HomeMy WebLinkAbout3401 SANTA CLARA CIR - Building PermitsApplicant �o flll in all
CITY OF COSTA MESA �P MIT NC
60NSTRUCTION?�ERMIT �I L -.;
Address
�itense NO.
Address A1 �a Il�if%' , - -
b� d�7 f
Contracror Phone
witnln neary Eortler lines ana zlgn ali aDProoriale tleclarations.
� TRACT NO. LOT NO. ' BLDG. NO.
LICENSED CONTRACTOR DECLARATION � -
I hereby atfirm tM1�t I am licensetl untler provislons ot Charler 9(com-
m¢ncing wllh 5¢CtlOn ]000) of DlvislOn 3 0( the Businesi antl
Protessions 'Cotle, antl my Iicense is In full torce antl atfect.
License Class License No.
Da[e Si9ndtura
WORKERS'COMPENSATION'DECLARATION '
I hereby affirm that I have a certifitata of ton5ent to self-Insure or a
certifirzte of Workers' Compen5ation �Insurance, or a certitiatl copy
thereof (Section 3800, LaO. C.).
?�,E�cy No. Company
�F'� a'ertifietl copy is hereby furMshetl.
"'_`ertifietl copy is filetl with the city Bulltling Division.
EXEMPTION F0.0M WORKERS' COMPENSATION DECLARATION
(This 5¢ction neeE not be completeC it the permil IS fo� one huntlretl
(E100) or less).
I certity ihdt in N¢ peAOrrTance of [he wo�k fo� w iich Ihis pe�mit IS
Issuetl, I shall not emplOy dny peR � i�/�dny man so a5 lo betom¢
subject�to t�he� W�% r�p¢ �Compensati .vs ot Cal
Date YL "��LSlgnature �
NOTICE: It after making tnii.tlecla alion, you Shoultl become subjecl
to (h¢ WOrkers' COmpensdtion provisions of the tabor Cotlo, you musl
forthwith comply with such proviSiOns or this permit Shall be tleemetl
r2vOkB0. , _ _
CONSTRUCTION LENDING AGENCV
I hereby affirm Mat there is a Cons[ruttiOn I¢ntlin9 agenGy tor the per-
tormance ot the work for which tnis permi[ Is issuetl (Section 3097
Civ. C.1. ' " " '
Lentler's Name
Lentl¢r•s aeare:s
OWNER'BUILOER DECLARHTION - � -
I nereby af(irm that I am exemp[ from [h¢ Contractor'S Licenu Lnw tor
tlle following reason (SCttion 7031.5 BUSine55 antl Prote551on5 Cotle:
Any city or rounty which reqW�¢5 a De�mit to conrt�uc[, alte�,
improve, tlemolish or repair any structure, prior lo itt issuant¢, alio re-
quire5 [he ap�liWnt /or suth p¢rmit to fllc a 519netl slatement that �e
is licensetl pursua to [he provisions ot the Contractor'S Licensa Law
(Cnapter 9 mencing witn Section ]000) of Division 3 of lhe
Bu5ine55 a dMsions Cotl¢) or that h¢ i5 exGmpl lh¢rGirOm antl th¢
basis tor e allegea exemOtion. Any violation of Section 7031.5 by
a liwnt tor a permit subjects lhe applicanl lo a civil penalty
more than live hun0�etl tlollars (§500j.
`QI
m[enaea or otrerea tor sa�e. u, nowever, In¢ nwwmg or improvemen�
is soltl within one year of completion, the owner wlll have tne burtlen
ot provinq he ditl not builtl or improve for the purpose o/ sale).
❑ 1. as owne� o! ihe property, am exclusivery conVaGfing with
licensetl cont�actors to const�uct the project (Section ]044, Business
antl-Professions Cotle: The Conlractor's Licenso Law tloes not apply to
an owner of properiy who builtl5 or improves tbereon, antl who Con-
[racts Irom sucn projecis �with a contraCtor(5) li<esne0 pursuant to
Ih¢ ConlractOr's LiGense Law).
