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HomeMy WebLinkAbout2941 ROYAL PALM DR - Building Permits ,�"1'," "'N CITY OF COSTA MESA 4 BUILDING DIVISION > •� , `i H DEVELOPMENTrSERVV�ES DEPARTMENT PE MIT NUMBER 1. 1 • PERMIT B06-01997 41/44%-oRinso 41. • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.yg.tLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2941 ROYAL PALM DR Status: ISSUED Suite: Applied: 11/29/2006 Vicinity: HOUSE AND GARAGE ROOF . Issued: 11/29/2006 Primary Occ: R3 Type of Construction: V-N Parcel Number: 13921515 Zoning: R1 Applicant: PEARSON, VESS Address: P 0 BOX 3908 . Phone: 562-429-7663 ISSUE\SL,,BY: SEAL BEACH,CA _ - Zip: . 90740 Owner: JOHNSON, MARK A -. r Address 2941 ROYAL PALMDR - Phone: ,714'-979-4964 COSTA MESA,CA - - Zip: 92626-3812 ' - +CJs Contractor: G M ROOFING COMPANY _ ' - n! - ®� tf‘�. i"'* �\ Address: - P O BOX 3908 - - E' ' ' / '- Phone: 56 -429 7663 - ' :A ' SEAL BEACH,CA; . � v/7 A „ Zip: 90740 -' License: 472566 ' A Arch : Eng: \� . Address: Address: ' Phone: ' Phone.' ` Zip: License: _ - License : . - r4'. N' - SCOPE OF'PERMIT �_ i TEAR OFF(E)ROOF MATERIALS,INSTALL 7/16"OSB SOLID SHEATHING,AND 1 LAYER OF 30#FELT,ON-A 4:12 PITCHED ROOF AND REROOF W/30 YEARS LAMINDATED COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE,APPROX 2700SF. ' FEE SUMMARY - -- Plan Check: $0.00 / r - - . '''I' Calc Valuation: , . $9,300:00 Permit: $181.25 --- " '- Claim Valuation: $9,300.00 SMIP Res: $0.93 • SMIP Corn: $0.00 . Other: $0.00 Inspection: $0.00 - _ - - : v r' Total: , . • $182.18 - - . : PLANNING &ZONING - _ SETBACKS _ ,,, MAIN STRUCTURE Front 0-0 Rear , 0-0 Left- 0:0"A. Right O-,0 - ACCESSORY Front 0-0- -Rear 0-0 'Left 0 0 -;Right i0-0 - - PARKING Existing: 0 Required: 0 Proposed: 0 - i1. ' Z . 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 . 2448-46(WOO) DECLARATIONS Li U - 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. ',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.work&s'compensation Insurance carrier and policy number are: Carder.'"/ S`( (kit: ela.C) Policy Number: _ pot( l 131- 2 — 006 t'(7his.secfion need nor 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 alifomia, d agree that if I should become subject to the workers'compensation provisions of Section 3700 oftheLabor Code,I shall forthwith comply withthesgo`ro cions. I fpplicem'Slgnauret \ �� � - ate_ ` LS 06 VEINING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDMON TOTHE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F 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 ohihe.Business and Professions Code,and my license is in full f rce-and.effem-ucrx 1'1- 5/{p 6 Class«--.C_-`l S �1. �_ Contractors Signature: �� Data -` I I- c- a- 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). Lenders Name: Lenders 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(Sac. 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.It,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. ❑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: I Will the applicant or present or future building occupant need to file end 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 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? 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No ...t .prop.. . 