HomeMy WebLinkAbout1657 SAMAR PL - Building Permits F 9 CITY OF COSTA MESA
4 BUILDING DIVISION
: am r • DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
%1 -14.‘".1.1I110141 PERMIT
S B03-00185
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 1657 SAMAR PL Status: ISSUED
Suite: Applied: 02/05/2003
Vicinity: Issued: 02/05/2003
Parcel Number 13928126 Zoning: R1 R1
Applicant: BULKLEY, WAYNE ISSUED BY:
Address:
Phone: 714-549-2700
Zip:
Owner: BULKLEY, WAYNE L TR
Address 1657 SAMAR PL -
Phone:
• COSTA MESA,CA Zip: 92626
Contractor:
Address: -
Phone:
Zip: License:
Arch : - Eng:
Address: - Address:
Phone: - Phone:
•
Zip: License: License:
SCOPE OF PERMIT
CONSTRUCT 40 LF,4FT.AND 90 LF,6FT HIGH BLOCK WALL ON THE LEFT SIDE PROPERTY LINE. 17FT. FRONT SETBACK SHOWN.
FEE SUMMARY
Plan Check: $54.11 Calc Valuation: $2,720.00
Permit: $83.25 Claim Valuation: $o.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $137.86
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 - Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Lek 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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)
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DECLARATIONS +_.J (�)
WORKERS'COMPENSATION DECLARATION: .
I hereby affirm under penalty of perjury one of the flowing 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' m n a nsur n e rier and licy number are:
Carrier: W Policy Number: •
(This section need not be co feted if th pe it is valued et one hundred dollars($100)or less.) ,
I 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 subject to the workers'
mpensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of t e Labor Code,I shalt forthwith
comply with these pr visions. ��// \�
Applicant Signature: Ct.{.y I �f/ Date: 2/ Z ! U ?
WARNING:FAILURE TO S CURE WO KERS'COMPENSATION COVE GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES D GVI FINES UP 0 ONE HUNDRED
THOUSAND COLLARS(5100,000),IN ADDITION TO THE COST OF COMP SATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.LIc.4 _ Class 4
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lender's Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjec e applicant to a chril penalty of not more than five hundred dollars($500).):
I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt uer sec. Business and Professions Code for this reason:
Signature: I Date: 3
Owner ID verified by driver's licensees No Driver's License No. 1Expir s:
Verification of Ownership by(type of docum t,i.e.- operty tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No -
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 9 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 greeter than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 9 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑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(Duality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No
8 (If yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection pu oses.I agree not to occupy or allow occupancy of any building authorized by Tr It unci al' spection.
ignature Of Legal ner(s) Date
And/Or Authorized pplicant Date
CODE a INSPECTION TYPE • PALE INTRIALS CODE t INSPECTION TYPE QA FT, JNTRIALS
• 1616 Fixed System Final Fire Prevention _ _ _ 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof /�/ ,,,„„„... '''' 210 Final Electrical
201 Final Block/Retaining Well -L.•i/ / n t ' 212 Final Fire Prevention
202 Final Factory Fire Place Q 220 Final Planning Approval - •
203 Final Sign 222 Final Site ,
204 Final Demolition • 250 Final Building/Occupancy
I
•THIS SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BEIWEIN 2'6.6:6'IN 14110fT SHALL
ONLY. APPLICANTS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 10' FROM FRONT PROPERTY LINE
AN ACCURATE R*YRFSENTATION OF HI IR PROPERTY
IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •SOLID WALLS/FENCES SHALL NOT EXCEED 2.6`IN HEIGHT
WITH THE INFORMATION PROVIDED ON THIS SHEET. WITHIN 10'OF THE FRONT PROPERTY LINE Nat UNE).
