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Home My WebLink About3008 ROYAL PALM DR - Building PermitsCITY OF COSTA MESA BUILDING DIVISION f 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.cwsta-mesas s �•,gM10 FOR INSPECTIONS CALL: (714) 754-5626 fi PERMIT NUMBE B07-00907 PERMIT TYPE B_ROOF2 STATUS: ISSUED _... DATE ISSUED: 08/20/2007 ISSUED BY: RMD JOB ADDRESS: 3008 ROYAL PALM DR CM Suite/Unit_ Vicinity: GARAGE ONLY Const Type:,;7 SQ. FT: 800 <>';•" - _ - - -=Valuation . 80.00 r SCOPE OF WORK: TEAR OFF(E) ROOF, MATERIALS, AND REROOF WITH A BUR SYSTEM ON FLAT ROOF GARAGE ONLY, APPROX 8 SQUARES. ` OWNER: NETHERTON;.LAURENCE'M AND CYNTHIA A, _ _� _ -,-Address: 2913 PEPPER TREE LN APT_ A Unit: PHONE: 949-724-4551. City/State/Zip: ,- COSTA MESA, CA APPLICANT: VALVANO,. DOMENIC i, Address: 1100 IRVINE AVE Unit: - PHONE: 866-783-4400 `- City/State/zZip: TUSTIN, CA . CONTRACTOR: SUPERIOR ROOFING L License No.. 865713 Address: 1100 IRVINE AVEUnit: PHONE: 866-783-4400 City/State: TUSTIN, CA ZipCode: 92780' CELL:' ARCHITECT: .' License No. .: „ PHONE::i ENGINEER: - - License No. ._ - - . PHONE: FEE SUMMARY 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. CODE k. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re -Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE INTMALS CODE r INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DATE INinIALS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this peril is issued. My workers' compensation Insurance carrier and policy number are:C_7t�4 (This section neee Trot be comWelee d the rrad is valued at one hundretl bellars (Sl 0) or less.) `'- 1 �3D?3Z Policy 'Nu Number: ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to t e' vers' compensation provisions of Section 3700 of the Labor e, F( rthwith comply with these provisions. p `ZJ �J AV can's Signature t_Date—; WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Class'#— G- 3 7. -o- r i I CONSTRUCTION LENDING 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.). ❑ lam exempt under sec. Business and Professions Code for this reason: 3057-16 (W07) Owner ID verified by drive. Driver's License No. .tse. ❑ Yes ❑ No Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: - ❑ 1 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, a 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. Applicant's Signature Dale Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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 fling with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ 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 ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. 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 ocyupy or allow occupancy of any building authorized by this permit until fin pection. Signal of Date �ti a o _11AWar AuthonzEU Applicant _ ___ Date I (714) 754-5273 • Fax (714) 754-4656 • www.ci.costa-mesa.�aUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3008 ROYAL PALM DR y�6tatus: ISSUED Suite: Applied: 05/15/2001 Vicinity: DUPLEX RESIDENCE ONLY Issued: 05/15/2001 Parcel Number: 13920211 Zoning: R3 R3 Applicant: CHRISTIANSON, CHUCK ISSUED BY: Address: 1939 MONROE ST - Phone: (909) 351-8556 RIVERSIDE, CA Zip: 92504-5223 Owner: JACQUES, DONALD F Address 2913 PEPPER TREE LN APT A Phone: COSTA MESA, CA Zip: 92626 Contractor: CHRISTIANSON ROOFING CO INC Address: 1939 MONROE ST RIVERSIDE, CA Zip: 92504-5223 Phone: (909) 351-8556 License: 599505 Arch : 1 Eng: Address: Address:' Phone: Phone: Zip: License: License: DING & ZONING%, /„\ IV Left 0-0 - Right "0-,0,"-, Left 0-0 -� Right,`/�0-"0 Proposed:. -,=_,0- ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446<6 (6/00) bt UNt Ur- 1-tKlVll l . ?PLAI REROOF: TIO EXISTING ROOF, REPAIR SHT_G AS NEEDED,'2 LAYERS`15#'FELT, APPLY 20 -YEAR FIBERGLASS SHINGLES. SETBACKS 23 SQUARES, MAIN STRUCTURE Front �0 - - Rear -0-0 ACCESSORY Front 0-0- Rear 0-0 PARKING Existing: TEE SUMMARY -Required -, 0 Plan Check: $0.00 Calc Valuation:��, $4,100.00 Permit: $111.25 Claim Valuation:;<: $`a,loo.