8 (If yes',attach certificate of compliance from thee appropriate tee a 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 end Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penally 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-describedpropertyproperty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Vitt— Signature Of Legal Owner(s) Pate r-Artd/Or Authorized Applicant N ate CODE I INSPECTION TYPE ' DAM INTfTIAL$ . CODE It INSPFCTION TYPE OAIE INTIMAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final —"a� 208 Final Plumbing 200 Final Re-Roof / Ae7r, 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 - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ • �^ PERMI NO. TRACT NO. ,LOT NU. UNIT NO. • CITY OF COSTA MESA / CONSTRUCT ON PERMITi I I ✓1n1 ) ,I �1 .�/l/�/��' r 33 asp ' I 9710 5/02/88 5 00 TL ,Protect Address 9 j 971 A /fH !� I , r [V a • 11 TYPE OF CONSTRUCTION LJ NEW LI ADD H ALTERATION r(,J�wEPAIR Applicant's Mallin /d1r ss ad) /"� /'/ ❑ CONVERSION ❑ DEMOLISH ❑ OTH_ER p,P.# _ _ _ ' Zone _ • Owner's Name Q!/�/01/no//��Oph' Phone 7 79.446 e•� DESCRIPTION OF WOR K/USE OF BLDG. Address 5q. //�/ S Main Building: - Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ UNDATION ❑ STRUCTURAL E ��/yq Front ' O Address • ' j(/�� /q1//�Qp r/J/}/}-/� ❑ TENANT ❑ ELECTRICAL 1(G PLUMBING ❑ MECHANICAL g N + �� �AwkiAPLAAI ngov--05- ❑ OTHER K Rear ' G Contractor's Name ` - I • yPROJECT DESCRIPTION SQ. FT. • OCCUPANCY C Right • N Address(mailing)—/ r CONSTRUCTION TYPE VALUATION 5 $ Left City License No, ��� -7 ZONE GRADING CU.YDS. - ACRES R LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided E I herebyaffirm that I am licensed underprovisions of Charter 9 (commencingA t938 Q Remarks: • Planning Notes: RECEIVED APR 130© M with section 7000) of Division 3 of the Business and Professions Code,rand - T my license is in ful . ' and effect. o .I D? • _ S license as / • i ic-ns' No. O g. e - �r Signatureiri ��A i_ -Art - PLUMBING FEES - • - RKERS' COMPENSATION DECLARATION - - NN ereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink • \ 3800, Lab. C.) p },- , ^ Automatic Washer Transformer D 15-50 KW . ' N. Policy No.71)(la�— 7 Company 1 7 ? r1�1/1_ Backflow Irrigation Sewer Cap - - - Construction Pole Sub.- ❑ 50+ KW \ certified copy is hereby turn ishetl. / ' _ - Cert['y/l�ad-/L/p�py?led with the city g ' isi . f, Nc j Bathtubs Sewer Connection • Cooking Unit • Meter ❑up to 100 amps Date T !V/ 'U 4 Applicant EXEMPTION FROM WORKERS'CO ENSAT N DECLARATION Clarifiers Solar DOIIeClOr$ • Dishwasher Meter Dover 100 amps, • • (This section need not be completed if the permit is for one hundred ($100) or r - - ' less). Dishwasher Solar Piping 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 Fountains Solar Tank Fan Motors❑0-1HP ❑1G-8• Workers' Compensation Laws of California. ' Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ • NOTICE: If,after making this declaration, you should become subject to the — -- - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks comply with such provisions or this permit shall be deemed revoked. Urinal Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes . Li ht • I hereby affirm that there is a construction lending agency for the performance - g of the work for which this permit is issued (Section 3097. Civ. C.) Interceptors Water Heater 7Outlets Range Lender's Name 9 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 . Standing Sections following reason (Section'7031.5 Business and Professional Code: Any city or _ county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor -,y structure, prior to its issuance, also requires the applicant for such permit file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - Contractor's License Law (Chapter 9(commencing with Section•7000)of • vision 3 of the Business and-Professions Code) or that he/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 ' LJmalty of not more than five hundred dollars($509). • ' I, as owner of the property or my.employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 - compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section. 