HomeMy WebLinkAbout786 SCOTT PL - Building Permits it
F CITY OF COSTA MESA
BUILDING DIVISION
F • t.t•aterna
DEVELOPMENT SERVICES DEPARTMENT PER NUMBER
Z PERMIT
0, B03-01913
•
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa..ua uILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 786 SCOTT PL Status: ISSUED
Suite: Applied: 11/04/2003
Vicinity: ROOF • Issued: 11/04/2003
Parcel Number: 42417106 Zoning:
•
Applicant: KRIS WATSON ISSUED BY:
Address: 2219 W OLIVE AV
SUITE 282 Phone: 888-311-7663
BURBANK,CA Zip: 91506
Owner: BASTO, MARIA DEL ROSARIO
Address 786 W SCOTT PL
Phone:
COSTA MESA,CA Zip: 92627-3504
Contractor MODERN ROOFING
Address: 2219 W OLIVE AV
SUITE 282 Phone: 888-311-7663
BURBANK,CA
Zip: 91506 License: 807881
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF.INSTALL 30#FELT,30 YEAR DIMINSIONAL SHINGLE.WILL NOT REPLACE SHEATHING SINCE ITS SOLID
DECKING.29 SQUARES INCLUDES AN ATTACHED GARAGE.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $5,200.00
Permit: $125.25 Claim Valuation: $5,200.00
SMIP Res: $0.52
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
•
Total: $125.77 •
PLANNING & ZONING
•
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
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
2446-46(6/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: e 1
I hereby affirm under penalty of perjury one of the following declarations:
O 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: Sbatt cJtid. " —Policy Number. QCORIIQ — 1.001
(This section need not be completed it 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 I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: "__Date: is /y /03
WARNING:FAILURE-TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMGLOYER TO CRIMINAL PENALTIES AND CIVIL FINES up TO ONE HUNDRED
--THOUSAND DOLLARE(Sio0,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
-forie—a-nd effect.Lie.it Class tl Cr y
ContractorsSignature: cDate: /
Tit?
c
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 toe civil penalty of not more than five hundred dollars(5500).):
O I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). •
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 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 then thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 6,California Administrative Code).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,es 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 Flre
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 II 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 aermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ul Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 end 42303 of the Califomia Health and Safety Code).
7 II 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 Califomia 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 end 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.
Sig re Of al Owner(s) Dat
nig 103
And/0 uthorized Applicant ' D to
CODE I INSPECTION TYPE PAIL BEID8L5 CODE It INSPECTION TYPL RAIL =DLI
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof //'I —613 210 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 within heavy border lines and sign all appropriate declarations.
Cl- Y OF COSTA MESA PER r -1-47/6 6 TRACT NO. LOT NO. BLDG.NO. - 1 717 7/08/82 IQaQo ••
TL
•CONSTRUCTION PERMIT
:Project Address`pj ea-Ca C ,` TYPE OF CONSTRUCTION
'Owner .,; V0_,
0 s.* • Phone KNEW • 0 ADD 0 ALTERATION ,1� /,� ' -
•
Address ' 51.(0 Writ . _. 0 REPAIR 0 CONVERSION ❑DEMOLISH . / - r
• ZONING REGULATIONS
Arch/Eng. License No. 0 OTHER . - _A P ,-# - - -
Address - DESC• • I• OF ORK - ix - - '
JkIre
v, e A AL ZONE PLNG. REF.*'
•Contractor /�l�J Pone `�// TYPE OF PERM T - UILDING Tp g(/ILpmG NE-SETBACK C/L$T, VROPER .Y LINE —
Address //Q y - (p / �t+a�,. 0 GRADING •OUNDATION - at STRUCTURAL -- SIDE VARD - – • • •
LICENSED CONTRACTOR DECLARATIbN r .'D'TENANT•.O ELECTRICAL OPLUMBING ❑MECHANICAM :SSIDIE YARD --
I hereby affirm that I am licensed under provisions of Charter 9 (corn- - ��,-- �� c,•, „t RIGHT )
mencing with section 7000) of Division 3 of the Business and 0 OTHER REAR YARD(TO P/L) `.