❑ I am exempt untler $ection — B. 8 P. C. for'tnis
reason
Date Owner
1 herEby [ertify that I have reatl this application ana state that the above
information is correct. I aqree to camply wilh all city anG county
o�tlinances antl state ws relating to construciion, antl her¢by authOrizO
rep�esentatives of is ity t0 e t¢r upon the ab ve men_ tion¢tl
property for inz io �pose (r(yZ
Siqnahre Da[ �`� �
Drivers' License or 55 � .�
CMF 0865-46 White-Builtling; Canary-Applitant; Pink-Accoun[ing; G�
TVPE OF CONSTSHCTION �
❑ NEW �j/�DD ❑ ALTERATION
❑ REPAIR ❑ CONVERSION ❑DEMOLISH
❑ OTHER
DESCRIPTIONOFWORK � •�%!
TVPE OF PEFMIT "
❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL
❑ TENANT O ELECTRICAL OCLVMBING ❑MECHAI
O'OTHER
PROJECT DESCRIPTION
54. FT. '
OCCUPANCV_CONSTRUCTION TVPE
VALUATION ZONE
GRADINGCV.VDS. ACRES
PLUMBING
BATHTU85
LAVATORIES
KIT.SINKS -
SERV ICE $INK$
FLOOR SINKS '
DRINKING FOUNTAINS
INTERCEPTORS -
SWIMM�NG POOL
WATER SERVICE
GASSERVICE �
WATER HEATERS
SEWERCONNECTIONS
SOLARTANK.
'SOLAR GIPING $Y5.
ISSUE FEE
PLAN CHECK
SHOWERS
V R I NqLS
DOVBLELHVS
DISHWASHERS
SUMPS
FLOOR �RAINS
CLARIFIERS
PTRAP
ALTERATION
OUTLETS
BTU OUTPUT
COLLECTORS
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-300,000 BTU
ANDDUCTING 100,000+8TV
REFRIGERATION 0-100,000 BTU
SVSTEM 100,000+BTU
BO�LERS BTV
SVSTEM REPAIR,ALTERATION
EXHAVSTSVSTEM MVLTIPLE
ISSUE FEE
�
A.P. $ �%I Z + <
ZONE � - PLNTG(
SEpTBHCK G� 5T. � PF
L�EFTYARD �
5 D e
R�IGHTF1
REAR VARD (TO P/L) �(
PKG.SPACE REQ.
STREET WIDTH
ZONING APPROVE� BVD C
SPECIA� CONDITIONS:
PF30 V I DED
PARK FEE
ELECTRICAL PLAN CHECK
GENERATOR p.l KW_ 1-10 KW _
TRANSFORMER
APPI'LIANCE ]0-SOKW_50+KW_
� - MOTORS pd HP_1-30 HP _
(INC.SOIAR) 10-50HP 50i.HP _
' FI%TURES OUTLETS SWITCHES
GAS TUBE SIGNS
-POLE LIGHTS -
PHNELS ' MAIN
AMP
ISSUE FEE
APPLICATION APPROV ED
SUMMARV OF FEES
� � H•0� T�
DATE
BUILDING - ' • -
PERMIT $ SMIP $
PLAN CHECK E PERMIT
PLUMBING §� �SSVANCE $
PLAN CHECK § �/� GRADING b
ELECTRICAL E ��" `�v $ .
PLAN CHECK $ MICROFILM E
MECHANICAL E ' . TOTAL FEE $
PLAN CHECK g LE55'AO-
' VANCEPC $
. � FINALFEE EL'yL—
CONSTRUCTION AND PLANNING POOL & SPA . �., .. '' �'�` � . � � , .
