HomeMy WebLinkAbout2725 SAN LUCAS LN - Building Permits 4`p5111 A/ 9 CITY OF COSTA MESA
BUILDING DIVISION
1. 0-7a. DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER
1 r.n:n,MI I
F
-4• PERMIT 02-00223
1�
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 2725 SAN LUCAS LN Status: ISSUED
Suite No Applied: 03/20/2002
Vicinity: Issued: 03/20/2002
Parcel Nunmber: 14131210
Applicant: BARTON, EVANGELINE ISSUED BY:
Address: 2725 SAN LUCAS LN
Phone: 714-549-1026
COSTA MESA,CA Zip: 92626
Owner: BARTON, ROSS J
Address 2725 SAN LUCAS LN
Phone:
COSTA MESA,CA Zip: 92626
Contractor: OWNER-BUILDER
Address:
Phone:
Zip:
License: 0
- SCOPE OF PERMIT -
ELECTRICAL TO INCLUDE: 1 SUBPANEL TO 200 A
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 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0
Pool/Spa 50.00 0 up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 over 100 kva/kw $0.00 0
Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0
Service to 200a $0.00 0 Misc.Conduit $0.00 0
Service to 1000a $0.00 0 Misc.Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1hp $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
Motors over 100hp 50.00 0
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $30.50 1 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $54.00
Intermed Pole $0.00 0
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
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-48(6/m)
•
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 Cade,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed if the permit S valued at one hundred dollars(5100)or less.)
Of I certify that In the performance of the work for which this permit is Issued,I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with inose provisi ns. � q
plicant.SignatureT.:1 etc_
7✓ Date: 3— 20 —0—
WARNING:FAILURE TO SECURE WORKEfS 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 SECTION 37060F THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
force and effect.Llc.N Class 4
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior t0 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 properly 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.).
„TeCtI,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 u •er sec. =usiness and Professions Code for this reason:
r %?
Ignature: . r - Date: —20'n2-
by ( � Expires: 7-Z-a
Owner ID verified driver license. 71 Yes 0 No Drivers License No.
Verification of Ownership by(type of d.. I,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feel 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,Calitomla 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 Safely 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).
present
_..r.. .__..__.__.r..___
2 Does or will the applicant or preseor 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? 0 Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
6 (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- escdbed property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
2G. — 2-0 -07
(_Signature Of LegalOwner(s)� Date
And/Or Authorized Applicant Date
CODE I INSPECTION TYPE oat maim CODE( INSPECTIONTYPC RAIL Rf®AL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing - �[ 76 /YQ
200 Final Re-Roof 210 Final Electrical -///aJOoZ y "
y.A
201 Final Block/Retaining Wall 212 Final Fire Prevention PP U
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
4`,� 9 CITY OF COSTA MESA _.
BUILDING DIVISION
. .� I , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
4. .4. PERMIT
M02-00124
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
•
MECHANICAL PERMIT
Job Address: 2725 SAN LUCAS LN Status: ISSUED
Suite No Applied: 03/20/2002
Issued: 03/20/2002
Vicinity:
Parcel Number: 14131210 ISSUED BY:
Applicant: BARTON, EVANGELINE -
Address: 2725 SAN LUCAS LN •
Phone: 714-549-1026
COSTA MESA,CA Zip: 92626
Owner: BARTON, ROSS J
•
Address: 2725 SAN LUCAS LN
Phone:
COSTA MESA,CA Zip: 92626
Contractor: OWNER-BUILDER
Address: •
' - Phone:
Zip: .
License:0
SCOPE OF PERMIT
MECHANICAL TO INCLUDE:CHANGE OUT EXISTING HEATER AND INSTALL NC UNIT.
FEE SUMMARY
Quantity Quantity
ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0
Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0
Ins(FAU>100 k BTU $0.00 . 0 Ventillation System $0.00 0
Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0
Inst/Rep.Recess Wall Htr $0.00 0 • Commercial Incinerator $0.00 0
Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0
Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems
Gas Piping $0.00 0 Up to 3 hp/100 k BTU $14.70 1
•
Factory Fireplace $0.00 03 To 15 hp/500 k BTU $0.00 0
Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0
VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 " 0
Vent Fan/Single Duct, $0.00-- 0 Over 50 hp/Over 1,750 BTU $0.00 0
Appliance $0.00 0 Boilers
Fire Dampers $0.00 0 Up to 3 hp $0.00 0
Smoke Dampers $0.00 0 3 To 15 hp , $0.00 0
Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0
Air Handlers< 10000cfm $0.00 030 to 50 hp $0.00 0
Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0
Floor Furnace $0.00 0 Other Mechanical Fee
Floor or Suspend Heater $0.00 0 Investigation Fee $0.00
Plan Check Fee $0.00
Reinspection Fee $0.00
TOTAL CALCULATED FEES $53.00
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
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446+6(6/00)
DECLARATIONS s
WORKERS'COMPENSATION DECLARATION: .
