HomeMy WebLinkAbout779 SCOTT PL - Building Permits y c' .
4 CITY OF COSTA MESA
°y �
i '� I BUILDING DIVISION
F
DEVELOPMENT SERVICES DEPARTMENT % B98-00955
ti' PERMIT PERMIT NUMBER
4
(714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 779 SCOTT PL Status: ISSUED r-tt
Suite: Applied: 06/03/1998
Vicinity: Issued: 06/03/1998
Parcel Nunmber: 42417204 Zoning: .
Applicant: WOLDHUIS, CHUCK
Address:
Phone:
Zip:
Owner: ACCETTA& OLMSTED
Address ACCOUNTANCY CORP
SANTA ANA,CA Phone:
3621 HARBOR BLVD STE 265 Zip: 92704
Contractor: A R C GENERAL BUILDING & ROOFING CONTRACTORS
Address: 5570 MISSION BL
Phone: 800 893-7663
ONTARIO,CA Zip: 91762
License: 552543
Arch/Eng:
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
T/O ROOFING AND REROOF THE THYPLEX AND ONLY 1 GARAGE WITH FLAT ROOOF HOT MOP(4 PLY).
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,995.00
Permit: $99.75Claimed Valuation: $4,995.00 ,
SMIP Res: $0.50
•
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $100.25
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 Exi_stinn: 0 Required: 0 Proposed: 0
NOTES:
•
•
•
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
iJ
-
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number.
(This section need not be completed if the permit 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 o 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 t
Applicant Signature: Date: 6- 7� lO
WARNING:FAILURE TO SE ORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
T}CUSAND DOLLARE(5100, ),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.Lic. Class p
Contractors Signature: v Date: ['} 3'– "12-
CONSTRUCTION
1S /CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant 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 drivers license. 0 Yes 0 No Drivers 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 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? ❑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 end 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 a_nermit for such construction or modification
from the South Coast Air Duality Management District or from any other air pollution control district or agency? Yes 0 No
(Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the Calitomia 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
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.
nature Of I Owner(s) Date
to r 3—7
Authorized Applicant Date
=EL MSPECTION TYPE DATE MALS =El INSPECTION TYPF DATE afmlAL9
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final - 208 Final Plumbing
200 Final Re-Roof 4//9/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
•
244648 I
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO. TRACT NO. j LOT NO. BLDG.NO. . - 3718 - 3/25/82 6.00 TI
CONSTRUCTION PERMIT Pe _493 ' ` •
-
Project Address 779. )fC.c 41) r.z e I. TYPE OF CONSTRUCTION '
• Owner / ' Phones.5&-PC, 0 NEW , 0 ADD 0 ALTERATION' ♦ / '
Address 777 V Aid' _----A ei . • - - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH
ZONING REGULATIONS •
Arch/Eng. • v License NO. - - ❑OTHER - - --
DESCRIPTION OF WORK A.P.
• Addrebs / /f - - x . . - - - - ZONE ,PLNTGp. REF.p#-
Convactor��L74, ^L2G/.cElZ-il honCr f� TYPE OF PERMIT • - BUILDING CROPEIRTVNLHVE .-re '3
pqSETBACK C/L$T.
Address•"2,S (I��k �_-, •,,/ tom .�f/G'IaGRADING -❑ FOUNDATI,II.y ❑'STRUCTURAL SIDFE YARD
.LICENSED CONTRACTOR DECLARAT19I1 - - - - - -❑ TENANT 0 ELECTRICAL JPLUMBING OMECHANICAL sIDE YAW `
I hereby affirm that I am licensed under pfo4isions of Charter 9(corn-- . RIGHT
mencing-with section 7000) of Division 3 of-the Business and • 0-OTHER - - -- - '- - - -
Professions Code, zli, my license is in full force a tl f e / REAR YARD(TO P/L)
-�� ��p�' ���i�_�%' PROJECT.DESCRIP.TION' _ -
License Cass - 9Liced56'N �1 - •, PKG.SPACE REQ. PROVIDED
,Date �- fC4• Signature • YL ( "---• / SQ. FT: ' - ' _
'WORKERS'COMPENSATION DECLARATION - • - -- 't OCCUPANC •
Y_CONSTRUCTIONTYPE STREET WIDTH _ PARK FEE $
I hereby affirm that I have a certificate 9, sent to self-insure or a VALUATION ZONE ZONING APPROVED By I DATE
certificate of Workers' Compensation lis ce, Or a Hied cop - - . . - -- •
1
thereof (Sectio 380 b.C)). l q r//p GRADING CU:YDS. ACRES SPECIAL CONDITIONS: ,
'Policy %�/5�76"// Company jrl_� c4 ,2 .. . - . _ . - - .
