HomeMy WebLinkAbout1956 ROSEMARY PL - Building Permits CITY OF COSTA MESA
y' __ BUILDING DIVISION111
PERMIT NUMBER
f' 'w" DEVELOPMENT SERVICES DEPARTMENT.
A. rigt PERMIT
BOO-00554
(714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1956 ROSEMARY PL Status: ISSUED
Suite: Applied: 04/25/2000
Vicinity: Issued: 04/25/2000
Parcel Number: 42603242 Zoning:
Applicant: ANDESRON, BRIAN ISSUED BY:
Address: 1218 E POMONA ST
Phone: (714)543-5400
SANTA ANA,CA Zip: 92705
Owner: LOOMIS, BEATRICE D
Address 1956 ROSEMARY PL
Phone:
COSTA MESA,CA Zip: 92627
Contractor: A 1 ALL AMERICAN ROOFING
Address: 1218 E POMONA ST
Phone: (714)543-5400
SANTA ANA,CA
Zip: 92705 License: 693307
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF WOOD SHAKE REPLACE WITH 7/16"OSB AND 20 YEAR COMP. SHINGLES.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,100.00
Permit: $111.25 Claim Valuation: $4,100.00
SMIP Res: $0.50
SMIP Com: $0.00
Other $0.00
Inspection: $0.00
Total: $111.75
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
NOTES:
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 notcommenced 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
DECLARATIONS
•
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury o f the following declarations:
❑ I have and will maintain a certificate 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.
a:-D-ICI 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.
y workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed If the permit Is valued et 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 I: sof California,and agree that if I should become subject to the workers' n•.e.-• __ .• . 'skins of Section 3700 of the Labor Code,I shall forthwith
con.• ase•o•' io�
• .lic. t Signature: PA �a_✓r Date: L' —
-• • - TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT 1. • - •CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOI.LARE($106,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereb Irm t.- am licensed .p•er provisions of Chapter 9(commencing with Section 7000)of Divisio -_ - . -. -. and Professions Code,and my license is in full
for and e.=ct.Lic.M O Class N
ontracto s Signature: /,L— Date: L --
'C i
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 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 drivers 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 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,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 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 en 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 compiled with? 0 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 aREermlt for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes u 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? ❑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 end 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 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.
S• .cure Of Legal Ow •r(s) Date
y-2-sccie2
And/4.r .uth• .pp Ica
CODE r INSPECTION TYPE gait. ISL$ CODES INSPECTION TYPE PATI itimS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final /� 208 Final Plumbing
200 Final Re-Roof 5-4-no �l 210 Final Electrical
201 Final BIocldRetalning 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
244646
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 1956 ROSEMARY PL CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 057758
ADDRESS: LOOMIS BEATRICE D
1956 ROSEMARY PL i PERMIT NO: P 057758 PLAN CHECK NO: N GOVT: N SUPP: N
COSTA MESA,CA 92627
CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : REPLACE SEWER LINE 6 WATER SERV, REPIPE SQ FT:
PERMITTEE: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
ADDRESS: RESCUE INDUSTRIES, INC. ( 714 ) 835-1602
1085 N. MAIN ST C COMMENTS• PLUMBING WORK ONLY
((gyTpp ayteE�((:� CA 92 7 *>F�E�6�E�E�E�6*�E�F*�EEE�E+E�E�E�E�E*IE�E�ERE�E�E�E*�E�t�r+EaERE�E�E+ERE -�F*�E**RERE�F�E** RE�E�E�E*r�ERE+ESE*Rr�E�E�raE�E�E�ERE�E�r�E�E�E�6�E
LICENSED CONTRACTOKOECCARATIg4: I hereby affirm that I am licensed under provisions 01unapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T $
7000)of Division 3 of the Business and Professions Code.and my license is in full force and e ect.
CITYUG.: 03440gSTATELIC.: 3531 s. C36/ SETBACKS
— Date: h - s_— Signature: S — MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to Ansure 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.: WC76522003078 EXP.DATE: 01 /01 /93
COMPANY: ARn,O�,T�U 1e �� • PARKING REQ: PROV; PARCEL: 42603242 INE: REF NO;
D Certified copy is ere y arms ed. L`X erti ie copy is filed with the c'y Building Divisi PLANNING N(STES>
/� > ,,
�— Date: (9 -j z- 7� Applicant' �_' *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the perm s for one hundred WOO)or less). DEVELOPMENT S E R V I C E S! 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 the Workers'Compensation Laws of California.
