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HomeMy WebLinkAbout1100 SANDI LN - Building Permits • • CITY OF COSTA MESA mos ' F BUILDING DIVISION FANy 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 '#`O+nmmm fi 1 PERMIT NUMBER: BX11-00151 PERMIT TYPE B_MISC STATUS: ISSUED APN: 42204201 DATE ISSUED: 05/20/2011 Zoning: , ISSUED BY: V T5 JOB ADDRESS: 1100 SANDI LN CM Suite/Unit: Vicinity: Primary Occ: • _ Const Type 2?SQ. FT: 0 Valuation: $1,800.00 SCOPE OF WORK: REMOVE AND REPLACE DRY ROT AND DRYWOOD TERMITE DAMAGE TO A 2ND FLOOR BALCONY. REPLACE SIDING AT BALCONY. ICC ESR-2588 EXEMPT FROM CONTRACTOR LICENSE LAW PER SECTION 7051 OF THE CONTRACTORS LICENSE LAW. REPAIR DUE TO TERMITE DAMAGE. OWNER: LOVELAND,THOMAS G Address:: 1100 SANDI LN Unit City/State: COSTA MESA, CA Zip Code: 92627 Phone: APPLICANT: TEAMWORK TERMITE Address: 3900 E MIRA LOMA AVE Unit: City/State: ANAHEIM, CA Zip Code: 92806 Phone: 714-632-9300 CONTRACTOR: License No. Address: Unit: City/State: Zip Code: Phone Cell: ARCHITECT: License No. Phone ENGINEER: License No. Phone FEE SUMMARY Building Plan Check: $0.00 ;J: Building Permit: $63.15 Electrical Permit: $0.00 SMIP Residential $0.50 SMIP Commercial $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $64.65 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm:Prohibited all hours-Sundays and the following Federal Holidays: New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE F. INSPECTION TYPE DATE INTITIALS CODEC INSPECTION TYPE DATE INIITIALS 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 Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site �L, ,� ) 204 Final Demolition 250 Final Building/Occupancy )( -0k Ti ))- h) PI'N(/o 111, WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver license. 0 Yes 0 Na I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which.ihis permit is issued. • ❑ I have and will maintain workers'compensation insurance, as required by - I section 3700 of the Labor Code,for the performance of the work for which this DIVSION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,a demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gry (This section need not be completed ifthe permit is valued al one hundred dollars(5100)or less) 2 Art 2Sec.341,Title B,California Administrative Code). Policy Number: 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safely.as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No 0 Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? CIYes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑ No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. - ^/ Sgnatureof gal Owner(s) Date Signature Date � S-Y7 ' ' 3057-46(3/07) CAneler'Awnorized Apptt idtJ 05/19/2011 23: 17 19494297718 COMPASS PAGE 01/01 • S CO'MPPAS5 � PROPEPTY MANAGEMENT GCRPORATION DANA WOODS HOMEOWNERS ASSOCIATION May 20, 2011 Tammy Anson Teamwork Termite 3900 E. Miraloma Avenue, Suite B Anaheim, CA 92806 Via email: TAnsonateamworktermite.com RE: Dana Woods Homeowners Association Work at 1102 & 1100 Sandi Lane, Costa Mesa, CA 92627 Dear Tammy: • This is to state that the Dana Woods Homeowners Association is authorized to, and does hereby, authorize Teamwork Termite to perform necessary work at 1102 and 1100 Sandi Lane, Costa Mesa, CA 92627, within the Dana Woods Homeowners Association community. Such work will be in accordance with.Teamwork Termite's Work Authorization Contract and Inspection Report No. 4493 dated May 4, 2011, and that certain May 6, 2011 letter agreement between First Community Realty, Inc., on behalf of the Owner of 1102 Sandi Lane and the Dana Woods Homeowners Association, which includes the Dana Woods Homeowners Association's request for the new balcony design. Please contact me if you have any questions. Sincerely, Timothy T.Bennett, CCAM® Senior Community Manager Cc: Board of Directors Lynn McLaughlin,First Community Realty, Inc. 901 CALLE AMANECER,Sgrrw 120.54N agnitanrrg.CA 92673.PH,949-429-7717, Fx,949-429-771e, WWW,COMPA SSPROPEPTVMANACEMENT.COM 1101 CITY OF COSTA MESA o � BUILDING DIVISION Y �a DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT B06-02046 (714)754-5273 • Fax(714)754-4856 www.ci.costa-mesa.c$IIEILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1100 SANDI LN 3.v ;; Status: ISSUED Suite: ��;q,4 '';° ? y- Applied: 12/06/2006 Vicinity: �4swx E t y u. r.. 5e Issued: 12/06/2006 Primary Occ: R-3 Dwellings/Cong Res<70 ��T.XX-pe of Constr.,,- 3�f ION N l"" '""' Parcel Number: 42204201 6+'7 `?, Zi) lOgl�� Applicant: JOHN HERNANDEZ ,ALL® `. ED ' Address: 2220 E ORANGEWOOD phonePE 4- i,._ ISSUED BY: ',`�/// ANAHEIM,CA , - :. Zip: 92806 EXPIRES" /01//7/07 Owner: LOVELAND, THOMAS G , Address 1100 SANDI LN-'' - Phone: .' COSTA MESA,CA . ' ' Zip: 92627 F Contractor:-, WIN-DORINC - - - '� EXPIRED — Loki* 'Address:: -2220EORANGEWOOD- - DATE Phone: 714-385-1202 / • - 'ANAHEIM;CA-- , ' Zip: 92806;�, ' - License: 545553 'Arch :• Eng: . . - . . Address: Address: . • Phone: Phone: Zip: License: ' - • • License: SCOPE OF PERMIT CHANGE OUT WINDOWS AND 3 SLIDING GLASS DOORS THROUGHOUT S.F.D.TO MEET 1997 U.B.C.EGRESS REQUIREMENTS. HEADERS WILL REMAIN THE SAME. - . . -, .FEESUMMARY - Plan Check: ' $0.00 _ " _ . : . ' .r"-. ' Calc Valuation: $4,891.00 • Permit: $111.25 ' Claim Valuation: $4,891.00 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: ON . 