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector �
1. Temporary Electrical Service or Pole • 43. Pool & Equipment Location (�.�z,� �Q
2. Soil ipe-Undrgrn - 44. Steel Reinforcement
3. Electrical.Conduit Utility-Undrgm - - 45. Forms - -
_ 4. Electrical Conduit-Undrgrn ' 46. Electrical Bonding � � - �
. tee ein orce • 47. Rou h Plumbin & Pressure Test �
6. Electrical UFER Grn. 48. APPROVALTO COVER-6l�lEf�+£"- � � �2 _
7. Footings � 49. Electrical Conduit-Undr rn
8. Foundation - 50. Gas Pipe,- ❑ Undr rn, Test � (0-�2-
9. Wa[er Pipe-Undrgrn ' 57. Backwash Lines P-Tra ❑" ndr rn '
10. Structural Floor System 52. APPROVALTO DECK - Cs
. 1.1. Property Sewer. Line & House Connection 53. Backwash & Rece tor=Final
12. - Street Sewer Connection '�� - 54. Heater & Vent-Final
13. Rough Plumbing ' �
14. Rough ElectricConduit -' 56. Electrical-Final
15. Rough Electric-Wiring � 57. Solar System-Final �' '�
76. Rough Heating & Air Conditioning � � encing & Access Approval
17. Ducts in Structure - APPROVED fOR PLASTERING
18. Ducts, Ventilating � . . . . . ' �
19. Gas Pipe-Rough & Test _ 60. POOL/SPA.SYSTEMS FINAL
20. Roof Framing - . �
21. Roof Sheathin �' - - � � ' -
22. Frame and Flashin � NOTES: �� -
23. Insulation � -
24. Lathing & Siding - � -
25. Drywall Nailing � � �
26. Plaster Brown Coat ��
27. Electrical Power Meter-Final -
28. Final Electric -�
29. Final Heating & Air Condltioning - - '
30. � �Final as Pipe-Test _ �
31. �nal Plumbin ' � `� i
32. rvice-Final ' �
33. Gas Service-Final -
34. Solar pomestic-Final
35. Landsca e S rinklin S stem
36. Sound Attenuation �
37. Handicap Regulations - - --- � - - ' - � �
38. FINALSTFUCTURE&BUILDING
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co. •
42. CERTIFICATEOFOCCUPANCY
No. Date
(714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa.CBJLSLDING PERMIT � 77 FAIR DRIVE, COSTA MESA, CA 92626
t3Ul
�ob Address: 3401 SANTA CLARA CI
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 41206313
Applicant: BURKE, MICHAEL
Address: 1653 SUPERIOR AVE -
COSTA MESA, CA ,
Owner: CARVER, SALLY ANN
Address 1005 HICREST
Zaning: R1 R1
Phone: (949) 642-7222
Zip: 92627
� . " � Phone:
. � GLENDORA, CA Zip: 91741
Contracror. LEE ROOFING OF COSTA MESA
Address: 1653 SUPERIOR AVE
COSTA MESA, CA
Zip: 92627
Phone: (949)642-7222
License: 349686
ISSUED BY:
Status: ISSUED
Applied: 08/27I2003
Issued: 08127/2003
Arch :, Eng:
Address: � : Address:
. . Phone: � Phone:
� ,
' Zip: . � , License: License:
SCOPE OF PERMIT
REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING SHAKE ROOF, V2" OSB SHTG, 1 LAYER 30# FELT, APPLY "30-YEAR COMP
SHINGLES." T/O FLAT ROOF AND INSTALL HOT TAR B:U.R. SYSTEM WITH ROCK. 30 S�UARES �
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
��
Total:
$0.00
$18125
$0.97
$0.00
$0.00
$0.00
$182.22
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
Calc Valuation:
Claim Valuation:
PLANNING & ZONING
Left 0- 0 Right 0- 0
Left 0- 0 Ri9ht 0- 0
Prooased: 0
ss,�zzoo
ss,�z�.00
NOTICE: The work authorized by this permit shall comply with all applicable handlcap access requirements untler California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 1 BO days, or it work is suspended or abandoned
for a penod of 180 days. �
INSPECTIONS: In order for tha work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
�equl�ed Inapettlona end final epproval mus� be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 -
�
WORKERS'COMPENSAnON DECLARAnON: w
I hereby eHirtn under penalry of perjury one of �he lallowlnp declaretions:
❑ I heve entl w�ll maintain e certificate of consent to sell-Insure tor workers' compensetion, es proWded for 6y sectlon 3700 oi Ihe Lebor Cade, lor the pedormence of the
�ork for which t�is pertnit is issued.
heve antl vA�� me��tein warkers' oompensation Insurarke, as requiretl by section 3700 of the Lebor Gode, far the pertwmance ot Ihe work for whiU Nis permit is issued.
M workers' penseilan /Ins�urence carri nd ol number ere:
Carrier.Y ��14Ti� CUN+O–�1J� PolicyNumber: �O9lp—�Gi)�S
(This sect/on need no! be can0letetl l/ t permlf /s ve/ued et one hundred dollars ($100) or /ess.J
❑ I cenlly that in t�e peAortnence ol tha wo r which this permit is Issued, I shall not employ any person in eny menner so es to 6ecome subject to the workers'
compensetlon lews ol Celitomi ntl r et II I shoultl become suDject to ihe workere' compensatlon provlsions of Sactlon 3700 of the Lebor Code, I shell torthwith
comply with thes sio . /�
ApplicantSipnetule: ' � Dete: D�7/i
WARNINO: FAILUNE TO SECUFE � KE S' C ENSATIqJ COVEMOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINA� P TIES DGVIL FWES UP TOONE HUNDRED
TFKKISANp pp��pqE �5100,OOO�ADD ON TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIOED FOR IN SECTION 3106OF THE LABOR CODE, IfJrEREST, AND ATTORNEI^5 FEES.