7044, Business and Professional Code: The Contractor's MECHANICAL I ' FEES - • License Law does not apply to an owner of a property who builds or improves - thereon, and who does such work himself/herself or through his or her own ® DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ Zoning Approved By Date_ • • sale. If, however, the building or improvement is sold within one year of com- . . Canopy Type II I:1 pe the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By ' Date_.-/_L_ provrovthe for the purpose of sale). • ❑ I, as owner of the property, am exclusively contracting with licensed-con- Duct-Structural Refrigeration System ^ - Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES - builds or improves thereon;and who contracts for such projects with a con- . tractor(s) license pursuant to the•Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP ' $ proof of their Worker's compensation insurance should be provided to me. Exhaust System ❑ Multiple 0 System Repair/Alteration - PLAN.CHECK • $ L xPERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. (CBO# Fire Dampers PLUMBING $ F••3.DV ISSUANCE $ Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ _ - • l hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BT - ELECTRICAL • $ GRADING $ • information is correct. I agree to comply with all city and county ordinances II and state laws relating to building construction,and hereby authorize repre- • PLAN CHECK 50% $ MICROFILM $ sentatives of th' city to enter upon the above-mentioned properly for LL Inspection pur es ,// /�.(jG MECHANICAL $ .TOTAL FEE $ _►7�• Signature ��� . _ • CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND`PLANNING • POOL &SPA - Date Inspector - - Date Inspector APPROVALS Permitl APPROVALS Permit# 4: 1,'<Temporary'1Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. '�r. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms cc) 4. Erectrtoal Conduit-Undrgrnd. • 55. Electrical Bonding • : • 5. Steel Reinforcement i 56. Rough Plumbing & Pressure'T st . 6. Electrical UFER Grnd. 57. APPROVAL TO COVE R-GJ.INITE * 7. Footings ' r 58. Electrical Conduit-Undrgrnd•. 8. Foundatiop . 59. Gas Pipe, 0 Undrgrnd., Test` •- 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C?ijAdrgrnd.- 10. Structural Floor System 61. APPROVAL TO DECK W .r,. 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 0 Gas C Oil 23. Gas Pipe-Rough & Test 72. Underground Flush ` 24. Roof Framing 73. Undergrnd.Storage Tank O Gas C 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 r • 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 ./re to 39. Water Service-Final - - •• - • • 40. Gas.Service-Final t, 1- .. • - 41. Solar-Domestic-Final , 42. Backflow Preventer / • • • ;43. Backflow Irrigation t r • 44: Landscape Irrigation System' 45. Sound Attenuation • , 46. Handicap Regulations • L - 47. FINAL STRUCTURE & BUILDING - - ' 48. Special Requirements Completed . . - e. . 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co • - - . - . - 51. CERTIFICATE OF OCCUPANCY No. Date • . . • CONSTRUCTION AND PLANNING' r>' •POOL &SPA . .Date Inspector Date Inspector APPROVALS, Permit# - • APPROVALS Permit# , . 