ZONING APPROVED BY DATE:
Date: Signature:
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of 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:
lee DATE:
which Ibis permit is issued(Section 3097,Civ.C). ************************** ** * ** * DADA DADA*DATE***** ** *
LENDER: ************************************ DADA*** **i *****************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 7,00
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)01 Division 3 of the Business 2 5 Z SMIP/NON-RES
and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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 3 . 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
does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through TOTALS----> 7. 00 3, 00 0. 00 10. 00 10 . 00 . 00
his or her own employees,provided that such improvements are not intended or offered for sale.II,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: 10. 00 OVER/SHORT: 00
ffarthepurposeotsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE $MIP/TOT GRADING PLAN-CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 10. 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. *******************************************************************************
❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Oate: Owner:
I do hereby Certify that lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 SEWER, BUILDING / TRAI LER 5 . 00 5• 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a PLU 1 WATER RE-PIPE 2 . 00 2. 00
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from END OF FEES
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correc I agree to comply with all city and county
ordinances and state laws relating to building construction and herebyresentatives this city to enter upon the above-mentioned f _
property for inspection purposes. ( -
:h''L"
Date:(p- /Z - 9 L Signature: I
Driver's License or Social Security it:
Pink—Revenue:Goldenrod—Assessor
•
CONSTRUCTION AND PLANNING' . PO(, .t 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. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6_ Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-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 .:t. 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
-
14. Rough Plumbing • - 65. Electrical-Final
15. Tough Electrical'Conduit •
- 66. Solar System-Final
16. sough 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 .. i - APPROVALS. - Permit #
S . r••.y 1 t a • •
21. Ducts,in Structure " , , . 70. Underground Hydt
22. Ducts, Ventilating - - 71. Product Piping0Gai 0 Oil
23. Gas Pipe-Rough& Test - _ , - . 72. Underground,Flush_•
24. Roof Framing - •• • 73. Undergrnd:Storage Tank 0 Gas 0 Oil
25. Root Sheathing . .z ., - , . 74. Overhead Hydro - -
26. T-Bar Ceiling (Structural) & Monocoat _ • - 75. Dry Chemical - _
27. Frame and Flashing - , ' 76. Dry Standpipe - -
28. Lathing &Siding _ - i 77. FIXED SYSTEM FINAL _
29. Insulation' ' 78. .FIRE PREV. FINAL _ •
I
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. Fina)!Heating& Air Conditionings .• ,-