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed i/the permit is valued at one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If 1 should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these pro jsions. .y� �(�
ficeneSignetura'� �� r.� - 7 , `� cruZ.-"T�'� Date: .3 —Z-o—QZ_
RIVING:FAILURE TO SECURE RKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,0001,IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# Class#
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
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.It,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.).
rl,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 usinesj .professions Code for this reason:
Signature: c •,' _- , t a 2.w- 9-e . dh-�4�2— Date: [ —Z0 —0 2.
Owner ID verified by driver's lice se. es 0 No Driver's License No. ( Expires: 7' "O��
Verification of Ownership by(type of docu en,'.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 then 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 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 a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes IJ 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 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
6 (If"ye?,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-describbr property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
C C -q �/ 'le4sh 3 — 20 O 2
•
ferSgnature Of Legal,Owner(s)�- Date
And/Or Authorized Applicant Date
CODE r INSPECTIONTYPE On INTIAES CODE I INSPECTION TYPE 11DEE
1616 Fixed System Final Fire Prevention 206 Final Mechanical "7-1 5-Oa flAN
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 Site
204 Final Demolition . 250 . Final Building/Occupancy
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
ern,OF COSTA MESA CONST UCTION PERMIT PE ITN TRACT NO. LOT NO. UNIT NO. '
Project Address 2721 .f' ''" e,fro j/ /k -NG. TRACT
3�`� it 107 7/24/86 41.75 IL
i= / • TYPE OF CONSTRUCTION NEW ADD U ALTERATION U REPAIR ) -
Applicant's Mailin• Address 4
L/ _ L ✓_ _ . - yy�
❑ CONVERSION ❑ DEMOLISH El OTHER A,P,# 1'r—a"•129Ble' JL,.)— 3/2— /O. Zone $ (
Owner's Name Il'- c - - .✓ e 3
q ��r�, c DESC IPTIONQF W / SE OF G.
Address �TLv.:J , e ,-4!/y%e i/L C. o.L �y S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION Lel STRUCTURAL T Front (Q' —4 Z
//�/ O
Address erSir -- ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name J Phone ❑ OTHER _ • A _ - I
�i. PROJECT DESCRIPTION SQ. FT. OCCUPAN/[Y C Right G
Address(mailing) - CONSTRUCTION TYPE VALUATION$ {/ Q $ Left R
City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:" Planning Notes: Lo• 6 co CK W A LL 3,e" ' a.,) FF/\J M
with section 7000) of Division 3 of the Business and Professions Code, and ' •
my license is In full f ce and effect. - '-l..'72S 1* Z--] 3-7 SAN L_,UGAS T
License Class License No. _ S
Date igaature _ PLUMBING FEES _
•
• WORKERSE ATION DECLARATION Bar Sink - Showers
I hereby al rm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink -
)0, Lab. C.)' Automatic Washer' .Transformer ❑ 15.50 KW •
olicy No. Corn pony Backflow Irrigation Sewer Cap0 50+'KW "
• Construction Pole Sub.
U Certified copy Is hereby futhe -
•
Certifled copy Is filed with the city Building Division. Bathtubs Sewer Connection - Cooking Unit Meter ❑up to 100 amps
Gate Applicant •
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps
(This section need not be Completed if the permit Is for one hundred ($100)or
less). Dishwasher - - Solar Piping - Dryers OGas ❑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 a to become sub' to the Drinking Fountains Solar Tank FanWorkMotors❑01 HP ❑1'h 8
Gate E% i? Y Signatures Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ •
• NOTI E: If,after making this declaration, u should ¢come subject to the _
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave
CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet Device BoxesPoll! Light
I hereby affirm that there is a construction lending agency for the performance 9
of the work for which thi permit is issued (Section 3097 Civ. C.) interceptors Water Heater Outlets
Lender's Name // • Range
Lender's Addre O - 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 Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTrays
any structure, prior to its issuance, also requires the applicant for such permit Y Generator ❑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 .