1. Temporary Electrical Service or Pole • - 52. Pool'& Equipment Location. •2. Soil Pipe-Undrgrnd. • 1, " • 53. Steel Reinforcement 3. Electrical Conduit'Utility,Undrgrnd. ' , - 54, Forms _ - , - .4. Electrical Conduit{Uhd grnd: - - ' - • • 55. Electrical Bonding /1 5: Steel Reinforcement.. u • 56. Rough Plumbing & Pressure Test • , - 1 . i• ' ,6. Electrical UF ER Grnd.' f • 57. APPROVAL TO COVER-GUNITE • - 7.--Footings ,` _ ,58. Electrical Conduit-Undrgrnd. _ 8. Foundation � ' f•' 259. Gas Pipe; D Undrgrnd.,Test ' • 9_ Water Pipe-Undrgrnd, A •- • 60, Backwash Lines, P-Trap, ❑'Undrgrnd. •, 10. Structural Floor System a .. - 61. APPROVAL TO DECK .. . - . ' - 11. Property Sewer'Line & House Connection - . 62.- Backwash 8,-Receptor-Final ' , 12. Sevaer,-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 • 1,9. Rough Heating& Ay Conditioning FIRE DEPT. REQUIREMENT 20. .Rough Factory Fireplace , i APPROVALS, Permit 4 • 21. Ducts, in Structure } s 70. Underground Hydro • • T 22. Duds, Ventilating ' ' . 71.' Product Piping 0 Gas 0Oil . . 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 , i 27. ,Frame and Flashing - . • 76., Ory 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 - _ V • 37. Final Factory Fireplace � . • , Y . 38. Final Plumbing•! y/ �01. - . 39. Water Service-Final' , 40, Gas Service-Final i , - • 41. Solar Domestic-Final ' 42. Backflow Preventer :. _ - _I. 43. Backflow.irrigation. - : i l 44. ,Landscape Irrigation System - . • , , 4 45. Sound Attenuation ' i ' 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING - - .- /J 48. Special Requirements Completed • i - , - 49. Electric Release to Edison -- a-- . . . • ' 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANC` - i. ' s No. - - Date -_- _ - . . . - . _. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. "' - 7729 9/06/84 5,00 SLI CITY OF COSTA MASA CO SIR U(,j�J��O1N PERMIT; • ., PERMIT NO. rTRACTTVO. LOT NO. UNIT•NO., , i , • _ - �( I ;- Project Address•aaLILI I / !'(''i�m -• • P I 5-T09) 7 - _ ,• Applicantis Mailin Addre/sss�z 3 -''' argt) - - . 11.. TYPE OF CONSTRUCTION• ❑ NEW U ADD ,U.AL'TERATION ❑ REPAIR - • _ 4.' • Owner's Name ��1 t 11.�' Phone CONY ERSION '❑ DEMOLISH ❑ OTHER_ A.P.# -,. Zone - •• • i �IiC 't - DESCRIPTION OF WORK/USE OF BLDG. ', - - _ . Address JI, S Main Building: Accessory.8uilding' E ' Z n Arch/Eng.' - License No - - TYPE OF PERMIT ❑ GRADING_-❑/FOUNDATION ❑'STRUCTURAL' T Front - •1 . . O rV(�J Address ' - r ' _ • .LI TENANT ❑ ELECTRICAL ' t PLUMBING, ❑ MECHANICAL B Rear - • I ; •r . - N ' •wJ k `y, `n,n, ❑ OTHER " t' , I - I A r 1 Contractbr's NamrG • r\at.'.1,�,..,X��1�`4�,C,1't11C>;Phooe - , C Right ' I I ? 3 - - _ ' N �• Address(maili•ng) t3 tcQ &Q U11C� U ��-Y`V1Yl ' •• PROJECT DESCRIPTION SO. FT. OCCUPANCY K _ • C, . '7��.[ p� I ; I 'CON STRUCTION TV PE I ' I 4 -VALUATION S Left _ R LICENSED .,NCTOR �✓ •I' . ZONE ' • ' GRADING CU.YDS. I ACRES - Ping. Ref,# , Parking Req./Provided ! - E ' LICENSED CONTRACTOR DECLARATION _ _ hereby affirm that I am licensedson3 under provisions of,Charter,9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and . , , I T my license is in H f• -antl effect. , 4 , Liven Cl.ss ' ! I Licer No.- :n�r - $. Date •a Vi Signature s'c ' _- /la l I i PLUMBING • FEES �_ ' imei WORKERS' COMPENSATION DECLARATION ' - ' ' I hereby affirm that I have a certificate of consent to self-insure or a certificate ; Bar Sink 1 I _ Showers ! I ELECTRICAL < FEES of Workers'- Compensation Insurance, or a-certified copy.thereof (Section..'_ _ - _ , - _ 3800, Lab. ) f Backflow Preventer - -ServiceSink - -- Automatic Washer "-- - Transformer 0.15-50'KW' P y No �aCS 1219 to) BZ��aI �rY�Ur,, , ! 