0 titled copy is hereby furnished. - - REMARKS: .. / _ _ _
I Certified copy Is filed with the city Building Division- - I - ,
EXEMPTION FROM WORKERS'COMPENSATION-DECLARATION '. ' ' - L/ - '- -
;(This section need not be completed If the permit is for one hundred ,. _. -- _ '
($100) or less). - - - - _
•I certifythat In the performance of the work for which this permit is l/\/.�
issued, shall not employ any person in any manner so as to become PLUMBIN •P A@ Cf�EC - '�Jl `' , 'ELECTRICAL' PLAN CHECK
subject to the Workers'.Compensation Laws of California. ' _ - - - - -- •�/ • UW tLLINb -- -- - bAHH6t
Date - - Signature ' BATHTU S SH RS y"• SQ.FT SO FT
NOTICE: If after making this declaration, you should become subject TOILETS . URINALS '" , -.,- M'C f'/GENERATOR' - 0-1 KW_1-10 KW -
_itofo the Workers' Compensation provisions of the Labor Code,you must - I :TANSFORMER
PLIANC
-forthwith comply with such provisions or this permit shall be deemed LAV ATO DOUBLE LAYS PPLIANCE-' 30-50'KW_SO+KW - -
revoketl.. - - -- - - - - - ' - KIT.SINK DISHWASHERSMOTORS ' ' '0-1 HP_170 HP
.CONSTRUCTION LENDING AGENCY l hereby affirm that-there isa construction lending agency for the per- SEVICE SINKS - - SUMPS - UNC.SOLAR) - -10-50 HP 50+HP -iformance of the work for which this permit is lu_ ued (Setion 3097 -Crv: CJ: - - " - ' FLOOR SINKS FLOORDRAINFIXTURES - ' OUTLETS - SWITCHES ' -Lender's Name _ -Lender'{Address - - , - DRINKING FOUNTAINSGAS-TUBE SIGNS- - . •SOWNER BUILDER DECLARATION - - - INTERCEPTORSCLARIFIERS 'POLE LIGHTS ' - - • •1 hereby affirm that Iam exempt from the Contractor's License Law-for the following reason (Section 7031.5 Business-and Professions Code: SWIMMINGPOOL I -'PT,RAPLOKUL I ION-
Any City or county which requires a permit to construct, alter, - POLESLES T
MEERED SUB
improve,demolish or repair any'structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION • - , 'PANELS' - MAIN -' ' SUB
•
quires the apt.licant for such permit to file a signed statement that he - ,. - • '
is licensed pursuant to-the provisions of the Contractor's License Law a,krhVlr OUTLETS ,SERVICE '- - • • AMP - - - '
(Chapter 9 (commencing with Section 7000) of Division 3 of the f '
Business and Professions Code) or that-he Is exempt therefrom and th,� 'WATER HEATERS-. 1' BTU OUTPUT ' 1 r ' ' -- '' - '• - -
•
basis for the alleged exemption. Any violation of Section 7031.5 by ._ / s._ - " " '
any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS . - - '- - .-"
of not more than five hundred dollars ($500). - ' - - I
❑ I, as owner of the property, or my employees with wages a5 their SOLAR TANK' - - -- COLLECTORS' - T' - - - ' - - - -•- • '
sole compensation, will do the_work, and the structure.is,not Intended I
_ _
'or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. • • '' - • - _ • , -ISSUE FEE '- - • - • - ,
'Contractor's License:Law does not apply loan owner of a property - - - -- - - ,APPLICATION APPROVED BY-- ' DATE
'who builds or improves thereon, and who does such work himself or ISSUE FEE - ,
through his own employees, provided that such improvements are not __ _
intended or offered for sale. If, however,the building or improvement MECHANICAL PLAN CHECK •
SUMMARV.OF FEES
of pr.within one did r of completion, the owner will have the burden j -_ _ 1
'of proving he did not build or improve for the purpose of sale). , BUILDINGERMIT - -
❑ 1, as owner of the property, am exclusively-contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP, $
AND DUCTING - I - - - -•
'licensed contractors to construct ctheto project (Section 7044, Business 100,000+BTU PLAN CHECK $ 'PERMIT '. •