Division 3 of the Business and Professions Code) or that he/she is exempt . - •
-
'"erefrom and the basis for the alleged exemption. Any violation of Section
31.5 by any applicant for a permit subjects the applicant to a civil - '
•Ity of not more than five hundred dollars($500). $ 3
I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
-
c• pensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee ' $ 3 '
fo 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 E.
thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 -
sale. If, however, the building or Improvement 1s sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • Building Approved By ` i' Date
m
prove for the purpose of sale). - \V7
❑ I, as owner of the property, aexclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
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 ❑0-100,000 BTU ❑100,000 BTU SU MARY 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 ❑� Multiple 0 System Repair/Alteration BUILDING PERMIT $ 56t.9r SMTP $ O•SO
proof o their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ ��•ZJ PERMIT
❑ 1 am exempt under�— Section - - B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING ' $ ISSUANCE $
Date Owner t s, • Heating System&Ducting Registers • PLAN CHECK 25% $ ENERGY P.C. $
I her y Certify that I have read this plication and state that the above 00100,000 BTU 0100,000 BTL
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ GRADING $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to enter upon the •ove- - tioned property for -- / •�
inspection • ,poses. , fl /,e / �`/l/ + • MECHANICAL $ TOTAL FEE $ 1- I ` '
Signature_ . _ _ ,/a Date '6`77,(! Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License •r s* •
. 111 .11t
1 CMF 0885-46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor
CONSTRUCTION ANPLANNING POOL & SPA •
D
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding i
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. -/ 57. APPROVAL TO COVER-GUNITE
[
7. Footings ;i, ( 8/y S/$ 58. Electrical Conduit-Undrgrnd. -
8. Foundation 777 59. Gas Pipe, 0 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
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS Permit# -
21. Ducts, in Structure 70. Underground Hydro .
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough &Test: 72. Underground Flush
24. Roof Framing f. - 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing . , 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe .
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION • ,
I
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
33. Final Electric Notes:
i 34. Final Heating & Air Conditioning
e)k 'en G-►n tit aiaok6xp
35. Final Gas Pipe-Test
36. Hood or Canopy I
37. Final Factory Fireplace ,
38: Final Plumbing . .
,39.'Water Service-Final -
40. Gas Service-Final - '
41. Solar Domestic-Final
V
42. Backflow Preventer ,
43. Backflow Irrigation . '
44. Landscape Irrigation System
45. Sound Attenuation • .
•
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING Q{�/A6 r , 2 , ,i
48. Special.Requirements Completed 1/ LIQ
49:)Electric Release to Edison
50. Gas Release to Southern California Gas Co '
'
:se.-
51. CERTIFICATE OF OCCUPANCY
.
No. Date _ % _ e
PARTY YPLL AGREEMENT
THIS AGREEMENT, made and entered into this AS — day of
�u <y , 1983, by and between P ,ny-tecnt_e %3/ditroAI L /
hereinafter referred to as "LAND CWER", and__ TT / Vresa�nd/P�( Wicte_RIL-m
hereinafter referred to as "ADJACENT PROPERTY OWNER".
It is hereby agreed that a party wall will be constructed on the
property line between a 7.2 C SAN Lucer L.✓ tnsr4fos. NA 9)-iAZ
/ (Address of Adjoining Properties)
an, .! 4737 ' CAN LiA-e r I-.N. (1) o .r7.4 cft NA ,
in the City of Costa Mesa, County of Orange, State of California, as per map
recorded in Bock /3 / , Pageeo-.2O1 Miscellaneous Maps, in the office of the
County Recorder of said County. The party wall shall be permitted to encroach
CA) i3 o'rN fixore.uice v
IN WITNESS WIEREOF, the parties have entered into this Agreement the
day and year first above written.
LAND OWNER ADJACENT PROPERTY OWNER
(Sign ure) '/!��✓ n ea _ -4.,
i n._ ure)
6Mt,s- k1 2,4Rro&) Vrg�ie< Inv/cli W ckecc<a-Mt
Name (TyLxd or Printed) Name (Typed or Printed)
7?s C,W ates4t LA- tosra NsI 02737 L(A,t/ 2MIAS , (70-rTa4 4Ec,9
(Address) (Address)
•
(NOTE: Please see reverse side for notary's statement)
STATE OF CALIFORNIA ) •
ss.