0 50+ KW [tea"'[' Company Backflow Irrigation Sewer Cap Construction Pole Sub I I ertified copy is hereby furnished. ' • Ce d'(ep op lied with the city B I isi i Bathtubs Sewer Connection • Cooking Unit; , Meter Pup to 100 amps EXEMPTION'FROM WORKERS'COMPENSATIONthe per Dr one hu ATION_ Clarifiers Solar Collectors I 4 ! _ Dishwasher ,• Meter Dover 100 amp51 (This section need not be completed if the permit is for one hundred ($100) or ` less): 1 I ; - Dishwasher 1 I 1 Solar Piping I • Dryers ❑Gas, Electric iSubPanel I ` I certify'that in the performance of the work fonwhich this permit is issued, I ' - shall;not employ any person in any manner colas to become subject to,the Drinking Fountains ' Solar Tank ' Fan, r'• i , Motors 00-1 HP �1'/z�8 Workers' Compensation'Laws of California.' - - _ Date Signature I Floor Drains: I SwimmingPool w/S a,- I — - NOTICEI If,after making this declaration,you should become subject to the • - p -- F.A'.U. -Inc.Solar 09;15 HP 016-15+ Workers' Compensation provisions-of-the-Labor Code, you must forthwith Floor Sinks-- - Urinal i 'Fixtures - - - - comply -with' such provisions or this, permit shall be deemed revoked. - - - - -' Microwave r CONSTRUCTION'LENDING 'AG ENCV5 I T 1 - Gas Service ! r0 utlets Water Closet V - •• e' ' - ! Device Boxes I Pole Li ht I hereby affirm that there is a construction lending agency for the performance g of the iwork for which this permit cis'issued, (Section -3097 Civ. C.) Interceptors - ' _ ' Water.Heater99°-Q--Cd Outlets Range • I Lender's Name '- ' 1'Y • ' Lender's Address ' "' _ '` i - Kitchen Sink = `Water Service " r i Switches i , Sign 1 ' • OWNER BUILDER DECLARATION', - ' • I • _ _ - - I hereby affirm that I am-exempt from the Contractor's License Law for the , • I Lavatories ' ' following reason,(Section 7031.5 Business and Professional Code: Any city or ; - _ - - Garbage •Disposal ^Standing Sections county which requires a permit to construct;alter,improve,demolish orrepair• P-Trap - - ' ' ' - 'any structure, prior to its-issuance, also requires the applicant for such permit i - i Generator 00-5 KW 05-15 KW Trash Compactor ' I :to file a signed statementt hafhe/she is licensed pursuant to,the provisions of ' ' Roof Drains • Rhe Contractor's-License Law (Chapteri9 (commencing with Section 7000)of _ r ' i . - - Division 3 of the Business and Professions Code),or that he/she is exempt ' • - - i - -therefrom and the basis for the alleged exemption. Any violation:of Section . ' ' - '1 • 7031-.5 .by any applicant for, a permit subjects the applicant' too-a civil , .. . • ^ - _ I t ' i ' Renalty of not more than five hundred dollars ($500). ' i I _ - • - ; - i , LJ I, as owner of the property or my employees with wages as their sole _Reinspection-Fee , $15 Issue Fee. $ 31 • compensation, will do the work,and the structure is.not intended or offered • I for sale (Section 17044, Business and Professional Code: The Contractor's 1 - - ' ' • I MECHANICAL I f FEES Reinspection Fee I $15 Issue Fee $ 3 , License:Law does not apply-to an owner of a property who builds or improves thereon, and who does such.work:himself%herself or through his or-her own ! - . DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for . Boiler ' • ' Hood or Type I 0. •• - . sale. Ifhowever, the building-or'improvement is sold within one year of corn- - Canopy' Type II 0 ' Zoning Approved By Date ,. pletion„the owner will have the burden of proving:he/she did not build or im- Duct-Under Ground I Building Approved By' Date prove for the'purpose of sale). p(/ • e a-y/ I tractors s owner of the property, Se exclusively contracting with licensed con- Duct-Structural - Refrigeration