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HomeMy WebLinkAbout1110 SAN JOSE AVE - Building Permits CITY OF COSTA MESA Dyia MF4,9 BUILDING DIVISION o +OWAI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 °'°° ° PERMIT NUMBER: P09-00146 PERMIT TYPE PLUM STATUS: ISSUED APN: 41204325 DATE ISSUED: 11/1712009 ISSUED BY: RMD JOB ADDRESS: 1110 SAN JOSE AV CM Suite/Unit: Vicinity: SCOPE OF WORK: PLUMBING PERMIT FOR WATER HEATER CHANGE OUT, SAME LOCATION. OWNER: 6UNDY,MARK D TR Address: 1110 SAN JOSE AVE PHONE: 714-6624408 City/State/Zip: COSTA MESA, CA APPLICANT: LITTLEFIELD, SCOTT Address: 24707 SAN FERNANDO RD : PHONE: 888-611-4328 City/State/zZip: SANTA CLARITA,CA CONTRACTOR: AFFORDABLE WATER HEATERS AND PLUMBING License No. 627368 Address: 24663 RAILROAD STREET PHONE: 661-259-7131 City/State: NEWHALL,CA ZipCode: 91321-1742 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $35.80 TOTAL FEES: $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. MIL INSPECTION TYPE DATE INITIALS CODE* INSPECTION TYPE, DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing l it 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver s license. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performanceeof the work for which this permit is issued. ISI 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: ne person is required to descend,will be made in connection with work authorized '-+--L by this permit,and that no building structure,scaffolding.falsework,or demolition Carrier: i-hi or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not/ be completed the permd 4 valued atone hundred dollars($700)or less) 2,Art Sec.341,Title 8,California Administrative Code). Policy Number: jobS "1 F 7!) 0 As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall 1 hwith mply with these pro ision ////7/0C)eDivision of Industrial Safely Permit Number: plica Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# 63-73114 Class# L ` (Section 25533 of the California Health and Safety Code, with some ,0 '/// 7/C� exceptions, requires registration with the Costa nda Fire Departmentof y Y each business which u any one time has on hand a quantity acutely ontractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No 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 (Section 65850.2 of the California Govefinent Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications fa non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If'yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of L al Owner(s) Date Signature Date - ^� ////74 dfh 3057-46(3107) An4ior.AizCedt llca✓nt-- bate CITY OF COSTA MESA 4 a - BUILDING DIVISION 04 �.8 DEVELOPMENT SERVICES DEPARTMENT PMIT NUMBER PERMIT 4. IPA B05-00512 ittfro war no des (714)754-5273 • Fax(714)754-4856 • www.cl.costa•mesa.ratLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1110 SAN JOSE AV Status: ISSUED Suite: Applied: 03/31/2005 Vicinity: KITCHEN EXTENSION Issued: 06/01/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 41204325 Zoning: R1 Applicant: EASON, DAVID ISSUED BY: Address: 342 PEACH TREE LN Phone: 949-642-8028 NEWPORT BEACH,CA Zip: 92660 Owner: B DY, s SAN MARK AVETR �� fENSIr0'�-rN� Address 1110 SAN JOSE E � � 1 1� Phone: A ■ _L®�,_"1/1J COSTA MESA,CA Zip: 92626 1�1� \l"/ Contractor: p[O� Address: Phone: EXPIRES Zip: License: Arch : Eng: HUSZCA, MARIAN JOHN Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT 91 SF ADDITION TO REAR OF EXISTING SINGLE FAMILY RESIDENCE TO EXTEND KITCHEN.ADD 3 WINDOWS,2 ON 1ST FLOOR AND ONE ON 2ND FLOOR PLANNING: LOT SIZE=4,978 SO.FT. RESIDENCE/GARAGE=2,388 SOFT. DRIVEWAY=320 SQ.F T. LOT COVERAGE=2,708 SQ.FT.(54%) OPEN SPACE=2,270 SQ.FT.(46%) FEE SUMMARY Plan Check: $117.81 Calc Valuation: 510,000.00 Permit: $181.25 Claim Valuation: $10,000.00 SMIP Res: $1.00 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $300.06 PLANNING &ZONING 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 fora period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections end final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6(00) DECLARATIONS, '' 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 U issued. My workers'compensation Insurance carrier and policy number are: Cartier. Policy Number: (This section need not be completed If the permit Is valued at one hundred dollars($100)or less.) el 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 ag become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions TCS/. /U< Att,, Sigrlatu I Dt1:c7r W¢ :FAILURE TO SECURE W RS'COMPENSATION COVERAGE IS UNLAW FLL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOI AND DOUARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS 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.Lt.4 Class U 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,CMI Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is '•sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Con r nse Laws.). ❑ I am eI°am exemp er sec. Business and Professions Code for this reason: /// ga. Lmner ID verifi y driver's license. )Yes ❑No D er No`- ; �Y.. ./ lb Verification of Ownership by(type of document,i.e.-property tax bill or deed): 1>s�r ll���� 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 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 then a weight of 500 pounds.or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature end pressure). 2 Does or will tho applicant or present or future building occupant need to filo 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 then 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. _ ___ tion25._..._ _._.i._.._ _._. ...._ —._.____._ 4 If an RMPP is presentlyrequired,has Section 25534 of the California Health and Safety Code-been fully complied with?--0 Yes 0 No V Does or will the applicant or present or future building ct occupant require for the work which is the subject of this a plication eEermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j Yes 0 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 pert of the fedlity to be constructed under this permit be Within-1000-feet from the outer boundaries of a school? 0 Yes ❑No (I1 yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .._..r __....__ __.____ or thewor_.__.__—_ _. 7 If a permit from the South Coast Air Qualityced Management District or other et po Section districtben agency U requiredsfor the work which U the subject of this application,have all of the disclosures prescribed by CaliforniaCalifoHealth and Safety Code Section 42303 been made? ❑Ves 0 No ._.._... ._...__..._ _r._ ___.._ _.