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HomeMy WebLinkAbout1145 SALVADOR ST - Building Permits PROJECT ADDRESS: 1145 SALVADOR STUNIT}. CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 059974 OWNER'S NAME: Rai ert Sccd.Ac, ADDRESS: 1145 SALVADOR ST \ PERMIT NO: B 059974 PLAN CHECK NO: N GOVT; N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL ONE 2'X4 ' SKYLIGHT PER ICBO14538 SQ FT: 600 ' ADDRESS: UNIT: ' CLAIM VALUE: 600.00 CALL—VALUE; 600.00 GROUP OCC; R-3 /M-1 PERMITTEE: SHARP ROOFING (714 )771-2225 ADDRESS: 20062 FRANK ST COMMENTS• NO CUT RAFTERS+E REQUIRED TO INSTALL THIS SKYLIGHT, ORANGE C . 92669 ******** ****************** *************************�ESr+E�E�E�E**SE*;r****+ESE********* LICENSED CONTRACTOR DECLARATION: I hereby alarm that I am li under•motions of pier 9(commencing with Section Z 0 N 'I N G R EQUIR EMEN TS 70001 of Division 3 of the Business and Professions Code.and my I' se is i t force and1'ect. SETBACKS CITY uC.: 08266 STATE LIC.:57157 C ':,: 4'•f a. Date: a l7 1152 Signature: _ _ MAIN BUILDING ACCESSORY BUILDING _ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: Ihereby affix Mat l have a certificate of conch o sell-ins rr a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN Compensation Inryr n.sIcaappy thereof(Section 3800,Lab. ). POLICY NO.: 1 L / /D 139—`1 L EXP.GATE: E /0 '/41 COMPANY: STATE FUNDrrqY� /�/�- PARKING REQ: PROV; PARCEL: 14161128 ZNE: REF NO: ❑ Certified copy is hereby furnished. 1D Cendied c led he dry/ �17ivBi� r PLANNING NUTES> Date: Met /7 / AS � 5.1.7/ Applicant: � ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: 114 section need not be completed if the perm)is Imo one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this p' mit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE Date: Signature: NOTICE:If.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; ., DATE; Code.you must forthwith comply with such provisions or this permit shag be deemed revoked. // CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: S •r 'U�C ���'r�..y DATE; 7ZJ which this perms is issued(Section 3097.Civ.C). ************************* * g ** ****** 8ij%**4rLr�{iF iF***************** *iF******* LENDER: ************************************************R****************************** ADDRESS: LEGALIZATION:N F E E S U M MARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or N }I i17/188 50 repair any structure,prior to its issuance.also requires the applicant for such permit to life a signed statement that he/she is licensed PEA R 1 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES and Professions Code)or that he/she i5 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 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Coe: The Contractors'State License Law TOTALS----> 17. 50 0. 00 0.00 17. 50 17. 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through himprrovements solor her own d within onevided yearr ofthat competion rthemownerare win have intended burden offered ol povingsale. he/she did nothowever build or improve OF REVENUE DIVISION TOTALS--> COLLECTED; 17, 50 OVER/SHORT: 00 or the purpose of sale). BLDG ?PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOO - GRADING PLAN—CHECK 1I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ 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'Slate License Law),I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. tor this reason. TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 6001 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 600 . 00 I do hereby certify that I am aware of and understand the requirements 01 California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Airratify Management District.Residential construction aleph,1 ions are exempt from _ these provisions , / . , ' 1 7 '2 0} Dale: Applicant: Sig,.....tiont) I hereby certify that I have read this application and state 4AAAia�I�I�I�J4KKx��KKKt e above alir• J e1Z1,'x�,,�yrr ith all city and county ordinances and state laws relating to building construction.:eby au ' -repre r• city Darr e above mentioned ryeproperty for inspectionn err 05e5, �+4{7Ir•i�_ Date' /V_V✓ [ / / � <ignalure:Driver's License License or Social Security 1 - • 164146 Whne—Budding'.Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor 1 - CONSTRUCTION AND PLANNING: POOL& SPA -- APPROVALS Permit # - Date Inspector APPROVALS Permit #- Date Inspector 1. Temporary Electrical Service or Pole „t 52. Pool & Equipment Location t 2, v il Pipe-Undr rnd. C'T• %< 53. Steel Reinforcement F-- C . �4 ctricalConct l ility. Sndrgrnr},ep1 54. Forms -C :...04 '-Mt E$Sctrical Conda1c4sJtdrgrnd. IC 55. Electrical Bonding 'it Ca n. 0,S 1 q el Reintorc nt ' .< 56. Rough Plumbing & Pressure Test _, >.,.10wt d. Zctrical UFE,RSrnd. '- 57. APPROVAL TO COVER-GUNITE krnn - • ' -r C • Cltings 'SJnJ 58. Electrical Conduit-Undrgrnd. `i 1 t • - ^":-,Foundation 59. Gas Pipe, 0 Undrgrnd., Test t'n'F . -t9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. W. Structural Floor System 0 61. APPROVAL TO DECK ]3. Pkdperty Sewer Lire& Hdfse Coniaction 62. Backwash & Receptor-Final jQ. S wer Cap d N 63. Heater & Vent-Final l3. Roof Drains 64. Plumbing System - Final 1�;.' Rough Plumbi& a, 65. Electrical-Final .11} Rough Electriea4-Conduit 66. Solar System-Final 15: Rough Electric,AViring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electric-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT C ^ C"' *"...1 C-" '< Lt <'r 7C Orr'Si+ ..1, c• sU 20!S1oiu,�h ctny qtlace I f•-g.,1 `t'y * O % 0-'* * T,2\PPR04�tt�H"Yer?it # * m 71. tr > N r. 2* i :--- - S .. • * ] * * u, i _ r t. 1.-J J-.2. m * tri 21;�1upts,imStrgctu e* �S S a r* x.. -170. Undergl4,tIhty H 81ro x - ,71 22,,iDuRs, 'PFnt. tire I CJS X S <IC .c .c71. ProducT:P irg Ntis E Oil 23., a$'ip Roglh Ctest I _T7S x ?1 a' tt 0* x -i72. Underground Flush.. * 'o 0 cr--:ai--5-. fl e-7--'-- --cc ..;-'-*-9 4-4-9----4.--> *- -> 0 24tRoc'rD FEatnirtg O* I F= ••,rte * .> 0IS ? a �+x * S73• „`xy9 X9Under rn .Scor 3nk Gas ❑ 25. Rod} SF athin nM >, '-‘3 * 03h 0 CO* x 'S •.. .l-O X 9 O* d v ix a ? N* ic 74Cr:O.verheadilydrt0 x X 26FIf-Bey Ceiling (Strutftural) &S•4rrocoat * 9 C t0* * 750121 Che ical S'" * I"" a 4 2 �• •• .• tc* SC x n �• Ox * 5•. i �r' c-•'7 x _ " a 27,JFrame aqd Flash atccr x a• >r., to* * 76` Ury Stan ype �y * '' m p; . -• •r S Y r. ,- x . c . .•*-s- , r-28 ~Lat'Cing% Soinorl* ti -1<Ex-• n X •• •• ••x x 773' FIXED �Y fEF.CINAL* r, 0 w >• S O tN* O H - - > x 11 --\* * 1 x Y 29. Insulation . lc C. * ix * 782FIRE PREY. FlfbikL * > cc 't -.., J -� S--YJ 3 .. W O--; * > '30. Drywall NailTg m* x * x -1 HEALTM+DEP1:: RECPU IRSMENT 7:','n rt.:* ,--i x X X S No n x 031. Plaster ov t* x * * 79. FINAL Ir a CTI'qN * C C m - " ti O trt * S r- ix .x * '*' '?T .t. J... r r- .5 T-4- MO- r r '-327Electriaal PcwerMeal.-Final * CO Et .41 If * K 5180.'r,.c7FOOD CERTIFrogirE ISSUED tz >-33y�#irgii Ejgctr k ;r* d * cc. - * x n �y a m m m * * >K Nq s: "i -nil * ^ O VW: 110 r. HS -v34;Fin81 Heatin i& AiiicCoeditiori8t� t �: -44 * cC S n t * S CO q - 1--tm -1 Nx'n -n x i V H I "C * tr - - 35n in-al q Pia-T [ . x 7 xo O✓; * SC :-.r .. oo * 'S x .. k- 1,1 • ••C, • t„ : . to36d or Canopyiy.* J r-i x 0 * * E t no * 'C r c rt r, --'x n zT ALL - - * x '41 CO * 1-r• try ;37 , in F%tory Fire a-case- Sr 710 x M z * L n * i f E F x - * x x -. (l r x.,. •• ,. a. .0 w -, -C G ._5 - -'38. Final Plumbing x* v * * * S -, * v O Fe- r- •-..1* .1. v * x _ !S. X t/ 039. WA,- ServicreiFir7eP 1 o x .14 * n `.tr1 x CC O * S_ 1 * CC acre >i L * S x . .. ` t- - z. .. mu-40. Gas Ser;"ce- ina -x try yn-" s * . s .* Ot- "Jo.)y r r 71 s r * s * e X41. Solar Domegc-Fr3IS ft7 '• * x ccri r•; x r * * * Cr' "7O Cr * X 0 t'42. backfl ry Prevenrtgx r cd )5 "� C x x j Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Pr T TRACT NO. LOT NO. UN`T NO. CITY OF COSTA MESA T' C/Ate QN P�R_.MIT fyl ��7a A.P.# Zone Project Address I I ;Liu r - 1 - ' rr 11 S Main Building: Accessory Building: I 1 r�) TYPE OF CONSTRUCTION 0 NEW u ADD U ALTERATION LI REPAIR E Z Applicant's Mailing Address ■ Front .I, .Y7[� lir1 ❑ CONVERSION 0 DEMOLISH ❑ OTHER I T 0 Owner's Name ^I V D Phone L DESCRIPTION OF WORK/USE OF BLDG. A Rear N Address rr 11 Arch/Eng. License • TYPE OF PERMIT U GRADING U FOUNDATI STRUCTURAL C Right N Address //�.fYY 0 TENANT 0 ELECTRICAL 0 PLUMBING ECHANICAL g Left R Contractor'ss Nam•-I 1 i - rata cm- p '� ��rs' V IL ❑ OTHER I Ping. Ref.# gPlarking FliOga1RDJ3ided E rwvAddress(mailing) ;10Z fu ifel/t. i ' a • fiT• PROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes: �+C`��� `�U`r 9 t7171a M City License No. (f I1 000 1 I I CONSTRUCTION TYPE VALUATION$ RF L (1 ZONE GRADING CU.YDS. ACRES / Q '.7$$ T LICENSED CONTRACTOR DECLARATION RCCEI�ED NOV 1 I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: with section 7000) of Division 3 of the Business and Professions Code, and my license is in full fo e a e feet. ✓ye '27 ELECTRICAL FEES ...1' Rum � . - Licen • C -ss . 'I - i ens• N. 7 Date � ' Signature -ii PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS'COMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub. 0 50+ KW I hereby affirm that I have a certificate of consent to self-Insu • •r a certificate of Workers' Compensation insurance, or a certified copy thereof (Section Cooking Unit Meter Duo to 100 amps 3800, Lab. C. Backflow Preventer Service Sink \ Policy No. �Off5� U Company V �I i_r\...4.„- Backflow Irrigation Sewer Cap • Dishwasher Meter Dover 100 amps ,Certified cJJJJpy is hereb furnished. Dryers ❑Gas ❑Electric Sub Panel . e [flied copy s,/(led with the carp? Div/ ion Bathtubs Sewer Connection Date C /,I/'I eQjj—') Applicant � 'l�`. //1I, Uti Fan EXE TION FROM WORKERS'COSATION DE LARA ION Clarifiers Solar Collectors Motors 00-1 HP 01%-B (This section need not be completed If the permit Is for one hundr d ($100)or less). Dishwasher Solar Piping - F.A.U. Inc.Solar 09.15 HP ❑16-15+ I certify that in the performance of the work for which this permit is issued I Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa _ Device Boxes Pole Light NOTICE:If,after making this declaration, you should become subject to the Outlets Range Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AG ENCUGas Service Outlets Water Closet Switches Sign I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097 Civ. C.) interceptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink - Water Service _ Generator 00-5 KW❑5-15 KW Trash Compactor OWNER BUILDER DECLARATION 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 county which requires a permit to construct,alter,improve,demolish Or repair P—Trap Laundry Trays • 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)of1 Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee J $15 Issue Fee . $ 3 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)- $ 3 DEVELOPMENT SERVICES REOUIREMENTS: LJ I, a5 owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee compensation, will do the work,and the structure Is not intended or offered . Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's -MECHANICAL FEES .- Building Approved By Date 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 Boiler Hood or T ¢I ❑ Application Issued By a employees, provided that such improvements are not Intended or offered foryP sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 MARY OF FEES pletion,the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground - prove for the purpose of sale). BUILDING PERMIT $ SMIP $ , ///i ❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK 1'� tractors to construct the project (Section 7044,Business and Professions Code: �,�/ $ PERMIT Tr•/r� The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 6100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or Improves thereon. and who contracts for such oroiects with a con- - ' tractor(s) license pursuant to Inc Contractors License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration '/. PLAN CHECK 25% $ _ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ 1 am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLAN CHECK 50% $ MICROFILM $ / Date owner Heating System &Ducting Registers MECHANICAL -.1%'• //I'� I hereby certify that I have read this application and state that the above k0.100,000 BTU 0100,000 BTL— _ b_ `^ TOTAL FEE $ D" r information is correct. I agree to comply with all city and county ordinances "..he IX/ and state laws relating to buildi a construction,and hereby authorize repre- 1 sentatives of t is city to enter upon the above-mentioned property for inspection