System j ! Application Issued By Date C 1 Tt construct!License project (Section 7044, tBusiness and Professions property Code: • uil Contractor's!License .Law does pcontra t to an owner je pr withta who • Duct-Ventilating - - 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves [hereon;and who contracts for such projects with aeon- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration • _ I BUILDING;PERMIT ' $ SMIP 1 $ proof of their under .'s Compensation insurance should be provided to, me, PLAN $ ,PERMIT ' 0-I'am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# -• ( i ISSUANCE $ i r - PLUMBING ' $ i s J. nn • Date - Owner - i - - - Heating System& Ducting I . ENERGY P.C. $ - P,LAN CHECK 25% $ I hereby-certify-that I have lead this application and state that the above 1 ' ❑B-100,000 BTU 0100,000 BTL - - - ELECTRICAL $ s GRADING $ , information is correct. I agree to comply with all city and.countyh ordinances . antl•state laws relating to building construction, hereby authorize - MICROFILM $ repre- sentatives of this!city to enter u... the ab optioned property for , I PLAN CHECK 50% $ - inspection purer - !� aq_Cby I MECHANICAL $ TOTAL FEE $ < /'do SDrivers' _ 2e 0 Reinspection Fee '$15. Issue Fee • ' $ 3 PLAN CHECK 25% $ - ' Drivers' License or SS _ _ . , CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor OWNER HOMES VALLEY INC. DATE 6-16-59 JOB ADDRESS 29411 Royal Palm Dr. BUILDING PERMIT NO. 9600 GENERAL CONTRACTOR Dike & Colegrove VALUE $ 14,387.00 - AP. No. LOT263 TRACT2822 FIRE ZONE DESCRIPTION OF wonKRes. w/att. gar. INSPECTIONS i.y(,..y"f DATE I GROUP I & J TYPE V ZONE R1 Underground Soil J444( U.G. Water/f„.4.A -LQ-1 PERMITS ISSUED Underground Gas SUBCONTRACTOR DATE _ NUMBER 1 Overhead Water and Gas ' _ 1 Rough Heating "PS re-12-'t -y.- :.0/ fl . 7-5---S 7 Z411_7_/— n a Rough Plumbing /1141-5 gf n-3�/ ./L__. - 31- 17-S7 _L7"745- 1}" Miscellaneous //77 / Prop. Sw,r,Line fl use Con. St. Swr. 0/Sr eft-]=c.<.- • '...-3--- if,-//,7! 1 S 5 `L Ip' A Sprinkling System ! S Heating, Final ,4q/S /0 29- 7' :� ,/I' Plumbing Fixtures /1 -2?-.71- `ti ,/I Final Gas Test IC "�f� /� Construction Pole Underground Power Rough Wiring n/Aj, 1 r7I r;.0 t l d2s-'i ei /i/.i/tn-s.P i-/U-.59 o 97 / Trenches ✓ Forms (/ SteelQlO tut- t./ . 49 Floor System _(1 Steel Reinforce Chimney Re-Rod - Bond Beam Sheathing •7e I-- 19- qY Frame and Flashing 4 /.h _ Fr 0.1-51 Lathing, In F, Out of ej'F 9 - 3-“ Plaster, brown coat i'llli:' - (6 Mi.—/ _ Plumbing Fixtures, Final /YffS co-TL/-S( Electric Fixtures, Final /11.31 „9 r y Building, Final r' . ` OCCUPANCY I _ Form 210-3M-4-59 . �� ® o=EE RECEIVED • jun i s 18B9 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA, CALIFORNIA CITY 0:: COSTA MESA FOR APPLICANT TO fill IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 2941 Royal Palm Dr. • COSTA MESA, CALIFORNIA FOR OFF/CE USE ONLY . I RECEIPT NO. I PERMIT NO. r6iiti7 OWNER Homes Valley Inc. MAIL RECEIVED BY DATE RECEIVED //DATE ISSUED ADDRESS 419 EL 17th St. I l-/.5--.5-`7 I 6-/4-t17 TEL. BUILDING CITY Costa Mesa NO. Li S115L ADDRESS ARCHIITEENGINEER CT Carlson & NICC. COSTA MESA, CALIFORNIA ONj br00 CFIRE ADDRESS (:p TYYIP__n (3rn re ZONE DikeO& Colegrove, Inc. CONSTATE NT O. 167293 APPROVED DATE BY ADDRESS 419 E. 17th St., Costa Mesa ZONING LEGAL LOT 2822 ZONE NO.or I USE OF NEW f//\ DESCRIPTION No. 263 BLOCK TRACT 1 / PLANS BUILDING APPROVED / '//L-, A.P.NO. BY • f - DATE 6 G ly - SIZE NO.OF BLDG EVES OF LOT 60 x 105 I B.NOW ON LOT none. REQUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT V FT. IN. SETBACK LINE FROM CENTER