35. Final Gas Pipe-Test . I . • - -
36. Hood or Canopy . •, - .
37. Final'Factory Fireplace - ' - a ' .; ., ,
38. Final-Plumbing - c • .
i
39. WaterSewice-Final • - . • J.
40. Gas Service-Final - - '
41. Solar Domestic.FinaF : • -
n
42. Backflow Preventer ,.1 'I I - ,
43. Backflow Irrigation
44. Landscape Irrigation System .. r - a -
45. Sound Attenuation '
r
46. Handicap Regulation's - - : •'
47. FINAL STRUCTURE & BUILDING -
i
48. FINAL PLANNING' - , • . ',..
49. Electric Release to Edison -
50. Gas Release to Southern Califorrnia Gas Co i 'I . ,
51. CERTIFICATE OF QCCUPANCY ' • ' . =
No. Date
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 1956 ROSEMARY PL CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 057703
ADDRESS: LOOMIS BEATRICE D
1956 ROSEMARY PL PERMIT NO: P 057703 PLAN CHECK NO: N GOVT: N SUPP: N
•
. COSTA MESA,CA 92627
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER: 548-3526 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : SEWER REPLACEMENT SQ FT:
. PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC: /
ADDREss: RESCUE ROOTER ( 714 ) 835-1602
1085 N MAIN ST COMMENTS: NO OTHER WORK PERMITTED
�
�
CA 92667 ***************************RERE**RE**********RE*RF***RE*9F**************RE*************
LICENSED CONTRACT➢ N: I hereby affirm that I am licensed under provisions o Chapter 9(commencing with section ZO N I N G REQUIR EMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.:: 034 flop_ STATE LIC.:3 5 317 0 s>s ,cut3, /
Date: 6'10— signature: _ _a MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby tha Adelea cern care 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 38.:, ab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: WC 7 6 5 2 2 0 0 3 0 7 8 EXP.DATE: 01/01 /93
COMPANY: ARGAUNAUT ,INS PARKING REQ• PROV: PARCEL : 42603242 ZNE: REF NO:
Certified copy Is hereby furnished. L}Q//Certified copy is filed the cit : ring Division. PLANNING NOTES>
Date: !O 40-Q1Z / i —s, / >
Applicant: - ***********************************************:.********************************
EXEMPTION FROM WORKERS'COMPENSATIONDECLARATIr . (This ' uneed not becornpfet>n f .- : or one hundred($100)orless). DEVELOPMEN T SERVICES REQUIREMENTS
I certify that in the performance of the work for which this permijsued,I shall not employ any person in any manner so as to become
subject to the workers Compensation Laws of California. �- ZONING APPROVED BY
•
DATE:
Date: Signature:
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of 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 BY. { ,/ v. n 1
which this permit is issued(Section 3097.Civ.C). 4)-1 1F9FF iP /a DATE: * 0 4F\*
LENDER: *********************************************Bf*********************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm matt am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5 , Q Q
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commending with Section 7000)of Division 3 of the Business 2 5% SM I 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(55110). ISSUE FEE 3 , 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----> 5. 00 3 . 00 0 . 00 8 . 00 8 . 00 . 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through i'
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: 8. 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 8. 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'State License Law).I am aware *,**,*9P******************************iP*******************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.A P.C. INDIVIDUAL; F E E BREAKDOWN
for reason: '
TYPE QTY D E S C R I P T I O, N UNIT COST TOTAL COST
Date: Owner: w
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 SEWER, BUILDING / TRAILER 5 . 00 5 . QQ
25534 and that I or any future building occupant wilUwill not(circle one)n' i to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Duality Managem' • tistrlc •' .ental .'struction applicatiois are eyyy��emot from
these provisions. - /
•
/ r
Date: 6p/P-7� Applicant: / _44-..._....a.._ �
I hereby certify that I have read this applicatr and sta d the abo - nn is corn, ., • i c with all city and county
ordinances and slate laws relating to building onstructi nd hereby au .'lin
es of this city to enter upon the above-mentioned .
properly fororinspection purposes. /
Date: S!w/O Signature:/ �_ -4—! - a.
Driver's License or Social Security K: !t .11:, —• - -
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING- - POC. . 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
-y•t _.
4 -Electrical Conduit Utility-Undrgrnd,;•.r 54. Forms
-4:.Elettrical Conduit-Uridrgrnd. 55. Electrical Bonding
Jam` r:i
5. Steel Reinforcement t. r 56. Rough Plumbing & Pressure Test
'•6i .Electrical UFEIGGlnd . - 57. APPROVAL TO COVER-GUNITE
r - Y
f:/....f;ootings - 58. Electrical Conduit-Undrgrnd.
8: Foundation 59. Gas Pipe, 0 Undrgrnd., Test • •
.r , :y . , ,
-9. Water Pipe-Undrgrnd. / 60. Backwash Lines,P-Trap, 0 Undrgrnd. t -
10. Structural Floor System .. • 61. APPROVAL TO DECK
---
11.
11. Property Sewer Lineg& House Connection 2V
, ' 2 62. Backwash & Receptor•Final
12. Sewer Cap ,y 2 ! A
,/ 7l 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-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
_
20. Rough Faytorjf Fifeplace I -, r' t; ,. it • APPRONA p: -.Permit # - 1-
21. Duds,in Structure:- `.- „ s -- - 70. UndergrourdHydco -
t ,
22. Ducts, Ventilating-:.` - -71. Product Piping OGas OOil
23. Gas Pipe-Rough &•Test - - - C , .72. Underground Flush-
24. Roof Framing • ' _ ; '73. Undergrnd -Storage ank °Gas 0 Oil
25. Roof,Sheathing . 74.-Overhead Hydro -
26. T-Bar•Ceiling (Structural) & Monocoat - -- 'Tr" ' 75. Dry Chemical
27. frame and Flashing • 76.'Dry Standpipe _ ; N
28. lathing &Siding T 1 - 77. FIXED SYSTEM_FJ ..NAL _
-29. Insulation , I i c 78.-;.FIRE PREY. FINAL' - -
30. Drywall Nailing - ' It " HEALTH DEPT. REQUIREMENT
31. Plaster Brpwn.Coat ; I : 79/FINAL INSPECTION ,
32. ElectricabPower Meter-tFinal + . I - 80. .F000 CERTIFICATE ISSUED
33. Final Electric. r `r •Notds:411_7j 11. . .rMt1E7;.
Ixl /•r-
/s/r --
34. ,FinatHeating& Air.Conditioning', .