____ 8 (If yes',attach certificate of compliance from me appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the Information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. I. ature • L:II • )o" / /� / tl. •APPIraint (� /rDat4 — CODE T, INSPECTONTYPE DATE ItlID/ld CODF( ItlSPECTION TYPE an Map 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 .Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Slte _ 204 Final Demolition 250 Final Building/Occupancy c-7-08 Cgt • DECLARATION OF AUTHORITY Bldg. Permit# FOR AGENTS OF PROPERTY OWNER This Permit# TO APPLY FOR PERMITS Street Address: f//C 940 91/2956 >471.W. gE954////£ ga AP Number: 1. I (we), 11,4, 't aaaAid , declare that I am the Owner of Title of the above referenced real property, andel that I (we)hereby authorize: NameT7yt% 6,059,L)6,059,L)�—O. /,e)4//5 at) Telephone Number: C1/457 a cel_ ozr Street Address: 7I ,49,t.f// 7j2�E eif�''� City: IUE�/° R e1� a4-• State: a4z, Zip: 92.loll to obtain permits in my behalf,as owner/builder,for 44f' W" / _# ( at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa,as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the penalty of perjury that the foregoing is true and correct. 1C Executed this 120 day of PA'B 1 20 O s,at 6051 A µf SA ,California. A. Print Name: M D • Guava / .0c Signature: i// g *Date: (30 O :5 Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. 0779-46 trev.11100) deefe 2 . P_ --- -714,e_alex.aldynate 16 _ .14 � s Gut 266 - - .- �--_ cam-_ �.-_� _ - ei.ei _ A-0 - V10 _ _ _ „ __ ek-e -A_(÷ osca�c ¢- ate' ,/ l I _ d-e- _ 7/ < _/- 66, Yvo67 teoad-a-s _: - - - Bos- 0osi02 - -� �_ gos - 00606 9ao-co or( oN p N vs 9 CITY OF COSTA MESA 4 BUILDING DIVISION > -- _•. ` DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER J. righ •ti - lar , PERMIT ka ,rF VE05-00808 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1110 SAN JOSE AV Status: ISSUED Suite No Applied: 08/01/2005 Vicinity: KITCHEN EXTENSION Issued: 08/01/2005 Parcel Nunmber: 41204325 10) Applicant: MICHELLE HARRIS ISSUED BY: Address: 1060 TULARE DRIVE "`Phone. !714-556-17.90 COSTA MESA,CA Zip - 92626 Owner BUNDY, MARK D TR Address 111b SAN JOSE AVE ' - _ EXTENSION:` ' • Phone: y COSTA MESA, CA Zip: 9262ALLOWED', ED Contractor: T.H ELECTRIC PER �P Address. 1060 TULARE DR EXPIRES �i� �g -ar. Phone:"714.556.1790 COSTA MESA,CA Zip: 92626 License:791459 - SCOPE OF PERMIT c,' 'ELECTRICAL PERMIT FOR 91 SF ADDITION TO REAR OF EXISTING.SINGLE'FAMILY RESIDENCE TO EXTEND'KITCHEN.ADD 3 WINDOWS,2 ON 1ST FLOOR 'AND ONE ON 2ND FLOOR - REF it805=00512 WORK TO INCLUDE 21 LIGHTING.FIXTS,•16 RECEPT OUTLETS;`9 SWITHCES AND 1'SUB PANEL TO • FEE SUMMARY - . - - . • Quantity - . -Quantity ISSUE FEE $23.50 - :Temp Dist System/Lighting $0.00 0 Temp service test - $0:00 - • Busway/100 ft $0.00;- 0 Res.a/c package $0.00 - n Standing Sectio $0.00"' 0- New Res(1-2 units) $0.00 ` , -0 '` ,,,Misc-Electrical Equipment $0:00 0 New Res(3+units1„ . • $0.00 - 0 ' ' ,, :,••••• up to 1 kva%kw $0.00 0 Pool/Spaup to 10-kva/kw Lighting Fixts $22.73 'r21 t •- up to 50 kva/kw. $0.00 - 0 • Recept Outlets $17.60 . 16 -r'" _- - up-to 100-kva/kw $0.00- 0:. ,- Switches Switches -- 7 $9.90 4 9 - - • over.100 kva/kw •- $0.00 0 • Non Res Appl ' •- $0.00 • 0 - • Low Voltage Equipment • $0.00 I, 0 Res Appl --$0.00 "- ' '0,, a Low Volt Wiring System/Ckt $0.00 - 0 ... Service to 200a $0:00,f 0 i Misc.Condwt. :''$0:00 0 Service to 10006 $0.00 - Q "Misc,Conductor $0.00 0 Service over 1000a $0.00 :0• Circus(gen or ride) -,• $0.00 0 Motors to ihp $0.00 0 • -Circus(mech-ride or lights) $0.00 0 Motors to 10hp $0.00 0 - , Christmas:Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 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-abaed 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 ap able codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expi tion of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(6/00) 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. y❑._-Lhave 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. f--My works compensation Insurance cardsmnd policy number are: -1 Cartier: ,/nFic-au all .L-�r�s.�� ' Policy°rJuritber:K �NS I")61" `/r2S ( ,(ISisisect/dn`need not be completed II the permit is valued at ogihundred dollars($100)or less.) - - ❑ I certify that in the performance of the work forgythis permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation la., • -mia,and agree •uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with t - - .•_. A(pplicant.Signatuce:e-- /a - .�/i a.., -_ Date: R 05 WARNING:FAILURE TO SECURE WO- ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER IO CRIMRNL PE ALTIES A D CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR DE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am -= s=• _under rovisions 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- %p'''"" " '9/ L/ S C /o Cl ..8 C— / CohtractoCs,Signa e: D-ec e -/ - Q5 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,CMI Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,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 ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑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 10 or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes u 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? ❑Yes ❑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 prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No B (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 con• ith all state laws a4y .inances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-describe. • ..: inspection pure• not to oc py or allow occupancy of any building authorized by this permit until final inspection. •ignature 0 Legal Owner( 'may Date t,�.A •'• 'Authorized Applicant-;;- CODE# INSPECTION TYPE pint INITIALS COOE# INSPECTIONTYPE DAIF. INTIIIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing n 200 Final Re-Roof 210 Final Electrical W ' 0 201 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 `p5� F CITY OF COSTA MESA 4 @ BUILDING DIVISION - •N- r.,,,. _s I DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER I. we..