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HomeMy WebLinkAbout2718 SANDPIPER DR - Building Permits 501 F CITY OF COSTA MESA 49 BUILDING DIVISION - y°'�• i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT �* po woo,$ P01-00705 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2718 SANDPIPER DR Status: ISSUED Suite No Applied: 12/04/2001 Issued: 12/04/2001 Vicinity: Parcel Nunmber: 13953120 ISSUED BY: Applicant: ANTHONY,PAT • V Address: 1556 S ANAHEIM BLVD ' Phone: (714)758-7725 • ANAHEIM, CA Zip: 92805 Owner: SURBER, STEVEN R Address 2718 SANDPIPER DR Phone: COSTA MESA,CA Zip: 92626 • Contractor: PACIFIC COAST COPPER REPIPE Address: 1556 S ANAHEIM BLVD Phone: (714)758-7725 ANAHEIM,CA Zip: 92805 License: 661428 Arch/ Eng • • Address: Phone: • Zip: License: SCOPE OF PERMIT . REPIPE WITH COPPER PIPING. FEE SUMMARY AMT QTY AMT ' QTY AMT QTY ISSUE FEE $23.50' Laundry Tub/Washer $0.00 0' Sump Pump $0.00 0 Backflow irrigation $0.00 . 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 ' 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub S0.00 0 . . Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 ' Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $9.80 1 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $33.30 COMMENTS I SPECIAL CONDITIONS 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: Thispermit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned fora 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 244646(8100) DECLARATIONS WORKERS'COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: O 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 maim; work,rs'compensa'•••'.surance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'con:: -alien nsurance car er and policy r mbar are: ;j76 /TJ J� Cara ..— Se `e/ of Policy Number: yG/ 7—O/ (This section nee. o•be completed if the permit is valued•t one hundred dollars 100)or less.) O I certify that In the performance of the ,ark for which th' •ermit is i shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, Appl _• .•ree the it I ••uld become t to t - orkers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith cam. •.se provisions. . _ _ _ -/ y :: .i s�/ �te: WAR • :FAILURE TO SECURE W-• ERS COMPENSATION •COVERAGE IS UN '• • D SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DdlARE(5100,000),IN ADOrnoN TO THE COST OF COMPENSATION..AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CON ORS DECLARATION: I hereb • irm that I :.. icensed un.-r pr• 's.n�•1 apt: 9(corn..: wi ' tion 7000)of Division 3 of the Business and Pr•y.sion :,and my license is In full f.- is and effe•. c.ft 1 — — as- , • Contractors •ignature .I BWARr /r -Date: — a 4 -- � 1 CONSTRUCTION LENDING AGEN . O 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). Lenders Name: Lenders 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 subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole 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 driver's license. ❑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,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). O 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: I Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 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? 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,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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? Yes LJ 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 0 No __ B (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I cattily that under penalty of perjury the information given above is correct.I agree to comply with ail 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 end state that the information given is correct.I agree to comply with all state laws and city ordinances relating to buiidin• •nstruction,and authorize representatives of the Cityof Costa Mesa to enter upon the above-described property for inspection p Moses.I agree not to occ ancy of any building authorized by this permit until final inspection. Si. : xf :.:iner(s / / Sitir at07 e :.. a, c Date r. t CODE I INSPECTIONTYPE ME am. CODE! INSPECTION TYPE USE m. : 1616 Fixed System Final Fire Prevention 206 Final Mechanical /� A 1266 Pool Spa Final 208 Final Plumbing -. /tiff ( I, 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 I4- OJECT ADDRESS: 2718 SANDPIPER DR UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 05753( l. i `tWNER'S NAME: SURBER, STEVEN R � --ADDRESS: SURBER CYNTEIA L PERMIT NO: B 057530 PLAN CHECK NO: 00571 -92 S GOVT: N SUPP: N 2718 SAND?' P R DR COSTA MESA,CA 92626 CONSTRUC"ION TYPE: PERMIT TYPE: STR PURPOSE: OTH 241 -91131 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION , INSTALL DORMER IN 2ND STORY BEDROOM SQ FT: 1 , 600 ADDRESS: UNIT: CLAIM VALUE: 1 , 600. 00 CALC—VALUE: 1 , 600 . 00 GROUP OCC: R-3 / PERMITTEE: STEVE SURBFR ( 714 ) 241 -9431 ADDRESS: 2718 SANDPIPER DR COMMENTS: X CN CA 92626 ******#**************##************************************xE##***********r.►m**# LICENSED CONTRACTOR DECLARATION: I hereby aflirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 0l the Business and Protessions Code.and my license Is In full force and effect. SETBACKS CITY LIC.: STATE UC.: CLASS: Dale: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate ofconsent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: F'' IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT; :T IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ:_ PROV: PARCEL : 13953120 ZNE: R1 REF NO: ' . O Certified copy is hereby famished. ❑ Certified .. • is •.with the city Building Division. PLANNING NOTES> INTERIOR ALTERATION TO ADD A PONY WALL TO AN EX. STORAGE > AREA AND ADD A DORMER WINDOW. Date: Applicant: � *#***#***##*****#***'*#**##*#*)f#**#**###*#*********#*#***#Y-***?E##!##*-.:*****X**** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: completed if the penial Ls for one hundred MOO)or less). D E V E..L. O P M E N 1 SERVICES REQUIREMENTS I certify Mat in the performance of the work for which this permit 6 .•.:5 ' employ any person in arty manner so as to become • subject to the Workers'Compan tion Laws of California. \ ZONING APPROVED BY • DATE: • Date: 5 - '. Signature: BUILDING APPROVED BY DATE: thisNOTICE:If,after making this declaration,you should becomes tient . e' Li�, •rs'Compensation provisions of the Labor Code.you must forthwith comply with such provisions or permit shag be Ry med revoked. ', iL�=�7� T ^ DATE- OS--Z. Z CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lens • agency for the performance of the work for APPLICATION ISSUED .B Y: which this permit is issued(Section 3097.Civ.C). ***#**#*******34'*** ** ' ***4r*ih***** +F***#**:1F#**********#3h*******#-* fxu## LENDER: ************irk********************9e* ' #**********#*#********+:#**M** *#****xY** ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT; Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING EL :C.TR'IC MECHANIC FIRE SMIP/RFS/ GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 3 7 . 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 • �I SMIP/NON—R ES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)01 Division 3 of the Business PLAN 24 , 05 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant for a permit Subjects the applicant to a civil penalty of not more than live hundred dollars(3500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'Stale License Law TOTALS——--> 37. 50 0, 00 24 , 05 61 . 5 5 61 . 55 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.II,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 37. 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 el sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING" PLAN—CHECK I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 70Business 37 . 00 5 0 ❑ 4E 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 projects with acontractor(s)licensepurs . o the Contractors State License Law).l am aware ******IE**ff)E**********##***************##****#***********************#****fy?f>u 3F* that proof of their Worker's Compensation insurance should be pr. e. INDIVIDUAL F E E BREAKDOWN © I am exempt under Section: 0P7044 B.&P.C. r , tor this reason: ALL WORK BY UWNER \ TYPE QTY D E S C R I P T I O N UNIT COST -TOTAL COST __ Date: p,? 91 Owner: x � ` `NA SFR 1600 ALTER BY VALUE RES�.r'NDENTIAL NOZONE 1 , 00 1 , 600 . 00 I do hereby certify that I am aware of and understand the requirements of Coliforms Health. d At y Code Sections 25505.25533•and END OF FEES 25534 and that I or any future bribing occupant will/will not(circle one)need to comply with said 9e codes and the requirements for a AirDuality lot construction or modification from the Duality Management District.Residential constr lion applications are exempt from mese provisions. ', Date: APMicant: I hereby certity that I have read this application and slate that ' formation is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and here a e representatives of Ns city to enter upon the above-mentioned - properly for inspectiionnn,1purposes. •- - ------1 Dale: S—• - L Signature: - J Driver's License or Social Security a: 1641-46 White—Buibino:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor 4lifilCONSTRUCTION AND PLANNING POO, SPA �.�PPROVALS 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe,❑ Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing /;/ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing //� 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:KA or r' 4/4) //ay jc 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 76-61L eg,/61 e. - 6 48. FINAL PLANNING Lam[ 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _PROJECT ADDRESS: 2718 SANDPIPER DR UNIT: CITY OF COSTA MESA - BUILDING PERM? T PERM NO: B 057531 OWFER'S NAME: SURBER, S•:EVEN R ADDRESS: SURBER CYNTHIA L PERMIT NO: B 057531 PLAN CHECK NO: N GOVT: N SUPP: N 2718 SANDPiPE_R DR COSTA MESA, CA 92626 CONSTRUCT ::ON TYPE: PERMIT TYPE: STR PURPOSE: ALT 241-9431 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/ OFF RESHT RFROOF 4/ COMP SQ FT: 3, 900 ADDRESS: UNIT: CLAIM VALUE: 3, 900 . 00 CALC-VA',UE: 3, 900 ,00 GROUP OCC: R-3 / PERMITTEE: STEVE SURBER ( 714 ) 241-9431 ADDRESS: 2718 SANDPIPER DR COMMENTS: REF 857530 CM CA 92626 4(>ESE**** ¢at.*x*.x*******>E#********af>txaE*>E>t**1E*>t*****#yr******#***;x>f***> **>* K******tin LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON T NG R F Q U I R EMENTS 7000)of Division 3 of Me Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE UC.: CLASS: Date: signature: MAIN BUILDING --- ----- ACCESSORY BUILDING - WORKERS'COMPENSATION DECLARATION: t herebyaffirm that I have a certificate of consent to self-insure or a cenificate of Workers' FRN'f: FT IN REAR ; FT IN FRN'P; FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ- PROV: PARCEL: 13953120 ZNE: REF NO: Cl Certified copy is hereby furnished. ❑ Certified co• is ed with the city Building Division. PLANNING NOTES> > Date: Applicant: *)E***********************:***.1F##-1e31'±r•********5£#i('!F#Ili'Y1b#3e**aEat#!E*i;Je****i(-3E.Y,fr#i*)06*1Ele M' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This‘. \111. m (t be mdeted if the paint Ola one hundred 15100)or less). DEVELOPMENT SERVICES REQUIR EN E N_r•" S I certify ct toot ine the performance m ns twork for which this permit a. n`employ any person in any manner w as to became Date. to the workers'Com pensation Laws of CaSignature: ZONING APPROVED BY DATE Date: 1 1 Signature: --- NOTICE:II.after making this declaration,you should become wbje• too.a 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 B Y: — - DATE• o-5-2-01 an— whichthis permit is issued(Section 3097,Civ.C). *********************'' - •',... .. r..-it )f**************if***�`*it**Ttk 3838 LENDER: ************************************Y*******************************104*****SU-*# ADDRESS: LEGALIZA T ION;N FEE SUMMARY STRUCTURAL SEGMENT;Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING EL F(TR i C MECHANIC FIRE SM I P/RES r GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 63 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed ]N J pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM.I P/NON^R ESS and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE / I. as owner of the property or my employees with wages as their sole compensation, will d0 the work, and the BUILDING-DIV- > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 63 . 50 0 . 00 0 , 00 63. 50 63 . 50 .- . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ,. his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or REVENUE DIVISION TOTALS--> COLLECTED:_ 63 . 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 or the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN-CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63 . 0 0 . 5 0 , ❑ and Professions Code: The Contractors'State License Law does .1 a+, loan owner of properly who builds or improves thereon and who contractsfor such projects with acontractor(s)license l nt tot f f tractors'Slate License Law).l am aware ***he****If*#*************************+i**********if**********#****-****if*i#***Sc*Y*** that proof of their Worker's Compensation insurance should be pr. to me.\ INDIVIDUAL F E E BREAKDOWN © I am exempt under Section: 8P7044 B.6 P.C. v for this reason: ALL WORK BY OWNER TYPE QTY DESCRIPTIO N UNIT COST ' TOTAL COST Date: n Owner: Nk `` SFR 3900 REROOF BY VALUE REIEINOZONE 1 , 00 r 3, 900, 00 1 do hereby certify that I am aware of and understand the requirements of CaliforniaH:. h C? • `. Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/wig not(drde one)need to comply with 7.57 e code .nd the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction app ications are exempt from ft. these provisions. • Dale: Applicant- .,,_ , \ I hereby certify that I have read this application and state Iia ' hove infor . ion •rect.I agree to comply with all city and county ordinances and state laws relating to balding construction and he.•., IMfi:e rept.:nk' ..of this city to enter upon the above-mentioned '•/' property for inspection purposes. Date: Signature: _ — _ Driver's License or Social Security 0: D.57: L'' _. '' ...ms, 1641-46 White—Building:Green—Cade Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor ICONSTRUCTION AND PLANNING POOL SPA APPROVALS Permit# Date Inspector •APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ^ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑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 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy ■. 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41, Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING G.- GW4L 5 Ae . e / ® - ‘&-401- 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date JOB ADDRESS£(18 sandpiper Dr. r BUILDING PERMIT NO. 26944 GENERAL CONTRACTOR Mesa verde blurs. , Inc. DESCRIPTION OF WORK Res.w,f t.Gar. AP No. LOT 6T TRACT 6237 FIRE ZONE VALUE $ 15,305.00 INSPECTI9NS/, Signature Date GROUP I & ,TTYPE V ZONE Rl Soil tt_t-, q4- - 7 SUBCONTRACTORI PERMITS ISSUED Gas Date I Number I Signature Water Plumbing Rough Plumbing e`r n elZI�0`r � _„ -2. .. J .f� (8 : Prop. Swr. Line 'fouse Con.''1 `fAre-J�CSf seer lfj,/ S Sprinkling System Miscellaneous Rough Heating and Air Conditioning E.+� ` 7-/9-‘ Temporary Service or Pole Underground 0 Power 0 Rough Wiring .Z/ �r7 eating a�gJdjd Ve t. � Q 1 Trenches fl Forms p Steel Reinf. al t o r_q_‘7 " • ilif.ePI �� Floor System ,cad- f-,e-67 Bond Beam 0 Steel Reinforce 0 Sheathing r 7-6-67 Frame and Flashing m{,L P7--,2b-Al Lathing—In p Out ® Of 4_7-_41 Plaster, Brown Coat £M-' g„at-GZ Structural, Final A , I a„ec Heating, Vent., Refrig. and A.C., i al ,plow ��E // VTreellla iVAIM f'!7 Plumbing, Final and Gas Test 71 V fl "Si' Electric, Final I it /10-../^/ Building, Final %1f /m'-3,-`7 2G944 PAID APR 25-67--001275* ***158.25 CHSA -COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 317 COSTA MESA,CALIFORNIA \ / For Applicant to Fill In Completely APPLICATION FOR PERMIT Lot 67 TYPE OR PRINT Tract 6237 BUG For Office Use Only BUILDING ^/ 7/g ADDRESS .2//� i/h Cs RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA �'// l�-7f�/ //,% ?/{']R'/04/4 R[C /V' Dl R�YV 4 ! / / 4 Mesa Verde Builders Inc. OWNER Ninnt8Xtkatil nnilinaMEX o BUILDING MAIL ADDRESS 2850 Mesa Verde Drive ADDRESS �// //Iq/ TEL `549 ZONE TYPE • GROUP L / CITY Costa Mesa NO. • 5 APPROVED ARCHITECT OR ENGINEER Kaltenbach OR 8046 BY DATE AL as 823 E$ 17 h St. Santa An. ZONING cl Z-y( NO.01102., USE OF NEW Go —Mesa Verne ul ers ) Inc . / PLANB BUILDI QL Ir ice/ cv CONTRACTOR .XSS]5X7 , // / 71- /�/) / `(/� LEGAL //.z'!'; / - /7(. (�/J-37 ADDRESS 2850 Mesa Verde Drive DESCRIPTION _t Costa Mesa A.P.NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STLIC..NO. 187318 ATE NO' 549-0395 90'TOSIDEe REAR P.L. EAVES SIZE 3 X /0,s OF LOT NO.OFBLOGB. 0 NOW ON LOT ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREET) SETBACK LINE FROM FRONT 50.2.-FT. FT. CENTER OF STREET REAR YARD 4 SIDE YARD I LEFT I RIGHT R.SIDE FT. FT. DESCRIPTION OF WORK L.SIDE 7` FT. Fr. NEW X ALTERATION _ ADDITION REAR ,-y FT. V FT. DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS.BLDGS. REI...r( MOVING DEMOLISH VAR.# DATE BUILDING NO.OF SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALy, I ROOF Shake APPROVE9 T�/ ��/ YYY COVERING JtuCCO COVERING Sh ' n• BY l i DATE /// p9/ USE OF BUILDING AND WORK TO BE PERFORMED / New Residence lO 3 d- g 7/ BQ.FT. V)C • I HEREBY ACKNO EDGE THAT 1 VE READ THIS APPLICATION THE AMOUNT SHO UNDER VALUATION IS FOR THE 1', AND STATE THAT THE ABOVE IS ORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. D PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION BUILDING CONSTRUCTION. PERMIT FEE $ /D��Sl' SIGNATURE OF I '�/�/ W c'7 m PERMITTEE $ ^3s3 PO PLAN CHECK $ 3;2,7 i7 O AUTHORIZED AGENT ` TOTAL FEE S /J�"�r/a OWNER STEP' SANDEEN DATE 5/14/80 JOB ADDRESS 2718 Sandpiper Drive BUILDING PERMIT NO. 50103 GENERAL CONTRACTORCal Style Builders DESCRIPTION of WORK Solar heating System AP No.139-531-20 LOT TRACT FIRE ZONE VALUE $ 500. INSPECTIONS Signature Date TYPE GROUP ZONE SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing r r yf 1 ROUGH PLUMBING �/feCMN�� ge f VJ y1&o 710742 PROP. SWR. LINE ED HOUSE CON. U SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRINGrHeating and Vent. TRENCHES u FORMS fl STEEL REINF. fl FLOOR SYSTEM • BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT in PLASTER, BROWN COAT • STRUCTURAL. FINAL _ _ Elertric HEATING. VENT.. REFRIG. AND A.C.. FINAL E X P I R_F t] PLUMBING. FINAL AND GAS TEST n (DfS, ELECTRIC. FINAL inwnlplete Inspect Cancel BUILDING, FINAL 6859 5/IlIHI7 5a51; Ii.. COSTA MESA BUILDING-SAFETY DEPARTMENT APPLI TION FOR STRUCTURAL PERMIT .clr P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECE Ets0.3 C ' For Applicant to Fill in Completely —Use Ink Only .l/J' ! 1 J��� BUILDING A.P.NO. r /39 — 53/ - a o ADDRESS a7 1$ ,npi ,Q /34 a OWNER OR. /y�� r` ADIDRESS 7 9 TENANT C'c\A,' 2t, atA p.CJ)() CJ MAILING - r �`l�' UNIT OR ADDRESS3 ` i.,3 6/s^ f�oeA oic), TR.NO.SPACE LOT IBLK. rTE L. CITYCm�`n I Ipf74 /Y,7 NO. NEW ADD ALTER REPAIR MOVINGI DEMOLISH CONSTRUCTION / LENDER BRANCH _ ,y OWNERS �� //( 1/ ; ADDRESS / ARCHITECT TEL. US .4 r / �iza tVALUE E Q OR ENGINEER NO. ADDRESS i /��+���\ ZONE TYPE GROUP CONTRALTOFf f) ,a i /-7 CPgrin'f APBYPROV ED DATE ADDRESS&n t E . RR"Qa _ c. /41_00 ` D` TEL. CITX.6-�p^1#L1 An\p No.97) i • EH STATE l,v I—T ill CITY / APPROVED SETBACKS LIC.NO. 6-7a,(/,,,(., LIC. NO.iyi SIZE NO.OF BLOCS. (FROM VI_ - O. OF LOT NOW ON LOT FRONT FT. _ Q USE OF N. EXISTING BLDG. R.SIDE FT. rn 2 Separate permits are required for L,SIDE FT. Q electric,plumbing and heating work. REAR FT. F., USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q A DATE APPROVED ✓ APPROVED >. iB_Y DATE CC W I hereby acknowledge that I have read this application and state n 0 isd that the above information is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of 2 , the State of California. N FT. I hereby certify that I am properly licensed as a contractor under SQ. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOBE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business $ VALUATION PERMIT FEE $ and Professions Code, Division 3,Chapter 9. .5:.Q in Signature of ,,\\^.. ll //''y1.,� PLAN CHECK S Permittee�.�LC J '.11 )�a $ ` TAX E or Authorized Agent Date TOTAL PAID S /10