•VERIFY DISTANCE FROM CURB TO PROPERTY LINE
AND SHOW ON PLAN. VERIFICATION FROM THE CITYS
ENGINEERING DIVISION 6 REQUIRED. CALL(714)7545313
NOR INFORMATION.
a3 — D,7 /85- owcic ,
`APPR VED
CITY OF COS A MESA
PLA NTNG IVISION
SUBJE TO BLD . DEPT. REG.
'
C:
0 "4t5TE:A MON "`E DELET ONS, �0`
v � OR COR ECTIO S SHALL BE
J° :a BY THE PLANNING-DIV.
I •
•
BY DATE-°4/5 b3
J '.
DIVISION OF BUILDING SAFETY 4
CITY OF CO TA MESA
APPS' VIED
I _ Date
?Icy
/ e
BY Allt
This set ofplansaid •: �MUST,:ke on his job al all times and fisw o
F RESOENCE aEankeanydengesad6ealio/me�e • p i,..,aeLcmrhr DivisianotSIdsvg
� �
and Safety, Aly oFCosta Mesa. •
J ? •
Me of he plan spaafwetionsc NOTehddlopennderto an•,.,val E
y of the of any visions of any 1 ity o Cosb Mesa Ordinana and/ r Sta:law. r.
W _��S/ These plan and permd,hail expire by ,:' and hemme null and vcd'rf)h butvg or
fired. .- -s•r-,: :• • - U8CWsto)wenniau�Sys fiss�ante.
_ e'Haag mot ■ gr'Aa .'
�
o .rn sT �/C c L
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kc WALL LAYOUT FOR BUILDING PERMIT
e.
PLANNING DIVISION IR
' /
TYPICAL 6" CONCRETE BLOCK FENCE
Ask •
Cement Coping Optional ; ! N, -- =A —i GENERAL- NOTES •
Channel Block With 1-3/80
Horizontal Top of all ee �
Fences N '- � MORTAR: One Part Plastic Cement, and
[� Three Parts Sand
GROUT: One Port Cement Three and
For Fences 5'or Less 0l RINE It l (? One Half Ports Stand
Vert Bars 3/e"�at 4' o"D.C. itl o COPING: One Part Cement, Three
s For Fences Higher Than 5' P""'! '_x and_,«• "'.=MI I Parts Sand
Vert. Ban 3/B"¢ at 32"•O.C. I a' 0 IIIr' - - CONCRETE: well Mixed 1:2-1/2: 3-1/2
Fill Cells Solid With Grout 1 ': L Max of 7- 1/2 Gallons Of
7 !'I _ — ;,, J + • `• „ I_ Water Per Sack of Cement
Where Steel Occurs r - - -
S r
ReinforcingSteel Shall i 7 'p !;' GROUT MAY BE POURED FROM THE TOP
I i:�l;-'. -- •- i't > I I •
OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A-15-39 u 0 . •�
OCCURS.
A.S.T.M, Ili'..I�" .;�;i _`. !+ I CELLS AND AREAS OF HORIZONTAL REIN
• I V'w n 1.: . I s _' . - I FORCEMENT SHALL BE CLEAR,CLEAN&
All Steel to be Lapped + ey1 --- FREE OF ALL MORTAR DEBRIS,ETC.
Z4"or to Code _ e: i ... .i •,: �:. ^i I-, 'I -
NATURAL GRADE �a : �. v �' --, 9 SII
e + �- �+ .mow
TWO3/9"O BARS i . -,is- :.' '
CONTINUOUS TOP „RE r �.. :�
&BOTTOM --- -. El iTO 16. 0 C MAX '
I SEE CHART - I j1 s :
HORIZSTEEL MUST BE TIED IN BE LOWS '; t i p +p[eTH (.1.- [ARTHTCOTH
PLACE AT TIME OF TRENCH i l: 1; 1 i a ,' t L
I/3 THE HEIGTH or FENCE
INSPECTION. I - -ErLOW BOTTOM OF FOOTING
� I
4 �., f
_.�� _,.�� .� io ,1; 2” .J.- SCALE: I/2" B I'
•
FOOTING REOUIREMENTS CHART:`
-, I WALL HEIGHT 6 ' 5 ' '4' 3'
WIDTH . • 14" . . 14" . . . : 12". . 12"
THICKNESS . . 10" •• •. 10" . 8 " 8 "
DEPTH OF EARTHTOOTH 24" 20" .; 16" 12"
SPACING OF EARTHTOOTH 12' 14' 16' 16'
` .