+. , PERMIT P05-00606 4tbmPaRraso`4. (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa f11.9MBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1110 SAN JOSE AV Status: ISSUED Suite No Applied: 08/05/2005 Issued: 08/05/2005 Vicinity: Parcel Nunmber: 41204325 Applicant: TONY SPERA Address: 18972 SANTA MADRINA ISSUED BY: Phone: 714-928-8980 FOUNTAIN VALLEY,CA Zip: 92708 Address BUN MARK D TR EXTENSION Address 1110 SAN JOSE AVE EX 1LN 1 1 Phone: - Aar COSTA MESA,CA Zip: 92626 Contractor • TONYS PLUMBING SERVICE Address: 18972 SANTA MADRINA EXPIRESPERq Phone: 714-928-8980 FOUNTAIN VALLEY,CA Zip: 92708 • License: 644096 • SCOPE OF PERMIT 91 SF ADDITION TO REAR OF EXISTING SINGLE FAMILY RESIDENCE TO EXTEND KITCHEN.ADD 3 WINDOWS,2 ON 1ST FLOOR AND ONE ON 2ND FLOOR. REF.:805-00512 PLUMBING TO INCLUDE: 1 BATHTUB,2 SHOWERS,1 GAS(1-4 OUTLETS), 1 KITCHEN SINK, 1 WASH BASIN, 1 WASH BASIN SET,AND 3 WATER CLOSETS. FEE SUMMARY . AMT QTY AMT OTY, AMT MI 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 $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) - $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) 50.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $9.80 1 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $9.80 1 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) $29.40 3 Drain,Roof $0.00 0 Shower $19.60 2 Water Heater I vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 . ,0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor .$0.000 Water Service $0.00 0 Gas(1-4 outlets) $6.15 1 Sink,kitchen , $9.80. 1 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 'Sink,service/mop • • $0.00 0 OTHER , $0.00 Gas Repipe $0.00 0 . - Spa(private) $0.00 . 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00, 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0- - REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 _ . - . • TOTAL CALCULATED FEES: 5117.85 COMMENTS /SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work Is suspended or abandoned fora period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable.c 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)754-5826 2448-48(title) 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,es 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: Xsection need nor be completed if the permit is valued et one hundred dollars($100)or less.) I certify that it:::performance of the work tor which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' con pensatios of California, agree that III should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with / Ions. k 3 C _ C-Applicantignet : ! Date: _WARNING:FAILURE TO SECURE RS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTIONS/060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am liCensg under..• •,s•1 Chapter 9(commencing with Section 7000)of Division 3 of the.Business and Professions Code,and my license is in full Ilace and-effect.Lica# ._� . 7 cr—Class k - -S 6 Contractor's -- .. et..._ __ r d/b. Date: g-c-^O 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). Lender's Name: Lenders Address: Signature: _ Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I em exempt under sec. Business and Professions Code for this reason: Signature: - Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,Ire.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title 8,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 materiel? 0 Yes 0 No (Section 25505 of the California Health end 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 thea applicant orpresent or future buildingoccupant need to file a racutely "'-- PD registration form for hazardous materials? 0Yes ❑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 then a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _____.........._..r future baling uil_ ell._ ar._._._ __ 3 Does or will the0 applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materiels)? ❑yes ❑No (Section 25534 of the California Health and Safety Coda provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Flre Department of en 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 0 No 5 Does or wit the applicant or present or future building occupant require for the work which is the subject of this application a germit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IP Yes U 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? ❑Yes 0 No (if yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cale). .._ _.__.. _.__.t._..... e . _.___ 7 Ita a patron from the SouththCoast res Quality ed Management Heath other air po on control district3 agency Is required fqN work which Is the subject of this eppllcallOn,have all of the disclosures prescribed by Californiaia Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (11'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 end Emissions. Signature): Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. etdre :gal Owner(s) Dat An r thorized.Appllcant---- CODE I, g1SPELTIONTYPE PATE MAS LODE? INSPECTIONTYPE PATE IN1050ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 8-7-0? dt- 200 Final Re-Roof 210 Final Electrical 201 Final Block/RetalnIng 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 CITY OF COSTA MESA BUILDING DIVISION i er..I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci. osta-mesa.ca.us I- 1.%.=4 .,1. FOR INSPECTIONS CALL: (714)754-5626 . � PERMIT NUMBER: E08-00157 PERMIT TYPE ELEC STATUS: ISSUED APN: 42501603 DATE ISSUED: 0510512008 ISSUED BY: KJB • JOB ADDRESS: 1754 SANTA ANA AV CM Suite/Unit: Vicinity: . SCOPE OF WORK: MINOR PLUMBING, ELEC AND MECHANICAL WORK. ELECTRICAL TO INCLUDE:6LIGHTS,6 OUTLETS AND 4 RECEPTACLES.NO BLDG WORK ASSOCIATED WITH THIS PERMIT. OWNER: RENFRO,DEER Address: %DEE,R RENFRO Unit:COSTA MESA,CA PHONE: r City/State/Zip: 1754-B SANTA ANA AVE APPLICANT: DANAF,TALAL Address: 17165 NEWHOPE ST Unit:UNIT J PHONE: 714-444-2648 City/State/zZip: FOUNTAIN VALLEY,CA • r.): CONTRACTOR: ROVICS CONSTRUCTION INC License No. 800996 Address: 17165 NEWHOPE STUnit: UNIT J PHONE: 714-444.2648 City/State: FOUNTAIN VALLEY,CA ZipCode: 92708 CELL: ELECTRICAL PERMIT FEES • Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $42.20 • Reinspection Fee $0.00 , -.,) n TOTAL FEES $42.20 a; NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21.92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of,this permit. CODE R INSPECTION TYPE DATE INTITIALS CODE II INSPECTION TYPE LAA IN1TALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing � 200 Final Re-Roof 210 Final Electrical a l/ "-.Q-`•Vq c3 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lice ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: • permit is issued. My workers' compensation Insurance carrier and policy El hereby certify that no excavation five(5)or more feet in depth into which a number are: _ A v V J�/� person is required to descend,will be made in connection with work authorized Camera- T A rt f Gi by this permit,and that no building structure,scaffolding.falsework,a demolition C) ( ror dismantlingthereof,will be more than thirty-six 36 feet high.