COUNTY CF ORANGE )
On before me, the undersigned, a Notary Public in
and for the County of Orange, State of California, personally appeared
known to ne to be the person(s) whose names) is subscribed to the within
instrument and acknowledged to me that (he/she/they) executed the same.
WITNESS my hard and official seal. (SEAL)
Signature
Name (typed or printed)
STATE CF CALIFORNIA )
ss.
COUNTY OF ORANGE )
On JULY 15,1986 , before me, the undersigned, a Notary
Public in and for the County of Orange, State of California, personally appeared
EVAN(,K1 INE W.BARTON AND BETTY H. WICKERSHAM - -
known to me to be the person(s) whose name(s) is subscribed to the within
instrument and acknowledged to ne that (he/she/they) executed ,the sane.
WITNESS my hard and official seal. (SEAL)
•
°' OFFICIAL SEAL
(Signature)
NORA L. HURST
. NOTARY Pp9LIC Uld12HNIq
1 PNINCIPAL OFFICE IN
NORA L. HURST ORANGE COUNTY jt($
My Commission Expires May 31, 1989
Name (typed or printed)
Bldg. Permit # e.
NOTARIZED STATEMEN IF RESPONSIBILITY
TO WHOM IT MAY CONCERN: This Permit #
47a.V 5 )J Luis/Ps LA,wj PDS 0-9)6,76
Street Address AP Number
I, �✓/�9-aLNG/ Lv, Mier-6J , as Owner in Title of the above referenced
property, do hereby authorize:
6241a9) )114- ---.2,,2 1306 --P,2[s-
-A
„r Ke DehnNainVS/c,� �f SES (7 [ �/ Telephone No.
11/0;1:_ G2'liliZe'f�'�( / p�� �6 6
Street Address
tJi tem /' Gds-. go 62
City State Zip
to obtain permits in my behalf, as owner/builder, for the construction, alteration, moving, demolition or repair of
the above referenced property. .
Should any person become an employee engaged in the improvement of the property, I 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.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to-any other person,
company or corporation.
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.
E✓4iO EI-i PE hl. 12,Aft rD' q- 86
�� ,Prriinted Name Date
Signature
State of California
County of Orange I SS
City of Costa Mesa I
18
On this day of July , 1986 personally appeared
before me EVANGELINE W.BARTON
known to me (or proved to me on the basis of satisfactory evidence) to be the
person whose name is subscribed to this instrument,and acknowledged that ..
OFFICIAL SEAL
he/she executed it. NORA L. HURST
NOIARY PUBLIC CALIFORNIA
In Witness Whereof, I hereunto set my hand and official seal. - PRINCIPAL OFFICE IN
ORANGE COUNTY
My Commission Expires May 31, 1989
CMF 0779-46,rev.a/B3
CAUTION
pPPRNA� ON
�y ELECTRICAL LINE CLEARANCE REQUIREMENTS
STPUCjURA F pcpUll+tom IN ACCORDANCE WITH STATE SAFETY REGULATIONS, IF
4RFERMITS Q�:upgS;1G. CONSTRUCTION RE IRES WORKERS, EQUIPMENT, CRANES
SEP TR1C0.E „p OR HOISTING DEVICE S TO BE IN PROXIMITY
O� fpR E`f" Sfhtln_Q;IF." �'' LINES, OF OVERHEAD
•
�� PR
C D NtP..t,,�, _ .Y _., T��n[4( � 'ELECTRICAL OR UNDERGROUNp
_,._ FACILITIES, CALL SOUTHERN CALIFORNIA EDISON COMPq(��+
^ X696
OAPt' , \ IMMEDIATELY (714) THERN4
alifof CG Mesa Building � 2 _
ALLB AT TIMES , ,, -
MAKEEHO CHANGES WITHOUTST BE ON ORI0R APP0.OVAL - APPROVED
11:I�—
i ___------1(
; �' bC 6f Dt ( XaeP L}. vr, 7ZS
�F.DEPT. 0? A pEF.'+111 OR APPItD'lAl _ ___. - - �.. - (�
H3TfUE0 - yDE � CITY OF COSTA MESA
THE IFEEM+CE C3 TCATIGRANN SH ROT BE
;031111 y ' 1 7�7
noxs SHALL , _. - - � �D, .,
R
OF EE AS EW?MO rcR,O E AFT^s.OVAL Di, rimiL PRE' .`• ' . ' �1 ' lJECT TO ENDO. DEPT. RE0. _
PLANNING DEPT
TO EE A FEW? (Ck:"C:;S C: TTIIS CODE IID CANCEL TRE , •t '... ::' " ; . '. I, � .