•antl eSslons Code: The Contractor's proves thereon,
apply to • + - - ' ISSUANCE $
'an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU • .PLUMBING $ - n I •
'pacts-'from such projects with a contractor(s)-licesned-pursuant to SYSTEM - -- - - - - - - - _GRADING" E - '
:the Contractor's License Law). 100,000+BTU } PLAN CHECK $ ' ' , t -
o r am exempt under Section B7& P.C.for this - - $
BOILERS BTU ,ELECTRICAL $ - -
-PLAN CHECK -$ �-- - MICROFILM S•
'reason - ' _ - - -
SYSTEM REPAIR,ALTERATION TOTAL FEE 1.---C_
Date - - Owner - - - - ' MECHANICAL-$ • --
II hereby certify that-I have read this application and state that the above EXHAUST SYSTEM MULTIPLE ' LESS AD- - '
information is correct. I agree to comply with all'city arid county - - PLAN CHECK $ ' - ' '-- VANCE PC $ ' " '
ordinances and state laws elating to construction,and hereby authorize - f
representatives of this city// to enter upon the above mentioned ' yfJ '
property for sec /putpo _
7� FINAL FEE $ �S'0V
Signature A ' �' Date �`' .- ` •
•
Drivers' License or SS ( ISSUE FEE •--- - -- - - - _ --_ . - -
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL& SPA • -
APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - - -
- 2. Soilipe- ndrgrn _ 44. Steel Reinforcement - - . ._ .
. 3. Electrical Conduit Utility-Undrgrn - - 45. Forms
_4. Electrical Conduit-Undrgrn_ _ _ 46. Electrical Bonding -- - -. - .
5. _Steel Reinforce _ 47. Rough Plumbing& Pressure Test - _ - - - _
6. - Electrical UFER Grn - 48. APPROVAL TO COVER-GUNITE --- - _ . . - - - -
• 7. Footings _ _ . - - 49. Electrical Conduit-Undrgrn ,
-_8. Foundation- . _ _ - 50. Gas Pipe, ❑Undrgrn,Test ' ' .
_ 9.._.Water Pipe-Undrgrn - -_ - _ 51. Backwash Lines. P-Trap. H Undrgrn -• - -- ---- -
,_10. Structural Floor System - 52. APPROVAL TO DECK ' - - - - - - •
11. Property Sewer Line & House Connection _ ._. . • 53. Backwash & Receptor-Final •
.12. Street Sewer Connection . 54. Heater & Vent-Final
13. Rough Plumbing _ - 55 Plumbing System - Final - - - .i
14. Rough Electric-Conduit - -56: Electrical-Final - , • • _
15. Rough Electric-Wiring - • - 57. Solar System-Final
16. Rough Heating & Air Conditioning - . - - - b8, Fencing & Access Approval
• 17. - Ducts, in Structure - - . - - - . - - 59. APPROVED FOR PLASTERING •
18. Ducts, Ventilating - - - . ' • - - - _
, 19. Gas Pipe-Rough &Test .- - .. 60. POOL/SPA SYSTEMS FINAL
-20.-- Roof Framing . .
. . , .
21 Roof'Sheathing - - -- II I - (( (� o
22. Frame and Flashing NOTES l� l.� cit.
_ PST U.q/l, -e-- ,\ . ) f l_-% ]__ - '
23. Insulation - - - '. _ } ` U _
24. Lathing & Siding . . - -fly- �rf e/ • iiis- eae ` �( ( .II J 5t.• /c•�
25. Drywall Nailing - / /4.1. e,"- ay,,�- ' `
26. Plaster Brown Coat • - D T7•' _- _ • .
27. Electrical Power Meter-Final - -. . -
• 28. Final'Electric - - - - • - - - . - ' - - '
29. Final Heating & Air Conditioning - _- _ _ - - - •
30. Final Gas Pipe-Test - - ' ,
31. Final Plumbing _ ' '
- -
-
32. Water Service-Final - - - - . - - - •
33. -Gas Service-Final - - - -
34. Solar Domestic-Final - • -' - '
35. Landscape Sprinkling System - - - -
36. Sound Attenuation - - - '
37. Handicap Regulations • - - - -• - .
38. FI NAL STRUCTURE & BUILDING - -- - - - '
39. Special Requirements Completed - -
40. Electric Release to Edison - - - - - -- ,
-
41. Gas Release to Southern California Gas Co. - -
42. CERTIFICATE OF OCCUPANCY -- - - •
No. ' ' Date
r
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
•
CITY OF COSTA MESA ONSTRUCTION PERMIT PERM NO. TRACT NO. LOT NO. UNIT NO. 3295 P./I"./ .% ` c.