UCENSED CON1'AACTONS DECLARATION:
I hereby ettirm ihe� I am Ilcensed under provlsic
rorce antl eMea. Llc. s // /7 /
Contrectofs Signe�ure:
Chepter 9(commencing with Sectlon 7000) of Divislon 3 of Ihe B
O Cless N
Cotle, end my Ilcense Is in full
CONS7RUCTION LENDINGAGENCV:
❑ I hereDy alfirm that th�e is a consWClion Iending egency for the pertortnance ot the work for which ihis pertnil Is IssueO. (Sec. 3097, Civll Code).
Lenders Name: LenCers AdCress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
1 hereby eMirtn Ihat untler penelry oi perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business entl Professions
Code: Any Gry or Counry which requlres e pertnrt to consiruct, alter, improve, demolis�, or repair any sWCNre, prior to Its luuance, elso requires t�e appliwnt for such pertnit
b tile e signetl stelement that he ar she Is Ilcensed pursuent to t�a pmvislons of ihe Cantrectors License Law (Chapter 8(wmmenGng with Sectlon 7000) of Dlvlslon 3 of ihe
Business and Professions Code) or Iha1 he or She is exempt Iherefrom and the basis for the alleged examption. Any violetion ol Sectlon 7031.5 by any epplicant for e pertnit
subjects the eppllcent to e clvll penalry ai not more Ihan Ilve huntlretl tlollars ($500).):
❑ I, es owner o� �he properry, ar my employees wlih weges es ihelr sole compensatlon, WILL DO THE WORK, anG the swIXure Ls not ImenCetl or oHered for sale (Sec.
70a4, Business enA Professlons Cade: The Contrectors License Lew tices not appty to an owner of properry who bullQs or improves lheraon, and who tloes such wo�1c
hlmselt or he�sell or through his or her own employees, providetl that such imprrnemants ere not Inte�tled ar oXeretl tor sele. N, however, I�e bullding or improvement is
soltl within one year ol completion, the owner-bullder will have the burden oi proving that he or she tlid not build or improve lor purpose oi sale.). �
❑ I, es owner of the property, em E%CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct I�e pro�ect (Sec. 7044, Business anA Professions
Code: The cOnirectors Llcense Lew does not apply lo en owner ol properry who bullds ar Improves Ihereon, end w�o conireccs for such proJect wit� a coniractor(s)
license pursUant to the Contractors License Lews.).
❑ I am exempt under sec. Business end Prafessions Code for this reason:
Signature: Date:
Owner ID vartlled by tlAver's Ilcense. ❑ Yes ❑ No DriveYs License No.
Vedfica0on af Owners�ip Dy (type ol document, I.e. - proDerry tax bill or tleed):
Expires:
DIVISION OF INUUSTRIAL SAFETY PERMIT CERTIFICATON:
❑ I hereby certl�y Ihat no excevetlon flve (5) or more feet in depih Into which a peroon Is requiretl to descend, will De matle In connectlon with work euthorized by this
permit, end inat no bullding siructure, scaMoltling, felsework, or Oemolition or dismentling ihereo�, will be more ihan thirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Calllamle Atlminlstretive Code).
❑ As ownervbullder, I will not employ anyone to do wark w�ich would require e permil from tha Divislon ol Industdel Sefery, as notetl ebave, unless such person hes a
permit to do 4uc� work trom the division.
Signature: Date:
Division of IntlustnAl Satery Permlt Number.
CERTIFlCATE OF COMPLIANCE IWD AUTHOHIZA710N OF EMAY: I certily under penelty of perjury that � have reatl t�is eppllcetion end stete thet the information glven is
cortact. I agree to Grnnp�y w'Nh all state laws siM dty ordtnances relall� to buifding consVuciion, and authodze representetives of t�e Gry ot Cosla Mesa to enter upon the
above-descnbed proper�y for inspeclion purposes. I egree not to occupy ar sllow occupency of eny building euthorized by this pertnil unlil final inspection. '
GOUE �.