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00.; � Total: $111.75 DING & ZONING%, /„\ IV Left 0-0 - Right "0-,0,"-, Left 0-0 -� Right,`/�0-"0 Proposed:. -,=_,0- ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446<6 (6/00) ?PLAI SETBACKS MAIN STRUCTURE Front �0 _0-_ Rear -0-0 ACCESSORY Front 0-0- Rear 0-0 PARKING Existing: 0 -Required -, 0 NOTES: DING & ZONING%, /„\ IV Left 0-0 - Right "0-,0,"-, Left 0-0 -� Right,`/�0-"0 Proposed:. -,=_,0- ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446<6 (6/00) DECLARATIONS F) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carder: i%/��IFLtDU.4 �•� Policy Number: wcy 0983%Z6 (This section need not be completed if the permit is valued atone hundred dollars ($100) or lass.) ❑ 1 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 Cal,fprm and a e4'that if ould become subject to the workers' compensation provisions of Sectl n 370 of the Labor Code, I shall forthwith complywith the r I I �/ Applicant Slgnatur �� i6z Date: �� WARNING: FAILURE TO SECURE WORKERS' cc ci']-]bMMMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOL -ARE LEImm,DDD), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION W06 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed nderrovisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Businness andpp�ofessions Code, and my license is in full force and effect. Lic. N Class N G' 3l Contractors Signature: Date: .T-// ��O/ i CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 70(30) 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. 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 contractors) 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 ❑ 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: ❑ 1 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, Tltle 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? ❑ Yes ❑ 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 Dces or will the applicant or present or future building Occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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). .......................................................................................................................................................................................I............................ .............................................. -............... ........................ ........................... ......... 3 Dces or will theappplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes 11No (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 en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication egermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Li Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ............................................................................................................................................................................................................................................................................................................................................. 6 Wiil any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it 'yes*, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................................................................................................................................................................................................................................................................._........................I.................. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ............................... .......... ............................ ...............-................ ...................... ................................................................................................................................. .............................................. .......................................... ................................... .... 8 (If 'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. A SgRa ur f mer s) ��/s r�/ o And/Or Authorized Applicant Date CODE r. INSPECTION TYPE DATE INTmALS CODE INSPECTION TYPE gAR INTMALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root li 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 ;y Applicant to fill in. all spaces except those within heavy border lines and sign all appropriate declarations. - 't CITY OF COSTA MESA CON TRPERMIT PEa T N TRACT NO. '-LOT NO; UNIT NO. .. " Project, Address �06� l' /. MSI '- �- 7R71 I /aD/41L . TL 'ADD-, "ALTERATION Applicant's Mailing tlress: L ,�'Lj��. 1 TYPE OF CONSTRUCTION NEW PA -----� -❑ CONVERSION ❑ DEMOLISH A OTH # r Zane Owner's Name A Phoorn'e DE$ IPTION OF WORK/USE Ci r BLDG ,qP - .-, �/�J Address iq a W/ rrr -mac/ - e _ ( q S Main Building: -Accessory'B uildmg ti ) Z Arch/Eng. License No. TYPE OF PERMIT GRADING FOUNDATION ST RUCTU A i - T Front- - p .' ` -- ❑ TENANT ❑ ELE TRICAL PLUMBING ❑ MECHANICAL. B I ) N Addressl � f 't'J$�G' - ..❑ I'. t'sJ 'DTH ER �_- _ - 1 Rear � - N ConVactorsNa Phoneme S!�. �'1��+ - ?