HomeMy WebLinkAbout2222 RUTGERS DR - Building Permits 5111MFS CITY OF COSTA MESA
9 BUILDING DIVISION
> DEVELOPMENT SERVICES DEPARTMENT PERMIT MBER
Ft
PERMIT
4
03-01653
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cugs,ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2222 RUTGERS DR U Status: ISSUED
Suite: Applied: 09/29/2003
Vicinity: ROOF Issued: 09/29/2003
Parcel Number 41906206 Zoning:
Applicant: NAVARRO, FELICIANO ISSUED BY: c" :04--
Address:
4--Address: 2222 RUTGERS DR
Phone: 949-515-3764
COSTA MESA,CA Zip: 92627-1626
Owner: NAVARRO, FELICIANO
Address 2222 RUTGERS DR
Phone:
COSTA MESA,CA Zip: 92627-1626
Contractor: OWNER-BUILDER
Address:
Phone:
Zip: License: 000000
Arch : Eng:
Address: • Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF.INSTALL 30 YEAR COMPOSITION SHINGLES,REPLACE SHEATHING AS NEEDED,AND INSTALL 30#FELT.23
SQUARES INCLUDES TRI-PLEX AND ATTACHED GARAGE.
• FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,600.00
Permit: $111.25 Claim Valuation: $4,600.00
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
•
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
2446-46(6/00)
DECLARATIONS .
•
WORKERS'COMPENSATION DECLARATION: •
I hereby affirm under penalty of perjury one of the following declarations: '
❑ I have and will maintain a certificate of consent to self-Insure 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:
Carrier. Policy Number:
(This action need not be completed it the permit Is valued at one hundred dollars($100)or less.)
I certify that in the performance o e 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 ofdegree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these prow s.,
Applicant Signature: is C.tot ,,,' 1 r I Date: / / 2 ( / Q
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOI.ARE(5100,000),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.Lic.N Class k
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
O 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 Ucense 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
gects the applicant to a civil penalty of not more than five hundred dollars($500).):
I,as owner of the properly,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)
lice o the Contractors License Laws.).
I am amps derec. id
and Professions Code for this reason: /n
nature: c_:l�li1'L%e' id �.✓� Date: 7l bid ( o a
Owner ID verified by driver's license. Yes 0 No Driver's License No. Expires: 77/ ' i?S
Verification of Ownership by(type of doc en,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,faisework,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).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number: _.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,ora volume of 55 gallons,
or 200 cubic feel 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 ❑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? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No
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 COMPUANCE 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 co ply with all state laws an. 't ordinances relating t0 building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above- pe focrnspection•. ..se_ s.I ag = not to occup or allow occupancy of any building authorized by this pertpitilntil final inspection.
• r
Signature Of Legal Owner(s) Date •
And/Or Authorized Applicant Date
OODE r INSPECTION TYPE gall MI65 COPE INSPECTION TYPE au If♦TmAls
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200
Final Re-Roof '-7-4 210 Final Electrical
201 Final Block/Retaining Well 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
Pr
ADORESSOFBULDPIO: 2222 RUTGERS DR UMT: C CITY OF COSTA MESA - BUILDING PERMIT
CW NERSNAMEIFIOn.m: PETER ROGER PERM NO: M 071654
ADDRESS: 985 W 18TH ST 1°
\ PERMIT NO: M 071654 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA CA 92626
APR-MAaplcADORES& CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH
SALT ECT OR Dana Lit NO.: JOB DESCRIPTION ; FURNACE CHANGE-OUT SQ FT;
ARCH.OR ENO.'S ADDRESS: UMT:
CLAIM VALUE: CALC-VALUE: GROUP OCC; /
CONTRACTOR'S NAME: REMCO ( 310 ) 424-7725
CONTRACTORSMALWD 3618 PACIFIC AV COMMENTS; NO OTHER OWRK AUTHORIZED BY THIS PERMIT
ADDRESS: LONG BEACH CA UC.NO.: 704414 *****************+n*******************+A**********************************+E***+r**
90807 UMT: Z ONING R EQU I R EMENT S
LICENSED CONTRACTORS DECLARATION:I hereby Slim under panaly d perjury(hail.••licensed under provisions of Chaplet 9 SETBACKS
(commencing with Section 7000)d Division 3 d the Business and Professions Coda,and . P,s .n fuf force and elf
CITY 7,,, mums: C-36 UC• 0 EXP: 74 MAIN BUILDING ACCESSORY BUILDING
/ ye -� FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
Deis D °vnVadaLEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNDER DECLARATION:I hereby drum under penalty of pearly t . I: exempt from the Canlradors License Law for the
. rowwi,greason(Sacral 7wl-BusiesandPrdworsCode:AmMor•• rtiChrequires apermit toconstruct,aeer,improve. PARKING REQ:_ PROV; PARCEL; 00000000 ZNE; REF NO:
fiendish, nes
' ndish,or raper any eruct .prix to its issuance,ebo requires the applicant la atem
such permit to file a signed stent that he or she
Sensed ed pursuantto the provision of the Coaredote License Law(Chapter 9(=merging with Section 7000)d DNtsd ion 3 the PLANNING Nl� ES>
Business and Prd°vma Code]or that he or she is exempt therehan and the basis for the alleged exemption.Any videiion of Section >
7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than we hundred dopers(S500W ********ick**********************************************************************
❑ I.es°mar of the prosody or my employees weh wages as their sole compensation,SI do the work,and the structure is not iMencled DEVELOPMENT S E R 'V ICES REQUIREMENTS
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply loan Owner of popery
who bolds or improves thereon, So o does such work Nmself or herself or through his a her own employees.provided that such
nor are nintended or offered for sale.f.however,the building or inprovernent is sold within one year of completion, ZONING APPROVED BY
owner-builder will have the burden of proving he Or she did not build or improve for the purpose of sale). DATE:
❑ I.as owner of the property.am exclusively comrades with licensed contractors to canard the project(Section 7044.Business and
Professions Code:The Contractors License Law does nor appy to an owner of property alto wilds or improves thereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a contrador(s)licensed pursuant to the Contracts License Law). 2 �j•'�{'-
❑ Iamexempt under Sediom B.AP.C.,for the mason: APPLICATION ISSUED BY: L FE A DATE: � F �F �c
*************************** *Rf * ********************iF'7W*********** * *e* **
Det Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
I do hereby cattily that I en aware d and understand the requirements of CatManta Health end Safety Cade Sadirons 25505,25533.and
25534.and the I Or any future bulking omus will/wil nor(drub one)need to comply with said state codes and the requirements for
e permit larmmruction a modification from the Ai y•anep°melMnd.Residentil conamwion eppicetiau We exempt frontLheea PERMIT BLDG PMT PLUMBING ELECTRIC MECHANICIC FIRE SMIP/RES GRADING
provisiore.
Dale: Applicant: 25* SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby elfin declarations:under penalty of perjury one of the following declations: ISSN
have ed will mepntan a caddis.of consent self ensure M workers'conpenmtion.as provided la by Sorban 3700 of the Labor BUILE FEE 15 . 00
❑ BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Coda,for the performance avian this pamtsiswred. TOTALS 9 . 00 15 . 00 0 . 00 24 . 00 24 . 00 . 00
❑ I hawed ail maintain workers'compensation insurance,as required by section 3700 of the Labor Code.M the performance of the
w«klawhknmapanm sisered.Myw«kers compensation insurancevm
deraa policy number ate:
carded: REVENUE DIVISION TOTALS--> COLLECTED: 24 . 00 OVER/SHORT; . 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed a the Perna is/or one hundred dollars 1$1001 or lass) 24 , 00
o Homey that in the performance of the work for which this permit is neeAron sIn any manner so as to
became to the workers'Compensation laws d California. nee �jattbecors tabled to the workers' *******************************************************************************
c mpen at pre•'ts d 3700 d the Labor Cob,I h... . w
'. Date: ��LQ AppT,ant: IND D IV IDUAL F E E BREAKDOWN
,
Warning:Failure to secure workers'compensation coverage Is unlawful, • - arelact an employer tocminalpensltles and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
dvll fines up to one hundred thousand dollars(SIIAm0A/n addldon to 1 of compensation,damages as Provided for In
•
Sectlon 3706 of the Labor Cotler,Interest and attorney's lose MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which the permit is issued(Sedkn 3097.Cee.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and tale that the above information is correct.I agree to campy with all city and county ordinances
•
and state Laws raisin. •• ibis construction and hereby authorize representatives of this city to enter upon the abovementkned properly
for Inspection pu• - J •RC IA
/ o / � /Ci
, 01 00178349-0017880 TOT
��� •MtName SDATE: 03/2V QC Tri.'_; ..:.3
2'
. l
-N.., Ag/ Date ? 4
S'. .. ,of Ow'neriAgeWAppicankContractx
(5151 da.WP) White-Building&Safety:Green-F e:Canary-AppFem:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POC_ & SPA
APPROVALS Permit 4 Date Inspector APPROVALS Permit 4 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 Grqd. 57. APPROVAL TO COVER•GUNITE
j 7. Footings I 58. Electrical Conduit-Undrgrnd.