Project Address 2 /'/ �eln f� 744 P Apr 3/ a 9 9 a r I
Applicant's Mailing Address �-3 3 3 /J A I.0 M/4I 0�"/,'f/AAP/r9'J TYPE OF CONSTRUCTION U NEW 0 ADD U ALTERATION U REPAIR
Owner's Name III L .S 1416' - csoy
LI CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
'hone DESCRIPTION OF WORK/USE OF BLDG.
AddressAddress • 747Ffl f � S Main Building: Accessory Building:
TYPE OF PERMIT U GRADING ❑ FOUNDATION U STRUCTURAL E Front Z
Arch/Eng. License No. Er-
7 0
Address // n ❑ TENANT ❑ ELECTRICAL LJ PLUMBING ❑ MECHANICAL BA Rear — _` N
i Contractor's Nam• 1 A/C 1 uh T.''hone 7'? - ��V� ❑ OTHER
Address(mailing/AC-3
nse m I 3 Y//inA/a/ eJRhe.m
PROJECT DESCRIPTION SQ. FT. OCCUPANCY CK Right N
ay.3 v CONSTRUCTION TYPE _ VALUATION$ S Left G
City License No. 7 0 ZONE - GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
Q
I hereby affirm that) I am licensedion under provisionsBusnand Charterroi (commencing gemarks: Planning Notes: M
with section 7000) of Division 3 of the Business Professions Code,and • T
,� myUc license is in/u ltd of and effect. -S/��J� 5 1987 $
Class Cl <na LI e • No.pf p �VED AUGr` v
13
Date ,-30-1 Signatur �• ..e / -� +� PLUMBING FEES RECt
WORKERS'COMPENSATION DECLARATION Bar Sink Showers ■■ -
I hereby affirm that I have a certificate of consent to self-Insure or a certificate - ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section
" l Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW .,
(� 3olc Lab. C' /p/y Q dLO�t/e rP ,.--2"-xis0 50+KW
RC1 Policy No. 4t'G `Y- Company Backflow Irrigation Sewer Cap , Construction Pole Sub.
_certified copy is hereby furnished.
Cerifa-.3
. copy s filed with the city/Bdiltl in Division/ Bathtubs Sewer Connection CookingUnit Meter ❑u to 100 amps '
Date t+d0 -�7 _ Apphe city, Bdi7�,�ivjsion �✓-� PP
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 ($100)or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is Issued, I
o ' employ anyiperson of any manner so as to become subject to the 'Drinking Fountains Solar Tank .II Fan Motors❑41 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U.
I
NOTICE:If,after making this declaration, you should become subject to the Inc.$alar 09-15 HP ❑16.15+
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' Civ. C.) Interceptors Water Heater .....2
� Outlets Range
Lender's Name g
•
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 Garbage Disposal
• following reason (Section 7031.5 Business and Professional Code: Any city or P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW 05-15 KW
any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor III
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
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).
Ll I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 $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 I 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 Boiler Hood or Type0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for
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 Building Approved BYDate
prove for the purpose of sale). ^ {/
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date $ —10-Q.2
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 •-
builds or improves thereon,and who contracts for such projects with a con- SUMMARY OF FEES
tractors) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 , System Repair/Alteration BUILDING PERMIT $ SMIP $
proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
IDI am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ 0-4 ISSUANCE $
Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000BT GRADING $
information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre-
sentatives of this city to ent r u on the above-mentioned property for PLAN CHECK 50% $ MICROFILM
inspection p r /Like( /� p MECHANICAL $ /
- Signature !/ /+-O� Data '.�d �a 7 TOTAL FEE $ C3• d"
Drivers' License or SS# ? Reinspection Fee $15 Issue Fee PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement r s
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Press-gre Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVEEi)GUNITE
7. Footings 58. Electrical Conduit-UndrQrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd ,.Test
1
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 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning '
35. Final Gas Pipe-Test •
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing (2-2-$1 Lep
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
City of Costa Mesa
Building Safety Department CERTIFICATE OF OCCUPANCY N? 2426 C
P. O. Box 317
Costa Mesa, California
The Building located at 779 Scott P2rnco9 A,: A C
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group I is J Occupancy.