Professions Code, and my license is in full force and effect. PROJECT DESCRIPTION
License Class y`�4 License ryo��g/•f P- -- - ' - PKG.SPACE REQ. -
PROVIDED - _ - -
Date ---1--"•K- Signature SQ.FT.' - - - _ -
- .
•
WORKERS'COMPENSATION DECLARATION ' • •OCCUPANCYMA CONSTRUCTION TYPE -----V� STREET WIDTH PARK FEE $
I hereby affirm that I have a certificate o consent to self-insure ora 'VALUATION " ZONE ZONING APPROVED BY DATE
certificate of Workers' Compensation In-;.1 ce or certlfi•d copy _ - . _ •
''reof(Section 3800,Lab. C.). SPECIAL CONDITIONS: - , •
'__ ` GRAD)NG CU,. S. ACRES
:Y No. Company •7�I�• _ - _ __ Br?
p _ . _ . -
,:ertlfie0 copy is hereby furnished. y - REMARKS: ,`. " B 7 9 t9 _ _ _- -
•
`i.Certified copy Is filed with the city Building Divis{0 . r
EXEMPTION FROM•WORKERS' COMPENSATION-DECLARATION• Lh I/ .Q/71 Q,{E��IeJy,,. - - • -' -
(This section need not be completed if the permit IS for one hundred _ /I , • _I' . _ _
•
5100) or less). •
I certify that In the performance of the rk for
whichethis permit Is
Issued, I-shall not-employ-any person ' .any ma lryner s as o become PLUMBING-. - PLAN CHECK - -- - ELECTRICAL— - - - PLAN CHECK - -
subject t0 h kers'Compensation s Of J��•!�0rr - UW tLLIN6. _ t MHHGt
.t to at r BATHTUBS - - - - SHOWERS"-- ' - - ... .
Date d'yr - Signature �!/ _ _ - _ 50 FT. fin:FT
NOTICGfj f after making this declaration, you s ould be ome•subject -TOILETS- u „ . .URI,NALS-• - - GENERATOR -0-I KW__1-10'KW - •
to the orkers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE•LAVS -- - - • APPLIANCE - 10-50 KW_50+ KW- - -
revoked.
CONSTRUCTIOW LENDING AGENCY - - -- '- - KIT.-SINKS .- -• DISHWASHERS ' --- - -MOTORS- 0-1-HP---' 1-10 HP'-- -
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS -, SUMPS-- - --- - • . .. - -UNC-SOLAR) _. 10-50 HP- 50 + HP --- - - - - •
formance of the work for which Is permit is issued (Section 3097
Civ. C.). - - /� - - - - FLOOR SINKS - - FLOOR'D R'AINS- • - -T - • 'FIXTURES OUTLETS -SWITCHES -- - '
Lender's Name ,Q -- '
Lender's Address �/ DRINKING FOUNTAINS-- GAS TUBE SIGNS r
OWNER BUILDER DECLA AT.ION INTERCEPTORS • ' CLARIFIERS - " • •• - - ----- -'POLE LIGHTS - - --' - - -
I hereby affirm that 1 am exempt from the Contractor's License Law for COINS I Hui-I IUN _ •
the following reason.(Section 7031.5 Business and Professlons_Code: SWIMMING POOL PTRAP -• - - - -POLES METERED SUB
Any city or county which requires a permit to construct, alter, •
improve,demolish or repair any structure, prior to its issuance,also re- WATER-SERVICE - ALTERATION - - 7 - PANELS- "MAIN - SUB - _,
quires the ap,.licant for such permit to file a signed Statement that he .
