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HomeMy WebLinkAbout2268 RUTGERS DR - Building Permits .:DURESS dk DUILOW: 2268 RUTGERS DR LINT: CITY OF COSTA MESA — BUILDING PERMIT tWNERSNAME IF KNOWN: BAILEY, ROXANN E TR PERM NO: B 08465. MDRES& 2268 RUTGERS DR COSTA MESA,CA 92626 PERMIT NO: B 084652 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MANNO ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH ARCNRECT OR ENnNEER: UCS: JOB DESCRIPTION : T/OFF REROOF WITH COMP . SHINGLES SQ FT: 2, 500 MCN.RPM'S ADDRESS: UNIT: CLAIM VALUE: 2, 500 . 00 CALL—VALUE: 2, 500 . 00 GROUP OCC: R-3 / CONTRACTORS NAYS CONTRACTORS YOUNG COMMENTS: OMMENTS• X ADDRESS: l:.NO.: eifikffif#xyi f <*iy if io x iiit tiiiif t t f i i * f fi f e iiix r x t ix f f*Ix f f if is f it* f E E E x iE x f ifi tc iE if wit ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Min under peneky a perjury that I am licensed under provisions a Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Ph. bin NU force •i;.., No.: / In LIC CLASS: XP ; / MAIN BUILDING ACCESSORY BUILDING /�� / 7 cercomer Q/ �i FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Conrmosfor Me following reason(Section 70313 Business and Professions Code: y W county whkh requires a permit to construct.alter.improve. PARKING R Esy: PROV: PARCEL: 41905504 Z N E: REF NO: demdeh,or repair any structure.poor 10 its issuance also requires the applicant for such erne to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors license Law(Chapter 9(comme«ag with Section 7000)d Division 3 of the PLANNING NU TE S_)�' Business and Professions Code)or that he or she is exempt therefrom end the beat for the alleged exemption.My violation a Section "..1< 7031.5 by any generale for a panne subjects the applicant to a i penalty ci not more than five hundred dollen(f5000. .. 1. x if iE if if iE iF if yE iE tic if if1riE*iE#x fi iE iE it it is*df'1c?f df if df if if iF if if iF SE iE ii iF dE it if if iE'le>E iE if 3c if*iE df iE if#3i>F if if 3f if is*it 1f ih if if ii 3t is dT# 0 las owner alhe propeity or my employees will wages as their sole compensation,wvumthe work,and the structure i,not intended D E V E-•JL O P M E N T SERVICES R E U or offered for ale(Cas th 7044.Business and Puossianscode:The contmdarough ha Law daeatw appy loan owner dprapeny Q I R E M E N' T 5 who bolds or inmovea thereon,and vete does such work tenser or herself«t through ha or her own employees,provided that such �' improvements are not intended«offered lin sale.I,however,the building or improvement is sold within one year a completion, ZONING APPROVED BY DATE: ownerbuil:1m win have the burden of moving he or she did not build co improve for purpose rpose of sale). ❑ towner the°eCre� oeo�`mbmOa`�drotdi w and Professiiors Code:The Contractors Law not aan armee dpy who ae°Mrmwno BUILDING APPROVED BY : DATE: contracts for such projects with a contrador(s)licensed pursuant to the Contractors License Law). p IamesemgUnder swiom:BP7044 B.a P.C.,trwsmason: OWNER BUILDER APPLICATION ISaIED BY: DATE: 9 Date: Owner -0E#itiEiEii;Eie;EiEiEifjfjf'iEjFiE3FikiE****3Fiadf3eiE3Ejfdrda******* iF re***1E***Y-1t**4;ifffi#iffff fi yr ie iE LEGALIZATION:N F E E SUMMARY STRUCTURAL' SEGMENT:Y I do hereby cenify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533.and , 25534, Owlucio or tASgocamentwiOyWm(gem one)DDistrict wehsaid onam:tneMtherequiremm these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2534, and ori I ran future buildnh«ntheAi l/w of(&clsoi needieto comply wh construction es ns ends eremgemeNew provisions. PERMIT 74 . 75 . 50 Date: Applicant: S M I P/NON—RES WORKERS COMPENSATION DECLARATION:I hereby*rum under penaltya perjury one of the following dedarations: PLAN ❑ Ihave and veil maimenacertificate alconsent loeenia nrefor workepem .npbytheB n'comni:movidedforSedon3700ofLabor UILE NG- Code,fortheperfornancedwok BUILDING DIS > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ Ihave adail maw;a,wark« ne e'amnlaationnsurance.aereguiredbySecion3700dtheLaborCode,a»thepe„ a performance TOTALS > 75 . 