��-' PROJECT DESCRIP—T--10—[[[N11 SO. FTM �' OCCUP.a Y .0 K Right g G Address (mailing) 72 - •� CONST RUCTION'TYPE VALUATION $ �� C/ S Left - += R City License No. y 7 %� ZONE GRADING CU.YDS. RES Ping. Ref. # 1 - Parking Req./Provided E LICENSED CO NT fi A CTOR DECLARATION - _ hereby affirm that I am licensed under provisions of Charter 9 (commenting Remarks: 14 s Planning Notes: - _ M, with section •7000) of .Division 3 of the Business and Professions Code, and I T my license is In fn'/s�y/orce and effect. ! p•G ��z G ' 1 $ License Clays✓ / Lice o.. �1 'late' //?/ 'S"g 't A�w7— � PLUMBING FEES 5R KERS' COMPENSATIONDECLARATION Bar Sink Showers I , ' ' ' ELECTRICAL FEES ,ereby affirm that I have a certificate of consent to self -insure or a certificate - I of Workers'- Compensation Insurance, or a certified copy thereof (Section-- j - - -- --i - Backflow Preventer - -- 1^> ' -Service Sink - - - - - ^-- Automatic Washer - - -r, -- - -Transformer '❑ 15-50KW 3800, Lab. C.) - �L .1 Policy No. ��%� Company /�•� Backflow Irrigation Sewer,Cap- I ' ) El 50'+ KW Construction Pole Sub. Certifletl copy is M1ereby furn ishetl. artiJ' ea�,c7rs7f�,'J's filed with the city Bui$a of ion / / Bathtubs t 1 Sewer_Connection - - Cooking Unit Meter ❑up to 100 amps to 4ii 1 6 Eh �iALi(�GBON P EXE TI FROM WOR S'COMP SA ION DECLARATION _t Clarifiefs �-- ,- _ .Solar Collectors. - _ .__ _ Dishwasher,. �.._ _ .1 ;_ _ Meter ❑over'100 amps (This section need not be completed if the permitlis for one hundred ($100) or Ie• Dishwasher Solar Pipings s Dryers Gas Electric ❑❑ Sub Panel certify [hat In the performance tl, I cer the work for which this permit Isct an to shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors E1111 HP O1 -''A 1 8 -,' Workers' Compensation Laws of California. Date Signature I Floor Drains Swimming Pool w/Spa! F.A.U. Inc. Solar ❑9;15 HP 16-15+ NOTICE: If, after making this declaration, you should become subject to,the Workers' Compensation provisionsofthe-Labor Code, you must forthwith' FIOOY$inks' -'-' - Urinate` 1 ! - Fixtures• Microwave comply with such+provisions or this. permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - , . ' " Gas Service 5doutlets s' ' - Water Closet Device Boxes Pole Light ' I hereby, affirm that flier¢ is a construction lending agency for the performance 1 of the work for 'which this permit is issued -.(Section-. 3097 CI_v. C.) Interceptors, , - Water Heater - Outlets Range Lender's Name Lender's Atltlress Kitchen Sink " Water Service Switches ' Sign ' OWNER BUILDER DECLARATION ` I hereby affirm'that I am exempt from the Contractor's License Law for' the - i Lavatories_ 1 Auto' -Wash I _ .1 -' , Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code:.Any'citY or 1 county ,which requires a permit to construct, alter, improve, demolish or repair P -Trap Laundry Trays -- Generator ❑0.5 KW E15-15 KW Trash Compactor any structure, prior to its Issuance, also requires the applicant for such permit _ 'o file a signed statement that he/she is licensed pursuant to the provisions of ' Roof, Drains I ie Contractor's License Law (Chapter 9.(commencing with Section 7000) of - - Jivision 3 of the Business .and Professions Code) or that he/she is exempt and the basis for the alleged exemption. Any violation of Section _ - - -therefrom _ 7031.5 :by any applicant for a .permit subjects' the applicant to -a civil --I -penalty of not more than five hundred'dollars ($500). -employees - ' Reinspectign�Fee Si $15 '. l Issue Fee'• $ 3, - �❑ I, as owner of the property or my with wages as their sole - i _ compensation, will do the work, and the structure is not intended or offered Reinspection Fee $15 Issue Fee $ 3 for sale (Section! 7044, Business and Professional Code: The Contractor's' License'Law does not apply to an owner of adproperty who builds or improves: - I f- MECHANICAL I FEES aim - thereon', and who does such work himself/herself or through his or her own Boiler ' Or ( Type I. El_ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for ; is of com- Canopy Type ❑' Zoning Approved By Date sale. If, however, the building or improvement sold within one year the have the burden of did not build or Im- Duct - Under Ground , ,Hood II pletion, owner will proving.he/she prove for the purpose of sale). 