(Chap.3.2. (]his section needw6t be completed✓the permits valued at one hundred dollars(MO)a/e55.1 ra ( ) 9 Grp '7 2,Art 2,Sec.341,Title 8,California Administrative Cale). PolicyNumber: U q / C{ S 3 �' 2 0-o ❑ As owner-builder, I will not employ anyone to do work which would 0 I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall fo 'th comply with these provisions.5�U�/ 0 Division of Industrial Safety Permit Number: -gnalure Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FSO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect./ a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# ') 0 0 C c 6 Class# //'' (Section 25533 of the California Health and Safety Code, with some ss D 5- /D S jJ exceptions, requires registration with the Costa Mesa Fire Department by _ ! each business which at any one time has on hand a quantity of acutely ontracur's Signature r- Date hazardous materials equal to or greater than a weight of 500 pounds. or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUC I• • LENDING AGENCY: temperature and pressure). ❑ I hereby affum that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No Lenders Address: (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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Sectbn 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safely Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by Califomia License Law does not apply to an owner of properly who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and who does such work himself or herself or through his or her own 8 (If'yes".attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. ❑ I, as owner of the LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. • the information given is correct. I agree to comply with all state laws and city -- - ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal e s) Da/lp Signature Date f /- o C/V j 305]<6(3b]) And/ 'Aullimz pgicant —Date >/ r ,4`,- F 9 CITY OF COSTA MESA BUILDING DIVISION F DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 0 PERMIT 602-01158 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1110 SAN JOSE AV - Status: ISSUED Suite: Applied: 07/26/2002 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 07/26/2002 Parcel Number: 41204325 Zoning: R1 R1 Applicant: DEWART, JERRY ISSUED BY: Address: 2823 N LOCUST AV Phone: 800-572-6993 RIALTO,CA Zip: 92377 Owner: BUNDY, MARK D TR Address 1110 SAN JOSE AVE Phone: COSTA MESA,CA Zip: 92626 Contractor: ROSS CONSTRUCTION Address: 2823 N LOCUST AV r.. Phone: 800-572-6993 , RIALTO,CA Zip: 92377 License: 689408 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF:T/O EXISTING WOOD SHAKE, 1/2"CDX PLYWOOD, 1 LAYER 303 ASTM FELT,APPLY"EAGLELITE PONDEROSA TILE(7.0 PSF). ICBG#ER4660(STRUCTURAL CALCS SUBMITTED) 26 SQUARES FEE SUMMARY Plan Check: $108.71 Calc Valuation: $8,500.00 Permit: $167.25 Claim Valuation: $8,500.00 SMIP Res: $0.85 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $276.81 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 244646(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: - r 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. T of ❑ <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 workercomperisation Insurer a carrier and policy number are: / "Carrier--" I Ar.t '7C/UN/1 Poli 'lumber: A '003 2.l (This section need not be completed if the permit/s valued at one hundred dollars($100)or less.) L or—tify i in the performancethe work for which this permitecis issued,I shall not employry' any aon in any manner so tion becomef subject to the I shall f compensationhlaws rofo ininCalifornia,l ,and agree t ould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. L -ApplicantSgneturei; — Date: G 0Z WARNING:FAI —'TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of-ihe,Business d Professons Code,and my license is in full forc�and-effeG..LiC:�. C� ��� 'Gass'' C- ' C nlractods Signature: / � — -7— 3 r- v� • 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). Lender's 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).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? I Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. =g Mat(des wner(s) - Date asp-- � — .2c — 02 An JOr Authorized-Applicant ,- —Date CODE f WSPECTION TYPE a E INTRIALS COPED INSPECTION TYPE PSIS INTRIAL@ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final u 208 Final Plumbing �D,, 200 Final Re-Roof A i 1-'� t 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 • ,&2? _r i/St ,,.,L 9 2002 cspFESStOp,-- INSPECTION AND CALCULATIONS : .0 e •l ty�+�� BY ROSS CONSTRUCTION a , p #C ;32� a,�! 2823 N. LOCUST AVE. \. RIALTO,CA.92376 cx Exp.12. 1-2004 357-23 (909)REROOF21 'OF MARK BUNDY 1110 SAN JOSE AVE. COSTA MESA, CA. DESIGN LOADS(PER'97 U.B.C) ROOF LIVE LOAD 4:12 LL:= 16.PSF REDUCED FOR SLOPE ROOF DEAD LOAD DLT:= 7.2-PSF LIGHT WEIGHT TILE DLF:=6-PSF FRAMING/SHEATHING TL:=29.2-PSF TOTAL CEILING DEAD LOAD DLC :=2.5•PSF AT CATHEDRAL CEILING OR TRUSSES WIND AT 90 MPH: Cie:=20.8-PSF (PRESSURE) Ce:= 1.13 (EXPOSURE C UPTO 20 FT.) Cq:= 1.3 (SHAPE FACTOR) P :=Cq•Ce•gs P = 30.56PSF HORIZONTAL P:=0.7 Ce qs P = 16.45 PSF UPLIFT VERTICAL PROJECTION OF THE HOUSE IS UNCHANGED WIND LOAD REMAINS AS ORIGINALLY DESIGNED. SEISMIC ZONE 4 SEISMIC SOURCE TYPE A TABLE 16-S TABLE 16-Q TABLE 16-N TABLE 16-K TABLE 16-1 Na:= 1.5 Ca:=0.44•Na R:=4.5 I := 1.0 SOIL TYPE=Sd NEED NOT TO EXCEED... 2.5.Ca•I V2 := V2 =0.367 30-5 USE MATERIAL SPECIFICATIONS: WOOD DOUGLAS FIR 2X4(RAFTERS) Fb = 1885 PSI, F'v= 118 PSI, E= 1600000 PSI 2X6(RAFTERS) Fb = 1635 PSI, FW= 118 PSI, E= 1600000 PSI 2X8(RAFTERS) Pb= 1510 PSI, FW= 118 PSI, E= 1600000 PSI 2X10(RAFTERS) Fb= 1385 PSI, F's'= 118 PSI, E= 1600000 PSI 'THIS REPORT ASSUMES THAT THE EXISTING FOUNDATION IS ADEQUATED TO SUPPORT NEW LOAD. CONTENTS: 'ROOF INSPECTION SKETCH SHOWING EXISTING ROOF FRAMING PLAN AND ROOF FRAMING CROSS SECTIONS. `CALCULATIONS FOR RAFTERS,TRUSSES, BEAMS,AND TIE CONNEL 1 ED RAI'I ERS ARE INCLUDED IF REQUIRED. INSTRUCTIONS TO ROOFERS WITH DETAILS FOR ADDITIONAL FRAMING/BRACING ETC.ARE INCLUDED REQUIRED. ..1STRUCTION TO ROOFERS SECTION AA EXISTING SECTION IS ADEQUATE TO SUPPORT NEW LOAD. SECTION BB EXISTING SECTION IS ADEQUATE TO SUPPORT NEW LOAD. SECTION CC EXISTING SECTION IS ADEQUATE TO SUPPORT NEW LOAD. SECTION DD EXISTING SECTION IS ADEQUATE TO SUPPORT NEW LOAD. SECTION EE EXISTING SECTION IS ADEQUATE TO SUPPORT NEW LOAD. NOTE: 1. EXISTING ROOF FRAMING IS ASSUMED TO BE IN GOOD CONDITION. CONTRACTOR IS TO REPORT ANY SUBSTANDARD CONDITIONS OR DEFICIENCIES TO THE ENGINEER PRIOR TO COVERING ROOF. 2. ALL PURLINS AND RIDGES SHALL BE BRACED TO LOAD BEARING WALLS WITH A 2X4 STRUT SUCH THAT THE ANGLE FORMED BETWEEN THE BRACE AND A VERTICAL PLANE SHALL BE NO MORE THAN 45 DEGREES. ALL STRUTS GREATER THAN 8'-0" LENGTH SHALL BE 2X6 MEMBERS. 