HomeMy WebLinkAbout1612 SANDALWOOD ST - Building Permits PR ADDRESS: UNIT:
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ERS NAME:
ADDRESS: 1612 SANDALWOOD ST CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 063587
HHUGHES, STEVEN S'
UGHESANESTELLLLELWOOD ST '—PERMIT NO: B 063587PLAN CHECK NO: N GOVT: N SUPP: N
1612COSTA MESA,CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: 556-0172 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : T/OFF RESHT. REROOF W/COMP SQ FT: 3,700
PERMITTEE: CLAIM VALUE: 3, 700. 00 CALC-VALUE: 3, 700.00 GROUP OCC: R-3 /
ADDRESS: CHAMPION ROOFING ( 213) 259-0451
3257 VERDUGO COMMENTS: SMOKE DETECTOR REQ********4**********************************************************************UIRED PRIOR TO FINAL
�
CA 90q65 **********************************4**********************************************************************LICENSED CONTRACToDE TUITION: I hereby affirm that I am licensed under provisions of hapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS
CITY
LIC.: STATE LIC.: CLASS:
042725 429481 C-39
mtd be -?o-47 Signature: e V Es MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POucYNo.: PW226892 EXP.DATE: 05/01/94
COMPANY: GOLDENEAGLE PARKING REQ• PROV: PARCEL: 13921210 ZNE: REF NO;
❑ Certifiediecopy is hereby furnished. ''int( Certified copy is tiled with the city Building Division. PLANNING NOTES>
,.....„----CES" ' -cS) 9") Applicant: `NM l-PJ^i ********************************************************************.**'*********
EXEMPTION FROM WORKERS'COMPENSATION OECLARATION: (This sectnn need not be completed if the wail is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N:.T S
I certify that in the performance of the workUofl't Srthis permit is issued.I shall not employ any person in any manner so as to become '
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY :
DATE;
Date: Signature: _
NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : .' DATE: :.
Code.you must forthwith comply with such provisions or this permit shah 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: DATE• V Z0 -f
which this permit is issued(Section 3097.Cu.C). ************************ * *,4, ** ********************************** **
LENDER: **************************************** *************************************
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 fotowing 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
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 63. 00 . 50
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES
and Profession Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation, win do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors State License Law TOTALS----> 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,If.however the building or
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION 'TOTALS--> COLLECTED• 63. 50 OVER/SHORT: 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63. 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).I am aware *******************************************************************************
Mat proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date. Owner: SFR 3700 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3 700 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and r
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify That I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
i pro eenty for inspection purposes. -7��
�D,tel �- 2-r�— 9`h Signature: w (9 -r Cal 01 00145367-00145368 TOT 63.50
DATE: 08/20/93 TINE: 11:56
Driver's License or Social Security 4:
1641-45 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
F---r'CONSTRUCTIONAND PLANNING POOL & SPA
�PPROVALS Permit Date Inspector APPROVALS Permit#
Date Inspector
1. Temporary Electrical Servitor Palette. 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 1 53. Steel Reinforcement
:]
M
: Elec41619 ConduE.W lits-Oridrgrnd, S 54. Forms
c4:;Mectrycal Condurt•.Undrgrnd. v n 55. Electrical Bonding
'3. St`g,ilA14,�nforceicien4 ny 56. Rough Plumbing & Pressure Test
`• t
�itical UFER-GLnd. a 57. APPROVAL TO COVER-GUNITE
-c7.1___-- n -- Cr} o
, Fo[{ings fir^ a 58. Electrical Conduit•Undrgrnd. -
*2:: ? Wnda[uon „ `• 59. Gas Pipe, 0 Undrgrnd., Test
_:te.
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
P' -.