25 0 . 00 0 . 00 75 . 25 75 . 25 . 00 work t«which this permit is issued.My waken'compensation insurance ismer and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 75. 25 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed i the print is M one hundred done,.(Stmt or Am) 74 . 75 . 50 © I candy that in the performance of the work or which this penis '.. I .• riot empty airy person in any •as to dome eub'ed to the workers'compensation laws of %Ali •.f +bled 17W . n' .yfif#ififdfififdfdfififififlf#ifif#iEitiEififif#ifif#ififififdfif#ififififlfifiEifiE#ififififififlfiF#ifitififific3fifififif-kififiEififir#3fifififie paned proveoro.j ion 3700 d the Labor Code.I pr J.y.... A�bn: , � O� ) INDIVIDUAL F E E BREAKDOWN Dale: W. MR Faure teMORS Noreen'conyerreadon coverage Isunlawful,and she subject an employer to criminal -ea . TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST nesoaedthuan dollars(S100,000). to nn cost of compensation,damages as pray.,. .r in tSxgol5 to the LoCode, ry'0 ryp, SFR 2500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 500 . 00 CONSTRUCTION LENDING AGENCY: I hereby aifinn under penalty d Peden'that there is a construction lending agency for the END OF FEES performance of the work for which this penes b issued(Section 3097,Civ.C). LENDERS NAME: LENDER'S ADDRESS: I certify that I have read this application end date that the above information is coed.I agree to comply with all city end county ordinances end ewe law,rowing to buidbg construction and hereby authorize representatives al this dry to enter upon the above-mentioned property for inspection purposes. 53-IE-1997/fl2:11 P.i/575.25 a ROX� N BAI •LEY Q /627,:51-/$7 .29 ��' // / 7 PERMIT:084652 Date is 9 Sig'e of i'CaflAppicant/Contrect« (5151-46.WP) White-Building&Safety,Green-Fin:Canary-Apptrant:Pink-Revenue;Goldenrod-Assessor . V CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit • 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing& Access Approval 17. Rough Wiring Sign - ' . 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing /// 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing lainSt-. �r 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 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 p 10 • 48. FINAL PLANNING 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • . No. Date Applicant to fill in all spaces except those withinheavy border lines and sign all appropriate declarations. irCOSPERMIT NO. TRACT NO. LOT NO. UNIT NO. . Address CONSTRUCTION PERMIT ,B P 30230 Z$45 3Z . , 1; 6209 9/14/87 104045 TL let Address 2268 Rutgers I L __ .._ r� r I , (,... Appllcent's Mailing Address 226g Utgers TYPE OF CONSTRUCTION at NEW L I ADD H ALTERATION LJ REPAIR ' • _ - Condon John Son ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# �!) OS rj Q y • Zone Si. j t2wner's Name Phone 646 5303 Glnite- Spa only- 2268 Rutgers Costa Mesa, Ca. DESCRIPTION OF WOR K/USE OF BLDG. p Y Address g '/ 12n Sq. ft. ptal S _ Main Building: Accessory Building: S PA Reagan/Kramer. 2309T ! i Z Arch/Eng. License No. TYPrEIOF PERMITrraa ❑ GRADING ❑ FOUNDA I IOI�NNss Q S RUCTU RAC T.. Front - i 1 �'O b(, o Address 451 El Camino Real Tustin, CA. la TENANT EX ELECTRICAL PLUMBING LJ�IM ECH ANICAL R Rear - ( N Contractor's Name Mission Pools and SpaSPhone 643-2233 - ❑ OTHER /�� C .Right / . N Address(mailing) 27324 Camino Capistrano, #181 PRO.IECT.DESCRIPTION Sq. F7. g.Vit, OCCUPANCY ^�1,f..`��..�. K G Laguna Niguel, CON ST RUCTI`UN TYPEVALUATION$ 1.0:,(ja�2�' $ Left /I / . City License No. K g Ca. 92677 'a Cea3 r ZONE GRADING CU.YDS. . ACRESR LICENSED CONTRACTOR DECLARATION J ... Ping. Ref.