1 ❑ I, as owner of.the property, am exclusively contracting with licensed con- , , , _ Building Approved By, Application Issued By Date Date 1 �' Duct -Structural I 1 1 Refrigeration System ,- 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 --= - - _ _ ❑0-100,000 BTU. 1:1100,000 BTU V F FEES builds or improves thereon, and, who,contracts for such projects with a con 'SMIP •� $�' tractor( license pursuant to the Contractor's License Law). I am aware that Exhaust System El Multiple 11 System Repair/Alteration BUILDING PERMITO��•'-""". proof off their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT . ❑ 1 am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBG # Fire Dampers ISSUANCE $. PLUMBING $ 1 . Date I OwnerHeating System & Ducting I Registers 1 PLAN CHECK ; 25% $ I ENERGY P.C. $ -hereby certify that have read this application and state that'the above ❑0100,000 BTU'❑100,000 BT 1 i - ELECTRICAL $ 1 GRADING $ 1 information is correct. I agree to comply with all city and county ordinances and state laws relating to wilding cons dd��11tt��n, an .hereby authorize ' PLAN CHECK .50%' $ PLAN CHECK- .50%' $ MICROFILM $ -Z , ,up�fe I l abov mentioned pope ty• for sentatives of chi c y yfor up�fe abov mentionetl pope tY• for inspection pure /y 7�f �� 1 i i tenter ' MECHANICAL $ _�!�,._ ,�J TOTAL FEE $ Signature ate Cr (' ' Reinspection Fee $15 ` Issue Fee :$ 3 PLAN'CHECK :25% $ ! r� Drivers' License SS CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor -� CONSTRUCTION AND PLANNING`/ . / APPROVALS Permit #' ° Date/ - Inspector PC & SPA APPROVALS Permit # Date Inspector " 1. Temporary Electrical Service or Pole,'' 52. Pool & Equipment Location - 2. Soil Pipe, Undrgrnd. •'' - 53. Steel Reinforcement = 3. Electrical.Conduitr 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 Footings 7 • 58. Electrical Conduit-Undrgrnd. 8.' Foundation �;�� l - '' - 59.Gas Pipe, 0 Undrgrnd., Test 9=.- Water Pipe-Undrgrnd`. 7 - •� 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural'Floor System '10 ` - 61. APPROVAL'TO DECK 11. PropertySewer Line &House Co"nnection fy 62: Backwash & Receptor -Final 12. Sewer Cap, •,%" ` 63. Heater &Vent -Final i. 13. Roof Drains n 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 + r f 68. APPROVED FOR PLASTERING - ,18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &Air Conditioning. FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. .Rough Factory Fireplace 21. Ducts, in"Structure 70. Underground Hydro 22. Ducts, Ventilating . 71. Product Piping 11Gas EJ 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-Bai'Ceiling (Structural) & Monocoat - 75. Dry Chemical - 27. Frameaind Flashing - 76. Dry Standpipe 28. Lathing'& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL . 30. Drywall:Nailing HEALTH DEPT. REQUIREMENT X31. Plaster Brown Coat r. 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 Canopyl - - 37. Final Factory Fireplace, - -. 38. Final Plumbing - 39. Water Service -Final - 40. Gas Service -Final ,. 41. Solar Domestic -Final 42. Backflow Preventer ' 43. Backflow Irrigation 44. Landscape Irrigation. System - 45. Sound. Attenuation - - 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed' I - I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • -+' ,{ 51. CERTIFICAT E0FOCCUPANCY No. Date - COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 .'COSTA MESA. CALIFORNIA (-F RI ln3: l�ji0� MR APPL/CANT TO f/LL /N COMPLETELY APPLICATION I!rFORTUTMIT TYPE OR PRINT I'1 ` I BUILDING ' 3008 Royal Palm Drive I p� COSTA MESA. CALIFORNIA - FOR, Off/LL USE ONLY Dolce Colegmve, RECEIPT NO. I 'PERMIT NO. OWNER 1130• REL IV BY Dy; RECEIVED I DATE ISSUED I �I/�1/^ MAIL/� # EP 17th St. ADDRESS 419 9 105Q Costa Mesa, Calif TNO. •.�g^11S CITY • ADDRESS COSTA MESA, CALIFORNIA ARCHITECT Carlson & LIC. OR ENGINEER NO. Garden Grove t FIRE ADDRESS ZONE TYPE GROUP Dike & Colegrove, Inc STATE CONTRACTOR LIC. NO. 167293 APPROVED BY DATE ADDRESS 419 E. 17th St: Costa Mesa ZONING LEGAL LOT 6 IND. /.,p22 I ZONE NO. OF 'USE OF NEW DESCRIPTION BLOCK TRACT /�, yl PLANS J�I BUILDING APPROVED jj �L IA� A. P, NO. BY W DATE cf SIZE Q4 x112 NO. OF BLDG5none YARDS 1 � 'EW OF LOT now ory Loi REQUIRED AL WED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT r/ J FT. IN. SETBACK LINE FROM 1 ,1 1 CENTER OF STREET .REAR YARD R. SIDE FT. IN. SIDE YARD I LEFT 15' RIGHT 71 L. SIDE FT. IN. DESCRIPTION OF WORK REAR 1 FT. IN. v NEW X II ALTERATION I ADDITION I II MOVING DEMOLISH ING NO. OF'ZROOMS 3516 STORIESIOR WALL ROOF RING $tUCCO COVERINGF BUILDING AND WORK TO BE PERFORMEDltiple familydwelling withtached garage. (Four living units) „ 2 3 0. R nREBY LR ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONSTATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION IS FOR THE ITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. ING CONSTRUCT,VALUATION TURE OF �/ /y _ PERMIT FEE $50.00 ITTEE$ CHECK 1$ 25.00 30s 974dipPLAN Dike Colegrove, Inc.ORIZED AGENT TOTAL FEES 75oOO I