HomeMy WebLinkAbout1123 SANDI LN - Building Permits r
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ADDRESS OF BUILDING: 1123 SANDI LN wit CITY OF COSTA MESA - BUILDING PERMIT
\^ OWNERS NAME IF MOWN: SINCLAIR BRUCE C PERM NO: B 081429
t— ADDRESS: 1123 SAND I LN
COSTA MESA,CA 92627 • PERMIT NO: B 081429 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.MAILING ADDRESS: _-
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : T/OFF & INSTALL FIBERGLASS SHAKES SQ FT: 1 , 537
ARCH.OR END'S ADDRESS: LINT: -
CLAIM VALUE: 1 , 537 . 00 CALC-VALUE: 1, 537 . 00 GROUP OCC: R-3 /
cONTRAcT0WS NAME J D JONES ROOF CRAFTER ( 714 ) 826-4827
CONTRACTORS MMUNG 6011 SAN YSIDRO COMMENTS: RESIDENTIAL REROOF
ADDRESS: BUENA PARK CA uCNO.: 435996 **************iE*******************************+r'BtiEBEx-***********->F*+c***->E***+c..x..*B(- -+t*
90620 LOU:. ZONING REQUIR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chaser 9 SETBACK S
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.
CrrvLlc.NO.:029223 Llc.cuss: C 39 LIc.N 59 6 EXP: 09/97 MAIN BUILDING ACCESSORY BUILDING
3/-97 FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dae: �- Contractor: LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury t empl from the Contractors License law for the
following reason(Section 7031.5 Business and Professions Code:Any city of count which requires a permit to construct,altar,improve. PARKING REQ: P ROV: PARCEL: 42204213 Z N E: REF NO:
demolish,or repair ae.y structure,prior to its issuance also requires the applicant for such permit to fib a signed statement Nat he or she
S licensed pursuant to the provisions of the Contractors license law(Chapter 9(commencing with Section 7000)of Ditakn 3 of the PLANNING NOTES>
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 subjects the applicant to a civil penalty of not more then fire hundred dollars[S5001). *******************************************************************************
❑ I,es owner of the property or my employees with wages as mak sole compensation,will do the work,and the structure is not intended D E V E L O P M E N T SERVICES R V I C E S R E U I R EMENT S
or offered far sale(Section 7044.Business and Professions Code:The Contractors License Law does notappy to an owner of property Q
who builds or inproves thereon, herselfend who does such work himself orherself ..or through he or her own employees,provided that such
improvements me not intended«offered for sale.B.however.the building or improvement is solro as d within oyear completion,the ZONING APPROVED BY DATE: -
ownerbuilder will 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 exclusively contracting with licensed contractors to construct the project(Section 7044,Business and
Professions Code:The Contractors License Law does not apply to en owner of properly who builds or improves thereon and who BUILDING APPROVED BY : DATE:
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). / .., 7�/
❑ Iamesempurder°erion: B.APc..f«Nisreason: APPLICATION ISSUED BY: DATE: /
Date: sera LEGALIZATION:N F E E SUMMARY STRUCTURAL' SEGMENT : Y
I do hereby certify that I am aware of and understand the requirements of Calfomia Health and Safety Code Sections 25505,25533,end
25534,and that I or any future building occupant will/wit not(circle one)need to comply with said state codes and the requirements ler
apermh for construction ormodikation from the Ar Guaiy ManglemeM District.Residential ngwua'as
rnappicrseexempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 51 . 25 . 50
Dale: Applicant SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE
❑ Ihave and will meinlanacedAkateof consent toselinsure for waken'compensation.as provided for by Section 3700 of the Labor BUILD ING-DIv-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
ADcode.f«the performancew «
the wkf« hk
with permitia is issued.