'Required • 0.- ' Proposed: 0 - , , ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia 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 U U WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: - ❑ I have end 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. r f rrga 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. Y�--4..My workers'co pensation Insurance carrier and policy number are: CCI Car' **GI/2 W/A i/U.S�/2.ao4/C6 rPallacyNumberlc77-moi) 17�a- °)-0) ection need not be completed i1 the permit is valued at one hundred dollars($100)or less.) ❑ 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 Cali • I. and agree at if Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith oomph/with these provisi r / L,, � Scant Sig tura:. tee' `r iii//�� Date:.- 7— �✓— 4 iWARNING:FAILURE TO S .. RS(ORKERS'•• - N • ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE OD,..•,IN ADOITI• 0 - •a T OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: . I hereby affirm.lhat.hem licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 o���aq.Bpusiness and Professions Code,and my license is in full M1wnwM.r..r R�-oi aro°and.eHecbtfc a•3• - - Qi,a, ,.S'= - gtass,Y��. C./-7 �ntrac[oYeSlgnai e't,77 ele:.�-...._- / -- c C. - dt'd•_err.Lrte-•:sr•:�.1.-- A DCs. T:�cci: CONSTRUCTION LEND 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: r'r,r I hereby affirm that under,penalty.ol perjury,that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city dr 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 orshe le'Iicensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to,a civil penalty cf.'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 under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,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,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. 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 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). 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,hes Section 25534 of the Califomia 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 appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. / Siggna - •' �Owner(s) Date �...� /7 — 7,, - .62 . „•,r:.And/1..t. t`d._. zed;AppgEiri irViYrd:sv., �+TDate. '.d ^,'.x: .s"'i r..: deE----#. PORE I PECnoN TYPE . PATE INTRUL$'' CODEI INSPECTION TYPE r PEE IMI& 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 Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ADDRESS aMGM s1UV 01-lNUJ1 LN LIME OF COSTA MESA - BUILDING PERMIT MORGAN, GREGORY H PERM NO: B U87 /05 UNNEBSWMEIFIWOft 1100 SANDI LN , ' COSTA MESA,CA 92627 PERMIT NO: B 085785 PLAN CHECK NO: iV GOVIi N SU!'?: N APPL Ma DwESS: CONSTRUCTION TYPE: VN PERMIT . TYPE: SIR PURPOSE: 0TH ARCHITECT OR ENGINEER: UC NO.: JOB DESCRIPTION : I/O EXISTING ROOF /COVER WITH 30 YR COMP SQ FT: 1 , 600 • ARCH.ow EMI ADDRESS: WIT: CLAIM VALUE: 1 , 600 . 00 TALC.-VALUE: 1 , 600 . 00 GROUP UCC: R-3 / c«BgAcarsxAUE J D JONES ROOF CRAFTER ( /14 ) 826-4827 • • - cwmRACTORSMEE 100 HIDDEN ACRES LN COMMENTS : TEAR OFFEXISTING ROOF AND RE-ROOF WITH 30 YR COMP/NO SWIG. NEWCASTLE CA 4J797b itviEiiieiPiiiEiviiiiiEiiitififiriE*iE#iF+E#iiiFriii'frEiEiEiiiEieiiiiiiiEiriiiiieiiiiiticiiiricrivciciiiiiiiiiii. iiiciiviriiiiiiiiEiEiriF*iiifirticiciti ADDRESS: 95658 LIC NO.: Z ONING REQUIREMENTS LIME • S E T B A C ri S (commencing CONTRACTORS DECLARATION:Division 3 If hereby adcm underPnenskyio d perjury that I am licensediiMI f under e and effect. of Chapter 9 Igmmmandrg wGn SLecy 2 L M Division 3 d the B`n J y Professions Cede,aMm .libnse b in MI force and edea. . C LIC.NO.: LJ LIC.CLASS: y3 y�lb tick': V7/9�3 MAIN BUILDING ACCESSORY BUILDING y FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN /f__J �` � Contractor: LEFT : FT IN RGHT: FT IN LEFT : FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty d penury that am exempt from the Contractors License Law for the PAR-„-—NG R E Y nU V : PARCEL : 42204201 L,N E: REF N V lolaw'vg reason(Section 7031.5 Busaess and Praessons Code:Any city or county which requires a permit to construct,alter,improve, V demolish.or repair any structure.prior to its issuance,also requires the applicant ler such permit to file a signed statement that he or she PLANNING N V T E S> is licensed pursuant to the provisions of the Contractors License Law[Chapter S(commendng with Sedion 7000)of Direion 3 of the . lusiness and Professions Code]or that he or she is exempt therefrom and the basis for the Waged exemption.My violation d Sedionsrx>r It It it iex>r ii It It it ii irxxit ii ;rxio ii it i<irx i<rix ri; ,T ,?F, ;�Xri 7.