i0. Structural Floor System •-.) 61. APPROVAL TO DECK
11. Property Sewer Ling& HoyseConnGtion 62. Backwash & Receptor-Final
yr
12. Sew'Cap a. y c. 63. Heater & Vent-Final
13. Roof Drains o u
64. Plumbing System - Final
14. Rough PlumbinK ' 65. Electrical-Final
15. Rough electricatConduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
c
17. Rough Wiring Sin 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
[9 .- fl t9- .- : SO * - -C., a `7 tr' tT H W t-• co. * F al
20. Tough FBLtorp Fioplace I rr, <'1 * O 3 et.•: • PPPROVALS'u•Deerrtt+t# * rr
.� r to d s#: I SM 4� x S r. a* A '2CJI-•c. 7 E r tK
'K l •t-' X S * H t -i
21. 8uc irt_Strtrur. i* r .. .. H$ s ,' O I-•r .4 _0. Updergralaitydlo
J frJ D r
22. auctst Voatilating-Y OS ._, S �t'< > 571. Product Ffilntp 3t4 DOil
t .s n rK . .r ,s•rl
23. 'tilas Pef ou-21t& st aF�cs xM a c. Dit2. Under9 rcjiiFIuFl
'o -. '
I r, in ua t= t•' 0#1 s .. tr .aa 4 C 1-,A ' 1,-) o-
v
24. b1ookFrt ,ng.• f*
FF -Er; t> O r Hz * 3..3.41ndergrndsI toragdTaI CilGas OOiP
Cl*
25. RootShegthing 7;r S $'2 r3J G;e i4.�.vvrhead FYydro SiF•J c'
1 •J' * a •! 1 ...J. )M1 W' �J
26. �,-T. (Stro,Jiiural) & gonocoat r to C to* * 75-�rp Chemical > H •• Q
- r
27. Qrame and Flashirig^ # it ' • 76.FDR Stand O?' ''
{{5�,,,, t t {Il 17-1, (2:
,rte t . 44*
.•-. a
Itp. cathing 1,Sitlirtgt..'* [� '-c: 0 * S .. .. ••A # 77.IiFIXEDS -.--, •-,,-, AL., Li
n M
•29. Insulati R 0 .s:•^ 0 r: " " > v •r, a # m
d • g S .a ,K 78. IRE PREY. FINAI .kt F It > X y
r20. Drywall (+tailing Mr 1' x r H HEALTH AEPT4 EQUIREMENT
X21. Plaster BB3wrtLCot>t` 1 * a �9.SINAL INf'&CTI A Cl -y
it, ' 1 IT .>J. t. * r 7
r 2. tE•lectrical Povvyr fAcerryinal i x ra 1, x rS0. t9,OOD CER IFIQryr'fiE ISSU 'D
3 .4 r. '.J :u I n ,-.1
.. 1,
,33. fin�Ele tricL n,1 .-1 : tr a VI x : r5ilotR: y ,72*t a 7 •, CU e
t- t• - C LHH 1: t1 r .� r1, FAL r x I-CS
,44. rFinak.'He�jing- t At o ditior1I s n , x x :i. 0= x s oz'
35. FIinalGa6Pipe.Tesg4' it •i t K a n 0 n * t
SJ 7 .. * a •. e I-' R * :co ri < ;sir
x v . ' `36. 'fioog,Or" anopy Qs OC ,r -J rn « S S o �
'
•37. inaFFadforyFirePracel
stt' *Jl K ' z F1 ? ;
.i,. Z - u' .. . r ,_
8. Finattflumbing ¢< n1 .* x * s a I s
t- `Jr « -rr - _-
de.
[39. WaterService-Final -c I o * < s n torn a G
x r I * - >, Li X
r90. Gas Service-Taal " �� S II " 'ro " 'I
r ti- r, p Ou .:CJ
iM. Solar Domestic-Finai: s 0 •• * -3 4j IJ+ x
�, _
r .
F 2. Backflow Preventers r -3 ' I K .# x >e. . x.a t7 H
k
to r. to L)n _ A CI CA`s V
43. Backflow Irrigation* SSS * A ;ixaz(--o �. O r `i
•
544. Landscape IrEipatioi System,31 :Ti
z * , O Or A S :v pt 't.i:1 _ -
- 11 a .JS.. -. < C C ' ID : ... -, OTs - -
:45. ISound Attertilationx �rci- i*' *t c- t- K t n •^ -+ :J"u Z...%
> r IL, Ti TIC a' cr et • t-•:J
.6. fHandicap,ReClatiotTsai
S x *, •' •• ••* # i i ^ u ••-
�F 0 a S. R. •.l D.7 s
47. FINAL STRUCTURE & BUJ''DING ( 1 �. :..o's
Fr
-- = V/� x e t T •e -
48. eINq•"L PLANNING* , ,:,t, pt ;; 7. U.