8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe•Undrgrhd. -. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final'
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring _ 67. Fencing & Access Approval •
17. Rough Wiring Sign •- 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Fattory Fireplace • - APPROVALS ' Permit 4
21. Ducts, in.Structure - 70. Undergroupd Hydro
22. Ducts, Ventilating; , - 71. Product•Piping O Gas ❑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-fiat Ceiling (Structbrall & Monocoat 75. Dry Chemical .
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing & Siding . " 77. FIXED SYSTEM FINAL
29. Insulation . , 78. FIRE PREV. FINIAL '
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coati 79. FINAL INSPECTION
32. Electrical•Power Metbr-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric • Notes: 3-30_ -akar • 1� Al
• 34. Final Heating& Air Conditioning : 3.30 -Q f r .
35. Final Gas Pipe;Test • _ • - •
36. Hood or Canopy -
37. Final Factory Fireplace - 1.
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 - - I.
.t
45. Sound Attenuation ,;
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
PflpECTADOflESS: 2222 RUTGERS DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 068433
OWNER'S NAME: PETER RODGERS
ADDRESS: 3001 CLIFF DR PERMIT NO: E 068433 PLAN CHECK NO: N GOVT; N SUPP ; N
i N. B .
CONSTRUCTION TYPE; V-5 PERMIT TYPE: ELE PURPOSE; ALT
714 ) 631-2345
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD EELECTRICAL OUTLEST SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALL—VALUE: GROUP OCC; R-1 /
PERMITTEE: PETER RODGERS ( 714 ) 631-2345
ADDRESS: 3001 CLIFF DR COMMENTS: ADD 3 OUTLEST FOR SMOKE DETECTORS
N.B . CA 92663 *******x************+tat+r+r+f>E**iFiEiEx****x******>t**x+r>E+rstx+t*fr** ****aEit****x**FF***Tr***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and eftect.
CITY tic.: STATE LIC.: CLASS: EXP: SETBACKS
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent o sell-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: 42216103 ZNE: REF NO;
❑ Certilied copy is hereby furnished. 0 Certified copy'm tiled with the city Building Division. PLANNING NOTES>
>
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS
ify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
I to the Workers'Compensation Laws of California. e ZONING APPROVED B Y
!/� DATE;
a. 6• /�'ry Signature:
OTICE:If,eller making this declaration.you should become subject to the workers Compensation provisions of the Labor BUILDING APPROVED B Y DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y •
DATE:
which lois permit is issued(Section 3097.Civ,Cl. ********************.********.*******.* * **.*********************, ' *,*
LENDER: *********************************************************************** ** ****
ADDRESS: LEGALIZATION;N F E E SUM M A R Y STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby allirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code, Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 3 ..75
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 50'$ 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 of not more than five hundred dollars($500). ISSUE FEE 15 . 00 ) .
I. as owner of the property or my employees with wages as their sole compensation, wit 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----> 3 . 75 15 . 00 . .. -0 . 00 ' 18 . 75 18 . 75 . 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.It,however the building or
improvementpuof sae). BLD
one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUG . 00
forthepurpose PMT PLUMBING ELECTRICE DISION TOTALS——> OMECHANDIC FIRER SMIPO/TOT/S GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 18 , 75
❑ 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 ContractorsState License Law).I am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE B.'R E A K D O W N
N I am exempt under Section:8P7044 B.S P.C.
for this reason: OWNER—BUILDER TYPEQTY DESCRIPTIO S C R I P T I O N
� ., ar2UNIT COST TOTAL COST
rr Date' �' /G 9% Owner: '
I d ereby certify that lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and ELE 5 R EC EP T/OUTLET 1 ST 2 0 EA, .75 3 . 7 5
34 and mat or any future building occupant will/will not(circle one)need to Comply with said state codes and the requirements for a C D END O F FEES J
permit for construction or modification from Inc Air Duality Management District.Residential construction applications are exempt from C X F i R E 1' J/
these provisions. incomplete 1CSrsPf_tit/M!!' p
Date: Applicant: ��'p•�,�� I I Y_)1:`� _ —'
I hereby certify that have read this application and state that the above information is correct. agree to comply with all city and county gLii _ D 1 00165731-00165731
/ ^ 4F �� �•F�� TOT
ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned pet,
.�� �I�.Je— 5�,_ -~ p(W� �w DATE: OE/11/94 TInE: 15:42 lE'1�r
Crty for inspection purposes. Ipet, 1•1J U r
•
2 •/O— 9Y Signature: •x-4. 'teV D 'v
I's License or Social Security a: •
•
164146 white—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
.