• X h. /031.5 by any applicant for a permit subjects the applicant to a evil penally d M more than five hundredddlad($5001). .� . �M.*ii ❑ I,as owner of the property or my employees with wages as their sole compensation,'MI do the work,and the structure a not intended D EV E,;L V P M E N I SERVICES R E Q U I R E M E N'"1' S or offered for Sale(Section 7044.Business end Professions Coda:The Comrade."License Law does not apply to an owner d popery i _ who builds or improves thereon,and who does such work himself or herself or through his or her own employes,provided that such L VN-NG APPROVED I--- fY DAT- . improvements are not intended or offered for sale.h,however,the building or improvement is sold within one year of completion,the • owner.buaHer wig have the burden d proving he or she did not build or improve for the purpose of sale). ❑ I.as owner of the property,am exdusivey contracting with Roamed contractors to construct the project(Sedan 7044.Business and BUILDING APPROVED BY : DATE: r, v Professions Coda:The Contractors License Law does not apply to an owner of popery who builds or improves thereon and who / contracts for such projects with a co tradm(s)licensed pursuant to the Contractors License Law). APPLICATION __ _ - _ _._ __r.____ __. / / �/� ❑ Tem exempt under Section: 8.6 P.C.,for this reaves: APPLICAI ION ISSUED BY : DATE:' / +'� Q 9 io it-A-A-wm-sy st it se m-se iibtio seioiiii ifioiisest 7t st so sir at-st Six it so .'R stWR sr 7e st it xattt W'it7t sr 7.-n.m sit sr*Iss-mnese son Xsx.''I'R A.m stn.*kit Date: owner • LEGALIZATION:fN FEE SUMMARY STRUCTURAIL' /SEGMENT:Y I do hereby certify that lam aware of and understand the requirements d California Health and Safety Code Sections 25505,25533.end - I t 25534.and that I or any Mare building occupant wth/will not(dvbone)need to compywih said slate codes and the requirements for __ _ BLDG_ PMT__ PLUMBING ELECTRIC. MECHANIC FIRE SMIP/RES' GRADING e penndlorconstruction or modificathd onntheAs QualD yManagement 'utdd.Reapplicationsental construction appion are exempt from these PERMIT 71 L7 . 50 moviatons. SMIP/NUN -RES Date: Applicant: PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the allowing declarations: ISSUE F E E • ❑ Ihave and witmaintain a certificate oconsent tosehinsure toe workers'compenwion,asproviad edtorbySion3700althalebor BUILDING-DIII-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the of the work for which this pent is issued. TOTALS 71 . /7 0 . 00 0 . 00 71 . 77 71 /J . 00 th `❑ I have and wit mWntairworkers'compensation insurance,as required by Sedan 3700 of the Labor Code,for the performance of the . work for which this permit is issued.My w«Mere'n oft inaweggcwrier end pdiry number ere: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 51 . 75 OVER/SHORT : • \IV Caner: - _ - L -VtVll Paley Number: <u./ L. 01 /01 /98 BLDG ,PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-C$ECK This section need not be completed the permit is for one hundred dollars($1001 or lass.) __---5-1 . 25 . 50 r I L] I certify that in IM la/Ioniance d the work ler which the ad,I shag/101 employ any peoon to any manner eq as to .. .. .. 4 .. .. .... .. become subject to the woMers'compensation pews of oma. ...nee it Mould become sowed tote wore„' a;ii iron*ii ii it it ii Si iiiiioii it SO**se ii ii ii ii SO ii ii it iii sr-se—iioi 7,—**titseii 7i7t ioiiioii**"-io sr-si*ititiiitini lost sit 7c sr dr lit sr 7tii srmm is-io siioitio compensation proitsions of Section 3]77,00jL. se Labor Cad I shall I`! con h those pnovidone. 1N 1J I V Ill UAL. t' t E 1S it E A K D U N! N ' //—/ I / Applicant: 7 4S I 't TYPE QTY D E 5 C Lt I r 1 1 U;N UNIT COST TOTAL COST Warning:Failure to secure workers'conpwadon coverage Is unlawful,and • I subject an employer to criminal penalties and civil does W to one hundred thousand dollars 0f00,000),M addition to the out of compensation,damages as provided for In h Section 3706ofthe Labor Code,Interest and attorney's les. SYR 1600 RERUUF BY VALUE RESIDENTIAL NUZONE 1 . 