t49. %legit F3elease to Edison I A _ r Y - K
* k . r •f
5o. pas Release to Souttjern Californi,,,Gas Co e I ,, z s - " C -
i51. CERTIFICATE OF tCCUPA C'Y' r _ n r "
N r K i } 1,, ,ate ?: +. t' o
No. Date
-7.71.111111111
PROJECT ADDRESS: 1612 SANDALWOOD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069824
OWNER'S NAME: HUGHES, STEVEN S
ADDREss: HUGHES ESTELLE S PERMIT NO: B 069824 PLAN CHECK NO: 04421-94 L GOVT: N SUPP; N
1612 SANDALWOOD ST
COSTA MESA,CA 92626 CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ADD
( 714 ) 556-7165
ARCH/ENGINEER: DOYLE C . FORTH REG.NO.: NObin JOB DESCRIPTION ; ADD MASTER BED& BATH ROOM & LAUNDRY RM SQ FT: 400
ADDRESS: 1075 REDDING AV
COSTA MESA CA 92626 CLAIM VALUE: CALC—VALUE; 29, 600 . 00 GROUP OCC : R-3 /M-1
PERMITTEE: FORTH, DOYLE C AND COMPAN ( 714 ) 556-7165
ADDRESS: 1075 REDDING AV COMMENTS : TOTAL 400SF BEING ADDED WITH THIS PERMIT
COSTA MESA CA 92626 *********9k*+F*ak9r**9r************+FBF*******»9r+F****9E*TE**a9E*9E9F -**Tks******4.**;r-*aF"E** Fal
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I.am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q. U I R E M E N T S
7000)of Division 3 of the Business end Professions Code.and my license is in full force a d effect. SETBACKS
CITYLIC.: 3 511 STATE LIC.: 4543 0 6 us. B EXP : 05/95
�rr ja-4 Signature:�.v MAIN BUILDING ACCESSORY BUILDING
'ORKERS'COMPENSATION DECLARATION: I hereby affirat have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; 10 FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Sec �3800.Lab,C). LEFT; 39 FT 6 IN RGHT; 5 FT IN LEFT; FT IN RGHT; FT IN
POLIcr ND.: 0 7 8 3 2 5 3—9 4 EAP.DATE: 1 0/0 1 /9 5
mem: STATE FUND PARKING REQ• PROV:. PARCEL ; 13921210 ZNE; R1 REF NO;
❑ Certified copy
ii�shereby furnished. � Cemfiedcopy isfileeddwi; e cit (ding iwsion. PLANNING NOTES>.•MASTER BEDROOM AND LAUNDRY ROOM ADDITION IN REAR OF HOUSE.
/7�-9 /' '��l *******************************************************************************
Dat Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: e,is section need not be Completed if the permit is to one hundred(5110)a less). D E V E L O P M E N- T . SERVICES REQUIREMENTS
1 certify that in the performance of the work far which this p•/it is issued.I shall not employ any person in any manner so as to become1: Q/'
subject to the Workers'Compensation Laws of Californi.' ' ZONING APPROVED BY l'S I ( T
DATE:
Date: Signature: G
NOTICE:If.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED B . DATE: it 1 ( g_
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. O�
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: t9� DATE: G//1 D /f
which this permit is issued(Section 3097.Civ.C). • {p**** ***
LENDER: ************************************* *** ************************if(**********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from theContractors'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 284 . 50 2 . 96
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 184 . 93
any applicant tot a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S————> 287 . 46 0 , 00 184 . 93 472 . 39 472 . 39 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building orimprovement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE L7 —
_ OD2 OVER/SHORT;
torthepurposeofsale) BLDGPMT PLUMBING ELECTRICMECHANICFIRESMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 284 . 50 2 . 96 184 . 93
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware .w*..y.*****.*.****iF.fey.*******.rsit.*********.N.ia*.******ie*iE****io.p.****{r.*.N.******.1EM..lf.af**.**.ir.****.*.
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F, E E BREAKDOWN
O I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTION "-, UNIT COST TOTAL COST
•
Dale: OwnerSFR 400 DWE—TYPE V—WOOD FRAME —GOOD 74 . 00 29, 600 . 00
I do hereby certily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
2e534 and that or any mo building occupant irlOvl not one)need to R slid with saidstate i codes and therequirementsfor a I
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions,
Date: Applicant: •
I hereby certify that I have read this application and state that the above in orelation is correct.I agree to Comply with all city and county •
ordinances and state laws relating to building construction and hereby au e• ize repiese +lives this city to enter upon the above-mentioned 01 00171460-00171402 T 0 T 477.39
39
property for
in)peclion purposes. - /. DATE` 11/139/94 TINE: 16:13
Date' // #42), Signature: e."
Driver's License or Social Security
164146 White—Building:Green—Code Enforce•enr Canary—Applicant;Pink—Revenue:Goldenrod—Assessor
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 Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 0.47._74E C 6e_,j/ 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. l7t i7 Ukivi 57. APPROVAL TO COVER-GUNITE
7. Footings //J/7_qq �' ��//li 58. Electrical Conduit-Undrgrnd.
8. Foundation 3/a L 4l is Y ccih 59. Gas Pipe, 0 Undrgrnd.,Test
1 v G�17-y�
9. Water Pipe-Undrgrnd. /, 60. Backwash Lines,P-Trap,O Undrgrnd. _
10. Structural Floor System / • 61. APPROVAL TO DECK
: •
11. Property Sewer Line & House,Connectiop' - 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 7 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 //_21_'7g44.41-- 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing `2 7._clC{ vez___76. Dry Standpipe
28. Lathing & Siding `k..(_q(( t'c 77. FIXED SYSTEM FINAL
29. Insulation Ill -.g_q!!(�-E(�v' 78. FIRE PREV. FINAL
30. Drywall Nailing /LI-on-6cid/ HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ej."‘„,ciki GGv� 79. FINAL INSPECTION
32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning / 5 c.-4 114 era__ /Z_Z��ri -�
35. Final Gas Pipe-Test 9 e_ s.. 1-e ... Y
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 2,!-l:
48. FINAL PLANNING
49. •Electric Release to Edison .
50. Gas Release to Southern California Gas Co • - -
51. CERTIFICATE OF OCCUPANCY
No. Date
City of Costa Mesa
California 92628-1200 P.O.Box 1200
Insulation Certificate y/ 7{-G/
,/ Permit Number 3693/v!
//r�i Stvi ro �J% , f7i'� /�/ t-A_ :.
Number and Street City
i� ,9, /39 z/z /0
County Subdivision Lot Number
Description of Installation
ROOF 2 ��s
Material �iY Brand Name �'/
Thickness (inches) S" 30 Thermal Resistance (R-Value) .e— 3a
EXTERIOR WALL
Material T7 Brand Name
Thickness (inches) `0' Thermal Resistance (R-Value) -/3
CEILING
Batt or Blanket Type Brand Name
Thickness (inches) Thermal Resistance (R-Value)
Loose Fill Type Brand Name
Contractor's minimum installed weight/ft2 lb. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
RAISED FLOOR
Material Brand Name
Thickness (inches) Thermal Resistance (R-Value)
SLAB FLOOR
Material Brand Name
Thickness (inches) Thermal Resistance (R-Value)
Width (inches)
•
FOUNDATION WALL
•
•
Material Brand Name
Thickness (inches) Thermal Resistance (R-Value)
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
California Adminstrative Code.
cC. L7,e{ 5'Co l3 4-130‘,
eneral C tract r(Builder) License Number
/2- 20-937
Signaturereand Title Date
a.-
Sub-Contractor(Insulation Installer) License Number
Signature and Title Date
•
1907-46
( SC
PROJECT ADDRESS: 1612 SANDALWOOD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M - 069826
OWNER'S NAME: HUGHES, STEVEN S
ADDRESS: HUGHES ESTELLE S PERMIT NO: M 069826 PLAN CHECK NO; N GOVT : N SUPP : N
1612 SANDALWOOD ST
COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH
( 714 ) 556-7165
ARCH/ENGINEER: REG.NO.:
ADDRESS: DOYLE Cr FORTH NOM. JOB DESCRIPTION : ADD MASTER BED& BATH ROOM & LAUNDRY RM SQ FT:
1075 REDDING AV
COSTA MESA CA 92626 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
PERMITTEE: FORTH, DOYLE C AND COMPAN ( 714 ) 556-7165
ADDRESS: 1075 REDDING AV COMMENTS : RE: 869824
COSTA MESA CA 92626 ***yE**+E*+r•Tr•**************+E+e****+r**** FTE***********************gr-*****+rxar-*+r -*+E****+e
LICENSED CONTRACTOR DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my licens - in full rce and effect. SETBACK S
CITY LIC.: 511)551.1,51 STATE LIC.: 454306 uss: EXP: 05/95
Date' /_ 9r' Signature: 4._ MAIN BUILDING ACCESSORY BUILDING
MFRS'COMPENSATION DECLARATION: I hereby affirm II have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT • FT IN REAR• FT IN
Compensation Insurance.or a certified copy thereof(Sects 00,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICYNO.: 0783253-94 XP.DATE: 10/01 /95
COMPANY: STATE FUND PARKING REQ• PROV: PARCEL : 13921210 ZNE: REF NO:
❑ Certified copy is hereby furnished. EX Certified copy is filed wit a ing vision. PLANNING NOTES> .
CD dorl95/ s � >
Dale' Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (T section need not be completed if the permit is for one hundred($1W)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the performance of the work for which this pe is issued.I shall not employ any person in any manner so as to become •
subject to the Workers'Compensation Laws of California. -ZONING APPROVED BY
DATE:
Date: Signature:
nof theLabor -BUILDING APPROVED BY •
NOTICE:If,after making this v.ation.you should become subject to the Workers'Compensation provisions DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. - -
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for "—APPLICATION ISSUED BY: ' / DATE:
which this permit is issued(Section 3097.Civ.C). ***********************• --T- VI * *•S�ILL? * • ******************* * **
LENDER: ******************************** *** ***^!• *************************************
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Stale 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 14 ,00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed -
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15 . 00
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'State License Law TOTALS————> 14 , 00 15 , 00 0 . 00 29 , 00 29 . 00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or
to thepurpose improvement
isae) BLDGPMTPLUMBING ELECTRICMECHANICFIRESMIP/TOT
l within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE
�7 O —
_ OD29 , 00
OVER/SHORT:GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 29 . 00
❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *****************************************************************************.**
that proof of their Worker's Compensation insurance should be provided to me. IND I V I D U A L . F EE BREAKDOWN
❑ I am exempt under Section: 8.Si P.C.
mrthis reason: TYPE QTY DESCRIPTION - UNIT COST TOTAL COST
Date. Owner. MEC 1 GAS PIPING SYS 1 — 4 "OUTLETS 3 . 00 3 . 00
I do hereby certify that I am aware of and understand the requirements of Calitornia Health and Safety Code Sections 25505,25533,and MEC 1 INST HOOD W/DUCTS FED' BY MEC EXHAUST 6 , 50 6 . 50
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 9 , 5 0
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. END' OF FEES
I her Applicant:
I hereby es ifd thatatlaws
lttl to
ingtlon and state that the above Irf/ ion is I en of I is agree to comply all city and county /
ordinances and state laws relating to building construction and hereby out �eprese ryes of his city to enter upon the above-mentioned
property for inspection purposes. ,
c /t-6—fp ' Signature: / O..y_ 01 00171395-00171399 TOT 29.00
Driver's License or Social Security x:
Applicant;Pink—Revenue;Goldenrod—Assessor
•
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-Uridrgrnd. 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, O Undrgrnd.
10, Structural Floor System- 61. APPROVAL TO DECK
11. Property Sewer Line & Hotise Connection 62. Backwash& Receptor-Final %•.
12. Sewer Cap /�, 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 55. 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 r22 V� 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 !t. 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: !7 ,,..,.7
34. Final Heating & Air Conditioning 12-2D
�A /^ t2--2- / a v _A �?
35. Final Gas Pipe-Test ' - (`'t /2--'2t -il
_�r - 4
36. Hood or Canopy --H,
37. Final Factory Fireplace f-
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final a-20-CM-
41.
-20n,l41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47•. FINAL STRUCTURE & BUILDING •
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co /1
51. CERTIFICATE OF OCCUPANCY
No. Date
I PROJECT ADDRESS: G D UNIT:
OWNER'S NAME:
ADDRESS: 1612 SANDALWOOD ST CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 06982
HUGHES, STEVEN S
HUGHES ESTELLE S PERMIT NO; P 069827 PLAN CHECK NO; N GOVT; N SUPP: N
1612 SANDALWOOD ST
COSTA MESA, CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
44 ( 714 ) 556-7165
� ARCHIENGINEER: DOYLE C . FORTH REc.xo.: NO JOB DESCRIPTION : ADD MASTER BED& BATH ROOM & LAUNDRY RM SQ FT;
ADDRESS: 1075 REDDING AV
PERMITTEE: COSTA MESA CA 92626 CLAIM VALUE: CALL-VALUE: GROUP OCC : R-3 /M-1
ADDRESS: FORTH, DOYLE C AND COMPAN ( 714 ) 556-7165
1075 REDDING AV COMMENTS: RE: B69824
COSTA MESA CA 92626 *****+ **************+r9t****r+r+r+r•****+r-+r********+e***yF*+Fat*****+c+.+E+c*BtatBtr**********+r**
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed nder provisions of Chapter 9(commencing with Section
2 ON ING R EQU I R EMEN T $
7000)of Division 3 of the Business and Professions Code,and my licen ' .in full irce . d effect. S E T BA ACK S
CITY LIC.: so 4, STATE LIC.: 454306 • EXP ; 05 /95
ate: l7.-- Signature:— MAIN BUILDING •
ACCESSORY BUILDING
ORKERS'COMPENSATION DECLARATION: I hereby affirm t; I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT : FT IN REAR: FT IN
Compensation Insurance,or a certified copy thereof(Sectio/:00.Lab.C). LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICYNO.: 0783253-94 71). 10/01 /95
COMPANY: STATE FUND PARK ING RE • PROV: PARCEL : 13921210 ZNE: REF NO:
D Certified copy is hereby furnished. LX Certified copy is fneo 2,0 Division. PLANNING N T ES>
a /J/
i0 414 Applicant: / **************> _ •
*************************if***************************************
EMPTION FROM WORKERS'COMPENSATION DECLARATION: is section need not be completed it the permit is for one hundred(6100)or less). DEVELOPMENT SERVICES. REQUIREMEN TS
I certify that in the performance of the work for which this p it is issued.I shall not employ any person in any manner so as to become •
subject to the Workers'Compensation Laws of Callforni ZONING APPROVED BY -
DATE:
Date: Signator : _
NOTICE:If.atter.making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code,you musi forthwith comply with such provisions or this permit shall be deemed revoked. {�/ It [//p(//���+++
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for
APPLICATION ISSUED B Y: ` J..J(..L.t �y //' DATE: aFiF# p+f 4F
which this permit is issued(Section 3097,Civ.Cl. ************************fl iF 41E��FF aF if ***** **************** **F*iF++FF * ***
LENDER: *************************************** • ** **********************************
ADDREss: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I 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 28 , 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5 R
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 20 . 00
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING—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----> 28 . 00 20 . 00 0 . 00 48 , 00 48 . 00 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or
improvement
re)hin one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE BLDGV PMTPLUMBING ELECTRICMECHANICFIRESMIP/TOT
O COLLECTED :
DS O /$
for tnepuposeot sale). GRADING PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 48 . 00 . .
❑ and Professions Code: The Contractors'State License Law does not apply loan owner of property who builds or improves thereon .
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *..**.**.µ***.****.*********.*******{f***.**.*.******.)♦**.)f****.****.>F***..M.*.**.*.*******.N,.IE.N,*****,M,
that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL . FEE BREAKDOWN
o I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner PLU 1 BATHTUB
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and 7 . 00 7 . 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a PLU 1 LAUNDRY TUB OR WASHER _ 7 . 00 7 , 0 0
permit for construction or modification from the Air uality Management District.Residential construction applications are exempt from PLU 1 WASH BASIN 7 . 00 7 . 0 0
these provisions. PLU 1 WATER CLOSET ( TOILET) 7 . 00 7. 00
END" OF FEES
Date: Applicant:
I hereby certify that I have read this application and state that the above i .rmation'.correct.I agree to comply with all city and county
ordinances and state taws relating to building construction and hereby ant!'.ize rept"'ntat ' of this city to enter upon the abovetmenuoned Lit 0017139&-oenl398 YCET 48.00
property for inspection proposes. /401) y CAT[= 11/09/94 TINE: 16:12 •
�dtq Signature: :A " M1I
Driver's License or Social Security
.Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
4=*.� .
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permitr 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. LL 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. 4 ' to' 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor Systerrri! 61. APPROVAL TO DECK
11. Property Sewer Line & Hoose Connection / , 62- Backwash & Receptor-Final •
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing I2 t_c /W-- 65. Electrical-Final
15. Rough Electrical-Conduit C"'T�, 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 69. 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 C Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
i
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat -i 79. FINAL INSPECTION
32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED
33. Final Electric (.Notes:)1._ts-._94_. . 6entAA .sO Z 4K4
34. Final Heating& Air Conditioning _ #z z y,A- v�(-241-12 a
35. Final Gas Pipe-Test
' I =2° `'fid i ��� -re- n-
36. Hood or Canopy
37. Final Factory Fireplace -
38. Final Plumbing fir). -
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
48. FINAL PLANNING
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADE: 1612 SANDALWOOD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06982`_
OWNER'S NAME: HUGHES, STEVEN S
ADDRESS: HUGHES ESTELLE S PERMIT NO: E 069825 PLAN CHECK NO: N GOVT; N SUPP; N
1612 SANDALWOOD ST
COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE; OTH
( 714 ) 556-7165
ARCH/ENGINEER: DOYLE C. FORTH REG.NO" NONW. JOB DESCRIPTION : ADD MASTER BED& BATH ROOM 6 LAUNDRY RM SQ FT:
ADDRESS: 1075 REDDING AV
PERMITTEE: COSTA MESA CA 92626 CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /M-1
ADDRESS: FORTH, DOYLE C AND COMPAN ( 714 ) 556-7165
1075 REDDING AV COMMENTS: RE: B69824
COSTA MESA CA 92626 *********+r�E*********3trirat************+e+r+F*******it*********kr****�6ar******+r*x-�c******
LICENSED CONTRACTOR DECLARATION: I hereby Arm that I am licensed under provisions al Chapter 9(commencing with Section Z O N I N G R E Q [S I R E M E N T S
7000)of Division 3 of the Business and Professions Code.and my licens i n lull ice and effect. SETBACKS
CITY LIC.: c1 STATE LIC.: 454306 ss , EXP ; 05/95
Date _if- Signature:— MAIN BUILDING ACCESSORY BUILDING
ORKERS'COMPENS TION DECLARATION: I hereby affirm th have acendicate of consent to self-insure or a cenificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 00.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: 0783253-94 .DATE: 10/01 /95
COMPANY: STATE FUNIZ PARKING REQ; PROV; PARCEL : 13921210 ZNE: REF NO:
❑ Certified copy is hereby furnished. LX Certified copy is filed with cii ion. PLANNING NOTES>
1wa/
.♦oat¢/ /��,Y Applicant: >
J *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thi coon need not be completed it the permit is for one hundred)$100)or less). D EV EL OP M EN T SERVICES R EQU IR EMEN TS
I certify that in the performance of the work for which this per ' issued.t shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY
Date: Signature: DATE:
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the labor BUILDING APPROVED BY : DATE:
Cade.you must forthwith comply with such provisions or this permit shall be deemed revoked. p�(j/J / (/Q-(//��/
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY : T `i�4r 1F ar — i * +elf�t W
DATE-
which this permit is issued(Section 3097.Civ.W. ((�� DATE
**********************'1h*. ***a� * * * * f *** • ************* * * ***
LENDER: ****************************************** * ********************************
ADDRESS. LEGALIZATION: N F E E S U M M • R Y STRUCTURAL SEGMENT: N
OWNER BUILDER DECLARATION: I hereby attirm 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 3 0 . 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
pursuant la the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0:1% SMIP/NON—RES
and Processions Code)or that he/she is exempt therefrom and the Oasis tar the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects tie applicant to a civil penalty of not more than live hundred dollars(S500). ISSUE FEE 15 . 00
I. as owner of the properly 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 altered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 30 . 00 15 . 00 0 . 00 45 . 00 45 . 00 . 00
does not apply to an owner of a property who builds Or improves thereon,and who does such work himself/hersell 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 wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 45 . 00 OVER/SHORT: . 00
for the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 . 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts cor such protects with a contractorts)license pursuant to theContractors'Slate License Law).l am aware ***.*******..***-******.**.**,********************************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. IND I V IDUAL F E E BR E AK D OWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: ELE 9 FIXTURES LIGHTING 1 ST 20 EA. , 75 6 . 75
Ido hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and ELE 15 R EC EP T/OUTLET 1 ST 20 EA, . 75 11 , 25
25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ELE 12 R EC EP T/SWITCH 1 ST 20 EA. . 75 9 . 00
these provisions. ELE 1 MOTOR/POWR APPARATUS 0 . 0 — 1 . 0 HP 3 . 00 3 . 00'
Date: Applicant: END OF FEES C/
I hereby ceracy that I have read this application and state that the above i .rmation i .rrect.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby au�•be r'i reserves, this city to enter upon the above.mentioned
property lot inspection purposes. D E 00171397-00171397 T CE T 45,00
�/� r it
DATE: 11/09/94 TIME: 16:11
Dat �� Signature: /LS
Driver's License or Social Security of
1641.46 White—Building:Green—Code Enforce,•'nt;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
•
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 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 C'
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap,❑ Undrgrnd.
10. Structural Floor System' f 61. APPROVAL TO DECK •
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap / - 63. Heater &Vent-Final
13. Roof Drainsi
•
64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit ,.,,I 66. Solar System-Final
16. Rough Electric Wiring /Z 5167. 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 L7Gas 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
x/29. Insulation • 78. 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 /01;1,fr Notes:
34. Final Heating & Air Conditioning // 4•
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
48. FINAL PLANNING "
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER OOSS ATTF i Aun rn • DATE 7/ 9/q9
JOB ADDRESS 3632 Sandalwood St. BUILDING PERMIT NO. 9866
GENERAL CONTRACTOR 1-11 kr, Pr Colegrove, Inc.. VALUE $ 13,715.00
AP. No. LOT 212 TRACT 2822 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar.
INSPECTIONSN-S-9 DATE GROUP I & J TYPE V ZONE R1
Underground Soil /je7.f5 U.G. Water 4¢fS&-s--set PERMITS ISSUED
Underground Gas SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating ,4745- 9-2-4 S% Nm .i ., ' x;714=S_. - D .
Rough Plumbing /I 5 /p/-.K/ �iX�r.Le.n.) t i ,. 7,=,f, cf-r ',Pia/,.5"` _ /�
Miscellaneous ""�� -y�.--�p�✓ i
Prop. Swr. LFne—Hataton. St. Swr. i'/lW3TI 4'--W^-ti'-ri'W'W e7/3u�Xj ({(L S'4 ✓ �`0
Sprinkling System f i /
Heating, Final kg-/-V-Ce I I ,_/
Plumbing Fixtures / p
Final Gas Test /A:/i. / .4=54/,
Construction Pole
Underground Power
Rough Wiring 114S 41G W a3n h h)ei ////-7//74/In , 9-Al-cy /4 i.56.. ✓
Trenches, Forms/7 Steel/7' A/
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing /MI,/ /0.-/-5-54
Frame and Flashing ,13 4-f JCS-j'
Lathing, In If Out !3 1J ./0"43-
Plaster, brown coat / 7d- //-7- ref
Plumbing Fixtures, Final !—S— ¢
Electric Fixtures, Final 7�'�
Building, Final �(S / I
OCCUPANCY I I
Form 210-3M-4-59 Y866
986
JUL 13 1959
COSTA MESA BUILDING-SAFETY DEPARTMENT ,- Sr 1rinr L];_:-
EP-{,
P.O.BOX 317 COSTA MESA, CALIFORNIA • ,t1-••\L'- LI-• 1,
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDDRESSRESS 1612 Sandalwood St.
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
Rosslane Land Co. RECEIPTNO. I PERMIT NOI4
OWNER 44 �
MAIL � ll v� - R O IVSD BY O�ATE./RECEIVED DATE ISSUED
ADDRESS Uc E. 17th St. 17 / I "7-9-,n
f
CITY Costa Mesa T�o1.181159 ADDRESS
ARCHITECT Carlson & LIC. COSTA MESA, CALIFORNIA
OR ENGINEER Aiidllebrouk NO.
ADDRESS Garden Grove FIRE
ZONE
CONTRACTOR kColegrove, Inc. LIC.STATE
167293 APPROVEDADTE
ADDRESS 419 E. 17th St., Costa Mesa ZONING
LEGAL LOT 2822 ZONE /� NO.OF USE OF NEW (,/(I'��
DESCRIPTION NO. 212 I BLOCK TRACT K, I PLANS I BUILDING �J /Y
A.P.NO. APPR�OIVED 74 D ICI 'QT% JDATE -J3—St
BY /Q/'/�J p• ✓
SIZE NO.OF SLOGS. YARDS EVES
OF LOT 69 ]{ 102 NOW ON LOT none REQUIRED ALLOWED
USE OF (CENTER LINE ST.) (''
EXISTING BLDG. FRONT aJ 0 FT. IN.
SETBACK LINE FROM
CENTER OF STREET - 52t REAR YARD 301 R.SIDE 3—„,
IN.
SIDE YARD LEFT 10� . I RIGHT 51 L.SIDE S FT. IN.
DESCRIPTION OF WORK '
REAR FT. IN.
NEW IX II ALTERATION II ADDITION I
REPAIR I II MOVING I I DEMOLISH
SZIEDING 1365 NO.OF
ROOMS 6 STORIES 1
EXTERIOR WALLL,, ROOF
COVERING 8LAIC CO ICOVERIN(ROCk
USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage. •
Plan - 10AR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF &_ PERMIT FEE $ 32.00
PERM ITTEE YYY nn
$ PLAN CHECK $ 16.00
& Inc.. 13,715 48.00 nnnn
AUTHORIZED AGENT Dike Colegrove„ TOTAL FEE $ 8 8.00