TOTALS----> 51 . 75 0 .00 0 .00 51 . 75 51 . 75 .00
r° itsneissed° ngecoaiurce « 703 of cynu Code,for the performance of theworkfor and maintainworkers'
is issued.My insurance,
insurance cama d pol number
STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 51 . 75 OVER/SHORT: 00
Policy Number. 285-UN1T00024J 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN- HECK
(This section need not be completed I the panni is for one hundred dollars/$fno)or less.) 51 . 25 . 50
❑ 1 certify that in the performance of the work for which this permit is issued,I that not employ any person in any manner so as to
biome subject la the waken'compensation laws of Caldemo a, and agree that R I should become sables to the workers' **************************************************************************iE****
compensation pmvisi ns of Section 3700 of the Labor Code,I shed!forthwith comply ' provisions. INDIVIDUAL F E E BREAKDOWN
Dae: /- 3 /-9/ Applicant:
Warning:Failure to secure workers'compensation coverage is unlawful,and IIs r an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(Sf00,000),In addition to Me coat compensation damages as provided for in
Section 3705 of Ne Labor Code,interest,,andafornsy's fees. SFR 1537 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 1 . 517 .00
X7 .00
CONSTRUCTION LENDING AGENCY:1 hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which the permit S issued(Section 3097,Cit.C).
LENDER'S NAME:
LENDER'S ADDRESS: •
I certify that I have read this application and sae that the above information S coned.I agree to comply with all city and county oedbusxes
and state laws relating to building construction end hereby authorize repr°sanative°of this city to enter upon the above-mentioned propertyf -
ornnsadanpurpoesa.REGINA JONES 01-31-1997/1
•'int Hama RC ',.+••
�//////-��- Dae: /3/-?7 • PERMITi
SignelWao /AOenvAPpiceni/Contractor
(5151'46 W P) White-Buidkg&Saley:Green-Re:Canary-Apps ant:Pink-Revenue:Goldenrod-Assessor
L., - -
l
�/
CONSTRUCTION AND PLANNING , - POOL & SPA
• APPROVALS Permit # Date Inspector APPROVALS Permit # • Date Inspector
•
' 1, Temporary Electrical Service or Pole: 52. Pool & Equipment Location ' ,
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,
3. Electrical Conduit-Utility-Undrgrnd. ' 54. Forms . •
:4. Electrical Condut-U
indrgrnd,55, Electrical Banding - ,
'_6,.Steel Reinforcement.- 56. Rough Plumbing & Pressure Test •
6. Electrical UFERiarnd. - :57, APPROVAL TO COVER-GUNITE - •
'-:.7. Footings - 58. Electrical-Conduit,Undrgrnd: • -
-`8: Foundation - - 59. Gas Pipe, 0 Undrgrnd., Test. '
• 9. Water Pipe-Undigmd.`- • 60. Backwash Lines,RTrap, 0 Undrgrnd. ' •
10. Structural FloorSystem . -- , 61. APPROVAL TO DECK
11. Property Sewer:Line & House-Connection - • 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains •- . • 64, Plumbing System - Final
14. Rough Plumbing -- 65. Electrical-Final •
15. Rough Electrical-Conduit ' - '66. Solar System-Final
-
16. Rough Electric•Wiring , , •• - 67. Fencing & Access Approval
17. Rough Wiring Sign '68. APPROVED FOR•PLASTERING
18. Rough Electrical-7 Bar Ceiling , - • - 69. POOL/SPA SYSTEMS FINAL '
19. Rough Heating& Air Conditioning -- - - FIRE DEPT.-REQUIREMENT-- •- - - -
.. - - t
20. Rough Factory Fireplace - - .j - -= APPROVALS . Permit # '
21. Ducts, imStructure - __ - _ -� 70.x-Underground Hydro
22. Ducts, Ventilating-_ - - - , _ : 71. Product Piping O_Gas 0 Oil
23. Gas Pipe;Rough &Test -' - . f 72. Underground Flush- =
24:Roof Framing ^i` - - •- ' = , .--
-,-j 73. Undergrrid.Storage Tank O Gas ❑Oil
25. Roof Sheathing =' - '
• "'4/9/_ 'jell!, .: •' 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoatr _ 4: 1k , 75. Dry Chemical _.,-.7. ._ - - •,.
..
27. Frame and Flashing•, :- 76. Dry Standpipe. `-
28. Lathing& Siding -- _ •- _ 77. FIXED SYSTEM FINAL _
29. Insulation ' , `' , . :. 78. FIRE PREV. FINAL • - -
30. Drywall Nailing = _ ' _ , HEALTH DEPT-REQUIREMENT
' 31. Plaster Brown Coat; - ' 79. FINAL INSPECTION :.
32.-.Electrical Power Meter-Final • ^ _ r '• 80: FOOD CERTIFICATE ISSUED
33.'Final Electric. .- Notes: 'r '�
34, Final Heating-& Air.Conditioning-.. - - _ ---
35. FinEl Gas Pi Pe-Test - • . , ,_ - -
36. Hood or Canopy V ' - • '- - - - - -
37. Final Faciory Fireplace A - - '
v
38. FinaLPiumbing - - �^
• 39, Water Service-Final'r. . ' '
40. Gas Service-Final ,• - - - • . > - -
41. Solar Domestic-Final -i. - jh _ -
T _
42. Backflow Preventer- - ._ -
43. Backflow Irrigation - ' M -
r-
44, Landscape Iriigation System •- '- _ _ x: - •, c
45. Sound Attenuation. _ _
r46. Handicap Regulations Ail. : . -
47. FfNAL STRUCTURE& BUILU(NG ��•�/O - - "
48.-FINAL PLANNING - . `+ 7 -c7
o
49.:Electric Release to Edison : .l
50. Gas Release to Southern California Gas Co - - - . _ I
_
51. CERTIFICATE OF OCCUPANCY - _
M1'
No Date
>'ADDRESSOFBUILDING: 1116 SANDI LN UM: CITY OF COSTA MESA - BUILDING PERMIT
j- ONNERSNAMEIFIDIOWN: FANNING, PATRICIA A PERM NO: B 081427
ADDRESS: 1116 SANDI LN
COSTA MESA,CA 92627 PERMIT NO: B 081427 PLAN CHECK NO: N GOVT: N SUPP: N
•
APPL.MAIUNG ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: LID NO.: JOB DESCRIPTION : T/OFF & INSTALL FIBERGLASS SHAKES SQ FT: 1 , 537
ARCH.OR ENG.'S ADDRESS: UNIT:
CLAIM VALUE: 1 , 537 . 00 CALC-VALUE: 1, 537 . 00 GROUP OCC: R-3 /
OONmACTarSNMIE: J D JONES ROOF CRAFTER ( 714 ) 826-4827
I CONTRACTORSMAIDIS 6011 SAN YSIDRO COMMENTS: RESIDENTIAL REROOF
ADDRES& BUENA PARK CA uc.ND.: 435996 *******+t*********atitRt**iE*Rt***x-Rt**stat*Nat*Rtx*******Rt*itx-xaF******x-***+t*stat***->F -+F*****x-
90620 WIT: Z ON ING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of penury that I am licenced under provisions of Chapter 9 • SETBACKS
(commencing with Section 7000)of Division 3 el the Business and Professions Code,end my license is in full force and effectt
crruc.No.:029223 uc.cuss: C 39 uc.No.: q96 EXP: 09 /97 MAIN BUILDING • ACCESSORY BUILDING
Dae: l- 3/
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
�7 contwa: a 0� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally a perjury that I exe from the Contractors License Law for the
following reason(Section 7031.5 Business and Professions Code:Any city or county whi requires a pens to construct eller.improve. PARKING REQ: PROV: PARCEL: 42204209 Z NE: REF NO: -
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 PLANNING NOTES>
is licensed punaant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)a Division 3 of the
Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any vi lotion of Section >
7031.5by erne applicantfor a permit subjects theepplicaf to a civil penally of not more than Ore hundred dotter,[5.5001). *******************************************************************************
❑ I.as ovmer of the property or my employees vnth wages as their sole compensation,will do the work,and the stmcture is not intended DEVELOPMENTSERVICES REQUIREMENAT S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does nor apply to an owner of pronely r
who builds or improves thereon,end who does such ovals Nmself or herself or through he or her own employees,provided that such •
improvements are ml intended or offered for saleff,however.the building or improvement is sold within are year a completion,the ZONING APPROVED BY DATE: '
owner-healer will have the burden a proving he or she did not build or improve fa the purpose of sale).
❑ L as owner of the property,am exduewely contracting with licensed«xaactas to construct the peeled(Section 7044,Business and BUILDING APPROVED BY : DATE: '
Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who // i• /r
contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). /✓ /� :iE iF iF 13/-2z/ iF iY1F
❑ lamexempt under Section: B.AP.C.,for this reason: APPLICATION ISSUED BY; DATE:
DateOwner: LEGALIZATION:N F E E SUMMARY STRUCTURAL'- SEGMENT:Y
I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505.25533,and
25534.and that I or any future building occupant will f wit nal(circle one)need to comply with said suite codes and the requinsments tor . BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
a permit for construction or modification from the Ar(lushly Management District.Residential oonsUWon eppkmions are exempt from these
provisions. PERMIT 51 . 25 . 50
Date: Applicant: S M I P/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby aDvm under penally el pottery one of the following declarations: ISSUE FEE
❑ I hems and MImaintan a certificate o consent toseffAmur,for workers'compensation.as provided for by Section 3700 of the Labor BUILD ING-DIv-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code.for the performance athewakiawNchhmpemdiaeeaed. TOTALS----> 51 . 75 0 . 00 0 . 00 51 . 75 51 . 75 . 00
C I hakfoHoii. rkatnsucecybcde for the performance of theworwh �this issued.Mr orers insurance,
inrancarriier and pol700 of icy number
Carie: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED; 51 . 75 OVER/SHORT: . 00
Poly.Number: 28S-UNIT000243 • 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be camplead$the canna is for one hundred dollars($1001 or las.) 51 . 25 . 50
❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner an as to
become subject to the workers'compensation laws of California and agree that if I should become subject to the workers' **************************************************************************if****
compensation provisions of Section 3703 of the Labor Code,I shall forthwith ply with provision.. I N D I V I D U A L F E E B R E A K D O W N
Date: /` 3 / -97 Applicant .---
y�yr,///
Warning:Failure to secure workers'compensation coverage Is unlawful,end an employer to cnmml penalties and TYPE QTY -DESCRIPTION UNIT COSTTOTAL COST
civil gnu up to one hundred thousand dollars($104000),In addition to the I o compesatior1 damages as prodded for in
Section 3705 of the Labor Cods,Interest,and attomey'slees. SFR 1537 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 537 . 00
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097.Civ.C).
LENDER'S NMIE
LENDER'S ADDRESS:
I certify that I have read the application and state that the above information is cornea.I agree to comply with all city and county ordinances
and slate laws relating to building construction and hereby authorize representatives of the city to enter upon the above-mentioned property
for inspection purpeaae.REGINA JONES 01-31-1997/12:52 PM/$S1.75
RC
14111
• Date:
Name /_3/-97 , PERMITe081427
Siemtu rF9enVAppticanUConlrecta '
(5151-40 WP) White-Building A Safely:Green-Rte:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
-� - - - POOL & SPA ' - . ' -
CONSTRUCTION AND PLANNING - -. - - - _
APPROVALS Permit# Date Inspector APPROVALS Permit 4 Date Inspector
1. Temporary Electrical Service or Pole t 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 LIFER Grnd. . 57. APPROVAL TO COVER-GUNITE = ,
7. Footings -. 58. ElectricalConduit-Undrgrnd. . - .
• • 8. Foundation = E - 59. Gas Pipe, 0 Uddrgrnd:, Test' -
.9. Water Pipe-Undlg nd.^ - 60. Backwash.Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System . 61: APPROVAL TO DECK
•
11. Property Sewer Line & House-Connection - 62. Backwash & Receptor-Final ;
12. Sewer Cap ' 63. Heater & Vent-Final -'
13. Roof Drains , - 64. Plumbing System -Final
•
14. Rough Plumbing - . . • -65. Electrical-Final ' • •
15. Rough Electricai-Conduit . -66. Solar System-Final •
16. Rough Electric Wiring _ .F 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, inSttuMure - - - 70.-Underground Hydro •
22. Ducts, Ventilating_ • `•• :
y ' '' ,, 71. Produc(Piping 70 Gas OOil
23. Gas'Pipe:.Rough &Test = -- r - //J_ 72. Underground Flush- .24. Roof:Framing - • - -'_F7//i7 A 73. Undergrnd.Storage Tank O Gas O.Oil
25. Roof Sheathing ; _ _ - 74. Overhead Hydro �.
26. T-Bar Ceiling (Structural) & Monocoat r -
75. Dry Chemical •
27. Frame and Plashing = „ , - - - .- 76. 'Dry StandpipeL C - r -
. 28. Lathing& Siding_•• r-: - _ • _ •• •• 77, FIXED-SYSTEM-FINA'L
29. Insulation . :• r, 78. FIRE PREV. FINAL - _
30. Drywall Nailing .; +" . • _ -HEALTH DEPT.REQUIREMENT
31. Plaster Brown.Coat; -.• 79. FINAL INSPECTION
- 32. ElectricafPower Meter:Final ... _ • ' 80. FOOD CERTIFICATE ISSUED
•
33. Final.Electrlc • "' Notes: _ ' - -
34. Final Heating& Air Conditioning• - . - 7, 1 =
35. Final'GeV:Pipe-Test` . r ' - - _ --
36. Hood or-Canopy • _ ' _ • -. .: - r - -
-
37. FinatFactory Fireplace-_ 7-.:.. - H .-. ! - -
ce
38. Final'Plumbing - J - * _ -
39. Water Service-Final` -• - . - - ' '
-
40. Gas Service-Final - -
41. Solar Domestic-Final -' - - • . `
42. Backflow Preventer. -
43. Backflow Irrigation = - - - --
44. Landscape Irrigation System-r - - 1
-45. Sound Attenuation - - '_ . -
-46. Handicap Regulations l -' r".
r 47. FINAL STRUCTURE & BUILDING y�j�/O� � ' - -
48. FINAL PLANNING. Y� ;
49. Electric Release to Edison `
50. Gas Release to Southern California Gas Co - - - •
51. CERTIFICATE OF OCCUPANCY -
No. Date
.
rPROJECTAI/BRESSE: 1123 SANDI LN UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B UfbU /
OWNERSNAME: PATTERSON IRVING BRADLEY
ADDRESS: 1123 SANDI LN PERMIT NO: B 056073 PLAN CHECK NO; N GUVi ; N SUFI': N
COSTA MESA,CA 92626
N CONSTRUCTION TYPE• —N PERMIT TYPE: STR PURPOSE: ALT
( 714 ) 650-5126
,M1 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : DEMOr WALL; ARCH DOORWAY & ADD WINDOW SQ FT: 500
ADDRESS: UNIT:
' CLAIM VALUE: ! i;00 CALC-VALUE: 500 . 00 GROUP OCC: R-3 /
PERMITTEE: IRVING BRADLEY PATTERSON ( 714 ) 650-5126 � �� _ e_ 1 12�(QZ
ADDRESS: 1123 SANDI LN COMMENTS : SMOKE DETECTOR(S) REQUIRED IN HOME. (4 6t 7l't re dC�ct��zu/,/
COSTA MESA CA 92627 *+"************�F***** ***>'FNF�S6**6 *�P*Sc* ******�F* �F�F *K***** "*Mill()f\G*Eyn rori
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS REQUIRED
CITY LIC.: STATE LIC.: CLASS:
Date: Signature: FRNT: FT MAIN
INBREARING FT IN FRNT: FTCESSINYREAILDING FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C).
POLICY NO.: EXP.DATE: PARKING REQ: PROV: PARCEL: 42204213 ZNE; REF NO;
COMPANY: PLANNING NOTES>
7 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
Date: Applicant: DEVELOPMENT SERVICES R E Q U I R E M E N:-T S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the per 't is for one hundred($101)ar less). ` .,---rI certify that in the performance of the work for which this permit is issued,I shall nyyyym any pe n in any manner so as to become
subject to the Workers'pCompensation Laws of California. // �.��� 7 ZONING APPROVED BY DATE: L•--
�� Date'. 2- J -C- Signature. l��/ 4frat BUILDING APPROVED BY •
DATE: '
NOTICE:II.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor '?
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: ,diai-- DATE: /q
which this permit is issued(Section 3097.Civ.C). *********************4 +e******ie***fit *1F�C/z3t **
LENDER: ************************************ ***1j*****1E****"!E*/*************it .*********14
ADDRESS: LEGALIZATION;Y 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 30 . 0 05 0
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON -RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
I. as owner of the properly or my employees with wages as their sole compensation, will do the work, and the — 30 . 50
❑ structure is not intended or otiered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS-- -> 0 . 00 0 , 0 0 3 0. 50 30 . 50 , 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
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• 30, 50 OVER/SHORT: 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC F IRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 30 . 00 , 50
❑ 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 projects with a e ctogs)license pursuant to the Contractors'State License Law).I am aware *******.+E****************************************************;i****************1E*
X�, that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
u I am exempt under Section:B P 7 0 4 4 B.S P.C.
for this reason: ALL WORK BY OWNER �
L TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date: ..2—,3—Fe— Ownerr
SFR 500 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 500 , 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 will/will not(circle one)need to comply with said state code nd the requirements for a
permit for construction or modification from the Air Duality Management District Residential nstruction plications are exempt from
these provisioner? 522 _, /��� �
�� Dale: Applicant: A/
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 stale laws relating to building construction and hereby authorize representatives of this city to rater upon the above-mentioned
property for jpspejpon,purposes. /°
O��li- Xir+' f 1 n00107E38-131C7839Ti:,'1 ,
Date: Signature: ¢ 1 _ .
Driver's License or Social Security e: 1 I•'' DATE: 02/03/92/922 TIME: 11:26
1641-46 While—Building:Green—Code Enforcement:Canary—Aoolicant;Pink—Revenue:Goldenrod—Assessor
r-r=', !. -
• COh,STRUCSION AND PLANNING.. POO :PA
APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector
•
- 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. _ - 53. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement - 56. .Rough Plumbing & Pressure Test '
6. Electrical UF ER Grnd. . 57. APPROVAL TO COVER-GUNITE
7. Footings58. Electrical Conduit-Undrgrnd.
8. Foundation . 59. Gas Pipe, 0 Undr'grnd., Test ' f ,
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. ;l
10. Structural Floor System 61. APPROVAL TO DECK . {
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap `-.r .r 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final 1/ � / - ' , .
14. Rough Plumbing _ 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final 'r
16. Rough Electric Wiring 67. Fencing & Access Approval i
-
• 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. Root Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation - 78. FIRE PREV. FINAL
30. Drywall Nailing , • HEALTH DEPT. REQUIREMENT
y
31. Plaster Brown Coat 79. FINAL INSPECTION
i
32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED
33. Final Electric r Notes:
34. Final Heating & Air Conditioning f ; ,
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 Domesticinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System -
45. Sound Attenuation
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING of--57-1.2.. Q4",,,/4.
48. FINAL PLANNING
49. Electric Release to Edison •'
: i
50. Gas Release to'Sduthern California Gas Co
- 51. CERTIFICATE-OF OCCUPANCY
No. Date
._ .. .
•
,
. Re. : Bs-6 073D
Michael R. Gabriel Structural Engineer
•
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Date
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2kAti MISIMilkti ditnOtS1010
• APPROVED .
•
. . .
City of C sta Mesa Building Dept.
• - •
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BY
nntifiv-9-4409, 'kr. I - • - : ..-! '-'—' 4---.'
1 ,
" i THESE PLANS tv, ,,T BE ON JOB AT ALL TIMES MARE1
..9zESSIOAt4 t
NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. 1 ' Z .-1
ti, R: ' e • - i
THE ISSUANCE OR GRAN:Pi:IC: OF A:PERMIT OR APPROVAL OF '
‘Z‘.‘W;itc' ry E I
. .._ ..... .
PLANS AND SPECIFICATIONS :ILEILL NOT BE CON:TRUED TO BE A
PERMIT FOR OR AN APRKC:VAL OF, ANY VIOLATION OK ANY OF :
, I
— THE PROVISIONS OF THIS E.0::E.NO PERMIPPRESUM/NG TO GIVE ati/ : lf -r" • .1
AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF THIS I
, cC No. S 939 r I
----- . CODE SHALL BE VALID ETC I E'T IN SO FAR AS THE WORK OR USE :
WHICH IT AUTHORIZES IS LAWFUL. Exp.931.'
: —---
N.... •• --i
THE ISSUANC'C: OF E. PERMIT BASED UPON PLANS ;AND—• —4': ' — *" —5'...0 . ...,,6 V.• • !
v.
. _.-.. • SPECIFICATIONS SHALL I TIT PREVENT THE BUILD?'!.; OFICIAL : ci> f I 0 C TO •A\?. i
FROM THEREAFT EP PFICUIRING THE CORRECTION OF°TROLLS IN 44 0S1' L
SAID PLANS AM) FPFTIFICATIONS OR FROM PREVENTING : f' OF CA :
---•
BUILDING OPE DICI IONS<ct:ING CARRIED ON THEREUNDER vvI Pr N 1
IN VIOLATION OF 1 kl S3 ;.:1)DE Oil OF ANY OTHER ORDINANCE OF
e./9-4fr - 1
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- PROVED
•
CAQ. Ac q/C 4..5„ 1/
‘City of osta Mesa Building Dept.
• z- •
•
litv DATE 19 .
0 THESE PLA 'JUST BE ON .':13 AT ALL TRIES MAKE
NO CHANGE ,!.. 1AF THOU] PETC:H APPROVAL OF DEPT.
• II IE ISSUAN :E Of; GRAN";":•:: CI- A Pc7;;A!IT";"2.t2PROVAL OF
PLANS ANC)St IF ilifilmb :,,,..J [CI Lyi--::..:NHz,irCED TO I3E A
-Ki i Vit.7.1,TleiT FOR. )! Al YPT,P.OVAI_cr. /,‘).,, v:.:1Li; ic'i OF ANY OF
irt ti" 10VISIC J; OF THIS(.:0">-_.I-4;1-11:LAT FTC ,1_,:t1INO TO GIVE
. AUTHORITY •Tc I 101 ATE Oci CA.:.':: L. ","---] PI;.."..A.,'CIONS OF THIS
• . CODE SHALL I E AL U EXCEP•I :N...."_,T-p. 3 T:-:E.:AORK OR USE
• • WHICH IT AUTI 0 UZI S IS LAM IAL
THE ESL '4 GE Or A :'":I-7 RC - t.'—'"I PLANS AND
SPECIFICPT1O Ic Sr'`.LI NOE -"--_t . •A. NG OFFICIAL
• FROM THERE/.:"rill -?E'CiARiNc","TT'"CA •A...,:".•.. :OF ERRORS IN
• . SAID PLANS A C) SPEC.Cr A.:..."i,1:• : .-I i'l,•; .1 PREVENTING
- 131:1LIINC CPI: R. FIC 4.-_6.7.::.:•71 4";";-, : ::d" A .!-:UNDER WHEN
rr: VAIILAT:::',A: )I It- El 4";0•. : GI":6. !,..,:'t; :-:uRDINANCE OF
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