HomeMy WebLinkAbout1144 SEA BLUFF DR - Building Permits p5ip M 9 CITY OF COSTA MESA
o BUILDING DIVISION
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DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
t i PERMIT /
4• nil
V P06-00722
io
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaPLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1144 SEA BLUFF DR Status: ISSUED
Suite No Applied: 09/01/2006
• Issued: 09/01/2006
Vicinity: GARAGE
Parcel Nunmber: 42232207
Applicant: ARENAS, ERIK ISSUED BY: ��/
Address: 9911 LARSON AVE / /
Phone: 714-530-2440
GARDEN GROVE,CA Zip: 92644
Owner NELSON, SUSANA MICHELLE
Address 1144 SEA BLUFF DR
• Phone:
COSTA MESA,CA Zip: 92627
Contractor: A AMES PLUMBING, HEAT, AC
Address: . 9911 LARSON AVE
' , Phone: 714-530-2440
GARDEN GROVE,CA Zip: 92644
License: 250307
SCOPE OF PERMIT
CHANGE-OUT OF AN EXISTING WATER HEATER IN THE GARAGE OF A DWELLING UNIT.
+ : NO OTHER WORKAUTHORIZED WITH THIS PERMIT.
-FEE SUMMARY -
AMT QTY AMT QTY AMT QTY
ISSUE FEE . . $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation . $0.00 0 . Landscape Irrigation $0.00 0 Swimming Pool , " . $0.00 0
Backflow Preventer ' $0.00 0 - P-Trap -- - - - - $0.00 0- Trap Primer $0.00 0
. Bathtub . $0.00 0 ' - Pressure Regulator $0.00 0 Urinal $0.00 ' 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) ' $0.00 0 Receptors $0.00 0 • Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher' , $0.00 0 Sewer Cap for Demo - $0.00 0' Wash Basin Set $0.00 0
Drain Floor ',� $0.00 0 ' Sewer Conned. , ..-. $0.00 0 Waste and Vent System $0.00. 0
Drain,Rainwater - - $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet)- . . $0.00 0
Drain,Roof $0.00 0 Shower... $0.00 . 0 Water Heater/vent $12.30 1
Drinking Fountain - $0.00 , , 0 Sink;'bar $0.00 .0 . Water Piping(Inst or Rep.) $0.00 0
Expansion Tank' $0.00.,': 0 y >.,';Sink, commercial $0.00 0 ' ' ,-'Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 v v,0_ - --Sink,Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 ';'•-, 'Sink,-kitchen $0.00 0 Water Softener 7, . $0.00 0
Gas(Over 4 outlets) ' $0.00'/ 0 ,.'''-->`,,-,,,Sink,service/mop ' $0.00 0 . '. - OTHER- '/ : /" $0.00
Gas Repipe $0.00 - 0 • '•-••--:Spa(private)' $0.00 0 ' ' VIOLATION' $0.00
Gas Service ` "$0.00' 0 Spa(public) $0.00 0 - PLAN CHECK ' $0.00
Interceptors(Grease,Oil),C$0.00 _:0" 1 , ' - REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0 ' ' " -
' ' - TOTAL CALCULATED FEES: $35.80
•
COMMENTS/SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
•
--regiilations.,(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(WOO)
DECLARATIONS f )
WORKERS'COMPENSATION DECLARATION:
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 pertormance'of the
—,l work for which this permit is issued.
fid.r 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.
/•4- My workers'compensation Insurance carrier and policy number are:
Carrier rC1rg r .F✓N O P C12:_imber: p°o 0 5-6 t'?do b
�(7hissecton 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 Califomia`nd agree t if I should become subject to the workers'compensation provisions of Se lion 3700 of the Labor Code,I shall forthwith
comply with these prove...,"
�� � Cate:.
WARNING:FAILURE E( SE SWORDER COMPENSATION COVERAGE IS DWFULAMAGES
AND SHALLSUBJECTFOR I N EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPN ONE HUNDRED
THOUSAND DOLLARS(S ,000),IN ADDmON 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 underrovisions of r 9(commencing with Section 7000)of Division 3,of the Business and Professions Code,and my license is in full
force and effect.Lic.#— 1,40 3 8 T L Gass#.)
rLC
ContraofsrSig'tY_e1 / "
O (p
CONSTRUCTION LEIND NG AG CY:
❑ 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 end Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation.WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,I.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
O 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,Califomia 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 implication apermit for such construction or modification
from the South Coast Air Quality 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).