,..-
4 CONSTRUCTION AND PLANNING POO 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 Conddit'Ufility-Undrgrnd. 54. Forms 3 If
•
4. Electrical Conduit Undrgrnd. 55. Electrical Bonding
.1
5. Steel Reinforcerneht 56. Rough Plumbing & Pressure Test
•.6. .Electr-isal UFE.FjQrnd. 57. APPROVAL TO COVE R-GUr li
:7,.Footinms _ 58. Electrical Conduit-Undrgrnd. ' r -
_.8. Foundation '' 59. Gas Pipe, 0 Undrgrnd.,Test
- 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line,& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbirig 65. Electrical-Final
15. Rough Electrical.-Conduit 66. Solar System-Final
a
16. Rough Electric Wiring 67. Fencing & Access Approval
1(. Rough Wiring Sign 68. APPROVED FOR PLASTERING
le. Rough ElectricalT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace n - - v .: (APPROVALS%% Permit # -
ti
21. 9u445,in-$try2ture,; .. .. - r .- `/0. UadergroundjiHyd7o
22. Ducts, Ventilati -ng,fe J 'I_ <• `C- - ••1. Product Ptaitig0-Gas ❑Oil -
•
23. Gas Pipe-Rough&•T,ist . . '
• rl - 72. Underground Flush;
24. Roof Framing . ' • - - - J 73.- Undergrnd. toraganGas Se.Tk 0 DOD
25. RodySheathing .- • - r, '1 74. Overhead Hydro •
-
26. 1-Bar Ceiling (Structural) & Monocoat ' _ - ':7 75.;pry Chemical -1 0- :1
27. Frame and Flashirit`, ''. .75', 76. Dry Standpipe . 4 ,
28. Lathing & Siding`I- . -+ ._ •• •' P. -"FIXED
29. Insulatio(t -r .� _ •' ' I l.-.. - 78.4IRE PREY. FINAL . '
30. Drywall Nailing x - a y ( it -- HEALTH DEPT.'REQUIREMENT
.31. Plaster Brown-Coat.: .. ; 1 I i .79- FINAL INSPECT16-03,I. '
32. .electrical-Power MeterFinal • . 't 1 � i, * 80..400D CERTIFICATE-'ISS ED A '.
,33. FinaTElectric _ Note:till f1 e 2
��
•34. FinaPHeajing& Alt Gonditioriing- ;> i ii
1 ;- Ps__ Vii•I , ,q 8 ��i j
35. Final-GaIPipe&Test• '`- ,• . . I i / j` . r_T-- . UI 'm'•/ • _elJ`-. i {(�]. ,_,
36. Hoodor'Canopy "-T.;r ` - - " •; t 1 - r CC,
37. FinaFFactory FirePlac�' , - 't i '• %I / Q - -
38. Final Plumbing I , • l.f( �/�
39. Water Service-Final : I t ( f"f�1�
40. Gas Service-Final - ; 1 i - •
41. Solar Domestic-Final '. • - - I i• ' • . -
42. Backflow Preventer '• ' ; - 1 I i.. • J >;-. v
1
43. Backflow Irrigation -
44. Landscape Irrigation System -, a .y 4 _1
45. Sound Attenuation* .. . ..
1 I l• -y• r
46. H'andicap,f?egulatior'Ls -
47. FINAL STRUCTURE & BUILDING __
c
48, FINAL PLANNING s • ' ' i
49. Electric Release to Edison 4 I `
50. Gas Release to Southern California Gas Co - - -
51. CERTIFICATE OF OCCUPANCY- - - - _ -
No. Date
.• —PROJECT ADDRESS: 2222 RUTGERS DR Ptl UxIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 068434
OWNER'S NAME: PETER RODGERS
ADDRESS: 3001 CLIFF DR PERMIT NO: P 068434 PLAN CHECK NO: N GOVT : N SUPP; N
N.B .