35. Final Gas Pipe;Test °'' ' - '
,36. Hood-or Canopy . .. .z •
E.
37. •Final'Factory Fireplace- "- '
A L
38. Final-Plumbing J. • . r •'
.T
39. Water.Ser vice-Final - ` x
is
40. Gas Service-Final - - .
•41. Solar Domestic-Final -• ¢-
42. Backflow Preventer ' -
43. Backflow Irrigation . • . -
•s , .1.
44. Landscape Irrigation System J, . i - J -
45. Sound Attentiation - _ ' t '
46. Handicap-Regulations - • .. .i =
7
4 . FINAL STRUCTURE & BUICDING '
r
48. FINAL PLANNING' y '
49. Electric Release to Edison , " `
50. Gas Release to Southern California Gas Co t• - y -
51. CERTIFICATE OF OCCUPANCY .
No. Date •
. , a
PROJECT AODRS: uxlr:
1956 ROSEMARY PL ., CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 065134
OWNERS NAME: LOOMIS, BEATRICE D
ADDRESS:
1956 ROSEMARY PL PERMIT NO: E 065134 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA, CA 92627
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
ARCH/ENGINEER: flEG.NO.:
ADDRESS: UNIT: : SQ JOB DESCRIPTION SERVICE UPGRADE FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 /
PERMITTEE: THOMAS ELECTRIC ( 714 ) 546-9303
ADDRESS: 2361 FORDHAM DRIVE COMMENTS : NADA
COSTA MESA CA 9264,26 **********************************************3E*************,c*****************4
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions a hapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of Me Business and Professions Code.and my license is in lull force and enact. S E T BACK S
CITY LIc.:02q 401 STATE LIC.:401360 CLASS:C_
/..'..--.'—
Date: /2--' —4 3 Signature:_ _ . _.7 Lf MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cemficate 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.: EXP.DATE:
COMPANY: PARKING REQ: PROV; PARCEL: 42603242 ZNE: REF NO:
Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the penit b for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the penormance of the work for which this permit is iss d,I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California.
ti S ZONING APPROVED BY DATE :
Date: Z—i"Q 3 Signature:
.----- NOTICE:II.alter making this declaration.you should become subject to the Workers'Compensation provisions of 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 penormance of the work for
APPLICATION ISSUED BY: E.
which this permit is issued(Section 3097.Civ.CI. DATE : 1 0 1/I 31
***********************************�t '�r .**************************W4AIFTRW*RW**
UNDER: *******************************14.1E**********************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 45 . 00
pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 13% SMIP/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 or 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—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 45 . 00 15 . 00 0 . 00 60. 00 60 . 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: /------60 , 00 OVER/SHORT: . 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC IP/TOT GRADING PLAN—CHECK
as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 60 . 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 contraclor(s)license pursuant to the Contractors'State License Law). am aware *******************************************************************************
that prooffolof their Worker's Compensation insurance should be provided It me.
❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E E BR E A K D O W N
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
I do hereby certify mat l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 1 FIXTURES LIGHTING 1 ST 20 EA. 75 75
25534 and that l or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 1 RECEPT/SWITCH 1 ST 20 EA. . 75 . 75
permit for construction or modltication from the Air Duality Management District.Residential construction applications are exempt from ELE 1 NON—RES APPLIANCE NOT OVER 1 . 0 HP 3 . 00 3 . 00
mese provisions. ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18 . 50 18 . 50
ELE 2 MISC APPARATUS NOT LISTED REQ PERMIT 11 . 00 22 . 00
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with an city and county END OF FEES
ordinances and state laws relating to building construction and hereby author@ epresentatives of this city to enter upon the above-mentioned
property for inspection purposes.