DF ANY OF THE FRCS:•-. EPT in
SO '• (riitl: r . ✓ , ��/� 'BY �DL 'MMoATE �'Z`f - So."
10T VIOLATE ORS V✓ t ' ' `,,�
WE
AUitTXc SHALL DE VALID, i8 LA�NfUI. 'Gdi1' COt:SC" ` ' .A ( "'�
if
SUMJIiG TOF. .. .. / ' J
FARPROVISIONSTHE CF THUS COC- - AL'1 dORlZE4 REQUInEME•:'"' _-�" ,� DIRECTO!OP PLANNING
THE YORK OR USE STiiCR iT ,�,_,�� ,
•
FAR AS A'T BAgE�U"C•I PSAIIS A IL
-Inc ISSUANCE OF . FMAIT r T.Of.ICI,
SPECIFICAT;CNS SRA.L In VC:T TIL. e33C"f, ,
TROh1 MEWS-TER REC8I0 •L'LG WE OCT,: '.:11,r an, i.
Mf'!"1." _
IN SNO RL.i GID 5.:..1:ICRT:t.)G+ •R:SEJ;S0.3 i,.,.+,
•
. T
CUILOIRG CC OF TIi1S Cl ,EOR CF f••• J..
HI clC',;,T;CN C - •
•
.
RESIDENCE• R[[IR[RC[ R[QClRC! RtlIMRt!
6i1 jO u enures
w
~
W W
W
t in
1.. M
•
• 7� 2��� � � F®rr���s�e��e��s
Call
STREEr A _ n ra I
• d 62?
•
TYPICAL 611 CONCRETE BLOCK FENCE
a
CI a GENERAL- NOTES
Cement Coping Optional II ■, II l 1
Channel Block With One �Bu� I
FencanufTop ofall•
•
111I MI
1 MORTAR: One Part Plastic Cement, and
IIIIII• Three Parts Sand
jilt 11111111111 IF
I I 7 GROUT: One Port Ports Three and
For . W or Len a , 7 2 1 One Half Ports Stand
Ven.Bars 3/8'6 et t'-0"O.C. tea a° COPING: One Part Cement, Three
For Fences Higher Than 5'
Ili �` u 'n--�, I Parts Sand t 1
Ili , — CONCRETE: Well Mixed I: eh : 3/2
Vert,Ban 3/8' at 32" O.C. i o: W y
Fill Cells Solid With Grout 111 > .'� " 1 I' Max. of Gallons of
• z l Water Per Sack of Cement
Where Stell Occurs > —
Reinforcing Steel.Shall 111 :E t -� I GROUT MAY BE POURED FROM THE TOP
OF THE FENCE
Conform to Sec.A-16.38 v o
A.S,T.M. Iii I CELLSANDAREASOFHORIZONTALREIN-
=:$II W n �' -'� l I REIN-
FORCEMENT SHALL BE CLEAR.CLEAN&
IS'SteeltCodLapped fff ' FREE OF ALL MORTAq DEBRIS.ETC.
ffEfjpsl _
OM
NATURAL GRADE v 111 UI II BONDS SHALL BE PROVIDED BY LAYING
MEI I= > B 111=111 j III= BLOCKS IN STRETCHER COURSES SO THAT
.�"
MI We - ai • VERTICAL JOINTS ALTERNATE IN EACH
� ° is
. O .r • • COURSE.
•
TWO 311r BARS ca. �. • _• ... . . .
CONTINUOUS TOP I�
&BOTTOM y„� WIDTH O TO 16. 0 C. MAX.
eO SEE CHART p '. O
o BELOW n ^• ; DEPTH OF EARTHTCOTH
VP 5).
1/3 THE HEIGTH OF FENCE
ea
° . .
Mow BOTTOM OF FOOTING.