00 1 , 600,00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a conauudion lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097,Ca.C). • s l LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and date that the above information is coned.I agree to corn*with all city end county ordinances and stale awe relating to buldag construction and hereby authorize representatives of this city to enter upon the ebove'memioned property - x for hnepecthon Purf"3"'PHILLIP HAUSER �'' 11-18-1997/01:59 111/351,75 Print Name - , ' RCPT#:61-0at 90 p/` orae: ill 0 p-1' G'ERMITe@85785 / Signature of Owner/Agent/ApplicanVContmdo - (5151d6.WP) While-BuiMLg&Safely;Green-Rle;Canary-Applicant:Pink-Revenue:Goldenrod-Assessor __ . --- . 'i , POOL „PA CONSTRUCTION AND PLANNING � ' ' - �" - Date Inspector Date Inspector APPpJVALS Permit# APPROVALS Permit # 1. Tea porary Electrical Service or.Pdle r 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 j 5. Steel Reinforcement 56. Rough Plumbing & Pressure-lest 6. Electrical UFER 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- I 12. Sewer Cap - 63. Heater& Vent-Final 13. Roof Drains 64. Plumbing System •- Final 14. Rough Plumbing ,65. Electrical-Final • r • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring67. Fencing & Access Approval r, 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 T. APPROVALS Permit # - - 21. Ducts, ip Structure 70. Underground Hydro • 22:.Ducts, Ventilating •71. Produc 'Piping,❑Gas '❑Oil - 23: Gas Pipe-Rough &Test - 72. Underground El sh . 24. Roof Framing . - 73. Undergrnd.Storage Tank 0 Gas 0 Oil r 74. Overhead Hydro • 75. Ory Chemical, 27. Frame and Flashing . 76. Dry Standpipe i 28. Lathing & Siding ' 77. FIXED SYSTEM FINAL 78. FIRE PREY. FINAL t Drywall Nailing HEALTH DEPT. REQUIREMENT �� 31. Piaster Brown Coat ' •' 79. FINAL INSPECTION , 32. Electrical Power Meter-Final i , 80. FOOD CERTIFICATE ISSUED ' -.71 • Notes. • .. .,-. 35. Final Gas Pipe-Test . ' ' 39. Water Service-Final . 41. Solar D. . 45. Sound Attenuation • - • 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING . : . . 49. Electric Release to.Edison /, I 50. Gas Release to Southern California Gas Co ' _ I 51. CERTIFICATE OF OCCUPANCY • - No. Date - Applicant to fill in all_spaces except those within heavy lines and sign all appropriate declarations. 'x PE - - - I LU1;NO. UNIT NO. 9583 -4/291 8 CITY OF.COSTA(M/EJ$An C NSTJ/RtUCTIOnNnPERMIT /7 ti TQ 5.00 j TL • Project Address ' HOS CONSTRUCTION L/Onie Q / �' T I Applicant's Mailing A,.fess i ' N . TYPE OF CONSTRUCTION L-I NEW LJ ADD H.ALTERATION H REPAIR' - • I 3 ❑ CONVERSION ID DEMOLISH ❑ OTHER - _ q•p•# _ 1 -Zone Owner's Name. ��5�' r • Phone • Ste ' .J . DESCRIPTION OF'WORK/USE OF BLDG. Address A�C ' - S Main Building: Accessory Building: • Z Arch/Eng.' License No. TYPE OFPERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front - O Address - • ' QQ qq ?/I/7j� ❑ TENANT '❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear • N Contractor's Nam- , if :s I maJlfVW Phone /Of:)y!!1 ❑ OTHER ' I A , - .- - _ PROJECT.DESCRIPTION' SO. FT. OCCUPANCY C Righty -N Address(mailing) )S33 /1l)CAG1V f • K G • 593 p (/ CONSTRUCTION TYPE VALUATION $ ' • S Left 1 , 988-." City License No. 7� 6 ZONE GRADING CU.YDS. ' ACRESParking-Req./ProvidedR LICENSED CONTRACTOR DECLARATION L- • Ping. Ref.# • E hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I Planning Notes: ErEIVEn qpR 2 '+ 0 with section 7000) of Division 3 of the Business and Professions Code,e, and - 1 2. + 1988 T my license is in full t• ce an• effect. n/�G.7 / • • RECEI�ED MAR 1� S Licens- Class ' L e,s- NO. - ll Date r•'.�•� Signature ��— v /iiv! . PLUMBING -FEES • n _ , , • `WORKERS'COMPENSATION DECLARATION Bar SinkShowers • treby affirm that I have a certificate of consent to self-insure or a certificate . - ELECTRICAL FEES Workers' Compensation Insurance, or a certified copy thereof (Section - _ Backflow Preventer _ - Service Sink - Automatic Washer _ Transformer ❑ 15-50 KW - ,00, Lab. C.) /,cj(7//� ggp&2 INS - ❑-50+KW Policy No. (/Yd ''/(/ Company Backflow Irrigation Sewer Cap • Construction/Pole Sub. - ❑ Cert Stied copy is hereby furnished. - `' ' I:erti d stsp r�s}�ed with the city Bu I Div s10 • Bathtubs Sewer Connection ' CookingUnit Meter ❑u to 100 amps • Date •1•%//Yd6 Applicant �/'C Z�(��/M'IL[I - p P 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 — • Tess). Dishwasher • Solar Piping _ ' certifythat in the Dryers ❑Gas ❑Electric Sub Panel , I performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank . Fan Workers' Compensation Laws of California. 1 Motors❑0-1 HP ❑1'/x:8 - Date Signature Floor Drains Swimming Pool w/Spi • F.A.U. Solar 09-15 HP 016-15+ NOTICE: If,after making this declaration,-you-should become subject to-the - — Inc.