Is licensed pursuant to the provisions of the Contractor's.License-Law -GAS'SERVICE - 'OUTLETS - -' - - -• - -SERVICE- • ' - I
(Chapter 9 (commencing with Section 7000) of Division 3 of the ,
P' 'ness and Professions.Code) or that he is.exempt therefrom and the. WATER HEATERS -- BTU OUTPUT- -• - - - ' - ' . --
for the alleged exemption. Any violation of Section 7031.5 by -
-
Applicant for.a permit subjects the applicant to a civil penalty SEWER CONNECTIONS- ' ' ' - - ' - - -- - - -' ' -- -
o. .,ot more than five hundred dollars ($500). - '
0 I, as owner of the property, or my employees with wages-as-their SOLAR TANK - - COLLECTORS • -- -' '
sole compensation, will do the work, and the structure is not Intended - •' -- " ' '
or offered for sale.(Section'7044, Business and Professions-Code: The SOLAR PIPING SYS. ' . . - ' -_ ISSUE FEE - - - -' • - '
Contractor's License Law does not apply to an owner of a property -- 'gPPLICATION APPROVED BY DAT E'-
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 ' SUMMARY OF,FEES •
Is sold within one year of completion,the owner will have the burden -BUILDING •
of proving he did not-build or improve for-the -purpose of sale). HEATING SYSTEM 0-100,000 BTU �-
0 I, as owner of the property, am exclusively contracting withPERMIT-- $ �- $MIP• E
licensed contractors to construct the project (Section 7044, Business AND-DUCTING 100,000 + BTU
PLAN CHECK E 'PERMIT
and Professions The Contractor's s¢ Law does not apply to - - _ - - _ ISSUANCE E- -
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING E '
tracts from such_projects with a contractors) licesned, pursuant to SYSTEM - I' - - - - GR •
ADING' E
the Contractor's License Law). • - 100,000+-BTU , PLAN CHECK 5- ..
O I am exempt under Section B.& P.C.for this- -- • -_ ELECTRICAL E • $
BOILERS BTU'
reason. - - -- ' PLAN CHECK $ - •- ' MICROFILM E
SYSTEM REPAIR,ALTERATION '
Date Owner TOTAL FEE$ •
•
I,hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ - - MECHANICAL E - -
PLAN CHECK- $ LESS AD-
information-is mrr I agree to comply with all city and county VANCE PC S_ -
ordinances and st a jaws relating to c truction,and hereby authorize - ,
representatives- f this •ci to e e upon the above m ti mentioned - -- •
property for/) sp ction 's. „..--
Signature
� 9_S7 /1
Signature G /, �' Ddte �%].C.SL FINAL FEE $ l/ - ,
Drivers' License or SS- �'^ / ,ISSUE FEE _ • _
CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL& SPA - . Na.
Y /- Date Inspector r
APPROVALS Permit# -C Y1(1" APPROVALS Permit# Date Inspector
1. •Temporary Electrical Service or Pole 43. Pool & Equipment Location - -
- 2. Soil Pipe-Undrgrn . 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_ , - - -_ • 7- i.`_q_ 3 r>Il49. Electrical Conduit-Undrgrn - '"-
, _8. Foundation . . - 50. Gas Pipe, ❑Undrgrn;Test •
-_ 9. Water Pipe-Undrgrn - -. 51. Backwash Lines, P-Trap, ❑_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 •