CONSTRUCTION TYPE: V-5 PERMIT TYPE; PLU PURPOSE: ALT
714 ) 631-2345
ARCH/ENGINEER: flEG.NO.:
AODflE55: UNIT: JOB DESCRIPTION ; PLUMBING WORK SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-1 /
PERMITTEE: PETER RODGERS ( 714 ) 631-2345
ADDRESS: 3001 CLIFF DR COMMENTS : REMOVE & REPLACE W/ BATHTUB & WASH BASIN
N.B . CA 92663 aE***+t***‘*x***+E*********+r*+E****+tkEx********aESF****+E*****EF** titx*SF**+r**************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect.
CITY LIC.: STATE LIC.: CLASS: EXP: SETBACKS
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV; PARCEL: 42216103 ZNE; REF NO:
❑ Cenilied 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 net be completed if the permit is far one hundred($100)or less), D EVEL OP MEN T S ERVIC ES 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
s to the Workers'Compensation Laws of California. / ZONING APPROVED BY DATE:
I ?. l9a— y Signature: , e, c—
TICE:II,alter making this declaration,you should become subiect to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE;de.you must forthwith comply with such provisions or This permit shall be deemed revoked. R l ,
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: j DATE: L Y
which this permit is issued(Section 3097.Civ.Cl. *********************************** ie MiiiiFFFF iE���ffff{{{{FFFF*-***********************::1
-*blit**************ititit***it* it **till
LENDER: *********************************** ******************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the lollowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 14 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% 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 of not more than five hundred dollars($500). ISSUE FEE 20 . 00
I. as owner of the properly or my employees with wages as their sole compensation. will do the work, and the BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 14 : 00 20 .00 0 . 00 34 . 00 34 . 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: 34 . 00 OVER/SHORT: . 00
fur 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 34 . 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 *********.******.*****************,***,*,***********************,*****,***************
that proof of their Worker's Compensation insurance should be provided to me.
y. I am exempt under Section: B p 704 q B.&P.C. INDIVIDUAL F E E BREAKDOWN
Iforthisreason:
_ OWNER—BUILDER / TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
�' /�'�� Owner: /�r/r4r
reby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 BATHTUB
7 .00 7 , 00
2 34 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 WASH BASIN 7 .00 7 ,0 0
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES
these provisions. EXPIRED
Dale. Applicant: Incomplete Inspect
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county 01001557J2-00165732 T
dinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above.mentioned @04191c_
�p T 'J¢.�0
p rperty for inspection purposes, .,fr/ —'<+ DATE: OP/11/94 TIME: 1S;¢3
�0 le: C•/U 9/ Signature: e ? J (�
river's License or Social Security a:
1641-46 White—Budding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
. ----_ -i
r
CONSTRUCTION AND PLANNING , - POOL & SPA •
Date Inspector Date Inspector
t APPROVALS Permit# `- APPROVALS Permit
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
'3i .Electrical Conduit Utility-Undrgrnd. 54. Forms
41 Electrical ConduitlUndrgrnd. 55. Electrical Bonding -
_ _ i
5; Steel Reinforcement 56. Rough Plumbing & Pressure Tes't'y
"&i Electrical UFER-Gr'md. 57. APPROVAL TO COVER.GUNTT5
:7,,, Footings o 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
r-
11. Property Sewer Line-& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
-•
13. Roof Drains64. Plumbing System - final
14. Rough Plumbing T 65. Electrical-Final
15 Rough Electrica'i Conduit 66. Solar System-Final
16: Rough Electric Wiring 67. Fencing & Access Approval
`7.7. 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 _ ' J r. -7' 'r StPPROVAtUJ;Permit #
21- Ducts:,in StructurWi' ; _ -y: : 0. Uradef inend-hci o
22. Ducts, Ventilating : )1. Product•Piekirig 0t$ 0pil
m
23. Gas Pipe-Rough&Test 3. ,., - r, _,< . .72. Undergrourgd,Flush,
24. Roof:Framing-. . . • :T3. - ti- . 73. •Undergrnd='Stora74-.Tank OGas 0Oi1
25. Roof Sheathing 74, tverhead Hydro -, - e
26. T.Bar,Ceiling (Structural) & Monocoat - " 75.iry Chemical i ' ' - - -
27. Frame and Flashing: ' t 1- • )'-; r -• -' r
a . . 76. dry Standf�Pg c .r _!r...
y.lt _
28. Lathing&Siding - - , -n-; ; - 77. 'FIXED SYSTEM FINAL' -i
'29. Insulation' .; .. . 78.-LRE PREY. FINAL; - ,
30. Drywall failing .{ .. 1 14 : I _ .1 'HEALTH•DEPT°REOUFREMENT
31. Plaster Brgwn Coat i r,, 7
t j 1 C 79. ' tNQL tN?ECTION ;
'32. Electrical Power MeterI Final ; `4 r ; 1 ,60. .ROOD CERTIFIC E ISSUED
-,
33. Ei nai Electric . •
` r'' . - `Note's: _ y- -
i
1.