OF STREET 50t REAR YARD 21St R.SIDE Cr-. FT. IN. SIDE YARD I LEFT St' I RIGHT 51 - L.SIDE tr % FT. IN. DESCRIPTION OF WORK .. .T� X REAR „.V.:-/ FT. IN. NEW I X II ALTERATION I II ADDITION I • REPAIR I V MOVING I II DEMOLISH I BUILDINGNO.OF SIZEE 1430 ROOMS 6 STORIES 1 EXTERIOR WALL .I ROOF Shingle COVERING stucco COVERING USE OF BUILDING AND WORK TO BE PERFORMED Single family residence with attached garage. Plan 130DR I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND'STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. VALUATION SIGNATURE OF 1.-.��%/J�I PERMIT FEE $ 34.00 PERMITTEE • '� -''L PER $ +-�F,387 PLAN CHECK $ 17.00 (ZED AGENT Dike & Co(�legrovej I® ' TOTAL FEE $ 51.00 OWNER DAVIES. C. DATE 11-25-69 JOB ADDRESS 2941 Royal Palm Drive BUILDING PERMIT NO. 31135 \ GENERAL CONTRACTOR AirFlo Awning Co. DESCRIPTION of WORK Patio Cover AP No. 139-215-15 LOT 253 TRACT 2822 FIRE ZONE VALUE $ 280.00 _ INSPECTIONS Signature Date GROUP J TYPE I ZONE R-1 SOIL SUBCONTRACTOR PERMITS ISSUED _ GAS Date Number Signature 7Q\ WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. n SPRINKLING SYSTEM MISCELLANEOUS • ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS 0 STEEL REINF. fl FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT n - PLASTER, BROWN COAT STRUCTURAL, FINAL Electric _ HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ❑ ELECTRIC, FINAL BUILDING, FINAL J( _ iL-41_4.9 ti 35 NOV 25-69�NSAO01066 Et*****5.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely — r�'1I [/ �/J nail RECEIVED BY DATE RE EIVED DAT 155 ED ADDRESS r �/ ,n/Gij'yg� / ai/ D�' 'J /'/t ( ' OWNER C P4//GS A.P.NO./39— /7r/5 js PESM ?I'�S.ri MAIL �//� _ BUILDING 9V/Poyt taw rl. . 2 ADDRESS seine_ �j/ ADDRESS d�/T�y ) 1 9 ((i(j( da 1 U CITY 19Osf4 �tSg No.i779/637 TRACT(& R LOT, BLOCK. Z < CONSTRUCTION 2nIC NEW DD1 ALTER (REPAIR (MOVING DEMOLISH O N LENDER � 0- CO J D BRANCH / k. J Cr) OWNER C. 0(LV-<-[A-- CO J ADDRESS ../947-a, CO �, VALU$e2 kL\ ARCHITECT ] TEL. USE mss/ .. ' y OR ENGINEER -ser ¢/719 N NO C FIRE w Q ADDRESS a y/C AO Ate 3� j$ �^ ZONE TYPE � GROUP /1 W Z CONTRACTOR AtlQ F.I O nW N ✓V i BYPROVED -I/ DATE 5 / Do0 sr / -J Z IT/CC ADDRESS 13012 CP..4Yl�y r//P-0 /34.4./O W WTEL. ZONE NO.OF USE OF NEWa i✓ 0= CITY PLANS BUILDING Z_I- tut!) No. P.-( a4-4 .- 0 STATE ^ CITY YARDS APPROVED YARDS APPROVED N K LIC. NO. d'3 a--l t / LIC,NO. MAIN BUILDING ACCESSORY BUILDING 70 (pjiQf�Gti ip.e.Tn)/-.� A SIZE NO.OF BLDGS. FLG�dclCo�i(I�.vy..+��" OF LOT 6i x jar NOW ON LOT � RONT T. ii FT. USE OF ��// )O s SIDE a"/ EXISTING BLDG. ,('j t_-S iv gig/Q R SIDE FT. FT. F SIZE OF /is,/. / " NO. F • Z NEW BLDG. X // ROOMS / STORIES L.SIDE FT. FT. Q EXTERIOR WALL ...- • ✓ COVERING COVERING /ILL//I REAR t6D 'FT. FT. - J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0. MAIN BLDGS. ACCESS. BLDGS. DATE 0 g41.//7 f-r60 flcdjc Arr/////p/y C U.P..3W APPROVED I— fJ/C /yOUJG APPROVED'//��j e �J` / n W to .S/0.0 _BY !!!///t!/i La'r/ DATE /d'J .6 / 0 pU I hereby acknowledge that I have read this application and state ✓ that the above Information is correct and agree to comply with _ CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of CO the State of California. so I hereby certify that I am properly licensed as a contractor under SQ. FT. 2 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 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 CC VALUATION •/v and Professions Code, Division 3,Chapter 9. .•., w PERMIT FEE $ / N Signature of�' /0�i!' �"_ m Permittee /AS* / C/ al $ d� PLAN CHECK $ E On° 0 Authorized Agent / •-.. `5'- a TOTAL FEE $ •