14. Rough Electric-Conduit - - -` - - _ -- .56:- Electrical-Final - _ - '
15. Rough Electric-Wiring - - - - " -_ 57. Solar System-Final .
16. Rough Heating & Air Conditioning b8.'A 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 . . • - • - • '
22. Frame and Flashing - -- . . 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 Conditioning. - - - . ' •. .
I 30.' Final Gas Pipe-Test - - - - -
31. Final Plumbing- - - -. .
32. Water Service-Final - -
33.r Gas Service-Final • - - - - -
34. Solar Domestic-Final . ' ' • . '
-
35. Landscape Sprinkling System - _ _ • _
-
36. Sound Attenuation - '
37. Handicap Regulations
38. FINAL 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 - _- - -- _ _
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
OF COSTA MESA P RMIT O TRACT NO. - ' LOT O. BLDG.NO. 8722 6/21/82 34.32 TL
CONSTRUCTION PERMIT 6 " . 963 .t24- 2(-/
Project Address Ike, S'� I 71 • TYPE OF CONSTRUCTION. • . 1
Owner je// Rn l,Rt,42, i • Phone p I .NEW 0 ADD ❑ ALTERATION _ '
Address 3302 W. /%0414) F739/4" ALB,• ❑ REPAIR 0 CONVERSION ❑DEMOLISH ►
Arch/Eng. License No. 0 OTHER 4-2---94-ZONING REGULATIONS� s -
DESCRIPTIONOFWORK ^ A'P'# 171 0 -e-
_Address a&C. /S LOCIC (NA'Q-. 3
ZONE PLNG.gREF.SF
Contractor d (n0 So LIE lye Phone4•7•f 4%Zj TYPE OF PERMIT 5E7BP.CK C/L ST. ROP If�P�LINE -
Address /gyp cl/sr sipe'eT U .S.O0 GRADING 0 FOUNDATION STRUCTURAL ~SETBAARC)
LICENSED CONTRACTOR DECLARATION- 0 TENANT 0 ELECTRICAL ❑PLUMOING ❑MECHANICAL SIDE YARD ^�7 t
I hereby affirm that I am licensed under provisions of Charter 9(corn- RIGHT
mencing with section- 7000) of Division 3 of the Business and 0 OTHER 0 v�^' -�/�
Professions Code, and my ll so In full force antl f ct. REAR YARD(TO P/L) •Ite
PROJECT DESCRIPTION
License.Class ce �'s,�ars_
PKG.SPACE REQ. - PROVIDED
Date 7ER f-f'L Signature 91.4 SQ. FT. �,r� - -
WORKERS'COMPENSATION D CL RATION - OCCUPANCYLMLI_CCONSTRUCTION TYPE -..r. STREET WIDTH - '� ` PARK FEE E /
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION 7 2.00 ZONE ZONING APPROVED BY64/4DAT 91 �
�t3/eof(Section 3800ate of ,Lab.C.Compensation Insurance, raPe�tl certified copy GRADING CU.YDS. ACRES MMMM /// �'7
r I•' ed SPECIAL CONDITIONS:
key No. Company - - -
Certlfieo copy is hereby furnIshetl. .- .REMARKS:• - • _ _
rtified Copy is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - . . - -
(This section need not be completed if the per 't is for •ne hundred _ -
($100) or less). - - - .
I certify that in the performance of_t ork r whi /th - permit is —
•issued, I shall not employ any perso any anne 7 o become PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK
subject to/th kerryy ompensati ws .Ilio -a.r- • _
1 y�� fira ,, BATHTUBS SHOWERS UWtLLINL, t,AHAGE
Date r (J/ gnature SQ FT Sq FT -
NOTICE: if after making this faration, you shout. •ecome subject —7-0-7.-E. lb , - URINALS GENERATOR " 01 KW 1-10 KW
to the Workers' Compensation provisions of the Lab• Code,you must - TRANSFORMER '• '
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS • APPLIANCE — 10-50 KW-50+KW' •
revoked. _ _ .
CONSTRUCTION LENDING AGENCY ' KIT.SINKS DISHWASHERS - - MOTORS 0-1 HP 1'10 HP -
I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - • - (INC.SOLAR) ' 10-50 HP 50+HP '
formance ofuthe work iduwhich.t s permit is issued (Section-3097 -
Civ, C.). 1, ,J i. YL` • , ,l. ` FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES -
LenCiv. C 's Name 7s '
LendeiAddreps . -.DRINKING FOUNTAINS , GAS TUBE SIGNS
OWNER BUILDER DECLARATION 4a•
INTERCEPTORS CLARIFIERS POLE LIGHTS' - -
I hereby affirm that 1 am exempt fiom,the Contractor's License.Law for I
the following.reason (Section'7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNE I Hui_1'LN
Any• city or- county which 'requires a permit.to ,construct, alter, POLES METERED SUB
'improve;demolish or repair any structure, prior to Its issuance,also re- WATER SERVICE .` ALTERATION ' PANELS MAIN SUB
quires the api.licant for such permit to file a signed statement that he / - -
•
Is licensed_pursuant to the provisions of the Contractor's License Law -GAS SERV ICE+ OUTLETS SERVICE AMP
(Chapter 9• (commencing With 'Section 7000),ofoDivision\,.3„of, the'
9psiness and Pro/essions Code) or that he Is exempt therefrom'and-the I WATERHEATERS' BTU OUTPUT -- -.