8 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
\ gnature Of Legal Owner(s) ey / (Dt9 Date
And/Or Authorized Applicant /Date--)
CODES INSPECTION TYPE INTIAL$ 000U INSPECTIONTYPE gag INTIBALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical /
1266 Pool Spa Final 208 Final Plumbing (
•
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
•
203 Final Sign 222 Final 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.
•
PE NO. TRACT NO. LOT NO. UNIT NO.CITY OF COSTA MESA/��(O STr1RUCTION PER/MIIT, n A.P.# I Zone '
Project Address /7 QV CONSTRUCTION
r 9& L47 r2 9/13 1
,/ _ •� ))� •, - S Main Building: - Accessory Building: 1
t Applicant's Mails ddress �S 33• U J• /( I/UQUL N TYPE OF CONSTRUCTION L I NEW U ADD L I ALTERATION LJ REPAIRZ
❑(L5 /-//, ' ' ,' ❑ CONVERSION ❑ DEMOLISH . ❑ OTHER T Front O
Owner's Name /•-7�-�/On�1 R�� Phon¢�T�(/SL-L� DESCRIPTION OF WORK/USE OF BLDG. - A -Rear - N
Address
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING H/FOUNDATION L STRUCTURAL C Right G
Address _ - ❑TENANT 111 ELECTRICAL R"CUMBING ❑ MECHANICAL . s • Left R
,/ E
Contractor's Name ••�i m� A Phone��a3Y �0 ❑OTHER Ping. Ref.# Parking Req./Provided
�e•. PROJECT DESCRIPTION Sq. FT. OCCUPANCY Q
Address(mailing) U 3 3„� Li/Ue(]( N Planning Notes: • M
CONSTRUCTION TYPE VALUATION $
City License No. ZONE GRADING CU.YDS. ACRES aC rn A'
LICENSED CONTRACTOR DECLARATION y' C 1\�+����Ctls��ll xs 7'
�^^^ S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /��'T-Ly/�'U /� �l TG 2 /Ja-r-t/� 1 R C N i Yff'i
with section 7000) of Division 3 of the Business and Professions Code,and rte+- Al /�+�
my license is in full forc- .n• •ffect. /p/ /q7/ n ELECTRICAL FEES
,t`�` License la LI en nIX//(O.S/
�0 • ' • Sr Signature ywle. /-/ .ate.._• PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
KERS'COMPENSATION DECLARATION Sink Showers Construction Pole Sub.
- ❑ 50+ KW
:by affirm that I have a certificate of consent to self-insure or a certificate
Workers' Compensation Insurance, or a certif'ed copy thereof (Section Cooking Unit Meter ❑up to 100 amps
3800, Lab. C-) /' /' Backflow Preventer Service Sink
so
Policy No. Q`1d`,YD Company EAVES Backflow Irrigation Sewer Cap Dishwasher Meter Clover 100 amps •
v tified copy is hereby furnished. ' ' —
Dryers ❑Gas ❑Electric Sub Panel
Certdaatl o y i@@-.�� ted with the city B dp Nisi Bathtubs Sewer Connection
Date O -a/""d/ Applicant /5/1 rPi/:../OMfd Fan Motors❑0-1 HP ❑1'h-6
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors
. (This section need not be completed if the permit Is for one hundred ($100)or - F.A.U. Inc.Solar 09-15 HP 016-15+ -
..
less). Dishwasher Solar Piping .