07/18/2002 10: 21 9093572379 ROSS CONSTRUCTION rHbt n 7 -111 cc_ MnicS Icy/ � r i y(p I QX6 It/G"' 1 ' o 4 rci, L LT/ axs Q;��' as �/ y COx.. t . ; Bt b � J j . • .` y, /� S �q? *b7Ees l6 ` ... .. _ . . .. �- ��� .._."_'�` - -K eQ0t L16�Fn�rH"SXAN .. . �Z+.rind .. 7_ .. 6d _s e i ,. i0'MnXy+4ai ;... Seat) . ! .... ._ ! 1 1 07/18/2002 10:21 9093572379 ROSS CONSTRUCTION PAGE 0 CL'CI'l,+tl A -A - Y8 ZiP etecp 344 $ G 'X6 kNr7f /6'oc $0 Sits; l it 81 " .rQ. R:pct 8, o e 9/ F DEc7iati?.a-B c_,2/6 R,4FT25/ Ncsc . . Qarii5 S 131i x tirst BeAcipeGr F 1)EGroA3 G -c • • axb r -5 - Bord.sass . ._ . . . . 1 t ; . • • IS IJ ggJ. I a ` 13 � 07/18/2002 10:21 9093572379 ROSS CONSTRUCTION PAGE 0{ Fri/a0.17 17 - As g'4D4- dcfice'p e s 'lk .max fi it « " • . ;or,/ ...5j)47 g - P6_ l2 ' / 1 3 i _Sra70/0 .(--E 9x',2 BE.i'? XXL 2s a /6 "cc • $c67Y s 5 . 1 . gx12 'Y/2 f • 3 .1. i i. R.T.WHARTON AND ASSOCIATI NC. • STRUCTURAL ENGINEERS 601 S. MILLIKEN AVE,,SUITE H ONTARIO, CA 91761 RE-ROOF PERMIT INFORMATION - Date: CONTRACTOR: 5-STAR SERVICE NO.: CONTACT: CUSTOMER: ADDRESS: ADDRESS: CITY, STATE,ZIP: CITY,STATE,ZIP: PHONE: PHONE: DESIGN CRITERIA: (1997 U.B.C.) LUMBER PROPERTIES: LIVE LOAD: 20 psf Pitch less than 4:12 Pb= Allowable Bending Stress= 16 psf Pitch 4:12 and greater Includes 25% = 1885 psi 2x4 increase for 1635 psi 2x6 DEAD LOAD: 7.2 psf New EAGLE Tile Roof Loading 1510 psi 2x8 1.6 to 4.3 psf Framing and Sheathing' 1.5 psf New 1/2"CDX Plywood 1385 psi 2x10 1.4 psf Miscellaneous&Felt E=Modulus of Elasticity= 1.6 x 106 psi 14.0 to 16.7 psf Total Dead Load w/o Clg. 2.5 psf 1/2"Gyp.Brd. 16.5 to 19.2 psf Total Dead Load w/Clg. *Depending on Rafter Size CALCULATIONS: The maximum allowable span of a member shall be determined by the lowest value of two methods of calculation: Maximum allowable bending stress and maximum allowable deflection (L/180 w/out clg.; 1./240 w/clg.). r 1 8 S Fb 384-El 3 384•F-I3 Lbending ' (DL+LL)•SF-12 L [(180).5•(0.5•DL+LL).SP.144] L .-[S.(240)-(0S-DL+LL).SP.144, (No Ceiling) (With Ceiling) Rafter overhangs at eves shall be determined by the 2.F .S lowest value based on member stress or deflection: Lb.o _ (DL+LL)-SP 12 L d .o ._- 8-El 3 [180-(0S-DL+LL)-SP-144, WHERE: Fy is Maximum Allowable Bending Stress(psi) E is Modulus of Elasticity(psi) S is Section Modulus of Lumber(in) I is Moment of Inertia(in') LL is Live Load(psf) SP is Rafter Spacing(ft) DL is Dead Load(psi) L is Span(ft) TABULATED VALUES, MAXIMUM ALLOWABLE RAFTER SPANS: Rafter Rafter Pitch <4:12(No Clg.) Pitch >4:12(No Clg.) Pitch>4:12(w/Clg.) Over Hangs Size Spacing Single Double Single Double Single Double at Eves 2x4 12" 9'-10" 12'_4" 10'-5" 13'_0" 9'-4" 11'-7" 4'-7" I =5.36 in° 16" 9'-0" 11,_3„ 9'-6" 11'-11" 8'-6" 10'-7" 4'-2" S=3.06 in3 24" 7'-9" 9'-10" 8'-4" 10'_5" 7,_S, 9'-4" 3'-8" 2x6 12" 15'-5" 19'_3" 16'-4" 20'_2, 14'_7, I8'-l" I =20.8 in° 16" 13'-9" 17'-7" 14'-8" 18'_6, 13'-2" 16'-7" S=7.56 in3 24" 11,_4" 15,_5„ 12'_1" 16'_4" 11' 7" 14'-7" 5'$" 2x8 12" 19'_10•' 25,_2•' 21'_1•' 26'-6" 19,_P, 23'-8" I =47.6 in° 16" 17'11" 23'_1" 18'-6" 24'-4" 17'_5, 21'-8" 8'-8" 5= 13.14 in3 24" 14,_3" 19'_10„ 15'-3" 21'-1" 14'-7" 19'_1" 7'-1" 2x10 12" 23'_11" 31'-ll" 25'-6" 33'-6" 24'-3" 29'-11" 11'_11" I =98.9 in° 16" 21'-0" 28'-8" 22'-8" 30'-4" 21'-6" 27'_6, 10'_6, S=21.4 in3 24" 17'4" 23'-11" 18'-6" 25'-6" 17'_9" 24'-3" 8'-8" ENGINEER'S COMMENTS: Existing roofing material must be removed. The maximum span values are for vertical gravity loading only. All framing shall comply with the Uniform Building Code. Cosmetic cracking of walls and ceiling can occur during and after re-roofing. Furthermore, visible deflection of the roof can occur, especially for rafters approaching maximum allowable spans. Cracking and deflections do not affect the structural integrity of the roof framing. This form is provided as a convenience to homeowners and contractors. Eagle Roofing Products Company and the Architect or Engineer assume no responsibility for the accuracy of the information supplied by others. • To specify your title block on Title: Job# these five lines,use the SETTINGS Dsgnr: Date: 2:53PM, 19 JUL 02 Description: selection on the main menu and enter your title block information Scope: will be printed on each page. User 510100 xwe6013a3.Ver 5.1.3,11-0un-1999,wiN2 UsGeneral Timber Beam Page 1 (cl U/1963A9 ErvERCULC_VOb52000\00re.r00(S\fere0f5.eCW CdlNld_tl- Description 6X16 WOOD BEAM DISTRIBUTIVE LOAD General Information Calculations are designed to 1997 NDS and 1997 UBC Requirements 1 Section Name 6x16 Center Span 16.00 ft Lu 2.00 ft Beam Width 5.500 in Left Cantilever ft Lu 0.00 ft Beam Depth 15.500 in Right Cantilever ft Lu 0.00 ft Member Type Sawn Douglas Fir-Larch,No.1 Bm Wt.Added to Loads Fb Base Allow 1,350.0 psi Load Dur. Factor 1.250 Fv Allow 85.0 psi Beam End Fixity Pin-Pin Fc Allow 625.0 psi Wood Density 34.000 pd E 1,600.0 ksi Full Lengh Uniform Loads Center DL 277.00 ft/ft LL 280.00 ll/ft Left Cantilever DL #/ft LL gift Right Cantilever DL #/ft LL #/ft r(1 Summary ' Beam Design OK Span= 16.00ft,Beam Width=5.500in x Depth=15.5in, Ends are Pin-Pin Max Stress Ratio 0.642 : 1 Maximum Moment 18.5 k-ft Maximum Shear* 1.5 5.8 k Allowable 30.0 k-ft Allowable 9.1 k Max.Positive Moment 18.47 k-ft at 8.000 ft Shear: @ Left 4.62 k Max.Negative Moment 0.00 k-ft at 0.000 ft @ Right 4.62 k Max @ Left Support 0.00 k-ft Camber: @ Left 0.000 in Max©Right Support 0.00 k-ft @ Center 0.241 in Max.M allow 30.01Reactions... ©Right 0.000 in fb 1,006.30 psi fv 68.24 psi Left DL 2.38 k Max 4.62 k Fb 1,635.05 psi Fv 106.25 psi Right DL 2.38 k Max 4.62k Deflections Center Span... Dead Load Total Load Left Cantilever... Dead Load Total Load Deflection -0.160 in -0.312 in Deflection 0.000 in 0.000 in ...Location 8.000 ft 8.000 ft ...Length/Deft 0.0 0.0 ...Length/Defl 1,196.7 616.13 Right Cantilever... Deflection 0.000 in 0.000 in ...Length/Defl 0.0 0.0 Stress Calcs _r Bending Analysis r.- ,. - , , - . . . . v ,_ , .