hj•lsrfor dpe'alleged exemption. Any violationof..Section 7031`.7031`.51))44, \
Sb
� -
applicant forpermit subjects the.applicant to a'civil 'penalty SEWER CONNECTIONS - - ' •
.+,'I'; e ,
not more;than\free Hundred dollars ($500).,. Y -"- ' r, - - •
U I, assowner of the property„or my,empioyees with wages as their SOLAR TANK\ . ♦ COLLECTORS -
lsole compensation, will:do'the,work, and the structure is not intended '
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS., ' ISSUE-FEE
Contractor's License,Law does not apply to an owner of a property / /8
•
who builds or improves thereon, and who does such work himself or - ISSUE FEE APPLICATION APPROVED BYV1711272
through his own employees, provided that such improvements are not DATE6f/
intended or offered fur sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARYOF FEES-
Is sold within one year of completion, the owner will have the burden 7- ,
of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING 20 /�
PERMIT $ a&a SMIP $_aro
0 I, as owner of the property, am exclusively contracting with AND DUCTING '
licensed Contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ / 3. 32. •PERMIT
and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ • '
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $
tracts from such projects--with a contractor(s) licesned pursuant to SYSTEM • - - GRADING . E
the Contractor's License Law). 100,000 +BTU PLAN CHECK S - '
❑ I am exempt under Section -- - B.& P.C.for this BOILERS BTU ELECTRICAL $ - $
reason • - MICROFILM $
SYSTEM REPAIR,ALTERATION PLAN CHECK -$ -
-Date- Owner - TOTAL,FEE$ -'
hereby certify that I have read this application and s to that the above EXHAUST SYSTEM MULTIPLE J MECHANICAL $
information is corre . Ia agree to comply with a cityand countyPLAN CHECK $ - - VANCEP
9 pYVANCE PC $_
representatives
and state�a� s ly tg • con l ruction,a • hereby authorize _ - ,
prrsf O'Is ity to/e apo. t above mentioned ' • - �, / -I
.property for ins• do r••• �!�`' L _ t7 2I
6J
Signature A ``• a •.
- ISSUE FEE . - - . . - - - ..
CMF 0865.46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING 1
POOL&SPA
APPROVALS Permit# 6-3443 Date Inspector APPROVALS Permit# _ Date _ -Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location • -- . - . .
2. Soil Pipe-Undrgrn - 44. Steel Reinforcement _. • . • '
3. Electrical Conduit Utility;Undrgrn. . 45. Forms
4. Electrical Conduit-Undrgrn . - •. • - . '- ' 46. Electrical Bonding
5. Steel Reinforce
-3o4?_ .'NZ , 47. Rough Plumbing &Pressure Test . - .
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE • - " . .
-
7. Footings (ca.._ b(& )' - 49. Electrical Conduit-Undrgrn
8. \Foundation.• ... 50. Gas Pipe, D Undrgrn,Test
•9. Water Pipe-Undrgrn - 51. Backwash Lines, P-Trap. ❑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 ,
14. Rough Electric-Conduit .56. Electrical-Final '•sem -
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 FINALr
20. Roof Framing -
21. Roof Sheathing (F-f.Gs)
22. Frame and Flashing - NOTES: b_2-�_S c / r'-2
re-.(f� .".V L -
23. Insulation ) $ 73 21 s - /
24. Lathing & Siding 6,-)26,-)2q- cL
- q_ $A- D _24.4.. Z&j -4-1,;-.0--Ln
.a01,,
25. Drywall Nailing �r* •a cag
,ir,.,,, p,. h o' L e
1 Th,,..,
26. Plaster Brown Coat oleo d- al..-4. �.'Z�p•,,,.. , ,{ a e.• Cryi-c i, 4„I
27. Electrical Power Meter-Final ISPA
28. Final Electric 7-/3- > L4' 6t t /0 ;0 0 An, car
29. Final Heating & Air Conditioning TA/ 4,,uL.,[h , IAi- eat r�
30. Final Gas Pipe-Test At_ q,,,",Q aNt4.a4-a /0;aa ii',
31. Final Plumbing tMM ,,,,�� 4 R
• 32. Water Service-Final t� -..SAs4a4 ;>tiS \\ L• P-�
-- 33." Gas Service-Final r
34. Solar Domestic-Final
35. - Landscape Sprinkling System-
36- Sound Attenuation ._. _. • •
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING i-41-4--- 934:S
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY - -
No. Date •
- \
i
TYPICAL 611 CONCRETE BLOCK .FENCE.