911 BUILDING DIVISION
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CITY O' OSTA MESA PROPERTY DETAI ZEPORT
1657 Samar PI
Costa Mesa, CA 92626-3627
Owner: Bulkley Wayne L Phone: (714)549-2700
Resident: Bulkley,Wayne Phone: (714)549-2700
Site Address: 1657 Samar PI Tax Address: 1657 Samar PI
City/Zip: Costa Mesa/92626-3627 City/Zip: Costa Mesa/92626-3627
Parcel Id: 139-281-26 Own. Occ.: Yes
Location: Costa Mesa City School District: Newport-Mesa Unified
Neighborhood: Unknown Census Tract: 063802
Wealth Code: 8.0 Year Listed: <1993
Legal Desc.: N Tr 3487 Lot 105
Zoning: Unknown
Subdivision: Unknown
Usage: 001: Single Family Residential
Style: Unknown
Construction: Unknown
Year Built: 1959 Ttl. Rooms: 6 Blktop Paving: Unk.
Stories: 1 Bsmt.Type: Unknown Concrt Paving: Unk.
Bdrms: 3 Bsmt. Fin.: Unknown Carport: No
Baths: 2 Full Gar.Type: Attached Garage Deck: Unk.
Heating: Unknown Gar.-Cars: Patio: Unk.
Cooling: Unknown Gar. Sqft: Pole Barn: Unk.
Irr. Lot: Unknown Roof Mater.: Unknown Pool: No
Terrain: Unknown Roof Style: Unknown Fireplace:
Water: Unknown Attic Type: Unknown Gas: Unk.
Sewer: Unknown Condition: Unknown Electric: Unk.
Sqft 1st: Lot Dim: Units:
Sqft 2nd: Lot Size: .191 acres
Sqft Bsmt: Lot Sqft: 8319.96 sq. feet
Sqft Total: 1510
Market Value: $62,227 Gross Tax Semi Ann.: $439.87
Assessed Land: $21,889 HB920 Credit Semi.:
Assessed Bldg: $40,338 RB Credit Semi Ann.:
Assessed Total: $62,227 RBA Credit Semi.:
Percent Improved: 65% Homestead Exemption:
Delinquent Taxes: Spec. Assmt. Semi.:
Tax Semi Ann.: $439.87
Sale Date: Apr-12-1982 Mortgage Date:
Sale Amt.: Mortgage Amt.:
Deed Type: Unknown Mortgage Type:
Volume& Page: Volume&Page:
Seller: Lender:
Title Company: Unknown Mortgage Term:
Multi-Parcel: No Mortgage Rate:
The information is deemed reliable but is not guaranteed. 2002-2003 Tax Year Copyright 2003 Haines Printed Aug-08-03
SOUTH ORANGE CA
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, . e
• Cr` F COSTA•PAESA; BUILDING SAFETY DIVISION
POST= IN CONSPICUOUS PLACE ON THE JOB
NOTICE . 7$ L— S 3-L'
Schedule inspection one workday in advance. To schedule inspections; II (714) 7.54-5626. Pro de t ollowing information:
1) Permit number, 2)Job address, 3) Inspection item number,4) Day an nsp�Jecti000n.