Use of Building Ttiplest With ettrebr'd (arwfjeD
Legal Description 114..1-n2a h
(See reverse side for Metes and Bounds)
Building Permit No. 257a.i Electrical Permit No. 2FP(ly Plumbing Permit No. h8' hO
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments— 3 and/or guest rooms
ISSUED TO: Building Official ��J�
EVELYII Ems by �i•'t�� L!/i K"r/U�-
Date Decaliter 19� 4966
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
• except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form Bu34.-1M—11-133—S-B P
VVYIIMal f5L''1'1'AS' L''Vi''LY1V ' 'C
•••-•••'• ' V-7v vc�
JOB ADDRESS 779 Scott Place, ABBUILDING PERMIT NO. 25781
GENERAL CONTRACTOR Gentosi Brothers DESCRIPTION OF WORK Triplex wfatt.garage
AP No. I6..i 02_Olt. LOT TRACT FIRE •
ZONE VALUE $ 51 130.00
INSPECTIONS Signure Date GROUP 1W' TYPE V ZONE 72
Soil L PERMITS ISSUED
Gas Of til" SUBCONTRACTOR I Date Numberr I Signature
Water - o--64..
. - ' 6 Plumbing
Rough Plumbing _ Ina 3 k 7 ' 7-i2--44 tinge "'—
Prop. Swr. Line;. House Con. i'. 7 2. K tt-'H. Q f.-- 7-/ %/n6 1/7.60(1
Sprinkling System I
Miscellaneous
Rough Heating and Air Conditioning >> {lye cS
Temporary Service or Pole it /.75 .46
Underground 0 Power p
Rough Wiring 972.6 G Heating and Vent.
Trenches1g Forms 0 Steel Reinf. 0 j ?-/)-G __
Floor System - -vt 1 rf�ip/I;�' (meq
Bond Beam 0 Steel Reinforce 0
�'!" °' �� d�,p •-/(�-(,l/� -% 3 ({a-
Sheathing e 7/9/ S��r i ,a I- // -G 6 &e�7 �.r
Frame and Flashing .9,A,.-66 _
Lathing—In El Out in R••nn��,yy,����� U-30-G 6
Plaster, Brown Coat /yy c- /0/7/,16;
Structural, Final Electric
Heating, Vent., Refrig. and A.C., W.
�1• / :2- -4fr ',[ aLU /• 7-/,3-(,0��.O.
Plumbing, Final and Gas Test 'j. �' b -1�)ktjylj�� 7.-/q�,a6�9
Electric, Final /�� Z.L_t
Building, Final . Fjrh?a- ..912- -9-6'b
•
25781 \\ IOFCeSIAMESA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 JUN 9 1966
For Applicant to Fill In Completely TI1 21,?;, PERM
TYPE OR P INT
BUILDING 717 q
,i i3 �,e,77-134,,c.
ADDRESB / F _
RECEIPT NO. ' PERM1T
COSTA MESA. CALIFORNIA _ D/� �jj5 RBC[ YiC7to r-1?o (
SSUED
OWNER U2 (�. 7 I� „to 7--7..J.
4 W BUILDING
MAIL qq ADDRESS
FIRE
ADDRESS
/71.'4
/� ^ -P -y+
CITY / _ / y, TEL ZONE TYPE , GROUP.t
t_r 1. _ ' NO.
APPROVED~ ( "ZP
ARCHITECT TEL,' BY DATE
OR ENGINEER 'Pc S lea pre),et
NOL:Coh,�y6lo?� ZONING
ADDRESS CO .'7 L. 1 Oo ` /91K AR- x,.1_31 NO.OF ^ 'I USE OF NEW"
NG
CONTRACTOR T./p ){.fro Si Eke
0 —1 //PLANS DI INK
ADDRESS
1996 LV r/9IY �� ei�VA DESCRIPTION �1� I 3 •` �L ` I
/ A.P.NO.
en //6 - lo-2 - 6
CITY C.
NOTE: NO RAVE OVERHANG SHALL BE LESS THAN
LIC.N / TE 41
g`�{i-PY'/ DO'TO SIDE B REAR P.L
LIC. E L'^ 4.c 7�
VES
61ZE ,P.yr V p I NO.OPBLDas. _ ALLOWED (U.B.C.REQUIREMENT)
OF LOT i.J /l Oa( NOW QNWT</
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING 1
EXISTING BLDG.
t • i <FROMC LSTREET/
SETBACK LINE PROM 96/1 ppp
CENTER OP STREET REAR YARD /, FRONT n. RT.