•
Cement Coping Optional
a
�,i, . t-.,� • ' - GENERAL- NOTES
Channel Block With 1-3/8 _
0 Horizontal Top of all - {
MORTAR: One Part Plastic Cement, and
Fences
�' Three Parts Sand
GROUT: One Part Cement Three and
For Fences 5'or Less f _ �-'� I One Half Parts Stand
Vert. Bars 3/8" Oat 4' -0" O.C.. • oo •_ • - - COPING: One Part Cement, Three
•
SH w inion- Parts Sand
For Fences Higher.Than 5' CONCRETE: Well Mixed 12-1/2 : 3-1/2
Vert. Bars 3/8" Dat 32" O.C. re z -,' I -
a = Max. of 7- 1/2 Gallons of
Fill Cells Solid With Grout > Water Per .Sack of Cement
Where Steel Occurs r - —-
aIIIM
-
Reinforcing Steel Shall f --- - �■ GROUT MAY BE POURED FROM THE TOP
Conform to Sec.A-15-39 w o - - -_ OF THE FENCE IN CELLS WHERE STEEL
A.S.T.M. _ ; . Ls) eny •
1,t _1 . FORCEMENT sRHEAALS
CLEAR CLEAN&N
All Steel to be Lapped — -
PPe t' . FREE OF ALL MORTAR DEBRIS,ETC.
24"or to Code' - -�— PROVIDE CLEAN-OUT AND INSPECTION
HOLES AT THE BOTTOM OF CELLS CON-
NATURALGRADE ' i TAINING VERTICAL REINFORCEMENT.
' v - �� - II BONDS SHALL BE PROVIDED BY LAYING
•S.. Aden ,- i ,1 II l _) I BLOCKS IN STRETCHER COURSES SO THAT
!%'% /��Ii _ it • . - u - • NM - • VERTICAL JOINTS ALTERNATE IN EACH '
�"N. .0\�; v'' tr. . -0 N_ D .p b • e •• COURSE.
TWO3/8.OBARS ar a �. o . . s a . . e .
CONTINUOUS TOP
&BOTTOM -1B-1 . WIDTH TO 16' O.C. MAX. •
p'
SEE CHART Y e e
ALL STEEL MUST BE TIED IN 4 BELOW e DEPTH OF EARTHTCOTH
PLACE AT TIME OF TRENCH • I I y t I/3 THE HEIGTH OF FENCE
INSPECTION. V . q L j' . . BELOW BOTTOM:OF FOOTING.
o" Io" _ •
2,.� SCALE: I/2° = I'
•
FOOTING REQUIREMENTS CHART
- WALL HEIGHT / 6 ' 5 4' 3'
WIDTH 14" 14" 12" , , 12"
THICKNESS 10" 10" 8" -- 8 "
• • DEPTH OF EARTHTOOTH . 24" . . . . . . . . . .20" 16" ._ 12" I
• SPACING OF EARTHTOOTH. . 12' 14' 16' 16'
_ OWNERS NAME: -' /`L /� a—��JOB i
City of Costa Mesa, California
PERMIT ODNUMBER RESS _ � �A��L/�L �L
Building Department SIGNATURE: /��/_ ' /'-f_ _ _
FORM CV21-2M-1_62
For Inspections
APPROVE ® srRAPPROVAL Call
UCTURAL _ONLY 7545627754..567:7 \k
City of Costs Mesa Building Dept. SE AP RATE S ARE REQUIRED
811 _DATE4/2/_79 FOP, ELECTRICAL, P1U°'B'iIG,THESE PLANS MUST BE ON JOB AT ALL TIMESMAKE
HEATING, IF'Tn •�-,IIID AND
OF DEM
O CHANGES WITHOUT PRIOR APPROVAL REFRIGERATION VVORK APPROVER
eV -Le...— .0 024 /47'
THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL ������ = 3 -- CRY OF COSTA MESA
OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED .�Q6 3 PLANNING DEFT.
TO BE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION THIS IVIII'113FR IVII `' + Qi\I&,T TO BLDG. DEPT, EE0.
OF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE- US' 'ACCOMPANY
SUMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE ALL INSPiCTIO,R REQUESTS
PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO — --- BY-.��y DATE
FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL. DIRECTOR Of PLANNING
EILVGSVHC
,E PERSONSE i0
THE ISSUANCE OF A PERMIT BASED UPON PLANS AND LOYED, P(E SUGGEST THAT THESPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL OE CALIFOPoIA DIVISION OFFROM THEREAFTER REQUIRING THE CORRECTIONI OF ERRORS IALTED FOR
IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING NAL REQUIREMENTS.