• :
Applicant-to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA �CONSTT UCTIOJ PERMIT PER�y�NO TRACT NO. LOT NO. UNIT NO. • { BBO 3I26/86 c
O� !l I 7"" 131, I' E. IL
Project Address 1 Ay-) UGiS 4� ywI - LI I '
Applicant's Mailing
rAddress
/ 11/10 IA✓Q..) , G TYPE OF CONSTRUCTION LJ NEW ❑ ADD '4 ALTERATION REPAIR
Owner's Name 1�Ar'64_1 Phone-a991 ❑ CONVERSION C7 DEMOLISH ❑ OTH� A.P.# ' Zone
DESCRIPTION OF WORK/I' (r.14S W pp I
Address . C. - i Sym '�. • S Main Building: Accessory Building:
Arch/Eng. �J'A License No. 44;4044/k) TYPE OF PERMIT LI GRADING FOUNDATION ❑ STRUCTURAL E Z
Front_ • O
Address ////����� Cl TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear • N
• Contractor's Name_t /QF�GQ e g✓ i Phone 6-55'15 7
CI OTHER C Right N
Add �Q PROJECT DESCRIPTION SQ. FT. OCCUPANCY
City License(mailing) '�/C (�r�rr- SSP 'G -+�✓i/�L• K R
A h r CONSTRUCTION TYPE VALUATION $ S Left
City License N0. - ZONE GRADING CU.YDS. • ACRES •
LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9'(commencing Remarks: . Planning Notes: • Q
with section 7000) of Division 3 of the Business and Professions Code, and M
my license is in full foy a and effect- T
License'Class `^ 36. License No- 4/4546 $'
Date -2-o'T6-fi12 Signatures. . ( - PLUMBING FEES
'YORKERS'COMPENSATION DECLARATION - Bar Sink Showers
lereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
I Workers' Compensation Insurance, or a•certified copy thereof (Section - _.1
3800, Lab. C.) Backflow Preventer Service Sink. Automatic Washes Transformer ❑ 15-50 KW
•
Policy No. Company Backflow Irrigation • Sewer Cap Construction Pole Sub. 050+ KW '
Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit! Meter ❑up to 100 amps '
Date Applicant
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 ($100) or
mss). Dishwasher Solar Piping I Dryers ❑Gas ❑Electric Sub Panel '
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Fan
Workers' on,qp Safi n Laws of California- Motors❑0-1 HP 01%-8
Date 3-aY-s' Signature ./ —
Floor Drains Swimming Pool w/Spa F.A.U.
'NOTICE: If,aftterr making this declarati4("you Ou ubject to.the • _ Inc.SOlar 09-15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed revoked. • Fixtures Microwave
CONSTRUCTION LENDING AGENCY / Gas Service s-Outlet$ 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 HeaterOutlets
Lender's Name Range
•
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 Auto-Wash
following-reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal ;Standing Sections .
county which requires,a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays- •
•
any structure, prior to its issuance, also requires the applicant for such permit y - Generator ❑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 - •
'he Contractor's License Law(Chapter 9 (commencing with Section 7000)of , • .
'vision 3 of the Business and Professions Code) or that he/she is exempt •
erefrom and the basis for the alleged exemption. Any violation of Section • -
.-
,031.5 by any applicant for a permit subjects the applicant to a civil
oenalty 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 $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered .
for sale (Section 7044, Business and Professional Code: The Contractor's - . MECHANICALReinspection Fee $15 Issue Fee $ 3
FEES
License Law does not apply to an owner of a property who builds or improves 1
thereon, and who does such work himself/herself or.through his or her own • ` - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for . Boiler • Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- - 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 IA
el() for the purpose of sale). Building Approved By Date _ ®=
o
LI I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - , Application Issued By f
tractors to construct the project (Section 7044,Business and Professions Code: _ Dat: _ i ,_
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ' • ❑0-100,000 BTU 0100,000 BTU • •
builds or Improves thereon;and who contracts for such projects with a con- _ _ - SUMMARY DF FEES
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration • BUILDING PERMIT $ $MIP $
proof of their Worker's Compensation insurance should be provided to; me. - PLAN CHECK $ �\ PER MIT
❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers SV ,
•
PLUMBING $ 5 ISSUANCE $
71111E
Date Owner • Heating System & Ducting Registers ENERGY P.C. $
_ _ _ PLAN CHECK 25% $
I hereby certify 'that I have read this application and state that the above . El 0-100,000 BTU 0100,0008n_ - GRADING $
information is correct. I agree to comply with all city and county ordinances • ELECTRICAL $
and state laws relating to building nstructlon, antl hereby authorize repre- , , - MICROFILM $
sentatives of this city to enter on the above-mentioned property f r I PLAN CHECK ,50% $ ' TT
•
inspection purpojess. / r�6-� • MECHANICAL •$ TOTAL FEE $ •SV
DriSigners' eVii tr / Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or.SSS /��`� - - - - _
CMF 0865.46,rev. 10/84 White - Building: Canary •Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING PO( SPA
APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
• 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit'Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
'7. Footings; 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, ❑ Undrgrnd. .
