved By Date
•
prove , the owner will have the burden of proving he/she did not build or Im- - Duct-Under Ground Building Approved By Date
prove for the purposef property,
f ope). 9' �J O�
0 I, as owner construct
t the pr project am t 7 44, contracting ing with licensedioncon- Duct-Structural Refrigeration System Application Issued By �j Data 7 -J
The[orsttiactor s the project (Sections Bto
o and Professions ert Cotle:
The s Contractor's Licensen,-Law does noteraapply to an owner je is thta who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with aGoa-
tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 System Repair/Alteration • BUILDING PERMIT $ SMIP $ ' •
proof of their Worker's Compensation Insurance should be provided to me. •
PLAN CHECK $ j��� �p\ERMT
�
❑ am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit ICBG 4 Fire Dampers PLUMBING $ • ,thSSUANCE $ '
Date • OwnerHeating System& Ducting Registers PLAN CHECK 125% $ • ' ENERGY P.C. $ •
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,0006T •-
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ GRADING • $ l
and state laws relating to building construction, and hereby authorize epre- PLAN CHECK 50% $ MICROFILM $
sentatives of s Indy t•. -nter u•on the above-mentioned • oper •r - L_
Signature
L' a MECHANICAL $ TOTAL FEE - $ C_
Signature y�r P� 114..•4 'ir.i
Bs. - - - - - - _ _
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Plnk -Accounting; Goldenrod - Assessor ' . 7' -'
CONSTRUCTION AND PLANNING POOL PA
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. 54. Forms
4 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
-5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-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 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
20: Rough Factory Fireplace APPROVALS Permit#•
_
21. Ducts, in Structure •
70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping D Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final _ .. 80. FOOD CERTIFICATE ISSUED
33. Final Electric - Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ft•GSn t-CD
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final •
Fitt T
42. Backflow Preventer ``•' n`�`
43. Backflow Irrigation t-1 ' 't
44. Landscape Irrigation System ti 1'P1 t ��
r.•
45. Sound Attenuation ;3 t-t
46. Handicap Regulations •
(1 .
47. FINAL STRUCTURE & BUILDINGN
s_ •
o
48. Special Requirements Complete
49. Electric Release to Edison - ti)
50. Gas Release to Southern California Gas Co - v
.
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER SHERWOOD FOREST DEV. #4 DATE 6-4-58 ._
JOB ADDRESS 271 Rochester Street BUILDING PERMIT NO. • 6824
GENERAL CONTRACTOR Lido Const. VALUE $ 16,884.00
AP. No. LOT 3 TRACT 3227 FIRE ZONE DESCRIPTION OF WORK Res. & At. Garage
GROUP I & J TYPE V ZONE R4 PLAN NO. 6824
PERMITS ISSUED
I""PECTIONS DATE SUBCONTRACTOR
DATE NUMBER
__aches Forms Steel p_...-/.4- ,24-,$ II
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing giscic-'it `j" K .. }{^S
Lathing, In Out 4 -ie Y J12 }V
Plaster, brown coat A.--+.."1 /9 '4-3Y
Underground soil frits W/WPipe TestViS -ic--re '
Top Out o-,o"» i�rr `/
Furnace /Ws P--)S P' `SNrer Me/ c- ENE.• s4 L—Cr /SLCC S r
Gas Vents /
Rough Plumbing Ad/f e-/-3-r '�y'7-rr 'v a•..O-IYLGJ 6-v-S- I /.9 // V—
Cesspool Septic Tank ,/�
Prop. S'' Line It' t nn44f. t. Swr. a� �- "Sj Z to rD 41 eJ I e 2 F-IS-Se /c 9 0 / Y
Sprinkling System bp
Heating Final � 02 -6-P' !
Plumbing Fixtures, Final /HI'S /a-2-1-.5-7 \ t_bY
Final Gas Test /j /14-,i" /o -2 7-6� 11
C -uction Pole ' I Q V
1, eground Power T ' b/-' ,I
Rough Wiring /-J* Cr- S--)5(/tiari4,ct_AN.c 7 3�s8 L z-co I/ ,1V
Fixtures, Final /�U
_OCCUPANCY lir/�_,rSy� u / 1
Form 210-5M-1-57 y 6824
•
11.1 6824
- , i ,
,s'a7 - sK ow
COSTA MESA BUILDING DEPARTMENT
P.O.BOX 317 FINANCE DEPT.
COSTA MESA, CALIFORNIA CITY OF COST!! MESA
FOR APPLICANT TO FILL IN ' APPLICATION FOR PERMIT
BUILDING 271 Rochester Street BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
Sherwood Forest Developers #4 RECEIPT NO. PERMIT NO.
OWNER 6824
RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS 3404 Via Lido ..-----)i-71-' - -„?7 JUN 4 195£
CITY Newpor t Beach TNS: OR 3-1240 ADDRESS
Nr"—MER Raymond Levanas No: C 747 COSTA MESA. CALIFORNIA
ADDRESS 3432 Via Oporto, N. B. C FIRE
E
Lido Constr. 7520 ZDNE�. NO.OF TYPE GT:4_7r
CITY 1N O. {` PLANS �/ `,",///�,
CONTRACTOR NO. /i�
ADDRESS 3404 Via Lido Ho: OR 3-124 tPPRov D DATE
LEGAL LOT CORRECTIONS
DESCRIPTION NO, 3 BLOCK TRACT 3227
A.P.NO.