-. Ck 24.972 Le 4.118 ft Sxx 220.229 in3 Area 85.250 in2 Cf 0.972 Rb 5.033 Cl 0.997 Max Moment Sioc SicReq'd Allowable fb @ Center 18.47 k-ft 135.54 in3 1,635.05 psi @ Left Support 0.00 k-ft 0.00 in3 1,640.19 psi @ Right Support 0.00 k-ft 0.00 in3 1,640.19 psi Shear Analysis @ Left Support @ Right Support Design Shear 5.82 k 5.82 k Area Required 54.752 in2 54.752 in2 Fv:Allowable 106.25 psi 106.25 psi Bearing @ Supports Max. Left Reaction 4.62 k Bearing Length Req'd 1.343 in Max. Right Reaction 4.62 k Bearing Length Req'd 1.343 in Query Values M,V,&D @ Specified Locations Moment Shear Deflection @ Center Span Location= 0.00 ft 0.00 k-ft 4.62 k 0.0000 in ©Right Cant. Location= 0.00 ft 0.00 k-ft 0.00 k 0.0000 in @ Left Cant. Location= 0.00 ft 0.00 k-ft 0.00 k 0.0000 in • To specify your title block on Title: Job# • these five lines, use the SETTINGS Dsgnr: Date: 2:53PM, 19 JUL 02 selection on the main menu and Description enter your title block information Scope: will be printed on each page. Rd: 510303 Page 2 p User:KW59 3 Ver 513,323un1999 WW2 General Timber Beam EH (Q 198393 ENERCALC mac'\jobs2000\00 re-roofsVeroofs.ecw:Calculatl Description 6X16 WOOD BEAM DISTRIBUTIVE LOAD Sketch & Diagram 02 1.60 3 20 480 640 803 960 1120 1280 111:11 90 16.00 r r � � -r r �� � IIIIIIIIII 55i4kt iiiiY inliiiiii iirri rli infniiiti s57pR .. ._ . 92 I 1 111111 11 7 li ',11h I�.Ali Um l II,���III���JII YY .. III iql -083 i 1 1 II I x=18.Sk-R i� ��� omax=-0.3124) O shear Wal(k) __.. motion-Mew9,5 1 Mrnd (R) 1047 160 320 380 .....§..9)14,1):11)00 =9.60 1120 1280 1440 16.00 Rmax-1.6k lime=4.6k 1663 Vmax@Id[=4.6k Vmax@R=4.6k 1177 111111 1 .i f 12.93]108 ,.r. I III IF 1115 .1 '1 ,III ILII *LI;II III ' 923 III iI d III 111111�11I1� 11111V s s+ 444%).1;,1t-4,4'"1" Alli 1.ltitv `.11111 tl� 1. --. Be,19,0JIMo M k4[j_ Loation along Memba_{R 0 26D 3 ) 6 1 960 13 111 �0 114.40 !:1680 la i- 11 i� kl -0W I k� 4` 41 T h I blz c1,11,4±;',11::, ILII 11 I IIIr O16 - II NIIII r dII . I -U 19 �I I Ia i� r III '15 ___.- -035 Illll liil 111 1II 1L !11,E 41 28 — 1_ __— _ .__ Local le Deflection (in) Location aon9 Member(R) Notes P - "- < Calculations are designed to 1997 NDS and 1997 UBC Guidelines Section databases have been updated as of 2-Apr-1999 Allowable stress databases have been updated to 1997 NDS&1997 UBS values on 2-Apr-1999 To determine Cf values for sawn sections,the program looks for the identifying words in the"Stress"entry. "Select","No.1","Standard"and similar typical words are used to determine Cf category "Unbraced length"is multiplied by the following values to calculate"Le" When beam depth<=7", Le=2.06*Lu When 7"<beam depth<= 14.3", Le= 1.62 a Lu+3d When beam depth> 14.3", Le=1.84*Lu To specify your title block on Title: Job# • these five lines,use the SETTINGS Dsgnr: Date: 2:51 PM, 19 JUL 02 selection on the main menu and Description enter your title block information Scope: will be printed on each page. 51General Timber Beam K) 0380 Page ' Rev: 5100601313,Ve 5.1.3,33 Jun-1993,Wue2 (c)19v-s9-59 wmw.0 CNObs2000\00 re-roofs\rerr000ffs..ecw:Calculad, ,, Description 8X12 WOOD BEAM DISTRIBUTIVE LOAD General Information Calculations are designed to 1997 NDS and 1997 UBC Requirements ` Y _-y^_ Va�` Section Name 8x12 Center Span 20.00 ft Lu 2.00 ft Beam Width 7.500 in Left Cantilever ft Lu 0.00 ft Beam Depth 11.500 in Right Cantilever ft Lu 0.00 ft Member Type Sawn Douglas Fir-Larch, No.1 Bm Wt.Added to Loads Fb Base Allow 1,350.0 psi Load Dur. Factor 1.250 Fv Allow 85.0 psi Beam End Fixity Pin-Pin Fc Allow 625.0 psi Wood Density 34.000 pcf E 1,600.0 ksi - Full Lengh Uniform Loads Center DL 140.00#/ft LL 100.00 #/ft Left Cantilever DL #/ft LL #/ft Right Cantilever DL #/ft LL #/ft Summa AA ry ?_,�...,r..., , 4' Beam Design OK Span=20.00ft,Beam Width=7.500in x Depth=11.5in,Ends are Pin-Pin Max Stress Ratio 0.561 : 1 Maximum Moment 13.0 k-ft Maximum Shear* 1.5 3.6 k Allowable 23.2 k-ft Allowable 9.2 k Max. Positive Moment 13.02 k-ft at 10.000 ft Shear: @ Left 2.60 k Max.Negative Moment 0.00 k-ft at 0.000 ft @ Right 2.60 k Max @ Left Support 0.00 k-ft Camber: @ Left 0.000 in Max @ Right Support 0.00 k-ft @ Center 0.569 in Max. M allow 23.22 Reactions... @ Right 0.000 in fb 944.99 psi fv 41.30 psi Left DL 1.60 k Max 2.60 k Fb 1,685.40 psi Fv 106.25 psi Right DL 1.60 k Max 2.60k Deflections Center Span... Dead Load Total Load Left Cantilever... Dead Load Total Load Deflection -0.380 in -0.616 in Deflection 0.000 in 0.000 in ...Location 10.000 ft 10.000 ft ...Length/Defl 0.0 0.0 ...Length/Defl 632.3 389.43 Right Cantilever... Deflection 0.000 in 0.000 in ...LengtluDefl 0.0 0.0 Stress Calcs ,. _ .. _ . _ . . . . , Bending Analysis Ck 24.972 Le 4.118 ft Sxx 165.313 in3 Area 86.250 in2 Cf 1.000 Rb 3.179 CI 0.999 Max Moment Sxx Req'd Allowable fb @ Center 13.02 k-ft 92.69 in3 1,685.40 psi @ Left Support 0.00 k-ft 0.00 in3 1,687.50 psi @ Right Support 0.00 k-ft 0.00 in3 1,687.50 psi Shear Analysis @ Left Support @ Right Support Design Shear 3.56 k 3.56 k Area Required 33.523 in2 33.523 in2 ' Fv:Allowable 106.25 psi 106.25 psi Bearing @ Supports Max.Left Reaction 2.60 k Bearing Length Req'd 0.555 in Max.Right Reaction 2.60 k Bearing Length Req'd 0.555 in Query Values f h M,V,&D @ Specified Locations Moment Shear Deflection �I @ Center Span Location= 0.00 ft 0.00 k-ft 2.60 k 0.0000 in @ Right Cant. Location= 0.00 ft 0.00 k-ft 0.00 k 0.0000 in @ Left Cant. Location= 0.00 ft 0.00 k-ft 0.00 k 0.0000 in To specify your title block on Title: Job# these five lines, use the SETTINGS Dsgnr: Date: 2:51 PM, 19 JUL 02 selection on the main menu and Description enter your title block information Scope: will be printed on each page. Rev: S10300"10General Timber Beam Page 2 User:510966 01313,Ve 5.1.3,11-tun-1939,w,n31 (c h983 9 crvmwc , ,. , a c:�obs2l10.1011 re-roofs\reroofs.ec T:CaI W� Description 8X1 2 WOOD BEAM DISTRIBUTIVE LOAD Sketch & Diagram t0 2.00 100 6.00 8.00 10.00 12.00 11.00 1fi00 18.00 20.00 rT"iT,Tfj I!ITel i T PTRTITlTITITMTfTTITT . .cei. _ _ 24q44,„„„,„,„,,,,dillYt r nrnnn n11r 1 Norm p pp��I .-. 71-411141 --__ Ismil 4I6 �1 IIL Ilii Mak��n VIII N v' •b.,. 71-4lr 1 IT S ,' III€� ! Y03 . ' 1 ill III IINih Dna--0.616n $bear laa0(Y) lmtrn Aleq MenVrer(RI 13.02 2.00 400 6.00 „,13.00-11000177a00) y 14.03 16.00 18.00 20.00 Max92.6k Amax°2.6k Vmax0left"26k Vman00.2.6k 1041 ,fit [ CIL_ Ft! 911 .e: RI111 It n Y it ". IIS 7-81 4 f— [{ I y 651 /1$ FIl�k ,+;:i It 11 Ii 4ii� At iI 1�A ^I,, ._ :1.: - 21 ,,,GGG ry1 -4, 1911 IGi �f--• _� i 'N� '� . .-_ i' Y '- 1 . �- I w , l St,..N =;, ��iP' Y } - 11 t k'll lmbm Ahq Member(R 0op 2.00 :46... 05777:j I 1,:::;"10.00- 12aa is„ r 0177-441:9077.120.80 1i da...