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final •
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
)7. 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 LJ Gas 0 Oil
i
23. Gas Pipe-Rough&Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL •
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. •FOOD CERTIFICATE ISSUED
33. Final Electric Notes: • 4Crai . real... RAC Lan
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test 3-2b_S/. CAP
36. Hood or Canopy •
37. Final Factory Fireplace
38. Final Plumbing 3-24-14, LAW
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY
No. Date . ,
',1917-77W00 731 d****25.00
CITY OF COSTA MESA PLANNING ...APARTMENT
A.P. No. 14 _3170'9'5
Bldg. Permit No. 3 J
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address 2725 SAN LUCAS A . COSTA MESA
Owner's Name R. Barton
Bachelor or 1 - Bedroom Units 1 @ $25.00 = $25.00
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00 =
Total Number of Dwelling Units 1 Total Fee $25.00
Planning Department Approval Date 3-1742 Park Area No. 16
ByW.L.D. Bob Applicant's Signature
CITY OF COSTA MESA PLANNING 2ARTMENT
PAM
IR 17-7700 7314dfi***25.00
A.P. No. 141 312 18
Bldg. Permit No. .3y4/s`-5/
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
L ei'e/
Project Address 7720 CAN LIIrAS , COSTA MESA
Owner's Name R ilarton
Bachelor or 1 - Bedroom Units ] @ $25.00 = $25.00
2 - Bedroom Units @ $40.00 =
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00 =
Total Number of Dwelling Units Total Fee 525.00
Planning Department Approval Date 3-17 72 Park Area No. 15
By W.L.D. Bob Applicant's Signature
OWNER BARTON, R. DATE 3-17-72
JOB ADDRESS 2725 San Lucas Lane BUILDING PERMIT NO. 34454
GENERAL CONTRACTORContractors Production DESCRIPTION of WORK Add Rec.Room _
NAP No.141-312-10 LOT TRACT FIRE ZONE VALUE $ 5t 306.00
INSPECTIONS Signature Date GROUP 1 TYPE V ZONE R-1
sol_ PERMITS ISSUED
SAS SUBCONTRACTOR
Date Number Signature
WATER Plumbing
ROUGH PLUMBING I I
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER ❑ 727.-
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF.FLOOR SYSTEM e. 7
BOND BEAM n STEEL REINFORCE n I
SHEATHING /.7,. Li(•S�7L
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant
to Fill
in Completely
REG
02/BYDA ERC I
VED DATE ISSU
-V
BUILDING £/ / / /I ^
ADDRESS /24.r1 A'an LA PERMIT NO.
OWNER c " .<7447.I/ A.P.NO. pLIIj-'I�-IO
BUILDING
MAIL p
ADDRESS�,11.5 5471/41 L UCAS L
Z ADDRESS pc-40.0 - 31
Lt.
0-0 CITY (.OJf� �/Yf�� , NO. TRACT 7� ` I LOTI I BLOCK
ZZ /�/
< CONSTRUCTION NEW ADO ALTER REPAIR MOVING nFMOI ISH
OI- �O LENDER ,( '
J D BRANCH /---"
Jul OWNER , 134P-1-011.i
m J ADDRESS r � N VALUE ,./
m ARCHITECT �f ' n TEL p SE et) O%/1 $4JV Jerk
UN OR ENGINEER RC/T �Q.0/'i(l�/G NO. .Z/512 FIRE
Q J a
W 2 ADDRESS Axe r �,,�j/X l� - ZONE TYPE GROUP
o_Uri / / APPROVED 1 �J
J Z CO NTRACTD����AZ,/��v094rcy/t,� BY y' ATE✓ �,'�/ Z
co Z /// U
:I.
W ADDRESS /r , ...24-2,9„/„5,1,6417�� /4 ZONE NO.OF USE OF NEW �ZEL
0= - TEL �a� R PLANS BUILDING p
z, CITY "0.20/,/ ....0.,1
0.20ft/ 7 NO.77 FI�/zl k P (304A-
-
w0 STATE CITY YARDS APPROVED YARDS APPROVED
ow LIC.NO. grey, /'d,2�0 f' LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D0 SIZE 41•$5X $6 .l a'X ND' T NO.OF BLOCS. (FROM C/L STREET)
OF LOT g3 Ass c (5.57_ INOW ON LOT / FRONT 2&FT. FT.