Building Address: ! G ((mo�i(S yJ ' r 1�-�rC� Owner. 13A_/R. i-VLi
Building Permit t3 ' SOI SSElectrical Permit#: Contractor 07-e) l } n /7
Mechanical Permit A: Plumbing Permit at: Job Desaiptoq_ f^� / i /t (/ //
Type: Group: r'n(- ��'-/>l( _U : lV/���-�`-'�._
PI. No. Issue Date: 7.1. Ca
ki 4.___ -., r
ADD ALTER REPAIR MOVING/DEMOLISH
PERMITS EXPIRE 180 DAYS (6 MONTHS) FROM ISSUE OR (LAST INSPECTION
COUSTRUCTION APPROVALS 1
Item# STRUCTURAL Date " ;Inspector Item# POOL&SPA Date Inspector
4 Footings 2—/e-03 drie94 Pool&Equipment Location
6 Slab 96 Steel Reinforcement
8 Structural Floor 100 Electrical Bonding
11 Pre-Inspect Roof 102 Rough Plumb&Pressure Test
12 Roof Sheathing 104 Approval to Cover-Gunite
14 T-Bar Ceiling-Structural 106 Elec Conduit-Underground
16 Shear Panel 108 Gas Pipe/Underground Test
18 Frame&Flashing 110 Backwash Lines,rrap,
• 20 Lathing&Siding Underground I
22 Insulation 112 Approval to Deck;
24 Drywall Nailing 116 Pool Plumbing System-Final
-26 Plaster Brown Coat 118 Pool Electrical-Final
30 Pre-Grout ¶2 i)3 %f 122 Fencing/Access/Alarms Approval •
33 Disabled Access 124 Approval for Plastering
e
. . FIRE DEPARTMENT APPROVAL.
1 1610 Overhd Hydro/Overhd Rough
1612 Dry Chemical
- 1614 Dry Standpipe
ELECTRICAL 1616 Final-Fixed System
36 Ufer Ground I
38 Elec Conduit-Underground FINAL INSPECTIONS
44 Rough Elec-Wiring Call(714)754-5626 for the following: Date Inspector
46 Rough Elec.Conduit 200 Final Re-Roof
48 Elec T-Bar Ceiling I 201 Final Block/Retaining Wall Z-2.4 CiS 1St
50 Elec Power Final j 203 Final Sign
51 Temp Power Final i 204 Final Demolition
206 Final Mechanical
208 Final Plumbing
. 210 Final Electrical
PLUMBING&MECHANICAL I Call(714)327-7400 for the following: Date ; Inspector
52 Soil Pipe-Underground 212 Final Fire Prevention
54 Water Pipe-Underground I 'Call(714)754-5335 for the following: Date Inspector
55 Underground Gas 214 Final Transportation Sys.
62 Rough Plumbing Call(714)754-5671 for the following: Date Inspector
64 Rough Mechanical 216 Final Engineering Approval
66 Rough-Factory Fireplace - Call(714)754-5307 for the following: Date Inspector
68 Sewer System 218 Final CMSD Approval
72 Gas Pipe-Rough Test Call(714)754-5245 for the following: Date - `:Inspector
90 Gas Pipe Test-Final 2201 Final Planning Approval
92 Water Service-Final Call(714)7545626 for the following: Date Inspector
222 Final Site f.,-c:
NOTES: SEE REVERSE .---- --- -->; 250 Final Building/Occupancy
559-06 (rev.owls)
PROJECT ADDRESS[' 1657 SAMAR ~$L UNIT: U - - CITY OF COSTA MESA - BUILDING' PERMIT PERM NO: M ' 046347_
.. OWNER'S NAME: WAYNE BUCKLEY , .
ADDRESS: SAME AS ABOVE '- ! • PERMIT_NO: M 046347 .PLAN CHECK NO: • ' _ N. • GOVT: N SUPP:. N '
' - ' CONSTRUCTION TYPE:,' 1. . • PERMIT •TYPE: 'MEC PURPOSE: OTH
• 714 %549 2700 . , • - • - .
aflcx/ENWNEER:= • 'REGNO.: JOB ' DESCRIPTION REPLACE HEATING SYSTEM SQ FT: •
" ADDRESS:•- , _ • • UNIT: - - ..