- _ Workers' Compensation provisions of the Labor Code, you must forthwith • Floor Sinks UrinelFixtures Microwave comply with such provisions or this _permit shall be deemed revoked. ^I^ CONSTRUCTION LENDING AGENCY Gas Service Outlets / Water Closet PVO - Device Boxes Pole Light 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 an Outlets Range Lender's Name _ 9 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-TrapGenerator Trays' ( ❑0-5 KW 05-15 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 _ ',vision 3 of the Business and Professions Code)-or that he/she is exempt - -- _- - - - - met ram and the basis for the alleged exemption. Any violation of Section , i31.5 by any applicant for a permit subjects the applicant to a civil LJenalty of not more than five hundred dollars($500). 3 I, as 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 - - ' - Reinspection Fee I $15 Issue Fee r--$ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL I '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 ownDEVELOPMENT SERVICES REQUIREMENTS: - employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of comm Canopy Type II ❑ Zoning ApprovedBy , Dat¢ pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground - - Building Approved By Date aa rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By • • �j • 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 00-100,000 BTU ❑100,000 BTU • SUMMARY OF FEES 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 - BUILDING PERMIT $ SMIP $ I proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $- - PERMIT ❑ am exempt under Section B.& P.C.for this reason - Firepl/Fact.Blt. ICBG# Fire Dampers -• PLUMBING $ 5•°"'nn ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $. ENERGY P.C. $ - I hereby certify that I have read this application and state that the above ❑0-100,000 BTU ❑100,000 BT ELECTRICAL $ GRADING $ - information is correct..I agree to comply with all city and county ordinances: - --• and state laws relating_to building construction,and hereby authorize repre- $ ' 'MICROFILM $ sentatives of this cit to.enof pon the above-mentioned property f _ PLAN CHECK 50% inspection purpo Via.. / Uhir - MECHANICAL $ S�O • Signature /!L_/ ora 3 _ - TOTAL FEE $ Drivers' License or SS � - - - Reinspection Fee "$15 Issue Fee $ 3 PLAN CHECK 25% $. CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - - CONSTRUCTION AND4PLANNING POOL&SPA - _. - - , r, u'� Date • Inspector' .' Date ' Inspector APPROVALS Periniti# - APPROVALS Permit# 1.t-Temporary Electrical or Pole • 52. Pool & Equipment Locatigit ; : I al 1 . 2` Soil Pipe-Undrgrnd. 'I - 53. Steel Reinforcement, ..w 1 • 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms 'n . I .' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •Y� . � I '7 rSI 5. Steel Reinforcement 56. Rough Plumbing ur & Presseliest I I I . . • 6. Electrical UFER Grlpd}& 57. APPROVAL TO COVE44(.U1:1ITE' 7. Footings 58. Electrical Conduit-Undrgmdtif • , . • 8. Foundation-' -- - - -' 59. Gas Pipe, ❑ Undrgrnd.,7gst,,j • ' rr I 9. Water Pi a„Undr rnd _ 60..Backwash Lines, P-Trap, 0 Undrgrnd.) •• , 10. Structural Floor System 61. APPROVAL TO DECK • , 11. Property Sewer Line & House Connection 62. Backwash Se Receptor-Final • y 12. Sewer Cap •• 63. Heater & Vent-Final. - I , 13. Roof Drains - 64. Plumbing System - Final • 14. Rough Plumbing • 65. Electrical-Final - 15. Rough Electrical-Conduit 66. Solar System-Final I , - 1 16. Rough Electric Wiring • - 67'. Fencing & Access Approval - -- ' 17. Rough Wiring Sign - • - , 68: APPROVED FOR PLASTERING • ' ' 18. Rougli Electrical?T Bar Ceiling. r 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT • 20. Rough Factory Fireplace APPROVALS • , Permit# - 21. Ducts, in Structure 70. Undergound Hydro i' 22. Ducts, Ventilating 71. Product Piping 0 Gas O 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-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical •• .` t, 27: Frame and Flashing • • - 76. Dry Standpipe - .- -- ' 1 - F 28. Lathing & Siding • 77. FIXED SYSTEM ANAL - _•1;! • 29. Insulation 78. FIRE PREV. FINAL . .:P1:11;.:11:1:• 1 30. Drywall Nailing REQUIREMENT HEALTH DEPT. IREMENT ' ,1 r; 'u � 31. Plaster Brown Coat. 79. FINAL INSPECTION •_ ;rld ' 32. Electrical Power Meter-Final 80: FOOD CERTIFICATE ISSUED ' "' ) ' 33. Final Electric Notes: 1'/�!f*".. h0 cal fweY� <ealtat/o7' 34. Final Heating & Air Conditioning , 35. Final Gas Pipe-Test 36. Hood or Canopy . • .-�, 3Final Factory Fireplace - 7,_ , 38: Final Plumbing • A7Z7fek tt13 r . 39/WaterService-Final . 40. Gas Service-Final • , - " " - ' ' '41. Solar Domestic-Final . - - '42. Backflow Preventer ' - •,43. Backflow Irrigation , - - - ' - - r - _ ,44: Landscape Irrigation System - - • - r _ • '45: Sound Attenuation -• G 46. Handicap Regulations • . - ' - ' - _ - _ • 47. FINAL STRUCTURE & BUILDING - - , !1 • •.. • 48::Special Requirements Completed " - •t - - 49. Electric Release to Edison' .✓. • - SQ. Gas Release to Southern California Gas Co 51_`CERTIFICATEOF.OCCUPANCY - - 7.- - - No: Date - - - �• . - I . . . . _ t . - . _ _ . 2 -. - -• __ _.- - --. - - — -- Applicant.to fill in all,spaces•except those,within heavy border lines and-sign-all appropriate declarations: - -- ----- - - — - — • 'CITY•OFCOSTA MESA CONSTRICTION PERMIT PER NO: T CNO LOT-NO. L., UNIT NO.. o• = - ! _' Pro)ect'Addres5 II'QC) SANDI .( A/• ' - - ' + ff � Li , • ': r . - i, 0732 3%11/86 .. ,t 7.0C Applicant's MailingAddress 'SAnE TYPE OF CONSTRUCTION -LI NEW_ u-_ADD ALTERATION Li REPAIR • - _1 - ❑ CONVERSION t DEMOLISH I, ❑ OTHER - -' - - Owner's Name p1�QAQ!♦ fgs/�� 'PhongyZ-4CX� ".; A•P.# � � ! �_ —, , Zone!*i1 _ DESCRIPTION OF WORK/USE OF BLDG. - ' ' i.s+ Address 1 1 e» SAk-Joi IL h/• - ' i. - S Main Building: Accessory Building: r - • Arai/Eng: - • License No: • I - ' TYPE OF PERMIT :❑ GRADING ❑'FOUNDATION 15kSTRUCTURAL T Front r - 0 Address • - - - Ct•� 7 ❑ TENANT-❑ ELECTRICAL S PLUMBING ❑ MECHANICAL' ` R Rear _ t 1 N' Contractor's Name CALIF' SI<'1L1G PhonnI STSYy) ❑ 'OTHER I . - I - C Right N' Tali S,� PROJECTDESCRIPTION SQ. FT. OCCUPANCY , Address(mailing) i T Sli ' 2r. - ' • -. K G. I. , � •7.�•S CONSTRUCTION TYPE ' .VALUATION$ 5 ao s Left - - R City License No: oG ) / ZONE GRADING CU.VOS. ACRES LICENSED CONTRACTOR DECLARATION 1 ' Ping. Ref.# II Parkmlg Reck/Provided E with soy affirm that-I am licensed under provisions of CM1arter 9 ns Codon Remarks: I Ti Planning Notes: /Ys N ,WI v>1.Vshorny.• $ • with section 7000) -i Division 3 of the Business and Professions Code, and 1 - - • - -' yU41 1 . `t,J^ .III - M • my license is in/ or a and effect. Y l Li con Cla s �� Lin5e No U9•�r - - - - - - - - - Date Signature' Com'- [A.�•C&M _ - PLUMBING, i FEES , ;WORKERS'COMPENSATION DECLARATION ELECTRICAL FEES I.:- - d'' Bar Sink Showers $--aereby,affirm that I have a certificate of consent to 5 f-insure or a Certificate ' Workers' Compensation Insurance, or a certified copy thereof (Section-r- Backflow Preventer Service Sink' • s '50100, Lab- C.1 �•e / �s L Automatic Washer, Transformer 0 15-50 KW Policy No.�I��I 'T - • Company STYksr&" CO'I� Backflow Irrigation , Cap - , 056+KW ' �fgrtifie copy is hereby furnished. __ Construction Pole Sub. , cora,gopyiiyflled with the city Bui1..l.. D' -on. , Bathtubs — Sewer Connection Cooking Unit. I • Meter ❑up to 100 amps • ' Date / o Ni. Applicant t mi.: i'sr ' • ' EXEMPTION FROM WORKERS'COMPENSATION OEC L'ARATION• -- Clarifiers _ - Solar Collectors • - - Dishwasher- ' •—• - - Meter-Dover 100 amps, - - (This section need not be completed if the permit is for one hundred ($100)or ' less). l - , Dishwasher Solar Piping ;,q, 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 Tank , r ' Motors❑0-1 HP ❑1'/:-8 Fan • • Workers' Compensation Laws of California. ' Date ' Signature - Floor Drains • ' Swimming Pool vv/Spa F.A.U. • • 'NOTICE: If,after making this declaration,you should become subject to'the _ • _ IncInc.Solar ❑9-15 HP ❑16-15+ Workers' Compensation provisions-of the Labor-Code, you must forthwith ' Floor'Sinks • Urinal Fixtures comply with such provisions or this. permit shall be deemed revoked. - - - .. CONSTRUCTION Microwave CONSTRUCTION LENDING AGENCY- --- • -s - ..Y.. I hereby affirm that there is a construction lending agency for the performance Gas Service Outlets Water Closet Device Boxes ! Pole Light I , ,• of the work for which this permit is issued '(Section:- 3097 Civ. C:) Interceptors • . ' Water Heater - ' , Outlets • - Range Lender's Name - - • - - Lender's Address - Kitchen Sink . . W• ater Service , , t. 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 - _ following reason (Section 7031.5 Business and Professional Code: Any city or - - g P• ;Standing Sections „ \ i,f county which requires a permit to construct;alter,improve,demolish or repair. - P_Trap - ' . _ .Laundry Trays. - Generator ❑0.5 KW ❑s-15 KW ' Trash Com actor _ •• ' any structure, prior to its issuance, also requires the applicant ch permit , _ P r-•, (-- to file a statement-that he/she is licensed pursuant to the provisions of ROOF Drains • ' ' • ' - the Contractor's License Law (Chapter 9 (commencing with Section 70003 of - _ , - % • 'Iivismn 3 of the Business and Professions Code) or that he/she is exempt : - - •"' ' erefrom'and the basis for the alleged exemption. Any violation of Section : • !' _ - • - , r =s 1• 031.5 by any applicant for a 'permit subjects$500).he..applicant to a civil , , _ _- enalty'af not more than five hundred dollars ($500).. ' • LJ I, as owner