Date: /1—(— nil Signature: /(-...— /L.u. 01 23151`4%-00151 47 TOT 66.03
Driver's License or Soda!Security
DATE: 12:0_•93 TIME: 09:12
164146 White—BWWmg:Green—Cade Enlorcemenf Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING PO• . SPA
'APPROVALS Permit
Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locet on
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Uthty•Undrgrnd. 54. Forms
4. Electrical Condu.t-U:drn'-.d. 55. Electrical Bonding
5. Sten. Reinforcement 56. Rough Plumbing & P•„ xure Test
6. Electrical UFER Grnd 57. APPROVAL TO COVE?-GUisiTE
7. Footings 58. Electrical Conduit Undrgrno.
8. Foundation {{ 59. Gas Pipe, 0 Und,grn.d., Test I -i
9. !later Pipe-Undrgrnd. t•
_ E0. Backwash L . P Trep, t•' 1-1,-elrg-r b Ifl_
10. S1ruct ura! Floor System E1. APPROVAt TO D:CK_
11. Pointy S<^s.er Lmu &. Hc..se Connection 62. Backwash & Rec titin•471.1 .1
12. Sever CaP I 63. Heatei & Vent-F�nal � ---
r,.._ - 4
^y 13. Rout Drains 64. Plumbing System f m,,I
14. Flour
g Plumbing 65. Electrical-F n, i
h Electrical-Cordua y-- --___- _-_ --+.
15. Rou
66. Solar SystannFn;,i
16. Rough Electric C:inrg 67. Fencing & AccJ» Apn'oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTE(‘'.S FINAL
19. Rough Heating & Air Conditioning 4 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace I APPROVALS Venn it
21. Ducts, in Structure 70. Undergrounu Hy). o
22. Ducts, Ventilating 71. Product Piping ' G.•; ' :O.' -- - -_•
23. Gas Pipe-Rough& Test 72. Underground Flush 1
_
24. Roof Framing
73. Undergrnd.Stnram- ir:rk ;: Gas - U.. i
25. Roof Sheathing --- j 74. Overhead Hvorn
26. T-Bar Ceiling (Structural) & Monocoat i 75. Dry Chemical
27. Frame and Flashing 76. Dry Standp.Pe
•
28. Lathing& Siding 77. FIXED SYSTEM FINAL j
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIRE'.iELT
31. Plaster Brown. Cort 79. FINAL INS°CCT- G ----_- -_ --� -
32 Electrical Power Meter-Final 30. FOOD CER rir'LATE ISSUED
33. Final Electric 23 •
----
34. Final Heating& Air Cord:tionicg
35. Etna! Cas Pipe-Test - - - - --36. Hood or Canopy `- - ------ ------
37. Final Factory Fireplace - --_ - -- __ - -♦---- -
38. Final Plumbing 1
39. Water Service-Final 1
40. Gas Service-Final
i'
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation 1
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING ---
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
•
51. CERTIFICATE OF OCCUPANCY
No. Date
ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT
NBroadway
orth
ANA, CALIFORNIA • BUILDING
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
I
Q 5
ADDRESS RECEIPT NO. PERMIT,NO.
BUILDING Y 3 So 3 2_ 3
SCHOOL DIST. �L
OR TOWN C ' RECEIVED BY DATE RECD. DATE ISSUED
NEAREST
SST12.10 �
' ;-s;
19-
/CI -S-3
ILDING J/� fADDRESS 'OWNER
GL RUE HI. HOLSTEIN 01-
J1{MAIL
[
•
ADDRESS 166 E. 1794yt OR HOTOW DIST. (711..4-1:5--4,_,,,
CITYTEL.
COSTA MESA, CALIF. NO. NEAREST •=�]
CROSS ST. `�
ARCHITECT OR LIC. ZOpIB� NO. OF TYPE I GROUP
ENGINEER NO. //����..// I PLANS '// yn 7'`z
ADDRESS-- APPROVE �✓ / J Q
ULVI\UC IR. fIUWi )CIIi ns JVf.J LIC. BY • DATE
CONTRACTOR ler E. ITA Vi NO.
II CORRECTIONS
ADDRESS COSTA MESA. CALIF.LEGAL
//
DESCRIPTION I NOT / 2 I BLOCK I TRACT/4 7k
(ATTACH METES
�IS[BOUNDS)
NO,OF0
SIZE OF LOT '90.1,6 / I NOW ON LOTS
USE OF NO. OFNO. OF
EXISTING BLDG. }� FAMILIES I ROOMS
SETBACK LINE FROM: 2 (4 REAR YARD 4i 7
CENTER OF STREET (//h SIDE YARD
DESCRIPTION OF WORK xi
0
NEW I A I ALTERATION I I ADDITION I O
Z
REPAIR I I MOVING I I DEMOLISH I D r
-
BUILDINGNO. OF �,/
SIZE g'Z/ ROOMS / STORIES I
EXTERIOR WALL I •ROOF .