1816
1268
200
201
202
203
Fiietl Sys�em Finel Fire Pravention
Pod SDe Flnal
Finel Re-Hoo�
Final BIocWRetelning Well
Finel FedOry Fire Place
Finel Sign �
204 Final Demolltion
PAIE It�6fl
COUEI INSPECDONTYPE
206 Final Mechenicel
208 Flnal PlumCinp
210 Finel Elecldcal
272 Final Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final BulldingiOccupancy
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OWNER HELTZER ENTERpRISES-COSTA MESA DATE 9-26-69
JOB ADDRESS 3401 Santa Clara Circle BUILDING PERMIT N0. 3099t
INSPECTI
GAS
WATER
LOT TRACT FIRE ZONE VALUE
�iqnature Date GROUP T �C .7 TYPE
�f �7 G'
� — n ... .. ., ., .. . �. .. .. � .. �.
HOUSE CON.
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH HEATING ANO AIR CONOITIONING
UNOERGROUNO � POWER U I I I
ROUGH WIRING C .r Neafin a 71 Ve
TRENCHES � FOftMS � STEFL REINF. ��-/j'7 -"
FLOOR SVSTEM -1 � '
BOND 6EAM � STEEL REINFOHCE '
SHEATHING If f C
FRAME AND FLASHING /-O 7C
LATHING - IN OUT � � G 0
PLASTER, BROWN COAT � Y
STRUCTURAL, FINAL }j�
HEATING, VENT., REFRIG. AN� A.C„ FINAL - � � - � O
PWM9ING. FINAL ANO GAS TEST I1 �'ZO �
F
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�o��e
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA. CALIFOHNIA 92626
';OY 17_-69PAi��O 459� **° 12U.5�
CMSA
- APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
FECEI �j DAJ� C V DATEISSUED
BUILDING 3401 Santa Clara Circle / `7'��� $EP 2 6 1960
ADDRESS
Heltzer Enter rises-Costa Mesa PERM��a
OWNER p A.P. NO. /��. J�J�G I
MAIL 740 N. La Bled AVO. ADIDREss 3 y0� CG�2.a�
ADDRESS
CITV I+.A. Cal. No'937-2171 TRACT 663 LOT 66 BLOCK
CONSTRUCTION United California Bank
LENDEFi
aanNCN Main Office
ADDRESS 6th and Spring, L.A. OWNER
VALUE �J /f n/iil�
APCHITECT F. Gonzales TEL. —6HJ S O $Aos�r�`f"
OR ENGINEER `/ �/
aoor+ess 1336 E. Chapman Ave.,Orange,Cal ZONE TVPE I GROUP r
Geor e J. Heltzer & Associate APPROVED
CONTRACTOR g BV DATE
ADORESS .Sdill2 8S above
TEL. ZONE NO.OF USE OF NEW n$ e 81�
cirv No. R P�+^� 2 aui�oiNc Res. v att.G z'
STATE 'zOLOJH CITV 1707 VAROSAPFROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BVILDING
SIZE NO.OF BLDCS. (FROM C/L STREET)
OF LOT NOW ON LOT RONT FT. FT.
USE OF
EXI5fING BLDG. FT
SIZE OF NO. OF
NEWBLOG. ROOMS STORIES L.SIDE FT T.
EXTERIOR WALL ROOF
COVERING COVERING REAR OFT. FT.
USE OF BUILOING AND WOFK TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLOGS. ACC6S BLDGS.
Residence with attached garage CURP.qW navRoveo
Plan No. 402 APPROVED D '
1 haraby acknowledpa thet I hava reatl this oppllcatlon antl atata
that Na ebove information ia correct enG aprea to comply with
ell laws regulatinp buildinp comttuction, anG I shall noa amploy
eny perwn in vloleilon of tha workmen'� compenaation law� of
the Stete of Celitornia. D m
I hareby cartify thet I am properly licansatl ez e contrector untlar / � SQ. FT. G S� �� C
t�e State Ot California Buaineaa antl ProfeasiOna Code, Divislen 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR j
Chapter 9, antl Net a�c� Ileensas ere In full forca entl etfaet, or I THE PURP06E OF ESTABL4SHING A VERMR FEE ONLV: Q
em eaempt trom the Orovisiona of tha Stem of Callfornie Bu�ineas VALUATION
antl Profassions Code, DI lon 3, Che r 9. PERMIT FEE $ S�• d� �
Sipnatura of r/ � ,
Permlrtee S �Z � 03'/ PLAN CHECK $ �/�^� E
� o
LL
Authorizetl Apent TOTAL FEE $ � ,r�U