-.Y- 1 I y 'i, -01z If in _If 1Fl , 'prvi V . -026 t' I r l t:7;:t: i�-' 114iIId 1 f 11',d _—• -031 I i 7_II 14' -4 ��i t� ---- am I L 1w 1 i ..1474:1.71E&I l I l�� ip 1 ;ViM ''" tan]Y Deft&on(N) Lntbn None Member(R) Notes Calculations are designed to 1997 NDS and 1997 UBC Guidelines Section databases have been updated as of 2-Apr-1999 Allowable stress databases have been updated to 1997 NDS&1997 UBS values on 2-Apr-1999 To determine Cf values for sawn sections,the program looks for the identifying words in the"Stress"entry. °Select°,"No.1","Standard'and similar typical words are used to determine Cf category °Unbraced length"is multiplied by the following values to calculate"Le" When beam depth<=7°, Le=2.06'Lu When 7"<beam depth<= 14.3°, Le= 1.62*Lu+3d When beam depth> 14.3", Le= 1.64'Lu •` • To specify your title block on Title: / Job# • these five lines,use the SETTINGS Dsgnr: Date: 2:53PM, 19 JUL 02 selection on the main menu and Description enter your title block information Scope : will be printed on each page. Rev: 510300 Page 1 Usa:KW:060143,ve 5.1.3,22-1una999,W1n32 General Timber Beam CO 19133-99 ei'AV1L c:jobs2000\00 re-roofs\reroofs.ecw:Calcvlttl�, Description 8X20 WOOD BEAM DISTRIBUTIVE LOAD General Information Calculations are designed to 1997 NDS and 1997 UBC Requirements ' Section Name 8x20 Center Span 20.00 ft Lu 2.00 ft Beam Width 7.500 in Left Cantilever ft Lu 0.00 ft Beam Depth 19.500 in Right Cantilever ft Lu 0.00 ft Member Type Sawn Douglas Fir-Larch,No.1 Bm Wt.Added to Loads Fb Base Allow 1,350.0 psi Load Dur. Factor 1.250 Fv Allow 85.0 psi Beam End Fixity Pin-Pin Fc Allow 625.0 psi Wood Density 34.000 pcf E 1,600.0 ksi • Full Lengh Uniform Loads 1 Center DL 555.00#/ft L LL 560.00 4/ft Left Cantilever DL #/ft LL #/ft Right Cantilever DL #/ft LL #/ft Summary Beam Design OK Span=20.00ft,Beam Width=7.500in x Depth= 19.5in,Ends are Pin-Pin Max Stress Ratio 0.932 : 1 Maximum Moment 57.5 k-ft Maximum Shear* 1.5 14.5 k Allowable 63.2 k-ft Allowable 15.5 k Max.Positive Moment 57.48 k-ft at 10.000 ft Shear: @ Left 11.50 k Max.Negative Moment 0.00 k-ft at 0.000 ft @ Right 11.50 k Max @ Left Support 0.00 k-ft Camber: @ Left 0.000 in Max @ Right Support 0.00 k-ft @ Center 0.429 in Max.M allow 6320Reactions... @ Right 0.000 in fb 1,451.08 psi fv 99.04 psi Left DL 5.90 k Max 11.50 k Fb 1,595.64 psi Fv 106.25 psi Right DL 5.90 k Max 11.50k Deflections Center Span... Dead Load Total Load Lett Cantilever... Dead Load Total Load Deflection -0.286 in -0.558 in Deflection 0.000 in 0.000 in ...Location 10.000 ft 10.000 ft ...Length/Deft 0.0 0.0 ...Length/Defl 838.5 430.03 Right Cantilever... Deflection 0.000 in 0.000 in ...Length/Dell 0.0 0.0 Stress Calm , Bending Analysis Ck 24.972 Le 4.118 ft Sxx 475.313 in3 Area 146.250 in2 Cf 0.947 Rb 4.140 CI 0.998 Max Moment Sxx Req'd Allowable fb @ Center 57.48 k-It 432.25 in3 1595.64 psi @ Left Support 0.00 k-ft 0.00 in3 1,598.88 psi @ Right Support 0.00 k-ft 0.00 in3 1,598.88 psi Shear Analysis @ Left Support @ Right Support Design Shear 14.48 k 14.48 k Area Required 136.321 in2 136.321 in2 Fv:Allowable 106.25 psi 106.25 psi Bearing @ Supports Max.Left Reaction 11.50 k Bearing Length Req'd 2.452 in Max.Right Reaction 11.50 k Bearing Length Req'd 2.452 in Query Values h M,V,a D @ Specified Locations Moment Shear Deflection II @ Center Span Location= 0.00 ft 0.00 k-ft 11.50 k 0.0000 in @ Right Cant. Location= 0.00 ft 0.00 k-ft 0.00 k 0.0000 in @ Left Cant. Location= 0.00 ft 0.00 k-ft 0.00 k 0.0000 in . • 7`- To specify your title block on Title: Job if these five lines, use the SETTINGS Dsgnr: Date: 2:53PM, 19 JUL 02 selection on the main menu and Description enter your title block information Scope: will be printed on each page. Rev: 5113300 Timber Beam Page 2 Uta:51133005W-06 1.Va 5.1.3,22.106-1993,wnli (c)1983-99 ENF#AlC c jobs2000D0 re_roofskreroots.ecw:Calculatl Description 8X20 WOOD BEAM DISTRIBUTIVE LOAD Sketch & Diagram 1200 100 600 8.00 10_00 1200 14.00 1800 ....18.00.......20.00 'awn(CTITi 1Tr11-,11111 111:11111,I 1 ITliT{i i n • 11156/811156/8 E Iill i •I - - i I1. I„ 4:31:101 18 1011. I11'I' L111 I'� r_ tltill 1 I flp..57.5441 S 9.1 6N •2 -- c.c.4155Bm Shear Load (p lmmn MOM Member(60 5748 200 100 6.00 600p 1 66:u0�07.2.00 1410 0600 1800 20.00 Amu•11.5k Rmea•11.56 517] t i -_-IM nVmxa o lea•1186 Woo0 rt•11.5k wn Air: fi 1iIilk I+k' IV I`IIII.!I I "' K 3+19 Ali fill ;11361 11101 I gin t„..--Ta-7, ii - 28 7I t '\. 2299 �1 (Id:�I ;!��I��l01 I., '1 i 11'16^l II 1 11 - `1I . N 17.24 At '41 III'I1I��1I'O 1 . f 1 iggii i, i : ti i5]5 Y 1 F= ,, F ii i,t i.l:, 1! 1 �iIIII f-..: 1'- > 1J ' :H 'TbrIt imm"r:p QIyIWI Te tsroj 2i M '14.etter(at 16.60 1t66"72o.00 k -011 � &111 , 2 hwu;� I k , 1_ o v I iI�II SII - €s I��I� i ' K. � y1 4.28 1 3 If tic.:±4,11, Iillii A1T,T –_— tltl 1 Iff 91rp1t "—[ -039 11I111�1111ImllC l61111d III'V' -,# . .0.45 I .�Il,ltFe Loral Y renannn M) . LLocum un;Mamba(R) Notes 1. . ._______ _ y .-_ . . s Calculations are designed to 1997 NOS and 1997 UBC Guidelines Section databases have been updated as of 2-Apr-1999 Allowable stress databases have been updated to 1997 NDS&1997 UBS values on 2-Apr-1999 To determine Cf values for sawn sections,the program looks for the identifying words in the'Stress'entry. °Select°,"No.1°,"Standard"and similar typical words are used to determine Cf category "Unbraced length'is multiplied by the following values to calculate'Le" When beam depth<=7", Le=2.06•Lu When 7'<beam depth<= 14.3`, Le= 1.62•Lu+3d When beam depth> 14.3°, Le= 1.94•Lu Jo#16 4 3Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. • UNIT NO. , Project Address 1110 San Jose TY\ \41 Io3 p-i • 4637 7/20/84 7.011 TL 2890 Via Martens TYPE OF CONSTRUCTION ElNEW L`J ADO ❑ ALTERATION U REPAIR Applicant's Mailing Address ❑ CONVERSION ❑ DEMOLISH '❑ OTHER A.P.# Zone Owner's Name Mary Stone Phone 556-8064 DESCRIPTION OF WORK/USE OF BLDG. Address 1110 San Jose S Main Building: Accessory Building: Arch/Eng. License No. _ TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ® MECHANICAL B Rear N Contractor's Name Air Management Phone 632-7590 ❑'OTHER A - I PROJECT DESCRIPTION SQ. FT. _ OCCUPANCY C Right N Address(mailing/ 2890 Via Martens CONSTRUCTION TYPE • VALUATIONS S G Left R M City License No. 29640 ZONE GRADING CU.YDS. ACRES plug. Ref.# Parking Req./Provided R I LICENSED CONTRACTOR DECLARATION O I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: • M with section 7000) of Division 3 of the Business and Professions Code, and - my license is In full force and effect. • T License Class — License Nc. S- kate .7-6-84 - Signature 0 pin l-.1 LL PLUMBING FEES • - W00.KERB'COMPENSATION DECLARATIONBar Sink Showers ELECTRICAL FEES • hereby affirm that I have a certificate of consent to self-insure or a certificate , f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - ' I Automatic Washer Transformer 0 15.50 KW 3800, Lab. C.) 0 50+KW — Cdr, pvo. C2-216996-8 Company INA Backflow Irrigation Sewer Cap Construction Pole Sub. • Certified copy is hereby furnished. X Cer tie coq y is filed with the city B I Ing Diivisio�n.(, .,r.(.