SIDE YARDI LEFT .arr I RIGHT ... R.SIDE / F
7 TS
I
DESCRIPTION OF WORK L.SIDE Fr. / FT.
i
NEW ALTERATION ADDITION REAR f PT. CJ FT.
DISTANCE BET. BBT.MAIN&
MAIN BLDQB. ACCESS.BLDOS.
REPAIR MOVINQ DEMOLISH
BUILDINGNO.OF
VAR.# DATE
SIZE 15x4A• ROOMS STORIES '+ C.U.P.# APPROVED
EXTERIOR WA ROOF Rod? APPROVEDLap ///fff 6 V
COVERING i COVERING /y�1'���/����'/[wJi IN
�/1TE Cn � G,
USE_OF BUILDING AND WORK TO E PERFORMEC }JtI 111 0i
p 7 ric9 pi.-ex 4 /tIIOLD rUR �t'EC1A tQU1RE ENTS N
• /41L U/, d- , a-a - ilP?(i `w " i.:
moo"
I HEREBY ACKNOWLEDGE THAT I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CON- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL CITY ORDINA AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTIONGO
SIGNATURE OF ,[_-" PERMIT FEE S 1'93 _ w
PERMITTEE �sry- +) 7 I 7,7 w
io/ ,� i h 1 1 Z0 PLAN CHECK S !_�-_
AUTHORIZED AGENT C..... ...ed-..-C.0 yc/ V /1 ��/ (�
TOTAL FEE $ 2.1,5
- 779 + �' RtCEiVtu
. 9659 tJN i .
d 1959
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA, CALIFORNIA CITY OF COSTA MESA
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR P-RIIN�T / BUILDING
BUOADDREBUILDISS NG 7A/�gasc / PJ A.BIC r/1 w`
COSTA MESA. CALIFORNIA FOR OFf/GG USE ONLY
T NO.
OWNER WI/^ /Ail 14,1 PAR5c,u I RECEIPT NO. I �//`si
MAIL t es- Sinn I T- RECEIVED BY LOATE RECEIV DATE1ISSUED
ADDRESS /1 (JJf , t-1�I/`- f o ,�.•y I v-�A - l
CITY C.v374 MC' �,y TN O./)J�O �"1�
ADORE S
ARCHITECT Rny A EY4N45 uC. T- COSTA MESA, CALIFORNIA
OR ENGINEER JL! NO. ///
FIRE
ADDRESS
ZONE r / - /
1' Eir: r Dc, ,/ STATE/ '/ ♦ APPROVE• ./ / -Lie,
CONTRACTOR w) I�1 �/r AL ]f /'�-IC.NO./�O7'� BY g DATE L'7
ADDRESS 1 ,1,5' Q Pay 5 r ZONING
LEGAL LOT a 9 a ZONE Q NO.OF USE OF NEW i)2
DESCRIPTION I NO. 1st I BLOCK I TRACT / \ ANS
�-BUILDING /vlp�//.
A.P.NO. 1f rte/ O BY DATE/ l 'iIZ •
DATE -�f^.����I/
OF LOT / J ^ O NOW ON LOTE//`.H+�
REQUIRED Y S
ALLOWED
USE OF (CENTER
EXISTING BLDG. Ata Ai E_ FRONT LINE ST.)�/VFT IN.
SETBACK LINE FRQFI I I /^
CENTER OF STREET yS0 REAR YARD / R.SIDE T FT. IN.
SIDE YARD I LEFT 5, RIGHT r/ L.SIDE LJ FT. IN.
DESCRIPTION OF WORK
`�//� REA /! . 6-i f- -7
IN.
NEW I' \ ALTERATION ( ADDITION I
REPAIR I I MOVING I II DEMOLISH I
BUILDr/ Gf) Si NO.OF e
SIZE I 7x /p ROOMS / I j� STORIES I /J
EXTERIOR WAL�U (CROOF
OVERING Roc_br� 70 � �G
COVERING,O{ Q( �Jp/{�/ y- O" /� /��/
U l / 1 cU`L / ^L.s WORK TO5B6 nivk �Cl !
// 1. •
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS PLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND E TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY GROIN ES AND STATE REGULATING
BUILDING CONST ON. I.(/l� /�/// VALUATION fa
SIGNATURE OF /0/7 GY j - PERMIT FEE $ /�
PERMITTEE
$ al?/ 3y •I r PLAN CHECK $ a 0-SQ
AUTHORIZED AGENT / ,J TOTAL FEE $ 6 .1. C