' ' c' I CLAIM VALUE': ' CALL-VALUE: GROUP OCC:• •
PERMRTEE: AHC HEATING 6 A/C ( 714 ) 50-0972 - •
. _ - - '
' ADDRESS: 2951 GRACE LN COMMENTS: : ' ' 'T •
-
C'.M . CA 92626 ****************e6 ***** *4* ia***********aa**** -+Ear*********x*****************� **,*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G R E Q U I R E M • E •N T S `
7000)of Division 3 of the Business and Professions Code, .•• .. license is in full force and effect. -
CITY uc.: 0 6 0 41 STATE LIC.:0 CLASS: 6• 2 0 , SI E T D A C K .S
----Date: (o;-%U Signatur.• _ //AL - ' �I •
1' MAIN BUILDING - - -'= •
- ACCESSORY BUILDING I.
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 TN "
Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). LEFT: . ' FT IN RGHT: • FT IN' - LEFT: FT . . IN RGHT: FT : IN.
• POLICYND.: WCG10330ll EXP:DATE: 01 /01 /91 •
COMPANY: SUPERIOR NAT. . - . . PARKING REQ: PROV: • PARCEL : 42516419 ZNE: . RE£ NO:
7 Certified copy'is'hereby furnished.. (El Cenitied c•• is filed • the city Building Divi' n. • PLANNING NOTES> _.. - _ . . •. . ... - t
o ,,' >
Late: 3(o^ 9v Applicant: - *************************IE****************************************************.* ' -
EXEMPDON FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for,one hundred(5100)or less). D E .V E L O P M E N T• S E R'-V• I C E S : 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 • ,-- - •
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - : ' '' . . + 'DATE:
Date: ., - Signature: _--• + -__ __ . -
NOTICE:If,after 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 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 BY: 1 • . . ' DATE: .S. 9/J`
which this permit is issued(Section 3097,Civ.C). . , ************************************.* ' **********I >w*******.**** •*46W*
ADDRESS •
I I - LEGALIZATION:N FEE S U M M A 'R- Y • - STRUCTURAL SEGMENT:N ' •
OWNER.BUILDER DECIMATION: I hereby affirm that lam 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 .- - 9 . 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 ' t 2 15% SMI P/NON-RES
pursuant to the provisions of the Contractors State 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 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 em 16yees with wages as their compensation, will do the work,-and the BUILDING-DIV-> •PERMIT - ISSUE PI?AN-CHECK TOTAL - PAID , {DUE
'❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code:-The Contractors'.State License Law TOTALS'---'-'-> 9 . 00 15'.00 ' - ' 0 :00 24 . 00 ' 1 24 . 00 , 0 0 ,
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through -1 '.• I 1
'his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS.--> - • COLLECTED: 24 . 00 OVER/SHORT': •
'Improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve0
:for the purpose of sale). BLDG PMT PLUMBING ELECTRIC. MECHANIC FIRE SMIP/TOT 'GRADING' PLAN.-CHECK
I,as owner of the roe • ' ' 24 . 00 ' •
• property,rty,am exclusively contracting with licensed connectors to construct the project(Section 7044,Business
- ,
•❑ 'and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon
and who contracts for such projectswith a contractor(s)license pursuant to the Contractors'State License Law).I am aware - ******************************************************iE******************fie**>F** t
that proof of their Worker's Compensation insurance should be provided to me. , . • • ' ' • • I N D I V I D U -A Ll: FEE BREAKDOWN '
am exempt under Section: B.8 P.C. , 4 - • - _ -
tormisreazore - TYPE QTY - •• 'D E 'S C; R I'. P T I O' N UNIT COST' . TOTAL COST
Date: Owner: J ' MEC T ' ' INSTALL FORC'/ATR FURN <= 100 K BTU/H - 9 . 00 , 9 .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 I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a . - - _ c.- . •
permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from .? '
these provisions. , ' - - _ _ •
•i
Date: Applicant: ,.; .. I
•
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 • • ' • , .