of the property or my employees with wages as their'sole Reinspection-,Fee ' , $15 Issue Fee' $.3 v� " :7 1 'compensation, will do the work,and the structure is not Intended or offered - ' - Reinspection Fee• ' I $15 Issue Fee in 7;` ')6 $ 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 . - -, .I1 thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUI ENJE T �1l employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ KJ"L ( 1/),/� yil ' sale. If,'however, the building or improvement is sold within one year of corn- - Canopy Type II ❑ • Zoning Approved By 1 I,Jc-�J"-' 'Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Groun(I Building Approved By �� _ Date- — —rte/ prove for the purpose of sale). , e ❑ I, as'owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System { Application Issued By I Dat- -- —:- tractors to construct the project (Section 7044,Business and Professions Code: - q - The.Contractor's License Law does not apply to an.owner of,property who Duct--Ventilating -- -- - .001 00.000 BTU ❑100,000 BTU 1 OF FEE$ ' ' builds or improves thereon, and who contracts for such projects with a con- — _ i SUMMARYC tractor(s) license pursuant to the Contractor's License Law). I am aware'that - BUILDING PERMIT $ ' too 00 SMTP $ _ oSa proof of their Worker's Compensation insurance should be provided to me.; Exhaust System 0 Multiple 0 'System Repair/Alteration _ °_ -' ;� CJ PLAN CHECK $ a �� PERMIT I l ❑ I am exempt untler Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG,# Fire Dampers C. h t r cC4-;enS , PLUMBING • $ ISSUANCE $ Date • - ! ' I owner 1 Heating System&Ducting Registers li'),:,::":Ii1:%,6 II Iai.1 • - - _ PLAN CHECK 25%' $ ENE RG V'P.C. $ 1 hereby certify that I hiive read this application and state that the above ❑0.100,000BTU 0100,000BTL GRADING $ - information is correct. I agree to comply with all city and county ordinances ' a. ELECTRICAL $ I . and state laws relay -' o buildin• construction, and hereby authorize repro- ' • A __� .alg _ - P ' • I MICROFILM $ ' sentatives of ity s.. enter upon the abve-mentioned ,property,for (], IB ,__ LAN CHECK ,50%� $ inspection pure' - . ' / - i ' Signature �I - .✓ Date 7-, I -2I ' MECHANICAL , $ 1 • TOTAL FEE $ hay CO Drivers'ILicense or SS Pink -Accounting; Goldenrod - Assessor ' 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.-Electric• al'Conduit'Utility-Undrgrnd. - 54. Forms - ' 4.'Electrical,Conduit_Undrgmd. 55. Electrical Bonding - 5.-Steel Reinforcerdent•• 56. Rough Plumbing & Pressure Test 6.4Electrical"LIFER 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 j, - 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 'i •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 - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - - 75. Dry Chemical 1(0,27. Frame and Flashing �`7 3I, � : i 76. Dry Standpipe - • 28. Lathing;& Siding - 77. FIXED SYSTEM FINAL 29. Insulation78. FIRE PREY. 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 I i 46. Handicap Regulations ' -47. FINAL STRUCTURE & BUILDING XP p ' Incom tete Inn specc tions 48. Special Requirements Completed • - �j + CWC 49. Electric Release to Edison Date lig$ ` 50. Gas Release to Southern California Gas CO . - 51. CERTIFICATE OF OCCUPANCY: . No. ''Date 1 . - 1 - - • , NV _ _ _ _ CITY OF COSTA MESA PARK FEES No 222 Fee Payment Receipt / Project Address Ito/9-- /1...2a Z..enA ve�i AJ • Park Area / A. P. No. f9CO3_i_-_—_/_2_/- t� Building Permit No.110l O/4— -Ile Owner's Name Pbf3et, � � er + � f j21tC . Mailing Address 4 / J /�-�7.a11 CN • X), 's_ FEE Single Family * No. of Units@ $455.20 = Multiple Family ** No. of Units cp Lit @ $321,32 = '11/1n r fiR Total Fee 7711. 6g Planning Department Approval 14 e a - & By C-(LJf2P� Applicant's Signature A es * city Ordinance 72-44 k ** City Ordinance 72-45 i *** City Resolution 74-124 ' O�° d °l�1 d White-Planning;Canary-Planning;Plnk-Finance;Goldenrod-Applicant CMF 0174-26 I 7 Lt''t•- • 4n614 SEP 0-7 E,Tilitil3S5.' ? 3 ::::tg_.Za COSTA MESA BUILDING-SAFETY DEPARTMENT - P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APP ION FOR STRUCTURAL PERMIT For Applicant to Fil 'n Com.letely — e In. Only. _, RE•p1 ED BY D EEAECEIVED BUILDING - . • ✓ ll.. !/!