I certify that in the performance of the work for which this permit is issued, I Fixtures
shall'not employ any person in any manner so.as to become subject to the • Drinking Fountains Solar Tank .-.- Microwave
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes / Pole Light
NOTICE: If,after making this declaration,you should become subject to the ' Outlets
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Range
comply with such provisions or this permit shall bedeemed revoked. Switches •
CONSTRUCTION LENDING AGENCY - Gas Service ' . Outlets Water Closet Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections •
Lender's Name __ Interceptors Water Heater eiO
Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor ,
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 . '
county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' Laundry Trays s
•
v structure, prior to its issuance, also requires the applicant for such permit • ^'-
'le a signed statement that he/she is licensed pursuant to the provisions ofRoof ,Drains - Qom• '
-ontractor's-License Law(Chapter 9 (commencing with Section 7000)of -
:ion 3 of the Business and Professions Code) or that he/she is exempt ' Reinspection Fee $15 Issue Fee $ 3
_refrain 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
enalty of not more than five hundred dollars ($500). I DEVELOPMENT SERVICES REQUIREMENTS:
rLI I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee $ 3 1'j
I �
compensation, will do the work,and the structure is not intended or-offered 1 Zoning Approved By Date
for sale (Section Business and Professional Code: The Contractor's - MECHANICAL FEES ' Building Approved By _ Date 4. �7
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 Type I 0 Application Issued By ^ Doh '�V/�i
employees, provided that such improvements are not Intended or offered for -',
sale. If, however, the building or improvement is sold within one year of cold- Canopy Type II 0 .;r SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground
prove for the purpose of sale). i '-' BUILDING PERMIT $ SMIP $ -
❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System •
tractors to construct the project (Section 7044,Business and Professions Code: PLAN CHECK $ PERMIT
-The Contractor's License Law does not apply to an owner of property'who Duct-Ventilating 00-100,000 BTU 0100,000 BTU ') PLUMBING $ 5:00 ISSUANCE $ -
builds or improves thereon:and who contracts for such oroiects with a con- '
tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ' ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ •
GRADING $
❑Tam exempt under Section - B.& P.C.for this reason Firepl/Fact.BIt. ICBO# Fire Dampers r., MICROFILM $
PLAN CHECK 50% $ _ //``
Date - - Owner - - Heating System&Ducting Registers• MECHANICAL $ TOTAL FEE $ �UV
I hereby certify-that I have read this-application and state that the above • 00100,000 BTU 0100,0006T -
Information is correct. I agree to comply with all city and county ordinances - PLAN CHECK 25% $
and,state laws relating to building construction, and hereby authorize repre- -
sentatives of this cit to Ante upon the above-mentioned property for
Inspection purpas�.// / iA Dated-09n/
Signature - f/� (.� •
0 y a 0133 5 00
C 064.4 CL_ 6494 TPT T
0965-46,rev:5/88 ' "White _Building; Canary - Applicant; Pink -Accounting; Goldenrod . Assessor DATE1 :16/27!29 �r �1 .6 ?E
g.
•CONSTRUCTION AND PLANNINC F &SPA _
Date Inspector Date Inspector
APPROVALS Permit# - APPROVALS Permit#
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location -
2. Soil Pipe-Undrgrnd. .
•- 53. Steel Reinforcement •
3. Electrical Conduii Utility-Undrgrnd - -' 54. Forms < •
4'."Electrical Conduit-Undrgrnd. 55. Electrical Bonding '
5: Steel Reinforcement56. Rough Plumbing & Pressure Test
•6. Electrical UFER Grndf. ,.r' 57. APPROVAL TO COVER-GUNITE •
_
7, Footings - 58. Electrical Conduit-Undrgrnd. • '
8. Foundation -, - r 59. Gas Pipe, 0 Uhdrgrnd.,Test .44
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 . i 62. Backwash & Receptor-Final
12..Sewer Cap •63. Heater & Vent-Final '
13. 'Roof.Drains .-.i .64. Plumbing System - Final
14. Rough Plumbingc 65. Electrical-Final
15. Rough Electrical-Conduit - 66. Solar System-Final
116, 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 ,
26? 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:9_ter_8ty G ._Chao- 4.60
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test •
36. Hood or Canopy 1
-
37. Final Factory Fireplace
38. Final Plumbing £1/T/ [_/tom - -
39. Water Service-Final CJ. '
40. Gas Service-Final
41. Solar Domestic-Final -'
42. Backflow Preventer ;.:; ,
43. Backflow Irrigation
• 44. Landscape Irrigation System - -1
45. Sound Attenuation v '
46. Handicap Regulations c•
47. FINALSTRUCTURE & BUILDING •
-
48. Special Requirements Completed
49. Electric Release to Edison _ • I
50. Gas Release to Southern California Gas Co , 5%r"+
51. CERTIFICATE OF OCCUPANCY " /
-
No. - Date 7;
ADDRESS OF BUILDING: 1.144_SEA, BLUFF DR . _
-_.___ ____ _ mil; — _.__...__ r._ _ - CITY OF COSTA_MESA_.-_ BUILDING .P.ERMIT_._
wINEWSNAMEMID1oWN:BLANCHARD ROGER H. TR __.___. _ _ __..--._. _. ___ _ __ _ .___ . .._P.ERM_NQ: _8__ 086189
ADDRESS: P 0 BOX 15052 -- --- — —
NEWPORT BEACH CA _ _ . :__. PERMIT NO: B . __086189 PLAN CHECK NO: N GOVT: N. SUPP: N
)80696_ _._ _ _. 92619642-7635 .