COVERING COVERING
USEOF NEW
BUILDING • J
APPROVALS
FOUNDATION: LOCATION SPECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS. MATERIALS,
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. Le3 // / `` ,
BRACING. BOLTS 'tel
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
/ LATH. INT. �-1{ .Q`�
SIGNATURE OF
a /,p, LATH. EXT. .-l/"CII �1- -2-943-
L
PERMITTEF �Yl Y
PLASTER. INT. .6�
AUTHORIZED ACT.-;I ` PLASTER, EXT. iQ4 ift.c5s ,
PERMIT FEE $ I tO MASONRY REINFORCED
VALUATION $
/V_ 7S-0_ PLAN CHECK S •1 BOND BEAM //�/ '
FEE S I'f. FINAL ..:."4/42 6 -A0 -34'
SM 3-30-53 '
. •
•
, -
a:
0
cr . .
. _
• , \
\ •
....••
•
STREET.
• •••
PLOT PLAN
Shaw location and distances from
property line and-between buildings. - -
3.
• •
- - '
•
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•
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F • • \
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• ORANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT
BUILDING
636 North Broadway
�w ,� n SANTA ANA, CALIFORNIA
a
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
BUILDING I C I_ �J SX4.\.----b3 z /
ADDRESS bT r Oy
SOR TOWN CHOOL DIST. RlJ(,J1'ET/I^V/,E/I}D/��AQyY DATE'()RECDr\/^^^''J]]] DATE ISSUED
NEAREST
CROSS ST. /� /J� (/ \ I'� V --- I 7-g n
OWNER IIIJJJBBBLLL/DDRESS G//r��,///�
ADDRESS fin�'-'
MAIL 6Et/RbE M. HOLSTEIN & IWC SCHOOL DIST.
ADDRESS -COSTA MESA,
177th S OR TOWN �y
TEL.
CITY -COSTA MESA. CALIF NO. NEAREST
CROSS
��pp CROSS ST.
ARCHITECtj EY/F,�E t' HOLSTEIN 8r'.`-4 c. &VED
a NO. OF TY� I GRO�
ENGINEER Nb: IPLANS
1BD t. I.n SIADDRESS (Y)CtA MACCS.AntGGn '.
CONTRACTORRGE M. ROLSiFIN & . 1N1C. BY DATE 9'
i , L. (nn at NNDOO CORRECTIONS
ADDRESS (`(1CTA I1.1;..1 PAI IF
DESCRIPTION I NOT BLOCK LEGAL LOi
I TRACT/67(�
(ATTACH METES IA BOUNDS/
•�O V/p /I NO.OFBLDGS. O
SIZE OF LOT /� . Z. NOW ON LOT
USE OF NO. OF I NO. OF
EXISTING BLDG. FAMILIES ROOMS
SETBACK LINE FROM: /� ' REAR YARD ��
CENTER OF STREET SIDE YARD
DESCRIPTIONyOF WORK 0
3
NEW I I ALTERATION I I ADDITION I Z
REPAIR I I MOVING I I DEMOLISH I r
BUILDING 3 / NO. OF
SIZE ✓o ROOMS / STORIES /
EXTERIOR WALL CIL- I ROOF V / -
COVERING �'(�,{b(.p COVERING ,1,/-0
USE OF NEW
BUILDING
APPROVALS
FOUNDATION: LOCATION �IINNS`PEECTOR J� DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS.UNDER-PINNING A LS A�.1'!_ l /✓ -/ '` I`
APPLICATION AND STATE THAT THE ABOVE IS CORRECTA~
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS, n�,�j /n �9_�`t
BRACING. BOLTS ata#45 I r
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
LATH. INT. ���/
SIGNATURE OF I ` LATH. EXT. Liao /AP•2-
FERMITTE 'L • as,.......0 - -
L/ / PLASTER, INT. /`y} /��J tt
AUTHORIZED ACT. 41
PLASTER. EXT. YGCf1a /'f`1
• PERMIT FEE $ ./ MASONRY REINFORCED
VALUATION $ 7 2,0_
ALAN CHECK 5 /�
BOND BEAM /� �,
aa#TOT
45 g!/4 FINAL ..G(/'S .3-/O so/(//�{
5M 9.90-59
w
w
J �
•
•
o
a a
a 0
a. • a
a
•
rt
STREET -
PLOT PLAN
Show location and distances from
• property line and between buildings. •-
•
•
•
•
•
• .1
• •