,ordinances and state laws relating to building construction and her e representatives
ofof thistcity to enter upon the above-mentioned • _ ;-' ' -
property for inspection purposes. F /'>• .. ,
i
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Date: ^� '9'D signature: R- C�4✓(�yt(/IZ 01 00055355-00055355 TOT 2i �jp
' Driver's License or SocialSecurityx: DATE: 03/05/90 TIME: 09:42 •
1- 1641-46 White-Buildinq;Green=Code Enforcemenq Canary-Applicant;Pink-Revenue;Goldenrod-Assessor - - - - - - - - -- -
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NT:.
CONSTRUCTION AND PLANNING -
Date " Inspector - Date Inspector
APPROVALS Permit# - - _ APPROVALS Permit # 9
1.•Temporary Electrical Service•or'Pole:, , 52. Pool & Equipment Location ;
• 2.,•Soil Pipe-Undrgrnd.., ,:. "..•� '__, - • 53. Steel Reinforcement ry-
• :3.FElectrical Conduit Utility-Undrgrnd;i-+ - 54. Forms _ - •-',1
' ' .,Electrical ConduiCUndrgrnd. -‘,3--- ,
4
55. Electrical Bonding
r:5. Steel Reinforcement 56. -Rough Plumbing & Pressure Test
C:6rElectHeal UFER Grnd. - ' 57. APPROVAL TO COVER-GUNITE _ _•
- 7..' Footings _ 'fit. . 58. Electrical Conduit-Undrgrnd. • .".p
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. •8. Foundation '4; t f9 - 1 - lr. 59. Gas Pipe, 0 Undrgrnd.,.Test • "•
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9. Water Pipe-Undrgrnd." - t.: o - - 60.- Backwash Lines, P-Trap, 0 Undrgrnd.
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10. Structural Floor System - -. _- 61. APPROVAL TO DECK t.
11. Property Sewer Line'& House Connection' -' 62.•Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final -
13. Roof Drains r _ . 64. Plumbing System - Final '
14. Rough Plumbing _ - 65. Electrical-Final
15. Rough Electrical-Conduit _ 66. Solar System-Final - .
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16. Rough Electrid Wiring. z 67. Fencing & Access Approval •h
17. Rough Wiring Sign I - 68..APPROVED FOR PLASTERING �'
18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL e .
19. Rough-Heating&'Air Conditioning - � - FIRE DEPT. REQUIREMENT
20 rcRough Factory Fireplace -•- _ - 'APPROVALS:.'_Permit# ' `--'
21 Ducts,iii Structure' -`
-• • ', Y :70. Undergroind Hydro t.
x
22.„-Ducts, Ventilating
LI 2..;--- - - `- -• `
9,. , . _ _ t- y: v71. Product:Piping 0 Gas ❑,Oil
23.•Gas•Pipe.Rough & Test _ : +. t•7 F- "v !c Y. .' :12. Underground Flush- -
24..Roof Framing a; ` - -▪ . ' .73rUndergrnd.StorageTank,O'Gas GOil
25. Roof Sheathing _ - *' 74.JOverhead Hydro'; x
r 4
26.: M2rib
2626.:T-Bar Ceiling (Structural) & coat . ,- - '-.:, e 75_.Dry Chemical 1_•r; e `J - _
27.=Frame and Flashing: 76. Dry Standpipe F
:28. Lathing& Siding ' -- I �• r 77:T FIXED . .--SYSTEM .; --•
29. Insulation _ r. 78i;FIRE PREV. FINAL - '` r
•-30. Drywall Nailing _. - 1_ `�: HEALTH,DEPT REQUIREMENT
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0'31. Plaster Brown Coat: ._ x s: ». -79. FINAL INSPECTION • * -, e•
_32._Electrical Power Meter Final• i ;* • `]80. FOOD CERTIFICATE ISSUED "
:1.'31-Final Electric s _m i i x Notes:�(`QJ; _ ia•aa?cwamE-t-c,�o. GOO
34.• Final Heating & Air Cgnditioning- `` •^ _:-: -• n -: * = _`
C] _.