APDL.MAILING ADDRESS: , CONSTRUCTION TYPE.:V-N_ _. ._. .__.. _..PERMIT_. TYPE.: STR • PURPOSE: OTH
ARCHITECT ORENGNEER: UC.No.: , JOB_DESCRIPT.ION-__:__T,/OREROOF-_W/FIRE,.-FREE. RUSTIC SHAKE SQ FT: 12, 821
.mfr ARGIL OR ENG'S ADDRESS: WIT:
CLAIM VALUE: . _. _1.2., 821 .00_ . .CALC-VALUE:.__ 12, 821 . 00 . .GROUP OCC: R-3 /U-1
CONTRACTOR'S NAME: CRANK BROTHERS_ ROOFING.CO ( 714 ) 548-5569
cONTRACTows MAU% 126 COMMERCIAL _WY . COMMENTS: T/O REROOF. 2500SF RESIDENCE W/RUSTIC FREE SHAKE
ADDRESS: COSTA MESA CA uC.ND.: 408677 ***************+E**********+r***+t*it*At+E**r*****Sr**+PSE**Sr+ASP+rAE*B6AE*+E*RP**+r*RP*BPRCSp*RETr***R6
. . 92627 WMT: -. Z O N I N G ' REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under sanely d perjury that I am licensed under provisions of Chapter 9 _ _ SETBACK S.
(commencing with Section 7000)at Division 3 d the Business and P A.esaiors Code.and my rte;a in end anted.
CRY LIC.NO.:005993 UC.CLASS.:,C 39 :C.NO.A08 • " a : 06/98 MAIN_BUILDING ._ ACCESSORY.._BUILDING
Date: /2—/G—f7 -' C I FRNT: FT IN REAR: FT IN FRNT: _ FT IN REAR: FT IN
LEFT: FT _IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm u • of perjury that I am exempt from the Contractors License Law for the •
Idlowing reason(Section 7031.5 Business and Profess. e:Any city or county which requires a permit to construct.after,improve, PARKING REQ. PROV: PARCEL: 42232207 Z NE: REF NO:
demolish,or repair any structure,prior to its essence,:.• -•«res the applicant for such permit to file a signed statement that he or she - /' /'"'
is licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)d Division 3 d the PLANNING NOTES>‘..._ _ I
Business and Professors Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section >I^
*************** l',.....--17031.5 by any applicant w
nt for apermbpdsthe epptoant toadvg penalty of not nmere than ibis hundreddollars If50o). ****************************************************************
❑ I.as ovmer cl the properly or my employees with wages as their sole compensation,will do the work.and the structure is not intende'd— D E V E L..O _P. M E N T SERVICES R E U
or offered for Businesssale(Section 7044, and Professions Code:The Contractorsnot License Law does nappy inter to an erd property
I R E M E N •T'::S
who bolds«improves thereon.and who does such work himself or herself or through his or her own employees.provided that such f. t.
improvements are rot intended or offered for aaJe.I.however,the building or improvement is sold within one year of completion,the ZONING AP PROVED.'B Y_._ : DATE:
owner-builder will have the burden d proving he or she did not build or improve for the purpose of sale). ✓ -
❑ Presol.adonact�:Theproperty.eCContraeo9s contrawcting nnt�rolp wconstruct ho vSection 7esthereo Business and
eD
BUILDING. APPROVED .BY._.: DATE:
contracts for such protects with a contractors)licensed pursuant to the Contractors License Law). 5I --
❑ I am exempt under Section: B.SP.C.,lor this reason: APPLICATION. ISSUED_BY-: DATE: IZ-^1(q' ��1
Date: owns LEGALIZATION:N_ _____ __ __ F E E _ SUMMARY . _.. ___ STRUCTURAL SEGMENT:Y
I do hereby cemiy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and
25534,and that 1 or any future building occupant will/will not(circle one)need to comply with said sloe codes and the requirements for
apermit for construction ormodificationfromtheAirWaanagementDimdm.Re.idemwccminK.tionapplicatinsareexemptfromthese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE _ SMIP/RES GRADING
provisions. PERMI.T__ . _ 199 . 75 . .. 1 . 28
Data: Applicant: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penury of perjury one of the Idfowing declarations:
❑ lhave and wimaintaacerprtcatedconsent w
self-insure as provided for by Semd
Section IUILE FEE_
ln
BUILDING-DIV-.> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Codefor the performance of the work for which this permit is issued.
O I have and WM maintain workers'compensation insurance.as required by Section 3700 ol the Labor Code,for the performance ol the •• TOTALS----> _. __ . 201 . 03 0 . 00 0 . 00 201 .03 201 .03 . 00
. work for which this permit is issued.My workers'compensation insurance carrier and policy number ere:
CarriergT4TE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 201 .03 OVER/SHORT: 00
Pa amber 7A�i-44tTNTT00774 01 /01 /98 BLDG PMT _PLUMBING ELECTRIC MECHANIC . . FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed thepermh is for one hundred dollars(sl001 of less.) 199 .75 __ . - . - _ . . 1 . 28
❑ l certify that in the performance d the work for with this permit is issued,I shag not employ any person in any manner so es to
became subject to the workers'compensation laws of California.and agree that it I should became wbted to the workers' **************************************************************************dr****
compensation provisions of Section 3700 of the Labor Code,I shall I h Som 'h/h��'hose provisions. I N_D I. V I D U A L F E E B R E A K D O W N
h Date: /2 -/I 9 7 Apfi tam: �J.ei c.
Warning:Figure fo secure workers'compensation coverage Is unlawful,and the subject an employer to criminal pans:Nu end TYPE QTY D E_•S C R I P T I 0 N UNIT COST TOTAL COST
civll Ones up to oat hundred thousand dollars(S104000),M addition to the cost of compensation,damages as provided for In
Section 3106 of the Labor COW,Interest,and attorney's/ova SFR 12821 REROOF.BY VALUE RESIDENTIAL NOZONE - 1 . 00 12, 821 .00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097.Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application and state that the above information is coned.I agree to comply with all city and county ordinances
and awe laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property
for inspection purposes.
JIM CRANK 12-16-1997/10:52 W$201.03
N. RCPT#:21-U016910
// - i PERMIT:086189
�. I S ur-d Ormer/ t/Cantrad« Data./2---. /r0
(5151-46.WP) White-Building&Safely:Green-File;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
4
CONSTRUCTION AND PLANNING Pu.JL & SPA -
APto PROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
n -
1. Temporary Electrical Servicecor Pole • 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd.. c� ' 53. Steel Reinforcement -
.;¢3J IectricalCond tji<{"}lity-Un.,rgrnd. - 54. Forms 7f - .i
- •, _., ..t .H
44 EElectrical Condolt'Slbdrgrnd. 55. Electrical Bonding . C`.
-t{`j3'`Steel Reinforceiner} 56. Rough Plumbing & Pressure Test S
•6H£lectrical UFER•Grntl. 57. APPROVAL TO COVER-GUNITE
`1^7-Igrfotin s ;7th 58. Electrical Conlefg,-Undr rnd.
'2;1-18.E4undation d ;i 59. Gas Pipe, 0 Uitdtgrnd., Test
", 9. Water Pipe-Undpgg,d.Vt 60. Backwash Lima:g-Trap,0 Undrgrnd,.
•
E-10. StLuctural FIOOHSystem - e 61. APPROVAL T ;4ECK- - -
it. Property SewerlinC& Hous`i:Conhection 62. Backwash & Receptor-Final
-12. Sewer Cap c- - -6 • 3. Heater& Vent-F�t'llal '
13. Roof Drains -- -64. Plumbing System - Final •1
I-
•
14. Rough Plumbing, a, �'' • 65. Electrical-Final -
15. Rough ElectricehCozfduit .. : •66 -
. Solar System-Rh-41
16. Rough Electric=Wiritrrg '"67. Fencing & Ac �" '
: L . �.Sti-,pproval -
17. Wiring RoughSin
9 g y68. APPROVED Ft6R•PLASTERING •
18. Rough ElectriczY-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19.,.,Rough Hgating &c-Air Conditiorlin9 o'.7 ,, v m .Zx. t; PJR€'dk€PTEOUIR •T N
EMEN
t'1 a -1 6..-, c,..., m -.N �n m Ac >. to
20.criotirjh Proof' FLi lace St^ ' Q •* s -i a* r' APPBOV;:11LS. .4 P?mit # * •'
2; rV 1-4 0-4-/ Y C '* {--1 '1*is N L S 7"16 ill X C i
r 1 .• .• L-i� * a LJ �* !- £tJL, 1 4 h
21.7ju1is, i 4Sj tructuf * S� x C) H r,,- 70.e-Undergnound Itydro *
T _ :3� : 44: . '.-IS . 7 4.
22.`DucTs, VentitaYin�* r, t. 0 c:�C) E.* 1 71. Prod �i in s Oil -.
..
23. GasLiptotbh Ost p': * rh c K 0* .
�. „ ` a I «-,C y *
^ � Syrqund F,4s}y; * t-. x
>• s
p,/. -f 4 > D r m - s'
24.Roof Framing 0s to * > to r,* Undergrnd.Stolt anti 0 Gas 0 Oil
* L• i �'k N* ,V rj K
25.• oa#;Sheathing G* N `Z4Ziket-. j* 74 Overhead Hydesiv ;.
.i.e- ' -•.-� •It -yam rx-
26.rT-Bac Ceiling (Straspturall & Mai-Moat * 0 q* 751 Dry Cheini@al ='z -t
-. -a - s Y `T * '-,-J m(,' n$ * S rn e
27.'Fra eaki Fla`,shia* D'^� *' 01 >4 ''I" C -n `= r. 0
CI v i P* ^tn CD Cr * >,* 76. Dry Star pJpe<ri * 0 CO 0
t 1 28. Lat�iing�_ Siding'* ✓ 7x=' a fi Z ,• • ! ••P. 77!- FIXED`•3*FSTEM--'FINAx- n t
.r :J K ^ S .. I tt: r , '!�**t' * r •1.
29. Insulatiod 0 0* S (3 x S I I a; FIRE PREY. hr'vNL
•-' W c f :_ rI '-' -- M
30. Drywall Nailing T* I-' I * H I S C,HEAL H DEPT. REQUIFJEMENT
! _ r '1
° 31. Plaster Brow�CA'a ' S I I.;tyE-i �` he ` 79. FINAL;1y.4��PEC N '*
'i' ,S. `-1 lux ,� I Y .0 t x , --i- 1
32.-Electric3t•Power Meter-Final { �:tc I * 8th FOOD CERTIOCATE IRSSIUEEN '%
1. _ .e pi 1 I x .n .. h s r z,
33. in Ele tric' ;1::.1 .-,....r1_ ; Y x I ( f« NAtes: � mn `s G yS
r, 34. in4-Heatinat AiraCottdltioning - * LY 1.k :t it krn
35.!_Final Ga, Pipe'Tea C^< ". ! I `4 `- .0 C!� * Si yt"
cr * 0 I Erni I a c t r i t TC3 1. s:.?- -
J 36.±ioop or(EanopY 7,*�.-,n I ,tra CA 4r .,,_ I .rn x0 41-1
C+ 37. 1 inat'Fa ory Firis-Plart�'Z ' `;E; * I I K [*, * !�
t: :J
twi 38. Final.Plumbing * m C:jt * 1I x 1-I ci CC t n
�
( 7, re e r 2 n-r. , 0
39. Water Service=Final* E i * rs I - ce -. *-
r. u C1* r.; y: I IX Ho • i; r: to
40. Gas Service-Rinalm;f M '¢[•`rtr- h ; ,-I 1 I �- , C
s•+ 41. Solar Domestic-Final ` I lh i•. ^1w tr * r.
�m x 0 Gam-"• * s
-,
42. Backflow Preventelt •NE ^.�.-{ * 1-4 t r`t-1 ^. I � ,� E.
43. Backflow Irn tion* >1 * CC 1. * n •
n: * - 1 M m 'v -�* u. :u ,L (.4 L * :�
44.�I..andscape Ir�rigatiop System-,yam n * _ -c .•-<"1 ' * _ E o MDQ * S h
45.Sound A tenuationt • •• * 71 �4''l ?t* i^ 7 '= Q • ;:� *
-f}6. Handicap'Regulatio s S •• * S I I ' "t ^1t-0 r
-A7.P1 •.LSTRUCTURE & BUILDING / it?Q / 1 tr * E--
" r• ••,J :r: I I'.7!tr /-(V W V . . • Cc y '-7 * 0 4-4
48.111'9Y{L LST.ANNINGt i ;,E. {{ I i _ m S a N
r . t- Y
r49.yElectric-Release to Edison ' * I Pt v`, •n n cn
,.. * _t I KK �I m 0.7.-. is n "I
'40.=bas$eleasetoSoutBiro * • a-
ernCalifoaGasCo t 7U * ni 0
`51. CERTIFICATE OF OCCUPANCY t ' -
No. Date