# Parking Req./Provided E 60 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:�' /��•--'s 7s ��Planning Notes: /�,,T M with section 7000) of Division 3 of the Business and Professions Code, and lj/ ;2-- ( Ihn my license is in full forcep� and effect. • V•1 License Class C_5I Llcen o. S Date 9 10 87 Signature PLUMBING FEES — �t WORKERS'COMPENSATION DECLARA ION I (r _1 I hereby affirm that I have a certificate of consent t If-insure o e.+.mrtlficatt - Bar Sink Showers • ELECTRICAL/ FEES ,V of Workers' Compensation Insurance, or a certifiedcopy the dt'(`Seecttion ( 3800, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW ' Policy No. PW( &0=0288 ROA Company RrPn CQ� , I Backflow Irrigation Sewer Cap 0 50+ KW Q Certified copy (/��1/�'� - n _ Construction Pole Sub. [ is hereby the /" I. Certified copy is filed with the city Building Divisio . Bathttbs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 9-10-87 Applicant;oci nn g - . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors' Dishwasher • Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100)or - . less). Dishwasher Solar Piping Dryers ❑Gas DElectric 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 Workers' Co RRppsation Laws of California. Fan Motors ❑0-1 HPp1'/a-8 Date /H Signature Floor Drains w.:.,.,„6rg P.,o11v/Spa Qf.(L1 / NOTICE: If,after making this declaration, you Should become subject to the - - - �� `I 3 F.A.U. Ina Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. • 3 Fixtures .; Microwave • CONSTRUCTION LENDING AGENCY /I yrGas Service utlets Water Closet I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors L, Water Heater Outlets Lender's Name 4 rf/ Range Lender's Address 771 AA Kitchen Sink Water Service et - OWNER BUILDER DECLAnATION Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or ✓ Garbage DisposalStanding Sections county which requires a permit to construct,alter,Improve,demolish or repair Pe P-Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW any structure, prior.to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000) of ^_ ,Stet_ 9 Q� Division 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 , penalty of not more than five hundred dollars($500). ❑ 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 - Professional Code: The Contractor's Reinspection Fee $15 Issue Fee $ 3 for salese (Section e Business and MECHANICAL FEES ern Law does not apply to owner of a property who builds or improves thereon, and who does such work hi aes f or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees,ho ever, that such improvements improvement are not intendedhior year o edf c for Boiler Hood ano or Type ❑ yl,� sob. if, thwown, the building urden of pro issold within one yeur rim- Canopy Type ❑ Zoning Approved By ••s Date ' - 0 prove the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date i/fil� J prove for the purpose the property, f ope), �y� ?(/4-7517 ❑ t as owner of the pr project t 7 44, contracting with licensed con- Duct-Structural Refrigeration System Application Issued By �1/H� Date The t construct the project (Section 7044, Bto and Professionsfproperty Code: ,- - - builContractor's License Law does notgraapply to an owner ie pr withta who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with aeon- C .70 tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System D Multiple ❑ System Repair/Alteration BUILDING PERMIT $ 8a `.Jo SMTP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B. & P.C.for this reason Firepi/Fact Blt. ICBG# Fire Dampers PLUMBING $ ( .QO ISSUANCE $ Date Owner —N-,</, Heating System& Ducting Registers PLAN CHECK 25% $ 75 ENERGY P.C. $ • I hereby certify that I have read this application and state that the above ' 0o-100,000 BTUX100000BTL GRADING $ . information is correct. I agree to comply with all city and county ordinances '�/S ELECTRICAL $ Il •CO and state laws relating to building construction,and hereby authorize repre- _ sentatives of this city to enter up.n the ah ve ertioned property for PLAN CHECK 50% $ q. - 5e, MICROFILM $ 1 TOTAL FEE $ inspection p rp.ses. ✓` n Q �• f �1 7 _� Q-�7 MECHANICAL $ 4 AS DSrivers' y• .