/,^/ DATESISSUED�J ADDRESS a.. fn- k- - f !' ,L/l..J �V^/� �/ ! q 1 ler PERMIT NO: OWNER , A.P. NO.I S."031-1 ((((��'' S j BUILDIN d it =- �� - a Ard. MAIL sr�/1,.i /� ADDRE � _ae� n- ��-• �I ADDRESSi6f ':/ `• i/ = --------eQ CITY ••• ,rSSSJJJ / 7 NOLae:0fl TRACT �S3 s•. LOT {.0 BLOCK CONSTRUCTION [VEW ADD ALTER REPAIR MOVING DEMOI ISH LENDER X BRANCH -y tI OWNER �cf': -l��,lt> �V L:>A INS ADDRESS //��//r��//��//��//JJ � ,//�''7)JJ Q�r 1VALUE M: OARCHITECTR ENGINEER O//M•�'"'a"� NO —80Q USE �,�A✓ ` l V^ -tri$ /'J e ADDRESS /_/, c2J j. is Q`J ZONE I V , 7 GROUFIRE � J' CONTRACTOR/P©( �,.r��E APPROVED / DATE ,d✓✓✓'/ -74 • ADDRESS ZONE NO.OF USE OF N&a/Utz-es-eV . �� - TEL. f {. -Mt I PLANS BUILDING .p CITY NO. r Vi (_`1J �hJA'(�i 6A1�, . N. STATE CITY YARDS APPROVED YARDS APPROVED g I LIC.NO. LIC.NO. (FROM MAIN C/ BUILDING ILDI TG ACCESSORY BUILDING ly OFSIZE ^7^ 00 4y I 'NOW ON LOTNO.OF S Q FRONT T. y-' ,�/`r/v ycJ /a ' 0.. LOT (// Q USE OF 7 EXISTING BLDG. //ia -0 _ _/y R SIDE FT. FT. U) 6 rSf�i(� i-, Separate permits are required for - L.SIDE I FT. -. S kA_)D i FT. welectric,plumbing and heating work. REAR ID FT. FT. ilit USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ��js�, MAIN BLDGS. ACCESS. BLDGS. �a [/ '�!T C U.P.#''_ +,/7S/^/-T7 APPROVED / 0-0.-2c s APPROVED /p� stI V.P DATE J�—`� 74. .-1 le OLD FOR SPECIAL P,FCpUIRF11AFNTc a O I hereby acknowledge that I have read this application and state ' � 84 that the above information is correct and agree to comply with N. O. all laws regulating building construction, and I shall not employ m Z any person in violation of the workman's compensation laws of / m the State of California.I // �/r ^-- ) 3 I hereby certify that I am properly licensed as a contractor under • ( �0 SO. FT. r1 sJ /,5�( N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: -" am exempt from the provisi of the State of California Business 'o VALUATION PERMIT FEE $ V and Professions Code, ivision ter 9. J JI C`' U. - m Signature of Die • ./ PLAN CHECK $ 71 ne o Permittee $ y'J. TAX $ d" `2 Zf) jJ )) t`) 1/--_ U Authorized Agent A 'TOTAL PAID $ c7 '�5' OWNER PROPERTIES WEST, INC. DATE 10-14-76 ) JOB ADDRESS 1100, 1102 Sandi>Lane BUILDING PERMIT NO. 40614 — GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK I 1AP No. 115-031.17 LOT TRACT FIRE ZONE VALUE $46 • I to INSPECTIONS Si.nature Date TYPE V GROUP I & J ZONE PDR— II SOIL1r F ISS r SUBCONTRACTOR GAS a;eoleai�n Date Number Si•nature %%WATER f '/ _ / 7 Plumbin. ROUGH PLUMBING ll.a.��itrr/ ���/ rw— fFWl 7O 34 - 'PROP. SWR. LINE 7 HOUSE CON. 1'� ease t j.-_;-ee�f�•S=/i' [EVII lel O SPRINKLING SYSTEM S!t ':If!'SZMINIEWIQ1] P114:114 MISCELLANEOUS A ad /L'3=Lr7rt`onsto miny �A ROUGH HEATING AND AIR CONDITIONING A .2S• Warn TEMPORARY SERVICE OR POLE - . _ UNDERGROUND Q POWER ❑ ROUGH WIRING ra- - Heatin. and Vent. . TRENCHES 5 FORMS • STEEL REINF. f ����J�� sf CTLInst �� k 121 FLOOR SYSTEM 7I� =MI - ,.- / _ ,ice_,,'____ . >0 BOND BEAM • STEEL REINFORCE • IIIMEMMINal_ SHEATHING ..5,M21911i FRAME AND F ASHING Arima: - 1 LATHING - OUT /J' e� � _ PLASTER, BROWN COAT STRUCTURAL. FINAL A HEATING. VENT.. REFRIG. AND A.C., FINAL 1J i .r n.14..!� wirrne r-PZt�.- , . PLUMBING. FINAL AND GAS TEST [�j�. ,/`js 4111:1r � /� �j �� , 101 K.: ELECTRIC. FINAL r IS"- �� !:111riP?rIzigEF.Ftra BUILDING, FINAL pl W 4a c0 / 4 1r:T 1 tI-7f.`;, 7 )., 2t9 <::::,;:: 78 r0 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A P C 'ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use InIc Only RE `(ddv g cloud / DATE RECEIVED DATE ISSUE (// ` M � ADDRESS Y � s usr Ike, PERMI NO. OWNER A.P.NO. /� MAIL BUILDING//� D /t c A/ ! L . ADDRESS ADDRESS / //et / CIL_ /q/I/ N TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NSW ADD ALTER REPAIR MOVING DFMOLISH LENDER X _ BRANCH OWNER op rie-5 �s�('i'- hic ADDRESS (�/�'^ �^'�I�/� V LUE ARCHITECT TEL. USEDII, $ OR ENGINEER NO FIRE �((,/ ADDRESS ZONE TYPE �(' GROUP In APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED gLIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING W SIZE INO.OF BLOCS. (FROM C/L STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. a USE OF i. EXISTING BLDG. R.SIDE FT FT. ca ~=• F• Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR / 'Fr. FT. s: USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 4 `MAIN BLDGS. ACCESS. BLDGS. a w/ 2'. I /7 VAR.# DATE C.U.P.# APPROVED 7 /// APPROVED >. —BY DATE ..I I% t_ 41 , 0.1 © I hereby acknowledge that I have read this application and state in LY. that the above Information Is correct and agree to comply with h. L all laws regulating building construction, and I shall not employ m Z any person In violation of the workman's compensation laws of a 2 the State of California. 3 I hereby certify that I am properly licensed as a contractor under SO. FT. ry `I the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o V+ Chapter 9, and that such licenses are in full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY " am exempt from the provisions of the State of California Business ///...��� y VALUATION PERMIT FEE $ and Professions Code, Division 3, Chapter 9. JI Signature of ,., / PLAN CHECK $ 2 bs Permittee $ �t TAX $ u N k U Authorized Agent ` TOTAL PAID $7/