BUILDING OPERATIONS BEING CARRIED Ofl THEREUNDER WHEN I
IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE ' ---- ._
OF THE CITY.
•
W/ 7
•
lb
4.
RESIDENCE RESIDENCE RESIDENCE RESIDENCE
I-
I- Lu
LI W
LI D:
D;
I- h
V)
I
I
STREET LL _ _
OWNER Robertson DATE •10-20-58 _
` JOB ADDRESS 782-%-0( Scott Place BUILDING PERMIT NO. 7825
GENERALCONTRACTOR 0.Z. Robertson VALUE $ 22,528.00
11�-
"No.
6 LOT TRACT FIRE ZONE . . DESCRIPTION OF WORK Triplex & Garage
/UP H & J TYPE V ZONE 112 PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
��r,
"" ,S .J r/,ply DATE NUMBER
S
Trenches Forms Steel - 6' ,m-
Floor System _ .
Steel Reinforce Chimney Re-Rod
Bond Beam .
.
Frame and Flashing t7 6 g / ad '‘.% y
Lathing, In Out ,g/$a / 4 - .1 r
Plaster, brown coat4./E% . -/7 J
Underground soil / vetW/G Pipe TestL W/0'3/4 / _
Top Out /A;VFW •
r
Furnace ////R./)-55 - - f - - i j
Gas Vents .:-.‘v lA�s�• "••- -
Rough Plumbing _ ' /7. 3�ID'��i ��I1-� 1
Cesspool Septic Tank / 7
Prop. Swr. Line House Conj(IC&t. Swr. r$.0-
Sprinkling System h
F ig Final k led 4 c/' SQ `0
A
P._...oing Fixtures, Final Af F„7 y .�
p 'y I
Final Gas Test /A :1 ?r-61 •. s
Construction Pole , t . '
Underground Power NOV 5 1958 'dC8 Ir
Rough Wiring t no) /.ft'f9' .J/ /b.-, E7e CT. // 3 -SS7 _1 ?. —,.;
Fixtures, Final /�Z,b 4/I 'fl •
-
OCCUPANCY /d/ Jr-P/f. rI
Form 210-5M-1-57 A 782C
•
OWNER ROBERTSON DATE 10-20-58 _
' JOB ADDRESS 786 Scott Place BUILDING PERMIT NO. 7825
GENERAL CONTRACTOR 0. Z. Robertson VALUE $ 22,528.00
13o.-.001-6. LOT TRACT FIRE ZONE DESCRIPTION OF WORK Triplex
1. AAP H Rt J TYPE V ZONE R-2 PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches Forms Steel fjt 1L—S 41
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beamf,+ d' �kr
Frame and Flashing } L .. f
Lathing, In Out Cr ) . rc - `..
Plaster, brown coat e'.5--"g 2. - / 7 --r7
Underground soil W/G Pipe Test
Top Out _
Furnace L.W I1)_17,t�' i �(1
Gas Vents -G,.p,,a/J.y-/SPT A)'a3'e /6 e y •`
Rough Plumbing .�.'W/Q•l7. KK ro
Cesspool Septic Tank1
Prop. Swr. Line House Con.).ii/St. Swr.--19.9).. iti /4-4_4z t L (f
Sprinkling System IIS
F g Final £.yd# 1Is;
�f, ,
Ph—ming Fixtures, Final r //� 'G>�?�I �'__ (.4'3;0f
Final Gas Test itATM , �
Construction Pole ,,,,'
Underground Power Iilul p Ib8 {ICts
i•i
Rough WiringII2-12 4„ Le.) A / r . I/-3 -S`SQ /7cFixtures, FinalY iy.OCCUPANCY
Form 210-5M-1-57 C (7825
OWNER . RO$$RTSON DATE 10-20-58
• JOB ADDRESS 784 Scott Place BUILDING PERMIT NO. 7825
lENCONTRACTOR 0. Z. Robertson VALUE ; 22,528.00
P' No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK Triplex
l_ ;UP H & J TYPE V ZONE R-2 PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
P C DATE NUMBER
Trenches Forms Steel a--e-- II—s— k
Floor System
Steel Reinforce Chimney Re-Rod .
Bond Beam
Frame and Flashipg Wi'/G 1-4 -1 ,
Lathing, In Out p..:5_s; a ' n, '.{
Plaster, brown coat f ..- ?:I -Tr—
Underground soil W/G Pipe est
Top Out I
,{�,
Furnace I its, avt-S-g n • 1V\
Gas Vents Bp P eY�OE/ %b-.? o•Sg /6 . 'J`
Rough Plumbing k Ij 1?-h-0
Cesspool Septic Tank .r�/ \ pl
Prop. Swr. Line House Con.LW.St. Swr. /2-/7A / 3-04e c P1
Sprinkling System
. 1 tg Final /[ (�{j..J 39 1
Ph-aging Fixtures, Final / i orf .$l - h
Final Gas Test /(t;f, _aVt-.20 ssV
Construction Pole
Underground Power IYUV p IDDO litiD
Rough Wiring !-- orm S i it/i/ LC rrl 2/- 3-S8 .8.5-7...S £- ,
Fixtures, Final 1 /dtY, tq YOCCUPANCY - 4--2 0 n),
Form 210.-SM-1-57 B
7625
'7825
COSTA MESA BUILDING DEPARTMENT ` ~,c•
P.O.BOX 3,] COSTA O: at}�T¢(�3.00
COSTA MESA. CALIFORNIA art tu-scPD,«� -43flOD.
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
ADDRESS
BUILDING 7 A j V- d'6 / BUILDING
COSTA MESA. CALIFORNIAFOR OFFICE USE ONLY
' ^� RECEIPT NO. 70
PESIIT N1/40c
OWNER L/ t'//,J,J
RECEIVED BY DATE RECEIVED
DATE ISSUED
MAIL
ADDRESS 77/ IIn7/ S- n - _, /D- /T/717 <O - O -S_OJ
TEL. BUILDING
CITY C....., i 0,2/�ti NO. ,e .- A-/64/ ADDRESS
ARCHITECT i - _ ^ LIG.rY COSTA MESA. CALIFORNIA
OR ENGINEER i// NQ. •
ADDRESS /9/1I S • FIRE
I 4 ZONE
7 2 NO.OF TYPE GROUP
/'j ITV LIC. �/
CONTRACTOR L//�. �. NO. �e S ]I �(y `• vvv��� fff�� P L
rrJ TEL. ,,,fff A PROVED {' ® LIr�
ADDRESS '7 I' (.[J /9fI Y / NO. N/ted -/LL/ B /� D��'y Y
LEGAL LOT J ///y. CITY Ci9RRlr IPt,S
DESCRIPTION NO. / 9 BLOCK TRACTj72 le
L'Sii
P:.' I NING DEPT.
A.P.NO. /O 6 B SUBJECT l BLDG. DFPT RE!•
SIZE /" NO.OF BLOTS. /,�A/� /��� y
OF LOT 7U . C (.> x 79 Cf J NOW F LOTUSE II t, /
EXISTING BLDG.F PLAN TFCI4 [SST /`1 `S T?
SETBACK LINE FROM JA1-iwFE / // Z
CENTER OF STREET �1 '; REAR YARD //-. 3 - /x
SIDE YARD RIGHT ff ��
S i /, LEFT S �� O
DESCRIPTION OF WORK //(��V��y,,���n (t�
NEW r/ ALTERATION .N ADDITION -` �V
II n l'
REPAIR MOVING uDEMOLISH WU
SBIZE
/ / / ROOMS S STORIES NO.OF /
Gay rI7-(,
EXTERIOR
COVERING WALLL Lt�l,.?� COVERING ROOF
VTL ._ hi,:7 ^ ] r/ j ��-f,(/ 0 J
USE OFNEW .. .YWV. /� -C 3 ' ! ' ® (/ /3
BUILDING `^, /) 'J
\f0_ .. / S y,/ y. Cv rte} -SO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC•
TION. VALUATION //
•
SIGNATURE OF C/ 9.c „ / PERMIT FEE $ Y” 2�
PERMITTEE A-// .f(/'f/7 -{
^-/�� $ J ? `^-I, U PLAN CHECK $ pt/
AUTHORIZED AGENTCP-- ✓JOf J `rl TOTAL FEE $ 63 ,M/
I \ A