- - _ mal p $ 3 PLAN CHECK 25% $ Drivers' Licenr or SS _ Reinspection Fee $15 Issue Fee CMF 0865.46,rev.10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor / V /1 k.. CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit#: Date Inspector APPROVALS Permit t; Date Inspector :r 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location k Ind f3' 'I-n- 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 8Z r v 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 554*-( Electrical Bonding 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - - ,; 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59.,Gas Pipe, LRthdrgrnd.,Test PA-Q7 0,61-- 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. eyy (,�.....� 10. Structural Floor System 61. APPROVAL TO DECK Vp 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final i/ 8 $rf De 13. Roof Drains 64. Plumbing System - Final !) 1it7, .PKI 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 16, Rough Electric Wiring 67. Fencing & Access Approval I /g �7 Q 17: Rough Wiring Sign 68, APPROVED FOR PLASTERING J4877 L- 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I ��C0 -- 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 7.pu•. 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough &Test - -' .72. Underground Flush 24. Roof Framing 4 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - - • 74. Overhead Hydro - . 26. T-Bar Ceiling (Structural) Si.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 SSf' ISSUED �- 33. Final Electric Notes: q�j 3740 ). �K_ 34. Final Heating & Air Conditioning Al v 35. Final-Gas Pipe-Test - !' ff 10 ( ) 36. Hood or Canopy • 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 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . , ' iii- : No. Date , ,f ` Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7095 10/08/67 non(I 11 ( CITY OF COSTA MESA CONSTRUCTION PERMIT_—' PERMIT NO. TRACT NO. LOT NO. UNIT NO. 7f-el �3 06 4 2., Pro' 'I Address iTS f. a �s /� /� TYPE OF CONSTRUCTION �I NEW 0-ADD ❑ ALTERATION U REPAIR Applicant's Mailing Address e47.324 L_l�/'1/i✓p(,,.(YA�7' "44/0 Owner's Name ��I�� !�ON,cJS pL✓1/FPlhooe6✓� Le ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • A-P,# Zone p DESCRI•TION OF WORK/USE OF BLDG. Address y�'8 r/(J✓T6(•1•C Goy>4 NEfi? / r . - S Main Building: Accessory Building: E Arch/Eng.,/Se-o- .f,�'. ' License No. TYPE OF PERMITpI CR • G FOUNDATION STRUCTURAL T Front _ O Address 'T S/ Fi tt Q/,,, fp -icy__ ✓s.J III TENANT IW ELECTRICAL El PLUMBING ❑ MECHANICAL B Rear N Contractor's Name /CS✓0C-/ OD Z ❑ OTHER A /�1 P Phon ��3 C Right N Address(mailing) 27234- eVir.4.t+� �Firiv a PROJECT DESCRIPTION SQ. F OCCUPANCYK ._COv3/ CONSTRUCTION TYPE � ' VALUATION$"-OA — S Left _ G City License No. .. ( SD ZONE GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions code, and my license is in full force and effect. Zt T License . s B _ t s;�License N lini_� $ to Date • i Signature • O, ^,, PLUMBING FEES WORK R CO PENSATION DECLARATIO I s I hi- I ri- II 1J�-2� Bar Sink Showers giCi I hereby affirm that I have a certificate of consent to : -insure or a certi Ica a ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Sectio Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW 3800, Lab C.) q go �1�11 � � % Policy NO.PkV Ci43'O A Rfrg U 'Companyi. z� I—Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW l Certified copy Is hereby furnished. . Certified copy-is filed with the city B ild'ny Division. ' 16-1 -_ Bathtubs Sewer Connection Cooking Unit / Meter ®up to 100 amps S OCP V Date 10/10 FROM ECt nw.L 55/ ry-'�7-- •EXEMIO FROM WORKERS'CO EN$ATI N DE LARATION Clarifiers Solar C011ecto • Dishwasher Meter Dover 100 amps • (This section need not be completed if/ he permit Is for ddd a hundred($100)or