USE OF
EXISTING BLDG. -1 R.SInF I Fri FT.
H SIZE OFG NO.OF 7
ZZ NEW BLDG.GLX� 6 ROOMS / STORIES / L.SIDE FT.
EXTERIOR WALL f ROOF T
V COVERING ..� irG� /`
I COVERING./�I� {�-' REAR 2.-L --L FTFT.
d USE OF L ING ANDWORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
�tZZ�y�l ,4 MAIN BLDGS. ACCESS.BLDGS.
Q VAR.* DATE
O C.U.P.# W p. APPROVED
z —AAPPROVED 1, , `lam r'� DATE 3117(,7-.-
O l/
I-
0
- STATE U 1 hereby acknowledge that I have read this application and state '
✓ that the above information is correct and agree to comply with 'j
CC all laws regulating building construction, and I shall not employ J
I"' any person in violation of the workman's compensation laws of
Nthe State of California. ve
Z3 S I hereby certify that I am properly licensed as a contractor under SQ. FT, o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
CC
am exempt from the provisions of the State of California Business
VALUATION
and Professions Co e,Division 3,Chapter 9. 2 _. co
PERMIT FEE $ ;a 01
Signature of �� � // E
Permittee / $ �3v6 PLAN CHECK $ ! (O
4, o
Authorized Agent � u.
TOTAL FEE $
,�1 12242
COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RE
P.P. O. BOX 917 COSTA MESA, CALIFORNIA .�
issr_ 'rI �
For Applicant to Fill In Completely APPLICATION FBNANMIPEPT•
TYPE OR PRINT Lot # 11 BUIEIIRCs)F COSTA MESA
BUILDING
ADDRESS e:71.7 Q5--San Lucas Lane Plan # 2C
COSTA MESA. CALIFORNIA For Office Use Only
ERMIIT NO.
OWNER Masa Del Mar Development Co. i I RECEIPT NO. I P (l',V/
ADDRESS Suite 1, 3800 E. Coast Highway RECEIVED BY DATE RECEIVEDDATE ISSUED
..,...0.--/eY 6 /3—LO I a - ifs 60
CITY Corona del Mar TEL.Or 34220 BUILDING
ADDRESS San Lucas Lane
ARCHITECT
ymond Levans 'Or 37010 O. COSTA MESA. CALIFORNIA
ADDRESS 3432 Via Oporto, Newport Beach FIREelk
�
ZONE TYPE 7"GROUP G Fi
CONTRACTOR Macco Corporation APPROVED
BY DATE
ADDRESS Suite 1, 3800 E. Coast Highway ZONING
NSaleb
CITY Corona del Mar :GNE R_1 1 "`"s2 I BUILDING EWMod.el
STATETEL. Or 34220 LEGAL 7.7/7.7/LIC.NO. 98808 NO. DESCRIPTION Tract # 3749
SIZE t 1 I NO. OF BLDG*.
0 67 'x 93/ NOW ON LoT O
OF LOT 9 A.P.NO. nnne
USE OF
EXISTING BLDG, YARDS EVES
_ APPROVED ALLOWED
SETBACK LINE PROM (CENTER LINE ST.)
CENTER OP STREET 40 REAR YARD 20 FRONT 1'
4o FT. IN.
SIDE YARD I LEFT 5 I RIGHT 5 R.SIDE l8 FT. IN.
DESCRIPTION OF WORK L.SIDE 5 FT. IN.
NEW I }( II ALTERATION I V ADDITION I REAR 20 FT. IN.
REPAIR I II MOVING I II DEMOLISH I APBYPROVED W. L. D. DATE 6-13-60
SBZIE LDING 55 X 50 ROOMS 6 STORIES 1 /
EXTERIOR W LL stucco I ROOF 1 / h (�(� �(
COVERING I I! COVERING wood shi I : e / �--n n
USE OF BUILDING AND WORK TO BE PERFORMED / / 116 o
Construct Single Family Residence try
I HEREBY ACKNOWLEP E THAT I HAVE READ THIS A UCA ON THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT TH* BOVE IB CORRECT AND AGR TO COM.
PLY WITH ALL CITY 0 INANC88 AND STATE LAWS oULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRU N. VALUATION �J
SIGNATURE OF .. / ' PERMIT FEE 5 C "
PERMITTEE Lfrl N
j
Project Manager $/36-2‘.5--:Ob PLAN CHECK $ /14.AUTHORIZED AGENT / o
1 TOTAL FEE 0