-...r- Bathtubs Sewer Connection Cooking Unit Meter Out)to 100 amps Date �_g—i54 Applicant U.L11 a.m../ !J (Dm - • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed If the permit is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I - shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-B Workers' Compensation Laws of California. Date Signature ' Floor Drains Swimming Pool w/Spa F,A.U. Inc.Solar ❑9-15 HP 016-15+ NOTICE:II,after making this declaration,you should become subject to the - . Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave . CONSTRUCTION LENDING' AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is Issued .(Section 3097 Clv. C.) Interceptors Water Heater Outlets Range Lender's Name Lender's Address _ -- Kitchen Sink - Water Service Switches Sign OWNER BUILDER DECLARATION. I hereby affirm that I am exempt from the Contractor's License Law for the • Lavatories - Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap any structure, prior to Its-issuance, also requires the applicant for such permit • Generator 0 0-5 KW 5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ,the Contractor's License Law(Chapter 9(commencing with Section 7000) of m ivision 3 of the Business and Professions Code) or that he/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)- LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves — thereon, and who does such work himself/herself or through his or her own 4 00 Hood of Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: Boiler employees, provided that such improvements are not intended or offered for 1 - sale. If, however, the building or improvement is sold-within one year of corn- Canopy Type II 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- , • Duct-Under Ground Approved By Date move for the purpose of sale). - LJ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Colide, Data 2-2.-(-- tractors U tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con • - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $ Date Owner - Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above • 00-100,000 BTU 0100,000BTL— - ELECTRICAL $ GRADING $ information Is correct- I agree to comply with all city and county ordinances - and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection purposes. 7-9-84 MECHANICAL $ #-Rf1 �_� TOTAL FEE $ 7 .00 Signature eA tutu- i3JQ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS — CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor • CONSTRUCTIONAND.PLANNING PDC_ ..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 r 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings ' ' 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, D Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System 61. APPROVAL TO DECK . 11. Property Sewer.Line & House Connection 62. Backwash & Receptor-Final 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 l 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil - 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing73. 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 Flashing76. 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 3g4.5 era)35. Final Gas Pipe-Test ,"'r 36. Hood or Canopy 37. Final Factory Fireplace . . , 38. Final Plumbing • 39. Water Service-Final1 • 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. Special Requirements Completed 49. Electric Release to Edison - - 50. Gas Release to Southern California Gas Co \ 51. CERTIFICATE OF OCCUPANCY • \ No. Date ' _ t,. COSTA MESA BUIL, 3-SAFETY DEPARTMENT APPLIL. MN F MI'R,..t i'ERMCF89.8I I P.O.BOX 1200 COS..,MESA,CALIFORNIA 92626 RECEIVEV PERMIT - For Applicant to Fill in Completely - Use Ink Only ( N° 4 7 7 5 0 BUILDING 1110 San Jose Ave. A.P. NO. :-. 171/jo -aye — �G� ADDRESS - BUILDING OWNER OR Wimbledon Assoc . ADDRESS 1110 San Jose Ave. TENANT MAILING 1470 Jamboree Rd UNIT ACENO. 40 ADDRESS �i jVQ CITY Newport Beach To 40-6800 718975 LOT 40 BLK. CONSTRUCTION NEW ADD ALTER REPAIR I MOVING DEMOLISH Imperial Savings & Loan LENDER X BRANCH Pasadena OWNER Wimbledon Assoc. ✓1a?5 61 So. Lake Ave. // ADDRESS VALUE/ II -51 AORREHNGITECTINEEFr#'or. bin Yamafu]i NO,TE`549-7124 USE PRD , 5 ADDRESS 17992 Mitchell So. , Irvine ZONEPO/ZJJJJJJD /�/.��TV PE `fid=,s�GROUP /\— E: APPROVED '/ 20/5I CONTRACTOR McLain DV. CO. BY DATE ADDRESS 1470 Jamboree Rd CITY Newport Beach TEL-640-6800 F APPROVED SETBACKS STATE C. NO. 273875 uc.NO. 18873 SIZE NO.OF BLD . (FROM B�/Ls 6Tf1CCT) P.L. CW. OF LOT NOW ON LOT FRONT (90 FT. xt USE OF c.n EXISTING BLDG. , R.SIDE S FT. in El(-1 /r Separate permits are required for L.SIDE 6/ FT. Ci electric,plumbing and heating work. REAR d3,/ FT. _ F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION -C G 7[� L/ 7 Q 2a - 78-37 DATE a--.:77- C8 PRD - New construction APPROVED Single-family dwelling _e,{I' DATE, l a CU HOLD FOR SPECIAL REQ T; 00 hereby acknowledge that I have read this application and state N gd that the above information is correct and agree to comply with 60 all laws regulating building construction, and I shall not employ i 4 any person in violation of the workman's compensation laws of RI the State of California. ' I hereby certify that I am properly licensed as a contractor under ��0� SQ. FT. (] .�`+ / the State of California Business and Professions Code, Division 3, THE AMOUNT SHIVN UNDER VALUATION IS FOR EI Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ q and Professions Code,Division 3,Chapter 9., ,2473,LQ ,3, in m PLAN CHECK $ 0 s Signature of ,s / �j o Permittee $('/�rl 3� TAX $ V wQ L U Authorized Agent Date (((( •' 1 a/ TOTAL PAID $ / ► U o+ OWENS-CORNING Fiberg . • Blanks Insulation- The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance and that the Blanket Insulation is in- stalled in conformance with current energy conservation regulations, California Administrative Code,Title 25, State of California, in the building located at: /�)� /I& Son J05r AC . #fid • / 77S Street Lot Number Tract Number Exterior Walls • Owens-Corning Fiberglas Blanket Insulation 3 2 // Thickness R-Value Ceilings ,, /y Owens-Corning Fiberglas Blanket Insulation • Thickness R-Value Floors Owens-Corning Fiberglas Blanket Insulation • Thickness R-Value Foundation Walls Manufacturer Type Thickness R-Value General Contractor License No. By Title Date (Signature)/% /' Insulati ontractor^^/����AA/.'��92tc � S'/7�/�rr%h? CLicense No. • By_ a� 2 Title 'J ? ' Date �`/O/f/ ignature OWENS/CORNING FIBERGLAS Homeowner Copy (While) State Copy (Yellow) Builder Copy (Pink) OWENS-CORNING FIBERGLAS CORP. Insulation Operating•Division Pub.No.16-BL-6995-A Limo In U.S.A.,July 1977 Fiberglas Tower,Toledo, Ohio 43659