our•. • �g i l o �/0i p Drivers' License or SS* �� ,����Da • - Reinspection Fee $15 Issue Fee $ 3 O1 00019385-00019386 T n T 24.03 0865-46,rev. 5/88 White - B tiding: Canary - Applicant; Pink -Accounting; Goldenrod -Assessor DATEI 11/14/88 TIt1E: 12:11 \ t CONSTRUCTION AND PLANNING • • POOL & SPA I APt3ROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1..Temporary Electrical Service or Pole • • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel'Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFEIi 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 d _ _ 12. Sewer Cap - 63. Heater & Vent-Final 13. Roof Drains ' t . 64. Plumbing System - Final 14. Rough Plumbing i 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 L,18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL x-19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '29. 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 0Oil; 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing &Siding 77. FIXED SYSTEM FINAL 129. 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: /.y-S9 L£f7'Coco. t.69 34. Final Heating & Air Conditioning j/cit tee') 35. Final Gas Pipe-Test I 36. Hood or Canopy i 37. Final Factory Fireplace t t t / i i F r il 38. Final Plumbing I 0 r 39. Water Service-Fina( l E� 40. Gas Service-Final I \ 41. Solar Domestic-Final i i • / , � .i 42. Backflow Preventer ' -1 7 14' 3-• 43. Backflow Irrigation: ' i// -r 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE'& BUILDING i 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co r • 51.'CERTIFICATE OF OCCUPANCY /. No. Date 11 PRO.`'CT ADDRESS: 1145 SALVADOR ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: 33 0597.,9 4. OWFER'S NAME: ••rn-r..r ... ,. .,`, ` Dope-s�pe� yr ADDRESS: 1145 SALVADOR ST /` L,L PERMIT NO: B 059759 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT, REROOF W/EAGLE LITE TILE SQ FT: 9, 800 ADDRESS: UNIT: CLAIM VALUE: 9, 800. 00 CALC—VALUE: 9, 800 . 00 GROUP OCC; R-3 / PERMITTEE: SHARP ROOFING ( 714 ) 771-2225 ADDRESS: 20062 FRANK ST COMMENTS- ICB0#4661 ORANGE CA 92669 #x##%#####1E#dF##k#############fE%i(%iE##If##iE%#####-%1F#x####K#IEi(#3(K#•li##•/E%*:(44x#x w## #x LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed unde provisions o apter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my nse isA force and •ffect. SETBACKS CITY tic.: 0/82716 /.6 STATE LIC.:5715— t co: CT, Date: sof (12- Signature;— _ _�_ — MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby affix that I have a certificate of consent to selhinsure 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: STATE FUND PARKING REO: PROV: PARCEL : 14161128 ZNE: REF NO: ❑ Certified copy is hereby furnished. 03 Certified copy is filed with the city Building Division. PLANNING NOTES> ' > Date: Applicant: ####################x#######################K#i(#############x•##############K### EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section n•'.not be•'mpfeted if the permit i,$e hundred(51001 or less). D E V E" L OPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this per s issue all`,�oy any per.�� . •er so as to become subject to the Wo kers' mpensation Laws of California. / !% ZONING APPROVED' BY DATE; ,, ate: to '30 4 1- 7 Signature: �.r _ L NOTICE:It.after making this declaration,you should beco• subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : / DATE; , • Code,you must forthwith comply with such provisions or is permit shall be deemed revoked. y //�� //� 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• 70 r30 L 1 which this permit is issued(Section 3097,Civ.Cl. ######*################## ######** k#############1(###x#####x-i(x##wirwlt x—itx**### LENDER: ###############-#####################lE#!E#######x########'IEN##########dt#####N##### ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 117. 00 98 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 .. 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($5001. ISSUE FEE • I, as owner of the property or my employees with wages as their sole compensation, wig 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----> 117. 98 0 , 000 . 00 117. 98 117. 98 . 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: 117, 98 OVER/SHORT: 0 0 forthe 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 117. 00 . 98 ❑ 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 ################*######************#,####################*****#################?f that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL.' FEE BREAKDOWN ❑ I am exempt under Section: B.&P.C. r for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 9800 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 9, 800 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that 1 or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements Mr a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from , these provisions. Date: Applicant; I hereby certify that I have read this application and state that th , e 7 n is torr:gree to comply with all city and county / ordinances and state laws relating to building construction.her utho .aati'e� it to enter upon the abovementioned • / property too(r i�spe/c�ti ppJurposes. ,' ���/// —te: �7•T' • I Signature: /I— , Driver's License or Social Security a: Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & SPA '-� APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service oc 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 OF 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, ❑ Undrgrnd. 10. Structural Floor System -- 61. APPROVAL TO DECK - 11, Property Sewer Line &-House Connection 62. Backwash & ReceptorFinal 12. Sewer Cap 63. Heater & Vent-Final - • 13: Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final Rough Electrical-Conduit 66. Solar System-Final 16.,Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1&.&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 u(/ii fr ill 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat ll 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding I 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing i • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED /J I 33. Final Electric '�' Notes: .//�Uwr .enn �j)_ 34. Final Heating& Air Conditioning / „/72C-_ 35. Final Gas Pipe-Test I- 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 I 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING i t/,/' �, 48. FINAL PLANNING /' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 20239 CPOSTA MESA BUILDING-SAFETY DEPARTMENT FEE E R r (� E 1, E(1 P.O.BOX 917 COSTA MESA.CALIFORNIA L / IJ / For Applicant to Fill In Completely IAP&ICAIfftirsl FOR PERMIT TYPE OR PRINT FlNAMUIL6INGf. CI1ForoPffibe 1!Sfi1L24VY BUILDING ADDRESS 1145 Salvador St. RECEIPT NO. !'1(I�BIWIj�(O. COSTA MESA, CALIFORNIA d�-'L/. �I�JJI RECEI`p;D BY DATE RECEIVE 55UEp /// 4 I� OWNER Mesa Del Mar Development Co. 7._ BUILDING MAILp Hie ADDRESS 3800 E. Coast waY FIRE ' TEL.Oriole ZONE TYPE / GROlin CITY Corona Del Ma.r,Calif. NO. 422C ARCHITECT TEL �ople APBY DATE OR ENGINEER MaCCO Realt7O0• NO. _/I/Pn ZONING ADDRESS Same as above ZONE NO.OF USE OF NEW singl•iam• R-1 I PLANS C. "BUILDING I a+t an,. CONTRACTOR Ma cc() Realty Co. LEGAL DESCRIPTION Lot 36 Tract 5023 ADDRESS Same as above A.P.NO. none CITY Same as above 1� ' ^ NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE LIC.NO.2073k3_A-SB-1 NO. Oriole 34220 30"TO SIDE B REAR P.L. EAVES SIZE p NO.OF BLDGq� ALLOWED (U.B.C.REQUIREMENT) OF LOT 651 x 971 NOW ON LOT �Ione YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. None (FROM C/L S REST) SETBACK LINE FROM FRONT FT. CENTER OF STREET 501 REAR YARD 361 / SIDE YARDI LEFT 51611 I RIGHT 551611 -R.SIDE 5FT. (/� FT. DESCRIPTION OF WORK _L.slDg L, FT. Fr. NEW %. ALTERATION _ ADDITION REAR 3 rr. FT. I DISTANCE BET. BET.MAIN S MAIN BLDGS. ACCESS.BLDGS. REPAIR _MOVING DEMOLISH (�+I. VAR.* DATE S ZIE DIN 74/11611 yyyyp`',,{11ROOMS 7 STORIES 2 C.U.P.# APPROVED EXTERIOR WAL Wood I ROOF Shake APPROVED . B DATE -22-6 COVERING C • I COVERING •• •I. - - USE OF BUILDING AND WORK TO BE PERFORMED / r1 Single family dwelling w/attached Dwelling 2266 S. garage. plan 500-A Garage 460 S.F. N SQ.Fr. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION 7 �• m BUILDING CONSTRUCTION. J .4 SIGNATURE OP PERMIT FEE D PERMITTEE 1 al O. .S° 9 $ 23,925.00 A, .- 3 77 0 AUTHORIZED AGENT / .[ r� TOTAL FEE $ //?• J o