34. Final.•Heating& Air Conditioning T. :', x ��
. � k g-art- GLe C_3¢ -
35. Final Gas Pipe-Test' _ I 1 iI- '
� t• -
.t3,6. Hood,or Canopy -- 1 ' ' _ - -
I n
37. Final:Factory Firepl`ace-1 ' I :1 ' ' - -
38. Final-Plumbing T- _ • r
39. Water-Service-Final.- I I• :
40. Gas Service-Final 1 11.: ' _ . -
41. Solar Domestic-Finan - a - I I. •,_
.11
47. Backflow Preventer , I I k) , • 1
43. Backflow Irrigation T.'== ' ,.
44. Landscape Irrigation System t -; 1 - -. .. •
45. Sound Attenuation r -' •3 F'" • • ' -
46. Handicap Regulations ; T �;
47. FINAL STRUCTURE & BUILDINGI 1. •..
48. FINAL PLANNING _ ' - i 2 - -
49. Electric Release to Edison i rI- -"r •^
•
50. Gas Release to Southern California Qias Co I , ,., --1 - .
51. CERTIFICATE OF OCCUPANCY -
No. Date
80'74 'D
u LL
NOV 24 1958(;,,
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O. BOX 317
COSTA MESA, CALIFORNIA CITY OF COSTA MESS
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
ADDRESS 2222 Rutgers Drive A) B, C BUILDING
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO, Pai/ 0Y
OWNER Towne Estates, Inc
MAIL 1555 Placentia Ir
- RECEIVED BY DATE RECEIVED L' DA' ISSU
ADDRESS n--I eft [ �f `�-' L�-J Q /I ,,
CITY Newport Beach, Cal. TNO. MI 6-3227 ADD RISS �-2 eu 7c-ij
ARCHITECT owner LIC.
ENGINEER ENTICTER NNC.
COSTA MESA. CALIFORNIA
FIRE S •
ADDRESS ZONE
/�
8534 ZONE NO.OF TYPE GROVP
R. W. Koll Const. Co. CITY LIC. PLANS
CONTRACTOR NO.
TEL. APPROVED'''. //
ADDRESS game NO. `same BY erne DATE //A
LEGAL LOT
DESCRIPTION NO. 15 BLOCK TRACT 2788 CORRECTIONS
A.P.NO. V A q+1
SIZE 60 x: 100 No.of BLDGs. 0 A 1 71r. C Lr
OF LOT Now ON LOT R 111YYY SS V
USE OF pp^^pp l �"t l'1 n
EXISTING BLDG. n. in�Lp I I 1'„111 'I�j� pyy
SETBACK LINE FROM 45 (y. .a Si �� S IA kJ 9J
CENTER OF STREET y I/. REAR YARD 10 �/ ,
SIDE YARD RIGHT 10 LEFT 10 I %.t o._
2 9r- 0 /-dr----- II
DESCRIPTION OF WORK f� UAIt
VAR. NPH APPROVED_=
X 1
NEW ALTERATION ADDITION
REPAIR MOVING II DEMOLISH
DIN
SIZE 280 sq ft. y2 STORIES 2
G4NO.
ROOMSOF .L
EXTERIOR WALL ROOF
COVERING stucco COVERING hot mop
USE OF
BUILDING Apts. Triplex and attached
3 car garage.
02 fire)"/ — AZ
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ANL ^ ,. -_
STATEITYTHAT IN NCE •NDE ITE CORRECTAND AGREE COMPLY OWITHNST ALL 6/O - (oJy(%(/
CITY ORDINANCES •NO STATE LAWS REGULATING BUILDING CONSTRUC-
TION. A-4—J VALUATION
SIGNATURE O PERMIT FEE $ 1/2•1•" aC
•
PERMITTEE • t 1
$ �7 i437_. PLAN CHECK S AQ..‘I u
AUTHORIZE GENT O( TOTAL FEE $ 6� CO ,Pfr