35:Final Gas Pipe-Testy C,. .. r .-. , -,f/: �• - T `.
x`36. Hood or Canopy ; -- - -' y' ,Th 1 /.,t .i: _ s �. _
--37-Final Factory Fireplace- -,i-- i " y: . - _
738. Final Plumbing .. t'' 'f-• 'c .t.,., I-^ +: n
7 73
' 39. Water Service-Finals - ' x - ` '
'"'"40. Gas Service-Final ' r ' '-'T"' _ * r ' :oe rF - ..7);`-t _
="41. Solar. Domestic-Final- r x 'y'; _ ti• _
42. Backflow Preventer ry, r , • - c * r� .--,
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43. Backflow Irrigation '`� -'`- ,
• "44. Landscape Irigation Systerr ` - i.-.). 0* ." - _=i i- tTh
45 Sound Attenuation ^� ` -rr r
46.-Handicap Regulations C * c C.::.= - .
47-FINAL STRUCTURE & BUILDING , . _
48.-FINAL PLANNING ^ '• I ` - `
49'-Electric Release to Edison .J.,' , _ �. a:
-50:Gas:Release to Southern California Gas Co I" x ;
' 10936J
• /--y Et nn t C :I 1,1h IJ
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA. CALIFORNIA 4t/ �/.5?c7
FINRNCE DEPT.
FOR APPLICANT TO FILL IN COMPLETELY APPLICATIONCMDRtCP�ERMITsr.
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 1657 Samar Place
COSTA MESA:CALIFORNIA FOR OFFICE USE ONLY
6 Nt 31.8
OWNER Glenverde Homes, Inc. RECEIPT NO. ll.Y
MAIL Box 65 _ RECEIVED
DAY/// $ @E[EI� Ar'DATE IS '7 /
ADDRESS p I�n / VED
Balboa Isla]d,Callf. TEL.Or3_µ2ZO BUILDING
CITY NO. ADDRESS
ARCHITECT LIC.
OR ENGINEER NO. COSTA MESA, CALIFORNIA
ADDRESS FIRE i
ZONE TYPE V GROUP._L
rt 986
STATE APPROVED
CONTRACTOR 1.+acco'Corp. LIC.NO. 48 BY DATE
ADDRESS Box-65, Balboa Island,Calif. ZONING '
LEGAL LOT l05 3 87 ZON NO.OF I USE OF NEW.s .1/
DESCRIPTION NO. BLOCK TRACT V / PLA////N��1�S BUILDING
A.P.NO. _ _ BYPROV ED (1
DATE, ' /
^ )01 0 .
SIZE 7000 INNwOoNBLLOoCiS. 0 YARDREQUSG OF LOT RED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT --, FT. IN.
SETBACK LINESFROMSTREET
70 REAR YARD 3O /V FT. IN.
CENTER OF S 5 /-g^�` R.SIDE
SIDE YARD LEFT I RIGHT/D / -�/
L.SIDE FT. 'IN.
DESCRIPTION OF' WORK REAR 3J .1 IN.
NEW I XII ALTERATION I II ADDITION _
REPAIR I II MOVING I I DEMOLISH
SIZIE DING1525/l.1LID NO.OF ROOMS 8 STORIES 1
EXTERIOR WALt,L� ROOF
COVERING SLUCCO COVERING rock
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USE OF BUILDING AND WORK TO BE PERFORMED
residence j[/Q {tom_
g - 3vv
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A,-PERMIT FEE ONLY.
BUILDING CONSTRUC ON. VALUATION
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SIGN - -E OF, NVERDE HOMESERMIT FEE $
PE- ' ITT• 1+ A INC.jHC
it,... /i G SAS- /7j Al PLAN CHECK $ /,
�4ED A — \ / TOTAL FEE.$ 1,��`-
N.