less). Dishwasher Solar Pipi•• 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 ank Fan Motors❑0-1 HP ❑1'h-B Workers' Compensation Laws of California- A Date Signature ,�j/ ` Floor Drains S miming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE:If,after making this declaration,you ffhould become subject to the — - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes ' I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Clv. C.) Lender's Name (he/Ak- Interceptors Water Heater Outlets Range 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 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 Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 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 malty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $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 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 ❑ sale. If, however, the building or improvement is sold within One year of com- Canopy Type-1 I 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). - ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigerati 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 00-10 , 00 BTU 0100,000 BTU SUM 'Islay O FE 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 that Exhaust System ❑ Multiple 0 S em Repair/Alteration BUILDING PERMIT $ SMIP r $ proof of their Worker's Compensation in urance should be provided to me. _ 0 I am exempt under Section $.1 IN B. & P.C.for this reason . Firepl/Fact.BIL (CBO 4 Fire Dampers PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ P ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BTL ELECTRICAL $ n •0v GRADING $ information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon t e gp ove-mentioned property for - inspection p roses. �¢�(� /-` -s� MECHANICAL S TOTAL FEE $ ' ' 00 Signatur JA I _ Date\n-X- T Drivers' License •r 55 - •' . • Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ • CMF 0865-46,rev. 10/84 White - B ilding; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING . POOL &SPA APPROVALS Permit.,# �\ Date Inspector APPROVALS Permit# Date Inspector 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-Undrgrnd. , \ 55. Electrical Bonding - , 5. Steel Reinforcement. 56. Rough Plumbing & Pressure Test ' ` 6. Electrical UF ER Grnd.: 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation ' i 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd•. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line &House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT y 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro • _ 26. T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe I j i • 28. Lathing & Siding 77. FIXED SYSTEM FINAL '- •• i 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ) 1 • 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final !t2. iR 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ...- .,.1 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' 36. Hood or Canopy - 37. Final Factory Fireplace -- - I if/ 38. Final Plumbing _ - 39. Water Service-Final - • 40. Gas Service-Final • 41. Solar Domestic-Final j r - • r • 42. Backflow Preventer • _ _ • 43. Backflow Irrigation • 144. Landscape Irrigation System _ „ 45. Sound Attenuation - - 46. Handicap Regulations . `47. FINAL STRUCTURE & BUILDING ' • 48.. Special Requirements Completed • - 49. Electric Release to Edison / 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date ` . 6unite ( LY Post-Tensioned Concrete REPORT Of INSPECTION ON Masonry ( ) Fireproofipg Concrete ( ) Reinforcing Steel SILL T0: Address: • • CANER: C/ a,9ti PROJECT: r i wsilo. Address: .2A675 / - • . Permit No., /'t 30A 30 Architect: Contractor: 711-1.41,01-014- P Address: ' Address: ./ Gtret., herat, 44- Engineer: gfitva ./�-zte-L Subcontractor: � CI 4 ' (Gunite)L- �w � Address: C'etek y�--tn '2 6.„r, - Masonry or `71404,00.024) -Cpm p Concrete) Inspector: yet�{� Ar -' Address: 0 ot3 1'eea-t i yi w+-.e #S86 Mix Used: sF Db/ Slump. inches: mit Ad : 4e- /G't/a ' • Designed Strength, PSI : Z.10o0 The following inspection was performed in accordance with the approved drawings: Cu.Yds. No. of DATES Placed Cyls. Remarks - • /get-4 . 4,/flie . ' � -Cisw J yid /c/4/ 7 A&tee 19tir„„M...aaJ „ aeL(5). ,aJ�s taid:at 7S1, razuji_tate_6&id' 92s.t.--, ft4,,szle,,,,,,,, e_teli ne., - -44 ' --41-2,11:44:-‘il_e iteittjua e7€24/1_,:_,it A-G-4, U Copies of Reports to: (Indicate which Bldg. Dept. : furnish address of any not listed) H.V.Lawmaster & co., inc. laralrEl TESTING & INSPECTION ENGINEERS 7940 Main St. • P. 0. Box 246 • Stanton, Calif.9%80 87-cMs-1982-034 Telephone Atea Code 714 828-8040 Field Data on Test Specimens Concrete Gunite XXX Grout/Monar Job Therapy spa, Johnson 2268 Rutgers, Costa Mesa, CA Contractor Mission Pools, Laguna Niguel, CA . Mia Designation 4 to 1 Admixture Concrete Plant Cement Brand Average Slump Spec. P.S.I. at 28 Days 2000 Total Cu. Yd. Placed No. Test Specimens 1 Marked #1 2268 Age to be Tested 1 @ 10 days days days days Hold Location in Structure: East wall Date Cast: 10-5-87 Made Bac Malcom Jack Hubbard, Deputy Inspector Remarks: For Laboratory Use Only LAB. AGE/ DATE SPECIMEN UNIT ULT. LOAD NO. MARK DAYS TESTED WEIGHT WT. DIMENSIONS AREA LBS. PSI MPa 565 1 10 10-15-87 6"0 x 12" 28.27 112,800 3990 I Hubbard/2 Costa Mesa/1 Respectfully Submitted, H. V, Lawrnester L Co. , Inc. BY s SIJ/ AMegairmar_ of,m ".014 H. V. LAWMASILK & CO., INC. OWNER SHERWOOD FOREST DEVELOPERS #3 DATE 5-23-57 JOB ADDRESS 2268 Rutgers Drive BUILDING PERMIT NO. #5112 GENERAL CONTRACTOR Lido Constr. Corp• 1' VALUE $ 11,88)1.00 LOT 32 . BLOCK TRACT 28µs Res. w/att. gar. GROUP I & J TYPE V ZONE Rh FIRE DISTRICT 5097 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench e • - -6.). Foundation Forms and Grade to Garage Rough FramingA-4•--S 9-r,$ Plumbing, Rough to Slab _ 1 ,. - ��-"��t,ty a-}O�.i c- "-S.7 95/0?$ se-- Plumbing, Plumbing, Rough Complet ,Siiat1g-1.-77-47; d_. U Temporary Pole -t T'' 9 - >c- Wiring, Rough ,l7 -.46-ti rn10 Z -atQn na. 5-3S--,S-7 el e, 9 6 V. Heating,Rough 7114-C ?;5-97 Heating, Final tiLtLS '0-,3/:2 AltralM1. s,-7e1-7 /o !S7 V Sewer, House CX Sewer,St.M/�hz-S Q/G-4'7 - LU._tt'g&. 0„ , ' 9-/0-57 /0777 Septic Tank or Cesspool Lathing, In Out �,i6 =pv7- ; . Plastering 04/5 ,AQ /-I- Plumbing,Final,Fixtures Com,., p p,/lete}G S o- /- 7 Plumbing,Final Gas Test )S' yv1[ 5 . /-..5" l .j1 Wiring,Final _ rn- I- /- , QIx-y ..-... l t I I \ / _lit fin a Occupancy 1f /6...3/-r1 FORM 210 3M 10.55 • 5097 FEE RECEIVED COSTA MESA BUILDING DEPARTMENT `1'V\ c t 1 ci C , 9,R P.O.BOX 317 COSTA MESA. CALIFORNIA FINAN-C?qDEPT. FOR APPLICANT TO FILL IN APPJTM,gefl'cyYVA♦ 4 PERMIT ADDRESSDBUILDING . : ;ut: ers Drive COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. P5M112 OWNER Sherwood Forest Develo•ers #3 V/ MAIL RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS 3404 Via LidoEEjj,,,, ....c•-/ ... MAY 2 3 1957 CITY h. - •ort Beach Nyjar. 7171 ADDRESS ARCHITECT OR ENGINEER Ra mond Levanas LICNd`C747 COSTA MESA. CALIFORNIA FIRE ADDRESS 3432 Via. O.orto N. B ZONE Li.O OnStti 2ONE1 CONTRACTOR Cor oration CITY NIC. 6434 alialtian ADDRESS 3404 Via Lido, N. BZ,;Har. 7171 ABPPROVED DATE / LEGAL LOT 32 2845 CORRECTIONS DESCRIPTION NO. BLOCK TRACT A.P.NO. SIZE NO.OF OF LOT 64x102 Now OryBLDG LOi� USE OF EXISTING BLDG. ,SETBACK LINE FROM CENTER OF STREET 501 REAR YARD 241 SIDE YARD RIGHT 51 LEFT 5' DESCRIPTION OF WORK 1 NEW X'ALTERATION Il ADDITION REPAIR ■. MOVING ■ DEMOLISH SBUILDING 1400 s . . ft.ROOMS 6 STORIES 1 EXTERIOR WAL Wood ROOF COVERING tllCCO COVERII�am�yyalCe-Shln_leUSE BUILDIINGEW Dwellin• I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC• TION. //�� //)� VALUATION SIGNATUREe,t Ft OF / y/} - PERMITTEE L ( / � S Ny //J��w PLAN CHECK $ / AUTHORIZED AGENT / TOTAL FEE $ — SAF