SIZE OF LOT 74 x 88 NOBL
NOWW F LOT BLOCS.
USE OF C'
EXISTING BLDG.
SETBACK LINE FROM (
CENTER OF STREET 301 t REAR YARD 17 —
E
SIDE YARD RIGHT 61 LEFT 71
DESCRIPTION OF WORK
NE` X ALTERATION _ ADDITION1
\-L`
REPAIR MOVING {h DEMOLISH 4
5121E DING NO.OF
1688 sq.ft. ROS 8 STORIES 1 1
EXTERIOR WA).,, Wood ROOF Rock
_COVERING btUCCO COVERING
USEL OF NG Dwelling
Att. Garage - 400 sq. ft. i (((���
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND /� {J / �_ e.
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ���� v/'/(
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC•
TION. VALUATION
SIGNATURE OF 9 T I / PERMIT FEE 5 3 G
PERMITTEE // 1
�'
5 / v /// e cv �/_ PLAN CHECK 5 /e -j
AUTHORIZED AGENT TOTAL FEE 5 ..S 9MT
OWNER HURST, JOHN T. DATE 12-41-58 .
JOB ADDRESS 271 Rochester Street BUILDING PERMIT NO. #8125
GENERAL CONTRACTOR Owner Buil der VALUE $ 165.00
AP. No. LOT 3 TRACT 3227 FIRE ZONE DESCRIPTION OF WORK Redwood Fence
GROUP TYPE ZONE PLAN NO.
PERMITS ISSUED
I' 'DECTIONS DATE SUBCONTRACTOR
DATE NUMBER
'1 tenches Forms Steel
Floor System
Steel Reinforce Chimney Re-Rod i
Bond Beam
Frame and Flashing
• Lathing, In Out
Plaster, brown coat
Underground soil W/G Pipe Test
Top Out
Furnace �/
CG(�
i�Q � •
Gas Vents •(Yr/� �J� K.,—�e.� �..- �"
Rough Plumbing y f
Cesspool Septic Tank /�.� / ..
Prop. Swr. Line House Con. St. Swr. Calc i�(.h% i / rt7/ j
Sprinkling System rr ,. •
Heating Final t
Plumbing Fixtures, Final • J.,
Final Gas Test
!ruction Pole
L__aerground Power
Rough Wiring
Fixtures, Final
I
OCCUPANCY
Form 210-5M-1-57 8125
a .‘ COSTA MESA BUILDING DEPARTMENT - - - '''
P. O. BOX 317 D I 81-�5 I a § L
COSTA MESA CALIFORNIA �cc .C�`�° 2�
cJ FOR APPLICANT T FULL IN
C.L. OF STREET- ik id �, ;P1 ] BUILDING-AD�DRE-SS 7/ � +c2,77 r- s]zPROP LINE _ _ _ �I�P COSI 61(IS� Owner —d cX -77- ../-742,/-,S7---
ill
--- --��- = - 12 FT. 61N. 3R Q�{V C� S}A.�/e
W.
FT. FOR 60 FT. STREET�r50 FT. STREET I Mail Addresq///
I I City L-esT /1�1sa Ph. No. // Fe07_4
I
Contractor e 7C t Ph. No.
F' f Address
I APP R OV E 1)50 FTI IF FRONT City Lic. No. State Lic. No. _
I DF PROP. i_
50 FT• „ CITY OF COSTA MELA AP No. o
PLANNING DEPT, Size of Lot 74.A'n l 74 �T 7-2 22
F SUBJECT T• BLDG. DEPT. 2E0. + F r ”
/ � 1 Setbacks: C/L Street �� f Rear
J Side Yard - Right / � Left co
nA ' / j . fNdY
11/ çt
N TcCH. O. O L ��d�i' (� ?
V Type of Fence , 4
4 NALLEY OR-FR LINE or
cii ,,Gc' " Zc:z G7-
0. \ ai
1::--- > I hereby acknowledge that I have read this application and state
¢ LLZ 1 ) -I that the above is correct and agree to comply with all City Ord-
cir_�p _ 1E,
l gQ a ; -
}.)
Iinances and State Laws regulating buildiing construction.
\i ` /3� - i10 I Signature T 4'">/
} e I of Permittee + / i ,� -T
FT Agent
I I
57 6 IN. I 4 o FOR OFFICE USE ONLY
FT.
J I FT
PermityNo.
rcF- -. 6 60 FT ST. ---1 Rec d by Date Received Date Issued _
d I I
II50 Ft ST. i F e I I IL - 7 -5 /.2 - `f --C-2di-
- 1
JiPROP. LINE -- - I` - - - _ - - - -, i VALUATION permit Fee $ °I' U
$ � ( Plan Check $ " A/
C.L. OF STREET--,, . . �J C��
• TOTAL FEE $ 0`
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS