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HomeMy WebLinkAbout2829 SAN JUAN LN - Building Permits p F CITY OF COSTA MESA 44.., 9 BUILDING DIVISION ),• .�I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT itbeibitartit PO4-00391 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2829 SAN JUAN LN Status: ISSUED Suite No Applied: 06/02/2004 Issued: 06/02/2004 Vicinity: ISSUED BY: Parcel Nunmber: 14167118 Applicant: MILTON, MARIA 0 Address: 2829 SAN JUAN LN Phone: 714-641-7180 COSTA MESA,CA Zip: 92626 Owner: MILTON, MARIA 0 Address 2829 SAN JUAN LN Phone: COSTA MESA,CA Zip: 92626 Contractor: Address: Phone: Zip: License: Arch / Eng : Address: Phone: Zip: License: SCOPE OF PERMIT REPAIR WORK ON WATER PIPE FOR S.F.D. 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 $0.00 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 Bktow(14) $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.) $9.80 1 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446.48(WOO) DECLARATIONS ,( WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued, My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed if the permit fs valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' co compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith cou• with these provisions. ,l./��/ .p cant Signature; �� D r "`�"""' 04; gi- o a_O/7 ""` ^4 - I` •SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPL. TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLARE(S100,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.LIC.a Class a Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). 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 fore permit subjects the applicant to a civil penalty of not more than fwe 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 en 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.). • tsI,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 Contactors License Laws.). ❑ I xempt under sec. Business and Professions Code for this reason: _ _ _ Signature:- „__HCA'Z4_7- 1-71117f, __- _ _ Dater 'I . er verified by drivers license. Q Yes 0 No o�p=7E9 can-se <- • Expires: • ©• Verification of Ownership by(type of doctient,i.e.-property tax bill or dee. : 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(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the DMsion of Industrial Safety,as noted above,unless such person has e permit to do such work from the division. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 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 feel 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 en RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia 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 __.r_____i__..._......__...._ or _... 5 Does or willo theoast Air or present a future building occupant at y efor the work which is the rsubject this application a eNnii for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes �No (Section 65850.2 of the California Govemment 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 Califomia 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state taws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for insp c' purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. inspection. Signature Of Legal(Owner(s) ate And/Or Authorized Applicant Date POE IP INSPECTION TYPE fLAIE Its LODEt INSPECTION TYPE PATE RNTLIndLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical / 1288 Pool Spa Final 208 Final Plumbing Z -5-00 Pry 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 ' MF • V CITY OF COSTA MESA BUILDING DIVISION t- 4`- , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER j�,4,y� • PERMIT 5-00371 (714)754.5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2829 SAN JUAN LN Status: ISSUED Suite: Applied: 03/07/2005 Vicinity: Issued: 03/07/2005 Parcel Number: 14167118 Zoning: Applicant: MILTON, MARIA 0 ISSUED BY: Address: 2829 SAN JUAN LN Phone: 714-641-7180 COSTA MESA.CA Zip: 92626 Owner: MILTON, MARIA 0 Address 2829 SAN JUAN LN Phone: COSTA MESA,CA Zip: 92626 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CHANGE OUT WINDOWS THROUGHOUT S.F.D.TO MEET 1997 UNIFORM BUILDING CODE EGRESS REQUIREMENTS. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,200.00 Permit: $125.25 Claim Valuation: $5,200.00 SMIP Res: $0.52 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.77 • PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 • 2448-46(6/00) DECLARATIONS t WORKERS'COMPENSATION DECLARATION; I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) orig.&certify that in the performance of the work for which this permit Is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California.and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall fdrthwith comply with these provisions, Applicant Signature;4/10,244.5-- Ait-e4_J gats;--73 —T — 2 a O s VANy- NG: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE($103,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provision&of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class a Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O 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.). 130 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 net 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.). E� ❑ I am exemp der Pec. Business and Professions Code for this reason: 3 -9--200...) o—Slgnetnre—�i ,,9 ®`'(Date - Owner ID verified by driver's license. 1 pa Yes 0 No &D roers:Llcense N(o�-. 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,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the Califomia 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 Cede,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? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air(Duality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspeFtion purpovs.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 3J2% -2 001 I tA-OPLe`gaTOWner(s)----- . " Date And/Or Authorized Applicant Date COPE P INSPECTION TYPE PATE INTRIALE CODEI INSPECTION TYPF RATE INTRIAL3 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof _ - _ 210 Final Electrical 201 Final BlocklRetaining 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 6-Plc,-a.,44- PRWECTADDRESS: 2829 SAN JUAN LN . UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 045236 OWNER'S NAME: DAVID EMERSON , ADDRESS: SAME • PERMIT NO: B 045236PLAN CIiECK NO: 01771--89 S • GOVT: N SLIPP2 N • • • CONSTRUCTION TYPE: - PERMIT TYPE: STR PURPOSE: ADD 'ARCH/ENGINEER: REG.NO.: JOB •DESCRIPTION : 140 SF• SCREENED PATIO ROOM SQ FT: 140 4 ADDRESS: UNIT: - • CLAIM VALUE: • 5,000 . 00 CALC—VALUE: 4 ,739 . 00 GROUP OCC: •R-3 / PERMITTEE: SEABREEZE AWNING CO ( 714 ) 530-1062 . ADDRESS: 1773 W. WILSON — D COMMENTS : ICBG It5014P ANAHEIM / CA 92030 .**x******xx-******.:***************iE*x-x***x*** -*** ********Net.****** **)4**tEW *Ax*aE LICENSED CONTRACTOR DECLARATION: I hereby affirm that I:m li•-nsed under provisi• sof Chapter 9(commie ting with Se i n Z ON ING R .E Q U .I R EMENTS . 7000)of Division 3 of the Business and Professions Code,and iy ense is in full forc;Lnd Matt.' SE TB AC K S ' • ctnuc.:01.605.1 sTATEuc.:34925' :CG / � ' �`�7 �` X - MAIN BUILDING • -- ACCES3ORY BUILDING Date: ��- '7 ignature: , FRNT: FT IN REAR: 15 FT IN FRN'P: FT IN REAR: FT IN ""tRKEflS'C PEN IDN DECLARATION: Iherehy attirmt alhave a '1�cate of consent to self-i eoracertificate of Workers' LEFT; 18 FT IN RGHT: 21 FT IN LEFT; FT IN RGHT: FT IN 'pensationk1nsyrre90cC ardce nifietl opY thereof(Section .a Lab. .7 .ICY NO.; 11999H •77-if t� E P.OAT ' 6/15/90 I • cOMPANrS'I'A'IE FUND i , PARKING REQ: PROV: : PARCEL: 141671.1.8 ZNE• R1. REF NO: 0 Certified cop is hereby furnished., 3 Certified copy is file •iththecityBuildingDivisi,•. / PLANNING NOTES> OK • TO PROCEED 140 SQUARE FOOT PATIO ROOM •' A _ `` > . Dater rAPDlicant: xI / *fE*M************************************************************************* * ...........4-......, AI EAEMPDON FROM RICERS'COMPENSATION DECLARATION: (Dli.section need not mpleled if the permit is fo•e hundred 4100)or less). D E V E L O P M E N T S E R V I C E S R E Q L] I R E M E N T S . I cenity that in the performance of the work for which this permit is issued,I shall employ any person in any manner so as to become subject to the workers'Compensation Laws of California. ZONING APPROVED BY COT .DATE: _Ill^ -g Date: • Signature: BUILDING APPROVED BY NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor —_ _-. '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: Z : `g which this permit is issued(Section 3097,Civ.C). **********************�*'iF******************* ***************** 'iF iFLF;F LENDER: *************************B'r**************************************************** ADDRESS: ' LEGALIZATION:N F E E —S U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: t 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: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT ' ' :72 . 00 . 50 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 PLAN 46 .-8 O :SMIP/NON—RES. 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 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—D'IV—> PERMIT ISSUE PLAN—CHUCK TOTALPAID ' DUE J structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—--—> 72 . 5 O . 0 . 00 46 . 80 119 . 30 j 11.9 . 30 . 00 • does not apply to an owner of a properly 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: 119.•30 OVER/SHORT: , 00 • improvement sold within). e year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOTGRADING PLAN—CHECK for the mpurpose ofd let. I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business • 72_ 00 S O 46 . 80 ❑ 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)iicense pursuant to the Contractors'State License Law).l am aware '**************************************x*********************iE*****************ti that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E ' B R E A K D 0 W N' 0 I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N . UNIT COST : TOTAL COST • • • Date: Owner: SFR 140 • RES—PATIO COVER—ENCLOSED PATIO • 33 . 85 , 4, 739 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,andEND OF -FEES 25534 and that I or any future building occupant vg1Uwill not(circle one)need to comply with said state codes and the requirements for a • • permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from • I • these provisions. . Date: Applicant: AP • ' I hereby cenity that I have read this application and state that the a•ove i 'matron is correct. i 4ree t.comply with all city and county • • • ordinances and state laws relating to building construction and hereby:u'•rhe representatives 0:Is city U enter upon the above-men'oned - .. .. property for inspec�'on purposes. �� / /,- y ' • Date: /y�Y�/^ (Signature:• � . _�/�_ -. / - 01 00048320-00048822 TOT 119.3D• Driver's License or Social Security Sr / DATE: 12/04/89 TItIg: 10:04 1641-46 White-Building Green-Code Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor - - - - - . • CONSTRIieTION AND PLANNI, - JOL & SPA APPROVALS . Permit# .Date Inspector APPROVALS Permit Date Inspector • 1. Temporary Electrical Service-Or-Pole 52. Pool & Equipment Locationj 2. Soil Pipe-Undrgrnd. �;i % 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.COVE R-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. , 8. Foundation - ' '-' 59• . Gas Pipe, 0 Undrgrnd.,Test ' ���' 9. Water Pipe-Undrgrnd.^ (s. � J '.� 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System ..,1,-.-1/ .- 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection , / 62. Backwash & Receptor-Final '7 12. Sewer Cap - ." ;1 63. Heater & Vent-Final 13. Roof Drains - 44, -. •' 64. Plumbing System - Final 14. Rough Plumbing '- ; 65. Electrical-Final ' 15. Rough Electrical-Conduit . -i'-'C 66. Solar System-Final �' 16. Rough Electric Wiring 1 ,,- ?� 1 67. Fencing & Access Approval r' 17. Rough Wiring Sign •i 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. Duets, Ventilating- 71. Product Piping 0 Gas 00i 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 ; I 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 ) )41.4911 V ' - 48. FINAL PLANNING ' ( -," 49. Electric Release to Edison . - 1 • 50. Gas Release to Southern-California Gas Co - ' ' . 51. CERTIFICATE OF OCCUPANCY • - No. Date • OWNER MESA -DEL_MAR DEV: CO DATE q_1(1_63 JOB ADDRESS j • a• .• 4 BUILDING PERMIT NO. .20 3 GENERAL CONTRACTOR Macco Realty Co. VALUES 20,288:00 ' AP No. LOT 15 TRACT 5252 FIRE ZONE 3 DESCRIPTION OF WORKRes.&At.Gar. INSPECTIONS Signature DATE 1 GROUP I&J TYPE V ZONE Rl i Soil ..-" /..)-,-C 3 SUBCONTRACTOR PERMITS ISSUED GasDATE NUMBER Water /O-/V-C 3 Jr. e/'-7-c.r ._ Rough Corn. Rettig. i Air Cond. 0 Rough Heating I ',2- y_67:1OCT- 4 Nod Rough Plumbing 'Fr /Z'/a- 3 .i r-,� �a E EP 1 7 1963 i .C. y,P1 l. k Miscellaneous 0r'' Prop. Swr. Line 0 House Con. 0 St, Swr. 0 V,,,, fo'- /-G 3 -j/.�.,- DCI 2 8 1963 •f I}4y(�.� Sprinkling System /1 it?-e; y LVA LY ''s{C- -\-I r� -' - Construction Pole ✓ 11y16* Underground 0 Power :0 Rough Wiring 14 2 1443 re—n-4- !It , r ?-J4?/ S$ Trenches CAS Forms Y'Steel Reinf. Er- rao`Q— , Floor System I _9_. _l_Q- .4 Bond Beam 0 Steel Reinforce 0 Sheathing ,f4-4.( ,c--‘,--(-,5 ( Frame and Flashing 77/31¢ I, -7e-63 Lathing-In�� Out la /�3 r'-3-6 9 Plaster, brown coat /Pif'her '1 -3—(,g Refrig, 0 Air Con. 0 Final - Heating, Final t Pity✓ y' -1./t Plumbing Fixtures, Final v ' ' 3-i7-pX' Final Gas Test Electric Fixtures, Final -6 i rte=�j-7y-� i OCCUPANCY Building, Final ,-.'G� itra f>' to Form BU4-5M-.3-63--s-8 P 1—...... ... • 20533 FEE RECEIVED - SEP 1 0 1963 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. 0. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT pTYPE OR PRINT BUILDING BUILDING ADDRESS 282/ ,SA).//fA'J i,'), COSTA MESA. CALIFORNIA For Office Use Only OWNER Mesa Del Mar Development Co„ I RECEIPT NO. e,t inARIOJ,^•0,. MAIL. RICE D BY TE ECEI E CPLtAT'A'lIBBIUSPACr� ADDRESS 3800 E. Coast Highw- a _�D� S r 1 U Itl63 TEL.Oriole BUILDING CITY Corona. Del Mar, Calif. N0.1 2?9 ADDRESS ARCHITECT TEL. 10.Is COSTA MESA. CALIFORNIA OR ENGINEER Ma000 Realty Co. NO.3 4220 FIRE C ADDRESS Sarre as abO7' ZONEIRTYPE GROUP ✓/J`♦ CONTRACTOR MaCCO Realty CO. APPROVED BY DATE ADDRESS Same as above - ZONING �' , L ZOry11 NO.OP USE •,F N `/ CITY Same a ass a boys 1� l -- ' I PLANS I BUIL:. G IAIk , LIC.TE NO. 207343-A-SB-1 TEL NO. Or1018 —4220 LESCRIPNON • VVV 98868-0D-1 t 1 Tracl 2 2 • SIZENO. OF SLOGS OF LOT 861 x90' NOW ON LOT None A.P.NO. USE OF YARDS EVES EXISTING BLDG. 1 ••' APPROVEDALLOW SETBACK LINE FROM (CENTER LINE B � j ClNTER OP STREET II 21 REAR YARD26 1l0II FRONT FT. Y IN. r k� V` SIDE YARD LEFT 71611 RIGHT 10 R.SIDE / FT. IN. DESCRIPTION OF WORK- CC C IN. L.SIDE 1/n NEW I XII ALTERATION I II ADDITION I REAR \v FT. /0 IN. REPAIR - I MOVINGrI ADEMOLISH I APPROVED /nj�]1,� .-1 , —6j P S ZE BUILDING 611611 X5111 OMF STORIES Living area 1896 S.F.aaa DATE «» 0� EXTERIOR WALL WAOd & ROOF Shake & COVERING . I COVERING • • •• - Garage II 4.83 S.F. garage. Plan 1100 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 OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION //., (3112SIGNATURE OF PERMIT FEE S 6 PERMITTE Y' . D- y- 1.. - ••ll' • • qT n • By: zf - S 20,288.00 PLAN CHECK S Y e ap - AUTHORIZED AGEN ad), Z 8 TOTAL FEE -- PROJECT ADDRESS: 2829 SAN JUAN LNUNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 066156 OWNER'S NAME: MARIA MILTON N ADDRESS: 2829 SAN JUAN LN PERMIT NO; P 066156 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE; PLU PURPOSE: OTH ARLMIENGINEER: REG.NO.: JOB DESCRIPTION ; WATER HEATER REPLACEMENT SQ AODM& UNIT: FT; CLAIM VALUE: - CALL—VALUE: GROUP OCC: R-3 / PERMITTEE: NOCK PLUMBING ( 714 ) 895-1246 ADDRESS: 11610 SEABOARD CIR COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT STANTON CA 90680 ********************************************+E**ec******************erg-*+e**eE*+E**r* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMENTS 7000)of Division 3 0l the Business and Professions Code.and nse is in fun force and effect. SETBACKS CITY LIC.: 3861 STA`TE�LIC.:51197 CUSS: C 0 _if IX q T Signature: MAIN BUILDING ACCESSORY BUILDING IRKEAS'COMPENSATION DECLARATION: I hereby allirm that)have a certificateofwnsent to self-insure . . • ers' RNT; FT IN REAR; FT IN FANT; 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 ND.: 1 16 7 9 9 2-93 EXP.DATE: 03 /01 /94 COMPANY: STATE PARKING REQ• PROV; PARCEL : 14167118 ZNE: REF NO: 0 Certified copy is hereby furnished. ® Certified copy a M 'lb the city Building Division. PLANNING NOTES> ® > far 7-n> iat Applicant: ******************************************************************************* IPTlON E M WORKERS'COMP NSATNJN DECLARATION: (This section need not be computed if me pemid Ola one (5100)or less). DEVELOPMENT SERVICES REQUIREMENT S I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE:II.alter making this declaration,you should become subject to the workers Compensation provisions of the Labor BUILDING APPROVED BY . DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. „ 77 '' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: A� — DATE: V which this permit is issued(Section 3037.Civ.C). ********************** * **• * • • -***- * LENDER: ****************************************************************************.k** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMING G 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 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 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—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($500). ISSUE FEE 20,00 I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered fpr sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 7 . 00 20 , 00 0 . 00 27 , 00 27 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himselllherself or through his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or improvement fd withinone year of completion,the owner wit have the burden of proving he/she did not build or improve REVENUE V O — _ OD ? . 00 /S forthepurpose ofsale. BLDGPMTPLUMBING ELECTRICMECHANICFIRESMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 . 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 for such projects with aconlractor(5)license pursuant to theContractors'Stale License Law).I am aware **********.)E*******.********.*********.*******.*.)f*.x.***.{I.****.)f*..µ*.**.*.*******.*.******.N.**.N, that proal of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. tor his reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: OwnerPLU 1 WATER CLOSET ( TOILET) 7 . 00 7 , 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 codes and the requirements for a 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 ordinancestand statetawsrelating to building construction and hereby authorize rep enp(iv enter open the above-mentioned for in ection1urposes. i r��/'� e�! �} Signature: •, ee [ 0100155846-00155846 TOT 27.00 over s License or Socpl curry 1914 DATE: 02/23/94 TIME: 09:59 1 1641-46 Wmre—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING . SOL & 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 9, Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, El 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 D 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 28. Lathing& Siding 77. FIXED SYSTEM FINAL 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 Notes: ,t 34. Final Heating& Air Conditioning 3-2� _C�4 &A./Acre:ix_a( re7L 71r.1 35. Final Gas Pipe-Test �E`!•T 36. Hood or Canopy 37. Final Factory Fireplace • - 38. Final Plumbing .! •24 14- 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation Synem 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - - .•r. 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _